South Africa, a Place of Extremes

By Kellie Kozel (Augustinian Volunteer presently in South Africa) So far South Africa seems to be a place of extremes. All of last week there were thunderstorms and high-speed winds and this week it has been sweat-til-you-drop hot. In the first month our car was stalled more than it was running, and now we could take on Mario Andretti in a race down Inanda Road (or at least we like to think so). One day you can spend the whole morning laughing hysterically with a patient as you muddle through the language barrier, and then that same afternoon have tears stream down your face as you watch someone pass away. In the last week at the Respite Unit we have lost 5 patients, 3 of whom were younger than me. While you expect death when you work in a clinic for late stage AIDS patients, the expectation does not keep the pain, frustration, and flood of emotions at bay. Last Thursday I was asked to take a recent admit to up to a nearby clinic. Her name was Ntombenhle and although her ID book says she’s 15 years old, she weighed no more than 35 lbs and looked about 7 at best. Our goal was to get her ARV medication transferred from a hospital about an hour and a half away to this clinic, which was only about 10 minutes away from her house, making them much more accessible. ARV’s must be taken every single day, at the exact same time each day, otherwise they are not effective and may actually be harmful in the long run because your body can develop a resistance to them. Considering the distance of the hospital and the fact that the family does not own a car, I think it’s a safe bet that Ntombehle missed more than just a few days of meds. After a long day waiting in various queues and fighting to get the information we needed, we had successfully transferred the ARV’s and also gotten Ntombehle in to see a child specialist. Later that afternoon as I was leaving work, my supervisor told me the specialist had called and said that Ntombenhle’s chances were not good and it and it would be a miracle if she pulled through. I know that life is not a math equation, but despite this bleak prognosis I convinced myself that since we had lost a beloved long-term patient earlier that same day, Nthombenhle would get her miracle. Her life would balance out the other’s death, it just had to. On Friday I had a work retreat with some of my co-workers and got home around 3. I checked my phone at 4 and saw a missed call and a text from my supervisor. My stomach dropped into my feet as I opened up the text, already knowing what it would say: Ntombenhle passed away at 3:30 on Friday afternoon. She was 15. When I took her to get bloods done on Wednesday she could barely stay awake and my coworker had to carry her everywhere like a child. Only once did she perk up and look awake and excited- when I asked her about school and told her I could help her with her homework later. She said she loved learning and practicing her math and English. When I got the text I started sobbing uncontrollably and thinking about how she was so young, and had such potential. When I was 15 the last thing that would have dragged me out of a stupor would be the promise of extra school work (that was probably what put me in the stupor in the first place). She spoke English fairly well already, she was so sweet, she could have gotten out of the valley, she could have made a better life for herself. But instead she spent her 15 short years of life being poked and prodded by needles, in and out of clinics, her body being ravaged by disease.