Ashton on Spooning Cheetahs Kirsti Zitar on Spooning Cheetahs Alek on First Week of Clinical Ro…
It is my final week here in South Africa! I cannot believe it; honestly, the idea that I will be back in Georgia at least by next monday is insane. But before I start with all my goodbyes, let me talk a bit about my past week and today.
Last week I was in internal medicine. Everyone has talked about how internal will be super boring, but I absolutely loved it. I’m not saying it is the most action packed place in the hospital, but I have had the opportunity to truly understand how people heal, and well the flip side, deteriorate. Since most of the folks reading this blog probably could not care less about the medicine, I’ll skip some stuff, but please realize how unbelievably common HIV and TB are here in SA. I am not suprised when I have a patient who is HIV negative or does not have TB. When I go back to the states, I am pretty sure I am going to make a complete fool of myself by thinking everything is TB or a complication of HIV. But anyways, the doctors I followed were fantastic, but there was one in particular who loved to make me realize that I truly know absolutely nothing.
Being in Durban for the month of June, I felt like I got a decent understanding of HIV. WRONG. I know jack squat, haha this doctor I followed made me realize that HIV is just insanely complex and that it will take me years and years to truly understand the disease. However, I am proud to say that I can now read (mostly) and perform an ECG. I learned about these tests during my Human Physiology class, but actually getting to do them on patients was fantastic. The first ECG that I was responsable for was with Larissa. It was a man, so finding the spots for the leads was not difficult. HOwever, friday was my first day by myself. Because one of my doctors had been on call the whole night, he had me do an ECG on a woman by myself. I was given no warning, but after I introduced myself to the patient and told her I was a student, my professionalism wavered. When you are doing an ECG, the leads have to be in very particular places; on women, they must be under the breast. My patient was obese and had some sort of tumor growth on her nipple. Not only was I incredibly taken aback by having to hold up her fat and push her chest rather hard to feel her ribs, but then the dang machine did not work. A surgeon who had just gotten off call helped me but he still couldn’t get the machine to work. I then had to go to the ICU and get there’s; even though I asked a sister I was still sort of yelled at for taking it. ROlling this machine back to the woman’s ward was probably the most embarassing moment of the past two months. This machine was sqeaking so unbelievably loud in a silent hospital with hundreds of sick people shushing me. However, once I got that machine back, I got her ECG test done and all was well.
Another interesting patient from internal was actually a hospital error. While on rounds, this elderly lady more or less fainted then was only semi-consious and made no sense. She had been given insulin early that morning (she’s diabetic) but never any food. After a few scary moments, a glucose drip was set up and she was 100% better in five minutes. It was insane to see such a huge turn around in such little time.
I also had a few moments where I could not help but judge the hospital. I know I am young and very naive, but a woman sitting in her own urine for over two hours is absolutely unacceptable. I had a patient beg me to discharge her because of the horrible neglect she was receiving in the hospital. It truly broke my heart.
As I said earlier, today was my first day in ortho. I had an insane amount of fun. I cleaned dozens of wounds, cut stitches, and put on castes. I have plaster all over me. As gross as it may be, I love cleaning wounds; its really cool to see how the body tries to heal itself and how in just a few days you can barely tell a wound was even there. HOwever, I am freaking done and tired of all these gunshot wounds! I saw six today. Just random people with gunshot wounds on feet, hands, ankles etc. These people are just going about their days and bam, they get shot! I have had a few gangsters for patients, but most folks who come in are just random bystander.
One of my favorite patients of the day was a man named Mr. Swartz. We shared a last name, but he was a Black south african who was rustafarian. He had a gunshot wound, and since I was with him for about an hour, we got to talking. By the end he was convinced we were related because we had “similar souls.” That may have been the highlight of my day or perhaps the man who proposed to me because I was a hard working girl. He may of just been trying to be nice because I couldn’t get the dang scissors to work to save my life. (DOn’t judge until you have seen these scissors). But overall, I am ecstatic in ortho and cannot wait for tomorrow!
