Tuesday, December 30, 2008

Dear "H" (Found in comments section of blog and worked in Swaziland for 3 years)
Thank you so much for your incredibly kind, insightful comments. It means a lot to me that you took the time to leave me a few "words of wisdom".
I don't know you, but you are obviously a humanitarian whose random act of kindness has warmed my heart and also created a few more tears in my eyes.
Thank you

Cape Town continued

We continue to have a lovely time in Cape Town.
Yesterday we drove down to the Cape of Good Hope. It was incredibly beautiful although I do have to admit that I miss the ever present cows, goats and Swazi people as we drive along the roads. Here in Cape Town, you don't get people waving at you, doing a little dance or screaming "sawabona" to you. This is what I found incredibly endearing about the Swazis- they were always happy to see you and shout out a greeting, even if they didn't know you.
We walked from Cape Point to the Cape of Good Hope. I'm not sure Graeme was too impressed with yet another long, difficult walk. He didn't come with us when we made the steep decline down a cliff face onto the beach and perhaps he was the smarter one because us girls certainly felt the effects afterwards. My large Swazi butt certainly got a work-out coming back up the cliff face! We had lunch at the famous restaurant called "Two Oceans" which stands (apparently) at the junction of the Atlantic and Indian Oceans.
We then drove on to Simonstown where we went goo-gah over the local African penguins that inhabit the place.
Today we went sailing on the harbour and delighted in the seals and penguins that frolicked around our boat. We really have been so lucky with our wildlife sightings on this trip.
It's our last night in Cape Town and we decided to end our time here with a fancy dinner. Graeme chose this beautiful restaurant on the water which specialised in local South African cuisine. I should have guessed that the evening might not turn out so well when I only had jeans to wear to this 5 star restaurant. As I have mentioned previously, I have no other suitable clothing and no money to buy anything new, so my jeans- lined with Siteki mud- had to suffice. The ambience was serene, the decor immaculate and the food and wine list extensive. It was all going reasonably well up until the conversation faltered and I started to let my mind wander. I started crying. I looked at my sisters entree of fried camembert and brie and Graeme's pate of bilton and blue cheese and all of a sudden, I felt desperately out of place. I remembered back to our meals at Good Shepherd Hospital where we would all scramble to contribute something. We would have to be creative and substitute ingredients when we didn't have the variety available. We would drink warm white wine from a cardboard box and we thought it was the elixir of the Gods. We used to congregate at the student house and be so incredibly humble for what we could put together. We would all help prepare the meal together and we would often laugh, cry and share the bizarre stories of our life as it existed. They were some of the most special meals of my life. Sometimes, when we ate, we would talk about what we would rather be eating and through imagination (and the addition of more salt) we were able to "create" amazing feasts. It was all so simple and yet so incredibly delightful. It's only been a few days since I have left and already I miss it terribly. Pre-Swaziland I used to love going out to dinner at fancy restaurants and now it all just seems overwhelming and frivolous. My meals were so much more enjoyable when I was covered in red dust, sweating, laughing until I cried and surrounded by some of the most incredible people I have had the privilege to meet. Despite my best efforts, I continued to cry and Rachel told me to go to the bathroom to "sort myself out" and that just made me cry harder. My parents just sat in uncomfortable silence and I felt incredibly alone because it's going to take a bit more than a trip to the bathroom to sort myself out. Nevertheless, the meal continued without event, even though Graeme returned his ostriech twice to the kitchen because it was undercooked...
From now on, I think we'll be eating at MacDonalds.

Sunday, December 28, 2008

Christmas and Cape Town

Christmas this year was one of the most special that I have had in recent memory. After my ward round, we went to pick up Elsie and her family. (Elsie was the lady who washed my clothes and cleaned my flat during the time I was in Swaziland). Despite the fact that our communication at times was restricted by her lack of english and my lack of SiSwati, we became firm friends and it seemed only natural that I invite her and her family to share Christmas with us. Elsie and her family are really poor. They live in one of the houses made of sticks and mud. Elsie used to take my discarded newspapers as she would use them for toilet paper (and other feminine hygeine products). She would also collect the 5 litre water bottles I used to throw away and she would use this to collect water from a local stream. One of the most special things I have ever done, was pay for one of her daughters to finish school. This was never within my budget, but once I knew that her daughter was not going to finish school because of financial restrictions, I had to step in and I know that I gave her daughter one of the best gifts possible.
Elsie, her husband Sabelo and their 4 children all turned up to Mabuda Farm wearing the biggest smiles I have ever seen. I have never seen chips and soft drink devoured quite so quickly! They enjoyed the turkey and our "umlungu" (white person) salads. We were also joined by Susan and my friend Wiseman (my TB nurse who did a ward round with me once a week and taught me everything I know about the disease). We all had a wonderful time and I will always treasure the memory of the eldest daughter singing her own version of "Silent Night" for us and the two younger girls doing a little Swazi dance as we clapped along. It really was incredibly special. Elsie cried and cried as we said goodbye and I couldn't help but feel somewhat overwhelmed that she was no longer going to be getting a source of income from me. Thankfully, she also works for Susan so there will still be some income for the family.
The next day, I went back to Good Shepherd Hospital to do my final ward round. I couldn't help but feel an incredible sadness as I said goodby to the nurses and looked at my patients for the very last time. Despite the enormous challenges I faced there, the heartache, pain and tears, the reality is, it has been the best experience of my life. I have grown personally and professionally and I feel incredibly privileged to have been a part of that hospital for a short time. I sobbed as I walked up that rugged hill to say my final goodbye to Susan and I then had tears in my eyes as we drove into the airport at the metropolis otherwise known as Manzini. As we boarded the plane, my Mum asked "Are you sure you want to leave?". The answer of course is that I'm not sure I'm doing the right thing by coming home, but I have no money and I have a good job awaiting me when I get home. I also know that there were times when it was all so terribly hard that I struggled to keep well both mentally and physically. I need to go home.

The trip to Cape Town was complicated when our flights and transfer through Immigration were delayed and we missed our connecting flight. Mum and Graeme's nerves were frazzled and Rachel had diarrhoea. It was not pretty. The one thing about my time in Swaziland is that I have developed incredible patience and things like this no longer bother me. This is a virtue that hopefully will remain once I return to Australia as it makes life so much less complicated.

Cape Town is an amazing place. It's a modern, cosmopolitan, harbourside town that is blessed with incredible scenery, good shopping and fabulous restaurants. We are staying at the famous Victoria and Albert Waterfront and compared to Siteki, it feels like we are on another planet.
On our first morning, we went into the retail district. This is when I felt the full effect of the reality I am about to return to. Everyone was just so well dressed, wealthy and happy. There are very few black Africans here and it is hard to believe that South Africa is also a country ravaged by the effects of AIDS. It's certainly not evident here. I was wearing the same clothes that I have worn for the past 5 months- cargo pants, a t-shirt and running shoes. I have been aware of my rather casual appearance during my time in Swaziland, but I was never embarrassed by it- I always looked better than my patients and my nurses thought I was pretty cute in my attire. Here in Cape Town, I was embarrassed and I felt out of place. At one stage, I noticed a big mark on the back of my trousers- some of the pervasive red dirt that coated my skin and my clothes during my time in Siteki. Suddenly, I felt dirty. My hair, which is now troubled with dandruff, was loose and a mass of waves that can only be described as looking like a birds nest. I suddenly wanted to hide away from everyone and I have to say, the enormous crowd of tourists started to bother me. Despite this, I still enjoyed going to the top of Table Mountain. I savoured the meal we had in an Italian restaurant and today I even went on my first ever wine tasting tour in a beautiful vineyard nearby. I felt incredibly peaceful as we walked around the botanical gardens of Kirstenbosch and tomorrow I am looking forward to driving down to the Cape of Good Hope. I also feel incredible privilege at being able to visit these very famous places.
In less than a week, I will be home. Whilst I am looking forward to the familiarity of home, I also admit that I feel some trepidation. I already miss Swaziland and I miss the warmth of its people and the assistance I was able to provide them. I don't think it will be too long before I am back again.

Thursday, December 25, 2008

A very Swazi Christmas

It's Christmas morning here in Swaziland. This morning, I did a ward round with my mum and we got to see all the patients for whom Christmas is a just a remote, far-away concept.
It's been a week of highs and lows coming back to Good Shepherd. Because it's Christmas, I'll talk about all the depressing things first and then I will try to finish on a more happier note.

