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).
Monday, May 24, 2010
Tuesday, May 4, 2010
Brangelina Day
April 28th, 2010: Today we had went to visit an orphanage about 30 minutes outside of Durban. Today we also experienced “African Time”. We left the house around 7 and got to the bus stop at 7:40 to catch a 7:50 shuttle. We were informed that the bus is on the way and it should be here shortly. The shuttle was just going to take some sisters, Hailey, and I to the orphanage directly. 7:50 came and passed, so did 8:15, so did 8:45, 9:15, and yes even 9:30. Where the hell is this bus? Maybe it was a horse drawn carriage. We kept trying to keep ourselves occupied but a rock hard wooden bench can only be comfortable for so long. The lady behind the counter leaned over and apologized for the delay, “It’s the day after a holiday, it’s always a little hectic”. I didn’t know driving a car could be so hectic but hey whatever. I never got mad or anything, I actually thought it was an entertaining experience. Finally, we got picked up and headed off.
When we got there, we noticed that it was another Islamic compound. Every place we’ve been to in the past few weeks has been of Islamic influence (although some of the implications can be classified as brainwash). We got a tour of the place, fully equipped with prayer rooms and the whole shebang. I wonder if the kids are forced into this religion and what happens if they don’t conform while they are there. We eventually ended up at the ABC, a nice name for Abandoned Babies Cottage. Oh my God I felt like Oprah. A whole swarm of kids came running up the hill with their hands in the air screaming. We put out our hands and got about 90 high-fives from 18 kids. They were playing around on their tractors and tricycles doing their thing. They wanted to get pushed around and be picked up after a while. One boy gravitated towards me immediately. He seemed to be running the orphanage with his rambunctious attitude. Luckily, I liked him a lot too. Every kid cried like 5 times when they got in a fight over a tricycle or tractor. At one point, I had about two and half kids crawling all over me, all of them wanting to touch the ceiling or just be held or take a picture. For those of you who know my passion for kids (FYI, the word passion can be used negatively), you would think I would have lost it. But I really enjoyed running around and playing with the kids. Especially when I would hold them upside by one foot. It was the one really hot day in Durban we’ve had in a while and of course we would spend it outside. I was working up a sweat pushing three tractors at a time and throwing kids in the air. Also, it was a disaster to wear a white shirt to the orphanage. I got pretty filthy with the kids’ dirt, blood, sweat, and tears. They operate in a cascade, once one kid does something, the rest all follow. So if one kid threw dirt in my face, I would get 20 more. Eventually, I was worn out and went back up the hill for a break (this would constitute a tea break). While having our tea, we realized how nice the definition of a break is in SA. I actually felt rejuvenated having tea, cookies, and spending time reflecting what just happened. It was much better than booking it to Starbucks, stressing out in a giant line because you have to be back in time or you’re castrated, getting your caffeine fix to-go, running back before you get a parking ticket, spilling it on yourself, and making it back to your work station so the next person can repeat what you just did (shoutout T! ☺ ).
The rest of the day went fine, when it was time to go we went back to the front office to wait for the shuttle. It would be 2 hours late…again. Therefore, we had tea…again. T.I.A. man.
When we got there, we noticed that it was another Islamic compound. Every place we’ve been to in the past few weeks has been of Islamic influence (although some of the implications can be classified as brainwash). We got a tour of the place, fully equipped with prayer rooms and the whole shebang. I wonder if the kids are forced into this religion and what happens if they don’t conform while they are there. We eventually ended up at the ABC, a nice name for Abandoned Babies Cottage. Oh my God I felt like Oprah. A whole swarm of kids came running up the hill with their hands in the air screaming. We put out our hands and got about 90 high-fives from 18 kids. They were playing around on their tractors and tricycles doing their thing. They wanted to get pushed around and be picked up after a while. One boy gravitated towards me immediately. He seemed to be running the orphanage with his rambunctious attitude. Luckily, I liked him a lot too. Every kid cried like 5 times when they got in a fight over a tricycle or tractor. At one point, I had about two and half kids crawling all over me, all of them wanting to touch the ceiling or just be held or take a picture. For those of you who know my passion for kids (FYI, the word passion can be used negatively), you would think I would have lost it. But I really enjoyed running around and playing with the kids. Especially when I would hold them upside by one foot. It was the one really hot day in Durban we’ve had in a while and of course we would spend it outside. I was working up a sweat pushing three tractors at a time and throwing kids in the air. Also, it was a disaster to wear a white shirt to the orphanage. I got pretty filthy with the kids’ dirt, blood, sweat, and tears. They operate in a cascade, once one kid does something, the rest all follow. So if one kid threw dirt in my face, I would get 20 more. Eventually, I was worn out and went back up the hill for a break (this would constitute a tea break). While having our tea, we realized how nice the definition of a break is in SA. I actually felt rejuvenated having tea, cookies, and spending time reflecting what just happened. It was much better than booking it to Starbucks, stressing out in a giant line because you have to be back in time or you’re castrated, getting your caffeine fix to-go, running back before you get a parking ticket, spilling it on yourself, and making it back to your work station so the next person can repeat what you just did (shoutout T! ☺ ).
