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Almost two years passed before
I managed to save the money and return to Ecuador last September.
I was trying to follow-up on Doņa Carmen, an Ecuadorian woman
who had been HIV-positive for 10 years with no symptoms. Her
five-year-old daughter had died of AIDS, there being no medicine
or treatment available. I met Doņa Carmen while she was caring
for another HIV-positive woman, Doņa Teresa. Doņa Teresa had
died of HIV complications one month before I had last returned
to Ecuador.
Expensive, intermittent access
to HIV meds, no government or social support and shame will
do that to infected women in less technologically developed
countries.
Doņa Teresa left two daughters
in the care of Doņa Carmen. No one else, it seemed, wanted
to be bothered with anyone with HIV. It was left to the small,
personal, shared caring of those individuals living quietly
and socially isolated by having the virus. I simply could
not imagine that Doņa Teresa had had her children tested for
HIV. To have children tested for the virus in this very conservative
country first meant having the economic means to do so, and
secondly, even more significantly, having to disclose that
you yourself had the virus, and risk severe social ridicule
and ostracism.
Too, too hard.
I was, then, hoping to see
how Doņa Carmen was faring. I work with HIV-positive individuals
in the U.S., and wanted to see how a woman with HIV and no
symptoms (thank goodness, for the only medicines available
on a half-assed, arbitrary basis is AZT, which given alone
was long ago considered sub-standard in this country) could
continue to not progress to AIDS with no antiretroviral medications,
be alive, well, and healthy after having HIV for so long.
I wanted to hold on to that
sliver of hope that Doņa Carmen had not progressed to AIDS.
Especially since there is so little HIV medicine, and few
doctors in Ecuador who have knowledge of HIV/AIDS to be able
to successfully treat patients. Or the personal or medical
will to do so.
In the two years since I
left Ecuador, Doņa Carmen never responded to my letters. Never
told me how she was doing. Never told me how the daughters
of my deceased friend Doņa Teresa were faring.
The mail system in this Andean
nation of some 12 million is, shall we say, sporadic. Some
letters and packages get through. Sometimes, lots of times,
they dont. Sometimes packages from the U.S. get opened; sometimes
letters get read. I wondered if that was the reason that Doņa
Carmen never responded to my inquiries as to her HIV status.
Then, too, how often was it that she went to the post office
to mail a letter to anyone in the U.S.? That would be noted,
and remembered. I also assumed that she was literate. Perhaps
my formal, academic Spanish was hard to comprehend.
I also remembered that Doņa
Carmen was barely eking out a living as a health educator.
No one paid her a consultant fee or an honorarium for coming
out publicly about her status. With no extra funds, buying
a pen, paper, envelope and a stamp would be a frivolous luxury.
Not to mention the cost of getting on a bus to go to the nearest
post office to mail the letter.
Which is why I decided to
travel back to Ecuador, to see with my own eyes how my friend
was doing.
She was not available. In
the two weeks I was in Ecuador, I tried contacting everyone
I knew who knew her. My former Peace Corps program manager
had not heard about Doņa Carmen in almost a year. Another
person, a wealthy and well-connected German woman who had
lived in Ecuador for more than two decades and had been giving
money to Doņa Carmen to care for my deceased friends two
daughters, was in Germany while I was in Ecuador.
I gave it my last shot. I
took the eight-hour bus trip from the nations capital, Quito,
to Guayaquil, the second largest city in the country, where
Doņa Carmen lived on the outskirts, to see if I could find
her or someone who knew her.
Doņa María was a professional
woman employed by a nationally recognized family planning
and health agency in Ecuador, and knew Doņa Carmen. She had
invited her to come and speak at talleres (workshops) on
reproductive health and sexually transmitted diseases. Doņa
María said that she had not heard from Doņa Carmen in more
than a year. The last she had heard, Doņa Carmen had gotten
tired of being asked to disclose her status by public health
agencies. While Doņa Carmen was publicly applauded and much
admired and supported for going public about her HIV status,
and of the death of her daughter from AIDS, afterward she
was reviled, humiliated and made the subject of much negative
gossip.
So Doņa Carmen went into
hiding. She was unavailable due to her HIV status. She tired
of being the only public HIV-positive woman in the entire
country of Ecuador! I could imagine what a cumbersome, negative
burden that would quickly become. Somewhere in Guayaquil,
along with the daughters of my deceased friend, Doņa Carmen
was living a quiet life. I hoped.
I left Ecuador one day later.
In my thoughts and spirit, I sent Doņa Carmen and the daughters
of Doņa Teresa all my long-distance support, compassion and
prayers. It was all I could do. They could use that. And so
much more.
Corella Payne, M.Ed.,
MPH, is a returned Peace Corps volunteer (1991-1995). She
works with HIV-positive women, dedicating herself to serving
the African American community through South Side Help Center
in Chicago.
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