FEEL IT! IT IS HERE!

AYOBA! The World Cup has well and truly kicked off [don't even excuse that awful pun] in South Africa! It's so cool to be out here during the World Cup, especially since it's the first time the tournament has been hosted on the African continent. [Just for some people's [i.e. the football commentator's] information, Africa is NOT in fact a single country...;)] Everyone is so psyched up for it and you really get the sense of the nation coming together, everyone is so so proud to be South African right now. I kind of wish I could pretend I am, but I guess being British will have to do me...[just kidding!].


For weeks now, people across the country have been wearing football shirts to work on a Friday in support for Bafana Bafana, the national football team. You even see news reporters on TV in football tops and a scarf, pretty weird when they are giving all the latest on the war in Afganistan etc etc! All the members of the South African government go to their version of the House of Commons in their Bafana shirts which I think is pretty cool, can't see ever that happening in the UK. Then there is the vuvuzela, which for those of you living in the dark ages, is a kind of horn thing that is a huge part of the football culture here – all the fans take them to matches and they make SO much noise. Even a single vuvuzela is loud, especially when someone is blasting one outside your bedroom window at 5am...Needless to say, Sam and I are not the biggest fans of them. Either way, in recent times, the sound of someone playing a vuvuzela has become as much a part of the background noise in Zithulele as the crickets, Rambo's morning tunes and the barking of the Transkei dogs!



There are also two catchphrases that people just take it upon themselves to drop into conversation [or yell at you from the side of the road]: 'Ayoba!' and 'Feel it! It is here!', both of which have some ambiguous meaning to do with the awesome World Cup vibe that is going about. Thabo [who works with me in the pharmacy] feels it is necessary to shout 'AYOBA' any time he hears a vuvuzela...so that's all the time then!



The build up has been impressive and has continued for a pretty long period of time – I remember when the countdown on the TV was well over 100 days – so you can imagine how crazy it was here on June 11th, the first day of the World Cup 2010. It's a real testament to the spirit of the thing that it's penetrated even the deepest and darkest parts of rural South Africa [or a testament to the power of modern day advertising, depends how cynical you are]. Zithulele was a changed place that morning, such a buzz was going around that it was hard not to get involved in the excitement. It was vuvuzelas galore as we ventured into the hospital, oh how the sicker patients must be dreading the coming month...



OPD was a sight to behold: as we've rigged up a TV in the waiting area, everyone had come along to get seats for the opening ceremony later on so it was packed, meaning morning prayers were insanely loud, and on top of it, Sandile [a rather outgoing male nurse] was dancing up and down the front entrance playing a giant vuvuzela in time accompanying the singing – it was great to see everyone having SO much fun :) Somehow we struggled through a working day to the soundtrack of a community gone wild on the World Cup – I must have been told 'Feel it! It is here!' at least ince every two minutes by various staff members, patients and even a crazy woman dressed in a Bafana shirt on a far away hill marching up and down with a vuvuzela, repeating 'FIFA World Cup 2010! Feel it! It is here! Ayoba! Bafana Bafana!' over and over again alllllllllllllllll morning!



For the opening match, Sam and I decided we would stay in OPD and experience the inevitable chaos and excitement that went on there. The place was packed out: all the waiting benches were full and a crowd was crammed into the space at the back and all the patients who were waiting overnight for treatment were sleeping on the floor at the front [I doubt they got much sleep!]. As the match got underway there was an enormous roar and lots of shouting at the screen. As soon as the South Africans got the ball everyone would start cheering and yelling in Xhosa and even if they passed the half way line, you'd think they'd scored from the outburst of noise that came from the crowd. If the goalkeeper saved a shot or there was a piece of good defending [or if the Mexican team made a mistake] there was a huge round of applause. And of course, whatever was happening, there was the constant blast of numerous vuvuzelas...

