Take a moment and imagine that you are a nineteen year old girl living in Port au Prince, Haiti.
For most of us, we can not even imagine the struggles and difficulties that would entail, even in the best of circumstances. I encourage you to try anyway...but be warned - these are not the best of circumstances.
Delmas area, Port au Prince. Heat. Pressure. Noise. Pregnant.
You were kicked out of your mother's house - a two bedroom bare cinder block structure shared with a handful of extraneous family members smashed in between thousands of other similar dwellings. Your mother learned of your pregnancy and became angry. Physically angry. She can not find enough work to support herself and your siblings, and has at times resorted to selling her body in order to eat. There is currently a man in the picture that she relies on for support - and your mother is certainly not going to risk losing that relationship on account of your unplanned pregnancy. You are now not just one more mouth to feed, but two.
You are on the street. The street is made up of gravel, dirt, sand, and garbage. Pregnant and vulnerable, you try to make a life with the father of your child who has little education and no work. It does not go well.
Months pass, and now the street is also made up of rubble. Rubble from buildings that fell into that street during the earthquake on January 12, 2010. The earthquake changed everything, only not everything...so many things are still the same. Things are still unbelievably hard.
You leave the city to visit your boyfriend's family in a smaller town in the south. You give birth to a baby girl there in a home surrounded by family that is not your own. You are thankful that you survived, and that the baby survived. You are not sure what will happen next. You never are. It is March.
You move back to Port to start the next chapter of life in a structure your boyfriend built while you were delivering your baby. It is made of scraps of lumber with tarps wrapped around it - tied in some places, nailed in others, crimped with bottle caps at the corners. It is built in a now empty lot where a house used to be prior to the 'goudougoudou'. There are many other homes like yours sharing this lot, many neighbors with stories mirroring yours.
October comes. You are sick. You stop breast feeding your baby because you are afraid she will get sick as well. She gets skinny. You are afraid.
Your boyfriend leaves you.
You are alone.
You have a sister that visits you and is concerned by your weight loss. She brings you to a clinic where it is discovered that you are HIV positive. Your sister is devastated. You are still in shock from the events of the past year. You go back to your tent and continue to try and survive with your daughter, who is also losing weight. To others, you may seem depressed...to you, what is the difference? Things have been so hard for so long that it hardly matters that your situation just got so much worse. A chronic illness may seem a welcome relief and end to the suffering at times.
The clinic that tested you wants to test your baby girl and has concerns that you might also have tuberculosis. You decline. You do not want to know.
Your sister convinces you to come - at least for the baby's sake. She tells the people at the clinic trying to help - 'li rayi tet li' (she hates her own head). That is her only explanation for why you won't come and get the help you need. The good news that your baby girl does not have HIV does not change your situation at all - but it is good news all the same. A sliver of light piercing the black cloud over your days.
You reluctantly agree to go and take a test for tuberculosis at the government hospital. It is necessary before you proceed with treatment for HIV. There are clinics with medicines available that can slow down the AIDS virus and improve your life, or so you are told, but you are not sure you believe it. The last time you came to this hospital for help you eventually gave up discouraged and dejected after failing to gain admittance. You had an appointment. It didn't matter.
Only the strong and assertive get what they want and need. You are neither.
Someone you have never met and who barely speaks your language comes to pick you up and take you back to the hospital and try again. You get in the car, because your sister is there and asking you to try again for your daughter's sake. Your daughter is with you and instantly falls asleep. Neither of you have been this comfortable in a long time.
You arrive at the hospital, not waiting in line this time because you are in a car with a foreigner with connections inside. You buy a cookie and fruit drink from a vendor outside the gate for your baby who will surely wake up hungry. Your sister gave you the money.
You leave your baby sleeping in the car with your sister while you go for your tuberculosis test.
The TB ward is housed in a temporary structure staffed by a volunteer doctor from somewhere else. She is overwhelmed but takes the time to talk to you and give directions. She orders the tuberculosis tests, fills out paperwork for chest X-rays, and shows you to the waiting area for patients. The tests are handled in a temporary office and lab set up under a tent.
You sit and wait outside for your turn. The paperwork takes some time - there is some confusion about the spelling of your name. The nurses are impatient and not necessarily gracious. They are sweating profusely and trying to keep a fan circulating air without blowing their papers out into the street. When it is your turn, you spit into a small cup, screw the lid on, and drop it into a plastic bin sitting on the ground. There are many other cups in the bin already, with names written on tape stuck to the sides.
You are instructed to return the next two mornings and repeat this process. You don't know how you will get there again. Next, you need to get chest X-rays. Some of the staff at the government hospital are on strike, and the radiology lab is closed. You will need to pay for a private lab. The X-ray alone will cost thirty-nine dollars. If you were fortunate enough to have a job in a factory, you would make five dollars a day. You do not have a job. Arrangements are made to cover the costs for you.
You check on your baby before going to the private lab. She is awake and soaked in sweat. Your sister needs to leave to run some errands. You walk the three blocks to the lab, passing vendors covering every inch of sidewalk along the way. During the walk you are harassed to make purchases, ridiculed for your appearance, questioned about your connection to the foreigner walking with you, and short of breath from the exertion of walking in the heat and carrying your child.
In the lab you sign in and wait.
Over three hours later your name is called. You are very discouraged and wanted to give up many times. Your escort shared the sentiment but did not know how to get a refund - so waited alongside you while wondering why so many others came, finished their business, and went in the meantime. You both question the preferential treatment of others but know you can not say anything about it. You endure the stares and hushed voices in the waiting room...the forced advice on child rearing and proper attire.
When it is finally your turn you have to leave your baby in the hands of a stranger while she screams.
Then you walk back to the hospital.
While walking back to the hospital you are criticized by other pedestrians for the way you are holding your child. One passerby encourages you to give your baby away since you are so young and poor and sickly.You are too out of breath and tired to respond.
By the time you return to the car, your sister has given up on you and taken public transportation home. You have not eaten anything all day. You ask to borrow money that you know you can not repay in order to buy a styrofoam container full of oily rice, bean sauce, and vegetable stew. The food is sold out of pots on the side of the road being cooked over charcoal. You are heckled and cat-called while you cross the street. You share the meal with your daughter.
The five mile drive back to your home takes over an hour.
You are relieved when you return home to your tent, and given instructions about your future appointments. You stare blankly wondering how you will make it back to the hospital for the follow up testing and results, not sure if you want to know what they will say.
To be continued...