It has been three weeks since I left Swaziland, and I am missing it already. My debriefings have all been completed and I am back in Leicester. My head of mission told me that he had been reading my blog and thought it was a great insight into what it was like being a clinician in Matsapha. The UK office is going to look at some of my blogs and may be publishing them “officially”.

In order to fuel my blog with insights and ideas, I have kept a file of subjects which I dip into and write about. In this blog, I have cleared out the file.


What Swazi women want for sex?

It was a classic billboard headline, guaranteed to sell a few hundred extra copies of the paper. As we drove past it on the way to work, I read it out, as a rhetorical question, ” What do Swazi women want for sex?” Rather facetiously, someone suggested 500 Rand. One of our health workers in the vehicle said, “Maybe. Depends on whether it is at month-end (near payday) or not. The price does vary.” He had taken the question seriously and answered revealingly. The car fell into an embarrassed silence for the next few minutes until we reached the clinic.


I read the newspaper article which was based on some research done a few years ago. Three groups of women had been approached to give their views:  married, university and “aspirational” – women who hoped that their relationship would lead on to something more desirable, such as marriage.

“Most do it for love, despite financial gain”

High on the list of reasons to have sex were clothes, phones, airtime and other gifts, love and marriage, as well as having a good time out. Sexual satisfaction came midway down the lists. Sadly, “place to sleep for the night” and “takeaway meal” were listed by the university students.


I was wandering around SuperSPAR at Ezulwini when I came across a man wearing traditional dress, a cloak wrapped around his torso and a leopard skin loincloth, carrying a plastic shopping basket. This is not an unusual sight, but what drew my attention was a string of beads hanging over his shoulder, decorated with Christmas baubles and tinsel.

The driver who took me to the airport is called Justice. He told me that he was the first baby that his mother had ever taken to the clinic. She had never attended school and did not know how to read and write. She was intimidated by the clinic nurse, who asked her for the name of her baby. She panicked and told the nurse that she had forgotten his name. The nurse laughed scornfully and said that he must have a name. So she said the first thing which came into her head, “Plastic“.  Later on, his brother gave him his proper name, but that’s another story.

Another driver has an interesting moniker. His name translates as “Lift him up“, something which is impossible now as he must weigh well over 120kg.


I saw a lady in clinic and asked her what medication she was taking. She hunted around in her shopping bag for a while and finally brought out a single shoe. So much for my communication skills.


The man said he had two problems. He removed a plastic pair of shoes, worn without socks, to reveal the worst athlete’s foot I had seen in ages. I explained how to treat this and then he told me about his second problem. Last night, he dreamt that someone stabbed him in the upper arm. He woke up and felt something under the skin, but there was no wound. “Do you think this was a witch’s work?” he asked me. “Maybe, let’s take a look and see.” I could feel a foreign object, close to the surface of the skin, but without a puncture wound. He showed me a scar on his wrist, resulting from an injury 30 years ago when he was a schoolboy. I removed a 2cm sliver of wood (my mother would have called his a large “spelk”) from his arm under local anaesthetic. I have no idea where it came from, perhaps it had migrated over the years up his arm. Apart from witchcraft, he had no explanation for it.


Sometimes I add a bit of showmanship to my consultations. For example, when examining the abdomen of children, I often play a game with them by pretending I can tell what they had for breakfast by feeling their tummy. Of course, it helps when there are just a few options from which to choose. I was examining a child yesterday and the conversation went something like this:

“Now, I can’t feel any banana…but that might be because it has been mashed up.” – No.

“Is this squishy stuff here sour porridge?” – Noooo.

“Ah, I know what it is, emahewu!” – How did you know?

The child was delighted, but her mother was aghast. I realised she was thinking I was some kind of wizard who could magically detect what was inside her daughter. I smiled at her and told her it was just a trick to get children to relax when I was examining them.  She clearly didn’t believe me, and kept giving me sidelong glances, wondering what magic I was planning to perform next.

Bye Bye docotela



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.


  1. May I please use your picture of Fish Paste for a TEDx Talk I am giving on February 27?
    Thank you, Meh Sod Paw

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