Hiy'all,
I've been really wanting to write something, but just didn't know how.
I just got an email from a friend in Namibia, a few minutes after opening up one of my bags. My stuff has been stored at my parents' and FINALLY it arrived in Norris Point. We've just moved into a more permanent house (beautifull by the way and PLENTY of guest bedrooms... It's a bit big for 2 people, but it's the off season in Gros Morne, so very very cheap...) Anyway there was ONE bag I was looking forward to unpacking. The bag I packed last before leaving for Namibia, so all those really nice things that didn't make the cut for out 22 kg allowance. Opened it and found some, oh, so wonderfull wonderfull brown corduroys. Mark says that makes me very square, but I don't care.
Well, hey, it's Octover, there is snow on the Tablelands, it was just Thanksgiving. So tho' it's hard to remember the heat of Namibia, here, curled under my wonderfull wonderfull duvet. It's COLD!
Mark and I are well. We're travelling twice to New Brunswick, once to Labrador and once to Gander to check out some job opportunities...
I'll add pictures when I figure out PICASA.
Thursday, October 15, 2009
Saturday, July 11, 2009
A wedding and a funeral
My brother is getting married today. Philip and Dominique are getting married at Robin Hill. It's quite small, about 28 of us. I flew back a few days ago (Oh my word, 17 hours on South African Airways is a loooong time, but really quite straightforward) and am here for 10 days. The bride will wear fuscia, the groom will wear clothes (probably). The forcast was for rain and thunder, but I think it's going to hold off till later tonight. It's beautifull sunshine right now, so here's hoping. (Mummy hung rosaries on the clothesline last week, which seems to have worked!)
It's also the day of E.'s funeral. You may recall she was one of our personal patients. She was 12 and had had HIV since birth, and Tb twice. She wandered about the hospital saying very very little. She was discharged a few weeks ago as she was doing well. I saw her in the OPD a few times, and she seemed to be doing ok. But then the other day she was readmitted, very short of breath. The day after that she seemed a bit better (I was in Outjo by then), but I got a text to say she'd died. I didnt' want to believe it and had to phone the ward and to talk to one of the nurses about it. It's one of those things that surprise you, even tho' it shouldn't. She was sick with 2 lethal diseases, and probably got a third infection on top of it... But still very, very sad.
So two very important things to pray about today.
It's also the day of E.'s funeral. You may recall she was one of our personal patients. She was 12 and had had HIV since birth, and Tb twice. She wandered about the hospital saying very very little. She was discharged a few weeks ago as she was doing well. I saw her in the OPD a few times, and she seemed to be doing ok. But then the other day she was readmitted, very short of breath. The day after that she seemed a bit better (I was in Outjo by then), but I got a text to say she'd died. I didnt' want to believe it and had to phone the ward and to talk to one of the nurses about it. It's one of those things that surprise you, even tho' it shouldn't. She was sick with 2 lethal diseases, and probably got a third infection on top of it... But still very, very sad.
So two very important things to pray about today.
Monday, June 29, 2009
Outjo
Unfortunatly, 2 weeks ago, a Dr Samunto, who was working in Outjo, (about 130 km from us) died in a terrible car crash. He was driving between Otjiwarongo and Outjo, and hit another car. It is thought he had a broken leg, and apparently bystanders were trying to help him get out of the car. He phoned his wife (who is also a doctor in Outjo) and they spoke. The ambulance was on its way. But before they got there, a truck ran into the group - killing Dr Samunto and a woman who was helping him! Just awfull. It's thought the truck driver was drunk.
I'd only met him once, casually, outside the grocery store in Outjo. He was from DRC, so we spoke french. Everyone spoke really highly of him.
We had a gathering in Khorixas hospital, prayers and singing, for him, last Monday. And we've been sending releif doctors to Outjo. (There were 3 docs there, so they are 2 down, as his wife is travelling back to Congo for the burial. They have 6 children.)
It's my turn this week, to go to Outjo, but I've been waiting for the transport for 4 hours now, and still nothing...
I'd only met him once, casually, outside the grocery store in Outjo. He was from DRC, so we spoke french. Everyone spoke really highly of him.
We had a gathering in Khorixas hospital, prayers and singing, for him, last Monday. And we've been sending releif doctors to Outjo. (There were 3 docs there, so they are 2 down, as his wife is travelling back to Congo for the burial. They have 6 children.)
It's my turn this week, to go to Outjo, but I've been waiting for the transport for 4 hours now, and still nothing...
Saturday, June 20, 2009
Traditional authority
Now, within a few days of Mark and I handing in our letter of resignation, a few things happened. I found it all a bit disturbing and scary, but it's all worked out fine. First there were rumours that the location would "strike" and protest in front of the hospital, complaining against the PMO. And then, on Friday last week, we received a letter, an invitation to meet with the traditional leaders, to explain our "unusual resignation".
I was really upset. I didn't know how many people were going to be there (would it be in front of the whole community? was there going to be anger, threats of violence? I know it sounds melodramatic, but there were stories, from a few years back, of the people of the community lifting a doc's car and preventing him from entering the hospital) Apart from that, there was the difficulty of explaining ourselves. It was a really hard decision to make, and some of the reasons were very much about personal relationships at work making work quite unpleasant, and clinical decisions we were struggling against. We had no intention of making that public.