The crowd assembles in the OPD waiting area

When the time came that Tshabalala made that stunning shot and scored Bafana Bafana's opening goal, the place exploded – I've never seen anything like it. There was complete chaos. The uproar was deafening, screaming, yelling, cheering, clapping, singing and somehow the trumpet of the vuvuzela even managed to double, actually no, triple in volume. Everyone was hugging and dancing, jumping up and down, waving their arms and some people got so carried away that they bolted down the corridor of OPD in complete hysteria because they were SO excited. It was hilarious, crazy, ridiculous, brilliant....so much fun to be a part of it and let yourself get carried away with the patriotism.

The OPD crowd, still cheering 10 minutes after the goal!

The match went on and on like this and everyone got more and more worked up – the nursing sisters were coming in and out whenever they could [the theatre sister was even in her scrub cap] and the hospital managers [a group of four rather feisty women] were celebrating for a large proportion of the time by waving a blanket in the air, fun times all round! Even though it ended as a draw, everyone was so proud of their team and left in high spirits, it was such a brilliant start to the World Cup and the beginning of a month of football madness in Zithulele :)

When It's Hard To Breathe

[Here’s an explanation for that picture...]




I was in the pharmacy the other day with Olaf, a student from Princeton who was here for a week doing some research into HIV and religion, when Liz came in to say there was a Caesar going on if we wanted to watch. Naturally, we ended up throwing on scrubs and in theatre for the start of a very hectic morning.







The baby was in some considerable distress, so Karl [who is somewhat of an expert in maternity related matters] was there to resuscitate it if necessary. Everything seemed to be going fine and Karl and Liz were chatting about the upcoming World Cup, I think Karl may even have been texting someone, when they made the incision into the womb and suddenly an enormous fountain of amniotic fluid started pouring out everywhere! It literally spurted out all over the place, soaking Liz and Sister Gebe who was assisting [she even had to have a new pair of shoes brought in...eugh] – it seemed like it wasn't going to stop. Luckily for all involved it did [and the rest of the surgery was conducted in a particularly splendid puddle...]







The baby was eventually delivered, but wasn't particularly lively and had stiff lungs so was having trouble breathing on his own. Karl intubated him and he became stable so he tried removing the tube, only for him to immediately start to crash. Ben was called to give his opinion on the situation, followed by Taryn [so half of our doctors were there by this point] and it was decided that the baby needed to be transferred to an ICU where they could ventilate him. We don't have a ventilator and neither do any of the Umtata hospitals because some genius there decided to fix them all at the same time and surprise, surprise, hasn't actually done it, so the next option was East London. Karl called the hospital there and asked for them to send the helicopter to pick the newborn baby up.







The helicopter takes 40 minutes to get here [and this is the Transkei, so that can mean really anything] which meant that someone needed to ventilate the baby manually until then. It didn't make much sense for the one of the doctors to sit and do it when we had no definite timescale on the chopper’s arrival and the patients were piling up in OPD as ever, so I ended up doing it. Ben showed me the technique which always looks so easy when they do it on TV, but there's quite a delicate art to it, especially on when the set of lungs involved is so tiny. After some initial trouble getting the timing and synchronising with the boy's own breathing and feeling the correct pressure, I managed to get it right and the others left me alone with the baby and continued with their working day.







So there I sat in theatre, just me, the baby and the bleeping of the monitor. I had to make sure that the pulse rate and oxygen saturation were normal and had strict instructions to call someone if anything went wrong [people did keep checking up on me just in case though :)]. It was actually surprising therapeutic to sit and concentrate on something so simple and when I looked up at the clock to see two whole hours had gone past I was surprised! I continued on, watching the rise and fall of his tiny ribcage and hoping that the baby who was gripping my finger so tightly would survive and become strong enough to breathe on his own. I wondered what the mother must have been feeling, knowing that her baby was going to be flown away to a strange place without her, never having even seen it, let alone hold it in her arms.

