The Last Weekend

For our last weekend in Swaziland, we decided to do some hiking within the country and additional sight seeing. When we woke up, it was a bit rainy and misty, but we decided to go up to the area anyway because there were some indoor shops/attractions we could check out if the weather didn't clear up. We drove up to a town called Piggs Peak with Sandile and Zakhele to a hiking area called PhoPhonyane Falls. There were several different trails to choose from depending on how long of a hike you wanted to take. We chose the 1 hour path and it was a nice hike with several "viewpoints" to the falls. The first was from a distance, on top of the hill adjacent to it.

Next was at the foot of the falls were you could walk all around the bottom area. The last was from above, but honestly it wasnt as good as the other two.

We were thankful the weather held out for our hike. Once we finished the path, we got in the car and drove to another acclaimed craft market in this area. They had a renowned store called Tintsaba, which was very similar to another shop we went to before that I loved (Gone Rural). They products were similar in idea, but still unique to the company, with several different objects like woven ornaments, flowers and jewelry. I got a couple of the woven flowers and I plan to use them as decoration in some way for our wedding :) Had I not already stocked up on gifts, I probably would have bought more here, even though it was a little more expensive.

We left the shops to head back toward Manzini, planning to stop at Maguga Dam on the way back. It started raining a little bit on the way, but we still decided to stop to get a look at it and to eat at the restaurant overlooking it. We got to the location at about 4:30 pm, and the restaurant was closed for the day (places here have weird hours)! So we snapped a couple pictures that pale in comparison to the falls, then got back on the road to stop for food in the capital city of Mbabane on the way. Once we got into the city (about 5:30), we found alot of those restaurants closed or closing for the night as well. So we finally found a sit down restaurant that was open til late and ate there. The food was fair, but we were so hungry it didn't matter. We were just glad to find an open restaurant!

After we finished our meal, we stepped outside and it felt like we had walked into a cloud. It was unbelievably foggy, more than I've ever experienced in the states. You literally could not see the people, or even lights, on the opposite side of the street. Apparently its a pretty common occurance in Mbabane because of the elevation. We were so thankful Sandile was familiar with the roads. I have no idea how he drove them even with that advantage! And some people were driving extremely recklessly for the conditions, which made us more nervous. But once we decended from the city, we were back in the clear and soon back to Manzini.

Sunday morning we went with our friends in The Luke Commission to the church they regularly attend. It was very much like the services in the US, except in Swazi fashion, about 3 hours long. Harry and Echo helped lead the worship team and it was fun to see a different side of them. The message was very good. I especially liked one sentance the pastor said in his sermon; "The church is a hospital for sinners, not a showcase for saints." Afterward, we went to eat with all of them and spent time getting to know them a little better. I also asked many questions in regard to returning in the future to volunteer at some clinics and brining a medical student/my soon-to-be-husband. I think he would enjoy helping in something like this, and I truely want to come back one day. It may be quite a while before that happens, and he may be done with school by then, but I whole heartedly intend to return.

We had to spend a little more time the past few days working on assignments due by this Friday so we haven't been up to much outside of our shifts. We are all getting very excited to come home. 48 hours from this moment we will be in the air in route to London! Even in my anticipation to arrive back in the states, I'm already starting to think about where my next international destination will be. I've even thought about when I will be able to come back here again and bring friends and family that would like to see Swaziland. I know, I'm getting ahead of myself! haha! But seriously, sometimes I think I missed my calling in life to be a world traveler :)

Kruger Adventure Part 2 and this past week

On Sunday morning, we got up early to go on a guided bush walk. Our guide taught us quite a few things about nature in the bush. We had to dodge alot of huge spiderwebs too. We learned about the marula fruit, which is in season right now. The animals, especially the elephants, love it. The locals actually make a "marula wine" from it and sell it on the streets. In the intestines of some of the animals that eat the fruit, it doesnt break down the pit, so it comes out whole in their feces. Our guide found some, cracked open the pit with a rock and ate the nut inside. He offered some to us, but we passed for obvious reasons. Later he even ate giraffe poop! Its supposedly edible and good for fiber intake, but I don't care if its just leaves and grass, it came from intestines of an animal.

Once we returned to the camp we packed up our things and gathered for breakfast. Look who joined us:

The breakfast was very nice. Supposedly, the meat provided was from a warthog. It tasted just like ham, which I guess it would make sense because they are a pig, so I don't know how you'd tell the difference anyway. Regardless, it was really good. After we finished, we were back on the road to the airport with a couple of scenic stops planned along the way. The first stop was Blyde River Canyon. It was a beautiful sight.

On Friday, our guide suggested we see The Potholes as well as the canyon. When we asked him to explain what the Potholes were, he said "they are holes, that are pots." And he kept giving the same explaination! After much laughter and failure to explain what it was to us, he just decided he had to take us to let us see for ourselves. It was definitely worth stopping at to see. It would be a nice place to sit and relax for a few hours if there weren't tons of people around.

We wondered around there for 15-20 minutes, then we were back on the road to the airport. When we were halfway there, we came into a town with a road block. There were large rocks thrown out into the road, as well as a cut down tree covering the entire length of the road. The tree was in flames. Many people were out surrounding the streets. Turns out, they were making a road block in protest because their town needs water. Our driver kept saying how stupid the people were, that blocking the road is only impeded drivers, and didn't do anything to actually bring them water. We didn't wait long before he turned the car around and had to find another way there. I could tell he was stressed because he had another pick-up after our drop off. But we made it there in good time, and he was only about 10 minutes late for the other people. Even though he was running late, he took the time to help us map out a different way home so we didn't have to use those horrible roads again. We thanked him for everything, we had a great time with him.

While our route back to Manzini looked way out of the way on a map, it went so much smoother than the drive up here. All paved roads, not nearly as curvy and winding. And we still made it back in roughly 4 hours. So, note to anyone who comes to Swaziland in the future and rents a car - get a VERY good updated map, and avoid the roads labelled on it as "untarred". DON'T TRUST GOOGLE MAPS ONLINE! Its great in the states, but not so much in Africa (at least not this time). Also, rent with AVIS through their website, their prices are the best and they don't charge an additional fee to take the car across the border (Europecar charged us an extra 750R last time).

This past week has been fairly uneventful. I'll admit I've been rather irritable, the stresses of being in a foreign country get to you after a while. I really miss American food. Stephanie made Lasagna Wednesday night for dinner, and it was soooo good! Maybe it tasted so heavenly because I haven't had food like that in a while, but still, it was delicious. I hope to try making her recipe sometime in the near future. Emily and I have been craving Mexican food since before Rachel left, so I plan on that being one of my first meals after I get back to the states! Don't get me wrong, I have enjoyed this trip very much and I would absolutely do it again (in fact, I plan on doing alot more traveling in the future). But I'm definitely looking forward to returning to the comforts of home very soon.

Wednesday morning and today, I rounded in the Special Care Unit, where the premature or sick newborns are kept. I have never seen so many tiny babies in my life, especially all at once like that. There are a total of 15 in the unit currently. Not one of them weighs more than 2 kg (4.4 lbs), most being in the 1.2-1.5kg range. The tinest baby was 950g, thats just barely 2 lbs! Most of them are doing fairly well considering the circumstances. Its amazing.

