chief's festival, yellow suits and other mad pics

highlights of this week:

- working in clinic.
- seeing babies and kids in clinic.
- making a 4-year-old with a big sore bump on his head go from crying and scared and hiding under the bed, to laughing and happy - merely by playing in silence with him – by waving toilet paper in the air.
- going out to katete town on thurs night! this place called ‘kings’ was rocking! zambian music is fantastic – great beats and hip hops, and even remixes (one memorable one of four season’s ‘oh what a night’).
- drunken zambian ladies... *shiver*... hoon remember the ‘whale’ from 1st year? yepp...
- drunken zambian lady whale telling me that she ‘likes’ me. i screamed. then big d (coolest irosh doc, 7 feet tall and feet the size of small eastern european countries) saved me by intervening. then she kept hanging on this arm. and his way of getting rid of her – doing the ‘yawning’ trick – i.e. lifting his arms up so high she couldn’t hold on any more.
- zambian prostitute saying ‘hey sexy, come over here!’ while i walked back from the toilet. *eek*
- zambian beer! mosi!
- zambian beer called ‘shake shake’ or ‘chibuku’ – an alcoholic beverage made from maize which comes in a 1L milk carton. tastes like absolute shite. something hoon would have recommended. great fun drinking it though!
- drunk zambian guys on the dance floor.
- drunk zambian guy who came towards me, took his shirt off, grabbed my hand, and tried to put it to his abdomen... *eeeeeeeeeek*
- how all the guys in our group got harassed soo much by women and men, and how the two european girls in our group didn’t get hassled at allll.
- drunk zambian guys telling you all about their life stories and then asking you to sponsor them and take them back to your home country with you.
- playing stupid card games involving sticking cards on your head, slapping each other, slapping oneself etc., all night.
- finally watching ‘kiss kiss bang bang’ – i *loved* it! hilarious!
- telling the pink panther joke to a whole bunch of people. and absolutely no-one, i mean no-one, laughing.
- hearing tracy say ‘darling’ this morning. perfect way to start the day. pity the connection died before i could reciprocate properly :(
- walking to the computer room in the magnificent sun with finlay quaye’s ‘your love gets sweeter every day’ playing on my earphones, and kids running after me laughing. perfection.
- moving in to my new house with the two irish docs donal (big d) and ronan, and the dutch med student mohammed.
- using the ‘bucket’. there’s no hot water and only a bathtub. so this is how we have a ‘bath’, or rather – a bucket: heat up a kettle. pour into bucket. heat up another kettle. pour in bucket. fill to top with the cold water. for extra luxury one can add another kettle, but by that time the first kettle water is cold, so it’s a lot of effort for not much gain. then – sit in bathtub with bucket between ur legs. then use small bowl to pour the bucket water over you.
- the twenty-or-so owls that live above our room.
- finding out that apparently ‘dhamma’ means ‘adultery’ in zambian. :-S
- my yellow shirt and pants! brilliance!
- chief’s festival yesterday! food, drink, lots and lots of people. great culture – dancing, performances, music... and great souvenirs.
- driving on african roads at 120km/hr in a beat up toyota corolla with the windows down, under the magnificent sun, with keith sweat playing loud.

back to saint augustine (male medical ward) tomorrow. i’m nervous. i hope it doesn’t turn out to be a demoralising disaster like last time...
hope everyone is well!

third week already!

i can’t believe it’s almost the end of the third week here, already!

this week i have spent mainly in clinics – which actually has been a welcome (oh my goodness – what a welcome!) change from the minefield of life that is st. augustine (the male medical ward where i was last week). it’s kind of like a gp practice, being in general clinic – people just rock up and you take a history and exam and then decide what to do – prescribe some meds, followup, or admit to wards. btw did i mention that we can prescribe, and basically do anything here? that’s pretty kewl. so in a day you can see about 20-30 patients with a wide range of conditions. for example today i saw an amputated finger, assault, sickle cell crisis, a new dx of diabetes, pneumonia, tb, pleural effusion, depression, sciatica, anaemia, epistaxis (blood was everywhere! i had to do an emergency packing. sounds grander than it actually is tho), impetigo, malaria, bowel obstruction, massive stroke and unconsciousness, and probably a lot more. i’m actually really enjoying it. maybe i should become a gp? not. hehe it’s not sexy enough (as ilia would say)?

