African Holiday

my goodness, i started this blog entry over 2 weeks ago and am just now posting!! oops, better late than never i suppose.....

so my african holidays - AWESOME. it was definitely hard to be far away from family and any semblance of cold weather that would make it feel like christmas, but a whirlwind of travels made it a little easier to deal with :) we worked through christmas eve than flew to durban (southeast coast) for christmas weekend - short but really fun. got to spend christmas day with a friend's family which was lovely, just really nice to be with a family on christmas, even if it's not your own :) they were amazingly generous and welcomed us in as their own with a delicious christmas lunch then time chatting and sharing stories. the next day we went to a cricket match (south africa vs. england) which was really fun - similar atmosphere to a baseball game, though much slower process. it's a 5 day tournament and south africa didn't even finish batting the first day! i.e. one VERY LONG inning. headed to a pub afterwards and witnessed some proper south african drinking....amazing what some of those guys could put away before 5pm! got to spend a little time on the beach (the friend we stayed with has an apartment on the beach, SO nice) and put away a fair amount of sushi in our 3 day weekend. also managed to skype with the family on christmas day, a little touch and go there for a while....here's before/after we thought we couldn't connect to the internet:

so that was christmas....came back and worked the next week through new year's eve, then left for an AMAZING trip to cape town. after clinic had to book it to joburg then caught a late flight to CT and managed to get to the NYE party before the countdown.....of which there were 2 by the way, one at roughly 11:57 and 39 seconds, and one at actual midnight. classic. we met up with some friends from lesotho at hands down the biggest NYE party i've ever been to and danced the night away with approximately 53 million 18yr olds (ok, slight exaggeration, but that's the legal drinking age in SA and i think every 18yr old in CT was out celebrating that fact). spent the next several days seeing cape town.....new year's on the beach (again with sushi), next day touring the wine country, the next seeing table mountain, the next driving down to simon's town to see the penguins then on to the cape of good hope, and the last day relaxing/shopping before heading back. CT is beautiful by the way, definitely in the top 3 places i've visited. the water is blue blue (not just regular old blue), the city fun and alive, the food amazing....not to mention the cape which is breathtaking - an expanse of raw, untouched beauty and powerful wind/waves that leave you speechless. already planning to go back for easter :)





so that was new year's.....then back to work where clinic has been CRAZY post-holidays. tons of patients, deadlines for abstracts....all in all has been a bit hectic! starting to slow down a bit, thank goodness, so hopefully will be a bit better this week. next week leigh and i head to serowe (smaller town 3 1/2 hrs north) for 2 weeks, where life is definitely slower! have a trip to the salt pans (kalahari desert) and a rhino sanctuary planned while we're there so not too bad :) hope all is well at home and that everyone had a blessed christmas/new year's - love y'all!

christmas parties

look at me, blogging again after only a week, miracles do happen :) had to though cause we've had not one but two christmas parties in the last couple of weeks and i haven't said anything about either of them! the grown up party was just that, a party - lots of food, dancing (learned some traditional dancing, or at least tried), and a chance to spend time with everyone from work outside of the stress of clinic. we also had some friends from south africa who came through on a motorbike trip and tagged along to the party....we were quite the spectacle with our car + 3 motorcycles! good times had by all....i think the clinic is getting used to leigh and i making spectacles of ourselves :)

the other was the christmas party at the clinic for the kids.....a carnival really. and though i was dressed in a santa hat with tank top, shorts, and a lot of sweat, it somehow still felt like christmas. probably had something to do with the joy overflowing from hundreds of children as they played games, got their faces painted by a clown, jumped on blow up castles, went kareening down the water slide (don't worry, only one head busted open and a dozen stitches), danced, laughed, and the grande finale....a fun new back pack filled with books and markers from santa (aka me and leigh in santa hats). there's just something about the joy of children that reflects their Maker and points beautifully to the reason for christmas....Christ. and so, despite being 100 degrees and playing in water rather than snow, the kids' christmas party was the closest i've felt to christmas this season.

