don't worry, we can make a plan

don't worry, we can make a plan

Wednesday 26 May 2010

And I almost forgot...

Liz isn't leaving any more! Yay :)

Blogging fail

I realise I've been a bit pathetic with keeping up to date in recent weeks; between the increasingly chaotic ARV programme and spontaneous trips away I haven't got around to it. Here's a brief run down of what's coming up when I finally sit and write:

 - what it's like bring the only white person in church
 - more pizza
 - more births
 - more letters
 - getting an HIV test
 - spontaneous trip to Mdumbi
 - lots and lots of pills

And of course the usual helping of good times and epic fails!

With only 12[ish] weeks left the end is in sight and it's pretty bleak :( But many exciting things are on the horizon: Mum's visit, East London road trip with Lisa, Sam and I go on holiday...

Thank you to whoever posted the poem, it sums up things quite nicely for me :)

xxxx

Monday 17 May 2010

Epic Days and Nights In The Rondavel: Part I

[An account of the 15th May]





Zandile, what a legend!





Friday was a very happy day in the pharmacy when Christmas came early in the form of a massive delivery from our friends at the depot. The highlight was definitely the 1200 containers of D4T which solves that major crisis [see prev. blogs] at least for a week or two! We also received 50000 paracetamol tablets that have to be prepacked into packs of 20, does it get any better? Oh, and how could I forget the 15 boxes of TB drugs that we welcomed with open arms! The entire pharmacy was filled with boxes up to head height – the extreme level of excitement that this provoked in me is testimony to the fact that I have been here a bit too long!!! After a little raid through the boxes to see what else was back in stock, we left the piles of boxes for next week's work [why not spread the joy until Monday?].


The back room AFTER [!] we'd cleared most of the stock





Asanda came over mid afternoon to teach us how to make traditional Xhosa bread. Turns out it isn't that difficult, you just chuck flour, warm water, sugar, yeast and a tiny bit of butter in varying quantities until it makes a gloopy dough. We left it to rise for a while and watched some of the latest TV series that we have stolen from Anita, Rome [the BBC one]. I'm not sure there's ever been a more violent, scandalous and disturbing depiction of life in ancient Rome, but oh well! Eventually, Asanda decreed that the dough had risen enough and said we should start to cook it. The bread gets cooked on a stove by putting it in a pan lined with an oil/flour mix, most bizarre. Due to the unpredictable and uncontrollable nature of our little stove, it got a bit chargrilled on the bottom within about 2 seconds, but eventually we got it settled at a nice heat.







That was until the power went off. For the second weekend in a row. [Good times all round.] Over the next three hours, our bread went through varying stages of being left on a cooling stove, being ignored on the worktop, being blasted on a gas stove, being serenaded by Beyonce tunes, being toasted on a hot plate with stones on it...I suppose it’s no small wonder that it ended up completely black on 90% of its surface area! We were in stitches the entire time at how much of [yes, here comes my favourite expression] a complete EPIC FAIL it was. Asanda tried to stab it to see if it was cooked in the middle but the knife just bounced off the outer crust – is that enough of an illustration of how burned it was? Despite the burning, Sam and I were determined to make the most of our beautiful/hideous creation and it actually turned out to be really good in the middle. Once we'd sawn through the 4-5mm layer of charcoal, the inside was the Xhosa bread we had come to know and love during our stay at Coffee Bay over Easter :)

Xhosa bread fail :)

"What day is it?

...and in what month? This clock never seemed so alive.






I can't keep up and I can't back down, I've been losing so much time.



~Lifehouse ”



I very much like that song, just in case you were wondering.



It's been a busy week!







Monday was a productive day at work and I managed to cross off a fair few of the things on my To Do list. It is SO good to have Bonga [our new pharmacist] here to get things up and running again in the pharmacy :D I got everything prepared for my second ever visit to Wilo clinic which is the latest place that we have expanded the ARV down referral system to. The first visit was a bit of a trial run as there were only 3 patients [compared to the 60-70 at each Mapuzi/Ngcwanguba day!] but at least it gave me a chance to get the system implemented.







We had long and competitive game of Frisbee, great fun as per. It's now getting dark really early at around 5pm so we have to play by floodlights which makes it pretty difficult to see the Frisbee [not helpful when you have little hand-eye co-ordination to begin with!]. After over an hour of very fast paced play, we ended with the traditional first to three contest, and then there was the weekly eat vs. shower dilemma before Grey's Anatomy at 7.30pm. Since Sam had made dinner, I chose eat :D Grey's is beginning to take things a bit far: a famous surgeon came in and demanded to be allowed to be awake during his own surgery – yeah, okay, that would be allowed! [But we still love it...]







On Tuesday I set off for Wilo with Etienne in the mobile dental clinic. I only had ten expected patients [next month it’s up to around 25 though] and half of them had already arrived when I got there. I was really impressed with the ARV counsellor there – she had made a list of all the patients for me, set aside a room, called them all in and dispensed their ARVs perfectly. It was miraculous considering the mass amount of mix ups that happened [and still happen!] at the other two clinics. Hopefully as we increase the clinic number gradually the Wilo days will become a really successful part of our ARV programme. It's especially rewarding to see this clinic work because I have been able to oversee the setting up and training of the counsellors myself :D







I spent the rest of the morning prepacking in the front seat of the dental truck while Etienne saw his patients. I had just fallen asleep with my half empty container of Ibuprofen when he finished up and we set off along the long road to Mqanduli to fill up the petrol tank. By the time we arrived back at Zithulele it was 4pm leaving very little time to get anything started in the pharmacy. We're having a major crisis in terms of vacolitres [the liquids used for drips] so I did the order for that then did all the remaining paperwork for Wilo before leaving the pharmacy at 5pm for the first time in absolutely aaaaaaaaaaaaaaaaaaaaaaaaaaaaaaaaaaaaaaaaaaaaaaaaaages!


