Reports from Swaziland

This is a topic that is discussed throughout this blog, but today, during the doctors meeting, we discussed a particularly interesting situation that I thought I would mention here. Around this time of year, many children get measles. When they come in for the HIV treatment, they would be waiting around the clinic for many hours, and in the process, exposing many other patients to measles as well.  One of the visiting scholar’s here suggested that we pre-screen them somehow and ask them to sit in another room while they wait.

A simple idea, right? But there are many other aspects to consider. Firstly, there is a question of whether families will even bring in their child with measles. Apparently, in Ethiopia, communities believe that if a child with measles is brought into a clinic and gets a shot, they will die– thus, children are not brought in many times. If they get very sick, mothers sometimes decide to go to the clinics, and when they go to the clinic, they get a shot of medication, but still die because they were so sick in the first place. This obviously reinforces the community’s idea that getting the shot causes death. Secondly, even if we put out a sign on the door of the clinic, asking people so sit in a certain place if they had measles or chicken pox, there is a question of whether the patient would be able to actually identify the illness they have. If we describe the symptoms on the sign, and say that people with a rash or bumps on their skin should sit aside, we may have many people lined up because there are many illnesses people have here with those symptoms. The simple idea isn’t so simple anymore!