It's Not Called AIDS Here

The previous post was kind of rushed at the end. I was attempting to write the challenging part of our trip – and then contrast it with the great parts of our trip so far. Alas – as the evening approached, I had to sign off rather quickly.

Unfortunately, we are not able to walk around the town after dark. The area that the hospital is located ( hence, the area we are living in ) is considered “not safe” after dark. So we must be in the compound, finding various ways to amuse ourselves.

The endurance of the people here continue to astound me. People walking on broken bones. Small incisions with no local anaesthesia. Ryan and I were trying to figure out if the pain threshold of the Swazi people is actually higher than that of a north American.

We are sharing a flat at the hospital with 3 others. Dr. Karen from California. Dr. Linda from New Zealand. And Nurse Mary-Ann from Quebec. It’s a very, very small flat, so it becomes the ultimate team-building experience.

The twins that were delivered by c-section the other day are in the maternity ward. Mary-Ann was in the ward, and went over to say hello to the woman and her new twin girls. The Swazi woman is HIV positive. The Swazi woman asked Mary-Ann if she wanted to name the two girls, which she humbly did. The Swazi woman then asked Mary-Ann if she wanted one of the twins. To take home.

What level of destitution must exist for a new mother to offer up one of her new born girls?

There is a clinic adjacent to the main hospital for VCT ( Voluntary Counselling and Testing … of HIV ) and an ARV clinic ( AntiRetroViral ). The stigma of AIDS is so great here that the term AIDS is not acceptable. Instead of AIDS, a person has ARVD (AntiRetroViral Disease). Testing is not mandatory, and most people do not want to be tested. It is easier to live without the knowledge than it is to face the stigma of being HIV positive. Fortunately, for those who are tested and found to be positive within the city, there is a network of help available. For those out in the rural communities, it is not so easy.

Our group was scheduled to go to a rural community clinic this morning. A small community about 1 hr from the hospital. We were literally climbing into the van when we were informed that the trip was cancelled as there was no doctor to accompany the team there. This means that the people who were expecting a mobile medical team to come to their community today will have to wait another month before a trip is made to their clinic.

Jenn and Andrea learned to suture with dental floss this morning.

Ryan is doing history taking and diagnosis in medical outpatients already.

And I am helping the surgical team with imaging. An inpatient from an MVA with a head injury was complaining of abdominal pain – so I suggested he get an ultrasound ( I’d suggest a CT… but that ain’t gonna happen here). His belly was full of fluid and his spleen was not in good shape. 2 hrs later, the guy is on the surgery table, with what looked live 18 litres of blood sucked out of his belly and a fragmented spleen removed. It was awesome to be able to follow the guy from the ward to imaging to surgery and back to the ward all in a few hours.

Every day here poses new challenges. And we are venting to each other on a daily basis… trying to comprehend what we are seeing and experiencing. How it is that we can see the things we see, and come back to our flat to listen to our mp3 players and drink our purified bottled water knowing that we will eventually get on airplanes and return to our homes where things are clean and efficient and if we are really, truly helping the Swazi people.

I’d like to think we are. And I’d like to think that we can leave just a little bit of knowledge behind that will help others when we’re gone.

Andrea, Ryan, Jenn & Chris