By Anna Beth Wildman
“For you created my inmost being; you knit me together in my mother’s womb. I praise you because I am fearfully and wonderfully made; your works are wonderful, I know that full well. My frame was not hidden from you when I was made in the secret place. When I was woven together in the depths of the earth, your eyes saw my unformed body. All the days ordained for me were written in your book before one of them came to be” (Psalm 139:13-16).

Baby Elizabeth is carried into the examination room at Spring of Life, an SIM ministry for people living with HIV/AIDS. The ten-month-old waves her spindly arms as SIM nurse Susan Bertrand lifts her from her mother’s lap. Elizabeth opens her mouth and gives a pitiful, scratchy cry. “Oh, she’s totally positive,” Susan’s voice cracks. As Elizabeth cries, Susan continues, “She’s got a bad case of thrush.” She turns to me. “Elizabeth’s mom, Sarah, has never been here before. She was in the market and a friend of mine approached her and said, ‘Your baby needs help; I’ll take you to Spring of Life.’”

I glance at Elizabeth’s mother, Sarah, who is very thin. She sits expressionlessly, too tired to care.

Susan turns to Sarah. “Have you ever been tested for HIV?” Sarah stares back at her confusedly.

A Nigerian nurse suggests, “First we should counsel the mom, then test the mom and baby.”

As the nurse leads Sarah to another room, Susan turns to me. “We’ll explain what HIV/AIDS is, and describe the symptoms and stages. Then we’ll test her and the baby. They might just be malnourished, but Sarah looks very sickly, and Elizabeth coughs like she has TB, which often goes along with HIV/AIDS. I could be wrong, but I have a feeling they’re both HIV positive.” She stops to greet a Nigerian staff member in Hausa. “Sannu. Yaya gajiya?” (Equivalent to the American, “Hi, how are you? Not tired, I hope.”) Susan’s face lights up as she converses in Hausa with the staff member. Then she turns back to me. “We send our positive patients to the hospital to get PEPFAR, which stands for President’s Emergency Plan For AIDS Relief. It was started by President Bush and involves free anti-retroviral drugs that suppress the HIV virus. We have over 1000 people on this therapy. They’re gaining weight, which is excellent.”

Susan is interrupted by another patient. Little Kabiru is between six and eight months old. Susan takes him in her arms. The baby leans against Susan and closes his eyes, too tired to care. Susan cuddles him closer. “Poor baby! Look how thin he is. He’s so cute, but way too thin to be six months old. We can’t test him for HIV/AIDS when he’s this young, because the test will be inaccurate.” Kabiru coughs weakly. “Listen to that cough. He may just have TB and not have AIDS—we’ve had babies take TB medicine for five or six weeks and then they’re fine. But why is he so thin when they say he eats so much?”

Larai, a Nigerian faculty member, translates into Hausa for Kabiru’s mother. Larai turns back to Susan. “She says she is not the mother.”

“Where is the mother?”

“She is late.” Kabiru’s mother passed away. This woman is taking care of him.

Susan gropes for words. “Tell her… I’m really worried for this baby because he is so tiny although he eats a lot. She should take him to Dr. Blyth at Jan Kwano [people refer to Evangel Hospital by this term]. I will ask him for the results.”

As they leave Susan turns back to me. “I’m really worried about him. But there’s a chance he’s not HIV positive and just has TB.”

A traveler from America just delivered a box of supplies for Spring of Life. Susan sorts blood testing equipment as she continues explaining about Spring of Life. “After a mother tests positive it’s not good to breastfeed the baby even if the baby’s positive. We have an infant formula project where a mother is given one can of formula every two weeks. A can lasts about three days. Normally the cost is $5.00 per can, but we give them away free. The mother stops breastfeeding and mixes the formula with grains we provide—it’s a little like oatmeal and has lots of protein. Without treatment, 40% of Nigerian children die before they are one year old. If Baby Elizabeth doesn’t get help, she will die within the next one or two months. If Elizabeth tests positive, she’ll die at an early age—those are just the facts.” She pulls several black purses out of the box. “These will make awesome gifts for the staff here!”

Susan continues talking about Spring of Life. “We provide awareness, counseling, and home-based care. Our awareness program is a community outreach. We go to schools and churches, teaching about AIDS and providing voluntary counseling and testing. In addition, youth programs teach about abstinence. Counseling is given here at Spring of Life, before and after blood tests. If the mother is HIV positive and expecting a child, we start her on anti-retroviral drugs to prevent mother-to-child transmission. Another aspect of our ministry is home-based care, which involves caring for people with HIV/AIDS. This includes training people in local churches, distributing food and drugs, and helping women and children get more nutrition.”

We walk into the tiny room where Elizabeth and her mother are being tested for HIV/AIDS. Elizabeth cries and squirms miserably as the nurse pricks her toe and squeezes out a drop of blood. They smear it on the test… and wait. Two thin lines, a pink one and a blue one, slowly appear. It’s positive.

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