This will be the last installment of my blog before we leave on Wednesday.
Today Jamil, Hennie and I met with Neil McKerrow, the heaqd of pediatrics for Kwazulunatal, our mentor on healthcare here, the man who both helped us and put reins on us. I have dealt with Neil since last April, and feel that I still do not have a good read on him. Neil is an incredibly dedicated man, with a computer like mind and a long term vision which he follows religiously. He rules with an iron hand. Today, I felt that Neil was very pleased with the fact that we had followed his bidding and really became familiar with the system. I felt that, at last, we had won his confidence as opposed to many of our predecessors who were mostly talk and little action. He and Jamil discussed ways in which Jamil could serve as an advisor, was very pleased with the contributions Larissa had made, and expressed plans for Daksha's future visit.
Larissa met with the occupational therapists and formulated a report on how physical stimulation and play could be incorporated into the hospital system.
I then had the opportunity to meet with Ruth Davidge. Ruth is a young nurse who through her intellect and approach to people has accomplished the difficult task of bridging the gap between nurses and doctors in the neonatal field. She does trainings for the nurses, is involved in establishing the systems in nurseries throughout Kwazulunatal, and works with the physicians in training and patient care. We discussed how Daksha could contribute, and Ruth was extremely excited about Daksha's participation. Another dedicated and inspiring person working in extremely difficult conditions.
We all came to South Africa, each determined in his own way to make an immediate difference in the care of children here. At times we were frustrated by being asked to bide our time and observe the many expressions of the system. As we leave we know that we have not erected a single structure, YET, that we have not changed the delivery of pediatric care, YET, that we have not extablished a comprehensive pediatric stimulation program, YET, and that we have not put a dent into the shortage of vital equipment, YET. Whar we have accomplished is in setting up relationships that will grow and spread and will, ultimately, lead to small steps in accomplishing all of the above goals. What I have learned is that by our presence and desire to help we have won the confidence of those we have touched. Sometimes, just knowing that people from so far away genuinely care and are anxious to help is inspiring to those working so hard agains such adversity.
Marty
Monday, February 28, 2011
Friday, February 25, 2011
Sweetwater Primary Care Clinic
Today Jamil, Hennie and I visited the Sweetwater Primary Care Clinic which is a rural clinic affiliated with Edendale Hospital. I drove there with Tim Kerry who is a primary care physician in charge of multiple clinics. During the ride, he enlightened me about the clinic system and his concept of the role of the primary care physician in South African healthcare. Tim feels that the GP is the cornerstone of the system and what is keeping things afloat. He has no trouble recruiting young GP's for all of the posts allocated to him. The problem is that there are too few posts. He leads clinics in a variety of fields from HIV treatment to psychiatry.
Sweetwater Clinic is in a poor area and is staffed by nurses, with one physician coming 4 days per week. The grounds are quite pleasant and notable are lovely vegetable gardens which the hospital maintains to act as a role model for the community. The waiting areas are packed with patients who arrive before the clinic opens at 6 AM. The nurses seem quite efficient and pleasant and all have been there for quite some time, which makes the patients feel more comfortable. There are TB, and HIV clinics on site. We got to visit an ante-natal and counselling clinic where we met a wonderful counsellor. She has programs that include fathers in support groups and HIV counselling. She, herself, is HIV positive and acts as a role model for young people to be open about preventing and treating the disease, and helps to remove the stigma.
Larissa spent the day at Edendale Hospital where she spent time with the pediatrician in charge of the sexual abuse program, a very busy program here in South Africa. She met with a social worker who so moved her that Larissa went out with her own money to buy supplies off of this person's wishlist.
That is all for this week. I will post 1 more time on Monday and then we return on Wednesday.
