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