Wednesday, September 11, 2013

Chapter 14: She ran away, and then came back a month later.

Rachel and Leah are 10-months old
This month has not been easy.  I left to take Chloe to school in Taiwan and Nomsa ran away from the hospital. Well, technically she was given a five-day pass and then decided not to return. She was lonely, hurting, very afraid and needed time alone to think.

Nomsa asked me what she should do? Should she start the treatment for XDR-TB* (she doesn’t know that only one person has been cured of XDR-TB in Swaziland through treatment)?  How much would she suffer with the side effects of another layer of medication?  Would she be better to go home and die alone?  How long would that take?  Her questions were heart wrenching and not having an answer for any of them was even worse.  I am a problem solver, but I can’t solve this problem.

Here were her options: 

1.              Stay at the TB Hospital in an isolated room and begin a minimum of 8-month new treatment regime (see photo of one months supply including daily injections), suffer from new side effects and a high likelihood of losing her mind while she watches others die through the tiny window of her door.
2.              Leave TB Hosptial and go to her homestead where there are no people, no food, no electricity and no clean water.  A nurse would have to come and give her the daily injection, but without any food her body would succumb to the medications themselves.
3.              Pretend she is fine, go back to a life of prostitution and infect an infinite number of people with XDR-TB and HIV/AIDS.

Nomsa spent the last month praying, thinking, reading her bible, and praying some more.  She asked me again and again what she should do?  What could I say?  I can’t begin to put myself in her shoes and really understand what she was/is going though.  By staying away from the hospital she had effectively made the decision to not take her TB treatment and that effectively was a death sentence. But wasn’t taking the medication in the hospital almost also certain death?

Last week she contacted me and said she was going back to the hospital. If they would agree to treat her at home, she would start treatment again.  If not, she would not return to the hospital to stay and take the treatment.  We met up outside the pharmacy and I helped her pack eleven boxes of pills and a huge box of injections in to her large purse.  These would last her a month and then she would return for the next prescription refill.
Nomsa's new cocktail - one months supply.
The really sad part is that the Doctors have no way of telling Nomsa WHICH of the drugs she is actually resistant to.  Sadly the government is lacking the funds to pay its bill at the facility in South Africa that reads those results. Fortunately for Nomsa she/we have a mutual friend who has a friend who can help us get her test results.  I had her go to a different clinic in Manzini and she gave them a Sputum sample on Monday of this week.  They are sending it to Belgium for free (as a personal favor to my friend) and we will know in 8 weeks which of the drugs she is resistant to (or if she is resistant to them all, which is a strong possibility).  For now, we have 8 more weeks to pray.

On Tuesday Nomsa called me and said that the government had just run out of funds to provide health care workers to go in to the community to give the injections to TB patients.  She was distraught because without that person giving her the injection and without that part of the treatment she would not be able to continue it all.  Later that day she was offered a room at her Uncle’s house so that she can live there and go to a local clinic for her daily injection.  She was happy again.

I am not going to lie here … I am highly suspect of this “Uncle” who didn’t care about her before, but now that she looks and feels healthy (and she is a beautiful young woman).  Nomsa assures me he is a “man of God”, but I pray for her safety if she goes to live there.

I just called her on the phone so that I could give you all an up-to-the-minute update and she said that the Uncle has told her to “hold” on moving as he doesn’t have a room ready yet.  She also said that a man showed up unexpectedly at her homestead today and gave her a very large bag of mealie meal (ground maize) and some soup stock (dried for flavoring the maize).  She was astounded and thankful for the provision of food.    You and I are likely thinking the same thing … who is this “good Samaritan” and what does he want?  I have no answer for that.

That is my report for this week.  If you are confused, it is because it is confusing.  If you are heart broken, it is because this is heart breaking. If you are called to pray more for Nomsa than ever before, it is because you are called to pray. Remember, Nomsa represents thousands/millions of women in Swaziland and other parts of Africa and the world who are living with and dying of TB and HIV.

Let us pray together.


*XDR-TB is Extremely Drug Resistant Tuberculosis