Highlights

Well, we are home and slowly adjusting to life back in the US. It's so strange to have things like internet and phones and be able to order labs at work. A post describing our entire week of vacation would be extremely long but I thought I would share some of the highlights of the week for me.

Our husbands arriving in Botswana has to be on the list. It was great to see them after 3 weeks. We all went out and climbed Kgale hill the day they arrived and it was a lot of fun showing them what we have been up to. Plus, we found yet another way to climb the hill so every trip has been different.

Our entire trip to Kwara camp in the Delta was amazing. Our guides found just about everything we wanted to see (except for the elusive leopard) even when it ment driving off road, over shrubs and trees to get there first. We saw lions eating a zebra (just a few feet from the car), a large pride of lions with 19 month old cubs, wild dogs killing an impala (gruesome as that was), cheetas, hippos, elephants and every antelope species you can imagine. the camp was beautiful (it's my kind of camping to have hardwood floors in your tent) and the food was great. Couldn't have asked for a better trip. We took a scenic flight over the delta which was great. It's fun to see the animals from the air and even saw a rhino which is apparently really rare.

Victoria Falls was beautiful, there is so much spray that it feels like it was raining. We even got to take a helicopter tour over the falls. It was short but one of my favorite things from the trip. I'm going to try to get some pictures uploaded later today, however I am not as smart as Micah and may not be able to figure it out. If not, I'll post a link to my snapfish account (assuming I can figure out how to post a link. I know it should be easy but I'll blame it on jet lag).

Made it home

We all made it home and are glad to be back. Will be talking to all of you soon. Note we are now driving on the right side of the road!

Short stopover in Germany

Last leg of our flight is on time and we are getting ready to board at 9:20am Frankfurt time with arrival in Houston still scheduled for 2:30pm Sunday afternoon!

Arrival in South Africa

We all just made it off the last prop job plane for quite a while. Think that makes 6 props total excluding the heli flight :)

So we will still be updating the blog with pictures/day-by-day blows of events, but it will have to happen from the comfort of our homes in the states, as dynamic, realtime blogging doesn't work so well when there is lack of power/internet

Leaving Botswana

So it appears Botswana doesn't want is to leave. We arrived back in town yesterday and are now in transit to the airport. The funny thing is that while it is in the 90's (deg. F) today, we got caught in a brief hail storm. Below is a picture of ice caught by one of Becca's luggage.

Still Alive

All, we have made it to the town of Kasane where we are looking at the Chobe National Park. will be trying to update the blog a big more now that we are at our second location which has power... well sometimes (we got back from our game ride this morning and the power was out, once it came back on they told me I should hurry ;)

(We will try to post some pictures later time/power/internet connection permitting)

We absolutely loved our first camp - Kwara Camp (Hi Blue - manager, General Custer - Guide/Best off road driver ever, and Justice - our expert spotter). We flew from Gabarone to a bare landing strip where "the General" was waiting to pick us up. From there we drove to our camp which had no electricity except for what could be provided by with a few solar panels (3 lights per tent only). Even with this limitation we really liked the camp and the people we met while there.

We had game drives where we would hardly ever stick to the roads and saw lions feeding on zebra, wild dogs (which I spotted the last day) attack a small antelope, etc...

I have < onclick="BLOG_clickHandler(this)" class="blsp-spelling-error" id="SPELLING_ERROR_6">internet time... Will post more later.

More Pictures and Plans

Well the guys (us) made it to Botswana today. Think the plans are to go hiking tonight before the sun sets... have to also find time to eat. Longer term:

1. We will start driving ourselves to Maun tomorrow (Saturday).
2. From there we will stay at a camp in the Okavango Delta (Kwara camp) for 2 days
3. Next we will fly up to the Chobe National Park where we will stay 3 days at the garden lodge
4. Take a day trip to Victoria Falls in neighboring Zimbabwe where we will need a visa to enter the country

As becca said someone posted the Africa Blog to Digg.com! Thanks to whomever that was. If you like this site please go to digg using this link and signup and digg us! so that others will have a chance of seeing this site.