This week in the EC (Emergency Centre) has been fantastic but pretty bloody. In Cape Flats, there is a gang war going on between the “Americans” and the “hard-livings.” One of the top gangsters in the Americans is getting released from jail a few years early; he will be out in two weeks. Right now, there is a struggle for territory between the two gangs and the Americans want to gain as much land as they can before their leader is released. Besides hearing gunshots farely frequently, being in the EC has given me the opportunity to actually see most of the gunshots I hear.
I have gotten pretty dang frustrated though because guess what, the gangsters are not the ones who are dying and getting shot; its the innocent bystanders who are paying the price. My first gunshot patient was a very sweet 52 year old lady who was at work, I think she is a painter, when she got hit by a stray bullet in the ankle. This woman could not have been nicer, but she was so shocked that she actually got hit by a bullet. When she came in, I had to put pressure on the wound with gause, and then I had to hold her foot while they put on a caste. The whole time the woman kept trying to hold my hand; while they were putting on the caste (which is called a Pop here in SA), I was able to give her my hand to squeeze. This woman could not have been kinder and she was a great patient, so letting her squeeze my hand was not a problem, but later that day I seriously regret letting another patient squeeze my hand.
Something I don’t think I have written about yet is the rediculous driving here in SA. Yes, believe it or not all of you who think I am a horrible driver, I have driven here (both in Durban and Cape Town). Now driving on the opposite side of the road is not the hardest part; the people and minibuses going all over the road is what is absolutely insane. In fact, in Durban the taxi (minibus) drivers rule the city; police are not allowed to fine or give them tickets because without the taxi drivers no one can get to work. So, the minibuses drive through red lights, cut you off, and stop all the time in the middle of the road. My patient was a pedestrian who was a victim of a hit and run. Both his tibia and fibula were broken forward and he had a huge gash on his leg above the fractures. His hand was also destroyed with multiple fractures and one of the craziest wounds I have seen yet, but for my lovely godmother Idelle I won’t go into further detail. I had to hold this man’s broken leg for a little over 1.5 hours. If I moved he screamed. Me and this patient ended up getting along, but I’m pretty sure he hated my guts in the beginning.
The last patient whom I referred to early is the only person I have seen who made my jaw completely drop (luckily I had on my TB mask so I still looked professional). This man was outside Shoprite (a grocery store) when he was hit by a stray bullet. He had both an entry and exit wound, THROUGH HIS HEAD. This man, I just don’t even know how to describe it, but woah. The doctors ran to CT once he was stabilized which left me alone in the room with him. He kept trying to get up and pull out his IVs so I had to keep him down. When the doctors finally came back, they had to put in another IV. While they put in another IV, I let him squeeze my hand. BIG MISTAKE. He dug his nails into my palm as hard as he possibly could causing me to let out a small yelp. It took two people to get him to release his grip on me. When we wheeled him to CT (CT scan), he started vomitting a lot of blood. I had the airbag so we could recuss him if needed. I stepped in the blood. However, seeing his CT scan was incredible. There were fragments throughout his brain yet this man was talking! I tried to find out today what happened to this man, but he was transferred to a new hospital with a neurosurgeon.
My week in EC was crazy and I definitely learned a lot, but I’m very curious what the next two weeks will hold with the head American getting released after an 8 year term!
