Well, I am back early! Due to a string of very stressful, but in the end furtunate, events I am back home :)
The last few days in Durban were enjoyable, with the group spending a lot of time together and trying to see any last minute things. We took a tour of the city, looking at the pollution problems. About a month ago, they found out that in one area, chromium had leaked into the drinking water. Now there are stations set up that will check your blook for chromium for free, to see if you have been affected. We also saw the oil streams, leading into the ocean (a horrible sight to see) from the factories nearby. Shola was giving us the tour, and she explained that there is only 1 environmental activist group in Durban... they try very hard, but environmental activism is for the most part a joke, in many peoples' eyes. We were able to go to the Gateway mall after the tour on Thursday; this mall is the largest in the southern hemisphere!! Apparently there was rock climbing and amusement rides inside, but I spent most of the time having a leasurely lunch with my friend Eve (we had a great time!!). On Friday we had a wrap up meeting and then went to the Botanical gardens. The gardens were HUGE and despite all of the beauty that was around us, we spent the majority of our time on the sun deck. Why? Well, there were beams and poles all over the sun deck... for climbing of course. haha. OK, maybe that wasn't the intended purpose... but we had a blast. I was in my glory, climbing the poles... it was pure joy. Anyhow, after we left the botanical gardens, we made our way home. Janet and I decided to check out a live jazz performance, but when we got there, we discovered that the jazz wouldn't we playing that night. We sat and had a chat with the waiters that were "working" and we really enjoyed ourselves. We had some great conversation, talking about Canada and South Africa. One of them was an aspiring jazz musician and the other was in engineering. The most interesting thing that emerged from the conversation was a discussion on HIV/AIDS and sexual promiscuity. The 2 men said that it was expected for males to sleep with as many women as possible, because anything else would make them appear "strange/ dysfunctional/ hopeless"... they went on to say that the risk of HIV/AIDS won't change this mentality. In fact, it will not even change the desire to have sex without a condom. The reason for this, they said, is that "for us, it's not a matter of preventing HIV; it's like this: you see how long a guy can go on for without getting it... like, how long can he survive without HIV... almost everyone will get it." I was sad to hear them talk like this, and even though this is only the commentary of 2 guys living there, I think it represents the mentality of too many people. The prevalence rate of HIV in South Africa is supposed to be between 20 and 25%, but as several doctors have indicated, the prevalence in the black population is MUCH higher. In the rural regions, one doctor estimated that it was more like 80% or more. The waiters commented on this by saying that people who are unemployed get bored... they said that men get to the point where all they think about is sex, and that is what they get. They also said "nothing is going to change that... the mentality to have sex all the time, with as many women as possible, won't change." I'm sure some people would disagree with these guys, but I am also sure that many would agree.
It was sad to end my trip in South Africa, but I was also eager to get home. On the way home, when I was leaving the Durban airport, I found out that my flight had been changed in the computer, to leave London immediately after I arrived. I wasn't sure how that happened, as it was originally scheduled for Sunday night. When I finally decided to go with that flight, and check my bags through to Canada, I found out that the flight was not approved and they could only check my bags to johannesburg. To make a long story short, I found out that they could not sort anything out in Durban, but I was assured that they could fix everything in Joburg. When I finally got to joburg, I had to pick up my luggage, figure out my flight to london, and recheck the bags and myself. Unfortuately, time was a bit short, and if I didn't figure out the flight from london before I got into the air, there was no guarentee that I could get to Canada before I left for El Salvador!!!!! I was pressed for time and I needed to find an air Canada representative (which they told me I would find in Joburg, but of course I did not, as Air Canada does not have flights to South Africa). I was sent from place to place to try and find the right person who could sort this out. Unfortunately, the staff at this airport is VERY unhelpful (something that I had heard, but was not familiar with until now) and it seemed that no one understood my dilema or where I was going. I felt so alone, stressed about the time, and frustrated about the misunderstandings. Suddenly a man asked me if he could help (in perfect English, understanding that I was in a mess) and I just burst into tears. Even longer story short, he helped me figure things out and made me feel better. His flight had been delayed 3 hours, so he spend an hour with me trying to get things sorted out. I can't tell you how much I needed him to help me at that point; I was so lost and confused. To be honest, a lot of things had gone wrong up to that point... the past few days had thrown a LOT of curve balls at me... as I was waiting in the line to check my bags, I thought about all of the things that had gone wrong and I was overwhelmed with guilt... each time something had happened, someone was there to help me. I felt guilty because so many people had spent so much time helping me... just me... not saving lives, not working for a greater cause, but just spending their time and energy helping me and solving my problems. I felt like in the way of spreading God's love, I had soaked up so much of it, and given none back. I felt like I was draining the pool of resources... using up all this kindness all because I was having a stroke of bad luck. In Cape town, a man and his wife helped me when I lost my friends and was all alone in a festival; in the mall, the man working at the camera store helped me to sort out some problems with my camera (and my stress level :S... we didn't fix the camera, but I sure felt better); people were helping we everywhere I went and I felt overwhelmed. As I borded the plane for London, feeling much better thanks to Laurence, I still felt so guilty. I wanted to feel something else, but I couldn't. I prayed to change my outlook on everything that had happend. Finally I started to realize that I had been showered with grace. Not just showered, but bathed... maybe even drowned. I had been shown so much grace that I felt suffocated by my own neediness. I feel overwhelmed frequently, by the grace of God in my life. We don't deserve the grace that He shows us in all of our weakness and sin, but He pours it over us constantly. I rarely feel guilty about His grace... maybe it is because I am so familiar with His promises and know that he has infinite wisdom, energy, strength, compassion, and understanding. However, I was experiencing more than God's grace; I was experiencing the grace of His children. In this fallen, broken, and painful world, it's easy to see that unlike God, the world doesn't seem to have an unlimited supply of any of the qualities that I listed. I felt like I was using up a limited supply. I know that I didn't deserve any of the kindness that was shown to me by complete strangers, but that's the beauty of grace: it's undeserved. Grace from God is underserved, but grace from the world is not only underserved, but unexpected. I have never been saved by so many people, in such a short time. I sat on the airplane in total dibelief of the past few days. I usually try to live with the goal of giving, not of receiving... but I had spent so much time just taking it all in... soaking up all the grace that came my way. I'm still in awe of the people I met; still with mixed emotions of joy and guilt. I learned something so important. I learned how much I need God's people. I have always acknowledged the need for God; He sustains me and is behind all of my goals and desires. I have also acknowleged the need to worship with His people, and the need to help His people. Now, however, I understand how much I need the grace that lives in his CREATION and the kindness of the people around me. I am so thankful for all of the stangers that helped me during the week and I am so happy to be the recipient of so much kindness. I am home, I am safe, and I have been given more kindness than I could have ever asked for.
Monday, July 30, 2007
Saturday, July 28, 2007
Leaving South Africa
I am off this afternoon!! I have a stop-over in England, so I won't be home until Monday night, but I hope to find some time to write while I am in England. I am so excited to see my family, even though it's only for a day. Wed morning I will be leaving for El Salvador... please pray that I can spend some time reflecting and preparing for El Salvador before it is time to leave. I wish I had more time to share now, but I am taking my host-mom's daughters back home now. Bye for now!!
Tuesday, July 24, 2007
Amazing weekend!
