Day 241: HIV - When Negative is Good
Who knew they could know so fast? Photo: Isaac Stone Simonelli
THE full-body security scanner whirls around me before my phone and fire wallet (not that anyone ever notices that my wallet is capable of bursting into flames) are returned to me by one of the guards at the Kencom Building, also known as City Hall.
The security screening took places behind a locked gate at the Wing A entrance, which itself is manned by two guards, one armed with a short-barreled, semi-automatic firearm.
One of the two sleepy attendants at the desk asks for my passport, then asks for me to open it to the picture page – she's struggling. I'm put into the system and handed a visitor pass for Marie Stope: First floor, room 159.
The Kencom Building is a dingy, depressing high-rise. The elevator is taking a man in a pinstripe suit to the third floor and a well-dressed woman in heels to the seventh floor. The low, off-white ceiling panels and walls on the first floor have developed a light brown hue, like a newspaper that's started to oxidize. Some doors are numbered, some have names and titles associated with them. It seems that there are mostly doctors on this floor. The hallway runs four sides of a large square. On the third side, I find room 159: Marie Stope HIV, Children by choice, not chance.
Linda, the nurse with whom I was having a solid laugh about anal warts the other day, arranged for me to come back in for a proper appointment. This time, with someone other than a gynecologist.
Inside, the receptionist has no idea who I am or why I'm there. Either Linda didn't call them or they don't remember. After a bit of confusion, I decided to start fresh and have another conciliation to see where things go from there.
A young male doctor sits me down next to his desk. He doesn't introduce himself and I don't ask his name. To be fair, I'm only presuming he's a doctor because I was told a doctor would be seeing me. However, with all the doctors in Kenya on strike, who really knows?
Public sector physicians walked out of hospitals on December 5th after the government failed to follow through on a 2013 agreement to double salaries and hire thousands of new doctors to fill a sever shortage. With Kenya doctors making roughly 10,000 dollars straight out of medical school, many are pulled toward careers oversees or within the private sector, leaving those that remain, roughly 5,000, to serve a population of nearly 50 million.
Nurses, who are not on strike, are at the moment doing their best to take care of people, but millions are estimated to be impacted by the strike. And though doctors and government representatives have come to the table, deals are falling through and the government is now threatening imprisonment or simply firing all doctors who are protesting. Who they'll find to replace them is a serious question.
So, running with my assumption that the man in front of me is, in fact, a doctor, I show him the picture of my anus, which admittedly is a strange thing to be carrying around on your phone, but saves the hassle of me dropping trousers in the office.
“Do you mind if I ask you a personal question?” he asks.
“Since we're on the topic of anal warts, I can't think of much that could be off topic.”
“Have you ever...”
I cut him off and launch into the same spiel that I gave Linda a couple nights before.
“I'm heterosexual, so I'm straight and I've never had sex with a guy. The last time I had unprotected sex was about six months ago and the last time I had sex was about a week ago,” I say. “I was pretty surprised about them being anal warts too. I have no idea how they ended up back there.”
“Yeah, though it is most common in homosexual men, it can happen,” he concurs.
In the next room over, a nurse prepares to give me a Syphilis test and an HIV test, as recommended by the doctor.
“When was the last time you were tested?”
“Maybe a year and half ago,” I say, though in all honesty it could have been two years ago.
A gush of air escapes her lips. Clearly, it's been too long between tests.
It's 500 bob per test, she explains before opening the packages.
Holding my arm out, large veins at the elbow bulging, ready for a serious loss of blood, I'm surprised to see the nurse approach with the tiniest of needles.
She pricks my pointer finger, causing me to flinch then pulls out a few drops of blood to be put on a rapid test result sheet, which look like the PH test strips we used in science class back at Jackson Creek Middle School. These, however, have the potential to provide slightly more interesting results.
“How long does it take before you know the results?”
“Only eight minutes.”
It really is incredible, I figured that the blood would be sent to a lab, and then I'd have to be anxious for a month while they attempted to get the test results back to me.
I'm not anxious about the results, but you never know, right? There's always the possibility of the strip coming back HIV positive. It's the idea of calling previous sexual partners and having to deliver such scary news that is the most worrisome aspect of the test results being positive, which, if you think hard about it, doesn't make a lot of sense given the serious, long-term consequences have being HIV positive.
“So how accurate are they?” I ask.
“Much more accurate than the Chinese ones.”
Up until sometime in 2015 Kenya was using Chinese and Indian HIV test kits, which were of questionable quality. Since then, they switched to those provided by US Aid, the nurse explains.
After a few minutes of holding a fluffy cotton ball against my finger to stop the bleeding in the lobby, I'm called back into the doctor's office.
There's an unanticipated tightness in my chest. He lets out a big breath as I sit down next to his desk. Not looking at me, eyes down on the test results he lets a moment of silence pass before speaking.
“The test results all came back negative,” he says.
With a hand-written prescription folded up in my pocket, I pay 1,000 bob for the tests. The receptionist doesn't charge me for the conciliation. I can't tell if it's an oversight, not included because I'm paying for the tests or if it's being waived because the last conciliation I had was with a gynecologist.