Well I am finally here in Cape Town; this city is incredible! The mountains surround the city which is lined by the ocean. My new homestay and roomates are fantastic! The new leaders of the CFHI program here in Cape Town are also incredible and truly go out of their way to make sure you are healthy and happy. I will spend all four weeks at G.F. Jooste hospital in the various wards. My first rotation was in surgery. I had the opportunity to observe several surgeries including a colonectomy, an above the knee amputation, and the draining of a knee abcess. I have now seen a total of 14 surgeries while in Africa. However, possibly the most interesting part of my surgical rotation was hearing the surgeons complain and stress about the status of the hospital and their patients. Due to the fact that some things people said should not be published by me on a public interface, I will not say specifics. However, the hospital is shutting down in a few months for three years as it gets renovated. This hospital deals with patients which should not be seen in only a level two hospital, but since it services most of Cape Flats, with the lack of resources this hospital treats high trauma patients. The man who received the colonectomy died only 30 minutes after his surgery. Before and during his surgery the doctors kept saying that they shouldn’t be doing this, but that the man stood absolutely no chance if they didn’t. The doctors are incredibly frustrated with the situations they are put into.
The weekend was the garden route tour. I had an absolute blast! From going through caves which were so narrow that I had to turn my head to the side to get through to jumping off the highest bunjee jump in the world, this weekend was amazing! I am now in my trauma and ER rotation.
Today, a woman was woken up in her bed with her two kids by being shot several times in her knees. The woman came into the hospital and one of the bullets had somehow gotten all the way to her buttox without damaging her femur. We watched them take out the bullet. Another woman came in with a bandaged foot which had a grocery bag tied around it because it was leaking a yellow fluid. Her glucose level was so low that the doctor said it was insane that she was even conscious. I will write more later, but I still want to digest my impressions of the ER before I write any judgements I might regret. I cannot believe that I am almost 3/4 through with my time in africa! It seems absolutely crazy!
I have little to no time right now, but hopefully later today I will have more. I am completely fine and have been having the time of my life. I am now in Cape Town. My last week in Durban was great; I was on my pediatric rotation at King Edwards Hospital. During that rotation I found myself getting really angry fairly frequently. When it comes to children who are young enough where their parents have full control over them, I get furious when parents make what I feel is the wrong decision. This three month year old has liver failure and will die sometime within the next 3-6 weeks. Her mother refused Anti-retroviral treatment while she was pregnant, so when her child was born, she was HIV positive. That woman’s choice to not take ARVs will kill her child. How is that right? With my studies into ethics I do try and look at every angle, but I keep coming to the same conclusion that a pregnant woman should not be able to endanger the life of her child if she is choosing to have the child. However, I do classify myself as pro-choice. The case of this girl has stuck with me the past few weeks. During the orientation tour in Cape Town (two weeks later), one of our guides alluded to the infamous herbs which some locals believe cure HIV; he was one of those people who believed these herbs to be a cure even though he has had access to high levels of education. I do not mean to be disrespectful, but I cannot understand how educated persons can further the rumor of an herb which cures HIV when their are hundreds of children dying in hospitals because of HIV complications.
During the peds rotation, I also got to know two amazing little boys, Tyrique and Liam. Both were admitted with respitory issues, but we saw them several days in a row and they both recovered very quickly. Larissa and I let them play with Iphones and they tons of pictures and videos; Liam was also an incredible artist! After the final week in Durban wrapped up, Jen and I had to figure out what to do with our week off. We were incredibly lazy and didn’t even make any plans until that Saturday…However, we ended up having a nice week at the beaches south of durban, unfortunately the weather was not on our side. Before leaving Durban though I got to go to a lion park and drive around some lions. They are huge!!! Durban was a great adventure, but Cape Town seems like it will be even better!
