Laura Fitzgerald, CNM

Back home in New Haven, the nurses at my old clinic bonded over oversized cups of Dunkin' Donuts coffee and a box of assorted, trans-fatted baked goods.  On my last day of work, my usual was waiting for me on my emptied desk, a small regular with cream and real sugar and a corn muffin.  I was unexpectedly touched.  Alternately, my nurse-midwifery classmates and I convened over wet glasses of Sam Adams and refried beans at C.O. Jones' free 5 o'clock burrito bar, a pleasingly noisy establishment conveniently situated a mere block from my clinic.  It seems that nurses' rituals frequently involve carbohydrates and mood-altering beverages.  Of marginal sociological interest is the fact that although I've traded continents, substituted coastal Tanzania for New England, this ritual remains remarkably unchanged.

After my first day at an African hospital, I was handed a cold Coke in a glass and a packet of hand-roasted peanuts.  Two nurses, drained from a busy day at the HIV Care and Treatment Clinic, positioned their wooden chairs underneath the ceiling fan and leaned back, taking single generous swigs from their bottles.  I did the same.  They rolled the peanuts around in the palms of their hands to loosen the papery red skins.  They blew away the disintegrating bits of covering, leaving liberated nuts in their hands and red debris on the floor.  I followed suit.  They then dropped the peanuts one by one through the necks of their bottles and watched the white spheres sizzle and bob in the carbonated liquid before tilting the nutty Cokes to their mouths.  When I gave it a go, I couldn't get over how good it tasted.

My Tanzanian nursing colleagues are comfortingly familiar; the handful who, earnest and slyly observant, garnered my instant respect, the bosomy and belly-laughing matron-in-charge who welcomed me with maternal concern, and the furtive, gossipy pair who worry me in a nonspecifically threatening way.  The turf of nurses - I know this ubiquitous zone.  Geography is almost irrelevant.

But then I was introduced to a new ritual. 

Every three months, the gaggle of them, jostling and laughing and adjusting uniforms or commenting on new hairpieces, prick each other's fingers and run simultaneous HIV tests.  They line the test kits up on the table, passing a container of white bread "scones" around the room while they wait the requisite ten minutes for their results.  It has all the pomp and circumstance of an outing to the beauty parlor, all the drama of waiting for the last coat of Cotton Candy Pink to dry on their fingernails.

When in Rome, right?  I offered my left pointer finger and submitted to the process.  I've been tested, with more or less regularity, every six months since my early twenties when my then-boyfriend, a sub-Saharan African native, got me into the habit.  It scares me every time.  These women were nonplussed.  What if one of us is positive?  I couldn't help silently stressing about the possibility.  What a horrible way to find out, I thought.  This venue was so very public, a seemingly inappropriate blur between the professional and the deeply personal.  Tanzania is a country in which one in every ten people in HIV positive.  There were at least ten people sitting around the room, ostensibly unconcerned, chewing and chatting.

It was probably a self-selected group.  Like me, they'd been tested plenty of times in the past, knew their risks, and just wanted quarterly reassurance.   "Safi!" they said in unison when the negatives results revealed themselves, "Great!"  High-fives crisscrossed the crowd as we nurses congratulated each other.  It was an initiation of sorts for this American interloper, a sobering reality-check and a whole new ballgame. 

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