Tuesday, February 21, 2012

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 :)

Friday, February 17, 2012

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!

Wednesday, February 15, 2012

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...

Monday, February 6, 2012

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!

Saturday, February 4, 2012

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.