I went to Capetown this weekend and it was a great weekend. I saw the most beautiful things that I have ever seen. I saw the sun reflecting onto the Ocean in what appeared to be an endless line the width of 2 ocean liners. I saw the Ocean, infinately large, and where thewaves begin and where they end, crashing onto the massive rocks. The rocks along the ocean were a deep brown, as in the pictures Oma paints. The ocean was bright blue and the mountains that towered over the ocean looked perfect. I was overwhelmed by the beauty that I saw this weekend. We weren't able toclimb table mountain on Friday because of the weather, so we went on a half day wine tour, then to a fancy dinner (which was actually about $15$) and then around town. Saturday we went on a cape point tour, which was perfect. We saw penguins, went biking through the most beautiful surroundings I could have ever pictured, had a picnic lunch after chasing away baboons (literally!!) and then went on hikes in the cape point area. The cape point areah has mountainous areas where we were hiking. You can see both the Indian and the Atlantic Ocean from the area (although you can only tell the oceans apart by the temperature) and the hiking was a GREAT workout. We had dinner at a pub and then went to bed early. Sunday we went to Robben Island, which is where many political prisioners, including Nelson Mandela, were held up until 1990. After that, we went to table mountain and took acable car up and down. This is where I saw the ocean and all the beauty it posesses. It really was a spectacular weekend. The weekend also involved a lot of challenge, which I won't get into too much. There were 4 girls travelling and I think the most important thing that I took away from this weekend is what is most important to me. I was driven to keep patient, understanding, and self-sacrificing because of my desire to be an example of Christian character. I'm sure there were moments where I did not please God, but I know that there were many moments when I connected with Him, praying for the virtues that I know only He can give. I am so thankful that I have learned how to pray for disipline and self control, so that I can get through many situations with prayer. I hope that I can continue to grow this way. I felt like every minute was significant when I was trying to do God's will. Not His will for my life, or even for the summer, but His will for each moment.... it was very refreshing. Today we were shadowing doctors and there was a moment when I got very frustrated about one of my colleagues... it made me feel rotten that I was frustrated, but now it makes me feel good that I could at least recognize that negative feeling as something that I need to protect myself from.
Yesterday I was sick and I couldn't go to clinic. I was disappointed, but after a string of unfortunate events, I had come accross a BAD DAY. Just your ordinary bad day, but I didn't have anyone to hug!! Luckily it passed after a short while, after calling my parents, and praying for peace... but it makes you miss being able to have a big hug at any time you want!
This morning we were at Keto Manour clinic, which is supposed tobe a MTCT clinic, but it was awful. There was really nothing for us to do. I was able to go outside and help give polio vaccines, which was fun for the half hour that people were there... but once everyone had been given the oral vaccine, there was nothing left to do. We visited psychiatry, but soon after, they went for tea and never came back. Luckily, we were able to get transferred to another clinic, a tertiary care centre, where I saw a urologist in a consultation and also watched a bone marrow biopsy. It wasn't overly exciting, but I was so happy to at least be able to watch SOMETHING. I'm happy that we made the contact with the urologists because they invited us to watch them in surgery tomorrow at a different clinic :) Tomorrow will be the last day in clinic because Thursday we are going on a tour of a pollution centre and Friday we have a wrap up meeting. I hope that tomorrow will be a good last day!!
Today, if you can pray for our drivers... it may sound strange, but we have had 3 drivers:Krean, AJ, and Shane. They are awesome. AJ has gone out of his way to drive us around and make sure we have a good time. He actually was the one that organized our weekend at the Game reserve and he is the one that makes sure we have a safe ride home. Shane is a Christian and he will be reading The Purpose Driven Life (I think he started today actually!), so we can all pray for him too. I don't know why I thought of that, but I feel especially grateful to all of them now, and they could use God's blessing!
Yesterday I was sick and I couldn't go to clinic. I was disappointed, but after a string of unfortunate events, I had come accross a BAD DAY. Just your ordinary bad day, but I didn't have anyone to hug!! Luckily it passed after a short while, after calling my parents, and praying for peace... but it makes you miss being able to have a big hug at any time you want!
This morning we were at Keto Manour clinic, which is supposed tobe a MTCT clinic, but it was awful. There was really nothing for us to do. I was able to go outside and help give polio vaccines, which was fun for the half hour that people were there... but once everyone had been given the oral vaccine, there was nothing left to do. We visited psychiatry, but soon after, they went for tea and never came back. Luckily, we were able to get transferred to another clinic, a tertiary care centre, where I saw a urologist in a consultation and also watched a bone marrow biopsy. It wasn't overly exciting, but I was so happy to at least be able to watch SOMETHING. I'm happy that we made the contact with the urologists because they invited us to watch them in surgery tomorrow at a different clinic :) Tomorrow will be the last day in clinic because Thursday we are going on a tour of a pollution centre and Friday we have a wrap up meeting. I hope that tomorrow will be a good last day!!
Today, if you can pray for our drivers... it may sound strange, but we have had 3 drivers:Krean, AJ, and Shane. They are awesome. AJ has gone out of his way to drive us around and make sure we have a good time. He actually was the one that organized our weekend at the Game reserve and he is the one that makes sure we have a safe ride home. Shane is a Christian and he will be reading The Purpose Driven Life (I think he started today actually!), so we can all pray for him too. I don't know why I thought of that, but I feel especially grateful to all of them now, and they could use God's blessing!
Thursday, July 19, 2007
A great week at Kwa Dabeka!
Well, despite my uncertainties, I had an amazing week at the clinic in Durban!!! As I mentioned before, it is basically a HUGE primary care centre, but they get all kinds of health care problems. The unfortunate thing (for students, that is) is that they refer all of the "interesting"
patients to a hospital right away, but fortunately, I learned so much this week and I am so happy that I was able to gain this experience. One doctor I was particularly fond of was there from Tuesday until today. He is a "generalist" but the other doctors send him all of the TB patients because he is very good at treating them. Today I was able to see cryptococcal meningitis in a patient. He could not walk and his communication was limited. Kevin and I diagnosed him with nstagmus (spelling?), which was a riot for us because the med student there looked at us like we were crazy until we did the test for it (first time I got to do one of those little clinical skills tests on a positive patient) and saw that he had dramatic nstagmus. I saw so many x rays of TB and post-TB scarring... it is like nothing I have ever seen in Canada (well as far as class examples go). The doctor encouraged me to take pictures of the x rays because he knew that I wouldn't see them again. I feel so lucky to be able to see all of the things that I have seen this week. I saw a child with CP with 2nd degree burns convering his lower body. This case was particularly touching because of the time I have spent with Cassie. Most of you know Cassie, who is so normal that it's almost hard to notice her gate! This boy on the other hand, was completely deformed. His feet had flexed into themselves and his knees were permanently flexed. This boy will never walk. The tragic thing about seeing this is the fact that if this boy had received physio and done the right exercises when he was younger, he would probably be walking. In Canada I would think that the parents had not spent enough time or energy with him, but here it is different. This clinic is in a VERY rural part of Durban, where many of the people are uneducated and unable to understand the importance of intervention. This is the same area that sees countless children die because they have been given enemas for various reasons, dying of dehydration and hepatotoxicity. Today a nurse told us that one of the most common remedies used is sunlight detergent or colgate toothpaste (up the bum!). My heart really went out to this boy, 13 years old, who will forever be dependant on others for care as simple as going to the bathroom... all because of something as simple as intervention... prevented by a problem that is too big for me to fully understand (the lack of education).
At this clinic there were 4 very young women and 3 men who were physicians for the clinic. This was a very impressive number for such a rural clinic, but there were still hundreds of patients in the waiting rooms. The unfortunate thing about this is that children with flus and other acute ailments are waiting with immunocompromised patients! Not only that, but the chronic disease patients (diabetes, hypertension, epilepsy) were waiting full days for refills on their treatments. These patients could have easily been seen by nurses or interns in a clinic elsewhere (an initiative that may one day become a reality) so that the doctors could get the other patients through faster. The reason that this is so problematic is that currently, a patient will come at 5 am to wait for the doctor, and will not see him/her until mid-afternoon. This means that the patient has not taken their medications and their condition is now acutely out of control. For example, a patient will come in with a blood pressure or sugar level through the roof and the doctor cannot do anything about the chronic problem (the reason for the follow up to get meds) because the acute changes are scewing the tests!!! This happens over and over, unfortunately.
