today i went on some home visits with the physical therapist. we went to 3 different homes and worked with 3 elderly women. the first one apparently was so weak she couldn’t walk a few months ago so they had taught her to use a walker. she met us at the door today…walking with only a cane!! the next lady was unable to stand so she scoots around. our job was to fit her for knee pads! as we were leaving her place we noticed a marijuana plant in her yard…we laughed as she explained it was ‘medicine’ for her high blood pressure!! the third woman also scoots around due to a chronic ruptured patella tendon and severe contractions of her hips and knees. we taught her a few stretches and tried to get her standing with a walker…

each of these elderly women are called Gogos. it translates roughly to ’grandmother’ but everyone uses it when referring to an elderly woman. it’s a term of respect and my goodness these ladies deserve it, they are tough as nails.

yesterday we were going to do a hip replacement but realized at the last minute that the hospital used the last of it’s blood on an emergency c-section that morning. can you imagine running a hospital with no blood? they do it all the time here. it’s actually unusual if they have blood. in the states we transfuse people at a hemoglobin of about 10 (normal is 12-15)…here they wait until it’s like 4..then maybe you’ll get some blood. last week i saw a patient here with a hemoglobin of 2, we transferred her out to a bigger hospital with blood. seeing this blood shortage has motivated me to donate blood once i’m back in the states. i know it won’t help them here at mseleni but i still feel like i need to do something.

well i’m off for one last run on the beach and a nice dinner at sodwana bay with the docs. i’ll write more once i’m in durban!    

so if i haven’t told you the children’s home is next to the hospital and is run by Dr. Fredlunds wife. they keep kids from 0-21 that either have lost their parents or need to be removed from their homes. right now they have 35 kids living there with capacity to take just over 40 i think. could you imagine how wonderful it would be for them to have a marimba!!

i played squash last night!!! it was a lot of fun, thank you everyone for your advice! i played claire first, she has never played either so we were equally matched and i thought we were doing okay. i won and was then paired against cat. she’s played before and pretty much wiped the court with me! claire and i ended up practicing a lot afterward so i think i’m a little better now. i’m not sure if i’ll get to play again since i’m pretty busy the rest of the week but i’m glad i at least got to play once. it is a lot like racquet ball but the ball doesn’t move as fast or bounce as much.

i can’t believe the month is almost over. it’s gone by so fast in some ways and so slow in others. i will miss mseleni a lot and hope i can come back seomday, but i’m also very excited to be back home with dan and reese! i’m going to durban friday afternoon for my saturday afternoon flight, so tomorrow is my last day here in the hospital. there is so much that i never wrote about and so much i want to write about. maybe friday night/saturday or even once i’m home i can write out some of the other crazy things that happened.

well this was a completely random blog and now i’m off to do some laundry and get ready for bible study. have a great day! 

there were 11 of us total and had 2 cars to get back. as we were loading one car the key broke off in the back…leaving 11 of us to go in 1 car! we packed up all out camping stuff into the broken car and piled into the other, 6 in the front 5 in the enclosed bed of the truck. as we were leaving the campsite 2 men with a pickup truck saw us and offered to drive a few of us to the nearest town, about our halfway point. so me and 3 other girls piled in the back of his truck and one guy jumped up front with the men. it’s all dirt roads through the countryside to this town..it was the most beautiful drive. and a ton of fun too!! (my butt is a little sore from the bumps!)   yesterday polly, cat, and i returned with the spare key to retrieve the stranded car. this time we drove the whole way along the coast and through the countryside..again i can’t even describe how breathtaking the land is here. it’s never been touched. every now and then there is a house or 2…but for the most part i imagine the land has looked this way since the beginning of time. very different from our man made america.  

maybe i’ll have time this week to post a few pictures. the days are getting more and more packed with stuff. tonight i’m playing squash, tomorrow is bible study, thursday we’re going to sodwana beach for a nice dinner and friday i leave.

it looks like i won’t get to see an elephant this time…which i’m bummed about. but it just means i have to come back…with dan!

