Friday, April 23, 2010
Later that night Boom Boom and I went over to Hailey’s homestay family for a game called DONKEY. Eager to learn this game, I listened closely only to hear that it’s spoons + horse. First one to spell Donkey loses. When you spell Donkey, you have to do a dare. These dares are already prewritten essentially and they were quite barbaric. Choices included jumping into their pool (this pool’s pump has been broken for months and is full of algae, bugs, green, murky, and probably has a crocodile in it), eat dirt (wtf?), drink half cup of chili juice + chilies, fear factor drink, drink toilet water, streaking, cut off part of your hair, or drink 2 liters of water with one break. I was determined not to lose!! I REFUSED to partake in any of those. Thankfully, I did not lose. Minnie, who is Hailey’s youngest brother lost. We chose the fear factor drink for him. Hailey, her 2 brothers, Boom Boom, and I concocted this drink that I remember consisting of creamed spinach, beet juice, raw egg, salt, soy sauce, peri peri (African hot sauce…its HOT), chili juice, water, cottage cheese, and garnished with a coconut marshmallow. Pretty much it was the grossest thing I’ve seen. It took some strong convincing, including some by Zola, the mom, to get Minnie to even drink a sip. Apparently it was insanely hot. His lips went pretty numb and he began to drool. In the end, he did not satisfy our needs so we dragged him to the pool and threw him in to cool off. It was the first time our families came together, and it turned out to be a great time. Then it hit me, this weekend would be the last weekend in Durban. Next Saturday, I am packing up all my stuff, leaving the family I became very close with, and flying to Cape Town to start all over again. Although very exciting to move onto a new place, to start all over again seems somewhat daunting.
We arrived at Dr. Khan’s office that is in a private hospital. This is an opportunity that no other intern has yet to see. All previous plans are with public institutions. I wasn’t expecting to see anything special this week but at least I get to compare. The building smelled like smoke but there were no long lines, not under staffed, no feeling of helplessness. We got into the office where we get put to work going through the files. We sit in a tiny table right behind the receptionist, Abigail. Patients would come in occasionally but never anything like the overload we’ve seen at the hospitals and clinics. Dr. Khan checks on us frequently which is nice and answers all of our questions. He proceeded to ask us if we wanted to witness a surgical procedure. Thinking it was an abscess; I was ready to take it on. Noooope, it was something new again. It was an adult circumcision. I was happy we were in a private hospital for this because I wouldn’t be surprised if the pubic sector bludgeoned the foreskin off with a butter knife from the upstairs café. The patient was taken back into a room and was prepped for this procedure. As a guy, it was alarming to see what was going to happen. Hailey seemed fascinated. Dr. Khan outlined the procedure to the patient and to us. He gave the patient a couple shots in some unfamiliar places (yes it looked like it hurt) and apparently he was numb. The procedure was quite simple… simply pull and slice 3 different times and stitch back up. He asked if I wanted to help suture up. The last part of the body I thought I would do my first alive suture would be a freshly circumcised penis but hey I’ll take anything. Unfortunately, I wasn’t technically “properly scrubbed in” so maybe next time. After that, Dr. Khan gave me a sex talk that I wasn't sure I was ready for...or anticipating. Obviously, 98% of the information was uninformative for me.
Going through the files was quite cumbersome at first. It was hard to locate the information I actually wanted and how to actually sort it out so it became easier to read. I took down CD4 counts, viral loads, age, coinfections, if they disclosed to their partner about their status, and their partner’s status. Some of the files had some major booboos. For example, I found a man with vaginal discharge. That one left my head scratching. Also, there are missing pages and some mix-ups in patient names.
My massage was magical to say the least. I managed to talk to the lady the entire time. Her name was Joy and she was an amazing lady. We talked about pretty much everything and I still managed to enjoy the massage. I was greeted with a fresh juice cocktail (score! My favorite!). Hailey got pampered for 3 more hours after I was done with my 90 minute massage so she thoroughly enjoyed herself to say the least. Since she stayed so long for all her treatments they gave us another room to hang out and shower after. Finally, we packed our stuff and said goodbye to the great staff and headed out. We stopped by Margate beach and had some food. There were vendors selling more African crafts along the beachfront. Like an addiction, we had to barter for some more. We decided to eat at muffin haven AKA Mugg and Bean. This would be muffin to-go attempt #2. When the waiter asked what we wanted, he was blown away by our accents. He asked where we were from and we said from California and Washington and he about had an anxiety attack. He went into complete hysterics like we were a piece of royalty and fled our table…forgetting our order and our menus. To this date, I say this was the best reaction thus far. The entire weekend was great beginning to end… none of the previous interns that we know of came here. It was nice to go off the beaten path and explore something new only to find a true South African gem.
The sun was starting to disappear over this cliff around 4 so we decided to pack up and leave. As we were driving back to our room, we parked and decided to get some ice cream. This jolly Italian man flagged us over to his shop and started elaborating on how great his ice cream was. We became slightly apprehensive and were eyeballing the Milky Lane across the street (Baskin Robbins of SA). However, we felt somewhat bad so we bough some ice cream. Let me say it was the best decision of my life. This ice cream was amaaaazing. It was truly homemade gelato with some great flavors. I got this almond ice cream with chocolate chunks + crème caramel with a homemade cone dunked on top. I inhaled it leaving ice cream all over my face as usual. We came back to the guesthouse and saw a 90 minute massage for a pretty good deal. We made an appointment for the following morning after breakfast. Hailey went on a slight spa binge and booked an additional manicure, pedicure, and hair treatment.
