African Queen

The first time I saw Hawa, she was wearing the orange batik fabric of Orphanage Africa in a traditional style, complete with matching headdress. She was outgoing, in a quiet way. Regal, in an African way. She didn’t speak much, but she exuded strength, grace and calm.

Hawa and OA met last July when she happened to walk by the Well Women’s Center in Frafraha. Though she was 8 months pregnant, she weighed only 35 kg and was very anemic. Terri Clifton, the former director of the WWC, beckoned her over to tell her about the antenatal care available. The protocol for the WWC was to have all pregnant women tested for HIV; if they did, then they could access certain services and drugs for free.

Some women who came to the Center would not agree to be tested, but Hawa came back and Terri took her to St. Martin’s for the test. The result came—positive—and OA was there to support her both financially and emotionally. Vera and others at OA have been her support network, since for nearly a year, Hawa has kept her status from her husband and mother, fearful of how they might react.

Her husband, a difficult man who was away on business when she delivered, might accuse her of bringing the disease into their home. She knew she couldn’t tell him herself, that he would need counseling. Her mother still holds the common belief that only prostitutes get such a disease; Hawa was also worried that the news might seriously affect her mother’s already high blood pressure. So she stayed quiet at home.

She gave birth to a son she named Inusah: Innocence. At first, Hawa didn’t breast feed, since that increases the likelihood of transmission of HIV to the child. But he got sicker and sicker and wouldn’t take any food, so she had little choice. Inusah died before his 6^th month. Hawa started to take drugs after that and her health has improved drastically. She now weighs over 62 kgs. The drugs cost 4.5 million cedis/month, but the government provides a subsidy so that it is only 50,000. OA helps Hawa pay this.

She told me these details several weeks ago, under the shade of a tree in her front yard, her hair in curlers. We shifted our plastic chairs back; a neighbor washing his laundry was within earshot and seemed to be straining to hear us.

It was only the day before, on the 13^th of May, that her own husband went to be tested and found out he was positive. After several illnesses, he had finally agreed to go with Vera. Hawa pretended not to know she was positive and was re-tested.

When the counselor told the husband, she asked him to whom he would break the news. He said Hawa. The interaction that followed was surprisingly ok.

“They say that I am HIV positive…I love you; will you still be my wife?”

“I am also positive. We will stick to each other.”

Back at home, though, the husband could not accept the result fully, saying the doctor told him he had a virus, not AIDS. He is reluctant to take the drugs, claiming that the doctors were just trying to get money from him. But he also apologized to Hawa, saying he knows he is the one responsible for bringing the disease. He tells Hawa not to tell anyone of their status, because then no one will come near. “Don’t even tell the stones in the front of the house or they will want to move!”

The stigma is what kept Hawa from telling her husband and her mother. But three months ago, she began to speak out to others as part of OA’s outreach programme.

“I saw the thing is real and want to reach out to people because I know. When I go on reach out, most mothers with HIV always worry their baby will die. I have to tell them that there are some children with HIV positive mothers who become negative. I tell them that they should only be happy and have love for the child.”

Hawa has to leave her house at 5 am to get to an Accra clinic each Tuesday by 7 am, when the pregnant women come for check-ups. This morning, Hawa wears a small heart with an “I” engraved on a silver chain. I ask her what it stands for, anticipating Inusah, but she tells me she doesn’t know, that her mother gave it to her.

She stands before the women and tells them her story. She can’t tell her own family, but she can these women. She advises them to get tested for HIV because it is better to know your status. For many women, this is the first person they have meet that they know has HIV. Even for me, Hawa is the first. She doesn’t look frail, she doesn’t look like she’s dying. If she could have it, what’s to say you might not too?

Hawa gives a similar talk each week at the largest local hospital’s Maternity Ward. She does outreach at churches and schools. Once a week she visits the hospital’s Fevers Ward for HIV patients. She encourages them to take care of themselves, to take their drugs. These patients are the ones you might envision when you think of HIV. They are very sick. Most did not know they were infected till the disease had already progressed significantly. Most did not start drugs as early as Hawa.

The women at the clinic, over 150 in the waiting area, have plenty of questions. Usually the first question is how she got it, since a common belief is that only prostitutes have it. Can you sleep next to someone with HIV? Eat with them? If you get the virus, how do you know? How did you feel when you found out your result?

The nurse announces that the next question will be the last, but you can see that there are more. The women clap for Hawa, for her courage. “God bless you!”