THE FULL VIEW

By Yasmin Ahmedi

The fort is the center of town. All roads commence here and lead to nearby villages. Atop the fort, there are inscriptions written by young couples. My favorite note reads, "never let love die." This inscription is near a hill, which slopes down into a freestanding doorway made by two large stone pillars and bricks laying across the top. Small pockets of grass find their way through the stones. I take a picture from behind the stone doorway but the view of the town is obstructed by the structure. I tell myself that soon I will come back and see the town from the other side of the wall. For now, it is a little past six o'clock and I am late for my first day at the hospital.

As I enter the Antiretroviral Clinic at the hospital, there are hundreds of people waiting near the entrance. I make my way through the crowd and meet my translator. We get to work immediately as there are many patients to survey. As the first man walks through the curtain, I observe his appearance. He has dark skin, walks with a slight limp, and has been on Antiretroviral medication for over a year. I see small red dots covering part of his body when he sits next to me. His ankles are a bit swollen and it seems as though he is losing hair. The translator explains that we will be asking survey questions about his treatment, family, environment, and attitude. The interview begins beautifully and we learn about Mr. K's education, HIV status, and treatment. We move on to another section of the survey and ask Mr. K about his family and life at home. His head drops suddenly. He no longer looks at me, only at the translator. I begin to lose focus as he gives an answer to the question. It is hot and the cup of tea that I just finished is making me even hotter. Time seems to stand still for more than ten or fifteen minutes until something in the room changes and I look up. The translator has his head down and both he and Mr. K are crying. Mr. K takes out a small, white handkerchief and wipes his eyes. The translator looks at me and says abruptly. "His wife also has HIV." Mr. K continues to weep as the translator explains further by remarking, "His wife has HIV. But, she does not know her status. She doesn't treat people in her village who have HIV very nicely. They are not allowed in her house. If she finds out that she has HIV, she will kill herself. He really loves her so much. He wants to know what to do. How should we counsel him?" Counsel! That word seems so foreign even though it is spoken in English. I am only a student here to learn about how HIV affects people's lives. How can I counsel people when my knowledge of the field is so limited? I feel inadequate and inexperienced. All I want to do is leave.

At the end of the working hours, I return to the fort and sit near the massive stone wall that I found earlier in the morning. All I can think about now are the day's events. I do not have enough experience to counsel, but perhaps there are other ways to help. I start to think of all of the projects that could benefit HIV patients. A new goal comes to mind. I want to learn about all of the issues that affect people with HIV and find resources and organizations to address these concerns. As I write down a new list of questions to ask and topics to research, something disturbs the silence atop the fort. There is a little boy peering through doorway in the stone wall. He is small, about eight years old, with dark brown hair and eyes. He wears an Adidas t-shirt and bell-bottom cotton pants. His sneakers are a little big for his feet. The setting sunlight reflects off of his lunch pail as he walks behind me. Quite suddenly, the little boy sits down and states boldly, "Your name please." I look at him and can't help but smile. He is so innocent and sweet. His name is Sendil and after spending an hour helping him put together a new kite, I realize that it is time to go back to the hotel. I bid Sendil farewell and make plans to see him again. He is familiar with the hospital and will come there soon. I look forward to his visit and envision Sendil as a large help for my new project goals. He will be a tremendous resource for helping me navigate through the town.

Today, time is flying at the hospital. I have learned so much about the hardships faced by HIV positive patients. Many patients find it difficult to get to the hospital to pick up medication every month. For this reason, they often miss doses. Others cannot afford the food that is necessary to keep their bodies healthy enough to fight off infections. As I see my last patient, all I can think about is my plan for the rest of the day. I want to visit nearby villages and hear about the resources people need for dealing with HIV. Walking out of the clinic, I spot a sharp looking eight year old speaking with a group of doctors. Sendil is very quick to make friends. As I approach, the doctors get silent and walk away. I have yet to make friends with any doctors at the hospital. Sendil smiles and grabs my hand. He is eager to get going because his family has invited me over for dinner. I am excited at the prospect of meeting Sendil's family. Maybe they know people affected by HIV?

The bus ride is intense. Sendil is sitting far away because it is so crowded. He says that he will call out my name when the stop comes. After exiting the bus, Sendil leads me to a narrow street where there are small houses lined next to each other. His whole family is standing in line as we walk into the house. There are sisters, brothers, aunts, uncles, mom, dad, grandma, and grandpa. Sendil's mother grabs my hand and takes me to the washroom so that I can freshen up. They pin flowers in my hair when I return to the front room. The jasmine smells more beautiful than anything I can remember. As we sit down for dinner, Sendil's father and grandfather join us. They are very quiet. Sendil's mom serves us and keeps putting food on my plate. As I tell her that I am full she cries out, "No you are not full…Eat." She wants to know whether or not I am comfortable and looks at her husband before saying, "I have asked this lazy man sitting next to me to fix the chairs but all he does is read that newspaper." I feel very much at home in their house and dread having to leave.

