Preparing the Ground

December 8th, 2010 by Jess Cosby

To every one’s relief, the rains have continued since the first, sharp showers of last month.  The previous few years have been dry years, with the rains coming late, or not at all.  After preparing the soil at the first sign of rain, people plant their land with food for the future.  If further rain does not follow swiftly, these seeds, planted with expectation and hope, will shrivel in the soil and yield nothing.  Late rain is, in some ways, as good as no rain at all.

There is a constant sense of sadness in the clinic for those patients who also arrive too late, when, despite our best efforts, they are past any help at all.  They come draped on blankets in wheelbarrows, fragile and barely conscious.  Unable to deny or resist any longer.  They come with desperate family members, who have probably watched their demise helplessly.  They arrive with a frail hope, but, perhaps, deep down, they also understand that coming too late is, in some ways, as good as not coming at all.

But, like the rains that are falling even as I write, not all patients arrive too late.  And when they come, in the same way that the rains revive the drought- weary land, we are also revived and refreshed and restored.  We are reminded that our work has value.  Because some of our patients come right on time.

Like the group of school leavers I met last week who came to be tested for HIV.  I held my breath whilst we waited for the results.  They were all negative.  They were all counselled on how they can stay negative.  These boys are just about to take their next step towards adulthood and independence and they arrived right on time.

There are other patients too.  Like the pregnant women who come to register for our programme to prevent mother-to-child transmission.  They know that if they come early and take the anti-retroviral drugs, they have the best chance of having a miraculously HIV negative baby.  Right on time.

Sadly, there are still many barriers to coming to the clinic, so many reasons to deny, delay and defer.  We’re trying to remove these barriers, one by one.  Cost is just one.  High unemployment and the poverty and insecurity that follows makes healthcare inaccessible for many.  Our clinics are free.  Travelling is a challenge in the rural communities we serve.  We are supporting isolated clinics so they can offer quality services to the same population we treat.  Stigma, sadly, remains another barrier, and, for me, the most painful.  Our community liaison officers seek to address this through education, and through the kind of openness that ignorance and falsehoods hate.

For the past few months, early in the morning, I have passed by fields full of people digging soil, moving rocks and sweating over the earth.  I have watched as wasteland is cleared and rich, dark soil is turned with backbreaking effort.  We can’t control the rain and make it fall on these hungry fields.  Likewise, we can’t force our patients to come and receive testing and treatment, however much we would like to sometimes.  All we can do is prepare the ground and wait with hopeful expectancy.  Often, like the rains, to our relief, they come.

Mourning

November 18th, 2010 by Jess Cosby

I’m standing in the rain outside a cinder block house in Mkoba listening to the sound of drums and funeral songs escaping from the open doors and windows. The rain has finally come and shattered the heavy heat that has been hanging over us all.  The storms are spectacular.  The sky turns a sudden, menacing black and the wind picks up, bothering the dry, dead branches of the tall palms.  Rainfall is heavy and insistent.  If you are caught off guard, however close the shelter, however fast you move, you will find yourself wet and cold and shivering by the time you reach cover.  And when the rain comes, making people wet and cold and shivering, these people celebrate.  People here always seem to find a reason to celebrate, even in the midst of grief.

Water gathers in rust-coloured pools around my feet as we wait in small huddles to enter the room and file past the open coffin.  Family and friends have travelled great distances to share this moment of grief together.  Funerals last for several days and cannot start until the most important family members are present.  Traditionally, word of the loss would have spread locally through the haunting sound of women keening.

I stand in front of the mourners and my words of condolences, carefully rehearsed in Shona and word-perfect just moments ago, desert me.  Actually, all words desert me, and I stand mutely, silenced by suffering.  The funeral is not a patient this time, but a colleague, a friend.  I stand and share with people, who did not need to be reminded how cruel and unjust life can be, as they learn new lessons in loss.

I stand there in the wet, trying to remember that the dark, brooding sky, this cold, heavy rain, is actually a benediction.  A reason to celebrate. Trying to remember that there is a life here to celebrate too.  Later today, our friend will be moved to her rural home to spend a final night there.  Tomorrow, at the burial, the community will gather around the grave and share stories.  We’ll honour the memory of our loved one.  Remember her kindness and compassion.  Maybe we will talk about her work with MSF.  Her commitment to a job which ameliorates this grief and suffering that we can never entirely avoid.

Perhaps it will rain again.  The sky will become dark and threatening.  But in the fields all around, full of waiting crops, the rain will be making all things new.