For dinner we went to this Italian restaurant and ordered a pizza and a sandwich. The waitress asked if we wanted any wine and I jumped on it. She offered some free samples of the wines, all South African. We ordered a sample of a white wine, a rose, and sangria. Their sample consisted of a regular wine glass filled almost ¾ to the top! “Stuck” with 3 glasses of wine, we enjoyed them tastefully. Lightning began to appear in the sky but with no thunder. We didn’t think much of it until it started drizzling 30 minutes later. Without any notice, it turned into this torrential downpour. We rushed underneath the overhang and switched tables. The rain was coming down so hard and the lightning was so bright that it made it quite the entertaining nightshow. Then, the power went out in the restaurant and we were left in the dark. Luckily, our food had just finished cooking so we didn’t have to wait any longer (and trust me, when you go out to eat in SA, you’re going to be out for a loooong time). It seems like they’re just slaughtering the cow when your order a burger. It wouldn’t surprise me, but I’ve just learned to wait patiently.
After a spending a marathon of time in the sun, I knocked out pretty early. Jayson woke me up with multiple phone calls midway through my sleep. Since I’m such a great person, I trecked over to the lobby and skyped with him for a little bit.
Saturday, April 17, 2010
After caring for her, we checked on in the woman with cellulitis. She has been improving since the previous day. It was kind of cool to finally track a patient for more than one day and see some progress. As I rounded the corner to check on the next patient, I saw a familiar face that I thought I would not see again (nor would I want to). She turned over and saw us and gave us a friendly wave and said hi. It was the hemorrhoid woman from the gynie clinic. She had been transferred to this unit for some reason and here she is again…. hemorrhoids popped out for the fourth time. The doctor told us that he was going to try and push them back in again. This would require her being knocked out again and going through all that pain. Even better, we were the only people in that ward who had witnessed the surgery yesterday so we had to stay and tell them if the hemorrhoids had gotten any better. The patient had such a good attitude going into this whole thing, she was joking to save the anesthetic for after the procedure was done. So the procedure happened again, but this time I stayed pretty alert! I did not get queasy at all and was actually able to assess if they had gotten any better. I stayed with her until she woke up and felt just dandy. I wandered around the ward after that trying to find something to do or see. I was feeling pretty good and somewhat involved at this point. I saw the curtain pulled around this bed and decided to take a look. The nurse was taking off the dressings off a wound that spanned this woman’s back. I saw her carefully pull back the dressings to see these huge what looked like burn marks. I asked what happened and she got into a nasty car accident with one of those taxi buses (very common) and she got ejected onto the road and what was on her back was road burn. Ouch! The nurse then put some ointment on her back with a popsicle stick and it did not look like it felt good at all.
The next patient was downstairs in the high care unit. I was guessing that it would be some sort of anal problem. Well… wouldn’t you know, I was right on the money. We approached this lady who was definitely afraid of doctors. She had this terrified face on her and was apprehensive to let anybody touch her. I grabbed her chart and took a look. Eight days prior she had her sigmoid and rectum entirely removed because she had cancer in that area. She hasn’t been able to move this entire time and consequently developed bedsores. Further, I think she was pretty embarrassed, I could see it on her face.
Coming away from that patient, a doctor pulled us aside and just started talking to us and asking why we were here and how South Africa is going. He was very interested and engaged in the conversation. He gave us some an awesome opportunity at that point. He gave us a patient for ourselves. He emphasized the value of examining a patient and trying to see what’s wrong without the patient telling us how he/she is feeling. He gave us this man with a head wound and told us to examine him and see what special signs he is displaying. The doctor left the room and left us with this man who could barely speak. He had a pretty sweet laceration across his forehead and was pretty disoriented. I asked him to wiggle his toes, follow my hand, and see if he could feel my fingers on his foot. I noticed he had a left side motor skill deficiency among other things. The doctor came back and we reported our findings and we were right on with the majority of our findings! He was pretty impressed with us and continued to explain his condition. The patient had been hit over the head with a spade (South African for shovel) by his amigo. They were both drunk and now this guy has a pretty severe sub-arachnid brain contusion. Apparently his friend who hit him over the head brought him in…arm in arm laughing about the situation not knowing how severe it really was.