Life in the TK: kids beating goats



A pizza outing had been planned for that evening so we all met in the Plaza to arrange lifts. It then became clear just how many of us were going – it was a mass exodus from Zithulele as eighteen of us left for Papazela's in a convoy of four 4x4s! We arrived and rearranged the furniture to fit our giant group in: me, Sam, Anita, Etienne, Shannon, Marlie, Megan, Liz, Sarah, Bernard, Rob, Surabi, Pria, Asanda, Jess, JT, Ayanda and Mhla. The pizza was great as usual, overall a top night :)








Wednesday was Zithulele ARV clinic: with only 95 expected patients compared to last week's 146 it seemed almost manageable! Bonga and I worked together for most of the morning so that she could learn the ropes. Thanks to some serious ineptness at the medical depot, we are out of D4T AGAIN. There are very very few patients who don't take D4T as part of their drug regimen so everyone had to only get one month of treatment and is coming back next month, meaning that on that date, we will have all these 95 patients plus however many were given multiple months treatment in March and April – yay! We think that we might be able to get round it by prepacking for the 95 patients so they can just pick them up without having the wait in the queue...providing we get some more D4T of course.


The dispensing table

After work we had Wednesday's Frisbee match, this time with some of Tom's friends as guest players. It was another extremely fast game during which one Frisbee was thrown out of the court never to be found again and another ended up in the sewage pit, much to Karl's despair [it was his favourite Frisbee]. I got completely flattened at one point when George ran straight into me as we went for the same Frisbee – Frisbee injuries are getting far too common, at least one person goes home bleeding/bruised each week!








After Frisbee, Jess, JT, Asanda and I did a beautiful rendition of an HIV/AIDs education drama as a practice run for a performance [which, after people saw this one, we will NOT be doing] at a local football match which aims to encourage people to take an HIV test. It was all improvised, but if there was a script it would look like this:







Jess [woman with multiple partners]: *dances around oblivious of her HIV+ status*



Me [the HIV virus]: *chases Jess in a menacing way*



Jess: *goes for an HIV test*



Asanda [the nurse]: *gives Jess some ARVs*



JT [the ARVs]: *jumps on my back, throws me on the ground and stands on my head, symbolically killing the HIV*







As you can see, the climactic scene got a bit violent! It brought those watching to tears [although sadly not because they were so deeply moved...] Anyway, after we'd recovered from that excitement and Sam and I had had fajitas for dinner [with homemade tortillas!] it was time for cell group. We had a long discussion about community – what it means in our context in Zithulele, the pressures of living in a place where friends and colleagues are one and the same, whether it’s possible to have a long distance community - all interesting stuff :)







On Thursday I got up and did some paperwork at home for an hour or so after falling asleep before completing it the previous night. I went up to ARV clinic around nine and it looked blissfully empty so the morning spent there was not so stressful. Lots of defaulting patients [including a few kids] came back much to my happiness so it was a very positive day in terms of that :) We did, however, discover that we also had seriously low stock of another two drugs so everyone was getting the bare minimum of ARV rations...again!







Anecdote of the day: Taryn saw a patient and noticed that their file number was Z5000; a little odd considering that we only have about 1400 patients in the system at the moment. After some investigating, it was discovered that the patient registration book had a unique numbering system: 1098, 1099, 2000....2098, 2099, 3000...3098, 3099, 4000...I think you get the idea! Bit of a basic counting fail right there - and that's reason number 837475 that I love working here so much :D







After clinic was over – and Zandile and I almost fainted when the last patient left before 5pm – we had a new extracurricular for Zithulele: ceilidh dancing. Our current medical student, Rob, is from Calendar so between the two of us we managed to get everyone down to the Frisbee court for a little taster session of everyone's favourite Scottish pastime :) There was a good turn out and after some rather amusing attempts we managed to get the Gay Gordons going. Having mastered that one [well, to be honest, there's just a tad more work to be done!] we moved onto a slightly more hectic dance and introduced Strip The Willow which tired everyone out considerably! It was a lot of fun and will hopefully become a regular fixture on the Zithulele extramural calendar, watch this space...



xxxx

Saturday 15 May 2010

The Spirit of Zithulele: Braii, Rugby and Power Cuts

[8th / 9th May 2010]




On Saturday afternoon, Joff and Megan were hosting a braii at Orbi's white house at Hole in the Wall so I made my way there on foot. It's a great walk, especially when you come to the top of a giant hill and see the Hole down below you :D It took just less than an hour to get to the H.I.T.W beach then I slowly wandered along the road to the white house.

The view over Hole in the Wall



I was quite late because I walked so there was an enormous group of people there already: Megan, Joff, Joff's parents, the Le Rouxs, the Gaunts, Sarah, Bernard and some friends, Rob [our new medical student], his friend Euan, Jess, Karl's brother and Liz, her mum and her sister. We had a braai and I spent most of the time entertaining the Emma, Josh and Grace by playing a marathon game of hide and seek which mainly involved running around the garden and having mud thrown at me, fun times! :D







In the evening we played one of the most hilarious games of 30 seconds yet, then went up to Orbi's main house to watch the Stormers play the Sharks in the Super 14. With half of those watching supporting each team it was an enjoyable game to watch, especially with the legendary Karl Le Roux excitement reaching new heights. Sadly for Karl, the Sharks completely dominated the match but the Stormers held on valiantly to keep the score at 21-14 [or something like that!].