Mark wrote a fantastic letter. I wish I could reproduce it, but he's away in Spain (at a wedding) with his computer. It was very honest, heartfelt as well as diplomatic. It acknowledged the difficult working relationships without blame, and without making them the main reason for our resignation. It was great.
I managed to get 10 copies made for the meeting, and that is about how many people were there. There was the chief of the #Aodaman tribe, the mayor of Khorixas and a bunch of councillors. What a room full of intelligent and locally powerfull people. And Namibia being so small, they probably can talk to the president easily enough (well, they implied that, and I believe them).
It lasted about 1 hour and was nominally conducted in Damara, through a translator (tho' the translator seemed really powerfull too, and seemed to run the meeting, with the traditional chief's ok). Having things translated was actually really helpfull, to sort of diffuse emotional content, and time to think about answers.
Suffice it to say, it went well. For which I am very gratefull.
I was really upset. I didn't know how many people were going to be there (would it be in front of the whole community? was there going to be anger, threats of violence? I know it sounds melodramatic, but there were stories, from a few years back, of the people of the community lifting a doc's car and preventing him from entering the hospital) Apart from that, there was the difficulty of explaining ourselves. It was a really hard decision to make, and some of the reasons were very much about personal relationships at work making work quite unpleasant, and clinical decisions we were struggling against. We had no intention of making that public.
Mark wrote a fantastic letter. I wish I could reproduce it, but he's away in Spain (at a wedding) with his computer. It was very honest, heartfelt as well as diplomatic. It acknowledged the difficult working relationships without blame, and without making them the main reason for our resignation. It was great.
I managed to get 10 copies made for the meeting, and that is about how many people were there. There was the chief of the #Aodaman tribe, the mayor of Khorixas and a bunch of councillors. What a room full of intelligent and locally powerfull people. And Namibia being so small, they probably can talk to the president easily enough (well, they implied that, and I believe them).
It lasted about 1 hour and was nominally conducted in Damara, through a translator (tho' the translator seemed really powerfull too, and seemed to run the meeting, with the traditional chief's ok). Having things translated was actually really helpfull, to sort of diffuse emotional content, and time to think about answers.
Suffice it to say, it went well. For which I am very gratefull.
Tuesday, June 16, 2009
Survival of the most adaptable...
We've been here 4 months now, and for the last month Mark and I have been talking long and hard about how things are going. What follows will sound like a justification of why we have decided to resign early, and it is, but perhaps you'll understand us.
The goal of VSO is to accomplish sustainable development: sharing skills, changing lives. We felt, since the beginning, that what we are doing is not sustainable. We have been filling a post they could not fill otherwise. That was a bit annoying, but we still felt we had something to offer the hospital and the community here.
We've been stressed, again since we arrived, about licencing. Rather dull stuff, but it takes years to get a license here in Namibia, and we had (have) real concerns that Mark (and maybe me!) might not be able to work in Canada without being properly registered here.
And working with colleagues as a team... Oh dear. There have been storms and storms. We all have our strengths and weaknesses, and 2 of our colleagues aknowlegde, for the most part, their own weaknesses. Mark and I (we hope) know when we are out of our depth and ask for help.
When patient's lives are at stake, it's not the time to be self reliant. It would be different it we were really out in the middle of an untracked jungle, we would have to do the best we could. But here, we are 4 tarmac'd hours from our referral center, where there is an ICU, and actual laboratory investigations can be done regularly, CT scans and everything. Conflict about referral of really sick patients has come up again and again. Conflict about treatments. It's unpleasant.
So we've re-evaluated our priorities. What we came to do is something we believe is not only valid, but also interesting and fascinating. I love caring for patients who are actually sick! (The worried well are few and far between her) But not at the cost of our ability to work together in the same country.
So we handed in our resignation last week (we'll work till Aug 15th). This, or something like this, we would like to do again. But we'll look into our placement with different priorities next time.
The goal of VSO is to accomplish sustainable development: sharing skills, changing lives. We felt, since the beginning, that what we are doing is not sustainable. We have been filling a post they could not fill otherwise. That was a bit annoying, but we still felt we had something to offer the hospital and the community here.
We've been stressed, again since we arrived, about licencing. Rather dull stuff, but it takes years to get a license here in Namibia, and we had (have) real concerns that Mark (and maybe me!) might not be able to work in Canada without being properly registered here.
And working with colleagues as a team... Oh dear. There have been storms and storms. We all have our strengths and weaknesses, and 2 of our colleagues aknowlegde, for the most part, their own weaknesses. Mark and I (we hope) know when we are out of our depth and ask for help.
When patient's lives are at stake, it's not the time to be self reliant. It would be different it we were really out in the middle of an untracked jungle, we would have to do the best we could. But here, we are 4 tarmac'd hours from our referral center, where there is an ICU, and actual laboratory investigations can be done regularly, CT scans and everything. Conflict about referral of really sick patients has come up again and again. Conflict about treatments. It's unpleasant.
