Visiting the Mafutseni clinic

Today we split up. I was supposed to go the ART (antiretroviral therapy) clinic, but they thought the nurse I was to mentor was already out in the field. They considered sending me to the surgical unit, such as it is. I tried, gently, to disabuse them of that notion, when the change no longer was necessary.

The nurse for the ART clinic hadn't yet left and so I was privileged to join him in going to the Mafutseni clinic. Many of the patients are unable to get to the hospital in Manzini, so the hospital gathers up a box of meds and charts (and a number of large bags of corn meal) and takes off to rural clinics to dispense meds. In Mafutseni, the clinic consists of the container part of a large truck, taken off the truck, and placed on the ground. Two windows are cut into it, a corrugated roof is constructed on top and, voila, a clinic. There were people of all ages and in various stages of health waiting for us when we arrived. Some had walked long distances to get there. One of the patients came up to me, I think she thought I was a doctor, and started describing how proud she was of being in such good health, having been diagnosed in 2004. She, rightly, attributed that to her adherence to her meds and wanted me to know that. Anyone who knows anything about the side effects of these meds, and they don't have all the newer ones we have in the States, knows what an achievement this is. They use a lot of Zerit. We don't use that much anymore in the U.S. due to such lovely side effects as severe peripheral neuropathy and lipoatrophy, among other things. It was remarkable to see the patience and all around positive attitudes of these people, many of whom are quite ill, and almost all of whom are desperately poor.
When we returned, I had a long talk with the nurse about the educational needs of the nurses coming in to work in the ART clinic. Fleshing out the curriculum in that department may be a focus of my four weeks here.
An amazing day.