"'truly, i say to you, unless you turn and become like children, you will never enter the kingdom of heaven. whoever humbles himself like this child is the greatest in the kingdom of heaven. whoever receives one such child in my name receives me....'" --matthew 18:3-4

hope....

a friend recently gave me a devotional book that is written specifically for christian physicians. it is published by the international christian medical and dental society and has entries from physicians all over the world. it could not have come at a better time as the first page i read talked about the overwhelming amount of death in third world countries and the challenge of seeing and reflecting light amidst so much darkness.....as i read the page and the scriptures mentioned in it i wept for all of the precious lives lost since i got here. i wept first in great sadness but then in hope and joy as i imagined them praising their Father in heaven. why is it that my heart first goes to sadness/darkness instead of the light that overcomes it? i know that grief is natural and healthy and necessary even, but i pray that the hope of eternal life might be greater than the burden death brings....that such hope may overcome any despair and fuel my heart and life here.



"and i heard a loud voice from the throne saying 'behold, the dwelling place of God is with man. he will dwell with them, and they will be his people, and God himself will be with them as their God. he will wipe away every tear from their eyes, and death shall be no more, neither shall there be mourning nor crying nor pain anymore, for the former things have passed away.'" --revelation 21: 3-4

november....

another month gone by in africa.....wow. hard to believe it’s already been 4 months! as it goes, in some ways it feels like so much longer, in others it feels like yesterday that we got here with our 2 tons of luggage. the last month has definitely flown – i spent the first 2 weeks on wards and then went to serowe (smaller town 3 ½ hrs north of gabs) for 2 weeks. between the two i got to go to south africa for one of the most beautiful weddings ever. needless to say, it’s been a full month :)

so wards....yet again a difficult experience, yet better this time not being quite so fresh out of residency or quite so fresh to botswana. i think somewhere along the way i learned to let go of some things – i.e. getting labs in a timely fashion, or at all, same with xrays, even medicines sometimes. you have to pick your battles around here or you’ll go crazy! i find myself much saner picking a handful of things that i feel strongly about and focusing on those. little bit different than our do absolutely everything we can (sometimes to a fault) mentality in the states. the limitations are often frustrating, but now only really get to me when they affect my patients. the number of deaths is still overwhelming....this past month i had 2 that were particularly difficult. one, an 8 month old with HIV and pneumonia that i took care of for a week and a half before he died....he was very sick, but still it was the first child i’d had die that i’d been taking care of for a while and had had sole responsibility for. and again, with better respiratory support he probably would have lived. the second was my very favorite patient ever....just the most precious 3yr old boy with soulful eyes and a contagious sweetness that touched the whole pediatric ward. i admitted him my first month here with a disease called langerhan cell histiocytosis - which is a bad disease even for the states - but he’s been getting chemotherapy in the hospital since that time and has looked so well, then got worse quickly and died because we were out of blood transfusions. heartbreaking.

serowe....definitely a different experience than working in gabs. our role there is more of a mentoring role, which means we work with doctors in local clinics to help them learn pediatric HIV care. as you can imagine this gets a little tedious....there are so many patients that come to these clinics (sometimes over 100/day for 2 doctors) that they don’t have time to spend on details and understandably just try to crank through as fast as they can. another opportunity for picking battles. the town is much smaller with very little to do so life is quieter there, which is a nice break. one of our doctors is there full time so we’re not alone, and she has some cuban friends that make excellent food and provided free salsa lessons – definite bonus!

south african wedding....AMAZING. we were in a town called pietermaritzburg which is about an hr from durban (on the coast). our ex-neighbor and pyschologist at the clinic, lindsay, got married to one of the old PAC doctors and it was such a lovely wedding. very similar to a wedding in the states except that many of the rehearsal dinner speeches are given at the wedding (best man, father of bride & groom, and groom himself). it was neat cause everyone got to share in their story. oh and i forgot the best part - there was a trampoline. leigh and i spent a good amount of time with said trampoline, once again acting our age :)
















k, that’s definitely enough for one blog! hope all is well at home, will try to be more faithful with the blogs so they’re not always so long! lot’s of love :)

halloween weekend africa style....

