Monday, May 30, 2011

It's off to work I go


Now that we’ve been here for nearly two weeks, things are beginning to settle into a routine. Work is going well—everyone continues to be welcoming. I’ve started branching out from the mother-children health room and to other parts of the clinic. This afternoon I assisted one of the nurses in the consultation room. Because the clinic is short staffed due to the strike, there is only one doctor in the entire clinic, and she is needed for HIV consulting. Therefore, the nurses have to complete the entire consultation and prescribe medications to patients. I am learning how to collect a patient history and the kinds of medications that are prescribed for various ailments. Tomorrow I will be going with a nurse to a local preschool to help administer Vitamin A drops to children between 12 and 59 months. I’m very excited, especially because I imagine the kids will get a kick out of me because I look and sound so different from them. I think on Wednesday I will go to the HIV testing part of the clinic. I have a feeling that this may be the most challenging part for me because patients are tested and receive their results all within a single consultation. I’m not sure what to expect, especially in the situation where a patient receives positive results. In this part of the clinic, patients are also counseled on the ARV (Anti-Retroviral) treatment protocol. All patients must complete extensive counseling because adherence to the treatment is crucial. There is a very small range between maximum efficacy and viral development of resistance to the drug, a fate possibly worse than no treatment at all. This Thursday is a holiday, and we may try to arrange an appointment to spend some time with the cheetahs at Mokolodi. If there are no available times, we will try for a later Sunday. I can’t believe that we only have 4 more weekends before our internships are over. Time is flying by, even in Botswana time, which is notoriously 20 minutes late…

Thursday, May 26, 2011

Botswana on Strike


 I’m not sure if it’s being reported in the US, but there is a huge strike going on in Botswana. Thousands of public service workers have been on strike for the past five weeks, demanding a 16% salary increase from the government. All the government owned schools have been shut down (which is most of the schools because the government pays for education) and there are mass shortages of workers throughout the country. A few weeks ago the government gave all workers two weeks to return to work or else they would be dismissed. The two-week mark has passed and the government has submitted court appeal to workers in the health, education, sewage, water, and a few other fields to return to work or else they will be the first to be dismissed. Strikers say they will not give in, and they believe the government must give them the demanded increase. This is the first strike to ever happen and right now people are very concerned for the future of the country. It is impacting all areas of work, including the government clinic I am working at. There are significantly fewer patients coming to the clinic because they fear that the nurses and doctors working there are potential targets for choosing not to strike. However, the strike has not become violent against health workers, and there has been increased protective action. Today the leaders of the union were arrested, which may prove to be a turning point for the strike.

Botswana is a relatively new country, having gained independence in the mid 60’s, and this is the first strike they have ever experienced. It is clear from everyone’s reactions that this is something new and there is a lot of anxiety over how this is going to end. The government hasn’t followed through with their threats of dismissal, which I think might be giving hope to the strikers that there’s a chance of getting what they want. I don’t know much about their politics or economy, but I think 16% is pretty extravagant and it’ll be interesting to see how the government and workers resolve this, especially because resources are being stretched and the economy is already suffering because of the of the decreased demand for diamonds (Botswana’s primary export).

Other than the strike, work is great! As I mentioned, I was relocated to a clinic where I’ve been helping out in the mother-child health room. I finally succeeded in taking blood pressure (I knew how it worked in theory, but I could never hear the beats through the stethoscope) and I learned how to record everything on paper (no computers at the clinic!). Everyone I work with speaks Setswana and at least a little bit of English. The other nurses gave me the Setswana name “Masego” pronounced “Mahseho”, which means “Blessed”. I think they’ve already forgotten my English name, and now I immediately respond to Mahsego. They all get a kick out of my American accent, especially when I try to pronounce Setswana words. Everyone is very friendly at work, and I’m learning a lot about the Botswana culture and day-to-day life. I think the most interesting thing is that the government pays for pretty much everything, including health care and education (all the way through higher degrees, including medical school). I think in Botswana it’s especially important that the government pays for health care because of the extremely high HIV rate (>24%), but working at the clinic has also opened up my eyes to the problems created by free health care. From what I’ve been told by the nurses, and from what I have seen, there are people who seem less inclined to take care of themselves or their medical records/prescriptions because they know they will get new records or prescriptions whenever they need as long as they go to the clinic. One of the nurses noted that given the responsibility of paying for things, people will generally be more careful, if for no other reason than to avoid extra expenses. It’s still only been three days, so I’m sure I will observe and learn much more in order for develop a more informed understanding of how things work down here.

I think my body is finally beginning to adjust to Botswana time, though I will say waking up at 6:15 am every morning is still rough. Kaitlin, Julia and I went on an epic grocery run yesterday so hopefully we’ll have enough food to last us for at least two weeks. After work we come back to the dorms and usually chill until we’re too hungry to handle, and then make dinner. Tonight we’re baking some vegetables and making scrambled eggs. Dinner of champions.