Manually ventilating the baby in theatre

The ventilating became automatic and I was completely mesmerised by the vitals monitor, but then the oxygen saturation started dropping below 100% in rather rapid fashion. I started panicking and shouted to the sisters in the other room, but they couldn't hear me, so I tried dialling my phone only to hear the dreaded message telling me I had 'insufficient credit'. The pulse had dropped down to 60-70 beats [low for a newborn] and oxygen sats. were below 85% and I was starting to worry that I was going to cause the baby to die when finally Sister Gebe came in and called Ben for me.







Ben came running to check and quickly discovered the root of the problem: the monitor had fallen off of the baby's foot, so the machine wasn't getting a proper trace...so not a real medical emergency after all! [All that adrenalin rush for nothing, what an epic fail – but that's not the point.] After he had clipped it back on, everything went back to normal and I resumed my role as the ventilator for another hour or so with no further hiccups.







I heard a commotion in the corridor and then the paramedic arrived...then disappeared for about 40 minutes under the guise of 'looking for oxygen'. Pretty sure he went outside and distilled it from the air from scratch, but anyway. When he came back, the baby was put in Sister Gebe's arms and with Liz holding the oxygen cylinder and me ventilating we managed to awkwardly shuffle through OPD and out to our overgrown basketball court where to the helicopter was waiting for us. We handed him over to the paramedics and soon enough they flew off into the distance leaving everyone on the ground in high spirits knowing we'd done everything we could for the baby.







But this story does not have a happy ending. The baby died a matter of days later from some kind of congenital pneumonia [at least that's the expert opinion]. He died without a name, without ever feeling his own mother holding him in her arms. The mother never even saw the child she had carried for nine months except for the pictures that we took while I was ventilating. I held that baby's hand for three hours straight, yet the one person who should have been doing that was denied the chance to do so. Once again it hit me how raw life can be out here – a place where the reality isn't concerned with the petty problems we obsess over in the first world, a place where the reality is devastating, brutal and unforgiving. It's a cliché to go on a gap year to the third world and come back with stories of the poverty you've witnessed, but I will never forget the things I've seen here. I've always known that life in the UK is an endless privilege, and it's times like this that reaffirm that knowledge.

You Don't Know What You've Got Till It's Gone

[Life in Zithulele, 7th June-13th June]








You may remember my post about how excited we all were at the arrival of our new pharmacist Bonga? Things were finally looking up for us – the 5pm finish at work was looking like it may become a possibility, stock was arriving, good times were being had by all. Sadly, on the 28th of May, I woke up to the following text:







'Hi I'm gone, have left keys with security, please give 7 rand to the nurse who sells scones'







And that was how I found out that Bonga had resigned! So we're back to the status quo - long, hectic working days in the pharmacy :)







I did go on holiday with Mum [see blog post] for the week immediately following her resignation so probably missed out on the craziness that ensued, but if this week has been anything to go by it can't have been easy!

Wilo Clinic support group room - pretty sobering huh?

On Tuesday I went to Wilo clinic to oversee the ARV clinic date there for the last time. It's great to have watched it grow from strength to strength over the last three months and from now on I'll just be sending the packs there and letting the counsellors dispense the drugs. Faniswa, the main counsellor there, is a complete legend, so efficient and helpful :) After we were done with Wilo, we drove up to Mthatha for a variety of purposes including picking up some stock from the medical depot. I finally discovered why the depot is in such a state when we went into their staff offices to find a few stressed out pharmacists hiding under heaps of unfiled paperwork. We were there for around half an hour, during which time our boxes of stock were swapped around two or three times and I ended up signing a load of random forms but in the end we left with the drugs we came for. Epic win.

