I stepped onto the tarmac after the short 55 minute flight and was instantly met by the heat and humidity, so characteristic of the summer months. I had just landed in Durban, where the climate is far more tropical, the pace of life far slower, and the feel far more “African” than that of Joburg. It was wonderful to be back in the city I think of as my first South African home; to be met at the airport by my South African family, Jenny, and to hear “Sawubona,” the Zulu word for hello, as I approached the security guard standing by the main entrance to the hospital. His face registered a smile of recognition, signaling that he remembered me from years past, just as I remembered him. Yes, it felt good to be back at McCord.
The familiarity of the people at McCord makes it easy to return and quickly slot into a comfortable rhythm at the hospital. Before the end of the first day, I was immersed in meetings with various staff members. We discussed the tremendous progress taking place at the hospital, the challenges ahead, and our shared ideas about new programs and opportunities to expand the Gift of Hope. It was an energizing and positive day, full of optimism for the future.
But as I learned long ago, joy and optimism are often temporary and transient emotions at McCord; before long you will invariably encounter a human story of pain and loss endured by one of the patients. Thankfully, with improvements in antiretroviral therapy, the heartbreak of losing a child to AIDS is now a rare exception—an enormously positive change from some 10 years ago, when burying a child was far too common an occurrence. Today, most of the children at Sinikithemba and in the Gift of Hope program are doing exceptionally well on treatment. But you only need to sit and talk with one of the patients or their caregivers to appreciate that health problems are only one component of the myriad of challenges facing South African families. You hear their stories and then are left feeling overwhelmed and sometimes helpless, holding a piece of their pain as if it somehow belonged partially to you.
I found myself soon on the downward side of that all too common emotional roller coaster ride on the second morning of my visit. I was meeting with Lungile, the social worker who runs the pediatric counseling program at Sinikithemba, to review the list of children being sponsored. We were ensuring that we had all of the correct information on these children; their age, sex, date of enrollment in the program. It began as a routine conversation about administrative matters, void of any human stories of consequence to stir ones emotions. But the conversation was certain to take a turn, as there is nothing about the lives of these children and their families which is routine or void of circumstances which can easily reduce you to tears. And no one knows this better than Lungile, who is intimately involved with Sinikithemba patients and their caregivers, and the daily struggles they encounter.
As we made our made our way through the list of names, Lungile suddenly paused and let out an audible sigh, a look of sadness spreading across her beautiful face. In a slow, quiet voice, she began to relay a story about a family I have known since the inception of the program. Like many families in this region of the world, this household is comprised of six AIDS orphans, where the eldest, a girl named Zinkhle*, is now 22 years old and is the head of the household. Barely more than a child herself, Zinkhle was forced to quit school and assume the role of a caregiver after losing both her parents to AIDS in 2006, when she was just 16 years old. With a very modest government grant as her only source of income, she dutifully shops, cooks, cleans and cares for her five siblings, who now range from 9 to 22 years of age. She has no one to help her financially, physically or emotionally—no parents, grandparents, aunts, uncles or cousins. She is alone and struggling, trying to cope with a 19-year-old brother who is doing drugs and stealing from her. She spends time after school with her HIV positive sister, helping her overcome learning issues, all the while ensuring she takes her daily regimen of ARVs and remains healthy.
(* Zinkhle is not her real name, and is being used to protect her identity)
Zinkhle’s life is not easy, but she loves her siblings and works tirelessly to care for them in whatever way she can, all the while dreaming of simply being able to return to school to study social work and have a future of her own. When I spoke to her last July, I asked her how she was managing and if it was getting any easier. She shrugged her shoulders and in a hushed tone of acceptance, replied, “I am trying. I am getting used to it. It is still hard, but there is nothing I can do.”
As Lungile begins to tell me what has happened, I am initially confused. Her expression and voice reveal pain, but her words tell a different story; Zinkhle, she tells me, was recently granted a loan to return to school and had begun her studies in social work. I am thrilled at this news, knowing that she is now in a position to pursue her education and dreams for the future. But then the story abruptly reverses course. Lungile describes a recent string of tragic events that has threatened to shatter this young woman’s dreams, and her entire world: the suicide of her 15-year-old brother, Sanele.** (** Sanele is not his real name, and is being used to protect his identity)
Back in January, while Sanele was working as a clerk in a store, two thugs from his neighborhood attempted to rob the store. He recognized them and bravely tried to put an end to the crime, grabbing the knife one of them carried and stabbing him, although not fatally. The two were arrested and imprisoned, but then soon released (for reasons unclear to me). News somehow got back to Sanele that they were reportedly coming after him to take revenge for the stabbing. So fearful of what they would do to him and his family, Sanele took his own life before they could attempt to do the same. It was Zinkhle who came home to discover her brother had hung himself.
