May I Help You?

Woof.  Back in America is crazy.  But more on that later, let me summarize the last days in Africa.

So on Monday, I presented my research, which was actually awesome.  It was really satisfying to present my work that I am so passionate about to others that were at least marginally interested in it.  I then got to listen to everyone else’s presentations.  It’s absolutely fascinating how varied all of our research was.  Monday night most of us stayed at the program house, where we cooked a big communal dinner, and watched Bridesmaids.  

Tuesday we got up pretty early to debrief the entire program.  Joy.  Then we left to drive to St. Lucia where we would begin our two days of safari!  We started with a boat safari in the estuary, and saw a bunch of Hippos and Crocodiles, and it actually got to be pretty boring, but it was nice just to relax with everyone.  We all went out to dinner that night, which was again very relaxing.  

Wednesday we got up at the ass crack of dawn to get to the game park.  We got there as the sun was rising (which actually did look like the lion king) we started driving and BOOM ELEPHANTS.  So after having an inner freakout at how amazing my life was, we kept going.  Then all of a sudden there was a giraffe in the middle of the road.  IN.  THE. ROAD.  Kept trundling along and there were impalas EVERYWHERE.  And babies too the little cutesy things.  Then we saw a mama warthog with a bunch of babies.  So.  Cute.  Then some zebras posing along the road, a dung beetle, and some rhinos.  Then we found some big mommy kitties.  LIONS! So. Cool.  Then more rhinos, another elephant, mor giraffes and some buffalo.  Pretty big day.  We all got some groceries and hung out before bed, but we all turned in early.  We woke up crazy early again to go to the airport.  It was so strange that it was my last day in Africa. First flight was fine, little puddle jump to Joberg.  Second flight was fine.  Of course I was sitting next to a guy who lives around the corner from my job in somerville and works for the Harvard School of Public Health.  Of course.  The third flight (after we all got sprayed down for yellow fever.  lolz senegal) sucked.  I decided to take an ambien (prescribed, calm down) but it just made me super woozy, and I spent the majority of the flight throwing up, but since it was Ambien induced, I barely remember it.  Then I landed in DC and had the easiest customs of my life.  I was practically skipping through the airport.  I got a blueberry muffin, OJ and hot chocolate from Dunkies.  Then I hopped on my flight to Boston.  I flew over NYC and saw Manhattan and the Statue of Liberty which was really nice.  Then I landed, and SPRINTED off the plane to the door where my parents were waiting.  I pretty much flung myself at them.  Lots of crying.  Then we grabbed my suitcases and brought me home.

Being back in the US is weird. I keep having these feelings like I’m just dreaming and I’ll wake up back in Durban.  It’s also SUCKED being home for the biggest consumer season of the year.  I was bumming around downtown with my mom the other night and a woman said to her boyfriend “Well you can buy me THIS Gucci belt” and I nearly flipped a shit at both of them.  It’s sucked, because I know many people don’t have the perspective to understand how sad this is.  There are people living in South Africa in the direst of conditions, and here we are trying to find the perfect holiday gift.

I think, in retrospect, that as much as many aspects of this trip sucked and were extremely difficult to deal with, this was probably the biggest and most important learning experience of my life.  I have a much broader perspective on the world, and I have gained so much knowledge about healthcare, and about myself.  I am so grateful to my family and friends, and also all those that I worked with in South Africa for all of their help, love and understanding.  

This is me signing off until the next adventure

Ngiabonga kakulu (thanks a lot) for reading!

So I handed in all of my work today.  Basically my oeuvre.  2 gigantic papers and a presentation later I’m done.  Which means I’m academically done with South Africa.  I’m sorry what?  Didn’t I just get here?  More postings about the safaris to come later.  Stay tuned

Wednesday was pretty slow, just a transfer, a mildly psychotic patient who was tweaking out from her ARVs, and a hypertensive.  I was sad because it was my last day with my favorite crew.

Thursday was a vaginal bleeding, and 2 transfers.  I took some photos, so I’ll try and put those up shortly.

But Friday was the beginning of my adventure to CAPE TOWN!!!

