Thursday, December 4, 2008

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.