On to the next thing...

Well, my time in peds is done. Yay! and I'm feeling pretty good about it. I think I may actually be able to do it as a job if I had to... probably not my first choice though. One final thing that I must say about peds is that on Friday I saw one of my patients leaving the hospital (he'd been there for quite a while and we were both counting the days until he could go home). and he gave this hand shake/signal to me that several patients had before, like a snapping motion except with two separate thumbs (two people's thumbs). I only have learned later that it goes with a saying "sharp, sharp" (pronounced shop, shop) that means I am ok, everything/ life is good. I was teased for not being able to infer what the signal meant, they said it was like two thumbs up communicating that everything was good! "where was I from that I didn't know that that is what that meant"!

Anyway, I think I did ok in peds, and no better way to celebrate than going to my first every rugby game with a few work friends! I learned a ton about basic rules of rugby and loved being at the game. Turns out rugby is super fun! I would say that America should get more into this rugby thing, but we would just rule it all up and it wouldn't be fun anymore! They even taught me how to throw a rugby ball after the game (it has to do with a down-by-your-side-two-handed-spin-pass thing)... The rest of the weekend was kind of low key/relaxing. We tried "Mama Shebeen's", authentic S.A. food, and a few of the local pubs with our nursing friends from Kansas. On Sunday we traveled to the market and grilled some ostrich, cooked vegis, chips (fries) and drank wine with the Kansas crew. In all a very nice, but not altogether sleepful weekend!


Today was my first day of neuro in Bara. I spent about an hour of the morning getting "oriented" to neuro wards, and then they sent me off to see my/Emily's leftover patients. Not too bad so far. It was all pretty much things I've seen before (except Guillain-Barre which is just like a spinal cord injury except it gets better). Everyone is VERY nice and helpful in the neuro section. although some maybe still slightly intense... I had a patient refuse me today and I had tried bargaining with her, telling her this is the only way she'll get out of the hospital, anything I could think of, I even tried just getting her set up and doing it anyway but she started flapping her arms and saying no. So I told one of the older PTs in the neuro section who reported to the MD and proceeded to just fling her up from the bed and into a chair even with the flailing and refusals. I was thinking 'ok so that's how you do it'; although I think I would have had to stop in the U.S. though, no is no there. On my last clinical in the States I learned that if the 80yo woman says 'get the F*** out of my room' you just turn around and leave! I am praying for a good experience in neuro these next two weeks and hopefully can learn a ton too..

Adventures

We have already had many adventures in our short time here in SA, and I'm sure we'll have many more. The first fun (non-work) things we did included visiting the "Origins" museum here on Wits Campus (tell about the origins of the human species here in Africa), and this weekend we went on a tour of Soweto (stands for south west township) which is where Bara Hospital is located and included the Apparthtide museum. We figured that we should know a bit about the majority of the people that we are treating in the hospital. The museums are very interesting, and the Apparthtide was touching. After a trip to the museum, we were taken to Soccer Stadium, Nelson Mandela's house, the memorial to where Hector Peterson was shot (12-13 yo boy shot in Apparthtide protest), and finally the different housing districts in Soweto. Upper class Soweto which in my opinion looks like middle class larger city (because they are very close together) USA :

Then there was the middle class housing which looked pretty low by US standards (look past the tin low income home and to the brick house:

These long concrete buildings are divided into government owned units converted from old mine housing (Jo'burg used to have gold mines) which are free but don't have water, sewer, or electricity:

Finally here are the poor shanty houses made of tin scraps: 

It was very interesting to see the different regions here in this poorer African suburb. It was also very, very sad. It hurt my heart to see how these people who are the majority of this suburb live everyday with water pumped from a well, port-a-pottys for toilets, and no electricity (which makes it impossible for us in the hospital to send them home with oxygen if they need it). I know that we have homeless in the US very similar to this, but to see the magnitude and volume of poor here felt like someone had punched me in the chest. I felt like the worst person in the world for leading the life that I do. I still get upset just thinking about it and knowing that there is not much I can do. The government here is working to help but it all takes so much time which is not what these people have. I thought that I knew how I felt about this from working at Bara, but I was apparently mistaken because it hit me like a ton of bricks no matter how clique that is. I pray for the best, or at least survivable conditions, for all of these people here and that everyone reading this blog never has to experience this in their lives. Anyway, the tour was very interesting and eye-opening. And I’m sure there will be more.