So the internet in Botswana is a bit slow, but I managed to get some good photos uploaded...

South Africa Arrival

Scott and I, had a good flight from Germany just a bit bumpy other than that we met some nice Canadian & South African (working in Canada), needless to say I understand much more about African tribes and marrage culture.

We had some luggage issues which forced us to claim Scott's bag then get passports stamped both in and out, We are now enroute to our short 1 hour plane ride to Gaborone

See our beautiful ride:

Ha, thought you would fall for that... this is the real plane:

Last Day at Work

Hey everybody, it's our last day of work today. So someone posted our blog on digg.com. I've never heard of digg which according to Portia makes me out of the loop. I should be used to this by now I guess. It was posted by cottonsheep, who I also don't know. At least I don't think I know someone named cottonsheep. Maybe I do, who knows. A day of new things I guess. So if you are cottonsheep and I know you let me know who you are and if I don't know you, hello, nice to meet you.

The guys should be nearing Jo'burg now. Their flight was a little delayed but they should make it in plenty of time. We'll be picking them up from the airport. Then we start our week of vacation. We, in theory, are climbing Kgale hill this afternoon. I say in theory because let's face it, it has been really really hot the last few days and it doesn't get cooler until after the sun goes down (not the safest time to climb the side of the mountain). We may start and collapse on the side of the hill and never get up again. And I'm pretty sure that Tim or Paul (i think his name is Paul) or which ever taxi driver we use will not exert much energy to come and find us. By the way, I love the fact that I am in a country where you are walking around somewhere and a stranger comes up to you and says "do you need a ride" and you get in his car. Just like that. Oh well, it's worked so far.

Tomorrow we get up ridiculously early and drive to Maun. Which is very far away and will be a very long drive. Luckily there is a rhino sanctuary along the way and since in Kruger I only saw a rhino for .2 seconds before it turned it's butt to me and walked away, I think we should stop. We'll stay in Maun for the night then fly to Kwara camp in the delta where it is 2 days of game viewing in croc and hippo infested waters (at least that's what I keep telling Portia). Next, we head to Chobe where we will be staying at the garden lodge for 3 nights. One of those days we will head to Zambia to see Victoria Falls. Should be a good time. I don't think we will have internet access so most likely further updates will be once we get home.

More things you can't get in Botswana:
IO set ups
A maid who doesn't eat all your bread
Real Snickers (it says Snickers on the package but doesn't taste like Snickers) - Snickers is kind of a fun word.
All mexican food products - they say they are here but they are lying.

More later - Becca

9am Frankfurt Germany time

So we made it to our 12 hour stopover in Germany, we had a good day (though it was a bit wet and rainy - we layered clothes and were fine). We ventured to the city for a look around and am now back in the airport awaiting our longest leg to Johannesburg, South Africa... Both of us taking cat naps trying to get used to time shift!

Germany likes America

Sorry, this isn't of much value... But I thought it was funny. This sign was outside of one of the many museums in Frankfurt... Course it was also right near a line of trash cans.

7:10 - Over Washington DC

Not sure if this is Washington DC, but the video screen shows that we are close. Food was good (Beef) with lots of liquids. Only took one nap so far, Scott and I mostly reading books/ebooks

Last Week

Well, we are on our last week before our vacation starts. The time has flown by. I'm still on the wards and it's been interesting. The lack of resources (though I admit I am spoiled because I work at TCH) is frustrating but more so is the apathy of the staff. Here when children die it seems not to be a big deal and I just can't wrap my brain around that. I know that more often here than at home times will come when you just can't do anything but I think you should always try. There is no medical school here so I'm sure that plays a part. I have now been to 2 resucitations. One the child died in the ICU and the other I think is fine. There are no IO needles here so you try to use regular needles (guess how well that works). We ended up fluid bolusing a kid via NG because after 2.5 hours no one had managed to get a line. It actually worked quite well but not something I'm willing to do at home.

