Reports from Swaziland

This week, Ben and I spent three days at the Cabrini Clinic, a small facility situated on St. Philip’s Mission in the eastern part of Swaziland. On the drive across the country (about an hour and a half away), I was quickly made aware of the fact that life in Swaziland changes drastically outside of the main cities of Mbabane and Manzini. We’ve spent most of our time here so far on paved roads, with reliable running water and electricity in houses and facilities, but my perspective was greatly expanded while at St. Philip’s. My eyes were opened to thatched roofs and makeshift shelters, with access to water for many families a very long trek away. The clinic itself was fortunate to have water and electricity, but the nuances of well-staffed and equipped facilities like we have at Baylor were not to be seen. Some clinics like this are fortunate enough to have a doctor visit once every one or two weeks, but aren’t able to have access as often as they would like or need. Things like unreliable transportation systems prevent many patients from coming to seek treatment, and thus many lives are regrettably damaged.

On the first morning, after the daily staff meeting and check-in, I went out “tracking,” which consisted of driving through the most rural homesteads and communities I’ve seen in order to find patients who had defaulted on medications, missed appointments, or been otherwise unresponsive to their HIV counseling and treatment. I had no idea this practice existed, as it is part of a recent effort to strengthening community linkages, but I am beyond impressed by the dedication to patients’ wellbeing that it demonstrates. It would be so easy to let unsuccessful clients slip into the cracks and stop treatment altogether, ultimately letting them give up on increasing their quality of life. However, this method of tracking utilizes the strong community ties and support of the area in order to maximize the treatment of patients, and it takes great emotional and mental vigor to be successful.

Over the next couple days, I was also able to sit with the nurses to show them our adherence charts, and they were all very excited about how straightforward the charts are. Though the response was wonderful, such enthusiasm actually made it very difficult to present, since I know that the design isn’t quite yet in the implementable stage. They were begging for me to leave them a few charts (even secretly), but based on the Ministry of Health’s orders, I was not able to. I can only hope that we are able to get the charts to such a stage quickly, as they would allow a very simple and realistic improvement in the daily lives of many clinicians. I was also able to demonstrate the centrifuge for the first time, since they had no alternative method to centrifuge blood or test for anemia, and they seemed to like the concept, even though they were not that familiar with the need for such a device.

Being in the field, with the physical and structural constraints that we have talked about all year up to this point, was a really great experience, and I look forward to spending more days doing outreach like we were able to do with Cabrini. Seeing such different situations, surroundings, and methods of approaching healthcare is very important to understanding the greater cause of health problems worldwide. I am very appreciative of this opportunity, because I know it has already significantly changed my outlook, and know that no matter what challenges I face here, I am learning more each day than I am even yet aware of.