Stories about Sipho, Part 4

Since September, we've been posting Stories about Sipho, blog entries by Dr. Ryan Phelps about a Swazi boy named Sipho. We've been thrilled to see that Sipho is regaining his health due to the antiretroviral treatment that (RED) money is helping to pay for, through the Global Fund. --bn

Here's Ryan's latest update:

As I entered the pediatric ward, Sipho was still marching the halls. He recognized me immediately and walked toward me smiling, his arms outstretched. I was flattered by this gesture, for the previous time I saw Sipho he had waited for several hours in our crowded clinic lobby only to have me greet him briefly and stick two needles in his gluteus maximus, one on each side. Sipho could barely stand then, even before the shots. There was no reaching out that day, and there was no smiling.

Today was different. Sipho's wide grin uncovered several blackened, decayed teeth (another sinister legacy of the virus). When he reached me, I placed my hands under his arms, lifted him up and sat him down on a metal gurney in the hospital corridor. Sipho was still feather-light, his ribs thin and narrow under my fingers, like wicker furniture. His pulse was rapid, a compensation for his watered-down blood. I climbed onto the wheeled cot and sat beside the patient I had just mistaken for dead.

Sipho reached for my stethoscope and I helped him hang it around his neck. My movements were exaggeratedly deliberate and gentle, for despite my medical training I harbor an irrational fear of somehow breaking extremely frail children.

Sipho placed the listening end of the stethoscope in his ears, picked up the metal bell, and looked at me. I guided Sipho's hand to the ribs overlying my heart. His forearm felt like a skewer of tightly packed, uncooked marshmallows. He placed the bell next to my necktie, squinted for two seconds, and then smirked with satisfaction. As far as I know, it was the first time he had heard the amplified beat of a human heart.

I looked down at the cold shiny steel and small plastic wheels of the gurney beneath us. I was no longer sad or angry. An eight year-old who seemed destined to perish was alive, not only alive but sitting contentedly beside me, listening to my heart beat and smiling.

I smiled too, and not just for Sipho. If ARVs can restore life to a child so deathly ill, there is hope for thousands of other HIV-infected children.

After a minute or so of listening, Sipho carefully placed my stethoscope back around my neck, climbed from the bed, and scampered – as any normal child would -- toward the pediatric ward's food cart, where a nurse was distributing buttered bread.

TO BE CONTINUED…

ABOUT THE BAYLOR CENTER OF EXCELLENCE
In southern Africa, 40 to 60 percent of all deaths of children under age five years are caused by HIV/AIDS. Despite this fact, in almost every resource-limited setting worldwide where HIV/AIDS treatment has been initiated, children are grossly underrepresented among its recipients. The Swaziland Center of Excellence is helping to address this discrepancy. The COE is part of a global network of clinical centers created by the Baylor International Pediatric AIDS Initiative (BIPAI) at Baylor College of Medicine. These clinics are modeled after two landmark HIV/AIDS care and treatment centers that BIPAI constructed and opened in Constanta, Romania and Gaborone, Botswana. The purpose of this network is to build critical infrastructure and human capacity to catalyze access of children worldwide to HIV/AIDS care and treatment.

These clinics are staffed by local health care workers and members of the Pediatric AIDS Corps, a group of over fifty health professionals that are linked to one of the Baylor Children's Clinical Centers of Excellence for purposes of professional development and training, continuing education and clinical consultation. In collaboration with local health professionals, we spend our time here building local capacity through one-on-one clinical mentorship and didactic trainings. We also provide high-quality pediatric HIV care for children like Sipho.

For more on Dr Ryan Phelps’ experiences in Swaziland, go to pediatrician-in-swaziland.blogspot.com.