In the scorching sun of a June afternoon, a gaunt teenage boy arrived at Kinyinya Health Centre. Weary and out of breath, Ishimwe made his way into the crowded waiting area and found a seat in the back row. He wiped the sweat beading on his forehead with the back of his hand and patiently waited for his turn.  

Minutes later, Dr Gaju, a young physician on her first post-grad rotation, came out and called his name. Ishimwe sheepishly got up and followed the physician into a tiny consulting room. Alarmed by the boy’s frail and fatigued appearance, Dr Gaju asked him the reason for his seeming overtiredness.

"I walked to the centre,” he replied.

"Where do you live?”

"Gikondo,” he retorted. And added, looking down, "I had no money for a taxi.”

Kinyinya is 7 miles away from Gikondo; a 2-hour walk for a healthy and energetic person. But Ishimwe was neither.

"Please don’t do this again,” she implored. "There is a health centre in Gikondo...”

Before the doctor could finish her sentence, Ishimwe whispered an inaudible, "I know.”

Dr Gaju nodded, Ishimwe’s reason suddenly clear to her.

Ishimwe is HIV-positive. Because of the stigma associated with the disease, a considerable number of patients on antiretroviral treatment prefer distant health centres and hospitals in their attempt to conceal their diagnosis. These health facilities usually have specific consultation days for children and adolescents living with HIV. And this undoubtedly adds to the pressure. Therefore, the farther away the centre, the lesser the odds of running into an acquaintance or a neighbour.

After screening Ishimwe for opportunistic infections and noting his weight and CD4 cell counts, Dr Gaju asked him about his dietary intake. Appropriate nutrition is vital for optimal care in HIV patients because of their weakened immune system and predisposition to malnutrition. Besides, severe weight loss is known to increase mortality in patients with HIV. For this reason, health centres in Rwanda are required to provide nutritional support (usually the porridge flour Sosoma) to young HIV-positive patients.

Unfortunately, Ishimwe wasn’t getting the nutrients his body sorely needed. Things weren’t good at home money-wise; even the Sosoma he received at the centre, he shared at home. Dr Gaju was distraught by Ishimwe’s confession. Life had dealt the young boy a terrible hand. She pressed for more information, and he obliged.

After the death of Ishimwe’s parents, an aunt took him in and his baby sister went to live with another family. Ishimwe’s aunt was out of work and couldn’t provide for them.

There is no greater pain for a child than the loneliness of a world from which the two people who put them in it are gone. What’s more, when the child’s inheritance is a lifetime of medication and stigma, life acquires the bitter taste of despair and hopelessness.

A teary Dr Gaju reached for her purse to retrieve some money and a tiny piece of paper. She wrote down her number and handed it all to the boy: "If you ever need anything, call or text me.”

It’d be months before she heard from Ishimwe again. Life hadn’t gotten any easier, his aunt was still unemployed. Dr Gaju inquired about his life. Was he taking his medicine? Was he eating well? Or better yet, did he have enough to eat? Was he getting enough sleep? Ishimwe hadn’t been sleeping well, he yearned for a comfortable mattress. Dr Gaju, true to her promise, bought him one. And over time, she would provide food, tuition, transportation, school supplies, etc.

Despite his health and financial woes, Ishimwe excelled in school. He was later awarded a government scholarship to study Technical and Vocational Education and Training (TVET). Dr Gaju’s latest gift to Ishimwe is a graduation gown. Her dear Ishimwe recently walked the stage, blurry-eyed but head held high.

On the morning of his graduation, Dr Gaju received the following text: "I thank God, every day, for our chance encounter, and your impact in my life. I vow to Him to pay it forward. But, to you, my doctor, I’ll die forever in debt.”

It takes a village indeed to raise a child. And every now and then, a chance encounter to change a life.

The writer is a commentator based in Kigali.

The views expressed in this article are of the author and do not necessarily represent those

of The New Times.