On Rounds

The men’s ward is a truly frightening place. There is a long, narrow hallway of concrete with little light aside from that which comes in from the doors at each end. Passing by the patients’ rooms, their sunken eyes stare up at me. God only knows what they’re thinking. Each room contains a row of beds and nothing more, windows with bars, and draping mosquito nets. The men are wasted away – some just skin and bones. There is so much AIDS here in Zambia, it’s horrifying. The stigma associated is still so bad that Dr. Lena never says “HIV” or “AIDS” around patients. Though most of them don’t speak English, they definitely recognize those words. Instead, she says patients have RVD – retroviral disease. The people are also plagued by malaria, tuberculosis, pneumonia – all things that no one should ever die of, but still, so many do, especially when their immune systems are compromised by HIV.

The stench is absolutely suffocating. Sometimes I can hardly stand it. Clearly, Dr. Lena has gotten used to it – nothing seems to faze her here, and that gives me hope. I know that if I was forced to, I too could adapt, but this initial difficulty is really troubling. I feel so guilty because I want to care for these men, I want to help, but how can I if I’m scare to be near them? And I am scared. I’ve never felt disease so close to me before – disease is the inescapable presence, bearing down on me in every room. Everywhere I look, I see it. I feel it. I step outside and gasp for air, but still, it’s there – the stench, the sickness, the death and the rot. And I don’t know what to do.

Today was a better day, spent mostly in the children’s ward and malnourishment ward, which is basically just an extension of the children’s ward, since everyone here is malnourished. Children tend to start crying when we come on rounds, our white faces and white coats, strangers in a strange place. Big steps, however, were made today when I realized that the crying eventually dies down, and just like with children at home, it helps to come at them sideways. I smile at them out of the corner of my eye and wink. Some play coy, hiding their faces in their mother’s chest for a moment, then looking back up, smiling, to see if I’m still smiling at them – a game played back and forth.

One baby boy, about 2 years old, cried and clung to his mother when we tried to examine him. The baby had pneumonia, and it was impossible to listen to his lungs while he cried. I rubbed his back and gave him the end of my stethoscope to hold. He eventually took it, touching it carefully at first and then shaking it in his fist. I traded him a pencil for the stethoscope, and I was finally able to listen to his chest. I made several little friends in the children’s ward today, and I feel as though my hope has been renewed.