Varayini Pankayatselvan, MD: Beth Israel Deaconess Medical Center Internal Medicine PGY3

Botswana: February 2022

 It was 7:30 AM, I just arrived at Scottish Livingtonstone Hospital after my 15-minute commute where I saw several kids in their yellow shirts and black bottoms head to school.

 It was my 2nd day of work, and I was excited to meet and learn from the new patients admitted overnight.

 As I scanned the paper files, I came across M.L. She was a 23-year-old female with a past medical history of HIV, who presented with 1-2 months of fatigue and a new “rash.” She was found to have a platelet count of 2.

 After reading this one-liner, I rushed to see her. I will never forget saying hello and watching her slowly rise from bed. She was emaciated, cachectic, and frail. She had ecchymoses scattered throughout her body and petechiae all over the inside of her mouth.

 Her eyes were wide, they had a sense of calm, yet subtle fear. I stared for 5 seconds – stunned – she was 23 years old, yet she was only about the size of the school children I saw that morning.

 She had yet to receive any platelets because the hospital ran out; the nearest supply was 1.5 hours away.

 This was the first experience of the many resource limitations I saw in this country. My heart sank for this young lady…

 My time in Botswana was humbling, incredible, enlightening, and beyond anything I’ve ever experienced. I truly cannot wait to return one day to continue to help and learn from them.