On February 15, 2002, I had the privilege of starting anti-retrovirals (ARVs) on the first two patients in Masaka, Uganda.

As president of the Physician Assistant AIDS Network (PAAN) and as a clinician at AIDS Healthcare Foundation's (AHF) Global Immunity program (GI), I was sent to Masaka, Uganda on February 3 to meet with the Uganda Business Coalition (UBC) to prepare a clinic for accreditation and to begin ARVs. It was an experience that will remain forever in my heart.

Here's how it all began. During the 14th International AIDS Conference held in Durban South Africa in 2001, AHF's president, Michael Weinstein, met with several key people from South Africa and Uganda who wanted to establish HIV clinics in their poor countries and to provide ARVs. At that time, ARVs were available only for people who could pay or who were enrolled in research trials. Of the 21 million people infected with HIV in sub-Saharan Africa, less than one percent are on ARVs. This began our research and development of AHF's Global Immunity program. We entered into shared programs between AFH/GI and two nongovernment organizations: NETCOM in Durban South Africa and Uganda Business Coalition (UBC) in Kampala, Uganda.

On the first day of my arrival, I met the wonderful people at UBC. We met for several hours and strategized the work ahead. Then began three weeks of nonstop work. We needed to do the following: supply the clinic with furniture and with office and medical supplies; negotiate lab costs; hold meetings with the Ministry of Health and other local politicians; draw blood on 37 patients to obtain CD4 cell counts; obtain accreditation of the clinic; and buy ARVs for the first 20 patients who qualified with CD4 counts of less than 150. I was also scheduled to do an intensive one-day seminar with healthcare providers about HIV medications, side effects, and resistance.

We were able to meet our goals with the help of two CBOs--the TASO HIV Prevention program and the Kitovu Mobile Home Care program--which conducted initial screenings of patients and referred them to us. I could not believe how helpful and compassionate these folks were. For over 20 years they had witnessed the death and dying of the people of this small town, Masaka--10 miles from the epicenter of where HIV began--where more than 30 percent of the population are HIV-infected and caskets line the streets for sale. And now, treatment was becoming a reality.

I have never worked so hard and yet have never been happier. It was such a joy to work with people who meet each patient with humility, compassion, and a belief that no obstacle is too difficult to overcomeÑno matter how disappointing the constant dying and the government's inconsistencies may be. After all, this is about their family and friends.

I made many new friends in Africa whom I will never forget. I hope to visit again one day. For the present, I'm just happy that we started ARVs. The first woman to receive medication gazed at me with her sunken-in eyes and a huge smile and said, "Maybe now I'll live to see my children grow up."

I want to take this opportunity to thank AHF/GI and the courageous people of UBC for letting me be a part of a new beginning of hope in the "Pearl of Africa," Uganda. It was an experience of a lifetime.

Mary Adair, PA-C, is a physician assistant with the AIDS Health Care Foundation and National Coordinator, Physician Assistant AIDS Network, Los Angeles, CA. For information on clinical rotations in Africa, contact the author at <>.