Olivia Hollenhorst is an International Ambassador for the International Degree and Education Abroad (IDEA) office. She is a senior studying Public Health and considering a GIS Certification. During Winter and Spring terms 2013 Olivia participated in the CIEE: Community Public Health Botswana program.

As a Public Health major with only a basic understanding of anatomy and an expired CPR certification under my belt, I felt a little underqualified standing next to Dr. Suzie, the competent French speaking doctor from the Democratic Republic of the Congo (DRC). As she began to cauterize the blood vessels on our adult circumcision patient, I thought to myself how lucky I was to be observing in such a unique environment. This was my third month in Botswana and already I had crossed four borders, eaten breakfast next to white rhinos, picked up enough local Setswana to ask for directions, and now here I was observing births and circumcisions in the small village of Kanye.

My study abroad program was specifically designed with a public health emphasis, allowing myself and the other students to spend 10 hours a week observing and learning in the local clinics around the capital city of Gaborone. Botswana was an especially exceptional country to study in due to its celebrity in the public health world for its management and response to the HIV/AIDS epidemic. Just 10 years ago, Botswana’s life expectancy was in the 30s. With a 40 percent prevalence rate across the country, the already small population of Botswana took a hit physically and economically.

With the help of foreign aid, the government of Botswana has been able to expand health care coverage to around 90 percent of the population. This coverage includes HIV/AIDS counseling, anti-retroviral therapy, and co-infection treatment for tuberculosis. While still extremely limited in resources and man power (17 percent of the health care work force was depleted due to the epidemic), Botswana has raised its life expectancy back up to 60 years and lowered the adult prevalence rate to 23.9 percent. Though the pervasiveness of HIV/AIDS still leaves Botswana with the second highest prevalence rate in the world, there is no doubt that care and treatment for HIV/AIDS have been drastically improved.

Botswana’s health care system is centralized on primary health care through the government. There is a nominal fee of five pula (equating to 58 U.S. cents), but anyone who needs care receives it. Although the national health care system is accessible and inexpensive, there are still gaps in quality of care and management.  One of the largest problems Botswana faces in most government factions is human and resource management. While there may be a clinic in every major village, they are not always adequately stocked or staffed. Being on the ground, observing and assisting in clinics made me realize how variable and inimitable health care is. Every country must have a characteristically unique system in order to provide the most comprehensive and accurate care for the population. My five months in Botswana left me with a committed interest in global health and an understanding of how much more I have to learn.