Safrica Day 11

Late again. Now there is a surprise. You would think that we would be on-time for one of our last days working for ADP. We wound up staying up pretty late by the fireplace doing nothing. The three-minute showers followed by breakfast on-the-run have pretty much become a routine around here.

Regardless of our late start, we managed to make good time on the trip over to the office and out to our respective sites. It looked as though Dominic and Santosh would have another day full of kids as they were already lined up in greater numbers when they arrived. Jenny and I looked like we would have to make up yesterday’s relatively slow day as well. We started whittling down our line of children and fortunately were able to work through those kids before 10:30am. However, they started transporting kids over from the other sites to us to redistribute the work. They were moving about twenty-five kids at a time – all crammed in the same van we took on a daily basis. It was quite the site. We were able to work through about three transports full of children before lunch. We had planned on taking a lunch break, before receiving another load of children, but decided it would be much more prudent to have lunch in the taxi as they moved us to other sites. So, we piled they last sixteen kids we assessed, a couple of the ADP workers, Jenny and myself into the van and carted us off. Jenny went to help Dominic and Santosh in Saxon Sea and they took me to Masakhane to help Jena, Rose and Elana with the massloads of toddlers they had there.

We got to Masakhane and it truly was chaos. I thought I was going to eat when I got there, but it rapidly became obvious that there was just no time for lunch. There was a preschool full of kids that needed to be assessed. Kids were screaming and playing in the back while others were lined up to be examined. Luckily, most of these kids were fine, but there were also the complicated cases that were further drawn out by the fact that these kids were so young and needed a more comprehensive exam. That and being one of our last days of exams, we were nearly out of most of our disposable equipment. Otoscopes were dying, speculum tips were becoming a valued commodity and we had managed to break nearly every mercury thermometer we had. Despite these issues, more and more help arrived and we managed to clear out the daycare in a timely fashion.

Having completed all of our business for today, we again headed back to the ADP office where they gave us the update of which sites had been finished and which still had children that needed to be evaluated. The sties that hadn’t been completed would be finished tomorrow during our short day of work. They also informed us that there was some sort of debacle at the radio interview this afternoon. When we first arrived, they told us that the local radio station had requested an interview with some of our group. So, Dominic said he had some broadcasting experience and would like to go. Aaron also expressed interest so he also went. Since there was already some tension building in the power-struggle arena, I thought it would be prudent to have Jena go as the third person. So, I don’t know what happened, but I’m sure we will find out at some point in time.

The staff then also informed us that they had arranged for us to have transportation to Canal Walk, a nice mall area, for dinner. We had thought that this meant that they would be joining us but we found out that this was not the case. This met with mixed reviews as we had wished to spend more time with the workers. However, it became apparent that while the idea was a good one, we would not be able to arrange transport for the volunteers from Atlantis to Canal Walk. However, we were able to treat our driver, Isaac, whom we have terrorized and undoubtedly annoyed with our chronic tardiness. The restaurant, Ocean Basket, was delicious and by the end of dinner, we were all stuffed and somewhat lethargic from all the food.

Upon our return to the hostel, we found ourselves in our familiar places in front of the fireplace in hopes of soothing our bloated bellies by the fire. There, we noticed Claudia cutting cardboard boxes into poster-sized sections. She said that her mother asked her to fashion signs that would aid in directing participants to the UFO convention tomorrow. We were initially puzzled and wondered if she actually meant something else when she said, “UFO.” In this case, she didn’t. Betsy was helping run a UFO convention. All weirdness aside, she recruited us to help with signage and we gladly obliged. It was a fun detour from our usual routine and by the end of the night, we had helped create ten original masterpieces.

Safrica Day 10

In what has become a near routine for our group, we all got off to a late start today. The majority of us rolled out of bed around a quarter to nine and the van arrived to take us to Atlantis at 9am. We barely had enough time to cram down our breakfast before we all piled into the van. It was especially a task because we needed to pack away Karysse’s luggage since she was heading off this evening.

When we got to the ADP office, we discovered that we would be heading out into new areas. Jenny and I were going to be working in Kerria, a school classroom that was being used as a medical assessment point while the school children were on winter holiday. We saw maybe about twenty kids before lunch and the rush pretty much dropped off after that. Not only did we have time for an excellent lunch, but also had the opportunity to walk around the area. We stumbled into a public gym and got to watch a small assembly program for the kids. They had a talent show and both Jenny and I were amazed to hear these kids sing.