We got into Mabuda Farm on Sunday night. It was an incredibly long drive from Motswari back to Siteki, but it was a safe, uneventful journey and we all just had tea and toast before we fell into our beds.
The next morning, I got up early to start my ward rounds. I took my mother in with me. Although she does not have a medical background, she feels as though she went through medical school with me and there are times when I think her medical knowledge rivals that of a medical student. She found the ward round to be one of the most fascinating experiences of her life. I have got so used to everything that I often have to take myself back to my very first days at Good Shepherd so that I can empathise with the "shock and awe" that people experience when they first arrive. It wasn't too long before I realised the devastation I had left behind was still pervasive throughout the ward. Most of my patients were languishing in the terminal stages of their HIV. One lady, in her 30s had a massive abdominal tumour that now has formed an enterocutaneous fistula. This is where there is a connection between the bowel and the skin so that faecal material just oozes from her abdominal wall. She was incredibly emaciated and you could see every bone in her fragile body. She was vomiting everywhere and too weak to even roll over to vomit on the floor.
Another patient, this time in her 20s had HIV with a CD4 count of 5. She also had severe TB and was 30 weeks pregnant. She went into labour yesterday (her temperature was above 40 degrees celcius and this often precipitates premature labour). She delivered a tiny little girl who is surprisingly still alive today. The baby isn't exactly thriving and I wonder who will die first- the baby or her mother.
Another lady had this massive fungating tumour on her (R) leg and it had spread to her lungs. I had nothing to offer her and she died yesterday by asphixiation
We have run out of blood here in Swaziland and most of my patients have severe anaemia secondary to the HIV suppressing their bone marrow. The normal value for a haemogloblin is about 11-18g/dL. Most of my patients have a haemoglobin count between 1-4g/dL. They are so pale and weak and can barely walk. To the ones that could walk, I offered to discharge them. I did not see any point keeping them in hospital (where they have to pay for every day as an inpatient and where they are susceptible to catching germs from other patients). I sent them home and told them to return in the next couple of weeks to see if any blood was available. I'm afraid some will be dead in this time.
This morning, Mum and I saw a 21 year old girl with AIDS. She had what is called "wasting syndrome" where she was completly emaciated and not able to move a single limb. Unfortunately, as is regularly the case, she died whilst we were with her. My mother, with her intuitive compassion, just sat and stroked the patients forehead, so at least she had some human contact during her final moments. My mum has obviously not witnessed anyone die before, particularly in such deplorable conditions, but she was incredibly strong and only shed silent tears. I feel that through this experience, she now has a more intimate understanding of what I have seen here. Rachel, my sister who is a lingerie designer, also came on ward rounds with me yesterday and was confronted with desperately ill, AIDS ravaged patients. I think the experience was a little overwhelming for her although she seems to have bounced back today. I think both my mother and sister recognise they are extremely privileged to pay witness to what is happening here in Swaziland.

The highlight of our week here in Siteki has been our time spent with Kristin and Andrew (Peace Corp). On Monday afternoon, My family and I made the arduous trek to their place in the blistering heat. Graeme complained bitterly with every step we took and I think it will be a long time before he lets me forget the exercise I made him endure. However, Kristin and Andrew were thrilled that we made the effort to walk out to see where they live. It also gave us the opportunity to walk through the local villages and see how Swazi's truly live. As usual, the children all ran out to greet us and it reminded me of the photos I have recently seen in the "Australian Woman's Weekly" where Princess Mary was greeting children from Uganda. The experience here in Swaziland is not too different as children here just seem to thrive on us waving at them and greeting them in english. We walked back to Mabuda in much cooler weather and then had Susan over for a lovely dinner. Susan and I spoke of all the local gossip and some of the projects we have been involved in. I became acutely aware that during our conversation my family didn't really have a good understanding of what we were talking about and I realised that even though they are seeing a lot of Siteki during their week here, they will never truly understand what I have seen here in the past 5 months. At times it seems a little lonely when I think of all I have seen and done here.
Kristin and Andrew decided to spend a couple of nights at Mabuda so they could spend extra time with us and I was absolutely thrilled to have them around. After my ward round on Tuesday, the six of us went to the local game reserve called Hlane. It was there we had lunch and got up close to rhino, hippo and elephant as well as antelope and wart hogs. It was Kristin and Andrew's first experience in a game park and they were incredibly excited. It meant a lot to me that we got to share this special time with them. We then spent the next two days together and it was like we were one big family. They got on extremely well with my family and they even commented that it meant a lot to them that they got to be part of a family in the lead up to Christmas. Last night we had a big roast dinner with Susan as well. Much to the horror of my vegetarian mother and sister, we had a big, fresh turkey that had been sacrificed the day before and it was delicious!
It was with many tears that I said goodbye to Kristin and Andrew this morning. They are going to spend two days in Mozambique with some fellow Peace Corp volunteers. We have created such an incredibly special bond during my time here and I love them as though they are my family. Their acceptance of me and all my little quirks, their unconditional love and understanding and their gentle kindness and compassion have sustained me during the difficult times here in Swaziland and I know that they will be my friends for life.
Today we are hosting Christmas lunch at Mabuda Farm. We are hosting Elsie (my housekeeper) and her 5 children as well Susan and various other volunteers around the hospital. It should be fun although I have to admit, after my sad ward round this morning, it will be hard for me to feel overly festive.
I will miss Siteki and the Good Shepherd enormously. For all the heartache and tears that I have shed, I have also been enormously enriched in a way that I have never experienced in Australia. I feel like a part of this place and I suspect I will be returning some day (although it won't be for a while- I need to earn some money. I checked my bank account the other day and I have the grand total of $1 left in it....)
Tomorrow we say goodbye to Swaziland and head for Cape Town. I have already started carrying tissues around with me because I randomly break down into tears- who knows what I'll be like tomorrow..

Saturday, December 20, 2008

African adventures

It has been an absolute privilege staying at Motswari private game reserve in Kruger National Park. It stretches over an unfenced area of the park and therefore allows wildlife to meander around our rondavels, swimming pool and dining areas. At night, we have to be escorted around the site as wildlife, particularly a very curious elephant, can be found on our doorsteps! The accomodation is not just comfortable, but also luxurious and a welcome escape from the oppressive heat. The food is sumptuous and I am sure that in the 3 days that I am here I will put back on the weight I lost during my episode of peptic ulcer.
We are woken each morning at 5am. Whilst this does not appear to be a civilised hour to wake up when one is on holiday, it does give us the opportunity to see wildlife when they are most active. We meet for coffee and a muffin at 5.30am before we start our game drive at 6am. We get back at 9.30am, have a gorgeous brunch before we spend the middle part of the day resting. My family tend to head for the pool whilst I head for the computer and then go and have a much needed rest before we meet again at 3pm for lunch and the commencement of our second game drive. During the middle of our game drive, we stop to drink wine in the middle of the African wilderness and it is such a treat. We get back at about 7.30pm before we go for cocktails and a 5 course dinner. Yes, life has indeed been difficult recently for Dr Mel.
We have seen an abundance of wildlife. We have been up close and personal with elephants, rhino, giraffes, antelope and lion. I used to think that lion were my favourites amongst the big cats, but last night, we had the amazing experience of finding a young leopard and I have now decided that they are most definitely my favourite. My mum has been to Africa 4 times and has never been able to see leopard, so it was such a thrill when we heard that one was wandering around and was quite active. Our guide, Giyani ,heard of the sighting over the radio and made a beeline for the cat. I have to say, it was a hair-raising adventure. I can only liken the experience to being on the "Indiana Jones" ride at Disneyland because at times, we seemed to be airbourne in our open-air jeep. It was simply exhilarating to be going through the african wild with the wind blowing through my hair and the scent of animals wafting past my nose. The white knuckle trek was rewarded by the sight of an exquisite young female leopard who was about 10 months old. She almost appeared to be showing off for us. She perched herself on a log which made for a fabulous photo opportunity and then she sidled up against the jeep just so we could appreciate the intricate patterns on her coat. My Mum started crying as she was so overwhelmed by the experience (is it any wonder why I cry so much when I come from a gene pool like this?)
This morning we saw baby elephants having a wonderful time rolling around in a pool of mud and we were within 2 metres of 7 lions who decided that they were on a photo shoot and gave us perfect poses.
I feel like the luckiest girl in the world having such a magnificent experience.
Tomorrow, we face a very long drive back to Siteki. Whilst many of you may think I'm crazy, I have decided to work at the Good Shepherd whilst we are there for 4 days. The fact is, I miss the patients. I miss being with Swazi people. Their smiles, their kindness and their lives have affected me deeply and I just want another opportunity to be with them- even if it means facing the devastating consequences of HIV. Whilst I describe the many wonders of Kruger, I also spend a great deal of my time by myself thinking about the past 5 months at the Good Shepherd. Whilst my family will tell you that I haven't changed a bit, the fact is that this experience has changed me forever- we are on holidays at the moment and the full impact of my experience in Africa is not being felt. There are times here when I actually struggle to enjoy myself because I am still trying to recover from paying witness to abject poverty. I'm still thinking about the diseases that have ravaged my patients and I am still battling with doubts about whether I should be coming home to my life of privelege or whether I should continue to be where I am most needed and most appreciated. Life here in Africa has been the greatest challenge of my life so far but I still feel as though my time here is not over. I am struggling to identify just what I should be doing with my life.
Nevertheless, I will continue to try and enjoy my time here. It's truly spectacular and if any of you have ever considered an African safari, I can assure you, it's what dreams are made of.

