Accepted

I am thrilled to announce that I have been accepted to Oregon Health & Sciences University! I will be starting medical school in August. Thank you to everyone who has supported me along the way. I received the e-mail early this morning and it was a wonderful way to spend my last day in Cape Town. Today I was back in surgery. I observed a complete medial malleolus fracture debridement and vac dressing application. I also observed an above the knee amputation, calcaneous debridement, and scrotal abcess. Tonight Ryan, Molly, and I plan to celebrate the end of our time here in Cape Town and my acceptance! Tomorrow Molly and I head to Durban for a new four week rotation through the program. I will update you all as soon as I have internet access again.

T.O.P Day 2

MATURE READERS ONLY

These are my observations of the health care provided minus the graphic details. I have put all politics and beliefs aside:

I arrived in the T.O.P clinic at about 8:30 this morning. Procedures began at 9 AM. The women scheduled to have terminations arrived at 7 AM and were given another dose of cytotec internally. Each are instructed to bring a towel to wrap around themselves as well as a plastic bag to catch anything that may come out before the procedure. They begin with the earliest gestations and progress to the latest. The registered nurses are allowed to perform the first trimester terminations without physician supervision. I watched 18 first trimester terminations which were finished around 11:30. I was the designated hand holder for many of the women, especially the younger ones. These women are not given any anesthetic. The reasoning behind this is that the procedure is quick and the injection is equally painful. Thus, they choose to forgo the pain relief. The nurses are rather unsympathetic to those in pain and conduct the procedures in an unemotional manner. There are only 3 physicians (all female) in Cape Town that perform 2nd trimester terminations. The doctor arrived and got set up for these ones. There were 17 second trimester terminations performed today. They are only given a local anesthetic around the cervix for pain relief. About half the women abort the fetus before entering the procedure room. Those that have not delivered are finished in the room. It is crucial to remove all products to avoid infection. Thus, the physician expels all contents carefully and makes sure that all the parts are accounted for. I apologize for the delicate nature of this topic, but I felt that it was important to share. These women are extremely grateful for the medical care they are provided. Many social as well as economic factors come into play in these communities and it is certainly an extremely complicated issue.
--

Freedom Day

Tuesday was Freedom Day, a public holiday in South Africa. We had the day off from work so Molly and I decided to venture out to Arra Vineyards owned by Neil and Monica. MOnica was a teacher from Nigeria when I was in school there. She is now married and owns a vineyard with her husband, Neil. We intruded on their quiet morning with their daughter Zara to say hello and check out their place. What a beautiful location they had! Neil let me taste a few wines and showed us around their cellar. It was great to see Monica and her family again after almost 10 years!
We had to get the rental car back early so that Jay could get to the airport. He left the program early to go home and graduate from Temple University Medical School. When Ryan got back from dropping him off we all went to the waterfront. Ryan needed to fit in some last minute shopping and then we headed back to Athlone.
Our driver to and from the hospital is "Uncle." He recommended that we try the "Great Gatsby" at the Golden Dish a local favorite restaurant. So, Ryan, Molly, and I conquered the task of finishing equal portions of this massive sandwich. It starts with a 2 foot long loaf of bread. Fries, peri-peri chicken, sauce, lettuce, eggs, and cheese are then piled on. I have attached a picture for effect. We finished this unbelievably huge and tasty delight. I would definitely recommend the Great Gatsby to anyone that ever makes it to South Africa!