We got on the plane at the ungodly early hour of 7:45 (we woke up at 5) and after landing, took a bus to our hostel.  Cape town has actual public transportation.  Incredible.  Our hostel was located in the middle of where all the clubs were, so it was bustling! Our hostel even had a popping bar in it.  We hung around for a little bit, then walked down to the waterfront for the ferry to our tour of Robben Island.  For those playing along at home, Robben Island is the famed apartheid political prison in South Africa.  We took a fast ferry over there (think the P-town one).  Our tour started with a 45 minute bus tour of the island, where I learned a bunch of history I didn’t know previously (It used to be a leper colony, people actually still live there, etc.).  Then we had a guided tour of the maximum security prison by a former political prison (FYI the murderers and rapists were kept in medium security, they thought the political prisoners posed more of a threat).  I saw Nelson Mandela’s cell.  It was smaller than the kennels they had for the dogs.  Then we got to explore the island for a little bit, saw the penguin colony they had there and then took the ferry back.  We grabbed a bite, and then took a four hour nap (whoops).  We went out to a couple clubs, but then I called it a night as I was feeling kind of sick (little did I know it would morph into a full blown head cold) and we had to wake up early in the morning for…..

TABLE MOUNTAIN

This is the mountain that overlooks the entire city. Half the time a cloud descends to cover the top but we picked a gorgeous day to take the theoretical 1 hour hike up.  Theoretical, because a) I was sick b) it was wicked hot and I ran out of water and c) because I’m not as in shape as I thought.  Thus it took about 2.5 hours.  So 1 camelbak and a water bottle sweated out later, I hauled my ass to the top.  And holy crap am I glad I did.  The view was spectacular.  Plus I was so incredibly proud of the fact that I had actually climbed all that way.  It was all steep stone steps.  Saw a bunch of lizards on the top (Thought of you Kim.)  Then we took the cable car down, and took a nap, grabbed some AMAZING dinner, and had a fun night out.  We woke up early for…..

CAPE OF GOOD HOPE

This tour consisted of a bunch of stuff.  We started off just traveling around the cape point, seeing all of the beaches and mountains.  Then we went to the Cape of Good Hope.  I, Abby Tapper, stood on the tip of Africa.  No big deal.  I found a piece of blue seaglass too =).  Then we went to the lighthouse that doesn’t actually work, and then to the PENGUIN COLONY.  I pretty much giggled the entire way through, took way too many obsessive pictures, and spouted way too many penguin facts to my roommate.  We went through table mountain national park, saw a bunch of ostriches, baboons, and a bonte bok! (big antelope)Then we hung out, went to the airport only to be told that our flight was delayed.  We were two hours early for our flight.  Which meant we were 4 hours early.  Awesome.  But there was good internet, so I got to see some important people’s faces =)

That brings us pretty much up to date.  We’re all pretty stressed about writing (me included, despite my personal deadlines) up our projects.  I’m ver ready to come home.  Speaking of which, back to writing =P

DISCLAIMER: This post is very graphic.  In my attempts to portray how life really is here, I am not leaving anything out.  That being said however, if you are reading this with your kids, proof it before they see it.  I will not lie.  Friday was one of the hardest days of my life.  I don’t want to jinx it or anything, but it was awful.  Everything had to do with infants, and if you know me, you know that everything I do is all about the babies.

We started the day off with a call for a collapse.  We showed up at this nice office building with a private company already there, but since it would be abandonment on our part to leave, we had to stay.  This woman went from a Glasgow Coma Scale of 15-3 in about a minute prior to our showing up.  For those non-emts among you, that’s going from normal to dead unresponsive.  Her eyes were fixed and dilated, and she was also 3 months pregnant.  They took 20 minutes trying to get a response out of her, then trying to contact her doctors.  She was stable, breathing and heart rate wise, but they weren’t transporting her.  It was really bothering to me.  The next call was the hardest, and worst thing I have ever seen in my entire life.

We were called to a miscarriage.  Now I was thinking just going to be a lot of blood, like a super heavy period or something.  I was wrong.  We showed up to this shit hole of a one room apartment above a butcher, with the woman lying on the floor in front of the door.  I walked in and immediately noticed the blood.  There was more blood than I had seen in my entire life.  We started asking her what happened etc, when she said she was 4 months along.  I hadn’t realized how formed a baby was until I saw it.  There was a pile of bloody blankets and as they unwrapped it, they uncovered a 4 month old fetus, more blood, and all of the placenta and after birth.  After the call, the paramedics I was with said my face lost all color when I saw it.  I forced myself to look, but then I couldn’t anymore.  My emotions couldn’t decide whether or not I should cry or vomit.  I did neither.  We cleaned her up, put the fetus in a warming blanket, and then in a garbage bag.  We transported her to the hospital, and then left.  

