Sunday December 14, 2008

Umjani, which is a common greeeting here which means 'how are you'.
My first whole week of work has come and gone and it appears I have survived it. I must say that I am greatly challenged by the very slow pace here. I have gone from 'being the boss' to not being familiar with any of the culture, sights, smells, chaos, slowness, medications (even the generic names are different), proceedures or basically any of the routines. Our day starts quite early since the sun rises at 4:30 am, by 6:00 am I have had a cold shower (the water has been flowing all week!) and have started the coffee and had a big bowl of cereal. Carbohydrates are my life now, please do not tell any of the boys at David Barton Gym, I am sure that they would be horrified. (In case you are wondering, Zone bars are our favorite protein bar, the chocolate and caramel or chocolate fudge.) Protein is very difficult to come by, the poor little dead chickens in the store couldn't be any thinner and the red meat is completely unrecognizeable. Back to the start of my day. I can look out our front window, while eating my Corn Flakes, and see the beautiful valley in the distance. Now instead of just seeing all the beauty I am overwhelmed by what lies hidden in the homesteads.
The degree of suffering is just starteling. During one of my home visits this week I saw a young man who was 35 years old. His face was grostequely swollen from Karposi Sarcoma and he had numerous other lesions all over his body. The flies were all over him and his infant son who was dressed in rags. The only medications we had to offer was Tylenol with codeine (only 8 mg of codeine, instead of 30 mg or 60 mg) and some ibuprofen. One of the other nurses thought that I was giving him way too much medication, it took all of my strength to explain that he was not getting too much medication and be able to remain respectful to my colleague. The women that I work with have been doing this for many years and the fact that they just show up for work and are witness to this sitaution is quite amazing. They are all very strong and committed to their work and are somehow able to manage day after day, year after year.
The earth is quite unrelenting here. They have been in a drought situation for many years. Often it clouds up at night and there is a tremendous amount of lightening and thunder with little or no rain to follow. I pray that they will receive some rain because many people have to grow their own food to survive. The corn is only 10 or 12 inches high and it should be four feet high by now. Corn is their main source of food and without a good crop I really cannot imagine what the winter will be like when the rainy season has come and gone. We often spend our day making home visits in the valley that lies directly below Siteki, I am not sure of the direction it is in but I do know that it is 10 to 15 degrees warmer that where the hospital is. The average daily temperature has been about 34 degrees celcius or 94 degrees. As we drive down into the valley you can feel the heat rise and the air becomes drier. As we drive from one homestead to the next we make quite a dust cloud, there are only dirt roads to travel on once we leave the main road. Along the roads there are these bushes that have very large prickers on them, they are at least an inch long and every branch is just covered with them. Needless to say I have no idea of where I am going and often the others forget a turn or two so we have to back track often, doing a U-turn while trying to avoid the pricker bushes, cows and large ruts in the road can be quite challenging. Our gas tank sprung a leak yesterday but we were able to make it to all of our home visits. By the end of the day I am covered with sweat and dust and dirt and I feel a bit paralyzed but what we have witnessed. I guess that it what I have been stuggeling with most. Why here, why these people, why do I (we) have some much and how can I make a real difference. I think that I am here just to simply bare witness to the situation, the suffering as well as the joy on the faces of the patients when they see our truck and know that they will get some food and attention. We have very limited medications, the food we supply only lasts a couple of days but the the people are so grateful and gracious for our visits. Just being heard and seen and touched seems to make a difference. I am working hard to open my heart and soul and to see clearly the human being who is in front of me, and give them the respent and dignity they deserve and is possible during a five, ten or twenty minute visit before we have to leave to see the next patient. I have to look past all of the choas, inefficencies and lack of structure. I am rather entrenched in structure and organization but I am open to learning. People often come up to our truck to receive care, which can be both helpul (less traveling involved) and a hinderance. Thursday a woman and her 6 month old child who could not have weighed more than 8 or 9 pounds came up to me and handed me the child. He had a terrible case of thrush and he just cried and cried, neither his mother or I were able to calm him. Both parents have HIV/AIDS but the child had not been tested yet. Luckily, we were able to give them some nystatin and money for bus fare to come to the hospital the following day.
Yesterday, Saturday, we were able to get out of Siteki and drive (we got a ride from a local kid called Thando, his mother works at GSH) into the town of Manzini to do some shopping and just have a little getaway. Manzini is a city of about 50, 000 people, I think? The main street has many shops and is comprised of cinder block two story buildings with shop after shop in them. Most of the shops are run by Indians rather than Swazi's. It kind of looks like something you might see in a poor neighborhood of Los Angeles or what you might imagine in an African city. We have been plagued with electrical problems. I plugged the short wave radio into the 240 current outlet and it basically burnt up. David's cord for his computer shorted out and now my camera has stopped working. So we are looking for some replacement parts and places to fix them, wish us luck. Karen has already sent off a new cord for the computer so soon we may be able to see a movie on DVD, which I am quite looking forward to.
Tonight we are having a couple of Peace Corps volunteers over for dinner, they are Andew and Kristen (married), in their mid twenties, from Boston and really quite nice, so we are looking for good conversation and a few cocktails. We have yet to see much wild life. There is a game reserve about 40 minutes away by car but have not managed to get there, hopefully soon. David is well and again I am so grateful that we are here together.
I am so impressed by how many people do this on their own. Kathleen Hartman RN started this Home Based Care program many years ago (2001, I think) and I am so impressed with her commitment and compassion and ability to work with the system and create a helpful evironment for the patients. She is such a strong person, an amazing nurse and quite the humanitarian. The work she has done is so very impressive! She has been quite the role model for me and a great mentor as well.
I hope that I have not been repeating myself too much. I am not trying to complain, we are doing fine, there are numerous adjustmements but that is just part what we have signed up for. The journey has been amazing already and it will only get better I am sure. Just another quick story before I sign off. Behind our house, oh about twenty feet away is the trash can for the houses that are next to ours on the grounds of the Deaf School. Well, day in and out the can got fuller and fuller and then overflowed onto the ground. So the locals would just empty their trash on the ground next to the can because there was no more room in the can. We started saving up our trash inside the house waiting for the can to be emptied (Lord knows I do not like a mess), well that day never came. One morning the lady next store simply took a match and some gasoline to the pile of trash, now the trash is gone and we are left with a pile of ashe and soot. The job is done, not exactly how I had imagined it but completed just the same.
Peace,
Scott