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…

Live Wire

I could tell this was going to be a rowdy session when the teacher warned the class, “The visitors will be showing some graphic images of sexual diseases, so if anyone feels that they are not mature enough to see them, please leave now.” This produced a roar of anticipation from the boys on the…

NaHSAR at Pigg’s Peak Hotel & Casino

We were scheduled to leave after the project meeting on Friday morning, but I had a patient with HONK. That’s the abbreviation for HyperOsmolarNonKetoacidotic coma. A type 2 diabetic lady had inexplicably stopped taking her medication. She was as dry as a crisp and sweeter than honey. Once I was happy she was on the…

Preparing for NaHSAR

NaHSAR: The 12th National HIV Semi-Annual Review took place this weekend, here in Hhohho. I must be going deaf. I misheard and thought I was bound for Houston when the clinic supervisor told me I was going to NaHSAR. It should have been held last weekend but there was no room at the Pigg’s Peak Hotel…

Sex in Two and a Half Minutes

Swaziland is a sexy country. Perhaps this is why, a decade ago, it lost a quarter of its population to HIV/AIDS and continues to have the highest prevalence of HIV in the world. Perhaps this is why last week in clinic,  I had an 83 year old man asking for help to maintain his erections. Or…

Tuberculosis

If I had the luxury of a choice between being infected with TB or HIV, I think I’d choose HIV. Most of my patients don’t have that choice; if you have HIV, you have a 50% chance of developing TB. And if you are diagnosed with multi-drug resistant TB (MDR-TB) at the same time as…

Soka Uncobe: Male Circumcision in Swaziland

Soka Uncobe is the slogan of the Male Circumcision (MC) programme which began in 2008 in Swaziland. A Task Force led by the Ministry of Health aimed to integrate male circumcision into the services of all hospitals and health centres. Its ambitious target was to circumcise of 80% of men in the 18-49 age group…

Circumcision Day

In Africa, it has been shown that male circumcision substantially reduces the risk of HIV transmission from women to men. Of course, using condoms will reduce the risk even further. The Ministry of Health has set Kakumbi Rural Health Centre a male circumcision target, and Nurse Martin Mwanza intends to meet it. When I arrived…