The team has finally arrived. They go here on Saturday so Matt and I watched their kids, as the Village kids for a while, while they went to Joburg to pick the team up from the airport. They showed up late that night and things have been a little different since then. There are six people here for two weeks and it feels so weird having this many people around. However, it has its perks. For example, Matt's dad and sister are on the team and they came bearing gifts- and by gifts I mean candy, which I have not had in a while so it was a sweet surprise (see what I did there?) In addition, they schedule things for the team that we wouldn't do when its just us such as a trips to Thabong (the township where most of the poor live), mine tours, and a Fourth of July barbecue in the works.
Since they are here working on construction mainly, Matt and I are staying back from the hospital three days a week as well to help out. Work is moving incredibly fast and the house is now sheetrocked, painted, bricked around the outside, with mainly just interior touch-ups and furnishing left. They began building it in early May and it should be done in about the next week which is really awesome. Sometime very soon we will also be breaking ground on the foundation for the O'Tool's home here on the Village property. I have been working mainly alongside Louis and his brother Tim, who is here doing construction for 3 months. On a scale of 1 to 10 I know very little about construction so I have just been doing any labor that requires no skill (such as hauling bricks or digging holes) or whatever Louis tells me to, while we play games such as "guess the movie quote" or "how many S verbs can we think of". I may be unskilled labor but I like to think I'm worth my wages (think about that one for a second)
At the hospital, we continue to split our time between the medical wards and the ARV clinic. One day in the wards we were in a room of 8 patients and every single one of them had TB. If that doesn't make you hold your breath, I don't know what will. There was a man in the next room who had TB 5 times previously, which meant that he probably never took his medication and had a very high chance of MDR. We also saw a woman in the ward who we had ordered to be admitted when we saw her in Tshoanelo clinic. She had TB and a variety of other issues, so it was cool to see our efforts being worth something. There is an interesting phenomenon we've seen which I would like to do more research on when I get back home, HIV-induced vasculitis. Essentially, the virus attacks the walls of the vessels and they become inflamed which leads to poor circulation and possibly gangrene or stroke depending on where it is. This is what causes the number of young stroke patients to be so high here. The literature says that it is a rare condition but in just the last month we have seen more than I can count on one hand so clearly there is more to be learned. It is such a real treat being able to learn about these diseases so rarely seen in the US (HIV, TB, Meningitis, SJS, etc) and to learn them so in-depth and firsthand. I'm honestly going to miss having the chance to work with them when I get back home and stuck with boring old things like pancreatitis and broken fingers.
In the clinic, we have seen probably 75 patients so far overall. I would say about 90 percent of them we are able to take care of without consulting a doctor. Its interesting though how unique each case is and even with such a pointed focus we see different combinations of issues- high ALT, low Hb, pregnant, noncompliant, peripheral neuropathy, suspected TB, malnutrition, transfer, you name it. I really enjoy problem solving so it is actually a very fun experience for me. Some days we sit in with Dr. Nhiwatiwa in the teen HIV clinic as well and there is one case that specifically stuck out. He told us about a pair of twin girls that came in to him in 2003 when they were 9 years old. However, one was HIV-positive and the other not. The infected one was so small and sick that the other was carrying her in. The South African government wasn't allowing ARVs to be given then but he did anyways and now they are both 16 and doing better but the one is still so much smaller. It is a case where clearly HIV is the issue and not malnutrition or something else, and I wish HIV denialists could see what I see every day. With that specific girl though she now had TB and kidney issues which Dr. Nhiwatiwa missed until I showed him and so she was admitted. I look forward to reviewing her case.
I came in to this trip with a slight inclination towards infectious diseases and needy populations, but these experiences have put almost any question out of my mind that this is what I want to be doing. I have seen such a need in the population here and I know that there are places like it all over the world. I also went along with Louis today for a Bible study that he holds in Thabong. On the way we discussed missions and I explained to him where my passions lay. He told me about the things which drew him here and the amazing areas where God has been able to use him in ministering to the kids and many others. The great commission in Matthew 28:18-20 says, "And Jesus came and said to them, "All authority in heaven and on earth has been given to me. Go therefore and make disciples of all nations, baptizing them in the name of the Father and of the Son and of the Holy Spirit, teaching them to observe all that I have commanded you. And behold, I am with you always, to the end of the age." In poor and uneducated places there is a huge huge need for not only the gospel to be preached but for discipleship to take place. In South Africa, Christianity is actually pretty widespread but the people are so susceptible to the winds of any strange teachings and the addition of superstition and things like ancestor worship. The Lord is the greatest passion in my life and medicine is near the top, and I see so many reasons why missions would be the best place for me satisfy both of them.
