All That Is Bitter and Sweet (28 page)

Veronica, a prostituted woman who was six months pregnant, was my entrée. Moyra, a mother of two, had picked up on how anxious she was about the health of her baby. Dr. Rene and I talked to her about mother-to-child transmission and how critical it is to know your status, and also about syphilis, which causes birth defects. Then I pounced: “Why don’t you and I go to the public health clinic tomorrow to be tested?” She said yes. On a roll, I asked others. Five of them said they would. I couldn’t believe it. As I sat there trying so hard not to roar with joy, they bickered among themselves about the time and finally settled on three p.m., plenty of time to grab a little sleep after a night’s work and tend to the kids. Our group dispersed into the night, and my satisfaction melted into worry about attrition and who, out of fear, would blow it off and not show up.

To our delight, not five but seven from Sahouly’s group showed up to be tested for HIV, some with their children in tow. While we ate pizza, I asked if the women would prefer to wait to discuss our tests at the center, out of earshot of the café staff, because the taboo was so extreme. Again this remarkable group of strong women surprised me: They didn’t mind discussing it one bit. We talked about Nini, the pregnant homeless woman from the rice tents, whom I was hoping to get tested with us. Even though Dr. Rene had scoured the streets to bring her here today, he had not been able to find her. I was afraid she might have vanished forever.

After eating, we gathered in the waiting room of Dr. Rene’s clinic to have our blood drawn. It was a little awkward when the time came, so I shot my hand in the air like an eager schoolgirl and volunteered to go first. By this time I’d had so much blood drawn at clinics and voluntary testing centers that I should have had a tap attached to my inner elbow. Moyra, who is afraid of needles, declined the invitation, but she dug deep to sit by Veronica’s side and held her hand through the test.

When it was over, I was more than disappointed to learn we could not get the rapid results we expected. There was equipment available that could get results in minutes, but it was not at the clinic that day. The quick test is so important, because 35 percent of all people who are tested do not return to find out the results. But we were forced to wait in suspense for another twenty-four hours. We hugged and kissed and bade farewell again. I wondered if they would all have the courage to come back to face their status.

Meanwhile, a woman named Annie who had AIDS and might be willing to talk about her condition on television—as long as her identity was disguised—had been located in town. She was terrified that her neighbors would kill her if they found out she had the disease, so we agreed to meet in a café far away from her home.

To get there we walked a narrow red dusty street lined with little shops selling small goods. The businesses here were tinier than the stands in American parks where you can buy a pop or snow cone, barely big enough for a person to work behind the rough wood counter. We found Annie sitting in a café patio. She was a tiny, lovely-looking woman, terribly frail and missing some teeth but quick to smile and giggle. She ordered a glass of milk and, speaking through Nouci, told me her husband was also infected, and they didn’t know who had given it to whom. Their kids were eleven and fourteen and didn’t know the family secret. Only Annie’s husband and mother knew her condition.

She explained that she had a message for her people: be wise. AIDS is here, and it is not something the Americans made up as a reason to spend money—which was one of the rumors going around. AIDS will infect and kill you if you don’t prevent it in yourself and your family, she said. Unfortunately, she had decided she would not repeat this message on television. It was too dangerous for herself, her family, and her place with her ancestors. Annie was afraid she wouldn’t live to see the day when people could talk openly about the virus. She was sure she would be dead in a year. I tried to rebuke that fear and reached out and rubbed her neck as she bit back her tears. Then she looked at Nouci and asked, “Isn’t she afraid to catch my disease?”

“Oh, no, no, no …,” I told her, and pulled my chair closer. I gently twined my arms around her and hugged her close. She was stiff and anxious at first, then melted into me. I think it had been a long time since anyone had held her.

We told Annie where she could access antiretroviral drugs to treat her illness and about the secret support groups for HIV-positive people where she would be welcome. She was very keen to go, although she said she wouldn’t tell her husband. She didn’t think he would approve. Too much fear.

The next day, I sat in the now familiar public health clinic waiting room, tense about what might happen, waiting for our friends. I was relieved as each arrived, calmly and shyly. Dr. Rene, we were told, was stuck on a bus in traffic. We did not want to receive our results without him because he would need to help with the counseling in the very likely event that one or more of the women were positive. I asked the women about how work had been the night before. They said they had fallen asleep on the sidewalk, leaning against a building, while chatting. And how had they spent the day thus far? Typical housekeeping and child-minding chores. One of them told me she did her wash with our water purification product, Sur’Eau. Ever since a huge cyclone in 2000 caused flooding that ruined much of the country’s drinking water, PSI/Madagascar had teamed up with CARE and the Centers for Disease Control to produce and distribute the mild bleachlike solution to prevent waterborne disease. Apparently it’s also great on stains, and we know it’s cheap!

