Tuesday, November 25, 2008

Mortuary

Last week I went to the mortuary with Nthabeleng to pay the fee for an 8-year-old TTL client who had passed away. The girl’s grandfather asked TTL to pay the fee and to transport her body from Mokhotlong to Molikaliko, a nearby town. The mortuary is on the hospital grounds, just across the road from TTL. We entered the building tentatively. A man wearing a surgical mask sat at a table taking notes, and to our left an open door exposed a naked male body lying on a table. Taken aback, I looked away.

The man gave us a slip stating how long the girl’s body had been at the mortuary, which we then had to take to another building where the bill could be calculated. We were also handed the girl’s bukana—the book that contains all medical records throughout an individual’s life. Flipping to the last entry, we saw an urgent note from the Mapholeneng clinic stating that the girl had presented as comatose after a period of vomiting, and that she had apparently been taking two prescriptions of ARVs for four days. The note ended with a command to stop all medications at once and refer to the hospital. Unfortunately, the girl died upon arrival.

Very hard to know what to make of all this. Against all odds, this girl had survived with HIV until she was 7 years old, when she was finally diagnosed and prescribed ARVs. After she started her medication her health improved, and the account in the bukana shows that on her last clinic visit she presented with no complaints. It is not entirely clear whether the overdose of ARVs caused her death, but the timing seems suspect. We spoke with an American doctor who saw her at the clinic, and she suggested that it could have also been meningitis, but that there appeared to have been some horrible miscommunication regarding the drugs as well.

Ellen rode in the outreach car the following day to bring the girl’s body home to her remaining family. They had to pick the body up at the mortuary, wrap it in a blanket, and place it in the trunk of the car. If TTL didn’t perform this service, apparently a family member would have to take a taxi to town, and then return with the body in a crowded combi. Though it seems like such a bare, bare minimum, at least TTL could do this small act.

Ellen said that the mourners were gathered at the rondavel when they arrived, and when they carried out the body the girl’s older sister began wailing hoarsely, like she had been doing nothing but that for days. She, who had buried her mother three years ago, then had to bury her sister, a victim, though perhaps in a different form, of the same terrible disease. Yes, very hard to know what to make of it all.

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