Yesterday we went on outreach which Portia has already talked about so I won't go into details. She failed to mention that as we were bumping along the Botswana country side the radio was playing such great hits at Ace of Base and We Will Rock You which our Botswana counterparts were quite excited about. It was entertaining. All were we missing was some hairspray and ripped jeans.

Since we go done early yesterday afternoon we went out to Botswana craft which is sort of a cooperative of local women who make some of the local crafts. They have some of the most interesting baskets. Unfortunately, the big ones were well out of my price range. They also have a lot of stuff made out of ostrich egg and I got a bracelet. Apparently, they use the eggs to store water then when they break make jewelry and other decorations out of it. For those of you who don't remember my last trip to Africa, never eat an ostrich egg. It deceptively looks like an egg but has a really gritty consistency and an after taste that just won't go away.

Scott and Micah should be nearing Frankfurt right now. They take the same route we did on the way here and should get here tomorrow afternoon. Can't wait to see them.
Becca

Almost off the ground

We are currently on the tarmac, should be in the air soon
-Micah/Scott (we were too shy to take pictures of ourself)

Outreach

Outreach basically consists of going to people's homes and checking up on them etc. We drove to a nearby village to test 2 children for HIV. The mother knew we were coming and "went to go get firewood"...for about 6 hours. Just trying to avoid us because we cannot test the children without her permission. They lived in the traditional circle huts made of mud with a thatched roof. There was nothing inside the hut other than a few scattered items like a shoe, bowl, etc. There was a small cooking area outside that consisted of a fire pit and a few grilling pieces. The next house was a plaster house with only one room and of course no indoor plumbing/electricity. An older sister and brother stayed there and took care of their younger siblings. However, the older sibs were unemployed and unwilling to look for work, which means their younger sibs are on Food Basket and government programs which barely provide enough for basic dietary requirements. (and absolutely no veggies - scurvy crossed my mind) We were checking on her little sister who was taking her TB medication and recovering from malnutrition. She actually looked pretty good today. Stunted growth of course, but no signs of overt deficiency now. She also had speech delay, but you can add speech therapy to the list of things you can't get in Botswana. Next we went to a daycare and a local clinic to see if anyone needed us. There is a large group of orphans coming to the daycare next week that they will arrange to meet and test if they want. Another group of kids really needed a PPD, but we don't have them. Hopefully tomorrow we can get some from a local clinic and go test these kids. I'm so sure the younger brother has TB, I don't know if I even want one. :-) We went to the last house on our list to check if a recently diagnosed mother had taken her kids to get treated at the local HIV clinic. Of course not. We had a long chat about the importance of treatment blah blah blah. If she doesn't show up in clinic tomorrow, we are going to find her. I am going to try and do outreach again tomorrow. So far I have enjoyed it the most out of all the things we have done. Hopefully, tomorrow we are going to meet a group of kids for testing.

We have also been working on a presentation for journal club tomorrow. My brain is fried thinking of maximal likelihood analysis and phylogenetic trees. I can't wait until that is over. I never want to hear the words "phylogenetic tree" again.

Answering Questions

1. You can get coke products (especially fanta) everywhere for 3.5Pula. They do have a KFC, but no McDonald's. The more popular fast food chains are Nando's (chicken), Winky's (burgers), Hungry Lion (chicken), Debonairs (the afore mentioned pizza place), and Something Fishy (a fish place). No drive thru. You can get a lot of the basics here (including toilet paper), they just aren't the brands you are used too. Fresh milk only available in the whole milk variety. We finally found pretzels yesterday. The mexican food people say is available here still eludes us. Lots of chips, including beef flavored.

2. Guns are illegal in Botswana and only the army has them. Not even the cops. So.. no GSWs. (and I haven't seen a spear wound yet...I think that is more the Zulu's) Mainly lots of infections.

3. It is super hard to get a line here. (I'll let Becca talk about that adventure later) They don't have IO kits (they just use the biggest needle they have). And forget about central lines or cut downs.

Going on Outreach to people's homes today. Will tell you how it goes later.

