I’m working I swear: Part 3

Mm.. so our time here is wrapping up now. It’s really pretty impressive how time goes by. Even though the one thing people constantly tell you is that [insert life event] is going to go by before you know it. And you try to take it to heart but you really don’t understand until said life event actually -has- flown by without you noticing. This last week, Andrea and I basically ran around the hospital tying up as many loose ends as possible while still working on community outreach with Asha.

Anyway, I promised to write about some of the things I’ve been up to in the hospital.

With the technologies, it’s been the same-old-same-old. Discussing with nurses about how they enjoy using the technologies, if they find anything irritating with the technologies, or if they’ve thought of any extra features they’d rather have. For the most part, the nurses don’t have much to say about the technologies we’ve given them besides that they’re beginning to integrate them into their routines. Which is great, but simultaneously unhelpful for improvement, haha. There are, however, several nurses who are diamonds in the rough and have a lot to say about either their ward, the hospital, or the issues that our technologies are targetted toward. They’re clearly the most helpful and they’re the nurses we’ve obviously ended up befriending. I will definitely miss a good number of the ladies here and I wish them all the best in their future~ ❤

Actually, to the suggestion a senior pediatric nurse, we've actually worked with maintenance to create two wall mounts for the phototherapy lights we've given the ward. It was like pulling teeth but we finally got the maintenance guys to drill a couple holes, and now peads has a place to put hang their lights for any jaundice patients!

Another thing we’ve been up to is testing Breath Alert and IV DRIP, Andrea’s and my devices. Andrea (finally) got her technology up and running again and hooked it onto several pre-mature infants to check breathing sensitivity along with whether the vibration motor was enough to wake up a child from apnea.

Similarly, I also (finally) got to hook up IV DRIP on a patient! The entire time I was just reveling at the fact I was even allowed to do that… I’d never even dare to ask if I were in the States, haha. Adrenaline pumping through my body, just praying that the stupid little mousetrap would go off… any.. time.. now.. …. ..

But! The good news is that it works like we thought it would! With all the same flaws we already knew about, haha. But haha, if only you guys could’ve seen the relief on my face when that counterweight fell. Could’ve died happy right there next to the TB patient. There’s still a few kinks we’ll need to sort out but if fortune has it, our team will be able to continue working on the project in the coming year.

Also Andrea and I did a fun photoshoot with a baby! Unfortunately (or rather, fortunately I guess) there was only one patient in the peads ward and he didn’t need an IV line.. heh. So.. we may or may not have staged these photos, but they’re still pretty good if I do say so myself. 😉 And I got to discuss some good info about the device with a couple more nurses who seemed to really appreciate the targetted issue.

The other major thing that we’ve been doing is being SPIES! Kidding, we’ve been doing a syringe use safety report going around the the different wards observing syringe use and interviewing nurses of different statuses. That took about a week.. and.. well I don’t have any pictures because the point was that we were supposed to be on the covert side, haha.

Anyhow, I think that about wraps up the very very brief update about our work in the hospital! Had a fantastic weekend going to Malealea Lodge where we went hiking and pony trekking and ate amazing food and played pool and did some other fun…. extracurricular activities. We had two gooooood nights, each in their own way. 😀

I’m working I swear: Part 2

I told myself I would regret not writing more and I am now. I love how past me knows future me so well, and even though past me is always advising current me, current me just takes it under consideration instead of really doing what it should. Ahh, you never learn, Melissa.

Anyhow, I figured I’d toss in some more interesting things about what we’ve been up to since it probably seems like we’re not working at all.

Andrea and I went out to the community again to talk to the caregiver/grannys. Remember last time when we told them about the mother-baby packs they could get in the hospital? This time we went to talk them about income generating activities. They were the ones who suggested it actually.

So the two of us and Asha prepared a little educational lecture, organized up all the information and decided it was going to be too boring. So instead we created a skit! After we’d explained to the caregivers the ideas of resources, materials, costs, profits, and markets, we threw together a little story illustrating the importance of saving the money you make to put it back into your business.