Marty
Sweetwater Clinic is in a poor area and is staffed by nurses, with one physician coming 4 days per week. The grounds are quite pleasant and notable are lovely vegetable gardens which the hospital maintains to act as a role model for the community. The waiting areas are packed with patients who arrive before the clinic opens at 6 AM. The nurses seem quite efficient and pleasant and all have been there for quite some time, which makes the patients feel more comfortable. There are TB, and HIV clinics on site. We got to visit an ante-natal and counselling clinic where we met a wonderful counsellor. She has programs that include fathers in support groups and HIV counselling. She, herself, is HIV positive and acts as a role model for young people to be open about preventing and treating the disease, and helps to remove the stigma.
Larissa spent the day at Edendale Hospital where she spent time with the pediatrician in charge of the sexual abuse program, a very busy program here in South Africa. She met with a social worker who so moved her that Larissa went out with her own money to buy supplies off of this person's wishlist.
That is all for this week. I will post 1 more time on Monday and then we return on Wednesday.
Marty
Thursday, February 24, 2011
Newcastle
The blog today starts with last night where we had dinner with Duncan Andrews the director of Tandanani, the ngo we visited the first week, which does community development, and Robyn Hemmens, the director of Dlalanathi, an ngo which does psycho-social counselling, including children who have recently lost a caregiver. Dinner stretched to 3 hours as these dedicated and interesting people told us of how they have a cooperative relationship for their work and for fundraising. Robyn grew up in a very vulnerable situation, and only having been befriended by an American social worker and being an exchange student in Iowa, did she find herself. She was an activist for the end of apartheid and then spent several years working with street girls, before starting her present position. In all, 2 remarkable people who have dedicated their lives to helping others.
This morning Jamil and I and Hennie flew up to Newcastle in a Flying Doctors, 9 p assenger aircraft. The flight lasted about 45 minutes, and was quite comfortable. We were acoompanied by Dr.Graham Ducais, head of neonatology at Grey's Hospital who I met in April. Graham is one of the most passionate [ep[;e I have ever met, and the quintessential teacher. He is constantly teaching and has caused many reforms in neonatal care. Newcastle is a mining area, and Newcastle Hospital is the former white hospital in the area. The physical structure is excellent. The hospital partners in many ways with Mandanani Hospital, in the neighboring community, which was the former black hospital. Newcastle Hospital sports an excellent neonatal unit and the hospital receives all high risk pregnancies. There is one pediatrician who is helped by 4 general practitioners who minimal pediatric training. This to cover a large nursery and a 40 bed ward. The nursing staff was cheerful and cooperative.
We then drove 15 minutes to Mandanani Hospital which was truly depressing. The building was old and in poor repair, the nurses aloof and surly, and the 3 general practitioners who covered the 50 pediatric beds and nursery seemed burned out. There are no pediatricians, and care seemed poor. Such a sharp contrast in 2 hospitals so close together. Thbis seems very common here and our days have alternated between days of surprising hopefulness and depressing hopelessness.
Larissa spent her day observing adolescents to learn more about their play habits. Tonight, Jamil meets with the emergency committee of the 3 Pietermaritzburg Hospitals to discuss his experiences during our stay.
Marty
This morning Jamil and I and Hennie flew up to Newcastle in a Flying Doctors, 9 p assenger aircraft. The flight lasted about 45 minutes, and was quite comfortable. We were acoompanied by Dr.Graham Ducais, head of neonatology at Grey's Hospital who I met in April. Graham is one of the most passionate [ep[;e I have ever met, and the quintessential teacher. He is constantly teaching and has caused many reforms in neonatal care. Newcastle is a mining area, and Newcastle Hospital is the former white hospital in the area. The physical structure is excellent. The hospital partners in many ways with Mandanani Hospital, in the neighboring community, which was the former black hospital. Newcastle Hospital sports an excellent neonatal unit and the hospital receives all high risk pregnancies. There is one pediatrician who is helped by 4 general practitioners who minimal pediatric training. This to cover a large nursery and a 40 bed ward. The nursing staff was cheerful and cooperative.
We then drove 15 minutes to Mandanani Hospital which was truly depressing. The building was old and in poor repair, the nurses aloof and surly, and the 3 general practitioners who covered the 50 pediatric beds and nursery seemed burned out. There are no pediatricians, and care seemed poor. Such a sharp contrast in 2 hospitals so close together. Thbis seems very common here and our days have alternated between days of surprising hopefulness and depressing hopelessness.
