Operating on Swazi Time
When we first arrived in Swaziland, Dr. Stephanie, one of the BIPAI doctors, sent us a welcome email telling us to enjoy Swazi time. Since that time, we have had several experiences that got us well acquainted with this infamous Swazi time, but today, it afforded us a rather unique opportunity.
Yesterday, we finally had a meeting with ICAP, in which we clarified the issue of the missing adherence charts (a project started here last year). So today, we duly went over to a print shop in Mbabane where the order had been made. We arrived, confirmed that the proofs they had were of our charts, and placed an order for them to be printed.
While we were waiting for the driver to come pick us up, which has become a bit of a custom now, we decided to explore the complex a bit. The print shop was located in an industrial area of the city, part of a large, two-story building. We found an environmental building, a clothing store, and a dentist office!
Curious, I stepped inside to see what a Swazi dentist office would be like. It was a small office, with room for only one patient in the back. The front reception area was even tinier and was separated from the procedure room only by a glass door covered in thin lace. While the facilities were not spectacular in any way – they were fairly comparable to conditions found in the US – it was quite interesting to listen to the dentist talk about the standards she kept.
One major point of interest is that she took the same precautions with all patients as though they are all HIV positive. Often times, patients come to her office without knowing their status or even having any desire to be tested. As an oral healthcare provider, she is often able to identify co-morbidities that only affect those who are HIV positive and uses them as evidence to help convince patients to get tested. Patients need this sort of persuasion because in Swaziland, despite the prevalence of HIV, there is enormous stigma against it (as discussed in my previous post). Thus, many adults would rather not know their status and get treatment than to be looked upon as an untouchable.
The dentist gave personal examples of patients who she had seen things like angular cheilitis and hairy leukoplakia, which are only found in immunocomprimised patients. Being a dentist in Swaziland, she was in the unique position to see these patients in a seemingly unrelated setting and help them gain access to HIV care. What an amazing story! And the only reason I heard it was that things in Swaziland run on, well, Swazi time!