By Martha Henry
It started in preschool for Mosepele Mosepele. His mother was an Operating Room (OR) nurse in the Mahalapye District Hospital in Botswana. In the morning, she dropped her son off at school on her way to work. If she had an early operation, young Mosepele would sit in an office with a window overlooking the OR. Though only five years old, the boy would watch the surgical team operating. “People were dressed up all in blue with big lights hovering over the patients like in a TV show,” remembers Mosepele, who is now a doctor and researcher with the Harvard AIDS Initiative (HAI). “It didn’t scare me,” he said. “I was fascinated.”
The doctors in Mahalapye were mostly male Europeans, mainly from Scandinavia. “I admired them,” said Mosepele, “but I thought, why aren’t local people doing this? Maybe I could try it.” While still in preschool, he decided to become a doctor.
Mosepele came of age in Botswana at the height of the AIDS epidemic. “In the 1990s, the people of my generation remember our middle school and high school teachers getting sick and dying. Some of my favorite teachers passed away. You would go on school holiday and come back and they would look very different. And before the end of the school term, they were gone.”
At the age of 19, Mosepele spent his year of national service working in the pathology lab at Princess Marina Hospital in Gaborone. Then, because Botswana didn’t have a medical school, he attended the University of Melbourne in Australia to earn a joint undergraduate and medical degree.
He returned to Princess Marina Hospital and, a year and a half after finishing medical school, became Head of the Infectious Disease Care Clinic. In his training in Australia, he’d seen only one patient with HIV. Now he was in charge of one of the largest AIDS clinics in Africa, providing treatment to thousands of patients. It was demanding work, but he thrived.
After his clinical experience, Mosepele went to the Hospital of the University of Pennsylvania for his internship and residency in internal medicine. While in Philadelphia, he worked in the Prison Health System, providing HIV care for inmates. Security was tight. Prisoners were brought into the examining room, which had a Plexiglas door so that guards could see in. “It was very challenging,” said Mosepele. “Unfortunately, many of the inmates suffered from mental health issues, or IV drug use, or other risky behavior.” He wore a panic alarm to pull if a situation became threatening, but he never had to use it.
Today, Mosepele combines the hard-driving intelligence of a top researcher with the warmth of a friendly internist. He recently graduated from a fellowship in Infectious Disease at Massachusetts General Hospital and Brigham & Women’s Hospital in Boston. He is currently working towards his Masters in Clinical Epidemiology at the Harvard School of Public Health.
He is also the Principal Investigator of two pilot studies looking at the connection between HIV and heart disease. “My primary interest is to establish whether HIV patients are at an increased risk for heart diseases and strokes,” he said. “And if they are, I’m also looking at underlying mechanisms to explain why, especially the role of persistent residual inflammation, even when HIV is well controlled.”
“Mosepele recognizes the importance of being at the cutting edge of research, like the interaction between AIDS and cardiovascular disease, ” said Dr. Max Essex, Chair of the Harvard AIDS Initiative.
Cardiovascular disease (CVD) rates are higher in HIV-infected patients, yet the impact of this condition in sub-Saharan Africa is largely unknown. Addressing CVD risk among the almost 25 million HIV patients living in sub-Saharan Africa requires a detailed understanding of risk factors and actual disease rates. Mosepele’s pilot study will provide much-needed information.
With years of training complete, Mosepele has returned to Botswana to treat patients and conduct research with collaborators at Harvard and elsewhere. He will also teach at Botswana’s brand new medical school.
“Mosepele will be an excellent mentor,” said Essex. “He’ll also be a great example of how young doctors can combine both clinical practice and research that is of particular importance to Botswana.”
“People respect him and they listen to him,” said Dr. Stephen Gluckman, a Professor of Medicine at the Perelman School of Medicine at the University of Pennsylvania and one of Mosepele’s mentors. “He is and will continue to be an excellent role model for young Batswana physicians.”
Mosepele looks forward to his role as a mentor, especially to teaching young doctors how to interact with patients. “You have to acknowledge the person first,” said Mosepele. “That way you can begin to see each other as human beings and work collaboratively to solve your problem. It’s about us working together.”