Last Day in the Kalahari

The second night was a little more restful. At least I didn't hear any animals though the other tent had something scratching at it all night. Probably just a mouse but more fun to think it was something bigger. We woke very early again and set out for another game drive. More of the same springbok, hartabeest and orynx. We also found a couple of large tortises and an eagle. We followed leopard and lion tracks for quite a while but alas they eluded us. After our drive we ate breakfast and packed up camp. On the way home we stopped at the Kutse Lodge for lunch and a swim in the pool. The cold water was very refreshing after 2 days in the dessert without airconditioning. The rest of the trip home was rather uneventful. It did rain on the way home and as our land rover had no windows I got a bit wet.

More things not found in Botswana:
Gentic workups
Metabolic workups
Vending machines

More later - Becca

More of the Kalahari

The tents we put are "lion proof". The tents are made of heavy duty canvas that is cross weaved so if they do put a claw in, it only goes an inch or so. Apparently this makes it "lion proof". We were under strict instruction that if we had to go out at night, we were to go in groups or call Tim and he would go with us. We had hyenas in our camp the first night (never heard them, but the tracks were there in the morning). We heard the lions talking to each other at about 3am. I thought they sounded far away (which helped me sleep), it wasn't until the morning I found out they were only 500m away. The next morning at sunrise (530am augugh), we went on another game drive to find the lions. We finally found them a couple of kilometers down the road. They commonly follow the road to travel (its easier). There was one male and 2 females. Becca got some great close up shots as they were only 25 feet or so from the car. There are 5 prides of lion that live in the Kalahari, and the researchers are doing a lot of stuff with them. Apparently 6 years ago they stopped breeding for 3 years. No one is really sure why, and then 3 years ago, they started breeding again, but this time all of the cubs survived (usual death rate ~95%). They are trying to find out why. We returned to camp and sat in the heat for a few hours. I tried to sleep, but it was too hot in the tent. We went out again in the afternoon. Becca and I were riding on top of the land rover and got quite a sunburn (even using sunscreen). Once we finally stopped, we saw rain coming in. I thought it was actually kinda fun to see the rain roll in across the desert. (btw, the desert is covered with grass that is about 2 feet high and looks like johnson grass. there are a lot of scrub bushes except on the pans, and a few small trees. under everything is only sand). It wasn't as much fun when we went to camp and had to fix our tents and collect the things that had blown away/gotten wet. That night we all went to bed a little early we were so tired. I learned a lot of things however from quizzing Tim incessantly. He showed me some basics of tracking (what the prints looked like, how to tell how old it is). And I just learned a lot of random facts about the animals. Kodo can tolerate raises in their core body temp, they dont sweat, and they can stop urinating to conserve water. They excrete a concentrated uric acid pellet instead. They are the most adapted of the desert antelope. Lions travel in prides which consist of the lioness, a dominate male and perhap a couple others (if there is more than one male, they are usually related), and the cubs. Males come and go and they are only there to breed and protect the lionesses from other male lions. The lioness hunts and protects the territory. Once a male is 1-2 years old, he is kicked out of the pride and spends some time in solitary until he can take over a new pride. Once he does, he kills all the cubs of the previous male (unless the lioness can hide them). Male lions often only live to be about 5 years old in the wild and are usually killed by other lions (if not by humans). The government prohibts the killing of lions and reimburses you for the loss of an animal if it is killed by a lion. what else.... ostrich's share the responsibility of sitting on the nest. Giraffes live to be about 15 years old. Rhinos and hippos stomp out fires if they see them. Elephants are very aware of their surroundings and are actually amazingly quiet. There are a number of lion prides in northern botswana that have learned to hunt elephants. I'll think of other stuff later. Gotta get back to clinic.