The next day I spent the morning washing all my clothes and then Sam and I watched a few episodes of Army wives. We had just finished making some bread dough for homemade pizza when another wonderful power cut came our way. Luckily, Liz invited us over to braai with her mum and sister so we decided we would make our bread on the fire, but by the time we actually arrived at her house, the power was back on so we just used the oven.







The power cuts continued all night but the Gatleys showed their braai skills and we had a lovely dinner :D Lisa arrived back from leave too and had acquired a copy of the Zithulele hospital promo video which makes everything here look so epic [think those videos they have on Comic Relief to make you donate] – it's getting put on the Zithulele website soon so when it is I'll post a link.







When we got back to our rondavel the power supply seemed to have temporarily stabilised so we settled down the final episode of Army Wives [which was NOT cool due to an extreme cliff hanger], then went to bed, weekend over.

Bulungula: Getting Away From It All

[7th /8th May 2010]










On Wednesday at cell group, Karl and Sally talked me into taking Thursday afternoon and Friday off of work and go to Bulungula for a break. Sam, Anita and Thandeka [the preschool teacher] were going for an Education workshop there and so we arranged for me to go with them and just chill out while they were working :)







At 1pm on Thursday I left ARV clinic and hopped into our good old friend the Jabulani Golf which had miraculously recovered from both a flat tyre and a flat battery. We drove along the Mpame road which is rather scenic, if a little potholed. After an hour's drive we arrived at Bulungula store where we disembarked and prepared for the long walk down to Bulungula Lodge.







We set off cross country towards the sea – although it turns out that what I assumed was cross country was actually the road! It's a 4x4 only track but it would still be insane to drive on given that it's strewn with huge boulders, extreme ruts and crazy inclines. As we walked down through the villages we saw lots of local kids and even a baby goat that started to follow us and which we did consider kidnapping and taking home :)







After an hour and a half [the overly optimistic guide time was forty five minutes] we arrived at the lodge. It's in an absolutely stunning location overlooking the river mouth and a beautiful white beach and it's completely isolated from the civilised world - the perfect place to get away from it all and not have any of the stresses of work. The main lodge comprises a lounge area, kitchen, bar and outside fire circle, then there are separate shower and toilet blocks. There are also six or seven guest rondavels each sleeping four or so people and painted in bright colours and patterns.
The psychadelic toilets!







Bulungula's 'thing' is being 100% eco-friendly and they do a pretty good job of it. There is no electricity or running water so they employ a few intelligent ways of getting around it. They have massive [also brightly painted] rainwater tanks which they fill up over the rainy season; apparently if they run ever out of water, they will just close. This water is used for the showers and for washing dishes and local spring water is provided for drinking.







The dorms are lit by candlelight only and the main lodge has gas lighting, refrigerators and cooking equipment meaning that their fuel bill only comes to around R800 per month as opposed to R10000 of the average local backpackers! Lack of water means that the toilets are long drops, but Bulungula manage to avoid the stereotypical horrible hole in the ground with a cleverly designed compost toilet – I won't go into the details, but there is a strict code of conduct on the back of all the doors tastefully labelled 'Talking Kak'...nice!





The showers are also a bit of an adventure. They are known as rocket showers and consist of a long pipe that you light a fire in the bottom to heat up the hot water. Everyone takes a mini teapot full of paraffin into the shower and pours it into the 'rocket'. You then take a length of toilet roll, stick it into the paraffin and use the conveniently attached lighter to start the fire. After a short while, hot water will start coming through and you just add cold water until it reaches your preferred temperature.







Well, that's the idea. Having a major mental block when it comes to using a lighter, I struggled with that for a while, only succeeding in getting a friction burn on my thumb. After an embarrassingly long time I eventually struck gold, found a box of matches, lit the flames and opened the hot tap, looking forward to the cascade of hot water that would come forth and the subsequent enjoyment of the showering process. I was instead rewarded with a sad little drip of water reminiscent of Chinese water torture, although this was torture in the form of being naked and cold with ever decreasing shower prospects. I was considering giving up and just warming myself on the miniscule flame at the bottom of the rocket when the drip evolved into a trickle that had at least some cleansing potential. I then decided I would risk opening the cold tap with the dual purpose of a) cooling the water and b) stimulating some decent water flow.

Shower fail






Due to some deformity with the shower head, this resulted in a stream of cold water flying out at right angles to the hot water and soaking my pile of clothes. So there I stood [still completely naked] looking from my vertical stream of burning water to my horizontal stream of ice water to my heap of sodden garments. Defeated, unwashed and with a just a little less dignity than I'd arrived with, I threw on my towel, picked up my clothes and got out of there as fast as I could.







Anyway, back to the night before. They have a self service bar [I cannot imagine that concept working in many British bars!] so the four of us had a cider and sat outside chatting until it got dark. Dinner was one of the best yet [yes, I know I always say that] – chicken curry made by the mamas who work in the kitchen. I'm always so impressed with the way they cook because all they only use one giant pot for the curry and one for the rice yet it still tastes a thousand times better than any of the mass cooking they attempted at school. After dinner we sat around the fire for a while but by nine o'clock (Transkei midnight) we were all knackered and went to bed. As we walked back to our room, I looked at the sky and I have never seen so many stars...







Next morning I got up and had my previously described shower fail but decided I should persevere in my pursuit of cleanliness, went back and tried again with moderate success. I placed my breakfast order at the bar then went for a walk along the beach. Sam, Anita and Thandeka had already left for their education workshop so I had the whole day to myself. I wandered barefoot along the whole length of the beach, enjoying the early morning sun and the feel of the warm sand between my toes. The beach was totally deserted and it felt like I was the only person in the world. Luckily I wasn't though because otherwise my lovely cooked breakfast wouldn't have been waiting when I got back ;)



Bulungula beach




Myself and four American students had signed up for a hiking and canoeing trip so around 10am our guide came to pick us up. He gave us all kayak paddles to carry which confused me somewhat and he didn't speak great English so we just had to follow blindly and assume he had some kind of plan for the day! The hike took us through acres of the beautiful Bulungula landscape until we finally came down to the river, at which point our guide ran off with vague assurances that he would be back.







