Clicks and Clucks

Sowubona everyone! I have learned my first few words in Zulu.  That one means hello or good day.  I have also learned “how are you?”, “I’m fine”, “yes”, “no”, and “thank you”.  I would tell you how to say them in Zulu, but they are even worse than the French when it comes to adding unnecessary letters to words.  My favorite word is “Aibo”.  When spoken without enthusiasm, it means no, but when exclaimed loudly it means “oh no” or perhaps, not so nicely “oh shit”.  For example, when one mom looked over and saw her child about to dump his porridge on the floor….”AIBO!”

I was planning to learn 3 new words a day, but I’m afraid I might be limited in my learning by the darn clicks and clucks of the Zulu language.  There are three types, one that sounds like when you say “tsk tsk”, one where you cluck your tongue on the roof of your mouth, and another that I can’t for the life of me decipher how it is different from the first.  I think the Zulu nurses are getting a great kick out of watching me try to learn. I can make the sounds by themselves, but when I try to incorporate them into a word, I just end up spraying spit everywhere and entertaining people while sounding disturbingly similar to a chicken.

I was surprised to find how incredibly frustrating it is not to be able to communicate directly with any of my patients.  In the U.S., the majority of non-English speakers are Hispanics so I am still able to speak to them.  I feel like not even being able to ask if my patients are ok or what I can do to help makes it much more difficult to gain their trust and establish a relationship.  It doesn’t help that the Zulu nurses who do all the interpreting cannot possibly be translating more than 10% of what the patient says.  The patient will talk for two straight minutes and the nurse will turn to me and say “She doesn’t have a fever.” I have found that even just being able to say hello in Zulu puts the patient and their family more at ease.  I keep finding myself clicking and clucking away while I’m taking a shower or walking around the grounds.  Perhaps I will succeed eventually.

In terms of medicine, it hasn’t been a terribly exciting two days.  I have been spending my mornings on the pediatrics ward and my afternoons in the RU which is their emergency room.  It stands for resuscitation unit.  I have seen some pretty sick kids, but haven’t been lucky in getting many procedures.  Bryan got to stitch up a guy’s hand and Dandi drained an abscess. It’s a cool place to work because I can actually do things without feeling like I’m in the way.  If I say “this guy needs a chest x-ray and an IV”, the nurse does it without even asking any questions.  It’s a very strange feeling to have people listen to you! Because most of the physicians here trained in adult medicine, they are happy to let me see any kids that come their way.

I think I made a mistake in teaching the peds ward how to bounce balls off their heads.  I can no longer even walk in the door without everyone wanting to play catch or have me watch their new tricks.  There are usually bouncy balls coming at me from all directions followed by lots of giggles. It’s fun though to see how excited the kids get when they see us in the hallway getting ready to round in their unit.  They run around and gather all the balls and wave until we come in.  My little “roly poly” whose mother abandoned him finally got to go home today.  His mom came back, and it turns out that one of her other children at home had died and she had been attending to the funeral and other things.  Talking to people here about what they go through really gives me a new perspective on my own life.  To have a child in the hospital with HIV, TB, and starvation and not have that be your biggest problem is almost unimaginable to me.  It really shouldn’t be that way for anyone.  Thankfully, she was happy to see him and he was VERY happy to see her.  I am so glad he gets to go home, but I can only hope and pray that she is able to continue to care for him once he gets there.  It is much harder to “leave work at work” when most of my patients are in situations like these. 