After our lunch break, we went back to the classroom and decided to wait an hour to see if any more kids were going to show up. As fate would have it, none showed up so Jenny and I went to Protea Park to help Dominic and Santosh with the rest of their kids. I was of very little help because the first boy I saw wound up taking more time than most of the other kids. Lucky for me, and very much unfortunately for him, his testicle had not descended and he needed several more operations to fix that. I say lucky for me because this problem was the last topic of discussion during our case presentations with Dr. Peterson. By the time I was done with that case, Dominic, Santosh and Jenny had pretty much clean up every other case and we were ready to head back to the ADP office.

So, we packed up our things began driving. While I thought we were headed back to the office, we actually wound up at a youth center where members of the Africa Jam group were hosting an event for local children. Several members from our group had been there for quite some time already and everyone was utilizing this opportunity to relax. I figured this would be a great opportunity to catch up on the mountain of paperwork that I still needed to finish from earlier this morning. So, I sat in the corner and kept on writing away. I paused once and a while to look around my surroundings, I noticed that the kids here were much more forward with their interest in our presence. I say that because I noticed flashes strobing through the kids as they pleaded for their pictures to be taken. Kids surrounded each of us as they danced to the thumping music. Even several were running up to me as I sat in the corner. As the numbers of children steadily increased, I consigned myself to the fact that I would not be able to make as much headway on the paperwork as I thought and joined the others in one of our few moments to relax.

We made it back around 5pm and we fairly exhausted by that time. We had planned for a brief dinner at the school which was to be followed by a short presentation by Dr. Petersen on HIV/AIDS in the Atlantis community and South Africa. Since the dinner was planned to start at 6pm, we were given the opportunity to run to the school’s computer lab and try to get onto the internet. Most of us needed to check the status of our loan consolidation paperwork and others needed to send out e-mails to let everyone know we had arrived in South Africa and were still alive and well. This met with mixed success since all the lab computers we subject to firewalls and did not allow us to use any e-mail sites, including our school accounts. Eventually, we all relocated up to the ADP office and commandeered one of the office computers. All thirteen of us took our turn using that computer and managed to finish off most of our urgent business.

As the last few people returned from the computer, dinner was dished out and we all returned to the familiar setting of the conference room for Dr. Petersen’s AIDS talk. Although we all admitted to the possibility of forgetting many details from Biochemistry, it was comforting to be able to recall all of it based on his powerpoint presentation. As he surveyed the group for answers, we were able to intelligently discuss disease process and treatment options. He concluded his presentation with a very Elephant Man-esque patient parade. He brought up patients of different ages and discussed how they presented to him, how he treated them and their current progress through therapy. Most of us were discouraged that we really didn’t have much time to interact with the patients or have any sort of personal dialogue with them. The talk was otherwise really beneficial for us to dispel some of our misconceptions of how AIDS was being treated and viewed in South Africa. It was also good to see the current statistics for the epidemiology of the virus and how those numbers were changing. The entire talk was concluded with a short goodbye for Karysse as this was her last night with the group. Dr. Petersen presented her with a small gift we can only assume to be a CD of some sort. With that, we all piled back into the van and headed back to the hostel. When we arrived, we all had our opportunity to wish Karysse a safe journey back to the states before she was taken to the airport.

After being completely exhausted by the Africa Jam celebration and the AIDS talk, we all returned to our familiar positions by the fireplace. We pretty much all had been wiped out by the drive to and from Addo coupled by our long day. Rose, Santosh, Dominic and Elana, however, headed out with Ranier and Claudia to the Cape Town bars. They promised to be back early since tomorrow was another work day, but I’m still dealing with this cold I caught the last time I went out and I know tomorrow is going to be far busier than today was. Who knows when they are going to get back and how they will wake up in the morning, but I’m perfectly happy with my spot next to the roaring fire.

Safrica Day 9

Because of the semi-debacle surrounding our trip up to Addo, we decided to make an effort to leave the park early in hopes of arrive back in Melkbosstrand at a decent hour. We were able to organize ourselves and be on the road by 9am. Since we had already visited a winery on the way to Addo, the only remaining tour stop we had was to do some whale watching before sunset.

The trip back was fairly uneventful. We had some visual exchanges between the vans, but I think I will blame that on the monotony of the road. As time passed and we noticed the sun drifting closer to the horizon, it appeared that we had grossly underestimated the time it would take us to reach our destination… again. When it became apparent that we had missed our opportunity, we blazed forward toward Cape Town. The new plan was to have dinner at The Africa Café.