T.O.P. Clinic: Day 1

MATURE READERS ONLY

Today marked my first day in the termination of pregnancy clinic or "T.O.P. clinic." The women are gathered in a waiting room at 8 AM. A "sister" (what they call all the nurses here) then briefs them on what they will be doing today. First step is each woman comes in to the consultation room to have HIV testing done. I performed all 35 of the HIV tests on the women ranging in age from 15-43. The HIV test involves a quick finger prick similar to those used for blood sugar testing for individuals with diabetes. The blood droplet is placed on a testing strip and buffer is applied. It takes about 10 minutes to get results. Thus, the women are filed through quickly until everyone is tested. Then they are called back in to be given their results. If someone tests positive a confirmatory test is done that is more sensitive then the first. In addition, they have their blood drawn in order to get their CD4 count. I also performed three blood draws and confirmatory tests for the three women who found out that they were HIV positive today. It was exciting but also disturbing to see how excited some women were to hear their HIV negative status. The reason I say this is because firstly that it is relieving to discover that you are safe, especially in an environment with a 60% HIV infection rate. However, it was disturbing at the same time because these women had no idea whether they were negative or positive because they weren't taking the necessary precautions to protect themselves from such a devastating disease. I will speak about this more when I touch on the counseling sessions.
After every woman is told her status, the physician performs ultrasounds at rapid speed. I have never seen something as efficient as the system they have in place at G.F. Jooste. The physician arrives at 10 am and is gone by 10:30 am, having performed about 35 ultrasounds. The ultrasounds are done in order to find out the gestational age of each fetus or embryo. A bi-parietal diameter (transverse skull) measurement is taken for fetuses over 14 weeks, a crown-rump length measurement is taken for fetuses between 8-13 weeks, and a sac measurement for anything less. They only perform terminations up to 20 weeks. Therefore if the gestational age is found to be 19 weeks then the woman can still have the termination done on Thursday that week.
Each woman is invited back into the consultation room one at a time. A brief patient history is taken and they are counseled on contraceptive use. Most of the women were not using condoms or taking contraceptives of any sort. This is unfortunate because they are not protecting themselves from pregnancy, HIV, or STI's. The sister counseling each woman was terse and adamant about condom use. This is the one thing they drill at each counseling session. I took down a big box of condoms and put it in front of each patient. I was hoping to encourage them to take a pack with them in the privacy of the office. Condoms are free virtually everywhere here, yet a stigma still exists and people are embarrassed to take them in public. Quite a few woman, I believe, felt more comfortable taking some with them in the privacy of the consultation.
The terminations are divided into first trimester and second trimester. The woman are then given an appointment date on Wednesday, Thursday, or Friday that week according to their category. The second trimester individuals are given Cytotec. Cytotec is a drug that causes the cervix to dilate in preparation for the abortion. They take 2 tablets every three hours beginning at 3 am of the day they come in.
Overall, it was a very interesting first day in the clinic. I learned a great deal about gestation, ultrasounds, and counseling methods that are effective in this community. Tomorrow is a public holiday in South Africa so I will be back in the clinic on Wednesday. Although this is a sensitive subject I am approaching it from a purely medical point of view. These women need quality medical care and that is what is being provided at this clinic. I am certain the next three days will be an eye-opening experience.

Paths, Penguins, and Points

We set off on our Cape Point tour on Saturday morning. We drove southeast toward Kalk Bay. Coffee was needed, so we stopped for a light breakfast and coffee at a small bakery looking out at the ocean. Feeling rejuvenated we continued along the eastern coastline of the cape to Fish Hoek. We stopped here to check out the recommended beach path known as the Jager Walk. The path looped around the bay which looks reminiscent of a fish hook. The picture above is from that walk. We certainly lucked out with superb weather for the day. After our walk we drove further south to Simon's Town. Here we explored the ocean side shops, took a walk up higher to check out the view, and checked out this quaint navy town. Up next was Boulders Beach just down the road.

Boulders Beach is habitat to a massive Jackass penguin colony. This time of year is the mating/moulting season. Many of the penguins were in hollowed out sand holes in the surrounding vegetation preparing to lay eggs or mate. We were able to find quite a few down on the boulders and get within a foot of these adorable creatures. The picture above was certainly my best photo sitting next to this friendly penguin. We ate at a restaurant at the boulders. Molly and I both enjoyed the fresh fish and chips. Bridget, Molly's friend from Tacoma who went to the aquarium earlier in our trip joined us for the rest of the day. After visiting the penguins we drove all the way to Cape Point. This national park has quite a few baboons living there. We saw big males, females, and babies. They were cute,lazy baboons, but also bared their enormous fangs whenever they yawned. I certainly wouldn't want to make one of them angry! Below is a picture of the southern tip of Cape Point.





