My first 7 days have been interesting to say the least.

It has included a touch of malaria....well maybe a bit more than a touch, some heart wrenching cases at the clinic, and calls for charity that one struggles to ignore.

I learnt last time hearing stories of the locals is one of the more enlightening/enriching experiences.

This time has been no different.

Aroada is a lady supported by the Jesuit Preists here where I am staying.

She is a mother of one child who is ten years old. She also happens to be HIV positive. Give this disease by her husband he then turned her out, left to fight for herself. Funnily enough so did her mother and father as soon as they learnt that she was positive. Left on the street she had no choice but to turn to crime.

This as she recalled to me with tears in her eyes is something that she regrets. Ostracization by your family is common when you are diagnosed with HIV.

I have had to learn this at the clinic.

I would appreciate being able to screen everyone I see for the disease, not only because it can present in so many different forms, but because it would surely limit its spread. This I cannot do for a number of reasons. People would not turn up knowing they are to be screened automatically for the disease. Why would anyone risk most certainly being pushed out onto the dusty street by yourself for the rest of your life.

Further the cost is prohibitive. Each patient can barely afford the 50 shilling fee for the consult let alone a barrage of tests to screen for diseases they may not have. All they want is treatment there and then and 'the cheapest cost please'.

It is a dilemma I face everyday.

The patient has Symptoms b, d, and e.

In Australia you would do a test, charge Medicare and tell them what they have.

In Kangemi you have to guess. Guess the test they are most likely able to afford, guess the right disease from the limited information gathered from the wrong test you had to order.

Then you have to guess the treatment and ask them to return if/when it doens't work.

Medicine is different in Africa.