I saw a lot of chronic diseases that were dealt with the same as they would have been in Canada. The doctors are so educated; I feel on the same level as the other medical students I have encountered, no question!!! It seems that the medical education is wonderful, but I wouldn't say the same about the nursing education. Unfortunately, many, many doctors leave to go overseas (for more money and better living conditions), leaving mostly nurses. I get so frustrated by the nurses.... they can be so apathetic that I am close to an outburst. Today we had a wrap up meeting with the whole group and one of the girls started crying at the thought of how some of the nurses treated the patients. It really is heartbreaking to see patients being treated like "dogs" as she put it. We started talking about the health care system here and what changes might make things better. One of the interesting things that was brought up, which I hadn't given much thought (and I am ashamed to say so), is the fact that never once has a doctor educated a patient about their condition. Disclaimer: there is a HUGE emphasis on education about HIV... which I believe is different because the modules are a requirement to receive treatment. I think this is great; the modules are fabulous... but there is still a huge problem with non-compliance. Despite the fact that patients still fail to comply 100% with treatment, I strongly believe that the modules make worlds of difference. I can't even imagine how awful it would be without them. Having said this, no one is counselled on diet, life-style modifications, sighn/symptoms, etc when they have other diseases like hypertention or diabetes. Maybe educating them wouldn't make everyone comply, but surely it would help!! AND I am sure that patients would be less apathetic about their own conditions if they were educated! However, it's not as simple as just spending time with each patient. The fact is that many will still fault on their treatments and failt to change lifestyle factors... and when you are looking into a hallway FILLED with faces waiting for treatment, the urge to spend an extra 10 minutes with a patient staring blankly into your eyes... well, it's just not an appealing option. The task of seeing all patients seems impossible each day... and each day some patients are not seen.
I have been talking about so many problems, but I do not mean to sound negative. I feel so lucky to gain what little bit of insight I have, and I want to share it. I've had such a great week and I feel like I have learned so much about medicine here and at home. I almost forgot... one of the most exciting parts of my day... I put a canula into Kevin's arm while we were in the RU. I hadn't done that before, so as silly as it sounds, haha, I was pumped.
Tomorrow at 6 am 4 of us leave for Cape town... we will be hiking table mountain by noon :)
Next week I will be in a MTCT clinic (mother to child transmission.... should have a P in front for prevention!), which has a clinic and a research centre. I am excited to see the research centre because I have heard good things about it.
I think that today we should pray for the horrible apathy of patients and providers. Please pray that patients and providers will put some heart into healthcare!!! Pray that doctors will see something different about that patient who might just comply with their orders, so that they will be inspired to take that 10 minutes and explain to the patient how they can take control of whatever ailment is against them!!! Thank you so much for your continued support. I love you all.
patients to a hospital right away, but fortunately, I learned so much this week and I am so happy that I was able to gain this experience. One doctor I was particularly fond of was there from Tuesday until today. He is a "generalist" but the other doctors send him all of the TB patients because he is very good at treating them. Today I was able to see cryptococcal meningitis in a patient. He could not walk and his communication was limited. Kevin and I diagnosed him with nstagmus (spelling?), which was a riot for us because the med student there looked at us like we were crazy until we did the test for it (first time I got to do one of those little clinical skills tests on a positive patient) and saw that he had dramatic nstagmus. I saw so many x rays of TB and post-TB scarring... it is like nothing I have ever seen in Canada (well as far as class examples go). The doctor encouraged me to take pictures of the x rays because he knew that I wouldn't see them again. I feel so lucky to be able to see all of the things that I have seen this week. I saw a child with CP with 2nd degree burns convering his lower body. This case was particularly touching because of the time I have spent with Cassie. Most of you know Cassie, who is so normal that it's almost hard to notice her gate! This boy on the other hand, was completely deformed. His feet had flexed into themselves and his knees were permanently flexed. This boy will never walk. The tragic thing about seeing this is the fact that if this boy had received physio and done the right exercises when he was younger, he would probably be walking. In Canada I would think that the parents had not spent enough time or energy with him, but here it is different. This clinic is in a VERY rural part of Durban, where many of the people are uneducated and unable to understand the importance of intervention. This is the same area that sees countless children die because they have been given enemas for various reasons, dying of dehydration and hepatotoxicity. Today a nurse told us that one of the most common remedies used is sunlight detergent or colgate toothpaste (up the bum!). My heart really went out to this boy, 13 years old, who will forever be dependant on others for care as simple as going to the bathroom... all because of something as simple as intervention... prevented by a problem that is too big for me to fully understand (the lack of education).
At this clinic there were 4 very young women and 3 men who were physicians for the clinic. This was a very impressive number for such a rural clinic, but there were still hundreds of patients in the waiting rooms. The unfortunate thing about this is that children with flus and other acute ailments are waiting with immunocompromised patients! Not only that, but the chronic disease patients (diabetes, hypertension, epilepsy) were waiting full days for refills on their treatments. These patients could have easily been seen by nurses or interns in a clinic elsewhere (an initiative that may one day become a reality) so that the doctors could get the other patients through faster. The reason that this is so problematic is that currently, a patient will come at 5 am to wait for the doctor, and will not see him/her until mid-afternoon. This means that the patient has not taken their medications and their condition is now acutely out of control. For example, a patient will come in with a blood pressure or sugar level through the roof and the doctor cannot do anything about the chronic problem (the reason for the follow up to get meds) because the acute changes are scewing the tests!!! This happens over and over, unfortunately.
I saw a lot of chronic diseases that were dealt with the same as they would have been in Canada. The doctors are so educated; I feel on the same level as the other medical students I have encountered, no question!!! It seems that the medical education is wonderful, but I wouldn't say the same about the nursing education. Unfortunately, many, many doctors leave to go overseas (for more money and better living conditions), leaving mostly nurses. I get so frustrated by the nurses.... they can be so apathetic that I am close to an outburst. Today we had a wrap up meeting with the whole group and one of the girls started crying at the thought of how some of the nurses treated the patients. It really is heartbreaking to see patients being treated like "dogs" as she put it. We started talking about the health care system here and what changes might make things better. One of the interesting things that was brought up, which I hadn't given much thought (and I am ashamed to say so), is the fact that never once has a doctor educated a patient about their condition. Disclaimer: there is a HUGE emphasis on education about HIV... which I believe is different because the modules are a requirement to receive treatment. I think this is great; the modules are fabulous... but there is still a huge problem with non-compliance. Despite the fact that patients still fail to comply 100% with treatment, I strongly believe that the modules make worlds of difference. I can't even imagine how awful it would be without them. Having said this, no one is counselled on diet, life-style modifications, sighn/symptoms, etc when they have other diseases like hypertention or diabetes. Maybe educating them wouldn't make everyone comply, but surely it would help!! AND I am sure that patients would be less apathetic about their own conditions if they were educated! However, it's not as simple as just spending time with each patient. The fact is that many will still fault on their treatments and failt to change lifestyle factors... and when you are looking into a hallway FILLED with faces waiting for treatment, the urge to spend an extra 10 minutes with a patient staring blankly into your eyes... well, it's just not an appealing option. The task of seeing all patients seems impossible each day... and each day some patients are not seen.
I have been talking about so many problems, but I do not mean to sound negative. I feel so lucky to gain what little bit of insight I have, and I want to share it. I've had such a great week and I feel like I have learned so much about medicine here and at home. I almost forgot... one of the most exciting parts of my day... I put a canula into Kevin's arm while we were in the RU. I hadn't done that before, so as silly as it sounds, haha, I was pumped.
Tomorrow at 6 am 4 of us leave for Cape town... we will be hiking table mountain by noon :)
Next week I will be in a MTCT clinic (mother to child transmission.... should have a P in front for prevention!), which has a clinic and a research centre. I am excited to see the research centre because I have heard good things about it.
I think that today we should pray for the horrible apathy of patients and providers. Please pray that patients and providers will put some heart into healthcare!!! Pray that doctors will see something different about that patient who might just comply with their orders, so that they will be inspired to take that 10 minutes and explain to the patient how they can take control of whatever ailment is against them!!! Thank you so much for your continued support. I love you all.
