Winstone Zulu Speaks Up: Just Another Planet?
By Winstone Zulu
For the past two weeks I have been staying at Keith D. Cylar House at 743-749 East 9th St, between Avenues D and C, in New York, NY 10009, USA. Cylar House is one of the four full-service health centers in New York of an organization called Housing Works. Housing Works provides integrated health-care services which includes full medical checkups and regular follow-ups, one-on-one help with medication, full-service dental care, daily hot and nutritious breakfasts and lunches, and a full exercise and fitness gym. Housing Works also provides people living with HIV and the homeless long-term and transitional apartments and guest rooms in a homely environment that gives them stability to recover and heal. It also provides job training that guarantees graduates a good job. Further activities are substance use and mental health therapies, including clean syringe exchange, sober-living skills groups, group therapy, and creative art therapy classes
All these first-rate services are provided free of charge.
This is where I am writing from right now. It is not from Mars or some exotic planet somewhere in the galaxy — I am only six time zones away, or 15 hours of flying, from home at Hope House 174, Luanshya Road, Villa Elizabetha, Lusaka, Zambia.
In Zambia we still face drug stock-outs for diseases like TB and AIDS. Medicines indicated to be taken with food are often swallowed on an empty stomach. I know everything about what happens if you skip doses, but I have yet to see widespread information on what happens when drugs are not taken as prescribed. Hunger is so serious in many communities that some patients do the unthinkable to put food on the table. Sherry, the man who played second guitar in my brothers’ band The Echoes, sold his TB drugs so he could buy food for himself and his wife and two young children. He used the drugs the first month and recovered so well that his appetite was at its peak, yet he could not afford a single meal a day. The only possession he had worth bringing in money for food was the remaining TB drugs. Sherry later died of the disease because when it returned the bacteria had become resistant. This was way back in 1993. But in 2004 a woman came to me complaining of having been told by health workers that she had now recovered from TB, which would mean being struck off the list of people receiving a small food parcel of beans, cooking oil and soya powder that was part of the treatment package. The food parcel was the main source of livelihood for this widowed mother and her children. She wished she still had the TB so she could continue receiving the monthly food parcel.
The indignity of being born and living on the wrong side of the world only becomes more pronounced when you stay and receive services at a place like Housing Works. Only then do you realize just how wrong and unacceptable it is for any child, anywhere on this planet, to die feeling the pangs of hunger. At Housing Works, transport is provided to doctor’s or dentist’s appointments. This Thursday I have an appointment with a GI specialist on the other side of New York and a vehicle has been arranged to come and pick me up. Contrast this humane service with the story of a woman living at Mukalashi in Chibombo in the central province of Zambia who gives birth in the dead of the night, on a scotch cart, on the way to a health facility 10km away, having hastily swallowed her single dose of resistance-building, prevention-of-vertical-transmission Nevirapine at the onset of labor. If the baby survives the birth and the cold of the night, mosquitoes will feed on it and it could die of malaria. If the baby survives the first few weeks, the mother will feed it exclusively with HIV-infected breast milk until the baby is six months old. Thereafter, it is weaned to a life of hunger and likely to die of malnutrition before the age of five. If it survives all these horrible ordeals it is likely to become an orphan because the mother may have acquired resistance from the single dose of Nevirapine given to her to prevent the vertical transmission of HIV.
What a cruel world this planet can be. What a crime that there can be so much on one side of the world and so little or nothing at all on the other side.
My only hope is that one day the Housing Works model of care will be replicated wherever there are homeless people living with HIV and AIDS. The aim of universal access to treatment is a mockery if some of the people in need have no place to call home. I am impressed that a large percentage of the funds used to provide these services are raised by Housing Works’ own private enterprises, making the organization to a large extent self-supporting. This model is wonderful, practical and replicable. It is not just a belief I have. It is already being tried in the Western hemisphere’s most impoverished country, Haiti.