Minutes, Meetings and Spreadsheets

November 10th, 2010 by Jess Cosby

It’s been a long time since I’ve written.  The seasons have changed here in Zimbabwe and Gweru is now dripping with heat and jacaranda blossom.  In town, the sun ricochets off glass and metal and soaks into the tarmac.  In the countryside of Lower Gweru, a warm wind whips up the dust and makes our patients’ long walk to our clinic longer still.  When they arrive, they wait patiently in long lines on benches pulled into the shade, or lie under the trees in the shifting shadows.  Everyone, everything, is waiting for rain.

I don’t know why I haven’t written for so long.  Maybe it’s a result of the inertia that the heat inevitably inflicts.  Maybe.  Or perhaps it’s not that at all.  If I’m honest, I think it’s because recently I’ve been immersed in meetings and minutes, reports and seminars.  Spending less time in the clinics, less time with patients, it’s all too easy to lose sight of your purpose, to lose your inspiration.  Basically, I have a suspicion that spreadsheets stole a little of my soul…

I think I got it back yesterday in a very simple way.  It doesn’t take much.  I just shared a journey with a patient.  One of the five thousand patients we treat at our HIV clinic in Lower Gweru.  Just one.  She was a young woman who needed to be transferred to town to have a chest x-ray.  Too sick to go alone, I accompanied her.  I could do very little for her.  I helped her take sips of tepid water from an empty coke bottle.  I steadied her as she moved from the vehicle to the wheelchair and back again.  On our return to the clinic, she shifted listlessly, trying to make her body and her breathing more comfortable.  Eventually, she rested her head on my shoulder and slept.  Her hair was damp from the heat, from the fever, from the effort of movement.  I braced myself and tried to absorb the impact of the road, tried to make the journey a little shorter for her.

Back at the clinic, we held the chest film up to the light.  It was easy for the doctor to diagnose tuberculosis.  It was what we suspected.  Here in Zimbabwe, amongst our HIV positive population, tuberculosis has swept through the country like fire through dust-dry savannah.  It is the biggest killer of HIV positive patients here and, without access to drugs to treat the disease, prognosis is poor.  Here in Lower Gweru, thanks to spreadsheets and international orders and policies and protocols, we have the drugs.

This patient doesn’t know it, but she needs someone to sit in meetings discussing how best to implement WHO guidelines.  She doesn’t know it, but she needs someone to pour over spreadsheets, calculating consumption rates of medication, estimating project needs, placing orders.  Because heaven forbid a patient arrives one day in need of lifesaving medication that we do not have.

I need to learn to juggle all this.  The nurse in me wants to rush always to the clinic.  Another part of me knows that this, on its own, is not enough.  I need to find a balance.  To sit at my desk and write reports, to attend the meetings and discuss all the issues, without losing sight of the weary woman who thirsts for a sip of water.

Outreach at the Gweru Agricultural Show

August 6th, 2010 by Jess Cosby

Despite the surprise of finding Gweru recently on a world map (in the absence of the likes of Harare and Bulawayo) the fact remains that Gweru is, in reality, a small town that feels like a large village.  I’m certain that I could walk from one side to the other (and probably back again!) in the course of a lazy, uneventful morning.  And it’s not just about the geography.  Locals will often know the name, if not the face, of anyone you care to mention and they’ll probably know what they are doing too.  Possibly even before the person in question does.  Being a part of this small community means many things.  Most recently, I realized that it means that an annual event like the Gweru Agricultural Show is a very big deal.

For many of the local businesses and organisations that would be representing themselves at the show, work started a long time ago.  For me, it began early on the morning of the event itself, where, equipped with coffee, our talented communications officer, Patricia, and myself sorted and folded several hundred T-shirts adorned with various health messages.  TB can be cured, even if you’re HIV positive.  Stop child abuse.  MSF is on the move against TB and HIV.

Later in the day, at our show stall inside a tent, we liberally distributed health information leaflets and encouragement, sound advice and condoms.  As I took my turn manning the stall, a young teenager in a bottle-green school blazer approached the table, and I offered him the chance to win a pen in return for answering my questions correctly.  What do you know about HIV?  I asked.  It’s a virus that attacks the CD4 positive T helper cells, came his reply.  Clearly, I’m going to have to up my game, I thought.  And hand over the pen….

