It wasn't really a tough call.  It didn't take a decision tree to know what needed to be done.  But it didn't make the decision any easier on some more human level. 

We visited the Gashi's this evening, having taken the responsibility to check the health records, and find out whether the immunization records the school board would require to register the youngest of the children existed.  The first page of the first one showed that the test for Hepatitis B was positive.  I checked it twice, and then read further into the file.  They did the blood test twice; it was still positive.  A bright yellow sticker said "Notify MOH", which I assume stood for Medical Officer of Health, as the form was a Ministry of Health form.

Then I looked at the mother's file; her Hepatitis B test was negative.  Whew.  So it was just one of them.  Wrong.  I looked further.  The next one was negative, and infectious.  Oh great.  And it turned out that everyone except Hanushe is Hep B positive.  Amazing how quickly the language becomes informal, the enemy becomes intimate.

When we got home, we checked the 'Net.  What did we know about Hep B? We knew it wasn't the fatal one.... that is Hep C,  and not always fatal but close.  We knew it wasn't Hep A, the most common.  But we knew nothing else.   Again, we were grateful for instant access to authoritative information on any subject whenever it's needed.

It's not fatal; it's not common.  And it can be prevented with a vaccine, and treated once infection has occurred.  It's transmitted through blood or saliva; no mention of semen, although sexual partners of someone infected are high-risk and advised to get vaccinated.  So are household members with someone known to be infected.

So where did that leave the sponsor group? We're not household members, but we are like extended family.  And one of our members has an infant -- we obviously had to tell her.  In fact, as I said, it wasn't hard to figure out that we had to tell everyone.  Public health takes precedence over privacy of a family.   Everyone knows that.  So why does it feel like I've betrayed them?

I'm concerned that others in the sponsor group will treat them like lepers, or like the fearful and ignorant treat those who are HIV-infected.  The parallels are frightening, except that if our doctors recommend it, we can be vaccinated against this not-easy-to-catch and not-fatal disease. 

It's not my fault. I'm not responsible for this. I had nothing to do with the family members getting Hep B.  I was not "in charge" when they arrived, and assumed someone else had reviewed the health documents in the first day or two.  I have done the responsible thing in advising other sponsor group members to check with their physicians about whether to be vaccinated. And I have been responsible in putting things in motion to be sure they see a  physician themselves as promptly as possible.  No-one will die.  No-one will even get serioiusly ill, if we have any luck at all.

But still, I sacrificed their privacy so that I could be responsible.  In doing the "right thing", I feel I may have done them damage.  I have to be optimistic that our sponsor group members are sufficiently sophisticated that no-one is going to act irrationally. But feelings aren't rational, and the quality of their bond with these people may be damaged, even irreperably. 

Responsibility sucks.  Being a responsible adult sucks. But someone had to do it, and this time, I had to do it.  It still sucks, though.

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