One hot and slow afternoon at the clinic in Mafi Seva, a taxi drove up with an old woman accompanied by three of her adult children.   While she lay sprawled out in the back seat, the children got out and approached us to ask if it might be possible to treat their mother.

They explained that while walking in the fields about three years earlier, she had experienced a sharp pricking pain on the tip of the large toe of her left foot. It had immediately become quite inflamed, and she went to the hospital for treatment. The inflammation subsequently had subsided until about four months ago when with no apparent cause it re-emerged. This time though the inflammation spread and treatment at the hospital had proved ineffective.