Pearl sat in the Clinic waiting room nervously flipping through an ancient magazine.
HOW TO MAKE BEAUTY TREATMENTS WITH WHAT YOU HAVE IN YOUR KITCHEN! blared the title of the article. Egg-white face peels...Avocado face masks...Cucumber face masks, exfoliating scrubs with olive oil and table salt...
“Mrs Chabalala? Please come in.”
Pearl got up and walked into a tiny white cubicle hung with bright wax-crayon pictures of vegetables and fruit drawn by children of varying artistic ability. The nutritionist, a tiny woman in a white coat ushered her in.
To one side was a dented filing-cabinet painted bright red and a scale, a tall sliding ruler with which to measure children’s heights; next to the desk a white wood and glass medicine locker with lots of vials and bottles with colourful liquids and pills inside. And two chairs, of course, one swivel chair behind the desk, and the second - wood painted sky-blue - looking distinctly rickety and overworked, opposite it. The woman gestured invitingly towards it, and Pearl gingerly lowered herself into the chair. It squeaked, and Pearl cleared her throat. "Hello."
“Hello, Mrs Chabalala. I have here Thalie’s reports forwarded by Dr de Bruin's office and his recommendations.” The tiny woman smiled, “Next week, you bring in Thali, but I like to meet the caregivers first , to see what the family situation is, so we can be completely honest; and understand and help each other.”
“I am not Mrs, I am Miss Chabalala - Pearl - and that sounds very fine to me.”
“Pearl! How pretty. Pearl are you Thali’s Mother?”
“No Madam, I am not. But I look after her, and I love her very much.”
“Pearl, I ask this - you don’t have to answer - but I ask for good reason: are you HIV infected?”
“No, Madam, I am not.”
“Good. It is hard to deal with a sick child. Harder still when you are sick yourself. This way, we need only worry about Thalie.”
“Please, Madam? What is your name?”
“OH! I am sorry Pearl! I am Heather Umlozi, I am a nutritionist, that means I will help you to choose foods - plan a diet - to keep Thalie stronger for longer.”
Pearl smiled. “Yes Madam, I know that.”
“Good! Now! I see from what Dr de Bruin says, Thalie is small for her age, and thin.”
“Yes, Madam, she is.”
“That is common in HIV positive children. You see, the children with HIV use up more energy than healthy children, and the sicker they get, the more energy they need. Now, a lot of people have trouble giving their children the right food. Because they are very poor or live in a place with no refrigerator.”
“We are not poor, we are very very lucky. We have healthy food, and a refrigerator, and clean water.”
“Excellent, but having good healthy food does not mean it is the right food for a little girl like Thalie. Thalie must eat fats and proteins and vitamins. The right kinds of foods. So if you make pap for the family, for Thalie you add a spoon of butter."
Pearl frowned. "Butter? Not margarine?" She took a small notebook out of her purse and a pen.
"Yes, butter, if you can get it! Now for a fat child you would not do that. She does not need extra fat or energy. With a fat child we must encourage the body to burn what is stored. But Thalie has nothing stored. So we must give what she needs for a normal life, and a little more to fight with, and another little bit to encourage her to store up a little fat. Maybe put on some weight. "
Pearl nodded. "Butter..." She wrote it down, "In the pap..."
"So in the porridge or the pap you add a little butter in the morning, or you beat an egg and mix it in when the porridge is cooking, or the mash potatoes. But always cook the egg very well. Raw eggs may have bacteria, so no eggs sunny-side up; or soft boiled, OK?"
Pearl obediently made a note: ALWAYS COOK THE EGGS...NO RUNNY EGGS! She sighed, Thali loved her eggs sunny-side up...
"Scrambled eggs or boiled eggs or mixed in the food, are a very good way to add extra protein. Foods like beans are good for protein too, though animal protein is better. But if you can’t get it, beans are very good. Nuts too. Nuts are vegetable meat” She smiled, which brings us to my favourite! Peanuts! I love peanuts. Very good food for skinny children, bad for fat children!”
Pearl smiled “Thali loves peanut butter.”
“Most children love peanut butter.” She nodded at Pearl, “I know what you think. Very expensive in a supermarket, peanut butter, but easy and cheap to make at home. And healthier too! I will give you a recipe.“ Pearl nodded and made another note in her little book.