Mildly worried but not disheartened, the five of us sat and chatted for a while, then for a bit longer, then, just as it seemed we had been abandoned, we saw the guy paddling along the river in a canoe having gone to get an extra one to fit us all in. He then started with possibly the best canoeing teaching method ever tried which should be known as 'Push-Them-Into-The-River-And-Hope-For-The-Best'. Luckily, most of us had canoed before so there was only a little bit of going in circles but I worry for anyone who unwittingly signs up without prior experience!







We paddled along the river for about an hour and after getting used to paddling kayak style in an open canoe it was actually really good fun. The four students and I got on really well and it was especially refreshing to chat with someone new :D The river and the valley were just spectacular in the blazing sunlight – I know I always go on about how beautiful it is here, but I'm not kidding! The students, who have been living in Durban and haven't been exposed to the Transkei, were completely in awe of it and one of them kept saying 'This is OUT OF CONTROL' which I think sums it up nicely.



The view from the door of our dorm :)








After an hour, we reached a little grassy bank and our guide hopped out of his boat and promptly fell asleep, leaving us to our own devices. When he finally woke up half an hour later, he announced that we were going to paddle back upstream against both the flow of the river and the wind, oh great. The paddle back was not so enjoyable since we all got completely soaked but it was decent exercise so it wasn't all bad. We reached the bank where we had set off and then had a twenty minute conversation about what to do next, summarised below:







Guide: Now we are going to the beach.



Student #1: By canoe or by walking?



Guide: By canoe.



Student #1: How long will it take?



Guide: 5 minutes.



Student #1: Oh great, let's go.



Guide: *paddles towards the shore as if getting out*



Student #2: But aren't we canoeing there?



Guide: We must walk there now. It is a 35 minute walk.



Student #2: Are we going back to Bulungula beach?



Guide: Yes



Student #3: Can we canoe to that beach?



Guide: Yes, it takes 35 minutes.



Student #1: But you said it takes 5 minutes! Where are we going and how?



Guide: We are walking to the beach.



Student #3: Bulungula beach?



Guide: No.



Student #4: Is it near Bulungula beach?



Guide: Yes, it's 5 minutes away.



Student #2: So we are walking 35 minutes to a beach, then it's five minutes to Bulungula?



Guide: No, we are canoeing now for 5 minutes.



[Continue ad. Infinitum]







Eventually we turned out to be walking back to Bulungula and it took about an hour, but you can't blame the guy for trying :D







I intended to spend the afternoon reading and making a start on my community report for Project Trust, but ended up sitting outside on a giant cushion and falling asleep in the sun...good times. Dinner was butternut and mutton bredie which was a sort of stew thing, almost as tasty as the previous night. All the different groups from the education workshop then had some kind of performance competition where they sang songs which were rather amusing. It was a showdown between Bulungula, Mdumbi, Coffee Bay and Zithulele so of course everyone was roped in and I found myself singing random preschool songs in isiXhosa. In the end I think Bulungula won with a song about a baboon climbing a tree to eat a mango, how could Friday night entertainment get any better?! But there was still more hilarity to come when the music was put on and everyone had to dance, with Thandeka showing off some pretty impressive moves ;)







When the dancing died down, we went outside to the fire where Sam and I encountered two of the weirdest people in the world. One was the stereotypical new age white guy with dreadlocks smoking some kind of mind-altering drug and the other was this bizarre beardy man who just talked complete rubbish and whose every second word was 'ma bru'. They both had drums and you could tell they took drumming pretty seriously by the hushed tones they were using but when we actually listened to their conversation we had to try extremely hard not to burst out laughing at how ridiculous it was.







Dreadlocks: I've got these amazing beats to show you.



Bru: Wow, ma bru, I've been drumming for seven months now, ma bru, but you're really gonna take me to the next level.



Dreadlocks: Listen to this one – beat, tone, tone, beat, tone, tone [aka, a 3 beat rhythm]



Ma Bru: Wow, ma bru, wow. *attempts it and fails*



Dreadlocks: I've got so many beats, like, a 4 beat, a 6 beat, an 8 beat, a 16 beat, like, I just drum, dude.



Ma Bru: I feel you dude, like, drumming, ma bru. *continues beating drum without any semblance of a rhythm*



Dreadlocks: Wow, you're really getting that beat, tone, tone rhythm.



Ma Bru: Yeah, bru, I'm going to sing a song now.







And then he proceeded to sing/mumble the worst song ever, clearly just saying anything that came into his head and accompanying himself with any random drum rhythm. And of course, every second word was still 'Ma bru'. It was beautiful.







And that was the end of my getaway to Bulungula.







Xxx







PS. Thank you Karl and Sally :)

Sunday 9 May 2010

The Day The Pharmacy's Prayers Were Answered

And so, on the ninety-eighth day, God sent Zithulele a new pharmacist and some medical supplies...










As you've probably gathered from the last few blogs, our pharmacy has been in a bit of trouble lately with regards to, well, everything to do with it. We've been without a pharmacist since January 27th when Monique left us, the depot has been very erratic with our orders and we've been without many vital drugs for long periods of time – basically 98 days of semi-organised chaos. However, last Tuesday was a day of major wins for the pharmacy :D







First of all we got an enormous delivery from the depot. The boxes took up almost all the available floor space and opening them all was like Christmas! Among the items we welcomed back into stock were non-giant sized gloves, syringes of volumes more practical than 2ml, paracetamol, loperamide, water for injection, erythromycin, amoxycillin suspension, methyldopa [apparently very useful in maternity], IV klaforan [apparently very useful for everything], hypodermic needles that weren't of knitting needle gauge, cannulas, warfarin, aspirin...