Monday, July 16, 2007
Back in Durban after a week in Hlabisa
Hi everybody!
Today was my first day back in Durban after a GREAT week in Hlabisa. I was in the clinic there for 4 days and then I slept at a house that closely resembled a very humble farm property. The clinic was amazing; the best experience yet! So far I have been interjecting interesting facts about what I have learned in the clinics, but after last week, I wouldn't even know where to start! I learned so much about HIV and TB, along with many other health problems that affect the people in rural communities. It was an exciting week, full of learning opportunities with doctors that were fabulous. There were about 8 doctors, which is more than any hospital we have been at so far, and almost all of them were an incredible blessing. We woud meet with them during their daily meeting at 7 30 am and then by about 8 we would follow one of the doctors on their rounds. My favorite was internal medicine rounds, which they refer to as either male or female "medicine." I liked seeing the inpatients and I learned so much by asking question after question. I was so excited to find that no one EVER discouraged my questions... in fact, there were 2 doctors that loved answering the questions I had, and I am so thankful for both of them. After round, we would have lunch, and then after lunch everyone (including the doctors) would go to the out patient department to see the walk in patients. As I mentioned before, at all 3 clinics I have been to, the OPD is the only form of primary care medicine (uness individuals are willing to pay for service) that is available to the patients. I think this is unfortunate, but we have that problem more and more in Canada too.... One thing that I really like is that the government pays for ALL medications.... even birth control injections. None of the patients have to pay for anything! At the clinic that I was at today, they do not do any investigations or invasive procedures, so they provide transportation at 7am every morning to take patients to any of the referral hospitals that the doctors refer to. Speaking of today, it is nothing compared to last week, so I am trying very hard to keep interested. Today was bascially a family practice clinic... there were really no interesting cases.... actually, there was one woman with what appeared to be a lipoma on her back, but she had 2 other masses elsewhere, so she was sent for biopsy and I have no idea what it could be... I hope that I will be there to hear the results! At the end of the day I also watched an abscess get drained and a pleural effusion get drained (not overly exciting.... more painful to watch). Anyhow, I am at this clinic until Thursday, so I hope that I will have some interesting stories to share.
Back the the past week..... staying in the house in Hlabisa was fun, but I was excited to get back to the comforts of Durban. In Hlabisa, there was NO street lights or house lights, etc. so when it was past 6 pm and up until 6 30 am, you couldn't see anything. I mean, you actually couldn't see anything. At night, if I put my hand 2 inches from my face, I would have absolutely no idea that it was there. This made finding the outhouse very difficult haha, so I would feel my way to the light switch and flicker the light just long enough to find the bucket, but short enough that I woudln't wake up my roommate. I'm sure you can guess what the bucket was for... Bathtime was also interesting. We took our "baths" in a cement room... we would stand on the cement and use a bucket to wash ourselves..... I would try to stay warm by washing my body first, drying off, and then washing my hair as if I were at the hairdressers. It was pretty fun.
On Thursday night, our host sister took us for a walk through the town and it was amazing. We saw where they kept the cattle during "bath time" and we saw where the children played soccer (and got swarmed by 40 boys, shouting "whites" in Zulu and gigglig... it was a riot- in a good way). The last night, we went to the King's house for dinner and he made a speech about how badly he wanted us all to come back. He asked us to comment, one by one, and his excentric gestures and grunts made for a good time. His wife was so sweet, and insisted that we go home in time to et a good sleep before the game reserve on Saturday. Saturday we woke up eary and left for the game reserve. We had such a great time this weekend, seeing all the African animals. The "big five" are elephants, lions, white rhinos, water buffalos, and lepords; we didn't see leporsds, but we saw the other 4, plus giraffes, monkeys (although the monkeys were in/around our hotel room that night haha), zeborahs, and springbok. Then on Sunday we went on a boat in St. Lucia and saw hippos and crocodiles! So many animas in one weekend!!! Next weekend 4 of us are going to cape town, upon the advice of Kelly's friend Danielle, who live in Johannesberg. She has been so good to me, answering all my questions and recommending great places to go. We have a weekend full of fun planned and I am so pumped to climb table mountain on Sunday :).
In the mean time, please pray that the group will learn a lot this week, so that we can make the most of our time here. I'm asking for this prayer because I know that the clinics this week are nowhere near as interesting as last week, but there is still so much to learn. I hope that we can make the most of every opportunity!
Today was my first day back in Durban after a GREAT week in Hlabisa. I was in the clinic there for 4 days and then I slept at a house that closely resembled a very humble farm property. The clinic was amazing; the best experience yet! So far I have been interjecting interesting facts about what I have learned in the clinics, but after last week, I wouldn't even know where to start! I learned so much about HIV and TB, along with many other health problems that affect the people in rural communities. It was an exciting week, full of learning opportunities with doctors that were fabulous. There were about 8 doctors, which is more than any hospital we have been at so far, and almost all of them were an incredible blessing. We woud meet with them during their daily meeting at 7 30 am and then by about 8 we would follow one of the doctors on their rounds. My favorite was internal medicine rounds, which they refer to as either male or female "medicine." I liked seeing the inpatients and I learned so much by asking question after question. I was so excited to find that no one EVER discouraged my questions... in fact, there were 2 doctors that loved answering the questions I had, and I am so thankful for both of them. After round, we would have lunch, and then after lunch everyone (including the doctors) would go to the out patient department to see the walk in patients. As I mentioned before, at all 3 clinics I have been to, the OPD is the only form of primary care medicine (uness individuals are willing to pay for service) that is available to the patients. I think this is unfortunate, but we have that problem more and more in Canada too.... One thing that I really like is that the government pays for ALL medications.... even birth control injections. None of the patients have to pay for anything! At the clinic that I was at today, they do not do any investigations or invasive procedures, so they provide transportation at 7am every morning to take patients to any of the referral hospitals that the doctors refer to. Speaking of today, it is nothing compared to last week, so I am trying very hard to keep interested. Today was bascially a family practice clinic... there were really no interesting cases.... actually, there was one woman with what appeared to be a lipoma on her back, but she had 2 other masses elsewhere, so she was sent for biopsy and I have no idea what it could be... I hope that I will be there to hear the results! At the end of the day I also watched an abscess get drained and a pleural effusion get drained (not overly exciting.... more painful to watch). Anyhow, I am at this clinic until Thursday, so I hope that I will have some interesting stories to share.
Back the the past week..... staying in the house in Hlabisa was fun, but I was excited to get back to the comforts of Durban. In Hlabisa, there was NO street lights or house lights, etc. so when it was past 6 pm and up until 6 30 am, you couldn't see anything. I mean, you actually couldn't see anything. At night, if I put my hand 2 inches from my face, I would have absolutely no idea that it was there. This made finding the outhouse very difficult haha, so I would feel my way to the light switch and flicker the light just long enough to find the bucket, but short enough that I woudln't wake up my roommate. I'm sure you can guess what the bucket was for... Bathtime was also interesting. We took our "baths" in a cement room... we would stand on the cement and use a bucket to wash ourselves..... I would try to stay warm by washing my body first, drying off, and then washing my hair as if I were at the hairdressers. It was pretty fun.
On Thursday night, our host sister took us for a walk through the town and it was amazing. We saw where they kept the cattle during "bath time" and we saw where the children played soccer (and got swarmed by 40 boys, shouting "whites" in Zulu and gigglig... it was a riot- in a good way). The last night, we went to the King's house for dinner and he made a speech about how badly he wanted us all to come back. He asked us to comment, one by one, and his excentric gestures and grunts made for a good time. His wife was so sweet, and insisted that we go home in time to et a good sleep before the game reserve on Saturday. Saturday we woke up eary and left for the game reserve. We had such a great time this weekend, seeing all the African animals. The "big five" are elephants, lions, white rhinos, water buffalos, and lepords; we didn't see leporsds, but we saw the other 4, plus giraffes, monkeys (although the monkeys were in/around our hotel room that night haha), zeborahs, and springbok. Then on Sunday we went on a boat in St. Lucia and saw hippos and crocodiles! So many animas in one weekend!!! Next weekend 4 of us are going to cape town, upon the advice of Kelly's friend Danielle, who live in Johannesberg. She has been so good to me, answering all my questions and recommending great places to go. We have a weekend full of fun planned and I am so pumped to climb table mountain on Sunday :).