yesterday i did a ward round on the female medical ward though, as colleen was sick and i had to replace her there for the day. i was dreading it at first, but it was actually really really good. there were 3 psych patients on the ward, which i kinda plunged into. there was a case of depression, a brief psychotic disorder, and a relapse of a chronic paranoid schizophrenic whom i thoroughly got stuck into. she had the most fantastic delusions and her behaviour, speech and thought were totally disorganised. anyway my point is that i found them interesting because i find psychiatry so thoroughly enjoyable and interesting. mental illness is tough enough back home, on the patient and the family. but here, when families already have such limited resources, it can be devastating. i would almost understand if people abandoned mentally ill people here, but the love and compassion from families is quite amazing. the rest of the ward round was great too. no disasters. things made sense, and things were working.

so in summary, this week is going quite well. touch wood.

we won our soccer game on sunday 3-2. (p.s. rayji how are the kinky nuns doing without their star goalkeeper? cough cough. i miss u guys). no real amazing saves from me but a few crucial ones especially a couple in the last few minutes, and also a massive graze on my right knee.

been drinking a lot of zambian beer (mosi and castle) and having nice evenings hanging out with everyone. there’s a good bunch of people here. there are the odd doctors who can’t seem to stop whinging and whining. i hate that. sure, it’s not easy. sure, everyone needs to whinge and bitch a bit to vent emotions. but some people seem to be constant whingers, like the constant whine of a mosquito in your mosquito net (the bastard must have bitten me ten thousand million times last night! bastard bastard i kill you!). they seem to think that things should be perfect like they are so perfect back home. it just gets everyone down beyond a certain point, and furthermore it just wastes time and does nothing productive. i wish i could tell them to get over it and build a bridge. maybe i will one day :)

i can’t wait for my yellow suit! friday is the day! i am sure tracy will love it! she will love it so much i reckon, that she will love it to bits if i turn up to heathrow airport to pick her up, dressed in my yellow african suit. i think she will love it so much in fact, that she will promptly turn around and go straight back home.

we’re trying to plan to go on a safari next weekend to luwangwa national park (i think that’s how it’s spelt). and in our last week in zambia we’re planning on going to livingstone to see the magnificent victoria falls, and do some touristy things, and maybe even do another safari. it’s all very exciting! especially since there might be about six of us doing it, so it might work out cheapest to actually charter a plane! how extravagant like donald trump’s hair!

anyway. another looong blog! actually it’s not *that* long. voops. it’s so good to hear from everyone. keep the emails and blogs flowing. i love hearing from you all - it really warms my heart and makes me smile at the end of a long and tough day. hope you are all well,

dha

some photos from katete

this is 'fly', short for 'flyness' - the cutest doggie in the world.



















blogger.com seems to have put all these photos in a rather random, non-chronological order... anyway i hope most of them are self-explanatory. the first pic is a bunch of us having dinner to farewell the physiotherapist girls from england. the next is a pic of the front of the hosp. the next is a lady carrying sugar cane. it is amazing what women can carry on their heads, almost always with no hands! such poise and grace! :) will try and put up some more pics of the hospital soon.

take care everyone,

superdha

happy birthday hoon!

happy birthday to you,
happy birthday to you,
happy birthday dear hoon c,
happy birthday to you, you crazy munt!

dha
p.s. hope you had an awesome day dawg! all the best for a fantastic year ahead, munting it up in akh :)

one and a half weeks at saint francis' hospital, katete, zambia

hello everyone. here i am at this ancient computer i discovered in one of the offices, which has internet access. at 56K modem speed. yeah. anyway, it saves having to go all the way to chipata (1.5 hours away) just to use the internet. it costs 500 kwacha (zambian currency) per minute. which sounds like a lot, until you remember that NZ$1 = 2000 kwacha. so it's not too bad.

thanks for all the messages on my blog guys - it's turning out to be hugely popular! hehe :-p

anyway. so. it's 0141 here on a sunday morning. i figured i would come at this time because one, there's no one else, and two, it's been a while since i've updated you all on things.

it's been almost two weeks since i've left now, and yet if feels like i have lived through months of experience. last week, i.e. tues - sunday, were all quite good days. sure it was a shock initially getting used to everything, the system, the people and their problems, and so on. but since it was all a steep learning and cultural curve it was all sort of new, and exciting.