At 4 months, the fetus looks exactly like a baby, except smaller.  It was just a little baby.  The mother was so calm the entire time, absolutely no affect.  One of the paramedics commented that he sees this a lot with desperate women who figure out that they can’t actually take care of a child, and do things like fall on purpose (which this woman did).   I was completely sickened.

The last call of the day was another infant.  This beautiful little baby had aspirated meconium (basically, giving her a bacterial infection that can be tricky to treat, also resulting in things like developmental difficulties), and was being transfered from the nice private hospital to the not-so-nice public one.  Why would the parents want to do that?  They didn’t have a choice.  They couldn’t afford to pay anymore, so the hospital was basically kicking them out.  I wanted to go down to billing and say I’d pay myself, but I knew that would accomplish nothing.

After all of that, I came home and couldn’t even force myself to go out.  I just needed to process everything, call my mom and Sam and cry for a little while at how unjust the world is and how everything is taken out on the worlds youth.

Saturday was pretty relaxed, went to an outdoor market (Pair of pants with camels on them, new fake ray-bans, a scarf and earrings for R270 $33.75), and then Saturday night I was on a shift.  It was apparently pretty tame for a saturday, with only 4 assaults, 1 labor call, 1 gastric pain, and 1 auto vs. pedestrian.  I got to splint, board, collar patients, which was pretty cool.  I even got to sleep a few hours on a stretcher mattress.  The labor call was a 20 year old, which freaked me out mildly.  Here was a girl sitting across from me who was my exact age, and she was having a baby.  One of the assaults was another pregnant girl, only a year older than me, who had a restraining order on the babies father, which hadn’t stopped him from coming and getting into a fight with her, resulting in him kneeling on her abdomen.  He was at the door of the ambulance when we were starting to treat her, and looked at me started to say “Ma’am I would never” and I just glared at him and held up my hand.  If I could have beat his ass I would.  The mother of your unborn child.  Really?  One of the other assaults was only wearing jeans.  No underwear.  The guy who was assaulted with him had just given his shoes and shirt to the guy who had stopped to help.  The guy who stopped to help had said “I helped you, what can you give me”.  The other guy said “I was just robbed…”.  Crazy nights in South Africa, right?  I got home by 6 AM Sunday, slept til noon, then bummed around for the rest of the day.  I did get to see Tower Heist (thanks for the recommendation Mom and Dad!)

The past couple of days have been sloooooooow.

Monday I had an overdose, but it was definitely just a cry for help (she took ibuprofen).  Then a D + V (diarrhea and vomiting) per usual, an MVA with 2 pretty much uninjured patients, and a transfer.  I went to a cardio kickboxing class but had to stop after 1/2 an hour because I felt like dying.

Today was inSANELY slow.  We didn’t get our first call until 10:30.  It was “malaise” which actually meant TB, which I didn’t know until I was taking her BP and she said she had night sweats, weight loss, and coughing.  Awesome.  But she also was working in a legitimate sweatshop (sewing machines EVERYWHERE) so that may have caused the coughing as well.  2 hours later we had a guy that got his foot run over by a minibus.  2 hours after that we picked up a guy with a UTI from literally across the street at the clinic.  2 hours after that I was all set to go home when we got a call that was another potential miscarriage.  Right before this one, I heard on the radio of an abandoned baby in a bathroom.  In the words of Caroline King “oh for GOD’S SAKE”.  I audibly uttered a “fuck!” and my heart rate jumped because I knew I couldn’t handle another scene like before.  We pulled up to a fish and chips shop (I also got really afraid that I wasn’t going to be able to eat fish and chips ever again) walked upstairs and….she had a UTI.  Thank the gods.  And here we are now.

If there’s one thing any of this has taught me, it’s how thankful I am for my family and friends and boyfriend that supports me, that I am reasonably healthy and fit, and that I never have to live like any of my patients do.

…But let’s not make comparisons.

So I have been having SO MUCH FUN on the ambulance it isn’t even funny.  I’m even thinking of staying longer so I can see more cases (kidding parents and Sam).  I’ll give you a quick summary of my days so far:

1st Tuesday: went to the control center.  Freaking state of the art, very streamlined, very efficient.  I was duly impressed.