Larissa spent her day observing adolescents to learn more about their play habits. Tonight, Jamil meets with the emergency committee of the 3 Pietermaritzburg Hospitals to discuss his experiences during our stay.
Marty
Wednesday, February 23, 2011
Larissa's In Service and Imbalenhle Public Health Clinic
Today was Larissa's day to shine as she presented an inservice on play therapy to 50 occupational therapists and related professionals who came from 6 locations as far away as 2 hours. Her presentation focused on many activities to help stimulate children and was fabulous. The audience was captivated and took notes feverishly. Many props were distributed which we had brought along with us. Larissa also distributed one page fact and contact sheets and had the people (only 2 males) give her wish lists of what they needed to better perform their jobs. Meg Redfern, a Rotarian here, also attended and will be heading up a volunteer group to help continue Larissa's work. Jamil and I were helpers and took pictures.
This morning Jamil and I visited Imbalenhle Public Health Clinic. This clinic serves an enormous amount of patients in a peri-urban impoverished area. We had some of the most pleasantly surprising experiences at this institution. The clinic among many services takes care of 6000HIV/AIDS patients and adds 70 new patients per day. It is open 24/7 with few doctors and a wonderful staff of nurses. The head nurse, Mrs. Banase, is the administrator of the clinic and a truly remarkable and inspiring individual. She has been a nurse for 12 years and is the youngest nurse in the clinic. She is an incredible manager of people and you can see the admiration and respect with which she is received by staff and patients alike. By the way she is the youngest nurse in the clinic and came there straight from training because she wanted to make a difference at the grass roots level. The nurses are friendly, professional and some have been in nurswing as much as 40 years. They have a maternity ward for uncomplicated deliveries, an operating theater prepared to do tubal ligations and circumcisions, great anti-natal and counselling services, and an in credible attitude to deal with the overwhelming tasks. The clinic could use a little more equipment, and some refurbishing and we will try to help with that when we return. It is individuals like Mrs. Banase who give hope that there is a light at the end of the tunnel and hope for the medical system in South Africa.
Marty
This morning Jamil and I visited Imbalenhle Public Health Clinic. This clinic serves an enormous amount of patients in a peri-urban impoverished area. We had some of the most pleasantly surprising experiences at this institution. The clinic among many services takes care of 6000HIV/AIDS patients and adds 70 new patients per day. It is open 24/7 with few doctors and a wonderful staff of nurses. The head nurse, Mrs. Banase, is the administrator of the clinic and a truly remarkable and inspiring individual. She has been a nurse for 12 years and is the youngest nurse in the clinic. She is an incredible manager of people and you can see the admiration and respect with which she is received by staff and patients alike. By the way she is the youngest nurse in the clinic and came there straight from training because she wanted to make a difference at the grass roots level. The nurses are friendly, professional and some have been in nurswing as much as 40 years. They have a maternity ward for uncomplicated deliveries, an operating theater prepared to do tubal ligations and circumcisions, great anti-natal and counselling services, and an in credible attitude to deal with the overwhelming tasks. The clinic could use a little more equipment, and some refurbishing and we will try to help with that when we return. It is individuals like Mrs. Banase who give hope that there is a light at the end of the tunnel and hope for the medical system in South Africa.
Marty
Tuesday, February 22, 2011
Church of Scotland Hospital
Today, Larissa, Jamil, and I travelled to Church of Scotland Hospital, about 2 hours outside of Pietermaritzburg, in an extremely poor area which is the world epicenter for tuberculosis. We travelled through lush areas of sugarcane, followed by barren areas where people lived in small huts amongst the rocks. We passed villages where local markets were underway. The scene and dress were very African looking with bright colors and long skirts and shawls.
