At the request of many of you I will try to continue to update you on the remainder of my trip.
Yesterday was one of those days that just completely tests your ability to be very very far from home in a city that can be very dangerous at times.
Corey, Regina and I went to Table Mountain at 4:30 and waited to watch the sunset and catch the last cable car down the mountain. It was amazing. We got in a cab and the driver tried to take us out of the way to get more money on the meter so we got out about 8 blocks away from where we were staying. While on our walk my Mom called my cell phone and I told her to call me back because talking on a cell phone on the street is dangerous because it draws attention to you. Two minutes later Corey was walking a few steps ahead of Regina and I and two boys in their early teens came up to Corey and cornered him on a wall. Regina and I thought they were just really aggressive beggars (because there are a lot of those in Durban and Capetown), so we started yelling and pulling them away from Corey. The one who was closest to Corey got scared because of our yelling and stepped away and then we ran. When we stopped Corey said, "He had a knife. Did you see his knife?" Because the young boy had his back to us we didn't see the knife or hear him tell Corey to "empty his pockets" and so we were persistent in getting him away from Corey. What an experience.
When we returned to our accommodations my Mom called and it turns out that my bank card was present when the purchases on it in Durban were made, which means that the most likely (as in almost 100% likely) culprit is someone who lived at my home stay or someone who found my credit card in my bag that I left at my home stay. It is really hard to think that the wonderful family I stayed with is capable of this, but I suppose (much like the attempted robbery of Corey) it is just very telling about how many people in South Africa are barely getting by and have to resort to stealing to stay alive. Yesterday we didn't want to leave our accommodation at all and when we went to get some food and the waitress tried to call to us to give me an earring that had fallen out we started running from her until we saw the earring in her hand.
Incidents like what happened to Corey and to me are tests to see how much we can handle living in a different society. The truth of the matter is, either of these things could happen to anyone of us in New York or San Francisco, it's just that much harder to take when you already feel like a foreigner, much less a target to be robbed.
Nevertheless, does this change my previous want to come back to South Africa? Not really actually. If anything it proves that I can survive here and do so much more good as a result.
**I really didn't want to post a blog about these incidents because I don't want to worry anyone, however I think that it is important everyone gets the full picture of what it is like here, much like the preacher said: The good and the bad.**
Friday, June 29, 2007
June 21st
I started this morning with the C-Section at 5:30am. Raj did an amazing job assisting while I assisted Tom with the anesthesia (yes, the same Tom who is in charge of the TB ward...the doctors here have to be able to do anything).
Maya and I spent the morning shadowing Handy, another doctor from London who is specializing in pediatrics. Most of the patients in his "high care" or intensive care unit in American terms were there because of the enemas they had been given by traditional healers. I really find pediatrics fascinating...there is such a balance involved in children because their bodies are so resilient but at the same time the balance is delicate and can be impossible to get right. Still, I have to say that the pediatrics rotations I have done have been my favorite out of all the rotations. I never would have guessed that.
Handy was great at explaining maintaining the correct fluid balances in children and definitely had a way of calming the babies down. He did lecture one of the mother's of a six month old who was sick because the mother had given the baby an enema containing shoe polish and toothpaste at the advice of a traditional healer. Handy said simply to the mother, "Shoe polish. That's for shoes. Not for babies or children. Toothpaste. That's for your teeth. Nowhere else." The mother didn't react.
After the wards rounds there wasn't too much to do because the hospital is nearly empty because of the strike. We got to see Tom put in a catheter and I got to see the 15 year old female patient in the TB wards I saw the day before and she looked much better. The patient suffering from renal failure had passed away during the night.
Maya and I decided to walk almost the entire way home and got to see the sunset. We went straight from our walk to where Corey, Ben and Jonathon were staying: At the Royal Family of Hlebsia's house! They had sacrificed a sheep in our honor! Ben, Corey and Jonathon woke up to a breakfast table that Ben referred to as, "Fear factor." On the table was the head of the dead sheep (fur still intact), the intestines, liver, etc. Ben and Jonathon tried a piece of the ear and some of the liver. Corey abstained. For dinner we had the cooked sheep and actually it was really good. All 11 of us sat at a long table filled with food while the Royal Family and our families (all members of the Tribal Counsel) sat in the living room watching us and then eating. The food was amazing.
At the end of our meal the local preacher made a speech to thank us for coming to Hlebsia and for having dinner with them. It was an incredibly moving speech. He told us that he knew this was our last day of clinical rotations in South Africa and that over the past four weeks we have probably seen a lot of good and a great deal of bad things about the people of South Africa. He encouraged us to remember both: He emphasized that the "bad," the cultural differences, the problems with the health care system were all important things for us to remember so that we know we need to return to South Africa to continue to help the people here. He reminded us of the good: The families who have taken us into their homes, talked with us and opened up about their culture, fed us and cared for us. He encouraged us to remember them and know that we do not owe a debt but that the families want to see us return in the future.
I don't know if I will return to South Africa. I do know that in my heart--in spite of the fact that there is no timetable to how society operates here, that for a control freak like myself this country seems to run on a principal of a disorganized chaos, that the health care system is crumbling under the weight of growing epidemics of AIDS and TB and that crime continues to be a problem throughout the country--there are times when I have never felt more at home than I did here. There were more times when I felt like my presence here was of such a greater asset than it will ever be in the U.S., even if that was just a feeling.
No matter what. I wouldn't trade these last four weeks for anything. My sincerest gratitude goes out to all of those who supported me in this venture: Emotionally and financially, without your support I would never have made it.
Thank you again.
**As a side note, both Regina and my medical supplies were delivered directly to Chatsworth Hospice and to Hlebsia Hospital and also incidentally, any clinical site that hosts the CFHI students is given monetary compensation from our program dues**
Maya and I spent the morning shadowing Handy, another doctor from London who is specializing in pediatrics. Most of the patients in his "high care" or intensive care unit in American terms were there because of the enemas they had been given by traditional healers. I really find pediatrics fascinating...there is such a balance involved in children because their bodies are so resilient but at the same time the balance is delicate and can be impossible to get right. Still, I have to say that the pediatrics rotations I have done have been my favorite out of all the rotations. I never would have guessed that.
Handy was great at explaining maintaining the correct fluid balances in children and definitely had a way of calming the babies down. He did lecture one of the mother's of a six month old who was sick because the mother had given the baby an enema containing shoe polish and toothpaste at the advice of a traditional healer. Handy said simply to the mother, "Shoe polish. That's for shoes. Not for babies or children. Toothpaste. That's for your teeth. Nowhere else." The mother didn't react.
After the wards rounds there wasn't too much to do because the hospital is nearly empty because of the strike. We got to see Tom put in a catheter and I got to see the 15 year old female patient in the TB wards I saw the day before and she looked much better. The patient suffering from renal failure had passed away during the night.
Maya and I decided to walk almost the entire way home and got to see the sunset. We went straight from our walk to where Corey, Ben and Jonathon were staying: At the Royal Family of Hlebsia's house! They had sacrificed a sheep in our honor! Ben, Corey and Jonathon woke up to a breakfast table that Ben referred to as, "Fear factor." On the table was the head of the dead sheep (fur still intact), the intestines, liver, etc. Ben and Jonathon tried a piece of the ear and some of the liver. Corey abstained. For dinner we had the cooked sheep and actually it was really good. All 11 of us sat at a long table filled with food while the Royal Family and our families (all members of the Tribal Counsel) sat in the living room watching us and then eating. The food was amazing.
At the end of our meal the local preacher made a speech to thank us for coming to Hlebsia and for having dinner with them. It was an incredibly moving speech. He told us that he knew this was our last day of clinical rotations in South Africa and that over the past four weeks we have probably seen a lot of good and a great deal of bad things about the people of South Africa. He encouraged us to remember both: He emphasized that the "bad," the cultural differences, the problems with the health care system were all important things for us to remember so that we know we need to return to South Africa to continue to help the people here. He reminded us of the good: The families who have taken us into their homes, talked with us and opened up about their culture, fed us and cared for us. He encouraged us to remember them and know that we do not owe a debt but that the families want to see us return in the future.
