I think our role is quite well covered by the slogan for sports footwear: “Just do it!”  It’s satisfying to sit beside a doctor who is not a paediatrician but a gynaecologist – he’s been assigned the children’s HIV clinic in this small provincial hospital.  He is reading from the slim, precise manual on how to treat HIV in children as he goes – and it works.  Sick children have grown from their last visit, their hair thickens and shines, their dull, sandpapery skin starts to become smooth and to glow, their faces become more animated and they talk, laugh, and learn.  The doctor might be a bit grumpy at getting this job, which he never asked for, but he’s doing it well.

As a UK doctor, I’m contented being a part of CHIVA Africa. I can’t talk about the impossible despair of it all. I go to South Africa, expenses subsidised, for a week or so, to meet colleagues.  We chat, boost morale, exchange information.  I learn a lot from my African colleagues of all professions – it really is an equal exchange.  And the kids – they seem to be doing all right once they’re treated, there’s nothing to pity there.

I am proud of the equity and mutual respect in the exchange that has been CHIVA Africa.  It is something to brag about.  If it’s change management you want, well that’s what we do.  From a few hundred children on treatment to over 40,000 in six years (see Thilo Govender’s earlier blog): that’s change.  Not imported into KwaZulu Natal by the beneficent CHIVA Africa, but systemic change from within.  And systemic change depends on systemic exchange.  All closed systems need to open out and reconfigure themselves, and the respectful team of colleagues with a different set of experiences and knowledge is the agent to accelerate that.

The problems of the HIV pandemic are not solved and new ones are emerging as fast as we can respond.  But we must interact.  It’s a cause worth supporting. 

Ed Cooper is a recently retired consultant general paediatrician with UK NHS and international experience. Ed has been volunteering with CHIVA Africa since its inception in 2006 and co-coordinates the doctors group.