I know the previous couple of days have been somewhat brutal and frustrating for me. Whatever the case, I am enjoying my time here and soaking up the experience. Within the past few days especially (Friday went very well too, just to foreshadow), I really have enjoyed my experience on the jobsite and I’ll continue to have my positive can-do attitude there and then try to untangle my true feelings on here. I know it’s coming off as if I’m complaining most of the time, but let me just put this out there. When I write these blogs, they are uncensored, unedited, and sometimes not pretty. I write down how I’m feeling as raw as I can so the people back home can get a sense of what it is like over here. I am well aware that having the opportunity to experience something like this is rare. Directly, this experience is not pretty, it’s not glorious, and it’s not easy. I am not here to check little childrens' heartbeats, put band-aids on minor cuts and scrapes, or dangle little toys to help keep kids from crying. There is no time, no resources, and no advantages to doing such things here. The theme of healthcare in South Africa as one doctor put it kind of goes like this, “One thing the South African healthcare system teaches you is apathy. You appreciate and learn it because if we didn’t have that ability, there would be no doctors in South Africa.” Indirectly, when I arrive back home, I will be able to realize what exactly I have back home and how much of a valuable experience I just had. I love this continent and this country; this is one of the reasons I have returned. Obviously I am not on a 20 day safari, I am not getting serenaded by Zulu dancers with a gin and tonic in hand, and I’m not getting a detailed guided tour of everything beautiful. I returned to see the other side of Africa and work within its constraints. With that, that edited version with smiley face stickers can't be found here.
Wednesday, April 14, 2010
It was this man with something wrapped around his leg. They had just unveiled it and it was pretty horrifying. His leg was essentially rotting away and skin had been sloughing off. I immediately asked what happened and the intern said, “he got attacked by a lion”. My jaw dropped. I completely believed him because it definitely could pass for a lion attack. The leg was obviously infected; there was exposed flesh from knee to ankle and pus was oozing down his leg (getting queasy yet? I was hiding behind an intern). It looked like…really marbalized meat. There was a towel that had been soaking up all the fluid from the affected area. Smirking, the intern turned to me and said, “just kidding, he has diabetes”. Somewhat disappointed, I was still shocked that diabetes was the result of this. The reason is because he had obviously not been taking care of himself. A possibility is that he could have a condition called osteomyelitis that went untreated. Consequently, he legs became necrotic, developed gangrene, and now is in serious danger. They were going to try and debride it (remove the dead tissue. I have no idea if they knock him out for it but that’s about how much my mind could handle at that point). Most likely, they will have to amputate the leg, which is not uncommon here. Thankfully, I made it out alive without passing out on the floor. There was this frail man who kept pointing at me but I just directed him to a nurse.
After that, we went over to the gynie ward (that’s actually what they call it, I think I’ll take it back with me). I was relieved that we were going there because I figured gynie cases aren’t tooooo bad right? Except for maybe a septic uterus… and yes they occur. We get to the gynie ward and surround the bed of this one woman. I don’t think it could get any better than this. Our next case would be… drumroll… a severe case of prolapsed hemorrhoids. C’mon man!! Coming right off of a necrotic leg, prolapsed hemorrhoids were not what I was anticipating or desiring. Sigh… but the gruesome train must continue its path I guess. She was turned over and wow it was a hemorrhoid. I mean WOW. To give an awful descriptor that’s been haunting me all day, size for size it looked a strawberry frosted donut…with white sprinkles. She was obviously in a lot of pain, the hemorrhoid had made a bigger and better encore appearance after she had just given birth. The doctors were talking about pushing them back in. Wondering why they just remove them instead of reinserting them, they said they just needed to do something right away and “just for comfort reasons”. Waiting for hemorrhoid operation could take weeks. I asked if she’ll be knocked out for this operation (since their track record has been almost no anesthesia), and they said yea. Finally, somebody gets relief without having to go through even more excruciating pain for it. Funny enough, this operation did not happen in an operating room. It was a bedside operation. They knocked her out and did it with everyone of her bedmates watching. The procedure was quite primitive, she literally just turned her over and shoved them all back into her rectum. It wasn’t the prettiest procedure and should be very painful it she was awake. Once they were forced back inside of her, they started to come right back out. I started feeling a little queasy at this point because the woman started to move and scream in pain. But I held myself a little better than the first time even though I had to walk away at one point. Still, it was somewhat frustrating.
I began thinking to myself, “why is this still happening?” I mean to come so far in my college career and all the volunteering and other extracurricular activities… can I not do medicine simply because I am getting queasy with almost everything? I am not really getting used to anything it seems like. It feels quite defeating. So that has become my biggest problem here in SA. I am now taking on some internal battles on whether I’m truly cut out for this. Am I wasting my time? What am I going to do when I get back home and have to apply for medical school? I know I shouldn’t be making decisions like that right now but it’s definitely lingering in the back of my head.
I got back home to my homestay and was pretty hungry. I knew exactly what I wanted to eat, I had bought a muffin from the casino from my favorite place, Mugg and Bean. It was a HUGE blueberry muffin, perfectly cooked. I brought it home after my day at the beach and was saving it for breakfast or when I was hungry. But I was so tired that I took a tiny 30 minute nap. After my nap, Sibongile walked in with her big smile on her face and said the following, “Hi Miles! Oh you know something? I saw this muffin in the pantry and said to myself ‘this muffin has Miles’s, so you know what I did? I grabbed some coffee and ate the entire thing!’” as she clapped her hands joyfully. My eyes must’ve tripled in size but I kept my composure. I don’t think she had a clue that I was saving that for myself but I definitely can’t get mad. I put on this smile and replied cheerfully, “oh was it good?” She insisted it was a fantastic muffin and she was so full from it that she was going to skip dinner. Sigh… lesson learned.
