One evening in October 2012, a woman was admitted to the remote health centre in Cobue, Mozambique. Because of the Anglican Diocese of Niassa’s comprehensive ‘Salt, Light, Health’ community health project and many ‘Life Team’ activists who work in the Cobue region, Cobue offers better health services than most communities its size. She was very poorly, covered in infected ulcers all over large areas of her body. These raw wounds left her unable to sit up or walk. Cobue’s seasoned doctor, made woozy by these oozing sores, began removing dead tissue. A traditional midwife and the patient’s mother waved cloths to keep the flies at bay. Her prognosis was poor. But her name? Esperança. The Portuguese word for “hope.” And for Esperança, hope proved to be stronger than the bacteria that fought for her life. Today’s #StoriesofLoveComing is a Story of Hope.
A team of dedicated people worked for hours each day to clean Esperança’s sores. The process must have been agonizingly painful, but Esperança never complained or grumbled. Behind Esperança’s wounds lurked an even more concerning problem: her immune system had been decimated by HIV. Someone with a healthy immune system typically has a CD4 count of maybe 1000. A CD4 count of 350 or below indicates widespread damage to the immune system, and is a cause for significant concern. Esperança’s CD4 count was 12. She had first been diagnosed with HIV in 2008 and had faithfully taken her ARV medications twice a day, as instructed. But the ARVs were no longer working.
In hushed discussions with the doctor, those working with her compassionately hoped that Esperança could at least recover to the point of being able to sit up before she died. But three days into her wound care, with thousands of milligrams of antibiotics circulating through her body, Esperança greeted the health workers with glee. Giddy, she explained that she had managed to leave her bed overnight to go to the bathroom outside. This was something she hadn’t done in weeks. Esperança, already all too familiar with death (having lost her only child), now admits that death was on her mind during these days of hospitalisation. But that morning, her joy of having been able to get out of bed overwhelmed her thoughts of death.
A team of efficient and dedicated people in high places got authorisation from the national Ministry of Health for Esperança to begin a new regime of ARVs—a significantly more expensive set of “second line” medications that are only available to a small proportion of Mozambicans living with HIV. Within days, Esperança’s increasing mobility and healing sores proved that these new ARVs were effectively halting HIV’s reproduction within her body. Esperança continued to improve and was discharged from the hospital only a month after she’d arrived.
She arrived home to surprised celebration. Friends and neighbours told her they didn’t think she’d ever step foot in Mala again. The Mother’s Union from the church surrounded her with prayers of thanksgiving. Esperança had clung to the hope that too often eludes most of us. She had the courage to live beyond the facts, fully aware of the possibility of being humiliated in that hope.
William, a fisherman turned HIV technician extraordinaire and one of Esperança’s primary caregivers, explains “most people didn’t think she’d live to seek the weekend.” “I praise God.” Today she is still alive and farming.
Esperança wouldn’t be alive today without second line ARVs. She wouldn’t be alive if her family hadn’t received treatment and teaching about HIV from Salt, Light, Health and Life Team activists. She wouldn’t be alive if her mother, her primary care-giver over the past months, had given up. She wouldn’t be alive without the daily wound care she received from a team of informally trained lay people. She wouldn’t be alive without the thoughtful conversations between several different doctors, hundreds of miles apart. She wouldn’t be alive without the activists around the world who lobbied over the years for lower ARV prices, and the PEPFAR funds that made her medication available.
But the obligatory prerequisite to all of that was her own deep hope. Esperança’s esperança. She must have practiced living out her name for years. Only a well-practiced hoper could have hoped like she did.
You are Hope and you bring hope. Thank you for bringing hope to hopeless situations. May we too learn to hope like Esperanca and be living examples of Hope every day.
This story was from Rebecca Vander Meulen who has been working in Niassa for years, quietly in the background, exemplifying Love Come Down. She has told the Esperanca’s #StoriesofLoveComing. But she embodies that truth too.
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