The dinner promised to be a unique experience with courses from all over the continent. We started with a soup and some small finger foods. After that, we enjoyed a couple of main courses including a chicken and ostrich dish. At this point, there were also a group of workers that were parading through the eating area singing and dancing to the beats of dueling djimbe drums. The dinner was concluded with a delicious dessert and hot tea. After we settled the bill, which was about $20 per person, I looked through the gift shop. I was pleased to find a cookbook with all of the recipes and quickly purchased a copy.

From there, we traveled back to the familiar confines of the Melkbos Backpackers Hostel and Betsy’s welcoming promise of hot tea and a warm fire. We didn’t have much time to enjoy either as it was nearly 10pm when we had gotten back and we had to get back to work tomorrow morning.

Safrica Day 8

After an eventful day and restful evening, we were afforded a late start. So, most of us crawled out of bed around 11am and got to work on a fajita brunch. We had two cabins working on cooking up the chicken and vegetables and within the hour, several plates of filling and hot tortillas were ready. We quickly consumed our fill and made plans for the rest of the day.

While some people decided to take a guided horseback ride through the park, the rest of us decided to drive through the park a second time. This was mainly in hopes of spotting a lion or two, but I wasn’t going to get my hopes up. As we drove through the park, new veterans from our experiences yesterday, we spotted more of the same wildlife we had seen previously. We drove through some different terrain and scoured the grounds for signs of slumbering predators. We searched until we were forced to head out of the park before the gate closed. Despite the apparent absence of lions, we witnessed another spectacular sunset on the open plains of the park.

Having found such great comfort around the fireplace in Melkbosstrand, we decided to continue the tradition here in Addo. We made a fire in the grill area outside our cabin and huddled around the flame, attempting to stay warm despite the frigid cold of the outdoors. Having spent nearly a week in South Africa, we were able to think about how our lives have been changes in our short time here We were also able to set our goals we hoped to accomplish in the week to come.

Much more importantly, we were able to sit and talk with Carlo about his experiences in South Africa. Not only growing up during Apartheid, but also how his job affects others in the present. Carlo is intimately involved in the process of making reparations to those displaced by the forced movement of Colored and Blacks from their homes. It was a sad story to hear, but it also helped us gain an understanding about the community that we are serving through this project. Although it appears the government is taking an active role in acknowledging and healing the mistakes of the past, it is hard to imagine that the injury could ever be completely forgotten.

Safrica Day 7

Waking up at 9am was such a challenge this morning. Despite it being two hours later than we were used to for the last few days, the work we have done left me pretty much exhausted. Even so, Buddy and I woke up and stepped out onto the balcony and took in the vast expanse of our new backyard. It was pretty surreal to stand on our balcony and watch the packs of warthogs run through the brush.

Breakfast was pretty much a flashback to the cafeteria. We were cooking a dozen eggs at a time on the stove and everyone else was making peanut butter and jelly sandwiches on the table for the afternoon. It was scrambled eggs on toast for everyone, mainly because we didn’t have the foresight to realize our two plates were not going to be enough for fourteen people.

After breakfast, we headed to the main area to book our evening tour of the reserve. The evening tour sounded the sweetest because not only were we told we would see both day and night animals, but they also would feed us cheese and alcohol. So, you can pretty much see why we chose that tour. We had a couple of hours to waste before the guided tour started and decided that going though the park on our own would be fun. We set out in our van and drove through the park. It was pretty much a run-of-the-mill park tour. We drove around and saw some wildlife. I was astounded that most of the animals were wandering so close to the van except that we had driven for nearly two hours and had not seen an elephant. That is, until we started towards the gate and three elephants poked out from behind the bushes near the exit. It was truly awe-inspiring to see these elephants just a mere yard from the van window. Unfortunately, we were rushed to meet the tour bus so we had to take in as much as we could before speeding out toward the meeting point.

As we pulled up to the meeting point for the sunset tour, it was clear that the guide was less than pleased with our tardiness. That and there were two other people booked to this safari and they seemed to be in a rush to get into the park. After a great deal of complaining on their part, we left for the safari, nearly leaving Karysse behind. As we entered the gate, the same three elephants were still slowly enjoying their evening roadside meal. We pulled up next to them and were had ample time to take photographs and think about how surreal it was to be mere feet from one of nature’s largest creations.

