A typical Monday for me begins with a 4WD ride, heading over unpaved roads from the small town of Thyolo to Thekerani village where I spend most days of every week working. Nowadays, it has been very cold . Last May, the rainy season has ended and the thick fog marked the beginning of winter.
© Husni Mubarak Zainal

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 go between 10-15 degrees Celsius. 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 mutter 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 has become 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 wakes me up from my vivid dream and flies me back to reality – to a very busy car with a heavy box on my lap. Every trip, the car is packed with nurses, a clinical officer and with boxes of essential medicines and antiretrovirals (ARVs) – drugs for people infected with HIV, which we receive from the Ministry of Health. 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.
© Husni Mubarak Zainal

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 who wave every time 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 crowds 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 a 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 into the house to leave my personal belongings and also to stretch my joints after a long and tiresome trip as I prepare myself for 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 the Ministry of Health (MoH). Medecins Sans Frontieres (MSF) assists the MoH in decentralizing healthcare for HIV and tuberculosis (TB) from district level to rural health centers. One noontime, I receive 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 on my mobile phone twice and spontaneously grab my medical bag. I walk fast. I am almost running to see the patient immediately. My adrenaline has eased away the pang of hunger and body pain. The patient I am attending to has 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 suspect that she has ectopic pregnancy – a pregnancy complication which is life threatening to a mother. The pregnancy cannot continue to birth. All we can do is to stabilize the patient and refer her to the hospital for surgery. This article is first published in www.kompas.com in Bahasa Indonesia language.

Comments (1)

  • anon

    Dear Kak Husni reading your blog is so encouraging and not to mention I'm so proud of you, heard your name a lot in the campus and been willing to join MSF since i read the dr. James's blog All the best for you in the field and also for the patients, hopefully I'll be able to join you

    Sep 21, 2012

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