In the mean time, please pray that the group will learn a lot this week, so that we can make the most of our time here. I'm asking for this prayer because I know that the clinics this week are nowhere near as interesting as last week, but there is still so much to learn. I hope that we can make the most of every opportunity!
Sunday, July 8, 2007
A great first week!
I am fortunate enough to have access to the internet today to update you on the rest of the week! I was in pediatrics yesterday, in the morning. The doctor was only there very briefly, but I was albe to follow him for about half an hour, and then I had the chance to talk to 2 medical students in Durban schools! It was interesting following the doctor because my observations (which were later confirmed by the knowledge of others) led me to believe that the nurses working there were not as educated as they should have been. The first case was a baby who looked unwell and was on oxygen. The nurse said that he was admitted for asthma, but when we looked at the x-ray, there was an opaque lobe on a chest x-ray! The first though from all of us was lobar pneumonia, and sure enough the child was being treated with a type of penicillin. Unfortunately the treatment had been started a few days ago and the child hadn't improved much. The doctor decided to prescribe another antibiotic (I think he is supposed to prescribe it in addition ie keep the child on the first one as well, but I'm not sure that he did... althuogh he was very good at what he was doing, so I'm sure he followed protocol!). Anyhow, he was suspicious that this infection was either not clearing because the child was immunocompromised, or that the infection might even be TB, which would again mean that the child was immunocompromised. The mother had claimed to be HIV-negative, saying she was just tested, but the doctor ordered a PCR anyhow (this is a unique test for children because the usual tests looking for antibodies against HIV are not made in a child until they reach 18 months... it is an expensive test from what I have heard, and it takes some time to get the results, but the doctor was very confident about ordering it... and for good reason). I hope that the child simply has an unusual case of pneumonia, but HIV is so common on the pediatric ward!
I was also able to go to the burns unit in the pediatric ward. This was very interesting. Burns are very common in children here. The families that live in the rural areas often live in one room houses, where they have to boil their water for everything. Often these families have many children, so as you can imagine it would be easy to have an accident where boiling water falls on one of the children running around. The children mostly had second degree burns. The one girl had second degree burns covering abour 40% of her body. Since she is so young, it is essential that all protocols are followed, the most important being fluid intake!!! This child was on an IV, but the nurses had not fed her more than 40mL in the last 13 hours, and she was supposed to be getting 40mL EVERY HOUR!!! Protein is also very important for these children because without skin on the wounds, protein is also lost. The therapist doing the assessment did not think the child would live until Monday.
It is so sad to think that there are such gifted doctors, but their orders are not being followed!! Someone shed some light on the situation, saying that the nurses are very unhappy with their wages and do not work as hard as they would, under different working conditions... this seems pretty typical of service providers that are unhappy with their working conditions, but these children are dying!!!
I was happy to get a chance to talk to the medical students about their experience with HIV. I asked them what their opinion of HIV is... like everyone else that we talked to, they said "you are lucky"... or, "lucky are you" when they discovered that HIV was not a big problem in Canada. They said that a big part of the problem was educations (which most of teh doctors also indicated). I asked them if they knew people living with HIV and they said yes, one had family members living with HIV. She said that yes, she has seen them decline and that it is very sad. However, she is just so frustrated to see people practice unsafe habbits despite knowing the risks!!! She doesn't understand why people take chances when they are surrounded by people suffering from the consequences. Obviously she was referring only to people who contracted hIV from risky behavious, and obviously she acknowledges that it is a complex problem, but it was interesting to hear her voice that simple and passionate frustration. I asked her if she thought that people here react to a positive HIV status as a death sentence. I feel as though many people in Canada would, despite knowing that the treatment prolongs life for decades potentially. She confidently said NO... people do NOT consider it a death sentence... they see people living with years of heath and a positive status. She indicated that yes, it is terrible and frightening news, but that people accept their status relatively quickly. I wonder if that causes people to be less frightened, increasing risky behaviour? I don't know... it's still a horrific disease and although there are years of health, there is also a time limit... eventually HIV will lead to AIDS, almost certainly before they would die of another cause.
This is a big prayer... but please pray that there will be enough education and fear about contracting HIV in those individuals that are engaging in risky behaviours, so that they will take precautions.... they can save their life if they just take precautions!!!! Please pray that God will help those can use precautions to use them.
Yesterday the group went to the market and we shopped at some locals' stands. Then a few of us went to the horse races, where everyone dressed up in their very best (except us of course haha) and bet on the races. It was so fun to watch everyone there!!! We went out for dinner after that, which was great. This afternoon we will be going to the beach to watch a surfing competition. I am very excited about that.... apparently there is an air show on too!
This will be the last email that I write before I come back from my rural rotation next Monday. I will not be in clinic again until Tuesday, which will be my first day in the rural hospital. I'm excited to go to this family; I have heard that they dance in the evenings! We will be getting picked up Saturday morning to go to a game reserve and then we will be coming home on Sunday. I hope that I can update you on the week next monday.
Please pray for this next week, that I will stay safe and learn a lot!
I was also able to go to the burns unit in the pediatric ward. This was very interesting. Burns are very common in children here. The families that live in the rural areas often live in one room houses, where they have to boil their water for everything. Often these families have many children, so as you can imagine it would be easy to have an accident where boiling water falls on one of the children running around. The children mostly had second degree burns. The one girl had second degree burns covering abour 40% of her body. Since she is so young, it is essential that all protocols are followed, the most important being fluid intake!!! This child was on an IV, but the nurses had not fed her more than 40mL in the last 13 hours, and she was supposed to be getting 40mL EVERY HOUR!!! Protein is also very important for these children because without skin on the wounds, protein is also lost. The therapist doing the assessment did not think the child would live until Monday.
It is so sad to think that there are such gifted doctors, but their orders are not being followed!! Someone shed some light on the situation, saying that the nurses are very unhappy with their wages and do not work as hard as they would, under different working conditions... this seems pretty typical of service providers that are unhappy with their working conditions, but these children are dying!!!
I was happy to get a chance to talk to the medical students about their experience with HIV. I asked them what their opinion of HIV is... like everyone else that we talked to, they said "you are lucky"... or, "lucky are you" when they discovered that HIV was not a big problem in Canada. They said that a big part of the problem was educations (which most of teh doctors also indicated). I asked them if they knew people living with HIV and they said yes, one had family members living with HIV. She said that yes, she has seen them decline and that it is very sad. However, she is just so frustrated to see people practice unsafe habbits despite knowing the risks!!! She doesn't understand why people take chances when they are surrounded by people suffering from the consequences. Obviously she was referring only to people who contracted hIV from risky behavious, and obviously she acknowledges that it is a complex problem, but it was interesting to hear her voice that simple and passionate frustration. I asked her if she thought that people here react to a positive HIV status as a death sentence. I feel as though many people in Canada would, despite knowing that the treatment prolongs life for decades potentially. She confidently said NO... people do NOT consider it a death sentence... they see people living with years of heath and a positive status. She indicated that yes, it is terrible and frightening news, but that people accept their status relatively quickly. I wonder if that causes people to be less frightened, increasing risky behaviour? I don't know... it's still a horrific disease and although there are years of health, there is also a time limit... eventually HIV will lead to AIDS, almost certainly before they would die of another cause.
This is a big prayer... but please pray that there will be enough education and fear about contracting HIV in those individuals that are engaging in risky behaviours, so that they will take precautions.... they can save their life if they just take precautions!!!! Please pray that God will help those can use precautions to use them.