I don't know if I will return to South Africa. I do know that in my heart--in spite of the fact that there is no timetable to how society operates here, that for a control freak like myself this country seems to run on a principal of a disorganized chaos, that the health care system is crumbling under the weight of growing epidemics of AIDS and TB and that crime continues to be a problem throughout the country--there are times when I have never felt more at home than I did here. There were more times when I felt like my presence here was of such a greater asset than it will ever be in the U.S., even if that was just a feeling.
No matter what. I wouldn't trade these last four weeks for anything. My sincerest gratitude goes out to all of those who supported me in this venture: Emotionally and financially, without your support I would never have made it.
Thank you again.
**As a side note, both Regina and my medical supplies were delivered directly to Chatsworth Hospice and to Hlebsia Hospital and also incidentally, any clinical site that hosts the CFHI students is given monetary compensation from our program dues**
Thursday, June 28, 2007
June 20th Hlebsia
June 20th, 2007This morning Regina and I walked almost the entire 8km from our home stay to the hospital. It is very hilly but absolutely gorgeous. We got to see the sunrise again and it was wonderful to get some good exercise in.
Maya and I got to shadow Tom, a doctor from London who wants to specialize in Infectious Disease. We went on ward rounds with him in the TB ward and it was very interesting. There was a patient who was 15 years old with advanced HIV (stage 4 AIDS) with a CD4 count of 4 (normal is between 500-1500). Her chart read that she was sexually active for several years with an older boyfriend. She said this was consensual sex. For her to have such a low CD4 count and symptoms of advanced AIDS you would think she would show at least a glimmer of anger towards her boyfriend.The odd thing is she doesn't. Even when the counselor (according to the notes) interviewed her and asked her if she considered charging her boyfriend with abuse for infecting her she said she didn't think of it as abuse.
Maya and my x-ray reading skills were put to the test in the TB ward. It was amazing to both of us how much we have learned since our first week at St.Mary's when an abnormal and normal x-ray pretty much looked the same to me. The x-rays and the diseases we get to see here are out of the textbook (in other words, we would never get to see them in the states other than in a textbook).
There was one male patient in the TB ward who was suffering from renal failure and at the end of his life in pain and quite agitated. Tom said at this point he was more focused on palliative care for the patient and was treating him much like the patients at Chatsworth Hospice. It's amazing how so many of my experiences here are coming full circle.
Arthur, Raj, Regina and I were the on-call medical students tonight and stayed in the doctor's quarters. We ran into one of the doctors from Hlebsia in the grocery store and invited him to dinner. Before we knew it we were making dinner for 7 people! With only two pots and very limited cooking supplies we worked as a team and made a fabulous dinner for ourselves and three of the other doctors. It was great being able to talk to them about what they thought of Hlebsia (they are all here studying different specialties for one year). It also made all of us consider possibly coming back to do something similar.
We didn't get woken up until 5:30 am, which was nice considering we were waking up at 6am anyway. We got to see a C-section and Raj assisted and I didn't pass out. It was amazing.
More to come...love you all.
Maya and I got to shadow Tom, a doctor from London who wants to specialize in Infectious Disease. We went on ward rounds with him in the TB ward and it was very interesting. There was a patient who was 15 years old with advanced HIV (stage 4 AIDS) with a CD4 count of 4 (normal is between 500-1500). Her chart read that she was sexually active for several years with an older boyfriend. She said this was consensual sex. For her to have such a low CD4 count and symptoms of advanced AIDS you would think she would show at least a glimmer of anger towards her boyfriend.The odd thing is she doesn't. Even when the counselor (according to the notes) interviewed her and asked her if she considered charging her boyfriend with abuse for infecting her she said she didn't think of it as abuse.
Maya and my x-ray reading skills were put to the test in the TB ward. It was amazing to both of us how much we have learned since our first week at St.Mary's when an abnormal and normal x-ray pretty much looked the same to me. The x-rays and the diseases we get to see here are out of the textbook (in other words, we would never get to see them in the states other than in a textbook).
There was one male patient in the TB ward who was suffering from renal failure and at the end of his life in pain and quite agitated. Tom said at this point he was more focused on palliative care for the patient and was treating him much like the patients at Chatsworth Hospice. It's amazing how so many of my experiences here are coming full circle.
Arthur, Raj, Regina and I were the on-call medical students tonight and stayed in the doctor's quarters. We ran into one of the doctors from Hlebsia in the grocery store and invited him to dinner. Before we knew it we were making dinner for 7 people! With only two pots and very limited cooking supplies we worked as a team and made a fabulous dinner for ourselves and three of the other doctors. It was great being able to talk to them about what they thought of Hlebsia (they are all here studying different specialties for one year). It also made all of us consider possibly coming back to do something similar.
We didn't get woken up until 5:30 am, which was nice considering we were waking up at 6am anyway. We got to see a C-section and Raj assisted and I didn't pass out. It was amazing.
More to come...love you all.
Capetown
Hi all...so this blog is really only supposed to be about what I did with CFHI while in South Africa but I thought some of you may want an update of what I am doing for the remainder of my stay here...I am still a bit behind on my Hlebsia blogs but I will get them in as soon as I can.
So Regina, Corey and I spent the past few days driving around the win elands and visiting many wineries (Regina ended up having to ship some stuff home because of all the wine she bought for people!!). It was all absolutely gorgeous. However I have to say not much of what we saw looked like the South Africa that we have seen thus far during our trip.
I also found out that I was the victim of identity theft was I was here...I never lost any of my credit cards but somehow someone got my debit card number and had some fun emptying my bank account. Oh well. On a better note, I left my cell phone at a cafe and the cafe called people in my phone book to get in touch with me. Everything all evens out in South Africa.
I will try to post more pics as soon as I can. Miss and love all of you!
So Regina, Corey and I spent the past few days driving around the win elands and visiting many wineries (Regina ended up having to ship some stuff home because of all the wine she bought for people!!). It was all absolutely gorgeous. However I have to say not much of what we saw looked like the South Africa that we have seen thus far during our trip.
I also found out that I was the victim of identity theft was I was here...I never lost any of my credit cards but somehow someone got my debit card number and had some fun emptying my bank account. Oh well. On a better note, I left my cell phone at a cafe and the cafe called people in my phone book to get in touch with me. Everything all evens out in South Africa.
I will try to post more pics as soon as I can. Miss and love all of you!
June 19th in Hlebsia
June 19th, 2007So I almost passed out twice today. I guess it was the whole blood thing that got to me, although it has never bothered me before. The first time I almost passed out was when I was watching a normal delivery of a baby ( e.g. not a C-Section) and I thought I was going to lose consciousness. I sat down and felt much better. The second time I thought I was going to pass out I was assisting the surgeon with a C-Section so there wasn't really any option of sitting down. All I kept telling myself was-"you don't want to be a patient here" and "you have to prove to yourself you can do this." I was profusely sweating, but other than that I stayed on my feet and it was an absolutely incredible site. What an opportunity. I loved the rush of surgery: It was a very focused and pressure-filled environment. After the C-Section we went to the labor ward where Arthur, Lindsay, Maya, Regina and I all got to put in IV drips and assist with pelvic exams (to monitor how the labor was progressing) and delivered babies!! It was very interesting to say the least. The sanitary practices and the overall treatment/attitude towards the patients here is definitely different than in America. The midwives stick needles in the mattresses when they are done using them before taking them to the sharps container. They typically only wear gloves when they are doing a pelvic exam or delivering a baby, but not while they are drawing blood or putting an IV line in. The midwives and nurses interact very differently with the pregnant women than nurses in the US: The major difference is that they treat every patient with virtually the same stern hand and often with a tone of voice that can be perceived as indifference. When the medical director Dr.Adams spoke to us this morning he talked to us about the patient Maya and I had seen yesterday and how you have to develop a "hardened heart" to cope with those situations. Perhaps this is what makes the nurses and midwives seem so "indifferent" from an outsider's perspective: They see so many HIV positive women and young women (the one that I helped deliver today was 16 years old), that it is probably easier for them not to have an emotional reaction. If they did for every case they had they would be exhausted emotionally and physically every day.