Friday, December 19, 2008

All of us to Bulembu

Mum, Graeme and Rachel were incredibly excited about visiting Bulembu and we made our way there on Tuesday.
The weather was simply terrible. It was raining and the mountains were shrouded in mist. Visiblity was perhaps four metres at best. This only compounded the treacherous conditions as we made our way up the mountain which is a dirt (mud) road with many twists and turns. Rachel was designated driver and she took the corners like a natural rally car driver. The car was coated in a thick crust of mud when we eventually made it to our destination.
Our first stop was the Sullivan's where we caught up with my "famous five". The kids just loved making new friends and we spent hours playing with them. I think Rachel and I now have additional pressure to produce grandchildren as Mum and Graeme were in their element with this group of 3-4 year olds.
The next morning, we went over to the other orphanage which houses the babies. Again, my family were just overwhelmed playing, cuddling and making silly baby sounds which may as well have been SiSwati! My Mum got particularly attached to Simon. He arrived at the orphanage only a couple of weeks ago and his story, like everyone else's, is incredibly sad. He's two and a half and both of his parents died of HIV. Unfortunately, he too has AIDS. For the past year or so, he has been living with only his 9 year old sister. She has AIDS as well. Somehow, she has been feeding him and providing him with water. Someone in a nearby village noticed that it was just the two of them living alone and they notified the authorities. Now both of them are at Bulembu. Simon has just started ARVs and has a respiratory tract infection so he was feeling quite poorly. He's also an incredibly sad child and has obviously been quite disturbed in his short life. Mum spent a lot of time just holding him and trying to comfort him. When we left, she started crying and it was quite distressing for me to watch as I knew exactly what she was feeling.
I also felt a tremendous sadness as I left Bulembu. I have so many special memories from that place and I will treasure every second I spent with those children. I can't believe that I may never see them again. Heather and Andy (who care for the 3-4 year olds) have promised that they will send me regular updates and photos of the kids and I hope that this is enough for me to feel like I am still part of their lives.
We donated a suitcase full of children's clothes that my friend Karin had kindly organised and we also donated over $5000 (AUS) that many of you kindly contributed. Thank you so much- you have certainly improved the lives of many Swazi babies.
We then made our way to Kruger National Park in South Africa. Only a week ago when I was transferring that kid with the scaphoid fracture, I noticed a chimpanzee sanctuary that was established by Jane Goodall. Upon arrival to Swaziland, I immediately informed my family that we needed to adjust our itinerary slightly so that we could include a visit to this place. Whilst I love people, I also have a passion for primates. I have been fortunate enough to travel to Rwanda to see the gorillas and Borneo to see the orangutans. Chimpanzees, although not exactly in the wild, was an absolute "must see" for me.
The sanctuary is home to chimps that have been rescued from places such as Sudan, Angola and Mozambique. It's incredibly tragic to hear of some of their stories. Some have been held in nightclubs throughout Africa as "attractions" where people have been able to give them alcohol, cigarettes and even illicit drugs at times. Often they have been held in tiny cages with little access to food and water. Some were kept by people and used as "surrogate children" and dressed up in human clothes and fed a diet of pizza, soda and chips. All incredible forms of cruelty. Others were kept by people who regularly beat the animals and one of the chimps has even sustained brain damage and has the intellect of a chimp much younger. All of these chimps have been brought to the sanctuary where they are enclosed in hectares of protected forest. They are rehabilitated so that they can live as they would in their natural environment. They will never actually be able to return to their natural environment as they will be an immediate target for poachers. Chimpanzees are on the verge of extinction and as humanity, we should be disgusted with ourselves. The experience I had there was enlightening and uplifting and certainly one of the highlights of my trip so far.
We are now at Kruger National Park and staying at an incredible place called Motswari Private Game Reserve. It's an amazing place and deserves a individual blog entry which will follow in the next few days.

Monday, December 15, 2008

Melanie's family at last in Swaziland

At last my family have arrived!
They arrived on time, much to my relief and I started crying as soon as I saw them. Unfortunately, I was able to see them waiting in customs, so by the time they had cleared customs and come through the luggage area, I had been crying for quite a long time! My Mum just held me for the longest time and I sure it made for dramatic entertainment for all the on-lookers.
In typical Swazi style, there were a few hiccups- namely, their luggage didn't arrive and then the transfer we had organised to take us back to the hotel also didn't turn up.
I have to admit, whilst I didn't want to see my family frustrated, I was inwardly smiling at just how typical this was for their arrival here in Swaziland. If everything had gone perfectly, then it would have made a mockery of all I have experienced in Swaziland so far!
Thanks to me now being considered a "local", I was quickly able to organise transport for us and we made our way to the hotel- sans luggage. Thankfully, Mum, Rachel and I share a similar body habitus (although I have been reminded that my butt size exceeds theirs by vast quantities....) so I was able to lend them some clothes. Graeme's a man so it didn't bother him at all that he didn't have another set of clothes.
3 out of their 4 suitcases arrived this afternoon, so they all now have their clothes and the vast quantities of children's clothes, colouring in books, pencils, balloons and 1500 condoms that will be distributed throughout the Swazi community. Rachel carried the condoms in her hand luggage and apparently the guys in the luggage scanner looked at her very strangely as she went through...
Today we went to Swazi Candles for lunch and we did the few "touristy" things that we are able to do in this area.
Tomorrow, we leave for Bulembu and no doubt this will provide for a very interesting blog post. Stay tuned.

Saturday, December 13, 2008

Combis and Chaos

My last couple of days in Bulembu were without any medical problems except for some minor abdominal pain and gastro in some of the Swazi 1000 participants
I spent Thursday afternoon with my friend's- the Sullivans. I was supposed to borrow their computer so that I could type out protocols for the Clinic, but I got distracted by a much more entertaining project. They were responsible for decorating brown paper gift bags that were going to hold gifts for 65 of the older children in the orphanage. As my family will testify, I am an "ideas person". I come up with what I consider "fabulous" ideas, but often they involve a lot more work than if we just simply went with the original task at hand. I convinced the Sullivans that we were more than capable (as a team) at hand painting stars on all the bags. My "idea" was met with some hesitance, but I eventually convinced them that it was not a difficult task and the extra work would be worthwhile. I'm surprised they didn't just get a gun and shoot me.. It took hours and a lot of effort and mess to paint those damn stars, but if I do say so myself (and the Sullivan's eventually agreed), the bags turned out beautifully and those older orphans are going to wake up on Christmas Day to some very brightly coloured, lovingly made, gift bags!

In the evening, I was sitting watching "Hi-5" with the kids. I had Lily on one knee and Doris on the other. I'm not sure how much communication goes on between 3 year olds, but obviously word had got out about the mysterious soft foam under Aunty Melanie's shirt. Lily, being the braver of the two, suddenly pulled down my t-shirt and pointed at my bra asking "What's this?". Pretending that I was quite accustomed to having my breasts exposed, I proceeded to tell her that it was something you wore when you became a lady. (I have no idea where the crap that comes out of my mouth comes from). They fingered the lace and ribbon and seemed quite content with my answer. I congratulated myself on being able to make sense of the world for two 3 year old African orphans.

It's not easy getting to and from Bulembu and I was faced with the challenge of somehow making my way back to Manzini. After a morning of contemplation, I decided that my only option was public transport. Thankfully, my friend Lorraine (Social worker from Zimbabwe) was also trying to make her way to Mbabane, so we decided to travel together. The initial trip from Piggs Peak to Mbabane was quite pleasant. I insisted that we catch a big bus as I considered this the much safer option compared to the mini-buses described as "combis" here in Swaziland. The journey was pleasant and Lorraine and I talked the whole way. She was going to catch another bus from Mbabane, to Jo'Burg and then catch another bus to Zimbabwe and she had a big trip ahead of her.
When we reached Mbabane, I knew that the rest of the trip was not going to be as pleasant. No big buses are available.The bus rank contained at least 100 combis and all of them were blasting their horns trying to attract people onto their buses. People were scattered everywhere all intent on serving their own purposes. Rubbish littered the ground because here in Swaziland, it not deemed socially inappropriate to simply throw your rubbish on the ground. People were yelling and bustling around and I tried my best to pass through them with my two pieces of luggage. I eventually found the combi that would take me to Manzini. I sat down and waited for the combi to fill with passengers (there are no scheduled departure times for combis- you just have to wait until they are full before you can leave. Sometimes this can take half an hour, sometimes it can take 6 hours...) I knew I was in trouble when there was no where to store my luggage. I thought that perhaps I could pay for an extra seat and have the luggage next to me. This is not the "Swazi way" and this "fabulous idea" of mine was prohibited. Now when I say that the combi cannot leave until it is full, I mean FULL. If there is a seat for two, then it must seat at least 3 passengers, sometimes 4. I sat there as more and more passengers were being packed in like sardines. I started to verbalise my concerns about my luggage and in typical Swazi style, my concerns were brushed aside. I'm white and I'm female. I don't know shit.
Eventually, the combi was full and as I predicted, my luggage didn't fit it. People were starting to get pissed that the "white girls'" luggage was causing a problem and I was decidedly uncomfortable and yet unable to provide any solutions. Eventually, this kind Swazi man offered to hold my massive suitcase on his lap, much to my horror. I couldn't hold the suitcase as I was in a seat for two being occupied by four people. I only had one butt cheek on the seat and I couldn't balance the bag. Once we managed to close the door, we started off at speeds well above the legal limit. On combis, there is always a man who stands on the step of the combi to help maintain calm and collect the money. This guy thought nothing of leaning over me so that he could chat with his mates up front. His body was pressed up against my face and I could barely breathe. This, combined with the body odour that eminates from the sweat of others crammed up against you, makes for a very unpleasant journey. I knew I had already caused "trouble" so I didn't dare complain about his body encroaching on my personal space.
After what seemed like an eternity, we finally reached Manzini and I was suddenly able to breathe again. I then had to struggle trying to get my luggage off the combi and drag it through the bus rank (again crowded with combis, Africans and rubbish) to try and find myself a taxi to take me to my hotel. I eventaully found a "taxi" which in fact was a car that was older than me- lacked windows and a door that couldn't be opened from the inside. I seriously doubted it's ability to make it out of the bus rank, let alone get me to my destination. But, this is Africa and things continue to surprise me. I made it safely to the hotel and I was greeted by kind, Swazi (yet english speaking) staff who seemed to appreciate the fact that I was a little frazzled after my rough journey. They escorted me to my room where I proceeded to collapse on the bed. However, the bed was soft, the pillows in abundance and the room was cool thanks to air-conditioning (something I have not experienced for 5 months). After a quick meal, I settled my self into the bed, snuggled under the covers and proceeded to watch two movies. One was a Julia Roberts movie called "Dying Young" which made me cry like a baby, but this was soon followed by "Miss Congeniality" and I found myself laughing out loud. For a while there, I actually forgot that I was in Africa and I felt safe and comfortable.
Only one more sleep until I am joined by my family and I am incredibly excited. I keep hoping that their flight is uneventful and goes according to schedule. Not surprisingly, I am a little cynical and trying to prepare myself for the inevitable delays that may occur. I'm going to try to be patient and understanding, but I have no doubt that once they finally arrive, I'll probably dissolve into tears.