Outside of the hospital, yesterday was pretty interesting.  It was one of the physical therapist’s last days, so we had a going away party for her.  All of the doctors and therapists went (about 25 in all) and it was really nice to have a chance to get to know the other people here.  They are from Germany, South Africa, Australia, and England but they all speak English with a British accent, so they think we talk funny.  Before dinner, everyone wanted to go have drinks on a nearby lakeshore at sunset.  This sounded like a great plan to us, and our friend Jonas offered to drive us, so off we went.  Up until then, we had only been in the very small “downtown” of Manguzi.  I had no idea that it sprawled for miles and miles of farmland.  We hopped in Jonas’ compact rental car (a Hyundai a believe) and began to follow the others in their jeeps and pick-up trucks.  It quickly became apparent that we were essentially “off-roading” to the lake.  Jonas swerved in and out of sand dunes and grasses and we all jostled around in the backseat.  The first time he got stuck, some of the others were right in front of us so we all got out and pushed, and were able to get unstuck quickly.  The second time was similar, and so was the third.  By now you’re probably getting a picture of how this car ride was (or perhaps was not) going.  The fourth time, we were really stuck. We all got out, but the other cars had gone on ahead.  Looking underneath, it turned out the car had actually been grounded on the sand dunes between the tire tracks on either side.  It was NOT going to move.  The others eventually came back to see what happened to us and we ended up digging/wedging/pushing/lifting the car out.  Seeing as my biceps were not of much use when there were seven strong young men doing the heavy lifting, I took the opportunity to catch the scene on video.  I don’t have time right now, but I will definitely post some pictures of it later this weekend. 

Miraculously, we made it the rest of the way to the lake.  And it was worth it.  It was absolutely beautiful.  We had some drinks and watched the sun go down and got to know all our fellow Manguzi doctors.  Then, we took a much less eventful route back to town (turns out we’d been on the wrong one before) to have dinner.  One of the girls knew a local guy about our age who recently started his own restaurant.  Most restaurants here close at 5 p.m. but he kept it open just for us.  There is a large Indian influence in South Africa, and he cooked up quite an impressive chicken and beef curry.  It was really quite a wonderful evening.

Well, we are off on safari for the weekend in about an hour here and I’ve still got to pack.  Hopefully this update will hold you all over until Sunday when I return from Tembe Elephant Park.  I would imagine that I will have many stories and pictures to share.  We are in search of the Big Five which, in case you are like me and have no idea what that means, are the lion, elephant, leopard, cape buffalo, and rhino.  Much love to everyone and thanks for continuing to support me on this journey.  I haven’t had time to reply to comments, but please know that I read every one of them and that your encouragement is so much appreciated.  Sowubona!!

This Is Africa

So the doctors here say T.I.A. all the time.  Racking the medical part of my brain, I came up with transient ischemic attack.  Which made absolutely no sense in context.  So I finally asked.  It stands for “this is Africa” and they use it as a way to explain the unexplainable, the rare, and the ridiculous.  You might hear it said when you see a child dying of an easily treatable disease or you might say it when a lizard craps on your head.  It’s quite the versatile phrase.

Anyways, my point in all this is that yesterday was my day to realize that this is Africa.  And it is absolutely nothing like home. This is neither a good thing or a bad thing, but when jet-lagged, hungry, and homesick, it is quite overwhelming.  Today I am feeling a bit more adjusted (and less homesick thanks to lots of emails from friends and family.  You guys are amazing!), so I think I’m ready to write about everything.

I started my first day in the pediatrics ward.  Bryan, Brett, and Dandi split up between the male and female wards.  Within the first hour, I saw five patients with diseases I had never seen before.  There was tuberculosis meningitis, Kwashiokor malnutrition, and worms to name a few.  Although I expected to see very sick children here, I did not expect SO many to be THAT sick. It was a lot to take in.  The other three had similar experiences with new diseases and procedures.  Dandi got to do a spinal tap on her own and Brett got to drain the fluid off someone’s chest.  The opportunities to learn new things here are amazing.  They are so short-staffed that they are essentially letting us function as much like doctors as we are comfortable with.  For instance, one of the staff physicians and I ran the high risk prenatal clinic today.  They do not have specific ob/gyn docs here, so we pretty much split up the patients and he trusted that I knew how to manage them as well as he did.