So we've re-evaluated our priorities. What we came to do is something we believe is not only valid, but also interesting and fascinating. I love caring for patients who are actually sick! (The worried well are few and far between her) But not at the cost of our ability to work together in the same country.
So we handed in our resignation last week (we'll work till Aug 15th). This, or something like this, we would like to do again. But we'll look into our placement with different priorities next time.
Saturday, June 6, 2009
May I recommend
davesboringblog.wordpress.com
How do I show links beside my blog? I'd also like to do a hit counter, but anyway, when I'm smarter...
Dave is David Cutting, he's VSO in Opuwo, and his blog is very funny (as is he, don't you know).
How do I show links beside my blog? I'd also like to do a hit counter, but anyway, when I'm smarter...
Dave is David Cutting, he's VSO in Opuwo, and his blog is very funny (as is he, don't you know).
A typical day
Hullo!
I thought I would try and describe a typical day, now that there are typical days…
Well, we wake up in separate beds (2 single camp beds tied together by the legs), and crawl out from under the mosquito net. Actually for the last week we have forgone the mosquito net as it is bloody cold- I’m not sure what temperature it is in the middle of the night, but less than 20 C at 7 AM. I’m wrapped up in a blanket inside my down sleeping bag, and am nice and toasty. So we’ve separate beds and separate sleeping bags. Then Mark has a freezing shower (I only shower every 2 days, and I turn the hot water on for about 45 minutes before I get in.) We have breakfast, usually porridge these days, and coffee from our fantastic Bodum-type cafetiere, that Anne and Andy gave us when they visited. Then go to work, walking 15 minutes to the hospital.
At work we each do ward rounds. Currently I am on Paediatrics, Male and Tb wards, Mark does Maternity and Female ward. We start around 8.20. Tb ward only is done 2ce a week: Monday and Thursday. These are confirmed cases of Tb who are in the initial intensive phase of treatment. In other hospitals they are only kept as inpatients for 2 weeks, then followed weekly, but here we tend to keep them for the full 2 month intensive phase.
After that, I’m now on “CDC” as in “Centre for disease control”. Tho’ the only disease we control is HIV (well, we’re working on Tb prophylaxis too…) and Mark is in the out patient department. I’m seeing all and sundry who have HIV in the Khorixas area. Everything is very much about following guidelines, which are, on the whole, very sensible. It requires so much concentration!! I’m prescribing nearly the same thing to every one: 3 drugs for the HIV, 1 to prevent Pneumocystic jirovecii pneumonia, 1 to prevent Tb and 1 to reduce the side effects of the Tb drugs and multivitamins. But then, not all are on the same 3 drugs for HIV, not all need the PCP or Tb prophylaxis, do the have anaemia? Is their liver ok? Do they have Hep. B? All makes minor variations, and luckily, I’ve the guidelines to tell me what to do!!! I just have to remember to read the guidelines.
At 1 PM it’s lunch time, till 2. If we’ve walked to work we have lunch there. Sometimes I’ve remembered to bring leftovers, but often we eat fat cakes: balls of dough that have been deep fried. Don’t knock it till you’ve tried it.
We knock off at 5 PM and walk home. Evenings aren’t very exciting: sometimes we visit the rest camp a few km out of town, and use their pool, having a beer or cider afterwards. Rarely we eat there (the food is basically alright, but not more than that). The exercise is nice, but it is getting colder now. No problem for Mark, but I’m a bit wimpy… otherwise the sun is setting at 5.15 these days, so we are eating, watching movies or shows (friends have given us electronic versions of all sorts: the first 3 seasons of Seinfeld, How I Met Your Mother, and movies galore… ) and bed is quite early: 9 PM, often enough.
I thought I would try and describe a typical day, now that there are typical days…
Well, we wake up in separate beds (2 single camp beds tied together by the legs), and crawl out from under the mosquito net. Actually for the last week we have forgone the mosquito net as it is bloody cold- I’m not sure what temperature it is in the middle of the night, but less than 20 C at 7 AM. I’m wrapped up in a blanket inside my down sleeping bag, and am nice and toasty. So we’ve separate beds and separate sleeping bags. Then Mark has a freezing shower (I only shower every 2 days, and I turn the hot water on for about 45 minutes before I get in.) We have breakfast, usually porridge these days, and coffee from our fantastic Bodum-type cafetiere, that Anne and Andy gave us when they visited. Then go to work, walking 15 minutes to the hospital.
At work we each do ward rounds. Currently I am on Paediatrics, Male and Tb wards, Mark does Maternity and Female ward. We start around 8.20. Tb ward only is done 2ce a week: Monday and Thursday. These are confirmed cases of Tb who are in the initial intensive phase of treatment. In other hospitals they are only kept as inpatients for 2 weeks, then followed weekly, but here we tend to keep them for the full 2 month intensive phase.