Wednesday, December 10, 2008

Bulembu, Barberton and Breasts

I visited South Africa prematurely today. Not for pleasure but rather to take a 16 year old boy with a hand injury. He fell on his right hand whilst playing soccer last night. He was in a lot of pain and I suspected a fracture, so I applied a backslab and planned to take him to South Africa the next morning for x-rays. (We could have gone to a hospital in Swaziland but we knew we would have had to wait for at least 8 hours and if there was any pathology there are no orthopaedic surgeons to treat it).
We left for a place called Barberton which is about an hour away from Bulembu. The scenery was gorgeous and we were able to listen to an SA radio station which played music very similar to what I listen to in Australia. I think I have mentioned this previously, but I have really missed music whilst being here in Swaziland and any song that I recognize provides me with immense pleasure. I even sung along with John Farhnam (an Aussie icon) as we listened to “You’re the Voice”.
Anyway, back to the patient. We had x-rays done in Barberton and they were normal. I was still highly suspicious of a fracture of a bone called the scaphoid and the patient had developed numbness of his entire thumb which I was concerned about. I managed to get my hands on a list of orthopaedic surgeons in a nearby town called Nelspruit. I simply called one randomly, explained that I was an Aussie doctor working in rural Swaziland and asked him if he would mind providing me with a second opinion. I think he thought it was quite a novelty to have a random Aussie doctor call him and he agreed to see us whenever we arrived. Let me tell you, I got my first inclination of the culture shock that awaits me when I get home. Nelspruit could well be any suburb that I have visited in Australia. The houses were very similar, there were shopping malls and the medical facilities were even better than most private practices I have seen in Australia. It was all quite bizarre to be in Africa and yet feel like I was back home. The only difference I noticed was that all the houses had large concrete fences surrounding them and on top of these were barbed wire. Apparently this level of security is quite benign compared to what I will experience in Johannesburg.
We saw the orthopod and his office was immaculate with modern furnishings and expensive pieces of art work. Again, it crossed my mind that as an emergency physician I will never be able to have the beautiful office with plush waiting room and there is part of me that thinks I’m absolutely crazy choosing the specialty that I have…
Anyway, the orthopod agreed that it was likely to be a scaphoid fracture (these fractures often don’t appear on x-ray until about 10 days after the injury). We were instructed to then go somewhere else to go and get the plaster. We got to that place and were told that the patients medical insurance didn’t cover the plaster and that we had to go and get clearance for it at some other place. We couldn’t find this other place and by this stage I was getting concerned that we would not make the border gate that closed at 4pm. I certainly didn’t want to have to find a place to stay overnight. I made the decision that I was perfectly capable of applying a scaphoid plaster and we decided to come back to Bulembu and apply the plaster here. It’s funny, but I have become a little insecure in my abilities here. I was so incredibly challenged with my patients at Good Shepherd that I’ve started to forget that I actually can practice my “western skills” here as well. I guess what has also concerned me is that at Good Shepherd we did the absolute best we could with what little resources we had and this often fell short of what is considered “Western standards”. I got used to that and began to accept it. Now, I am treating wealthy, white South Africans and the standards and expectations have changed dramatically. I’m now going to great lengths to treat relatively benign complaints when for the past 5 months I have been desperately trying to treat incredibly serious, life-threatening conditions that I could do little about. The irony is, I think I got a lot more from the effort I made there (despite the results being tragically poor) compared to the efforts I am making here (with very successful results).
The border crossing was interesting. The South African side was all computerized and I was scrutinized more closely. The Swazi side consisted of hand writing my name in a big book and then being asked if I would like to purchase some craft work from some ladies loitering in the office. It was particularly endearing and I know that I will miss the old-fashioned, traditional ways here in Swaziland.
I applied a particularly good scaphoid plaster back in Bulembu and the patient walked away without even thanking me for the efforts I had gone to throughout the day…..

I was then able to go and spend the late afternoon with my special friends. We had a wonderful time as we watched a movie called “Madagascar”- a children’s film that I have not seen previously. The movie was hilarious and it was particularly special because I was never without a child in my lap. The orphans are in no way institutionalized, but they do seem to have a more pronounced concept of “sharing”. Without any discussion, they would each spend about 20 minutes curled up in my lap and then they would leave so that the next one would get special “cuddle time” with Aunty Mel. I treasured every moment. I made sure I gave each of them the same number of kisses and made sure I told them each that I loved them as they left my lap. I have bonded incredibly well with these children and I know I am in for one big heartache when I leave. There are about 50 orphans under the age of 4 and I spend nearly all my time with the 3-4 year olds. I thought I would just take a moment to describe each of them and hopefully when I can download photos, Courtney will be able to attach them to my blog.

Enoch is 3 and has been at Bulembu since he was born. He has the most incredible smile and he definitely knows how to use it! He “flirts” with me and he knows that this often gains him an extra cuddle and kiss compared to the others. Enoch is particularly talented with his ball skills and I know that if he is given the right opportunities, he could become an amazing sportsman when he grows up.

Dexter is almost 4. When I first met Dexter he was barely able to walk. He was incredibly sad and never smiled. In the time that I have known him, he has flourished. He is almost able to run and whilst his vocabulary is delayed compared to the others, he has progressed in leaps and bounds. He now has this drop-dead gorgeous smile and has become particularly affectionate towards me. I scoop him up and start kissing his ears whilst telling him “I’m going to eat your ears” which makes him giggle uncontrollably. He has now taken to coming up to me and saying “Aunty Mel, can you eat my ears?”

Alan is the oldest of the 5 and he will advance to the next level in the orphanage next year. He and I are not so close but he always informs me of any recent “news” like if he has had a fall, has a headache or has a sore ear. Kisses cure everything.

Lily is gorgeous and from the moment I met her I started telling her so. She now runs up to me every time she sees me and says “Aunty Mel- I’m gorgeous!” She has recently got glasses and a whole new world has opened up to her. She’s definitely a “girlie girl” and she loves showing me the contents of her handbag.

Doris is the youngest and the most recent addition to the group. She is incredibly affectionate and loves a cuddle with her Aunty Mel. During our cuddle times, she has discovered that I wear padded bras and she is completely fascinated by them. She’s often poking me and marveling at the fact that I appear to have foam permanently attached to my chest. I don’t have the heart to tell a little African girl that it’s probably not socially appropriate to be fascinated by my breasts.

Another day over and now only 4 sleeps until the family arrive.

Tuesday, December 9, 2008

Friends at Bulembu

Less than one week to go before Mum, Graeme and Rachel arrive in Swaziland. I am counting down the days, hours and minutes. I miss them so much. I am going to have to try and remember the feeling of missing them, because I will need to draw on the experience the next time they drive me absolutely nuts……
Their bags are packed and they have informed me that amongst a huge amount of donated items they are bringing with them, they also are bringing 1500 donated condoms. I have to admit, I wasn’t overly thrilled when I heard this. Whilst I am certainly not against condoms, I just am fearful that if word gets out in Siteki about the donation, I will forever be known as the “condom doctor” and this is certainly not the legacy I intended to leave behind.

Last weekend, I was incredibly blessed to have my other “family” here with me at Bulembu. Kristin and Andrew made the treacherous trip here and they arrived on Saturday morning. It was wonderful spending time with them and showing them all that I have discovered here at Bulembu. We enjoyed ourselves playing with the orphans, eating good food and sleeping in plush surrounds. Kristin called upon my skills as a doctor when she randomly fainted, but I think that good coffee and red wine were a shock to her system. She recovered without complication. They had to return home to Siteki on Sunday afternoon, but it wasn’t our last goodbye- I will be catching up with them again over Christmas when my family and I are in Siteki. I feel like the luckiest person in the world having them in my life. I love them dearly and consider them part of my extended family. They have certainly embraced me with tremendous kindness and comfort and I know that our friendship is going to span a lifetime. When they left, I was filled with an overwhelming sadness. Whilst I battle with my guilt about leaving Swaziland, I also battle with my desire to remain here with them so that we can see this adventure through together. I suspect I will spend the next two years worrying about their safety and comfort.

I have made other friends whilst staying in Bulembu. One of my good friends, whom I have dinner with every night, is Lorraine. She is a social worker and has recently left Zimbabwe to take up a position here in Bulembu. We have spent countless hours talking about the conditions she has left in Zimbabwe. Her husband came to Swaziland first and she soon followed him. Trouble is, they were so uncertain about the conditions in Swaziland, that they left their 18 month old son in Zimbabwe with her parents until they found stability here in Swaziland. Now that they are both employed, they are trying to get their son a passport so that he can join them. The regime in Zimbabwe is so bad that obtaining a passport may be quite difficult (and will probably require a lot of money to bribe officials). I cannot imagine what it would be like to live with this kind of uncertainty. They had to leave Zimbabwe to escape a brutal regime and now they have to anguish about getting their son to join them. (not to mention the concern associated with the current outbreak of cholera)
Before getting her job in Bulembu, Lorraine has worked in other orphanages throughout Africa and she has described absolutely horrendous conditions and appalling abuse of children. She has also told me of some of the terrible abuse that children have had to endure prior to reaching the orphanage and some of the stories have made me physically sick. There may well be an international charter that tries to protect the rights of children, but it is certainly not enacted in some parts of Swaziland. Thankfully, things here at Bulembu are a refreshing change for her and I know she will do well. Her role will be to provide counselling for some of the older orphans and hopefully she will help co-ordinate some international adoptions. Whilst I am particularly involved with the orphanage that looks after babies and toddlers, there are other orphanages here that house older orphans. One of the places here called “Jacaranda” exclusively cares for girls that have been abused (in all forms) and I suspect she will have a role in their rehabilitation as well. Lorraine is an extraordinary woman working with extraordinary people, so there is great potential for her here at Bulembu.

