Michael, Mignon, Will and Katie came for a great trip through Swaziland and South Africa - it was an epic journey! After 5 days in London, they joined us with Cisco and Caroline in Swaziland. We started them off with a bang - the whole crew, including Cisco and Caroline, were treated to a case of food poisoning. At three in the morning when everyone was making a mad rush to to the bathroom we discovered there was no electricity - soon after there was no water. Nothing says welcome to Africa more than having 6 guests with gastroenteritis and no water or electricity. We just wanted to make sure they didn't think our lives were too easy here! Also starting the trip off on a low point ensured that the rest of the trip would seem phenomenal in comparison!! It only got better from there...
We had a nice evening and game drive through Kruger the next day to Hazyview.
This was June 28th, Meredith and my 11th Wedding Anniversary! We actually both remembered it this year! A step up from last year when we both forgot amidst all of the turmoil of making our move to Swaziland.
We had couple of days back in Swaziland to rest....
From there we headed to Cape Town, one of the most beautiful cities we have ever been too!
We drove down the coast to Cape Point - known to be where the Indian and Atlantic oceans meet (beautiful spot but not actually the furthest south point of Africa where the two oceans truly meet, but still breathtaking all the same).
We stopped at Boulders Beach along the way to see the Penguins.
The scene with the moon and the twilight was gorgeous - so much eye candy. The pictures can't do it justice.
We stayed in a great house that was really stunning as well...
We ate great food and enjoyed the aquarium...
We all live in a Yellow Submarine...
Caroline spent three great weeks with us, spending her days volunteering at a local orphanage (www.leadershipforafrica.org/SandraLeeCenter.html ) and nights with Sophia and Luca. Then Cisco joined us for her last week in Swazi. We had a blast in 5 short days with a few days on safari and a trip into Maputo to have lunch at the seafood market. I skipped all the animal photos but here are a few of my favorites of people!!
Fairy Princess on Wheels!
So we are kind of isolated from real Swazi life living in Mbabane - a wealthy urban center that is quite developed and westernized. Most of Swaziland is rural and the society is structured around the homestead. We had the opportunity to visit a homestead with a visiting medical student who had been a Peace Corps Volunteer here in Swaziland near Lavumisa. He took us to the homestead where he lived for a visit. It was a nice day. We had a braii (BBQ) and a goat cook, partly to welcome us but really to celebrate the children's performance in school - they had all passed and several had placed first in their class! The Babe (said Baabay - father) always slaughters a goat and has a cook between school years to fete his kids advancing on to the next grade. The family was very welcoming, and Sophia immediately felt comfortable and explored the homestead-a few houses for different family members (in this case siblings of the baabe, since his second wife lived elsewhere), hut for women to cook in, pit latrine, goats and cattle, and a tree for relaxing and eating outside in the shade. This family is very well off, relatively speaking, and has a borehole for water within a short walking distance which is very lucky considering the drought is taking its toll on all small scale agriculture and livelihoods.It was a good reminder of how most Swazis live-amongst family, in rural areas where water and work are scarce, gender roles and social structures very defined, and opportunities like school cherished; a far cry from the city we see, full of big houses and BMWs.
I don’t know exactly why I haven’t written about work. I can come up with lot’s of excuses – too personal, too sad, too hokey, too voyeuristic, too unbelievable, or the inability to capture the moment and do it justice with my poor writing skills. All of the above...
But yesterday there were a couple of scenes I wanted to share – funny, sad and inspiring. I’ll finish with funny.
So I called the next patient, #83. A young child walked up to me looking timid but resolved. “Who is with you today?” I asked not seeing a caregiver approaching. “I am alone,” he responded. This is not an unusual case – there are many orphans, teens and some younger, who manage their own care, but this one struck me because he looked very young.
Once we were in the consultation room I discovered
that he was actually 12 years old and was extremely stunted, looking
about 7 years old. He is an orphan; both parents died a few years
ago. He had been living with his Gogo (grandmother) in S. Africa until
about a month ago when she passed away after a stroke. He was now back
in Swaziland, living with an older brother. There wasn’t enough money
for bus fare for two, so he came alone.