Wednesday:first day on the ambulance! It was a little awkward (with all the crews I’ve been with) when I explained that I was looking into adherence to protocol, but once I made them comfortable that I was on their side, they relaxed.  I immediately noticed on the ambulance that they had maybe a third of the resources that ambulances in the US do.  I also noticed on my calls that there was also an extreme lack of shocks on the vehicles themselves.  Had a bunch of calls and transports

Thursday: started with an MVA to which we were cancelled, then to a difficulty breathing, where the patient was DOA (dead on arrival), did some more sick and ill patients, one guy who the police had us take who was very obviously high, and then one of the medics I was with flipped on a woman for not getting TB treatment for her father and exposing her, the community and her children to the disease.  Get it.

Friday: Had a meeting with my advisor, who’s a professor of emergency nursing at UKZN.  Super helpful.  Also found out that there’s someone doing PHD research on the topic I’m doing.  Lolz.  At least it’s getting studied though.  

Weekend: pretty chill, went to some clubs, hung out, etc.  

Monday: hung out with the youngest medic there (23.  This is not a young persons profession).  Picked up another woman who was pregnant and coughing and vomiting blood.  Awesome.  Grabbed a white guy who only spoke to me (awkward again) who had severe pain from hemorrhoid removal surgery. Even more awesome.  Then I did another transport, where at the receiving hospital they played the “we-don’t-know-where-this-patient-came-from” game, and FINALLY we got him a bed.  

Tuesday:  Started my day with an MVA (doo daaa doo daaa), actually got to board and collar a patient.  Transported to a private hospital.  Have I mentioned how much nicer the private hospitals are than the public?  So much nicer.  Next we went to a collapse, which I deemed heat exhaustion because it was umpteen degrees outside.  The thing was though, it was in a shanty town, so we had to have the patient walk up this hillside to the ambulance (also, pretty sure an umlungu (white person) had never been in this place before, as instead of getting cat called, I just got stared at point blank).  When we finally got her up to the ambulance, we discovered that the radiator pipe had cracked, and all the water had leaked out, so it wasn’t driveable.  So we waited about 40 minutes in the sweltering heat for another ambulance to show up.  I went with them, because otherwise I would have been sitting by the side of the road in jeans waiting 3+ hours for the tow truck to show up.  Not awesome.  Then we picked up a sprained ankle to transport to another private hospital that was once again GORGEOUS.  Then I had the most heart wrenching case I’ve had yet.  They told me they’d drive me home, but then I found out it was an infant transport, so I was like HELL NAH THAT’S ME.  We went to the dispatching hospital’s NICU to pick up the baby.  He was 7 weeks old and was obviously born premature.  He was tiny.  He was born with an obstructed airway, and was going to the nice public hospital to have surgery that night.  He was trying to breath on his own though, and was fighting the tube.  He was trying to cry as well, and I was fighting not to cry.  I kept rubbing his leg and his forehead, just to make sure he knew there was someone there.  After we transported him to the hospital, I watched from the doorway as they moved him from the mobile incubator to the hospital one, and in my mind the words “go, live and become” popped up.  I sent all the vestiges of my energy to that little guy (I’d been up since 6, working since 7:30, and it was now almost 8 PM), willing him to live.  I know it doesn’t count for that much, but I just wanted so much for him.

Wednesday: pretty slow day.  we were dispatched to a post MVA, which turned out to be this old white guy who got hit by a bike, and was living in a one room apartment in a hooker hotel.  Good morning Abby.  We were then called and recalled several times, finally going to a collapse that was deemed to be post-ictal (after a seizure).  The guy was smelly, homeless, wet (someone dumped water on him when they saw he was seizing.  Awesome job, security guard), and pretty unresponsive.   Next was another post-ictal in another shanty town.  This guy at least had family with him.  Then we were called to a post CVA (stroke) but it turned out the guy was just majorly drunk.  And smelly.  

Thursday: I finally remembered my stethoscope, so I wore it all day today, at the insistence of my crew, because they wanted to see how many people thought I was a doctor.  Total was 4.  1st call was in a squatter camp in an abandoned-ish building. Total shit-hole, pardon the language.  This woman was lying in a room that was walled in with fiberboard, no ceilings, and the permeating smell of urine and stale cigarettes.  All of her neighbors came to help us, so there was at least a sense of community.  The 2nd patient was in yet another squatter camp, although this was the first one with Indians and a white guy who looked like he got transported out of a bad redneck movie, down to the missing teeth and huge, shirtless, flabby, white belly.  This woman was having a miscarriage I suspect, but I couldn’t say that obviously.  The next patient of the day was a woman who had had a mamogram the day before, and now she had a huge cut under her breast, and was leaking fluid.  Her grandson called me Miss America.  The last patient was having chest pain, and we picked her up from a clinic and brought her to the hospital. 