Next, a gaggle of young girls arrived and after we had talked about TB, I asked if they had any questions.  Yes, said one girl.  If we are vaccinated against TB as babies, how come there is so much TB in Zimbabwe now?  I was struck by the intelligence of the question, and it occurred to me that, perhaps, asking the right question is almost as important as having the right answer.  Curiosity, in a world of taboos, misunderstandings and assumptions, rather than killing the cat, could actually save its life.  There’s hope for the future, here, I thought.  These kids are smart.

The excitement around the prizes spread quickly and groups of children soon littered the show ground, huddling around the pamphlets we had provided in order to be able to demonstrate sufficient knowledge to earn the much coveted pens and T-shirts.  Our table was constantly surrounded by youngsters and adults.  The older members of our audience were encouraged to get tested, sometimes being led over to the testing facility that MSF was supporting within the grounds.  Know your status.  It’s the first part of the battle.

With the younger ones, we searched for appropriate questions.  One little girl almost stumped me.  She came with her older siblings and she could barely see over the table.  She was desperate for a pen.  She solved my problem by spontaneously coughing in front of me, and instantly covering her mouth.  More than simply a polite gesture in a country riddled with TB.  This practical demonstration of good heath behaviour earned her the prize and she left happily.

At the end of the day, I took a short cut on the way home.  As I walked through the waist-high grass, I heard the group of excited children before I saw them.  Raised voices and laughter and shrill whistles.  As I rounded the corner, they appeared like exclamation marks.  Pink, neon sunglasses.  Bright plastics beads.  Bags of candy floss.  They smiled and waved and I paused to smile and wave back.  And so they went on their way.  Hope for the future in tiger masks and tiaras.  A vivid splash of colour against a winter landscape of khaki grey.

Despite the surprise of finding Gweru recently on a world map (in the absence of the likes of Harare and Bulawayo) the fact remains that Gweru is, in reality, a small town that feels like a large village. I’m certain that I could walk from one side to the other (and probably back again!) in the course of a lazy, uneventful morning. And it’s not just about the geography. Locals will often know the name, if not the face, of anyone you care to mention and they’ll probably know what they are doing too. Possibly even before the person in question does. Being a part of this small community means many things. Most recently, I realised that it means that an annual event like the Gweru Agricultural Show is a very big deal.

For many of the local businesses and organisations that would be representing themselves at the show, work started a long time ago. For me, it began early on the morning of the event itself, where, equipped with coffee, our talented communications officer, Patricia, and myself sorted and folded several hundred T-shirts adorned with various health messages. TB can be cured, even if you’re HIV positive. Stop child abuse. MSF is on the move against TB and HIV.

Later in the day, at our show stall inside a tent, we liberally distributed health information leaflets and encouragement, sound advice and condoms. As I took my turn manning the stall, a young teenager in a bottle-green school blazer approached the table, and I offered him the chance to win a pen in return for answering my questions correctly. What do you know about HIV? I asked. It’s a virus that attacks the CD4 positive T helper cells, came his reply. Clearly, I’m going to have to up my game, I thought. And hand over the pen….

Next, a gaggle of young girls arrived and after we had talked about TB, I asked if they had any questions. Yes, said one girl. If we are vaccinated against TB as babies, how come there is so much TB in Zimbabwe now? I was struck by the intelligence of the question, and it occurred to me that, perhaps, asking the right question is almost as important as having the right answer. Curiosity, in a world of taboos, misunderstandings and assumptions, rather than killing the cat, could actually save its life. There’s hope for the future, here, I thought. These kids are smart.

The excitement around the prizes spread quickly and groups of children soon littered the show ground, huddling around the pamphlets we had provided in order to be able to demonstrate sufficient knowledge to earn the much coveted pens and T-shirts. Our table was constantly surrounded by youngsters and adults. The older members of our audience were encouraged to get tested, sometimes being led over to the testing facility that MSF was supporting within the grounds. Know your status. It’s the first part of the battle.

With the younger ones, we searched for appropriate questions. One little girl almost stumped me. She came with her older siblings and she could barely see over the table. She was desperate for a pen. She solved my problem by spontaneously coughing in front of me, and instantly covering her mouth. More than simply a polite gesture in a country riddled with TB. This practical demonstration of good heath behavior earned her the prize and she left happily.

At the end of the day, I took a short cut on the way home. As I walked through the waist-high grass, I heard the group of excited children before I saw them. Raised voices and laughter and shrill whistles. As I rounded the corner, they appeared like exclamation marks. Pink, neon sunglasses. Bright plastics beads. Bags of candy floss. They smiled and waved and I paused to smile and wave back. And so they went on their way. Hope for the future in tiger masks and tiaras. A vivid splash of colour against a winter landscape of khaki grey.

