I can't actually remember when I wrote last. But it's been awhile. I am in a routine here at Baylor now. My days usually go like this:
6 AM: awaken by my alarm. Get up out of bed. Make coffee. Pour bowl of cereal and drink said coffee. If its a Monday or Thursday, wonder if the cleaning lady will come before I leave and hopefully I have remembered to do dishes so I don't appear as a lazy American.
6:30 AM: walk to work, admiring the flowers and the huge mansions - I appear to live in the consulate laden and rich part of town.
6:38 AM: ask the kind front desk person to let me upstairs, because although I have been fingerprinted twice the fancy green fingerprint reader does not let me go anywhere in the building. Get to the office and call Jimmy on FaceTime. Smiles. Talk and check email.
8 AM: ask someone to let me downstairs (again, the fingerprint reader) and see patients in clinic. This can run anywhere until noon or 3 pm. See lots of patients. Communicate well with some of them, others go and beg for a translator.
After Clinic: eat lunch, usually this is around 2pm. Work on piling together research to help with a study they are trying to get published here. Talk with the volunteer staff (which includes Botswanans, Canadians, Americans, and a German) and listen to Botswana office drama.
5pm: Home.
After 5 pm, I do a variety of very normal American things: eat dinner, watch TV, go to movies. Last Friday, I went to a Botswana concert with two of the PAC doctors. One of their spouses is a very good saxophonist and plays in a local jazz band. He is also a physician and I cannot but wonder how he has kept up his musical abilities while studying medicine. Leah says its because he doesn't sleep.
Anyway the concert was good. And there was dancing. And there was a Botswana star, Eugene Jackson grabbing Leah, one of the PAC doctors, and serenading her on one knee. I think the local ladies were jealous and Leah was embarrassed. And then there was Ringo, a South African artist who sings in Zulu, and hence is not understood by people here, but whom the crowd was crazy for. They were screaming, singing every word, and dancing up a storm. It was quite fun.
This weekend got me thinking. I think I like traveling because I lose any ounce of self-consciousness (well maybe not all of it) and do things that I keep myself from doing back home. Like dancing.
12.20.2010
12.13.2010
It's tough being a teenager anywhere
I spent a long time in clinic today with a patient who I will call Becky. She is 15 living with HIV. I asked if her if there was anything that she was concerned about today. She told me no not with her health, but somedays with her head. I gave her a puzzled look. She then mumbled, "You know with HIV and my head. It's difficult." She went on to elaborate how some days she sits and cries because she becomes so saddened by her illness. Most of her friends do not know her status - there is still stigma here in a country where around 25 percent of the population is infected. She only feels she can talk to her sister who is away at college. This relationship appears to have become a little rocky recently as her sister, concerned about Becky, told their mother about Becky's sadness. Becky was then yelled at by her mother.
I have worked with enough teenagers to know that this is just part of the story, Becky's side. I know the relationships and situations are much more difficult, but my heart breaks for her just the same. I know that teenagers with all sorts of illness feel as isolated as Becky - like the only one and that the illness is overtaking their lives, limiting their futures. Even if this is not the case. HIV is not the death sentence that it use to be. Medications keep the infection silent when taken properly and the regimes are not as complicated as they once were. (And Becky after defaulting in 2005 has been doing well now that she is back on treatment). But how does a young person necessary believe in hope of the future, especially in a country that has so many orphans from the illness and where most people know someone who has died from its complications.
I think this visit elaborates the most difficult thing for me here. For those of you who have had the conversation with me about why I chose to do this silly thing called Triple Board know that I cannot ignore a sad child. And there have been many sad children here. I have watched them break down in tears because of a sick sibling in the hospital, because of being teased at school, because of remembering a mother who was lost to the illness that they now struggle with... this has been the hard part. Made more by the fact that many of the children do not speak my language to understand comforting words. I feel hopeless to help in this realm, and the core of my being just wants to make those tears go away.
I have worked with enough teenagers to know that this is just part of the story, Becky's side. I know the relationships and situations are much more difficult, but my heart breaks for her just the same. I know that teenagers with all sorts of illness feel as isolated as Becky - like the only one and that the illness is overtaking their lives, limiting their futures. Even if this is not the case. HIV is not the death sentence that it use to be. Medications keep the infection silent when taken properly and the regimes are not as complicated as they once were. (And Becky after defaulting in 2005 has been doing well now that she is back on treatment). But how does a young person necessary believe in hope of the future, especially in a country that has so many orphans from the illness and where most people know someone who has died from its complications.
I think this visit elaborates the most difficult thing for me here. For those of you who have had the conversation with me about why I chose to do this silly thing called Triple Board know that I cannot ignore a sad child. And there have been many sad children here. I have watched them break down in tears because of a sick sibling in the hospital, because of being teased at school, because of remembering a mother who was lost to the illness that they now struggle with... this has been the hard part. Made more by the fact that many of the children do not speak my language to understand comforting words. I feel hopeless to help in this realm, and the core of my being just wants to make those tears go away.
