After my adventures up on the border with Chad and Central Africa, I thought that returning to the hospital in Boguila would be less adventuresome... somehow more staid than the derring do of the mobile clinics.
I spent the day interviewing the national staff (inadvertently getting in the middle of a contract negotiation crisis) and talking to the expats.
An Angolan nurse who runs the HIV/AIDS and TB program at the hospital told me that he really hopes we can do more about HIV and stigma in the area. He had treated a woman with HIV and TB who was about 26 years old. She had a small baby and her mother was taking care of her in the hospital where we were giving her medicine to allow her to live with her illness. Her mother had other children and grandchildren to look after so took her out of the hopsital and brought her home. In Africa, it is up to the family members to bring food and nurse the patients. It's not unusual to go into the Intensive Care Ward and see an old man with three ladies sitting on his bed, trying to feed him some manioc. I had been told in our Markounda office that one of the problems we had ws trying to convince people to go to our hospital in Boguila because it was so far away (almost a three day walk) and people didn't like the food. Which sounds flimsy until you realize that in order to take care of someone who might die anyway, you have to prioritize them over all the children and family members that you normally take care of. You have to sleep surrounded by strangers and scavenge for food in an area that is not your home. It's not that easy.
Anyway the Angolan nurse was worried about this woman because he knew she didn't have acess to her medicine. He asked the mobile health clinic to go into the village and look for her. They did and they found her lying on a mat, near to death. The family refused to return with her to the hospital. The staff demanded of everyone “Who will save this woman’s life?”. There were no takers.