This weekend we are planning to go down to the yacht club to watch the sunset. No one is really sure what to expect from the yacht club, especially because Botswana is a land locked country so the only place for the yachts is the lake. On Sunday we’re going to try to hike to the top of Kgale Hill. We hiked up part of it last Sunday, and I must admit it’s a pretty steep path, but definitely doable if we give ourselves enough time, wear proper clothes, and bring enough water. I also think we’re going spend Saturday at some place where we can get free wireless (still no wireless, still sharing an Ethernet cord). So hopefully I'll be able to post pictures on Saturday! I’m not sure if I’m going to post them here or just post the link to a picassa/flikr account. We’ll see.

Hope everything in the States is going well! I feel like I know so much about what’s going on in Botswana, but pretty much nothing about anything in the US!

Monday, May 23, 2011

Mokolodi-- A Night to Remember


Today was our first formal in-country orientation with the University of Botswana and the Botswana-UPenn Partnership (BUP). The BUP program directors are Gill (pronounced Jill) Jones, her daughter Nikki Jones, and a Botswana native Zeine. All three are amazingly kind, and I especially love Nikki Jones. We had a pretty standard talk about safety on campus and in Botswana, and about our resources at the Botswana-UPenn Partnership Office. After a hearty lunch and, get this, TEA BREAK (there are so many quirky British customs here), we had a break before our trip to the Mokolodi Game Reserve.

We arrived at Mokolodi and were greeted with glasses of champagne and some mango juice (they drink mango juice like water, it’s GREAT). We then boarded a 16 person “drive” truck and headed into the bush. I think Mokolodi is to Botswana what might be a cross between a zoo and a national park to us. It is a zoo in the sense that school children are taken there to learn about animals and wildlife preservation, and a national park in that everything is natural and is meant to be a place of preservation. The drive itself reminded me of the Indiana Jones ride at Disneyland—it was very bumpy and safari-like. We saw ostrich, impala, zebra, giraffe, hyena, cheetah, and warthog. Ostrich are HUGE, like the size of a small horse, at least. Boitumelo heard that the only way to kill one is to shoot it in the neck because its feathers are so large and strong. I’m not sure if that’s true, but after seeing its size I would not be surprised. Also, Nikki told me that people of Botswana use every part of an ostrich, including its beak and talons for diamond cutting. Impala are very cute, and one particular type has enormous ears that look like flower petals. The baby’s ears were literally the size of its head. The hyena and cheetah were actually kept in a sanctuary because both had been rescued very young. Like the ostrich, the hyena was surprisingly big. The guide attributed it to the fact that it was so well fed and comfortable in the reserve. If I had to pick, I’d say spotting the giraffe was the highlight of the game drive. Because the sun was in the last phase of setting, there was a beautiful mixture of purple, pink, and blue stripes in the sky. We were heading back for dinner after already seeing all the other animals. Suddenly Boitumelo excitedly gasps and we all turned our attention to what she saw—a huge giraffe standing still against the backdrop of the sunset. There was just enough light to distinguish the pattern of the giraffe but still be taken aback by the sight of its silhouette against the backdrop of the sky. I’ve seen a giraffe at the zoo, but seeing one in the wild is a completely different experience. It was so gracefully lean and its coat was beautiful and bright. At first the giraffe just looked at us, but as we began to follow it, it started to move away from us (we were in a giant, noisy truck). However what struck me was its lack of fear. Once it established a safe distance, it just stood there and continued to look at us. I almost wish I had one of those nice cameras because the combination of the light and its poses would have made phenomenal photographs that just don’t compare to what my little camera caught. However, maybe it wasn’t meant to be photographed, like it was something that needed to be experienced.   

We were all surprised when we stopped at a cove in the middle of the reserve and saw a fire and tables set up with plates, glasses, napkins, and food. When they uncovered the pans, there were massive amounts of chicken, beef, and sausages. Then they uncovered the maize-meal, cooked butternut squash, and garlic bread. For salad there was regular lettuce salad, a tangy bean salad, and coleslaw. To drink we had a choice of tea, coffee, or some Botswana cider. Because many of us hadn’t eaten since lunch, we felt like we were in heaven. Everything was delicious, especially the butternut squash and garlic bread. I really think that I could live off of butternut squash, it’s that delicious. While dinner was winding down, we began to hear voices chattering and singing in Setswana. Then a group of about 20 young Batswana came walking out singing a song in their native language. They were dressed in traditional clothes including seeds and leather wrapped around their lower legs that they used to hit and make sounds while they were dancing. They performed a few songs/dances for us that were phenomenal. Their energy and enthusiasm was amazing, not to mention the incredible physical shape they must have been in. Their dances included a lot of foot stomping and leg-drum slapping. Boitumelo explained that the songs and dances were a form of story telling. Traditional dancing is taught at many schools to children and then becomes a class option for older students. I think teaching these songs/dances to children is a great and effective way of preserving culture, especially because after either primary or secondary school, Batswana children are taught in English. That integration of cultural tradition with education is something that the United States is lacking.

