Rose sits down on the chair next to my clinic desk with her arms full of toddlers. Her 18-month-old twins, a boy and a girl, are determined to head in different directions in the clinic, and the mama struggles to rein them in.
To help Rose – and to make friends with my patient – I pick up the little girl, Elizabeth. Her short hair has been carefully twisted into tiny, 1-inch braids all over her head. She has enormous eyes that immediately make you think she will grow into a great beauty. She is adorable.
I pull out some stickers from my pocket to woo her with bright smiley faces, and she quickly puts them all over her hands and mine. Of course, I am enchanted by her.
Her twin brother, Kyle, sits more calmly in his mother’s arms, watching me with matching big, brown eyes. I hand over some stickers to him as well, and he smiles at my little gift.
Then, I get to give their mother a much better gift.
Rose is infected with HIV, but during the entire time that she was pregnant and through a year of breast-feeding the twins, she took 3 HIV medicines to keep the virus at a very low level in her body. Every day, she took the medicines — while her babies grew and ate and slept and became these feisty little people. Rose also made sure that her twin babies had preventative HIV medicines for the first months of their lives. She brought them to clinic at AMPATH every month, and we watched them grow and tried to keep them extra-safe with medicines to prevent infections. We try to protect babies from HIV all the way through pregnancy, child birth, and breast-feeding.
Today, I get to tell Rose that it worked. Officially. On their third and final test — the test that we can only do once babies hit 18 months of age — I get to announce to her that these precious babies are HIV negative. All of Rose’s work meant that the HIV virus in her blood does not infect her babies.
When I told her, Rose’s eyes crinkled and filled with happy tears. So did mine. Such great news.
We are actually really good at preventing babies from being infected with HIV. If a woman starts HIV medicines while she is pregnant or even during the time of delivery, we can reduce the chance that her baby will be infected to less than 2%. There is no reason that we cannot give every HIV-infected mother the gift of good news that Rose received today:
Your baby does not have this virus.
In 2012 alone, programs like ours that are funded by the U.S. government’s PEPFAR program averted at least 230,000 babies from being infected with HIV. Worldwide, we have prevented at least 1 million babies from being infected. No baby should be born with this virus. If we can get women tested and linked into care and if we can get them to take these medicines like Rose did, we can make sure that no baby will be born with the virus. It’s a big “if”, but it is possible. An AIDS-free generation.
The gift of two HIV-negative twins was a gift to me too. As the only pediatrician in an HIV clinic, I usually end up seeing lots of really sick kids, the complicated cases. The clinical officers see most of the regular patients who are doing well. As their consultant and supervisor, I get to see their difficult cases. I spend most of my time in clinic trying to figure out what on earth to do for the children who are having all kinds of problems.
This makes it a special joy when I get to play with healthy, happy, growing toddlers like Elizabeth and Kyle. And the very best part of the day — a gift to me and an even bigger gift for Rose and her children — is to celebrate over the verdict that these little lovies are HIV-free.
I long for the gift of good news for all of the mothers and grandmothers who wait with their babies in the HIV clinic.