It's been a few days so there is a lot to catch up on. Friday morning I did end up in labor and delivery. It was a humbling experience to say the least. These women are not aided in their labor at all. The cots are lined up side by side with no curtain or partition of any kind. They labor naked, and if told to switch position or walk, they are to do this on their own. I went over to one woman to assist her with standing up as she was clearly in quiet agony and needed to move from the cot to a gurney as she was headed for a c-section. I was told that she must do this without any assistance. I wanted to scream but, as with the Prime Directive (hello Star Trek fans) I am not allowed to interfere with their processes. Another woman came in, gave birth, cleaned herself up, rested for 4 hours, and was sent home with her baby. I watched the c-section, which was especially exciting as the electricity kept going out. Terrifying. I was handed her beautiful and healthy baby girl and brought her to a heater to await her mom's recovery, and that was lovely, but I saw her mother and many others that morning, treated so coldly, so unkindly, that I cried afterwords.
After that, thankfully, Betty, Linda and I headed to Mtubatuba in South Africa and I honestly have no words to describe what I encountered this weekend. I've been trying to upload some photographs but I'm having some trouble. We left, with our Safari guide, at 4:30 Saturday morning and, for the next 9 hours, I was engulfed in the most devastating, the most profound beauty, that I have ever experienced. Africa is unimaginably, almost painfully, beautiful. The contrasts that exist here are dizzying. For now, it is Sunday night and I'll be up at 6:00 tomorrow morning to go back to work. I'm exhausted. I will try to get pictures up tomorrow.
Sunday, February 15, 2009
Thursday, February 12, 2009
Rain and more rain
It has been raining pretty much non-stop for the past 2 days completely screwing up my internet access. As a matter of fact, if this entry stops abruptly, you'll know why. Yesterday was not one of my favorites so far. I spent the bulk of it creating a powerpoint presentation regarding the college's preceptor handbook. A preceptor is a nurse who acts as a mentor to student nurses as they come into her or his area for clinical rotation. It isn't that I don't enjoy working with preceptors, I just didn't enjoy so much spending the day at a desk. People who know me well won't believe this but, of the three of us, I'm considered the most tech savvy. Today my two colleagues and I ran a full-day workshop with preceptors and faculty on developing their preceptor program. This was a great experience. We really got to become better acquainted with the people with whom we will be working.
Tomorrow morning I'll be in labor and delivery which I'm very excited about. They had 14 babies born yesterday morning alone. Jaw dropping. I should be back in the ART clinic on Monday, Peds, possibly on Tuesday, and I'll be running in-services on antiretroviral therapy and HIV prevention on Wednesday. At least that's the plan. The likelihood of this plan actually occurring is quite small. Plans are very fluid here. Oh, and I am keeping my fingers crossed - today it was suggested that they would like me to try and go with nurses on some home visits! This would be wonderful! They haven't had a community health nurse from SOAR here before. The administrator says they have a real need for mentorship in this area so they'd like to utilize me for this. I really hope it happens.
Tomorrow afternoon Betty, Linda and I will get in a car for a road trip to Mtubatuba and St. Lucia in South Africa. Our plan is to go on Safari there and return back on Sunday. I'm hoping to get some great pictures. It will, of course, be nice if the rain lets up for that but whatever happens, happens. I won't have my computer there so I'll probably post again on Monday.
Tomorrow morning I'll be in labor and delivery which I'm very excited about. They had 14 babies born yesterday morning alone. Jaw dropping. I should be back in the ART clinic on Monday, Peds, possibly on Tuesday, and I'll be running in-services on antiretroviral therapy and HIV prevention on Wednesday. At least that's the plan. The likelihood of this plan actually occurring is quite small. Plans are very fluid here. Oh, and I am keeping my fingers crossed - today it was suggested that they would like me to try and go with nurses on some home visits! This would be wonderful! They haven't had a community health nurse from SOAR here before. The administrator says they have a real need for mentorship in this area so they'd like to utilize me for this. I really hope it happens.
