Wednesday, January 11, 2006

The Chaos Within - Feet

I washed my first dead body on Tuesday.

Nagesh was our 8th client to die. He came to us in Stage IV of HIV/AIDS... the last stage. He was also an alcoholic. I met with him just last Friday. He had returned home from the Sahara Care Home and refused to go back. Errol, who runs Sahara, came with me to convince him to return. We succeeded. Three days later Errol called to tell us that Nagesh had died. Did he know like they say some people know? Did he want to spend the last few days with his family? Empty questions.

This time we were determined to use the death of a client as an opportunity to dispel ignorance and fight stigma. The other clients thus far had never made it home to the community to be ceremonially washed. The body had always been taken straight to the crematorium and had hurried rituals performed before the body was incinerated. When Prakash died the ambulance brought his body home, but before we could get there, the family whisked it off to be cremated. On Tuesday I sent half the team to Nagesh's house to make sure that this did not happen again. Saraswathi, his wife (also one of our HIV+ clients) was distraught and was in no condition to insist on performing the necessary rituals at home in the community.

As expected, when the corpse arrived there was resistance. The team was told that there was the very real risk of HIV passing onto those who washed the body etc. No matter how many awareness programmes are conducted about how one gets HIV and how one does not, the fear remains. As Lata said in the morning, "We will have to do it and show them." We did.

I had kept half the team with me as the Mother General from Wantage was visiting the Deep Griha centre at Tadiwala Road that day and was especially interested to hear about the HIV/AIDS project. By the time we arrived Avinash and the rest of the team had managed to convince the family and community, and Nagesh was laid out, still in his white shroud on a steel bed in the little gully in front of his house. The men of the community were busy building a palate of straw and bamboo to carry his body. Lata informed me that the DISHA team would have to wash the body. I agreed immediately. We had to show the members of community crammed into that gully that Nagesh deserved the same dignity and reverence that they accord to those who die of a heart attack or pneumonia. We had to show them that AIDS was just another tool in death's arsenal.

The pristine white shroud was stained. Dead bodies leak. He had spent the night at the morgue at Sassoon General, but I had been there before, to collect Usha's body in August, and knew that the giant cave of a freezer did not always have power.

We gently stripped the shroud off and undressed him. Lata, Maya, Vaishali, Avinash and I took charge. He was wearing the same dark blue sweater and sky blue shirt that I had seen him wear on the Friday. His limbs were cold, but supple. His skin was alive to my touch. His fingers pliable. His eyes were still open in shock at the sight of nothingness and his mouth gaped open in wonder at the same nothingness. At first we thought that we would wash only his torso, but then we decided to strip him naked and wash his whole body. We continued to gently undress him. I undid his trousers and slid them off his skin-on-bone legs. As I was doing this, some of the men who were watching us came forward and helped me. We then laid a towel across his genital area and slipped off his sodden underwear.

Avinash and the girls then sat him up and began to bathe him. I bathed his legs. A crumbling cake of Life Bouy soap suddenly appeared. I broke off half to wash his legs and feet. The two men that had helped me take off his trousers then helped me by pouring water onto his legs as I scrubbed. Then, one of them took the soap from me and applied more. Together we washed his feet. They were dirty feet. Gnarled, workman's feet. They were the fleshiest part of him. I wondered at how the soles of feet never lose flesh. Or was it just layers of calloused skin... I thought of Christ and his penchant for washing feet. I thought of my mother who died just over a year ago. I wasn't in the country when she died. I wondered about who washed her body. A faceless undertaker. I smiled as I imagined how she would have reacted if she saw what her son was doing. My mother always had a faint aroma of Dettol about her. She was finicky and a little obsessive compulsive when it came to cleanliness. The man who washed Nagesh's feet with me was crying silent tears. Nagesh was his brother.

Then, I had to struggle to stop myself from smiling because I remembered a salesman who recently rode his bicycle outside my house one afternoon in the blazing sun chanting "ya amma, ya akka, ya maushi..." He was selling soap and was calling upon 'mother' 'sister' and 'aunt' to come and see the six cakes of soap that he would sell you for a mere 10 rupees. Then, I realised how apt his call was... mother, father, sister, brother, aunt and uncle, come and see that a man who has died of HIV/AIDS deserves dignity, deserves respect, deserves to have his loved ones around him to mourn his passing.

They were there. His mother, wife, sister, brother, son, daughter, friend. Their wails echoed in the narrow gully. Their grief bounced of coulourful walls. Their tears fell like drops of lead and drained into the gutters with the water that had purified his lifelessness.

We dried his body and dressed him in the traditional white pajama trousers and shirt, and placed what is commonly know as the Maharashtran 'topi' at a jaunty angle on his tousled damp head. The DISHA team stepped back. The men of the community came forward and moved him on to the palate. They unfurled a pink cotton silk shawl and laid it over him. Garlands were brought and he was adorned. Then with the wails in tow they carried him shoulder high to the waiting ambulance.

Avinash and I went ahead to the crematorium, where they performed more rituals before he was rolled into the oven and the fire consumed him.

I told Avinash on the way back to the centre that DISHA had taken another step forward that day. We had shown the community that we had no fear of HIV flying off a dead body and entering insidiously into us. We had made a mockery of this myth. Ignorance and stigma give rise to these myths and the year ahead of us is a challenge that we cannot turn from.

Nagesh's case also shows us how important it is for PLWHA to come forward early, in Stage II so that we can help them live a qualitative life. They are reluctant to come forward because in Stage II they still look healthy and no one would know that they were HIV+. We have to make the community sensitive and supportive to PLWHA. They must have the confidence that they will not be discriminated against and marginalised by family and friends and those that they live amongst.

But, in the end, all I could think of were his feet. The fleshiest part of him. The feet that I had washed with the help of his brother. I lit a cigarette with those same hands immediately after, and my thumb habitually brushed the end of the filter. When was the last time he had washed them? When was the last time that they had been scrubbed so thoroughly?

Who washed my mother's body? Who washed her dead feet?

Empty questions?

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