On a lighter note, this morning Regina and I walked about 3 miles on our way to the hospital (we got picked up by the van taking everyone else at about the half-way point). We got to see the sun rise and it was amazing. Tomorrow we are going to get an earlier start and try to walk the entire way (about five miles).
On our way home, Maya and Lindsay and I walked for about a mile. It was an amazing walk. All of the children and their parents would come out of their houses to say hi and wave. They were so excited to see all of us. I even got to take a picture with about five kids. They were so loving and sweet it was incredible. Everywhere we go in Hlebsia people are so happy to see us and excited to show us where they live.
Hlebsia is a truly gorgeous place. I am really happy that we get to stay with host families and work in the local public hospital. This way I get to see the cultural and societal forces behind the traditional medicine practices as well as the consequences of those medical practices.
Today we saw a man with abscesses on his elbows and on his buttocks, which resulted from an infection after he injected an herbal remedy above his elbows and on his left buttock. He told the doctor he did this because he had chest pain and that now the chest pain is gone. He also said he could just cut out the abscesses himself. The doctor said he needed to see a psychologist. He laughed and so did she. A lot of the doctors at Hlebsia are not guarded in voicing their opinions on the traditional medicine practices of their patients and at times (in the aforementioned case in particular) can be quite harsh and act superior to their "third world" patients. Again, I have to wonder if this is because of the "hardened heart"? While I agree that it is frustrating to feel like in most instances you are treating people for diseases they brought on themselves because they didn't go to a western medicine doctor first, at the same time does this mean that a non-western approach is automatically always the wrong option? By criticizing and dismissing the medical practices of the Zulu people, are the doctors being ignorant because in doing so they are dismissing years of cultural history and practices that make the Zulu people what they are today?
Love to all.
On a lighter note, this morning Regina and I walked about 3 miles on our way to the hospital (we got picked up by the van taking everyone else at about the half-way point). We got to see the sun rise and it was amazing. Tomorrow we are going to get an earlier start and try to walk the entire way (about five miles).
On our way home, Maya and Lindsay and I walked for about a mile. It was an amazing walk. All of the children and their parents would come out of their houses to say hi and wave. They were so excited to see all of us. I even got to take a picture with about five kids. They were so loving and sweet it was incredible. Everywhere we go in Hlebsia people are so happy to see us and excited to show us where they live.
Hlebsia is a truly gorgeous place. I am really happy that we get to stay with host families and work in the local public hospital. This way I get to see the cultural and societal forces behind the traditional medicine practices as well as the consequences of those medical practices.
Today we saw a man with abscesses on his elbows and on his buttocks, which resulted from an infection after he injected an herbal remedy above his elbows and on his left buttock. He told the doctor he did this because he had chest pain and that now the chest pain is gone. He also said he could just cut out the abscesses himself. The doctor said he needed to see a psychologist. He laughed and so did she. A lot of the doctors at Hlebsia are not guarded in voicing their opinions on the traditional medicine practices of their patients and at times (in the aforementioned case in particular) can be quite harsh and act superior to their "third world" patients. Again, I have to wonder if this is because of the "hardened heart"? While I agree that it is frustrating to feel like in most instances you are treating people for diseases they brought on themselves because they didn't go to a western medicine doctor first, at the same time does this mean that a non-western approach is automatically always the wrong option? By criticizing and dismissing the medical practices of the Zulu people, are the doctors being ignorant because in doing so they are dismissing years of cultural history and practices that make the Zulu people what they are today?
Love to all.
Sunday, June 24, 2007
Hlebsia Blogs 6/18-6/21
I wrote in a journal and I will try to get the entries typed up in my blog as soon as possible. In the meantime I am in Capetown with Regina and Corey (the CFHI alumni who helped us during our stay in Durban) and we are meeting up with Arthur and his partner and later in the week Ben from our program. We are staying in the city until tomorrow and then headed to the wine country, Stellenbosch, for two nights and then driving down to Cape Point. Then back up to Capetown and then we stay one night in Durban before we go to Zambia!!! The number of times I will be packing and unpacking during the next few weeks is insane but I am so lucky to be able to travel like this.
Here is my first entry during the rural rotation in Hlebsia:
June 18th, 2007
The Hlebsia Hospital was chosen as the Presidential project by President Mbeki (the only hospital to receive this "honor"/funding in South Africa), so it is in the process of being completely re-built. Unfortunately when it will be completed is yet to be determined because many of the funds have been pulled to pay for the building of facilities to host the 2010 Soccer World Cup.
The medical director of the hospital, Dr.Adams, is a very nice, well-educated man who is incredibly invested in making sure we all have the best experience possible at Hlebsia. **As a side note, I learned this week that CFHI donates money to the clinical sites where we work--while this may be perceived as "paying off" the staff to "put up" with us, I think that it's great because that means our program fees are really going to a good cause.** Back to Dr.Adams, he talked to us about this morning and told us that the foremost challenge they deal with at Hlebsia is the practice of their patients using traditional healers before western medicine. These are "practitioners" who many Zulu people go to when they are ill. This practice is deeply rooted in the Zulu culture. However the healers practices often include very outdated and dangerous techniques including bleeding patients through small incisions in their skin and also by administering various "herbal" drinks. They also perform some surgical procedures. One doctor told us today that five women delivered still-birth babies (babies dead at birth) a few months ago. All of the women were from the same township and had gone to a traditional healer. The doctor visited the healer to find out what had been given to the women (who wanted to induce labor). The healer said he had put "heavy water" in the drinks--aka mercury. Dr.Adams said this is just one of thousands of examples of patients they see who are sick because of what the healer gave them, which can be doubly confusing when the patients have no idea what they took. Dr.Adams said other than the problems faced with patients who go to traditional healers, their greatest challenges at Hlebsia are HIV/AIDS (he estimates that 50% of their patient population is infected) and Tuberculosis.
Maya and I were supposed to see a C-Section but the patient had a normal delivery. It's very challenging as a medical student when at times you find yourself disappointed that you didn't get to see a procedure in spite of the fact that this typically means the patient is doing well and is much better off.
Anyway, we went to the outpatient clinic and saw patients there. Maya just completed her second year of medical school in Canada so she is very knowledgeable. The most interesting case we saw was Choriocarcinoma which had metastasized to the patients liver and pancreas. When she was admitted she was in renal failure and was actively bleeding out. Dr.Adams said that because this woman was not able to be treated at King Edward because of the strike she went to a traditional healer (she had markings all over her body). Dr.Adams said there wasn't much that could be done other than palliative care.
We met our home stay family tonight. The house is absolutely gorgeous. It was built in 2005 and is very modern for the rural area. The family used to live in small cement huts before their current house was built. It has electricity and some running water. There's an outhouse but it's probably nicer than many public restrooms in the US. So Regina and I are happy about that.
Our house father is a teacher and is very stressed about the finances of their family because he has not been able to work for three weeks due to the strike. He said that he hopes the strike will be over soon because he's not sure how much longer his family can survive like this. At the same time he said the teachers have already compromised by demanding 10% from 12% and the government has only compromised from 6.5% to 7.5%. There are four children staying in the house and one man who is a teacher in his 20s. They are all very nice. Our mama and baba took us to the grocery store so we could tell them what we liked to eat. In addition, our baba (father) is a member of the Tribal Counsel of Hlebsia as are all of our homestay familes. One family is the royal family of Hlebsia. Ben, Corey and Jonathon are thus staying at the King or Chief's house.
Where we are living, because it is a rural area is very safe. Yes!!! Regina and I are planning on walking to the hospital (8km) tomorrow morning.
My love to all.
Here is my first entry during the rural rotation in Hlebsia:
June 18th, 2007
The Hlebsia Hospital was chosen as the Presidential project by President Mbeki (the only hospital to receive this "honor"/funding in South Africa), so it is in the process of being completely re-built. Unfortunately when it will be completed is yet to be determined because many of the funds have been pulled to pay for the building of facilities to host the 2010 Soccer World Cup.