One foot in front of the other

July 13th, 2010 by MSF Field Blog

On the evenings when meetings don’t run over and patients don’t arrive too late, I like to walk home from the office. It’s a golden walk, with the sun low in the sky behind me and my lengthening shadow ahead.

After leaving the office compound on the main street of Gweru, the town quickly peters out. My path takes me through the police camp, where I greet the clutch of children who come out to meet me. Then behind the Anglican Church. Sometimes I have the pleasure of hearing the choir practicing and I stop dead to listen. Then my route takes me behind the provincial hospital. I cut through a field of maize and turn and I’m on red earth. Now my path runs alongside the railway track and I’m nearly home.

Back in England, on my walk home from the Emergency Department, I would probably be trying to quantify my day. Separating the who from the what and adding how much. Confidently dividing the successes and the failures. Here in Africa, I don’t seem to be equipped with the correct tools for this task. I just don’t know how to take the measure of a day. So I just let the day slip through my mind and settle somewhere deep.

Today, I’m thinking about a generous gift of avocados from a woman who probably didn’t have food to spare. I’m thinking about the colour of a stillborn baby’s perfect feet and the shadow in the empty crook of her mother’s arms. The agonising and helpless journey we spent together in the back of the land cruiser. I’m thinking about the pleasure of being chosen by a child. Taking the offered hand, returning the smile. And realising suddenly that the tuberculosis medication is working and this little boy is miraculously, wonderfully, being restored to health and mischief.

As my mind drifts onto this path, it’s easy to forget that I’m actually in a race. To be home before dark is more challenging now winter has arrived. I don’t make life easy for myself either, as a weakness in me makes me chose the prettiest, not the fastest, route. Even when I arrive home breathless, on the brink of dusk, it seems worth it just to pass the trees jewelled with seed pods and blossom and avoid the noise and dust of the hectic Shurugwi road.

But still, I don’t know how to take the measure of a day. I don’t know whether simple gratitude for deep generosity is enough, when you can’t possibly return the favour. I don’t know whether just being present with a grieving mother is enough, when you can’t save her child who was born too early, born upside down. I don’t know whether rescuing one little toddler from an untimely death is enough, when the disease kills almost two million people a year.

I don’t know how to take the measure of a day. So I just let the day slip through my mind and settle somewhere deep. And I keep putting one foot in front of the other.

White noise (but tiri kuedza)

June 30th, 2010 by Jess Cosby

White noise.  I’m hunched over the radio, but however close I lean to the receiver, I just hear white noise.  I’ve got my eyes closed and I’m frowning.  I’m actually trying to squint with my ears.  It sounds like a mouse has crept into the microphone and is scrambling around in there.  Some small creature, tormenting me with the thought of a miscommunication.  Our radio operator takes the receiver.  “Message copied, Mike Kilo One.  Gweru Base out.”  What message?  He grins.  I sigh.  Communication here, as everywhere, is often challenging, occasionally frustrating, but always essential.

It’s not just about the technology, although it feels like I’m at its mercy sometimes.  It’s not that I’m not grateful for the mobile phone network here in Zim.  But when I’m balancing on a chair in the corner of the filing room trying desperately to send a message, it feels like a fickle friend.  It’s not that I’m not grateful for the landline service, but when I finally manage to get through to my family after trying and trying and the line is cut suddenly, irretrievably, the cliff hanger conversations feel like a mixed blessing.  But, it’s not about the technology.  It’s about people.

I’ve been told that I’m fortunate that there are only two main tribal languages here in Zimbabwe.  I’ve been told that I’m lucky that I don’t travel just a few miles down the road and find a new, mysterious dialect.   But I feel like it doesn’t really matter how many languages you don’t speak.  The confusion and the potential for isolation is the same.  Still, I love to listen.  I enjoy the new rhythms and the unfamiliar sounds.  The soft, percussive clicks of the Ndebele tongue are like the sound of fingers gently tapping on wood.  I listen like someone searching for secret, hollow places.

To say that my understanding of Shona is better than my understanding of Ndebele is not admitting much, but I can say at least that I’m an enthusiastic student.  When I first arrived, I would push off from the shore with a few simple greetings and quickly find myself drowning in words, without finding any meaning to grasp onto to save myself.  Now, I’m still floundering gracelessly, but just occasionally, I come up for air and it feels good to float, if only briefly.

