In Burkina Faso- Nathalie Turcotte

Report from a volunteer in the fight against HIV-AIDS in Burkina Faso

Nathalie Turcotte is a 12-month Uniterra cooperant, mandated to conduct action research in Bobo-Dioulasso, at the Association REVS+ (an organization of persons living with HIV).
 
The other day, a real miracle happened on my doorstep. It was a weekday and I was just about to take a siesta when Awa announced that there was a woman at the door that I had to listen to. In general, when women call they ask for money or seek employment. On that particular day, I wasn’t feeling patient and wanted to sleep. Awa insisted that I hear her out, saying this wasn’t the same as usual, otherwise she would have already sent her away. Holding a baby in her arms, the woman informed me that she had just given birth... that she was HIV positive and that she wanted to rejoin her husband in Côte d’Ivoire.
 
SO, WHAT AM I TO DO? I ask her in and listen to more of her story. She’s breast-feeding her baby, naturally—but, she can’t go on for much longer because she’s destitute. She tells me that she lives with an old woman and that each day she goes out asking for charity. She wants to go back to Côte d’Ivoire to her husband and her eight other children… OK, THAT DOES IT. ENOUGH IS ENOUGH… First, does she know that I work in the HIV sector or did she just knock on my door by pure chance? If it was the latter, talk about UNBELIEVABLE luck… either that or she was sent by God, hence the “miracle.” Feeling impatient, as I mentioned, I write down the address of a place where she can go for assistance and give her money for a taxi. I quietly tell Awa to prepare lunch for her so that at least she won’t leave hungry.
 
All of a sudden, I “crack.” I just have to do more than that. I take a cold shower, get dressed and go out into the hot sun. Off we go to the Association for Persons Living with HIV, where I work. On the way, I decide to hold the baby to let her rest a bit… and I start explaining that a ticket for Côte d’Ivoire is expensive.
 
I can’t give her that. What I can do is help her to cope with her HIV infection through regular visits to an association, where she’ll receive medicine, anti-retroviral treatment, staple foods (flour and millet), and where she’ll meet people like her, including friends, perhaps. The main issue then was to find powdered milk for her baby and to never breastfeed, whatever the pressure to do so, given the great risk of infecting her child with HIV—something avoided at the hospital through ARVs and a caesarean section. Finally, on arriving at the Association, I registered her membership and paid her fees so that at least she would have access to medicine. Afterwards, I saw her once a week at the Association, when she came to consult with the doctor and obtain her milk at the pharmacy.
 
Suddenly, one day, she tells me that the pharmacy is only giving her three boxes of milk a month for her baby although she needs a box every three days. I almost cried. I check up on this and am told that it’s true. Here’s the problem: some women were known to have frittered away their powdered milk by putting it in their coffee for example. The result: strict rationing of milk. “And anyway Nathalie,” the woman in question, “has already used up her three boxes.” What??? The pharmacist gives me some tips for weaning a baby more rapidly and getting it to eat solid food. Boxes of milk, which are expensive, aren’t always practical in this kind of context. 
 
Meanwhile, I was wondering how does a woman who is so poor manage to survive? After talking it over with my colleagues, they told me to tell the President of the Association who might be able to help her. So I explained the situation to her. It occurred to me that maybe she doesn’t have HIV.  Maybe she heard about this “rich” (by definition) white woman (me)... in short, maybe she was using me. The President informed me there was no longer any stigma attached to admitting that one has HIV—and that as a result everybody is claiming to be seropositive as a way to obtain charity. Hmm… I decided to invite the women to lunch at my apartment to clear up this whole situation. Upon her arrival I gave her some milk and a hot meal since she hadn’t eaten since that morning. We talked. She showed me a paper from Doctors without Borders (Ouaga) indicating that she had tested positive for HIV and that she wanted to go to Côte d’Ivoire. This document was addressed “to whom it may concern... please accept my patient” (it was intended for a doctor in C.I.) and included a signature and official seal. It even gave her CD4 rate. I was so happy that I listened to my intuition and helped her on the day we met. I felt proud of myself because at least I had given her a little help. That said, I almost became an adoptive mother when, suddenly stricken with despair, she wanted to leave her baby with me.
 
(...)
Just another day…

(...)
 
I had the opportunity to visit villages in Burkina Faso that seemed so far away to me, but were only 45 minutes from Bobo. There, where people live so simply, drawing their water from a well, riding donkey carts or rust-covered bicycles, where the cash nexus is nowhere to be seen and where life seems so calm and peaceful. And yet, I was there to visit three branches of the PVHIV (Association of Persons Living with HIV). Two years ago, the Association felt the need to create outreach branches to offer services and care for persons living with HIV. In the villages, I saw another face of HIV, a face I wasn’t familiar with—one I practically knew nothing about. I saw persons of both genders weakened by the disease, but most were women, victims of their vulnerabilities. Women are more often identified as HIV seropositive than men since they’re the ones who go to associations to obtain as much assistance as possible, especially medical and food aid and help for their children. These women were surely infected with HIV by men, but in general the latter die of AIDS very rapidly.
 
Thus, it was these widows and victims of AIDS who showed me their faces and confided their problems regarding the Association and the services offered—in the hope that we would fix every problem the very same day. HIV is neither urban nor rural. Nor, in my opinion, is it Christian or Muslim. Many of the women who visit the Association are veiled, sometimes in black, from head to toe. HIV affects women mostly. And this will become truer still with the arrival of ARVs. Whereas women are willing to go for screening and treatment, men give clinics a wide berth and only go for a consultation if affected by a physical incapacity, which prevents them from working and bread-winning. As a result, women will prolong their survival even as men dig their own graves. This model of behaviour must be changed. The solution: a gender-based approach.
 
Why must we as women be assigned with specific tasks such as ensuring the health and education of our children? Why must the role of men be to carry out other different tasks? If men were also responsible for the health of their children, they would go to health centres more often and learn about the importance of early HIV detection. Please don’t tell me that in these little villages the answer is to condemn the lifestyle of the “butterflies of the night” (sex workers) and women’s sexual behaviour. How does HIV penetrate families and attack them so unjustly? The issue that needs to be looked at, probably, is people’s mobility. Frequent travelling for work or provisions may lead to couples being separated, which in turn may plunge them into…
 
These are some of the thoughts that go through my head having met row after row of patients in the Association’s waiting room and having heard each of these women’s stories.  

Nathalie in Africa
Bobo-Dioulasso, (Burkina Faso)