Acknowledgements We are grateful to Ruth Mubiana and Vutita Dokowe for data entry. The following doctors are acknowledged for their contributions to the work of the endoscopy unit over this time: Dr Asombang, Dr Dean, Dr Johnson, Dr Kayembe, Dr Leaver, Dr Louis-Auguste, Dr Mark, Professor Mulla, Dr Mundia, Dr Munkonge, Dr Namushi, Professor Odimba, Dr Raymond, Dr Squarr, Dr Watters and Dr Zimba. We apologise to any other staff whose contributions we have accidentally omitted, and would be most grateful to hear from them. VK was supported by the NIH Research Training Grant # R25 TW009337 funded by the Fogarty International Center, Office of the Director, National Institutes of Health, the National Heart, Blood, and Lung Institute, and the National Institute of Mental Health.