Monday, May 24, 2010

Culture Shock Round 2-Cape Town

Obviously it has been a while since I’ve updated my blog. Reasons being that I don’t have as much time as I did in Durban amongst other things. Either way, at least I’m getting to it now rather than never : ) . I just want to start off and say how much I love Cape Town. Upon arrival, I immediately fell in love with the city. It is totally different than Durban. The climate, people, language, and overall vibe of the city is just different. Again, I felt the culture shock slap me across the face. Hailey and I were greeted ecstatically by our program and medical directors, Marion and Avril. They ran up to us and gave us a big hug and welcomed us to Cape Town. Immediately, I felt welcomed and a sigh of relief came to me. We drove to Avril’s house for orientation and were initiated via a song named “Welcome to Cape Town”. How fitting. We were sitting on the outdoor/indoor entertainment area. The sun set and instantly it became freezing. This is very typical of CT, when the sun sets, the temperature begins to plummet. Table Mountain towers over the entire city, wherever you go it just towers over everything. Again I saw the clear divide between success and poverty, more so than in Durban. During Apartheid, families of colour were forcibly relocated to an area called the Cape Flats. It is a massive area containing millions of people in townships and neighborhoods. This is where my homestay is. I live in an area called Athlone, a coloured neighborhood.
I met my family and right off the bat I can tell its completely different. The mom Carol is very nice of course, and the dad George is a riot. The first thing he told me is to make sure the cops don’t bring me home if I’m too drunk. This is also the family that has been with the program for the longest of any other family. Another thing they emphasized was my availability of privacy. I didn’t have too much in Durban since the boys or Sibongile would come in at their leisure. To be honest, I didn’t mind it at all. Actually, I kind of liked it. Either way, it was just very different. But the best part of all, was that the family has a SHOWER!! I was so excited to finally shower instead of taking a bath. After taking baths for 5 weeks straight, a shower was the closest thing to amazing. Dinner is also very different, this family is very independent and you can have dinner at your leisure and it’s never together. Again, no big deal, I am here to live with the family and how they run their lives. I’m not expecting anybody to change the way they live their lives for me. Also in the family, there is three year old Mikayla. She lives with Chantal who is the daughter in-law in a separate part of the house. I see Mikayla all the time and she is cute as can be. She loves to play…a lot. Whenever you ask her how she’s doing, she responds “fabulous”. Diva in the making if you ask me!
That night, Ryan (the previous intern that would leave the next day), Hailey, Lauren, and I went to Camps Bay for dinner. Having no idea what to expect, I was quite curious. My oh my was I in for something completely unexpected. After a 15 minute drive, we pull up to this immaculate, beautiful, palm tree lined, luxurious, amazing waterfront filled with restaurants. You could drop me in Newport Beach and I wouldn’t be able to tell the difference. I couldn’t believe this was Africa! I got out of the car with the strangest look on my face. I was thinking what a transformation this is from where I had just spent 5 weeks in. Also, the raw amount of success and money that’s apparent in this part of town is just astounding. It is common to see a Ferrari roll down the street and nobody attack it. We had dinner at this place called Blues. We were sat down by this lady with a seductive dress and were given luxurious blankets to keep ourselves warm. What the hell, where am I?
Monday morning rolled around before we knew it and it was the first day of work. I ate breakfast and got picked up by our new driver, Uncle. He strictly goes by Uncle and nothing else. Another thing about him, he is EXTREMELY punctual. Since I’ve been here, he’s apologized for being late one time by three minutes. If I remember correctly, three hours late was OK in Africa time. Anyway, we were driven about 5 minutes to Jooste Hospital. This would be the hospital I would stay at for the entire duration of my rotation. Now Jooste has quite the reputation. It is situated in between Manenberg and a couple other gangster towns in the Cape Flats. They have a huge patient population that overwhelmes the hospital all the time. As a result, the hospital has suffered. Jooste has become the Friday night hangout for stabbings and shootings. Also, it’s been deemed the hospital where all hope goes to die. If you have a staggered chance at living, just don’t go to Jooste. Barbed wire and tight security surround the hospital and for a good reason. When word gets out that the person that got assaulted survived, the assailants would ambush the hotel, run to the ward, and finish the victim off.
We were taken to Estelle, the hospital program coordinator at Jooste. Right off the bat, this program seemed very organized. We choose to rotate at the infectious disease clinic for the week. When we arrived there, we were split up and we all had our own doctor. My doctor, C.J., was an amazing doctor. He was young, just completed all of his schooling, and was able to communicate effectively with his patients. I admired all that he did throughout the week. Most of the week consisted of seeing HIV and Tb patients. Overall, it was a somewhat low key week. We would go on rounds on Monday and Thusday with the doctors. I remember one moment in particular however. During rounds on Thursday, we were in the women’s ward attending to some patients. They were examining this very sick woman with meningitis, HIV, and Tb. She has sputum and blood coming out of her mouth and did not have a mask on. I had to stand back from her because it just looked like a whole lot of contagiousness going on. Right next to me looked like a bank vault door. It had a sign on top of it that said “isolation”. I had been by there earlier and the door was shut, abiding by common sense and protocol. This time, with the meningitis and Tb spewing woman to my left, the isolation door was wide open to my riiht. I glanced over at the isolation charts lying on the table, highlighted in pink highlightier was MDR-TB. Awesome, multiple drug resistance Tb air drafting right at my face and I couldn’t really move anywhere. At that moment I realized that I hadn’t seen anybody really throw up. So that made me somewhat happier so I moved closer to the meningitis woman who had just been given a mask. No less than thirty seconds later, she starts vomiting through the mask. I felt so trapped and felt like I was getting hit from all angles with all sorts of dangerous aerosols. I’m hoping I don’t get exposed to Tb (long shot at this point) because if I test positive even as a carrier in the U.S., I have to be put on antibiotics for 9 months to a year. Those medications come with its side effects and eliminate the ability to “party” if you know what I mean. Personally, I think this is insanely overboard for the U.S. (you can’t pass on tb if you’re a carrier), but hey it is the U.S. afterall. From what I’ve observed so far, it is the land of the overly paranoid and wasteful. This is definitely something I’ll take back with me. I hope I can go back and only utilize the resources I truly need and not waste them on uneccessary precautions (i.e. the Tb medication, spending millions of dollars on research for something that happens 0.00001% of the time).

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