The HDU is the first of its kind to operate in the Manzini region. High-dependency care had long been a health gap in Eswatini, with only three units operating nationwide. These are always full, potentially leading to premature deaths. The MSF HDU focuses on offering specialised care to critically ill patients, particularly those with non-communicable diseases, including cardiological and neurological conditions.

The unit currently has six beds and offers 24-hour care. We take referrals from all facilities in the area and discharge patients back to general wards, to a hospital with a higher or lower level of care, or to their homes, depending on their condition.

In the same project, we run our Sitsandziwe clinic – which means ‘we are loved’ in English. The clinic provides comprehensive sexual and reproductive healthcare, including family planning, laboratory-based diagnosis and treatment for sexually transmitted infections, screening for human papillomavirus, HIV testing and prevention, antiretroviral therapy for people living with HIV, and mental health support to marginalised communities. Sitsandziwe addresses the diverse needs of the LGBTQI+ community, students, factory workers, and young women, implementing a patient-centred model of care and using innovative medical tools.

In 2024, we held four roundtables with community leaders, the Ministry of Health, MSF staff, and patients, emphasising our ‘People and Patients as Partners’ approach, where we made significant progress in informing and designing the care we provide. As a result, we have extended the clinic's opening hours to better meet patient needs, and strengthened our partnerships by supporting community outreach events.