Julianne and I recently spent a morning at the pre-natal clinic at Macha hospital. Once a month, the hospital holds a clinic for expectant mothers and mothers with young children. One of the benefits of Julianne being pregnant (aside from, you know, the creation of a new human life) is that it is allowing us to experience the care of this hospital that is at the centre of our community here, and without having to get malaria or break an arm. Everyone we have interacted with at the hospital has been absolutely wonderful, and the care has been excellent.
The clinic was an interesting experience. Couples who are expecting a baby are required to attend a session as part of their registration with the hospital. Since the class is normally conducted in Tonga, the local language, we were treated to a private version conducted for us in English by one of the nurses.
He was professional and thorough, taking us through topics such as nutrition for pregnant women, what to expect during the birthing process, and how to monitor your baby’s health and growth after leaving the hospital. He did laugh a little as he took us through some of the material, which I think he was required to cover but which he knew probably would not apply to this couple from Canada. I learned, for instance, that I should give Julianne a break from working in the fields during her pregnancy. I have dutifully complied with this instruction.
One of the standard parts of the registration is for both parents to take an HIV test; the test is not a requirement but is strongly encouraged. The HIV pandemic has hit Zambia hard, with and adult prevalance rate of nearly 22% at its peak. And while education and prevention efforts of the last couple decades have helped bring the rate down, the statistics say that even today nearly one in eight adult Zambians carries the virus. The testing of expectant mothers is particularly important, because the virus can be passed on to infants. There are ways to prevent this, or at least reduce the risk, but only if the mother’s status is known.
Julianne and I were both tested as part of our registration with the hospital. After filling out the consent form (the first form I have completed in my life where I have been asked to indicated how many spouses I have), I had my finger pricked to get a small amount of blood. For Julianne, since her body has a slightly more central role to play than mine in the whole pregnancy thing, a few more tests were required. After these were done, we were told we would have our HIV results in a matter of minutes.
Getting the actual results was an interesting experience. The nurse we had been working with had a certain flair for the dramatic, so he built up the suspense a little. He put the papers face down on the table.
“I have your results here. But first, let’s talk a little. How would you feel if you were negative?”
“Good. And how would you feel if you were positive.”
“Do you know that at this hospital we have a very good program of medicines for supporting those who are positive?”
“Yes, I did know that.”
“And if you are positive, will you take advantage of that program?”
“Well, yes, I suppose would.”
Now, I am pretty aware of the behaviours that can put you at risk for HIV. And I am pretty aware that the frequency with which I engage in those behaviours puts me in a pretty safe spot in terms of the likelihood of getting HIV. But if this guy kept asking me any more questions, I think I might have started to worry that I might be seeing a “positive” on that page.
At any rate, the suspense was about to end. He flipped the results over, and with a deft cross-handed manoeuvre he put my results down in front of Julianne, and her results down in front of me.
Both negative. Which was not a surprise. What was a surprise was this you-see-hers, she-sees-yours approach to sharing them. It doesn’t strike me as the kind of thing that would happen in our privacy-conscious culture in Canada. But as I thought about it more, it made a lot of sense. In a culture where women do not always have the say and the rights that we take for granted in Canada, this gives a pregnant mother a clear view of her partner’s status. It gives her information she might not get otherwise — information that may help her protect herself and her baby.
I am thankful for Macha hospital. I am thankful for the role it plays in the community here. And I am thankful that, while we are getting ready for this new little life to join our family, we get to experience first hand what a wonderful place it really is.