Church of Scotland Hospital is fairlylarge and manned by 10 general practitioners who see all of the patients, do deliveries, surgery and anesthesiology. Night call is by 2 doctors who cover the entire hospital. We were greeted by a white physician who has been at the hospital for 25 years. There are nights when he will do a c-section, administering spinal anesthesia, doing the surgery, and if the baby is in trouble, intubating and caring for it, all by himself. He went on to tell us that they ran a full ob-gyn service, but the physicians had on there own decided not to perform abortions, even though it is legal in South Africa to perform abortions. We asked if this was based on religious considerations, and he denied it.
We were then turned over to a young physician, a general practitioner from Belgium, who had been working in this hospital for 1 1/2 years. This young woman had an interest in tropical medicine and sought a position in South Africa. She is covering a 50 bed pediatric ward on her own and doing quite well despite little support or ongoing education. She has a wonderful rapor with the nurses and children and truly enjoys her work. She lives on the hospital grounds in a small flat with 2 other women, but it does provide her security. We brought up the issue of abortion, of which she is a proponent, and she told us that the senior staff are devoutly religious to the point of believing in creationism and denying evolution. She attributes religion to their being able to work and live in these conditions for such a long period of time. She gets around the system by providing women requiring abortion with carfare to Pietermaritzburg and the names of places providing it. Dr. Janssen is a young woman who epitomizes all that is good in the medical profession.
Larissa spent the day with a young occupational therapist, who was grateful for all the help. Larissa is giving a training tomorrow in which professionals from 6 locations will be attending. She has made an excellent impression and has accomplished much.
Marty
Church of Scotland Hospital is fairlylarge and manned by 10 general practitioners who see all of the patients, do deliveries, surgery and anesthesiology. Night call is by 2 doctors who cover the entire hospital. We were greeted by a white physician who has been at the hospital for 25 years. There are nights when he will do a c-section, administering spinal anesthesia, doing the surgery, and if the baby is in trouble, intubating and caring for it, all by himself. He went on to tell us that they ran a full ob-gyn service, but the physicians had on there own decided not to perform abortions, even though it is legal in South Africa to perform abortions. We asked if this was based on religious considerations, and he denied it.
We were then turned over to a young physician, a general practitioner from Belgium, who had been working in this hospital for 1 1/2 years. This young woman had an interest in tropical medicine and sought a position in South Africa. She is covering a 50 bed pediatric ward on her own and doing quite well despite little support or ongoing education. She has a wonderful rapor with the nurses and children and truly enjoys her work. She lives on the hospital grounds in a small flat with 2 other women, but it does provide her security. We brought up the issue of abortion, of which she is a proponent, and she told us that the senior staff are devoutly religious to the point of believing in creationism and denying evolution. She attributes religion to their being able to work and live in these conditions for such a long period of time. She gets around the system by providing women requiring abortion with carfare to Pietermaritzburg and the names of places providing it. Dr. Janssen is a young woman who epitomizes all that is good in the medical profession.
Larissa spent the day with a young occupational therapist, who was grateful for all the help. Larissa is giving a training tomorrow in which professionals from 6 locations will be attending. She has made an excellent impression and has accomplished much.
Marty
Monday, February 21, 2011
Game Park and Back to Work
We had a most pleasant time on safari this weekend. We drove 3 hours North to a lovely gamepark and spent 2 1/2 days viewing girafees, elephants, zebras, rhinos and all sort of game with the exception of cats. The accomodations we stayed in were right in the midst of things with the basic comforts and magnificent views and surroundings. Hennie and Beth treated us well, cooking for us and taking us all over. They love the parks and have great knowledge of them.
This morning it was back to work. Hennie and Bill and I met and it was felt that there was still much organizational work to be done in Thokomala Nahti before actual planning of the mother's lodges could be accomplished. Hennie will pursue some fund raising for start up capital and to hire a director. Bill felt that he could accomplish further things by phone and email, and has decided to leave us tomorrow. He will be missed.
Larissa and Jamil went to observe an activity specialist and came away very impressed. We then went to attend rounds in the pediatric ICU. Very unusual and interesting cases and things we do not get to see in the US very much.
