From a pandemic's heart, a 'magnificent' sound

No goodbyes passed between Dr. Krista Dong and the HIV-positive patients with whom she worked and lived for more than three years in sub-Saharan Africa. No waving, no shaking of hands. Last June's conclusion to the many days and nights dedicated to helping the Zulu people of an impoverished village on the outskirts of Durban, South Africa, move from dying of AIDS to living with it called for a more intimate gesture -- one more expressive than an embrace, more eloquent than tears.

"They would take their hands, gently hold your face, look you in the eye, and say, 'I will miss your face.' That was their way of saying I will miss you -- you the person, you the individual," said Dong, 42, while taking a break from her clinical work at Massachusetts General Hospital, where she continues to treat the disease that afflicts 1 in 4 South Africans.

She pressed the base of her palms together and held her hands face-high, as she described receiving and returning that gesture.

The woman whom Dong has missed most since leaving Durban five "long months" ago will revisit Boston today as a member of the Sinikithemba Choir. Among the 15 voices harmonizing in a pair of Boston-area performances today, Dong will listen for the sweet timbre of the woman who was a patient and became a translator, co-educator, inspiration, and friend during her time in South Africa. She will listen for the voice of Zinhle Thabethe.

Dong recalled the dire circumstances under which the two first met in 2001. A couple of weeks into anti-retroviral treatment, Thabethe had suffered a severe drug reaction that went undiagnosed until she met Dong.

"She was febrile, emaciated, and covered in welts from head to toe," said Dong. "She thought that it was just the side effects of the new medicine she was taking, you know, something to be toughed out. We treated the reaction and talked a lot about her treatment and the way the meds worked."

In time, Thabethe, then 26, regained her health and continued to educate herself about her condition. Dong began to see in her a role model for a community ravaged by HIV/AIDs. Faced with the obstacles of poverty, limited education, and ostracism, Thabethe overcame each one.

"There's no trump card that could be played against Zinhle," said Dong, of Thabethe's outreach work. "She cut through the superstitions and myths surrounding AIDS, a disease some locals jokingly define as 'Americans' Idea to Discourage Sex.' She would not accept poverty or lack of education as excuses for not getting help. Here was a woman who had to crawl from the bed in her mud hut to a pit latrine for three months. Here was a woman who had educated herself about her illness, despite what would be the equivalent of a fourth-grade education here."

Then there's the ineffable beauty of her voice. "I cried the first time I heard it," said Dong. "There was no other way to respond to all the emotion, all the beauty coming from the voice of this woman who then weighed less than 100 pounds."

That incongruity of strength and frailty struck Dr. Bruce Walker as well when he first heard Thabethe and the patients who would become the Sinikithemba Choir. Walker is the director of the Partners AIDS Research Center at MGH, an organization that has collaborated with hospitals, universities, and the government of South Africa to improve AIDS research and treatment. They're also sponsoring the choir's third visit to the United States, which includes stops in Boston, New York, Texas, and Washington, D.C. It will perform the music Walker first heard when visiting a newly founded patients' support group at McCord Hospital in Durban a few years ago.

"People need to hear this music," said Walker, 52, ignoring his beeping pager for a moment. "The warmth, the joy, the magnificence of this music juxtaposed with the horrors of the HIV epidemic -- it's overwhelming.

"We all hear the statistics: more than 70 percent of people admitted to hospitals in Durban have AIDS, more than 50 percent of women who give birth there are HIV-positive. These are not statistics. These are people. Names. Faces. Voices. People." Walker checked his pager then reclipped it to his belt.

"You know, when we started in South Africa, we were strictly research," he said. "It didn't take long, though, to realize that we couldn't in good conscience continue that way -- we needed to find a way to provide treatment.

"How could we board a plane here in Boston, where HIV has become an outpatient disease, and land in Durban, where patients were struggling or dying because they had no access to treatment?

"Krista saw that right away," he continued. "What could have been a few months stay for her stretched to almost four years. We need to get more doctors like her over there."

Dong echoed the need for continued collaboration as well as her willingness to return to Durban "in a heartbeat." She was quick, though, to place her greatest hope in the Zinhle Thabethes of South Africa.

"She buried her brother a few months ago," said Dong, "and still she is coming here to sing in a choir whose name means 'we give hope.' She is coming here to put a human face on a pandemic. She is coming here to raise money so that one more neighbor in Durban can get the medication that has kept her alive."

She is coming here in friendship.

The Sinikithemba HIV+ Choir will perform today at 10 a.m at Union United Methodist Church, 485 Columbus Ave. in the South End, and at 3 p.m. at the CambridgeSide Galleria Food Court. Money raised will benefit AIDS research and treatment for people in Durban. For more details call 617-621-8666.