MAITHRI Goonetilleke decided early on that he wanted to do as much as he could to help a pimple-sized nation on the sub-Saharan heel of Africa. When he was a fifth-year medical student with an interest in infectious diseases, Swaziland had one of the highest mortality rates in the world as HIV/AIDS claimed about 7000 people a year. The mountainous landlocked country, a fifth the size of Tasmania, also had the world's lowest life expectancy - just 31 years of age - leaving one in every 10 children orphaned.
When the then 25-year-old medical student made his first visit to the country in 2006 and landed at the remote township of Siteki, nothing could prepare him for what he encountered.
''There were more coffin vendors than grocery stores,'' he says at his parents' Melbourne home. ''Every day there was a funeral - adults, children, little coffins being marched through the streets. I was living in the hospital quarters at the time and every night you'd hear the wailing, just screams coming from the wards.''
It was an experience that had a profound effect on him.
''I just felt this very tangible, visceral change,'' Goonetilleke, now 32, says. ''It was almost as if the lens through which I saw the world had been drastically altered.''
When he returned to Australia, he set about raising money to help the Swazi people, spending every spare minute talking to anyone and everyone - churches, hospitals, schools, even skateboarding clubs - about Africa. In four months he raised $40,000, which he immediately used to build a schoolhouse for 200 Swazi orphans in Siteki.
Goonetilleke's life had taken a new direction. At first, he juggled his residency at Heidelberg's Austin Hospital, where he planned to specialise in infectious diseases, and the work he was doing in Australia and Africa to improve living standards in Swaziland.
With help from medical colleagues and social workers, Goonetilleke began to pull together the first threads of what would become Possible Dreams International, a not-for-profit organisation that worked with rural communities across Swaziland to help them find a way out of abject poverty, malnutrition and endemic disease.
Goonetilleke decided give up his ambition to become a specialist in infectious diseases to work as an emergency doctor in rural and indigenous communities around Australia. This gave him the time and flexibility to spend up to six months a year in Swaziland.
''My whole way of looking at things always seemed a little bit alien to some of my colleagues,'' Goonetilleke says. ''I had a different idea of what I wanted to do with medicine. I always wanted to use my skills to help people living in difficult circumstances.''
His feeling of being at odds with the establishment was not new. As a student he was driven to Carey Grammar School in Kew in a 10-year-old Mitsubishi Sigma while fellow students pulled up in late-model Mercedes or BMWs.
''I was made conscious of my difference and my status,'' says Goonetilleke, who was born in Sri Lanka and fled to Australia with his family in 1986 as a six-year-old during the the civil war there. He still has vivid memories of his school bag being searched for bombs.
That he was at Carey at all was due largely to a generous 75 per cent discount on fees offered to children of Baptist ministers (Carey is a Baptist school). ''In grade three or four, I remember some kid saying to me, 'I don't want to go to your ramshackle house again.' I didn't even know what ramshackle was.''
His difference was also underlined by the fact he was ''one of the only brown faces in the school'' and was sometimes the subject of racist taunts - mostly beyond the school gates.
In spite of this rough introduction to Australia, Goonetilleke does not dwell on his negative experiences but prefers, as the song goes, to accentuate the positive.
''You look for validation by what you see around you when what's presented to you is a negative stereotype of what it is to be a man of colour,'' he says. ''My dad always said to me, 'We need to raise the bar a little higher, we need to live lives that are exemplary'.''
It shows. When Goonetilleke - who won last year's Carey Medal honouring extraordinary past students - discusses racism, in the same breath he praises his teachers and the instruction he received at Carey for ''putting me on course to study medicine''. When he raises class issues, he points to the ''little cocoon of love'' that sustained his family and convinced them that Australia was the promised land for a new life for themselves.
But it was the unstinting positivity of his Baptist minister father, and his work for the House of the Gentle Bunyip in Clifton Hill caring for people with schizophrenia, that inspired Goonetilleke and helped shape his world view.
Indeed, it was this upbringing - steeped in optimism, independence and compassion for the underdog - that led him to establish Possible Dreams International.
PDI has a staff of 12 and works with communities in Swaziland to build about 10 houses a year, supply nutritional supplements to about 300 orphaned children, provide clean water and help the poor to start small businesses and grow their own vegetables.
The emphasis is squarely on self-sufficiency, as opposed to big foreign handouts that might see a water tank built, used once or not at all, then left to corrode and crumble. ''We try to give people their dignity back as a human being … [create] a conversation about how you can help yourself,'' Goonetilleke says.
It's also listening and talking to the Swazis themselves that enables PDI to get the job done. He cites as an example matron Anna Zwane, a 71-year-old nurse who has tutored him on the ''unseen'' community network within Swazi culture that delicately entwines the kingdom's tribal, political and cultural framework (although governed by a Westminster-style constitution, the country still has a ruling monarch).
Zwane has taught ''dokotela'' (the Swazi word for doctor) when to speak, what to say and with what gesture and tone.
When a mother whose husband died of AIDS abandoned her six young children, she assured him the mother would return. When she did, they built her a house, helped plant maize and find work for her as a child minder.
In turn, he teaches community leaders that when a baby dies of diarrhoea, it's from drinking contaminated water, not because they've been cursed.
Goonetilleke says that tackling HIV/AIDS isn't solely about treating sufferers with antiviral medication, but also involves the broader issue of poverty. He gives the examples of the patient who didn't have the two rand bus fare to travel to hospital for medication; and another who vomited up his medication because he hadn't eaten for a while.
Some of Goonetilleke's stories of life in Swaziland and the resilience of its people, are contained in his forthcoming book, Vula Bevalile: Letters from a young doctor. Vula Bevalile is Goonetilleke's Swazi name, given to him by matron Zwane, who pinched it from the back of a bus. It roughly translates as, ''when you come to a locked door, you open it''.
''It's not so much a nickname as a command,'' explains Goonetilleke. ''Matron said, 'it'll help you in your work'.''
There is another powerful bond between him and the Swazis - a deep love of singing. ''The Swazis sing in almost every circumstance of life; culturally it's huge,'' he says.
Goonetilleke was raised on gospel and soul by a father whose voice he describes as ''a gift''. He won the VCE singing prize and has sung professionally in a jazz band.
When he was invited to sing at the end of a medical consultation for one community, Goonetilleke put aside his discomfort when he saw another chance to break down a barrier. ''It was a way of feeling a part of the community.''
This led him to establish a 24-strong choir of young locals, including orphans and amputees. They sing when a house is built, but also to give comfort to the dying.
''When we have patients in stage-four HIV, dying … lying in their own waste, covered in opportunistic infections, can barely move, that are garments of skin over bone, the choir sits at the bedside and sings. It's just overwhelming. It does so much that the medicine can't achieve.''
Goonetilleke is preparing for another month-long trip to Swaziland. When he returns in early March, he's bringing the choir back for a 19-day tour of Australia to sing and tell their stories.
In Australia, a group of 20 Melbourne students, known as the Dream Council, will show the choir around - there are plans for a soccer clinic with Melbourne Heart, a trip to Healesville Sanctuary and Phillip Island.
Goonetilleke says while this is exciting for the choir, it is not their chief interest. ''Some said they wanted to see the biggest house in the world but the consensus was, 'we want to come to Australia and heal Australians with our music'.''
Voices for the Voiceless Choir Tour runs from March 4-26. Tickets are available from www.tickethost.com.au