It’s been decidedly chilly in clinic this week


Perhaps you’ve heard the expression: “Four seasons in one day”? Yesterday, the weather forecast for Manzini was 22C and snow! The photograph above shows an electric bar heater in the immunisation room. I hope the nurses didn’t leave it there; you can see the infant weighing scale just above it. It’s good to keep babies warm, but we don’t want cooked kids.

The weather was crisp this morning; the sky was cloudless and caerulean blue. By lunchtime, it was unpleasantly hot. The sky clouded over and by 2pm it had become very humid. The thunder and lightning started at about 3pm, with a drenching downpour that rattled the clinic roof. The storm cut short the flow of patients into the clinic, so we were able to finish just before 5pm. It was dull and cloudy on the journey home before the storm started up again at 6:30pm. As I am writing this at 9pm, thunder is still grumbling in the hills and the temperature has plummeted.

The cold weather seems to bring some strange patients. While I was consulting with a nurse yesterday, a female patient in her 20s told us that she was suffering from a headache. We listened as she described her symptoms, but these were vague and her story was inconsistent. She realised that we were not taking the bait, so she told us that she had an offensive vaginal discharge. We took a sexual history and the nurse decided an examination was necessary. She asked the patient to remove her panties. The nurse then looked at the gusset of the patient’s knickers, which were as clean as a whistle, showing no stains or discharge. As a result, the nurse decided she didn’t need to do a vaginal examination.

The patient got dressed and nurse looked into deeply into her eyes, as if to ask, “What do you have to say now?” After a long pause, the patient coughed. She wasn’t feeling ill. In fact, she had spent most of the morning walking around the factories in Matsapha seeking work. When she saw a group of people walking up the hill to the MSF clinic, she decided to follow them, wrongly thinking they would lead her to another employment opportunity. She soon realised that she had walked into a health centre, so she thought, “I might as well get some medicine while I’m here.” As you do.

We weren’t vindictive. We just took the opportunity to suggest she may want to have an HIV test and offered some health advice. But not a job.

By Dr Alfred Prunesquallor

Maverick doctor with 40 years experience, I reduced my NHS commitment in 2013. I am now enjoying being free lance, working where I am needed overseas. Now I am working in the UK helping with the current coronavirus pandemic.


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