Dr. Rene finally arrived, his glorious smile in place, accompanied by Nini, whom he had worked hard to find. That was why he was late; he’d been out searching the streets again for her. She looked, if possible, in even worse shape than when we’d first met, or maybe it was just daylight revealing more than her stench, which a breeze from the open window swirled around the room. Her feet, bare as many Malagasy’s are, were filthy and crusty, and her legs were far too thin for a woman in her ninth month of pregnancy. Her eyes were glazed and her mouth was raw with open blisters, which she had used her red lipstick to cover with pitiful effect. She told us that her two-year-old was sick, and I could not imagine where the baby had been throwing up and pooping and how Nini had been coping with a sick kid while living on the sidewalk. I made a silent vow to help her if I could.

As the clinicians prepared to give us our results, I sat with one of Veronica’s children on my lap, a precious eight-year-old girl in a fairly clean dress with only one tear, dotted with a sweet daisy print. She had on red patent-leather shoes that did not match but were obviously worn with pride on her special day of meeting me. I braided her long ponytail to keep the sour smell of her hair more confined. Then, as I stroked her, I rested my other hand on Nini’s belly. Finally, the first number was called.

I accompanied the woman who matched the number (all names were kept anonymous) into a small counseling room. She sat in a chair across a desk from a social worker, and I knelt beside her, my arm around her shoulders, eyes fixed on the small stack of papers that I knew were everyone’s HIV test results. The social worker went very carefully over the number on the card the prostitute produced, visually and verbally confirming that the number matched the certificate and that she was the age and gender indicated. The social worker then slid the paper forward with the test outcome validated by an official stamp: NEGATIF. The woman went through a transfiguration akin to Jesus’s on the mount, from grim, fearful stoicism to an outburst of relief and joy.
“Negatif!”
she kept repeating, shaking the social worker’s hand as if she’d been given a diploma, crying some, but really being far too overjoyed to do any one thing for more than a second. I bawled shamelessly, caught up in the miracle but also knowing that the next woman’s result could be disastrous. We had six more to go before we were done.

The process repeated itself again and again, the frightened but resolute woman in the chair, me on the floor beside her, numbers and details verified, and results presented. They were unbelievable:

NEGATIF.
NEGATIF.
NEGATIF.
NEGATIF.
NEGATIF.
NEGATIF.

A series of miracles and the most eloquent tribute possible to the power of peer education. Seven veteran prostitutes with more than seventy-five years on the streets and thousands upon thousands of tricks turned among them had tested negative for HIV.

We all reacted in our own way. The social worker immediately began reinforcing risk management behavior and correct, consistent condom use. Our stills photographer, squished in a corner, a veteran of some of the world’s grimmest scenes in countries the U.S. State Department might not be able to find on a map, cried openly behind her lens. The VH1 documentary crew openly declared it the heaviest thing any of them had ever been through. Moyra didn’t breathe until pregnant Veronica and the toothless granny—the two we had been most sure would be HIV-positive—were also declared negative. Back in the waiting room, when we realized that all of us were free and clear (this time, at least), jubilation broke out. There was clapping, dancing, singing, and a prayer.

Now I could leave my friends without the sense of panic I had felt a day earlier when we had parted. They were free from HIV, and I fully expected all of them to remain that way. Sahouly and I shared a quiet moment when she said she couldn’t wait to go home to tell her husband, although we both confirmed the importance of them using a condom together. Relief must be tempered by reality.

As we left, I spoke with Dr. Rene about passing him money to pay for all the medical care everyone’s ailments required and in particular what to do about Nini. We agreed that at our farewell gathering that night, we would give him a small fund out of which he would settle prescription costs. It was the least we could do and in fact was very inexpensive. The costs for delivering Nini’s baby at a clinic, plus her medications, her two-year-old’s meds, and the meds for all the other women’s sick babies was less than $100.

We wrapped up our visit to Madagascar with an official press conference to thank the government and our donors, followed by a big party for everyone involved in the trip, which officially kicked off our thrilling collaboration with the Top Réseau health clinics. When we arrived at the hotel ballroom, I chose for the first time all week to speak English instead of French. I have been told by a marquis that I speak a very good seventeenth-century French, which might have been a bit formal for this setting. I thought I could transmit more spirit and attitude for the kids in the room in English. However, when dear Nouci came to translate for me, she totally froze, numb from exhaustion, and told me
I
had to help her! I took the mike back and translated myself into French, satisfying the government officials in the room with a little wave and shout-out when I was finished. The event wrapped when our energetic peer educators did a dance that told the story of the ABCs (abstinence, being faithful, correct and consistent condom use). After celebrating their commitment and spunk, I slunk out of the reception to sit quietly in my hotel room (the one with seventeen chairs), to pray for guidance about Nini. I called Dario and told him that if I were to leave here without helping her, her life and the lives of her children would be on my conscience. He offered to help, and I decided to present my plan to our country director in the morning.