I met a sad teenager yesterday. She was married in February and became pregnant immediately. When she came to the antenatal clinic in February she found that she had also become HIV positive. When I asked her how she felt about this she told me she hated herself. She was given the anti-viral drugs that are essential to protect her baby from catching the virus from her but it turned out that she hadn’t been taking them properly. She finds them really hard to swallow and can only manage it when she has porridge, which isn’t every day.

I spoke to Joy, the lovely midwife in charge of the antenatal outreach clinic, who immediately gave the girl some food from the leftovers from the staff lunch. We then sat her down and tried to explain as gently but firmly as we could the absolute necessity of taking the drugs on a daily basis. How to explain the perils of acquired drug resistance with poor compliance to a teenager who left school half way through her primary school education? Not so easy. Her husband has gone off to Kampala apparently looking for work and she has been left with his mother who she doesn’t want to tell about the HIV, even though it is almost certainly the husband who infected her. Life is so hard here sometimes.