The medical director of the hospital, Dr.Adams, is a very nice, well-educated man who is incredibly invested in making sure we all have the best experience possible at Hlebsia. **As a side note, I learned this week that CFHI donates money to the clinical sites where we work--while this may be perceived as "paying off" the staff to "put up" with us, I think that it's great because that means our program fees are really going to a good cause.** Back to Dr.Adams, he talked to us about this morning and told us that the foremost challenge they deal with at Hlebsia is the practice of their patients using traditional healers before western medicine. These are "practitioners" who many Zulu people go to when they are ill. This practice is deeply rooted in the Zulu culture. However the healers practices often include very outdated and dangerous techniques including bleeding patients through small incisions in their skin and also by administering various "herbal" drinks. They also perform some surgical procedures. One doctor told us today that five women delivered still-birth babies (babies dead at birth) a few months ago. All of the women were from the same township and had gone to a traditional healer. The doctor visited the healer to find out what had been given to the women (who wanted to induce labor). The healer said he had put "heavy water" in the drinks--aka mercury. Dr.Adams said this is just one of thousands of examples of patients they see who are sick because of what the healer gave them, which can be doubly confusing when the patients have no idea what they took. Dr.Adams said other than the problems faced with patients who go to traditional healers, their greatest challenges at Hlebsia are HIV/AIDS (he estimates that 50% of their patient population is infected) and Tuberculosis.
Maya and I were supposed to see a C-Section but the patient had a normal delivery. It's very challenging as a medical student when at times you find yourself disappointed that you didn't get to see a procedure in spite of the fact that this typically means the patient is doing well and is much better off.
Anyway, we went to the outpatient clinic and saw patients there. Maya just completed her second year of medical school in Canada so she is very knowledgeable. The most interesting case we saw was Choriocarcinoma which had metastasized to the patients liver and pancreas. When she was admitted she was in renal failure and was actively bleeding out. Dr.Adams said that because this woman was not able to be treated at King Edward because of the strike she went to a traditional healer (she had markings all over her body). Dr.Adams said there wasn't much that could be done other than palliative care.
We met our home stay family tonight. The house is absolutely gorgeous. It was built in 2005 and is very modern for the rural area. The family used to live in small cement huts before their current house was built. It has electricity and some running water. There's an outhouse but it's probably nicer than many public restrooms in the US. So Regina and I are happy about that.
Our house father is a teacher and is very stressed about the finances of their family because he has not been able to work for three weeks due to the strike. He said that he hopes the strike will be over soon because he's not sure how much longer his family can survive like this. At the same time he said the teachers have already compromised by demanding 10% from 12% and the government has only compromised from 6.5% to 7.5%. There are four children staying in the house and one man who is a teacher in his 20s. They are all very nice. Our mama and baba took us to the grocery store so we could tell them what we liked to eat. In addition, our baba (father) is a member of the Tribal Counsel of Hlebsia as are all of our homestay familes. One family is the royal family of Hlebsia. Ben, Corey and Jonathon are thus staying at the King or Chief's house.
Where we are living, because it is a rural area is very safe. Yes!!! Regina and I are planning on walking to the hospital (8km) tomorrow morning.
My love to all.
Saturday, June 16, 2007
Weekend on the South Coast
Hi all...so we are going to the rural rotation next week and we will be staying with host families there because as far as we know the strike is essentially over. Woo hoo. However, I will not have access to email for all of next week--until Friday--but I will hand-write blog entries and then type them in as soon as I get back to email the following week.
On another note, this weekend 11 of us hired/rented cars and drove to Port Shepstone (about an hour drive south of Durban). We are staying at a gorgeous hostile, called The Spot Backpackers in a cabin with 12 bunk beds. It is gorgeous and the staff here are amazing. We went to Oribi Gorge yesterday and hiked and then I went bungee jumping (spelling?) off of the gorge--a 100 meter free-fall and the largest "swing" (because it was more of a swing than an actual bungee cord) in the world. It was incredible. I will never do something like that again but it is great to say I did and I have some incredible photos and a certificate as proof of what I did.
Today we went to the beach and hung out. The area we are staying in is very affluent and sometimes looks just like America. I have said this before but I will say it again--the dichotomy of the first and third world and their close proximity in South Africa never fails to amaze me.
Tonight we are going to a French restaurant in Ramsgate, which is one of the top ten restaurants in South Africa. Should be amazing.
There is only one computer here so I am going to get going....Happy early Father's Day to my Dad and John and all of the other fathers! I miss you all dearly and I can't wait to tell you about my experience in the rural rotation. From what the other students who did it last week have said, it should be incredible.
Love to all of you.
On another note, this weekend 11 of us hired/rented cars and drove to Port Shepstone (about an hour drive south of Durban). We are staying at a gorgeous hostile, called The Spot Backpackers in a cabin with 12 bunk beds. It is gorgeous and the staff here are amazing. We went to Oribi Gorge yesterday and hiked and then I went bungee jumping (spelling?) off of the gorge--a 100 meter free-fall and the largest "swing" (because it was more of a swing than an actual bungee cord) in the world. It was incredible. I will never do something like that again but it is great to say I did and I have some incredible photos and a certificate as proof of what I did.
Today we went to the beach and hung out. The area we are staying in is very affluent and sometimes looks just like America. I have said this before but I will say it again--the dichotomy of the first and third world and their close proximity in South Africa never fails to amaze me.
Tonight we are going to a French restaurant in Ramsgate, which is one of the top ten restaurants in South Africa. Should be amazing.
There is only one computer here so I am going to get going....Happy early Father's Day to my Dad and John and all of the other fathers! I miss you all dearly and I can't wait to tell you about my experience in the rural rotation. From what the other students who did it last week have said, it should be incredible.
Love to all of you.
Pictures
Hi all...for those of you who didn't get a link to my pics here it is:
http://www2.snapfish.com/share/p=147141181824437129/l=273466873/g=90532595/otsc=SYE/otsi=SALB
http://www2.snapfish.com/share/p=147141181824437129/l=273466873/g=90532595/otsc=SYE/otsi=SALB
Thursday, June 14, 2007
Strike Is On
Yesterday I didn't blog because we were at the mall. Again. Oh well, at least we get to see that part of South African culture.
The strike got very violent yesterday around the country but particularly on the streets of Durban so our taxi driver took all of us to a few malls in the area. For some reason the strike does not seem to be getting a lot of international coverage. The New York Times article yesterday said that the strike was "confined to teachers, health care workers and other workers in the public service sector." Last time I checked, that's a lot of people. Apparently at the New York Times though it isn't. On Tuesday one of the hospice nurses asked us what we would do in America if a strike like this occurred. None of us could come up with a response other than it never would. Which is probably why it is so hard for us to understand this situation, let alone some reporter sitting at a desk in New York. Nevertheless, the BBC apparently has been giving some attention to the story and apparently President Mbeki (president of South Africa) and members of their Parliament are not accepting raises in their salaries....progress is progress.
Today at Hospice they were not going on home visits because their name is on their vehicles and they were scared to be driving around in them. Tomorrow will be the same. So we are planning a trip to the South Coast to go surfing and Kayaking.
On Sunday we will leave for the rural rotation. Because the strikers have reached that region as well we are only allowed to go and stay in the doctor's quarters on the hospital campus, which is heavily gated and guarded. While we will not be able to see where our patients live (unless hopefully the strike has ended by then), we will get to see a lot according to the group of students who just returned from there. The doctor's quarters are apparently like condos so that should be nice.
I am going to send out an email for everyone to view both Regina and my pictures from the trip so far. Finally!!
Love all of you so much.