This afternoon we went to meet with the Westville Rotary Club. They presented some of their projects invovlving working with orphaned youth and population control and counselling projects. They expressed gratitude for our support in the past and were a very enthusiastic club.
Marty
This morning it was back to work. Hennie and Bill and I met and it was felt that there was still much organizational work to be done in Thokomala Nahti before actual planning of the mother's lodges could be accomplished. Hennie will pursue some fund raising for start up capital and to hire a director. Bill felt that he could accomplish further things by phone and email, and has decided to leave us tomorrow. He will be missed.
Larissa and Jamil went to observe an activity specialist and came away very impressed. We then went to attend rounds in the pediatric ICU. Very unusual and interesting cases and things we do not get to see in the US very much.
This afternoon we went to meet with the Westville Rotary Club. They presented some of their projects invovlving working with orphaned youth and population control and counselling projects. They expressed gratitude for our support in the past and were a very enthusiastic club.
Marty
Thursday, February 17, 2011
Canoe Race, Kresh and Hosptals
Today we woke early and were out of the house by 5:30 AM to see the start of the Dusi Canoe Race. This is a 60 year old, 3 day race (with legs like the Tour de France) that utilizes what we call "kayaks" and involves both paddling and running across land with the kayak on your shoulders. Part of the course runs through deep rural areas. There used to be trouble with people accosting the contestants, but since they have included some charities in these areas that are supported by the race, things have gone more smoothly.
Today we all went in different directions. Jamil started off in the tracheostomy clinic. There is a Red Cross program aimed at teaching tracheostomy home care to parents of pediatric patients. Larissa spent the entire time in that clinic interviewing the mothers, playing with the children, and again using the camera as a means of understanding the thoughts of the children. Jamil, then went to the neonatal ICU to spend time with Dr. Graham Ducais, who I had met with in April. Graham is a gifted teacher, impassioned about working in the public sector, and giving excellent care with limited staff and resources. He is most proud of a milk bank, opened within the past year as a result of years of his pushing for it. It is remarkable how dedicated and sacrificing are many of the physicians we have met.
I went back to the Edendale Valley to visit a kresh or daycare run by a black pastor I met at the meeting of the all black Rotary Club. We drove through impoverished neighborhoods and turned down an unpaved alley with wandering goats and chickens. There, in a relastively small, dilapidated house, the pastor's wife and a few volunteers cared for 75 children. The first transient arrivals arrive at 6 AM and the last leave at 7 PM. 12 of the children sleep there with a volunteer because they have nowhere else to go. The kresh receives no government funding and relies on meager donations to support itself. I gave out the smaller shoes that I had brought as well as some balloons. Like children everywhere, they smiled, waved and were delighted with the attention and the gifts. The larger of the 60 pairs of shoes I brought will be distributed at an elementary school.
We had lunch at Hennie's Rotary Club where we were welcomed enthusiastically.
Tomorrow, we leave for our R & R at a bush camp in a game reserve, 3 hours north in Zululand. Since there is no internet in the bush, my next writing will be on Monday.
Today we all went in different directions. Jamil started off in the tracheostomy clinic. There is a Red Cross program aimed at teaching tracheostomy home care to parents of pediatric patients. Larissa spent the entire time in that clinic interviewing the mothers, playing with the children, and again using the camera as a means of understanding the thoughts of the children. Jamil, then went to the neonatal ICU to spend time with Dr. Graham Ducais, who I had met with in April. Graham is a gifted teacher, impassioned about working in the public sector, and giving excellent care with limited staff and resources. He is most proud of a milk bank, opened within the past year as a result of years of his pushing for it. It is remarkable how dedicated and sacrificing are many of the physicians we have met.
We had lunch at Hennie's Rotary Club where we were welcomed enthusiastically.
Tomorrow, we leave for our R & R at a bush camp in a game reserve, 3 hours north in Zululand. Since there is no internet in the bush, my next writing will be on Monday.