Actually, it doesn’t always feel good!  Because one of my self-appointed (and much loved) Shona teachers has been concentrating on the more colourful vernacular, I was able to catch a comment made in the office about my generously proportioned rear!  I’m told here in Zim this is a compliment, although it’s a stretch to appreciate this.  I would suggest that not everything translates!  Like the other ‘compliment’ I received recently.  I am, apparently, worth ten cows.  It came with a proposal of marriage and I’m told it’s a good price.  I promised to pass the offer on to my father, but I’m not sure how he’ll respond!  Again, I would suggest that not everything translates…

Communication is challenging.  It takes patience and grace.  Mostly, I’m discovering, on the part of my new friends and colleagues.  I’ve been accidently asking men how their husbands are in public.  I’ve had people sit for a long time trying to explain some linguistic subtlety that I over simplify or misunderstand.  Or remind me of words again, that I’ve forgotten, again.  I’ve had people stand quietly for long minutes whilst I desperately search for words that are escaping me.  Mira, mira.  Wait, wait.  Ndiri kufunga.  I’m thinking.

But whether I’m puzzling over the radio, learning a new Shona word, chatting with a colleague in the office or speaking with a patient, I am constantly reminded how essential good communication is to our relationships and how important these relationships are to our work.  Sometimes it feels like two slow steps forward, one shove back.  Two small misunderstandings, one brief connection.  It will never be perfect, never always right.  But tiri kuedza.  We’re all trying.

This world is crazy, mixed up.

May 18th, 2010 by Jess Cosby

Ntabamhlope is one of my favourite clinics. And it’s not just the fascinating name that I enjoy. It’s the cross-country journey we take to get there. It’s the ancient, broad trunked tree in the corner of the compound. It’s the way someone has planted flowers around its base and is taking the trouble to tend them. The pharmacy is almost bare, but the limited stock is stacked neatly on the shelves in alphabetical order. The nurses there are already very skilled, but they let me teach them what I can and their uniforms are the whitest I’ve ever seen.

Arriving today, though, feels different. I’m greeted by a tense nurse. “We’re glad you’re here.” I fight the urge to look behind me, even though I know I’m alone and they mean me. Suddenly, I’m not glad to be here at all. My heart sinks a little as I’m led into the clinic room.

The patient is a young woman. She’s emaciated, exhausted. I’m relieved to see her make eye contact with me when I greet her. Less relieved when I instinctively reach for her wrist, and find no radial pulse. I watch her carefully. She’s taking a short, shallow breath every second. Every second. Too much and not enough.

The three of us work together. We can’t get a drip in. We can’t get a drip in, and then we do. Fluids. A double dose of co-trimoxazole. Whatever intravenous antibiotics we can find. A flurry of activity and then, much, much too quickly, there’s nothing else to be done. We look at each other. Idle hands are a nurse’s biggest fear.

We need to transfer her to the provincial hospital, which is nearly ninety kilometres away on terrible, bone-shaking roads. We carry her to the land cruiser and lay her on a sheet in the back. Jury rig a drip pole. Something soft for her head. It’s a long, uncomfortable journey for me, watching my patient’s chest rise and fall much too rapidly. Longer for her grandmother. Longer still for her. We take her to the female medical ward and transfer her onto a stained mattress. There’s no oxygen. A hospital without oxygen. And she’s exhausted. We hand over to the nurses, and I leave hoping we’ve offered more to her family than false hope, and the burden of paying to have her body returned ninety bone-shaking kilometres back the way we came.

At my next opportunity, I go to visit her. A couple of days have passed and I’m expecting to hear the worst, hoping to hear better. I go to the nurses’ station and enquire after her by name. The nursing sister looks at me. “She just stopped breathing,” she says. Just stopped breathing? JUST stopped breathing? Then grab some oxygen, a bag-valve- mask. She’s twenty-six years old. Put out a crash call. Do something. But there’s nothing to be done, and the nurse in front of me has seen this too many times.

“Does this happen in your country?” she asks. I’m shaking my head. No. The short answer is no. I could elaborate on this. Of course people die young. Of course people suffer. I could talk about statistics, demographics or philosophy or religion. But I’m talking to a woman who is nursing in a country with one of the lowest life expectancies in the world. The whole world. So, essentially, the answer is no. No, it doesn’t happen in my country.

I’m still shaking my head slightly when she turns away. “Does MSF have gloves?” she asks. “Please. Bring some gloves.” How about piped oxygen? A defibrillator? An anaesthetist? How about some justice? Gloves. Right. No problem.

