He complains of a pain in his chest.
Slightly dull and poorly localised. Present for about 5 months off and on. Worse in the evenings. Not affected by food or exercise.

He is dressed smartly but no smarter than the average young Ugandan male, except for मय्बे the shiny black briefcase he held under his arm and placed on the desk.

It could have been any number of things I guess. Heart. Lungs. stomach. Rib cage. But his heart was clear. No history of cough or breathlessness. And

Most probably it was skeletal or trauma. He was after all a farmer, like the vast majority of the population. So I prescribe some anti-inflammatories in the hope it just clears up. Take two panadol and call me in the morning.

'Do you have any medical conditions?', I ask as an afterthought.

'Oh yes, I have diabetes'.

I raise my eyebrows, and get the translator to confirm this. Not the every day thing in these parts.

He was born with it apparently and is working on the family homestead as a 29 year old subsistence labourer.

He flicks open his briefcase and pulls out a school exercise book neatly ruled into columns. With pride he shows me his glucose readings, nicely ordered and filed under mornings, midday, and evenings. He also shows me his insulin schedule with corresponding blood sugar levels before and after each dose. He asks whether it might be better to increase his medium-acting insulin at lunch-time and decrease it in the evenings to give him a bit more energy in the morning. And whether the long-acting one could be increased slightly.

The look on his face is genuine and concerned.

I just sit there stunned.

Somewhere, living in a thatched hut amongst the rats and snakes, with no internet or electricity or running water lives a young man who controls his diabetes better than half of New Zealand.

Uganda is full of surprises.