ABSTRACT
Ethnography is a means of investigating the intersections of scientific innovation, healthcare policy, daily practices, and personal lived experiences. The personal narratives and experiences of patients and healthcare providers tell the story of crisis and change in AIDS-stricken Malawi. They are also an invitation for practitioners and policymakers in other countries to think about the promises and challenges of antiretroviral therapy (ART) rollouts in their own nations. Some of the strategies implemented to deal with health workforce shortages in Malawi and elsewhere, although necessary and timely, have had unintended and undesirable consequences. Shortages in the workforce, limited supervision and support, and exploitative staffing policies have a cumulative effect on the stress felt by healthcare providers. Global health policymakers are usually well intentioned, well informed, and committed to basing policies on the best available evidence. Improving healthcare systems is the only way to prevent the next major epidemic and end the suffering of millions of people.