I have also had the pleasure of catching up with a man called Volker, whom I met at the Board meeting when I last came to Bulembu. Yet again, another extraordinary person. To simplify his role here, I can only describe him as another “Bill Gates” but on a smaller scale. He was an entrepreneur in Canada when he decided to focus his efforts on establishing Bulembu. He is a very clever business man who has been very successful but has now devoted his time, knowledge and resources to establishing and maintaining this novel place. The first time I met him, I was incredibly intimidated by him. I thought my role in Swaziland paled in comparison to his work here (and I still feel the same way) but I am no longer intimidated and we have become friends. He teases me incessantly and laughs a lot at my expense, but he is sensitive to what I have seen here in Swaziland and the other night, after Kristin and Andrew left, he paid witness to one of my unfortunate “meltdowns”. He could tell that I was a bit down, so he asked me to join him outside for a chat. He smoked and drank red wine whilst I cried and cried about the nightmares I am still having about my time here in Swaziland. I spoke of my enormous guilt and the sense that I am “abandoning” the disaster here. Perhaps it’s his wisdom and experience that he has accumulated over the years, but he was able to talk to me in a way that made sense and gave me tremendous comfort. I appreciated his down-to-earth response and the fact that he doesn’t see what we are doing here through “rose coloured glasses”. I haven’t made an enormous difference here, but the reality is that no-one, despite their best abilities and intentions can make a huge difference here. It’s all about doing our little bit for the time that we are able to do so. I am currently reading a book at the moment called “The problem with Africa” and whilst it talks about international aide on a much grander scale, it also highlights that there are problems here that will perhaps never get better. Quite a sombre concept but helps put my experience here into perspective. I appreciated his paternal overtures and the wisdom he kindly afforded me.

Heather and Andy Sullivan and their daughter Cassi also provide me with a “home away from home”. I spend most afternoons with them and their small group of orphans. They also allow me to use their computer to type out my blog in a word document- something I am particularly grateful for. They are looking forward to meeting my family next week.

My “official work” continues, although no way near as dramatic as what I have experienced at Good Shepherd. Lots of ankle sprains, lacerations and bouts of gastro that leave me terribly disinterested, however, I did evacuate a girl yesterday with appendicitis and I hear she is doing well after surgery in South Africa.

Today, Neil and I spent the morning teaching the nurses here how to treat acute emergencies. I spend the afternoons typing up protocols for emergencies as well as simple “clinic” presentations that I got particularly good at dealing with during my time at Good Shepherd.

I spoke to my Dad this morning and he asked me how I felt about Christmas that is just around the corner. The truth is, it doesn’t feel like a typical Christmas here and I suspect many in Swaziland who are particularly afflicted with poverty won’t even know it’s Christmas. It certainly will be a different Christmas experience for me, but at least I will be with my family. 5 days to go…..

Thursday, December 4, 2008

Internet site for Swazi 1000

If any of you are interested in following the progress of what is going on here in Bulembu, go to the following site:
Follow the links to "Swazi 1000"

Bulembu continued....

I’ve now been in Bulembu for almost a week and I have achieved much more than I thought I would. Neil and I finally sorted out all the donated goods and now we have set up an Emergency Department here at the Clinic. I am so proud of what we have achieved. It looks great and is incredibly functional. Next week will be spent making up Emergency protocols suitable for the nursing staff to enact and then we will spend time teaching the nurses how to deal with simple emergency situations. I really feel like I am “giving back” a little of the knowledge I have accumulated over the past 6 years as a doctor. Perhaps I will take sometime out in the years to come just going to third world countries and establishing basic emergency services. Who knows what the future holds for me?

The medical “emergencies” that we have been seeing in the volunteers have been trivial and not dramatic. The patient we transferred to South Africa is still in hospital and has been diagnosed with a heart condition, so I am reassured that our dramatic evacuation was entirely appropriate.

Word has got out amongst the locals that there is a doctor in town and I have had various requests to consult with patients. Yesterday morning I went to the local kindergarten and looked in kids ears and down their throats and felt their little rounded bellies that are there because of protein malnutrition. My “consulting room” was outside on a picnic table and it was certainly a different way of practicing medicine. I don’t think I did much other than reassure and give some dietary advice. I have also seen a workman who got dirt and grass in his eye and various other minor complaints. I went and saw a young woman who appeared to be having a psychotic episode. Her work colleagues had tied her hands and feet together to restrain her, but after I arrived and realised that there could be some cultural component as well as a minor psychiatric component, I was able to untie her, give her some valium and take her home. Everyone keeps asking me why I don’t stay in Bulembu permanently, but the honest truth is that there is not enough here to keep me stimulated and all my skills that I have gained as a doctor would not be put to good use.

Now that I have been introduced to yet another Swazi community, I face the same barrage of questions that I have had to answer numerous times already during my stay in Swaziland. Firstly, everyone wants to know if I’m married. Here, you need to be placed in a “box” that society assigns to you, and here in Swaziland, I do not fit into a “box”. They all have a very difficult time understanding how I can be a “successful” doctor and yet at the same time be a “failure” by not being married. The perpetual, yet unanswerable question is “Why are you not married?” I tell them that Aussie men just don’t think I’m pretty enough (it’s a simple enough answer and quickly deflects from the all-important M-word!) but they scoff and tell me that Aussie men are obviously stupid (and I quietly agree) because here in Swaziland, they consider me quite gorgeous.

Despite being away from Good Shepherd, I still find myself a little “fragile”. Sleep has been my constant problem since arriving in Swaziland. If you remember back to many blogs ago, I mentioned that I was initially having nightmares. I no longer have nightmares but I am often plagued with debilitating insomnia. I have always been a bit of a “thinker”, but now I’ve become a ruminator and I lie in bed at night just thinking very deeply about what I have seen and encountered during the day. Sometimes I lie awake at night and wonder what I am returning to once I get back to Australia. I have to admit that the insomnia got so bad at one stage that I started taking diazepam (“valium”) but I didn’t like the hangover effect that it left me with the next day. I then started to take a drug called “Mersyndol” (it’s extremely cheap here) which contains codeine and a sedating anti-histamine. I found it worked really well and left me feeling refreshed the next morning. Trouble is, the insomnia got worse and I’ve became dependent on the Mersyndol in order to get to sleep each night. I’ve never had this problem before, but then again, I’ve never worked in Africa before. Needless to say, I’ve recognised that I need to stop the drug and I decided that I would use my time here at Bulembu to “detox”. I’ve found it to be incredibly unpleasant. I still lie awake at night for countless hours and I just can’t seem to turn my brain off. I have been averaging about 4 hours of sleep at night and this is about half of what I need. However, I’m determined that I need to establish a normal sleep pattern and I have to do it now, otherwise it’s just going to get worse.

I visit my special group of friends (ie the orphans) on most afternoons. We have established a regular routine where I watch “Hi-5” with them and then we colour-in and draw until they have their bath and dinner. I am privileged to be the recipient of lots of cuddles and kisses and I find it very relaxing just to colour and “be in the moment” with these young children.

Kristin and Andrew (Peace Corp) are coming to spend the weekend with me and I am very excited by the prospect of seeing them. I am still in regular contact with Chris and Susan. I miss seeing them everyday. Susan leaves tomorrow for a 2 week holiday in Sri Lanka with her husband and Chris returns to the States next week. That will just leave the Peace Corp as the only original members of our gang left in Swaziland. I am in regular contact with Julia and she seems to be settling back into western life adequately.

I still seem to have a daily battle with my own conscience about leaving Swaziland. There is so much to be done here and there is a desperate need for people like me to come in and try and make a difference. I feel incredibly guilty that I am returning home to all my luxury and privilege when I know I am abandoning a place that is in the face of a human disaster. I don’t know how to reconcile my feelings about wanting to help but also wanting to return to the life I knew previously. I suspect it is going to take me some time to work through all of these emotions.
My parents have contacted me and I have been delighted to hear that those who read my blog have donated nearly $3000 (AUS). Never in my wildest dreams did I think we would raise so much and I am incredibly appreciative of your extraordinary generosity. It is just a little over a week until my family arrive and I can assure you, the benefits of your kind donations will be felt immediately as soon as my parents deliver the cash. THANK YOU. You have benefited the lives of ~45 orphans and I will ensure that you see for yourselves the incredible difference you have made.