today i gave a lecture to our nurses in mduku. they deliver babies there on their own. so they had questions about cord prolapse and hypertension in pregnancy. i know you’re proud mom! but don’t get too excited it was by far the simplest talk i could give. very basic things for them to do until the patient can get to a hospital.

i have a lot of respect for these nurses, and yet i am scared for the patients too. luckily they do have a low threshold to refer a patient. the bottom line though is that doctors are needed.

at the clinic today i saw an 83 year old woman! you do not see elderly people here so i was really excited. the poor thing is weak, but in good spirits. the family was concerned that she was weaker than usual and thought she needed to go to the hospital, but they didn’t want her to go because they figured she was at the end of her life and wanted her to die peacefully at home. on exam i didn’t find anything wrong. just an 83 year old woman who had lived 83 good hard years in africa. so we sent her home, the family was so excited. i really liked this patient, i have no idea what her name is and though i told her to come back next week so we could check up on her i doubt i’ll see her again. but i wish i could’ve gotten to know her. i wonder what kind of stories she has. think of what she has seen. when she grew up hiv/aids wasn’t around. so while she is untouched physically she has seen it affect her children, grandchildren, community… not too many people in the generations below her will live to be her age. she has probably out lived the majority of her own children already. and to go through the aparthied era and see nelson mandela take office… 

it was nice to be able to send her home. in the States i think we would have admitted her for no good reason other than we don’t like it when people die. and who knows she may have a long time yet to live, she sure seemed like she had some life left in her!

dad, i also saw a patient today with afib. a young woman probably about 25. we did admit her to the hospital because her INR was out of wack and the only way we can make sure it levels out and to know that we have her on the proper coumadin dose is to have her sit in the hospital until it normalizes. anyway made me think out you!    

next week us doctors are having a squash tournament! i’m really looking forward to it despite the fact that i have never played squash before. it should be fun though! if any of you have played squash i would love any tips

we tell moms not to do zulu meds but i’m not sure they understand just how dangerous it is. and it’s such a part of their culture that many shrug off our warnings. i wonder what the best approach is to educating them?

i guess there are other battles here besides HIV/AIDS and they will take just as long to fight.

bright and early saturday, martha (an engineer here with engineers without borders from the UK) and i started the day with a long walk on the beach. afterward we went snorckeling…it was amazing! we saw turtles, sting rays, and the most colorful fish…the highlight though was the school of dolphins that swam within arms reach of me!! i can’t even describe how incredibly beautiful the ocean is and all the wildlife in it.

later that day me, martha and polly went for a long run on the beach and passed a turtle laying eggs on the beach. that night we had a bry (bbq) and just hung out around the campfire. it was cat’s birthday so we celebrated that.

by sunday we were all pooped. we spent the morning reading by the campsite, took one last walk on the beach and headed home for evening church. 

it was a great weekend. strange how mozambique, only a few miles from south africa, was so different. hopefully someday i’ll get to explore more of that country.

short update on baby catching and then i’m off to play tennis. i did catch 2 babies on friday, yeah! despite having to sit there all day and wait for them i’m glad i got to do it. it was a pretty cool experience, i’ll try to deliver a few more while i’m here. don’t worry mom, i still do NOT want to do OB AT ALL! 

         well i’m off to play tennis. miss you all and can’t wait to write more later!

on a more depressing note we had a sick baby come in last night with difficulty breathing. it looked like me might have to intubate her and put her on the ventilator. but before that is even considered an hiv test must be negative. if the child is hiv + it is standard treatment to not resusitate the baby if it stops breathing. to care for a ventilated baby they have to be shipped to a bigger hospital by helicoptor and the health care system is so overwhelmed that the major hospitals will not accept hiv + children with life threatening problems, it wastes too many resources on a child that is doomed anyway. this baby was hiv negative and she did get tubed and shipped out, but if that test had come back + this story would have a very different ending.

to end on a positive note i found a woman who uses condoms!! very few people here do, it’s very taboo, and very few people are monogomous. but we continue to ask and encourage. the other day i asked a women, expecting the usual, ‘NO!’ and instead i got ‘YES!’ i gave an audible wahoo nearly jumping out of my chair in excitement!!

