RVD

Today was our first real day at work here. In some ways, we felt right at home (our first task was to draw blood on a number of patients on one of the medical wards). In others, the differences were striking. For example, we are accustomed to seeing HTN and DM (hypertension and diabetes) as nearly ubiquitous in patient problem lists. Here, we instead saw RVD, which we quickly learned stands for "retroviral disease". It took us about 30 minutes to have a sense of surprise when we came across a chart with the comment "RVD negative". Even in those who don't have RVD, it's placed on the problem list on admission as something to rule in or out.

To put things in perspective, here are some statistics on the state of the HIV epidemic in South Africa:

In 2007 there were an estimated 5.7 Million people in South Africa infected with HIV with 350,000 deaths attributed to HIV. The prevalence in South African adults in '07 was 18.1%, the 5th highest in the world. The top 4 are all in sub-Saharan Africa as well. This number has grown incredibly in the last 10-15 years. In 1990, for example, there were an estimated 160,000 adults in South Africa infected with HIV (prevalence 0.8%). We're hoping to get a sense of what these numbers mean for people who live and work here.

Will post more soon.