The tour continued with more of the same safari-type events. We saw more wildlife and the guide imparted his sage wisdom as we passed each one. In addition to the wildlife, we were treated to a spectacular sunset. As the sun drifted beneath the chance clouds, the sky turned a brilliant orange and cast a rusty hue on the brush and wildlife. Just as sun passed the horizon, we drove into the midst of a herd of elephants. This was one of the most awesome experiences of the trip thus far. We were literally inches away from over twenty elephants. It was like the Discovery Channel in three dimensions. Two young elephants were playing behind the jeep. A small family was pulling leaves off of the trees to our left. In front of us, five elephants were releasing an unbelievable volume of urine. It was surreal to say the least.

After the herd dissipated, we drove onto the next watering hole. There we were able to step off the jeep and enjoy the snacks and wine. As we were chomping on some biltong and chips, we were amazed to see that the herd of elephants had actually followed us to the watering hole and were going to take a sunset bath. As this was happening, it began to get dark and a cold wind quickly gathered strength. Before long, it was time to get back onto the jeep and head back to the gate. It was only a short drive, but the biting chill wind made it seem like forever.

By the time we had exited the game area, most of us were frozen to the bone and ready for dinner. We all headed to the restaurant and sat down for what promised to be an excellent meal. In the spirit of adventure and trying the local culture, I had a Kudu steak which was absolutely delicious. I only had about half of it, but that was more than enough to fill my entire stomach. We all enjoyed our dinner and capped it off with coffee and copious amounts of Malva Pudding. After we paid our bill, we headed back to our cabin to relax and reflect on the days events.

Safrica Day 6

It was a miracle. We had set out to depart for the Addo National Elephant Park at 9am and we were packed and outside the hostel at 9:10am. We were nearly on time. Unfortunately, our van was not. In fact, not only was our van late, but when it did arrive, we soon discovered that it was about two seats too small and reluctant to start. So, we phoned the rental service and requested that they drive a van that was breakdown-free and to change the reservation to include a trailer, or “boot” for our luggage. The only bright side of this story is that the rental company offered to give us two smaller vans for the same price. Of course, that would delay us another hour. It was nearly 12:00pm when we finally headed out to Addo.

The trip was not without its own obstacles. For me personally, I had woken up with a vicious sore throat. It was as if my tonsils had swollen to the size of a grape and swallowing became quite the task. We were already running three hours behind schedule and the drive was slated to last about eight hours without the small stops we had planned. The first stop was at a winery to do some wine tasting and to possibly pick up a bottle or two of local wines. We eventually settled on a winery and headed toward the tasting cellars. The wines were great and the tasting price was reasonable. In fact, it only strengthened my belief in the previous statement, “alcohol is ridiculously cheap in South Africa.” I wound up buying a couple of bottles of quality red wine and will probably have one or two to bring back.

After the wine tasting, it was back on the road. Don’t panic. We were civilized wine tasters and spit out most of the wine we tasted. As we traveled onward, we noticed that the drive along the coast from the West Cape to the East Cape was bound to take longer than eight hours. I can only make it from Illinois to Pennsylvania in eight hours. It wasn’t long before we encountered sunset which was rapidly followed by darkness. Nightfall had crept in and we weren’t even halfway there yet.

We wound up driving for another six hours and reached Addo National Elephant Park around 1:00am. Just as we were sure that pillows and beds were within our reach, we noticed that the gate was down and nobody was staffing the entrance to the park. We were assured that we would be able to access the grounds at any hour, but we weren’t sure that midnight was ever in the minds of the preserve staff. We backed out toward the entrance and headed out of the park. We were brainstorming with ideas about how to handle this situation. We decided to return to the entrance and hope that the ranger was just napping in the office. Sure enough, as the high beams penetrated the office window, a head emerged from the darkness and the door opened. We received our keys and were on our way to dreamland.

We split into pairs and ran towards our respective cabins. I had no idea how nice the accommodations would be. We were paying R200 each night which roughly converts to $30. This was for a beautiful cabin which abuts the fence to the preserve. We had warthogs feeding literally feet from our patio. We were very fortunate to have come across such great housing. With that, we all are tucking ourselves into the beds as jackals and hyenas wail at the moon. Sweet.

Safrica Day 5

Learning from my mistake yesterday, I woke up early today. It’s kind of silly to think that waking up early here entails rolling out of bed 7:00am. I blame it on the time zone difference and the jet lag.

