Fellowship Site: Botswana

The Botswana-Harvard School of Public Health AIDS Initiative Partnership for HIV Research and Education (BHP), located on the grounds of Princess Marina Hospital, is a fully outfitted research laboratory and training center. At the heart of BHP's mission is a collaborative approach to conducting clinical and laboratory-based research with an emphasis on training and building local capacity. The research and training initiatives of the BHP focus on questions of epidemiology, virology, molecular biology, immunology, genetics, clinical treatment and social and behavioral medicine relevant to the epidemic in Botswana and southern Africa. The Partnership includes over 20 doctoral-level researchers working on site in Botswana and at the Harvard School of Public Health.

The Botswana-Harvard Partnership is an exciting place, filled with diverse research opportunities and dynamic mentors. The Scholars this year have focused their efforts working on an acute HIV infection study, Tshedimoso: Early and Acute HIV-1C Infection in Botswana. Their time has been evenly divided between study recruitment and developing and implementing more traditional laboratory research. The recruitment aspect involves a wide array of skills and activities. It includes opportunities for clinical experience, educating health providers about acute infection, development of promotional materials, and the building of relationships with NGOs working with at-risk populations. Each of the fellows worked with a particular Gaborone City Clinic and was able to devote at least 2-3 mornings a week to clinical experiences with a primary care doctor while educating that particular doctor about acute HIV infection. The current fellows plan to focus their lab projects on viral diversity in acute HIV infection. They have been able to gain a number of laboratory skills and work closely with their PI to explore and develop appropriate protocols.

This program also has significant depth and experience in training visiting researchers including faculty, students, medical residents and post-doctoral fellows.

NIH-funded clinical research at the BHP includes the following projects:

1. Prevention of Milk-Borne Transmission of HIV in Botswana
2. Cost Effectiveness of HAART for HIV and AIDS in Botswana
3. An Analysis of Risk Factors for Adverse Pregnancy Outcome among HIV-Infected and HIV-Uninfected Women in Botswana
4. Health of HIV-Infected Mothers Following pMTCT in Botswana
5. Early and Acute HIV-1C Infection in Botswana
6. Markers of Viral Set Point in Primary HIV-1C Infection
7. HAART to Prevent HIV Transmission to Infants in Botswana
8. Host Genetics of HIV-1 Subtype C Infection, Progression, and Treatment in Africa
9. Micronutrient Therapy and HIV in Botswana
10. Risk Factors for the Development of Lactic Acidosis and Pancreatitis among HAART-Treated Adults in Botswana

Housing Availability:
The BHP Administration will assist in securing accommodations, including three group houses available to Scholars. Students should expect to pay up to US $1,000 per month for a rental near the Princess Marina Hospital. It is possible to find safe, shared housing in Gaborone for $350-500 a month. There is also cheaper housing available in the villages outside of Gaborone proper; this allows Scholars to get a feel for smaller town life, but can require a longer commute and is not always the safest option. Students generally travel by group cars, minibuses, taxis or on foot.

Health Issues and Immunizations Needed for This Site:
Malaria prevention medication is not needed for work at the BHP, as there is no malaria in Gaborone, nor at any of our satellite research sites. However, interns planning to travel in the north of the country (e.g., the Okavanga Delta) or in surrounding countries where malaria is a concern should bring medication with them.

Quality medical care is available in Botswana through either the Princess Marina Hospital or the Gaborone Private Hospital (GPH), or through private physicians. Most Harvard staff use GPH. Staff generally pay for their care and are reimbursed by their medical insurance carrier, and others have chosen to adopt the Botswana Medical Aid Insurance (BOMAid) and co-pay their care as with U.S. HMOs.

See the Centers for Disease Control and Prevention Web site and The Yellow Book: Health Information for International Travel for additional information.

The FICRS program mandates that all Scholars see a physician prior to their assignment abroad. The site will require a formal letter from your physician stating that you have received the necessary immunizations prior to the start of your fellowship (hepatitis A, hepatitis B, and typhoid).

Safety and Danger Issues:
See the U.S. State Department Web site for specific information.

Language Requirements Other than English:
There are no linguistic issues in Botswana for English-speaking students. The local language is Setswana, but lack of Setswana language skills should not affect the ability of the trainee/researcher to function effectively. Arrangements for Setswana lessons can be made during the training program.

What is it like to live in Botswana?
In the view of the program staff, Botswana is a comfortable and interesting country with a democratic government and minimal crime and corruption. A modern infrastructure exists in the capital city of Gaborone, with less developed outlying areas.

Gaborone is often described in the guide books as dusty, quiet, and not a tourist attraction. While all of this might be the case, Gaborone is a very pleasant place to live. The people of Botswana are unfailingly friendly and Gaborone offers its own set of cultural events, nightlife, and happenings to keep you busy. A Zebras (the national football team) game at the National Stadium can't be beat.

Public transportation in the form of buses and combis is available. It is possible with a little bit of effort and patience to take these where you want to go in the city and even to the outlying communities. However, combis stop running at 9 p.m., have erratic and poorly marked routes and can sometimes be unreliable. For trips far outside of the city, and even for convenience within, a car is recommended but not necessary.