Kalahari Day 1

On Friday we had a half day of clinic and then headed off for the Kalahari. Our campsite is only 200 km from Gabarone but only 80 of that was paved. We were riding in a landrover with no airconditioning so it was a hot trip. The biggest problem on the way there were all the cows, goats and donkeys that would wander into the road. Our camp site was basic but nicer than expected. There was a "shower" and toilet area. Both were enclosed and the shower is a large bucket on a pulley that you fill with water and then turn a spout to let the water out the bottom. We quickly set up camp and went out for a game drive. The Kalahari is a scrub dessert and this is the rainy season so everything is relatively green. It is dotted with pans which are areas where water collects and therefore has a high salt content in the ground. Less vegetation grows here and it is easier to spot animals. We saw herds of orynx, red hartebeest, springbok, a couple kudu, 5 giraffe including one baby and lots of birds. That night was clear and you could see the milkyway perfectly. It cooled off once the sun went down which was very nice. We feel asleep that night listening to the sounds of insects, lions and jackels.

A few more random things to add to what you can not get in Botswana:
Colonoscopy's
EEG unless at the private hospital and an emergency (though no one could come up with something emergent enough to warrent and EEG)
Echo's read by a cardiologist (you read your own and let''s just say that doesn't work very well)
Hot Fudge - by far the most disturbing of the list.
Blended drinks such as pina coladas

I have to head to clinic now but we'll tell you about the rest of the trip later.
Becca

Weekend

Hello all, just a quick line to let you know we are leaving for the Kalahari this afternoon so no new posts until Monday. We'll watch out for the lions that occationally wander in to camp and take lots of pictures. Don't worry, we will be in lion proof tents. More later.

Becca

Princess Marina

Just realized I have never described the hospital to you. There are 2 hospitals in Gabs, one is a private hospital and ok from what I understand, and the other is Princess Marina. We work at Princess Marina which is the African equivalent to BenTaub. It is a series of one story buildings with walkways in between. (no air conditioning) The wards are divided by specialty and sex (males on one side, females on the other ward). The pediatric ward is a large rectangular room with 4 "pods" which are semi-divided areas that have 8 beds per pod. There are no dividing curtains between pods and absolutely no privacy. Usually the entire side of a pod listens in while we discuss things with the patient. There are beds and a small bed table, but nothing else. No IV poles or anything. All the charts are kept on a table in the front of the pod. The charts themselves are flimsy manila folders with papers inside. Very limited organization. Labs are not really recorded anywhere, just on backs of the paper if someone thought about it (almost always without a date). There is one treatment room where we draw blood and start IVs. A lot of the longer term chemo kids get smaller rooms in the back with only 4-6 kids per room. There are no ancillary staff (no phlebotomists, no respiratory therapists, nothing).

I found a lady today just outside the hospital that makes fresh french fries while you wait. mmmm. I also tried some fat cakes today which are basically doughnuts, but not as sweet and more dense. There are a ton of ladies who sell food around town for extra money for their families. Most are really good too. Lots of them also sell maize, which is basically a really large, not-so-sweet corn on the cob.

Random facts:
The phonebook for all of Botswana is smaller than the Temple/Belton phone book.
This is the rainy season...it has rained twice since we have been here.

Other things we can't get:
Oral cytoxan
PICCs
Portacaths for chemo kids

Things that don't work in Botswana

1. Cab drivers - never have change despite collecting small fares all day long
2. Pizza delivery - not on time (not that anything is here, and pizza has no sauce)
3. Medical Officers
4. The lab after 2pm
5. Firemen - come 45 minutes after you call
6. Anyone on a sunday
7. The workers in the information booth
8. Electronics may or may not depending on which house you are in
9. Radiology
10. Garbage men
11. Gardeners
12. Nurses (but only in Gabarone, in the other cities they are great - sometimes the only medical care available)
13. The entire NICU

Things that do work
1. The coffee machine downstairs. (quickly becoming addicted)
2. The baylor clinic
3. The electric fence (I think Becca has even gotten used to the beeping)

Adding to the list of medical things I can't get here: (I am in a listing mood today)
1. pheresis
2. ENT
3. Urine Cath
4. VCUG

Pictures at last!