Although the first procedure didn’t leave the greatest impression (digital rectal exam), the few other ones after that proved to be worthwhile. Enjoying myself, I took the chart for the next patient and read it. Written in big block letters on the front was something left to be desired. ANAL ABSCESS. “Eff this” I thought. I mustered up the guts to go investigate this and found this gigantic woman lying on the table, pants down and ready to be checked up. The weird thing was that I started feeling light headed before I even saw her. I didn’t last too long as the doctor probed around the affected area. The abscess had already been removed and I was still not feeling too hot. Following my usual protocol, I stepped outside and tried to catch some fresh air. I felt lightheaded, narrow vision, nauseous, hot, sweating profusely, clammy, thirsty, and really tired. Since this was the first time it happened, I forgave myself for letting my mind get the best of me. I stepped back inside was fine for the time being. I later found out that the procedure was a complete waste and they could have just looked it at superficially to determine what kind of abscess it was. Oops? Soon enough, the clinic just magically emptied and we were the only ones in it. Doctors were nowhere to be seen and we were just deserted. Eventually we were escorted to this other part of the clinic where we were put with some doctor who did not say a word to us. He just sat there and said I am busy sorry. He continued to help patients after that. Frustrated we just left to go find surgeries…which we ended up not ever doing. That day I felt like I was completely in the way the entire time. Nobody seemed to know our purpose or why we were there. The program had begun to let me down because this was not the first time we felt ostracized. We walked away from that day hoping that the next day would be a little better.
We arranged a hippo and croc tour at 4 pm where we would go on a boat in the estuary. We grabbed some lunch and took off for the boat. The best decision would be to bring blankets just in case. The entire cruise was rainy, windy, and freezing. We would have been miserable in our shorts, t-shirt, and sandals. The tour guide pointed out countless hippos but never any crocs since it was raining. We were even graced to witness a hippo mating, probably the last thing I was expecting. It was pretty sadistic since the male essentially drowns the female. The kids also watch on as the horror takes place. After two hours of being on a rainy and windy boat, we were happy to be back on shore.
When we got home we made dinner using what we bought from the fruit market and the local market. We made pasta, green beans with feta, braai garlic bread, (braai is a famous South African traditional barbecue that I am determined to experience before I come back), and a side of avocado. It was a compilation of things we miss back home + some new foods.
We arrived at the mall only to find the internet café broken for the fifth day in a row. For some reason, we managed to find another café in a video rental store. Now the problem was a 25 minute wait. Fast forwarding, we eventually got online and managed to book a place.
After work, Hailey and I bolted home and packed and left for St. Lucia. Everybody said it takes 3 hours to get to St. Lucia…. and of course you can’t check in past 7 pm. (the number of setbacks can be quite grueling sometimes). We forked over some extra money for an automatic because since I just learned, and since they drive on the other side of the road, plus being at night in an unfamiliar place… we figured it was a good investment. We asked Roy for some directions to the highway and they consisted of, “turn left out of the neighborhood onto that main road and make a u-turn at the sign where it says you can’t u-turn” or “when you smell bread, then go across the road and turn right”. Eventually, we made it to the highway. The drive was pretty easy and very pretty. There were many villages interspersed throughout the drive, they were filled with clay huts and traditional Zulu homes. However, things get a little crazy once the sun sets. All the sudden I see cars driving on the emergency shoulder, driving a little faster, everybody is flashing their brights and emergency blinkers. This became so chaotic and hectic. I was so confused as to why people became so uninhibited when the sun goes down. Turns out the emergency shoulder becomes an actual lane so that people can pass in the actual lane. Problem with this is that the shoulder is narrower than the actual lane so it causes all the cars passing to stick out into opposing traffic a little bit. I was trying to keep with the flow of traffic and would pass occasionally. I tried to pass this semi with plenty of room to spare (I thought so at least). I then realized I am not driving my VW Passat…. I am driving a Chevy Aveo that has about half the power of the Passat. It was a close call to say the least. Good thing is that we got there in two hours flat :)
We got the keys from some random person and headed to our villa. We had our own garage and two bedrooms. However, we did not expect the sheer size of it! It was huuuge. We both had our own bedroom, a nice kitchen, living room and dining room. Plus, we screamed when we saw SHOWERS! We have been taking baths since we arrived here since that’s most common here in South Africa. We about passed out when we saw there was fast internet available with no filters, or out dated computers. I finally got to upload my photos to Facebook and truly update everyone. Most of all, I was able to see Jayson for the first time on Skype. It made me feel really giddy inside and we acted like we had just met. Before I knew it, it was time for bed since we were waking up to go to beach the next day.