Short of giving you the script, it’s hard not to go into too much detail, haha. It was great fun to do and the caregivers were laughing at our over-exaggerated storytelling. They got the point impressively well, though, and that’s all that matters!

On top of working with Asha’s caregiver groups, we’ve also been working with the HIV orphans those caregivers actually take care of. On Sundays they all get together and we do a little education and activities with them as well. Also lots of fun albeit a good amount of preparation involved. Two weeks ago we introduced the idea of a “bridge” model where they’re standing on all the knowledge they already have, and through Asha’s program, they’ll create a bridge of life skills to walk over the “sea of problems” over to the side of a “healthy positive lifestyle.”

[Picture soon!]

This week: memory books to help track their progress over the bridge. Asha introduced the idea of “dreams” and “goals” to them, two concepts that we grow up with, but they hardly ever talk about with their teachers or elders. So we gave them each their own notebooks, and let them decorate the cover with their “dream” of what they wanted to do when they grew up!

Most the boys wanted to be soccer stars, but some wanted to be farmers, pilots, and soldiers and it was… so cute. Being boys, we weren’t sure if they were really going to get into the activity, but talking to one of the other Youth Leaders that helps Asha with her program, arts and crafts just isn’t really something Basotho children get to do, ever. The boys dove right into it dreaming up their own little future and gluing it on the cover of their books. Another of Asha’s group leaders reported that though he was supposed to take the books back so the kids wouldn’t lose them, the kids begged to take them home to show their parents, so what’s a guy to do? He let them take them home to show off a little. Hopefully most of them’ll come back next week with their memory books!

Well… this entry is getting sufficiently long, but I promise we’ve been doing work in the hospital, too! Next entry I’ll focus on the work I’ve been doing in the hospital, I promise!

Just a little reflection

So today’s the end of Tuesday. And there’s only a week and a half left now. That’s.. really… impressive. The time has really flown by. It always though though I guess.

We have two weeks… then we’re going to Cape Town to finish off our trip to Africa.

I’m in AFRICA. Like. Wow. What a stereotypical thing to do. Come to Africa and work in the hospital for a summer.

I’d like to think the things that we’ve done here are a little less than typical though. Usually people shadow doctors, or pretend to be med-students. We came with some technologies and wanted to try to show people how they could improve their patient care quality. How to help save just a few lives here and there that currently might be lost and chalked up to, “well it happens sometimes.” That’s good right?

It’s still pretty insane. I’ve learned about a culture I’ve never encountered before. I’ve learned how to do things I’ve never thought about before. My standards have changed, and my priorities have shifted.

This is starting to sound like a college essay, haha. It’s all true though, I think. It’ll be more true when I go back home and I’m hit by the onslaught of things that I’ve forgotten about living in a place like Africa.

You learn that you can live on so so so much less. You can live comfortably with so much less. I mean it’s not comfortable, but it’s not unbearable at all. You learn to appreciate the fact that you’ve got a bed, with warm blankets to sleep in at night. Things like cheese and milk become a luxury. Dusty things don’t seem dirty, just a little bit of nature on your floor. Carpeted floor is rich. And you wonder what all the huff huff at home is about when things are just never good enough and you’re always eying the next best thing. Here you have what you have and you don’t have what you don’t have. It’s a good and a bad thing, but one thing’s for sure, I can honestly say that I’m glad I came.

Africa. Damn.

I miss people..

… People like you!

This place is like a circus sometimes. Seriously. Imagine a circus in the twilight zone. That’s what it’s like. Sheeeeesh. 

Can’t say it’s not entertaining though.. I’m collecting a list of memorable quotes. Most of them don’t make any sense at all. But that’s because not much does here. You just go with the flow.

We went on a hike through a muddy river! 🙂

I’m working I swear: Part 1

Well. Thanks to my dad for pointing out that I haven’t really written anything legitimate in a while and it basically just sounds like I’m having a really bad vacation right now. So I guess I should give some real updates about what we’ve done… I’m doing some work here, I swear.