Sadly, we couldn't find any IV antibiotics except the klaforan which was a bit disastrous since this is, err, a hospital which has patients in it which, err, need IV antibiotics every now and then. Then, out of nowhere, this giant unopened box appeared and I opened it to reveal a range of stock that we have been wishing for for aaaaaaaaaaaaaaaaaaaaaages, including [fanfare please] the antibiotics :D Good times all round!

IV antibiotics! YAY!






So you can see why the four of us in the pharmacy were in a very VERY good mood already when Ben came in and announced that Bonga, our new pharmacist was on the road to Zithulele as we spoke. Cue mass excitement in the pharmacy and huge grins all round! We hurriedly packed all the stock away, tidied all the random stuff that had accumulated on the work surfaces until eventually the place looked almost as good as it did when Monique left :) It will be the start of a new Zithulele pharmacy era :D







EPIC PHARMACY WIN.








The pharmacy in its clean and tidy glory
x

How The Other Half Lives

[an account of the weekend of the 1st /2nd May]




This weekend both Liz and Lisa were away and were kind enough to let us house sit :) We arrived on Friday to a note from Lisa outlining the house rules and reminding us not to lose the key, something that Sam and I have a bit of a reputation for around Zithulele...



Friday night we had a quiet night in, enjoying the novelty of an oven that doesn't take a century to heat up and watching Army Wives, a series that Lisa has been trying to get us to watch for ages. It's pretty addictive and we ended up watching three episodes in a row. The basic idea is Desperate Housewives with soldiers and what it's like when your other half is away fighting a war – makes some very decent points, but also made me nostalgic for the good old days at cadets :( Either way, if it's ever on in the UK, it's definitely worth a look.



On Saturday I got up very early for an Mthatha road trip with Anita and Etienne who had got up at the crack of dawn to make homemade burgers for the journey :D After the 1.5 hour drive down the world's greatest [sorry, I actually mean WORST EVER] road we arrived at Spar which was to be our only stop in order to avoid Mthatha syndrome, where you end up spending the entire day there no matter how many things you actually want to buy.



The shopping was actually quite successful until we got to the check out and there was a power cut. Luckily, Anita and Etienne had got their receipt so bailed out of there as fast as possible. After some extremely inept technical assistants came in to look at the tills, used the tried and tested 'switch-it-off-turn-it-on-hope-for-the-best' technique, hammered the enter key about 1 zillion times, looked confused then ran away, the tills magically started working again. However, something strange had happened with Anita and Etienne's bill so the cashier had a mild aneurysm and decided that the R3000 bill was mine. I tried to explain to her that my basket of flour, yogurt, cocoa, bread and apples couldn't possibly come to that amount and after a lot of conversation [you know, the kind where you aren't actually talking about the same thing] they decided as long as I put my phone number on the back of Anita's till reciept, I could pay for my own food then go. There was some fumbling about with my credit card, more repeated pressing of the enter key, but finally they decided I had paid and I got out of there. And that's why no one likes shopping in Mthatha.



I opened the post box on the way home, good times. Contents of this week's bundle:

1.A letter from Mum detailing Dad's birthday at Carrick

2.A letter from Grannie detailing Dad's birthday at Carrick [I'm really not missing any news!]

3.A postcard of Gatehouse of Fleet, must have been here too long as it looks idyllic

4.A letter from Hannah with a minute by minute account of her watching RENT :D

Did I mention that I love getting post? There should be a big bundle of replies making its way to Scotland at the moment :D



At the house, we sat on the sofa [a real sofa! :D] and watched House and Army Wives for a few hours, then I made some biscuits [and managed to chargrill them]. I went out for a run for the first time in ages – I'd forgotten how much better it makes you feel. You couldn't ask for a more stunning place to run than here, especially with yet another spectacular South African sunset taking place as you come back in towards Zithulele :D



The other major news on Saturday was that the student rondavel [the one next door to us where medical elective students stay] was broken into. A man climbed in through a tiny window, stole 2 phones, a camera, cash and, rather bizarrely, underwear, a vest and my shorts from the washing line. Luckily he wasn't armed but it was still highly traumatic for the two students currently staying there! There's been quite a lot of crime targeted at the local white population lately[they've successfully stolen a car, a motorbike, a trailer and tried two more cars] which is a bit disheartening since everyone here is trying to benefit the community.



On Sunday we watched House all morning – I think that programme is starting to take the mickey, I mean, seriously, every episode follows the same format: patient comes in, House takes one look, prescribes treatment, treatment is wrong, the team chat, they pick the first diagnosis someone thinks of, House prescribes treatment, repeat, House tries to kill himself, has an epiphany and they solve the case with some paracetamol or a drink of water. Mind you, I still manage to find it very entertaining...



I went for another run and had a profound encounter with a local boy while I was sitting on a rock resting:

Me: Molo bhuti [Hello]

Boy: Give me a bicycle.

Me: Huh? You want a bicycle?

Boy: You give me the bicycle now.

Me: *looks around for bicycle* I don't have a bicycle, I'm out running.

Boy: Oh, give me a muffin.

Me: I don't have a muffin! I'm running! *makes a show of emptying pockets*
Boy: I want muffin.

Me: *withering look*

Boy: *thinks of something else he wants* Give me fkasfhadhfkfh [random Xhosa word I take to mean my sunglasses]

Me: *runs off in opposite direction*

Talk about taking begging to the next level!



