Barion Pixel TASZ | A Good Patient

A Good Patient

What it’s like to be a Serbian HIV-positive mother in treatment. Read the story by our guest author from Belgrade.

A rainy day in Belgrade can be a real torment if you're reliant on public transport. Buses are late, and often have no seats free. For Olivera, who has serious weight problems and bad legs, it's very difficult to get from her home to the Special Hospital for Substance Abuse in Teodora Drajzera Street, as there's no direct route. Nevertheless, she came to meet me. This is the place where she gets help when she most needs it, the place – as she puts it – with people who supported her when she decided to get off heroin. The place where she found out she was HIV-positive, and where experts gave her the strength to fight it, with people who helped her to give birth to her beautiful healthy girl.

It's a very pleasant meeting. She has a big smile on her face, a strong and sincere handshake, and from the start, is willing to answer any question I put to her. I like the way she talks, openly, frankly and above all without fatalism. While we are chatting, we discover that we are neighbours, and almost the same age. Olivera is 34 years old and lives near a wonderful park where she loves to play with her four-year-old daughter. She proudly shows me her picture on her cell phone. ‘Nina looks like me at her age,’ she says, with a lot of warmth in her voice. ‘You know, this is not my first time talking to a journalist. You can ask me anything you like. I’m not uncomfortable about anything.’ That was a huge relief to me, because I had so many very personal questions to ask.

‘You would like to know if I was HIV-positive when I decided to keep my baby,’ she says. ‘I was,’ she continues. ‘Nothing was planned. I was six months pregnant before I found out that I was going to be a mother. In fact I was already on methadone therapy, and that’s why the pregnancy test showed nothing. But I was getting bigger and bigger, my legs were swelling, and the doctors gave me an ultrasound. We were so surprised, and I was very frightened. In only three months I was going to be a mum, I am HIV-positive, unemployed, and on heavy-duty medical treatment. My doctor from Drajzerova helped me a lot. She sent me to her colleagues in a hospital in Narodni where good care was taken of me and my baby when she was born. The first thing I wanted to know after I gave birth wasn’t whether the baby was a girl or a boy, but whether she was HIV-positive. I can’t expres how happy I was when they told me she wasn’t. Because of my therapy, she had to stay in the maternity hospital for 40 days while they weaned her off the methadone. It was very successful, and now she's just like any other kid her age. There are some days when I just can’t play with her, or even get up off my bed, because my legs hurt so much. And there's never a day that I don’t say to myself: Be persistent, your child doesn’t deserve to suffer because you chose heroin when you were a teenager.

Everything that is happening to me now is the consequence of drug abuse. I know precisely the date and the place when I got HIV. It was the only time I trusted someone and took a needle because he told me it was clean. I had never before done something like that. I never took heroin in the street or in some dirty basement, and I’ve always had sterile equipment. But it happened. Who knows when I would have found out I was HIV-positive, without the Special Hospital for Substance Abuse. The first time I came here (in 2005) I wanted to get off heroin. It wasn’t successful, but at least I wasn’t HIV-positive. Four years later, ten years after my first shot of heroin, this hospital was running a campaign: Do the test and they give you 10 euro. Money was the thing that motivated me, so I came, did the test, and it showed a bad result. Then they sent me to the Clinic for Infectious and Tropic Diseases and it confirmed the diagnosis – HIV-positive.

That was the moment I really decided to get off heroin, and came back to Drajzerova. HIV isn't the same thing as AIDS, but if you don’t keep it under control, it becomes AIDS. So my aim was, and still is, to behave properly so that I can stay alive. Since I was a drug addict, the doctors had to put me on methadone therapy, and I’ve been on that treatment for five and a half years. Every Monday, I get my dose for the whole week, seven doses for seven days, and each day I split my dose into three, because I need to stay in full shape during the whole day. Since methadone needs three hours to have its full effect, I take my first dose around 5 am, and when my daughter gets up at eight I’m in good condition. The second one I take around 1 pm, and the third at 9pm. I’m lucky, because I'm a good and disciplined patient. That’s why my doctor is prepared to let me have seven doses at a time. He believes me, because of my clean urine tests. We have to do the analyses often, and if they show any trace of narcotic we are punished by having to visit the doctor every day, and take the dose in front of him. During the whole of those five and a half years, I've only been punished once, after taking Caffetin. I’m aware that there will come a day when my doctors tell me I'm ready to come off methadone as well, but for now, I must continue to take it because of my health. If I were to stop now, the virus can get stronger, and I can fall ill – and we all know what effect even a simple dose of flu can have, when you're HIV-positive.

Methadone is a very strong opiate, stronger than heroin itself, but it keeps our metabolism strong. That’s the power of hard opiates. I can’t remember ever being ill since I've used them. Unfortunately, some of the people who are on the methadone program abuse it and take their dose intravenously, instead of orally. One of them died as a result. People like that don’t deserve the chance we're given. Our methadone therapy costs the state about 2,000 euro per person every month. Not to mention that my binary therapy for hepatitis C costs about another 1,000 euro. I take Combivir and Aluvia. One of them costs 450 and the other one 500 euro. I also have to take Xalol to keep myself calm. That’s my reality. And I get very angry when I find out that some people abuse this program. Somebody gives you an opportunity to stay alive, gives you medication for free, helps you to get off the street – and you take your therapy in your vein, or even worse, sell it to others. I know that I'm in this position because of drugs, but I would never tell anyone, ‘Don’t take them because they're bad' – they're great, they'll give you a great feeling, but they'll also stop you being able to deal with your problems, and they'll give you bigger, much more serious problems, too.’

I realised how great the doctors in my Institute were, when I went to a health centre. The doctors who work there weren't just unpleasant with me when they heard my diagnosis, but some of them weren't willing to examine me, or even to write me a therapy prescription. I complained to the health inspectors. Nobody was suspended, one of them was just fined, and the result is that most of them now boycott me. It’s a terrible feeling.

As you can see, I’m fighting every day. I’m very grateful for all the support I have, but sometimes it's very hard. I have no job, nor does my husband. There are days when we don't have enough money for the milk our girl needs. Sometimes I buy her a formula which costs about 1.5 euro. It gives her all the vitamins, proteins and minerals she needs to grow. My only concern is that she shouldn’t suffer because of my condition and my earlier decisions. Her medical notes say she was born addicted to methadone. I don’t want anyone to point the finger at her and say that to her, or say that her mother is or was a junkie. She deserves the best, and I’m willing to provide her with everything in my power – starting with a healthy and clean mother.’

We've been talking for almost two hours. It’s still raining outside, and Olivera has a long ride to get home. ‘No park for Nina and me today,’ she says, and, in the same way she did when we met, shakes my hand and gives me a big smile.

Jasmina Lazić/Serbia

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