We're baaaaack!

Wow. Last blog entry September 27th, 2008. How young we were then...

Honestly, though. Has it really been this long?

The great thing about having a blog is that you can assume that everyone who reads it is uber-fascinated with your life. To that end, I guess we've left most people in the dark as to what we've been up to this past month. It shouldn’t surprise you. I mean, living in Africa is totally crazy. We get up each morning early so that we can hunt food for the day. Our jobs take place in thatch huts with no electricity and no running water. We have to hitchhike with child soldiers driving ATVs through 80 kms of bush to get to the one electric outlet that happens to have a computer (an Apple IIE no less) with dial-up internet access. We are really “out there.”

Or are we?

If you believe the above then please keep reading.

We live in Botswana, which at last count was about the size of the state of Texas (let me just tell you how the Batswana looooove hearing that, by the way). There are about 1.9 million nationals in the country, and anywhere from 40,000 to 100,000 Zimbabweans (depending on who you read) living here, most of whom are undocumented. 3% of the population is white and another 1% is South Asian. There are about 5 of 6 thousand Chinese. The GDP per capita is almost $15,000, which puts it in the neighborhood of Mexico, Venezuela, Grenada, and Bulgaria.

Thank you Wikipedia and CIA Factbook.

The point is this: Botswana is a fascinating place. People are generally friendly. It is safe – there are no guns on the streets (even police don’t carry guns). The government is democratic, responsive, and non-corrupt. There was a non-violent transition from British colonialism in 1966, since which time there have been 3 peaceful transitions of power. The government provides health care to nationals, including comprehensive HIV care.

People in the burgeoning middle class here in the capital drive BMWs and Mercedes to work while chatting on iPhones, but go back to their respective villages during any national holiday. For the population of 1.9 million, there are 1.42 million mobile phones. English is an official language, but you get much farther with a little bit of Setswana. It is a country that has benefited from its natural resources and invested heavily in health and education. 80% of the population is literate, and 8.7% of GDP is spent on education (10th in the world). Most people are Christian, and prayer through song is a part of morning rounds in most all hospitals.

The modernity that Botswana enjoys is countered by real health problems. Ours is a sick country. The HIV prevalence is anywhere from 12-60% in some areas (second highest per capita in the world). The rural-urban gap of health resources is widening, despite a well-designed decentralized health care system. Most doctors are not Batswana – the brain drain problem is a real one here. Until this year, if you were from Botswana and wanted to go to medical school, you had to get sponsored to go study in South Africa, Ireland, Australia, or Russia. Not surprisingly, many students end up training and then staying in those countries. But it’s an interesting time now - the health institutions of the country are expecting great things from its first medical school, which just opened its doors in August (but have yet to build an actual building to house the classes).

So that’s our context.

To catch you up on what we’ve been doing since our arrival, we’ll do it in stream-of-consciousness top-10 list form:

1) We finished the draft of the book we were working on
2) Our place is nice, quiet, and safe. We have potable tap water, hot water 24/7, and high-speed internet – it’s a hard-knock life.
3) We got a car – blue 1996 Honda CR-V (every doc in Premal’s group has one so why should we be any different, right?)
4) Matt turned 30
5) We bought a grill because BBQ is tasty and it’s a man’s right.
6) Cuban rum is num nums
7) Our colleagues are becoming good friends – they are fantastic people
8) Setswana is a hard language to learn, but we’re doing our best
9) Work is proving to be both challenging and gratifying – we are working on strengthening partnerships with local health institutions to build health care capacity in HIV, TB, and primary care
10) In minutes you can be out of town and on a game reserve where giraffes, rhinos, monkeys, cheetahs, and zebras roam

Disclaimers:

1) This will not be a play-by-play of our lives. As this experience demonstrates, Premal and I can hardly be relied upon to actually keep everyone current. We want to include the good stuff and exclude the mundane.

2) We feel privileged to be here at this stage of our careers, working with passionate and interested people.

3) Facts and opinions disclosed in this blog do not represent our employers, our country, or our respective tribes. For that matter, they may not even be facts or opinions - just a bunch of bullshit.

For the next entry, we promise fewer factoids and more thoughts/insights about our lives and work. We hope that this site becomes a place for our friends, family, and colleagues to take part in our experiences (for better or for worse!).

Oh yeah, and come visit!