Each afternoon I have continued to work in the Pediatric Out Patient Department (OPD) as I have since the beginning. I am seeing patients essentially on my own now. This is the most independant I've been since starting rotations period. I have to say, I kinda like it :) While I was initially put in that position quicker than I felt ready for, it actually helped me start my growth into the practitioner I need to become. I still ask their advice on patients, but sometimes all I need from them is to sign off on my orders and scripts, and they do so without hesitation. For once I feel like I'm being useful and actually helping, rather than just taking up additional space and time. They often thank me for helping out, and once Dr. Pawelos said I've been a blessing. I don't know that I would go that far, because I don't take that much off their hands, but it was still a nice thing to hear.

Its our last weekend here, and the start of our last full week! Like I said before, I've had a great experience, but I am getting excited to go home. Its been the longest Brant and I have ever been apart, and we still have to wait two weeks after I get back until we can meet up. It sucks, but we're almost done with this long distance thing for good. I'm also looking forward to seeing my family and friends when I get back. We have lots of things to do and plan for in the upcoming months! I'm going to be a very busy girl this year. Anyway, I'm going to do my best to fully enjoy my last week without getting side-tracked by everything I have waiting for me at home. But that wont be an easy task!

Kruger Adventure Part 1 (and other updates)

Well, its been over a week and it looks like I have alot I need to update you all on! I have plenty of pictures to include in this post as well. Bear with me, its going to be a long post, but hopefully it will be pretty entertaining. Before I share our experiences this weekend, I thought you would like to hear about our most recent rural clinic with The Luke Commission. As usual, we were picked up at 7am and drove about 2 hours to the site for the day, which was another primary school. Shortly after pulling in, the children surrounded the van, peering in at us and waiting anxiously to get out.

While the team took time to set up the clinic, I used the opportunity to take pictures and socialize with the kids. I took a picture of two young boys and then showed them the image on my camera screen. Within seconds, I was surrounded by children, all wanting their pictures taken and to look at them! And it seemed that the group of kids just kept getting larger and larger. They were hanging all over me, nearly pulling me down! They loved seeing the pictures and they laughed so much. Some wanted to take a picture of me and with me, so I let a few of them, and they really enjoyed it.

As I continued to take pictures and show them after, I could feel the girls behind me playing with my braided hair. They just stroked it and pet my head, saying how soft and beautiful it was. After a while, I decided to take it down for them to really play with it. They brushed their fingers through it and were so fascinated by my hair. (All of the children in the school have their heads shaved or hair kept very short.) Even though my hair became a frizzy, knotted mess afterward, it was neat to share with them, allowing them to explore something new and different then they are used to. The rest of the clinic went about the same as the others did, except it was a bit longer and we didn't get home until 12:30am.

Friday morning we set off to South Africa to experience Kruger National Park, one of the biggest parks in all of Africa. We rented a small VW car, which once again was manual so Emily had to drive the whole way. Our plan was to drive to an airport in Nelspruit, where we would be picked up by a guide for our weekend package deal. I looked up directions on Google, which said the drive to the airport would be just over 3 hours. So we left at about 9:30am, giving us plenty of time to make it to the airport for pickup by 1:30-2pm. The first hour of our drive was entirely normal and smooth. Then the road the directions had us turn onto became a dirt road. We laughed about it initially and weren't too surprised, since we are in Africa and its not uncommon. But the road continued to get worse, and we were concerned we weren't on the right route anymore. There weren't any signs telling us the name of the road, let alone which direction we were going. Luckily I'm pretty good at reading maps and I was able to tell we were on the right path.

We got to a town where google's directions became unclear and we circled around for a while trying to find our turn. We stopped at a tourist hotel and asked a man for directions. After trying to explain them to us with no success, he offered to just hop in the car with us and we could leave him in town right before the turn. So that's what we did, and he pointed us exactly where we needed to be. He was a nice guy and I felt like we should've given him a tip/gift or something, but he was out of the car before we could offer anything, so we continued our drive. This road was dirt and rock as well, and worse than the last road. And the quality of the road just continued to decline. There were several times that I thought it couldn't get any worse, but then it did each time. There were several times that the road forked and we just had to guess which way was right because there were no signs at all.

We then got to the worst part of the road we had been on yet, it was loose dirt and ash with large loose rocks that I was sure were tearing up the undercarriage of the tiny car we were driving. Plus, it was on the steepest of all hills we had yet to climb. We felt the car struggling and there was no way to dodge all the rocks. Hopelessly, Emily just stopped the car and put it in park halfway up the mountain. Our anxiety levels had built up to the max and we had no idea what to do anymore. We still didn't even know if we were on the right road. On the Swazi phone we had I tried to call the emergency number, but the man who answered didn't seem to speak English and he just sat the phone down. I was sitting there with silence on the other line for more than one minute. I don't think I've every prayed harder in my life! After sitting for over 5 minutes contemplating the next step, a truck with a couple of border patrol workers pulled up behind us. They confirmed we were going the right way and we were almost there. Knowing that the car would not pick up speed easily to continue the climb, not to mention the numerous rocks in the way that would make it even more difficult. Stephanie and I got out of the car and started throwing the bigger rocks out of the path so that Emily could get the car going without having to dodge things. She got it going without sliding back (remember its a manual car) and Stephanie yelled to just keep going and we'd catch up at the top. The car successfully reached the top and we continued our way to the boarder. Of course, there were still very few signs and the google directions did not clearly tell us how to get to the border, but we eventually made it. At this point, we had been on the road for over 4 hours, and we were only halfway there.

After crossing through the border, the roads were paved the rest of the way, however it was very curvy and still climbing up mountains. But we were just happy they were paved, so we didn't complain. The scenery was beautiful, and two large Baboon's ran across the road just feet from our car! I wish I had gotten a picture, but it happened to fast. I also wish I had taken a picture of the road before we crossed the boarder just to get the point across on how bad it was, but I had other things on my mind (like getting out of there)!

Our next dilemma was that we were obviously going to be late for our pick up. We tried to get there as quick as we could, but there wasn't much we could do. By the time we finally made it to the airport, after much more bad/incorrect directions from google, it was almost 4pm. I was sure that the person that would pick us up would be gone by now, since we were about 2 hours late. But to our surprise, he was still waiting! It took us a little while to find him, with some help from other tour guides, but he was indeed still there. We explained to him what happened and continued to thank him for waiting. We were the only people he was to pick up so we thankfully didn't hold up anyone else. From the airport, we rode another 3 hours in the van to our campsite. Upon arrival he took us on a short sunset game drive, which would have been longer had we made it on time. We still saw a good amount for a short drive. We actually witnessed two giraffes mate, which they said is very rare to see. I managed to get a decent picture of one, even in the dark.