The rest of the day went fine, when it was time to go we went back to the front office to wait for the shuttle. It would be 2 hours late…again. Therefore, we had tea…again. T.I.A. man.
Malagazi Township Clinic
April 26th, 2010: Case of the Mondays. It was hard to wake up as usual, but I was actually excited once I left the house. Today we were going to Malagazi Clinic in Umlazi, which is a township. This would be the most rural clinic thus far. We pulled into the clinic to see the usual long lines. We were greeted by Clementia, the head sister of the clinic. Overall, it was by far the warmest greeting I have received since being here. All of the staff was so happy to see us and said hello whenever they had the chance. We began by witnessing the family planning clinic, which consisted of a line of women sitting in a chair waiting to get injected with birth control. Like cows getting branded, when it was their turn they got up, dropped their dresses, got injected, pulled their pants up, got their stuff and left…all in front of each other. We injected about 20 women what seemed in like 5 minutes. Next we got to do the regular clinic and sit with a sister. I became extremely excited when she told us Hailey and I had to split up due to the small examination rooms. Finally, I got to be alone with a sister or a doctor for the first time. I went with Clementia and Hailey went with the other sister. The patients started pouring in with a variety of ailments. There were lots of cases with children and adults with sores all over their body. The main cause of this was their diet. Since this was a rural clinic, we got to see the repercussions of malnutrition and poor diet choices. Clementia was a 75 year old sister with a hard hitting attitude to come with it. She obviously has done this for a while, and she sternly lectured everybody about their diet choices and how they’re doing it all wrong. Everything she said was very harsh, but very true. This one baby came in with sores all over his mouth and she told me to listen carefully. She asked the dad (very rare to see a dad there) what the child ate and he responded, “Whatever he wants”. And there is your first problem. A lot of people in this community have no sense of proper balanced diet and give their children whatever they want. They also think that once breastfeeding is completed that milk consumption should be halted. In a community like this, it is close to impossible to compensate all of the vitamins and minerals that are lost with no milk consumption.
We had another patient come in; she was this very beautiful 18 year old girl. She was complaining of a headache amongst a load of other things. We found out she had multiple STI’s and needed an injection. She admitted to not using condoms with her sexual partners and when Clementia asked why not, she didn’t say anything. She just shrugged her shoulders or looked off into space. Clearly, she was impossible to get through. I assumed she would develop HIV in the next year or so.
The most interesting case was this 25 year old man who came in. He didn’t even need to explain himself since he just looked completely emaciated. The sister asked what wrong and he said he has been sick for a couple weeks. She also knew that he had not been eating. He said that he had not eaten in 3 days. I lifted up his shirt and noticed he also looked severely dehydrated. I pinched his abdomen and it felt like I pinched pizza dough. The skin just kind of stayed where I had pinched it, but slowly returned to normal. He tried to remove the rest of his shirt but he had so many aches and pains in his joints that he needed help. He had oral thrush (white coating of the tongue that bleeds when you touch it), which is a good indicator of HIV and a green discharge coming out of his eye. I took his heartbeat with my handy dandy stethoscope and it was beating so fast that I had to recount it a couple times. Sure enough he has tachycardia, or a fast heart beat. We asked him what he has done to help himself out during the few weeks. He replied that he drank a whole bottle of castor oil (not Castrol motor oil…don’t worry). Castor oil is this translucent, extremely viscous, unpleasant smelling oil that was banned in South Africa years ago but has come back due to the introduction of flavors (it still is to be avoided however). It basically acts as an extreme laxative and “cleanses” your body to the point of mass dehydration. The usual dose is a couple tablespoons. Traditional Zulu believe that you need to cleanse the body whenever something is abnormal, so they take a WHOLE bottle of Castor oil only when the sun is down to cleanse themselves. Hence, we see the dehydration. The sister recommended that we stop giving him care and him be referred to the next level of care. The clinic refunded his R40 (~$5.75, the price for all public clinics) since they couldn’t take of him. I asked Clementia how he would get to the hospital and she replied “well he might not, it’s all a matter of how much money he can get to get over there”. It was a pretty sad case to see a 25 year old so sick and only to send him off hoping he has enough money to get to the referred hospital before he dies.