Friday, April 9, 2010
This blog has serious issues posting, but here is a picture of bunny chow
but as of right now, I am in St. Lucia (after a crazy drive which I'll elaborate later) and plan on going on some safaris, beaches, and probably some other stuff. There is a map showing where I am in relation to Durban and what I am hoping to expect
Update later :)
I then switched rooms and went with another doctor who was doing the samething. She had to do some blood work and asked if I wanted to help. Eager to do something, I popped on some gloves and prepared to learn or do something. The girl came in and sat down on the patient table. She was totally content through the physical examination and immediately when the doctor put on gloves, she went into hysterics. At such a young age, she already had so many blood tests that she knew what was coming. I tried to settle her down, but we continued onward anyway. Then something took me by surprise. I am used to blood draws consisting of a needle going into a vein and a small narrow tube connecting to a larger collection tube. Oh no, not here. The doctor inserted the needle and well.... that was it. Blood started to pour out of the needle and she held the collection tube underneath the free flowing drip. In shock, she told me to open the next tube and hold it next to the one that was collecting blood. Upon the tube filling, she quickly removed her hand and I had to continue to shift my tube into the blood flow. No way in hell this was going to be clean. Praying to God she doesn’t go into some arm throwing hysterics, I kept a steady hand. Some blood spilt on the floor and on my hands (with gloves) but I figured this was ok. When we had filled three tubes she told me to decant some of the blood into some smaller tubes. Like trying to pour a gallon of milk through a straw, some more blood was obviously spilt. After I was done, I had HIV positive bloody tubes, HIV positive blood on my gloves and a screaming baby. Job well done. No really, it was a decent job.
Wednesday (April 7th) we went back into the paediatric resuscitation unit and were expecting to do rounds with the doctor. Hailey and I got there around 8 and waited to for 15 minutes. Nobody had a clue where the doctor was or where the interns were. We left and went to the computer lab for a little bit and came back around 8:45. Still, no doctor and no interns. We would do this until about 10 AM and finally asked, “do you know where we can find anybody?” None of the nurses knew where anybody was or when they would return. This has been a recurring theme in SA, time is absolutely non-essential. The doctor never really came and rounds were never done until later on the day when Hailey and I gave up. We peaced out in search of some authentic KwaZulu Natal cuisine- Bunny Chow. Before you animal lovers have a cow (so clever), this is not cute bunnies that are served for lunch. Bunny chow is an Indian/African dish where a loaf of bread is hollowed out and filled with chicken/beef/mutton curry. It was a very nice meal but damn it was spicy. With a spicy meal, one would usually drink milk or water. I asked for some basic tap water and out came the most absurd answer I have heard since my arrival here “We don’t have water, just coke”. WHAT!? This was not a joke as I asked like 4 more times. Small problem sista, I don’t drink coke. Hailey and I suffered for some quite time until some other employee came out and we explained our dilemma. 33 Celsius (91 F) + insane humidity + hot ass curry+ no AC+ no H20= crisis. Magically, water was made its appearance and was greeted with great applause. Let’s just say it’ll be BYOW next time.
I got home still reeling from that experience and just had to take a chill pill and relax. Eventually, I made my way outside to the kitchen where the family was about to make some fresh juice. They had bought all this fruit that was about to go bad and now they were going to liquefy it into a juice. We combined mangoes (which rival Costa Rica’s, sorry Mom), bananas, plums, oranges, and pineapples into this awesome juice cocktail. Since then, I’ve been drinking it non-stop. The boys and I played another 3 hours of Sorry, this time gambling the candy I had received before I left.
Thursday (April 8th) was another attempt in pediatrics. This time with a successful encounter with the doctor. We rounded with him and the interns. Ironically, this was the best doctor I had encountered. He was so helpful and even took the time to tell us some things. Finally, I busted out that stethoscope that had been collecting dust in my pocket. Now I had played with stethoscopes before… real ones. But I always had a hard time trying to recognize heartbeats and breathing patterns. I flat out told him that I really have no idea where/how to listen to a steth. He took the time and showed me and it looked pretty basic. I put my steth up to the boy’s chest and listened for his heart. Nothing. I tried again and listened carefully. I then tried on the boy’s sides and even on his back for his lungs. Nothing. Double checking the poor boy wasn’t dead, I was trying for quite some time it felt like. I don’t know what it is, am I deaf? Am I on the wrong spot? Is my brand new Littman stethoscope dysfunctional? I felt like even the baby was looking at me like I had no idea what I was doing. Defeated, I just said I heard the murmur and moved on. The rest of the day was filled with the usual sick children, HIV, malnutrition, and dehydration. I did learn a lot though.
Hailey and I ran up to the computer lab before we had our weekly meeting with Dr. Khan (he is our medical director for the Durban portion. He has like 4 or 5 clinics). We made a push for trying to find a car to rent that’s automatic. (I’m obviously not confident in myself or in South Africa that I can drive a stick). Luckily, we found something at the last minute and we finally have a car! Now we have to find reservations somewhere by tomorrow. We are thinking of going to St. Lucia, a town 3 hours north of here. They have a national park that has the Big 5 (rhino, lion, cheetah, hippo, and elephant), beaches, and other sweet things. Hopefully I don’t get swallowed alive by a hippo and have a good time.