The next two pictures above feature the lighthouse at the top of Cape Point. We walked up there to take in the panoramic view. The beaches below were pure white sand untouched by mankind. It was awesome. I enjoyed exploring the paths at the point. We continued up the western side of the cape until we reached Noerdhoek. From there we went on a windy, skinny road along the cliffs of the coastline. Amazing views of the Atlantic Ocean stretched forever until we reached Chapman's Peak. We all stopped there to watch the sunset with Hout Bay in the background. It was one of the best sunsets I have ever seen. This road was actually shut down for about two years to conduct repair and install rock fall prevention nets. We were lucky to be able to drive it! We stopped in Camp's Bay on the way back to Cape Town to have a quick dinner. We got home early so that the boys could get to bed. They went shark diving on Sunday and got picked up very early. Molly and I had Sunday to ourselves. Molly and I drove down toward Noerdhoek early Saturday morning. We stopped at McDonald's to test out the South African McDonald's breakfast menu. I am pretty sure there was legitimately authentic cheddar cheese on my breakfast mcmuffin! It was definitely better then the super greasy version at home. We wanted to do the Chapman's Peak and Hout Bay drive again during the day and it was just as spectacular. We eventually got to Camp's Bay where we had planned to spend our afternoon as beach bums and avid readers. We spent a good three hours baking in the sun. There were some professional volleyball players at the beach setting up nets. I walked over to the girls and asked if I could join in one game if one of them needed a break. I teamed up with a girl and played one match with them. It was great fun to play a little beach volleyball. One difficulty about this trip has been exercising. It is unsafe to run just about anywhere where we live, thus my exercise regimen has consisted of a few crunches and push-ups, walking down the hospital halls briskly, and throwing in a few lunges. Not much! I have realized how much I appreciate so many of the small things we take as normal back home.

Moyo!

On Friday we drove out to the Paarl region of the winelands. After some serious difficulties with directions, we found Fairview. Fairview is both a winery and cheese producer. Jay, Ryan, and I sampled six wines and a variety of tasty cheeses which Molly joined in on. We each bought a few excellently priced wines to take home. Molly picked out some cheeses and bread for us to snack on in the car together. The photo above explains Fairview's wine label: Goats Do Roam. They have two big goats at the entrance to the winery and the spiral castle is their special home. Quite a few of their cheeses are made from goat's milk. We then spent about 2.5 hours searching for two wineries, both of which we were unable to find. Exhausted and frustrated we decided to go straight to Spier Wine Estate. We had planned to go to Moyo, an African inspired restaurant there. Moyo was a fabulous choice that made up for our difficult day. The restaurant had an expansive layout with some tables in tree houses, others under tents or trees, and the main tent where we ate was beneath a massive canopy tent. I enjoyed a variety of delectable foods from the massive buffet. In addition, in the Xhosa culture white dots are used to create decorative patterns on the face to celebrate occasions. Molly and I both had this done as you can see in the picture above at dinner. It was a unique dining experience.

