Saturday, March 17, 2007

Whispers and averted eyes – What I was up to today, Part 1

Mural in Baylor COE waiting room.

Teenager with HIV are teenagers. They are bold but timid, awkward but desperately trying not to look it, and the boys and girls and preoccupied with the girls and boys, respectively.

Every month, the Baylor clinic here in Swaziland hosts a Saturday morning adolescent support group meeting. Today, I dropped by the clinic to check it out.

When I arrived, the group was gathered in the clinic’s kitchen having baloney sandwiches.

I am not a big boloney eater and those that were seemed to be enjoying themselves, so I went upstairs to check my email.

After the white bread and breakfast-time lunch meat were consumed, the group transitioned to the conference room, where the meeting started with a song, as Swazi meetings usually do. (I interpret the tradition as a polite way to say, “If you can hear us but are not singing, then you are late for the meeting so follow the voices until you are where you are supposed to be.”)

I was actually engrossed in email and running late myself when I heard the singing. I quickly clicked the ‘send’ button on my message. (Summary of message: “Dear so and so. Thank you for your email ridiculing me for my alma mater’s first round loss in the NCAA tourney. Even if Duke did lose, Texas (my other alma mater) did not, and besides, I am handily winning my ESPN Tournament Challenge March Madness bracket. Moreover, you can’t even dribble with your left hand. Love from Swaziland, Ryan”)

After my e-retort was safely on its way northwest, I scurried down the hall and sang the last verse of the song (or rather hummed it, as it was not a song that I knew). The music ended and the chorus of teens sat.

The chairs in the room were arranged in a large circle.

My eyes scanned the attendants. There were about two dozen of them, their age range approximately 10 to 18 years old. Most slouched in their seats (a habit I also picked up during puberty and have yet to shake), and nearly all had an arm slung over the back of his/her chair or sat with arms crossed, fitting, time-tested accompaniments to poor posture.

One young man caught my eye, for sat up straight on the edge of his seat, his hips at a perfect right angle. His hands were at his side. There was eagerness in his facial expression. Something was clearly on his mind, though I was never to learn what that thing was, for I never heard him speak.

Like most in the room, he was small for an adolescent. (Fighting HIV burns a lot of calories, and these children had been burning calories in this manner for a lifetime.)

Gugu, one of our clinic’s triage nurses, welcomed everyone and asked who in the group was there for the first time.

Four raised their hands.

The four were asked to introduce themselves, which they did in turn, each in a barely audible, whispery voice with eyes fixated on the ground in front of them. When Gugu would ask them to repeat themselves louder, they would repeat themselves, but softer still. As their voices sank, their gazes would sink also (nearing the shoes), and their faces would blossom (or perhaps wither) with self-awareness.

As I watched this, I wondered why they were so reluctant to speak.

Then, to the best of my ability, I imagined myself in their shoes, addressing a room of HIV positive peers for the first time, in doing so disclosing that they too were HIV positive, that they too had a lifelong, secret affliction.

My conclusion: Sharing a carefully kept, mortal secret with a group might indeed be easier in a whisper while staring at one’s shoes.

During introductions, a fifth first-timer briskly walked in. I noticed a cotton swab in her right ear as she passed.

Ear infections with persistent drainage are common in immunnosuppressed children. I wondered if there was pus behind the cotton.

The final newbie whispered her name (“Busi Dlamini”), age (“twelve”) and school level (too soft to hear).

After introductions, Nosipho, our clinic’s tireless social worker, passed out the meeting agenda. The first agenda item, she explained, was to reflect on last month’s “Voice of the Church” radio broadcast. (A few of the teens had been interviewed on nationwide radio about their status and why they sought treatment.)

Though the program (one of Swaziland’s most popular) was in SiSwati, I had been told that, when one of the teenagers was asked on the program why he wanted to know his HIV status and start medicines, he stated, “Because I was sick. Now I know I am positive. Now I am on treatment. Now I am better.”

Nosipho then pointed out the second item on the agenda: Fundraising, namely ideas about fundraising and how to spend any funds that are raised. The words “jumble sale” appeared in this section of the written agenda, which I later learned is the name for a “garage sale” or “yard sale” in a place where garages and designated yards are uncommon. (In any case, yards in Africa are called gardens.)

The final item on the mornings docket was “Drawing.” Nosipho explained that, if the teens are able to create some interesting, colorful illustrations, the drawings could be used in future HIV media campaigns or other HIV-related health projects, such as the ongoing effort in the clinic to package condoms in small, illustrated paper packets to make them more appealing to potential, um, family planners.

I looked forward to this agenda item, hoping that colored markers and paper might uncover the thoughts and ideas behind the whispers and averted eyes.

Alas, at that instant my cell phone rang, and I learned of an “emergency” that would cut my attendance of the adolescent meeting tragically short. About a half hour’s drive from the clinic, two of my colleagues—Eileen Birmingham and Juli Kim—were helping a group of high school students film a nutrition video to educate Swazi moms about infant feeding.

“We need you down here,” Eileen said.

“Do you want me to act in the video?” I asked excitedly.

“No no no, Ryan.”

“Technical support?”


“Do you want me to edit the script?”


“What, then?”

“It is something that you are good at.”

Now I was really confused.

“What, then?”

“Come on down. We really do need you.”


I asked a colleague at the teen meeting to take notes and drove down into the valley, past the Matsapha International Airport, and to the homestead where the video was being shot.

Though I had looked forward to the teen meeting, and though I was suspicious that the “emergency” may not be terribly “emergent”, I was curious to see the filming of the nutrition video as well. (There is certainly a need for this sort of teaching tool in Swaziland, where preventable infant malnutrition and death are common.)

I pulled into the gravel driveway per the directions I had received, and saw the students filming under a shade tree in front of the house that had been appropriately described as “terracotta” in color.

I got out of the car, eager to know the nature of the “need” I was to meet.

Eileen approached the car.

“So?” I asked.

(To be continued…)


At 9:49 PM, Blogger Steve said...

whats with the cliffhanger? is this "24"?

hmmm, something that ryan is good at. did they need you to light a campfire? make guacamole? bargain with a street vender? pile up dirty dishes in a kitchen sink? when will we find out?

At 4:46 AM, Anonymous Anonymous said...

Find information on HIV/AIDS and calories at the HIV ReSources Web Page:


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