1/23/09-1/24/09

1/23/09

I was so frustrated today. The nurses do no listen to me and I don’t know why. Maybe they think I am to young or maybe they are just to busy or jaded. Turns out my patient with drug induced hepatitis has been taking her efavirenz the whole time. For the past four days she has been taking the medication that is causing the problem she was admitted for. I am so frustrated. This is crazy. I wish I could speak with these patients and then I would be able to care so much better for them instead I survive on hand gestures and pieces of English.

After this frustrating experience I found my second patient with an infiltrated IV line. Her whole hand had puffed up two times normal and looked horrible. It was huge. Why didn’t she say something to the nurse why didn’t someone do something?

My other patient went to the HIV clinic yesterday and waited for four hours but was turned away because they didn’t want to see her while she was still in the ward. The doctor came over and told me that although my patient was recently diagnosed with AIDS and her CD4 count was 9 she did not need to start with the ARV training right away. She made it clear that starting ARVs is not an emergency and can wait. I guess I should have waited until she was ready for discharge and then sent her over but my patient was so motivated to start the process. I felt like there was so little I could do for her and this was something in my reach. I could send her to the HIV/AIDS clinic and maybe get her started on ARVs and that would be a success.

On our way home we came upon a group of young girls as we were entering the convent. The young college students live in a hostel the convent runs for young girls far from home. Their names were Mosa, Ledoll and Stao. Mosa was quite entertaining and outspoken. We spoke shortly and then were going to go home but Mosa insisted that we come see how they live. She grabbed Caitlin and I’s arms and dragged us in the direction of their home.  We walked past our little house and down the path toward their house. I only knew that that their house existed by the noise that would come from the hostel at very late hours. The whooping and laughter coming across the convent would keep me up at night. As we approached the building young girls were playing tag outside and running in an out of the gardens. The old building was two stories and clearly had seen better days. The entrance had a ledge above the front door and there where three women sitting up there chatting.  The place seemed to be teeming with young women. The smell didn’t hit you until you entered the building and worsened as you walked up the stairs to the dormitory. The smell of human feces was overwhelming. It was horrible and I couldn’t believe how poorly kept the house was. The girls who live in this house do their own cooking and washing and recieve little guidance from the sister that manages the building. The group had grown as we reached the top of the stairs and now we were surrounded by young smiling women and when Caitlin took out her camera the decibels increased by 100%. The dormitory was filled with bunks and accommodated 52 girls. It was unbelievable and a stark contrast to our little house. Mosa put a very large brimmed yellow hat on my head and wanted to take a picture of me with her cell phone. I posed with my usual funny face and they laughed and giggled again. We were escorted out by the young ladies and they asked us to come back.

1/24/09

Today we went hiking in South Africa with Phil, Sandy and Rick. We left the convent at about 9am and headed out into the countryside. We crossed the border in Ficksburg. We all had to get out of the car and have our passport stamped in South Africa and then we headed toward town. At the boarder crossing there were lots of people selling squash and I even saw a guy wearing a M. Jordan shirt. I had been talking with my father in the morning and he had particularly wanted to know about the squash and M. Jordan t-shirts. So as I saw both in the same minute I smiled. When you cross the border into SA there is a dramatic change. There is clearly much more infrastructure as evidenced by street signs at every intersection. In the town of Ficksburg there were tons of Africanns and it was weird to see so many white people.

The drive from Ficksburg to the Golden Gate National Park was beautiful. It was the same countryside as Lesotho but along the roads there were crops of neatly planted corn and large tractors rolling the hay. There were no herders for the sheep or cows as the livestock was fenced into their pastures. The landscape was impressive. The flat topped mountains were painted in reddish streaks of brillant color against the radiant green of the grass on the plains. The sun came in an out behind the clouds and created spotlights on the mountain tops. A team of bike riders passed by in their kits speeding by the small shacks where the farm workers were selling peaches. We went on two hikes at the park. One of which took us to the very top of one of the mesas and another which took us into a narrow canyon carved out by years of water and wind. As we walked we saw evidence of the baboons that live in the park. After the park we also went on a game drive. The game that inhabit this park are zebras, elands, antelope, and wildebeast. We sadly only saw one wildebeast and one eland.

After our visit to the park we went to Clarens. Clarens is a very fancy pants town with art galleries and coffee shops.  It’s claim to fame is that it is frequented by Brad Pitt. It was wild being there. I felt almost awkward as we walked through the square of this very ritzy town overflowing with white tourists each accompanied by a Mercedes Benz.