When we went back to the camp we enjoyed the best dinner I've had my whole time in Swaziland and we socialized with other people from all over the world staying at there as well. We met people from London, Canada, France, and even Israel. After such an eventful day, we were ready to settle in for bed as soon as the took us to our tree house/hut. It was really cute, but there was not a full seal from the outside so there were plenty of bugs, which was understandable. I slept under mosquito net for the first time ever, and it wasn't as bad as I thought it would be. It was alot like what I imagine the princess canopy beds would be like. The staff warned us that in the morning we need to bring all food back to them to be locked up, because monkeys WILL find their way in and will destroy things to eat the food, no matter how well you thought you hid it.

Being in a new environment with lots of new sounds and movements that get your attention, we all slept pretty lightly. I woke up several times in the night, and so did Emily and Stephanie. One time Emily got up to go to the bathroom and her walking woke me up because it shook the tree house. I was still half asleep, then all of the sudden Stephanie screamed monkey sounds!! It scared Emily and I both to death (Emily said she felt her knees buckle and go weak!). Turns out, Stephanie had been woken up by the sounds of a monkey earlier in the night. When she heard Emily get up and rummage through her things she thought we had a monkey in the room with us. The only thing she could think to do to alarm it to leave was yell monkey like sounds. We had a good laugh over that in the morning! It still makes me laugh out loud just thinking about it.

We got up early in the morning to meet up with our guide and head to Kruger National Park after enjoying a nice breakfast. We spent the entire day inside the park, and saw alot of animals, mostly from a distance. We saw more giraffes, zebras, antelope, wildebeest, elephants, buffalo, baboons, and a hippo. We even saw wild dog, which apparently is pretty rare, but I couldn't get a good picture because they were under a large bush/tree for shade. I was disappointed that we didn't see any African cats though. We all decided that a visit within Kruger park should be longer than one day because the place is so big (its bigger than the nation of Swaziland). It was also very hot out, reaching at least 40 degrees C/104 F, but we still enjoyed our full day safari.

We returned to camp as the sun was setting and again had a tasty dinner. Once we went back to our hut, we cleaned up and went to bed early. Since this post is getting long, and I still have so much to share, I'm going to split it up into two parts.

To be continued...

A low key weekend

After an eventful, tiring week, we decided to hang around here for the weekend and just enjoy some local sites. Friday evening we decided to go check out a local restaurant with Zakhele and Sandile. The one we originally had in mind was closed, so we stumbled upon a small "Latin" restaurant. The funny thing is, not a single item on that menu qualified as the "Latin" food we had in mind! There was German, burgers, Italian, and even Chinese, but no Latin dishes. Regardless, the food was very good and a nice break from our normal cafeteria dinners. It was also very cheap. Including the tip, I paid roughly $12 for my food, drinks and side salad. We had a good time laughing and talking about Swaziland traditions and customs. One tradition we learned about is the dowry expected from the groom to the family of the woman he desires to marry, usually in the form of cattle or other goods. At one point, man who overheard the conversation approached the table to greet us. He referred to himself as a "whitey living in Swaziland" and jokingly offered the guys 35 cattle to buy all 3 of us as wives! Thankfully the guys didn't take the offer!

The next day we decided to check out a local place called Malandela's. It is a restaurant, bed and breakfast, and "House on Fire," a venue for music and events. In May they host an annual music and arts festival named Bushfire. It was so pretty and unique, with gorgeous surrounding scenery. The grounds are also available to reserve for wedding ceremonies. So change of plans, Brant and I are getting married here:

Just Kidding!
But it would be fun to consider for a future anniversary/vowel renewal ceremony.
There were several nice shops there that sold goods made by the people of Swaziland. My favorite store was a place called "Gone Rural" and they had all kinds of woven home goods, from baskets to place mats, and coasters to floor rugs. I could easily have spent a ton of money there to stock up cute things for our future home! I did buy alot of goodies there to bring back as gifts. The products were also very reasonable priced. We ate a late lunch at the restaurant there which was also very good.

After we explored everything they had there, we decided to take Stephanie to see the Mantanga falls which Emily and I visited earlier with Rachel. The water level was higher than the last time we were there because of the rains we experienced a few weeks ago. You could also tell there had been flooding and where the water swept away the short path we used before to get to the falls. It was still as beautiful as it was before, and also just as relaxing. I walked a little ways away from the group, closer to the falls and sat on the edge of the stream with my legs in the water. The waters edge is very shallow, making it easy to wade in or sit on a rock safely and enjoy the cool, refreshing water. We found out that Sandile is quite the worrier! He would NOT get near the edge of the water, and I apparently he was worried about me being just 20ft away from the rest of them and partially in the water. As we were leaving he told me I was very brave. I laughed and told him if he thought that was brave, he had no idea! It was sweet of him to be so concerned for our safety, and I appreciate him looking out for us. We spent about an hour there and then headed back into town before it got dark. When we got back we watched The Chronicles of Narnia: The Lion, The Witch, and The Wardrobe, which Stephanie had brought with her on DVD.

Sunday morning we went to the Nazarene church with Sandile, which is associated with the hospital so it is right next door. Once again, lots of good music and excellent vocal talent. We recognized the songs they sang because they were hymns we sing at American churches. The first time through they would sing it in SiSwati, and then repeat it English. It was really nice and I enjoyed it. This service was thankfully shorter than the others we had been to, running right at 2 hours. However, most of it was spoke in SiSwati and not translated so we don't really know what the sermon was about. That afternoon we decided to go to one of the nice hotels and enjoy the pool. It was overcast, but still warm enough to be comfortable. I enjoyed studying poolside for a few hours, and was happy to have time to relax. We successfully caught a Kombi ride home all on our own (which is a first!) to make it home in perfect timing before it got dark.

Today I started out the morning in the Pediatric ward as usual, and then spent the rest of the day in the outpatient department. It was a little bit slow, but I got to see a few patients, and of course some precious little children. I still have a lot to learn, but I'm getting there. I'm glad I have chosen to repeat the Pediatrics rotation back in the states because medicine is practiced very differently here. I am learning alot of good stuff that I wouldn't have the opportunity to see back home, but I still need to learn the basics by American standards. We were joined today by a group of students from the states, many of which are from various towns in Ohio and Kentucky. Its a small world! I haven't gotten to know any of them too well yet, but I have seen them around.

That's all I have for now. This week will be more of the same in Pediatrics, and we will go out with The Luke Commission again as well. On Friday we will be going to Kruger National Park for a weekend packed full of more Safari adventures and sight seeing! We are pretty excited about it. Can't wait to let you know how it goes!

The Luke Commission and Pediatrics thus far

I didn't realize it had been a week since my last post! I kind of neglected my blog a little bit, sorry everyone! I apologize in advance for the length of this post. Anyway, it has been a very busy week for us. Sunday, Stephanie arrived safely after a minor mishap at Johannesburg airport that caused her to miss her flight to Swaziland, but was bumped to another flight leaving just a few hours after her original one. Otherwise, the day was pretty low key. We took her to eat traditional Swazi food (variety of cooked meat and pap) and then spent the rest of the day letting her get settled in.