At the end of that case, Goodness (yes that’s her name and she’s 100% awesome) came in and said something in Zulu to Clementia. Clementia turned to me and said that my tea was ready. Umm excuse me? MY tea? What about hers? I told them they didn’t have to that for me and when her tea was. She replied that she only gets tea if it’s not busy, only doctors get tea. Too bad I’m not quite the doctor you think I am… I felt completely undeserving for the tea but they insisted. Hailey and I walked to the back room of the clinic and were pretty touched with what they did. They set up a little table with teapot, teacups, tea, milk, and sugar for us with what little supplies they had. Granted we were having tea on the same table that the birth control medications were administered, I was really humbled by the gesture. To them though, it’s standard to serve the doctors tea. But since doctors rarely make appearances in this clinic, they really tried to make us happy. I busted out my severely bruised banana (my plum had exploded in my bag…sorry Jay) and began to eat it. Out comes Goodness with the biggest smile on her face and apologized for only providing powdered milk. We laughed and said it totally fine only to be greeted with tea cookies. The ones with the raspberry filling…mmm. Again, they really didn’t have to give us cookies.
After tea, we went back into our rooms and continued to see patients. I was sad when the clinic ended. I really enjoyed my day with a fiery 75 year old sister named Clementia. In fact, this became one of my favorite days here. I had the most patient interaction thus far and felt like I contributed to the clinic. I gave Clementia a big hug and told her how much I appreciated everything and headed home.
At home, GoGo continues to blow my mind when I see her hobbling around without her crutch. I don’t think she likes the crutch too much so she manages to get around slowly. A lot of family has been stopping by to check in on her. She continues to smile and also offer me a lot of food… so basically nothing has changed. That night Hailey and I took our brothers out to the arcade to hang out. I bought them some tokens and we all had a good time. On the way back, we had all of them screaming to some rap and even some Poker Face ☺.
We had another patient come in; she was this very beautiful 18 year old girl. She was complaining of a headache amongst a load of other things. We found out she had multiple STI’s and needed an injection. She admitted to not using condoms with her sexual partners and when Clementia asked why not, she didn’t say anything. She just shrugged her shoulders or looked off into space. Clearly, she was impossible to get through. I assumed she would develop HIV in the next year or so.
The most interesting case was this 25 year old man who came in. He didn’t even need to explain himself since he just looked completely emaciated. The sister asked what wrong and he said he has been sick for a couple weeks. She also knew that he had not been eating. He said that he had not eaten in 3 days. I lifted up his shirt and noticed he also looked severely dehydrated. I pinched his abdomen and it felt like I pinched pizza dough. The skin just kind of stayed where I had pinched it, but slowly returned to normal. He tried to remove the rest of his shirt but he had so many aches and pains in his joints that he needed help. He had oral thrush (white coating of the tongue that bleeds when you touch it), which is a good indicator of HIV and a green discharge coming out of his eye. I took his heartbeat with my handy dandy stethoscope and it was beating so fast that I had to recount it a couple times. Sure enough he has tachycardia, or a fast heart beat. We asked him what he has done to help himself out during the few weeks. He replied that he drank a whole bottle of castor oil (not Castrol motor oil…don’t worry). Castor oil is this translucent, extremely viscous, unpleasant smelling oil that was banned in South Africa years ago but has come back due to the introduction of flavors (it still is to be avoided however). It basically acts as an extreme laxative and “cleanses” your body to the point of mass dehydration. The usual dose is a couple tablespoons. Traditional Zulu believe that you need to cleanse the body whenever something is abnormal, so they take a WHOLE bottle of Castor oil only when the sun is down to cleanse themselves. Hence, we see the dehydration. The sister recommended that we stop giving him care and him be referred to the next level of care. The clinic refunded his R40 (~$5.75, the price for all public clinics) since they couldn’t take of him. I asked Clementia how he would get to the hospital and she replied “well he might not, it’s all a matter of how much money he can get to get over there”. It was a pretty sad case to see a 25 year old so sick and only to send him off hoping he has enough money to get to the referred hospital before he dies.
