The last couple of weeks have been busy but amazing. I spent my fourth week in South Africa at a government-run health clinic called Kwadabeka. The six female doctors there see 80-100 patients every single day. They have "little to no job satisfaction," but they couldn't imagine leaving South Africa or doing anything besides medicine. Because of the continuing strike, the clinic wasn't that busy, and we got to spend a lot of time talking to the young doctors. Last weekend all the other American CFHI students returned to the US because they are only doing the four week program instead of the 8 week program. Fortunately, another batch of 20 students arrived yesterday. I also have a new roommate who arrived last week. She is very nice, and I am thankful that she came a week early for her July program.
I spent last week at a privately funded research clinic called CAPRISA (Center for the AIDS Programme of Research in South Africa). It is almost entirely funded by US sources, including the NIH and PEFAR (The Presidential Emergency Fund for AIDS Relief). It is by far the nicest health facility that I have seen here. It is extremely well staffed, and unlike the burned out doctors that I see in the public sector, the doctors at Caprisa are excited about their work. They are doing several clinical trials at the clinic, including a HIV vaccine, a microbicide, and a study of acute HIV infection. We spent most of our time with doctors who are involved in a study aimed at determining the best time to start ARVs (antiretrovirals) in patients who are coinfected with tuberculosis and HIV. It was extremely interesting, and it was encouraging to know that there are people who are diligently working to find solutions to the AIDS pandemic. The CAPRISA center has received international attention, and representatives from the US government may be coming to visit the research clinic.
Thankfully, the strike officially ended on Friday after 28 days. Unfortunately it will take time for the health care system to get back to normal, and many of the city's biggest hospitals are struggling to provide adequate care to patients. This week I am rotating at a home-based care center that provides health care for patients who cannot travel to clinics. The site is in a large black township called Kwamashu. It has been really interesting to see where the patients live.
On Saturday I had the amazing opportunity to go to a membeso, which is a traditional ceremony for a couple that is getting married soon. The groom's family gives gifts to the each member of the bride's family. It was absolutely fascinating, and I am very thankful that I was able to experience traditional Zulu culture.
I can't believe that I will only be here for two and a half more weeks. The last five weeks have gone by so quickly, and it will definitely be hard to leave.
Thursday, June 28, 2007
Monday, June 18, 2007
Drakensberg
I spent last week at a semi-private Catholic hospital called St. Mary's. In general, the doctors there seemed apathetic, frustrated, and tired. Even before the strike started, several doctors quit in the middle of the week because they were frustrated with the lack of resources. Even in the private sector, resources are limited and doctors must work under extremely difficult conditions. The hospital appeared to be running as normal even with the strike. The nurses and doctors were told by the hospital management that they would be fired if they went on strike. However, it seems that some of the staff may have been working more slowly out of sympathy for the strikers. On Wednesday we didn't go to work at all because the taxis and buses went on strike. Basically the entire city was shut down, and people struggled to find rides to work. Despite the frustrating conditions at St. Mary's, I did have some really good experiences with the staff there. I got a good tour of the laboratory, where they do microbiology, blood tests, and 100 HIV tests every week. The laboratory technicians were extremely knowledgeable and showed us slides of tuberbulosis and a fungus called cryptococcus. They do intensive HIV counseling at the clinic there, and 72.5% of the HIV tests that they run are positive.
The strike continues, and negotiations seem to be reaching some end. The government has increased its offer to 7.25%, but the union is demanding a 10% increase. It is still unclear when the strike will be resolved, and until then patients will continue to suffer. Please continue to pray for a quick resolution of the strike and our continued safety.
Last weekend I went to the Drakensberg mountains with six other students in my program. We hiked about ten miles on Friday and 6 miles on Saturday. It was absolutely gorgeous, and I am hoping to visit the mountains again in July.
The strike continues, and negotiations seem to be reaching some end. The government has increased its offer to 7.25%, but the union is demanding a 10% increase. It is still unclear when the strike will be resolved, and until then patients will continue to suffer. Please continue to pray for a quick resolution of the strike and our continued safety.
Last weekend I went to the Drakensberg mountains with six other students in my program. We hiked about ten miles on Friday and 6 miles on Saturday. It was absolutely gorgeous, and I am hoping to visit the mountains again in July.
Monday, June 11, 2007
Healthcare in Africa
I finally had a chance today to come to the internet cafe. The last two weeks have been amazing, fascinating, and exhausting. I am not sure how to begin to tell you about all of my experiences, but I will do my best to give you a good idea of what it is like here. This is going to be a long update, so feel free to skim it. The first week I was here I went to a government-run clinic called Cato Manor. The nurses (called sisters) basically act as doctors because there aren't enough doctors in South Africa. Nurses can prescribe meds, make some diagnoses, and distribute meds. The healthcare situation in South Africa is actually worse than I expected. Patients who cannot afford to go to a private clinic go to the government-run clinics, where they usually wait all day to be seen. We got to talk to several doctors who specialize in HIV/AIDS, and the clinic has a strong program for the prevention of mother-to-child-transmission of HIV. We saw hundreds of young pregnant women, some as young as 15. About half of the patients that I saw are HIV-positive.
