Friday, July 16, 2010

Annappa.

Annappa was the first of the children to talk to me. He conscripted me actually. I was 22 years old, having been in India for 3 days, sitting with awkward terror on a slide and trying to figure out how to get kids to play with me. Or talk to me. Something. Some kids were chasing each other gleefully/angrily. Others were watching television inside. The older boys were playing cricket off in the distance. And one smallish boy was kneeled over a green coconut with a dry stale husk, determinedly bashing it with a fist-sized rock. I sat on the slide in the corner. He banged on the coconut. I sat on the slide in the corner, watching now. He dropped the rock and picked up the coconut and walked it over to a half-buried rock and began bashing the coconut against the rock. I continued sitting on the slide, wondering if I had an opening. He looked at me and shouted "Uncle! Uncle!", which sounded nothing like the word "uncle", so I was merely curious. After a moment, he stopped the "Uncles", picked up the coconut and walked over to the slide. Turns out I was "Uncle." Actually, turns out all foreigners are Uncle. (Or Auntie.) He gestured for me to help him crack open the coconut, though to my eye it did not look like it would be edible.


I obliged. I smashed rocks against the coconut, I smashed the coconut against the half-buried rock, I put the coconut on the buried rock and smashed the coconut with another rock, I smashed the coconut against the tree, I jammed my fingers into the rough husk and tried to rip it off with brute strength, I pretended to smash it against my head for comedic effect. Annappa cheered me on. I was heartened. Finally, I grabbed the coconut with my right hand, kneeled down and began slamming it repeatedly against the ground with a fury -- but then a motion caught my eye to my left and I saw an adult woman, standing right in front of me, looking perplexed. She was part of the staff. Very aware of how ridiculous I looked, I sheepishly introduced myself. Is it ok for a full grown man to be bashing coconuts against the ground in India? I didn't know the customs. But as I rose in embarassment, unsure of what to do or say…Annappa just took the coconut from my hand and continued beating it against the rock.


Annappa was 11 years old. He was a shade darker than most of the children, with coarse black hair. One of his eyes was very slightly lazy at times, but was otherwise a handsome boy, with clear compact features. He was born HIV-positive, contracted in the womb or at birth and was orphaned by AIDS when he was very young, possibly beyond memory. He was one of the very first children raised by FF. When they received him, he was chubby and had open sores all over his head. A caretaker shaved his head and washed his open wounds. Annappa eventually lost his baby weight, made friends in his new home, and grew into a healthy, relatively happy, boy.


Annappa craved and loved attention. He put his arms around others and often jumpted into my arms. His need for attention also meant he was rowdy - always in the middle of the scrum when the inevitable rowdiness of boys (plural) emerged. He hugged dogs. He leapt into other people's photos and had to be pushed out. He liked to be thrown into the air. Spun in circles. Go first (and second and third) in trust falls. He liked playing with his toys and asked for toy cars and toy trucks. He was always one of the first to crowd around sessions of Half Life 2 on the foreigner's laptop. And he wasn't all that physically coordinated. A little awkward. And he also had a temper that he didn't hold back. He sometimes hit other children when he was angry. He raised his voice more often than he needed. He cheated a little bit at small games. He had behavioral problems at school. But he was loving and wanted to be loved. Like anyone. Like everyone.


When I returned again to FF in 2006, Annappa hadn't changed a bit. I didn't get to spend much time with him, but there he is in all of the pictures, jumping in front, mugging for the camera. Sometime in 2008, he was sent away to another home, called Kalvery Chapel, where he would be given only a bowl and a mat on a concrete floor. His behavioral problems could not be controlled, so they sent him away. This has happened to over a third of the children I knew, which I thought was fucked up, but I held my tongue because I wasn't the one who had to raise these children. I was just the guy who played with them - not the one who was responsible for them. All said, even though I lived on the other side of the world, it felt unreal that might not see him again. And so when I finally returned to India in 2010, I hadn't expected a chance to see him. But Murugesh, the eldest boy at FF who has now become independent, had recently been admitted to Accept, a Bangalore-based Christian NGO for HIV/AIDS, and told me that he had seen Annappa in the wards - older, taller, thinner, but still much the same.


Kristen and I arrived in India on a Sunday for a jam-packed 10 day trip. All of our traveling was structured around making it back on Thursday for Murugesh's birthday, which was incredibly bad timing. After weeks of planning and discarding possibilities, we had settled on an early morning flight to Goa on Tuesday and an early morning return on Thursday. Having resolved that headache, we set about visiting the children and old friends. On Monday afternoon, I called up an old friend, an older English woman named Sheila who volunteered with the patients at Accept, to fit in a visit with her before she left for South Africa for a 2 month visit. While trying to work out our schedules, she suggested that I visit her that evening at Accept, where I could also visit Annappa, but I declined. I had just visited all of the FF kids again for the first time, met a handful of new ones and didn't feel up for trying to catch up with Sheila in the midst of a new care centre. Plus, we had already penciled in a visit to Annappa on Thursday, when we had a big block of time and could spend time with him.


