Are the blogs becoming less frequent? I somehow think so. Probably becsuse things are becoming "as they are", rather than quite so strange and different. We are settling, a bit. To be honest it was a difficult week despite that!

On Wednesday I treated 2 girls who had taken their grandmothers' diabetic treatment. They live about 80 km away on a farm. I'm not sure why, but they had to wait till the morning to even start the trek to the hospital. First a donkey cart to the road, then wait for a lift from a passing car (of which there are not many!) So I fear it was just too late for one of them. She has spent too long without sugar for her brain. She was very unwell and unstable in hospital. We were able to stablise her, but transport to Windhoek was very difficult, as both our ambulances and drivers were out, and would be too tired by the time they returned. Mark and I and a nurse and the aunty and the sister who was ok went in our car to the next town where an ambulance took all of them (without me, I was exhausted, Mark went) to Windhoek. She needed oxygen and monitoring. The oxygen ran out half way to Okahanja, and the monitor's battery died...so the hospital in Okanhanja gave them both and she made it to Windhoek in much the same state as she left Khorixas, which is all we could have asked for. The hospitals in Outjo and Okahanja were fantastically helpfull. We don't know how she is doing, yet.

I think the stress of that day took about 3 days to pass.
It's a bit strange what we can and can't offer here. In some ways, if we were more "in the middle of the bush" and couldn't even think of transfering her, we could cope with that. And certaintly patient expectations aren't high, people are quite fatalistic, used to not knowing what caused an illness or a death. I struggle with that. Many doctors do struggle with uncertainty.