Villages

Today I got up early to climb Kgale hill again. This time I went with one of the PAC docs, his wife and sister. We used a real path this time then got a bit lost and took what may have been a path and what may have been an old rock slide. It was a really fun climb but probably took longer than it should have. I took my camara this time so I got some views from the top. After the hike there was time for a quick shower and then off to visit some of the surrounding villages. Our first stop was Oodi where there are a group of women weavers. They do amazing work. Apparently it takes a month to do one square meter. And they doen't use a pattern. Our next stop was Gabane where they have a really great pottery shop. It's not open on weekend but there is a phone number on the door and if you call it the head potter will come and open the shop. He had really high quality really pretty stuff and I highly suggest that people stop there if in the area. I'm not sure how I'm going to get all the stuff I bought back and luckily I ran out of money otherwise I would have gotten more. After the shopping we stopped at a local bar/restaurant. On sundays you can go to their braai. You pick out your piece of meat (beef or chicken and priced by size) and take it to the grill. It comes with paup (spelled that wrong) which is the local carbohydrate. Doesn't taste like much and has the consistency of gritty mashed potatos. You can put various things on it like spices or your grilled meat. I think it's palatable, Portia likes it. That's was our trip to the surrounding villages. I am in clinic this week while Portia is over at the hospital. We'll write more later.
Becca

Safari :-)

So we went on our first safari on Sat. There is a game reserve just south of Gabs called the Mokolodi Game Reserve. We initially wanted to do the rhino tracking, but friends who were going with us decided to do the cheetah petting/game drive, so off we went. The cheetahs were orphaned as cubs when a farmer shot their mother. The initial plan was to release them back into the wild, so the reserve workers tried to teach them how to hunt. They would throw live chickens into the enclosure for the cheetahs to hunt, but as soon as the chickens would start making noise and flapping their wings, the cheetahs would get scared and run and hide. Same thing with goats. So.... they eventually gave up and now the cheetahs are there to stay. So when you go to pet the cheetahs you enter a gated enclosure with the guide and the instructions to "go and find the cheetahs". Even though they are tame, it kinda makes you nervous to go looking for a large wild cat. When you finally find one, as soon as they see you they start to purr. They sound like a diesel engine. One of them doesn't like to be petted as much and just walks away after a while. The other one let us scratch behind his ear for the longest time. He even started to "play" with Becca (I don't think it was appreciated). When they saw an impala outside the enclosure, they ran to the fence and acted just like my dogs do when they see something out the window. :-) The rest of the drive was a lot of fun too. We saw a herd of impala (including rutting males), 2 giraffe, 4 elephants (tame), lots of warthogs (including 2 babies), baboons, two hippos in the water, ostriches, and hartebeest. Becca got some great shots with her long range camera. Glad we didn't do the rhino tracking since even the rhino tracker didn't find the rhinos. The rest of the day was pretty lazy, had lunch at Sanitas (a local restaurant in a garden center), took a nap, and went out to the Riverwalk at night for pizza and a movie. (We saw Holiday since we figured the guys would never go with us).

I started in the hospital today. More of the same inefficiency. It took me less time to find materials (in the clinic not in the hospital) and draw blood than it did for the nurse to enter the order in the computer. Botswana has fairly socialist policies, so they try to employ as many people as possible. The result is 5 people for one job. Thus everyone has the attitude of "someone else will do it." Things are very difficult to get done, and most people find it easier just to say they can't do something or something isn't available than to actually go and look. Which reminds me I should go back over and check on something. Will post pics when done with the hospital. Unfortunately today you will only get the pics from my camera. Tomorrow we are going to bring Becca's long range and see if her memory card works in my camera.

Missing Continent

Interesting, I just noticed that the visitor map I attached about a week ago shows that the Africa, Botswana blog for Portia and Becca has been visited by every continent except for one...

Antarctica... I just had lunch with a friend Rhonda and her husband who will be traveling to Antarctica in the next couple weeks through South America and then a ship adventure, so I will put in a request to them that if once they make landfall (or is that icefall?) if there is perhaps an Internet cafe feel free to look up the Blog ;)

That's right, looking at the map it appears we easily have North America, South America, Europe, Africa (wonder who that can be), and perhaps the most interesting part is that besides Australia (trust me it is a continent... I will not make the same mistake that Jeff made during Survivor) and their high popularity in Europe, they captured Asia... and not by the usual suspects, but rather by either Iraq (most probable?), Iran, or Saudi Arabia it appears!