At the end of that case, Goodness (yes that’s her name and she’s 100% awesome) came in and said something in Zulu to Clementia. Clementia turned to me and said that my tea was ready. Umm excuse me? MY tea? What about hers? I told them they didn’t have to that for me and when her tea was. She replied that she only gets tea if it’s not busy, only doctors get tea. Too bad I’m not quite the doctor you think I am… I felt completely undeserving for the tea but they insisted. Hailey and I walked to the back room of the clinic and were pretty touched with what they did. They set up a little table with teapot, teacups, tea, milk, and sugar for us with what little supplies they had. Granted we were having tea on the same table that the birth control medications were administered, I was really humbled by the gesture. To them though, it’s standard to serve the doctors tea. But since doctors rarely make appearances in this clinic, they really tried to make us happy. I busted out my severely bruised banana (my plum had exploded in my bag…sorry Jay) and began to eat it. Out comes Goodness with the biggest smile on her face and apologized for only providing powdered milk. We laughed and said it totally fine only to be greeted with tea cookies. The ones with the raspberry filling…mmm. Again, they really didn’t have to give us cookies.
After tea, we went back into our rooms and continued to see patients. I was sad when the clinic ended. I really enjoyed my day with a fiery 75 year old sister named Clementia. In fact, this became one of my favorite days here. I had the most patient interaction thus far and felt like I contributed to the clinic. I gave Clementia a big hug and told her how much I appreciated everything and headed home.
At home, GoGo continues to blow my mind when I see her hobbling around without her crutch. I don’t think she likes the crutch too much so she manages to get around slowly. A lot of family has been stopping by to check in on her. She continues to smile and also offer me a lot of food… so basically nothing has changed. That night Hailey and I took our brothers out to the arcade to hang out. I bought them some tokens and we all had a good time. On the way back, we had all of them screaming to some rap and even some Poker Face ☺.
Bad Day for the Msomi Family
April 23-25, 2010: After a weekend in Durban, I began what is my last week here. I couldn’t believe I had reached this point in my trip already. I remember landing in windy Durban, completely confused, tired, and expecting anything. Now I feel like I have conquered this city (in my own way. I’m sure I would be conquered in like 5 minutes if I were to step out alone at night). My host family has now become my family and leaving them seems wrong. I have grown very attached to the family. Sibongile is such a respected woman in the community and she doesn’t take shit from anybody. She has raised her boys quite well given she can be quite intimidating. Since she is a school teacher, I asked the boys one day if she’s a cool or a mean teacher. They responded, “let’s just say we’ve lost some friends growing up”. Whatever the case, she has the biggest heart I’ve seen. She will take a bullet for anybody and could possibly kick anybody’s ass. Also, she wrestles with her boys all the time, each time giving them a run for their money. GoGo is the same way, being a GoGo in the household is an interesting position that I haven’t quite figured out. I think it is very revered and are looked at as the ultimate caretaker. GoGo has been through quite a lot in her lifetime. She is the oldest of 6 sisters and has lived in townships the majority of her life. She has gone back to visit frequently for days at a time. GoGo once told me that at one point, there were 20+ people living in her 3 room house in the township. She was the caretaker for that household as well. Like Sibongile, she can probably kick anybody’s ass. She also takes on her own grandkids and wrestles. Probably one of my favorite memories happened this weekend. Boom Boom and GoGo were beating each other up one day when Boom Boom ran into my room and slammed the door behind him, putting all of his weight against the door. GoGo attempted to push on the door to no avail. Boom Boom snickered back at her with his demonic sounding laugh. Before that could end, the door suddenly flies open sending Boom Boom onto the floor. Persistent granny actually charged the door with all of her might and knocked her grandson cold on the floor. At the threshold of my door was a huffing and puffing grandma wearing a yellow sundress. Best part is that her English becomes perfect when she gets angry, “Why are you laughing Boom Boom? It’s not Christmas! I’m going to throw you out that window and show who really raised you!” Essentially, I respect her immensely and do not want to challenge her to any sort of physical brawl. It was the next day that the entire family would be hit with a terribly stressful and sad day.
