Thursday, November 5, 2009

The worst of times, the best of times

Finally, after approximately 220 days of counting down, my long-awaited vacation begins on Sunday! While I’m super excited to see people from home and to lay on the beach, this means that for the last 2 weeks I’ve been scrambling around trying to finish things I’ve started, writing proposals so they can be reviewed while I’m gone, and generally trying to prepare for a 3-week absence. I’ve taught my final classes at Florence (schools are closing early this year to give the teachers a full week to grade multiple-choice exams), painted a world map at Pasture Valley Children’s Home, painted a bus shelter with a sign that says “Abstinence is 100% effective against HIV, Pregnancy and STIs. SEX CAN WAIT!”, and done a million chores around the house in preparation, including a month’s worth of laundry since the constant rains have made it impossible to keep my normal Sunday morning laundry date. It’s been hectic, but I definitely feel like I deserve a vacation!

Eliza had a big week too. She’s old enough that she’ll be going into heat sometime soon, and I REALLY don’t want her to be a puppy-making machine her whole life, so I decided to get her spayed before I go on vacation. I realize it’s bad timing since I’ll be gone for a while, but I know that otherwise I’d be worried about her getting pregnant while I’m gone (which, after looking at her insides, the vet said was a possibility). So, because of the impossibility of getting Eliza to Nhlangano for the surgery, on Monday afternoon the vet performed a rather invasive surgery on a heavily-sedated Eliza on my kitchen table, which I covered with a shower curtain so he could sterilize it. Only in Swaziland.

As convenient as it is for the vet to make house calls, it was a really stressful experience for me. (I realize it was probably worse for her…) After preparing the space and wiping everything down with the same purple liquid my family uses to polish their floors, I weighed Eliza on my bathroom scale (she’s 20kg) and the vet injected her with a general anesthetic. Immediately, she was out cold. So cold that she stopped breathing, which I frantically pointed out to the vet. He said it was just apnea, and that her breathing would regulate within a minute. But it didn’t, and I was freaking out. At some point during the second longest minute of my life (the longest minute is discussed later in this blog), the vet said “Oh God, please don’t let me lose this dog.” What? That’s not something you say in front of the dog’s owner! He quickly gave her an antidote and a different kind of anesthesia and, after being assured that she was breathing, I hid in the main house to watch a bad American TV marathon (Dr. Phil, Days of Our Lives, etc.) while the vet and his assistant removed all her lady parts.

By Monday night she was walking around, and by Wednesday morning she even had the energy to eat one of my shoes, so I think she’ll be alright. I still have penicillin injections to give her this afternoon, but the vet visited Tuesday night and said there weren’t any signs of infection so it’s just a precaution. And what a relief! And now I fully understand why, in the US, owners don’t see their dogs until the day after the surgery, because MAN it’s scary to see them coming out of anesthesia. My hypothetical future children are never allowed to have surgery because I don’t think I will be able to handle it.

The decision to get her spayed was a completely foreign one to my family and the community as a whole. When I explained to people why the “dokotela” (vet) was coming, people thought I was a freak. Most said things like “but you can sell puppies!” I tried to explain that I’d rather her be healthy than a profit-machine, but they didn’t get it. Others told me I was denying her of the fundamental right to bear children, which would be true if she was a person. But, honestly, if I knew I was going to get pregnant at least once a year for the rest of my life, that all of the babies would be given away within a few weeks of their birth to families who wouldn’t take care of them, and that any baby kept would mean that I would get only half as much food as before the baby, I wouldn’t want to have kids either. Besides, it’s not like she gets to decide how many puppies she has. There’s no dog family planning in Swaziland, so either she would have a litter of puppies approximately every 7 months, or she would never have them. I chose never on her behalf. I can say, though, that for the few hours she was under anesthesia I was seriously questioning my resolve to have a relatively invasive elective procedure done in my kitchen. Since the operation, half the neighborhood has heard about how the crazy white girl stole her dog’s uterus and people have come from far and wide to see if it’s true. I show them her stitches, then try to explain (usually through my Sisi Londiwe who is an excellent translator) the basics of dog population control. Personally, I think my option is better than what most people do—let the dogs breed constantly then drown the extra ones. And maybe some of the people I talk to about it will agree.

After a sleepless Monday night (the vet didn’t give me any pain pills for her so she cried all night), I felt comfortable enough in her health to leave Eliza home alone for a few hours (possibly a questionable dog parenting decision) to take my Sisi and her baby Mpendulo to the hospital in Nhlangano for the results of his HIV test. I’d called the head nurse on Monday morning to make sure the results were in (it had been 6 weeks, but this is Africa so you never know), but she was reluctant to give me the results over the phone. I didn’t say anything to my Sisi about it, but I spent most of the evening trying to figure out how to provide moral support to a woman who was about to learn that her baby was HIV-positive.

After the 45 minute mini-bus ride and a long wait at the hospital, they called her in to get the results of the test. I was standing in the doorway as the nurse shuffled a big stack of papers looking for his name and, over her shoulder, I could see the test register. On the first page, there was a list of about 25 names, and in the second column the results. Glancing down the page, I saw:


This was the longest minute of my life. Of all the tests on the page, only one was negative, and I was praying to God that it would be his. But what are the chances, right? His mom was in advanced stages of HIV and had stopped taking her medication before she got pregnant, and even half-way into her pregnancy her CD4 count (the measure of the immune system’s strength) was still considered high-risk. She’d been doing everything right—a C-section, regular check-ups, safe feeding practices, protecting him from her own blood, etc.—but, still, the chances of the baby being infected before birth were so high that neither of us had much hope.

So when the nurse pointed on the sheet to the word “NEGATIVE,” at first I didn’t believe it. While she explained the results to my Sisi, she handed me the print-out from the lab with his name, his ID number and his results. NEGATIVE. Out of all the babies on that sheet, he was the one with the negative test.

My Sisi and I made it about 20 yards outside of the hospital before we started crying. She said that she’d spent so long trying to convince herself not to cry when she found out he was positive that she hadn’t even thought of what to do if he was negative. While there’s still a very very small chance the test could be wrong (not likely at all since they tested 5 separate samples), at this point in his life he is HIV-negative. Which is huge. It means that he has a full life ahead of him. Not only will he finish high school, which is generally the goal for children born with HIV, he will grow to be an adult, he can marry, he can have a family of his own. It means he won’t have to spend his life taking ARVs and that he won’t have to suffer from TB, pneumonia, flu, cold and a million other opportunistic infections every year of his life. It means that when he does get a little sick, there’s not a huge fear of him dying. It means he’ll be a normal kid, then a normal adult. And it’s incredible because none of us expected it.

So it’s been an exciting and fantastic week. The dog is sterile, the baby is HIV-negative and (as soon as I pick up my Mozambican visa this afternoon) I’m ready to go on vacation. What could be better?

I’ll try to find a chance to write a blog or post photos during our trip, but when there’s lots of lying on the beach to do, wildlife to photograph and seafood to eat, I’m not sure how much time I’ll want to spend sitting in an internet café. But, don’t worry, I’ll be back in December.

Until then, happy Thanksgiving and whatnot.

Love from the Swaz!

1 comment:

Erin said...

That's great news about Mpendulo's blood test! And what a brave little puppy you have. I can't wait to see you!

2 days till we leave, 3 days till we see you!!!!!!!!!!!!!!!!!!!