12.10.2010
Clinic Adventures
After the first week here, they have us see patients and staff them with the PAC doctors. Today was my first day, having spent most of the week on outreach. I have learned so much about HIV care, but seeing patients on my own was/is a little nerve wracking. I mean, these patients have the same problems as all patients but their immunodeficiency makes each illness just that much more scary. I was suppose to see the uncomplicated ones, but triage here is not necessarily the best so I saw a mixture. Most of the kids were doing well, which has been the case for many of the patients but other not so much. I saw several children brought by their older sisters who were around 13 to 15. Mother, grandmother, or auntie couldn't make it today so sister came instead. We still see them and try to communicate back to the family. We also see a lot of teenagers on their own, in part as teenagers here are seen almost monthly as so many teens default (just like any chronic illness right?). I was exhausted at the end of clinic. I think in part because of the newness and double-triple checking that I did. I also feel uncomfortable at how long patients wait for us to finish charting. In Botswana every patient carries their own medical chart so patients can't leave until providers have finished documenting. This leaves a lot of awkward silence as you hurry to type the note and then send them on their way.
Christmas around here means that most natives head back to their cattle station. Cows are BIG here and hence beef is cheap. Everyone lives away from their home village and hence travel back during the holidays and family celebrations. I tried calling a patient's grandmother today and was told she was not reachable as she had already gone to the cattle station. Definitely a different world.
Christmas around here means that most natives head back to their cattle station. Cows are BIG here and hence beef is cheap. Everyone lives away from their home village and hence travel back during the holidays and family celebrations. I tried calling a patient's grandmother today and was told she was not reachable as she had already gone to the cattle station. Definitely a different world.
12.08.2010
Christmas Party, ex-pats, and flying missions
I know it has been awhile since my last post. I have been here for a week now and still surviving. Although that's not that hard here. Many people have referred to Botswana to me as "African Lite" including the native born population. Its definitely more like the USA, one of the reasons I think that there are so many ex-pats here and a HUGE peace corp volunteer contingent.
Saturday was the Christmas Party here at Baylor. They invite around 300 kids who are HIV+ to Baylor for a day of music, fun, games, and presents. It was awesome to watch them play and it makes you realized that here in Botswana you cannot tell who does and does not have HIV. I got to be in charge of first aid as the Baylor doctors had left in a rush secondary to illness in one of their members. Anyway, I got to give some Gatorade to 2 dehydrated children who had overdone the playing in the Botswana summer heat. :) Highlights were getting to talk to the several peace corp volunteers that showed up, playing with the children (as always!), and watching the teenagers perform a native dance for the younger children. A very fun day, although it is hard for me to think of Christmas in 90 degree heat. :)
Sunday I went to dinner at Lisa, a friend of Katie's - thank you Katie - who lives here. She works for a NGO that she formed here to work with Botswana teenagers around all sorts of teenage issues. She is an amazing women and has lived/worked all over. She was in the midst of writing a grant application and I learned more than I ever knew about the struggles of getting funding for NGOs. Its rather complicated and something I am glad I don't deal with. She had 2 people from Project Hope over as well and the strangest part of the evening was that one of them, Megan, had been BK's roommate in college. Strange, small world. And we had put the two together without reference to ultimate. :)
Remembering why I like being abroad - although I don't think I really forget that - and why medicine had been a draw when I lived in India so long along. Realizing that was almost 10 years ago now. I went on outreach this week and we actually flew to one of the sights. These sights were more of what I expected - more resource and staff poor and remote. Baylor goes to these sites to help local staff learn how to manage kids with HIV. They often go with other NGO groups that help teach the local medical officers as well. I spent yesterday rounding on the wards in a remote hospital with a American doctor, an Australian doctor, a Botswanan FM resident, and the local medical officer who was from the Congo orginially. Botswana did not have a medical school until recently and most Botswanans do not want to work for the government as the government can send you whereever and at these local hospitals you are the OB, the surgeon, the internist, and the pediatrician. Its a crazy life. This also means that usually the doctor does not speak the language of the patient. Some sad cases on the wards, which I won't detail here and some cases that I was amazed had been admitted. Those cases were both kids and I think there was some discomfort with the staff at that hospital which managing children.
I am learning more than I ever knew about HIV management and getting a glimpse of yet another culture. It is only making me want to practice abroad even more than I did before.