Woof, so that’s been my life.  I have tomorrow day, Saturday night (!!!), and then monday-thursday next week, because friday I leave for CAPE TOWWWWWNNNNN.  I booked my tickets for Robben Island today (For those playing along at home, this is the huge political prison that, under apartheid, held Nelson Mandela.  Think Alcatraz, but with worse reasoning.  All the tour guides there are ex-political prisoners as well, so we should be able to hear some great stories.  Then we’ll bum around the water front for a bit, grab some dinner, and have a reasonably early bed, because Saturday we’re gonna climb Table Mountain (the one overlooking Cape town) then we’ll go to Boulder Beach to see some penguins (!!!!!!!!!!!!!!!!!!! In case you didn’t know, I have a mild obsession with penguins.  Ask Sam or Liqa), and then to a big outdoor market.  Then it’s bar/club hopping Saturday night (Thanks for all the suggestions/help Alex and Kev!), Sunday will be spent relaxing and exploring, and it’s back for more lights and sirens Monday.

Wanna know something weird?  I leave for home in 3 weeks.  I’m fairly undecided how I feel about this.

Posted to my other blog, but here ya go

After my week of clinicals, had a week of lectures then I went off to Amatikulu.  Got to Amatikulu, had a presentation about community health workers, and then we went off with our mamas for the rest of the day.  I was with my darling Linda, and we got to cuddle for 3 days.  Holler.  Our Mama lived with her 8 year old son, and a bunch of other young men who we weren’t entirely sure who they were.  We threw our stuff in a room that smelled vaguely like a wet cow (I’ve smelled it, so I know), and then went with our Mama and her brother and sister in law to the grocery store.  I don’t think I’ve ever seen 4 full bins of cabbages before.  Or an aisle of eggs.  Just.  Eggs.  Went back, had a lovely full dinner of zulu food, and went to bed.  Except I couldn’t sleep, because the combination of being uncomfortably hot and the room smelling bad did not lend itself to my circadian rhythms.  Got up the next morning bright and early, had a delightful breakfast of unknown neon pink meat and margarine sandwiches, and set off.  Our mama doesn’t drive so we walked about 5 kms (about 3 miles) to her patients.  First one had cancer, and had one leg fully amputated, and the other foot done so as well.  We saw all her medicines, and then walked to the next patient.  She had active TB, so we sat outside.  The people we were with didn’t really understand how Linda could be black but not Zulu.  Last patient of the day was a woman who was HIV positive, but doing extremely well.  She gave our mama a HUGE woven grass mat, which one of the boys who we were staying with had to carry all the way back.  In the rain.  Once again, it looked like somewhere out of a movie.  We stopped by her supervisors house for lunch.  I was brought a steaming plate of….. Samp (mashed up beans and cornmeal) and intestines.  I took one look, felt myself tearing up, and just said to my mama that I couldn’t eat it.  So I got a roll with frosting on it instead.  Went back to the house, fell asleep, got a voicemail after my nap from my AD saying my apartment had been robbed.  Laptop, Droid, external drive, GONE.  Awesome. Cried a lot, went back early the next day to deal, cried more.  It sucks as all my research is gone, but I have all my photos on facebook, and all my everything else from before the trip backed up at home.  I just hope whoever took it bought food for their families or something.  Insurance is covering part of it as well.  The next day, I went to my ISP site, and after spending 15 minutes trying to find the building, I called the base manager and found the building.  It looked like some holdout from pre-fidel cuba.  Huge courtyard with ambulances parked in it, winding staircases.  Had my meeting with the base manager, went well, went out to get a minibus back, nearly had my necklace stolen.  So all in all, it’s been a shitty week, but hopefully ISP will be great.