Umtata depot main office/scrap heap

Wednesday was a very very long day. We started with the perinatal mortality and morbidity meeting during which one of our senior nursing staff remarked that it was 'news to her' that babies didn't breathe while in the womb...and it didn't ever really look up from there. I sat in my chair in ARV dispensary between half eight in the morning and six at night with no breaks. The problem was that one month previously we had had no ARV supplies whatsoever so had recalled all 146 of the patients from that day, plus everyone else who had been given that date in previous months. At one point I got up to stretch my legs but got such a look of disdain from the mobs of patients lining the corridor that I just sat straight back down again. By the time the day was over, the dispensing room had turned into complete chaos, with three doctors and the three of us from the pharmacy all dispensing from a variety of surfaces including cardboard boxes, the fridge and the window sill [pretty hectic]. When the last patient had gone, I just gave up and shut the door on the bombsite that the place had become and wandered home.







Or rather, I ended up at Liz and Lisa's with the giantest hot chocolate and rusks having a conversation about our favourite things about South Africa – won't come as any surprise that most of them were foods...So after I had been cheered up there, we headed to cell group in the pouring rain. It's only about a 400m walk to the Gaunts but I was so drenched when I got there that I had to borrow a spare pair of trousers, pretty much felt like I was back home enjoying the Scottish summer!

The best welcome home from work, ever!

Thursday was another day at work that blends in with all the rest – I'm sure everyone is sick of hearing that chat so I won't even start [but Liz and I were up all night AGAIN doing paperwork so I had to resume my tramp status on their living room floor].







Well, that was a highly exciting blog! Winter has definitely set in: jumpers are a necessity most days, the flip flops have been sidelined and all social events are conducted under the cover of blankets due to the severe lack of central heating in these parts. Not long to go now until I'm back to the sunnier [!] climes of Haddy.







Until then xxx

Guess what happened here?

Hectic day yesterday...

[Half a] Spontaneous Weekend

[22th/23th May]










On Saturday morning after playing PS2 and speaking to Gregor while a chicken climbed on my head [as you do] Sam and I headed over to a football tournament being held at a local school. The Jabulani Foundation had organised and funded it and invited a number of the local teams to come and play with a trophy and prize money on offer for the winners. The ARV counsellors were also running HIV testing all day with all the people who tested being entered into a prize draw to win an all expenses paid trip to watch a World Cup match in Port Elizabeth. The aim of the entire event was to attract young men [who are the demographic least likely to test] to test for HIV so that they could be counselled and prepared for ARVs if necessary.







It was a blisteringly hot day and there was a pretty giant crowd, the obligatory vuvuzelas and lots of random dancing – at some points more people were watching the dancing than the match, but oh well! After watching the football for a while [to be honest, it would be more accurately be described as head-ball as all they seemed to do was header it about] Sam and I decided that we should go for an HIV test – it may seem like a ridiculous idea since neither of us should have been exposed to the virus, but everyone here is encouraged to test so that they know their status regardless.







Despite the fact that I knew there's no way I could be HIV+, I was still pretty nervous. I can't imagine what it would be like to find out that you're positive. Before I came here, I thought that contracting HIV was a death sentence and despite all the education we supposedly get in the UK, there's still a lot of stigma surrounding the disease and people who have it. I've learned so much about it since I came here and know plenty of happy and healthy people living with HIV. Still, being HIV+ is life changing without all the medical implications – it complicates your relationships and makes you a slave to the 7am/7pm ARV times [imagine never having a lie in, going to bed early, or going anywhere at all without your meds]. So as I watched as my tiny speck of blood was tested for the virus there was a part of me that worried about what I would do if the two lines meaning 'negative' didn't appear.







Thankfully they did and the massive wave of relief that washed over me made me realise just how nervous I had been! Five minutes later, both Sam and I emerged with smiles on our faces at our HIV- status. The counsellors tested 160 people over the course of the day with 6 testing positive. [That's actually a really low percentage given that the prevalence in the country as a whole is % and I'm quite sure it's higher in this area].They will now have the option to start the ARV counselling process and start taking the anti-retroviral medication that can save their lives.