Monday, April 5, 2010
When we got back to the house, the car was sitting inconspicuously outside…waiting for me. I was given a ten minute verbal tutorial by Boom Boom and Tulani (who both don’t have their licenses) followed by words of encouragement by Hailey. Sibongile (the mom) hopped in the front seat and the kids in the back. I pushed the clutch in and tried to turn the car on…no response. I tried this for 5 minutes thinking I am doing something terribly wrong. Turns out the car has to be in first gear when you start it. Either way, I was demoted immediately and Sibongile gave me a little tutorial. We drove around and I was expecting to learn on something like a parking lot…or a non-congested street. Nope, in South Africa we learn by driving onto the grass of a city park. I hopped back in the driver’s seat and was so excited to finally move. I slowly pulled the clutch out, waiting for it to kick in and pushed the gas…and start off with a stall. Thinking that was totally normal, I confidently continued to try again. Thirty minutes later, we haven’t moved. Becoming increasingly frustrated, I continued to try with a little more force. Finally, I moved once and was able to drive round the park. Thankfully, I can drive once I get going. After that, I proceeded onto the road and did a little test-drive around the neighborhood with great success. Wanting to turn left, I turned my signal on and instead turned on the windshield wipers. Great, everything is opposite! The road, the signal location, and up on the signal means left/down is right. I continued onto a hill (my worst nightmare) hoping I could go once I stopped on the hill. Again, another fail… even worse I was on the wrong side of the road. A bunch of kids started to gather and watch the catastrophe unfold. The sweat began to drip down my face and I could feel myself start to go into overdrive (no pun intended). Luckily, a neighbor passed by and gave me a step by step on how to drive on a hill (how basic). Like trying to release a beached whale on the shore, I gave it a big heave and finally took off hopefully never to be seen again. Obviously, I still have to practice my starting skills but I am slowly getting the hang of it.
Continuing the eye-opening week at St. Mary’s, Hailey and I decided to spend in the day in pediatrics. We began upstairs at the neonatal unit and went on rounds with a Polish doctor. Most of the babies in the room were premature due to a variety of reasons. Next door was another room where the more stabilized babies were kept. Some had ants crawling inside the incubators. Of course the most scarring was left for last. We went down to the children’s ward where kids were playing around and some were laying in bed. The environment was pretty upbeat and the kids were all playing. Many of the kids had been staying there for quite some time; they had been abandoned by their mothers and are up for adoption. We continued to make our way around the beds but there was one kid in isolation with his mother. This child had HIV and pneumonia (which is the most deadly illness to have with HIV in South Africa). He was very sick… looked lifeless. The doctor told us that he would not have much longer to live. His mom was cradling him in her arms and bottle-feeding him. He was 4 years old. The mom looked completely helpless in her efforts. As we made our way down the row, more and more kids had HIV/Tb. We stopped at this girl who decided to throw up everywhere right as we got to her, so we just skipped her. After that, we reached a case I hadn’t seen yet-child abuse. The child’s mother got angry with him for some reason and bashed his head into the wall repetitively causing a 5-inch laceration on his head. He was found covered in blood crying in the middle of the street. I asked what kind of action is taken for child abuse here. She then told me it’s up to the social worker but he’ll probably return back to his home with the mother. Yet again, another frustration. Feeling defeated and helpless, I approached the next kid who was getting fed by a nurse. The child turned to me and his eyes were 70% whited out. I asked what happened and was informed of the quite horrific story. The 10-month-old child was found in a pig waste collection bin. He was thrown in there and abandoned. Due to all the fecal matter and bacteria in the bin, the child developed severe conjunctivitis (pink eye) in both eyes. It was so bad that it killed the sclera of his eyes leaving him about 70% blind.
I know much of this has been pretty dark and gruesome at points… but I feel like that’s been the reality of the situation and the majority of what I see. The health care system is in shambles, HIV runs rampant in conjunction with other diseases, and curing these diseases is proving to be an extremely slow and difficult process. But I guess I should try and update on how I am doing outside the job. So far, I am adjusting quite well to South Africa. The family continues to be warm and hospitable. They treat me like a family member, even though I am sure they’ve had many interns before. Boom Boom is very interested in my life and loves asking questions. He has this perception that I am this giant party animal (surely he’s wrong…right?). The weather has been quite humid and hot, leaving me a sweaty mess. Durban is in a nice geographical location, but it definitely has its problems. Safety is a big issue here, you really can’t be outside after dark or else something is bound to happen. We are also located about 10km outside the city centre and getting there isn’t too easy. Public transportation is a little sketchy, and driving around is scary enough as it is. We are advised not to take the public taxi buses, which are essentially Volkswagen Minibuses that pick up and cram anybody anywhere and drop him or her off anywhere (and by anywhere I mean in the middle of the highway, onramps, intersections, etc.). They drive very erratically and are also quite annoying with their horns trying to get peoples’ attentions. Some of them boast thumping sound systems that blast house music to attract the younger crowd. Even more, some of them have sweet names like BOYZ HOUSE, PLAYA BUS, DRIVING 4 JESUS, PHANTOM GRILL, and my personal favorite thus far DISCO BISCUIT. I’d like to take pictures, but it’s not really smart to bring cameras out. I’ve also been trying to get more access to the Internet recently, but it’s very difficult when it closes at 5:30. Gogo continues to offer me food at all hours of the day. Thankfully, the food here has been good. South Africa really isn’t into seasonings; most of my meat, rice, and salad are unseasoned and/or dressingless. Surprisingly, the food is still good and very natural. My G.I. tract has approved J . This weekend is Easter, which means that it’s a 4-day weekend in South Africa. This is one of the biggest holidays over here. Hailey and I tried to go to St. Lucia but couldn’t find any accommodations. Another issue is the fact that neither of us knows how to drive stick very well. Most of the cars are stick shift and to rent an automatic is twice as expensive and twice as difficult. Luckily, my host family has accepted the task of trying to teach me how to drive. They may have made a big mistake. We’ll find out
