Cape of Good Hope

I’ve been receiving numerous messages regarding my experiences here in Cape Town.  I am more than happy to answer any questions you have about my daily activities, the IES program or anything else—however, it is quite difficult to get any internet for free so it may take a while… please be patient and I will promise to return your messages as soon as I can!

So for last night-

We took a taxi down to the V&A Waterfront (the more touristy area of Cape Town) and had dinner at the Cape Town Fish Market.  The place reminded me of a really good PF Changs but specializing in Seafood.  We ordered two HUGE platters of Sushi and I was brave enough to try raw sushi for the first time.  I must say that the tuna, salmon and various rolls (rainbow roll) were amazing. For dinner I ordered a “Potjie” which was a hot pot of garlic cream sauce with mussels, potato, carrots and some sort of white fish—yum!  It was one of our first real meals out together alone which was really nice.  To get home we decided to walk around the mall for a bit and get gelato (sorry but it was much better than the Muar House) and pass the huge ferris wheel to the docks—not the safest trip but surely interesting since we had to sprint across a highway to get to the nearest hotel and call the cab home.  After hiking and getting up early for the market yesterday I was exhausted and fell right to sleep.

Today-

When I said that every day I experience something more amazing than the last day I was not kidding.  I for sure thought that yesterday was one of the greatest experiences of my life…Climbing devils peak was beyond beautiful and gave me one of the best views I have ever seen.  Okay maybe I am being ridiculous with my descriptions of these places but I cannot wait to post all of my millions of pictures.

Today we topped Devils Peak by going on a peninsula tour around the Cape of Good Hope, the most southern tip of Africa.  We took a tour bus along the coastline and Atlantic seaboard going through the beautiful ritzy area with huge homes and gated apartment complexes.  Before I knew it we were on a cliff with the mountains at one side and the sea down below.  Words cannot describe it—wait for the pictures!  I had no idea we were even going all the way to the Cape since the drive looked as if it would take much longer than an hour and a half but before I knew it we were at Boulder point scoping out the penguins that reside there.   After a lunch on the bay with fish and chips we took the bus to the Cape of Good Hope.  All that came to my mind was, wow unbelievable!  The sun came through the clouds and the rain stopped as we approached the summit to the lighthouse at Cape Point (literally though I swear I’m not trying to write ridiculous posts) and we were able to see for miles.  The Table Mountain National park is home to baboons and antelope so we passed many signs stating, “do not feed the Baboons, they are WILD animals.”  The best way to describe this would be through my pictures so I hope to post soon.

This week we will be at a different hospital working with various units.  I am hoping to hone in and specialize working with a nutritionist, dietitian or someone working with obese patients.  If this is unavailable I will most likely work with patients who have diabetes or other diseases such as hypertension so I am able to speak with them regarding nutrition and weight for my final research paper.  Wish me luck!

climbing Devils peak

Short and to the point: today I had an impromptu hike with a few friends up to Devil's peak.  It doesn't look that steep from here but the two hour hike was high and mighty.  With every few feet we were taking more pictures because the view was beyond amazing...Definitely one of the most amazing experiences I have ever had in my entire life!  Cannot wait to hike it again!

pictures week 1

Gugulethu: HIV/ AIDS treatment & A Birth

Wow, what an amazing week.  I honestly never thought that one week would have such an impact on me.  While I still have a lot to learn and experience I can now say that I’ve worked abroad in a health clinic, taken blood pressure, worked with HIV+ patients who have noncompliance issues, saw a woman deliver a baby (more to come) and test urine for pregnancy and abnormalities.

The doctors and sisters at the clinic quickly grew to love us and showed sincere gratitude for what little help we were able to provide.  Our teacher put it perfectly for us as we discussed our work in the pharmacy packing bags of medication for patients—though the work was boring and tedious and not always as exciting as working with the patients themselves, we helped over 300 people get their meds for the following day. 

Today in class we discussed the issue of the government intervening in healthcare.  The problem? No one knows where to begin.  These people wait all day, literally, for sometimes even the simplest issue such as a headache or sore throat.  Whether it be the lack of education that leads them to conclude they need the doctor that badly or not they’re still sitting there.  The conditions of the clinic are as good as they can afford with the resources they have but sanitation is a serious issue.  Even the nurses working in the HIV clinic lacked some of the knowledge of what exactly ARV drugs do to stabilize or improve the condition of someone with HIV.  I have never experienced something so frustrating—from sanitation to the management that leads to the patients lining up at the door at 5am when the clinic opens at 8.  The worst feeling is knowing that something could improve but no one knows how.

As for the fun and exciting part of the day:

After thinking that I had missed my opportunity to see a birth in the maternity ward I was pleasantly surprised when we were passing through the department and heard screams from one of the women in the labor room.  The women are placed in one of three rooms—the room for post-delivery where there were about 10 girls (very young teens to older) with their babies, another room where they lay waiting to dilate enough for labor and then the delivery rooms.  The woman was pacing and grabbing the beds in the pre-labor area and we were told she was 8cm dilated.  Our best decision of the day was to skip the beginning half of our lunch shift because within 25 minutes she was ready to push. 