We eventually rolled out of bed and were able to make it out to our 8:30am meeting in Atlantis on time. From there, we split up to our respective clinic areas. It was really interesting to hear about Wit Sand, the new site that we staffed today. This was the first township that contained only Black families. Buddy and Vita were the first to experience the madness that was the culture for the area. Jenny and I went back to Chatsworth and were surprised to find that the clinic was open and the Sisters were staffing for the day. So, we went in and began talking with the Sisters and figuring out exactly what goes on in the clinic. In South Africa, they refer to the nurses as “Sisters.” When in training, they are called “nurses” and as the progress in their vocation, they are called “Matrons.” In actuality, the Sisters are more the equivalent of the US nurse practitioners. They staff the clinics and are able to dispense antibiotics and other medications. Seeing as though we could not dispense any medications following our exams, we decided to leave the Sisters to what they do and head out to join Buddy and Vita around 10am.

So, as we left Chatsworth, we heard more about the Wit Sand area. It is apparently the “impoverished” area where we were likely to see the crazy zebra-type illnesses. Even with that warning, we weren’t quite ready to see the masses of children with the illnesses they harbored. For example, I was assessing a patient with abdominal pain early this afternoon. As I was obtaining the basic history and asked her what she ate last. I was certainly surprised to hear the translator report that she couldn’t remember what she ate. Further interview revealed that the patient hadn’t eaten in over a month. I guess I should have seen that coming. I mean it is an underserved, underprivileged area. It was still an eye-opening revelation. Even with ten of us there, we were not able to forage through the seemingly growing line of children. We eventually were forced to resign to our transport at 2:00pm and head back to Atlantis.

Back in Atlantis, we were scheduled to have a lunch session with Dr. Petersen and his colleague Dr. Reinquist. Dr. Reinquist wanted to give us a talk about their private practice and how they managed treatment for the surgeries and medical cases. Following this lunch meeting, we were taken on a brief tour of the public hospital nearby Dr. Petersen’s clinic. It was interesting to hear about how the public hospital functioned in the socialized healthcare setting. I admit that I had idealistic conceptions on how healthcare was delivered in this setting. I was saddened to hear the stories of local patients being queued and being told to wait several weeks for desperately needed acute care. Although healthcare was being subsidized by the government, it was clear that the people in this area still were not able to access comprehensive care.

Following the hospital tour, we continued to the HIV/AIDS clinic that was associated with Atlantis ADP. In addition, many of the patients that were part of this clinic were patients of Dr. Petersen. It was heartbreaking to hear the individual stories of the patients that were not only receiving care, but also volunteering their time as a major part of the support structure for new patients. We saw patients of all ages: adults, children, infants born to HIV-positive parents. It was a sight that I still feel I was unprepared to see. In the face of all this, the patients were still warm and receiving. While talking with each patient, never once did I get the feeling of hopelessness or despair. This clinic was truly a testament to how Atlantis ADP has positively impacted the community.

Back at the Fairview school, we had a quick debriefing session with Dr. Petersen. He had reviewed our patient evaluation forms from yesterday and selected a few cases to review. It was eerily similar to attending Morbidity and Mortality seminars at work. We went through several cases which were more informative than any series of PBL’s than I have had at KCOM. It truly makes me wish that we had organized this trip better and had details laid out for administration before we left.

Anyway, the lecture went well and we soon left for the hostel where we would be hosting various affiliates for a barbeque dinner. Being the fun-loving bunch that we are, we decided that we needed to go out to the local store and fetch some spirits for the evening. If there is another thing to add to the list of reasons to go to South Africa, it would be that the alcohol is ridiculously cheap. So, that being said, we bought some bottles of beer and walked back to the hostel. There, we were greeted by Dr. Petersen and Wally, the Headmaster of the Fairview School where WorldVision has its office of operation. Several WorldVision staff were also in attendance. It was a great experience and a great way for us to talk with our mentors outside of the professional atmosphere.