Monday we went out to a rural clinic with The Luke Commission. They picked us up at the hospital at 7am and took us to their base camp while the crew packed up the trailers with supplies. When we got there, their dog greeted us timidly but immediately became super friendly when she realized we were animal lovers. She was so sweet, and LOVED her belly rubbed. Those of you that know me well know it brought me great joy to pet her, I've missed loving on animals! She was pretty dirty, but I really didn't care about that. Soon we were on the road to the first clinic of the year for The Luke Commission (TLC). This group is headed by Harry and Echo VanderWal, a husband and wife who are a doctor and PA respectively. I think they are originally from Ohio; they both graduated from Cedarville University. They have 4 boys (one set of triplets!), and one little girl "in the oven." There are two nurses from America with them for the long term as well. Rebekah is from Corbin, KY and Melody from a small town in Iowa. They both graduated from Cedarville as well. They are assisted by a large group of Swazi staff that do everything from translation, set up, clean up, triaging, counseling and more. Its really a great set up, and these clinics are much needed in the rural areas of Swaziland.

We drove about 30 minutes out to the site, which was a primary school. So many adorable kids! I'm sorry I do not have pictures from this day, I forgot to put my memory card back in my camera after uploading my last set of pictures! Once things got set up and ready to go, we started out helping Harry quickly look over all of the school children for Tinea Capitus (ringworm on the scalp), scabies, and any other skin abnormalities we could treat. We also had a translator with us so if any had additional complaints, such as ear pain. There were many kids that needed treatment and they were prescribed free medication from the pharmacy for their problem, as well as free vitamins and more. After we finished seeing the children, we went to our stations to start the clinic officially. Emily, Stephanie and I were placed in Triage where we took blood pressure, blood sugar, and performed free HIV testing for those that requested it. The test was a bit tricky to do at first, but we got the hang of it. There were alot of people that came through as well, with over 100 that we tested for HIV.

Around 2pm, Echo sent for one of us to join her in the Surgery department, where they were performing Male Circumcisions. Male Circumcision for all ages is being heavily encouraged right now because it decreases the chances of contracting and spreading HIV. This year, TLC decided to offer circumcision to males who attend the clinics, as long as the cases were uncomplicated. It is very difficult for people in the rural area to make it all the way into town for a surgical procedure, on top of the costs of getting there, so they often have not had the procedure done for that reason. I took the opportunity to join her and I'm very glad I did. I got to first assist in two of the surgeries! (both were pre-adolescent boys around the age of 12) I had also never seen a male circumcision on anyone over a week old, so it was a good learning experience. Due to resources, the patients only receive local anesthesia and a dose of Tylenol with codeine, meaning they are awake for the entire procedure. There also was no screen to shield the patient from looking at the process taking place. Some of them get really scared and upset, even though they are completely numb (like the first one I assisted in). But others handle it well as long as they don't look. The second case I assisted in even fell asleep during the procedure! Echo said he got the award for easiest surgical patient of the day!

After the last case was finished, the crew started packing up and getting ready to go home. There was alot more to it than I ever would have realized without attending. Some of it gets pretty complicated, such as disposal of sharps and biohazard waste. But they do a great job of managing it all. When we finally returned from the clinic to the hospital, it was around 8pm. And that was a short clinic day for them! They work so hard to provide for the people of Swaziland and I admire their dedication. Exhausted we went to bed fairly early to prepare for our first day on a new rotation. I met Dr Pawelos in the morning and started off doing rounds in the Children's Ward. The children are so precious, and several have just broke my heart. I have learned alot about malnutrition this week. In the afternoon, I went to the Pediatric out patient department where I learned alot as well. In the notes my family sent with me for the trip, my Mom had included some smiley face stickers. I decided to bring some with me to give out to the kids to help them warm up to us and not be so afraid. They were a big hit! Their sweet smiles after receiving them were the greatest. Most of them understood what to do with them, but a couple ate them! It cracked me up.

Wednesday we joined TLC again for another rural clinic. This time it was about an hour and a half drive to the location, which was another primary school. I remembered to put my memory card back in my camera so I got some pictures this time! The morning went the same as Monday, first set up, next checking all the school children and then we went to triage. There were many more people seen at this clinic and the day was longer. The people of the village brought us food for dinner as a thank you for visiting them. It was chicken and rice as usual, but it was much better than the hospital's. Thinking back, I probably shouldn't have eaten it though. Oh well. They gave Emily and I an extra bowl each for some reason. We didn't want to waste it so we started to eat it too and noticed about 5 children standing at the window looking in at us. We looked at each other and immediately had the same thought, so we gave it to them. The way children accept things here are very respectful and sweet. They cup their hands and somewhat curtsy or bow when they are given something. Very different from American children! It warmed my heart to share with these kids. I love seeing them smile (side note - most have surprising nice and naturally straight teeth!)

The school kids lined up in the school yard before we quickly check them.

Just as the clinic was wrapping up and starting to pack things in the dark, a man in his 70s was brought from the village complaining of sores. He had severe HIV, neuropathy, and seemed to be bed-ridden. When we took him out of the wheelchair (having to lay him on the concrete with nothing more than his own blanket) we undressed the wounds to examine him. He had the worst decubitus ulcers (aka bed sores) I have ever seen in my life, and will probably ever see. There were several on both heels, legs, and ankles revealing tendons. They were also severely infected. The largest ulcer was on his buttocks, over the sacral region. It was as large as my whole hand, and so deep you could see differentiation in the muscles where they attach to the spine. It was horrendous. After tending to the man as best as we could, we sent him home with medications, extra dressing and instructions. There wasn't really anything else we could do for him there. Shortly after, the crew packed the rest of the things up and we were back on our way home. This time we got back to our room around 11pm. We were very tired but still had a great day.

Thursday and Friday I was back to working Pediatrics at the hospital. So far I really like it. This rotation has a very different dynamic than my last one! They actually do physical exams on the patients, which was very rare in Internal Medicine here. I know part of it is because the children can't always tell you whats wrong and you will find more on exam, but still. I've actually got to start seeing patients myself now, which is a big step up from the last rotation. My preceptor is really pushing me to start seeing patients on my own in the out patient department! I'm excited, but there's ALOT I need to learn before then. It doesn't help that the drug formulary here is different from that in the states. I really need to get the hang of Pediatric dosing as well.

I'm going to end this post here since it is getting pretty lengthy. I'll make a new one soon about what we've been up to this weekend.

Soccer and a Swazi Wedding

Before I talk about the title, I guess I should catch you up a little bit. We said goodbye to Rachel this week as she went back to the US. It was sad to see her go, and it has felt a little odd without her here, like we are missing someone. But I know she's glad to be back with her family and fiance, and I'm glad she made it safely. We'll be picking up another classmate, Stephanie, at the airport today to join us for the rest of our time here.