Back out on the street, the National Archives looms above me from across the street. Standing next to it, I consider going in. There's an unimpressive sign hanging from the metal gate surrounding the building explaining that the Murumbi Gallery is now open to the public. How old the sign is, I can't tell. And who is Murumbi? I have no idea.
I rattle the die in my necklace: evens I go check it out for 200 bob; odds I continue to wander the Central Business District, which is the first place I've been that makes me feel like I'm in a city.
It's a four.
There's a little electric thrill as the synapsis in my head fire off as I rolled the die. The die has felt neglected. This last month as been a near failure of a dice life. I'm disappointed in myself, but the dynamics of Nairobi – this disjointed collection of boroughs – the costs of getting around and the need to get at least the basic logistics for the rest of the trip underway, as well as the generic laziness that comes with comfort, has been overwhelming. It's been a great time, I'm getting to peek into all sorts of people's lives, but the dice are not being given their proper place. So, even this tiny roll is a grand step up from choosing what cocktail I'll order.
So, seriously, who is Murumbi?
The tiny print past the entrance sheds some light on that most basic of questions about Kenya's history: After spending several yeas in exile for his involvement with the Kenya African Union, whose key leadership members were vital to the country's independence movement, Murumbi came back to become the new nation's first Foreign Minister. He was appointed as the Kenya's second Vice President in 1966, though health the post for only a couple of years. A passionate collector of African art, antiques, books, historical documents on Africa and postage stamps, Murumbi achieved his dream of opening a Pan African Gallery in Africa. In 1978 he and his wife sold a large portion of his collection to the Kenya National Archives.
Part of the Murumbi collection is now housed on the ground floor in an enormous atrium with an internal wrap-around balcony looking out over the gallery. Inside, past the placard with too many words in tiny print, which are trying to cram a summery of Murumbi's entire life into a few paragraphs, there's an impressive and uncluttered selection of displays. On one wall is a collection of buffalo hide shields and a single knobby club, rungu, which would have been used by Maasai warriors, who are infamous for extorting traders of goods for permission to cross their lands. A number of bladed weapons, the metal blackening with time and exposure to oxygen, also hang on the walls. Not far away, entire tortoise shells hang motionless from pieces of rope after their bones having once rattled with each step of a cows.
On the back wall is a collection of paintings previously owned by John Boyes, King of the Wakikuyu, who at one pointed “owned” Mount Kenya – the tallest peak in the country. One of the paintings depict Boyes holding a bow and arrow, crouched next to a dead lion, blood running out from where an arrow protrudes. Game hunting was certainly a different thing back then – it's hard not to be impressed.
Up along the wall on the far side of the balustrade on the third floor are re-printed photographs of famous and important players in Kenya's independence, as well as an entire wall dedicated to Murumbi's stamp collection. Though I find stamp collection a bit strange as a hobby, it's amazing what history they preserve. Part of the collection contains stamps from the African nation of Tanganyika, which existed between 1961 and 1964. In 1964 it joined with Zanzibar in what then became know as the Republic of Tanzania.
On the wall of heroes is the final letter of a man sentenced to hanging. He writes his father: “I conclude by telling you only to do me favor by getting education to my son.”
Back outside, I wander the streets. A Kenyan grabs at my arm, my instincts to ignore the man completely are thrown by his smile.
“Hey! When are you coming back to camp?” the young man with a trimmed beard and a big watch asks.
“Oh, hey! I'm staying with friends now, but I might swing by for a drink at some point.”
He's one of the employees at Karen Camp. Maybe Nairobi isn't that big of a city after all.
It feels good to be one my own and completely independent. I pop into Christie's Cafe, where a sassy, impatient waitress snaps at me.
“I said, do you want black or white coffee?”
The quick breakfast of a fried egg, a sausage, a samosa and coffee for 150 Bob (1.5 dollars) is a steal. So it turns out that not every meal in Kenya is going to cost between five and ten dollars; that's a relief. The die ordered the breakfast out of the four options on the little laminated menu.
A boda boda driver in a black leather coat drops the price back to Spring Valley, Michael's house, from 500 Shilling to 300 Shilling, after start to walk away, muttering something about getting an Uber.
He's on a slick 180cc street-muscle sort of bike. The brand is one of the dozens of Chinese bikes that have flooded the African market.
Back at the house, Abby is with Hank. She warns me about the medications I picked up from the pharmacy downtown for my anal warts.
A survey released in December revealed that 17 per cent of the 300 prescriptions collected from 42 health facilities and retail pharmacies from across Nairobi County failed quality tests at the Kenya National Quality Control Laboratory. In June 2014, 926 people were arrested in a nationwide crackdown on illegal pharmacies.
I had no idea.
Though I did check the packaging of the drugs when I received them, Abby – who's a nurse by training – said that there was no way to know if they are real or not outside of having them tested.
At this point, expats are using word-of-mouth to promote chemists that appear to be serving up legitimate, quality drugs.
Had I known, I could have let the die choose the pharmacy.