Yesterday the group went to the market and we shopped at some locals' stands. Then a few of us went to the horse races, where everyone dressed up in their very best (except us of course haha) and bet on the races. It was so fun to watch everyone there!!! We went out for dinner after that, which was great. This afternoon we will be going to the beach to watch a surfing competition. I am very excited about that.... apparently there is an air show on too!
This will be the last email that I write before I come back from my rural rotation next Monday. I will not be in clinic again until Tuesday, which will be my first day in the rural hospital. I'm excited to go to this family; I have heard that they dance in the evenings! We will be getting picked up Saturday morning to go to a game reserve and then we will be coming home on Sunday. I hope that I can update you on the week next monday.
Please pray for this next week, that I will stay safe and learn a lot!
Thursday, July 5, 2007
Finishing up the first week
Monday is the last day at St. Mary's, which leaves me only 2 more days there. On tuesday morning at 5am, we will be leaving to go to a rural area. I will not have internet access, but I hope to keep a journal to update you when I come back.
Yesterday I was in OB/GYN and I saw a C-section and many mothers getting ready to give birth naturally (we missed both natural births, coincidentally-- once while in the C-section and once while at a lecture on palliative care). I helped a woman get to the shower and cleaned up after she was sutured up (it was her first baby, she gave birth naturally, and she did it quickly enough that there was no time to cut her, so the laceration had to be stitched). She was a quiet, but friendlygirl, but she did not look happy about the baby. The nurse left to take care of the baby (gave him vitamin K and cleaned him up... 6 hours later she would be giving him his immunizations), but I stayed wth the mother. I wanted to see if she would share anything with me. She said she was hungry, so I asked the nurse if she could eat and the nurse said of course... so I asked if we could get her something and she said no, they had to bring their own food to the ward! The same thing happened for soap... if you didn't bring it, you didn't get it. Anyhow, I went back to tell the woman what she already knew, and she added that her parents should be bringing her something to eat shortly. She also said that her boyfriend would come if he knew how to get here. However, she didn't seem at all concerned that the boyfriend had no idea where she was. I asked if she would like to marry him one day and she laughed and said no. She said that in January, she found out that another woman had his baby. She had been "exclusive" with her boyfriend for 4 years, and she is still with him, despite his fathering another child. I found out she was still with him by asking... her response was "yeah, we're together" almost as if it was a strange question... This made me sad because most people that I know would either leave, or if they sayed witht the person, would acknowledge their own sacrifice in staying with them.
I was able to see the same woman today. She looked happier, and she was breastfeeding her boy. Yesterday I was with her when she tried for the first time. She couldn't manage to feed him, and it was actually really special to see her trying to do this for the first time. The reason that I came to see her, was that yesterday as I was reaching to get her bag, I put my hand in some of the blood that was on her bed. Although without an open wound, you cannot get the viruse, I still felt a bit nervous. I didn't know her status, and it was the first time something like this happened. The doctor that I talked to told me to check her chart again the next day, so I was going back to see if the test had been done (it wasn't done yesterday when I was in the ward). Today it was completed, so I was able to see that her status was negative. Anyhow, I walked into the room where she was feeding, in order to see her chart, but she thought I was coming to see her baby! Of course I was excited to see her and her baby, but I felt a mixture of guilt and happiness at that moment when I saw her smile to see me back to see her and her boy.
Today I had a great morning. First I went to the HIV clinic, where I was told about the modules that they use for patients that test positive for HIV. The first module is to disclose your status to one family member, the second is to learn about the virus (its transmission, opportunistic infections, and other important information) and the third is to learn about the medications and start treatment once the CD4 count is below 200. When we walked into the clinic, there were around 80 people who were there to receive their monthly treatment. We noticed that everyone looked so alive and happy. I said that I thought it was partly because they were away from the people who were dying and around many others who were LIVING with HIV... 100% of the people there were infected, so it was almost like a support group of sorts. Everyone looked normal; no one looked sick. After this, we headed out for home visits. Everyone gets a home visit; they visit as many as possible, in order to see how the patients are doing and if they are complying with the treatment. This was great because a couple of the patients could speak english, and they were able to share a bit about their treatment. The fact that they are required to disclose information to one family member is important, because there was always someone there to support them in this time. The people who went out in the van were genuinely concerned about the patients' well-being, and they were so warm. I felt so lucky to be with them today.
I would continue on, but the group is ready to walk home, and I need a walk-home too... I am having a great time here. I think my favorite thing about SA is the vegetation! I love the trees, the flowers, and the grass as well. It is all so tropical (the trees have the shape as i the lion king!!) The most frustrating part is hospital staff who don't want us around... there are some here and there that just don't like us in their place, so they won't speak English to us... there are some who are wonderful though, so I can't say that it has been bad because of that!!
I will try to update you as soon as I can! Please pray that I am able to experience whatever god has set out for me, and that I may do so with an open mind and a willing heart.
Yesterday I was in OB/GYN and I saw a C-section and many mothers getting ready to give birth naturally (we missed both natural births, coincidentally-- once while in the C-section and once while at a lecture on palliative care). I helped a woman get to the shower and cleaned up after she was sutured up (it was her first baby, she gave birth naturally, and she did it quickly enough that there was no time to cut her, so the laceration had to be stitched). She was a quiet, but friendlygirl, but she did not look happy about the baby. The nurse left to take care of the baby (gave him vitamin K and cleaned him up... 6 hours later she would be giving him his immunizations), but I stayed wth the mother. I wanted to see if she would share anything with me. She said she was hungry, so I asked the nurse if she could eat and the nurse said of course... so I asked if we could get her something and she said no, they had to bring their own food to the ward! The same thing happened for soap... if you didn't bring it, you didn't get it. Anyhow, I went back to tell the woman what she already knew, and she added that her parents should be bringing her something to eat shortly. She also said that her boyfriend would come if he knew how to get here. However, she didn't seem at all concerned that the boyfriend had no idea where she was. I asked if she would like to marry him one day and she laughed and said no. She said that in January, she found out that another woman had his baby. She had been "exclusive" with her boyfriend for 4 years, and she is still with him, despite his fathering another child. I found out she was still with him by asking... her response was "yeah, we're together" almost as if it was a strange question... This made me sad because most people that I know would either leave, or if they sayed witht the person, would acknowledge their own sacrifice in staying with them.
I was able to see the same woman today. She looked happier, and she was breastfeeding her boy. Yesterday I was with her when she tried for the first time. She couldn't manage to feed him, and it was actually really special to see her trying to do this for the first time. The reason that I came to see her, was that yesterday as I was reaching to get her bag, I put my hand in some of the blood that was on her bed. Although without an open wound, you cannot get the viruse, I still felt a bit nervous. I didn't know her status, and it was the first time something like this happened. The doctor that I talked to told me to check her chart again the next day, so I was going back to see if the test had been done (it wasn't done yesterday when I was in the ward). Today it was completed, so I was able to see that her status was negative. Anyhow, I walked into the room where she was feeding, in order to see her chart, but she thought I was coming to see her baby! Of course I was excited to see her and her baby, but I felt a mixture of guilt and happiness at that moment when I saw her smile to see me back to see her and her boy.
Today I had a great morning. First I went to the HIV clinic, where I was told about the modules that they use for patients that test positive for HIV. The first module is to disclose your status to one family member, the second is to learn about the virus (its transmission, opportunistic infections, and other important information) and the third is to learn about the medications and start treatment once the CD4 count is below 200. When we walked into the clinic, there were around 80 people who were there to receive their monthly treatment. We noticed that everyone looked so alive and happy. I said that I thought it was partly because they were away from the people who were dying and around many others who were LIVING with HIV... 100% of the people there were infected, so it was almost like a support group of sorts. Everyone looked normal; no one looked sick. After this, we headed out for home visits. Everyone gets a home visit; they visit as many as possible, in order to see how the patients are doing and if they are complying with the treatment. This was great because a couple of the patients could speak english, and they were able to share a bit about their treatment. The fact that they are required to disclose information to one family member is important, because there was always someone there to support them in this time. The people who went out in the van were genuinely concerned about the patients' well-being, and they were so warm. I felt so lucky to be with them today.