“Vegetables, now. Very important. She must eat them.”
Pearl sighed: “Now that may be a problem…”
“For the little ones I tell the mothers to use colours. Green, and red, and yellow and orange…AND never soak the vegetables too long, takes away the vitamins. Like when you have your hands in the water too long? And your fingers get wrinkly? Soaking is bad for nutrients. And I tell you a secret, vegetables are even better for you if you eat them at the same time as oranges, or with lemon juice. Vitamin C mixed with the vegetables makes it easier for the body to use the nutrients.”
“What if I liquidize carrots in orange juice?”
“Good idea, very good idea. She eats the vegetables AND the vitamin C combined!"”
Pearl smiled back, and Mrs Umlozi continued: “Every day, Thali must eat a little extra something to give her that special energy. So between breakfast and lunch maybe you give her a slice of bread or two with peanut butter, or a glass of milk, a little later maybe a hand-full of nuts, like this!” And she cupped her hand to demonstrate.
“If you can - and you have said you have means - a banana and a slice of cheese. Or mash up an avocado with a little sugar, it is very good nutrition. Fry onions, add them to the mash, or the pap.” Mrs Umlozi frowned, “And make sure, always that your kitchen is very very clean. Your pots and pans, your plates and cups, your forks and spoons. Bad germs give children like Thalie bad tummy problems. They get diarrhoea or vomiting, and that makes them even weaker.”
Pearl nodded. “So everything very clean, all the water boiled, all the vegetables washed very clean.”
Mrs Umlozi nodded. "Yes. Thalie's biggest enemy will be infection by bacteria or viruses that will take advantage of the fact that HIV has left her with very few defences. we must build her strength, keep the energy level high, so the medication can help her."
"Yes, Dr. de Bruin has given me the prescription. He asked me to speak to you about how to give it to Thalie."
Mrs Umlozi sighed: "It does not taste good at all, but she must take it. An adult will understand, but a child, no. So mix it in with a small portion of something to disguise the taste. Like ice cream, or peanut butter, or jam. But it must be a little bit only, so you can be sure she eats it all and takes the full dose."
Pearl smiled. "Ice-cream...Thali will eat huge amounts!"
"Now, yes. Later...Later maybe not. Thali has been fairly healthy?"
"Yes! Only thin, and small. But happy, and healthy, with so much energy!"
"When did you notice she was not growing?"
"We have only had Thalie a few months. She was living on the streets when we took her in, so we thought that was why she was so thin."
"I see. She is a very lucky little girl. I wish all my children were as lucky."
"Lucky, Mrs Umlozi? Thali has a deadly disease. She may not live another year. How can she be lucky?"
"Pearl, every day I see AIDs orphans who have no-one to care for them; or if they do, the caregivers are afraid of contamination and don't hug them, touch them, show them affection. I see children who do not have the most important sustenance: love. Your love will feed and sustain Thali's spirit, even as you feed her body with nutrients and medication. Again and again, I have seen that where there is a passionate love for a child, miracles happen. No healing, my dear, but happiness for that child in the time they have, and quality of life. Love equals quality of life. I wish people understood that."
Pearl nodded, "I agree with you Mrs Umlozi. That is what I want for Thali. I know it will not be a long life, but it can be a good life. That is not so different from the ambition other parents have for their children: a good life."
"No, it is not. I think we will do good work together for Thali. So start supplementing her diet..." Mrs Umlozi handed Pearl a brightly coloured booklet. "This will help, it is mostly what we talked about, with some ideas for recipes and uses of traditional food, and ingredients; And next week you bring Thali to meet me."
"Thank you, Mrs Umlozi, I will." Peal got up and shook Mrs Umlozi's gloved hand. "Thank you. What you have said...It makes me feel not so helpless. There is a lot I can do, and I will do it. You have shown me how I can fight." Pearl shrugged, "I am a fighter, if I cannot fight, I am lost. You are blessed, Mrs Umlozi."
"Pearl, God has blessed me that I can help children, and God has blessed you too; but I think you are not just blessed. I think you are a blessing."
TO BE CONTINUED
Manuela Cardiga
