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**
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