This past week we were at the Antiretroviral (ART) Clinic, which is where HIV+ individuals receive treatment and free medications. The first day there, we saw alot of Kaposi's Sarcoma and chemotherapy treatment for the cancer. Kaposi's is almost exclusively a cancer that develops with HIV, and can manifest anywhere in the body, most commonly the skin and mouth. If treated with chemo the prognosis is generally pretty good. The variations in the forms of "lesions," as they call them, were interesting to see. However, the rest of the days there were excruciatingly, mind numbingly boring. We sat and watched the doctor talk to patients, refill medications, and run all over the place getting hardly anything done. Rarely, if ever did we get to do anything with the patients. Several times he said "Wait here, I'll be right back" and was gone for over 30 minutes, and all we could do was sit there, not knowing what to do. It was very frustrating. With the combination of that and other irritations building, I gave way to my emotions. The spoiled American in me reared its ugly head and threw a bit of a temper-tantrum. I wont go into details because it was minor and stupid, and only Emily and Zakhele were there to witness it. It didn't last very long though, and I immediately felt awful about it. I'm trying to keep things in perspective, but its not always easy.

Anyway, enough of that. Friday night we went to a double header soccer game - or football, as everyone but the US calls it. We watched some of the local professional teams play and it was a fun experience. As far as talent and speed goes, it wasn't as good as what we saw in the world cup, but I had never been to a professional football match so it was neat. The environment was much more open and laid back than any American sporting event (security was pretty light, and you could easily go down around the field if you wanted). The crowd was pretty fun to experience, very similar to the normal sporting crowd, with a Swazi twist. They loved to sing and dance, and there were several Vuvuezuelas (the strange, loud horns that caused problems at the most recent World Cup). There were alot of drunk fans too and just watching them was hilarious.

I have better action shots, but I thought this one gave a better view of the arena and atmosphere.

Saturday morning, our friend that took us to the game park invited us to his cousin's wedding. Honestly, we felt like Wedding Crashers since we didn't know the bride and groom, or anyone else there for that matter! Plus, we were the only white people there! Surprisingly, much of the ceremony was similar to American weddings, including the vows, the ring exchange, and the wedding party. There were several cultural variations of course, but it all felt very familiar. In typical Swazi fashion, it was a very long service (about 3 hours before the reception portion began). It made me even more excited for my wedding with Brant coming up in less than 5 months! I can't wait to marry him and spend the rest of our lives together.

Exchanging rings

There was lots of music and singing, I was particularly impressed with a choir they had sing a few songs. I was able to capture a video of some of their singing, if anyone is interested to see it just ask. It will probably take a long time to load on because of our slower internet but if I have enough demand I'll try it on the next post. Side note- I have seen so much raw vocal talent in this country. American Idol has nothing on Swaziland!

After the wedding was over, we decided to go see a movie. This too was a very familiar feeling, nothing much changed by the culture. But it was also at a touristy mall so thats probably why. We watch the Sherlock Holmes sequel (they were a little behind on what movies they were airing). At first I wasn't to excited about the idea of going to a movie here (after all we are in Swaziland, and theres lots to experience) but I really enjoyed the movie and I'm glad we went. It was a nice way to relax for a couple hours. 

This was our last week with Internal Medicine/Infectious Disease. This week, I will start Peds, and Emily will start OB/GYN. Stephanie will do the rotation we just completed. So now we will be all separated and on our own. It will be a bit of an adjustment for Emily and I because we have been doing all our shifts and such together, but I think we'll be fine. I'm excited to help care for the adorable children of Swaziland :) We also plan on going on more rural clinics with The Luke Commission. We are planning on going with them twice this week. I'll let you know how it goes! If you are interested in learning more about them in the mean time, their website is http://lukecommission.org/

Oh, I almost forgot! Remember the boy from my previous posts with severe Stevens Johnson Syndrome and additional infection? We hadn't seen him in several weeks because he was transfered to the surgical ward for treatment. Dr Costa told us Friday that the boy made a full recovery! I was so amazed and happy for him, I wish I could have seen him before he was released to go home! I thought those of you in the States that may have prayed for him would like to hear the good news :)

St. Lucia, South Africa

This past weekend we rented a car and drove about 4 1/2 hours to St. Lucia, South Africa. The only cars available to rent were manual drive and luckily, Emily knew how to drive them. Rachel and I felt bad that she had to do all the driving, but there was nothing we could do about it. Down here they drive on the left side of the road and everything is in kilometers instead of miles, so that was quite an experience! The speed limits are really odd, changing from 100 km/hr to 60 km/hr quite rapidly and its not always clear what speed limit you should be going. In the states, alot of these roads would have been 55 mph. So guess what? We got a speeding ticket, haha! As we were coming down a hill, following a truck who was also speeding, there were a couple police cars stationed at the bottom. One officer was watching through video the speed at which cars were coming down the hill, then one of the others would step out in the middle of the road and flag us to pull over. They stopped us, the truck in front of us and about 2 more cars at the same time. Emily had to step out with her license and go to another officer that showed what they clocked and then wrote out a ticket. We were going 79 km/hr in a 60 km/hr zone. Rough conversion, 60 km/hr is about 37 mph. Which seemed like crawling on that road. And just after where the police had stationed the speed limit changed to 80. It was kind of crappy, but the fine for the ticket was 60 Rand (which is roughly $7) so we just split the cost and went on our way. It was kind of a joke really! Even the ticket was written on old fashioned carbon copy paper.

The rest of the way we made sure to watch the speed limit closer and we followed the directions we had written down from google maps. We didn't get lost at all either. Although, crossing the boarder into South Africa was kind of sketchy. The road to get to the boarder station was a dirt road with few signs telling you where you are going. The facilities didn't look all that impressive either and directions of what to do were confusing. But we made it through just fine.

Once we arrived we booked into a hostel called Stokkiedraai for $15 per person. I guess its the off season because no one else was there. It was like we rented a whole flat to ourselves. The ladies at the front desk were nice, but pretty interesting. One of them, with the worst smokers voice I've ever heard, was very proud of her pet pig named Bacon, which was HUGE and apparently sleeps in bed with her. She was even recieving presents in the mail for its first birthday and showed us how she gives it kisses. It was strange, but they were still nice. After getting our things inside, we quickly changed into our swimsuits and headed to the beach! To get there we had to drive a couple miles to beach access. These beaches are "untouched," meaning there are no hotels, restaurants, homes or bars on the beach. The only building of any sort was a small bath house next to the parking area. The beach wasn't crowded like popular beaches are either. It didn't really feel like we were still in Africa.

It was a perfect day for the beach. Clear, blue sky, and nice warm weather. The water was actually quite cold, and the waves were very large so we didn't do any swimming. The waves were strong enough to knock you down if the water was up to your knees (it happened to Emily!), so we mostly just waded in the waves that washed up onto the sand. We stayed out there for about 2 hours or so then decided to head back in. I guess in our excitement to get to the beach we did a poor job of applying our sunscreen. I completely forgot my legs until I got there and was sandy, and thought "ah, they probably don't need it." I couldn't have been more wrong, they got FRIED!!! Even areas that I did apply sunscreen to got slightly burnt! I was pretty mad at myself because I know better, but it was too late. I'm still hurting!