On a lighter note, other than humility being learned on this trip, I have learned that South Africans do a lot of cool things. Like using energy in kilojoules instead of Calories to measure food products which takes away the negative connotation, I mean you need energy to survive right? They also use lots of cool words that are fun to say, like: explaining to us the dodgy (iffy) parts of town. I learned that local is lekker (awesome), you can use the word ‘shame’ to respond to something good or bad which could be useful when you don’t really know what someone just said to you (as long as it wasn’t a question), and when someone asks if you want chips say yes because they mean fries my fav food. They also make their own chocolate, wine, beer, and liquor here which are all very good. As Emily puts it ‘peri-peri makes everything better’. Peri-peri is a type of pepper usually made into a spice that is good on literally everything (all meats, rice, vegis, and eggs).They also make aluminum cans and plastic bottles much thicker here than are in the States so I shake my Pepsi can and try to sip more several times before I decide that it is really all gone. I guess my proprioception overrides the other senses because all my life I know that when the can is that weight there is still some soda left. I have learned a thing or two about security of the threat of security because everything even private residences have high walls and barbed wire around them, all grounds like universities and hospitals have gates with security, and in Soweto they have police that stop random cars to search you, the car, and your bags and question you about your travels. I don’t know what they were looking for but they sure didn’t look very hard which is why I say ‘threat of security’. None of the guards really do the most through job but it must be enough to scare off at least some of the criminals because it is everywhere here. No one is really bothered by it; that is just their culture here: if you don’t protect/lock it, it’s up for grabs. And finally I learned that the online weather for Jo’burg is never correct. It has said 80-90% chance of rain most of the days we have been here and its only rained twice.

Not too bad.

Having to work on your birthday: not great, but being in a foreign country on your birthday: not half bad! Both the head of the Peds dept and "The Intimidator" gave me feedback today and seemed to think I was going well. And I was thinking 'well you could try showing it a little more!' Anyway after work Emily and I went to "Mike's Kitchen" a South African restaurant. They had such amazing sea food, drinks/beer, and desert! I ate prawn for the first time and loved it! (Thanks to Emily for a really great birthday) All in all a very successful day, and I don't even have to go to work tomorrow!

Also sorry to Emily! I think I kind of freaked her out yesterday (and by kinda I mean very). I was all of 15 minutes late getting back to the office from the wards yesterday and she thought I'd keeled over or something. I treating my last patient, and I was thinking that 15 minutes in the States mean absolutely nothing but here when 15:45 hits and it's the end of the day everyone locks the door and bolts. My fault! I was still in an American mindset. What's weird is that productivity is just about as important here as it is in the States...


Here are some pictures of the grounds of the hospital were we work and the converted army barack wards that I work in all day:

So... Day 2 in Bara

Ok so I'm in a country that I'm not familiar with, with customs that I am not familiar with, and now I'm stuck in Peds for 2 weeks (Thank you Jesus, it's just 2 weeks) which I also don't feel very comfortable with... I kind of feel like I am double in over my head. Not to mention that my afternoon lead therapist is "The Intimidator". She (and quite a few therapists here) are very to the point, don't smile at me or give me much feedback at all. It could be my imagination but I think she gives me weird looks and I hope she's not thinking " what is that girl doing with that kid". I know that I take too long but she always just says yeah that works. I think peds treatments are kind of subjective, right? Like lots of things can strengthen, actively stretch, cause weight bearing, etc. during play right?? Well anyway I guess just say a prayer for me that my peds knowledge starts falling out of my head onto patients.

I was in the pediatric burns ward this morning. Very sad, very small, not as sterile as you would think. And of course everyone cries when you have to range them, so you leave feeling like the worst person but knowing you did it for their own good. The outpatient burns room was just a room. Moms and babies lined up all around the outside of the room and out into the waiting area. The nurses (sisters) would come by and undress the wounds, then the PTs would come spend 5ish minutes ranging, doing something functional if at all possible, and talking to the mom about how to keep/gain range at home, then each kid would see the MD and get a dressing put back on by the sister. It was complete caos: you would go child to child to an endless supply. I probably saw 5 patients in 40 minutes. Wow, but what else can you do with them...

Well back to work tomorrow.... Hope I can feel better about my situation/patients then.

In the Beginning-

First life skill I learned in Africa: how to change the proxy settings on my computer! Not what you’d think huh? But I learned a ton more things today, my first day of work at Bara Hospital. Supposedly the World’s largest hospital. Definitely huge and confusing. I know that I can’t do it justice by explaining it so I will have to take a picture soon. The quick description is that it’s a HUGE campus with long open to air halls that are divided into rooms that have multiple beds in them. There are also some multiple floor buildings as well, but I haven’t been in them much yet. I am stricken by how much treatment is the same as it would be at home, but then there are also times when it (or the circumstances) are very different. I guess that I came here thinking that it would all be very different so now I am amazed at how similar it really is.

A few cultural things that I have picked up are: word shortening, they have a lot of abbreviations or they just say the first part of the word. For example, I have written Feb. but I always say February not Feb. Also if you have to go to surgery you are going to the theatre. Sounds good right?!