this last week has been a really tough week though. especially after sunday. sunday was a great day - just chilling in the african sun, eating sugar cane and mealie meal (african staple - like maize made into a thick doughie thing that you eat with curries and relishes and veges), playing football and basketball with the locals, and generally recharging the batteries and soaking up the atmosphere. monday was actually not too bad. i am on the male medical ward (st. augustine) at the moment, and was doing my ward round on my half of the patients (the other doc, ronan, a crazy irishman, here with his even crazier, 7 foot tall fellow irishman, donal, who didn't shut his punts). anyway. monday was really really good. i felt like i was diagnosing and helping people. curing them, even. pneumonias were getting better. tb was getting diagnosed. thrush was being banished away. and patients loved me, and appreciated what i was doing. i felt good, like i was making a difference.

what a bubble it turned out to be! tuesday was the big pop. the 'obvious' case of malaria who seemed to improve remarkably after a few doses of quinine suddenly became a not-obviously-malaria at all case and suddenly dropped his gcs, aspirate all the food his loving family were shoving down his throat, spike temperatures, and generally deteriorate markedly. none of us could get a lumbar puncture. the nurses didn't do the nasogastric tube. i had to sit in his faeces and urine trying to get the lumbar puncture. the pneumonias got worse. the diarrhoeas suddenly got constipated and obstructed. the lovely patient with kaposi's who was actually super well otherwise, got a chest infection, diarrhoea, and a urine infection. simultaneously.

so. from tuesday to friday - this is what it was like... people deteriorated no matter what you did, despite every possible treatment for every possible cause of their problems. the relatively healthy people, the ones you nurtured your small amounts of hope with, suddenly got worse. and people died. many, many people died. i will never forget these patients. i don't mention their names or their details here, for brevity. but i remember all their names, their histories, their families, their stories. it was demoralising. suddenly it seemed like - are we really making any difference?

slowly it's getting better. you quickly learn that you cannot, must not, put everything, all the responsibility and burden, solely on your shoulders. you cannot blame yourself for people dying. many of these poor people are almost destined to die by the time they get to hospital, and no amount of thinking 'what could i have done differently? if only i paid more attention to this symptom, or read more about this' and so on, would actually have changed anything. you also learn to not let the few terrible, awful things that do happen every day, make you forget about everything else - the smiles you can put on people's faces, the things that you do get right, the people that you do cure and discharge, the many things that you do make better in this harsh environment.

so yes. it is definitely turning out to be a character building experience. it definitely is not easy going. every moment is challenging, intellectually, emotionally, philosophically. death is every where. when someone dies there soon follows a procession where the family carries the body away, while the women wail. it is a terrible sound. it always chills me to my bones, whenever i hear it. i talked to a patient, the one with kaposi's sarcoma who was pretty well but had developed a chest infection, and had just started talking to the next patient. two minutes later, literally two minutes later - he was dead. it's really hard to cope with things. one also learns quickly that one cannot get too emotionally attached in a place like this. i do get attached to patients though. i have fun with them, laugh and make things bearable, and genuinely want to make them better. i try everything i know. and in that sense i do get attached, and if they die - a part of me aches, because this was someone i was trying to help, someone who was more than a complex of symptoms and syndromes to me. but you learn quickly that, although it is ok to ache, and feel sad - that feeling cannot persist for very long, and it especially cannot be allowed to grow into anything larger, like guilt...

anyway. what about everything else. i have been trying to soak up the culture and experiences outside hospital as well. i am a very important member now of both the basketball team and the football team. in fact i have a big game tomorrow playing football against the chipata rangers, and in the next few weeks we might be playing a professional side from botswana! the people here are amazing - so friendly, welcoming, and unassuming. what you see is what you get. there is a genuine warmth and affection for fellow human beings here. the food is great. so many things bring back memories from my times in africa. the sun, the dust, the dry grass, the fanta in old-school bottles that isn't fizzy any more, the colourful clothes, the sounds of drums and lively music everywhere, the fruits, the markets, the smells and sounds.

i am getting a 'suit' (shirt and trousers) made from chitengas (cloths you can buy, with all kind of fantastic patterns/designs, and then give to tailor who makes the clothes for you out of them) - which i am very excited about! it's yellow, and very african. should be lethal! but fantastic.

next week is a big chief's party, which apparently all hospital staff are invited to. all the big chiefs are invited, and it should be a great time. hopefully my suit will be done by then.

anyway. i don't know what else to talk about. i am sure there is so much more to talk about. but i don't want to bore you to death with allll of it. i am taking so, so many amazing photos! i will try and put a few up here, if this computer lets me (i don't even know if it has usb ports!).