After the party had subsided, we realized it was our first weekend and free night in Cape Town, South Africa. So, the opportunity to head out and see the night life was an offer I couldn’t pass up. That was my first mistake. The next mistake was crawling into a taxi with four other people. As if that wasn’t dangerous enough, we sat there like a can of sardines shooting down the Cape Town highways at about 150kpm. It was like a bad movie. However, it was a cheap night at the bar and there was some pretty great dancing out at the clubs. It was a great cap to the week until the group split for the return trip to the hostel. One group took a different taxi back and we went with Claudia, Betsy’s daughter. Much to our surprise, we were stranded because the gear shifter was locked and we were stuck in reverse on the incline of a hill. It took us nearly an hour to locate and obtain a key and get on the road. Much to my amusement, the taxi that had left before us had become hopelessly lost driving back to Melkbosstrand and we had to locate them to caravan back to the hostel. Before we knew it, 5:30am had rolled around and I desperately needed to head to bed.

Safrica Day 4

I remember priding myself on my ability to roll out of bed and get ready within five minutes. Amazingly, we managed to shove breakfast into our mouths and run out the door to catch our ride back to Atlantis. There, we received a quick briefing and schedule for today.

After that, we were shipped off to our respective areas. Jenny and I were dropped off at the Chatsworth clinic and we were ready to tackle the next day of seeing patients. We blazed through the morning and managed to assess twenty-eight patients before our afternoon break. I saw a couple of amazing cases and was blown away by some of the ailments that I thought I would never see in real life. Shortly after I saw my last patient, we were told that one of the other sites was becoming overwhelmed and needed an extra person. As such, Jenny left to help and I was supposed to talk with Dr. Petersen about this morning’s cases.

When all was said and done, it was 2:00pm and Dr. Petersen arrived to review our cases from yesterday and council us on treatment courses. The concept was basically that anyone who wasn’t deathly ill was going to wait until next week to be reevaluated. With that, he rushed passed patients and drove off. It was surprising to me that we had a near riot when I told everyone that they would not be seeing Dr. Petersen and would instead be referred to the local clinics and hospitals if their condition warranted further care. Until that point, everyone appeared so content with their care – it was semi-heartbreaking. It was good to see that once we explained to everyone the situation that they appeared to be fine with our decision. After I ran through the eighteen patients we had told to come back today, I was ready to call it a day.

We ran and picked up the rest of the crew who appeared equally tattered and worn-down. We were ready for a hearty dinner. Lucky for us, we had been invited to have dinner at the house of a local Atlantis resident. The story goes that this family had a large part in the religious aspect of the WorldVision program we had recently joined. Dinner was fantastic and I sat in amazement that one woman could cook up dinner for eighteen on a single stove. Not like a four-flame stove, but a single electric hot-plate. We concluded with a gigantic plate of Malva Pudding, a local specialty which was reminiscent of warm chocolate cake drenched in a thick egg custard. It was truly a blessing to have been given the opportunity to see that side of Atlantis and eat with such fantastic people.

Safrica Day 3

We woke up early this morning to the smell of fried eggs and warm bread in the toaster. This hostel is simply amazing. It blows my mind that we are staying here for only sixty Rand, or US $10 each night. The beds bunked, but comfortable and the rooms are just warm enough. As everyone rolled out of bed this morning, it was surprising to find us all eager to get to work despite the obvious jet lag that had followed us from the US. We sat down and savored every bite of breakfast before our ride to Atlantis arrived.

We piled into the van and retraced our route to Atlantis. After about ten minutes, we arrived in the Atlantis area and pulled into the school that serves as one of the offices for Atlantis ADP and WorldVision. We were introduced to the staff and were ushered into a conference room where we received the final bits of information before heading out to the rural clinics and schools. We met with Dr. Petersen, the medical director for the Atlantis ADP program and he carefully detailed his expectations for this mission. It was thrilling to hear that he expected us to see patients in each township and provide assessments to people who desperately needed medical care. We would then return our evaluations to him and devise a treatment strategy that would be comprehensive, effective and be easily accessible to the citizens in each area. This seemed nearly identical to my preceptorship and I was eager to get to work.

Despite being freshly energized by the morning talk, it didn’t prepare me for the patients that we began seeing in Chatsworth. Even before we arrived, people were lining up outside the clinic. Within the first hour, we had twenty-one kids signed in to be seen. Jenny and I started seeing patients together and we realized how limited our care was as medical students. We were still being stumped by rashes and swollen lymph nodes. We saw an inordinate amount of ear infections. We saw some really sick children. We started to worry about the possibility that we could miss something. One year of medical school is a lot to rely on when you are charged with formulating a differential diagnosis for children who may be dying from HIV or AIDS. We had no medical records to rely on and a limited patient history that we could decipher from the translators. However, even when we were not able offer a definitive diagnosis, the patients and families seemed so grateful for whatever we could provide.

