“Practically everybody who works with immune-compromised populations has it.”
We’re sitting in our orientation, learning all the shocking facts about HIV/AIDS in Botswana from Melissa, HIV and AIDS Specialist and a development manager at WUSC. She tells us all the numbers, scary numbers, emphasizing the fact that incidence rates here for HIV work like a freight-train; they’re additive as the generations pass, so that what looks like a small percentage in the beginning — 2, or 3, or 4% — ends up resulting in a breathtaking 30% prevalence rate in twenty years (which is what it is right now). That’s if, she emphasizes, all of the work we do doesn’t work.
And if it does work, small changes at the beginning can have huge long-term gains. This is Really Good. And Melissa confident that what we’re doing can work, and that it will work.
We’re picked up from our apartment in the morning, and taken to our orientation at the WUSC office, a short drive from our lodgings. It’s a whirlwind day: an in-depth briefing on the socio-cultural and political issues in Botswana from Lock, a professor at the University of Botswana; meeting all the folks who work tirelessly in the WUSC office to make our trip possible; a refresher on all the reporting we’ll be doing; tips about culture and society (tl;dr: Canadians are loud); and, a wonderful traditional lunch at Botswana Craft Centre. Most importantly, a talk about why we’re really here: HIV.
“I think we should tell people before they come, about getting TB here: but it’s not really a big deal,” Melissa says. “You just need to know that if you ever have to take a TB skin test, you’ll likely test positive.”
TB is the most common opportunistic infection that comes along with HIV. Working with immune-compromised populations, like the teens at Baylor where I’ll be, inevitably means exposure to TB — but, Melissa stresses, as long as we’re healthy and don’t get HIV one day ourselves (or need radiation therapy for cancer), the TB cells will be dormant. And if we ever can’t fight them off, well, we’ll just go and get antibiotics.
“It will take two weeks or so, then you’ll be cured.”
She also suggested we go and get tested for HIV ourselves. Botswana has rapid HIV testing — like a pregnancy test, but with a drop of blood. “Even if you know, really know that you’ve never been in an at-risk population or situation, there’s a moment right before they tell you, where you’re terrified,” she says. The truth is this: everybody who lives in Botswana should get tested. Walking down the street, one out of every three people you see has HIV. They need to know, so they can get treated, and not pass it on to their partners. A large part our job is to get people to do this: we should know what we’re asking them to sign up for. It’s easy to understand, intellectually, that getting a result, even a positive one, is better than living in the dark. It’s another thing altogether to really, emotionally, face it square on.
Tomorrow will be my first day in my new workplace, meeting my coworkers, and getting the hang of my job. And I’ll get an HIV test on my way home.