St. Mary's Hospital

Sanibonani! (Hello in Zulu, the language commonly spoken in Durban besides English.)

Everything in South Africa is going wonderful. I haven't have much time to blog or get Internet access, but I thought I'll share a little bit of the week with you.

The first hospital we have been attending is St. Mary's Hospital. It is a primary care hospital, which is called district one here. It contains 200 beds, but sees approximately 6000 births, 48,000 in outpatient, and 15000 in inpatients and unknown # in their HIV/AIDS clinic.

Day One- My first day was in pediatrics. Since we had to register at the University of Kwazula-Natal, I only spent 2 hours in the ward. The children are happy and excited for visitors. Kids are so helpless and the most optimistic of all the pt I meet. I continually visited them over the week. I can't wait to post the pictures for you to meet them.

Day Two- "I'm young and feel great. I've never been sick a day of my life."

Chris and I spent the day in the iThemba clinic, an HIV/AIDS clinic. Each day, the waiting rooms and halls are packed with pt waiting for vitals to be taken, pills counted, pick up monthly meds, or see 1 of the 2 doctors or 2 nurses if they are sick.

We spent the morning taking vitals. It was humbling to meet all the pt. They were all friendly and helpful. 200 people are seen everyday. In the afternoon, I sat counseling for the different medication regimens. Generally, most pt are compliant and the clinic's strict pill counting and home follow-ups ensures compliance. During one counsel, a young man in his last year of university resisted treatment. "I'm young and feel great. I've never been sick a day of my life" was his response. He is right. Looking around, I would never have guessed these pt were HIV+ and that every pt I talked to were positive. This is a problem ingrained in the symptoms of HIV. PT are asymptomatic until it is too late. Therefore, pt never get tested until opportunistic infections occur.

Day Three- "I have a dream.."

Today was my day out in the community. Everyday, cars with counselors go out for home visits to check on ARV compliance or pt with limited support or resources. Our car today checked on children for proper care, support and treatment. The counselor work hard to educate parents as there is no system to remove children from their parents due to limited funds.

The trip provided the opportunity for me to view the living situation in South Africa. Houses speckled the green rolling countryside in densely packed areas with a few feet between each house with garbage covering the ground. Homes ranged from 5 x 5 mud square or mud huts. Most homes do not have running water or electricity. Garbage is piled everywhere. Currently, rubbish workers are on strike as are bus drivers due to low pay. In over six hours, we saw 4 families and visited 5 empty homes. As houses are scattered wherever there is free space, we drove up and down hills looking for families and only spent 5-10 minutes with the families we found.

Of the 4 families, the first was a HIV mother and baby who are both compliant to the meds, but the mother used the gov. grant money for baby formula on rent. Every situation is a catch-22. The choice is between hunger or shelter.

The second family we met was a 17 year old teenager with a previously malnourished baby living with her grandmother. She is one of many females in the country. Teen preg is very common and S. Africa is working on education and changing a whole society's beliefs. Condom use is not widely accepted and when the campaign initially began, more than 50% of the condoms were defective. For girls, protection or the choice to have sex is not an option. Many are raped and those that are not physically assaulted agree because they are supported by men. The government system also grants 220 Rand/month to teen moms, which is only $25 US a month. It is not enough to support a child, but to females with no money, it seems like an easy option.

Upon a hilltop, I met Innocent, whose Grandma is n ARV and sister on TB treatment. During our discussion, Innocent took me aside to ask me to help him with his problem. Outside, he told me he had this dream. It is to come to the US for job opportunities. He explains how he studies and reads the newspaper. Do I know of any sponsorships? Of all the people I met, he is the only one that specifically asked me for monetary support. Generally, the questions ranged from how long will I be here and when will I return. With no support from the govn., many look for foreigners for help. As an American, there is a sort of celebrity status. Children wave, cars honk and stop, people stare and favors are granted. In the end, there is so many problems to be solved and so many people to help. It is disheartening to know it is a long time before S.A. can rebuild so all can have even basic living conditions.

The next family was a short visit. Twin brothers walking on the sidewalk were hit by a car. One died instantaneously while the other one was badly hurt. Driving in S. Africa is madness. Right of way for pedestrians does not exist and people have to run to avoid being hit by cars. The sight of children do not even slow down cars. I saw 2 year old barely able to walk themselves grab younger siblings barely smaller them themselves hauling them out of the road as fast as possible

Day 4/5: Labor/Delivery

In the spring, I spent 10 weeks precetoring with an OB/GYN and it was one of the best medical experiences I had. I enjoyed the clinical and surgical aspects of the field. Seeing the labor/delivery ward in S.A. was such a contrast. When asked by our medical directors the biggest comparison between the states and S.A., it would not be the quality of care, but the lack of resources. Therefore, nurses and doctors offer the best care and pt pick up the rest of the slack. Those lucky enough to go to the hospital labor until they dilate 8 in the waiting room in wooden chairs, receive morphine and mandatory episiotomy without any lidocaine. There is no team of nurses, midwives, family and doctor. Nobody holds your hand or legs. The women scoot down the metal table by themselves. After the birth, the women literally pick up their belongings and move to the ward to spend maybe one night. There is no customer care.

I also witness 2 C-section. Very similar except the cut is made vertically instead of a horizontal cut as well as limited supplies. Everything is reuseable.

I hope this is specific enough. I have so much to say and so little time. Pictures are hard to take due to crime, but I tried to take as much as possible. In the future, most of my blogs might just be documented in pictures. Here is a link to my day in the community and Heidelbeg. Peds, labor/delivery, HIV/AIDS clinic to come.

I miss you all!

Community: http://www.facebook.com/photo.php?pid=34542033&l=15ebb&id=19712952

Heidelberg: http://www.facebook.com/album.php?aid=2149965&l=a51c6&id=19712952