I thought I might re-post this column here in light of the government considering the ending of free ARVs in Botswana. This was first published in New Internationalist.
Lorato came over today with her new baby, Stanley. I’ve hardly seen her since her wedding. We used to work together and we became quite close. She’s younger than me and I often thought of her as a daughter. But as people do, we’ve drifted apart. She’s now a chicken farmer up north and I’m a writer and our busy lives have dwindled down to SMSs on holidays.
She was in Mahalapye with her new baby, Stanley. Such a middle-aged man sort of name for a tiny baby. I supposed it matched his calm demeanour, fat stomach and the contemplative look he gave me.
“Is he okay then?” I ask Lorato.
Some years ago Lorato dated a policeman. She loved him at first but then problems arose. She found he’d been cheating on her. Worst still, she found that the woman he’d been cheating on her with was HIV positive. She confronted him, he denied it. She went for a test. She was positive.
The evening she told me, I felt like I’d been hit with a brick. I wanted to find a way to make this man pay for what he’d done to my friend. Her brother had died from AIDS four years previously, just before the government made ARVs free to all who needed them. She knew about AIDS. She’d been careful. This man did this to her.
But time passed and she met a new man and life went on. She got married. They wanted children and now here was Stanley, the wise little man-baby.
Lorato has been lucky so far and has avoided ARVs. She changed how she ate, eating more vegetables and fruits and drinking lots of water. “The biggest thing is I avoid stress,” she said. “I know stress, it will kill me.”
She told me how during the preparations for her wedding, a strife ridden affair in the best cases, but with her mother, who I know too well, it was a nightmare. Her CD4 count had gone down to 247. The ARV programme in Botswana advises HIV positive people to start taking ARVs when their CD4 count goes below 250. But Lorato refused. She knew it was the stress of the wedding. She just needed to get through it and she’d be fine. And she was right. Her CD4 count is at 412 now, even after giving birth. She’ll take ARVs when she needs them, but wants to put it off for as long as possible.
She took ARVs during pregnancy, though. Botswana’s Prevention of Mother to Child Transmission (PMTCT) programme is one of the most successful in the world. 95% of HIV positive mothers in the country are in the programme. Less than 3% of these mothers’ babies are born with HIV. She started taking the ARVs during the 29th week of pregnancy, three pills, two times per day. Once labour started she took the pills every three hours until Stanley was born.
“He was tested at six weeks, he’s okay,” she assures me. I look down at Stanley who seems to want to tell me something important, wagging his fists at me. “One more test at a year and half and we’ll know he’s safe and clear.”
He looks healthy and Lorato says he’s never been sick. The nurses advised her that it’s okay to breastfeed, but she’s taking no chances. She’s bottle feeding. “They told me it’s okay, but I don’t think so. Anything could go wrong.”
I hold Stanley who nods off reluctantly. “You know this is not all bad,” Lorato says. “There’s a good side to this HIV. I’m careful now; I pay attention to things… for him and for me. I don’t let stress get me down anymore. I manage it. I have to.”
There is so much doom and gloom around HIV. The scourge. There was a time in the 1990’s when it felt like the entire country was in mourning. Every weekend was for funerals. If you didn’t see someone for awhile, you didn’t ask. If a woman was pregnant and then never spoke about a baby, you didn’t either. During that time was when Lorato’s brother died. Sick and sick and then dead, at 22.
I look at Stanley and at Lorato and think about what a difference just a few years has made in Botswana and I’m very thankful.