As you’ve been following Felicity’s rapid progress over the last few months, have you wondered how ‘work’ is going? In March I started a new job, and I started writing this post… A few months have passed and I’ve finally got round to completing it (the post that is, not the job). My new job as manager of a HIV/AIDS project is supposed to be a half-time role but often spills over into all times of the day, night, week and weekend.
The project is aimed at finding the most hopelessly abandoned sick and dying HIV/AIDS patients in Ranong to dignify them with either a fighting hope or a peaceful death. For a western-educated professional, this is an utterly different world. At times of stress and overwork back in Wellington, friends and colleagues used to comfort me with the line “Don’t worry Andrew, no one’s going to die in a ditch”. True as it was then, I didn’t quite realize its gravity until I worked a job where that’s not true anymore.
In this world, the idealized rules we learn about at school, aspire to practice in society or teach our kids are rarely known and never work. In this world, the poor get poorer, the poorest get sick, the sick are abandoned, and the abandoned die – alone. Recent global events, the GFC and the Fukushima crisis, have been called ‘perfect storms’. It’s an image that’s hard to get away from when trying to describe the HIV/AIDS context here. Most of the Burmese here are migrants – enterprising enough to leave the idle destitution of Burma – but ill prepared to navigate the subtle and treacherous tides of migrant economic fortune.
The men often become fishermen on a Thai-run fishing boat. After a several-month-long tour of duty, they might be discharged in Ranong, giddy with their months’ wages in Thai Bhat, and no idea what to do with it. Without their family or community to guide their decision making, without any way to save or transport their money and without any idea when there might be more, without any notion of a plan, the quick and easy path to drugs and prostitution beckons. Months or years later their wives might make it to Ranong; just in time to catch the virus themselves and then watch their husbands die. Othertimes the wives come first and, being vulnerable young women in a foreign country, are forced to ‘take a new husband’ for protection and security. If they do manage to return to their original husband, it’s with a deadly souvenir.
Many others acquire the virus in the game of Russian-roulette that is admission to a hospital in Burma. With only one hospital in the country capable of screening blood for HIV, undergoing any procedure in the local hospital often means taking your chances with tainted blood. The healthcare system, as twisted as the regime, solicits blood by offering money. It’s no surprise then, that this scheme attracts those desperate for any sort of income – a group that naturally includes a fair number of HIV infected people.
I work within a little team of superheroes that tries to address the most basic needs of our patients. Fr. John, as director, makes sure we look after ourselves and remain true to the vision of dignity and compassion for all. Sr. Margaret, an RNDM sister from Burma, is the ray of sunshine that dispels the darkness of despair from the most dire situations and warms the hearts of the most hopeless patient. Meijay is the strong and calm one who silently accompanies those who can’t quite put their suffering into words – what better training to be a Marist Priest? Aon is our Thai translator and hospital liaison extraordinaire – translating for the patients and trying to get them medical care they would usually be denied. What they all have in common though are huge hearts, generous spirits and unfaltering devotion to the patients. My job is to make sure we use our resources effectively and efficiently, drive the car, manage patient records, churn out spreadsheets (my favorite part!) that track our progress against project objectives – and to make sure none of the patients are forgotten.
It’s a world away from the business of consulting engineering, but I find the skills I need everyday – organizing, prioritizing, identifying and managing risks, dividing tasks, motivating people and managing finances – are precisely the ones I developed at Beca. Big shout out to all my mentors!!
My job gives me a chance to both gain a bit of experience managing a team, as well as help some of the most poor, sick, and sorry folk on the planet in a real and tangible way. It’s an amazing feeling to be able to say that, through God’s grace, I was able to be the ‘good news’ to someone’s life today. It’s a profound opportunity to grow more human as I encounter people who cry out for a gentle human touch in their lives.
It will come as no surprise that there are, however, aspects of the job that I find hugely challenging. The language is the obvious one – while everyone in the team speaks (varying degrees of) English, the patients do not. My Burmese comprehension is coming along quite well now, and I can often pretty much catch whats going on, but it’s often best to avoid speaking lest my limited vocabulary isn’t sensitive enough for the situation.
I also find it impossible to relate to a good number of our patients. It sometimes seems that they conspire to destroy their own lives and the lives of those they love, repeatedly and with brutal cynicism in the incomprehensibly mindless choices they make. Sometimes I get angry. But mostly I’m saddened. Saddened by how reality can be so much more horrible than anything I can imagine. We found one of our patients, Ma Thain, a few days after giving birth to her second son, at home. She feared that she was positive so she didn’t breastfeed the boy. She couldn’t afford any formula so she was feeding him a mixture of condensed milk and water. Her first son, 11 months older than his brother, was similarly starving and was about the size of the then 2 month old Felicity. We immediately began providing her with formula for the babies and rice for her and her husband. Eventually we found out that she was told after the birth of her first son that she was HIV+. Whether she didn’t want to believe it or had no choice about conceiving the second baby is still unclear. She hasn’t told her husband as she fears a violent reaction. The reality is that they are all probably HIV+.
Do we tell the husband that his wife is positive? If he stays healthy, the family has a fighting chance of earning enough to support themselves. If we do, he might abuse or abandon her for infecting him. He might be positive already, but we can’t find out without breaching our confidentiality with Ma Thain, and potentially putting her and the babies at risk of serious physical injury. Do we provide ARV medication to anyone in the family? The father? The mother? the babies? We can’t provide it to everyone.
This situation might sound like a fictional dilemma that bright eyed, well educated young people might relish discussing over a few drinks so we can demonstrate our brilliant command of ethical decision making or our supremely sound judgement. Unfortunately it’s all too real and all too common here in Ranong. 10 years ago, a younger, wiser version of myself would have solved this and all my other dilemmas with a one liner; with a sweeping ideological statement that provided a perfect solution. Now I can only reflect on the monumental foolishness of the notion that a great idea or two, a decision brilliant as it may be, can always redeem a poor choice.
For most of our patients, there is no brilliant idea around the corner, no crucial decision that can quickly unseal their fate. I think most of our patients accept this. Perhaps they don’t know any better; perhaps it’s that stubborn Buddhist acceptance of suffering. But not I. My Christian faith, my experience of of life, my family, my wife, my daughter, all teach me to fight for life. Fight for the chance to find the goodness in life, to see it’s beauty and taste it’s hope. How hard it is to reconcile the two! And perhaps that struggle, that conflict of ideas, that tug-of-war, is the hardest thing about my new job.
P.S. Oh yes one incidental side-effect of my work is that I’ve developed an insatiable loathing for the selfish, the self-centered and the materialistic… I’m sure you find this understandable.