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…

Integrated HIV Care

HIV care is complicated. You need comprehensive guidelines which cover most situations regarding the management of HIV. These are usually written by WHO experts with input from local specialists and the Ministry of Health. Obviously developing countries aspire to provide as good a service as they can afford. The temptation is to design the guidelines…

Clinical Work

Just in case readers of this blog have the impression that I spend most of my time in Swaziland gallivanting around having a long holiday, I thought that I should slip in a few examples of clinical problems I have encountered at the clinic this week. This is the left hand of a woman in…

Dreams

Some mornings, my father would say that he’d done a “second shift”. This meant that he had relived the previous day’s work in his dreams. It’s happening to me now. Perhaps it is because I am sleeping lightly because of the heat, so I wake up during the rapid eye movement phase, when dreaming occurs.…

Straight Outta Compton

It was much too hot to walk this afternoon so I went to see Straight Outta Compton at the cinema. When I arrived, the cinema was half full, virtually all young Swazis who were busy WhatsApping and scoffing pop corn. Many of the audience came in late, some fifteen minutes after the film had started.…

General Practice, but not as you’d know it

A day in the life of Matsapha Comprehensive Health Care Clinic. The day didn’t start well. The King’s motorcade drove through Manzini at 7am, the start of rush hour, causing traffic chaos. We were late being picked up by the driver, and it took longer than usual to get to the clinic. The last patient…

Back in the saddle

I like a challenge. Life is more fun when there are new skills to learn and master. My role in Matsapha Clinic is a bit like being a GP. Half the work relates to people suffering from HIV and tuberculosis, the rest is like general practice, but hyped up on steroids. I see more serious…