That evening we grabbed dinner at a seafood restaurant across the road from our hostel. It was pretty good and it was nice to eat something different for a change. The hospital we are staying at provides us meals, which at least once a day is the same Chicken and rice dish. Its not too bad, and I love Chicken and Rice, but still, change is welcome after eating it almost 20 days straight! We ate fish and "prawn" which is what they call shrimp. They also cook it VERY differently. They just slice down the back, without shelling it, cook it and serve it to you. Head, legs and all still attached. It was really good, but difficult to get the meat out of. And it was extremely buttery so it was kind of messy. I also enjoyed a couple glasses of wine for less than $2 each (which is an awesome price!). After we ate we walked around the town and looked at little shops and markets. They sold fresh pineapple on the street so we bought some. It was very good! Better than any I've bought in store, and it was 10 rand, which is about $1.20. Once it got dark, we went back to our room, watched a little TV for the first time since we've been here and then called it a night.

The next morning we woke up about 6am and decided to swim in their pool around 7. It sounds crazy, but the sun had been up for more than 2 hours at that point and it was already quite warm. Assessing our sunburns, we decided to wear our clothes to the beach, just to go look at it and enjoy it a little more before leaving. This time we drove down to the Estuary (where the river meets the ocean) and walked around for a bit. After we had our fill of the beach, we ate an early lunch and headed back to Swaziland since the rental car was due back by 5pm. We made our way back without any problems and ate some chinese food at the mall. The internet wasn't working very well last night, if at all, so we didn't get to talk to our families and loved ones to update them on our weekend. But its back in full strength today so I'm thankful for that.

This week we are working in the Antiretroviral clinic, where individuals with HIV receive their medications and treatments. The doctor we were with today was very nice and tought us alot. Even after he finished all the patients he sat and answered many questions that we had. Anyway, I need to get to some assignments that are due at the end of this week that I've been putting off. I honestly kind of feel like I'm on vacation instead of rotations!

A few rough days, but finally some sunshine

Dr Costa set us up to do shifts in the ER all week, where we could get learn procedures and practice ones we already knew (such as suturing, I&D of abscesses, Lumbar punctures, and starting IVs.) The first day we mostly just watched and assisted the ER doctor. There were several lacerations from stepping on a broken bottle or something of similar nature. We watched her do a lumbar puncture and she walked us through the steps (which are fewer than in the US because they don't have access to tubing for measuring initial CSF pressure). We also were rebriefed on how to start IVs. The doctor told us it was a little slow while we were there, and the busiest time was around 7pm. So we decided that Tuesday we would work from 2-10pm. We were excited to put our skills to use and practice our technique!

Monday afternoon it started pouring the rain, which lasted into the night.When we woke Tuesday it was still pouring. The rain remained a steady downpour until Wednesday evening. Due to this, the ER was VERY slow. There were several asthma attacks and one little girl with a second degree burn from boiling water, but that was basically it. Needless to say, we were kind of disappointed because we sat around all night. We did make friends with a young doctor on call who spoke very good English. He taught us alot and quizzed us on things too. He was very helpful and our time with him seemed to make the night a little better.

The way the ER functions here is (obviously) somewhat different than in the states, but not necessarily in the ways you may think. We've noticed that often times, the doctor may leave the ER and be gone for an hour or so at a time. The nurses would continue work as usual, even doing sutures and I&D on their own. We noticed a young girl come in with a large cut on her face while the doctor was out. One nursing assistant immediately started prepping her for sutures. Emily asked if she could do it but he ignored her and did it himself. I cringed as I watched him suture her up. He was doing a very poor job and it really bothered me. For the size of the gash, I would have put at least two more stitches in than he did. But she was a trooper. She didn't cry and she barely flinched when he injected the numbing agent into the wound (which is the part that hurts the most). I have been carrying around Jolly Ranchers to snack on, and when we have had a kid come in for those procedures I usually give one to them when we finish. She definitely deserved one for being so good!

We left that night feeling a little frustrated but we were hopeful that Wednesday would bring somethings we could participate in. But the rain continued, and so it was still slow. When there were patients to see and things to do, the staff ignored us. This is when it got really frustrating. We tried to be more forward and remind them that we can do somethings, just let us know when you need us. We even tried to keep asking questions about patients, but the doctors were short with their answers. The way we were being treated made us feel like we were a nuisence, or completely invisible. One nurse in particular, that we will just call Bob, was really rude to us. He started on some sort of rant about keeping masks in our white coat pockets (which the doctors were doing as well) which then turned into some crazy lecture that made absolutely no sense. Part of it was saying "you Americans don't eat" and "if you don't eat, you will get TB. Thats why I'm 100kg." I was getting pretty aggitated with him as this point. After our lunch break, a boy came in with an abscess on his hand, where he was missing a few fingers. The doctor was still gone so Bob started prepping him for I&D, and Emily asked if we could to it. He said "No, I am doing it." She politely told him that we know how to do the procedure and he responded with "I will not allow you to do it." I was LIVID. It has been a very long time since I remember ever being so mad at someone. Luckily, just as he was about to start the procedure the doctor came back and stepped right in to do it while we watched. After he finished we tried to ask the doctor a few things about the boy (like what he would be prescribing) but again we were ignored. We were so angry that we just left. Yes, we walked out in the middle of our shift. Its not like anyone in the ER cared anyway.

We went over to the OPD in hopes to find our doctor friend from yesterday to spend a few hours with, but not a single doctor was there either. To our relief, we finally found Dr Costa with some patients and sat in with him for a little while. When he had finished seeing patients we gently informed him that we were being ignored and not allowed to do anything. So he said to meet him in the morning tomorrow and we'll work something out. In the morning he made a few calls and just reminded the doctors we were coming and want to practice doing procedures. He even called Bob directly and told him we need to do procedures. We went back to the ER where we found that a different doctor was working today and she was very receptive to us. Her name is Dr Sigwadti and she is from Zimbabwe (I've learned that there are alot of people here that are originally from Zimbabwe). Since the sun came back out, patients were coming in more frequently and we got to do them ourselves finally! We got to do at least 2 procedures each. The other doctor on duty was also nicer to us yesterday than he was in the past. We saw a 3 month old baby come in and he asked which one of us like kids. I said I did, but it turns out it was a bit of a trap. I got suckered into draining an abscess on this poor baby girl. It went well though, and I reminded myself she's probably too young to remember the trauma of this event.

The next procedure I got to do was suture a laceration on a 7 year old boy's ankle. This however, proved to be quite a task. He was a fighter!! It took four people to hold him down while I sutured and it was still difficult for them to hold him. One male nurse had to sit on him. I could hear the boy slapping, punching, and spitting at the others holding him down. Even after the numbing medicine had kicked in he still kept fighting strong. I think he was just mad at that point. Considering what I was up against, I feel I did a decent job closing the wound. It wasnt perfect, and I probably would have done the stitches a little closer, but it needed to get done fast. Once we finished the bandage we let him up and he chased the male nurse through the ER, still hitting him!! This sounds mean to say, but at that point it was actually kind of funny! Instead of giving the boy candy, I gave the nurse a piece for what he had to go through!

