Attitude is an important concept when tackling a problem of the magnitude of the HIV/AIDS epidemic. A conversation with a laboratory technician helped me to relate to the local viewpoint of the infection, and how this will affect the future of the epidemic in Botswana.
Upon spending time visiting the laboratory in Mahalapye, I became interested to see how HIV was monitored in the physical sense. Impressively, about half of the lab rooms were dedicated to HIV equipment, including numerous machines to measure viral load, CD4 counts and a bench dedicated to rapid HIV testing. As previously mentioned, Botswana uses two rapid HIV tests to best ensure that patients are accurately diagnosed. Whether there is need for this is hard to tell, though the commitment to reliable diagnosing must be applauded once more.
I spent time with the CD4 technician, who showed me how 40 samples could be processed in a matter of hours – yet another encouraging statistic, with respect to meeting the needs of the local people. More interestingly, though, he spoke of the devastation that HIV/AIDS had caused in the past 25 years or so, remembering the great suffering of the Motswana people. He remembers a time where HIV/AIDS was an unknown entity and there was absolutely nothing that could be done for those suspected of having contracted this unknown illness.
HIV/AIDS had changed Botswana, he continued: a previously improving mortality rate was seen to skyrocket once more, seemingly out of the control of the healthcare system. Attitudes changed towards healthcare. The more that people died, the less the locals believed in medicine, opting instead for traditional methods with no evidence background. Alongside this, death became once more commonplace in society. This has left the Motswana almost comfortable with the idea that their loved ones may not survive, an attitude I have encountered time and time again in the hospital.
One woman exemplifies everything I have just mentioned. Her twin babies were admitted to the paediatric ward with severe malnourishment, and subsequent widespread oedema. I saw her on the ward a few days ago, following the sad passing of one of the twins. Traditional medicine came out as the reason for her delayed presentation. The doctors did not hold back in letting her know. Yet she still seemed indifferent and moderately cheery, despite the death of her son the previous day. With her other son in great peril, it struck me as heart-breaking that she seemed unaffected by the whole ordeal. This, however, typifies the attitude to death in parts of rural Africa, where HIV/AIDS in particular has brought such destruction in the past. What will it take for this attitude to change?