On a recent school holiday, a few Acres of Love House Parents and a large number of our teens arrive, early in the morning, at Witkoppen Health and Welfare Centre for their quarterly appointments. Set in a suburb of Johannesburg, it’s impossible to see just how big the unassuming clinic is from the street. Once inside you find yourself in a compound of long buildings, courtyards, modulars, and smaller counseling buildings. This clinic offers our children regular check-ups by HIV trained clinicians, the proper ARV’s and medications, routine CD4 Count tests, and ongoing counseling support provided in pediatric group therapy sessions by the trained HIV counseling staff. In 2013, Witkoppen had 98,675 patient visits, and almost 77,000 of those were for HIV.
Even early in the morning, adults are lined in exterior hallways, sitting quietly on long benches while they wait through the day to be seen. Some are alone while others have children playing quietly at their feet. Nkosi (name changed to protect his privacy) and a few of our other teens file through the clinic, making their way to the brightly lit hallway of the pediatric wing. Here they stand in the queue, waiting their turn to be seen by the first nurse, who checks their vitals. Nkosi has his Witkoppen medical file, as well as his larger Acres of Love file in hand, chatting with his brother as they both wait. A friend who lives in another Acres Forever Home walks through the doorway and they high-five each other as they settle into their routine of waiting to be seen. Doctors here, and at other medical facilities, have been impressed that our children come with so much personal medical information. Each child at Acres of Love has a medical file that goes with them to each appointment, so doctors can see medical history and notes from other experts, as well as information on what other prescriptions the children are currently taking. Most patients who come here may not seen anywhere else.
After this first stop to the nurse in the pediatric wing, Nkosi and his brother get into another queue, this one to be seen by the doctor. The doctors at Witkoppen do an excellent job of empowering our children and teens to understand their bodies and their health. On this visit, the doctor explains to one of our boys the way his medication needs to work. His eyes light up when she explains that she is combining his prescription for daily multiple pills into just one tablet. When many of our children started with ARV treatments, they were taking “cocktails” of 20-plus pills a day at strict, regimented times. The advances made to allow for a one-pill-a-day ARV offer our children the opportunity to attend sleepovers, sleep away camps, pizza parties and the experience of a more carefree childhood. The doctor asks Nkosi how his swim team is going. He smiles proudly and tells her he just won three medals at his most recent meet. The doctor looks at his urine sample to check the health of his kidneys and then sends him on to take care of his blood work. Nkosi heads to another low building in the complex, where he sits in a new queue. After a few moments, his name is called and a nurse takes his blood.
Nkosi whistles as he leaves, and finds a small outbuilding where his brother and friends are waiting in a circle. Here they join a teen support group, led by a Witkoppen counselor, where the boys are able to discuss topics that include the medications they take, how to deal with HIV as a child, what it looks like to live a healthy life with HIV, healthy living and eating, and looking ahead in life. While the teens are in their support group, Nkosi’s House Mommy sits in another building, with the rest of the Acres moms who have brought children to the clinic today. They receive each of their children’s medications and have an opportunity to ask the medications specialist any questions about the drugs.
As the counseling sessions end, the Acres House Mommies collect Nkosi and the rest of their children to head back to their cars. Since today is a day off school, some of the families will stop by Wimpy for a special treat on their way home. In four months, each of these children will return to Witkoppen, for another morning just like today.
Over the last 15 years, we have watched a dramatic shift in the AIDS pandemic. In the beginning of our work, children and infants arrived on our doorstep, bodies ravaged by AIDS, and we fought hard and prayed harder for each of them. Most survived long enough to be eligible for ARV’s (Anti-Retroviral treatments) when they became available. A few were not able to hold on long enough. With each new medical advance in the treatment of AIDS and HIV, we have become more confident that each of our children can lead a healthy, long, and vibrant life, regardless of their medical status.
Today, around 45-50% of our children are living with HIV and many more are with us due to losing parents to the virus. They aren’t limited by this status, and they are living active, healthy, fruitful lives. Each of them spends a morning at a clinic like Witkoppen every few months; to check viral loads, receive new medications, and participate in counseling. In addition, our Acres of Love team continues to educate ourselves in order to better care for each child in our homes living with HIV. As our children grow and understand their medical status, we constantly communicate the importance of medical adherence in living healthy lives. Our team undergoes ongoing training at Witkoppen and other clinics so that we are well informed as we educate our children at each stage of their development. We know that AIDS is no longer a death sentence, but a chronic disease that requires proper treatment.