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Today has been absolutely insane so far and I am on‐call tonight! It is almost 5pm here and I will be returning to the hospital at 730pm. So today, my second day of my surgical rotation, was supposed to be a day of endoscopies and colonoscopies. After the first endoscopy, the doctor took a phone call about an emergency in resuscitation. A Man came in with 8 Gunshot wounds (4 Shots but both entry and exit wounds). The Male German Intern asked if he and his fellow German Intern could go see the trauma; Larissa And I Saw and opportunity and followed them. When We got to resuscitation (no Idea what is the equivalent to a resuscitation ward in the US), The patient was in X-rays. We Got to see the images which showed that the heart was not damaged but the abdomen was more or less shredded. When The patient came out the doctor put in a rubber tube to drain the blood from the internal bleeds. Then, the patient’s heart stopped beating. CPR was started, three different people did CPR For twenty minutes (including two of the Germans), Then the defibrillator was brought out. The Doctors shocked the patient two times, then his heart started beating again. I was in absolute shock that after 20 minutes of CPR the heart started back up especially since a sister told us that the patient stood no chance and was already dead. The heartbeat was weak as was the blood pressure, but the head doctor made the decision that the patient had no chance without surgery. We more or less ran the patient to the operating theatre. By the time Larissa and I had changed into the OR Scrubs and booties, the number of doctors present had doubled. Before the patient was opened, he went back in to ventricle fibrillation and was resuscitated using the defibrillator twice. We stood and watched as the patient’s chest cavity was carved open with a scalpel then the ribcage was broken apart with a hammer. The Opening of the ribcage was much more violent than what we see in movies! The Incision on the patient was from above the sternum to below the belly button, in order to see, the patients stuffed a ton of towel sized gauze to soak up all the blood. The Rubber tube that was inserted initially had already drained over a gallon of blood. The Doctors went to work pulling out the large intestine, the colon, just looking for where each of the internal bleeds were coming from.
. Three Surgeons were trying to suture up the patients various internal wounds when the patient went back into ventricle fibrillation. For The next 45 minutes, doctors used their hands and manually pumped the patient’s heart and used the internal paddles of the defibrillator three different times. The Head doctor came in and told the team to call it; the doctor whom we shadow called time of death. The Whole time, Larissa And I Were never more than two meters away from the patient. A large part of why I Wanted to do this program with CFHI Was because I Wanted to see if I Could handle being around death and still maintain a rather optimistic personality. Today Was my first real test and honestly, as horrible as this might sound, I Really did not feel any emotions besides absolute amazement. Seeing A surgeon reach inside a man’s chest and keep him alive for 45 Minutes by manually pumping his heart or as he said, “squeezing a sponge,” was indescribably incredible. I Felt down that the man died, but I Was still in a shock and awe of how incredible medicine is; this patient managed to live an extra four hours when the four gunshots he received should have been more or less immediately fatal. Yes, Over four blood bags were used, but, by the end, over 1.25 Gallons of blood were drained from this man’s chest. After The surgery, the doctors kept saying how bad then ending was, but I Overheard two of the doctor’s conversation in which they analysed everything they did and found nothing wrong; this patient just could not be saved. In Three hours, I Will return to the hospital and observe what being on–‐call in a surgical ward is like, and I Imagine it will be quite busy! The Patient today took 3 surgeons, so all of the surgeries they were supposed to be doing did not get done.
(please excuse the poor spacing and things, weird format stuff!)
OK wow there are a million things I want to write about but I have limited time and am using a friend’s laptop (thanks again Larissa!). First off, I want to give a brief overview of the medical highlights of the past week and today. My week at St. Mary’s was slow, but I saw two Caesarian sections, three endoscopies, tons of TB, physical therapy on a five year old with cerebral palsy, horribly burned pediatric patients, complications due to diabetes and HIV, and had a patient whose baby died inside of her so they had to induce a miscarriage. Today was my first day at King Edwards Hospital, home to the Nelson Mandela School of Medicine, so it is an actual teaching hospital. Today I saw two patients with horrible gangrene, one patient who had most of the skin taken off of her foot because of her diabetes (the wound was still open), several stabbing victims, a man who when the doctor saw him, he said, “We gave up on him two weeks ago, but for some reason he is still alive.” Because I am currently in a surgical rotation, I went into the OR and saw a completely open abdomen with the colon just kind of chilling on the side. Needless to say, I have seen some things here that have made my jaw drop.
