Friday, February 20, 2009

The end of the first week

Or 1%, as Mark pointed out!

I know people want pics, but I can't seem to upload them. The connection is no longer 3.5 G like in the city!

The hospital is about 1 mile from our house, at the east end of the township area. We often walk to work, at 8 am and 5 pm it’s often cloudy, and not too hot. Our car’s starter engine broke the day after we bought it, so we just didn’t use it.

At work, each doctor has a ward for which they take responsibility. There is a female/maternity ward, male ward, paediatrics and Tb wards. We have been allocated the paeds ward, which is really interesting. We’ve rounded in the Tb ward twice already, which is also fascinating.

This week, a typical day has been: rounding from 8 till it’s done (about 30-45 minutes if there is only the kiddies, 2 ½ hours if we do the Tb ward too) then Mark goes to the “CDC” centre for disease control, where the HIV work is being done. And I go to the out patient department/casualty and see patients. See patients till 1, and as Namibia has a strong tradition of a 1-2 pm lunch hour, but it’s awfully hot for walking home, we bring a lunch to work. Then again from 2-5 pm.

We haven’t been overwhelmingly busy. Currently the HIV clinic is only on a Wednesday, and over the next year we hope to expand that to 3 times/week. I am certainly not seeing the most patients in the OPD, 1 or 2 other docs are on with me, and there are certainly some slow times.


Khorixas is divided in to areas, 3 really. As you come from Outjo (or follow the road on Google Earth) to the right of the main road is the “Town”, where the house lots are quite big, the houses are big (to whit: ours), most, maybe all, have servants quarters. This is where, before independence in 1990, whites lived. After 1990, most moved out, apart from 4 families, apparently. I don’t know when the houses were built, but they are pretty uniform.
To the left of the road is what could be called the “township”, I think. Lot sizes are smaller, houses are small: from the outside they look as if they are 2 or 4 rooms, quite symmetrical, metal roofs, plumbing. Lots of satellite dishes outside of them. Apparently they are crowded with furniture inside.

Further to the south of the township is the informal settlement. I haven’t seen it yet, but houses are self built, maybe with corrugated iron. I assume no plumbing, but I don’t really know.

Namibian health care
HIV has so much attention and so much funding and support internationally and this is reflected in Namibia. I would be interested to know who has to pay for the treatment of AIDS in the US, but it’s free here. Namibia is a two tiered system: there is the state system, which we are working in, and a private system. Within the state system, yes, you can’t prescribe any medication: there is a NEDlist (Namibia’s Essential Drug list) and stocks aren’t always high, but when you do prescribe them, they are free. (for the medics out there: PPIs aren’t on the list, but tramadol is!) A patient who needs it can get transport to Windhoek to see a specialist (on Wednesdays), get a CT, have a kidney removed, whatever. I don’t know what the wait times are, of course.

The doctors we work with

There are 3 other docs here: Dr Everest Nkire, the Principal Medical Officer, a Nigerian who has also worked in Zambia, Dr Reddy from Hyerabad (India, I know I spelled it wrong) who has worked in Jamaica, Trinidad, the Seychelles, the Maldives and Goa!, and Dr Michael Ubunama, who is also Nigerian.

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