The day before I met former president George W. Bush, I had a meeting with a few other very important people: the Botswana Retired Nurses Society, or BORNUS. Mma Monare, who is a member of BORNUS, set up the meeting for me, and asked David, the Botswana-UPenn driver, to drive me to their headquarters in Tlokweng. Once there, I met with Mma Mabona and Sharon (a Peace Corp volunteer!) in the office to learn about their association as well as to gather ideas for Global Health Technologies projects.

BORNUS covers a wide range of services targeting crucial issues in Botswana, especially those related to HIV and TB. They run a day care center in which they enroll 50 children, usually orphans or vulnerable children, every year for preparation to enter primary school. They run programs that spread awareness regarding HIV prevention, testing, and treatment, and also provide skills training for HIV positive mothers so that they can sew clothes and bags for themselves or to sell. But that’s not all— they also coordinate community TB programs and Directly Observed Therapy (D.O.T.). For more information, see their website:http://www.bornus.org.bw/index.html .

Afterwards, I asked them what healthcare challenges they thought were significant. Their reply? They looked at each other and laughed. Bemused, I asked if it was a bad question. They just shook their heads and sighed, and said that there were too many big problems to list them all, and told me to narrow down my question. Out of curiosity, I asked what were the first two that came to mind. Their answer was surprising: water and gender inequality. By water, they meant that in small villages, — i.e., NOT Gaborone — people often did not have running water; instead, they would go to a tap outside and carry buckets of water back to their house. By gender inequality, they meant that gender dynamics, especially in regard to the idea of “power” and “consensus,” in Botswana encouraged the spread of HIV. Afterwards, I did a quick Google search, and found a few studies that actually talk about the empowerment of women in relation to HIV — pretty interesting (go Google it!).

Mma Mabona also pulled in another nurse, Florah, who was involved in the D.O.T. for TB. After listening to my spiel about why I was in Botswana and how our Global Health Technologies students design very useful solutions to healthcare challenges, such as the DoseRight Clips and the SAPHE Pad, I asked her if she had any ideas. She said that TB sputum testing often takes a while for the results to return, and that although GeneXpert is now available, it wasn’t available everywhere. And that leads me to my next point…

GeneXpert: http://en.wikipedia.org/wiki/GeneXpert_MTB/RIF
It’s a VERY big deal in TB endemic countries. The problem is that it’s very VERY expensive. The machine costs $17,00~$62,000 USD, and each cartridge costs $17~$120 USD (numbers are taken from the link below… I can’t seem to find the exact costs from a primary source online!). Considering that the countries with the worst spread of TB are also often the poor ones, there’s quite a bit of controversy. Here, read this:http://www.plosmedicine.org/article/info%3Adoi%2F10.1371%2Fjournal.pmed.1001064#s11

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