That's it for now.
jenny
Saturday was the Christmas Party here at Baylor. They invite around 300 kids who are HIV+ to Baylor for a day of music, fun, games, and presents. It was awesome to watch them play and it makes you realized that here in Botswana you cannot tell who does and does not have HIV. I got to be in charge of first aid as the Baylor doctors had left in a rush secondary to illness in one of their members. Anyway, I got to give some Gatorade to 2 dehydrated children who had overdone the playing in the Botswana summer heat. :) Highlights were getting to talk to the several peace corp volunteers that showed up, playing with the children (as always!), and watching the teenagers perform a native dance for the younger children. A very fun day, although it is hard for me to think of Christmas in 90 degree heat. :)
Sunday I went to dinner at Lisa, a friend of Katie's - thank you Katie - who lives here. She works for a NGO that she formed here to work with Botswana teenagers around all sorts of teenage issues. She is an amazing women and has lived/worked all over. She was in the midst of writing a grant application and I learned more than I ever knew about the struggles of getting funding for NGOs. Its rather complicated and something I am glad I don't deal with. She had 2 people from Project Hope over as well and the strangest part of the evening was that one of them, Megan, had been BK's roommate in college. Strange, small world. And we had put the two together without reference to ultimate. :)
Remembering why I like being abroad - although I don't think I really forget that - and why medicine had been a draw when I lived in India so long along. Realizing that was almost 10 years ago now. I went on outreach this week and we actually flew to one of the sights. These sights were more of what I expected - more resource and staff poor and remote. Baylor goes to these sites to help local staff learn how to manage kids with HIV. They often go with other NGO groups that help teach the local medical officers as well. I spent yesterday rounding on the wards in a remote hospital with a American doctor, an Australian doctor, a Botswanan FM resident, and the local medical officer who was from the Congo orginially. Botswana did not have a medical school until recently and most Botswanans do not want to work for the government as the government can send you whereever and at these local hospitals you are the OB, the surgeon, the internist, and the pediatrician. Its a crazy life. This also means that usually the doctor does not speak the language of the patient. Some sad cases on the wards, which I won't detail here and some cases that I was amazed had been admitted. Those cases were both kids and I think there was some discomfort with the staff at that hospital which managing children.
I am learning more than I ever knew about HIV management and getting a glimpse of yet another culture. It is only making me want to practice abroad even more than I did before.
That's it for now.
jenny
12.02.2010
First Day in Clinic
I thought today I would be over this jet lag, but alas that was not to be the case. Still jet lagged and did not sleep well last night. Spent this morning shadowing Leah, one of the American doctors who has been here for 1.5 years. Lots of patients who today were well controlled. One boy will stick out in my mind a 18 year old who looks like he is 9 for issues unrelated to his HIV status. This would have been treated long ago in the USA but he wasn't even able to be diagnosed until a little over a year ago secondary to access.
Most surprising thing: the clinic here is nicer than my continuity clinic back home and they are completely electronic. Not what I was expecting.
That's it for now. More adventures to come...
jenny
Most surprising thing: the clinic here is nicer than my continuity clinic back home and they are completely electronic. Not what I was expecting.
That's it for now. More adventures to come...
jenny
12.01.2010
Gaborone, Botswana
Landed in Botswana this afternoon after almost 3 days of travel. Luckily no flights were missed and my luggage came without any problems as well. I was a little worried that something was going to go wrong, but it didn't. I am really tired right now so forgive me if I stop making sense. I got a chance to fly on one of the huge new Airbus plane and then jumped on a little propeller plane for my next flight - definitely a change. Managed to get some sleep on the Airbus as it was not booked and I happened to get a row to myself. And I have to say Air France definitely puts more into their food than American carriers.
Impressions in Botswana thus far. Hot. And humid. Reminding me of my time in India just because of that along with the well worn dirt pedestrian paths along the roads. Maybe that's way I sort of feel at home and was brave enough to wander aimlessly hoping to find a grocery store tonight. (accomplished the task as well which is why you are hearing from me). So far I have met the driver for the center and he brought me to an ATM and to a fast food restaurant of sorts before dropping me off in an empty house. There is another participant living there but she's on vacation right now and so its just me. I start "work" tomorrow. I think its just going to be a bunch of orientation and culture shock.
By the way today is International AIDS day - show your support in any way you can back home.
jenny
Impressions in Botswana thus far. Hot. And humid. Reminding me of my time in India just because of that along with the well worn dirt pedestrian paths along the roads. Maybe that's way I sort of feel at home and was brave enough to wander aimlessly hoping to find a grocery store tonight. (accomplished the task as well which is why you are hearing from me). So far I have met the driver for the center and he brought me to an ATM and to a fast food restaurant of sorts before dropping me off in an empty house. There is another participant living there but she's on vacation right now and so its just me. I start "work" tomorrow. I think its just going to be a bunch of orientation and culture shock.
By the way today is International AIDS day - show your support in any way you can back home.
jenny
11.29.2010
Leaving the snow behind
I set off today and will arrive December 1 in Gaborone, Botswana. I will be working with the Baylor International Pediatric AIDS Initiative site while I am there. Check out the links for information about Botswana and about Baylor AIDS. I am excited to be going but I am going to miss my family, my friends, and my puppy dogs. And playing in the snow.
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