Dinner was a very civilised affair – Sam and I made our homemade pizza with any random toppings we could lay our hands on. I think I ended up with cheese, tomato, onion, pepper, garlic and butternut, a pretty tasty combination. We also made our own garlic bread but managed to burn the bottom so it was a bit coal like, a minor fail. We sat at Liz and Lisa's nice kitchen table and had candles and wine – makes such a difference to live in a proper house! We watched Army Wives until quite late then went to bed.



Sam and I reaching untold heights of civilisation

Thank you Lisa and Liz for letting us stay x

Sunday 2 May 2010

Working Hard, Hardly Working

It's been a tough week – never have I felt so exhausted from working [and I've done some epic 17 hour shifts between Housecall and the chippy!].










Wednesday morning I went to work early to get things in order after our day off. The nursing staff were all busy with morning worship meaning I couldn't get the pharmacy key so I just sat and listened. They were clearly in an excellent mood as it was one of the most lively morning services I've seen - they were all dancing, obviously having a great time. When it came to the time to pray [and at this point everyone prays out loud at the same time] it was an enormous rumble of voices which got louder and louder and louder until most of them were shouting. I'd never seen it get like that before, so many voices ardently praying together until it built into a giant roar that echoed all the way through OPD. The signal to stop praying is usually when someone starts the first line of a hymn but everybody was so loud that no one heard it! Eventually, three or four of the men absolutely bellowed the first line and the thunderous prayer became the most energetic singing the world has ever seen. And then suddenly it was over, and everyone started work just like that, as if nothing had ever happened. Rather bizarre, but fascinating to witness :)







Liz was back on chemist duty making Elemental Mixture and in a miracle of modern times, the diseased printer spelled it correctly [sadly, it was apparently mixed at 'Zighulele Horpital']. Lisa also came in to the pharmacy looking for a box – the therapists had rescued a tiny kitten from a drain [as you do]. I spent a while doing the paper work for all the defaulting patients, my least favourite part of the job, especially as lots of them are kids who have no control and whose parents are taking a serious chance on their lives. Most of the defaulters do eventually come back and restart, but this week I saw a prime example of what happens when you stop taking ARVs properly when a previously healthy man came in with a viral load of 190000 [normal level is zero]. Once you have virological failure like that you can switch treatments but there are only a few regimens and you don't have unlimited chances. [At least I think that's how it works...]







By the time I got up to ARV clinic, a huge number of patients had already been in so I had lots of files for back capture and the situation remained that way until the end of the day when I took a massive box home with me. I was so tired at Frisbee that I couldn't bring myself to run between one end of the court and the other, epic fail.







At home, I discovered we had a new roommate, the kitten who had been rescued earlier. He is extremely cute, just a tiny black ball of fluff and he follows you around everywhere you go. However, he is constantly miaowing – well, when I think the noise would be better described as a quack – which is just the tiniest bit irritating, so we decided to call him Duck. He sat on my desk until midnight while I captured all the ARV files from the day which was rather endearing, but sadly all affection for him was lost when I was up all night to the sound of 'quack, quack, QUACK [repeat ad. infinitum]'.







On Thursday I crawled over to work in time for grand rounds, can't remember what they were about but there was a woman who had made a spectacular recovery from something, most likely TB/pneumonia/fitting/an illness. I looked at all the things to do in the pharmacy and didn't really know where to start and actually ended up helping making up all the drug/equipment orders for the wards instead. This of course meant that a lovely pile of files for capturing was building up in ARV but oh well! The day continued in a very stop-start fashion as every time I sat down to do something, a patient would arrive wanting something or other. I did some prepacking, sorted out the ARV pack for Ngcwanguba, did most of the OPD order and the obligatory paperwork before heading up to the clinic expecting to pick up the files and leave.







Sadly, due to the absence of Ben, Taryn and Liz [aka 30% of our doctors] the clinic was still busy at 5pm so I helped out there for a while, seeing patients on a desk made out of a cardboard box. Just a tiny bit different from first world medicine! By the time we were finished I couldn't bring myself to take the pile of files home so they were added to my paperwork pile – must go and take a picture of this bad boy so you get the scale of it!







I arrived back at the rondavel to the picture of domestic bliss: Sam was baking bread and homemade burgers and being followed around the kitchen by Duck. Awwwww, how sweet:) It was a stunning dinner [the accompanying quacking was not] which was then followed by a dessert extravaganza of homemade meringue and homemade custard which took about an hour to make but tasted greeeeeat :D







Friday grand rounds saw us in paeds and back on the traditional vs. Western medicine topic. The mother of a seriously ill kid wanted to take him out of the ward to get a birthmark on his head cut off by a traditional healer. The local belief is that the birthmark will grow over the child's head and kill him and the mother is very adamant that it has to be cut off. Luckily, the hospital can forcefully keep the child while he is ill, but as soon as he is better the mother will be able to take him to the traditional healer and have the procedure which is extremely likely to injure or kill the child. It's a real predicament and one of the everyday challenges faced by the medical professionals here, but hopefully with ongoing education and working with the community things will eventually improve.







When I arrived in the pharmacy I found a note from Thabo saying 'Please order some TB meds and eye drops' which is a bit vague considering that there are about 20 types of TB meds and another 20 of eye drops! After making a guestimation of which ones we needed and how many to order, I went to Sally and Karl's house to type up the order on The Template of Doom [see previous post on the Saga of the Stock Take]. I had anticipated taking about half an hour to type the order, print and fax it, but alas it was not to be.