So there’s actually a lot, but I think most interesting would be to talk about the HIV information we’ve collected and learned about. I mentioned before that we’ve dove into the Wellness Center, aka their HIV/AIDS and TB counseling and medical department. Because of the stigma against HIV here, they still call it the “Wellness Center” as not to scare people off.

Anyway we interviewed the counselors here and found out some really interesting information – for example, traditional healers (a strong cultural thing here) are actually able to give their patients medicine that temporarily hides/engulfs the HIV antibodies which is what the tests use to determine your HIV status. But if all your antibodies are temporarily missing, patients will think that they’re magically “cured”/negative when they’re actually positive. Awkward.

Also, the general “common knowledge” about HIV is little to nil. Most of it is just rumors and flakey knowledge they got second hand. They don’t even know the difference between HIV and AIDS. Basically, if you know about HIV or want to know more, people are actually put off and might think that you have HIV. Otherwise why would you know so much about it? Why would you even want to know so much about it? Also awkward…

But! There’re also these really cool packs called “Mother-Baby packs” which are packs given to future mothers who come to get their pregnancy checked out. And their FREE! Really awesome. In order to avoid HIV stigma, ALL moms get one—there are three different packs: one for HIV negative moms, HIV positive moms, and HIV positive moms on HART (aka their HIV is in really late stages).

The purpose is to prevent mother to child transmission (PMTCT) of HIV in a country where nearly 1/3 of all people have HIV. “To raise a generation free of HIV.” And in order to avoid the stigma, everyone gets one, even HIV negative moms. All three packs have the same boxes inside whether they have things inside (for the HIV positive) or their empty (HIV negative). It includes a six month supply of medicines because as much as we’d like to encourage people to come to the hospital every month, it’s just not practical. They’re not going to, either because they don’t have the means, don’t have the time, or… they’re just lazy. Regardless, with these fun packs, they have all their medication to help them through their entire pregnancy from vitamins and ARVs during pregnancy, meds during labor, and meds for both the baby and the mom after birth.

Pretty cool, huh? It gets better! Tuesday, I actually went out with Asha, a small Indian girl who’s here on a two year public health job, to a village to a support group she’s set up with the “caregivers” of HIV orphans. The “caregivers” are these grandmothers that take in all the kids that are remotely related to them who have become orphaned because of HIV. It’s extremely common in Lesotho, unfortunately. Anyway, we went out there, sat in a little field in the middle of their village, and lo and behold, these grandmothers start showing up and before you know it, she’s got a group of about 8 grandmothers sitting in the grass wrapped up in their blankets.

With Asha leading, I get to teach these caregivers about the Mother-Baby packs, show them what’s inside of them, and emphasize their importance in being able to “raise a generation free of HIV.” We encourage them to tell everyone they know, and at the end, we split them into two groups and did trivia with them. Candy for correctly answered questions!

I could write a whole entry on just the support group, but I’ll try to keep it to the point. Basically, even though they really only absorbed maybe half of what we told them, they know these packs exist and hopefully they’ll tell people in their community and at least maybe we’ll help a couple future moms. But they did learn. And that’s really cool.

At the end, as we were getting everything together, we took a group picture… and then suddenly they just all started singing and jamming out and, oh it was so fun. Warm fuzzies and huge smiles everywhere. Just standing in a semi-circle and everyone’s laughing and clapping and singing and dancing and it’s awesome. Just. Awesome. Asha’s done some really good work here, and I’m so grateful I got to be a part of it.

…and then we “debriefed” the session, aka… went to a local pub and got some beers. 😀

Babies!

Check out this baby! What a badass! Check out his shades made of bandaids and sanitary pads! He’s getting some phototherapy treatment ’cause he was all jaundice’ed. He wasn’t as excited about it as we were.

