Wednesday, July 14, 2010

The Basotho Woman

In America, we have the image of the stereotypical suburban housewife: the one who can do the dishes, clean the house, and cook the meals all while wearing the perfect pair of heels. Although, that idea of extreme composure and poise is one that I respect, I'd much rather be referred to as a Basotho woman.

Even though they're much more suppressed in the society in which they live, I’ve come to see the Basotho woman as a symbol for strength and composure in the midst of a storm. In the more mountainous regions they’ll walk for a day and a half with a baby swaddled on their back to reach the nearest clinic.

It’s always interesting to watch the women unstrap their babies for examinations in the clinic. They unclip their blanket and take it off to reveal a second towel or blanket keeping their child strapped to their backs. The towels are tied once underneath the child’s bottom (securing their legs), once more around the child’s torso, and then all corners are tied around the woman's chest. Then, when it’s time to leave they’ll lift the child to their shoulders, the child will lock his hands around her neck and then the woman will gently swing him over her shoulder, so that he lies securely on her back. Then the towel and blanket are tied once more.


They'll also lug water for miles in the more rural areas and will often help care for the cattle, sheep, and chickens their family owns. They cook the papa, morojo, and stews and tend to their gardens meticulously as these growing fruits and vegetables are the family's only guaranteed food source.


Whenever I'm walking through the clinic and look a mother in the eyes, I often feel a need to avert my eyes; I feel like they know that they've handled much more than I ever will. Whenever I make that eye contact, I feel like, in some kind of inexplicable and disconnected way, I'm seeing a fast-forward version of all the hardships they've been through and that each second I spend holding my gaze, I'm witnessing all the sad events that they never gave me permission to see.


It's usually the mothers who bring their kids to the appointments and, every time they do, the doctors ask them if they've been tested and are on treatment. They'll almost always say yes to the first (as they're usually the ones who gave it to the child during pregnancy) and, about half of the time, will say no to the second. They're often so wrapped up in caring for their children and are already pushing the limit to the number of possible vacation days taken to care for their sick child, that they simply can't afford to take the time to care for themselves. Even though it's a pediatric clinic, they'll often take the moms on as patients to help them care for themselves and to have a chance to live long enough to see their children grow up.


After these questions, they'll ask if "ntate" (the father) has been tested. The usual answer is no and, even though the doctors tell them they need to drag him in for testing, they know that, not only will the men often refuse to test and blame the fact that the child is infected on the mom, but are often unaware of their own child's status.


The child and caregiver (usually the mother or grandmother if the mother is deceased) are given disclosure and adherence (basically, learning of the importance of taking the pills) counseling when they're initiated on ARVs (antiretrovirals, the drug regime given to treat HIV). However, the mom will sometimes never mention the status to the father or other family members because of the negative stigma placed on those tested positive. Often times if the father discovers their child's status, he'll beat and punish the mother for "bringing it upon their family." (I'll never forget the time a woman asked for one of the doctors to look at a bump on her head. The doctor asked what happened. She nonchalantly replied that her husband had hit her with a brick. As if it was something to be expected.) The fact that the mother is sometimes the only one who knows the child's status becomes an issue if the mother passes away. All the family's left with are mysterious pill bottles that they assume do something good for the child, but the extent to which the child needs the pills is unknown. No one is then there to administer the medicine and no one is there to explain what is happening when the child suddenly becomes extremely sick.


When we first arrived here we were given a series of lectures about HIV/AIDs in Lesotho. They covered everything from the origin and cause of the pandemic to treatment and prevention. One of the Basotho doctors here gave the lecture on adherence. After she finished, she told her story. She had gotten married and had a child, but her son soon became very ill. She took him to a clinic and soon discovered that he was positive. She was then tested and was told of her status as well. When she finally mustered up the courage to tell her husband, he refused to test and insisted that there was no possible way he had the virus. She continued to beg him to get tested and receive treatment, but he continued to say no. Finally, she mustered all of her strength, packed the few things she had, grabbed her son, and left. A short while later, the father passed away. They couldn't disclose the real cause of death to his family because the family refused to believe that he could possibly be positive.
She and her son take their ARVs every day and, because she took the initiative to get tested and seek help, are both leading happy, fully functional lives. She is also now one of the doctors empowering and treating other women and children to break the cycle of illness and oppression and helping to create a new generation of strong Basotho women.

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