Last week ten students in my program travelled to a rural hospital called Hlabisa. It provides care for about 85,000 people. It was absolutely amazing. It is a fairly large hospital, but they only have about 15 doctors. Most of the doctors come from Britain, Sweden, and Scotland. They come to Hlabisa for a year or two and then return to their native countries. Even the doctors from South Africa usually only stay at Hlabisa for a year because the conditions are so difficult. The hospital is located in a little town that has a supermarket, a couple liquor stores, and of course KFC (everyone seems to love KFC here). Given the isolated conditions of the hospital, the doctors at Hlabisa are here because they really want to provide adequate healthcare for South Africans. They were amazing teachers, and they were eager to help us to understand how the hospital operates. I saw more in that one week than I would ever be able to see in the States. I learned how to take a patient history, how to look for pleural effusion (fluid build-up) in a chest X-ray, and how to listen for evidence of tuberculosis in the lungs. My favorite day was the day I spent in maternity. I watched a doctor remove a retained placenta, and I learned how to determine the gestational period by measuring the height of the fundus. That afternoon I watched two caesarian sections, and two of my peers got to actually assist in the surgery. It was amazing to watch the surgeon deliver the baby, and I am hoping that I will be able to assist in a C-section soon.
The healthcare system in South Africa is at its breaking point right now. On June 1 the public servants of South Africa went on strike. This includes nurses, teachers, and doctors who work in the public sector. The rate of inflation is 6.3%, but the government was only offering a 6% raise to the public servants. To make matters worse, the members of parliament gave themselves raises from 37-50%. The unions are demanding a 12% increase. Thankfully, we were not really affected by the strike at Hlabisa because it is partly funded by private sources. However, conditions in Durban are worsening as the government hospitals are nearly completely shut down. Several people have already died as a direct result of the strike, including a woman who died of an asthma attack because her ambulance was not allowed to enter the hospital. This week I am working at St. Mary's in Durban, which is also semi-private and is still operating as usual. On Wednesday other workers will be participating in secondary strikes. The situation will most likely get worse before it gets better.
I have had an amazing experience so far, and I am looking forward to the next six weeks. Last weekend we got to go to a game reserve, and this weekend I am going to the Drakensburg mountains. This country is absolutely beautiful, and I feel privileged to have the opportunity to know the people of South Africa. I could go on and on about all that I have seen here, but my internet time is running out. I love you all, and I really appreciate all of your prayers. I will try to update again soon.
Prayer requests:
Safety as the public servants strike worsens
Resolution of the strike
That God will continue to give me strength, and that he will continue to remind me that despite all of the suffering that I see here, He is present.
Last week ten students in my program travelled to a rural hospital called Hlabisa. It provides care for about 85,000 people. It was absolutely amazing. It is a fairly large hospital, but they only have about 15 doctors. Most of the doctors come from Britain, Sweden, and Scotland. They come to Hlabisa for a year or two and then return to their native countries. Even the doctors from South Africa usually only stay at Hlabisa for a year because the conditions are so difficult. The hospital is located in a little town that has a supermarket, a couple liquor stores, and of course KFC (everyone seems to love KFC here). Given the isolated conditions of the hospital, the doctors at Hlabisa are here because they really want to provide adequate healthcare for South Africans. They were amazing teachers, and they were eager to help us to understand how the hospital operates. I saw more in that one week than I would ever be able to see in the States. I learned how to take a patient history, how to look for pleural effusion (fluid build-up) in a chest X-ray, and how to listen for evidence of tuberculosis in the lungs. My favorite day was the day I spent in maternity. I watched a doctor remove a retained placenta, and I learned how to determine the gestational period by measuring the height of the fundus. That afternoon I watched two caesarian sections, and two of my peers got to actually assist in the surgery. It was amazing to watch the surgeon deliver the baby, and I am hoping that I will be able to assist in a C-section soon.
The healthcare system in South Africa is at its breaking point right now. On June 1 the public servants of South Africa went on strike. This includes nurses, teachers, and doctors who work in the public sector. The rate of inflation is 6.3%, but the government was only offering a 6% raise to the public servants. To make matters worse, the members of parliament gave themselves raises from 37-50%. The unions are demanding a 12% increase. Thankfully, we were not really affected by the strike at Hlabisa because it is partly funded by private sources. However, conditions in Durban are worsening as the government hospitals are nearly completely shut down. Several people have already died as a direct result of the strike, including a woman who died of an asthma attack because her ambulance was not allowed to enter the hospital. This week I am working at St. Mary's in Durban, which is also semi-private and is still operating as usual. On Wednesday other workers will be participating in secondary strikes. The situation will most likely get worse before it gets better.
I have had an amazing experience so far, and I am looking forward to the next six weeks. Last weekend we got to go to a game reserve, and this weekend I am going to the Drakensburg mountains. This country is absolutely beautiful, and I feel privileged to have the opportunity to know the people of South Africa. I could go on and on about all that I have seen here, but my internet time is running out. I love you all, and I really appreciate all of your prayers. I will try to update again soon.
Prayer requests:
Safety as the public servants strike worsens
Resolution of the strike
That God will continue to give me strength, and that he will continue to remind me that despite all of the suffering that I see here, He is present.
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