Although the patients were just as sick today, it was a much better day for me. I realized this morning that, medically, there is very little to do for some of these children.  But they are still kids, and still want to be treated like kids.  So, some of the healthier kids and I moved the beds to the side and kicked around a soccer ball on the ward today.  It was an amazing experience.  Neither the kids nor I could understand a word of the other’s language and yet we had so much fun.  They were shrieking and laughing and looked like normal kids again.  One of the boys had a leg fracture and was stuck in bed.  He looked sad that he couldn’t play, so I took the ball over and threw it to him.  During our game of catch, what with my great aim and all, I accidentally bounced it off his head.  I have never seen a group of kids laugh so hard.  They thought it was the funniest thing of all time and spent the next ten minutes trying to bounce it off my head. It was also great to see their mothers relax a bit when their children were having fun.

As I knew I would, I have already grown attached to a few little guys.  One of them is two years old with HIV, tuberculosis, and severe malnutrition.  He has a type of malnutrition where his head and his belly actually swell so he looks really fat even though he’s so sick.  His pajamas are gigantic on him and he looks like a little old man.  He’s mr. independent and wants to hang with the big kids on his ward all the time.  His mother has abandoned him here for the time being so he mostly just does his own thing.  Today, he wasn’t his normal happy self and wouldn’t stop crying just standing in the corner by himself.  He eventually wandered over and started pulling on my pants.  The instant I picked him, he stopped crying and fell asleep.  I guess he just needed a little attention.  I’m gonna have a hard time not bringing him home with me. J

I know this is getting long, but just to end things on a lighter note, here’s a few blips of humor from the past two days.  We made the trek to the town’s grocery store yesterday.  It was a zoo! I almost got runover on the way there.  The German doc who is here pulled me out of the way twice!  Guess I can’t cross streets like I do in Lawrence, Kansas! The store was crazy….sooooo many people.  We found a few more edible foods, but it’s still pretty slim pickings.  Last night, we tried to make spaghetti for dinner.  Turns out, not only can you not turn on two kitchen appliances at once, but you can’t turn on two burners either.  It takes a little while to cook noodles, meat, and sauce that way.  Surprisingly, I have not seen a mosquito since I’ve been here.  Apparently the mosquito nets are actually more to block lizard poop, but it’s so small it falls right through the holes so I’m not sure what the point is.  Brett says he’s done with his cause he keeps waking up with the net along with lizard poop on his face in the morning.  Lastly, there is a very confused rooster somewhere in this neighborhood.  He fails miserably as an alarm clock, but crows from about 3:00-4:30 a.m. every night. T.I.A!!!

Miss you all and hope you are enjoying the updates.  I’ll try to keep them shorter now that I’m all settled in.



Our humble abode




My seat and the luggage that took it over



The hanging of the mosquito nets

Our shower--try not to be jealous

Louis, the resident gecko

Thank God for Protein Bars

Well, here we are in Manguzi.  My goal in coming on this trip was to get out of my comfort zone.  Well, I am so far out I can’t even see my comfort zone on the horizon anymore.  It’s going to be an interesting 4 weeks, but here’s to adventure!

Right now, the four of us are drinking wine and eating jellybeans (thanks Mom!) and reliving the day’s adventures.  So let me fill you in.

Right after my last blog, Bryan and I hiked up to the shopping center near our hostel and I discovered how horribly out of shape I am.  There were a lot of hills in Durban. We are now all set with a USB internet stick, something I never knew existed. But that is how I am updating this blog.

Once we were all back at the hostel we packed up our stuff and headed to something called the taxi stand.  This is a place where tons of “taxis” all gather and people with no concept of personal space try to sell you things you don’t want.  Luckily our driver from the hostel knew which stand we needed to get to Manguzi, and helped us with negotiating a price. And then the day got interesting.

Our next five hours were disturbingly similar to a circus clown car.  Just when you thought you couldn’t possibly fit one more person in the taxi…you were wrong.  The van looked full when we came up to it.  The driver looked at us for about 5 minutes, spoke some unintelligible words, and started literally rearranging people like he was trying to fit too much stuff in a suitcase.  Eventually, there were 15 people as well as our four large suitcases and backpacks.  Brett was shoved in the very back row between three sweaty and very aromatic Zulus.  Bryan was floating somewhere in the middle and Dandi and I were sharing a row with all the luggage which subsequently decided to fall over on me.  When it fell, Brett’s bottle of laundry detergent exploded all over the place which you might think was unfortunate.  Truth is, the smell of Downy was a welcome surprise.  Five hours in a non-air conditioned van with 15 already sweaty people crammed like sardines does  not make for a pleasant scent.

