The videophone and the popstar - A patient encounter

For those of you who followed my Swaziland blog (www.pediatrician-in-swaziland@blogspot.com), you have probably read several of my “Patient encounter” entries. Below is my first such account from here in Botswana.



Mpho should have died five years ago, but today, when I met her, she was very undead.

As I opened the door to the exam room, I saw a crouching child. Her feet were at shoulder width and her knees bent. Her left arm was outstretched, her index finger pointing at a nearby cell phone, which a nurse was holding up as if taking a photo. The girl’s right arm was bent, held at a ninety degree angle as if she were flexing, but she was not flexing.

She was, as far as I could tell, dancing. Her right hand was flat and upright, fingers outstretched. Her forearm darted back and forth quickly, leaving the five outstretched fingers to flap and quiver like sailcloth on a windy day. Her knees bobbed slightly to the beat and her shoulders swayed at approximately quarter time.

There was no actual music playing. Rather, the girl was singing the song to which she danced, her rendition of a local pop tune.

A few seconds after I walked in to examine this new patient and refill her antiretrovirals, the performance stopped and the scene was suddenly that of a ordinary clinic room. Immediately, Mpho rushed over to the nurse’s side and stared at the phone.

The child smiled broadly as she watched the cell phone’s playback of her performance. She tapped her toe to the beat of her tinny, digitized vocals.

After I watched Mpho sing and dance, I looked through her medical chart. This girl had been so sick, seemingly destined to die in an era (a very recent era) when HIV medicines were largely unavailable. Her destiny was to join the countless others that died in childhood, having never received treatment for a treatable infection.

Well, thanks to the vision and determination of some good men and women, ARVs became available and Mpho did not die. I know this because I saw six-year-old Mpho today.

I know this because dead six-year-olds do not dance. Nor do they sing. Nor do they watch the screen of a cell phone with a wide, proud grin.