After spending about an hour going the ridiculous template looking for all the items we needed, then double checking it against the depot's out of stock list [a list which is so ridiculous that I would need to do a separate post to do it justice] I tried to transfer it to Sally's computer to print. Sadly, the memory stick that we used had a mental breakdown and didn't work. Then we attempted to Bluetooth it across but the codes wouldn't work. Eventually, I Bluetoothed it to Sally's phone and then downloaded it onto her laptop and managed to print it. Finally, there was the inevitable wrestle with the fax machine and the constantly busy fax line at the depot. Three and a half hours later, our order was with the depot, what a [completely unnecessary] mission. I love my job :D







I showed back at work just to be nice, but after rearranging my To Do piles a few times I gave up and went home. The new pharmacist is rumoured to be arriving this weekend, I can't wait. Will keep you all posted!







xxxx

Freedom Day aka Road Tripping in the name of Medicine

Freedom day, a public holiday! Yay! A day off! The entire day to do anything we fancied! So, naturally, Lisa, Liz and I chose to go road tripping to pick up out of stock ARVs.










“Again?” I hear you say, and yes it's true – after last month's lucky escape with the 3TC/Lamivudine and last week's semi-effective fix with the D4T/Stavudine, we've now run out of Alluvia and had to deal out tiny rations of tablets to all the patients who needed it last week. It was like a failed [and less extreme] version of the feeding of the 5000. Mthatha medical depot had none in stock and probably wouldn't deliver it anytime soon even if they did which left no other option than borrowing stock from our neighbouring hospital Madwaleni.



Road trip!
Sounds inviting huh?





And so it was that we were on the long, dusty road once again. It was an absolutely beautiful day and the Transkei landscape was all the more picturesque for it. I saw a signpost for 'Great Place' but sadly we didn't go there, bad times! After an hour we finally showed up at the hospital. I was interested to see what it was like in comparison to Zithulele and it's actually quite different even though the two hospitals are relatively close together. For starters it's a bit bigger and a lot more spread out – their TB and isolation wards are actually separate [aka isolated] as opposed to ours which are pretty much only isolated by doors and common sense. The most bizarre thing is that their OPD has an enormous flat screen TV! It beggars belief that funds were available for that when so many other basics are not provided. Their pharmacy is very cool :D I was actually jealous of it; clearly I am getting a bit attached to the job. I think I can narrow down the top three things that I liked about it:



1. It has a pharmacist, and a switched on one at that



2. It has rooms, plural



3. It has stock!



There was more stock in their back rooms than in our entire pharmacy at the moment which is a bit depressing...Anyway, we were there for a purpose, not just to see how the other half lived. Thabo had negotiated a swap: Salbutamol inhalers and ORSOL for Alluvia, Iodine solution, aqueous cream and Diclophenac. I think we got the better end of the deal :D Either way, it's great that the hospitals can work together to solve these kinds of problems.







After that we went for tea with Alistair, one of the doctors there. The staffing set up is a bit different to Zithulele as they don't have a core of experienced doctors, meaning that the community service M.O.s are the most senior. Must be pretty hard for them in their first year of practice after internship! He also took us for a very brief tour of the hospital, of which the only lasting impression I have are a mobbed ARV clinic which made ours look tame and some free flowing sewage going past the nurses quarters. Another win for rural medicine I think!







Back in Zithulele I had a lazy afternoon until everyone went to the beach for a swim in the sea and sundowners. It was possibly the most incredible sunset we've had since arriving:

 
Sunset over Lubanzi

Saturday 1 May 2010

When Monday Night Isn't A School Night

This Monday we had the usual Foundation meeting, sans chairs as they were all still at the preschool. I had a surprisingly productive day at work and managed to cram in most of Tuesday's tasks as well in readiness for the holiday. We were hit by yet another stunning power cut so the pharmacy was once again plunged into darkness and resumed its status as The Bat Cave. Requiring a) power and b) light, I relocated first to maternity then to the therapy department, both of which are actually hooked up to the hospital generator. Thanks so much to the bright spark [ha, pun intended and apologies offered in advance] who decided that the pharmacy light circuit didn't need to be included in the power supply, great work, trebles all round!










Anyway, the therapists were happy to let me share their department and I was shown to the very organised 'working area' [as opposed to the non-working area :P ...I'm kidding, the other areas are for seeing/treating patients etc]. I sat and printed all my labels for Ngcwanguba clinic and did some exciting paperwork/admin. It seems to keep on piling up as more and more files and clinic cards land on my desk. I have so many piles of things to do, including a pile that only contains 'To Do' lists...keeping this ARV down referral programme going is definitely challenging me.







Finally someone up there said 'Let there be Light!' and behold, the Bat Cave was transformed into a pharmacy again. I said goodbye to the therapists and took up my rightful seat amongst the boxes of files, TB drugs and surgical gloves. As late afternoon approached, our honorary chemist Liz came in to mix up some potassium chloride suspension. Or, according to our label printer 'Rotassium Chloride Suspensios'. It's got some kind of virus that makes it print completely random spelling mistakes on the labels even if the template on the computer is perfect. Just another one of the little quirks that I love about the hospital!







As Tuesday 27th April is Freedom Day in commemoration of the first democratic elections in South Africa, we had the next day off which meant we could do whatever we liked with our evenings. This being Zithulele, that meant Ultimate Frisbee and a braai :D We played Frisbee for what seemed like forever with three roll on-roll off teams that were pretty evenly matched. You'll be pleased to know that I've slightly progressed from my early days as a Frisbee player and can now catch it on more than 1% of attempts and do, on occasion, actually score some points. It was a laugh as usual and [most importantly] some decent exercise, so I went home in a good mood.







Next on the agenda was dinner with Anita and Etienne at their house which is rapidly becoming the coolest place in Zithulele. They've made loads of their own furniture and this weekend's addition was a beautiful outside dining table that Etienne had made from the left over wood from the new buildings. They've also just had an outside canopy added so we sat outside and chatted, Sam and I taking teenage rebellion to new heights and sharing one beer between us :D We had homemade bread, cheese and herb potato wedges and of course some expertly braaied boerwors and steak, what a feast :D But then again, you are guaranteed some brilliant cuisine whenever you head up that way...