The strike got very violent yesterday around the country but particularly on the streets of Durban so our taxi driver took all of us to a few malls in the area. For some reason the strike does not seem to be getting a lot of international coverage. The New York Times article yesterday said that the strike was "confined to teachers, health care workers and other workers in the public service sector." Last time I checked, that's a lot of people. Apparently at the New York Times though it isn't. On Tuesday one of the hospice nurses asked us what we would do in America if a strike like this occurred. None of us could come up with a response other than it never would. Which is probably why it is so hard for us to understand this situation, let alone some reporter sitting at a desk in New York. Nevertheless, the BBC apparently has been giving some attention to the story and apparently President Mbeki (president of South Africa) and members of their Parliament are not accepting raises in their salaries....progress is progress.
Today at Hospice they were not going on home visits because their name is on their vehicles and they were scared to be driving around in them. Tomorrow will be the same. So we are planning a trip to the South Coast to go surfing and Kayaking.
On Sunday we will leave for the rural rotation. Because the strikers have reached that region as well we are only allowed to go and stay in the doctor's quarters on the hospital campus, which is heavily gated and guarded. While we will not be able to see where our patients live (unless hopefully the strike has ended by then), we will get to see a lot according to the group of students who just returned from there. The doctor's quarters are apparently like condos so that should be nice.
I am going to send out an email for everyone to view both Regina and my pictures from the trip so far. Finally!!
Love all of you so much.
Tuesday, June 12, 2007
Hospice Day 2
So we got to go back to Chatsworth Hospice today. It actually runs a lot like the hospice organizations in the U.S. in terms of its focus on palliative and holistic care.
We went on rounds to visit the four patients currently staying in the 10 person in-patient ward, which was very interesting. We got into a discussion about sex in the middle of the hallway with the medical director and the pastor for hospice! I could never imagine Americans talking so openly about sex like this--especially in the hallway of hospice! It was centered around religious beliefs as well, but nevertheless we were all surprised at the lack of censorship.
After rounds we had two talks with the head of Chatsworth Hospice and the pastor for the hospice. They both said that hospice was striving to help not only the patient physically but also socially, emotionally, financially and provide support to their family members as well. Because the population surrounding Chatsworth Hospice is mostly Indian and there is not as high an occurrence of AIDS/HIV in this area, when this hospice opened in 1994 the focus was on cancer and helping those suffering from cancer. However since 1994 two of the ten in-patient beds have been allocated for AIDS/HIV patients and a separate staff dedicated to a very rural area in Durban where AIDS patients are living was established. We will not be able to visit this area unfortunately because of the strike but from what the nurse told us it is incredible. The area is made up of houses made of whatever materials their inhabitants can make and they get electricity by stealing it from power lines. There is typically no running water. The residents of these areas are usually individuals who have been shunned from their communities or families because of their diagnosis of HIV/AIDS. Hospice has caregivers in this area to help the residents with their tasks of daily living and with cooking, etc. The nurse then tries to visit every two weeks to check in on the patients medical needs. It is too bad we won't be able to see this area.
Then we went out with two nurses to visit three hospice patients living at home. One of the women we got to see is in remission with cancer of the tongue and she reported a lot of the same symptoms that my Mom had after her radiation. It was good that I could relate to her but it definitely made me a little homesick.
On another note things with the status of our program are not looking good. The strike is on in full force and tomorrow we are advised not to leave our houses. Our rural rotation for next week may also be in jeopardy. The people here are telling us we are experiencing first-hand a key moment in South African history. We are all just trying to stay positive and think of it that way.
Sending all of my love.
We went on rounds to visit the four patients currently staying in the 10 person in-patient ward, which was very interesting. We got into a discussion about sex in the middle of the hallway with the medical director and the pastor for hospice! I could never imagine Americans talking so openly about sex like this--especially in the hallway of hospice! It was centered around religious beliefs as well, but nevertheless we were all surprised at the lack of censorship.
After rounds we had two talks with the head of Chatsworth Hospice and the pastor for the hospice. They both said that hospice was striving to help not only the patient physically but also socially, emotionally, financially and provide support to their family members as well. Because the population surrounding Chatsworth Hospice is mostly Indian and there is not as high an occurrence of AIDS/HIV in this area, when this hospice opened in 1994 the focus was on cancer and helping those suffering from cancer. However since 1994 two of the ten in-patient beds have been allocated for AIDS/HIV patients and a separate staff dedicated to a very rural area in Durban where AIDS patients are living was established. We will not be able to visit this area unfortunately because of the strike but from what the nurse told us it is incredible. The area is made up of houses made of whatever materials their inhabitants can make and they get electricity by stealing it from power lines. There is typically no running water. The residents of these areas are usually individuals who have been shunned from their communities or families because of their diagnosis of HIV/AIDS. Hospice has caregivers in this area to help the residents with their tasks of daily living and with cooking, etc. The nurse then tries to visit every two weeks to check in on the patients medical needs. It is too bad we won't be able to see this area.
Then we went out with two nurses to visit three hospice patients living at home. One of the women we got to see is in remission with cancer of the tongue and she reported a lot of the same symptoms that my Mom had after her radiation. It was good that I could relate to her but it definitely made me a little homesick.
On another note things with the status of our program are not looking good. The strike is on in full force and tomorrow we are advised not to leave our houses. Our rural rotation for next week may also be in jeopardy. The people here are telling us we are experiencing first-hand a key moment in South African history. We are all just trying to stay positive and think of it that way.
Sending all of my love.
Monday, June 11, 2007
Wonderful Weekend and Great Day
Hi all. I don't have much time to write but here goes....FYI I am going to try to download pics tomorrow if I can. Problem is I need someone to walk me home and wait for me to download the pics and no one wants to stay at the mall that long because of the danger of walking home so please understand why I can't do that.
This weekend in Durban was amazing. Regina, Arthur and I got to see so many of the sites in Durban and really enjoyed ourselves.
Today I was at Chatsworth Hospice, which is a hospice organization catering to cancer patients and patients with AIDS/HIV. They have a 10 bed in-patient ward and see approximately 350 patients each week in the surrounding communities. Today I was there to do an initial intake with a patient and it was fascinating and much like the hospice in the U.S.
I will try to write more tomorrow. Love you all dearly.
This weekend in Durban was amazing. Regina, Arthur and I got to see so many of the sites in Durban and really enjoyed ourselves.
Today I was at Chatsworth Hospice, which is a hospice organization catering to cancer patients and patients with AIDS/HIV. They have a 10 bed in-patient ward and see approximately 350 patients each week in the surrounding communities. Today I was there to do an initial intake with a patient and it was fascinating and much like the hospice in the U.S.
I will try to write more tomorrow. Love you all dearly.
Friday, June 8, 2007
Stirke is on but enjoying the city
Sorry I didn't get to blog yesterday. We went to clinic and got to work for about 10 minutes and then the doctors had a meeting and determined that the clinic could possibly be the next target for striking workers. They advised us to leave and not to come in on Friday. So we went to a mall and met with our medical director and talked about health care in South Africa. Shola informed us that next week 10 students will go to St.Mary's, 5 will go back to the clinic and 5 will work with Hospice Chatsworth. I opted for Hospice Chatsworth because that is the organization that goes to AIDS patients homes to check in on their health care needs. I think this will be very interesting and hopefully unaffected by the strike.
Today Regina, Arthur and I checked into a small hotel on Florida Road which has a lot of restaurants and bars and is centrally located. Definitely not a part of the "real South Africa" but it is nice to escape the suburbs for awhile and feel safe to walk around at night.
Today we visited the Botanical Gardens which were absolutely beautiful. It is about 70 degrees here and sunny. What a "winter" they have here. We are just going to walk around some more today and then go to a steakhouse and a club. What fun.
At the Botanical Gardens we got to lay in the sun and I think it was the first time I relaxed this entire trip.
The good news is, we only missed out on two days of clinic and if anything good can be said about the situation, it's that we learned more about the culture here.
The internet cafe I am in right now is insanely expensive so I'm going to sign off.
Love to all.
Today Regina, Arthur and I checked into a small hotel on Florida Road which has a lot of restaurants and bars and is centrally located. Definitely not a part of the "real South Africa" but it is nice to escape the suburbs for awhile and feel safe to walk around at night.
Today we visited the Botanical Gardens which were absolutely beautiful. It is about 70 degrees here and sunny. What a "winter" they have here. We are just going to walk around some more today and then go to a steakhouse and a club. What fun.