In case you hadn’t noticed, I haven’t been blogging as much because a lot of things have been same old same old in terms of lectures, adventures etc.  I did manage to go to the Victoria St Market a couple of times, and haggled over a ton of art and jewelry.  So I’ll start with last Monday.  We had a nurse come in to explain screening practices to us and how to take basic vital signs (which I didn’t use the entire clinical experience, but we’ll get to that later).  She used PowerPoint slides to explain how to take blood pressure, pulse, temperature, and breathing rate.  Now for those playing along at home, you know I am a licensed EMT in Pennsylvania and Massachusetts.  There are 2 other EMT’s in my group as well, and it was all I could do to contain my laughter when she asked if I was sure I heard the BP right.  It was kind of cool to show my fellow classmates tricks to find things too.  That was that.  I had my first day at the gym I joined (state of the art, 3 floors full of brand new equipment, tons of classes, a juice/breakfast/food bar, personal training, all for $62 a month.  Be jealous) which just made me feel so good.  Being here and not being able to eat the food I should or get the exercise I want has put my body all out of whack, but thankfully, with the help of the cooking of my fantastic flatmates and I (hey I make salad, eggs and pasta.  I’M A REAL GIRL) and the fact that a bunch of other people joined so I can usually go when I want, I’m slowly getting myself back to feeling physically good.  Then I went to bed because I had to wake up bright and early for…..CLINICAL PRACTICALS!!!  Other than my independent study project this is what I was most excited for.  I could finally use the skills I learned in my EMT class (Sorry MCEMSers, our stuff is not real).  So Tuesday we got there, and they had no idea who we were and where we were coming from.  Now normally this would faze normal people, but since we’ve been in South Africa for almost 2 months now (Holy Crap!) we’re all used to this state of disorganization.  I elected to go to the outpatient psych ward because hey, that sounded cool right?  So Emily and I went there and the psych staff had no idea we were coming either.  Great.  They asked us what we wanted to do, and clearly we had no idea.  Now I’m not saying this to sound like THAT American who’s all I AM HERE YOU NEED TO CATER TO ME but them having known we were coming and maybe having a slight idea of something we could do would have been nice.  So we asked if we could maybe sit in on some patient consults.  We went in with the doctor, and he gave us a quick run down of how to do a psych consult/analysis.  Cool, something else to add to my bag of tricks.  Then they brought in the first patient, who seemed relatively “normal” until he mentioned that he’d stopped hearing the voices telling him to hide in his bathroom as his neighbors were coming to kill him.  Alright paranoid schizophrenic!  Now what made me uncomfortable was not the patient, but the doctor asking us IN FRONT of him whether or not he was stable.  Yeesh.  The next patient was an agitated schizophrenic. Then the nurses brought us out to the reception desk and asked if we wanted to read any patient files.  Yeah HIPPA is not a thing here.  So we went to the clerk, who of course wasn’t there, and then went back to the desk and proceeded to sit.  For 5.  Hours.  We kept asking if there was anything we could do, but they just kind of ignored us.  It sucked, especially since many of the other people in our group got to see surgeries, weigh babies, etc.  So I left pretty disappointed.  The next day I was assigned to orthopedics.  Wednesday was their spinal clinic day.  Many of the patients were suffering from spinal tuberculosis, which occurs when TB travels through the blood to the spine to form a painful abscess there that depresses the spinal cord, resulting in paralysis, and loss of bladder and bowel control.  Very sad.  My first assignment was to marshal patients that are move them from the waiting room to the doctors.  I went around talking to many of them, seeing where they were from, why they were there, etc.  Using my broken Zulu of course.  The word for back has a click in it, so when I failed at that, I got a couple of smiles.  I met an 18 year old girl in a wheelchair with a  MASSIVELY kyphosed (twisted) spine, who was in 8^th grade because she started school late.  She lived with a state appointed guardian, and 4 other people.  She didn’t like Beyonce but she loved Lupe Fiasco.  She was so sweet.  I moved patients on stretchers to X-ray using my mad EMT skillz.  After that, I got to sit in on some patient consults, which was pretty cool.  Then I FINALLY met an EMRS (Emergency Medical Rescue Services, who I will be doing my ISP with) worker.  And it was a woman!  She gave me some great insight into the system.  It was a really eye opening day.  Many of the patients had come from as far as 7 hours away, leaving their houses at 2 am to get her, only to be told that the diagnostic test they needed, such as an MRI, meant they had to come back in December for it.  It was a shock to me that a) they couldn’t receive proper treatment at their local hospitals and b) that they had to wait so long for and MRI.  Things that would NOT happen in the US.  Thursday I had the pleasure and privilege of going to the pediatric tuberculosis ward.  The ward itself had 32 beds, and all but 1 were filled.  The ages ranged from barely a year to 8 years old.  Many of the kids were multi/extremely drug resistant.  A lot of them were in school when we got there, but a bunch were still too sick to go. While the head nurse was showing us around, I was making faces at this one little one I was standing next to, and she just reached out and grabbed my finger.  Heart totally melted.   A couple of the babies started crying, so I just reached out and picked them up and just walked around with them.   I feel like because the nurses are so busy taking care of all of these kids and their physical needs, their emotional needs can sometimes get left behind.  It’s hard to smile at a kid when half of your face is covered in a TB mask.  Then Friday was probably the coolest day I had here.  We got to sit in on surgeries.  So we got there, got scrubs (!!!), masks, foot booties and hair nets.  We went into the first OR and they told us they were doing biopsies.  We saw 2 esophageal and 2 bronchial.  I got to look down the scope into a guys lung!  Then they told us to go to the OR next door where they were going to endoscopically intubate a guy who had been in a car accident and had 2 broken vertebrae (C7 and T1).  We went in there, and I’m pretty sure the doc thought we were med students, because he had me starting bagging the guy after they put in an Oral Pharyngeal airway (thank gahd I knew what I was doing).  They then put the scope down his nose, but discovered a ton of secretions they had to suction out before they could put the tube in.  At one point, his oxygen saturation dropped (It has to be at 100, went down to 74.) and I got a bit nervous, but he came back and eventually they put the tube in through his nose.  Then we got to go back to the first OR, where they had already cracked this guys chest open and were removing a huge mucous coating that was around his lung stemming from his being stabbed and resulting in his not being able to breath.  As in I saw a cracked chest.  I saw a breathing lung.  Then I saw them pull his ribs back together.  I was practically dancing it was so cool.  It was definitely the most rewarding day.  

