(The patient.) A most difficult case 3 days ago...young man semi-comatose for 2 days...or is he just depressed and hysterical? Well no this patient was fading into unresponsiveness...then quick screening revealed immunodeficiency and an emergency CT of the brain(yes, it's available at present) revealed a 4 cm mass...probably lymphoma. Sadly he didn't last the day. More sadly this is most assuredly the future of healthcare in this beloved country as the epidemic rears its ugly head. We are not even close to being able to deal with it.

(Q & A #1) An epidemic of lymphoma? How does that come to be?

• The HIV/AIDS epidemic is still in it's growth phase here. Very unlikely that we can modify its course. Lymphoma is one of the opportunistic complications found much more frequently when infected with the virus.

(Q & A #2) Forgive the utter ignorance, but can’t HIV generally be managed these days with a daily pill/pills? I take it this is an epidemic of people who have never been tested and don’t seek treatment until things are acute?

• You are so right. And patients on properly managed treatment are at reduced risk of developing AIDS and reduced risk of transmission to their partners. But many of the public are unaware of the virus.. even some doctors. As awareness grows there are still challenges in ensuring supplies of tests and treatment. And conflicting influences between evidence based responses and moral judgement of those affected leading to stigma. There are, nonetheless, some amazing Timorese campaigners working closely with the Ministry of Health, to improve the prevention and treatment of HIV, meanwhile patients present very late as in the case sadly reported by Dan.