At the Botanical Gardens we got to lay in the sun and I think it was the first time I relaxed this entire trip.
The good news is, we only missed out on two days of clinic and if anything good can be said about the situation, it's that we learned more about the culture here.
The internet cafe I am in right now is insanely expensive so I'm going to sign off.
Love to all.
Wednesday, June 6, 2007
The Strike Is On. Our program may not be....
Last night we got a message from Shola saying we didn't have clinic today. Apparently the strike is truly in full force. Our sister and cousin's school principal was threatened by strikers that if he went to school they would burn it down.
I am not sure what is going to happen with our program now. We just received a text message from Shola that there will be no clinic tomorrow. We typically have our meetings with our medical director on Thursday so hopefully at least that will happen and we can find out what our next step is.
In the meantime, we are all trying to take advantage of the free time and see more of Durban. It was rainy today so Arthur, Regina and I had the taxi driver who drives the whole group around drive us to the Gateway Mall. The largest mall in the Southern Hemisphere. There is a huge wave machine, climbing wall, gym, IMAX, movie theater etc. So we went to see Pirates of the Carribean III, get some lunch, walking around, and we are going to play skeet ball (spelling?) after we finish up at the Internet cafe. When I walked out of the movies I swore I was walking out of Northgate theater at home. It's amazing here how you can be driving and one minute see houses built out of any materials the persons inhabiting them can find and then a few miles down the road is a giant mall. It's truly a third and first-world country here.
Pray that this strike will end soon or that we can somehow find a place to get clinical experience.
My love to everyone.
I am not sure what is going to happen with our program now. We just received a text message from Shola that there will be no clinic tomorrow. We typically have our meetings with our medical director on Thursday so hopefully at least that will happen and we can find out what our next step is.
In the meantime, we are all trying to take advantage of the free time and see more of Durban. It was rainy today so Arthur, Regina and I had the taxi driver who drives the whole group around drive us to the Gateway Mall. The largest mall in the Southern Hemisphere. There is a huge wave machine, climbing wall, gym, IMAX, movie theater etc. So we went to see Pirates of the Carribean III, get some lunch, walking around, and we are going to play skeet ball (spelling?) after we finish up at the Internet cafe. When I walked out of the movies I swore I was walking out of Northgate theater at home. It's amazing here how you can be driving and one minute see houses built out of any materials the persons inhabiting them can find and then a few miles down the road is a giant mall. It's truly a third and first-world country here.
Pray that this strike will end soon or that we can somehow find a place to get clinical experience.
My love to everyone.
Tuesday, June 5, 2007
Looking towards the future
Found the blog meant for Tuesday:
I am writing this blog at a much earlier hour because we had to leave the clinic at 12:00 today because Shola, our local coordinator, was worried about our safety during the strike. Apparently because the unions and the government have not come to an agreement yet, the strike is in full force and many of the striking workers target hospitals and clinics. They do so because they know the nurses and doctors are still going to work and getting paid while the strikers are not getting paid and fighting for a salary increase that the doctors and nurses will benefit from. While this is justified, it is definitely beginning to have an impact on our program. We hope that tomorrow we will be able to go to clinic. Even though we only got in about 4 hours today at least we got to go.
Today I shadowed a doctor and his staff who are a part of a research study (I do not have all of the details with me because I stopped by my house before coming here and left my notebook there) that began in January 2007 and is being conducted at 5 sites around South Africa to study HIV positive pregnant women during their pregnancy and during the first 18 months of life of their children.
In order to qualify, the women must have a CD4 count between 200-500 (below 200 is a diagnosis of AIDS). Then a random sample of these women are given ARV treatment between 32-36 weeks. They are then followed throughout the life of their children. A key part of the study is focused on whether or not the women feed their children by breast milk or formula. While the US recommends exclusively formula to babies with HIV positive mothers, WHO (World Health Organization) recommends exclusive breastfeeding during the first six months. They do so because if mothers do not have the ability to give sanitized formula (AKA do not have a stove or running water) it is better for them to give the babies breast milk because they are more likely to die from an infection from unsanitary water. The women are paid to participate in the study, however the doctor overseeing the study at the clinic said that of course ethically the baby and the woman's health are put first. It will take 4-5 years for the study to be completed and will involve a sample group of 1500 women. The results of this study will most likely rewrite the current WHO protocols according to the doctor I worked with.
Before meeting the doctor I had a chance to sit down with his nurses who wanted to know all about our health care system. They thought that the US had universal health care, I told them we didn't but once I got into the particulars of our system they felt like we were still ahead of them in terms of the health care we provide in America. For instance I asked them if they saw a lot of HPV or cervical cancer and they laughed. They said of course they saw a lot of it: The South African public health care system does not mandate pap smears until age 30 and then only every 10 years after that (unless of course a woman under 30 comes to a clinic with symptoms requiring a pap smear). When I told them the ages we typically start doing pap smears and how often they are required and how many women avoid getting their pap smears they couldn't believe it. We have so much to be thankful for.
Speaking of being thankful, our family (myself included) absolutely loved Regina's dinner. The girls were all gathered in the kitchen with us asking us what we cook and how we cook it. I told them about burritos--they had never heard of a tortilla so I said I would make Quesadillas.
Until tomorrow, sending my love to all.
I am writing this blog at a much earlier hour because we had to leave the clinic at 12:00 today because Shola, our local coordinator, was worried about our safety during the strike. Apparently because the unions and the government have not come to an agreement yet, the strike is in full force and many of the striking workers target hospitals and clinics. They do so because they know the nurses and doctors are still going to work and getting paid while the strikers are not getting paid and fighting for a salary increase that the doctors and nurses will benefit from. While this is justified, it is definitely beginning to have an impact on our program. We hope that tomorrow we will be able to go to clinic. Even though we only got in about 4 hours today at least we got to go.
Today I shadowed a doctor and his staff who are a part of a research study (I do not have all of the details with me because I stopped by my house before coming here and left my notebook there) that began in January 2007 and is being conducted at 5 sites around South Africa to study HIV positive pregnant women during their pregnancy and during the first 18 months of life of their children.
In order to qualify, the women must have a CD4 count between 200-500 (below 200 is a diagnosis of AIDS). Then a random sample of these women are given ARV treatment between 32-36 weeks. They are then followed throughout the life of their children. A key part of the study is focused on whether or not the women feed their children by breast milk or formula. While the US recommends exclusively formula to babies with HIV positive mothers, WHO (World Health Organization) recommends exclusive breastfeeding during the first six months. They do so because if mothers do not have the ability to give sanitized formula (AKA do not have a stove or running water) it is better for them to give the babies breast milk because they are more likely to die from an infection from unsanitary water. The women are paid to participate in the study, however the doctor overseeing the study at the clinic said that of course ethically the baby and the woman's health are put first. It will take 4-5 years for the study to be completed and will involve a sample group of 1500 women. The results of this study will most likely rewrite the current WHO protocols according to the doctor I worked with.
Before meeting the doctor I had a chance to sit down with his nurses who wanted to know all about our health care system. They thought that the US had universal health care, I told them we didn't but once I got into the particulars of our system they felt like we were still ahead of them in terms of the health care we provide in America. For instance I asked them if they saw a lot of HPV or cervical cancer and they laughed. They said of course they saw a lot of it: The South African public health care system does not mandate pap smears until age 30 and then only every 10 years after that (unless of course a woman under 30 comes to a clinic with symptoms requiring a pap smear). When I told them the ages we typically start doing pap smears and how often they are required and how many women avoid getting their pap smears they couldn't believe it. We have so much to be thankful for.
Speaking of being thankful, our family (myself included) absolutely loved Regina's dinner. The girls were all gathered in the kitchen with us asking us what we cook and how we cook it. I told them about burritos--they had never heard of a tortilla so I said I would make Quesadillas.
Until tomorrow, sending my love to all.
Monday, June 4, 2007
National Strike
A national strike in South Africa involving all persons working in the public sector started on Friday. At the time we were at St.Mary's (which is partially private) and there were no changes as a result of the strike. The children in our family however do not have to go to school until the strike finishes.