The Theater

Tuesday marked my first day in the theater. I began my morning by going through ward rounds with the surgeons. I was shocked to see a 15 year old boy who had survived a stab wound through the heart. Stab wounds are extremely common. The surgeons and trauma team here at GF Jooste have an unbeleivable survival rate. They are experts at saving those afflicted by stab wounds. I also saw an older man who initially had a mildly infected hair follicle which spread laterally until the infection covered his entire occipital region over 2 weeks. The solution to a carbuncle like the one this man developed is debridement of the area until the tissue bleeds and healthy tissue remains. The patient lost a tremendous chunk of tissue from the back of his head. The dressings are changed and the skin heals from the bottom up. I also saw a man who was in a car accident and suffered a superficial anterior tibia wound. It became infected and the area had to be removed. He was in for a skin graft to cover the area. He has been healing nicely over the last few days. These are just a few of the cases I saw on ward rounds. In surgery I saw a woman with a left ovarian ruptured abcess brought on by pelvic inflammatory disease that had been present for far too long.
A common theme among the cases they see here is that most patients wait very long to be seen. Their conditions have progressed much further then they should and the solution is surgery. For example, on Wednesday a diabetic man presented with a wet, gangrenous foot. He was going in for a below knee amputation. He has peripheral vascular disease and he had already lost his left foot. In patients with uncontrolled diabetes amputation is often inevitable. In surgery I got to watch a spinal block. Sometimes spinal blocks can be tricky if the ligamentum flavum (the ligament connecting the spinous processes) is calcified. This man had calcification which required some force to drive the needle into the subarachnoid space. The result after anesthetic is administered into the area is that the patient cannot feel anything below the waist. I saw another spinal block done on a young girl about my age who had a complete distal fibular fracture. It was quite a cool surgery to watch. I could see the bone and watched the orthopedic surgeon place a plate along the bone and screw it in place. Wednesday was a good surgery day!
Today I went on ward rounds. An older man was struggling with the decision on whether to agree to a below knee amputation. He fears the stigma of being crippled and chose to wait and discuss the matter with his family. His right foot was gangrenous and would either continue to rot upwards or require amputation down the road. He too had peripheral vascular disease. It's hard to see patients put off making decisions that would greatly improve their health, but in the end it is their choice to make. In surgery I watched a colostomy creation. This a re-routing of the colon so that a hole is made in the abdominal wall and the colon is attached to the opening. A bag is then attached and the individual will pass fecal matter through the opening. This lady had a malignant obstruction which prevented normal bowel movement. Surgery has been exciting and I have had the opportunity to see anatomy in action!

Tik Video Link

For those of you interested in learning more about "Tik" abuse watch this video. It is a documentary on tik abuse in Manenberg where GF Jooste Hospital is located.

Monday Monday

This morning began slowly during my last day in See & Treat. Whenever it rains hard here, patients have more difficulty getting to the clinic due to transportation challenges. I was supposed to be in Infectious Diseases this week. It was very slow today so they suggested I go back to See & Treat. I saw some interesting cases there. A did an ECG on a man with cardiomegaly and a history of TB. A woman with severe lower back and leg pain came in an the x-ray suggested a compression of the sciatic nerve between L4 and L5. The orthopedic physician suggested she needed an MRI to confirm. However, it is difficult to get an MRI here as the patient must see the orthopedic physician before being referred. Thus, the general practitioner schedules another appointment the next week with the orthopod who then refers the patient for an MRI at the tertiary hospital and so forth. Essentially, there is a lot of waiting involved. I also saw a patient presenting with a gangrenous foot concentrated on the 2nd and 3rd phalanges. It had been developing for 6 months! The interesting thing here in South Africa is that many patients are so used to pain, poverty, and unwellness that they tend to let things persist and develop far too long. When they finally see a physician it is often too late to help the person substantially. It is frustrating to observe but I'm learning about how patients think and what prevents people from seeking help even when they have access free healthcare. Toward the end of the day a woman with a posterior stab wound came in to trauma. I went to watch as they performed a thoracotomy. They were attempting to massage the heart, repair the injuries, infuse blood, etc but the trauma was too great. They were unable to save the patient's life. Stab wounds are very common in this area due to high use and presence of TIK, crystal meth. People will steal, kill, and squabble over anything because they are so addicted. Violence persists in the Manenberg area where GF Jooste is situated. The rest of the week I will be in Surgery or "Theater" as they call it here. More medical stories to come...

