In 2007, while in medical school, I spent six weeks working in a hospital in Gabarone, Botswana. I didn’t know it at the time, but those six weeks would change the direction of my career and life.
I was excited to go to Africa because I had been interested in HIV and TB since a college medical anthropology course, where I read a book called “Infections and Inequalities” by Paul Farmer.
Infections and inequalities was raw and honest. It told the stories of HIV and TB patients (many with drug-resistant TB), and the structural violence that affected their lives. Farmer wrote about the struggles of people like Darlene Johnson, born in Central Harlem, and Guylene Adrien, born in Haiti’s central plateau. The book also emphasized the interconnectedness of the rich and the poor parts of the world. Its conclusion was passionate:
“Three decades after the Surgeon General claimed that “it’s time to close the book on infectious diseases,” these pathogens, most of them treatable, remain the world’s leading killers. Is this the best we can do? If we fail to improve on our past performances and to resist the current trends, we risk sapping modern medicine of its vast power. If we lived in a utopia, simply practicing good medicine or conducting quality research would be enough. But, no matter how you slice it, we live in a dystopia.Increasingly, inequalities of access and outcome characterize our world.These inequalities could be the focus of our collective acton as engaged members of the healing and teaching professions, broadly conceived. We have before us an awesome responsibility – to prevent social inequalities from being embodied as adverse health outcomes. We have the technology. The poor, we’re told, will always be with us. If this is so, then infectious diseases will be, too- the plagues that the rich, in vain, attempt to keep at bay.”
Upon arrival in Botswana, the colors I saw were browns and pinks. Dust, boulders, scrubby bushes, flowering trees and funny-shaped cacti.
Most of the patients I helped take care of those six weeks had HIV and TB. Many died. But I leave their harrowing stories for another day. Today, World TB day, is for reflection and renewed commitment.
What have been the turning points in your life?