The Imperatives of Just In Case

A friend has an Aids test. She has punctured her rubber-gloved hand whilst stitching up that of a colleague – a young, male colleague whose age (and lifestyle) means he could be HIV positive; among the 1.4 million Tanzanians (6.5% of the population) who are, 70% are between 25 and 49 years old.


She urges her patient to do likewise.


The doctor – in a bush clinic – really can’t see what all the fuss is about. My friend is pronounced HIV negative, as is her colleague. He had a test in December, he  says, so did his wife. My friend doesn’t know how reassuring this information is. She decides, on the advice of another medic whom she is conducting regular and anxious telephone conversations with, to opt for antiretroviral treatment.  She understands that there is an outside chance she may have exposed herself to the risk of contracting the infection, she can’t ignore that. The doctor laughs and says it’s not necessary: come back in six months and we’ll test again, he says, if you’re positive we can deal with it then.


Deal with it then.


When it’s too late. 


Tanzania faces what is classified as a ‘mature, generalized HIV epidemic’; its predicament means it is included in a 15 focus countries plan which collectively represents 50% of HIV infections worldwide.


Nobody can afford to Deal with It Then.


I tell my friend I am sure that there is no need for concern, but I can understand her decision to take the drugs.  I relate the tale of another friend who punctured her hand whilst administering a vaccination to a horse which subsequently proved rabid. She opted for a course of anti-rabies injections.


Just in case.


Not that my little tale offers much in the way of solace: I can see my friend briefly weighing up the odds: go mad and die or get sick and die? Either way she’s a loser.


Do Africa’s tragedies, I wonder, inure some of those who are in a position to do anything to alleviate them? Is the task of protecting a nation from HIV, malaria, hunger so overwhelming that some people talk the talk without having the energy to walking the walk? Do others carry placards, dole out business cards, enjoy the salary, drive new 4x4s, and wear halos and sanctimonious smiles just because they can profess to appearing to give a damn?  Is the job just too big? Or is it made weightier by the paper pushing that attends it?


Am I too cynical?


Hat invents a game. An accident really. We are working on a project about malaria. Who isn’t apparently? Hat creates a simple board game. Couldn’t that be manipulated as a tool to educate about the disease, I wonder?  Wouldn’t a game be an additional and useful weapon in a growing artillery against the world’s biggest killer, especially given it’d be played by the most vulnerable victims? A child dies of malaria every 30 seconds in Africa. Do the math: it’s a lot of kids. When they’re not succumbing, their mothers are.


So I write to malaria foundations everywhere. I write to Mr and Mrs Gates. I write to the Presidents anti-malaria initiative. I write to Amref. I write to Bono, Sir Bob, a veritable plethora of the usual celeb suspects. I write to lots of people. A few write back and say things like:


While we appreciate how important your request is regarding an educational game about malaria, unfortunately, it is not within the current giving priorities of the foundation. (It is. I checked. It said ‘education’ on the site)


What you and your daughter have created sounds like a novel idea.  One of the key components of this project is Information, Education and Communication but I am afraid we cannot offer funding for this.


I’m not asking for money. I’m just asking that somebody take a look for God’s sake.


Some invite me to submit my proposal. And will they, I wonder, take it any further when I send them a child’s hand painted board and a few Coke bottle top counters? When I admit that I am just a mum. Not a doctor. Or a scientist. Or even a graduate. I doubt it.


Here’s a thing: as much as Africa needs HIV and malaria treatment, so she needs education. Without it, what point is the treatment, what point the prophylaxis? As my friend’s experience perfectly illustrates, knowledge is everything. Knowledge is empowering. How many Africans who come into contact with the threat of HIV have the education to understand the importance of Just in Case? How many have the confidence borne of understanding the risk to dismiss the Deal with it Then.


Not enough, that’s how many. 


It’s not rocket science.


Nor is it rocket science that is required.


20 Responses to “The Imperatives of Just In Case”

  1. Roberta Says:

    You are absolutely right! Education at an early age is more than half the battle! Good luck with your project, but please don’t give up! I encourage you to continue contacting – someone out there will listen.

  2. lulu Says:

    That sounds like a brilliant idea – keep at it x

  3. Potty Mummy Says:

    Good point RM. And good for you for trying to do something. Having just been in Australia for 5 weeks where it seems the collective response to a completely different problem (that of making life better for the indigenous peoples of the country) is a shrug of the shoulders and to say ‘Oh, yes, terrible isn’t it’ whilst looking the other way, I admire that you are doing something – anything.

  4. Maggie May Says:

    Education is the only way to combat these problems and of course the wealthier countries must provide more funding for immunization against these terrible diseases & of course the treatment of HIV.
    I am busy knitting woolly hats for SAVE THE CHILDREN who are sending them to parts of Africa & Nepal because babies lose so much of their body heat through their heads that they then get pneumonia & often die. Such a simple thing to do. Plus we have to pin a note on each hat for the Prime Minister (G. Brown) to read asking him for help.
    I will continue to knit & write my messages.