Non-medical highlights though are mostly from this past weekend in St. Lucia. I have now seen wild zebras, a cheetah, wildabeest, warthogs, elephants, hippos, crocodiles, giraffes, rhinos, and two types of monkeys ( know I am forgetting other animals). It got to the point on the safaris where we didn’t even stop because we saw so many animals. However, the coolest part of this weekend has to be spooning a cheetah. I am not kidding, I had the opportunity to literally spoon a cheetah (If the internet connection wasn’t so bad I would post a picture but watch out for them sometime soon hopefully!). Also, I got in a fight with a monkey who tried to steal my apple (I won, just saying).
Some medical stuff that I want to comment on:
First off, the day of endoscopies I saw someone get diagnosed with the same cancer that killed my father. I had the opportunity to see the tumor, but that was definitely a weird experience for me and sad for the 35 year old woman. It felt like a punch in the stomach, but so far the only thing that has caused me to tear up has been the physical therapy of the cerebral palsy patient. This five year old kid was screaming and crying in pain as his joints were straightened out. His face was extreme pain, and I couldn’t help but think about how he will have to undergo this pain for the rest of his life. He will never be able to walk completely independent. The fact that I had the opportunity to play with him before his therapy did not help. However, I also had a surprising revelation. Before coming here, I did not want to go near a pediatric unit because I do not want to be a pediatrician and I don’t think I can handle kids suffering and dying. While I was on rotation at St. Mary’s hospital, I spent a day in the pediatric burn unit. These patients were my favorite of the week. All of them had some of the most horrible injuries I have every seen most with burns on over 25% of their bodies, but I loved interacting with them and talking to the 12 year old boy. I am going to have the opportunity to spend a week at the pediatric unit at King George hospital my final week here in Durban, but as of now, I have had a complete turn around in my feeling towards pediatric trauma. Today was my first day in my surgical rotation at KG and wow, it was a bit crazy! This woman had extreme pain in her left ankle, but the doctors cannot find anything wrong so they are going to do a below the knee amputation. WHAT?!?! This patient is not septic; there might be some nerve damage but amputation should be a last resort, not some sort of explorative treatment. Phantom pain may even make her existing pain worse! I am struggling a bit to comprehend how the doctors find this an acceptable surgery. I also saw gangrene on both feet of a man whose bilateral amputation surgery I may have the opportunity to observe tomorrow. There are a bunch more things I want to talk about but I do not have time now! I will post more about the past two weeks soon!
I have gotten through the first week of clinical rotations. I spent my first day working at Chatsworth Hospice; this NGO offers free care to its patients and runs on charitable donations and volunteers. Chatsworth is a very interesting part of the city; during the apartheid, this section was where all the indians lived. Durban is home to the largest population of Indians outside India. When I arrived, uncle Roy walked me in and introduced me to sister barrel (Sisters are a step above nurses, what this actually entails I have yet to find out). Sister barrel is a large woman who always has a smile on her face, even when she constantly scolds her staff and driver. I also met sister Cathy who was raised somewhere near Cape Town, so she speaks Afrikaans, Zulu, and english. After a tour of the hospice, which only housed two patients, I went on home visits.
In CFHI’s manual, the one major rule is to always wear our ID/name card and our white coats. I have done minor research into the concept of societal trust in the white coat, but my day doing home visits made me realize how immediate the trust and comfort many sick patients feel when they see a white coat. Whenever we walked into a patient’s home, Sister Barrel introduced me and said I was a medical student from the US (I clarified with her several times that I was actually a premedical student, but she said that did not matter). I saw 6 patients and attended a Hindu funeral.
All of the patients I saw had some sort of terminal cancer. My day shadowing hospice was kind of my biggest fear. When my father was undergoing hospice, I found the women to be annoying and in the way. They asked stupid questions and wasted time my father did not have. However, Chatsworth Hospice starts seeing patients immediately after diagnosis, so they have had some patients for over 10 years. Therefore, when patients see Sister barrel, it is not a sign that all hope is lost. The day that I shadowed was sister barrel’s first day back after a few weeks though, so we saw the patients that had very little time.