Full and happy, we began to board the truck to head back to the cars to go home. As we took a short, unlit path, I took a moment to notice the sky. I have NEVER seen so many stars or stars as bright as I did tonight. I could actually see the color difference that distinguishes the Milky Way from the rest of the sky. It was breathtaking, and I love stargazing, so I think that one of the trips I want to do is to go to the Kalahari Desert to camp and star gaze. Apparently it is pitch black and silent, and according to Nikki, with a simple telescope you can see the rings of Saturn.

(Our wireless internet is not coming until early June, so right now we are sharing one Ethernet cord between 6 people and its REALLY slow, so pictures will come as soon as I have access to faster internet!)

Sunday, May 22, 2011

Dumela from Gaborone!



Dumela, meaning “Hello” is one of the few Setswana words that I can say without totally butchering the pronunciation, though it does not roll off my tongue like a native speaker’s. I arrived safely in Gaborone Thursday afternoon after a long 16-hour flight. Thankfully I wasn’t travelling alone; two other girls from my internship were on my flight, one of which I am living in a suite with. A driver and our student-assistant, Boitumela, picked us up from the airport and drove us to our dorms at the University of Botswana. She is starting her third year at University of Botswana, and she’s very nice and extremely patient. Over the past few days she’s spent essentially all her time with us (myself and the other interns). We are all so helpless and lost and she basically has to keep track and take care of us 24/7. Today at dinner she looked exhausted, yet she still asked us if we wanted to go out to a club after dinner, showing how much she wants us to have a good time. (We didn’t go to the club, everyone was tired and we felt bad for wearing her out over the past few days).

Botswana is a pretty simple city. They are entering the dry season, so everything is very dusty but the trees are still green. Right now there is a lot of construction happening at the University and throughout the city, so there are always big tractors on the roads, which are also simple. One very strange and disorienting thing is that they drive on the left side of the road! I’ve been in a car’s way at least twice, though the drivers are much more tame than Philadelphia drivers, so I’m sure I wouldn’t have actually been hit.  Everything is pretty much within walking distance of the university. Most people walk to and from work, but there are also taxis that always loiter around buildings looking for customers. As foreigners, we attract a lot of attention in the form of stares and sometime comments spoken in Setswana. Usually Boitumela speaks to them in Setswana, but when we are without her we usually respond to questions but not really to comments we don’t understand. I haven’t seen any wildlife other than some noisy birds outside my window and stray cats. Ironically, the Johannesburg airport was more stereotypically “African” than Gaborone is. At the airport there were several African stores that sold exotic items like animal skins and totem poles that only tourists would buy. Gaborone actually reminds me of a small town in way northern California, like the ones we drive through on our way to camp minus the excess of concrete and freeways. The weather has been very warm during the days and pretty chilly in the evening. Everyone keeps saying it is cold, but after surviving a few Philly winters my body is much more tolerant.   

Because our internships do not formally begin until Tuesday, we’ve spent the past few days adjusting to the time difference (I am 9 hours ahead of west coast time) and buying things for the dorms. There isn’t too much to do in Gaborone during the day, so we’ve been going to the mall pretty much every day to grocery shop and to get random things for the apartment. Tomorrow we are going to hike up a really big hill we drove by this afternoon, and Monday we have orientation. The other girls in my suite and I have been looking through our Botswana handbooks for activities we want to do, and we’ve added a few things to our list including buffets, Quizzo nights at a local bar, art exhibit, weekly movie screenings, stargazing (we can actually see stars here! And apparently the constellations are backwards because we are in the southern hemisphere), and more. So far everyone in the program seems pretty chill and friendly, and so I think we’ll be a close group. 

Also, it says that blogs are blocked on this network, so lets see how this goes...

Sunday, May 15, 2011

T-minus 3 days.

Well, I guess it should be T-minus 4 days, since I won't actually arrive in Gaborone until Thursday the 19th. For those of you doing the math, yes, I will be en-route for over 24 hours. I leave Philadelphia at 5:15 am Wednesday morning and arrive in Botswana at 12:35 pm Thursday afternoon. This past semester I took a class about sleep and chronobiology, and suffice it to say, my circadian rhythm will be WAY out of wack. Woohoo!

After reading through all my Botswana-related emails, I realized that I don't actually have much information on the details of my internship. I do know that I will be working in Princess Marina Hospital, and that I will be working on a hand hygiene project in the Infection Control Unit. We've been told that we'll get a better idea of what our project will be about once we start working, which will be Tuesday May 24th. I met with the girl who had my position last year, and she said that she spent a lot of her time putting together a report of the condition of hand hygiene in the different wards. From all the good things I've heard from her and others about her internship, I'm really looking forward to starting.

Once all the interns arrive, we'll have a few days to acquaint ourselves with Gabarone and each other.  On Monday the 23rd we'll have an in-country orientation at University of Botswana (where the other interns and I will be living) and then we'll go to the Mokolodi Game Reserve for a welcome bbq. I checked out the site and it looks like there are animals everywhere! Including rhinos and cheetahs and giraffes oh my!

 http://www.mokolodi.com/

Counting down the days...especially because philly weather SUCKS right now.