A typical Monday for me begins with a 4WD ride over unpaved roads from the small town of Thyolo heading to Thekerani village where I spend most days of every week working.
Nowadays, it has been very cold already. Last May, the rainy season has ended and the thick fog marked the beginning of winter.
Similar to many Asians, Africa in my imagination is barren, dry land, scorching hot weather, and packed with wild animals. It never crossed my mind that winter exists here. There is no snow but temperatures can drop to 6 degree celcius!. It is cold enough to make my tropical blood shiver. I am not prepared.
The jacket I bought in flea market few weeks ago keeps me warm, but not warm enough for the season. “Seems it’s getting colder and colder every month…” I muttered while rubbing my palms to each other to create a heat that I know won’t last long.
That’s why, on my every trip to Thekerani, it became a habit to fall asleep and dream that I am laying sluggishly in my hammock at Hoga Island, Indonesia bashing under the tropical sun with my iPod and shuffling songs from my favourite band Maliq&D’Essentials. But the bumpy road always woke me up from my vivid dream and flew me back to reality – in a very busy car with a heavy box on my lap.
Every trip is occupied with nurses, a clinical officer and packed with boxes of essential medicines and antiretrovirals (ARVs) – drugs for people infected with HIV. Hence, it leaves me with very little space to sit and stretch my joints.
“I feel like a sardine in a tin can!” I exclaimed once when one of the nurses asked me what I thought about the journey. She laughed at my answer.
The journey to Thekerani always fascinates me. We cross a vast expanse of tea plantations fenced with a tidy line of macadamia nuts trees. We pass by curious faces of tea leaves pickers waving everytime they see us driving by. Along the way, the car has to stop several times in various health centers to drop-off the staff. I am always the last one to be dropped off. Though every health center is different, the scene is always the same. There are always crowd of patients holding their colourful mastercards – a tool that we use to monitor the status of patients on HIV treatment – queuing to get their ration of ARVs. Normally, each patient will receive one to three months supply of ARVs, depending on their health condition and availability of the drugs in the clinic.
Usually, upon arriving in Thekerani, I go first in the house to leave my personal belongings and also stretch my joints after a long and tiresome trip as I prepare myself to another hectic week. However, there are times that I have to rush to the health center, immediately.
In Thekerani, I am the only doctor. The rest are nurses and staff of Ministry of Health. Medecins Sans Frontieres (MSF) assists MOH in implementing the provision of decentralized healthcare for HIV and tuberculosis (TB) from district level to rural health centers.
One noontime, I received a short message from the nurse in the health center: “Emergency patient in maternity, we are expecting you in the clinic ASAP!” I read the message in my mobile phone twice and I spontaneously grabbed my medical bag and shouted to Andy to follow me in the health center.
I walked fast. I was almost running to see the patient immediately. My adrenaline had eased away the pang of hunger and body pain.
The patient I attended to has a massive vaginal bleeding with a history of abdominal pain and no menstruation for two months. The pregnancy test showed that she was pregnant and we suspected that she has ectopic pregnancy – a pregnancy complication which is life threatening to a mother and the pregnancy cannot continue to birth. All we could do was to stabilize the patient and refer her to the hospital for surgery.