Garden Route Sunday

On Sunday morning we drove west to Botlierskop Game Reserve. We hopped onto a big safari rig with some other visitors and started our game drive. We saw elephants, rhinos, giraffes, impalas, black impalas, lions, waterbuck, and wildebeast. The giraffes were easily my favorite. The game drive was slow and bumpy on natural roads but our guide got us up close and personal to each siting. We enjoyed a great lunch and set off on the 4 hour drive back to Cape Town. It was nice to be back at the home stay after such an action packed weekend. The Garden Route was a superb trip and I am so glad I got to enjoy it and get to know the group so well. We had many laughs and bonded with Avril and Marion.

Garden Route Saturday

On Saturday morning we drove close to Port Elizabeth, the farthest eastern point of our trip. Here we got ready to do the Tsatsikamma Canopy Zipline tour. We had a crazy zipline leader Siya who joked with us the entire tour, taught us Xhosa phrases, and served as our personal photographer. There were 10 ziplines of various lengths and heights throughout the rainforest. The highest was about 30m and the farthest about 65m. You could seriously pick up speed on the zipline and enjoy looking around the rainforest on the long ones. I had a blast going from line to line. It was also a great warm up for the bungy jump later on. We grabbed box lunches to go and headed for Bloukrans Bridge around 1 pm. See my previous post for the bungy jump experience with pictures! After the bungy jump we continued on to Knysa Elephant Park. The park has saved about 12 elephants of various ages (including three baby/young elephants). We had the opportunity to feed them fruits. Their trunks were muddy and greedy as they cleaned out the food quickly. After feeding we broke into small groups and walked around with a guide. We could walk right up to the elephants, touch their ears, pet them, and look at their giant mouth molars. It was amazing! They were gentle creatures and seemed to love the attention and especially the food. After this awesome excursion we drove to Knysa lagoon where we took a cruise out to the entrance to the Indian ocean. We snacked on appetizers and enjoyed some drinks. I included a picture of myself with Avril, our medical director (right) and Marion , the program coordinator (left) on the cruise deck. For dinner we ate at Checkers, a pizzeria. Molly and I shared a delicious pizza and I had a great South African wine with my meal. Another tasty treat we have discovered are Don Pedros: ice cream blended with some Amarula, yummy! We drove back to the hotel after dinner and called it a night.

Garden Route Friday

We left Athlone at 5 am in our stylish bright blue VW van. Two medical students joined us who were on clinical rotation with Stellenbosch University. Shaziya from Germany and Inge from the Netherlands came along. We stopped for coffee and then ate breakfast at The Country Pumpkin about 3 hours into the drive. Continuing east another hour we arrived at the Cango Caves in Oudtshoorn. We started the Adventure Tour entering the first massive chamber containing massive dripstone formations as shown in the picture above. We went on to the second chamber to see more stalactites, columns, and dripstone formations. The adventurous part was maneuvering through tight spaces in a giant loop. We squeezed through the tunnel of love, up the devil's chimney, and shimmied out the letterbox. Jay and Ryan found the experience to be claustrophobic while us girls had a blast. It did feel great to emerge and escape from the humidity of the caves. We continued on to Cango Ostrich Farm. We interacted with Betsy, the friendly ostrich. I got to feed her and she gave me a hug with her flexible neck. Next we rode ostriches, yes rode them... Needless to say it was a bizarre experience to ride such a massive bird around! We ended our day in the town of Wildernis and checked into our hotel. Molly and I were so excited to find two large beds in our room. It was wonderful to sleep in a big, comfy bed compared to our little twin beds at the home stay. That night we ate at Blue Olive where a live band played as we enjoyed a great meal.

Bungy Jump Pictures

Here are pictures from the Bloukrans Bridge Bungy Jump I did on Saturday afternoon. Jay, Ryan, and I were willing participants while Molly did the zip line under the bridge instead. It was a thrilling as well as scary experience! This was just one of the many activities on the Garden Route Trip I went on over the weekend. Enjoy!