Monday, December 1, 2008

Swazi 1000

I got to bed late on the night of Thanksgiving and this combined with having to pack up my apartment, simply exhausted me, even before I got out of bed.
I was determined to make sure that all my patients on the ward were thoroughly sorted before I left and the ward round was long and complicated. By the end of the round, my nerves were frazzled and I was stressed out. I was drenched in sweat as the weather was unbearably hot and I was feeling the beginnings of a migraine coming along.
Thankfully, at midday, I was greeted by the delightful Heather and Andy Sullivan. They are the couple from Bulembu who care for the orphans aged 3-4 years of age. I have become quite close to them during my time in Swaziland and I was incredibly touched when they offered to make the 6 hour round trip to pick me up from GSH and take me back to Bulembu. The trip back to Bulembu was long, stifling hot and difficult as we made the treacherous climb up the mountain along an uneven dirt road. By the time we reached Bulembu, I knew I was in trouble. Ever since I can remember, I have suffered debilitating migraines that tend to manifest themselves at the most inopportune times. This was one of those times and unfortunately, I never made it to the “carols by candlelight” I was looking forward to because I was hurling my guts out whilst thinking that my head was going to explode. It was not pretty and it’s during times like this that I feel the most lonely.
I woke the next morning and felt much better. I looked around me and knew exactly why I felt better. I am being accommodated at the Lodge and my bedroom is simply delightful. Beautiful double wooden bed- with at least 100 thread count sheets. The polished wooden floors, the bath with claw feet and the features that take you back to a bygone era all make the experience incredibly comfortable and welcoming. The fact that I am being provided with three gorgeous meals a day and the staff know me well all contributes to me feeling like I have reached paradise. I am being treated like a first rate Swazi princess and I couldn’t be happier.
In case some of you have forgotten, I am here for “Swazi 1000”. This is a two week project in Bulembu where college students from South Africa have congregated to volunteer their time to restore buildings that will house orphans. I am incredibly privileged to be a part of this event as it is simply spectacular. The sheer enormity of this undertaking, the remarkably special people involved and the work that is being done- is overwhelming. This project is being co-ordinated with military precision and I am in awe of what is being accomplished.
I am here as the doctor who is available to deal with anything medical- emergency or otherwise that comes up during the two week exercise. I am accompanied by a young man named Neil. He is currently a student at Johannesburg University studying a degree in “emergency medicine”. Whilst this is not a medical degree, his knowledge is excellent and equivalent to what we term “Advanced care Paramedics” in Australia. He and I work really well together and already, only 3 days into the event, we have cared for numerous patients. Mostly lacerations, but some abdominal pain and cases of tonsillitis etc. We are amazingly equipped. Neil has brought defibrillators, intubation equipment, enough drugs and equipment that we should be able to cope with almost any emergency. I have more resources available to me than what I had at Good Shepherd Hospital!
Thankfully, these resources have already proved invaluable to us. Yesterday at 1pm I was called by Neil who told me that he had a 20 year old patient with chest pain and shortness of breath. I have to admit, I didn’t rush to this case. The night before I had some students come to my room and tell me that a young girl was seriously ill and it was an emergency- I jumped out of the bath, threw some clothes on and ran over to our temporary “hospital” only to find a young girl with some intestinal cramping. I took the opportunity to define what should be considered an “emergency”. When I was called to a 20 year old with chest pain, I didn’t think there was much to rush for. When I got there, my opinion changed immediately. The patient looked dreadful- the pulse was racing, the patient had laboured breathing and was drenched with sweat and in severe pain. The patient also weighed about 150kg (~300lbs) and suddenly I knew that I had to consider that this young patient may have a cardiac condition. Thanks to the amazing equipment Neil brought along, we were able to get a 3 lead ECG and I didn’t like what I saw. He was having dynamic changes to his ST segments and I started to worry that although unlikely, this patient maybe having cardiac ischaemia. My emergency training has provided me with many skills and diagnostic abilities, but I have to admit, over the years, I have developed this “gut instinct” that tells me when something is going wrong. I made the decision that we couldn’t keep the patient here in Bulembu and that we needed him evacuated to South Africa. The people here were simply AMAZING and thanks to Neil’s knowledge of the South African medical system and modes of transport, we were able to organise a speedy evacuation process. What occurred next simply could not be scripted. Somehow, with the assistance of fellow volunteers, we were able to lift the patient onto a dining table which we used as our “stretcher”. We then carried the patient out to our awaiting “ambulance” which was the back of someone’s ute. Just as we left the building, the heaven’s opened and it began to bucket down with torrential rain. I was drenched, but completely unfazed. We had an IV line, we had already given aspirin and 18mg of morphine as well as an anti-emetic in case the patient got nauseous. We had a defibrillator and I felt that Neil and I could cope with any eventuality. (although I was a little nervous about having to use the defibrillator- we were absolutely soaked and the thought of using an electrical current gave me pause). In fact, I was so unperturbed that at one stage I thought to myself “My gosh, these South African men are just gorgeous, I wish I was 10 years younger” (now that’s disturbing, but remember I have been through 5 months of a complete man drought) With the three of us cramped in the back of the ute, we drove to the South African border. We were met by some Advanced care paramedics (again, ruggedly handsome) and we safely transferred the patient into their care. Although the diagnosis is still uncertain, we heard today that the patient is doing well.
We haven’t had quite that level of excitement since, but Neil and I have spent the rest of our time at the abandoned hospital here. Our challenge over the next 2 weeks is to try and sort the place out. It was abandoned suddenly and there is a lot of equipment and resources that can be used elsewhere. The project is enormous and I doubt we will get through it in time. The problem is, the hospital received an enormous amount of international donations and most of it is completely inappropriate for the medical care we are able to provide here in Swaziland. Incredibly sophisticated pieces of equipment- hundreds of central venous lines, instruments for incredibly complex surgical procedures and even catheters for angiograms and other invasive diagnostic procedures. I know all of this was donated with generosity and kindness, but honestly, here in Swaziland, with our basic provision of health care, all of this is redundant. We have had to dump hundreds of thousands of dollars of resources simply because we cannot use them here. It breaks my heart. That being said, we have been able to salvage a lot of resources that will be invaluable to the Good Shepherd, so not all is lost. A lot of the equipment is from America and is 110 voltz. Here in Swaziland, we have 240 voltz, but some of the equipment may be able to be converted although it will be at great expense. When we have sorted out the resources, we plan to set up an emergency room here at Bulembu and then we will write protocols and train the nurses here to provide simple emergency care. This is a huge undertaking and perhaps overly ambitious for a two week project.
Not all of my time is spent working. I have been able to spend time with my beloved orphans. The babies are cute, but I prefer to spend my time with the 5 children aged 3-4 years. They have got to know me during my visits to Bulembu and we have established a close relationship. I spend hours playing with them, being the recipient of many cuddles and kisses and generally having the time of my life. I am completely and utterly in love with these children. I know my heart is going to be broken when I leave. This afternoon, I spent 3 hours with them. I sang nursery rhymes to them, helped them name Australian and African animals and helped them with colouring in. I don’t think I have felt this happy and this content for a very long time. They are beautifully behaved children and each take turns for their special “cuddle time” with their Aunty Melanie. I am never without a child in my lap or in my arms. I am absolutely delighted that their favourite show on TV is “Hi-5”. This is an Australian production and thanks to my many years as a babysitter I am very familiar with all the songs. We danced and sang and I delighted in the fact that no matter where you are in the world, all children are generally the same. We are all humanity. We all want to be loved, we all want to be able to express ourselves and we all want the freedom to do so.
I truly feel like the luckiest girl in the world to have this experience. Whilst I do feel bad about abandoning Good Shepherd early (and I know they are upset with me), I feel like I can truly enjoy the rest of my time here in Swaziland. I have temporarily escaped the devastation and for that, I am truly grateful.


I like to think of myself as a very patriot Australian, but on Thursday, the day of Thanksgiving, I was proud to consider myself a temporary “American”. My best friend is American and in the past 6 years, I have visited the country 7 times, so I think I have a good appreciation of the culture and especially the significance of Thanksgiving.
Given that I am the sole Australian amongst a large group of American volunteers, I was particularly keen to show just how “American” I could be. I asked Courtney for her recipe for Pumpkin Pie as I was determined that this would be my contribution towards the festivities. Thanks to a trip into Manzini, I was able to source all the ingredients and I have to admit, the dessert turned out spectacularly and was one of the highlights of our celebration.
We all went to great lengths to obtain a turkey and I have to admit, Susan was the one who came up trumps. She got her hands on a 20lb (~10kg) bird that was killed and plucked the day before we tried to squeeze it into the oven. The turkey was the best I have ever tasted- perhaps due to its “freshness” and the fact that we had to “google” cooking times because none of us had ever cooked a turkey before.
The event turned into something much bigger than we ever imagined. Somehow, we ended up having two more Peace Corp volunteers join us as well as two other Americans that had arrived the day before to volunteer at the Good Shepherd for 12 months. It was a wonderful way for them to begin their stay. We also invited all the other doctors from the hospital and in total, we catered for about 25 people. It was very festive and everyone had a good time. Krisitin made her traditional dish of sweet potato combined with cranberries, cinnamon and marshmallow and whilst I was initially sceptical, I can now assure you that I am a definite convert to this unusual dish. She also made pumpkin cookies with cream cheese frosting (absolutely divine), whilst Chris cooked great mashed potatoes and Susan provided our vegetables. We had a lot of fun preparing the foods together and I will forever remember the “sisterhood” and “camaraderie” we felt as we tried to create a traditional American experience. Susan said it was perhaps the best Thanksgiving she had ever experienced, whilst it was unanimously voted that the pumpkin pies I made were the very best anyone had ever tasted (THANK YOU COURTNEY!). It was also an emotional night for all of us as it was my last night at Good Shepherd. I cried my eyes out when Dr Pons said grace and I also shed a tear when, at the end of the evening, it was just me and the true Americans. We sat in a circle and each spoke about 5 things we were truly grateful for. It was an incredibly special moment and something I will remember forever. Each of us had different things to say and each were deeply personal and meaningful. In summary (and you certainly get the abbreviated form), the five things I was most grateful for include:
My incredible family who have provided me with enormous support and encouragement and who didn’t think twice about coming all the way to Swaziland to see me whilst I am here.
My friends in America, Australia, Ireland and England who have emailed me, written to me, sent me letters and parcels and have put up with moments where I have almost gone insane whilst being in Swaziland.
My experience whilst being here in Swaziland. Even though it has been the most challenging and difficult experience of my life, I have learnt a lot about myself and the world around me and I think this makes for one extraordinary life.
The fact that I am a doctor and have been able to make a difference in peoples’ lives despite the lack of resources available to me.
My hair straightner- my experience here would have been a lot worse if I had to endure my “birds nest” hair.