It was Sunday and the whole family went to church. GoGo goes to a Zulu speaking church while the rest of the family goes to an English speaking church. She walks there and back each Sunday morning and afternoon. It was the afternoon and she still had not returned. We got a voicemail on the house phone and it was GoGo but she sounded distraught and in a panic. There was so much noise in the background that we couldn’t hear anything. Eventually we get a call from Sibongile saying that GoGo was in the hospital. I thought maybe for her hypertension or diabetes but definitely not what I was about to hear. She was hit by a taxi bus while walking back to the house. She was literally the next street over, maybe a 3 minute walk. These asshole taxi buses that I’ve been talking about have added to the statistic. They are so aggressive and do not care for anybody else on the road. All they care about is getting to the location as quick as possible to make more money. They are in the highest incidence of car accidents here in South Africa. The story that went with it wasn’t much better. Apparently GoGo had fallen while she was walking and the taxi proceeded to run her over while she still down on the concrete. The taxi bus ran over her leg and it dragged her for a very short distance. Instead of stopping, the taxi bus kept going. She was put into another taxi and was taken to the hospital where she sustained a pretty nasty set of lacerations on her arm and a broken ankle. She stayed there overnight and was supposed to come back the next evening.
After all of that, you would think that would be enough for one day. But this wasn’t the case. After waiting 10 hours in the hospital, Sibongile came home from the hospital to the house. We helped open the gate and garage so that she could pull into the garage. The driveway is pretty steep and has some gravel patches. On her way up the driveway (driving stick, which she is new at), she slid on some gravel, lost control of the car, and slammed her new car into the side of the house. I don’t know what else we could do at this point… the day was simply not going to be a good one. She hit the house at the right front tire and the surrounding area. I checked out the tires and everything, and the car didn’t look moveable. I know at this point, I would have lost it if it were I. But Sibongile held pretty strong, although I know she holding a lot back. I felt so bad, I wanted to help out somehow but I’m not sure if I really could. To say the least, it was a bad day for the Msomi family.
It was Sunday and the whole family went to church. GoGo goes to a Zulu speaking church while the rest of the family goes to an English speaking church. She walks there and back each Sunday morning and afternoon. It was the afternoon and she still had not returned. We got a voicemail on the house phone and it was GoGo but she sounded distraught and in a panic. There was so much noise in the background that we couldn’t hear anything. Eventually we get a call from Sibongile saying that GoGo was in the hospital. I thought maybe for her hypertension or diabetes but definitely not what I was about to hear. She was hit by a taxi bus while walking back to the house. She was literally the next street over, maybe a 3 minute walk. These asshole taxi buses that I’ve been talking about have added to the statistic. They are so aggressive and do not care for anybody else on the road. All they care about is getting to the location as quick as possible to make more money. They are in the highest incidence of car accidents here in South Africa. The story that went with it wasn’t much better. Apparently GoGo had fallen while she was walking and the taxi proceeded to run her over while she still down on the concrete. The taxi bus ran over her leg and it dragged her for a very short distance. Instead of stopping, the taxi bus kept going. She was put into another taxi and was taken to the hospital where she sustained a pretty nasty set of lacerations on her arm and a broken ankle. She stayed there overnight and was supposed to come back the next evening.
After all of that, you would think that would be enough for one day. But this wasn’t the case. After waiting 10 hours in the hospital, Sibongile came home from the hospital to the house. We helped open the gate and garage so that she could pull into the garage. The driveway is pretty steep and has some gravel patches. On her way up the driveway (driving stick, which she is new at), she slid on some gravel, lost control of the car, and slammed her new car into the side of the house. I don’t know what else we could do at this point… the day was simply not going to be a good one. She hit the house at the right front tire and the surrounding area. I checked out the tires and everything, and the car didn’t look moveable. I know at this point, I would have lost it if it were I. But Sibongile held pretty strong, although I know she holding a lot back. I felt so bad, I wanted to help out somehow but I’m not sure if I really could. To say the least, it was a bad day for the Msomi family.