The conditions are soooo different from an American hospital—there are no men or family allowed in the Maternity ward (MOU).  The women are by themselves and know when they are ready to go to the delivery beds.  Until then they are pretty much on their own.  Sister nurses and mid-wives are the ones that deliver the babies since there is only one doctor for that ward and she is shared amongst about 5 other clinics and only comes once a week.

This particular woman was HIV+ and I was extremely surprised when the nurses did not take more precautions with her than another HIV- patient.  They helped her to get in the right position and then instructed her to push—no fancy breathing or hand holding.  The woman was in extreme pain but was alright with us being in the room which allowed for us to have such a great experience.   The tools used come in a big metal bucket along with some towels and gloves.  We stood behind and had a full view of the whole birthing process.  To be honest I didn’t know if I would be able to watch the whole thing (especially the after birth) but I realized that I would most likely never get the opportunity again so I grabbed Emilys arm and watched the whole process.  When the baby was finally cleaned and began to cry the mother just started whispering, “thank you jesus” over and over again.  It was one of the most amazing experiences I have ever had.

One of the most interesting aspects of the birthing process in this clinic and I believe South African culture is that the baby is cleaned briefly and placed directly on the mothers stomach with a blanket—no incubator or taking away for minutes/ hours for tests.  They do this within a few minutes of mother/ child connection giving time to create an instant connection. 

Tonight we are having a Braai (BBQ) with our RA and made a trip to the pick and pay (grocery store) to get cider and frozen mojito mix.  Up early tomorrow to visit the more touristy area and see the water front!  

Gugulethu Day: Maternity and Outpatient

Lets start with last night, the fun stuff of course.  A few friends and I went running and we stopped to pick up notebooks for class.  We went back to our flat and made a pretty amazing dinner if I do say so myself.  Peas, rice and sauce—the dinner of champions.  Later on we all went to this bar in the next town area called “Stones.”  It reminded me somewhat of Eddie Obriens or Parkers in Geneva and had a good American feel to it.  Matter of fact, we met a bunch of Americans studying here and volunteering.  Our RA came with us as our protector which was probably a good thing since the young doctors at Gugulethu informed us that we really should be with a South African when walking around where we live…how inviting.  The two for one special was a hit and I downed a few Castles (the main South African Beer) which was actually pretty light and tasty.  I had a great time going out and getting to know our group better and make some friends from different places.  I swear there were people from all over the world in this one bar and we were told that Long Street is even better and more exciting with famous clubs and bars.

Today we went back to Gugulethu and I really tried to go in with a clean slate.  I brought my trusty peanut butter sandwich and orange along with me.  The woman who had given me some problems yesterday was not around the area I was in so I felt comfortable and able to talk with the various nursing (sisters) staff and doctors that were doing their community rotation.  One really interesting thing about medical school or degrees in the medical profession is that students must give back ot the community by doing a year to two years of community service in these hospitals such as Gugulethu where no one wants to come work.

Today I was placed in Maternity and was able to see the tiniest baby being transported to a larger hospital.  At one point the power went off and we were so fearful of the effect on the baby but the sister nurses did not seem to think that it was an issue at all.  One thing that I found extremely interesting was how natural the birthing process is here.  While I did not see a birth today others in my class described it yesterday and we spoke with the nursing students who confirmed what they had seen.  Compared to America it is so much more relaxing and kind of in and out.  For mothers who are having normal pregnancies with no complications they can come to gugulethu and walk around a waiting area for mothers in early labor.  They groan and walk until they are dilated enough.  When it is time they move to a bed (there are about 4-5 beds for birthing) and the process begins.  Men are not allowed in the ward.  Post-labor the women all lay in beds in one room and they are there with their child the whole time by their side—breast feeding is much more open in south Africa as well.  I went to speak to one of the young mothers and she lifted her shirt to begin feeding—at first I was shocked but then realized that they are used to this sort of thing.  I should mention that many girls start having children at age 12.

The maternity ward was pretty quiet today and soon our nursing student left us to fend for ourselves.  I was moved to Outpatient (OPD) and that is where the real fun began.  I was given gloves and was able to call names of patients, take blood pressure and assign them to either a doctor or nurse.  The most saddening thing about this is that going to Gugulethu means they are there the whole day.  The lines are extremely long and even once they have been in line to be sent to the doctor or nurse they still must wait to see them too.  In addition to taking BP I also worked with another kid on my trip testing a few urine samples (yes we had gloves but NO it was not anywhere near as sanitary as in the US). 

I apologize for these being such lengthy descriptions of my day but there is so so much to tell.  I can try and make some more condescend posts that describe my experiences but I am also handing these in for grades as journal entries.  I will have a total of 3 papers (all around 3000-5000 words) as well but we are all hoping that they wont take away from our traveling and adventuring!