  5. Expat Mum Says:

    I think I wrote about 80 letters to various foundations in the States and Europe last year, trying to get education funding for a school in Ghana. The problem I faced was that because the school isn’t a registered charity, most foundations won’t even consider it, (they want the tax write-off). So I looked into getting charitable status, which is do-able but long and drawn-out. In the meantime my kids and their friends do the sponsored walk and raise thousands. Very, very frustrating and I can see some people throwing up their hands in defeat.

  6. daisyfae Says:

    even in the western world, people will spend more time researching the purchase of a high def television, or a washer and dryer, than they do researching medical care, risk calculus and decision aids. teaching these basics should be done by any means necessary… it’s worth a try! hang in there!

  7. reluctantmemsahib Says:

    Roberta, thank you. i will. keep going. i shall become proverbial thorn in everybody’s side; i am quite good at that. ask my shade x

  8. reluctantmemsahib Says:

    thank you lulu, i will. keep going. x

  9. reluctantmemsahib Says:

    PM, lovely to have you back. your trip was amazing, and you were amazing too, to keep writing whilst you were travelling. looking the other way is easy – and you’re right, its’accompanied by a shrug and a distant acknowledgment of the terriblemss of it all whilst rolling up electric windows on the heat and the dust and the smell and the clamouring that goes on all around so that the world is suddenly comfortably cool and quietly humming with the air con and not big raucous, reckless Africa. The thing is, once you’ve looked, once you’ve turned your head to look, once you’ve wound your window down, you have to do something. anything. smile, engage. bug somebody for money to get a game off the ground … thanks x

  10. reluctantmemsahib Says:

    well done maggie may. and you’re right: education is key. but so, as you comment, are simple measures. they’re often overlooked in the big power play that can accompany aid to Africa. i want hat’s game to be played so that rural african children have the opportunity to learn and have fun, sometimes they don’t get alot of that.

  11. reluctantmemsahib Says:

    expat mum, that’s alot of letters. i had not considered those angles before, the whole tax v charitable status thing. and i agree, lots of people do feel defeated, probably people with really simple ideas who dont have the confidence or the necessary qualifications to push an idea forward. i think the aid business is manipulated by grand sounding positions and – very sadly – corruption too. i’ve witnessed proposals being shoved forward attached to generous bribes.

  12. reluctantmemsahib Says:

    and here, daisyfae, and here. don’t be misled into believing that because a society is surrounded by hardship they feel compelled to do anything about it. indeed it often inures people. don’t for a moment imagine that first world gadgetry doens’t appeal just because abjectpoverty abounds. thank you for the encouragement.

  13. Tam Says:

    I think an educational game is a GREAT idea and really do keep persisting. I know exactly how hard it is to get funding for a novel, simple way of educating. I work in educational theatre, and i KNOW how effective it is as a medium – learning while having fun — DUH!! Sometimes i think that unless its [flipcharts and powerpoints which send people to sleep], no-one will believe it actually works. Damn. Keep at it. Someone out there with an imagination will see its value. eventually.

  14. reluctantmemsahib Says:

    thanks for dropping by Tam. Absolutely. Because a game, like theatre, is engaging. absorbing. entertaining. unlike the flip charts and the powerpoints. I think i need to make that point in my letters, its a very valuable one; thank you.

  15. Jane Says:

    You’re right. I’ve spoken to so many who don’t want to know – they would rather just get sick and die of something unknown than know they have what they feel is the death sentence of HIV.

    And even in our own home – a young lady avoided taking her malaria medication when she was sick – she was saving it in case she really needed it. When might that be?

    And our gardener’s wife died. She went to the hospital, and they couldn’t figure out what was wrong with her. They told her to try a traditional healer.

    My husband took a worker to the “European” clinic in town after he didn’t get any help from the local hospital for his badly infected finger that kept getting worse. The clinic didn’t help, either. So husband (no medical background) anesthetized the finger, cut and squeezed the pus out, and cleaned/disinfected the area a couple of times. The finger got better right away. This man could have died from an infected finger!

    There is such a lack of medical treatment. Where there is access to medical treatment, it is either ignored, or it’s not great to begin with. Life here sometimes feels so cheap, and IT’S NOT!

  16. reluctantmemsahib Says:

    No Jane, you’re right: it’s not. Cheap. It’s precious. Much, much more brittle-fragile-easilybroken than in the west, much more life and death vulnerable. But it’s not cheap; It’s priceless-hangonhardtoit-precious.

  17. Patsycake Says:

    Please check out They might be an resource for your wonderful project. My daughter worked with Kyla last year in Moshi.

  18. reluctantmemsahib Says:

    thank you so much patsycake; off to check out the link now. somebody new to harangue! x

  19. africanmama Says:

    you’re doing a great job – don’t let anyone tell you otherwise or sidetrack you either! Be persistent – it will pay off eventually

  20. reluctantmemsahib Says:

    thanks for the encouragment africanmama; i’ll keep bugging the masses!

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