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Case Studies

No One Should Die Due to Lack of Information

Amy Hill

By Meridah Mwania, University of Washington, Kenya

Meridah works with the DREAMS Innovation Challenge project of the University of Washington, which increases access to PrEP for adolescent girls and young women through public sector clinics in Kenya and aims to promote voluntary HIV testing among their partners.

It was mid-year 2011, a Sunday afternoon. My son Muma whispered, “Mama, you have a visitor.” He shook me cautiously since he knew I would be furious with him for interrupting my nap. (God knows naps are precious for working mums.) “What?” I barked. He told me that my neighbor was calling on me and ran off before I could ask which one. Outside our home, I found ‘Mama Twili’ waiting. “Come in,” I said. “No, thank you. But if you could just spare a few minutes, I would like your professional opinion on something. Kind of like a private consult if you are willing,” she quipped. “Sure, I’ll be right out,” I said.

Mama Twili wanted to know what could be done about the yellowing of her skin. I examined her and suspected that she had clinical jaundice – her eyes and tongue were discolored. I advised her to see her physician. Two weeks later, I found Mama Twili seated on her front pouch. She had lost a lot of weight, and her stomach was distended. She greeted me with a weak smile, informing me that indeed she had liver and renal failure and was undergoing dialysis twice a week. She was optimistic that she would recover. I made a mental note that I would check up on her as often as I could. I felt good because I had been of assistance.

 But unfortunately, as health workers, we can’t always be of assistance. Some months later, I was just getting home from night duty when another neighbor, Milka, met me at the door. “Mama Muma, we need you,” she said, pushing me into my house. I sat down, bewildered. Hanna, my other neighbor, joined us. “We have Kyende at my house,” Milka blurted out. “Her mother is dead, we think, but we need you to confirm.” She reached out and held my hand, since I was in shock. “When? How? Why?” was all I could say? Apparently Kyende’s mother had been HIV positive for a while, but had stopped taking her medications. Then she stopped eating. She lost hope, gave up.

After all was said and done, I told myself, ”Meridah, no one should die due to lack of information about HIV/AIDS.”