textbooks vs. real life

October means the return of Tanzanian medical students to the classroom and hospital wards. This week, I gave two lectures to 3rd year pre-clinical medical students about HIV epidemiology and patho-physiology.

As I was preparing my Power Point slides, I was reminded of the dismal statistics of the global HIV epidemic:

• 88% of all HIV infected children less than15 yrs worldwide live in sub-Saharan Africa

• In countries with very high HIV prevalence (e.g. Botswana, Swaziland), HIV/AIDS can be the dominant cause of death for children less than 5 years. In 2005, 57% of deaths in children from Botswana were attributable to the disease

• An estimated 12 million children in sub-Saharan Africa have been orphaned by HIV/AIDS

As I rattled off these numbers to the 50 medical students staring at me, I couldn’t help wondering if any of the students themselves were HIV positive, or had lost a parent to the epidemic. The chances for this are pretty high.

It was strange and somewhat surreal for me to be the one giving those lectures.  What did I personally know about living with HIV? My knowledge of it is still mostly the textbook kind. These medical students have almost certainly had their lives drastically affected by HIV, or they will—it’s estimated that 20-50% of all health care workers in Africa will eventually die from HIV/AIDS. A small number of them may contract the disease while on the job, some will become infected because of their own lifestyle choices, and some as a result of the destructive choices of others.