Is Mel medically cleared to work in Swaziland?

Today I woke up to find that during the night I had stripped the sheets off my bed and somehow I had wrapped myself up in the quilt so that I could barely move. I managed to untangle myself and when I looked in the mirror, I didn’t recognise myself. For the first time in my life, I looked haunted. Yesterday was a terrible day and I consequently experienced nightmares throughout the night. I do not usually suffer nightmares. I had four people die in front of me yesterday. One of the patients included my 13 year old, Patience. I knew her death was inevitable, but in the end it was quite gruesome. The three other patients who died yesterday were all younger than 30. I have obviously paid witness to death many times, but nothing on the scale of this. Dying from AIDS is one of the most horrible deaths I have ever seen. Before I left Australia, I knew that I would face this- I thought I was prepared, but the reality is far more than I could have ever imagined. I’m not falling apart, in fact, I haven’t shed a tear. Perhaps this is my problem. Perhaps a cathartic howl would do me good. I had my cup of tea this morning (this is my “drug” of choice at such times), had a shower and managed to face the day as positively as I could. Only one patient died whilst I was doing my ward round. I see this as somewhat of a good day.

Nearly 50% of the population here have HIV. This statistic means that one in every two people have a life-limiting illness. Most will die before they are 40. Imagine if we lived that way in Australia or US. Imagine having this disease and knowing that your country does not have the resources to treat it. Imagine not having enough food or water so that your disease progresses so quickly because you are malnourished. Imagine that you have no job, no income and yet if you want to see a doctor you have to pay money. If your doctor orders a test, you have to pay money. If your doctor prescribes you a treatment, you have to pay money. In fact, so many people here cannot even pay the bus fare to actually get themselves to a doctor. Imagine if you are a doctor and you know that your patient has no money and you know that if you order a test, or even order paracetamol (acetaminophen), your patient somehow has to find the money. It breaks my heart and causes me great anguish.

What has compounded my grief this week is the knowledge of what lies ahead next week. Next week, the King of Swaziland turns 40. This also coincides with Swaziland celebrating 40 years of independence. Huge celebrations are going to take place. In the newspapers, they tell us that 40 Mercedes Benz have been bought to transport officials- one of who is Mugabe from Zimbabwe. The King is also going to take a new wife next week. This will be his 13th. This week, he sent 10 of his wives, their children, the nannies and bodyguards to Dubai on a chartered aeroplane. This is for a holiday and perhaps so he can have some time alone with his new wife. The thought of all this happening whilst I pay witness to what is happening here makes me sick. But this is Africa.
I was planning on going to the celebrations, but I feel as an advocate for my patients, I should not attend. I do not want to be seen to support this. However, escaping this place for a day may actually do me the world of good, so I will see how I feel.

On a lighter note, I thought I would share something that brought a smile to my face. I am going to be registered as a doctor here in Swaziland. I filled out the necessary paperwork and I then had to get a medical certificate signed to “medically clear me”
The certificate read as follows:
I hereby certify that I have examined …… and find that she is not mentally or physically defective in anyway. That she is not an idiot, epileptic, insane, mentally deficient, deaf and dumb, deaf and blind or dumb and blind and that she is not suffering from leprosy, TB or trachoma.

I am not joking, this is exactly what the official document said. I was eventually able to find someone who would sign it for me……