When I received the job offer to work in a Médecins-Sans-Frontières (MSF) HIV clinic in the southern Chinese city of Nanning, I was quite overwhelmed. Finally, I thought, I was going to make real the vague idealistic notions I had had of working with the needy in a remote location. Was I going to enjoy it or would I fold under unfamiliar work conditions and lack of mod cons? Where was Nanning? (What I found when I googled Nanning were basic statistics, misleading weather descriptions and a web link to finding a Chinese wife!)

MSF is known for providing emergency medical aid, but in recent years has pioneered HIV treatment in resource-poor settings, but China? The news is filled with reports of her double-digit economic growth and ambitious public works. However, healthcare decentralisation and the lack of economic growth in the rural population have led to gaps in medical provision. Following the outbreak of severe acute respiratory syndrome (SARS) and the scandal of peasants contracting HIV through contaminated needles during blood donations, there was a more open and urgent confrontation of the HIV epidemic.

Of the 650 000 people estimated to be infected with HIV in China, 20 000 are in Guangxi province. Nanning is the provincial capital with a population of 2.5 million. The …