Rural Hospital Life at Zithulele

About time I wrote...the fact that it’s been a while is a reflection of how damn busy I’ve been with work.

The hospital has 9 drs, but 2 are part time mums and one of those is now on maternity so call it 7 ½ ! Zithulele Hospital is made up of four wards: Male ward, female ward, Paediatrics and Maternity. Then there is Out Patient Dept which serves as an OPD and A+E and a ward sometimes.

Most people have HIV +/- TB lung, all people are poor, unemployment is high, people pop babies like no bodies business...monthly income averages at 1000rand which is 70quid. A trip to the hospital for some can cost 100rand...so people sacrifice a lot to get to us. We are understaffed and facilities are limited. There is a bigger tertiary hospital in Mthata the big town (bit of a hole).

In an ideal world we have access to Xrays, running water, electricity, patient transport to big clinics for specialised stuff in Mthatha, oxygen for the patients. Unfortunately and various times in the last few weeks one or most of these things have failed. The oxygen one is hard to stomach as a child with pneumonia who needs O2 is a pretty basic thing.

I have seen all sorts so far. For the medics reading....lts of LPs, placental evac, taking blood off neonates, drips in kids, draining pleural effusions galore, crazy TB CXR signs. For the none medics, I’ve had kids kicked in the face by a horse, man crushed under a car with crumbled up spine (i managed to negotiate a helicopter transfer and am something of a celebrity dr now since they hadn’t managed to get one since 2004...the entire town came out for a peek.) I am also something of a legend on maternity as I solved the riddle of the smelly delivery room. It smelt like something gone off, but the floor was clear of grime, the midwives thought it was the mattress, til I glanced up at the aircon to see a dead mouse, tail hanging out of the aircon – mystery solved. When asked by them “how did you know to look there” I said that I’d spent time in Edinburgh and knew what a dead mouse smelt like!

Weekends (when not working) are wonderful....just to escape the hustle and bustle of the hospital. Lots of little beachy places within an hours drive on a dirt track. Pete’s trying his hand at surfing. Even a legendary place which makes pizzas in a big outdoor oven that are amazing Italian delights. The ‘Transkei’ one is particularly nice (basically like an Hawaiian Pizza)...Transkei is the old name for this neck of the woods, now renamed The Wild Coast because the waves are wild and wrecked a lot of ships.

I have learnt a couple of words...la la means lie down. Epefumela means deep breath please. Gogo is grandma, that one makes me laugh!

My emotions fluctuate from elation to deep despair on an hourly basis. Who knows which way they will go...it is exhausting. Pete is awesome though. I guess we’re really ‘living’ now not just grumbling along passing time. After all, that was the whole point of this year.

Pete took me away for a surprise birthday w/e in luxury bungalows which was beautiful. Seems a stark contrast though to the poor village we’d just left. Maybe I find this type of luxury uncomfortable now. Interesting thought.

There is a real community amongst the hospital staff....there are drs but also physios and Occupational therapists, a dentist and dietician (who is awesome)....the dietician told us the other day how he drove to mthatha to collect the weeks hospital supply of meat and was told to meet the lady for the meat at Chicken Lickin...ironic since she came empty handed as they have not been given money from depot of health the buy any meat...so getting protein is tricky for our malnourished TB patients with no muscles. When asked ‘how is the kitchen going these days’ Duncan replied ‘cloudy with a strong chance of rain’ – hilarious guy! He’s going to have some input in the preschool pete is setting up which is opening mid april all being well – though the rondavel (round hut) it’s going to be in is occupied currently so we can’t get in to check out the structure yet. Africa man, everything happens tomorrow. And we want it to have happened yesterday!

In summary...I am surviving, but work is mental and very tough and emotionally draining. I love the community feel here and you feel so alive doing exciting stuff. I am glad pete is with me on the adventure. I miss all you lovely people back home but hope you enjoy the blogging. X kim