Tuesday, November 25, 2008

My last Monday at GSH

Mondays in any medical setting are notoriously busy. I always start Mondays here with a sense of dread. Who died over the weekend and what new admissions await me?
Yesterday was by far the worst Monday I have experienced so far. Rather ironic that it just so happens to be my last. I had 16 new admissions over the weekend and this was in addition to the 20 or so that I already had on the ward. All the new patients had HIV, all were critically unwell and all required complex management plans that took me hours to organise. For the first time ever, I started to get really cranky at my nurses- something I have always prided myself on not doing. During the ward round, two of my patients died. One was 20 years old, had AIDS and presumably died of meningitis. Her neck was so stiff that when I went to lift her head off the bed, the rest of her body came up with her. The medical term for this is nuchal rigidity and I have never seen it quite as profoundly as what we see here. The second patient, also in her 20s also died from an AIDS related illness. I wish I could eloquently describe the feelings that emerge inside of me when I face days like this, but I am unable to put into words the series of emotions that leave me with an utter sense of despair.

Last night, as I lay on my bed, just staring at the ceiling, I started to think about what constitutes a “disaster”. When a bus crashes and people are killed, the news headlines read “Disaster”. When kids in China are poisoned with melamine, we call this a “disaster”. When the economy crashes and people have to tighten their belts a bit, we call this a “disaster”. I don’t want to trivialise these issues, because to the individual, these are important- but what do I call what’s happening here?
I’m working in a hospital where 100% of my patients have AIDS. They are suffering shocking conditions that we don’t always have the resources to adequately investigate or treat. We are now overcrowded and have to turn sick people away because we have run out of beds and floor space. We’ve even run out of sheets to put on the beds. Now most of my patients are between 20 and 30 years old. Most have children that will be left without a mother when my patient dies. Even if I manage to improve my patients’ condition, they are discharged home where they struggle daily to access food and water. They often can’t afford the medications that I prescribe them to keep them well. They can’t afford to pay for transport to come back for a review visit so that I can try and keep them well.
So I ask you, why then is this not on the front page of the newspaper and quoted to be a “disaster”? What needs to happen further before we realise that the lives lost here are just as important as the lives lost anywhere else in the world? I don’t understand why the world is not screaming out about the injustices that allow almost 50% of a population to be afflicted with the one disease.

Then I am faced with my own sense of guilt, because I am abandoning what I consider a disaster. Does this not make me as guilty as the rest of the world that chooses to turn the other way instead of facing the reality of this disaster here in Swaziland? But the reality is, I cannot face the pervasive smell of death any more. I’m not sure when the time will come when I can close my eyes at night and not see the bodies of my patients, emaciated, covered in fungal skin conditions and languishing in their own excretement. I don’t know when I will not be able to hear their cries and their desperate pleas to me to ease their suffering. I don’t know when I will ever truly state that I have any sense of hope for Swaziland.

I usually spend Monday evenings with the Pons’. I called them and told them that I wasn’t able to make it last night. I felt so completely depleted. At Helen’s insistence, I ended up going and I am pleased that I did so, because I felt a lot better afterwards. The Pons’ have been incredibly kind and generous towards me during my stay in Swaziland. Helen has become a particularly valued friend and she has provided me with a great deal of compassion and comfort that I will always be grateful for. At the end of the evening I brought home a companion called Ginger. He’s the kitten that belongs to the youngest Pons- Ruth. They are going away for a few days and they asked me to care for the tiny animal. He’s ginger (duh!) and has the most magnificent blue eyes. He is about 5 weeks old and no bigger than the size of my hand. I am completely in love with him and I think he feels the same way about me. I really like cats, but I have resisted the temptation to get my own as I have always felt that this would cement my future as a spinster. It seems that in my experience, all spinsters tend to have a cat and I am determined not to follow a similar fate. I do, however, feel that this is only a temporary arrangement and therefore unlikely to have a negative impact on my marriage prospects. However, I went back to check on him after my ward round and I was rather disturbed to find him playing with the strap of my bra that I had left out to dry. Whilst you may not find this anything to be disturbed about, this actual event is not the first time that an animal has taken a liking to my unmentionables. Last year, I looked after a dog, called Patrick, when his owners went overseas for a holiday. Patrick had the rather disturbing habit of going into my wash basket, selecting out my underwear and distributing it throughout the house. I believe he actually buried one of my particularly expensive bras, because I searched everywhere for that item and it was never to be found. So, it is with this new piece of animal evidence that I have concluded that the reason I can’t attract men is the fact that I must be secreting a pheromone that attracts animals only. Now I thought Africa was the only thing that had problems……

Sunday, November 23, 2008

New contact details

The computer at Good Shepherd has a virus and has crashed in a big way. I can no longer receive emails at
If you would like to contact me, please email

Saturday, November 22, 2008

One more week to go at Good Shepherd

It seems that despite only having one more week at Good Shepherd, I am going to be challenged right up until the very end.
It’s been a disastrous week in terms of what has been happening on my ward. Multiple deaths on a daily basis. On one day, I had 4 die within hours of each other and I was devastated. I started to question my ability and started wondering what I was doing wrong. In a moment of clarity, I was able to recognise that all these patients were incredibly sick with advanced AIDS and horrendous complications and no matter how much I fought for their lives, they were going to die anyway. It still doesn’t make it any easier.

I gave my nurses their last tutorial on Friday morning and I can’t help but feel that I am “abandoning them”. We have worked hard together and we have developed systems that have truly had a positive impact on patient care. I know that this will all inevitably fall apart once I leave as there will only be one physician to run both male wards/female wards and outpatients. An almost impossible task.

Julia returned to the USA on Thursday and we feel like we have lost a member of our family. She was one of the most incredible people I have ever had the privilege of meeting. At 23 years of age, she finished nursing school and came straight to Swaziland. An enormously courageous and selfless thing to do. She had been here for 12 months and during that time she integrated herself into the Swazi community by learning their language, immersing herself in their culture and dedicating herself to caring for the sick and destitute. She was also an incredible friend to me- her support and encouragement was invaluable. We shared many laughs and many tears and I feel a connection with her that will last a lifetime. I am so excited to see what her future holds as I know she is going to embark on more adventures that will lead to a truly extraordinary life.

By Friday, I was starting to feel completely depleted of any reserve to continue caring for my patients. I finished my ward round and then retreated to have a good cry. Thankfully, Susan informed me that she was going to Mbabane for a meeting and she asked me if I would like to join her. Being a volunteer, I have the freedom to say “I’m not coming to outpatients today”, so I happily accepted her invitation and we made our way into the capital city. We had a pleasant lunch and then made our way to one of the big hotels that was hosting a guest speaker from the USA. Her name was Dr Wafaa El-Sadr and she is the international director for ICAP (International Centre for AIDS care and treatment programmes). She is an infectious disease specialist who works at Harlem Hospital in New York under the auspices of Columbia University. She is an international expert on AIDS. She was giving a talk on AIDS and anti-retroviral treatment and she discussed the recent results of a huge international study called the SMART study. I listened to her in complete awe. It has been so long since I have been in an academic environment and I relished the opportunity to hear of her talking about disease, epidemiology, drug treatment and hopes for the future of AIDS. She must have noticed my enthusiasm for what she was saying because she came up to me after the talk and I introduced myself as an Australian doing my small part against AIDS here in Swaziland. She was very gracious and polite (and tried to convince me to give up emergency medicine and become involved in public health) and I found myself to be quite overwhelmed by being in her presence. I know this will sound absolutely ridiculous for some of you, but in medicine, there are some people who we consider “gurus” and I know she is one of them. I felt like I was in the company of a “super star”.
Susan and I felt re-invigorated that despite the hopelessness we see here, on an international scale, there is still a lot of passionate work being done to combat this disease.

By this stage it was about 7.30pm and we faced the dilemma of whether to drive back to Good Shepherd or stay in Mbabane for the night. We have been constantly advised not to drive in Swaziland at night as it is considered extremely dangerous. Despite the normal dangers of poor roads, the ever present cattle and goats that meander across the roads and the fact that no one here pays any attention to road rules or speed limits, we were also faced with poor visibility. However, I have not received any income since the beginning of July and my finances are starting to dwindle, so I was reluctant to stay in a hotel overnight. Susan was also keen to get home and she thought she was capable of safely navigating her way back to Good Shepherd. So we set out in the dark and I have to admit I was hyper-vigilant and nervous. Susan was extremely careful and as we made it closer to Siteki, I started to feel reassured that we would be OK. The reassurance did not last for long. We were within about 10 kilometres from home when a car recklessly came out in front of us and Susan had to suddenly slam the brakes and swerve off the road to avoid a collision. It was simply terrifying and we were physically and emotionally shaken. The rest of our trip was in silence as we both reflected on what could have occurred. There is no doubt in our minds that if Susan had not been so alert and her reflexes not so quick, we would have been in the midst of a disaster. There are no ambulance services here in Swaziland. The facilities here at Good Shepherd- if we had made it to a hospital alive- would have been inadequate to deal with severe trauma. We have run out of blood here, so if we needed a blood transfusion, we would not have had any blood available. I know these are all “ifs” but the reality is, we came close to tragedy that could have been avoided. I cannot imagine putting my parents through the agony of coming to Swaziland to collect my body and I am just so grateful that we escaped this event without us being hurt. I vow that for the remainder of my time here, I will not get into a vehicle at night. It’s just not worth the possible consequences.

I’ve decided to have a quite weekend and stay around at Good Shepherd. My tasks for this weekend are to write my Christmas cards and start packing some things up in preparation for my departure to Bulembu. I’m not exactly sure how I am getting to Bulembu, but at the moment it looks like I will be going on a truck that will be taking maize from Siteki to Bulembu. I’m just appreciative of any mode of transport. I will be coming back to Good Shepherd for a few days in December. I have offered to do ward rounds from the 22nd-25th of December whilst I am here with my family. It will give my family the opportunity to witness first hand the work I have been doing here and I know we are extremely short staffed during this time and my assistance will be appreciated.