At midday there was a break for some HIV education from the counsellors [who I must say, were absolutely buzzing with excitement and were hilarious as a result]. After persuading the young guys who were having a seriously odd break dancing competition by the music speakers to have a short rest, they started giving the crowd the whole 'Wear a condom, don't spread HIV' chat in extremely animated terms including a bunch of songs which were pretty catchy [I found myself whistling one in the corridor the other day and the ARV counsellors thought it was hilarious]. While they were talking the DJ decided to come and ask me if I was married/wanted to marry him so I ended up lying and saying that my husband was working in Johannesburg [ very bad I know], then fobbing him off onto the Sam. The break dancing then resumed and our giant preschool teacher Ronnie added his own legendary flair by trying to sell oranges at the same time as he was doing a weird walking-dancing-thing...







Back to the football and the hospital team were playing so there were a few familiar faces on the pitch: Thabo, my fellow pharmacy assistant; Mr Ntlantywa, a nurse; and Eric, a strange laundry man who never seem to do any work and had a picture of me as his phone screensaver for a while. I ended up watching with a small child who latched on to me, prompting a young guy next to me to ask, 'Why is your baby black?'... The match ended in a draw so we went to penalties, at which point, the entire crowd stormed the pitch and we crowded round the goal. There was loads of tension [poor goalies] but Zithulele pulled it off and pandemonium ensued when the final goal went in – everyone was running around like crazy, jumping up and down, yelling, hugging and, of course, playing the blasted vuvuzelas at one zillion decibels. Sadly for us, that was just the semi-final and we went on to lose the final, bad times :(

The crowd anxiously watches as Zithulele play

Pandemonium ensues as we win the penalty shootout!

After the semis were over, Liz mentioned something about going to Mdumbi for the night and after five minutes of conversation and ten minutes of packing, Liz, Lisa, Sam and I all ended up on the road to Mdumbi for a spontaneous road trip and night away :) [Or as Lisa likes to call it, half a weekend away with the wife and kids, since Sam and I are pretty much looked after by the two of them]. We were also joined by Kate's dog Jack, who did a fantastic job of slavering all over the back of our seats [thankfully missing our heads by centimetres alone]!







In a record time of one hour fifteen minutes we arrived at Mdumbi backpackers and were shown to our dorm and given a quick tour of the place, including my personal favourite, the 'iabulutions' aka 'the ablutions'. Putting 'I' in front of an English word in Xhosa is like putting 'le' in front of an English word and saying it's French. My personal favourite is 'i-plastic file', which means, er, 'plastic file', but if you don't say the i-, no one understands you!







We went for a walk along the beautiful Mdumbi beach as the sun was setting and had fun trying to take everyone's favourite picture, the epic jumping photo. It was a bit of a fail as there was always one person still on the ground but the pictures were cool none the less :) We had a quick swim in the sea then headed back up to the backpackers. There was a group from Madwaleni hospital there so we enjoyed a long night of banter on various [mainly inappropriate] topics and had a seafood dinner with mussel soup, crayfish, line fish, calamari and prawns.







The next morning I got up reasonably late and had a quick walk along the beach to wake myself up, had breakfast, then ended up back on the beach for with everyone else :) Lisa and I went swimming for about an hour, being joined part way through by the others, including Liz, who tried to kill me by dunking my head under water without prior warning, good times!







The road trip back was made extra exciting when we got a flat tyre, and the sight of the four of us unsuccessfully trying to wrench the hubcaps of drew in a crowd of local kids. After various attempts to get it to move, including two of us standing on the tyre iron, a guy driving past stopped to help and changed it for us in about 5 seconds, what a fail.







And that was the end of the spontaneous weekend!







xxx

Random Anecdotes

[17th May - 23rd May 2010]


- I had my first technological nightmare this week iDART, our pharmacy dispensing software, [i.e. the program I rely on for EVERYTHING] broke. I wanted to cry – if iDart or the laptop stops working, I'm not really sure what I'd do!Then the tablet label printer was jammed and the main computer just kept on restarting itself – the three broken machines were all lined up on the desk like some sad parade designed to ruin my day. Anyway, I phoned up the computer geniuses in Cape Town and after six hours of phone calls over two days and this cool thing where they controlled the laptop over the internet, iDart was fixed. Sadly, despite also unjamming the label printer, the main computer is still enjoying an endless cycle of turning on and off so we are writing all our labels by hand...