Some of the hard parts were seeing patients in the final stages of cancer that I have known people to die of back home. For example, I observed the bathing and vital sign taking of a very old man who was going to die of some sort of throat or mandible cancer. A dear friend of mine lost her father to throat cancer, and seeing the man suffer made me realize what she had seen and gone through. Also, the son who was taking care of his father (the patient) told me “I don’t want to end up like him.” Sister Cathy scolded him and said he could end up worse than his father. The son than motioned that he would rather commit suicide, and Cathy said something about when the lord says it is our time, it is our time. Then they moved the conversation to HIV/AIDS. Cathy and the son talked about how this horrible disease has forced parents to be burying their children rather than the reverse. I observed this conversation rather than taking place in it because the naked old man was shivering on the toilet (where he had been given his shower) and I wanted to help Cathy cover him up, but they continued talking while the old man just looked miserable. The one thing he said was how cold he was on this warm day.
The second patient I would like to talk about was an incredible sweet lady. She had breast cancer which had metastasized to her bones, lymph nodes, and liver after she had already received a double mastectomy. She used to be a dress designer, but now she rarely leaves her bed. During the visit, I sat on the end of her bed while Sister Barrel took her vitals. As we were packing up to leaving, the woman asked for me to examine her. I looked at Sister Barrel who interrupted me as I tried to explain that I am just a pre-medical student. I was then told to sit next to the woman and feel her stomach and chest which was slashed with scars and lumps protruded from the cancer in bones. I attempted to look like I knew what I was doing in order to make the woman comfortable, but again, I honestly have no idea how to examine a patient. Just because I was wearing a white coat, this women felt comfort in me feeling her stomach and holding her hand. As Sister Barrel and I walked back up the driveway, I told her that I am not able to give any sort of medical examination. She responded and told me it did not matter, that woman was going to die, and if that woman thought a US doctor examined, she would not only feel more comforted but also more important and special. I still do not know how I feel about lying to that patient, but there are still some friends of my dad who I truly hate because they abandoned him during his treatment because it was too painful for them. When someone is dying, shouldn’t we do everything possible to comfort them? But then isn’t my interaction with this woman too far? I really don’t know.
The next day, I shadowed at malagasy clinic. Wow, I wish I could show pictures of this excuse for a clinic. There are holes in the ceiling, some floors are dirt, some have tile. The medical closet and patient exam room is one in the same. I sat in the tiny room squished inbetween the medical storage locker and the door. I observed the treatment and diagnosis of 16 patients. Every patient who came in received anti-biotics. This truly horrified me; the threat of superbugs because of poor adherence to treatment and over-prescription is a truly scary future. I now see where these bugs are being born. Although all consultations were held in Zulu, I had the opportunity to see the treatment of a man who I imagine will die rather soon. He had a blood pressure of 220/120. He came in because of an STI and he was HIV positive. The man took his anti-biotics and two packs of condoms and left. He did not take advice from the sister who told him to go to the hospital immediately and did not take my advice when the sister tried to involve me to make him understand how dangerous his blood pressure was and how it could lead to a stroke. The conditions of this clinic and the over-medication are things I have read about, but never really seen. I am still in shock by some of the horrors of this clinic. It is not that I saw anything heart-breaking, but I know what this clinic is doing with respect to superbugs and transmission of HIV/AIDS. The lack of hygiene and people not wearing TB masks and the fact that all shots were given using the same needle to get the medication out of the bottle truly made me bite my tongue.
The last two days of this week, I was at the Blue Roof Clinic which is sponsored by the Alicia Keys foundation and Keep a Child Alive. This clinic deals only with HIV/AIDS patients and checks adherence monthly. I worked in the pharmacy, handing out ARVs and also sat in with the doctor. This clinic seemed to work as well as any clinic I have seen in the states. However, the hygiene of the sisters inbetween patients is still questionable.