After that, I’m now on “CDC” as in “Centre for disease control”. Tho’ the only disease we control is HIV (well, we’re working on Tb prophylaxis too…) and Mark is in the out patient department. I’m seeing all and sundry who have HIV in the Khorixas area. Everything is very much about following guidelines, which are, on the whole, very sensible. It requires so much concentration!! I’m prescribing nearly the same thing to every one: 3 drugs for the HIV, 1 to prevent Pneumocystic jirovecii pneumonia, 1 to prevent Tb and 1 to reduce the side effects of the Tb drugs and multivitamins. But then, not all are on the same 3 drugs for HIV, not all need the PCP or Tb prophylaxis, do the have anaemia? Is their liver ok? Do they have Hep. B? All makes minor variations, and luckily, I’ve the guidelines to tell me what to do!!! I just have to remember to read the guidelines.
At 1 PM it’s lunch time, till 2. If we’ve walked to work we have lunch there. Sometimes I’ve remembered to bring leftovers, but often we eat fat cakes: balls of dough that have been deep fried. Don’t knock it till you’ve tried it.
We knock off at 5 PM and walk home. Evenings aren’t very exciting: sometimes we visit the rest camp a few km out of town, and use their pool, having a beer or cider afterwards. Rarely we eat there (the food is basically alright, but not more than that). The exercise is nice, but it is getting colder now. No problem for Mark, but I’m a bit wimpy… otherwise the sun is setting at 5.15 these days, so we are eating, watching movies or shows (friends have given us electronic versions of all sorts: the first 3 seasons of Seinfeld, How I Met Your Mother, and movies galore… ) and bed is quite early: 9 PM, often enough.
Friday, May 22, 2009
The rest of that blognote
Last week Mark and I were away in Marienthal for in country training part 2. It’s away down in the south of the country. We drove Edith, Siew Wee, Vikas and Paulina down to Windhoek where we spent the night at Pratap’s, Joon’s and Xavier’s house. (as I write this, I realise, you get used to the international community. We spent the week with Kenyans, Ugandans, Indians, Philipinas, Singaporeans, Namibians, Brits, Candians, Australian and an UnitedStatesian. All VSO volunteers, here for different projects. I think we are an odd sight walking down the street, tho’) I suppose we learnt more about development and lots more about Namibia, but the best part was getting to spend that time with this network of people. We now know people all over the country (free lodging, heh, heh).
On the way back up, we spent another night in Windhoek, in Anne and Andy’s apartment. We had met these Canadians in Ottawa, and are ecstatic they are in Namibia too. Oh, my, though, was I loving their apartment! Unfortunately they were mugged a few weeks ago, in broad daylight in an ordinary part of town. They are absolutely fine, but it does show that there are some benefits to living in the sticks. Khorixas does have minor violence (stab wounds with broken bottles, usually) but very little targeted at white/tourists. Mostly because there are so few!
Back to work on Monday was very difficult. But this week was a 4 day week (Thursday off) as is next week. Some people are enjoying a 5 day weekend, but we’re on call…. Still had Thursday off (went to a low key campground, v. cheap) and will have Monday too, so can’t complain!
On the way back up, we spent another night in Windhoek, in Anne and Andy’s apartment. We had met these Canadians in Ottawa, and are ecstatic they are in Namibia too. Oh, my, though, was I loving their apartment! Unfortunately they were mugged a few weeks ago, in broad daylight in an ordinary part of town. They are absolutely fine, but it does show that there are some benefits to living in the sticks. Khorixas does have minor violence (stab wounds with broken bottles, usually) but very little targeted at white/tourists. Mostly because there are so few!
Back to work on Monday was very difficult. But this week was a 4 day week (Thursday off) as is next week. Some people are enjoying a 5 day weekend, but we’re on call…. Still had Thursday off (went to a low key campground, v. cheap) and will have Monday too, so can’t complain!
Blog seems to be acting up... Can't post.
Hullo! I got a couple of comments that I haven’t posted anything, and it’s true! Just noticed: May 1st was when I put on the pictures.
But then, of course, you’ve not commented on my blog!
Well, you have, some of you, in emails.
But there is something weird about just putting this stuff out there…
I’d love to share more of the medical stuff: but hopefully won’t put the non-medics off their lunch…
Assisted a C-section today, and we’re hoping to transfer skills: that is, our PMO knows surgery, and I and another Nigerian are interested in learning how to do a CS (not 100% sure I want to be able to do them, but it might turn out to be usefull). So I just closed the last few layers today (there are about 6 layers to close after a CS).
M. who had Tb and has HIV went home last week. She is one of our miracles, from just lying there like a stick insect to walking up and down the halls and smiling!! She gained 6 kg (up from 20 to 26… age 18). She actually spoke to me in English 2 weeks ago: I didn’t even know she could speak it. On ward rounds for the first 2 months she would just stare at us. The nurses would speak Damara, and she would nod, sometimes. It barely seemed she was awake. But I guess as she got better, her brain started functioning better. (She had meningitis during this admission, too). Anyway, she was moved into a ward with some other women, and I needed to ask a patient something, and she translated for us! It was really neat.
Friday, May 1, 2009
Monday, April 27, 2009
No good deed goes unpunished
For some weeks now we've been wanting to see the ocean. It's about 200 km due west from here. With call and other excitements we've been doing other things, but this weekend, we went. Sat morning 8 am (Mark finished call) we went west. Picked up some young chap, dropped him at his farm, and picked up a young kid there, about 11 yrs old, who'd fallen from a donkey cart and scrapped his foot. It looked a bit dirty and so on, but not too bad. His dad wanted to take him to the clinic in Bersig where there was a nurse, about 30 km along our route. So we did. The dad pointed out some elephant droppings and was able to tell us how many had gone by, and in which direction. Really neat (and I was thinking: no good deed goes unrewarded...)