Wednesday, February 16, 2011
Northdale Hospital
Before going on with today's blog, I would like to conduct some business. First, a retraction. Last night I was very tired and beside several major typos, I got the name of the hospital wrong. It is "Greytown'" not "Greyswtone." Also, it has been hard to send the notification emails from here. They do not seem to go through. Please checkfor the blogs each weekday, and I will try not to disappoint.
Today began early for Jamil and me. We attended the Greys Hospital version of our mortality conference, where they discuss deaths on the service and how they might be avoided in the future, without laying blame. In Kwazulunatal they take our version further in that they not only look for mistakes within the hospital and doctors, but, also, within the system. This is so important here, as they can determine where best to apply their limited resources to avoid deaths.
We then headed to Northdale Hospital, the former Indian Hospital under apartheid. This is classified as a community hospital which implies that there are no certified pediatricians or other specialists. This does not prevent huge numbers of patients from showing up in the outpatient department. There is a significant emphasis on "kangaroo" care for small birth weight neonates. This involves comfort and support for the mothers of premature babies to have the babies supported against their chests for feeding, comfort and control of body temperature. This conserves resources and nursing in these high risk children.
We then moved back to Greys, where we rounded with th echief of service for 2 1/2 hours. It has been a long time since I did this, and it is hard on the legs and backs. The cases were by and large very ill and quite interesting. The recurrent theme of HIV/Aids, TB, and malnutrition was very evident. Here, there was much brain involvement and other severe consequences. Most sobering was that there were several children who did not satisfy the criteria for admission to the ICU because there chance of survival was minimal, and there were limited spots in the ICU.Dadah, who was brilliant by any international standard. He discussed his choice of going into the public sector and passing up the riches of the private sector. He was inspiring, and we are all fortunate that there are people like him.
Hennie and Bill continued their work and even had a solid lead. Each day brings some good hope and we wish for that one break.
Larissa spent a successful day at Edendale Hospital working on the pediatric wards with the children and mothers. She got to interview some mothers and got to work on a photography project in which she had children use photography to express some of their feelings about themselves and their condition.
Another successful and inspiring day.
Marty
Today began early for Jamil and me. We attended the Greys Hospital version of our mortality conference, where they discuss deaths on the service and how they might be avoided in the future, without laying blame. In Kwazulunatal they take our version further in that they not only look for mistakes within the hospital and doctors, but, also, within the system. This is so important here, as they can determine where best to apply their limited resources to avoid deaths.
We then headed to Northdale Hospital, the former Indian Hospital under apartheid. This is classified as a community hospital which implies that there are no certified pediatricians or other specialists. This does not prevent huge numbers of patients from showing up in the outpatient department. There is a significant emphasis on "kangaroo" care for small birth weight neonates. This involves comfort and support for the mothers of premature babies to have the babies supported against their chests for feeding, comfort and control of body temperature. This conserves resources and nursing in these high risk children.
We then moved back to Greys, where we rounded with th echief of service for 2 1/2 hours. It has been a long time since I did this, and it is hard on the legs and backs. The cases were by and large very ill and quite interesting. The recurrent theme of HIV/Aids, TB, and malnutrition was very evident. Here, there was much brain involvement and other severe consequences. Most sobering was that there were several children who did not satisfy the criteria for admission to the ICU because there chance of survival was minimal, and there were limited spots in the ICU.Dadah, who was brilliant by any international standard. He discussed his choice of going into the public sector and passing up the riches of the private sector. He was inspiring, and we are all fortunate that there are people like him.
Hennie and Bill continued their work and even had a solid lead. Each day brings some good hope and we wish for that one break.
Larissa spent a successful day at Edendale Hospital working on the pediatric wards with the children and mothers. She got to interview some mothers and got to work on a photography project in which she had children use photography to express some of their feelings about themselves and their condition.
Another successful and inspiring day.
