Life as a homeless orphan

Let's pick up where I left off last time, with the discovery that I was homeless! Fortunately for me, there are many many kind and generous people here who have taken me in and looked after me over the last week while Sam has been away [even after I found the key again].








After my arrival back in big bad Zithulele, I went various places on an epic fail of a key hunt. I ended up at the Gaunts' who were throwing a mini birthday party for Thembinkosi, one of our community service doctors. Sadly, no cake for me, bad times, but I had fun and played with the three Gauntlets for a while before being given the use of the shower, HALLELUJAH. It was possibly the most brilliant shower ever after having being bathed in the sweat of the other sixteen people in the Mqanduli taxi of doom for three hours. Then I went back to Liz and Lisa's house [from now on to be known as The Orphanage] for some dinner (chilli if you're interested) and because they are both legends, they let me sleep there for the night.







Monday was a very epic 24 hours. Liz/Dr Gatley was doing her last ever on call day [see my previous post 'On Call with a Rural Doctor'] and kindly allowed me to shadow her, something which began with me pulling my clothes on at 5.30am and jogging to catch up as she went in for an emergency caesarean section. I must point out that Liz had already done a Caesar at 2am that morning, I cannot imagine how tired she was and how on earth she managed to drag herself out the door again!







Anyway, soon enough I was in scrubs (yas :D) and in theatre watching another birth...epic enough for you? I'd always thought that a Caesarean would be a much more pleasant affair than natural birth but after an hour's viewing of that surgery, my mind was completely changed. Getting the baby out was a relatively quick process, and aside from one part where Liz and Thembinkosi literally wrenched the woman's skin apart to make a big enough hole, wasn't too gory. The whole surgery was done without suction as the machine was broken, can you even imagine the uproar that would occur if that happened in the UK!? The baby was cute (as per) and he was fine so it was all good in that department. The closing up bit however, was pretty gross...







The womb got taken outside of the woman's body which is the most bizarre thing ever, and it was just sitting on her chest while the doctor's stitched it back up. I was surprised to see what it looked like, the best way I can describe it is kind of like a squishy egg with really thick walls [you can tell I'm going to be a greeeeeeeeat doctor, not] – I had always imagined it to be kind of transparent, but whatever. Everything was going nicely with the suturing until the woman started to cough and the presence of a gaping hole in her abdomen meant that her intestines literally exploded out of her body! I couldn't quite believe it, it was rather surreal, and made even more so when Liz hastily shoved them back inside...







Once that was over, we went straight to do the maternity ward as there was no point going back to sleep now that we were both awake and it was light. The rounds were pretty uneventful with the exception of one woman who was lying groaning and sweating on the antenatal ward. Liz went to do the PV on her, only to discover that the membranes were in fact bulging out of her, so the nurses then made her get out of bed and run down the labour ward as she was apparently imminently going to deliver, heeeeeeeeectic!







Back at The Orphanage, we had breakfast but no sooner had the coffee been poured than Liz had to go back to the hospital. After finishing my toast I too returned, just in time to see a patient who Liz had been called to by nurses who reported that he was 'acting strangely'. May sound like a pretty vague diagnosis, but after some observation and investigation, Liz too made the same decision. The man had a huge grin, was lying in a very strange position and repeated everything that was said. When we went to see him again later, he was even more odd, spinning around on the spot, repeating the word 'Apha (here)' very loudly and standing with one arm in the air, how bizarre. He was treated with a sedative and put into a cot bed to stop him roaming around like crazy, but apart from that there wasn't much you could do without access to lab tests, x-ray, CT scans and all those fancy things we take for granted back home!







Lunch was completely legendary pizza breads, then we were back in OPD seeing all manner of things, none of which I can particularly remember, Most of them were sick kids, malnourished in some form or other. I do remember there was a seriously melodramatic woman who needed her c-section wound cleaned and exclaimed that she was dying before Liz even touched her!







Liz and Lisa cooked me dinner (again) and let me sleep over (again) for which I am eternally grateful, especially as by this point I had found the key. After phone calls here and there to various people I went to look in the secret key hiding place and by chance saw a little glint of metal in the mud patch that is our garden, our long lost key! It's a complete mystery as to how it got there [let's blame the frogs] but at least I now had access to clean clothes, something that I'm sure everyone else was almost as glad about as I was!







At 3.30am the next morning I was up again with Liz seeing a man who appeared to have lungs filled with fluid. He sounded horrific when he breathed in and out; it was like he was drowning. After syringing about 120ml of fluid out through his back and giving him lots of furosemide injections, Liz took him for an ultrasound and I think I'm right in saying found a suspected pericardial effusion and after seeing that there was very little else that could be done right then, booked him for an urgent x-ray in the morning. The man died before the radiography department opened two hours later.







It's pretty depressing to know that doctors here can spend hours toiling in the night only for the patients to die because they lack a simple diagnostic tool like x-ray. I have so much respect for all the staff here who continue working day after day in the face of all kinds of obstacles that no one would even imagine in the first world, it's been such an enlightening experience, something that will stay with me for a very long time.







Anyway, that was the end of Liz's time on call in Zithulele, so much rejoicing was in order! Sadly, going to work was also in order, so she did that instead, as did I. Work was the same old fun and games in the pharmacy as always. I had one woman from the wards that came to me early in the morning looking for ARVs and then waited the whole day for me to come and see her kid but was so incredibly grateful to me just for a simple thing like giving her drugs :D On the other hand, some new ARV patients got very angry with me when I refused to start them on treatment until the afternoon and crowded up the dispensary door and started shouting 'Jesus Christ' at me...fun times!







Ngcwanguba clinic on Tuesday was a bit of a nightmare with defaulting patients deciding to turn up again and then finding that they hadn't been made a pack, then getting irritated and worried when they heard they must travel all the way to Zithulele to restart their treatment. Eventually I managed to make some kind of coherent plan for them and we got out of there in reasonable time. Hopefully we will stop having to go at all in the next few weeks.







That's all for now!







xxxx