But when we got to Bersig there was no nurse, she'd gone to Khorixas for the weekend! It was really annoying, what were we to do? Drop him, to wait for the nurse (and the wound to get septic?) Take him with us (there is a clinic in Terrace Bay, about 100 km further on) but what if that nurse was away as well? How would he get back? Would he be waiting for us? while we were sightseeing? UUURGH! How did it become our problem! Well, it became our problem when we picked them up... Soooooo we drove them back to Khorixas, at the hospital gates, and started again. 4 hours later...
We spent the night at Springbokwasser gate, at a campsite, for free. This is the Gate for the Skeleton coast national park. It was incredibly remote. A small group of buildings for managing the access to the park, surrounded by nothingness. We explored the river bed, took loads of pictures of Welwitchia (the miracle plant that grows in the desert... About 1 cm per year). Baked potatoes on the fire, slept, woke at sunrise. Wow, what an amazing sunrise. I don't see many sunrises, just not that kind of person, but I've seen more in Namibia than anywhere else. Mark took some amazing pics (we'll upload them later).
The seaside was cool, you could feel the air changing as we approached it. The seasonal campsite (only open Dec and Jan) was eerie with cormorants. Just beautifull. The water was too cold for me. (And I'd been looking forward to swimming in it.) Mark immersed himself, and I paddled.
We stayed for a few hours, and there was an enormous dune just back from the ocean which we climed. Very desert, very Laurence of Arabia.
Who knows? Was our good deed punished? We had a fantastic weekend, no matter if it was because or despite giving a lift to that child...
But when we got to Bersig there was no nurse, she'd gone to Khorixas for the weekend! It was really annoying, what were we to do? Drop him, to wait for the nurse (and the wound to get septic?) Take him with us (there is a clinic in Terrace Bay, about 100 km further on) but what if that nurse was away as well? How would he get back? Would he be waiting for us? while we were sightseeing? UUURGH! How did it become our problem! Well, it became our problem when we picked them up... Soooooo we drove them back to Khorixas, at the hospital gates, and started again. 4 hours later...
We spent the night at Springbokwasser gate, at a campsite, for free. This is the Gate for the Skeleton coast national park. It was incredibly remote. A small group of buildings for managing the access to the park, surrounded by nothingness. We explored the river bed, took loads of pictures of Welwitchia (the miracle plant that grows in the desert... About 1 cm per year). Baked potatoes on the fire, slept, woke at sunrise. Wow, what an amazing sunrise. I don't see many sunrises, just not that kind of person, but I've seen more in Namibia than anywhere else. Mark took some amazing pics (we'll upload them later).
The seaside was cool, you could feel the air changing as we approached it. The seasonal campsite (only open Dec and Jan) was eerie with cormorants. Just beautifull. The water was too cold for me. (And I'd been looking forward to swimming in it.) Mark immersed himself, and I paddled.
We stayed for a few hours, and there was an enormous dune just back from the ocean which we climed. Very desert, very Laurence of Arabia.
Who knows? Was our good deed punished? We had a fantastic weekend, no matter if it was because or despite giving a lift to that child...
Sunday, April 19, 2009
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.
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.
Monday, April 13, 2009
Easter
Hullo!
Frustratingly, Easter is a 4 day weekend, and we are working 3 out of 4 days of it. It is the life of a doctor, and we should be used to it, but somehow, being a volunteer, I find it a bit more annoying. But we did have Friday off together, which was nice.
Last week we met a Spaniard who is cycling in Namibia, scouting it to see if it's suitable for guiding a cycling holiday. I ran into him again Friday morning in the shop and he came by for a chat, some water and to use the internet. He's tired of cycling and taking a few days off, to do more typical safari type stuff, so we're storing his bike for him. I showed him Margo and Chris' blog. He cycles about 100km a day, carrying 8 liters of water with him. That's to last 2 days, in case he doesn't get to a campsite that night. It is so hot and dusty here and the roads are so straight, I can't imagine doing what he's doing. I don't think he's planning on taking tourists here either, as he keeps saying that the scenery is so "boring". Daniel, be warned. By the way, for potential visitors, I think the scenery is only boring if you're travelling slowly...
Otherwise we were very quiet. Mark worked very hard on Sunday, tho' we did have time for supper, with another visitor, Pratap. Pratap is also VSO and he travels about 2 weeks every month, helping set up campsites, coordinating conservancies and generally knows everyone. When he visits it's like the outside world is coming in for a while. We had chicken, potatoes, cauliflower cheese, some Indian vegetable Dr Reddy's wife had given us, a green salad. And Chocolate cake. It was reminiscent of any Sunday dinner we've hosted in the past, and completely lovely.
