Medical students aim to curb HIV/AIDS crisis in Botswana
[ UniNews Vol. 15, No. 6
17 April - 1 May 2006 ]
By Janine Sim-Jones
The harsh reality of the HIV/AIDS epidemic in Botswana really hit home for Maxwell D Nhlatho when he realised that at 25 years of age – if he achieved the average life expectancy of his countrymen – he had only 14 more years to live.
“In Australia hospitals in the main are for old people,’’ says the University of Melbourne fifth-year medical student.
“In Botswana it’s quite the contrary; it is a lot of young blokes my age. When I go home to practise medicine this is something that is going to be quite challenging.’’
Mr Nhlatho, a University of Melbourne medical student, is currently completing his clinical training at the Austin Hospital and will return home to do his internship in 2008.
He is studying at Melbourne as part of an agreement in which the University accepts eight Botswanan students to study medicine each year.
The agreement is part of a wider collaboration which sees the University of Melbourne working with the University of Botswana to establish its first medical school, so that the country does not keep having to send its students overseas for their medical training.
When Botswana’s aspiring doctors return home, they face the challenge of a health system battling an epidemic which sees almost 38 per cent of adults infected with the HIV/AIDS virus.
It is a devastating statistic and when students are thousands of kilometres away, it could be tempting to lose sight of the challenges at home.
But Mr Nhlatho and his fellow students were determined this should not happen and Botswana AIDS Melbourne, or BAM, was born.
Initially it started as an informal group that met at the Royal Women’s Hospital in the evenings, then at the University of Melbourne on Saturdays. Today it boasts about 70 members – or 70 per cent of the Botswana student population in Victoria – and a mission to help decrease the prevalence of HIV-AIDS in Botswana.
“Botswana AIDS Melbourne was an attempt to keep ourselves in touch with the reality of Botswana when we are here,’’ Mr Nhlatho says.
“In Botswana you are continually reminded of the problem (HIV/AIDS), you hear about people dying, about people who are very sick. You constantly hear the A (Abstinence) B (Be Faithful) C (Condomise) message.
“But once you are here you don’t see that any more – you don’t see it on the TV or hear it on the radio – and you can easily forget that it is your priority because you tend to prioritise the things that you live with more.
“Forming BAM was a way we could do something as a group, and give us a voice for communicating with the authorities and people in Botswana.’’
In its early days, Botswana AIDS Melbourne was helped by seed funding provided by the University’s Dean of Medicine Professor James Angus and Professor Roger Short (Medicine).
Mr Nhlatho was the ‘caretaker president’ until official elections in 2005. The group has since held two successful annual conferences, attracting an array of guest speakers including the Botswana High Commissioner to Australia, Molosiwa Selepeng.
The conference material changes annually, in 2005 the theme was HIV/AIDS: a multisectoral problem, which showed that HIV/AIDS was not just a problem confronting the health sector, as students from other faculties such as engineering and arts discussed how HIV/AIDS impacted on all aspects of life.
BAM has also held a successful fundraiser with the Cantorion Cymereig Victorian Welsh Choir to raise funds to help increase the awareness of HIV/AIDS prevention in Botswana.
Recent elections saw Mr Nhlatho and Bolokang Jones Makhura, a third year medical student, elected president and vice-president.
The group continues to keep close links with medical professionals back home and is working on projects to reinforce the prevention message to young Botswana people through regular newspaper articles in Botswana.
Outgoing president Sennye Mogale still remembers an HIV/AIDS talk presented at her high school by a woman who was infected with AIDS.
“The woman was talking about how she was infected because she was raped by her uncle and as a result she decided to infect others by sleeping with them,’’ she says.
Ms Mogale says she did not judge the woman, but the talk illustrated the lack of information many young people had about AIDS – despite the strong health messages being promoted by the Botswana Government.
She says that in particular, there is a disturbing trend of older men infecting young girls.
She also believes that some complacency may have crept in as the result of the Botswana Government’s decision to distribute free anti-retroviral drugs to all of those infected with HIV/AIDS.
“Because the anti-retrovirals have been successful in prolonging lives and stopping the symptoms of HIV/AIDS many young people have forgotten the ABC message. But we have to keep reminding them that the best situation is not to get AIDS.’’
Ms Mogale is now in her fourth year of medicine at Melbourne and is undertaking her Advanced Medical Science year with North Western Mental Health Services. She will return home to practise medicine in 2009, but says she may consider further study to become a psychiatrist.
However, in the meantime she is dedicated to spreading the prevention message in Botswana during her yearly visits home.
“People are starting to have sex at a very young age and we need to try and talk as openly as possible about sex,’’ she says.
“There are cultural attitudes that make it difficult to talk to a teacher about sex, but hopefully it is easier for them to talk with younger people such as medical students and people from Botswana AIDS Melbourne.’’
Although the group consists almost entirely of students – two of its members – Ms Margo Collins, a personal assistant in the Faculty of Medicine, Dentistry and Health Sciences, and Professor Roger Short – have been dubbed by the group as the “mother and father” of BAM.
Ms Collins recalls meeting Mr Nhlatho when he came into her office to meet the Faculty’s Associate Dean (Academic) Associate Professor Susan Elliott.
“When I met Max I found we had very much in common. I had previously worked for the Victorian AIDS Council and I found that I could be a good resource for the group in helping them form links with local HIV organisations,’’ she says.
“I was blown away to meet a group of people with such a strong sense of purpose to improve the lives of others and to see first and second year uni students showing such incredible leadership and dedication.
“They are prepared to take the future of their country on their shoulders.’’
Professor Roger Short is known internationally for his research into the effectiveness of lemon juice in preventing HIV transmission.
He has spent much time in Africa, including living in a mud hut in Uganda for six months, and developed a huge love of Africa and its people.
He has taught many of the Botswanan students and he says other medical students at the University of Melbourne can learn much from them.
“I was giving a lecture to a group of first year medical students a few weeks ago and I asked if there were any students from Botswana in the audience,’’ he says.
“Three very shy girls up the back put up their hands. I told the students that these girls could tell them stories from back home that you haven’t even dreamed of .’’
Professor Short has also supervised a number of the Botswanan students’ research projects. In particular, he is full of praise for the work done by students Modise Modise and Mr Nhlatho.
Mr Modise’s PhotoVoice project armed Botswana secondary school students with disposable cameras to document the impact of AIDS on their community.
Mr Nhlatho’s research found that male circumcision significantly reduced HIV acquisition in men. He found the practice was widely accepted by health professionals in Botswana and could be re-introduced.
His thesis is now being used as a background paper by the World Health Organisation.
Professor Short says the young medical students are the key to combating the rapid spread of HIV.
“It is a disease that spreads because of ignorance, and young people are the ones who need to teach others how to prevent the disease – not some old white face but young Africans talking to their peer groups,’’ he says.
In 2008 Mr Nhlatho will be back practising in Botswana. He says the hospitals will not be as well equipped as those in Australia, despite enormous demands placed on them by the AIDS epidemic.
Botswana has always trained its doctors overseas, and in the past many have decided not to return, but Mr Nhlatho says this is not an option.
“In Botswana I can make much more of a difference,’’ he says.
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