After dinner, the younger kids fall asleep. I sit down in the family room with Sendil's mother and eldest brother. Sendil's mother says that she is eager for her oldest son to get married. He gets up promptly and leaves the room. She points in his direction and leans forward. "This boy won't even look at me when I start speaking about marriage," she whispers. Then, in a voice loud enough for him to hear she points out that, "the neighbors are starting to wonder why he won't get married." Her worried face disappears and she looks at me. I think this is the time to ask her if she knows any people in the area that are living with HIV. Her face becomes sullen as I ask the question. It is obvious that her answer is yes. Sendil's mom comes closer to me and says, "There is a lot of fear surrounding HIV from people who have it and those who do not. There are times when people do not go to the hospital because others in the village may suspect that they have HIV. So they stay back and get sicker. I do not understand those who just ignore their symptoms, their health. I know people who try to do everything and still do not get better. I can not bear those who do not even try." Her thoughts make me wonder if people are just too afraid to be set apart from their community by learning about their diagnosis. How do you help educate whole communities about the stigma surrounding HIV? I fell asleep that night thinking about how much work there is to get done. Perhaps it would be possible to find counselors to travel into the communities and teach people about HIV transmission and treatment.

In the morning, Sendil and I get on a bus to go back to the hospital. I keep telling him that he does not need to come with me. But he says that he wants to spend the day there. I spend most of the day researching different organizations in the area that help HIV patients. It is difficult to put together a resource list of organizations because the NGOs change so often due to loss of funding or project relocation. Later in the day, Sendil comes to declare that the clinic is closing in five minutes. I pack my things and get ready to leave. Sendil and I leave the hospital compound and explore the town. Near the end of the night, we get flavored fruit shakes, his is lychee and mine pistachio. This is the routine every night for the next week. I work during the day and explore the town with Sendil in the evening. I realize that there is a lot of work to complete on my project. I want to start looking into ways to get health educators out to the various villages to explain the symptoms of HIV, discuss treatment options, and educate about nutrition. For this reason, I tell Sendil that I will not be able to spend time with him. I send him home. He needs to rest anyway and fight off a bad cough and fever for which I feel partly responsible. I have kept him out late every night for the past few days.

At the hospital, I work with a nutritional counselor to put together tips for HIV patients. We work steadily with organizations in the town that help HIV positive people. Another doctor and I go into the community to speak with health care workers that may be interested in village health education. On the way to an NGO serving the town, I spot a small boy. He reminds me of Sendil and the fact that I have not seen him in many days. After work, I decide to take the bus to his house. His street looks darker than usual. Sendil's sister greets me at the door and wipes her eyes with a headscarf. I hope she is just tired. As I come in, Sendil's mother is nowhere to be found. His father sits in the living room and is staring at the floor. There is sadness in the house and I foreshadow that someone has past away. Sendil's grandfather has been ill for a few months. An older woman, perhaps an aunt, leads me to a room at the back of the house. "Sendil is very sick," she blurts out. As we enter the room, Sendil's mother sits beside her son who is sweating and very pale. "What's wrong? Someone needs to get him to the doctor, " I cry out. It is the first time that I have screamed or cried since coming to this country and the emotions are difficult to stir up. Sendil's mother takes me out of the room and tells me to be quiet. There is nothing to be done. Her son is sick and no one can help him. "Why not? We just have to get him to the hospital," I yell. She turns around and looks at me strongly. "There is nothing that can be done." Over the next few hours, I learn that Sendil spends most of his time with the doctors trying to find a treatment that his body will accept. He is not responsive to any ART medications. I pick up my bag and run out of the house as fast as possible. I find myself back at the hospital and fall down near the entrance. How could I not have noticed that Sendil is always at the hospital? That he was always speaking with the doctors? That he felt sick the whole last week? My goals for this project were so simple. I just wanted to help the people in the town find resources to help them with their HIV. But, I couldn't even help my best friend here. I didn't even see him the past few days.

Before leaving the area, I returned to the fort. It seemed so inviting. I climbed up the steps and found myself in front of the stone doorway that I discovered on my first day at the fort. The massiveness of the structure was surprising. It was impossible to see above or to the sides of the stone wall. I thought about my first day at the fort and wanting to walk through the stone doorway for a full view of the town. As I stood facing the wall, memories of my first meeting with Sendil flooded my mind. I remembered the way his footsteps sounded as he trotted around the pillars of the stone wall. I remembered seeing his curious young face as he stared at me. Most of all, I remembered how excited I was at the prospect having his help to learn about the town and how HIV affected the area. I stood up to walk forward and stopped. So many thoughts and questions came to my mind. During my project, I focused heavily on addressing the concerns of the community, finding resources for the town, and fulfilling goals. But, what did I really learn about the town and the people? If I was more attentive, perhaps I would have put together the pieces of Sendil's life and his story. Sendil taught me a lesson that I will keep with me forever. There are a million things that can be fixed, bettered in any community. If you fail to see the individuals, however, there is no hope of helping the town. Each person has a story to tell and a history. You have to listen to the people before creating programs and projects to help out a community. This was my failure. That day, I walked away from the fort and the town. Someday I will return and carry out my project in a different way. Only then, when I have met the people of the town and heard their stories, will I walk through the massive stone doorway atop the fort for a full view of the town.

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