I asked if he knew
his HIV status, looking at the positive results of the rapid test that
was done a few minutes before I called him in. He said he was tested
in S. Africa and was told he was HIV negative; he didn’t know the
results of the test that was just performed. The counselor wanted him
to return with his brother for disclosure of the results.
So should I disclose his status? If I were him I would want to know, but he is a minor with a guardian. He probably has an idea anyway since we are asking him to return with his brother. I didn't tell him.
He
came to clinic because he had been coughing for seven months and it
hurt to breath. He most likely has TB and needs 6 months of multi-drug
therapy.
We gave him some money to get a chest xray and bus
fare for him and his brother to come back today. I was afraid I would
never see him again.
He came back today, chest xray in hand, and his brother at his side. He listened to the positive HIV test result and didn’t flinch. He was started on the TB medicines and was set up to come back for counseling to start ARVs. Handled it all with poise – like a 30-year-old in a 7-year-old’s body.
The other story is about another young man, 10 years old who came with his aunt. His parents were both deceased as well; his aunt is his mother’s twin sister. She took him in and now he is like her own she told me.
She is a talker… typically my Swazi patients are quiet around me – stoic and guarded around a strange umlungu (white/foreigner). But this aunty was chatty-chatty.
“He was dead when I brought him to this clinic.”
“Pardon me?” I say.
“
He was dead when I brought him here and Doctor Anouk and Doctor
Michelle saved his life. Now look at him. Now he doesn’t listen and is
always causing trouble.”
The description didn’t quite fit with the meek looking little guy sitting quietly next to her, flat warts covering his entire body. But he did have a sparkle in his eye and I saw him running around the clinic with a couple of other boys.
(
One might think it a bother to have kids running the halls in a clinic
– but it is like balm to see healthy playful kids laughing and running
in this clinic).
Then she says, “ Show the doctor what’s in
your bag.” I am thinking a toy, maybe one of those miraculous wire
motorcycles with moving parts perhaps he made himself.
Out comes a dead pigeon he gleefully waves flopping its broken neck back and forth, a huge smile across his face.
OK. I look at her puzzled, “Ah, it’s a dead bird,” I stated the obvious.
“It flew into the window outside and killed itself. “
“I see. And what are you going to do with it?”
“I am going to take it home and fry it.”
Pause.
“Well… it’s good it’s not going to waste. Good source of protein too. “
Our little tater is becoming a tot! Can't believe he is already one. He is cruising around now and has one bottom tooth (too cute) that he uses very efficiently to gnaw his way through almost anything you put in front of him. He uses "Dada" in context sometimes (or am I wishing?) but no definite words yet. He is pretty expressive with shaking his head no, waving bye-bye and pointing. He is totally a daddy's boy right now and wants to be held by Dan constantly. He even turns away from Meredith and clutches at Dan during hand overs.
Here are some photos of his party...
This is Buyisile, our nanny. She keeps our house running and sane. She has a ton of energy and is great with the kids.
Pretty aren't they? A little malarone for Luca, Sophia gets some erythro and malarone, Dan gets malarone and his ARVs. Meredith doesn't believe in malaria prophylaxis... Talk to her Pam. We only need it during our trips to the low veld. You probably want the story behind the ARVs (anti-retrovirals). So there is some risk involved with my work. Exposure to TB and HIV probably the greatest (after car accidents? I have been in two already while travelling for work- neither my fault! I was rear ended in both and luckily no one was hurt). I digress - so back in December I was drawing blood on a HIV positive 18 month old who was a fighter and the needle grazed my gloved finger. Luckily I hadn't hit her vein and there was no visible blood on the needle after both pokes so probably low risk but I took post-exposure prophylaxis just to be safe. I already had a ton of respect for patients who show up with 100% adherence month after month but it went to a higher level when I got to experience the side effects - particularly with kaletra. I get nauseated just thinking about it! Stomach upset, diarrhea, malaise.... I guess you get used to it eventually, but I was still feeling it after a month and lost 10 lbs. Imagine a life of that and trying never to miss a pill.