Hailey was sick today so it was just I going to the hospital. I had no idea where to go but I eventually ended up in the adult HIV clinic. As I walked through the clinic, I looked throughout the waiting area at the patients. There were men and women who looked deathly sick and there were beautiful well-put together women and men with smiles on their faces. One would never know that they were infected with HIV/AIDS. I started in the pill counting area where patients would come in and have their pills checked to see if they were adhering to their regimens. This is very very important because if they default and don’t to take their ARVs (anti-retrovirals) then the virus has the ability to build a resistance to the drugs. Once the virus builds its resistance, the drugs no longer work and the virus eventually kills the person or it’s passed on to other people. I encountered my first frustration of the day at the pill counting. Since the influx of patients is so great and the technology is not up to date, when the pill counters inputted their names into the computer, it felt like half of them came up with no hits. She said that it takes time for the people to input patients into the computer. I remembered one woman who was so nice and beautiful, and didn’t have a medical record for two months. Whenever they encountered this problem, they simply just put the file off to the side and continue to work on the next one or send them on a wild goose chase. I then met with Dr. Omar and spent the day with her. She begins the initiation process of HIV treatment and does check ups on patients. I saw a variety of patients and came face-to-face with HIV’s best friend, tuberculosis. We were told to put specialized masks on and sit by a fan so that nothing could touch us…hopefully. This lady came in with this whopping cough and sat down by us. It was here where I felt instantly paranoid about my surroundings. I sure don’t want Tb, especially when there are drug resistant strains out there. From then, I started to notice that everyone in the waiting room was coughing. I couldn’t tell the different between who was regularly coughing and who was infected with Tb.
More patients continued to file in, including a newly diagnosed man with a CD4 count of 4. To put it in perspective, a patient with full-blown AIDS has a CD4 count of 200 or less. When he left, Dr. Omar turned to me and said, “I can’t believe he’s still alive”. Another patient walked in, it was the same woman that had not been inputted into the system for two months. She was asking about when the new pills would be coming in. South Africa recently revamped their HIV drug program (since the current pills had severe side effects) and planned to start administering the new drug the following day (April 1st). Dr. Omar turned to her and told her that the new pills simply haven’t come in and probably won’t for a couple of months. What was worse was that this woman wasn’t responding to her current treatment anymore. Essentially, she is in a race against time and the government to get these new pills otherwise she will probably die in these next few months. She then turned to me and smiled with the same smile I had seen in waiting and pill counting rooms and said “I am going to be praying every night that I don’t get sick and that these pills come in soon. My son is getting married in Cape Town next month, I am so excited and hope I can make it”. I just smiled back and had one of those moments where you know you’ll never that person for as long as you live.
March 27th, 2010
Another momentous day, today was my flight to South Africa. I ran into some problems at the airport when I was sent around to 4 different places and nobody could find my reservation. From that, I lost my seat request and was rebooked a seat in the middle of the middle…in the very back. I sat between an Indian guy and a monk. I tried to keep myself occupied and found myself in Durban 9 hours later. A short drive later, I was at my homestay. The mom, Sibongile, greeted me. They all were so welcoming and accommodating that I felt right at home. They all helped me with my luggage up to my room. We sat and talked for a long time just exchanging information like dietary restrictions, family life, etc. In the Msomi family, there’s the mom, a grandma (nicknamed Gogo), a father, and two sons. They are devout Christians and attend church multiple times a week. I didn’t meet the two sons until the next day but this was still an overwhelming experience. I ate my first meal-chicken curry with rice and watched two American movies with the dad. I still felt slightly out of place and unsettled. But I figured this was normal. The next day I met the two sons, Boom Boom (17) and Tulani (15). The boys were very nice and somewhat shy at first, but that lasted like 5 minutes. After that, they started to open up quickly. Both boys are extremely intelligent. Boom Boom wants to become a clinical psychologist and Tulani wants to be the next Donald Trump (hopefully without the hair do). I got picked up at 10 and got a township tour. Durban is very divided economically. Signs of apartheid still linger around the residential and commercial parts of the city. There is railroad that runs through the city, this was a heavily employed area. Blacks and whites would come to work everyday and when the day was over, they would walk back to their respective houses. Except on one side of the railroad was dormitory type housing were the blacks would live- 8 people in each single room with a communal toilet on each floor. On the other side of the railroad were typical middle class homes, with a spacious yard. This is where the whites would live. These buildings still exist and are inhabited. Hailey (the other intern) and I visited an orphanage and How Long park (strange name for sure). We met with the builder of the park who is this man who wanted to create this oasis in the middle of the slums. He hand built this entire park by himself and continues to do so today.
