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

Sowbona!

That is how you say hello in SiSwati. We've been practicing greeting the people here with much help from our new friends. I'm still not sure how to spell these things, but I don't think I'll ever be so I'm just spelling as it sounds. The first person says "Sowbona!" (or Sowbonai if to a group of people), then the second person replies "Yebo" which means 'Yes'. Then they say "Unjohnay" which means 'how are you?' and the other replies "nepila" which means 'good'. Also "Sayabona" means 'Thank you'. Thats all we've got so far, lol!

This morning the sun rise was about 5 am, which is much earlier than we are used to. We woke up thinking we had missed our alarms that were set for 6am. The rest of the day gets some what confusing. Time in Swaziland is very different from American time. Things go much slower here and there is no 'urgency' to do anything. People do what they need to whenever they get around to it. For example, someone may say they will meet you at 7 to get breakfast, but then not actually meet you until 8. And it not big deal. I noticed alot more cultural differences, but I'll get to those later.

After we ate breakfast we called Dr. Costa Maonei to meet up with him for the day. He gave us a full tour of the hospital grounds and introduced us to most of the doctors and nurses we will be working with. It is very hard to remember their names, and it kind of seem like you insult them when you don't. We feel bad about it but most of them are not familiar sounds to us. There are a few with names we know well, like Colleen, Christine, and David, but otherwise its very different. Not to mention I'm not the greatest with remembering names initially anyway. When he finished showing us around, he told us to go "wonder" around a bit to get to know the place, then find Dr Gezahegne to spend the day with. Once we met up with him, we saw some TB patients  and then he dismissed us because he was finished and going on break. We then looked for Dr Costa but he too was on break and would come back at 2pm. It was only 11:30am. We killed some time by going to the store to get some things since Rachel's bag still hadn't arrived yet.

At 2pm, we went to the TB clinic and observed Dr. Costa with patients. This hospital is the only one in Swaziland that keeps charts on their patients. He said they took the idea from the US, but it is not nearly as detailed as ours (the charts are much smaller!!). Watching the interaction between doctor and patient was very interesting. This is going to sound bad, but the way the doctor talked to and treated the patient would not be tolerated in the states. He was harsh, blunt and sometimes downright mean, even yelling at the patient. Not to mention they had waited all day to see him who knows when. I'm not criticizing or praising this behavior, I'm just explaining what I witnessed. This encounter opened my eyes to the difference in health care in America from underdeveloped contries. I could go on and write an essay about that right now, but I'll save it for another post when I've had time to let my thoughts on this develop more clearly. But in short, here it is a priviledge to get to see a doctor. In the US, doctors are treated like waiters or customer service personel. Again, I'll expain this in detail later when I'm more rested and I'll let that thought linger in your minds until then.

I'll try to start sharing some pictures soon! I haven't felt comfortable yet just walking around snapping pictures, but maybe tomorrow I'll have some pictures of our living quarters.

Arrival and first day

After over 36 hours of travel time, Emily, Rachel and I finally reached Manzini, Swaziland. Mine and Emily's luggage made it, but unfortunately Rachels didn't :( Other wise, all the travel went smoothly. On our flight from Chicago to London, Emily somehow got bumped up to buisness class (lucky!). As I was walking through first class when boarding I was looking through the seats to find out where she ended up, then to my surprise I locked eyes with Kanye West. No joke. I did one of those awkward double takes after you accidently get caught staring at someone, haha! I wasn't completely sure it was him until one of the other passengers near me brought it up. After we got off the flight I told Emily she was sitting 3 seats behind him and she had no idea! After arriving at the London airport we were shuttled to the correct terminal by bus through what seemed to be a permanent construction zone. It was a very strange airport set up to say the least. We then had to wait 6 hours before boarding out flight to Johannesburg, but they don't annouce the gate number of flights until about 1 hour before boarding, and you'll have to ride the tram to get to the other gates. Like I said, its a weird airport. Nice, but weird. Our flight to Jo-berg was on a Boeing 747 aircraft - which was massive! Even though it was an 11 hour flight, it is probably one of the best I've been on ever. It was (dare I say it) comfortable, good food, and an individual television to watch movies of our choice. Of course I slept most the way, but I was still satisfied with that experience. The next flight we were on a teeny-tiny plane, but only for 45 minutes, which flew by compared to the last flights we had.

Dr Maonei is our coordinator for these rotations and he picked us up at the airport. All the people we have met here so far are very friendly, and funny too! They love to laugh and joke around! One of the first people we were introduced to Zakahle (pronounced like my name with -zuh in front of it) Dr. Maonei gave us the day to rest so we napped for a few hours and then Zakahle walked us down to the mall to get water and a cell phone that the hospital can call us at. We spent less than 50 USD on a phone, sim card and some local calling minutes. We walked around town with him for a while and he would tell us about the town, the language, and all sorts of other things. He shared so much that I wasn't able to remember alot of it! While most speak some english here, their accents make it a little difficult to understand. The native language is SiSwati, so I will share with you bits as we learn it. I know a few now but I'm not sure how to spell it. Zakahle walked us around the hospital a bit too. Our living quarters are pretty nice. Its no 5 star hotel, but we have internet, a little bit of AC and a kitchen. Oh, did I mention its Summer here? Well, the weather is wonderful! A bit humid but not unbearable.

Anyway, it is almost 9pm here so we will be heading to bed soon since we are still exhausted from traveling. And this post is getting long so I'll stop for now. I've got plenty of time to share more about Swaziland. Pardon any typos or grammer mistakes, I don't feel like reading over it right now since i'm still jet-lagged.