“Tom, Phridae has the camera and I need to go to Chipata Compound to document the plight of this lady. She needs to be brought to the clinic today.” My camera sat on my roughly fabricated pine-colored-wood desk.
Two members of the women’s group had been in the office speaking to members of the staff about the need to get to Chipata Compound quickly to intervene with a young pregnant woman and get her to the clinic for testing, care and treatment.
The organization’s women’s groups’ are a cadre of women who live in all of the compounds around Lusaka. These women become the organizations ‘foot soldiers’ in the communities identifying vulnerable children and pregnant women who are in need of medical assistance, HIV testing, care and treatment.
Compound is the term used in Zambia for local communities where most of the Zambian population lives in the Lusaka area. These compounds can be large areas (many square miles) with intricate social, political and cultural structures. Roads are mainly dirt/mud and would scare off even the most savvy off road, four wheel drive enthusiast. Plumbing, sanitation, electricity windows, and organization can be lacking but having said that, it is amazing to see how life in the compound carries on. Despite what I see as chaos, children run and are playing everywhere while neighbors talk, vendors sell their wares and things seem to function. People seem to get by. The compound in Zambia is analogous to the townships (SOWETO and the like) found in the Republic of South Africa.
Since I had the camera and I was in no position to let Charles (our ‘photo journalist’) trek off with my prized possession, I offered to go with the women (Stella and Junia) and Charles to see for myself life in Chipata Compound, help with the intervention and see how Stella and Junia work in their community.
We boarded an official blue Lusaka City Taxi on Cairo Road for the 15-minute drive to Chipata Compound on Great North Road. A newspaper sat on the dashboard and there was a significant shatter in the windshield. The dashboard was blue shag. Once we were in the cab and started off the driver kindly put on an English news program for my enjoyment I’m sure. The Zambian’s are always kind in this way: very respectful. The roads were chaotic as usual. Black smoke belched from trucks and cars in front of us. Stoplights were not working and cars darted in and out from what seemed to be all directions. I am becoming more accustomed to this and just kept busy sending texts to organize the staff for our return.
We entered Chipata Compound and the further we drove in the more the roads deteriorated. The taxi began to bottom out on the uneven surfaces of mud, rock and garbage debris. “We are here,” said Stella and the taxi pulled over and came to a stop. We got out of the car and true to form a crowd started to assemble wondering what we were doing in their neighborhood. I think the white man in the crowd drew the most curious onlookers. The children gathered and when they saw my camera immediately began to cluster for pictures violently pushing the other out of the way. Children of less than 10 years old carried younger siblings. All were filthy and mostly in tattered clothing. Girls donned corn- row hairstyles with colorful beads. Runny noses were flowing on most. The youngest cried at the sight of me. Diplomatically I started shaking hands. The kids laughed at the thought of shaking my hand. Others were hesitant and didn’t want to squeeze too tight.
The client’s home was not at all far from the road. Stella went in to announce our arrival and we were motioned to come to the house.
The house was a mud and clay structure with clothing hanging outside of the entry. The floor was dirt. Inside the dark room were two loveseat type chairs with the velour cushion covers all but disintegrated exposing only the foam cushion. There on the floor sat a young lady wrapped in her chitange (sorang) and a loose silky tank top. I couldn’t see immediately the woman was pregnant. I began to ask questions.
She was indeed pregnant. I asked her how far along in her term she was. Stella translated and the woman replied “nine months”. I couldn’t believe she was nine months along but malnutrition could have a significant factor on small sized belly. The woman was also a double amputee and had also lost her left hand. I asked if she had any pre-natal care to which she replied through the translator “no”. She was quite agile and moved around the room easily but I had a sense she did not feel well. She moved on her stumps to the next room where she changed her top. We took some pictures of her home and of the women who provided her care.
As we left the house to go to the waiting cab Stella told me the father of the child is nowhere to be found and offers no support. Often in these cases the woman does not want to discuss this key factor and sadly the pregnancy is the result of rape or incest. My heart sank. I put my hand on the woman’s shoulder and said, “It’s going to be OK. We’ll have a doctor look at you and get you care and medicine. We will provide you nutritional support for you and the baby”. Stella translated into Cinyanja and the lady smiled back at me.
Junia stayed behind in Chipata Compound and walked to her home and Stella, Charles, the patient and her sister got in the cab. I walked some of the way trying to prevent the low riding taxicab from bottoming out on our drive out of the compound. Within 15 minutes we were back at the clinic where the social welfare and medical teams surrounded the lady with loving care.
I was able to see her following her appointments as she was wheeled out of the facility to the waiting cab. I took her hand and squeezed it. She said “OK”. I talked with the clinical officer who said she is actually about seven months pregnant and did indeed test positive for HIV. She will have to undergo a cesarean section and doctors at University Teaching Hospital (UTH) were notified of her situation. A cesarean section will lessen the risk to the infant of contracting HIV during childbirth. Further, this lady will immediately start antiretroviral therapies that will also allow the baby better odds at not contracting the virus.
This scenario can be repeated many, many times a day here. This case was exceptional because of the woman’s other physical issues. I love what I am doing.