In case anyone would like a primer on continents see links here to start out.

Quick Update

Their 3rd day in clinic was very busy, will let them fill in the details later. As it is their weekend, they will probably not have internet access unless they decide to stop into town and find an internet cafe.

When I called Portia this morning they were actually on a mini-safari where they saw a few types of animals and aparently got to pet cheetas (something about the cheeta wanting to 'play' with Becca didn't make her feel too comfortable). I will be helping them post pictures hopefully Monday.

Tomorrow (Sunday) they are supposed to go and visit 2 villeges. I hope the report is positive!

Clinic Day 2

Well, not much to say today. We had another day in clinic. It was much busier than yesterday. People seem to be getting back from the holidays. We're still shadowing people but hopefully that will end soon as well. We have our plans set for this coming weekend. On Sat we are going to Mokolodi which is a private game reserve right outside of Gabarone. They have cheetas you can pet and other animals. It should be a good time. On Sun we are going to some of the surrounding villages with one of the PAC docs to get out and see some of the countryside. I'm really looking forward to that. Nothing else much to report for now.
Becca

Clinic at Last!

WE HAVE A CELL PHONE!!!!! We are no longer isolated. (can you tell how happy we are). The cell phone stores finally opened up today. We can now call taxis, loved ones, heck even get pizza delivery. We are no longer isolated.

our number is 011-267-72690783

Incoming calls are free, so feel free to call, but remember we are 8 hours ahead of you :-)

So, like the title suggests, today was our first day at clinic. Things are relatively relaxed around here. The clinic itself is amazing. Well air conditioned, computer in every room, otoscopes/opthalmascopes in every room, a medical library, and we are currently sitting in a room with 12 individual computers with internet access. Thought I died and went to heaven :-) The patients come in the morning. No appointment times, just first come first served. They are usually all seen by 2pm (that's when the lab closes). They have a cumbersome computer system that tracks and keeps medical records. (offline system) They also give a copy of the record to the patient. There are no real medical records here. Sometimes patients show up with blue cards stating they were in the hospital, but doesn't state why... or gives bogus reasons ("pressure on pain receptors" - useless). Most of the patients we saw today were here for routine checks or had medication compliance issues. The clinic itself has 3 clinics. One is the national program, one is if you are enrolled in the Baylor study, and the other is for screening of HIV exposed newborns.

This morning we showed up to morning report which is much different than our morning report. It was basically a rundown of the latest admits and what happened. About half on the list had died. It was just unbelievable. A couple of the kids wouldn't have made it in the states either, but one child was admitted for diarrhea and the next sentence was " he died the next morning." Even though we knew stuff like that happened, Becca and I were still shocked. He was in a hospital. And there was no explanation given in report. One kid they thought had congenital heart disease, but they can't get an ECHO. so frustrating. Turns out most of the docs in the hospital are actually medical officers. That means they have completed a medical school and a transitional intern year of training. There is a wide discrepancy in the quality of medical officers.

We took a tour of the hospital later. They showed us the NICU and everything. I think Becca will disappear into the NICU soon. There is an adult medicine person managing the one ventilator, and I don't think she can handle that.

For all of our resident friends..
These are the things you cannot get here:
IV fluids with potassium
TPN - don't know how much potassium you will actually get...or other stuff for that matter
Sensitivities on cultures - you are lucky to get cultures
Ventilators - only one in the NICU
Dialysis - broke down over Christmas
Blood gasses
MRI - they actually laughed at that one
the nurses are not like in the states - no blood draws, no IVs, vitals only if you ask, no feeding patients/changing bed linens.....

Occasionally:
spoons
routine labs - they went on holiday with the rest of the country lately. no urgent labs...

Gotta run! Talk to you soon. Will try to upload pics tomorrow.