When we finally made it to Sheila's that evening, we talked amiably and she eventually filled us in on his condition - something she had not done previously. Annappa had tuberculosis, had rapidly lost weight and become weak and bed-ridden. His condition had deteriorated to the point that the doctors had decided that even though it wasn't clear how long he had left, he was not going to recover and leave Accept. Annappa was beginning to experience "breathlessness", a symptom which can last days, weeks or months, but is a generally a sign that the patient was not going to survive. Annappa was also very aware of his condition and very afraid. He told Sheila and Murugesh that he knew he was dying and was very afraid. Sheila had bathed him and comforted him. She brought him juices and liquids he could consume. Before her last day, she told him that I had returned to Bangalore and that I was coming to visit very soon.

I didn't know what to do. We could cancel the trip and go to Accept 18 hours later, in the morning, or we could take our brief trip to Goa and see him two days later. In the past 5 years, only one child from FF has died, a six-year old from a drug complication. The rest remained healthy. We were just at FF - the children were jumping and running and playing. What could have happened in the intervening two years since he was sent to Kalvary to have so radically changed his health? In the end, we decided to stay with our plans to visit Goa. It was only 48 hours and he had only just begun to experience breathlessness. The chances of such catastrophe coming so fast were so small.


When we returned on Thursday morning, it was a brutally hot summer day in Bangalore. We arrived back at our hotel shortly after 11 and began scrambling to make our way to see Annappa, as thoughts of him had accompanied our entire trip to Goa. As Kristen got ready, I ran down the street to buy stacks of nature and car magazines and picture books, I darted into a movie store to pick up Spiderman 3 to watch with him on my laptop (he loved Spiderman) and we called Murugesh to meet us a couple of miles away from Accept so that we could meet to pick up a bag of fruit and three or four fresh juices for him to drink. Murugesh met us at the shopping center and we quickly split up, one to get juices, one to get fruits, and the other to get hot chips. After we got everything together, Kristen and I hopped back into the auto and Murugesh hopped on his scooter and his phone rang. He put on his earpiece and took the call. I was not thrilled. We were late and slow. It was hot and I was sweating and dusty. We had been waiting two days and were finally there to see him. I started to snipe at him to get off his phone. Annoyed, he held up his hands and waved me off. I continued sniping. He ignored me. He finally took off his earpiece and turned to us, "Annappa passed."


In shock, we all fell silent. After a few moments of speechlessness, we continued on towards, not sure of what else to do and to visit Varsha, another girl previously at FF. After getting lost several times, we finally made our way to the center and stepped inside. We discussed Annappa's passing with the staff, almost casually the way we've discussed passed patients, not knowing how else to communicate. They asked if we would like to see his body and then led us to another room. Murugesh and I walked in together, silently, with Kristen trailing behind, and the staff member continued to chat, possibly unaware of our history with him. Just another patient passing from AIDS - just another set of visitors coming after the ordeal was over.


The room was cell-like, with light green paint on the walls and fluorescent lighting. Annappa was lying on his back in a transparent glass case on the floor - a cooling box to prevent decomposition - about 2 feet wide, 1.5 feet tall and 6 or 7 feet long. He was wrapped in clean white gauze from head to toe, feet together, arms folded across his chest. The only opening revealed his unwrapped face, framed by the white gauze. His skin was the same deep brown, unblemished, almost wax-like. His eyes remained half opened, the whites incredibly clear and porcelain-like, and the pupils unfocused staring at nothing. I didn't recognize him. And he was so thin. The amount of space enclosed in the gauze was so incredibly small and frail, with the contours of his bones forming his outline, like a skeleton wrapped in cloth. I hadn't been there for him when he needed someone, and I had been there, in India.


I looked to Murugesh, unsure what he was thinking. He had grown up with Annappa. He was now 5 years older than Annappa and living with the same disease. Just a month ago, Murugesh had been diagnosed with tuberculosis and had suffered a stroke that left him bed-ridden. He had to be admitted to Accept for TB isolation. Exactly a month earlier, he had been blessed to test being Sputum-negative (non-contagious), but still required 9 months of constant treatment for TB. I don't know if it was a good idea for him to see his body or not, but I didn't stop him. He knew more than I what it meant to see Annappa, so I didn't interfere. A few minutes later as we walked out, he told me that seeing Annappa made him afraid - it terrified him. Soon after, he said he felt blessed to be healthy and alive. I just put my arm around him.


Annappa passed away on Wednesday, March 24, 2010 of AIDS-related wasting and tuberculosis. He was 16. He had no parents or siblings, and the closest people he had to siblings and friends had been separated from him. He died in the afternoon on a hot day in a tuberculosis ward, maybe surrounded by strangers, maybe alone. When most of his childhood friends and caretaker were living 2 miles down the street, in one of the rare moments that Sheila was not there and when we had returned to India to visit him, he spent his last minutes alone. And though he was loved, he didn't have it when it mattered. I'm sorry, Annappa.

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