Week Two

I have spent the last three days continuing to observe in the See & Treat and Casualty departments. A new physician in See & Treat has educated Molly and I a great deal about the process of diagnosis, what steps he takes to narrow down possibilities, and plenty of other useful tips. I got to observe the infectious disease ward rounds on Tuesday afternoon. An infectious disease consultant from the big tertiary hospital Groote Schur came to analyze the particularly challenging cases. Some individuals have HIV, TB, and other drug interaction complications. It is difficult to treat such complex cases, therefore it has been an informative experience for me to learn how they deal with these patients complications. Essentially TB treatment medications often have uncomfortable side effects or drug interactions with anti-retro virals. In the case where patients are responsible for taking their medications they often become non-compliant and stop taking some of their meds because the side effects are so difficult to live with. It often creates a vicious cycle of dealing with both diseases. I also observed a few femoral artery blood draws, did an ear examination, saw quite a few Deep Vein Thromboses, and a variety of other cases. A slightly disturbing situation occurred on Wednesday morning. During rounds in Casualty the doctors go around to each patient and briefly discuss their case so that the doctors for the new day know what has gone on over night. Some patients are passed over because their new or are being discharged for example. We passed by a middle-aged man on a wheelchair who looked asleep. About 5 minutes later one of the nurses quickly called over one of the doctors. The man had passed away in the wheelchair. It was an unfortunate circumstance because he had imminent liver failure from hyperglycemia related complications but he should've had a bed. This is a great example of the kind of patient load they are dealing with in their casualty department, the volume of patients is overwhelming and often there are simply not enough beds. I am learning a lot about the many healthcare challenges faced here in South Africa. This weekend we are going on the Garden Route trip with Avril and Marion our coordinators. It should be great fun and plenty of pictures will be up on Monday.

Table Mountain

We got to Table Mountain and starting hiking around 8:30 AM on Sunday morning. We chose the "easy" route known as Platteklip Gorge. It is about a 2.5 hour hike to the top. It was a beautiful sunny day with only a light breeze. It was a gorgeous hike with striking views all the way to the top. Essentially it was like walking on a stair master for two and half hours! I have included a few pictures of our ascent. At the top we explored the mountain top with its panoramic views. We ate lunch and got some sustenance from the cafe. After taking a few dozen photos we headed back down on the steep cable car. We went to Camp's Bay to lounge on the beach. Molly and I braved the frigid waters of the Atlantic Ocean as well. We went to Col Cacchio pizzeria for dinner and indulged in some delicious pizza and malva pudding. We were all tired out from the long hike! That night Molly, our host family, and I watched The Proposal before going to bed. Today, Monday, I spent my last day in See and Treat. A new doctor was here today and he was very helpful with breaking down some of his diagnostic approaches. I also chatted with him about medical school in South Africa versus America. I saw a few patients with him and he explained a lot to me. I also sat in on some patients with Molly. We did an ECG on a patient together and each of us learned how to do our first blood draw with assistance. I also saw a young lady with a grapefruit sized abcess located on the lateral right knee. The variety these general practitioners see amazes me everyday. It has been wonderful to gain exposure to so many issues and conditions. Overall, I learned a lot today!

Perfect Weather Weekend

I don't know if I have introduced you to the other students on our program yet...Ryan, Jay, and Erin are all 4th year medical students graduating as soon as they return to the States and entering residency programs. Erin has been here for three weeks already and this was her last weekend here in Cape Town. She wanted to go to Robben Island and climb Table Mountain. Both of these activities were weather permitting. We lucked out with spectacular weather. On Friday night we got our Ford Tracer rental car which took about 7 tries to get it started each time we got in the car and would have easily qualified as a clunker in the states. We went to Long Street where there are some great restaurants. We ate at Addis in Cape, an unbelievable Ethiopian restaurant. The pictures above show the traditional eating style and coffee ceremony we enjoyed. We also went across the street to watch and partake in some belly dancing at Mesopotamia. Early Saturday morning we drove to the waterfront to be the first in line to get "walk on" tickets for the ferry to Robben Island. We were lucky enough to get on board the 9 am ferry. Once on the island, we were loaded on to tour buses that took us around to the important locations on the island including the prisons, leprosy cemetary (lepers were concentrated on the island long ago), the lime stone quarry where ex-political prisoners labored, and the maximum security prison where Nelson Mandela spent 18 years of his sentence as an ex-political prisoner. I have included a picture of the cell he occupied above. When we returned to the waterfront in the afternoon we had lunch at a South African inspired restaurant called Karibu, the food was amazing. Then we explored the shops in the area since Jay and Ryan hadn't been there yet. Later we drove to Camp's Bay to eat dinner and watch the sunset. We had some tapas and sushi. It was a busy day!

