“Lord! Give me another chance. I want to live and look after my children. They are still very young.”
Vimbayi (not her real name) repeated this prayer for several nights during her last days. In spite of her desperate prayers, she died at the age of 28, leaving behind two children.
Perhaps the saddest part is that her death was avoidable if she had had the correct information and people to support her.
A relative of Vimbayi, I finally got a chance to see her five months after hearing of her failing health. By that time, she was very weak. I asked her husband whether she had been tested for tuberculosis. He handed me her medical records.
At first, I thought that this was a breach of confidentiality. Later, I realised time was running out and we needed to do our best from an informed position. In my community, before HIV/Aids, people easily shared medical records.
But the Aids stigma changed the way people share information about their health.
The records confirmed that two sputum tests for TB had produced negative results. Unlike her husband, I also realised that Vimbayi had tested positive for HIV. As someone who was working in the HIV/Aids field, I knew the meaning of phrases such as “patient referred to OI (Opportunistic Infection) Clinic” and “post-test counselling done and positive living discussed”.
Prophylaxis treatment had been prescribed but I could not see any signs of it. She told me she stopped taking it two months previously because there had been no improvement.
Vimbayi’s husband and I had both arrived the previous night. I had returned from Asia, where I was working for a non-governmental organisation. He came from South Africa, forced to go there because of the harsh economic conditions at home in Zimbabwe.
He was away for six months, with no idea about his wife’s deteriorating health.
We agreed to take her to the hospital that same morning. However, incessant rain pounded the village and an overflowing river separated us from the nearest hospital. We also soon learnt that the only doctor serving that hospital had already left for Christmas celebrations.
Other hospitals were out of the question. To reach the main road, about 40km away, we had to cross several streams, which were all flooded.
While waiting for an improvement in the weather, I sat down with Vimbayi’s husband. We talked about positive living and the availability of antiretroviral drugs to prolong a person’s life.
He assured me that he was prepared to accept any outcome and that he was not going to blame himself or his wife.
When we woke up to a cool blue sky, I received good news that the doctor had arrived the previous night. He told me that there was no film to carry out the chest X- ray, a common problem at government hospitals. The only option was a private hospital run by a mining company about 150km away.
The fee for the chest X-ray at that hospital was Z25-million, approximately US13 at the time (an amount beyond most people’s reach).
I took Vimbayi to the government hospital the next day and learnt there were enough TB drugs and an improvement in the supply of antiretroviral drugs. I went back home encouraged and convinced that Vimbayi would live and be able to look after her children.
Early the following day, the doctors gave us a month’s supply of cotrimoxazole and referred Vimbayi to the private hospital for the chest X-ray. Vimbayi and her husband had to go alone because I was nearing the end of my vacation.
Before I left, we had another lengthy discussion about treatment adherence to both TB and Aids drugs, CD4 tests, and positive living.
That was the last time I saw Vimbayi.
A week later I received a telephone call, telling me that she had passed away.
Her memories can fade, but the words in her final prayer continue to haunt those who were present. For her children, like many others in Zimbabwe, hope is like a distant horizon.