Since they are here working on construction mainly, Matt and I are staying back from the hospital three days a week as well to help out. Work is moving incredibly fast and the house is now sheetrocked, painted, bricked around the outside, with mainly just interior touch-ups and furnishing left. They began building it in early May and it should be done in about the next week which is really awesome. Sometime very soon we will also be breaking ground on the foundation for the O'Tool's home here on the Village property. I have been working mainly alongside Louis and his brother Tim, who is here doing construction for 3 months. On a scale of 1 to 10 I know very little about construction so I have just been doing any labor that requires no skill (such as hauling bricks or digging holes) or whatever Louis tells me to, while we play games such as "guess the movie quote" or "how many S verbs can we think of". I may be unskilled labor but I like to think I'm worth my wages (think about that one for a second)
At the hospital, we continue to split our time between the medical wards and the ARV clinic. One day in the wards we were in a room of 8 patients and every single one of them had TB. If that doesn't make you hold your breath, I don't know what will. There was a man in the next room who had TB 5 times previously, which meant that he probably never took his medication and had a very high chance of MDR. We also saw a woman in the ward who we had ordered to be admitted when we saw her in Tshoanelo clinic. She had TB and a variety of other issues, so it was cool to see our efforts being worth something. There is an interesting phenomenon we've seen which I would like to do more research on when I get back home, HIV-induced vasculitis. Essentially, the virus attacks the walls of the vessels and they become inflamed which leads to poor circulation and possibly gangrene or stroke depending on where it is. This is what causes the number of young stroke patients to be so high here. The literature says that it is a rare condition but in just the last month we have seen more than I can count on one hand so clearly there is more to be learned. It is such a real treat being able to learn about these diseases so rarely seen in the US (HIV, TB, Meningitis, SJS, etc) and to learn them so in-depth and firsthand. I'm honestly going to miss having the chance to work with them when I get back home and stuck with boring old things like pancreatitis and broken fingers.
In the clinic, we have seen probably 75 patients so far overall. I would say about 90 percent of them we are able to take care of without consulting a doctor. Its interesting though how unique each case is and even with such a pointed focus we see different combinations of issues- high ALT, low Hb, pregnant, noncompliant, peripheral neuropathy, suspected TB, malnutrition, transfer, you name it. I really enjoy problem solving so it is actually a very fun experience for me. Some days we sit in with Dr. Nhiwatiwa in the teen HIV clinic as well and there is one case that specifically stuck out. He told us about a pair of twin girls that came in to him in 2003 when they were 9 years old. However, one was HIV-positive and the other not. The infected one was so small and sick that the other was carrying her in. The South African government wasn't allowing ARVs to be given then but he did anyways and now they are both 16 and doing better but the one is still so much smaller. It is a case where clearly HIV is the issue and not malnutrition or something else, and I wish HIV denialists could see what I see every day. With that specific girl though she now had TB and kidney issues which Dr. Nhiwatiwa missed until I showed him and so she was admitted. I look forward to reviewing her case.
I came in to this trip with a slight inclination towards infectious diseases and needy populations, but these experiences have put almost any question out of my mind that this is what I want to be doing. I have seen such a need in the population here and I know that there are places like it all over the world. I also went along with Louis today for a Bible study that he holds in Thabong. On the way we discussed missions and I explained to him where my passions lay. He told me about the things which drew him here and the amazing areas where God has been able to use him in ministering to the kids and many others. The great commission in Matthew 28:18-20 says, "And Jesus came and said to them, "All authority in heaven and on earth has been given to me. Go therefore and make disciples of all nations, baptizing them in the name of the Father and of the Son and of the Holy Spirit, teaching them to observe all that I have commanded you. And behold, I am with you always, to the end of the age." In poor and uneducated places there is a huge huge need for not only the gospel to be preached but for discipleship to take place. In South Africa, Christianity is actually pretty widespread but the people are so susceptible to the winds of any strange teachings and the addition of superstition and things like ancestor worship. The Lord is the greatest passion in my life and medicine is near the top, and I see so many reasons why missions would be the best place for me satisfy both of them.
.The children's cemetery near Thabong. They add approximately 20 graves a week just for infants and kids under the age of 5.
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