It was exhausting. We finished around 4pm local time and headed back to Atlantis for a quick debriefing. After planning tomorrow’s follow-ups with Dr. Petersen, we returned back to the hostel. Upon our arrival, we were instantly treated to the aroma of fresh-cooked dinner. I feel the necessity to reiterate, this hostel is amazing. After being thoroughly stuffed, several resigned themselves to bed while others walked to the beach. The beach is a mere five-minute walk and has an amazing concentration of moonlight. Tonight is the full moon and it is hanging above my head, casting light upon our group as we each scribe our thoughts of the day’s events. The beach is empty and it is just the six of us under moonlight with the ocean waves breaking in the background.

Safrica Day 1 & 2

We left Kirksville this morning at 7:00am for Chicago O’Hare International Airport bound for Cape Town South Africa. The number of stumbling blocks that occurred prior to leaving the state appeared to herald a rocky start to this journey. I set my alarm for 6:00am in hopes of waking up and packing up the last items into my backpack and heading out to meet Rose in the driveway. Conversely, I awoke to Rose knocking on my door and using my computer. Fortunately, I had packed a great deal and still made it out the door on time.

Following that debacle, we headed out of town on Missouri Route 63 North. About five minutes on 63, Rose realizes that her ATM card is likely still flapping in the breeze at the ATM. So we drive back to US Bank and scour the general ATM area for her card. We admitted defeat and headed out of town and thought of the better times ahead of us. As a side note, on our first pit stop for food, we found another US Bank and Rose was able to obtain another card.

So the rest of the drive up to O’Hare was fairly uneventful and we pulled up to the terminal around 3:00pm. We did have to stop one more time to ask for directions to Parkson’s house from an old lady in Moline. Parkson was kind enough to feed us and drive us to O’Hare to spare us the ungodly long term parking charges we would have incurred for our three-week stay.

We reunited with the rest of the SAfrica crew outside the ticket counter at O’Hare and it was official. The SAfrica Trip was on. We checked our bags and got through security without much trouble and made it to the gate. It wasn’t but a few minutes before they began boarding our massive 777 Jet to Amsterdam. The first leg of the journey went quickly. The eight-hour flight seemed like nothing since we had just driven six hours before reaching Chicago. I slept for most of the flight waking up only to eat and use the fabulous aircraft toilets.

After eight hours in the air and a seven-hour time zone difference later, we arrived in Amsterdam at 8:00am, June 21st. The layover was a new experience for me. I had never flown into Amsterdam and the airport was completely different than any I had seen before. There was a museum, several sleeping lounges, and of greatest interest to me, a meditation room. At first I thought this was a loosely translated chapel, but upon investigation, it truly was an area for people of any religion to seek refuge from one of the fastest-paced locales in the world. Intriguing as it was, our stay in Amsterdam was short-lived as we boarded our second plane for Cape Town at 9:30am.

This second aircraft, while smaller, was much newer and obviously more advanced. Each headrest had a screen placed inside to give each passenger their personal entertainment options. I wound up watching The Grudge, National Treasure and a couple foreign films. In addition, I played a couple rounds of chess with other passengers and thoroughly perused the other game selections. I opted to stay awake for most of this flight to make the trip to bed easier when we arrived in Cape Town. Despite the variety of entertainment, this trip was noticeably longer. The entire flight lasted the better part of eleven hours and we arrived in our destination; Cape Town, South Africa at 10:00pm.

After deplaning and exiting through customs, we were greeted by several members of the Atlantis Area Development Program (ADP). These were people that Jena had worked with and were the basis for our planning the mission trip out to Atlantis. On the drive to our hostel, we were given the quick history of the area and the current living conditions. We stopped once for gas (petrol) at the station near the airport and we began talking with one of the attendants at the station. I was nearly shocked to hear the attendant, a pure African ask if some of the ADP staff were “Black or Colored.” It brought up in such a casual manner that it defied all logic set forth by the conservative society that we came from. However, the lines of descent are very clearly drawn in this are where “Blacks” are citizens of pure African descent and “Colored” are citizens with mixed heritage. There is language barrier between most Blacks and Coloreds and the easiest way to decide what dialect is appropriate is simply to ask.

