Of Cakes and Clinics

So far we have participated in two clinics at Sparrow. Every Monday night, a young doctor from Coronation Hospital comes to Sparrow to see the HIV-positive kids who are sick or need blood drawn, to check their white count, viral load, or other labs. We saw about 30 patients with him over 4 hours. Most of the kids speak English, though several were accompanied by an aide who would whisper to them in Zulu or Xhosa if they got scared or too shy to talk to us. They ranged in age from 1 to 11, but most of the older kids looked about 7. Almost all are physically developmentally delayed and some mentally or socially delayed as well. Dr. Karl let us examine the patients and alert him to any significant findings, then he would check them himself and draw bloods. The findings Kemi and I missed most often were clubbing and axillary lymphadenopathy (because we didn't think to check). The findings we couldn't help but pick up were some diffuse crackles and massive hepatomegaly.

Dr. Karl could draw blood from a rock - it was amazing to see. Using bare 22-gauge needles and a single vacutainer, in dim light, he was able to get blood on the first try from every child there, all ages, whether stoic or hysterical, and get them to smile afterwards if not during. The younger and chubbier the child, the more difficult to palpate a vessel. The sickest children were malnourished, with severe failure to thrive because of AIDS, or had lipodystrophy as a side effect of antiretroviral treatment. Either way, they have very prominent veins, but luckily these were few and far between. He has been known to take blood from the necks of very ill children when absolutely necessary. Yikes.










The other clinic Kemi and I ran with two nurse's aides during the day, as regular check-ups for all the well children. The older kids get back from school around 2pm, so then the aides brought in a group of the teenagers, who apparently routinely skip out on their allotted clinic times. They were a funny group. They are completely dumbfounded that Kemi is black and only speaks English. They would try speaking to her in Zulu and Xhosa and could not understand, despite repeated explanations, why she has the same accent I do. They didn't believe us when we told them there are lots of black-skinned people in America who only speak English. Finally, one girl gave a look of recognition... "Ahh," she said, "so your father is white!" No, said Kemi, but after a while we gave up explaining and just let them giggle.

Kemi blocking one of our many onlookers from entering the clinic room:

Meanwhile, our housemate Caroline, a middle-aged hospice nurse from Ohio who spends 3 months every year volunteering at Sparrow, invites small groups of kids over to our house to bake cakes for whoever has a birthday coming up. They learn to read, measure, tell time, and lick bowls. This week we hosted Night (age 10) and Thato (age 12). Night proudly tells us how he was the first child at Sparrow, found abandoned when he was just a few months old.

Above is a sign we made up for the pictures, which the boys say signifies "scissors." Below they found Zorro masks and, later, got the cake safely to the birthday boy, Pule (age 9).