Day 3 - Becca Update

Guess I should have checked my Google mail before working on this mornings' post ;) Becca sent me an update to post for her as there were some technical difficulties with the internet connection:

Happy New Years everyone. We rang in the new year at one of the AIDS Corp docs house with come people from clinic and other locals. There was fireworks (in the distance), poppers, sparklers, noisemakers and music. It was a good time. Yesterday we climbed Kayge hill (I'm spelling that really wrong). Tim, our Ugandan taxi driver/mountain goat decided to climb with us and led us straight up the side of the mountain sans path through prickly plants and over rocks. He claimed it was a short cut but he had also never climbed the mountain before. The view from the top was amazing and we'll have to climb it again when the guys get here. I discovered all the spots I missed with the sunscreen and am now speckled with red and white skin. After the climb Tim invited us to a brii (Botswanan BBQ) and said he would pick us up in 20 minutes. This is when we learned 20 minutes equal 4 and a half hours in Botswana. The brii was interesting. We learned about Tim's life as a child soildier in Uganada and how some of his family was left behind when he moved here. We played a Botswanan version of Sorry (I won) and ate some unidentified grilled meat and chicken which was good. It was a strange experience but good overall. This morning we awoke to the sounds of the gardener sweeping the yard. I'm not sure what he's doing but it's been going on for a number of hours. We trecked down to the riverwalk mall in search of a cell phone, internet and travel company. Everything is opened except for the cell phone place and the travel company. Hopefully we'll get that fixed tomorrow. Hope you all are well. As of tomorrow we will have some sort of reliable means of communication (hopefully)
-Becca

Day 3 - Hiking

I google chatted with Portia early this morning around 4am CST (Stick with me as I am reviewing the transcript on my cellphone as I try to piece together a blog update... I don't remember typing for as long as the transcript is... perhaps I can type in my sleep ;) , She had treked 45 minutes to make it to an internet cafe (hopefully with Becca as well?) to be able to find a network connection.

She told me during a previous conversation that the only thing she missed during packing was a gadget, which means that it was my fault (so lets see... Gameboy-Check, wristwatch GPS-Check, digital camera-Check, Ipod nano-Check, My mini computer - Nokia 770... Sorry I didn't think that she would have appreciated it... but she tells me that they could get free internet from one of the local hotels, sooooo I should have sent her the handheld computer so she would be able to get wireless internet... All I can say is I will bring with me later this month, even though it's potential use is probably diminished, but o'well... live and learn.

Both Portia/Becca are really hoping to get their cell phone tomorrow at work. They were not even able to buy/rent a cell phone today as they said that most businesses were closed for the holidays (for some reason I thought that the US would celebrate the new years more then Botswanaians, who knows).

In the update I understood that they hired a cab driver (I think the one which was recommended to them by a few other people from Baylor who had used him in the past?) to bring them to the 'mountain'. Aparently the cabbie then turned into their escort in that he hiked up with them (dual purpose security guard... I like)... It also could have been that he didn't want to wait for them at the bottom of the trail either. Aparently though he may be a cabbie and security guard, he was not a trail guide in that he had never hiked up there before and they ended up going up a hard side of the mountain. (going back to gadgets... Portia did you bring the GPS watch?)

All portia could say is that they were going to bring us later this month, but that they were going to take us on the easy route... I said no! I want the hard one, us men have a reputation to uphold (right Scott, back me up on this one). I did chide Portia for not bringing our digital camera (she wasn't sure if it would be safe), I can understand Becca not bringing her camera in that it would take it's own suitcase, but the reason for a small digital camera (Sony T30) is to bring it with you to take pictures of the gorgeous views I keep hearing about. Hide it when not in use, but I do agree if it doesn't seem safe... keep it hidden.

So while Portia didn't admit to her being burnt, I understand Becca did get too much sun (here is where the parents can step in and comment about how they should make sure to wear sun block ;) Believe Becca is ready to get going in doing more work and keeping busy, on the other hand Portia has finished one book and has started on one of the China books that I got her for Christmas. They will both get their chance when they start working at the Clinic during their day tomorrow.

End of chat transcript - duration 21 minutes, time I remember... maybe 5 minutes ;)