Day 4 - conference, puerto la cruz

Day 3 - second day in the delta

Day 2 - first day in the Amacuro Delta

Day 1 - hospital Manuel tovar Nunez

I had the good fortune of getting just 4 hours sleep before my first day which was also my birthday. Well worth it though -

Ward rounds start at 7am which makes sense given how hot it gets here.

The hospital was much like a district hospital in the UK, with excellent availability of drugs including most antiretrovirals which are all free.

My ward round had a heavy Toxoplasmosis theme to it - very common out here and usually treated with septrin as it's hard to get hold of sulfadiazine and pyrimethamine.

CMV is also something far commoner here and readily treated if suspected.

It's amazing how with more and more patients on HAART we are seeing very little CNS related admissions in the UK compared with when I started as an FY2.

It's 1am. Just arrived at my amazing hotel, paid for by my hospital's in house charity, the St Stephen's Aids Trust. Thank you. Dr Arias, his wife and daughter came to pick me up and told me first that Venezuela is a relaxed country unlike Spain (mm hmm) and I need to loosen up, and instead of saying thank you to Mrs Arias for the lift, they just say it with "un besito". Great I thought, I love relaxed.

Then the bombshell. "Pues, Farhad, yo vendre a cogerte las 6.30 ...". Relaxed, and 6.30am ward rounds... don't quite go together. Happy birthday Farhad ;-) better get to bed.

Farhad