I feel almost nauseous as I listen to this horrible story unfold and wonder how Zinkhle could possibly find the strength to bounce back from this tragedy. I pause long enough to appreciate that she is the same age as my own daughter Jamie. I wince, imagining if Jamie had to deal with anything approaching this magnitude, on top of the normal challenges Zinkhle confronts each and every day. I am reminded of the obvious—we lead such fortunate lives and largely take them for granted.
But before I can fully absorb this all, Lungile continues. A few weeks after her brother’s suicide, Zinkhle was returning home in a taxi shared by many other people. Next to her sat an elderly woman, carrying several packages in her arms. When the taxi stopped for the woman to get out, Zinkhle kindly offered to carry her packages and helped the elderly woman climb down from the van. The woman sitting behind Zinkhle offered to hold her purse while Zinkhle got out of the van, and Zinkhle trustingly gave it to her. But Zinkhle’s kindness was not to be returned. By the time she got back into the taxi, the woman was gone with Zinkhle’s purse.
Inside of it was 1800 rand (about $235)—the latest payment from the government to help her support her family, which was all the money she owned in the world. Zinkhle had carried it with her to ensure that her 19-year-old brother would not steal it. Now left with no money to purchase food or renew her electric card, the lights in the house soon went dark and the lunch bags she normally packed for her young siblings were soon empty. Desperate and alone, her siblings crying that they were hungry, she had the courage to reach out to Lungile for help, forever a source of strength for the children and caregivers who come to Sinikithemba. This is one of the many characteristics of the Sinikithemba program which make it so special and unique, and so beloved by the patients. The caregivers truly care about their patients and the families, and do whatever they can to help.
Lungile arranged for Zinkhle to come in and meet with the two of us, to see how we might be able to assist her through this extraordinarily difficult time. As I approached Lungile’s office I saw Zinkhle sitting quietly, her shoulders sagging, her face worn and void of expression. I greeted her with a forced smile and, as she stood up, I embraced her, offered her comfort, solace and reassurance that things would get better. She sat down and began to tell me small bits and pieces of the story, but soon she lowered her face into her hands and started softly sobbing. The details were simply too painful for her to recount.
I am not a social worker, a psychologist, or a grief counselor—not armed with the training, language and techniques to counsel someone through such a serious life tragedy. But wanting desperately to help in whatever way I could, I relied on my instincts as a mother and a human being, and did the best I could to give Zinkhle some glimmer of hope that the light would once again begin to shine for her.
We started by focusing on the immediate things we could do to ease Zinkhle’s burden, emotionally and financially. Lungile and I were most concerned with Zinkhle’s emotional health, as she was clearly despondent and depressed. She had been seen a week or two earlier by the staff psychologist at McCord, who had prescribed her anti-depressants. But following a visit to the government clinic, where the medication would be free, she was told to return in month to be seen by the doctor and fill the prescription. Concerned about her waiting this long to begin treatment, we phoned one of the doctors at McCord and got a prescription she could fill at the local pharmacy. It would cost Zinhkle about $7 to fill—a tiny price to pay, yet more than she could afford. It was hard for me to imagine being in this position, when I routinely spend this on my morning coffee and muffin—physical nourishment, yet so much less vital than the nourishment this young woman needed for her mind and her spirit.
We gave her money to cover the cost of her medication, as well as to charge her electric card and have her power restored. The next government grant was not expected for another two weeks, and so funds were arranged for her to buy groceries for her family. These immediate needs for sheer survival—food, water, power— are easy to resolve for anyone of us with income at our disposal. The total provided to her was less than $150; modest by our standards, yet of immeasurable value to this woman and her family, who literally have nothing. Once again, I was reminded of the modest effort involved in helping another person, especially those who are patients at McCord, and the power that each of has to make a meaningful difference in the life of another person. You don’t have to be wealthy or make a large donation; you simply have to stop and care.
The look of relief in Zinkhle’s eyes told me that we had helped. We certainly couldn’t erase the pain of her brother’s death, but we could help relieve her immediate financial burden, and remind her that she is not alone in this world; that there are people she can turn to who genuinely care and want to help her. We encouraged her to focus her energies on the positive things she was doing—raising her sisters and keeping them healthy and returning to school. We challenged her to find one reason each day to smile, even if just briefly, and assured her that with time it would get easier.
When Zinkhle said goodbye she had a smile on her face and a look of hope in her eyes; hope that life, as difficult and unfair as it had been to her, would eventually improve. It wouldn’t be easy or fast, but she knew that we wouldn’t abandon her and that if she started with baby steps, we would be there to help her keep moving along that path.
