When you are nine…

She brought her baby sister to the clinic all by herself.

When you are nine, you shouldn’t have to take care of yourself, let alone your baby sister. But when your mother has died and your father is sick and living somewhere else, you have to grow up far too fast. You are the one who makes sure that you both have food. You are the one responsible.

Caroline knew that her mother brought the baby to the AMPATH clinic. She did not know that her mother had HIV and that she was taking medicines to try to prevent this virus from infecting her baby. She did not know that the baby needed to be tested for HIV or when the baby was supposed to come see the doctor. But she knew that they should come.

Caroline’s mother spared her baby from HIV. By taking the medicines to prevent the virus from passing to her baby during pregnancy or during breast-feeding, she kept the baby free of infection. Caroline is not infected either.

Even though the medicines spared her baby, Caroline’s mother did not manage to spare herself. From what Caroline describes, she was very thin, coughing too much, and one day, a few weeks ago, she did not wake up. (My doctor’s guess would be that she had TB.) The day that she did not wake up will shape every day of life for her two girls.

We have a program for Orphans and Vulnerable Children that can help orphans like Caroline and her sister, and I was grateful to be able to refer them for assistance and follow-up. I was grateful to enlist help. I was grateful for a social worker to try to figure out if there was an adult who cared about them who could lift some of the responsibility from the shoulders of this nine-year-old.

I was grateful, but I keep thinking about them. A nine-year-old and her baby sister and the mother we could not keep alive.

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Wordless Wednesday


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The Heroes

I spent much of the day with some of my heroes.

Thanks to support from @ThePocketSquareProject and the sale of some lovely Kenyan handicrafts, we held an adolescent support day at our largest HIV clinic. Our oldest pediatric patients — young adults who were born with HIV as many as 20 years ago — gathered in our tent meeting space to talk and share and be family for each other.



These kids. Wow. They are bright and articulate. They are brave and beautiful.

They talked about walking through fears, how they struggle daily to ignore the many voices around them that tell them that they are worthless and dirty and doomed. Instead, they cling to their dreams, their faith, their laughter, and their hope for the future. And their courage — in the midst of sickness, poverty, and rejection — is incredible.


Matthew is the social butterfly of the group; he is an excellent soccer player who jokes freely and teases everyone, but also quotes Bible passages. He is quite good-looking, and I see the girls stealing glances at him. He led the discussion time for the support group, and when he talks about “living positively”, he grabs everyone’s attention with his organized points.

Be open with the ones who are close to you. Be as active as you can and find support from those who share your outlook. Be willing to love and to be loved. Matthew gets the group to discuss their emotions and fears and what it looks like to overcome them on a daily basis.

To encourage his peers to move beyond their fears, he uses a Swahili proverb: “A cowardly hyena lives longer, but it suffers the most.” These kids want desperately to live longer, but they do not want their potentially limited number of days to be marked by fear.

When I listen to these kids, I gather hope and energy for our quest to provide medicines, to fight the constant illnesses, to keep trying to fix the broken healthcare  system. They give me hope for their futures and for our work in Kenya.


“These kids are going to change Kenya,” says Lucy, one of the world’s best nurses. For years, Lucy has taken it upon herself to look after our HIV-infected adolescents at the referral clinic. They call her “mother.”

My hope and admiration for their bright and shining beauty is dimmed just a bit by how it brings the depth of our losses into such clear focus. Over 50 of the adolescents at this clinic died in the last 18 months. We have lost far too many bright and shining stars. The kids talk about their “lost brothers and sisters”, and we feel those holes in the midst of this assembled family.

And yet, the youth carry their mourning, their illnesses, the frailty of some of their bodies, their experiences of pain and discrimination. They walk on towards the future. They tell each other to choose hope every day.

“We choose to shine,” they say. “We choose to live positively.”

adolescent group_collage1

The youth are planning a special day in November (thanks again to our supporters!) where they will gather just outside of town at an outdoor conference facility. They are bursting with ideas about exactly what they want to do for this special day: play soccer, perform their own skits and poems and dance routines in a talent show, eat, and spend time sharing their stories. Their eyes dance in anticipation. They cannot wait.

These young adults shine with all they have. They choose hope. It’s an honor to walk beside these heroes.


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“This is how we play football in the dirt”

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As it happens, I am in the midst of major transitions in all aspects of my life. Truly, in all. I will be back to writing more here at Doctor V Goes Over the Sea someday, but for now, I am in survival mode from one day to the next. I hope you will be patient with me.

Probably the least of these transitions is that I leave tomorrow for six weeks in multiple other countries. I am all in favor of appreciating whatever a particular place has to offer. So, in the midst of complete life craziness this week, I commemorate in no particular order these wonderful gifts that I have been savoring in the U S of A:

  • Tamales
  • Bathrooms with toilet seats and toilet paper
  • Sushi
  • Roads with pavement. And lanes. And drivers who give actual thought to not killing other people.
  • Blazing fast internet
  • Lettuce that is easy to obtain and to sanitize
  • Jazz
  • Friends and family who show up with love in the midst of hard and heavy stuff
  • Blueberries
  • Bureaucracy that actually yields a desired result in the end
  • Peanut M&Ms
  • Espresso shots
  • A lack of need for bribes

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