Getting Tested.

Saturday when I had finished my work, I decided to go take the HIV/AIDS test. I took a moto to the private hospital only to be told that there was a fee for the exam. Because I had told the women that there wasn’t a fee, I was determined to not live a lie. I walked to the public hospital to find that the HIV/AIDS ward was closed.

I left my house this morning at 7:45 to make sure that I was the first patient seen in the ward at the public hospital. I went early for multiple reasons. One, I wanted to be discrete and not draw a lot of attention to myself. Two, I wanted to get it over with as quickly as possible. And three, I had a lot of questions and wanted to make sure they gave me the time to answer them.

The discrete idea went out the door when I walked into the complex. The man who cleaned the building asked me to wait outside. On the steps of the AIDS ward, I sat alone reading a book. Everyone who walked by greeted me and stared. Around 8:30 I was led into a room with chairs and a television. Then he asked me into his office. Quickly he revealed his roles as janitor, secretary, and nurse. He could possibly be a doctor or lab assistant too, but I was passed to another person before I had the chance to discover his other roles.

In the man-with-many-roles’ office, I was asked what I wanted. I told him I would like to be tested for HIV and he led me into a different office to ask a list of questions. This part was not hard for me, but I think it would be intimidating for Cameroonians. I was impressed with the list of questions and his explanations. For example he asked me if I knew the difference between HIV and AIDS? What are the ways in which the virus is contracted and how to prevent contraction? What will I do if I am positive? I then asked the price of the test and the price of medications. The test is 500 FCFA ($1) normally, but for the next two weeks the government is subsidizing the price and it is free. If your results reveal that you are HIV positive, you have to pay for your own medication, which can range from 6 dollars a month to 30 dollars a month. Once you have progressed to the next stage, when your immune system is extremely weak, the government then subsidizes your medicine. The man said this timeframe of getting sick to sicker is unknown. You make routine tests.  You can live with HIV for 10 years before anyone will know, but your immune system is constantly getting weaker. Possibly you will have frequent diarrhea or headaches. I was troubled with the fact that you have to get weaker to be given free medication. He responded that he didn’t like it either, but he had no control over the situation. The money is distributed by the government in Yaoundé. I asked him if he had seen an improvement in the past year, as I know the US has given Cameroon a significant amount of money towards HIV/AIDS. He said he didn’t know where the money was coming from, but that tests, consultations, and medication use to be much more expensive. He felt this change must have come from outside resources.

I was then led to the hallway to wait for someone to come and open the laboratory door. In the hallway I met no less than 5 more people who asked why I was there and my name. So much for confidentiality. I had my test number, but what difference does it make when you are being passed around like a celebrity. This is when I saw another white woman who ran up and hugged me asking me a laundry list of questions without stopping to breathe.  She is a doctor from Russia who speaks perfect French, is married to a Cameroonian, and has lived here for 27 years and frankly wants me to marry her son. She likes my eyes. I will never get use to the fact that the marriage question follows directly after the “where are you from” question. Each time it catches me off guard and I can never decide if I want to live a lie or not. I usually counter with, why does everyone ask me that? She continued to auction off her children for marriage and to tell me that she works in the Tuberculosis ward. I must go visit!

She then told the nurse to not let me go, take me directly to my test! Heaven forbid I wait! I was led into a closet sized room where a man in a white lab coat laid out all the test materials. He sprayed my finger using an AJAX bottle.

“Excuse me, is that really AJAX? Isn’t that a cleaning solution?”

“No,” he giggled, “it was AJAX but we’ve since filled it with alcohol.”

Ok… He opened the needle to prick my finger and didn’t wear gloves.

“Shouldn’t you wear gloves?”

“Well usually I do,” he said, “but really what difference does it make?”

“Well, if I am HIV positive and you have a cut in your hand, you could contract the virus too, right?”

He replied, “I don’t have any cuts and the needle could penetrate the gloves.”

He took my blood with a little plastic suction and put it in a litmus test. My finger would not stop bleeding and I said, “see this is dangerous! Who wants blood everywhere? You should wear gloves.” He handed me some cotton and through a smile told me to wait outside.

I was told to go sit in front of the television and wait. Less than 15 minutes later I was led back to the first office I had entered with a doctor I had not met. He had the results stapled together and held them in his hand. He closed the door and people talked to him through the open windows. They asked him why he closed the door and he said for confidentiality. Really, it’s confidential? Everyone out there can hear and is very attentive to the fact that I am here. Five minutes passed and two nurses walked in and out. This time seemed like forever. I had no reason to believe that I had contracted the virus, however sitting across from a doctor who is waving around a stapled piece of paper with my results and asking me what I will do if I’m positive did make me nervous as hell. After the nurses left, he opened it and asked me if I understood a couple different terms. As this was in French and I was nervous, I couldn’t think fast enough to respond. Finally I paused and then rebelled. Stop with the medical terminology and say positive or negative! He said, ok negative, have a good day. He shook my hand, opened the door and I left.

As far as the whole experience went, it would have been easier if I had someone with me, but it was much less painful than it could have been. I was impressed with many of the medical technicians that I met. I have no idea if there is confidentiality for Cameroonians. There definitely was not for me. I feel that the reality of taking a test that determines the fate of your immune system, the course of your sexual relationships, and whether you can breastfeed is scary. What is more frightening would be to test positive and then not be able to take medication until you are even weaker and the government will pay for it. If I were in that situation, I would rather not know, and can understand why people do not go to take the test. It is irresponsible, but making yourself an outcast with no options of medication is horrible.

On the same topic of medicine, it seems that there are only two illnesses here: AIDS and Malaria. When one goes to the hospital, it is like you walk in, sign your name, and bam! without questions, you have malaria. One possible reason is the in-pouring money towards the virus and malaria. The medication is often cheaper or subsidized and because malaria is a large problem, doctors just diagnose it for everything. I have a friend from Djilougou in town and she has been treated for malaria, but is still sick. She is returning to see the doctor today and said she knows she does not have malaria, but doesn’t know if they will treat her otherwise. Interesting to think how money towards one medical problem makes others be ignored. I also wonder whether if doctors stopped reporting X number of malaria cases, if testing and medication subsidies would be halted? Do doctors need to report a certain number of cases? There’s something to think about.

Go get tested. We all should know. That’s my two cents for the day.