I have been given a really good insight into the treatment of primary care here in South Africa. Next week, I will be observing at St. Mary’s hospital to see their secondary tier care!
I have just finished my first day of rotation. I started today in Chatsworth Hospice, but let me back up a bit. The plane rides here were long and consisted of many bad movies. While waiting in heathrow airport, for nine hours, I found out one of my best friends was there as well, unfortunately, I did not figure that out until she had just boarded her plane. Once I arrived in Durban, the person meeting me at the airport was a bit late, so thinking I had read the email wrong I wandered around the airport starting to have my first little freakout. However, Maureen came up to me and assured me that she was the right person.
Maureen and her Husband drove me to Woodlands, Durban where I met my new family and roomate for the next month! Zola, Vusi, Mzamo, Mienhele, Lazola and of course Larissa. I am proud to say I can now pronounce everyone’s name correctly. Zola is incredibly sweet and was very welcoming; none of her daughters are living with her, but she has three sons who are living with her, but one is currently with his uncle. Zola and Vusi are both school teachers and Lazola is their grandson who is incredibly cute at 2 years old. Larissa is my roomate and fellow CFHIer; she is from a small town in Texas but attends Harvard.
The day that I arrived, I sat on the couch and watched TV with the family. Now I do like TV but this set is never turned off! It is incredible. The obsession with american reality TV is rather funny. Later that first afternoon, I took my first shower. Now I am not telling you about my shower habbits to be my normal TMI self, rather, it was the strangest shower of my life. There is a bath tub, no shower spicket. I am not a picky person, but I was told to conserve water. HOW?! There is no way to concerve water, but I did try and stick my head and body directly under the faucet rather than allowing the tub to fill, but then my hair went down the drain and I freaked that my demise would be due to drowning with my hair still connected to my head clogging the drain. (My brother would absolutely love that irony)
The food was great and was an enormous portion, but Larissa and I attempted to eat as much as we could looking at eachother asking if the other was full, both responding a miserable yes, but continuing to eat in order to not offend our host mother. Zola has been very sharing and honest with us, but she is a highly religious woman. The first dinner she lead the prayer and I bowed my head. However, since the title of this post is in quotes, you might know what is coming next.
The next day was orientation. The meeting detail are unimportant and well I am running out of minutes. We took a tour with Steven of the Umlazi township. This township houses more than 2.2 million people. Some live in shacks with no water, electricity, and have children wearing grocery bags as clothes while some live in houses just like the one I am stayin in. In the middle of this township is the HOW LONG park. This man has been creating this park by himself for 15 years; his name, which I believe he gave himself, refers to how long will we be suffering. This tour was my first eye opener into the fact that I am not in the United States. Prior to this tour, I had not seen anything worse than some parts of Atlanta or LA.
While in this township we went to an orphanage which I hope to work with; all of the children were orphans because of HIV and many of them had the disease themselves. A couple has taken in 30 children, their house would be a home for maybe 5-7 in the US, but they have given everything to try and give these children a home. Although the government gives them no support, the police dropped off an HIV positive baby they found in a bush. The clinic in the township tries to help them, but I doubt these children receive any ARVs.
I am really running close on time so I will just write about the rest of the second and third day. That night at dinner, Zola asked one of us to pray, I kind of threw Larissa under the bus and volunteered her. After the prayer, Zola asked if we were christian. I was not trying to offend, but I did tell a small lie. I said that I was not christian, but my mom was Catholic (this seemed acceptable to her) however, I left out the fact that I identify and was raised Jewish.
The third day was a busy day running errands at UKZN and seeing the hospital at which we will be doing a two week rotation. We also had the opportunity to get to know our host family better as well as eachother. In fact, I told Larissa that I am actually jewish. She understood why I did not feel totally comfortable telling Zola that I do not accept christ as my savior. Larissa said she would help me with a prayer since it was obvious that it would be my responsability at dinner later that night.