just in case anyone was wondering, they don't celebrate halloween in africa. but don't worry, that didn't stop us from creating some of the best costumes EVER and bringing halloween to africa. our local friends already think we're crazy and this pretty much confirmed it.....though i'm happy to report there were at least a few that we've brought over to the dark side. i wouldn't call it dark exactly, more like the incredibly wonderful world of costume parties. i'm telling you, once you've been there, you'll never turn back. see below for the spectrum of costumes created between leigh and i and our neighbors.....definitely missed my call as a costume designer :)





pirate, prostitute, cheese, mouse, and bumble bee....quite the crew!






life has been good post-boards.....definitely more time for things such as making halloween costumes :) experienced a bit more of gaborone, and hopefully will see more of africa soon. for some reason it's still managed to be crazy busy even without board studying! i'll post more soon, just wanted to give a quick shout out since i haven't posted anything since being back, and let's face it, needed to brag about the halloween costumes :)

our big safari....

hmmm, so maybe i use the phrase "big safari" a little loosely....as you can see by my amazing pictures, there was a serious lack of animals. apparently they don't like cloudy/rainy weather - who knew? you'd think it would be a nice break from the blazing desert sun, but what do i know about being an african animal.

the big adventure took place in an area called tuli block, which is a strip of privately owned game reserves that runs along the southeastern border of botswana. it's around a 5-6 hr drive from gaborone, but the roads are good and the trip is broken up by a variety of things.....first of all, there were around 6 different stops where people were supposed to pull over and get a brochure on road safety. this is because people drive REALLY fast and rather recklessly around here and motor vehicle accidents are a common occurrence. while i applaud the government's attempt at public service, i have to say it seemed to have the opposite effect....after being forced to pull over, get out of the car, and listen to someone talk about road safety, everyone seemed to be in even more of a hurry and drove like a herd of bats out of hell. oh well, it's the thought that counts.

and speaking of herds, there were approximately 5 trillion herds of goats, donkeys, and cattle at various places along the road. they evidently have very little regard for their lives because they consistently walk out into oncoming traffic, stand in the middle of the road staring at you, or prance dangerously close to the shoulder. seriously i think the trip would be an hour shorter if it weren't for all those goats.

so we finally got to our lodge in tuli block and it was beautiful and tranquil and just what i needed after burning myself out studying for boards. i think i even said something to the effect of "you know, even if we don't see any animals i'll be perfectly happy just being here and getting to rest." little did i know i had cursed us....our driver picked us up for a sunset safari in what looked like a toy truck from the 1970's with seats taken from who knows where precariously attached to the truck bed with bunji cords (to give some perspective, most game drive vehicles are pimped out land rovers with stadium seating. very close to our vehicle, very close):

we took off down the dirt road and drove and drove and drove....and after 2hrs had seen several impala (african gazelles) and a lot of dirt road, and that was pretty much it. it was a beautiful night though and really it was nice to just be out in the bush relaxing. we tried again in the morning and drove and drove, but alas, nothing but impala. we even went on a 2hr walking safari in search of hippos and waded through a vast amount of large poop mounds (indicating that there are indeed animals), but no one came out to play. we did make one friend who inspired my favorite picture from the whole weekend:

i mean, priceless. truly embodies the entire safari experience. all of us staring at our biggest find, a turtle. it was an adventure though and we had a lot of fun searching for animals, even if there were none to be found :).

as some of you know i've been in the states for the past 2 weeks taking boards and visiting family/friends. it was so good to be home but definitely went by too fast! i'm now back safe and sound and free of boards (at least for now), which means i'll definitely be more faithful in the blog/skype/email/facebook department. and we don't have tv so it's either that or stare at the wall :)

been way too long!