and as for my catching babies goal i am failing misreably. everyday i have missed at least 1-2 babies by about 15min. it’s as if they know i’m coming and hurry up and slide out. so tomorrow i am staying with the midwife all day…i will not leave her side and i will have gloves on at all times…i will catch me a baby! but no lynn i will not be catching the ’baby bug’ like you…i’m leavin that up to becky!! :)  

 the fredlund house

 cat, me, polly on the indian ocean!

last weekend i went to a game park with Cat and Polly. Cat is a doctor from the UK that is working here for a few months and Polly is the wife of a doctor that had been working here for a year, they are also from the UK.

before all that maybe i should give you a brief overview…There are about 12 doctors here now, most are young (late 20’s) from the UK, a few are from South Africa and one couple is from belgium. the south africans are required to do one year of community service after graduating med school, equivilent to my intership, so that is what they are doing. The UK graduate their docs by age 23 (they start med school at 18) and so a lot of their docs come to south africa to get experience and also explore. they are not required to do a residency the same way we are so they can practice here for a while and then go back and specialize if they want later. some doc stay only a few months and others a year or two. it’s an amazing opportunity to gain experience and knowledge they won’t get anywhere else!

so with all these young doctors running around it’s not hard to find things to do. we had a BBQ (a bry) on the lake last week, and went for a beach run then swam in the indian ocean!! polly, cat and i explored last weekend. we went to a game park, unfortunately it was raining so not a lot of animals were out roaming. but we did see buffalo, rhinos, monkeys, strange south african birds (gross!), and some deer like things (they have real names i forget). afterward we went to a town called Mtuzini (about 2 hours south of mseleni) and met another UK doc (Zoe) there that is friends with Cat. we spent saturday night at Zoe’s place and had a nice dinner at a local restuarant (this was a much nicer town than the one i’m in…there is only a hospital and small market to buy fresh fruit and bread here). after dinner we went to the local pool hall so play pool. funniest thing about that was that they had zebra grazing out back! (this pool hall was basically a hut with a table it, the zebra could have very well ventured inside! at Zoe’s there were monkeys playing in the trees…imagine reese chasing a monkey instead of roofus (our squirrel that terrorizes reese) honey!! haha

sunday we sunned in the pool (zoe’s house was very nice and had a pool!) i finally have an african tan! then took a long walk on the indian ocean before heading back up to Mseleni. it is breathtaking on the beach, and the water is so warm.

this weekend a big group of us are going to mozambique to camp on the beach!!

i have so much to write yet about this weeks event, i was busy in the evenings this week and it’s put me behind on my blogging

2 praises and a prayer request…1st praise bible study has been so encouraging. there’s just something special about worshiping with Christians from all over the world. reminds you how big God is. 2nd praise i got an interview at the new ortho program in grand rapids. we did it last night, the director and i arranged that i would call him at 1am south african time. i’ve never done an interview in my pajamas before! and the prayer request is for peace about God’s plan for my life as far as residency is concerned. (this program will take one, six of us interviewed)

more to come!!

 the plane…do you know how to fly it dad?

 the cockpit, i didn’t get to sit in the front but it was still an exciting ride!

i have a tons more pictures of various animals i’ve seen so far but i’ll have to do it tomorrow. it’s almost time for dinner. i spent last night and tonight in the OR (the theatre they call it here) yesterday i waited 3 hours to deliver a baby, the mom never progressed so we took her to do a c-section. i was first assist! unfortunately the baby came out not breathing, we did revive him but he was gone for a long time. pray for both him and his mother, we have no idea what the outcome will be. today i saw a patient in clinic with septic arthitis/osteomyelitis which is a surgical emergency. this is a very common operation in the states by orthopedic docs so i was interested to see how they did it here without the technology and supplies we have. we just finished and it was very interesting and educational. in the end the same goal was achieved but the means of getting there were very different. these docs simply have to think outside the box…i’m starting to as well.

i have so much to say about the weekend too but it will have to wait.

have a great night! my goal for the week is to deliver a baby….outside the OR. i’ll keep you posted!