HIV/AIDS in the new millennium
Thomas Gass
The social conscience of medicine
Markus Frei
As a young tropical medicine doctor, Markus Frei traveled to independent Zimbabwe in 1980. What followed was a formative career spanning everyday hospital work, development efforts in Tanzania, and the fight against HIV/AIDS – a commitment that has left a lasting impact on SolidarMed.
Although largely out of fashion today, in the early 1970s it was common in Switzerland to apply the term “Third World” to countries in the Global South. The Third World movement in Switzerland reached its peak in the 1970s. In 1975, the report Developing World – Developing Switzerland was published.
“The intellectual and political environment at the time was very inspiring,” recalls Markus Frei. The primary school pupil's desire to go to Africa as a missionary gave rise to a new global awareness and the hope of being able to contribute to the development of a more equal world.
Functioning health systems are undoubtedly crucial. But maternal mortality will hardly decrease if no one knows how to perform a caesarean section anymore
Markus Frei, doctor in Simbabwe and Tanzania
In 1980, Markus Frei, now a doctor who had completed further training in tropical medicine, applied to SolidarMed for a position at St. Theresa's Hospital in Zimbabwe. After a long and bloody guerrilla war, Zimbabwe was finally free from colonial oppression and racial discrimination.
Now the hospital administration ran smoothly, the obstetrics department fulfilled its purpose, and the prevention programmes outside the hospital were effective. Frei performed caesarean sections, treated infectious diseases and broken bones.
At the same time, he was repeatedly confronted with the sad legacy of the war of liberation, for example in the form of unusually frequent anthrax infections.
Niklaus Labhardt (left) bids farewell to Markus Frei (right) as he steps down from the board at the 2022 general assembly.
Public health and the arrival of a new virus
In May 1983, Markus Frei left St. Theresa's Hospital and Zimbabwe. He travelled north, first to Kilimanjaro in Tanzania, then to the Sudan, where he worked as a doctor in a refugee camp for the Red Cross. Returning to Switzerland after three years was difficult, etched in his memory as a culture shock. He quickly enrolled in a master's programme in Public Health at the renowned London School of Hygiene and Tropical Medicine.
Markus Frei at the contemporary witnesses’ meeting 2023 at SolidarMed’s office in Lucerne
The mid-1980s was a turning point – both for him personally and in the field of epidemiology. In 1985, the first signs of a “new” epidemic began to emerge, one that had already had enough time to cause countless deaths: HIV/AIDS. Markus Frei compiled the available knowledge in a dissertation. It was to remain a lifelong and intensive preoccupation with the virus.
Then the Asian continent beckoned. After working in a hospital in Cambodia, Markus Frei travelled all over Asia with a friend. In Beijing, he received a phone call from Switzerland informing him that SolidarMed was looking for a senior physician for St. Francis Hospital in Ifakara, Tanzania. Markus Frei picked up a pen and wrote a postcard to Lucerne: “I am interested in the position” – a successful application letter can be that short.
Eye-opener Tanzania
In 1988, Markus Frei was back in East Africa. The East African country was in the midst of a deep economic crisis, with shortages of everything: sugar, flour, petrol. “The journey from Dar es Salaam to Ifakara was arduous,” he recalls. The dirt roads were rutted, the houses on either side of the track were thatched with straw, and the people's faces were gaunt. And then there was St. Francis Hospital. The hospital epitomized the economic misery of the entire country.
At that time, HIV/AIDS was still a big taboo in Switzerland and there were only a few practices that were interested in the disease at all
Markus Frei, doctor in Simbabwe and Tanzania
The SDC invested in the hospital's infrastructure. At the same time, it cut its operating budget, to which it had contributed via SolidarMed-managed projects since the late 1970s, and called for a shift away from purely curative, hospital-focused medicine in favour of strengthening basic healthcare in the districts. For Markus Frei, a doctor with training in public health, these two approaches are not contradictory. “Functioning health systems are undoubtedly crucial. But maternal mortality will hardly decrease if no one knows how to perform a caesarean section anymore,” he says.
The St. Francis-Spital in Tanzania
Return to Switzerland
Markus Frei returned to Switzerland in 1991. He joined the board of SolidarMed and a group practice in Lucerne. Many of his patients were drug addicts and HIV-positive. “At that time, HIV/AIDS was still a big taboo in Switzerland and there were only a few practices that were interested in the disease at all,” he says.
HIV/AIDS became a key issue at SolidarMed. In 2004, antiretroviral therapy became available free of charge for African countries. At the request of the SDC, Markus Frei and Thomas Gass developed a SolidarMed project for HIV therapy in four African countries. This project catapulted SolidarMed into a new era: through the HIV programme, the organisation developed new structures towards being a programme organisation – without, however, having to give up its long-standing partnerships in Lesotho, Zimbabwe, Tanzania and Mozambique.
People who have shaped SolidarMed
Since its founding in 1926, people with commitment and courage have shaped the history of SolidarMed. In this portrait series, we highlight individuals whose dedication has had a lasting impact on the development of SolidarMed and on healthcare in Africa.
This portrait is an extract from a series of historical eyewitness accounts, which were compiled on behalf of SolidarMed by Marcel Dreier and Lukas Meier. The historians’ complete work is available as a book.
