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 However the healers practices often include very outdated and dangerous techniques including bleeding patients through small incisions in their skin and also by administering various "herbal" drinks.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.