Orphans

Well, I apologize for taking so long to update. It has been a busy 10 days and I have so much to tell. I have decided to make the subject of this post, the orphans in the Kilema Kilimanjaro Region...I feel like I owe it to them to tell their story. The region surrounding 'our hospital' is a high prevalence area for HIV. I think I have mentioned it before but this is primarily due to the main road that travels through the town below the hospital named Himo Town. This is the trucking route from Nairobi in Kenya to Dar es Salaam, Tanzania's largest city. The truckers often stop for food or lodging and of course this raises the likelihood of HIV spread as they take part in other activities during their 'breaks'. The sex trade is alive and well in this region. Those men can either pass on the virus or catch it themselves. The availability of prostitutes in the area alsomakes it easier for men from the region to enjoy a night out. These men then go home and infect their partners. The effects of all of this activity over time have been devestating. We are now (and have been for a few years) seeing the emergence of children with no surviving parents. They live with grand parents or neighbors or older siblings. Most live in tiny huts in the villages surrounding Kilema. The Sisters (of our lady of Kilimanjaro, who run the hospital) started an orphan program 2 years ago that has, out of necessity, grown in leaps and bounds. Most of these children have been affected by HIV insome way and all are devastatingly poor. The program initially started with one day a month when the poor children in the region are invited to come to the Kilema Hospital Grounds. They usually receive a small snack and, if there is money available, they will be given some cooking oil or maize to take home. Some still live with parents and others not. Over the last size months, CACHA has worked to identify the highest risk orphans in that particular program. They have visited the homes of about 80 childen and documented where they live, the shelter, the care giver and health status of each child. These children now come on a separate identified day of the month. They receive a larger food package and this week were each given a pair of shoes (some new and others used). The shoes were purchased through a donation provided through Rotary in Canada. We also weighed and measured each child and had plans to complete HIV testing on somehad not yet been tested (many have and are HIV positive) but there wasn't enough test kits available in the Kilema HIV clinic to deal with the orphans who needed to be tested. We had overwhelmed the HIV clnic withpeople arriving for testing over the last two to three weeks. Each time we saw a patient at one of the dispensaries who was displaying any of the signs or symptms of AIDS , we referred them to Kilema for testing. With 3 docs and 4 nurses each seeing about 500 people per day, this resulted in a lot of referrals for counselling and testing. A number f the orphans have already been identified as positive and a few are on ARV's(anti-retrovirals). Many are not as they need to be fully assessed and reqire improvement in their nutritional status before we can safely treat them.
After 3 days of caravan the first week, there was the big monthly orphan day (yes, with the 500 kids. I missed it as I was out with the caravan in Himo Town (subject of my next post). Roman and Jack stayed behind with the CIDA and CACHA Interns to get the day off and running. In Roman's words, "it was one of the most incredible things I have ever experienced". Apparently the crowd gathered quite early and the children were exceedingly orderly. He said there was minimal pushing or shoving..for the number of kids that were present. Roman and Jack and Hannah made an attempt at playing soccer. Roman said he felt like the pied piper as he marched with 300 plus children behindhim up to the field. The others stayed behind to participate in another activity. Hannah sat with some of the little girls at the side of the field and entertained as usual..mostly saying things that she thought were funny and laughing at herself...her giggles are usually what make the kids laugh not the joke. Her Swahili is not well enough developed to really have a conversation with any of the kids. She seems to manage anyway. After the game the children all went back to the hospital area and had tea. Roman helped pour the tea and Hannah handed out something else. And Jack....played his violin (see picture to believe it!). It must have been pretty incredible to have an 8 year old Canadian boy serenading a bunch of African children. Roman said they seemed fascinated. He of course forgot to run back home and get the video camera. The Sisters thought it was a hit too.

We had a second week of busy caravan which Roman was able to fully participate in as our 'nanny' had arrived on Sunday after finishing her secondary school exams. Her name is Sylvia or as Tanzanians would pronouce 'Silivia'. She is a nice young woman who is fitting in well. It has taken a while to introduce the concept that it is ok to just play with the kids (colour or read). She wants to spend the day (or thinks she should) washing our clothes and the floors etc. Kids here are not really 'played with'or entertained in that way. They work.

After a great week of caravan (and pretty much feeling good about what we had accomplished, however small it was), we were introduced to the 'high risk' orphan group. My eyes are clouding over as I write this because yesterday was possibly the hardest day of my life. The children arrived mid-morning and we sat the eighty or so kids in the shade near the HIV clinic. As I mentioned, the initial plan was to test those who had not yet been tested but, were were soon informed that the clinic was running out of tests and it would have to be done next month. These children were visibly different than most of the sick children I had encountered even during the medical caravan. Their faces really reflected what I guess I could describe as nothing other than hopelessness. I was surprised at how difficult I found the day. There is nothing like a sick and hopeless child to make you feel completely inept. The hardest part was that we all knew that there was not much more that we could do for them that day or in the coming weeks or months. I was secretly dreaming about building a huge orphanage where everyone would be looked after, but what about the kids on the other side of mountain, can we build one there too? Sorry if I sound so weepy and pathetic but that is really how I felt....and it wasn't me who was suffering. Most of these kids need so much more than a pair of shoes. But CACHA is doing as much as they can right now with the available resources.
I will post a few pictures of Jack and Hannah putting maize flour into bags and playing hopscotch but it won't help you feel how had sad the air felt that day.

Despite my pity for myself, there were a few kids who really did smile, or shall I say beamed when we handed them their new shoes. For that moment, we had brought a little bit of hope even if it was with a second hand shoe from WalMart.