Marty
Tuesday, February 15, 2011
Greyswtone Hospitaql
Today Jamil, Larissa and I along with an attending went to visit Greystone Hospital, a satellite of the Pietermaritzburg hospitals serving a more rural community. The hospital is staffed by 12 physicians doing community service. These are generalists w3ho have had 2 years of internin g following medical school who are required to put in a third year, usually in more remote areas. There was a young man who was very sharp and who covers the entire pediatric service alone for 6 months before moving on to another specialty. There are about 60 pediatric beds, and his only support is a once a month visit by an attending. Otherwise he has to rely on telephone advice. Night coverage is by 2 physicians for the entire hospital which includes all specialties, emergencies, anesthesia, c-sections and surgery. Again the concept that if you do not do it, nothing gets done.
The physical plant was very nice and the nurses seemed the best we have encountered. It is very apparent to me that one has to stop and think that the patient population is so much sicker than what we are used to at home. Already, we take it for granted. The three big entities of HIV/AIDS, TB, and malnutrition are all pervasive. There was a ward just dedicated to malnutrition far beyond anything seen in the US with the addendum that many of the children on the other wards also had malnutrition accompanying other illnesses. The mothers sitting at the bedsides are frequently sicker than their kids and the social conditions are daqunting. We saw a baby who was very ill, probably secondary to some traditional medicine by a local healer. One has to bite their tongue and realize that one has to work in coordination with these healers because they have the confidence of the people. A typical African balancing act.
Larissa has been working with occupational therapists and seems to have hit her stride. We travelled with 2 young psychologists who were visiting a mental hospital near Greystone. I had a long informative discussion with them that touched on many subjects. How does one separate mental illness from cultural behavior when one is not part of that culture? How does a white woman win the confidence of Zulu men to facilitate treatment? How does one diagnose depression in a community devastated by death, disease, and starvation? The answers are difficult and I will share my limited understanding when I return. The young psychologists also brought up other interesting issues. One of them was very light skinned colored (mixed race). Under the present system in 2011 South Africa, affirmative action is practiced enthusiastically. She applied for school referencing her black origins and was told that she was not black enough. Under apartheid she was not white enough. In school, the professors were told that all blacks must pass, so it left all the competition between the whites and mixed races.
Bill and Hennie continue to work on making Thokomali Nathi a viable entity. They are now at the vicious cycle where they need a full time director to create enough viability to pursue fundraising. To finance the project they need about $30,000 US to pay the salary of the director. If anyone has an extra $30,000 or a sugar daddy in South Africa please let us know. In the absence of that, we push on beating the bushes (bad expression here).
Marty
The physical plant was very nice and the nurses seemed the best we have encountered. It is very apparent to me that one has to stop and think that the patient population is so much sicker than what we are used to at home. Already, we take it for granted. The three big entities of HIV/AIDS, TB, and malnutrition are all pervasive. There was a ward just dedicated to malnutrition far beyond anything seen in the US with the addendum that many of the children on the other wards also had malnutrition accompanying other illnesses. The mothers sitting at the bedsides are frequently sicker than their kids and the social conditions are daqunting. We saw a baby who was very ill, probably secondary to some traditional medicine by a local healer. One has to bite their tongue and realize that one has to work in coordination with these healers because they have the confidence of the people. A typical African balancing act.
Larissa has been working with occupational therapists and seems to have hit her stride. We travelled with 2 young psychologists who were visiting a mental hospital near Greystone. I had a long informative discussion with them that touched on many subjects. How does one separate mental illness from cultural behavior when one is not part of that culture? How does a white woman win the confidence of Zulu men to facilitate treatment? How does one diagnose depression in a community devastated by death, disease, and starvation? The answers are difficult and I will share my limited understanding when I return. The young psychologists also brought up other interesting issues. One of them was very light skinned colored (mixed race). Under the present system in 2011 South Africa, affirmative action is practiced enthusiastically. She applied for school referencing her black origins and was told that she was not black enough. Under apartheid she was not white enough. In school, the professors were told that all blacks must pass, so it left all the competition between the whites and mixed races.
Bill and Hennie continue to work on making Thokomali Nathi a viable entity. They are now at the vicious cycle where they need a full time director to create enough viability to pursue fundraising. To finance the project they need about $30,000 US to pay the salary of the director. If anyone has an extra $30,000 or a sugar daddy in South Africa please let us know. In the absence of that, we push on beating the bushes (bad expression here).