how is your holiday going ilia? drunk enough chianti to last a lifetime? how is everything at home, all you lovely new zealand people? keep me updated with the happenings back home! i hardly even get to hear about the news in the world! i heard about the whole london almost-bombing thing like almost a week later when my dad mentioned it!

take care everyone, and keep in touch!

dha
p.s. rayji! congrats on winning!! wow! maybe you guys don't need me at all!
p.p.s. thanks hoon for emailing me all that stuff. i kinda sorted it all out with my dad. i ticked mps cos that's what a lot of the senior docs recommended. but i might be wrong. anyway i'll let you know if i have any probs, as i may need your help!

why

my dad just called me on my cellphone.

i have been liaising with him in a last minute desperate rush to complete my job applications.

it was noisy. the computers were't working properly. the phone reception was bad. and i was frustrated, and stressed. and then i got cross.

in his voice i heard the sound of a tear, from deep inside. he misses me. he cried at the airport. i have only seen him cry twice before. and here he was trying to do as much as he could to help me, rushing to work at 9pm to sort out stuff that i should have been prepared for months ago, and i shout, raise my voice, and vent my frustrations on him.

now i am crying. apologies aren't enough sometimes, when the damage has already been done.

sometimes i wish i could simply press a button and rewind. change things that i have done, and said. how many things i would change...

'we live and we learn, yeah?'

i miss you tracy. i miss you thathi. i miss you ammi. i miss you, muntz.

in an instant i suddenly feel so far away again... the confidence i had yesterday suddenly seems so inappropriate. who am i, what good is what i do, if i hurt my family so?

hopefully i will be better by monday - when i will have to again face the never ending waves of illness, disease, poverty. the amazing patience, tolerance and hope that these poor people have despite all of the suffering, strife and death, really does inspire me sometimes, and puts into context our trivial, cerebral problems...

take care everyone,

i love you all,

-superdha

superdha in zambia

hello everyone!

it's only been a week since i left new zealand, yet it feels like so, so much longer!

here i am in chipata, a rather big town an hour and a half drive from saint francis mission hospital, which is where i am working at the moment. i've come here to chipata for one thing - internet.

ok. so much has been happening - i really don't know where to start! i will have to type quickly, so i am afraid that grammar, spelling and poetry will not have the highest priorities!

it's been a really great experience so far! i love being back in africa! the warmth, the dust and open landscapes that stretch out before you for miles and miles, the vitality and vibrance that beats around you all the time like the african drums themselves. the hospital is - amazing. i am on the male medical ward at the moment, with an african doctor and an irish doc (a 2nd yr house officer). words cannot begin to describe the things i am seeing and doing here. in my first day i saw more pathology than i think i have seen in the last two years back home...

- HIV/AIDS - almost everywhere
- Tb - pulmonary, miliary etc.
- Kaposi's sarcomas - the craziest KS ever, and disseminated KS
- severe cardiac failure
- 4L of empyema
- 4L of ascites
- Kwashiorkor
- horrific trauma
- meningitis - all the types, and lots of cryptococcal meningitis
- candida like one has never seen candida before
- herpes
- syphilis
- leprosy
- malaria - how could i leave this till last

and heaps more. i think i have made a list of about fifty things so far.

sorry for the medical blah. i was going to do a leo's email and explain it all in great detail (and with a slightly patronising tone) but i simply don't have the time just yet, i am afraid.

it hasn't been easy though. it has taken a lot of getting used to. and there are ups and downs. yesterday was a fantastic day. i did so much - ward round, HIV clinic, LPs and pleural and ascitic taps - and i felt like i really was doing something, you know? like i was really helping people. people appreciated me, and what i was doing, no matter how simple it may have been. i was helping people, and they were grateful.

i felt like a doctor. i feel like a doctor.

i feel like - i can do this.

but as i said. there are ups and downs.

i miss home so much. i miss my friends. i miss my mother and father.

i miss tracy.

it is a physical emotion now - it knaws at my insides.

i have to go now... i will try and write when i can. please write on this blog, and include some meaningful things sometimes! i appreciate every word!

take care everyone, and i hope you're having a good elective ilia,

i miss you all, and can't wait to be back,

till then i'm going to savour this as much as possible!

