After 5 days in Durban, Elizabeth, Lauren, and I set off for our placement in Manguzi, a rural town about 9km from the South African border with Mozambique. What we thought would be a 4 hour bus ride to get here actually took 7 hours. The bus was hot and crowded with people coming back from Durban to their rural communities. We drove through the beautiful South African countryside and saw small villages, mountains, lots and lots of sugar cane fields, a paper making factory, pineapple fields, a massive dam, one elephant, and lots of monkeys, chicken, cows, and goats.
Manguzi is a bigger town than I thought it would be. We were surprised when we got off the bus at all of the people milling about the market. Our host mama is very nice and friendly. She is a young, single mother with a daughter in middle school. She shares a house with her sister and her sister's young son, and most of the rest of her family lives in houses nearby. The family has been very welcoming and has been helping us with our very limited Zulu. We don't have running water at the house, which has been an adjustment. It is making us very aware of exactly how much water we use.
We started our work at the hospital this week. It is an interesting dynamic because we are coming in as foreigners without specific trainings or qualifications. Thus far, we have been shadowing doctors and trying to help out where we can. Sometimes it is hard not feeling very useful, but at a very base level we are trying to be respectful and (as Zed puts it) “affirm the humanity” of the people we are interacting.
Thursday, May 26, 2011
“We had out second day of work today. We all went to a meeting with all of the doctors this morning. Lauren spent the day in the female ward and got to see a C-section. Elizabeth was in the maternity wing, and I was in peads for the morning and then speech and occupational therapy for the afternoon. Overall, it went well. In peads, I observed a doctor making morning rounds of the ward. So many children were malnourished. After the round was finished, the doctor suggested that I go to the "allied health" wind, where they have speech & occupational therapy and physios, as well as dentists and some other services in another building. I helped one of the speech therapists monitor the infants in the neonatal unit. She was checking their vitals and if they can suck/latch for breast feeding. After that, I spent most of my time with one of the occupational therapists. I observed some of her treatment, helped her organize the office, and went to a "stim" session for children in the peads ward. We worked on their gross and fine motor skills by playing games. At there request, I taught them the hokey pokey and the macarena. It was great to see the kids so happy because I had been on wards when they were evaluated in the morning. Based on some suspicious injuries, several of the kids (who are as young as 8) have probably been sexually abused.
Overall, it was a good first day. The hardest part is feeling somewhat useless. We are all learning a lot, but we are unqualified and do not speak Zulu, so it is hard for us to be very useful. The nurses translate, but I would love to communicate with patients more.”
Friday, May 27, 2011
I spent the morning in the female ward. There are so many patients with advanced HIV, TB, meningitis, and other opportunistic infections. It is sad to see so many young women dying just as their lives should be getting started. There is a somber air around the ward as the patients wait with for the doctor to see them. Many labor with each breath and watch with gaunt eyes and timid smiles as the doctor approaches them. I follow quietly behind, trying my best to offer an encouraging smile through my face mask.
While rushing through rounds and setting up the hospital ward for the weekend, one of the doctors had to make a decision about allocating the last units of blood the hospital had left, as the hospital was about to run out of blood. The hospital is larger and more well equipped than I expected, but it is still limited by scarce resources and challenges in infrastructure. For example, I went to the lab to print test results for a patient who was supposed to be discharged that afternoon and referred to another hospital. The printer was broken when I went to the lad, delaying the process until it was fixed or someone was able to make official copies of the results. As is constantly the case, you make due with what you can.
Transportation is another huge challenge for patients. The hospital has a fantastic network of clinics nearby, so patients are able to get treated by busy clinic nurses on staff, and doctors when they visit the clinics periodically. However, reaching medical care at the hospital or a clinic is often a journey. The hospital does have a bus that picks patients up at the clinics, but it fills up quickly and often because of timing, patients can only ride it one way, needing to find and pay for alternative transportation to or from treatment.
In the afternoon, I was working with the pediatric “stim group” again. Several of the children remmebered me from yesterday and had called me back to visit them when I walked past the playground coming back from work. The "stim group" is such a nice break for the kids. They stop being patients and being sick and get a chance to play, which is not only fun but also important for their development and overall well being. I love hearing them laughing and seeing them enjoy some time outside of the ward.
While I was working with the "stim group," I got a call from Elizabeth. OPD (Out Patient Department) had a patient from Mozambique and needed a translator. I was trying to explain and ask him about a hernia in Portuguese, which was challenging. My Portuguese is so incredibly rusty after not taking it since the fall. He got the point though and it was nice to be able to put my foreign language skills to use.
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