But he’s all better now because our bililights were actually really effective! He got discharged in three days, whereas the old phototherapy lights that we replaced usually took about a week to two weeks to break down the jaundice. We’re pretty modest awesome, eh? No, but in all honesty, it was really rewarding to be able to report that back to Dr. Oden and Dr. Richards-Kortum when they came to visit. Look at him all happy and not screaming bloody murder anymore. 🙂

But yeah, Andrea and I have been working a lot with these babies and we go hang out with them even when we don’t actually have anything to do in there… But. I mean… who doesn’t love babies?

 

Also we should go ahead and add washing machines to the list of really really awesome things that the civilized world has. Like WOW! All my clothes are clean! And.. all I did was give it some some and push some buttons and.. magic! Technology these days.

 

… I’ll write a more legit post at some point. We’ve actually done a lot and I have some really interesting stories to tell. I’m just becoming an old lady and feeling tired/sleepy at 9pm.. I miss college where you stay up until 3am no problems, haha.

A boring update I have to do for my official blog

Monday, we got to see the bililights in use with a baby in the nursery! After replacing the old bililights from interns two years ago with our new and improved version, we found that our bililights didn’t fit the holder quite as well as the old ones. So, looking for an easy fix, we asked one of the nurses for a roll of bandaids and just wrapped our handle to make it fit more snugly in the holder. Then we took the entire holder and attached it to an IV stand so the nurses could move it straight to the incubator the baby was sleeping/screaming in. Done! Photoshoot!

The exciting part of this was actually that with our new phototherapy lights, the patient was discharged after just three days of treatment, whereas the old ones often took up to two weeks before the patient was discharged to go home. The nurses were pretty pleased, took the lights after they were done using it and packed in a cardboard box on a top shelf. Hopefully they won’t forget about it up there though, haha.

Tuesday, Dr. Oden and Dr. Richards-Kortum came to visit! It was a short visit and they were pretty exhausted from the long flight over. But being the Dr. Oden and the Dr. Richards-Kortum, we still exchanged all of our feedback and they gave us back a lot of good insights into what we’d learned in the two weeks that we’ve been here at Maluti. By the time Andrea and I sent them off, they’d filled our plates with even more to look into and do around the hospital.

Rest of the week was spent doing… the usual? Ha. There’s no usual here. We basically make a list 10 things long everyday and just go down the list as we try to find the people we need, all the while keeping our eyes open for any sudden opportunities to pounce on. And sometimes the opportunities pounce on us… This week we’ve really dove into learning more about HIV/AIDS and how it affects mothers and their babies. With a prevalence of around 23% (2009) nearly one in four people is HIV positive; needless to say it’s a major scene in the hospital we haven’t touched yet. We’ve learned a ton in just three days, but I’ll update more when there’re more interesting things to say than just spitting facts at you.

The end of each day is spent perfecting our cooking skills (we’re getting really good, seriously.) and chatting with the other ex-pats and volunteers at the hospital over a game of Yahtzee and a cup of rooibos tea. Not too bad of a life, eh? Except when the power goes out and it’s pitch pitch black. Scarrrrrrryy.

Weekend to Maseru

Went to Maseru, the capital this weekend! Took public transport there and back where they basically shove you in a little minibus and they fit as many people as they can in, collect your money and then drive off to wherever. Stayed in a little hostel which was fine, then bought some honey toffee candy (heh… ..), a pretty souvenir mug, and ate out! That was nice. Eating out. It’s funny how often I used to eat out (sooo much) and now it’s become a luxury again. Trip was fun though! Wanted to buy a cute jacket but it was expensive and the shape slightly didn’t fit me… Ah well. Maybe I’ll go back and buy it if I have left over money, haha. Now time to rest… phewph.

 

Dr. Oden and Dr. Richards-Kortum coming to check up on us next week. Better shape up, hahaha. Nah, we’ve got stuff to show them… though apparently they’re only going to be here for a couple hours… mmmm.. we’ll see if we pass the test. 😛

 

Anyhow, I’m gonna go play soccer with some orphans now! Doo doo doo…

Twinkle twinkle little star…

So. Let me tell you about these goddamn stars.

