Goodbye Durban, Hello Jozi

Our last week in Durban flew by. I celebrated my 23rd birthday on Wednesday with homemade lasagna, espresso brownies, ice cream, and wonderful company. Molly and I said our goodbyes to our amazing host family on Thursday night. The boys, Qiniso and Makabongwe, cooked a “braai” for us, which is a barbeque, to honor our departure.
On Friday morning we were dropped off at the Happy Hippo, a backpackers’ hotel. From there we got picked up by “Baz Bus” which is a backpacker transport system here in South Africa. We took a 10-hour scenic drive across Kwa-Zulu Natal, through the Drakensberg Mountains, and into Johannesburg. We could see Soweto stretching far and wide on our way in to Joburg. Soweto is the largest township in South Africa and home to “Soccer City” of the World Cup. Baz Bus safely deposited Molly and me at Brown Sugar Backpackers Lodge. We had a twin room booked for two nights at this hotel that resembles a castle and has quite eclectic décor. For example, above the entry way is a warthog head and on the other side of the wall is the warthog butt...
On Saturday morning, we made eggs and toast for breakfast down in the communal kitchen before starting our day. Molly and I are both battling sinus/head colds so we decided to have a relaxing day in Johannesburg rather then try to see it all in one day. We walked about 30 minutes to East Gate Shopping Mall. We bought tickets to see Sex and the City 2 and grabbed some coffee before the movie. I enjoyed a superb almond latte at Lattelicious (finally a good cup of coffee) and an almond croissant. Then, Molly and I grabbed some meds, orange juice, and vitamins at Clicks Pharmacy and went to enjoy the movie. On our way back we went to an African market to pick up a few last minute gifts. Then we enjoyed Won Ton soup and veggie spring rolls in China Town which was right down the road from our lodge. Tomorrow we catch a flight to Nelspruit to go on our three-day safari. On Wednesday night we start the long trek home. We are winding down into the last leg of our trip!

Malagazi Clinic

We spent the day at Malagazi Clinic run by the Islamic Medical Association. It is located near Umlazi Township and primarily serves rural, poor populations. Immunizations and family planning took place in the morning. Molly and I took turns giving immunizations and birth control injections. It was good practice for us!
The rest of the day was spent with patients presenting with flu, shingles, STI's, colds, and other common ailments. Molly and I were in charge of collecting medications to dispense and administering the injections... more practice!
Malagazi Clinic was similar to our Marianhill Clinic experience but far more hands-on.

Zodwa's School

Saturday was an action-packed day starting at 7 am! Zodwa drove Molly and I to Stanger, a rural town about 55 km outside of Durban. We picked up two other teachers along the way and arrived at her school. Thirty-one teachers educate over 1,000 learners in grades 1-3. Its an incredibly large school. Another school came to have an athletic fun day with the children. The kids did some socializing, singing, and introductions were made between the schools. The adults had some sandwiches before heading out to the playing fields. The teachers from each school formed teams and had a friendly match of Netball which is similar to basketball without bouncing the ball. One of the teachers fell and hit her head hard on the concrete surface. Molly, Zodwa, another teacher, and I accompanied her into Stanger to have her checked by a private doctor. She was given some medications, an ice pack, and sent home to rest.
When we returned we watched the boys teams battle it out in a soccer match. These kids were unbelievable at soccer! I finally understand the craze here, because these kids were better than any high school match I've been to in the States. Absolutely incredible little athletes. It was fun cheering on the kids and taking part in their victory over the other school.
We enjoyed some delicious barbecue or "braai" as they call it here. We helped pack up everything and left the school late at about 6. We spent a couple hours at Gateway Mall on the way home. It is a huge 4-story mall with everything you can imagine. Molly and I indulged in some soft serve ice cream, shopped a little, and strolled the entire mall.
On Sunday I slept in, finished a book, did some grocery shopping to make lasagna for my birthday on Wednesday, and relaxed with the family. One week to go!

Surgical Summary

Standing in front of the surgical board where they post the cases for the day.


