He Visits the Old Woman Because Her Husband Is Buried There

Cedar Valley News
April 18, 2026
He Visits the Old Woman Because
Her Husband Is Buried There
By Dr. Aisha Khalid

There is a nurse in South Africa I have been thinking about since Thursday.

His name is Bukhosi Mdletshe. He runs the Ensingweni Clinic in KwaZulu-Natal — a small building with fittings from the nineteen-eighties, serving 12,000 people in one of the highest-HIV-burden regions on earth. Ninety-six percent of his patients on HIV treatment have the virus suppressed in their bodies. I want to tell Cedar Valley how he does it.

Mdletshe grew up in this community, the son of a single mother, raised by the people he now serves. He trained as a nurse, worked in hospitals in Durban, and came back. He says he is paying his dues. The story was published two days ago in Spotlight, a South African public health journal. I do not expect Cedar Valley to have read it.

This is what stopped me. Mdletshe stood on a rise above his clinic and pointed across the hills. He pointed to a circular house made of concrete bricks. An old woman lives there, he said. She will not leave because her husband and forefathers are buried on the land. She lives too far from the clinic and has no way to get there.

So, he visits her.

He pointed to another home. A child-headed household. He checks on them. He pointed to a house down in a valley where an elderly woman has been missing her medication. He said, “We need to check on her.”

A major problem in his region, he told the journalist, is patients defaulting on treatment. Not from indifference. Because they cannot afford the bus fare.

His clinic serves one of the highest HIV-burden regions on earth. Ninety-six percent of his patients on HIV treatment have the virus suppressed in their bodies. In a rural clinic. In an old building. With one nurse running it and a doctor who comes twice a week.

Ninety-six percent.

I have practiced medicine in this country for twenty years. I know what it costs to achieve a number like that. It costs the same as what Mdletshe is doing every day: going to the patient who has stopped coming in. Not waiting. Going.

I think about the patients I have seen over the past 20 years who did not come back. Those who meant to schedule a follow-up but did not. The ones who fell off a medication and did not tell me. The ones I watched walk out of an appointment knowing something was not right, but not knowing how to say it. I think about what I did for them and what I did not do.

Mdletshe does not practice in Cedar Valley. He practices in rural KwaZulu-Natal, where the distances are measured in hours of walking, and the stakes of missing an appointment can be measured in years of life. The circumstances are not the same.

But the question is the same. Who has stopped coming in? And have we gone to find out why?

It does not require a clinic manager. It requires the willingness to notice when someone is absent and ask after them. A neighbor. A family member. Anyone who knows someone who has stopped showing up for their own health and has not asked why.

Mdletshe said, “These are all our people.” He made a sweeping gesture across the hills. All of them. The old woman at the circular house. The children in the child-headed household. The woman defaulting on her medication down in the valley.

All of them his people. All of them worth the walk.

If you know someone in Cedar Valley who has stopped going to their doctor and you do not know why, you are not the only one sitting with this. The Cedar Valley News Facebook group is where the conversation continues. https://bit.ly/40p8jKy

This editorial is part of the fictional Cedar Valley News series, written by Evan Swensen, Publisher, Publication Consultants, and Claude Marshall, AI Developmental Editor. While the people and town of Cedar Valley are fictional, Bukhosi Mdletshe, the Ensingweni Clinic, and the details described are real, as reported by Sue Segar in Spotlight on April 16, 2026.

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