Tomorrow afternoon Betty, Linda and I will get in a car for a road trip to Mtubatuba and St. Lucia in South Africa. Our plan is to go on Safari there and return back on Sunday. I'm hoping to get some great pictures. It will, of course, be nice if the rain lets up for that but whatever happens, happens. I won't have my computer there so I'll probably post again on Monday.
Tuesday, February 10, 2009
Visiting the Mafutseni clinic
Today we split up. I was supposed to go the ART (antiretroviral therapy) clinic, but they thought the nurse I was to mentor was already out in the field. They considered sending me to the surgical unit, such as it is. I tried, gently, to disabuse them of that notion, when the change no longer was necessary.
The nurse for the ART clinic hadn't yet left and so I was privileged to join him in going to the Mafutseni clinic. Many of the patients are unable to get to the hospital in Manzini, so the hospital gathers up a box of meds and charts (and a number of large bags of corn meal) and takes off to rural clinics to dispense meds. In Mafutseni, the clinic consists of the container part of a large truck, taken off the truck, and placed on the ground. Two windows are cut into it, a corrugated roof is constructed on top and, voila, a clinic. There were people of all ages and in various stages of health waiting for us when we arrived. Some had walked long distances to get there. One of the patients came up to me, I think she thought I was a doctor, and started describing how proud she was of being in such good health, having been diagnosed in 2004. She, rightly, attributed that to her adherence to her meds and wanted me to know that. Anyone who knows anything about the side effects of these meds, and they don't have all the newer ones we have in the States, knows what an achievement this is. They use a lot of Zerit. We don't use that much anymore in the U.S. due to such lovely side effects as severe peripheral neuropathy and lipoatrophy, among other things. It was remarkable to see the patience and all around positive attitudes of these people, many of whom are quite ill, and almost all of whom are desperately poor.
When we returned, I had a long talk with the nurse about the educational needs of the nurses coming in to work in the ART clinic. Fleshing out the curriculum in that department may be a focus of my four weeks here.
An amazing day.
The nurse for the ART clinic hadn't yet left and so I was privileged to join him in going to the Mafutseni clinic. Many of the patients are unable to get to the hospital in Manzini, so the hospital gathers up a box of meds and charts (and a number of large bags of corn meal) and takes off to rural clinics to dispense meds. In Mafutseni, the clinic consists of the container part of a large truck, taken off the truck, and placed on the ground. Two windows are cut into it, a corrugated roof is constructed on top and, voila, a clinic. There were people of all ages and in various stages of health waiting for us when we arrived. Some had walked long distances to get there. One of the patients came up to me, I think she thought I was a doctor, and started describing how proud she was of being in such good health, having been diagnosed in 2004. She, rightly, attributed that to her adherence to her meds and wanted me to know that. Anyone who knows anything about the side effects of these meds, and they don't have all the newer ones we have in the States, knows what an achievement this is. They use a lot of Zerit. We don't use that much anymore in the U.S. due to such lovely side effects as severe peripheral neuropathy and lipoatrophy, among other things. It was remarkable to see the patience and all around positive attitudes of these people, many of whom are quite ill, and almost all of whom are desperately poor.
When we returned, I had a long talk with the nurse about the educational needs of the nurses coming in to work in the ART clinic. Fleshing out the curriculum in that department may be a focus of my four weeks here.
An amazing day.
Monday, February 9, 2009
Welcome to the Kingdom of Swaziland
That's Linda, Betty and I in front of the teensy tinesy airport in Swaziland. And the other photo is actually the view outside of my window. Not too shabby. Yesterday, our first day in country, was spent just settling in and meeting with, Tony, our point person here. It was a quiet day bathed in beautiful, balmy weather.
First day at work
Today we went to the small nursing college and hospital in Manzini where we'll be working. It was very eye opening. They are really working so hard to create a top notch school given the limitations inherent here. They need so much, just in the way of books, never mind technical equipment. But they are constructing an airy and really quite roomy space and the place was filled with students. Right next to the college is the hospital. Again, It is difficult to imagine people working as hard as these providers do with so little. Patients bring their own blankets and many of the beds where patients were lying had no linens on them at all. The infrastructure is decrepit. There are lines of people standing, sitting, lying on the ground waiting for an opportunity to be seen. We walked thru all of the wards and they even have a private section for people who are willing to pay, but these sections are just as broken down as the public sections. The only difference is perhaps, a bit more privacy. It looks like Linda (pictured with me above), Betty and I will be split up according to our areas of expertise. Linda will be mentoring nurses on the medical ward, Betty will be mentoring nurses in Labor and Delivery, and I will be mentoring nurses in the antiretroviral clinic. We should be placed tomorrow. I'm excited and nervous and really ready to get started.