Techical fail

- We had another pizza night for Kate's birthday, once again filling up a giant table at Papazela's. Nomonde even made her a cake, good times!

Kate

- I came home from cell group on Wednesday to find Sam had made banana bread. However, turns out it wasn't as good as it sounded when Sam said, 'I made some banana bread but I accidentally cracked a rotten egg into the mixture, but then I cooked it anyway...' Now that's real Transkei baking :)

Why we love Sam!

- After working late on Thursday night, I stayed over at Liz and Lisa's. They said they had a toothbrush for me since I was there so much – turns out it was one of mine, left there from the time when Sam and I moved in. They, however, didn't know that, and were just going to give me a random toothbrush they'd found! Gooooooood times!



- I worked all Friday afternoon until there was a powercut and I had to fumble my way out of the pharmacy/bat cave in complete darkness. The generator had stopped working again so OPD was pitch black meaning that Jo [who was on call] was seeing patients by the light of her mobile phone! I fortunately had the pharmacy laptop with me so used it as a slightly more effective light – one poor woman came in looking awful and was diagnosed with meningitis in the dim glow of the screen: another epic win for rural medicine!
 
 
xx
NB: I WILL catch up this blog soon!!!

Epic Days and Nights: Part II

[16th /17th May]








Saturday won't take long to describe: Sam and I stayed in the rondavel all day in our pyjamas, watched House and made banana bread. I did feel the need to go outside at least once so headed over to Lisa's and took her some of our banana bread [Sam and I are all about sharing ;)]







On Sunday I had agreed to go to the local Xhosa church with Asanda so headed up there for the 11am start. Or more like, the 11am standing around session – when I arrived there was about eight or nine women standing chatting who all stopped to greet me and shake my hand. I joined them in their standing around and tried to make some kind of sense of their chattering [I figure I should be getting the hang of isiXhosa by now!]. After a while enough people turned up for us to start and I was shown to my place, right next to the pastor's wife who had agreed to translate the sermon for me. Asanda had forgotten to show up to I found myself alone in the church. It was a little odd being the only white person there and sitting at the front with the respected older women of the community.

The older women of the congregation and Mama Mfundisi

We started with some hymns and surprise, surprise, there was a rousing rendition of everyone's favourite hymn number 74. I've now heard it so many times that I know the words:



Mnqamlezo! Mnqamlezo!

Ndoqhayisa ngawo;

Ndide ndizuz' umphumlo

Ekhay' ezulwini



Or something spelt remotely similar...







After that there was time for everyone to pray and as is customary, everyone prays out loud at the same time. If you imagine sitting in a room where you know very few people, with your eyes shut and all of them shouting at the top of their voices in a language that you don't understand, that's what the experience was like – mildly frightening! The sermon was delivered by a very charismatic young guy who liked to shout and wave his arms around [also mildly frightening at times] and as far as I could tell it was on the subject of 'good people go to heaven, bad people don't', which I suppose is fair enough! Following that there were church announcements which included a notice of a football tournament that the Jabulani Foundation [the one I work for] was running. Since the person meant to be giving the notice was away I had to explain about the tournament, meaning I had to go and stand at the front of the church, introduce myself and explain about the tournament, fun times.







At the end of the service I got up to leave but the pastor's wife told me I must wait there a bit longer because the women of the congregation wanted to speak to me. Next thing I know, I'm back up in front of everyone, introducing myself [again] and explaining why I'm here in Zithulele. The women were all so supportive and thanked me endlessly for 'coming to make the healthcare here better' [because clearly I am singlehandedly doing that! [Not]]. They also thanked me for joining them at church because they want the local community to integrate with each other more. Then they offered to start finding me a husband and I knew it was time to head back home....