And now I'm on today, and it's been really tough. I'm not sure I can write about it, but it is part of the things I anticipated might be hard, coming here. A few days ago I identified a few things that make the hard things more bearable. It's completely corny, but completely true. There are a couple of young girls who are struggling with HIV and Tb, and both are doing
well. The older one, M, I've been taking care of almost every day for 6 weeks, and she was always just flat, recumbent, apathetic. Our boss, Nkire, got the rehab person to come and see her, and I think he gave her (and the nurses) confidence to use the walking frame! What a difference. Big smiles and applause at her first jaunts up and down the ward, and now big smiles on my ward rounds. She's not out of the woods, maybe never will be. The younger one, E, was picked up by her aunt to be taken home for the long weekend. She usually wanders the hospital, with a serious face, rarely a smile, up and down and around. Her too, I saw today, smiling and waving at me.
These are the things that will sustain us.
Frustratingly, Easter is a 4 day weekend, and we are working 3 out of 4 days of it. It is the life of a doctor, and we should be used to it, but somehow, being a volunteer, I find it a bit more annoying. But we did have Friday off together, which was nice.
Last week we met a Spaniard who is cycling in Namibia, scouting it to see if it's suitable for guiding a cycling holiday. I ran into him again Friday morning in the shop and he came by for a chat, some water and to use the internet. He's tired of cycling and taking a few days off, to do more typical safari type stuff, so we're storing his bike for him. I showed him Margo and Chris' blog. He cycles about 100km a day, carrying 8 liters of water with him. That's to last 2 days, in case he doesn't get to a campsite that night. It is so hot and dusty here and the roads are so straight, I can't imagine doing what he's doing. I don't think he's planning on taking tourists here either, as he keeps saying that the scenery is so "boring". Daniel, be warned. By the way, for potential visitors, I think the scenery is only boring if you're travelling slowly...
Otherwise we were very quiet. Mark worked very hard on Sunday, tho' we did have time for supper, with another visitor, Pratap. Pratap is also VSO and he travels about 2 weeks every month, helping set up campsites, coordinating conservancies and generally knows everyone. When he visits it's like the outside world is coming in for a while. We had chicken, potatoes, cauliflower cheese, some Indian vegetable Dr Reddy's wife had given us, a green salad. And Chocolate cake. It was reminiscent of any Sunday dinner we've hosted in the past, and completely lovely.
And now I'm on today, and it's been really tough. I'm not sure I can write about it, but it is part of the things I anticipated might be hard, coming here. A few days ago I identified a few things that make the hard things more bearable. It's completely corny, but completely true. There are a couple of young girls who are struggling with HIV and Tb, and both are doing
well. The older one, M, I've been taking care of almost every day for 6 weeks, and she was always just flat, recumbent, apathetic. Our boss, Nkire, got the rehab person to come and see her, and I think he gave her (and the nurses) confidence to use the walking frame! What a difference. Big smiles and applause at her first jaunts up and down the ward, and now big smiles on my ward rounds. She's not out of the woods, maybe never will be. The younger one, E, was picked up by her aunt to be taken home for the long weekend. She usually wanders the hospital, with a serious face, rarely a smile, up and down and around. Her too, I saw today, smiling and waving at me.
These are the things that will sustain us.
Wednesday, April 8, 2009
Some more pics
So this is Mark and Alice with Brandberg in the background. I saw an arial pic of Brandberg, really cool, so if you have Google Earth, I think it would be worthwhile. Then Mark and Alice's Condor stuck in the sand. 4 hot sandy hours later, we were free... Then a pic of the "White Lady of Brandberg". Cave drawings, about 2000 yrs old, probably of a medicine man, surrounded by people, hallucinations and animals. There are more than 20 similar caves in this one valley of the Brandberg, probably by Khoi Khoi (not San, tho' the difference between these tribes still eludes me.) And some pretty rocks at sunset.
Sunday, April 5, 2009
My brother Stephen used to complain (when I was living in Bolivia, in the era of group emails) that I would just write long speils about the weekends, and all my adventures (this was his excuse for not replying...)
Anyhoo, we went with Sue to Brandberg this weekend. Sue kindly took pictures of us stuck in a sandy river bed- which will follow.
Sue is ex-VSO (her placement was in Nepal), a vet and has worked in the Shetlands, the Falklands, New Zealand, the Dominican Republic and now Windhoek. Oh and she's Canadian-British, super fit and enthusiastic. She joined us Friday night and we had a little goat (one of the nurses gave me the front quarter of a goat. The kitchen staff kindly cut it up into small peices, and I roasted it with thyme.) We set off Saturday morning and got to the campsite before noon. Then set off to the "river" which sounded like a nice place to have lunch, paddle, maybe walk up or down it... The staff repeatedly told us not to drive in the river. Which we interpreted to mean don't drive up or down the river. When we got there, the river was dry and baking. There were tracks across the river and Mark (usually the most risk-averse) thougth it was good for crossing in our 2WD condor. It wasn't, unfortunatly. Oh my word it was hot. Digging out our tires, putting brush and our firewood under the tires, reversing, repeating the same thing. Trying to get Sue's Rav4 (a small 4x4) to tow our car out, breaking the tow rope twice. Stopping and having lunch... Trying again. I was near heat exhaustion, I think. I was just too hot to do anything after a while. That's when Sue and I went back to the lodge and got a worker with a 6 liter ancient Nissan and a big peice of nylon rope, and hauled it out... Thank goodness.
