Black Butterfly

I started my internship on Tuesday. Nguyen Van Hung (Anh Hung) is the one-man army behind the Smiling Group, a non-profit organization that raises awareness about HIV/AIDS and gives funding to disadvantaged people in Sai Gon. The organization is a way for about 90 people to receive medication, childcare services, and a community of emotional support for people living with HIV. My first day working with Smiling Group gave me a look into the world of Anh Hung and the public health crises of Vietnam. I was briefed on what we were doing that day, but I never expected it to be as intense as it was.

We started off by visiting the house of a diagnosed HIV patient living in the slums. Apparently she had been detained for the last five years and just got out of prison, only to find out that she caught HIV from a heroine needle in jail. She lives with her nine-year-old daughter and mother in a small, one room house no bigger than my closet. She was very ill and her throat was almost swollen shut so she needed immediate care - we took her to a local clinic, Anh Hung and I on his motorbike and the young woman and another volunteer on another bike.

It wasn't so much a clinic as it was a big open space with dividers between the rooms and no ceiling. People were smoking cigarettes and children were running around. I realized I wasn't standing do much in a clinic as I was a hospital. The other volunteer, Nhi, and his beautiful wife, Thiep were helping the patients. Anh Hung makes a point to positive around his patients, even if they are dying, he can be there as a patients advocate and liaison between patients and healthcare providers, or simply offer a tissue and a pat on the back to help clear the mucous from their throats.

Because the woman didn't have the proper paperwork, and in fact wasn't supposed to be living in Sai Gon after being relocated to the countryside by the government, she wasn't able to get the drugs she needed. As a matter of fact, without the papers, her daughter can't go to school either.

We went to a second clinic, this time a local NGO. I got to sit in on a conversation with the care provider as they discussed possible options. Our new friend was able to get a handful of ARVs (Anti-retrovirals) to last her about three days until the episode cleared up. The typical AIDS patient in the US gets put on a consistent ARV cocktail for the rest of their lives. She had three days. As for opening up her airways, they didn't know what to do without the proper healthcare medication. Anh Hung suggested using a children's asthma medication in higher amounts to clear her airways, and I interjected that it would only clear her lungs and probably wouldn't help with the swelling in her throat.

"I took the other pills you gave me, but I didn't feel better so I took another one, and another one until I was out."
"This is western medicine, dear. You can't eat them like candy, you have to wait a few hours."

If you thought the American health care system had its issues, there are still people living in the slums here who have probably never seen Western medicine in their lives. If you think this story sounds crazy because she was taking a mixture of children's asthma medication and a small number of ARVs to clear up her episode, then you're right, but in desperation for survival, there are no other options but to make due with what you have. Unfortunately, she has no money for the basic staples of rice and vegetables, let alone a consistent amount of medication. The NGO was running low on its supplies but was able to give her a small package of dried milk.

The woman is only 24 years old. She has a nine-year-old daughter, a cute little girl who doesn't know that her mother is ill. She lives in the slums with her mother in a community that fears and ostracizes those who are terminally ill and potentially contagious. I have never seen such poverty or desperation in my life.

Then Anh Hung's phone rang; it was time to visit someone else. We hopped onto his motor bike and sped off into the Sai Gon traffic. While riding on the back of the motor scooter, weaving in and out between the cars, I saw a black butterfly flying alongside our motorbike.

The second case was a young man, Quang, who suspects he has HIV. We met up with him at a cafe and sat down to talk with he and his mother. He is jobless, has a girlfriend he can't marry yet, and lives with his mother. Anh Hung was trying to persuade him to get tested so he can live a longer life. He was scared and said he would think about it. Anh Hung invited us back to his home, where Anh Hung tested him for opiates. Quang left with his mother but came back moments later to let Anh Hung know that it was time to for him to know for sure. Anh Hung gave him some suggestions for making money as well.

While sitting at the cafe with Quang, Anh Hung, and his mother, I got to hear Anh Hung's story. He recalled how in his youth, while war was going on, he used to live recklessly. He used to race bikes and smoke opium (because heroine had not been introduced to Vietnam yet), so he can relate to the many people he meets, mostly prostitutes and heroine addicts. After the war ended, he was imprisoned in a reeducation camp. He recalled a story about how you weren't allowed to go to the bathroom without counting out loud, because there would be an armed guard on the other side of the door who would shoot you if you became too silent. If attempted to run away, wading through the shit, you would be shot dead. After many years, he was released, and spent about twenty years selling travel guides on the street. He realized that he couldn't do that the rest of his life, and it was time to move on.

He is by all means a humble man. People respectfully call him Thay, meaning teacher. He refuses to let me call him Thay, and insists on Anh, meaning older brother, even though he is old enough to be dad. By his own accord, he started the Smiling Group and drives around from early morning until late at night, helping children and young people get tested, and running the many counseling and tutoring programs that the program offers. At night, he sleeps in the small, tiled space next to his desk at home.

I used to hold a certain disdain for drug addicts, but I now realize that people do these things out of desperation. After meeting their families, their children, their parents - one must realize that there's more to a drug addiction than a single bad decision, but a socio-political circumstance which victimizes the lower class as a whole. There's no room for judgment or bullshit here, only compassion.

"You can hide things from your family and friends, you can avoid talking about them and ignore the problem, but you cannot run away from yourself," he said to Quang, slowly sipping his coffee, and speaking with the conviction of a preacher.