I spent this week in Surgery. Surgery at King Edward is divided into teams and they work on different days of the week in order to divide surgical time. There is always a team on in-take which means they handle 24 hours of emergency surgical care. Molly and I bounced around with different teams throughout the week in order to make the most of our short experience.

Monday: After finding our feet in a new department, we hooked up with the gyne team. The elevators weren't working until about 10 am, so surgeries were quite delayed. We observed a total abdominal hysterectomy. The procedure took about 3 hours and was extremely interesting. At the end of the day we popped in the labor ward to see if we could watch a childbirth. We were in luck. Molly and I both had the pleasure of viewing our first child birth. WOW. It was an unbelievable experience! I commend all mothers after having observed a normal vaginal delivery.

Tuesday: I observed a tonsillectomy and adenoidectomy on a young girl, a zygomatic lift on a man who had sustained a fracture a month ago, and a laparoscopic cholecystectomy (which is the exact procedure I had two years ago). The most exciting procedure of the day was a soft tissue release and repair of a 4-year old who had a neglected club foot. The orthopedic surgeons were excellent teachers and explained the procedure thoroughly.

Wednesday: On the surgical menu for the day was a vaginal hysterectomy, genital wart cauterization, glenoid cavity fracture repair using a plate (the individual was shot, shattering his scapula and fracturing the glenoid cavity in half), mandibular fracture repair, and an open reduction internal fixation (ORIF) of a femur.

Thursday: I saw a femoral nail insertion which required a ridiculous amount of hammering! The nail is hammered down the shaft of the femur to secure the fracture. I also observed a right mastectomy on a woman with breast cancer.

Friday: Today a trauma patient involved in a road traffic accident came in to surgery. They repaired a tibial fracture and proceeded to repair a diaphragmatic hernia. After this lengthy procedure I observed an abdominal hernia repair.

This week was eventful in surgery! During our down time Molly and I would go check in on the kids in the pediatric ward, rock crying babies, and entertain the kids. It was a great week at King Edward. I am winding down to my last week in the program. I have to say I am looking forward to coming home!

Cute Kids

Fun times in pediatrics!

Weekend

Friday night we made popcorn with our host family and watched one of their favorite movies, Sarafina, with Whoopi Goldberg. The movie was about the student uprisings in Soweto, South Africa's largest township, during apartheid.
On Saturday I woke up to a very rainy day in Durban. Molly and I spent the day shopping at The Pavilion, one of the large malls here. We also saw the new movie, Robin Hood, which was excellent.
Sunday was a beautiful, sunny day. We rode a mini bus taxi to downtown Durban. From there we navigated our way to Victoria Street Market. My mission: to find Zulu baskets! I found a great market shop that had amazing, affordable Zulu baskets. I bought four for myself and one as a gift for my mom's birthday. Here are the baskets Molly and I bought.


After our market adventure we walked to North Beach where we enjoyed a tasty lunch at Joe Cool's overlooking the beach. Then we lounged on the beach for the afternoon. The rest of our evening we spent having dinner with our family.