Dr. Sigwadti complemented us that we are actually quite good at the procedures. It was nice to finally feel helpful and appreciated. We were thankful to finally have a good experience in the ER. We are going to work evening shift tonight because we were told alot comes in on Friday nights. This is Rachel's last weekend with us :( It feels weird that she's leaving already, we've had such a great time with her! So tomorrow we are getting up very early and heading to South Africa to see the ocean and hang out at the beach! The hostel where we'll be staying doesn't have internet so after tonight, I probably wont be back on until Sunday evening. I feel like I should end this blog with a good picture since alot of the content has been negative. So here's a nice group shot of us:

From left to right: Emily, Zakhle, me, and Rachel. I'm laughing because the girl taking the picture said "I'm tired of "cheese', say BACON!!!"

Have a good weekend everyone!

Safari and more

Saturday we went to Hlane, which is one of Swazilands "Big Game Parks." It is the one where the king's lions are kept. The total costs of getting in to the park and the guided tour was roughly $35. This place is really nice! They have camping spots available or small guest houses (fenced off from the animals of course!) I would love to stay there the next time I come to Swaziland. At the base camp there is a small restaurant and bar with a view of a watering hole where rhinos, hippos and elephants were cooling off. The only thing separating the two areas was 2 lines of barbwire "electric" fence (I'm not convinced it was on though). We were able to walk the fence line for a good distance, and got to a point where a herd of elephants were passing by fairly close to us. We got excited and were taking pictures. I guess we were being loud, which apparently upsets elephants. The next thing we know, momma elephant was charging toward us!!! I honestly thought she would plow through the fence, but luckily she stopped. Biggest adrenaline rush of my life! We all laughed about it so much back at base camp. It was a scary event at the time, but now its an awesome story. Not many people can say they were charged by an elephant (or atleast are alive to talk about it!)

The guided tour was great! We got VERY close to animals. First we came across a lone elephant, that seemed to be much friendlier. He gave us quite a show, getting pretty close to the land rover (about 30ft) and even bathing in a mud puddle for a long time. It also seemed he was following us as we slowly drove away like he wasn't done showing off! Soon after that we noticed something lying beneath a small tree near the dirt road. Sure enough, it was a male lion napping in the shade! I am not exaggerating when I say this: he was roughly 20ft from the rover. Less than 10 yards! He opened his eyes due to the sound of the truck, but didn't attempt to get up.

Zoom was NOT used when I took this picture, and I left the ropes from the side of the rover in the shot to give perspective of how close we were to him.
We sat there in awe of this lion and how close we were to him. Eventually he lifted his head, but still did not seem threatened by our presence. For at least a minute I just stared into his eyes. It was the most terrifying and exhilarating, yet almost soothing thing I had ever experienced. As he seemed to stare back at me, his demenor was so peaceful and calm. It was absolutely amazing.

Throughout the rest of the tour we saw many more elephants, plenty impala and antelope, a few rhinos, giraffes, warthogs, and one lone zebra. It was a great ride. Once we returned, the guys, which had stayed back at base camp, had cooked chicken for us over a fire. It was possibly the best chicken I've ever had! We also ate some potato chips and Pap (the white rice-like dish I had mentioned in another post but didn't know the name at that time). After we finished eating we headed back to Manzini and called it a night.

The next day, Zakhle took us to church again, but this time we went to the one he grew up in. It was drastically different from last Sunday's experience! It was in a very small concrete building in the middle of a rural community. The people there were so very friendly, many of them welcoming us with hugs. Although the service was almost 3 hours long, I liked this church better than last week. One of the lady's had a daughter who just recently started in college in Iowa. She asked if we could put us in her suitcase and take her with us! (jokingly of course) This church also had quite a few talented singers leading the music. One tiny girl (I think she was smaller than me, but I don't really know) had a surprisingly powerful voice and it blew me away! She couldn't have been more than 15 years old. The drummer, which was also awesome, was only 8! We plan to go back again at least once.

After we left church we headed to the Swaziland Cultural village and falls. They have a tour where they do traditional dances and such. However, we had to walk a very long way to even get to the entrance gate so by the time we made it we were a little late. We decided that the main thing we wanted to see anyway were the Mantenga falls so we paid a small fee to enter and walk to it. It was still another 1.7 km walk to them, and had I known I would be walking this much all day I would have worn better shoes! I also would have worn my bathing suit had we known we were allowed to swim too. But that didn't stop Rachel and Emily, they swam in their skirts! The falls were beautiful and relaxing, I can't wait to take Brant back one day. They also have camp grounds and huts within the village that I think would be nice to stay at as well.

Over all, we probably walked over 10 km that day. We were exhausted! Surprisingly, I'm not as sore as I thought I'd be either. My body was totally and completely worn out, but it was worth it! This week we will be working shifts in the ER where we will get to help with procedures like chest tubes and lumbar punctures. The doctors in Internal Medicine here don't really do procedures, they just send the patients to the ER to have it done there. Yesterday we just observed, but today we are working evening shift when its busier so we should get to do more.

Thanks for reading. Have a good day (where ever you may be!)

I'm really bad at coming up with creative titles.

Sorry its been so long since the last post. Time has gone by faster than I thought! Tuesday was pretty uneventful, we just did rounds and OPD (out patient department). Wednesday we went out to a rural clinic with a couple nurses from the ART clinic. ART stands for Antiretroviral Treatment, which is for HIV+ individuals. Originally we were going to be with a doctor, but that day the ART clinic at our hospital was understaffed due to a family emergency, so only the nurses went. We were told they leave at 8:30, but we didn't actually leave until 10:30. Then we had an hour drive there, half of which was on a rocky dirt road. It was nice to see the country side but I was again thankful I had taken Dramimine because it was a rough ride. Once we got there we observed their encounters with about 6 patients for management or initiation of medications. And then we drove back home. I took pictures during the drive and attempted to capture what some of the roads were like.

The small road you see in this picture is what we had just driven on, we were mounting a hill at the moment so it gave me a chance for a good shot.

This is also a shot taken after we had just driven over it. This bridge/dam was nice compared to others. The one below isn't very good because we were bouncing around and there was something on the dashboard reflecting on the window, but it puts the size into perspective. 

On our drive back we passed a lot of police officers, then several officers on motorcycles flagged us to pull over. A large caravan of nearly 30 vehicles drove by us, and the nurses we were with told us it was the King of Swaziland on his way to one of his residences. It was pretty cool to see. We got back to the hospital at about 2 so we quickly grabbed lunch then spent the rest of the day in OPD. That evening we decided to go to a restaurant at the mall and eat burgers with Zakhle and another friend Sandile (we were getting tired of chicken and rice all the time!) They were good, but they're better in the states of course. Also, the fries, aka "chips," made here are always soggy with grease so I don't recommend them! But we still had a good time hanging out with them. They are helping us alot with learning SiSwati!

Yesterday we went on another rural clinic visit, this time with an ART doctor. (We later found out that her grandfather is the brother of the King!) This clinic wasn't as far away and the whole drive was on paved roads. We again saw about 6 patients, but we finally got to do something instead of just watching! We took turns doing a short physical exam on patients being initiated on ARVs(antiretrovirals). One of the nurses showed me a sign on the side of the clinic and explained to me that most of the clinics they go to are funded by the United States. It made me feel like I had a greater connection to this place and the organizations now that I've been to these clinics. After coming back to the hospital, we spent a little time in the TB clinic with Dr Costa, but it was slow so he let us go early. On thursdays in Manzini they have a craft market that goes all day long so we decided to check it out. They had tons of goodies for really cheap! I bought way more than I intended to! But most of these will be gifts when I come back :) I think my favorite things to see in the market were artwork (which makes up most of what I bought). I can't wait to frame some for display at mine and Brant's future home!