I would continue on, but the group is ready to walk home, and I need a walk-home too... I am having a great time here. I think my favorite thing about SA is the vegetation! I love the trees, the flowers, and the grass as well. It is all so tropical (the trees have the shape as i the lion king!!) The most frustrating part is hospital staff who don't want us around... there are some here and there that just don't like us in their place, so they won't speak English to us... there are some who are wonderful though, so I can't say that it has been bad because of that!!
I will try to update you as soon as I can! Please pray that I am able to experience whatever god has set out for me, and that I may do so with an open mind and a willing heart.
Tuesday, July 3, 2007
First day in the hospital
Today was the first day in the clinic... I want to share the day with you... Before I do, I want to say that it is another world in the hospital. Outside of the hospital, I have only been in the main area of the city (and once downtown)... Here, the people, the stores, the resources I use and see used, are all identical to those in Canada. As I mentioned, outside of the hospital, the only big difference I experience is the need to be street smart. Inside the malls, I feel like I am in Canada. It's a great place and I am having am amazing time. I have been told that the outskirts have a lot of poverty and are quite different, but I have yet to see it. I was in a public hospital today, which is free for the people in the area... having said that, here goes:
Where do I start? I feel like I was in the hospital for days... not because it was slow-moving, but because there was so much to see and do. It was the first day back after the public servant strike (which led to many, many deaths due to lack of treatment btw), so they were short-staffed... they were disappointed to see that we were just students, but many of the doctors were still eager to teach us. I was in the casualty unit, which is like our ER. Actually, not quite... patients are admitted by a nurse to see a doctor... the doctor then assesses the patient and either orders treatment by the nurses or another department, or referrs to another unit/ hospital. We were able to stay with 2 doctors that taught us about each case. This was a huge blessing because they spoke to all of the patients, and to eachother in Zulu. Not only that, but these doctors were amazing. They were 100% as educated as any of the doctors that I have been taught by, AND 2 of the 4 were GREAT teachers!!
Many of the patients did not speak english, so if we wanted to communicate with them, we would have to ask the doctors. Speaking of family, it was moving how essential the family support was for the patients. The nurses give the treatment in the unit, but they have no time for chatting or ANYTHING but treatment. One nurse (who I can honestly say had a kind heart), was running around, moving patients whose IVs would nearly rip out of their arms, and bumping beds causing patients pain.... she was just so busy! As sad as it was, she didn't speak to the patients. Nearly all of the patients that I saw had HIV, and most of them had late stage AIDS and were infected with TB and cryptococcus. These patients were in so much pain; physically, emotionally, mentally, spiritually??... it was devastating. However, the nurse didn't speak to any of them... they had NO comfort from the health care providers, whatsoever. If they did not have family, they were completely alone. I couldn't even grasp the pain that could cause.... I still haven't had time to digest it. Skin and bones, lying on a stretcher, coughing with the only energy they had, and groaning in pain... these patients FILLED the unit. Nearly every chart read "RVD" amongst a LONG list of other ailments, most of which were due to a deficient immune system. So why RVD? It stands for retro-viral disease... an alternative word for the life-shattering sound of "HIV." This email might sound scattered now and as I go on, but there is just so much to say and my mind is just a pool of thoughts right now too.
It's another world in the ward. There was an HIV clinic above us, which is partly the reason that so many of the patients that I saw had HIV (I would say 9/10 that I saw today)... they would send them down to the casualty unit for simple things like an IV for fluids after dehydration. I would like to learn more about the politics behind certain decisions, as one of the doctors began to talk about how awful this situation is (sending patients down for an IV line) because it is a waste of resources.. similarly, patients are being sent UP to the HIV clinic for things that require care in the trauma unit because some staff are afraid of treating the HIV-positive patients!
So far, most of the people I have mt have been friendly. There was one pateint's family member that was very rude to me... likely because I stand out, but possibly just because he was frustrated (he didn't know that I was just a student and not a doctor). I hated that everyone respected me just because I looked like a doctor in my white coat and stethescope... I guess I just hated it because I didn't deserve it at all... I wasn't helping anyone; I'm there to learn... just a student! I wished I could do something, but I couldn't.
I think that the number of patients that were there changed the dynamic of my experience. There were an uncountable number of patients with HIV and AIDs... When I would see a patient lying there, near death, I had no way of knowing who they were before this, or even if they had ever had a life before HIV. There were 2 girls around 20 who were in the late stages of AIDS, and I don't know how young they were when they contracted the virus. I wonder how the family members felt, seeing thier loved one.... did they see them as the same person? Either answer would have its own story behind it. When you meet one person with such a tragic history, it touches you and you can really empathize with them. When you see dozens of people, all with unique stories and all suffering from a merciless disease, it's too much to empathize with. I didn't even feel overwhelmed; I didn't cry. It was just so surreal. It's so common, but it's no less of a tragedy, each and every time!! I wonder, could it ever be perceived as a lesser tragedy due to sheer numbers??? I can't imagine why or how. Then again, I couldn't feel the tragedy of an individual today... only of a population. The other thing that keeps running through my mind is the news of a diagnosis. I wonder if the incidence being so high changes the devastation of a positive result. I don't mean that it is any less devastating, but it's so common! 1/4 adults have it; surely they know many people who are living with AIDS and dying of it too. Does this change how impossible it seems to swallow a diagnosis like that? I can't imagine that it would, and yet I suspect that it might... I have so much to learn and I hope that some of the things I am wondering about now will be answered slowly.
I hope I didn't overwhelm you with the length of this email. Today, can you please pray for all of the people in South Africa who are dying of AIDS, who do not have a family or another support network. For all of these precious soles who are all alone tonight, please pray that they will be comforted by the only one who knows their worries and their fears, their pain and their loss.
Where do I start? I feel like I was in the hospital for days... not because it was slow-moving, but because there was so much to see and do. It was the first day back after the public servant strike (which led to many, many deaths due to lack of treatment btw), so they were short-staffed... they were disappointed to see that we were just students, but many of the doctors were still eager to teach us. I was in the casualty unit, which is like our ER. Actually, not quite... patients are admitted by a nurse to see a doctor... the doctor then assesses the patient and either orders treatment by the nurses or another department, or referrs to another unit/ hospital. We were able to stay with 2 doctors that taught us about each case. This was a huge blessing because they spoke to all of the patients, and to eachother in Zulu. Not only that, but these doctors were amazing. They were 100% as educated as any of the doctors that I have been taught by, AND 2 of the 4 were GREAT teachers!!
Many of the patients did not speak english, so if we wanted to communicate with them, we would have to ask the doctors. Speaking of family, it was moving how essential the family support was for the patients. The nurses give the treatment in the unit, but they have no time for chatting or ANYTHING but treatment. One nurse (who I can honestly say had a kind heart), was running around, moving patients whose IVs would nearly rip out of their arms, and bumping beds causing patients pain.... she was just so busy! As sad as it was, she didn't speak to the patients. Nearly all of the patients that I saw had HIV, and most of them had late stage AIDS and were infected with TB and cryptococcus. These patients were in so much pain; physically, emotionally, mentally, spiritually??... it was devastating. However, the nurse didn't speak to any of them... they had NO comfort from the health care providers, whatsoever. If they did not have family, they were completely alone. I couldn't even grasp the pain that could cause.... I still haven't had time to digest it. Skin and bones, lying on a stretcher, coughing with the only energy they had, and groaning in pain... these patients FILLED the unit. Nearly every chart read "RVD" amongst a LONG list of other ailments, most of which were due to a deficient immune system. So why RVD? It stands for retro-viral disease... an alternative word for the life-shattering sound of "HIV." This email might sound scattered now and as I go on, but there is just so much to say and my mind is just a pool of thoughts right now too.
