AIDS is smelly, ugly, dirty, unpredictable, insidious, no respecter of persons or social status or intelligence or wealth.
So how do we fight a foe that we can't see or hear or feel until... well...
Until The Luke Commission comes along to offer compassion. Until individuals become more important than "success rates." Until Americans and Canadians who love Jesus and their neighbors faraway decide to enter the battle. Until medications that suppress the deadly virus actually get into patients' mouths.
That's the challenge these days for Dr. Harry and Echo (PAC) VanderWal – to close the gap between persuading Swazis to test for HIV and starting them on anti-retroviral drugs, which will prolong their lives.
"I'm in turmoil about getting help for rural HIV patients we diagnose at TLC clinics," Echo said.
It's like a baseball season, she noted. "I don't want to lead spring training, buy uniforms, go to batting practice, stock the concession stand, cheer before the game, bat, hit, run to 1st base, sprint to 2nd, slide into 3rd, and then stop."
Echo continued: "People are dying of AIDS all around us. We're so close to home plate, but we're stuck on 3rd base."
So what is The Luke Commission doing to run "home"? Harry and Echo now hold hands, literally and figuratively, with the very sick for three to six months. "We want them to get used to coming for medications and to feel better. Then we'll refer them to the clinic nearest their homesteads," Harry explained.
During that initial treatment period, TLC will pay transport costs by reimbursing those who come to Manzini regularly as instructed by Harry and Echo.
It's a logistical nightmare, with many discouragements along the way. For instance, some AIDS programs want 0% default. This means occasional resistance when ARVs are needed urgently with real low CD4 counts because the patients might die anyway.
The man, his wife, and son leave for the hospital.
Echo assures this Swazi man who was near death when he collapsed at a recent TLC clinic.
"But until really sick people get better, we're not going to prove to the rural communities that ARVs extend lives," said Echo.
At a recent packed clinic, a young old-looking man collapsed as he stood in the medical line waiting to see Harry. While inserting an IV into his arm, Echo recognized him.
"He had come to a TLC clinic a couple of weeks earlier and tested positive for HIV," Harry remembered. "We drew his blood. When we received the lab results, we informed him that his CD4 count was dangerously low at 85. But due to lack of transport in his area he did not go for treatment."
Now he was in multi-system organ failure and needed immediate hospitalization. TLC translators gently loaded him into the back of a kindred partner's "bakkie" (pickup), along with his wife and small son, who were given food for hunger, blankets for warmth, and a Bible for comfort.
"If we had not seen him today, he would have died before in a few short hours," said Echo.
(As of this writing, the man is much improved, has weathered the side effects of ARVs, and gratefully tells his story to all who will listen. And he praises God.)
Another touching story unfolded at this same clinic, which began with a 5 a.m. departure from Manzini and a 2:30 a.m. return the next day.
A "girl", who looked so much younger than her 28 years, hobbled into the clinic on the arms of her mother and brother, who also appeared emaciated and gaunt.
She had a smile on her face, though, a smile that lit her otherwise sad eyes. She had never been to a doctor. Instead, witchdoctors, or traditional healers as the Swazis call them, were her mainstay. She had hundreds of nicks all over her body from knives used to let out evil spirits...
Harry's diagnosis was full-blown AIDS with bony tuberculosis. He explained that TB can attack different areas in the body. One knee and wrist were especially swollen. She was in pain but calm and quiet. Many times her family expressed thanks for TLC's tender care.
Her mother and brother agreed to let her be hospitalized with tears of gratitude in their eyes. "If we had only seen her a few months earlier," lamented Echo. "It's hard to know if she'll live more than a week." (She's still alive and much improved!)
The buoyant side to what's happening in Swaziland does bring blessings, however.
In full-blown AIDS, this young
woman's compromised immune system
is manifested in bony tuberculosis.
Echo gently hooks up an IV before the AIDS patient is transported to a hospital.
"Since TLC came, people are no more ashamed to reveal their HIV status," a bush pastor told Harry and Echo just this week. "They encourage each other to test. They are no more in denial."
"Now they recognize me on the buses," he continued. "When I ask them how others know me, they say ‘You were the pastor working with The Luke Commission. We saw you at a TLC clinic.'"
Delighted with his new status, the pastor exclaimed: "Now they search me out for help. They are open with me about testing."
He noted: "TLC did not come to expose people, but to show them that we do not have to be ashamed of our status. Now when neighbors and friends are sick, they tell them openly, ‘You need to test." To me, TLC is a very effective tool."
Yes, that's what we all want to be – a simple tool to bring others to Jesus, to relieve suffering, to make the sick see brighter days. Your prayers and your gifts are the underpinning of this endeavor in Swaziland.
To God be the glory!
Janet Tuinstra for The Luke Commission near & far, young & old, sick & well, believers & yet-to-be-believers
P.S. – A special thanks to all who donated for new vehicles. Time usually spent on maintenance of old vehicles is now used to follow up desperate medical cases. Some $20,000 was taken temporarily from the general fund to finalize purchase of two vehicles, so the clinics could get back on the road. Now these funds must be returned to the general account to purchase medications. This is an urgent need and prayer request.
Dumi (left) and Echo encourage the very sick lady that The Luke Commission team will do their best to help.