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When he touched down in Maseru, Lesotho, in September 2007, Salmaan Keshavjee had to help get a hospital renovated and a lab built. But first, his colleague Hind Satti said that they must visit a patient nearly 40 miles (65 kilometers) away. The ride through the small and landlocked African nation that sits like an island inside South Africa dragged on for more than two hours over obliterated roads until Keshavjee and Satti reached a small mud home.
The house was so dark they could barely make out the six-foot-two (1.9-meter) gold miner. He was only breathing twice a minute. He weighed less than 90 pounds (40 kilograms). The patient was coughing up blood onto the dirt floor because of his multidrug resistant tuberculosis (MDR-TB). He was also HIV positive. "I thought he was going to die," Keshavjee recalls. There was little they could do at the time, so the doctors left the dusky hut and drove back to Maseru with the intention of getting the man to the hospital in the capital.
View slide show of a renovated TB hospital
Keshavjee was in Lesotho as part of the Boston-based nonprofit Partners in Health (PIH) to coordinate construction of a new TB hospital and lab. Despite having to set up shop in a country with some of the world's highest HIV and TB rates, PIH had the facilities up and running in less than one year. But at the time Keshavjee arrived at the end of summer to meet Satti, the hospital would not be ready for at least another month, so the doctors decided to rent an apartment in Maseru for the miner. While Keshavjee bartered with contractors about air filtration systems for the hospital and calculated lab staff size, he ensured the apartment would have everything from a kerosene lantern to curtains.
Keshavjee returned to Lesotho two months later. HIV patients with MDR-TB can die in as little as two weeks, but the patient was still alive. The man's wife had moved to town and was hired as a cleaner in the new hospital. It is a center of excellence, equipped with locally trained health care workers and lab technicians. It all cost less than half a million dollars. Still, Keshavjee was unsatisfied. He knew one hospital cannot cure an epidemic.
Keshavjee didn't set out to be a globe-trotter, but today he flies around the world showing people that what they thought was impossible in health care for some of the poorest regions not only can be done, but is already happening.
Along with many other dedicated health workers and officials, Keshavjee is fighting drug-resistant TB. It is estimated that one in three people on the planet are infected with latent tuberculosis bacteria. The disease kills two million people every year.