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The
Neighborhood
8,000 Miles Away
By Rita M. Rooney
Her name was Nundemesa, and she was about nine years old, with chronic lung disease and all the symptoms of HIV infection. She stood out among others in the South African hospital ward because she looked much too comfortable there.
Scurrying about, like a little mother’s helper, she took younger children by the hand, and was seen feeding an infant. This place, where HIV-infected youngsters were cared for, was home to her. Her mother lay in a nearby bed, in the final stages of AIDS and tuberculosis.
Amisha Malhotra, MD, assistant professor of pediatrics, division of infectious diseases, one among many UMDNJ-Robert Wood Johnson Medical School physicians and allied health professionals volunteering on global medical missions to under-developed countries. |
Nundemesa was overheard crying herself to sleep at night, but during the day, she kept herself useful — one might even think happy. Then the time came for hospital rounds. The children linedup to be seen by the doctor, their mothers close by. Nundemesa was alone, because her mother was too sick to join her for the routine checkup. With bravado, the child stood tall and waited. Big brown eyes darted left and right, looking for a friendly face. The American woman they told her was a doctor saw her and smiled. Nundemesa managed a big, toothy grin in response. It never took much to make her smile.
The friendly face belonged to Amisha Malhotra, MD, assistant professor of pediatrics, division of infectious diseases, one among many UMDNJ-Robert Wood Johnson Medical School physicians and allied health professionals volunteering on global medical missions to underdeveloped countries. Dr. Malhotra was in South Africa for three weeks through a program sponsored by Bristol-Myers Squibb. Her days were long and hard.
“Conditions at the hospital and in the clinics were very bad,” Dr. Malhotra says. “There weren’t enough doctors, nurses, or HIV counselors. Ancillary services were lacking as well. We had to ship blood by car, over rough terrain, to another city. A child’s life often depended on that one vial that was at risk of being mislabeled or improperly collected.”
Patricia N. Whitley-Williams, MD, professor of pediatrics and chief, division of pediatric allergy, immunology, and infectious diseases, spent almost six weeks on the same Bristol-Myers Squibb tour to South Africa.
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“There was one hospital covering 15 clinics, none of which were equipped to handle pediatric disease of any kind,” Dr. Whitley-Williams says. “Clinics were housed in mobile homes with one waiting room. When it filled, people had to wait outside in 90-degree heat, followed by heavy downpours. Many were very sick and had walked for miles.
Prior to the program for the prevention of mother- to-child transmission of AIDS, conducted by volunteers such as Dr. Malhotra and Dr. Whitley-Williams, three or four children died each week from AIDS-related causes. Most were malnourished. Many had respiratory illnesses. When the American doctors weren’t treating children, they were training nurse-counselors to recognize the first signs of HIV in infants and administer Bactrim, a drug to prevent the pneumonia that is the leading cause of mortality in HIV-infected children during the first year of life.
Was it worth it to leave home and family, and spend their vacations in an underdeveloped country where a devastating illness claims the lives of so many women and children? Both women say it was, and that they are exploring the possibility of another tour.
“It was challenging, but I think we made a difference,” Dr. Whitley-Williams says. “That makes it worthwhile.”