After eating and some post-supper conversation we headed down to the Plaza where a mass braai had also taken place. We arrived just before 11pm with an apple crumble and proceeded to cook it [because late night baking at someone else's house is SO socially acceptable], eating a small portion before heading home before midnight arrived and we turned back into our true pumpkin forms.







Good times :)



x



.

Things to do in the middle of nowhere...

Last weekend was a pretty lazy affair after the excitement and adventure of the big city. On Friday I came home from work, collapsed onto the sofa/bed and watched 21 with Sam until we got a call from Anita. We went and collected chairs and tables for the preschool teacher training that was happening the next day – the highlight of this exercise was when I got to sit on the top of the 4x4 with all the tables [cool, as ever ;)].










Later on I went over to see Lisa for general chats about life, the universe, the usual. Suddenly, Sam's face appeared at the door looking a tad desolate – turns out she had just got the phone bill for the last three months: £1500! So we had a bit of a crisis talk about how she'd manage to pay that and afford to stay here and there was some drama and to-ing and fro-ing on the phone. Eventually we did the old Zithulele favourite and 'made a plan' [the general response to any drama here is: Don't worry, we can make a plan!] and then took the logical step of going to watch Wipeout with Megan and Jess.







So Wipeout is pretty much a one hour special of ridiculous Americans making a fool of themselves by wiping out on giant obstacle courses, a genius recipe for laughter. After that we went home to watch New Moon but I managed to fall asleep in the middle of the rain scene … think that shows how tired I was!







On Saturday I woke up at 9am, made some toast then sat in bed until well after midday updating my blog [hence the 5000 word essays I posted last weekend]. After a leisurely lunch - and a miraculous turn of events in which I managed to hand wash ALL my clothes before my hands started to burn from the soap powder - we went over to Lisa's. I have been collecting various things in the pharmacy for her to use in the therapy department for the all the creative things they get up to, so she had an enormous stash of various sized containers and we managed to spend a good hour or so thinking up various uses for them. Ultimately it came down to using them as waterproof valuables containers or mugs so I decided I would test out the Paracetamol container as a coffee mug. It wasn't wholly unsuccessful in that it didn't melt and spill coffee everywhere but it was a bit hot to handle! For the full story of this exciting product trial and pictures go to Lisa's blog http://lisainthetranskei.blogspot.com and if anyone's interesting in taking the product further let me know! [Of course I'm kidding!] Anyway, the mug is now sitting in the cupboard of my semi-second home in case I'm ever there and is aptly labelled 'Kayleigh's Ultimate Pharmacy Mug'. I think it shows dedication to my art :P







Next up on the schedule of fun was a practical joke in which we took being immature to the next level and emptied the entire contents of Liz's fridge. Some interesting discoveries were made, the remnants of my birthday cake probably being the most stunning [and mouldy]! I managed to cram everything into Lisa's fridge [except the health hazards lurking at the back which were unceremoniously flung into the bin] then refilled Liz's fridge with empty Bactrim containers and that lovely birthday cake. Go look at Lisa's blog for a picture of that! Our work there done, we considered moving all of the contents of Liz's bedroom outside a la Juno but maybe thought that was a bit excessive....

Liz's fridge






We ended up staying for dinner, or supper as it is called here, and enjoyed Lisa's cooking, baking and even a civilised glass of red wine! We really are going up in the world :D Back at home, we had a second attempt at watching New Moon, enjoying the really stellar acting that was going on … I mean seriously, you can't help laugh at how melodramatic it is! [And Hannah, all that was going through my head the whole way through was BELL-LA-LA! Remember those good times?]







Sam and Lisa cooking
Me being equally productive
Sunday saw pretty much the same start to proceedings but then Sam and I thought we'd take a nice walk on down to Lubanzi beach. We haven't walked down together since the second week so it was nice to get out. The tide was over the whole beach so we just lay on the grassy bank and sunbathed for a while then started the long walk home. We decided to take a different route through the forest and along some goat paths through the villages and at times got flashbacks of the whole getting-lost-and-stuck-on-a-cliff thing but eventually managed to rejoin the road and ended up safely back in Zithulele. [Wow, long sentence, awful grammar!] It's interesting to walk through the villages and see all the rondavels and plantations and see people going about their everyday life – reminds you that rural Africa is still out there even though we live in our little Western bubble.







Liz was returning from her weekend in Bulungula so I went and sat with Lisa waiting for the reaction to our fridge rearrangement. Lisa was mending and customising my shorts since they have a massive hole in both the leg and the pocket and are so threadbare it's hardly worth wearing them. I've yet to see the finished article but it involved pink neon thread so I'm a bit nervous! :D When Liz finally came home, it took a while for her to open the fridge because she had some epic stories of unpleasant French tourists exposing themselves by the fire, but eventually she did. After the initial confusion had worn off and she had ascertained that no, an entire fridge's worth of food had not been compressed into 8 containers, she saw the funny side and even appreciated the subsequent cleanout of the fridge :D Oh what exciting things we get up to out here!







I stayed for a while chatting [and being a general nuisance by hiding the milk and the coffee to convince Liz that she'd gone mad], had a coffee out of a real mug, listened to some tunes and then went back home to Sammy.







Even though I did very little with my weekend in the way of epic adventures, it was still one of the good ones :D As the days slowly tick away until my return to Haddington [and the 'real' world] it gets more and more apparent how much I'm going to miss this place, the people here and all the random things that we get up to :(







But, I guess, in the words of someone far more inspired than I, there's 'No Day but Today...'