After that experience, we continued our drive to our hostel in Melkbosstrand. Betsy, the lady who runs the hostel, was there waiting for us with hot cups of tea and coffee. I briefly looked around and noticed that we had obviously left the shambled confines of Atlantis and traveled to a seemingly affluent area of Cape Town. Houses appeared manicured and detailed, surrounded by shiny wrought-iron gates. Large placards blazed “Chubbs Security” and “Team Management.” It was fairly intriguing to find such different living conditions within five minutes of each other. We happily unloaded our belongings and retreated to the beds within the warm walls of the hostel.

over and out

And so goes my last shift at the PCRMC ED. It was an awesome time and a great, laid-back last shift. I'm spending my last night in Rolla, Missouri and suprisingly enough, am thinking about coming back.

Now, just as an aside, I will be out of reliable communication for several weeks while I am in South Africa. My cell phone will be off until July and I may check my e-mail intermittently.

almost over

I only have one more shift in the Phelps County Regional Medical Center Emergency Department and in truth, I'm a little sad. It has only been two weeks and I have had such a great time working here. Surprisingly, the twelve-hour work days have gone with amazing speed and I have learned so much every day. Everyone has been a great help and I learned a great deal from every member of the staff. It truly has opened my eyes to areas of medicine I had long closed the door upon. My previous experiences had biased me so much and it is such a relief to have new experiences to balance old prejudices. To be specific, the surgeons here have been some of the best physicians and teachers I have met. The ED physicians and staff have given me such great opportunities to practice skills I would have had to learn in my third year. It has been an awesome trip and I will never forget it.

In a less serious note, I also learned a great deal about the paperwork part of medicine. As part of our two-week rotation, we had to complete several patient encounter forms. These forms were completed on the internet and we were to assign a diagnosis code based on the International Classification of Diagnosis (ICD-9) guidelines. So tonight, I was searching for the code designated for "pelvic inflammatory disease." The following screen came up:

Sweet. Handgun. Who knew?

After a bit of research, the 900 group is designated for "Accidents or Injuries." I still think it would have been pretty sweet to diagnose someone as "Handgun."

I love my life

I remember people always told me to find a job that I love doing. These past few days in Rolla have been showed me that I will love my job. I knew as an undergraduate that I would be in healthcare. I often thought about just living life as a paramedic. I loved that job and still think about it often. However, this first week of "internship" at the hospital has given me an all new perspective on my future.

For the last seven days, I have been in a shirt and tie for half the day, people have been calling me doctor and I am doing things I dreamed about four years ago. Its a weird feeling that I didn't expect to have for another three years. I've been suturing wounds, working 16-hour shifts and scrubbing in on surgeries long after the end of my shift. Even more than that, I can't seem to get away from the hospital. The staff is great and I get to share this experience with my classmates. What a great deal.

I was in the ER this evening and there was a massive pile-up on the local highway. A mass-casualty (multiple EMS) incident was declared and our ER received a slew of patients. I remember running drills at the hospital back home, but luckily never had to actually put it into action. It was amazing. Doctors everywhere. Nurses everywhere. Radiology and respiratory techs everywhere. Patients in every room. Staff from every department was there taking care of patients. I love my job.

Afterwards, I just didn't know what to do. We were three medical students who had just seen a whirlwind of healthcare providers receive, comfort and care for so many patients. I was so drained but I just couldn't leave. We sat in the hospital like it was our home. We talked about what we had seen and done. Then, Keya delivered another baby. This job rocks.

today is the first day...

Ever heard that before? Well, sure enough - its true. I had my first day of my two-week rotation today and it was awesome. I seem to remember the wisdom imparted by that time-honored show, Grey's Anatomy. That's right - I went there and the view from the other side is truly spectacular.

I got to the ER at 8am today. This was the pre-arranged time - I wasn't late. The day shift had only been on for an hour and it was looking to be a miserable day. Four patients in beds, three in triage and another two rolling up in ambulances. Seriously. One doctor, four nurses, one medic, one tech, and non-patient care staff were supposed to tackle this. Holy crap. I need to find another specialty.

However, I soon learned that from a student's perspective, busy = fun. Ok. Maybe fun isn't exactly the best term, but I did more than I thought I would for Day 1. Granted, by more I mean a bizillion rectal exams and a bizillion + 1 male hernia checks, but I guess that's why they make us say "penis," "scrotum," "anus" and "rectum" until it isn't funny in school. Other than that, it was great. The attendings had me doing physical exams, writing patient histories and presenting cases. It was like being a doctor. Isn't it fun to pretend? So now I can look forward to finishing school.