Today we were supposed to be going to a secondary hospital (which sees patients with higher level care needs than St.Mary's), King Edward, however the gates were locked and apparently patients are not receiving care. It is very dangerous to show up to work at any public sector locations so our local coordinator moved us to a clinic, Kwadabeka which is near Pinetown to work today. Even though this is a public clinic, our coordinator Shola determined that it was safe. We are working on a day to day basis though and don't know if anything will change in terms of our program based on the negotiations that go on. The workers want a 12% raise and the government will not budge from their 6% offer.
That said, today was still a great, busy day. We each got to shadow a doctor and help them in consult with the patients. Most of the patients we saw had TB, Diabetes, high blood pressure or some sort of wound they let go untreated for weeks. In order to be seen in this clinic the patients get there at 3:00 or 4:00am and doctors finish seeing them by 3:00p.m.
All of my knowledge from last week was put to good use today as the doctors expected us to tell them what we would do if we were the doctors. One of our patients came in because of a mass on his chin, but he had several other skin problems on his face and ears. The doctor said he was bad at dermatology and asked me what I thought it was. I said, "Leprosy." Seriously a shot in the dark but I was right!! The doctor opened the patent's chart and sure enough he was on leprosy treatment. Thank goodness for my microbiology class. I knew so much about Leprosy the doctor was very impressed.
Anti-retrovirals are given out at this clinic and counseling for sexual assault victims and for patients on ARV's occurs here and we will be rotating through these areas throughout the week.
Regina is cooking dinner for me, my family and several of the other students to celebrate my birthday tonight. We are also going out Wednesday--I love extended birthdays!!
Thanks again for all of the birthday emails and phone calls. Keep your fingers crossed that we can go to clinic tomorrow.
Today we were supposed to be going to a secondary hospital (which sees patients with higher level care needs than St.Mary's), King Edward, however the gates were locked and apparently patients are not receiving care. It is very dangerous to show up to work at any public sector locations so our local coordinator moved us to a clinic, Kwadabeka which is near Pinetown to work today. Even though this is a public clinic, our coordinator Shola determined that it was safe. We are working on a day to day basis though and don't know if anything will change in terms of our program based on the negotiations that go on. The workers want a 12% raise and the government will not budge from their 6% offer.
That said, today was still a great, busy day. We each got to shadow a doctor and help them in consult with the patients. Most of the patients we saw had TB, Diabetes, high blood pressure or some sort of wound they let go untreated for weeks. In order to be seen in this clinic the patients get there at 3:00 or 4:00am and doctors finish seeing them by 3:00p.m.
All of my knowledge from last week was put to good use today as the doctors expected us to tell them what we would do if we were the doctors. One of our patients came in because of a mass on his chin, but he had several other skin problems on his face and ears. The doctor said he was bad at dermatology and asked me what I thought it was. I said, "Leprosy." Seriously a shot in the dark but I was right!! The doctor opened the patent's chart and sure enough he was on leprosy treatment. Thank goodness for my microbiology class. I knew so much about Leprosy the doctor was very impressed.
Anti-retrovirals are given out at this clinic and counseling for sexual assault victims and for patients on ARV's occurs here and we will be rotating through these areas throughout the week.
Regina is cooking dinner for me, my family and several of the other students to celebrate my birthday tonight. We are also going out Wednesday--I love extended birthdays!!
Thanks again for all of the birthday emails and phone calls. Keep your fingers crossed that we can go to clinic tomorrow.
Sunday, June 3, 2007
Celebrations All Around
This morning I came out of my room, glasses, retainers, etc. to find my family gathered around singing Happy Birthday to me. It was heart warming.
Yesterday going to the wedding was quite the adventure. It was about a 3 hour drive to "farm" country. The houses there are very simple--cement walls with metal roofs which leak a lot during the heavy rainstorms and no central heating (it is much colder and rainy in this particular part of South Africa). My mama's brother and sister were very nice--when we went to pick up her sister a bunch of people from the town came by the house and said they had been waiting all day to see us. At the wedding in the hall everyone was staring at us but were also very welcoming to have additional guests at the wedding--there were about 250-300 people (most of the town from what I understand) gathered in the hall so it was a large affair.
The wedding was very disorganized according to our family members (we thought that the disorganization was just a South African thing but they said it wasn't), so we ended up having to stay there until 10:00pm. We had to help prepare the food for the wedding...which was done in a makeshift garage with a leaking roof and a bin filled with rainwater was used to wash dishes and hands. We walked up out of the pouring rain into the garage and found four women cutting meat off of a dead cow carcass and interchanging the knife they were using to cut the meat with the one to cut the salad....our American stomachs are not used to this. It was quite the sight seeing all of those women working together like that. I have lots of pics (side note: I tried to download pics today but it was taking forever so I think when I get to Capetown at the end of the month and have more time I will download all of my pics) and they loved having us take them. They assigned Regina and I the task of opening about 30 cans of food with knives. At least we can add that skill to our resumes. Then the wedding was very different--according to one of mama's friends, Wendy, who traveled with us--than a normal Zulu wedding. She said this was "disorganized" and felt bad that we didn't get to see a better wedding. Regina got to see the traditional Zulu part of the wedding and said it was more enjoyable than the "western" portion I got to see. Again, lots of pictures of that.
I got a bit of a stomach ache and was ready to go home which caused quite the stir about the family--they are great caretakers and I think they were worried I was very sick. I think it was the first time I was really really terribly homesick. But once I laid down and got to talk to my Mom (I have had trouble with my cell so this was the first time we had talked for more than 10 minutes) and John and felt much better.
The standard of living here is just very different from the US. Even though we are staying with a middle class family, their standard of living is more like that of some of the poorest people in the US. They are all very intelligent and capable it's just that with the unemployment rate at 45% I don't think there are very many opportunities for them.
Mama's sister asked us if New York was in America and if we knew Ricki Lake. What we are doing--traveling like this--is completely foreign to them. A three hour car ride is the equivalent of us going from California to New York. We are so lucky to be doing this and that's what I keep reminding myself.
So I guess you could say I was experiencing some culture shock. John and my Mom reminded me why I am here and I felt much better--this is a truly life changing experience.
The clinical aspect of this trip is invaluable and I love all that I am getting to see. But when we get off of work (going from 7:00am-3:00pm) we have about 20 minutes in the mall before we have to start walking home (about 2 mile walk) and then it is dark and we can't leave the house unless we have a taxi waiting outside for us. So we sacrifice a lot of independence. We are not allowed to go anywhere alone. My family allows me to go on runs alone in the morning but only up and down their street (thankfully it has two big hills so it is a good workout) and the other day I almost got attacked by two dogs. What's that phrase? What doesn't kill you will only make you stronger?
Regina and I are laughing about everything we saw yesterday and just getting through the tough times together. They have a very interesting culture here.
Speaking of Zulu culture, I am doing my best to pick up the language here but with the clicks that they use it is difficult to train my tongue. One of my sisters, "Shorty" was helping me practice common phrases today. They are all such loving people who only want us to have a great experience.
So today is my birthday. I just finished reading all of my lovely emails from all of you. Thank you so much for keeping up with my journey and supporting me all the way through it.
I am off to the beach with my sister, two cousins and one of their friends. This is a very big deal for them to go into the city. They didn't want to come because they were worried about spending money so Regina and I packed some food and we'll buy them some ice cream and pay for the taxis.
We are meeting up with our friends at the beach then going back to my house for a birthday party and then maybe out in the city for the evening. Sunday night is a big night to go out here.
Again I love you all so much and I hope you are enjoying my blog. I love being able to share my stories with you.
Love,
Alexis
Yesterday going to the wedding was quite the adventure. It was about a 3 hour drive to "farm" country. The houses there are very simple--cement walls with metal roofs which leak a lot during the heavy rainstorms and no central heating (it is much colder and rainy in this particular part of South Africa). My mama's brother and sister were very nice--when we went to pick up her sister a bunch of people from the town came by the house and said they had been waiting all day to see us. At the wedding in the hall everyone was staring at us but were also very welcoming to have additional guests at the wedding--there were about 250-300 people (most of the town from what I understand) gathered in the hall so it was a large affair.