Pediatrics

On Monday I began my week at King Edward Hospital. This is a tertiary hospital in Durban that serves the entire province. It is a teaching hospital affiliated with the Nelson Mandela Medical School through Kwa-Zulu Natal University. I spent the first three days in the Pediatric Resuscitation Unit (PRU). This is where the severely sick patients receive extra attention and full work-ups until they are stable enough to go to a ward for care. Dr. Ramji was the consulting physician in PRU. He was an excellent teacher and Molly and I joined him on rounds for about three hours each morning. He was detailed, thorough, and compassionate with each patient. We saw patients afflicted by cardiac defects, HIV related complications, Gastro Enteritis, Measles, Chronic Nephritis, Epilepsy, and much more.
Two patients stand out for me. A 3-yr old boy came in who appeared to be under a year old in development. He had Marasmus due to severe malnutrition, HIV complications, and dehydration. This child needed help desperately. It was very difficult to see a child in this state. The children here are products of their environments: extreme poverty, uneducated parents, and other socio-economic factors. Another patient was a 10 year old girl suffering from stage 4 HIV infection (AIDS) complicated by cryptococcal meningitis and marasmus. Her mother carried her in wearing her hot pink sweat outfit and she was adorable and talkative with us. We checked in on her throughout the week to see how she was doing.
On Thursday we went to the nursery and mother/baby units. Babies were everywhere! They deliver about 30-40 babies a day at King Edward. They have an ICU with only three ventilators for the entire province. They also have high care, premature care, and another room for low birth weight babies with complications. I saw about 50-60 babies in the nursery. Some interesting cases I saw: melanoma, polydactyly, myconium aspiration, umbilical central line insertion, and countless lumbar punctures and blood draws. I also so a baby die because its chances of survival on ventilation were less than the three others already on ventilation. It was unbelievable to see how many babies were being cared for in these units and with so little resources. The physicians working in this environment are incredible.

Late Pictures from G.F. Jooste Hospital

The Trauma entrance at G.F. Jooste Hospital:



TB Prevention in all three languages:

Xhosa


Afrikaans


English


Theater scrubs!


Molly and I at the hospital staff entrance:


Last meeting with Marion and Avril

Ushaka Marine World

Molly and I picked up some flowers at the mall on Mother's Day for Zodwa, our substitute mom for the day. She loved the flowers! Then, Molly and I got a ride from Zodwa to Ushaka Marine World. Makabongwe or "Maka B" the 13-year old son at our home stay came with us. Ushaka has 16 water slides, a floating river, and a public beach nearby (equipped with shark nets). We all enjoyed the water slides and river float.



We grabbed some lunch and ice cream before heading to the beach. It was a perfect day to sun tan. Molly and I are determined to look like we actually went to Africa when we get back! The ocean water was warm and perfect for body surfing. Here is a view of the new world cup stadium and downtown Durban from the beach.


At the end of our day we decided to get home "African style." Maka B, Molly, and I hopped in a mini bus taxi and rode to Workshop in downtown Durban. The trip cost each of us only 50 cents. Next we caught another mini bus taxi from Workshop, the central Durban transport spot. We were dropped off right on our street back in Woodlands for about a dollar each! It was the cheapest, fastest taxi ride I've ever taken. One relaxing, fun weekend under our belt and three weeks in Durban to go!

Umlazi

On Saturday, our program group went on a tour of the second largest township in South Africa: Umlazi. This township is divided into districts A-Z and they have even progressed to districts AA, BB, and CC. The township covers an astounding area. Most homes do not have access to water. Every morning people form a que at the water pump and fill up a bucket of water for the day. Electricity and indoor plumbing are scarce. A shack serves as a toilet for a large area. Many people use this one shack as a toilet and place to bathe. We went inside one home that had extremely unsafe access to electricity, unhygienic kitchen and living quarters, and scarce amenities. The districts each have a council with appointed community leaders that keep the community safe. Some of these councils are so strong that crime is virtually erased from their district. They have been able to accomplish this by using "kangaroo courts" that dole out disturbingly harsh punishments for criminals. We also visited a small sanctuary in the midst of poverty. How Long? Park is a park built by hand over the last 30 years by a young man who had a dream to create a place free from suffering in that area. His question inspired the name of the park as he asked the question, "How long will we suffer?"



He and his wife started shaping the park and lived in a two-person shack. Through their hard work they have created an exceptional park and a great home of their own.