Marty
Monday, February 14, 2011
Greys Hospital
Today was a most satisfying and encouraging day for the team. We spent the day at Greys Hospital, the former all white hospital ynder apartheid. Bill Met with Neil McKerrow early in the day to gauge Neil's actuasl commitment to the mother lodges. Neil gave an enthusiastic go ahead and Bill seemed energized. There is still the long hard task of fundraising and hiring a local person to run the operation, but at least we have a positive direction.
Larissa was put in the company of occupational therapists at the hospital with whom she related well. She was able to spend the day with them and interact with the children. The occupational therapists seemed quite enthusiastic about the programs that Larissa brought to the table and this was gratifying. This seems like the proper avenue for Larissa to make a difference.
Jamil and I were given an introduction to the hospital as well as a better understanding of the strenghts and weaknesses of the healthcare system by the head of pediatrics. We spent some time in their emergency room and then experienced their pediatric cardiology clinic. Since Greys is a referral hospital, the wards are full of fascinating cases, and pathologies rarely seen in the US.
We all had a meeting with Neil McKerrow who better clarified our objectives and the definition of success in our mission. I think that we all left the meeting with a better feeling of the possibility of accomplishment, even on our short journey. The short of it is that we are a stepping stone in hopefully a long relationship that will have a significant impact. I believe that we are all content with this.
Tonight, too, was very special. Hennie has begun an all black Rotary club in Pietermaritzburg. It is the Rotary Club of Ugungundlovu. We all attended a meeting this evening. The club follows all of the principles of Rotary, but incorporates some of the Zulu culture to make it feel comfortable. It meets with a simple supper prepared by one of the members. Since cost is a major object, things are run tightly. There is an interesting variety of members inclucing pastors, nurses, a social worker, a farmer, and 2 men who work with refugees from other African countries. We all got to address them, and the gratitude expressed vocally and on their faces was heart warming and made me proud to be a Rotarian. This club should become a well earned legacy to Hennie and what he stands for.
The contrast between Greys and Edendale Hospitals is remarkable and is part of the problem of the healthcare system in its inconsistency. Tomorrow we travel to Greytown Hospital, a more rural Hospital.
Marty
Larissa was put in the company of occupational therapists at the hospital with whom she related well. She was able to spend the day with them and interact with the children. The occupational therapists seemed quite enthusiastic about the programs that Larissa brought to the table and this was gratifying. This seems like the proper avenue for Larissa to make a difference.
Jamil and I were given an introduction to the hospital as well as a better understanding of the strenghts and weaknesses of the healthcare system by the head of pediatrics. We spent some time in their emergency room and then experienced their pediatric cardiology clinic. Since Greys is a referral hospital, the wards are full of fascinating cases, and pathologies rarely seen in the US.
We all had a meeting with Neil McKerrow who better clarified our objectives and the definition of success in our mission. I think that we all left the meeting with a better feeling of the possibility of accomplishment, even on our short journey. The short of it is that we are a stepping stone in hopefully a long relationship that will have a significant impact. I believe that we are all content with this.
Tonight, too, was very special. Hennie has begun an all black Rotary club in Pietermaritzburg. It is the Rotary Club of Ugungundlovu. We all attended a meeting this evening. The club follows all of the principles of Rotary, but incorporates some of the Zulu culture to make it feel comfortable. It meets with a simple supper prepared by one of the members. Since cost is a major object, things are run tightly. There is an interesting variety of members inclucing pastors, nurses, a social worker, a farmer, and 2 men who work with refugees from other African countries. We all got to address them, and the gratitude expressed vocally and on their faces was heart warming and made me proud to be a Rotarian. This club should become a well earned legacy to Hennie and what he stands for.
The contrast between Greys and Edendale Hospitals is remarkable and is part of the problem of the healthcare system in its inconsistency. Tomorrow we travel to Greytown Hospital, a more rural Hospital.
Marty
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