It was a perfect place to "try out" our limitations, close to civilisation, with Sue and her car to help us. But it was 4 hours in the heat, really trying to get ourselves out.
Anyhoo, we went with Sue to Brandberg this weekend. Sue kindly took pictures of us stuck in a sandy river bed- which will follow.
Sue is ex-VSO (her placement was in Nepal), a vet and has worked in the Shetlands, the Falklands, New Zealand, the Dominican Republic and now Windhoek. Oh and she's Canadian-British, super fit and enthusiastic. She joined us Friday night and we had a little goat (one of the nurses gave me the front quarter of a goat. The kitchen staff kindly cut it up into small peices, and I roasted it with thyme.) We set off Saturday morning and got to the campsite before noon. Then set off to the "river" which sounded like a nice place to have lunch, paddle, maybe walk up or down it... The staff repeatedly told us not to drive in the river. Which we interpreted to mean don't drive up or down the river. When we got there, the river was dry and baking. There were tracks across the river and Mark (usually the most risk-averse) thougth it was good for crossing in our 2WD condor. It wasn't, unfortunatly. Oh my word it was hot. Digging out our tires, putting brush and our firewood under the tires, reversing, repeating the same thing. Trying to get Sue's Rav4 (a small 4x4) to tow our car out, breaking the tow rope twice. Stopping and having lunch... Trying again. I was near heat exhaustion, I think. I was just too hot to do anything after a while. That's when Sue and I went back to the lodge and got a worker with a 6 liter ancient Nissan and a big peice of nylon rope, and hauled it out... Thank goodness.
It was a perfect place to "try out" our limitations, close to civilisation, with Sue and her car to help us. But it was 4 hours in the heat, really trying to get ourselves out.
Wednesday, April 1, 2009
I just love these pictures. I bought Mark this camera about 3 years ago, it's ONLY 6 megapixels and the pics are massively reduced to go on the blog. But ANYWAY, the top one is a giraffe with Etosha pan in the background. Then that tree one: behind the tree, all in a row, are hundreds of springbok. It's amazing. Then the lilac breasted roller, which flashes blue in flight. Lovely. Then an Oryx (or Gemsbok) then an elephant. Did you know they walk silently?
Monday, March 30, 2009
Etosha mark II
We went back to Etosha this weekend. Mark and I had been on call one weekend each and we were very keen to get out of Khorixas!! Siew Wee and Celia went with us (Siew Wee is the Singaporean pharmacist who lives with us, and Celia is a physio from Bristol who works in Grootfontein. Grootfontein isn’t very close to here, about 3 hours if you have a car, but Celia hiked (hitched lifts, for which you pay by the kilometre) and met us in Outjo.
We tried to leave work promptly at 5, but is somehow just didn’t happen. The Gates of Etosha close at sundown (7 pm) so we camped at a lodge about 9 km from the park gates. We got up at 6 (yes, 6 on a Saturday) and drove. We saw thousands of springbok, oryx and zebras. A lot of them. A lot. And wildebeest, quite a few of them. Celia and Siew Wee were really keen to see something else, but Mark and I were just amazed by these prolific animals. They were just loving it; the grass, the water.
It’s not the best time of year to see game, because it’s rained so much. Etosha pan is usually an enormous flat bed of sandy whiteness. But we saw it full of water, stretching away. About 100 km by 40 km. Immense, shallow. In 6 months (or less?) it’ll be dry again.
Later in the afternoon we did see some giraffe, but the whole scene was quite beautiful. We spent the night in another campsite (fantastic hot showers, better than home). And Braii both nights (It means barbeque, but you can cook anything: we had a veggy stew and roast potatoes (or roast sweet potatoes)).
On Sunday (again getting up at 6) we explored north. We’ve decided all this driving is not the way to go. You just find a waterhole you like and sit there for a while…. Like 10 minutes… and the elephant just walks up to you! And drinks. And blows bubbles with it’s trunk. It was by itself, really quiet, and really cool.
There was also this amazing bird, a purple breasted roller. And eagles. And busterds. (Pics soon.)
Etosha is a weird place in a way. It’s so expensive, and the tourists are mostly white, the staff mostly these grinning black people. It’s beautiful, but completely artificial in a way. (I mean, the animals are wild enough, but still contained)
So we came back, and Monday morning waking at 6 am, (the joy of going back to sleep and sleeping in till 7!) going into work. Oh what a change! CD4 counts, difficult patients, patients who won’t talk to you, patients who talk too much, patients who just don’t get it: (when your CD4 count is 50 (normal >500) and haemoglobin is 3 (!) (Normal 12) you’ve something more to worry about than constipation- or potency, for that matter)
We tried to leave work promptly at 5, but is somehow just didn’t happen. The Gates of Etosha close at sundown (7 pm) so we camped at a lodge about 9 km from the park gates. We got up at 6 (yes, 6 on a Saturday) and drove. We saw thousands of springbok, oryx and zebras. A lot of them. A lot. And wildebeest, quite a few of them. Celia and Siew Wee were really keen to see something else, but Mark and I were just amazed by these prolific animals. They were just loving it; the grass, the water.