This week we have our last days of lecture, then a few days rural next week, then I start my ISP, and then I’m done.  How whack is that?

So I went from Real World: South Africa, to something that could actually be called “Real World: Durban”.  My apartment is beautiful, aside from a couple small issues.  We had to have a mini-stovetop/oven brought in because every time we tried to use the oven, it tripped the circuit breaker.  I may or may not be sharing a full size bed with my friend Emily.  It’s cozy.  But we’ve been cooking healthy, yummy food every night, we’ve had a movie night, and the view of the ocean is absolutely fantastic.  I have to admit, that for the first time on this trip, I’ve had a couple of just really good, really happy days in a row.  Being in control is a marvelous thing.  I get to wake up every morning with the waves greeting me.  What is my life?

So tonight is my last night in Cato Manor, the last night with my homestay family.  I’m sorry, since when have I been here for 6 weeks? False.  We have a big celebratory farewell dinner tonight, then I’ll go back home for the night, potentially go to the shebeen (illegal bar, kinda like a speakeasy) and then I’ll wake up tomorrow, and leave.

It’s been so eye opening to live here.  We didn’t have running hot water, and we ran out of things like bread and fruit.  I had to boil water to bathe in, and eventually I just got tired of it and just started showering at the SIT house.  All evenings were spent around the TV, except when we went to go visit my gogo’s friends.  I cooked once, and my family remarked that there wasn’t enough salt (that was kind of the point).  All meals had some type of simple carb, and usually had meat.  I was woken up every day by the 1 and a half and the five year old yelling and crying.  

I got to spend a lot of quality time with my 15 year old sister recently.  We went to the movies and went on a nice walk last night.  I really will miss them.  They opened up their lives to me and I just waltzed right in.  I saw their hardships, but they were so welcoming and happy about everything, I genuinely enjoyed staying there despite everything.  When I told my gogo last night about the dogs freaked me out by chasing and snapping at me, she promptly went over to the owners house and told her to tie them up! Superwoman!  

I often worry about what happens after the students leave (I’m their 15th).  Does life just go back to normal?  Or do they wait for the next one?  I worry that my sister won’t be able to afford to go to college.  I worry that my other sister will keep working the same dead end job for the rest of her life.  I wish I could do more here, but I don’t want to be slinging my privilege around.  I’ll try and see them again before I go, but I’m going go be so busy, I don’t know if I actually will.  I have to print out the family pictures we took last night too.  Sha la la!