-superdha

'please don't go home and cry'

'please don't go home and cry'.

the words fell like empty feathers through the air. the silence a gaping hole in my soul as i turned away, towards the door.

i try to rationalise. 'in the vast canvas of time, eight weeks is a mere dot of ink.' but the truth is that reality will hit me soon. you have all of your mind to think about what it's going to be like over the next eight weeks till we see each other again. but for me - my mind is occupied by so many things. what is africa going to be like? am i going to survive? will i get destroyed? or will it fuel me to the heights i have always wanted to fly to? will i flourish or falter when the time for me comes?

the reality is - in a week's time, deep in the heart of rural zambia - i will miss you. and i will miss you terribly. then, my tears will come.

what is this haze around me? a haze so fine, that it's almost unnoticeable. but it's there. it hums, softly.

silently, steadily, the shadows creep around me, dragging my consciousness to the realm of dreams.

goodnight sweetheart. i wish i could be the strength you need right now, instead of this haze of a person.

perhaps...

the countdown begins.

at the moment it is wednesday. well, the last remaining fragments of it anyway.
saturday is the day. at 1550 i am scheduled to leave.

auckland -> sydney. one night in sydney.
sydney -> johannesburg. one night.
jo'burg -> lusaka. one night in lusaka.
lusaka -> katete (rural town in zambia), by 'luxury' bus. 6 weeks working at saint francis memorial hospital.

then...

lusaka -> london. 6 weeks in london working at the maudsley at the institute of psychiatry.

then 12 days to spend with my lovely girlfriend in paris and the south of france.

i cannot help but be absolutely petrified about zambia. i know that it will be one of the most, if not the most, rewarding experiences of my life. but - it will all be so new and completely different to all the medicine i have done up till now. and - i probably will know nothing! (despite the 20% of oxford handbook of tropical medicine that i have managed to read). 20th panic attack for today occurs now.

but seriously. there is still so much to do.

perhaps...

i should really get myself into gear.

- list of things to take: not completed. mostly in my head. which has proven time and time again to be a terribly unreliable place.
- suitcase: as of today, check!
- packing suitcase: no. not even commenced. at all. nada. zip.
- sort out europe extravaganza, accommo in paris, travelling in france etc.: still to do.
- change bulb in room: not yet.
- read tropical medicine and psychiatry notes: hm. looking very unlikely now.
- spend time with mom, dad, tracy, nirosh, and everyone else: struggling.
- second labcoat: get tomorrow.
- get *correct* charger for ipod (after trying to be cheap and saving $5 on trademe buying one that really was the wrong one - my fault - i didn't read the auction text properly): do tomorrow
- actually get out of my writer's block properly and start writing decent things: working on it, as you can see.

perhaps...

consciousness in the fog

driving home in the fog. the guitar plays loud. i wonder.
as thoughts clamber one on top of the other -
swerve! -
this man walks across the road, an umbrella shielding him from the drops.
what is he thinking? are thoughts racing through his mind too? to what light does he drift towards, on such a night? what solace does he seek, drifting through this wet world?
and then it is red. and i stop. but thoughts surround me. one at a time they attack with a million forks of doubt.
amongst this mad description of the frenzy that has been the last few weeks, hides the simple fact - i am terribly disorganised - and this chaos of the mind is all a result of all this last-minute planning for what should be - a fantastic elective.
i actually look forward to getting on the plane, sitting down in my seat, letting my head hit the headrest. because then, there is no turning back. no more thinking. everything that i could have done, all the planning, all the worrying, everything - now is out of my hands. and then i can sleep.

who am i kidding.

i will miss her. her hair. her voice. the comfort i get when i lay my head on her chest and under the sheets i can close my eyes, pushing the tears and fear away. i will miss her terribly. yet why does it not show more? is it hidden by the frenzy i am swirling in? is the frenzy, this whirlwind all a shield?

i hate money. i hate oil. i hate conflict. i hate pride. i hate egos. i hate wars. i hate injustice. i hate corruption. i hate inequality. i hate a lot of things in this world.

where do i start? i can read all i want. i can know all i need to know about all the wrongs in this beautiful world of ours. i can read all about the amazing people who are dedicating their lives to making this world a better place for us all, without having to plant their flags anywhere or charge for their services. but what about me?

what am i doing?

the rain pelters down now.

hard. steady. drumming down further into the blackness of my room. the bulb just blew.

i am a teen crying in angst in the rain. in the middle of the street looking up towards the sky and screaming out for answers.

pathetic.