It’s hard to believe my family will be here in 3 weeks. I know they are incredibly excited. Graeme (my step Dad) has had his bags packed for a month already and my mother is trying her best to get everything organised so that the various donations that she has received can be transferred here safely. She tells me that a number of you have been extraordinarily generous and I just cannot tell you how much I appreciate your generosity. Pleased be assured that you are truly making a worthwhile contribution and your donations will have an enormous impact.

Monday, November 17, 2008

Royal Swazi Spa

Yesterday marked exactly 4 weeks until Mum, Graeme (my step-dad) and sister, Rachel arrive. Let me tell you, I am counting down the days. I cannot wait to see them. Not only will it be great to show them Swaziland, but it will also mean that I am one step closer to going home to Australia. I am ready to go home. I don’t know how much more fortitude I have left. I’ve even decided that I’m probably not even going to bother telling you of all the despair I see on a daily basis- you’re probably tired of it. I know I am.
The weekend was good. Saturday was Julia’s last weekend in Swaziland and we wanted to make it special for her before she returns to the States on Thursday. She rented out a cottage on Mabuda Farm and she invited Chris, Susan and I there as well as 6 local boys (aged 8-16). She has held a “games night” every Friday for these boys for the past 12 months she has been here and she wanted to give them a treat as her departing gift. They swam in the pool (I just potted around with the horses, cows and kittens) and then we all had a braai (African style BBQ) for dinner. Susan brought her laptop and iPod along and we were able to listen to some music. I cannot tell you how uplifting it was for me to hear music- it has been a very long time and I miss the enjoyment it gives me. Susan had some Motown on her playlist and I actually got up and had a little dance. I was just so happy! The beauty about my time here in Swaziland is that I have been completely uninhibited in just being myself. I can listen to daggy music and my friends here still think I’m pretty cool. I can openly admit that I think “The Sound of Music” is the best film ever made and no one rolls their eyes. I wear my ordinary clothes and my nurses think I have the most fashionable wardrobe in the country. The love my friends have for me is unconditional and it’s liberating to just be myself without having people trying to “improve me” or show me how to be more fashionable or what music I would be “cooler” to listen to.
We had fun with the group of boys- we simply had a few balloons that we spent ages trying to keep in the air. We danced and I even taught them Australian anthem and “Give me a home amongst the gum trees…”

On Sunday, 6 of us crowded into Susan’s small, 5 seater Micra to go to Manzini. Incredibly dangerous, but given that the locals pile into the back of utes and trucks etc- when in Rome…..
Thankfully we arrived safely. Kristen and Andrew had to go to a Peace Corp function whilst Chris, Julia, Susan and I went onto the “Royal Swazi Spa” Let me tell you, this place is not representative of Swaziland- it is over the top opulence and it was fabulous. It just screams luxury and I actually felt somewhat out of place. This discomfort soon vanished when I was served my cappuccino in the fine china (hooray- my stomach has now settled enough tolerate it) and then I enjoyed my salad with grilled houlumi cheese. The piece de resistance was the spa. I was desperate to have some waxing done and I took my chances to see if they had an appointment at short notice. I nearly jumped for joy when they took me into the sanctuary where the lighting was dim, soft music was filtered through the rooms and the colours all muted and inviting. It really is a shame that instead of having a massage, facial, total body exfoliation or body wrap, I had hair ripped out of me, but let me tell you- I felt like a new woman afterwards. I felt somewhat ashamed that such an unnecessary indulgence made me feel so good, but it has been hard on me not having me usual creature comforts I have back at home (I suspect it has been hard on my local beauty salon back home not having my regular patronage). It really was a lovely day and something I will remember fondly.
Shame I had to come back to work….

Thursday, November 13, 2008

A day with Home Based Care

Today I had the unique experience of joining Julia on her daily routine with a programme called Home Based Care. I did my ward round and joined her team when they headed out later in the morning.
Home Based Care involves going out to local homes and providing basic medical care and food to the disadvantaged who don’t have the means of getting to Good Shepherd or who have chronic conditions requiring a nurse to check up on them. We have similar care in Australia, the UK and USA. However, like everything here in Swaziland, it’s a little different.
Firstly, the people we visited were simply the poorest people I have ever seen. They have nothing- a few rags they use as clothing, a few basic items that allow them to make a fire and cook food, but otherwise- not much else. They walk kilometres everyday to obtain water and their existence truly is based around survival. And yet, despite these extraordinary circumstances, they always had a smile to share with us and it warmed my heart to see their courage and stamina.
Their homes are made out of sticks and mud. The floor is made out of cow dung. In fact, in one of the homes, I was able to watch one of the women “relaying the floor”. You mix cow dung with water and compact it down to make a smooth surface. Once it dries, it actually makes quite a stable surface. It has been raining a lot here recently and I am continually caked in mud, but these floors seem to resist being formed into a mud pies.
The houses are very smoky because people have open fires in them which they cook on. (the fires are also responsible for the large amount of burns we see here at Good Shepherd). Sometimes, if they had more money, they had a mattress to sleep on, but this is not always available.
Many of the people we visited had AIDS. As I have mentioned previously, if you are poor and have AIDS, the World Food Programme provides you with some staple nutrition (however, the WFP doesn’t reach everyone and we must not forget that many, many people here are starving and malnourished.). We handed out packets of corn-soya, maize meal, peanuts, salt, sugar and soap. Some lucky families were the recipients of some milk. Whilst it is very satisfying to be able to provide medication to the sick, I have to admit, I found it more fulfilling to give food to the poor. We all take food for granted and yet these people don’t know from one day to the next if they are going to eat. I can’t imagine what that must feel like- especially for the AIDS patients who do happen to be lucky enough to be on ARVs- these drugs can make you feel awful with debilitating nausea, so I can’t imagine what it would be like to have the side-effects from these drugs and also be hungry….
There were a lot of children around- almost all of them with little pot bellies that are a sign of Kwashiorkor (a diet that is deficient in protein). They were simply delightful and loved having their photo taken. Again, extremely impoverished- some without clothing. Continuous stream of nasal discharge that attracted the flies and yet they seemed happy enough. Perhaps it was just the excitement of seeing our vehicle and knowing it was bringing food.
I actually got to tend to some sick people. Very different circumstances to what I would experience in a clinic or hospital. I sat on the floor to examine them, took blood pressures whilst sitting on a log and I even examined a man’s penis behind our truck. He had some genital lesion that I didn’t have a clue what it was, but I was able to give him some basic antibiotics. We told him that he needed to use a condom otherwise he would infect his wife. He told us that he went to a nearby clinic and that they had run out of condoms! They wonder why Swaziland has the highest incidence of HIV in the world??!!
We were also able to administer simple analgesia, basic antibiotics, multivitamins and some other basic health care supplies. All of this was free thanks to kind Americans who donate to support this programme. These people would receive no other health care otherwise.
I came home exhausted, covered in dirt and yet extremely humbled that I was privileged enough to be part of this programme- even if it was only for a day.

Wednesday, November 12, 2008

Some divine intervention

I think I have begun every blog entry recently with “It’s been another difficult week”. I wonder if you are getting bored with my constant tales of misery and despair.
The abdominal pain has settled somewhat but I am still unable to eat certain foods. Of most concern is my inability to tolerate coffee. I tried it on Monday and found myself rolling around in agony. I know I initially complained about the coffee here, but thanks to Courtney and my step-Dad sending me copious amounts it, I have been able to enjoy my only real “vice”. Up until now that is.
I spent all weekend in bed and had plenty of time to reflect on my time in Swaziland and what the experience has done for me. Unfortunately at the moment, I am consumed by the daily despair I pay witness to and it has taken a huge toll on my mental health. I can’t remember feeling this depressed before. I know that once I get home to my familiar surroundings and support, I will look back on this experience as being one of the greatest of my life. It has challenged me and no doubt enriched me as a person. I just can’t really appreciate that at the moment. The truth is, some of my despair comes from the fact that I had such high expectations of Swaziland. I thought that by coming to a third world country and serving the poor, I would find my purpose in life. I would be able to justify why at 30 I’m single and childless. I truly believed that I was in this situation because there were “big plans” for me and these plans required me to be footloose and fancy free.
The reality is that I don’t think I can do this job long term. I feel like some of my soul has been destroyed whilst being here. My innocence and enduring optimism has been eroded somewhat. It’s ironic that last week Susan described me as “Chicken soup for the soul” and yet all I could think about was how I had lost mine.
Nevertheless, within 24 hours of emailing a friend and having a major catharsis of emotions that I think made me look like a raving lunatic, I find that an opportunity has opened up that will allow me to leave the despair of the female ward a little earlier.
Bulembu is hosting a massive project called “Swazi 1000”. I’m not entirely sure of the exact details but I do know that about 1000 college students are going to descend on Bulembu to devote two weeks to reconstruction of houses that will eventually house orphans. With such an enormous undertaking and some of the projects potentially dangerous, they require a doctor and the Board members have asked me to be there for the two weeks. I am delighted to help out. I will step back into my role as an “emergency doctor” and I will be on hand to manage anything that happens to the group of people who will be aged 16-24. This means I will be treating healthy people who don’t have AIDS. I will also get to see this massive project unfold which will be exciting and give me further hope for this project that I am passionate about. I will also be able to go and cuddle an orphan everyday and I think this will be the best therapy for me at this time.
I now have two weeks left at Good Shepherd and hopefully I can make the most of my short time left here.