Friday, April 23, 2010
Johannesburg bound? Or a pretty Durban weekend
April 22nd, 2010: This week has really been flying by. I continue to learn a lot from doing simple research at Dr. Khan’s office. I finished up compiling the information today and hopefully I can produce a memorable senior thesis. The week is so closing to ending and we are getting another car tomorrow. This weekend, we are planning to stick around the Durban area and go to uShaka (waterpark!!! Thankfully Paola isn’t with me or she’ll bring the water park curse), beach, and probably do some more knick knack shopping. Also, we’re hoping to take the SkyRail up to the very top of the Durban World Cup Stadium. But in the spirit of South African spontaneity, perhaps there will be a crazy, poorly thought out, and crazy trip to the mysterious place that is JOHANNESBURG! They say if you can make it in JoBurg, you can make it anywhere in the world. Obviously I won’t be going there to see if I can make it out alive, but to see what this unique, fast paced, and nonstop energy feeling you apparently get while you’re there. There are some cool things to do in the surrounding areas as well. However, this is a long shot since we really haven’t planned anything.
Those in glass houses...
Since this week isn’t the most mind-blowing week, the days have been somewhat uneventful but I have learned a ton. Also, I am getting inside information on why exactly this epidemic is continuing to propagate itself through generations. I saw plenty of cases where the patient does not take his ARV’s for one reason or another and has consequently become worse, developed resistance to the drugs, and then passed that resistant strain onto his usually multiple partners. The scariest information I’ve taken down is that it is common to not disclose your own positive status to your partner who is negative. I feel awful whenever I come across those because the woman truly has no idea what’s coming. Most likely, she’ll get infected and the epidemic continues. A lot of the people who have kept their positive status a secret have had previous partners who have died of an unknown illness (according to them). But really, you could probably guess what it was most likely from. Some of the patients have reported to be taking traditional medicine made by traditional healers, or inyangas. Nobody knows exactly what these medicines are made of but one thing is for sure- it doesn’t help. They suspect they are made from dishwashing detergent, ammonia based compounds, bizarre plant extracts, and some acids. For lunch, we went out walking around looking for something to eat. We were definitely in a very unsafe part of Durban so we needed to find something pretty quick before we look lost. We ended up at this pizza place and had a pretty good meal. When we walked outside the wind was blowing so hard that when we were crossing the street we heard this big smash. All the sudden glass starts falling from the sky and onto the sidewalk, on people, and on top of cars. Luckily, we were just outside of the area where some glass broke so we didn’t get hit. We looked up and a couple windows about 5 or 6 stories up blew out. To paint a grim picture, with all the dust, trash, papers, people running, and glass flying everywhere, it looked like a miniature 9/11. The glass explosions would not stop there. That night, it was actually chilly. And by chilly, I just closed my window and slept all the way under the covers. But we managed to make some hot chocolate. I remembered bringing some hot chocolate mix from home and thought I would never use it. I brought it out for the family to try and we boiled some water (we had no milk =( ). We took some glasses out and started pouring the water into the glasses. Thulani and I were preparing them so I was stirring after he poured the water. As soon as I put the spoon into the water, the glass exploded! I mean a clean cut, side bursting, Mt. St. Helens style explosion all over the floor and myself! Thankfully I’m quick as a damn cheetah and I moved out of the way in time to evade the majority of the explosion.
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.
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.
Male..49..vaginal discharge
April 19th. 2010: Back to work :( However, this week would be a tad different. I told our medical director, Dr. Khan, about my thesis on week 1. He offered me to go with him to his office so I could look through all of his files so I can compile some raw data. Hailey decided to join in on the act so we got picked up as usual and were taken to the City Centre of Durban. As we were driving through the City Centre, we noticed a TON of trash everywhere. There had been a strategically planned strike by the municipality of Durban. Right in time for World Cup, the municipality went on strike probably to ask for higher wages. As a result, no trash collectors, no maintenance workers, nobody. Imagine downtown L.A. without a day of trash pickup and how much gets generated everyday. There are no dumpsters so all the trash has been accumulating on the side of the road either in bags or just floating around in loose piles. But of course, T.I.A., and there must be some sort of twist. Most likely in order to speed negotiations, the workers took sledge hammers and smashed and/or turned over all the garbage bins in the area just to add to the mess. There is literally trash in every gutter, every sidewalk, and inside every building. It has been pretty windy here so when it blows all the trash blows up in the air. More than likely you’ll get a KFC box blown into your face.
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.
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.
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