LUSAKA, ZAMBIA — The sunny and spacious grounds of Kasisi Children’s Home are filled with playground laughter, the aroma of Sunday lunch cooking, brightly painted rooms, walls decorated with artwork from small hands. About an hour outside of Zambia’s capital city, in the middle of a gold and green landscape, this is a happy and healthful place.
So, even though you know why this place is crowded today, it knocks the breath out of you when you round a corner and see the quilt hanging on the wall in memory of children who have died: Moses, Memory, Elina, Lister, Mercy . . . and their ages: 10 months, 6 months, 1 month, 6 months, 3 months . . . Two more lines of names: Taurai, Prisca, Jane, Sarah, Andrew, Deborah, Abigail, Francis, Widson, Winnie; the oldest 9 years, the youngest one month. Gone before help came, one of the sisters says. “If you start crying,” she warns, “I will finish for you.”
All of them, the ones memorialized here, and on another quilt with 12 more names (Jacob 13, Jason 2, Emmanuel 9, Angelo 6, Benny 5, Moses 3, Mary 1, Alfred 2, Towela 10, Kebby 1) never had a chance in the years before medicine to save their lives made it from one side of the world to the other.
Before antiretroviral medicine to treat HIV began to arrive at the Kasisi Children’s Home, a little more than a decade ago, 20 to 30 children died every year here. That was when the ravages of the AIDS epidemic were peaking in this orphanage started by Dominican Sisters in 1926. Today the place is home to more than 250 children. About 60 of them live with HIV, more have lost their families to the epidemic, and all, by virtue of living in a country where about one in seven adults lives with HIV, are affected by the epidemic. They are infants, toddlers, elementary school students, teenagers, and college students — in England, the U.S., Zambia — whose accomplishments and plans the sisters proudly describe. Still, Sister-in-Charge Mariola Mierzejewska says, they lose a child, sometimes more, every year. Right now several children are in the home’s pastel-painted hospital wing, sick with tuberculosis, liver disease, heart damage, all HIV-related.
Sister Mariola came here 25 years ago. She remembers when the first children who were known to be sick from HIV arrived, when government policy still said the place couldn’t keep children with that virus that they didn’t know for certain how to contain.
“I could only keep the children in my room,” she said. “Until they died.”
Most of the children have a chance now. Some arrive only after the virus has become immune to the medicine that would otherwise have saved them. They are diagnosed and start getting the medicine, Sister Mariola explains, and then, when their mothers die, they stop getting the medicine. Some were already resistant to first line medicines — the most effective and least toxic drugs. When their virus becomes resistant to the next alternative, they are running out of time. And Sister Mariola adds, “Drugs will not help, if you don’t give them a good diet.”
The drugs now come from the Global Fund to Fight AIDS, Tuberculosis and Malaria. The President’s Emergency Plan For AIDS Relief supports a school the children attend. On this August day a team of American dental school students and their professor are donating services, particularly important for children with HIV. With this help, most of them can have the kind of life you want for your child, Sister Mariola says.
“The oldest one is twenty-two now,” she says, “and she is as fine as any other.”
One of the party of congressional staffers visiting today asks what they can do to help.
“You just continue what you are doing,” she said. “Because of you we get drugs. Because of you we can help the children.”