March 26, 2010
This was my 24 hours in Dubai day and boy did I make the best of it. For those of you who know me quite well, you might get a kick out of this. All those times where I said “I hate being a tourist/I like to blend in/Why are you being such tourists?” finally came back to bite me in the ass. I present to you, my worst nightmare/best 220 Dirham investment ever: the double-decker bus. Yes yes, I gave in and boarded this monstrosity and milked it for all it’s worth. It was great for the 24 hours I was there because I was able to see everything. With my headphones set to English, I began the tour around the newer section of Dubai. Immediately, I was on the hunt for the tallest building in the world-the Burj Khalifa. Well, it took about 0.2 seconds to spot since it dominated over every single building in the skyline. This thing was HUGE. It would be one of the last spots on my day trip however. I continued along the road in ~95 degree + humidity in a shirt and PANTS, since that’s the respectable dress in the Middle East. Already I knew I was in for a long day. I saw a mosque and a couple shopping centers (all elaborate of course). Finally, I got to a destination I wanted to be at, Jumeirah Public Beach (the rest of the beaches are private and only accessible if you are a hotel guest). It was here where I finally felt like I was on my own doing what I love to do-travel. I didn’t mind being by my self, I didn’t mind sweating profusely, I didn’t mind that I didn’t speak the language. It was here where I finally took a sigh of relief and just relaxed. I dropped trow mid beach (figured it was ok since the guys were in Speedos/were European) and changed into my boardshorts. I laid on the sand and thought about where exactly I was and just kind of laughed to myself. To my left was the Burj Al Arab, the world’s only 7 star hotel. It’s in the shape of a sailboat and constructed on a manmade island. The water was clear and very warm, and I pulled another tourist moment and asked somebody to take a picture of me.
I hopped back onboard the tourist mobile and proceeded with my tour. The next stop was at Atlantis on The Palm. The Palm is the largest manmade marine land thing (it’s so weird I cant even explain it) in the world. It has several branches and a trunk all consisting with luxury living and private villas. At the crescent, is Atlantis. I walked around and saw the aquarium and salivated at the site of the water park. Next, I was ready to hit up a major air-conditioned place…like the Mall of the Emirates. This would be my demise of the tour. I went inside and was amazed at the size of the place. It had every store PLUS the necessity of an indoor ski winter wonderland equipped with ski lift, 12 runs, sled runs, and an orb you can jump into. I didn’t have time to really go snowboarding or anything like that so I tried to make my way out. With a place so big and having to find the right exit, I found myself in the mall for 2 HOURS trying to find the exit. It was purely awful. I literally kept making circles and was so confused why I kept ending up at the same place. Finally, I found my way outside and headed to…well…another mall. This time, the biggest mall in the world…Mall of Dubai. I didn’t understand why this tour kept going to malls but they truly are insane. I didn’t bother looking around, but I did see the largest viewing tank in the world (yes another aquarium). But I was on a mission and was determined to complete it. After a 20-minute walk through the mall, I found myself at my ultimate destination: the Burj Khalifa. This building is a jaw dropping half mile high with a hotel, residential, and businesses operating. The viewing deck wasn’t open yet so I just got a neckache looking at it. The building represents prosperity of the UAE. Frankly, I think its just overkill but that’s just their style. I walked around the outside courtyard looking at everything and began to witness a famous Arabian sunset. This was timed with a fountain show analogous to the one at the Bellagio in Las Vegas. The show was very well done, and to Andrea Bocelli (yay Mom).
After the show, the sun was going down. I really wanted to see the spice and gold souks. The souks are essentially a giant marketplace where they sell gold, diamonds, and spices for very cheap prices. It was dark when I arrived there so I made the trip pretty quick. There must’ve been 300+ gold and diamond vendors all displaying their jewelry in the window. I was beginning to get approached by random people to buy fake Rolex watches and Abercrombie and Fitch t-shirts. The people would start escorting you down some alley and into their shop. No thanks. The whole place just began to get a little sketchy for my liking so I essentially ran out of there. While running, I started looking around and I continued to see men holding hands. I had seen it throughout the day but didn’t really take note of it. It was very confusing to me at first considering all affection, gay or not, is banned in Dubai. But this hand holding was not two gay guys holding hands, it is just simply a sign of friendship and that you care for one another. So… is it easier to be gay than straight in Dubai?? Who knows? I considered my day over at that point.
I couldn’t believe this date finally arrived. After all the months of preparation and deadlines, the final and most arduous deadline had finally surfaced. Everything was going fine through check in and I said goodbye to Mom and T, leaving me with Jayson. We both knew this day would finally come, and the surreal just became a reality. It was very difficult leaving the person that I’ve spent pretty much everyday with. With that, we were having our very emotional moment when I get a phone call from T saying, “YOU’RE NOT THROUGH SECURITY ARE YOU!?” Sure enough, I had forgotten my wallet on top of the car, and T was running inside to try and catch me. Obviously, it was a truly great start to such a momentous journey.
After gathering my emotions, I boarded Emirates Airlines bound for Dubai. Sure enough, I got to sit in the Dubai Daycare section with 4 children just in my row alone. 16 hours of screaming children later, I arrived in balmy Dubai.
Having only heard politically charged things about the Middle East, being there by myself just added to the element of suspense. Sure enough, Dubai started outdoing itself as soon as I exited the plane. With a brand new terminal just opened, there’s nothing better but to drench it in ALL Rolex clocks. Luckily, I got my bags and proceeded to the taxis. Arriving at the hotel, I was ready to pass out. However, this would come with a 45-minute check-in process (-1 point United States). The room was standard with one little interesting addition; on the ceiling of each wall there was a plaque with an arrow pointing towards Mecca (in which Muslims have to pray in that direction multiple times a day).