Aside from those things though, it was actually a beautiful drive.  While Durban was about as Americanized as can be (the first song we heard on arrival was Party Rock Anthem), as we headed north, I quickly began to feel like I was in Africa for the first time.  The scenery is gorgeous! We passed oceans, trees, fields, and lots of very rural, very traditional Zulu villages.  There were little children chasing each other with sticks, women carrying jugs of water on their heads, and cows everywhere. Oh, and more speedbumps than I thought possible.  But I guess I can’t complain since that does mean the roads were paved the whole way.

When we finally made it to Manguzi hospital, one of the doctors was waiting to greet us.  He hardly looks older than us! I guess most of the people who work here are fresh out of medical school as they don’t really have a residency and they are required to do some “community service” years.  He took us to our “rondavel” which is a fancy word for hut.  It is right next door to the hospital where the patients just kind of wander.  I took lots of pictures, hopefully I’ll get some up later.  We have four beds lined up in a row.  The sheets were covered in lizard poop, but luckily I brought my own.  There is a toilet, a sink, and a small room with a shower head that pours water out like a hose.  There is a kitchen with several small appliances, but we blew a fuse when we tried to use more than one at once.  Standing in a hut in pitch darkness was a little eerie.  We then proceeded to hang our mosquito nets, which was one of the more hilarious experiences of my life.  I can’t really do proper justice to the humor of the situation, so you will just have to wait until I post pictures.  Amazingly enough, they are all successfully hung, though I wouldn’t be surprised if we all wake up with them smothering our faces in the middle of the night.

Well, this is getting long so I’m going to call it a night, but I’ll at least make a quick reference to the title.  Dr. Marc took Brett and I to the one food mart that was open before he left us for the night.  We bought everything that appeared edible which included, noodles (no sauce, but we did find pureed tomatoes), peanut butter, jelly, bread, and drinkable yogurt.  So, I repeat, thank god for protein bars.  And wine.

From Kansas city to Durban

Hello everyone! We have made it successfully to Durban, South africa so here goes my first blog post. So far, nothing terribly eventful, but that's probably a good thing. But here's a quick update on our journey across the Atlantic. After a painfully long four hour layover in Atlanta we boarded our monster of a plane. Most of you know that the flight was what I was most nervous about. There were definitely a few tears and a lot of deep breaths, but I calmed down a bit once I got settled. I didn't do much sleeping due to the nerves, but I did watch a whopping 5 movies! They had a better movie selection than most blockbusters. Over 100 to choose from! Bryan and I lucked out and no one sat in the seat between us. We left that tv screen on the moving map so we could track our progress. If anyone ever tells you that a 17 hour flight won't actually feel that long, they're lying. It felt like forever!! I will say we were well fed though! And those free cocktails definitely helped me relax a bit. Once we landed in Johannesburg we waited in line for a long time to go through customs. It was not a particularly exciting experience. Once we had our bags I was not pleased to find that tsa had taken my tsa-approved lock off and not done a very good job of putting my stuff back together. So much for all that careful packing! At least nothing was missing. We had a pretty long layover there as well. I have realized I am going to have to work on understanding the heavy British accents down here. Especially when the natives speak English, it is very hard to understand. Our flight over to Durban was a short one. Just an hour. The last shuttle of the night was leaving just as we got there so we hopped on for a VERY bumpy ride to our hostel. As he pulled away we realized all the lights were off and the gate was locked. After nixing the idea of climbing over when we spied the four inch metal spikes along the top we rang the buzzer until the owner came out in her nightgown. Oops! Anyways, my Internet time is running out but the place was very nice and I slept decently. Now we are off to manguzi via a 6 hour taxi ride. Could be interesting! Hopefully we will have good Internet access there and I will be able to post again soon. Ive already taken lots of pictures so I'll have to get those up too. Miss you all lots!