Recently, I was talking with a friend at the office who had just returned from yet another family funeral. I’m so sorry. “It happens, Jessica, it happens. Jessica, it happens.” Shaking his head gently with an acceptance that both awes and infuriates me. It happens. But not to everyone, not everywhere. Some people have a greater chance of dying young, or losing someone young, than others. It’s the inequality that is most painful. Life is hard, sure, but harder for some than others. Which, I guess, is why we are here. This world is crazy, mixed up. And in the crazy, mixed up world of MSF, the most obvious reason to leave becomes the biggest reason to stay.
We weren’t able to save this woman’s life and today I can only tell the story. But at least the event won’t go unrecorded. At least it will be noted by someone other than the children she has left behind. On Monday, in a small town in southern Africa, a young woman who shouldn’t have died, died. Her name was Gunya. This is all we can do. We prevent the suffering we can, and bear witness to the rest.

We don’t beat the statistics, but…

May 13th, 2010 by Jess Cosby

The mango season is over here in Gweru, but everything else, for me, is just beginning.  The slow learning of language and landscape that makes me feel like an infant again.  Adjusting to a climate that finds me shivering in the early hours and then hurrying towards the shade at noon.  Recognising faces, remembering names and then, finally, coming to know the characters of my new friends and colleagues.  Adapting to my new home- lizards on the patio, geckos in the kitchen and frogs in the shower.

Over the past few weeks I have visited district hospitals, rural clinics and town offices.  I’ve had meetings with doctors, nurses, community workers and head men in aging provincial offices and under trees.  Slowly, slowly, from the blur of arriving, my work here is coming into focus.

At the end of March, I spent my first full day as supervisor at Lower Gweru clinic.  Early in the morning, we took the road from Gweru through the countryside, past the dam.  On our arrival, patients were already gathered under the thatched shade- almost two hundred of them.  Most arrive on foot, others on donkey carts.  Sicker patients often arrive in wheelbarrows.  I was greeted by the news that two of our four nurses were off sick.  We grit our teeth, juggle our small remaining team and get to work.

I find myself assisting a student in the bleeding room.  I can’t see the end of the queue, but we put our heads down and, after a long morning, eventually the last patient is bled.  The many samples are taken to be processed at the MSF-run laboratory at Gweru Provincial Hospital, and we move on to perform the daily rapid HIV tests.

A small group of patients, who have spent the morning receiving pre-test counseling, are waiting.  I look them in the eye, smile.  Check their names, give them mine.  We draw their blood with a needle and syringe.  As we’re doing this, I reflect on the fact that, statistically speaking, two of these six tests will be positive.  I don’t know which ones yet- maybe the seven year old boy who, bravely, didn’t flinch at the needle.  Or the twenty-two year old young man with the shy smile.  Or the shawled grandmother, who looked pleased when I tried an Ndebele greeting.

I’m not used to this.  At home, I am distanced from the laboratory by long corridors, swinging doors and white coats.  Results are returned without judgment, as sterile figures on a computer screen.  Here, as I watch the blood and buffer solution chase up the test strips to their inevitable and intractable conclusions, I’m sobered by the immediacy of it all.  If I look up from the desk, out of the window I can see the quiet huddle of patients on a bench in the shade, waiting to see if their life is about to change.

Statistically speaking, two of these tests will be positive.  But I want them all to be negative.  I don’t want anyone to contract this corrosive little virus, which starts by eroding trust and intimacy and works right down through flesh and bone.  I want them all to be negative.

But they’re not.  We don’t beat the statistics.  Two of our six patients will receive a positive result in a few minutes.  I distract myself with documentation.  I try to comfort myself with the fact that these two patients, like the other four thousand treated at our clinic, will at least receive excellent care and access to the essential, life-saving drugs too many of their fellow Africans are denied.

The clinic

The clinic

Biography

May 13th, 2010 by Jess Cosby
Jess Cosby

Jess Cosby

After completion of her nurse training at King’s College, London, Jess specialised in caring for those with HIV/AIDS, working at the infectious disease unit in St Bartholomew’s Hospital, London.

In 2002 Jess was awarded the Diploma in Tropical Nursing from the London School of Hygiene and Tropical Medicine. She then went on to work as a surgical nurse in Gambia and Sierra Leone. On completion of an MSc in Public Health Jess travelled to Botswana where she worked for 12 months amongst the local HIV/AIDS population providing support for local healthcare workers.

Jess will be in Zimbabwe for a year on her first MSF mission.  In between her time abroad Jess is based in Exeter, Devon, where she divides her time between medical repatriation work, emergency care and travel health nursing. (She likes thunder storms, camping trips, music and cake :-) )