Saturday, February 7, 2009
Saturday night update - 8:15pm
I ended up with a seatmate from Dakar to Joburg, which is actually the longer leg of the trip. He was a very nice man from Zambia and he volunteered to help steer me thru the airport when we landed, which he did. Now I’m at the airport hotel, having a glass of wine, sitting at an outdoor table by the pool on a balmy Saturday night at 8pm… Hey – I have to do my writing out here. They don’t have internet access in the rooms. But this does feel surreal. The knowledge is always there of the real reason I’m here and what my life here will be like.
I will try to get some pictures posted tomorrow night when we’re settled in Swazi. Meantime, lack of sleep and the wine is messing with my syntax.
I will try to get some pictures posted tomorrow night when we’re settled in Swazi. Meantime, lack of sleep and the wine is messing with my syntax.
Heading In Country
I’m writing this on the plane so the posting date is going to be a bit off.
It’s been a very full day so far and I’ve only just gotten on the plane. Last night I met the two other nurses with whom I’ll be working (They’re wonderful) and this morning we had our pre-deployment meeting.
Apparently there are 3 different categories of work we’ll be doing; Knowledge Building & Clinical Mentoring, Leadership, and, finally, Communities of Self-Care. Most of our work will fall under the first category but we will likely be delving into these other categories as well. With regard to "Communities of Self-Care, we were told an absolutely horrible statistic; 10% to 15% of nursing students in Swaziland do not live to complete their training. This is horrendous. They die before they finish nursing school! Remembering that close to 40% of the adult population is HIV+, this illustrates how every aspect of the population is affected, as well as infected. Here we'll be teaching about signs and symptoms of various opportunistic infections, and the nurses sitting in front of us will be experiencing those very same signs and symptoms. This is almost unbearable to contemplate.
And so, in a painfully tone deaf seque, and on a much lighter note…I lucked out! Nobody is sitting next to me! 17 hours in the air and I’ll have 2 seats all to myself!
As they say, I’m not worthy.
Johannesburg (or Joburg, as the people in the know call it), is supposed to be like “Escape from New York” so, since I’m traveling on my own (the 2 other nurses will meet me Saturday night in Joburg) I’m supposed to walk thru the airport as if I own the place. Thank God for New York bravado.
It’s been a very full day so far and I’ve only just gotten on the plane. Last night I met the two other nurses with whom I’ll be working (They’re wonderful) and this morning we had our pre-deployment meeting.
Apparently there are 3 different categories of work we’ll be doing; Knowledge Building & Clinical Mentoring, Leadership, and, finally, Communities of Self-Care. Most of our work will fall under the first category but we will likely be delving into these other categories as well. With regard to "Communities of Self-Care, we were told an absolutely horrible statistic; 10% to 15% of nursing students in Swaziland do not live to complete their training. This is horrendous. They die before they finish nursing school! Remembering that close to 40% of the adult population is HIV+, this illustrates how every aspect of the population is affected, as well as infected. Here we'll be teaching about signs and symptoms of various opportunistic infections, and the nurses sitting in front of us will be experiencing those very same signs and symptoms. This is almost unbearable to contemplate.
And so, in a painfully tone deaf seque, and on a much lighter note…I lucked out! Nobody is sitting next to me! 17 hours in the air and I’ll have 2 seats all to myself!
As they say, I’m not worthy.
Johannesburg (or Joburg, as the people in the know call it), is supposed to be like “Escape from New York” so, since I’m traveling on my own (the 2 other nurses will meet me Saturday night in Joburg) I’m supposed to walk thru the airport as if I own the place. Thank God for New York bravado.
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