Anyway, today has been pretty normal. Rounds in the morning and then OPD in the afternoon. We are getting ready to going to go eat with Zakhle, Sandile, and other friends tonight, and while there plan out our weekend. We are probably going to a game park for a safari! I'm pretty excited :)

Thanks for reading my blog! Have a good weekend!

Our First Weekend

Sawubona! (Thats the correct way to spell "hello" in SiSwati)
We had a fun first weekend here in Swaziland. Saturday morning Zakhle met us here at the hospital to guide us around where ever we wanted to go. I'm really glad he did! We never would have found our way around with out him! He doesn't drive or own a car so we took Kombi's everywhere. A Kombi is their form of public transportation, kind of like a bus but more like the size of a very large church van. To find out where a particular kombi is going, you have to look for the two cities posted with on the outside of the vehicle. It was a bit confusing at first since I don't know the cities here, but I now know to do some research before I decide to go somewhere! The cost ranges from 4-10 emangelini (which is about 50 cents to 1 US dollar) and they take you pretty far. But they pack those vans full of people! I recall standing on one for a little while down the road before we dropped someone off! But oh well, it is cheap. And I'm glad I've been taking motion sickness medicine! So far I havent gotten car sick at all, which is amazing for me (Dramamine 24 hr is awesome!)

Anyway, the first place we went was called Swazi Candles. These are hand made candles in all kinds of designs and shapes (including Elephants, turtles, and more animals). It was really neat. There was actually a station with a man who works there, hand molding and carving some candles. Next to it was a craft market and a few more tourist shops where we saw and bought a few goodies. Even though we rode a kombi to get to these places, we still had to walk quite a bit after they dropped us off, including on empty dirt roads. If Zakhle hadn't been with us, I would have been pretty nervous in that area! I enjoyed the walks though, it was a nice view of scenery and Zakhle told us some neat stories about Swazi culture (even though I'm not sure I believe all of them!). We spent the whole day going from place to place, walking around and exploring that area. We even saw some wild monkeys! We thought it was cool, but I bet to the locals they are just like squirrels and raccoons to us. Also, we saw a couple KFCs (but no other fast food chains from the states, not even McDonalds) When we told someone we were from the state of Kentucky they asked us if we brought them any fried chicken!!!

Sunday, Zakhle took us to his church. It was a very nice, large church with around 300 people there. The worship and service were filled with loud and boisterous praises coming from all around, much like the gospel churches in the US (or at least how they are displayed in movies). It was a bit hard to follow because every other sentance was spoken in SiSwati. The service was also very long. But overall, it was a good experience. And the kids sitting around us were absolutely adorable! One played peek-a-boo with me over the seat :) That afternoon, Dr Costa picked us up and took us to a pool where we relaxed for the rest of the day. He is a funny man! He also took us to eat at another one of his favorite drinking spots. We all shared a large dish that is common in this area (but I don't remember how to spell the name). Basically it was many different kinds of cooked meat surrounding a mound of white cornstarch/rice substance (that i've also forgotten the name of) brought out on a large platter that looked like a tiny canoe. And you just pick up the food and eat it with your hands, no silverware at all. It was a little messy and very spicy, but quite good. The meats were chicken, beef, pork and sausage. We had a great time.

I think I'm almost completely adjusted to the time zone change, finally. One time last week in the clinic I was so tired I nearly fell over while we were seeing patients! Today was good, but a bit frustrating. Instructions of where and when we are supposed to be places has been very vague, and they don't really tell us what they expect from us. Basically we've just been shadowing them, which is ok right now because we still are adjusting to the language barrier and becoming familiar with the services available at the hospital (which is very different from the US - for example, they don't have a CT scanner!) Also some of the patients we saw today got to me emotionally, and I have a feeling that will happen often over the next two months. We found out that the boy I mentioned before with Stevens Johnson syndrome was not on ANY pain medication. ZERO. I was floored. It was probably a good thing the mask was covering my mouth because I went slack-jawed for nearly a full minute. I had noticed before that he was shaking or quivering, which I now realize may have been from the extreme pain he was in. When Dr Costa noticed this, he put him on their version of Tylenol. And that was all. (In the states he would be given Morphine for his pain). Thinking back on it now still makes me want cry for the kid, I feel so, so bad for him.

On a brighter note, this place is beautiful! Its a perfect mixture of fields, hills and mountains. I've finally taken some good scenic pictures to share with you all. I'll just load a few each post so I don't overwhelm the blog with photos.  Enjoy!

Friday

Sorry I didn't post yesterday, but you can't expect me to post every day while I'm here :) Anyway, yesterday we spent the morning in the ward rounding with Dr Costa. We have seen ALOT of TB since being here. When rounding we wear special masks to keep from possibly inhaling air contaminated with TB. Unfortunately, those masks are very uncomfortable and make us feel about 3 times warmer than we were already. The masks are also pretty itchy, and too big for my small face so it either gets in the way of me seeing or nearly chokes me, but if it keeps me from getting TB I guess its worth it! As I mentioned before its the peak of Summer here so it is hot and humid, and the wards don't have A/C (just windows to hopefully circulate air if there happens to be a breeze that day). Plus we are wearing scrubs and our white coats. So needless to say, we were burning up!

We saw alot of interesting illnesses, including some that are not commonly seen in the states. We saw a 15 year old boy who developed severe Steven Johnsons Syndrome from a reaction to his antiretroviral medication. For those of you not familiar with medical conditions, SJS is a horrible, life threatening reaction to certain medications that develops in the skin that in lamens terms causes the top layer (epidermis) to separate from the lower layer (dermis) and just peel off. (Not at all like the peeling you may have after a sun burn!). Individuals with this must be treated in a burn unit and the only treatment for it is supportive (fluids and pain management). This kid had this covering his ENTIRE body and had also developed secondary infection. I have never seen SJS before, and I'm not sure I'll ever see a case this bad again in my life. Other interesting things we saw were Karposi's sarcoma, severe cases of pulmonary TB, and a case where TB had caused degeneration of lumbar spine and arthritis.

Rachel's suitcase arrived! So over our lunch break Dr Costa drove us to the airport to pick it up. It was nice driving around again to get to see the area more. He decided to take us out to dinner later at a place he goes often. That evening he picked us up and Zakhle came along too. The place was called Mvubu Falls Hotel. (Mvubu means hippo, but there weren't any there, haha) Costa had never actually eaten there, he said its were he goes to drink! So of course, the drink menu at least doubled the food menu! But it was good and we had a great time just hanging out with them. Like I said in an earlier post, the people of this area love to laugh and have a good time.

As promised here are some pictures of where we are staying! Its nothing fancy, but it works very well for us.
Where we sleep:

Bathroom

Kitchen