I can always tell when men come into my consultation room with an embarrassing problem. They often hold their medical records over their groin, they avoid eye contact and take a while before telling me what’s wrong. It’s almost as though they are trying pluck up courage.
My next patient fit the bill perfectly. He was definitely looking sheepish. He rolled up his trouser leg to show me some abrasions on his knee. “I fell off my bike a week ago,” he said. “I’ve injured myself on the crossbar.” I asked what part of his anatomy had been affected, he said he didn’t know the correct word in English. “Perineum,” I thought to myself. “Let me have a look,” I asked him.
He undressed and I examined him. I couldn’t find any bruises, but I did see a classic case of gonorrhoea. I couldn’t resist passing an unprofessional comment that he had not just been riding bicycles…
“No, dokotela, I don’t do that, honest, really! I am a religious man,” he said.
“You’ve got the drop,” I told him. This is the local slang term for gonorrhoea.
I raised my eyebrows questioningly and turned to my Swazi nurse colleague who was observing my consultations. He spoke a few choice words to the patient and he reluctantly confessed that he had a bevy of girlfriends.
“I’ll have to give one of them the sack,” he said, “Once I have worked out who I caught this from.”
“I think you should contact all your girlfriends and persuade them to come here for treatment,” I said. “You could have passed the infection on to other girls, too. Perhaps you should hire a Kombi to ferry them all to the clinic.”
He didn’t seem impressed by this helpful advice.
“Look, if all your girlfriends don’t get treated, the infection will continue to get passed around between you, like ping pong,” I told him.
I don’t think he understood my point. “Ping pong?” he asked. “Do you mean I am going to have to masturbate?”
“Well, that would be safer, but I was trying to explain how people can catch the infection again just a few days after they have been treated for it. Everyone should be treated at the same time,” I said.
I prescribed the medication and wrote out some contact slips for him to give to his partners. “Have you had an HIV test? Do you know your status?” I asked him.
“Yes, I do. It’s a long story,” he replied.
“How long can it be?” I asked in exasperation.
But that’s another story.