Casualty and See & Treat

My first three days at GF Jooste District Hospital have been a thrill. It has been an eye-opening educational experience thus far. Casualty is what we would call the ER back home. They have many many beds in a large open room with simple curtain sheets to draw around for privacy when needed. There are other students from the University of Cape Town in their 4th year of medical school getting practice. In addition, there is a full staff of nurses, doctors, and support staff. I have been following rounds in the mornings and then seeking out interesting patients and events throughout the day. They see a high load of "medical" patients during the day. This means they see an array of issues from HIV/TB complications, high blood pressure, DVT's, abcesses, stroke, TB, MDR-TB, and meningitis to name just a few. I got to observe two lumbar punctures (taking a sample of cerebrospinal fluid), blood draws, IV inserts, and many other small procedures. It has been most interesting to listen to the doctors line of inquiry and history taking with patients. I feel like I have learned so much in just a few days about how physicians go about reaching a diagnosis or a plan of attack to rule out possibilities. I also spent a great deal of time in the See & Treat section shadowing Dr. Isaacs a general practitioner. She sees patients on referral from the local day hospital. She will take a brief history and look at prior tests if it is their second time back. They see a great variety of issues in this section of hospital. I have really enjoyed learning from her over the past few days. Many things are drastically different here but the process of making a good diagnosis and treating patients effectively is quite similar. The kinds of complications are highly related to the poor sanitation, cramped living situations, and high rates of HIV/AIDS and TB in this region. The number of patients I have seen with TB and HIV is overwhelming. I didn't quite expect such a high percentage. I will be spending some more time in Casualty next week. Hopefully I will be able to post another blog on Monday about my weekend for all of you readers!

District 6/Township Tour

Yesterday we went to the University of Cape Town to get registered and get our ID badges. The university is beautiful, and covered in ivy. Other areas are more modern too. The student population is so different from home though, much more diverse. Next we met up with Colleen. Colleen was our vibrant, knowledgeable tour guide for the day. We would stop frequently so that she could explain the history and progression of South Africa for us throughout downtown Cape Town where that history started. We made our way throughout the city and eventually went to District 6. District Six is the site where people were forcefully removed by the apartheid regime. They were forced to relocate to the Cape Flats with hardly anything in an area comprised of sand dunes. Colleen and her family were from District Six and were relocated to Mitchell's Plain. Other townships include Langa (the oldest remaining township) and the massive Kyalitsha and Guguletu. It is impossible to describe what these places are like. The creatively pieced together shacks of scrap metal and other findings stretch form kilometers and kilometers. Everywhere you look are dangerously tapped electrical wires just to suck some energy from light poles. We ventured through all of these areas as Colleen described how they came to be and what they are like know. They look dirty and disorganized, yet there is great control and organization within them. Some of the major issues are HIV/AIDS, TIK or crystal meth use in youth, early sexual activity, and gang violence. Many organizations are there to help from grassroots efforts including Love Life funded by the Gates Foundation. Essentially, Tuesday was an overwhelming amount of information both verbally and visually. One uplifting place we visited was Philani Nutrition Center. This is a place where professionals go out and identify malnourished children in Kyalitsha. They then invite the children and their mothers to come stay. The children are fed and educated while the mothers make woven work to sell and earn a living. It's a wonderful place! What an amazing day though. I'll have more to tell about today (Wednesday here).