Hesperian Health Guides
Chapter 1: HIV is no longer a death sentence
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Every year since he was 7, Lefa has been too sick to sit for his end-of-school-year exams, so has never been promoted, returning every year to grade 3. Although he is now 10 years old, he is the same size as the 7-year olds in his class.
Lefa has lived with his grandparents since his father, a long-distance truck driver, died of AIDS, and he and his mother Justina came to live with her in-laws. They were glad to turn over the cooking and cleaning to Justina, but soon she too became ill. She started having headaches and seizures, and there were days she could not get up from bed. Before she died, she made Lefa promise that he would take care of his grandparents.
But Lefa did not grow well, and it was more and more difficult for him to clean the yard and help in the garden. Lefa’s grandmother knew that something was wrong, but she did not think of HIV. No child his age could have HIV and still be alive. And even if he did have HIV, what could they do? There had been no help for her son and Lefa’s mother.
By the time Lefa was 11, he was sick most of the time. He hardly ate anything and was always coughing. As she had many other times, his grandmother took him to the clinic – a four-hour walk, and then an hour in an expensive taxi to get there. Luckily a new doctor had arrived, one who was committed to treating HIV in children. She took blood for a test and told him to return the next week.
Although it was a hardship, they came back. The journey just about wore Lefa out, not to mention his elderly grandmother. The doctor gave ART medicines to Lefa’s grandmother and explained how and when the child should take them. She encouraged them both, saying the treatment should help Lefa recover his health.
Lefa is unusual because most children with HIV who do not get treatment will die before they are 1 or 2 years old. For whatever reasons, he was strong enough to fight HIV for 10 years, although it often made him sick, stunted his growth, and left him weak. But as soon as he started taking antiretroviral medicines, he began to improve. Imagine how different his life could have been if he had started antiretrovirals when he was a baby.
Starting a child on ART as soon as you know she has HIV is best for the child. It is the recommended and increasingly the real practice throughout the world. The sooner a child starts taking ART, the more strength she will have to fight other illnesses, to develop her mind and spirit, to grow physically and to live a full life — she can even have children of her own if she wants to, and then play with her grandchildren!