It's another world in the ward. There was an HIV clinic above us, which is partly the reason that so many of the patients that I saw had HIV (I would say 9/10 that I saw today)... they would send them down to the casualty unit for simple things like an IV for fluids after dehydration. I would like to learn more about the politics behind certain decisions, as one of the doctors began to talk about how awful this situation is (sending patients down for an IV line) because it is a waste of resources.. similarly, patients are being sent UP to the HIV clinic for things that require care in the trauma unit because some staff are afraid of treating the HIV-positive patients!
So far, most of the people I have mt have been friendly. There was one pateint's family member that was very rude to me... likely because I stand out, but possibly just because he was frustrated (he didn't know that I was just a student and not a doctor). I hated that everyone respected me just because I looked like a doctor in my white coat and stethescope... I guess I just hated it because I didn't deserve it at all... I wasn't helping anyone; I'm there to learn... just a student! I wished I could do something, but I couldn't.
I think that the number of patients that were there changed the dynamic of my experience. There were an uncountable number of patients with HIV and AIDs... When I would see a patient lying there, near death, I had no way of knowing who they were before this, or even if they had ever had a life before HIV. There were 2 girls around 20 who were in the late stages of AIDS, and I don't know how young they were when they contracted the virus. I wonder how the family members felt, seeing thier loved one.... did they see them as the same person? Either answer would have its own story behind it. When you meet one person with such a tragic history, it touches you and you can really empathize with them. When you see dozens of people, all with unique stories and all suffering from a merciless disease, it's too much to empathize with. I didn't even feel overwhelmed; I didn't cry. It was just so surreal. It's so common, but it's no less of a tragedy, each and every time!! I wonder, could it ever be perceived as a lesser tragedy due to sheer numbers??? I can't imagine why or how. Then again, I couldn't feel the tragedy of an individual today... only of a population. The other thing that keeps running through my mind is the news of a diagnosis. I wonder if the incidence being so high changes the devastation of a positive result. I don't mean that it is any less devastating, but it's so common! 1/4 adults have it; surely they know many people who are living with AIDS and dying of it too. Does this change how impossible it seems to swallow a diagnosis like that? I can't imagine that it would, and yet I suspect that it might... I have so much to learn and I hope that some of the things I am wondering about now will be answered slowly.
I hope I didn't overwhelm you with the length of this email. Today, can you please pray for all of the people in South Africa who are dying of AIDS, who do not have a family or another support network. For all of these precious soles who are all alone tonight, please pray that they will be comforted by the only one who knows their worries and their fears, their pain and their loss.
Monday, July 2, 2007
Here in South Africa... FINALLY!
Hi everybody!!! It feels like forever since I have been in contact with anyone! This is the very first opportunity I have had to access the internet, so I am happy to be able to finally say hi. I got to Durban on Saturday and immediately went to the city and to the beach with the nieces of the woman I am staying with. Sunday was orientation around the city and today we met the doctor that will be supervising us. Tomorrow we will start in the hospitals; I am places at St. Mary's first. This hospital was build by a German mission years ago, when there was still seperation, and it was run without the help of the government up until several years ago. I also found out that I will definately spend time in a rural hospital, which is very exciting!! I have heard that the care in a rural hospital is quite different, and that it will be a unique experience. The students that are here are very nice, and the lady I am staying with (Tiny) is sweet. She is a nurse at a hospital in the area, and she works long shifts almost every day. The downtown is very dangerous, so we only go in very large groups and we do not carry anything with us. We have a special cab driver here, who is a great guy! We are lucky to have him, as any other cab is not guarenteed to be safe. The taxis are not the same as cabs here! They are minivans that pile in about 16 people and they have many accidents. The buses are fairly unreliable, so most locals prefer to use the taxis, or cabs if they can afford it. We are SOO lucky to have our cab driver!! Also, we are getting transported to and from the clinic each day by a driver who is in his 20's, studying to be a chef. This is a HUGE blessing, as it solves the problem of transport. THANK YOU KREAN!!!
I love it here. I LOVE the city, and it's not scary if you are street smart. Yesterday we were dropped off in the downtown and left all of our things with the local coordinator, which was very convenient. We went to an indian restaurant and the food was great! We finished the orientation and talked about all kinds of safety, health, and home-stay rules/tips/insructions. We were told that we have a special health team in case of any heath problems that the students have. (So don't worry mom and dad, I will be fine if I get sick!!). Also, the water here is better than in Canada! haha. The tap water is very clean, AND there are no trace metals, as there has been found to be in the tap water around Hamilton and London.
There was a change of plans, so I am staying with Tiny alone. I was supposed to be with a whole family, but after someone dropped out, I was placed with Tiny. I was excited to live with a whole family, but I think this is a blessing because I am able to have some quiet time every day. I didn't get ANY of this in Germany, so I am devouring every minute now that I have it!! This morning I had a couple of hours to myself and I listened to the NT on CD. I was so happy to be able to relax and listen to Acts... I am praying that I will be able to find the time to do this every day... it is so important, and I don't want to get lost in all the excitement of the clinics. (Please pray that I can spend some time in God's word every day!!!)
I was able to talk to Candice for a while yesterday, which was great!! She even read me an email while I was on the phone with her... what are sisters for, right? haha. Thank you Candice!!!
Well, I think I will have internet access a lot more frequently now that I am here. I hope to come after clinic now and then. As I mentioned, tomorrow will be the first day that I will be seeing patients, so I should have a lot to talk about after that!
I hope everyone is enjoying the weather in Canada... Germany had dreadful weather and it is winter in South Africa now, so the weather isn't bad, but it's no 30 degrees (although I have nothing to complain about here... it really is so exciting to be here!)
Also, happy belated CANADA DAY!!!!
LOVE to everyone reading this,
Katerina
PS this was written fairly fast, as we don't have too much time here, so please excuse any typos (a special plea for excuse to my mother [aka essay editor], who can't stand my typos :) )
I love it here. I LOVE the city, and it's not scary if you are street smart. Yesterday we were dropped off in the downtown and left all of our things with the local coordinator, which was very convenient. We went to an indian restaurant and the food was great! We finished the orientation and talked about all kinds of safety, health, and home-stay rules/tips/insructions. We were told that we have a special health team in case of any heath problems that the students have. (So don't worry mom and dad, I will be fine if I get sick!!). Also, the water here is better than in Canada! haha. The tap water is very clean, AND there are no trace metals, as there has been found to be in the tap water around Hamilton and London.
There was a change of plans, so I am staying with Tiny alone. I was supposed to be with a whole family, but after someone dropped out, I was placed with Tiny. I was excited to live with a whole family, but I think this is a blessing because I am able to have some quiet time every day. I didn't get ANY of this in Germany, so I am devouring every minute now that I have it!! This morning I had a couple of hours to myself and I listened to the NT on CD. I was so happy to be able to relax and listen to Acts... I am praying that I will be able to find the time to do this every day... it is so important, and I don't want to get lost in all the excitement of the clinics. (Please pray that I can spend some time in God's word every day!!!)
I was able to talk to Candice for a while yesterday, which was great!! She even read me an email while I was on the phone with her... what are sisters for, right? haha. Thank you Candice!!!
Well, I think I will have internet access a lot more frequently now that I am here. I hope to come after clinic now and then. As I mentioned, tomorrow will be the first day that I will be seeing patients, so I should have a lot to talk about after that!
I hope everyone is enjoying the weather in Canada... Germany had dreadful weather and it is winter in South Africa now, so the weather isn't bad, but it's no 30 degrees (although I have nothing to complain about here... it really is so exciting to be here!)
Also, happy belated CANADA DAY!!!!
LOVE to everyone reading this,
Katerina
PS this was written fairly fast, as we don't have too much time here, so please excuse any typos (a special plea for excuse to my mother [aka essay editor], who can't stand my typos :) )
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