wow.....so you might think i've been doing something super exciting that has kept me from updating my blog, but sadly my only excuse is that i've been sucked into a black hole of pediatric board studying. that's right, living in wildly beautiful and fascinating africa and have spent the majority of my time either at the dining room table or on the couch studying! ahhh but don't worry, this will soon change....cause ready or not boards will be OVER after oct 12!!!! (those are both terrified and excited exclamation points btw)

some quick updates....the past 3 weeks i've been in the clinic (as opposed to the hospital), which has been refreshing and far less stressful. it's an extremely busy clinic and every day children seem to be overflowing the waiting room, which really is amazing considering that 10yrs ago most of them would have died from their HIV. it blows my mind what a difference the introduction of antiretroviral drugs has made, not only on child mortality but on transmission rates (both of which have plummeted since the clinic opened and the government started supplying these meds). the majority of the children are happy and healthy thanks to their parents dutifully giving them 3-5 pills twice a day - NOT an easy task, but haunted by the memory of their country ravaged by this disease, most do very well.

one of my favorite parts of clinic has been outreach - every day one of the doctors goes with our outreach nurse, boitumelo, to a rural clinic and works with doctors there to help see patients and mentor them in pediatric HIV care. it's a bit intimidating since i myself am still using my handbook to look up drug regimens, monitoring labs, etc, but it's been great to see the villages and meet local doctors/nurses. above is a picture of boitumelo and i in front of a clinic in phutadikobo/molepolole (mo-lay-pah-lo-lay). below are some pictures of the clinic and a nearby house. we get to go on outreach about once a week and visit clinics throughout botswana, some by car and some by plane (haven't gone on one of those yet but there will def be a picture of the plane when i do!).

one of my least favorite parts of clinic is covering the hospital referral clinic.....aka where any doctor in botswana can send a child to see a "specialist".....which means we end up seeing/managing a lot of things we're not specialized in, and doing so with limited resources. interesting, but frustrating as you can imagine! at least 2/3 of the kids are there for seizure management and have varying degrees of neurologic impairment, another challenge....any neuro friends want to come spend some time in botswana??

let's see what else....it's warming up so all of the creepy crawlies are crawling into our apartment, awesome. leigh and i had a battle with a GINORMOUS black spider the other night, and after much throwing of shoes/soccer balls/various inanimate objects and even more screaming, we totally lost. it was the fastest spider i've ever seen, seriously. we later learned it's dubbed the "kalahari ferrari," that's how fast it is. how did we learn this? we broke down and had to call our neighbor to kill the thing. he came armed with a bottle of "doom," aka super spider killer, and had a good laugh at our girlie expense. bleh, i hate spiders, what was i thinking moving to africa?!?? oh well, at least i've got doom....as long as i don't have to get close enough that the spider crawling on me is even a remote possibility, i should be ok. i took a picture so i could post it to prove i'm not just a huge sissy, but posting it means i'll have to look at it every time i go to my blog and i still have a little PTSD so it may have to wait.

ahhh, we have monkeys!! can't believe i forgot to mention that. there are totally little grey monkeys that run around the neighborhood and this morning were swinging through our backyard. craziness! they're super cute but our neighbor tells us not to trust them, or make eye contact....not sure what happens if you do, but going to try my best not to find out.

last but not least, this week we celebrated botswana's independence day - they've been independent since september 30 1966 and have a yearly 2 day celebration filled with music and festivals and food in all the villages. it's quite the party! i mostly heard the celebration from our backyard where i was (shockingly) studying, but did celebrate the fact that we got a 2 day holiday....and because of it and the fact that i got some extra study time, am going wild and going on a game drive this weekend!! which means it shouldn't be light years till my next blog post since i'll definitely be sharing pictures. hopefully the animals will cooperate :)