Chatsworth Hospice

I spent Thursday and Friday at Chatsworth Hospice. Chatsworth is a predominantly Indian area of Durban. Hospices in South Africa are individual non-profit organizations generating funds through philanthropy and fundraising at the community level. Chatsworth has ten beds available for hospice care. Their hospice system differs from the United States. They care for individuals in the community with cancer and track their progress. They follow up on these patients by doing home visits. Some patients they see weekly and others they see less frequently if they are healthy and in remission. These home visits allow them to assess whether that person should come to hospice if they are terminally ill or whether a few days in hospice may improve their pain management so that they can return home. Otherwise the visits are encouraging to patients undergoing chemotherapy and radiation therapy. Many patients in their culture prefer to die at home with the comfort of family care during that difficult time. Hospice provides the opportunity for families to learn how to care for the person during this time and they can help manage their pain better at home. Other patients can choose to stay at hospice and receive the palliation care they require. Chatsworth staff was very compassionate and loving. It is essentially a home away from home for cancer patients. We spent all day Thursday doing home visits. I saw a range of stages of cancer. The first man we visited was terminally ill from prostate cancer. He refused to come in to hospice and was choosing to die at home. His support system was excellent and he was receiving wonderful care from his family. We were there to check on the family to see how they were holding up and whether the man was doing alright. Each visit included a series of questions, blood pressure measurement, and speaking with the patient a while. A lot of love and concern went in to each visit. We saw about a dozen patients that day. On Friday we sat with the three patients receiving care at Chatsworth. Molly and I talked with each patient for a while, asked questions, laughed with some of them, and listened to their story. The rest of the day we went on home visits. Chatsworth was a great experience. They have done a wonderful job of providing such personalized care to their community.

Marianhill Medical Clinic

The Islamic Medical Association funds Marianhill Medical Clinic. Because it is a private clinic, patients must pay 40 Rand to be seen. There are 2 "sisters" or nurses that see patients. The other staff members organize patients, take observations (BP, weight, blood sugar), and explain how to take medications. I spent most of my time with Sister Karema over the past two days at this clinic. Between her and the other sister they see anywhere from 140-160 patients a day. The most common cases I saw were shingles, STI's (Sexually Trasmitted Infections), Flu, Sores, and a host of other common problems. There were many children seen at the clinic with flu, sores (poor hygiene related), and diarrhea. They have a Voluntary Counseling and Testing center in the clinic. The VCT counselor's name is Vusi. His job is to do pre-testing counseling, HIV counseling, and post-test counseling. He educates those who discover their status on how to go about staying negative or what to do next if they are positive. It's a difficult to job to give that kind of news.
Today one of the sisters took us around the rural area to do some home visits. Unemployment is extremely high and many people that are sick do not have enough money for food or transport to get to a hospital or crisis center for help. It was a very sad experience. Later in the day Vusi took us to visit the local Sangoma. A sangoma is a traditional healer in the Zulu culture. The sangoma is always a woman. She showed us the herbs, oils, and "mutis" (mixtures) that she uses to treat those that come to see her. It was a great experience to see where some of patients seek help and what is actually given to them. It is certainly a very ancestral, spiritual sort of practice. If anything, it works to ease the psychological stress of unwellness and harnesses the mind's healing power over the body. Many Zulu religiously believe in the healing power of the Sangoma.



My time at Marianhill was well spent. I learned how clinics operate to efficiently see many patients in such a poverty stricken area ridden with HIV/AIDS. Tomorrow we go to Chartsworth Hospice Center.

Durban

We arrived in Durban on the opening day of the King Shaka International Airport. It is a beautiful, new airport built for the upcoming FIFA World Cup. Durban is much warmer, greener, and more tropical than Cape Town. I'm loving it! Molly and I are staying with Zodwa and her two sons, 17 year old Qniso and 13 year old Makabe. They are both very nice young boys. Also joining our host family is Toffi, a lively Doxen-Bush mix dog. She is a sweet dog to have around. Molly and I relaxed yesterday and went shopping for groceries with Zodwa. Maureen, the program coordinator, stopped by to give us our phones. Today, we slept in, went for a run, and read for a while. When Zodwa came home from church she took us to "The Pavilion." We are at this HUGE four story mall at an internet cafe. The place is amazing and far nicer than the malls at home. I was shocked! Later today we have orientation with the two students that arrived. They both live at host families a couple blocks away. I am not sure how often I will have internet access so bare with me on the timing of my posts!