Time for a change

Early next month, I start work with Medecins Sans Frontieres (Doctors Without Borders) in Jahangir Puri, a slum area in North Delhi, at their new sexual and gender based violence clinic, Umeed Ki Kiran. The contract is for a minimum of 12 months. From the clean air and pleasant climate of South Luangwa in July,…

And POTUS begat PEPFAR

“And POTUS begat PEPFAR” sounds like a passage from the Old Testament. In 2003, George W Bush (POTUS) set up the President’s emergency plan for AIDS relief (PEPFAR) to combat HIV/AIDS. This initiative has saved millions of lives by providing medication, training, supporting labs and infrastructure. But there needs to be accountability, to find out…

Kakumbi Clinic – my final days

Yesterday, as I drove to the clinic, I saw a man at the roadside, flagging me down. Normally, I wouldn’t stop (the medical association discourages picking up hitchhikers), but this man was in uniform. And he was carrying a very large rifle. I pulled over and he got into the cabin. We greeted each other…

Marketina

“There is a belief in Zambia that if you are HIV positive and you sleep with a mad person, you will be cleansed of the infection, ” said Nurse Zulu. “That is why three quarters of the mad people are HIV positive.” Living with severe enduring mental illness in developing countries is bad enough even…

Excrement

Several months ago, I mentioned in a blog that an infusion of elephant dung is a traditional remedy to treat hypertension. About half of what elephants consume passes through its intestines without the nutrients being digested or absorbed, so it is just possible that vegetation could contain chemicals with an anti-hypertensive action. But I would…

Luxury in the Bush

If Bilbo Baggins had $5,000 to spend on a day’s vacation on safari, Luangwa House is where he would choose to go. It looks like a palace for hobbits. The thatched roof undulates over the crazy-paving walls. The dried grass porch outside the main entrance is held up by four tree trunks. The front door is…

Can you hit my head some more?

“Can you hit my head some more, Dr Ian?” Last month, I diagnosed a young lady with cervical cancer. Her symptoms of lower abdominal pain, vaginal bleeding and an offensive discharge had been repeatedly treated “syndromically” – in other words, treating the common diseases which would cause these problems without making a specific diagnosis. She…

Africa Heroes Day

Forget US Independence Day on the 4th of July. In Zambia it was a national holiday to commemorate the heroes who brought independence to Northern Rhodesia, half a century ago. There was no armed struggle. It was a peaceful transition from colonial rule. Britain had lost its appetite for an empire in Africa, demonstrated by…

Feathered Friends

I have come to love the birdlife here in South Luangwa as much as the animals. Here are a few photographs taken with my F2.8 70-200mm zoom lens.

Where there is no psychiatrist

Mental illness happens everywhere in the world. I have seen Zambian patients with depression, anxiety, obsessive compulsive disorder, psychosomatic conditions and hysteria. Being aware of the cultural context is important, and good communication is essential. To get a history from patients, you need a good translator who can help you interpret patients’ symptoms. It may…