It’s cold outside, chilly. And it’s dark. Like really dark. Just imagine a whole field of dark, no light from cars driving by, no light from street lights, no lights from buildings with people working overtime. It’s the darkest darkest black-blue you can imagine. Pretty much black with just a smidge of blue tossed in.

But the stars. Not just a couple above you and a shape you think is the big dipper to your right, and the moon off to your left. The stars, they’reeverywhere. Spread out your arms like you’re trying to measure you’re wingspan. From your finger tip up over your head down to your other finger tip — that’s how much sky there is. Literally nothing blocking your view of the night sky but some mountains and trees in the far off distance. And this sky is absolutely filled with the stars.

The sky’s not just speckled with stars, it’s filled with them. There are these cloudy mists hanging in the sky, like powdered sugar on that dark shirt you wore eating beignets. These mists are made of stars, accented by brighter stars sprinkled on, framing the cloudy mists. Then there are all the other stars in the sky, on top of these clouds as a second layer scattered across the entire sky. Literally a complete dome of stars above your head. Making the most gorgeous figures in the sky, like chaos, but so beautiful.

And then a falling star.
Your heart makes a wish before your head can think of a good one.

And you tear your eyes away because if you don’t, you’ll never leave, and there’re dogs barking in the dark, and you don’t want to be outside in the dark for too long.
One last peek at the entire galaxy blanketing you this chilly winter night. Then close the door into your room, crawl under four layers of covers, and wish you could say goodnight to your dumb boy… Fall asleep until your next day.

Plans? What plans?

There are no such things as “plans,” here in Lesotho, Africa. You can plan all you want, but when things are happening, they’re happening, and you can either hop on the bus, or try to stick to your “plan” as well as you can.

So Tuesday, Andrea and I decided to hop on the bus. Literally. Just as we’re walking to the hospital to start our day, we run into one of the doctors, Dr. Tibenda. Making small talk, we find out he’s going to an outreach clinic that day in Pitseng. Interesting… Then, as we start heading to the obstetrics ward, we spot another two doctors, Jair and Rooland, and deciding to take a change to jump an opportunity, we ask if they’re going to the outreach clinic too, and if we could come along. They wave for us to follow them, of course we can go along! So instead of our working off our plans for the day, we jump on the bus to Pitseng.

The clinic is about 45 minutes away, just a single small building. Maluti Hospital sends people every Tuesday morning: a driver, a nurse to take money, a nurse to distribute medicine, a nurse to take blood pressures of patients receiving “family planning” (aka birth control), and one or two doctors to see the patients. Patients come in either to get a check-up with a doctor, or to receive their monthly/bi-monthly/tri-monthly “family planning.” Those coming in for a check-up wait in line on benches grouped to one-side of the waiting room, those coming in for family planning wait on the opposite side.

 

Each patient carries a little book with them – essentially their medical history file. This little book serves all the purposes of a medical file at your own doctor in the US; you even need it to enroll in primary school. Each time you go to a doctor, the doctor writes down his/her diagnosis and prescription in your little book. You take your book to the bus where they collect money through a window and give you a receipt for your prescription. Then you take your receipt to the pharmacist, and she gives you your medicine. Done!

Andrea and I spent the day asking questions and observing different aspects of the outreach clinic to get a fuller picture of how the clinic worked. We took plenty and plenty of notes so we’ll have to sort through all of those and do some brainstorming to see where we might be able to help or make some improvements. It’ll be tough since, because it’s an outreach clinic, any tests doctors might want to run have to be rapid diagnosis tests (tests like pregnancy tests where it shows the results immediately). Andrea and I also think the outreach clinic might be a good place for sexual education to happen as well, seeing as so many women come in for family planning.

Overall, really informative day. And, as an added bonus got some really fantastic views of the Mountain Kingdom as we drove to and from Pitseng.  But you’re probably bored of hearing about those by now, anyway, haha. I’m telling you, man, I don’t know if I’ll ever get bored of these mountains.

Also because most of you only skim this for photos, here’s a photo of me, my partner Andrea, and one of the doctors who takes care of the outreach clinic, Dr. Tibenda. He’s pretty badass.