It’s not the best time of year to see game, because it’s rained so much. Etosha pan is usually an enormous flat bed of sandy whiteness. But we saw it full of water, stretching away. About 100 km by 40 km. Immense, shallow. In 6 months (or less?) it’ll be dry again.
Later in the afternoon we did see some giraffe, but the whole scene was quite beautiful. We spent the night in another campsite (fantastic hot showers, better than home). And Braii both nights (It means barbeque, but you can cook anything: we had a veggy stew and roast potatoes (or roast sweet potatoes)).
On Sunday (again getting up at 6) we explored north. We’ve decided all this driving is not the way to go. You just find a waterhole you like and sit there for a while…. Like 10 minutes… and the elephant just walks up to you! And drinks. And blows bubbles with it’s trunk. It was by itself, really quiet, and really cool.
There was also this amazing bird, a purple breasted roller. And eagles. And busterds. (Pics soon.)
Etosha is a weird place in a way. It’s so expensive, and the tourists are mostly white, the staff mostly these grinning black people. It’s beautiful, but completely artificial in a way. (I mean, the animals are wild enough, but still contained)
So we came back, and Monday morning waking at 6 am, (the joy of going back to sleep and sleeping in till 7!) going into work. Oh what a change! CD4 counts, difficult patients, patients who won’t talk to you, patients who talk too much, patients who just don’t get it: (when your CD4 count is 50 (normal >500) and haemoglobin is 3 (!) (Normal 12) you’ve something more to worry about than constipation- or potency, for that matter)
Thursday, March 26, 2009
buying a car in namibia
The first 10 days we were here, we were in Windhoek, doing admin type stuff, to be legal to work here. And we knew we wanted a car, but what kind? It was entertaining listening to 2nd hand car salesmen. (Well, it would have been, if it wasn’t so hot when we were looking) Everyone had advice. And stories. The best was the one of the 2 tourists in their 4x4 caught in a river for 4 days surrounded by crocodiles. The roads here are either tarmac, dirt or really rough. The dirt roads get muddy after the rains, then regraded each year. There are so many accidents, especially tourists, that car rental companies can’t get insurance. People go mad with the 4x4 and also too too too fast on the tarmac’d roads (speed limit is 120 kph, many people go 159 kph, because that’s the limit you don’t go to jail for) There are lots of Germans who are familiar with the Autobahn.
We wanted something reliable, powerful enough for the dirt roads of Namibia, but not necessarily a 4x4, we didn’t want something too flashy, and we were aware that the ability to give lifts was a bonus. Based on the difficulty we had with a VW in Western Newfoundland, we wanted something easy to find parts! Well, pretty much everyone agreed that Toyota was the most widespread car in Namibia. So one of the VSO staff scouted for one for us. He found a Toyota Condor. It’s a 7 seater, 2.4 l engine, a bit higher off the ground, (better for clearance, and seeing the animals) and our contact assured us the engine was fantastic. Of course the seatbelts, fuel cap, radio, window winders, back seat security, tires, spare tire restrainer could all be fixed… Well, they have been fixed now, but it took a while, and a lot of Mark’s patience. I would lose it every time I spoke to the guy. The tires really were bald, and we were planning on buying new ones, but didn’t before one of them exploded. Really. I’ve never seen anything like it. It tested our jack and pump, and found both wanting. However Namibian helpfulness was not wanting, and all was well. We now have 5 new tires, and I’m a lot happier about it. Oh, the radio isn’t fixed, tho’. And the starter motor packed it in the day after we bought it. But again, we learnt how to get things done, and it’s all fixed now.
We wanted something reliable, powerful enough for the dirt roads of Namibia, but not necessarily a 4x4, we didn’t want something too flashy, and we were aware that the ability to give lifts was a bonus. Based on the difficulty we had with a VW in Western Newfoundland, we wanted something easy to find parts! Well, pretty much everyone agreed that Toyota was the most widespread car in Namibia. So one of the VSO staff scouted for one for us. He found a Toyota Condor. It’s a 7 seater, 2.4 l engine, a bit higher off the ground, (better for clearance, and seeing the animals) and our contact assured us the engine was fantastic. Of course the seatbelts, fuel cap, radio, window winders, back seat security, tires, spare tire restrainer could all be fixed… Well, they have been fixed now, but it took a while, and a lot of Mark’s patience. I would lose it every time I spoke to the guy. The tires really were bald, and we were planning on buying new ones, but didn’t before one of them exploded. Really. I’ve never seen anything like it. It tested our jack and pump, and found both wanting. However Namibian helpfulness was not wanting, and all was well. We now have 5 new tires, and I’m a lot happier about it. Oh, the radio isn’t fixed, tho’. And the starter motor packed it in the day after we bought it. But again, we learnt how to get things done, and it’s all fixed now.
Sunday, March 22, 2009
Saturday, March 21, 2009
Pics from Etosha, our house and the OPD
Etosha: giraffes, lions (they were, umm, post coital, frequently), guinea fowl,
Our view, pretty canopy in Etosha (there should be the outline of a bird in there, but I can't find it again) and some really weird bug in the outpatient department.
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