The wedding was very disorganized according to our family members (we thought that the disorganization was just a South African thing but they said it wasn't), so we ended up having to stay there until 10:00pm. We had to help prepare the food for the wedding...which was done in a makeshift garage with a leaking roof and a bin filled with rainwater was used to wash dishes and hands. We walked up out of the pouring rain into the garage and found four women cutting meat off of a dead cow carcass and interchanging the knife they were using to cut the meat with the one to cut the salad....our American stomachs are not used to this. It was quite the sight seeing all of those women working together like that. I have lots of pics (side note: I tried to download pics today but it was taking forever so I think when I get to Capetown at the end of the month and have more time I will download all of my pics) and they loved having us take them. They assigned Regina and I the task of opening about 30 cans of food with knives. At least we can add that skill to our resumes. Then the wedding was very different--according to one of mama's friends, Wendy, who traveled with us--than a normal Zulu wedding. She said this was "disorganized" and felt bad that we didn't get to see a better wedding. Regina got to see the traditional Zulu part of the wedding and said it was more enjoyable than the "western" portion I got to see. Again, lots of pictures of that.
I got a bit of a stomach ache and was ready to go home which caused quite the stir about the family--they are great caretakers and I think they were worried I was very sick. I think it was the first time I was really really terribly homesick. But once I laid down and got to talk to my Mom (I have had trouble with my cell so this was the first time we had talked for more than 10 minutes) and John and felt much better.
The standard of living here is just very different from the US. Even though we are staying with a middle class family, their standard of living is more like that of some of the poorest people in the US. They are all very intelligent and capable it's just that with the unemployment rate at 45% I don't think there are very many opportunities for them.
Mama's sister asked us if New York was in America and if we knew Ricki Lake. What we are doing--traveling like this--is completely foreign to them. A three hour car ride is the equivalent of us going from California to New York. We are so lucky to be doing this and that's what I keep reminding myself.
So I guess you could say I was experiencing some culture shock. John and my Mom reminded me why I am here and I felt much better--this is a truly life changing experience.
The clinical aspect of this trip is invaluable and I love all that I am getting to see. But when we get off of work (going from 7:00am-3:00pm) we have about 20 minutes in the mall before we have to start walking home (about 2 mile walk) and then it is dark and we can't leave the house unless we have a taxi waiting outside for us. So we sacrifice a lot of independence. We are not allowed to go anywhere alone. My family allows me to go on runs alone in the morning but only up and down their street (thankfully it has two big hills so it is a good workout) and the other day I almost got attacked by two dogs. What's that phrase? What doesn't kill you will only make you stronger?
Regina and I are laughing about everything we saw yesterday and just getting through the tough times together. They have a very interesting culture here.
Speaking of Zulu culture, I am doing my best to pick up the language here but with the clicks that they use it is difficult to train my tongue. One of my sisters, "Shorty" was helping me practice common phrases today. They are all such loving people who only want us to have a great experience.
So today is my birthday. I just finished reading all of my lovely emails from all of you. Thank you so much for keeping up with my journey and supporting me all the way through it.
I am off to the beach with my sister, two cousins and one of their friends. This is a very big deal for them to go into the city. They didn't want to come because they were worried about spending money so Regina and I packed some food and we'll buy them some ice cream and pay for the taxis.
We are meeting up with our friends at the beach then going back to my house for a birthday party and then maybe out in the city for the evening. Sunday night is a big night to go out here.
Again I love you all so much and I hope you are enjoying my blog. I love being able to share my stories with you.
Love,
Alexis
Friday, June 1, 2007
St.Mary's
Sorry I didn't write yesterday, Regina and I went to do our laundry and we have to time everything that we do according to when it gets dark and making sure we have someone walking with us because it isn't very safe where we live.
Today and yesterday I worked with a young Pediatric doctor, she is probably 28 and VERY nice. All she wanted to do was teach us! I got to see about 50 chest xrays to check for TB etc. It was amazing.
I decided to work with Dr.Khose again today (usually we rotate) because of all that I got to see yesterday. I had a really tough time though. One boy that we saw is 10 years old and about Sterling's (my brother) height and age. He has AIDS. His mother died several years ago. Two weeks ago he was diagnosed with cryptococcal meningitis and it looked like today the antibiotics he was given did not clear the infection. He was in so much pain and could barely speak. The only words he could get out were to tell the doctor he didn't want to stay in the hospital. I don't think I have ever been so close to tears with a patient.
It is very frustrating here to see the young babies and children here because probably 8 out of 10 of them have HIV/AIDS or TB. It is so hard to see them suffer like this and you just want to shake the mothers and tell them to get tested, to be safe, to go on ARVs. I can see why they have a shortage of doctors here. In the short time we were at St.Mary's two doctors quit (including Dr.Khose who gave her one month notice today). Dr. Khose said that she feels as though she is fighting an uphill battle and she doesn't know where to begin to try to stop the spread of AIDS.
When Dr.Khose asked about what problems we see in America, one of the other students, Ben, said it very appropriately: "preventative diseases" (such as obesity, diabetes, hypertension, etc--this is not to say that cancer is not a problem in the US). Yet it could also be argued that AIDS is preventable if the right precautions are taken. I am learning that so much of medicine is based on the cultural practices of the patients being treated. We can shout it to the mountain tops to tell people to exercise and eat well in the US and similarly doctors here can ask over and over for HIV tests to be taken on a wider scale but if the patients don't comply the doctors are backed into a corner.
Thank you all for your comments. Tonight Regina and I leave for the wedding with mama. Last night we went out to dinner with everyone on the program and a South African medical student we work with at St.Mary's. Sunday we are going to the beach and then my family is having a birthday party for me and a bunch of the people from our program are coming out.
I am going to try to come here early Sunday morning to load up pictures. My love to all of you.
Today and yesterday I worked with a young Pediatric doctor, she is probably 28 and VERY nice. All she wanted to do was teach us! I got to see about 50 chest xrays to check for TB etc. It was amazing.
I decided to work with Dr.Khose again today (usually we rotate) because of all that I got to see yesterday. I had a really tough time though. One boy that we saw is 10 years old and about Sterling's (my brother) height and age. He has AIDS. His mother died several years ago. Two weeks ago he was diagnosed with cryptococcal meningitis and it looked like today the antibiotics he was given did not clear the infection. He was in so much pain and could barely speak. The only words he could get out were to tell the doctor he didn't want to stay in the hospital. I don't think I have ever been so close to tears with a patient.
It is very frustrating here to see the young babies and children here because probably 8 out of 10 of them have HIV/AIDS or TB. It is so hard to see them suffer like this and you just want to shake the mothers and tell them to get tested, to be safe, to go on ARVs. I can see why they have a shortage of doctors here. In the short time we were at St.Mary's two doctors quit (including Dr.Khose who gave her one month notice today). Dr. Khose said that she feels as though she is fighting an uphill battle and she doesn't know where to begin to try to stop the spread of AIDS.
When Dr.Khose asked about what problems we see in America, one of the other students, Ben, said it very appropriately: "preventative diseases" (such as obesity, diabetes, hypertension, etc--this is not to say that cancer is not a problem in the US). Yet it could also be argued that AIDS is preventable if the right precautions are taken. I am learning that so much of medicine is based on the cultural practices of the patients being treated. We can shout it to the mountain tops to tell people to exercise and eat well in the US and similarly doctors here can ask over and over for HIV tests to be taken on a wider scale but if the patients don't comply the doctors are backed into a corner.
Thank you all for your comments. Tonight Regina and I leave for the wedding with mama. Last night we went out to dinner with everyone on the program and a South African medical student we work with at St.Mary's. Sunday we are going to the beach and then my family is having a birthday party for me and a bunch of the people from our program are coming out.
I am going to try to come here early Sunday morning to load up pictures. My love to all of you.
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