The Only Doctor At A Hospital In Mozambique Shoulders The Burden Of HIV : Goats and Soda Dr. Marlen Baroso works at the health center in Beira, a port city in Mozambique. She treats patients with ailments, accident victims, women in labor — and thousands of people with HIV.
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The Sole Doctor In The Hospital Shoulders The Burden Of HIV

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The Sole Doctor In The Hospital Shoulders The Burden Of HIV

The Sole Doctor In The Hospital Shoulders The Burden Of HIV

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MICHEL MARTIN, HOST:

And now to southern Africa. The International AIDS Conference just wrapped up yesterday in Durban, South Africa. When the AIDS Conference first convened there 16 years ago, HIV was considered a death sentence. Now it's a manageable disease in many countries. But in some parts of the world, HIV and AIDS continue to strain health care systems. NPR's Jason Beaubien recently traveled to the port city of Barra in Mozambique. And he talked with one doctor about the ongoing challenges of HIV.

JASON BEAUBIEN, BYLINE: Dr. Marlen Baroso is not an AIDS doctor. She's a general practitioner at the Monyava Government Hospital in Barra. She has to deal with all of the ailments, accidents, pregnancies and other health crises that come in her front door. But she says HIV dominates her work.

MARLEN BAROSO: When I test someone and their result is negative, I get happy because we have many case of HIV here.

BEAUBIEN: Her health center has nearly 5,000 patients on daily antiretroviral treatment to control their HIV. Scores of them are waiting on long wooden benches outside the lab to get blood work done. Others have developed complications or tuberculosis and are waiting to be seen by a nurse in another part of the facility.

Baroso is the only doctor here. She says managing the existing number of patients that they have on antiretroviral drugs while simultaneously enrolling more takes up almost all of her time. It takes at least four visits over the course of a month to complete all the testing and counseling needed to get new patients onto the powerful, lifelong anti-AIDS treatment.

Many people in Barra, however, don't have a month. This is a port city, dominated by people who work in the shipping and trucking industries. Getting them to show up consistently for appointments, she says, is tough.

BAROSO: Treatment, we have. It's not a problem, treatment. The problem is to keep the patient here with us.

BEAUBIEN: Southern Africa, including Mozambique, is the area of the world with the biggest burden of HIV. Millions of people in the region are infected with the virus. In Mozambique, according to the U.N. AIDS office, roughly 10 percent of all adults are HIV positive.

Despite the virus being so widespread here, Barosa says there's still a lot of stigma, discrimination and denial swirling around it. She says some patients who've been HIV positive for years and are on treatment come to her asking to be tested again for the virus because they think this whole thing might have been a mistake. Others refused to tell even their closest friends or relatives that they've tested positive.

BAROSO: Sometimes they want to keep secret. I had a case, a woman who is taking medication, and her husband is taking medication also.

BEAUBIEN: But neither one knows that the other is HIV positive.

BAROSO: Husband and wife - and this is not the first case.

BEAUBIEN: Baroso says the basic tools she needs to manage the HIV cases at this health center, she has. She has an on-site lab that can monitor patients' viral loads. She has the drugs she needs. The thing she really lacks is time. And when a mother in the delivery ward goes into distress, Baroso has to drop all of her HIV cases, further adding to the backlog.

She can only see about 25 patients a day, yet she has thousands on lifelong HIV treatment to manage each month and dozens of other patients with all kinds of health problems waiting for her each morning when she shows up at the clinic. Jason Beaubien, NPR News, Barra, Mozambique.

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