Zola offered to teach us some zulu. It was the best possible forum; we were gathered in her kitchen cutting vegetables and chicken while she stirred up some amazing spices. I can now have a decent introductory conversation in Zulu but my clicks are still pretty rough. Zulu is very closely related to Xhosa; in fact, Uncle Roy, the man who drives me to my clinical rotations said that anyone who knows one language can understand the other. During this wonderful dinner preparation, Zola also informed us of the affect HIV has had on her family. She has lost 10 members of her family and she has also fallen into depression herself. South Africa is very much like parts of LA or Atlanta; I was almost dissapointed in the fact that SA was so similar, but the impact of HIV/AIDS is incredible. This disease has prevented the progression of this incredible nation, but the way in which the communities are dealing with countless tragedies is inspiring. I am truly out of time!
Once dinner was finally served, I looked at Larissa and we both knew what was coming. When Zola sat down, she said, “Sarah will you please bless our food?” In the past, whenever I have lead prayer, I simply leave out the dear god and the in your name we pray, but I knew that would be incredibly disrespectfuly if I did that in Zola’s house. So I went for it, Larissa chuckled the whole time as I stuttered out a prayer which gave thanks for some of the most random aspects in life, but I finally ended with “In Jesus’ name we pray,” for the first time in my life.
My name is Sarah Swartz. I am a rising junior at Claremont McKenna College. Currently, I am a biology-history dual major with a sequence in human rights. The youngest of four kids and the only girl, I’ve always had strong opinions and a loud personality. However, this summer’s adventure will probably tame much of my rambunctious qualities. During the spring semester, I applied and was accepted to receive funding to volunteer with Child Family Health International. I will be doing two programs: HIV/AIDS and Healthcare in Durban and Healthcare Challenges in Cape Town. Several other students will also be participating in CFHI programs in South America and India. In an attempt to prepare for South Africa, I researched the effect of gender-based violence on HIV/AIDS. I am really looking forward to understanding my research by seeing the healthcare side of the issue. However, my interest in CFHI stems more from my passion for limiting the effect of socio-economic status on quantity and quality of healthcare.
Beginning in my childhood, I wanted to be a doctor probably because my father was a physician. However, after taking AP Biology in high school, I quickly gave up that dream. During my freshman year in college, I attended a talk by an amazing man named Deogratias. During his speech, he showed a picture of a little boy who he informed us later died because of a disease which is easily curable. This picture, for some reason, reminded me of my nephew Jack. When Jack was three years old, he had to be put on a respirator. He needed some high-tech medicines and treatments, but he survived. Jack is now a healthy, rowdy, and sweet five year old. When I learned that the boy in the photograph who only needed a handful of pills died while my nephew lived, I attempted to come up with an answer for a logical answer for why? Why did my nephew deserve to live and that young boy in the photograph die? There is no answer; both of those boys deserved a chance at life.
Over the past decade, I have learned to accept the limits of science. However, I still cannot really understand how the major determinant of whether someone lives or dies is money. I’m not trying to preach, simply explain my main motivation. I hope to become a doctor who creates sustainable clinics around the world, but I realize I have got a whole lot to learn before I can really even think about how to accomplish this goal. The Center for Human Rights Leadership at CMC is allowing me the opportunity to truly begin my learning process.
In all honesty, I do not truly know what I will be doing with in South Africa. I know I will be living in a homestay in both Durban and Cape Town and work in clinics five hours a day. I am incredibly excited to be living in a homestay with two teachers and their three children. Well, their children are actually young adults; the youngest is 21. I do not know what my host family will be like in Cape Town. I leave thursday and arrive in Durban on Saturday. Although much of my actual responsibilities are still a mystery to me, I am sure that this is going to be an unforgettable, amazing, and enlightening experience!
Disclaimer: I am rather new at this whole “blogging” concept, and this blog is for academic purposes.