Gugulethu Day #3

For the fun and exciting stuff:

I had another great day at Gugulethu and am getting to know everyone in the program much better.  After a long day at the CHC a few of us went for a run which ended up being super short since we ended at the grocery store which is only a few blocks away.  We are hopefully going out to a bar tonight to hear a live band play.  I am told that happy hour is from 10-11 and the drinks are two for 1…aka about $1 for 2 beers since the conversion rate is so great.  We also bought a bottle of hard cider to try so I’m hopeful for that.  I am really really hoping to get to the local café tomorrow night so that I can write more and potentially add some pictures.  Until then, hope all is well!

More in-depth at Gugulethu

Last night I was finally able to go to bed early but ended up journaling for quite a while and then couldn’t fall asleep.  However, once I did I was out cold—literally!  The alarm came way too early at 7am so the snooze button was hit right away.  The bus driver arrived and we boarded for another day at Gugulethu CHC.

Today we were assigned placements around the clinic.  I jumped at the opportunity to work in the Trauma unit and was ready to be thrown to the wolves so to speak.  Right away we were shown to a child that had severe burns over most of her face from porridge spilling over her.  The shacks that many South Africans live in contain small heaters on the ground used for both warmth and cooking.   These are very easy for young children to grab hold of or have kicked and accidentally spilled on them.

The sister in charge spoke with us regarding our intentions at the clinic—many of the staff members believed that we were all medical students and were unaware of our backgrounds.  Since I am a public health major the sister thought that I wouldn’t be interested or that it would not benefit me to observe and work with the trauma patients so she hummed and hawed over where to put me.  To be honest I was pretty upset since I wanted to work with the trauma patients and observe/ take in the medical equipment available to them and learn how they perform so many procedures with such little technology.  I was told later on that they use x-rays to examine everything since they lack MRI and CT machines.

I eventually made my way to the pharmacy where I packaged bottles of olive oil, which is used to clean ears.  While the job itself wasn’t exciting or difficult it made me realize that every little bit of help does make some difference.  Everyone in the small pharmacy was running around frantically to get everything done and without our help they would have been even more stressed.

The healthcare system here has so many different aspects too it and a much more holistic approach to medicine—they do what they can with what they have for the most part. 

I believe that tomorrow I am being placed in the family planning unit and will be working with the woman in charge of pregnant patients recently diagnosed with HIV but still have a low CD4 count.  They use public health interventions and discussions to find ways to lower the spread of HIV and inform these expectant mothers of certain precautions.  The health promoter will also hopefully be on site.

Gugulethu Community Clinic: Day 2 South Africa

Today was an amazing day from beginning to end.  I woke up to the train passing by our apartment (it is very loud and right behind us but this is a good way to get up on the early mornings).  I made myself a bowl of oats in the microwave with a scoop of good old wegmans PB—I promise not to go on a huge tangent of the food but I am so happy I brought PB and that they have pretty good PB in the grocery stores because it is quick and easy protein.  South African time means that 7:30 means around 7:30 aka probably more closer to 8 but my roommate, Melissa, and I were still ready on time. 

We were picked us as a group and taken to a local school in one of the townships.  There we met our professor/ teacher for the term, David, and were introduced to the local principle and children.  Though we are not actually taking classes or working at this school it was a great way to meet the local children and interact with them.  They were so excited to see us early in the morning and performed dances and songs for us.  This was beyond hilarious because they played songs from the USA and asked if we had met the artists (including Lil Wayne and Rhianna).  When we went to leave they all gave us huge hugs and thanked us for visiting.  Such a great way to start the morning.

We were then driven to the Gugulethu Township Community Health Clinic (CHC). The head nurse, or sister, Mama Maboseala described her goals within the CHC and how they relate to those set by South Africa.  She described her definition of health as the exact definition used by the WHO, which made such a great connection to our studies here in the USA.  She showed us the facility that we will be spending the week in and we were exposed to the trauma, maternity and HIV/AIDS wards.  We met a lady that had given birth 20 minutes prior to us arriving and she was so excited to show us her new baby.  We later went to class in a nearby meeting room for a few hours.  The only downside was that it was absolutely FREEZING.  Thankfully we were able to stop at a mall quickly and pick up gloves scarves and fleece jackets along with some yoga pants (everything I took out at the airport)!

A group of us then went on an exploration for internet and groceyr stores.  We found Coco Wah Wah which is a local café that offers 100 mb of free internet—bring on the coffee, that hopefully isn’t instant (ew!).  We also explored and bought a few simple groceries from Woolworths which is a more upscale organic type grocery store which is supposedly comparable to mark and spencer in London so potentially a slighty lower end of whole foods but very upscale for South Africa.  They carry nicer vegetables and fruits plus soups and prepared foods—oh and nutella and yogurt! Pick and Pay, potentially a Tops type place, carries wine and we got some great South African selections.  I purchased a Chenin Blac for 25 rand which equals out to less than 3$ US.  To be honest it tasted REALLY good.  Later we went back and ate with two of the girls on our trip and had some of our wine. The evening was a great way to end such a long day which was both emotionally challenging and physically tiring.

Favorite Moment: The children at the local school—they were so extremely happy and excited to see us and take pictures with us!