Day 3

This morning I got up, made a wonderful breakfast of two eggs + yoghurt AND remembered my lunch! We’re making progress, folks. As soon as we arrived at the clinic, we were brought into the post-natal ward to watch as women received contraceptive implants after giving birth. These implants in the arm provide contraception for three years, so they’re ideal for women who don’t have the time to come in every so often for injections or don’t want to be responsible for daily oral pills. However, about halfway through the implantation, a woman sitting in a chair began having close contractions. Women don’t come into the labor ward until their water has broken but once they arrive they are asked to sit in a row of chairs until their contractions are enough that they need a bed. Since there are only three beds, the midwives and sisters prefer to keep them empty until the absolute last minute so that a woman with a long labor isn’t taking space away from somebody giving birth right then. However, this can be a problem when women wait until too late to leave their chairs. As this woman experienced major contractions fairly close together, the sisters tried to get her into a wheelchair to bring her to a bed. However, when she lifted herself up, the baby began crowning and, thus, she gave birth right then and there in the chair. After a large clean-up crew and some stabilizing support, she was able to get into a bed and breast feed / heal but it definitely started the day off with a bang.

Later in the day, once four other interns arrived, another mother gave birth with all of us watching. Honestly, I felt bad that her labor had become a viewing theater but she was very gracious about letting us watch. As the baby emerged and the sister asked for the time, every single one of us yelled “11:37”– our eagerness was palpable. As she cared for the mother, she let us weigh the baby and take its measurements (head circumference and length) then watch it as it laid under a heat lamp to avoid hypothermia. We showed the other interns how to feel the soft sutures of the skull and check for all of the other reflexes (balance, sucking, crying, etc.). Even after two days in the maternity center, we were learning a whole lot.

The day ended with a conversation between Nikki (Connect intern), the two Mercer interns, the “Jemster” (one of the nurses), and me. We discussed the differences in healthcare in South Africa and in the United States. It’s crazy that two nations can develop completely different systems that both have their pros and cons. Jemster was floored that the US had no government-run clinics or hospitals. Where we work, nobody pays for anything and it’s all government-funded. She was also amazed that we don’t have many paper files in America. She asked if “all nurses have to be computer technicians” to operate with that system which is an interesting way of thinking about the technological revolution in America compared to other parts of the world.

After work (and gym, shower, talking to roommates, etc.), Maci, Nikki, and I headed down to Bree St. for the famous “First Thursdays”. On the first Thursday of every month, galleries, shops, and restaurants open with special hours and streets close down for patrons to walk around. We started with dinner at IYO burgers where their bunless burger salads with all sustainably-sourced ingredients blew our minds. This one is high on the recommendation list. Afterwards, we walked around for a while, checking out a bar called “The Man and the Machine” (an ode to men and bicycles), a Patagonia store turned lounge, an Aperol Spritz truck, a gallery called L99P, and, finally, Sgt. Peppers, a bar with live music and a lovely deck for looking down on Long St. This was such a cool cultural event with many of the locals walking around (all impressed with American accents) and a very lively atmosphere. After a long night, I’m finally ready to hit the hay. The Xhosa phrase of the day is “I don’t know”: Andazi.

Day 2

This morning was rushed, yet again. So much so that I actually forgot my already-packed lunchbox. Another great start. However, after a sunrise drive complete with Coldplay music and excitement I was ready to hit the ground running.

Nikki (another Connect intern) and I decided to place ourselves in Maternity because according to another one of our fellow interns, that is where it’s at. And boy oh boy did it deliver (pun intended). As we walked into the labor ward at eight, we saw a woman with her legs spread, ready to give birth. After saying hello to the sisters, we walked over to the post-natal clinic to meet the sister working with the plethora of mothers since Wednesdays and Fridays are when all newborns come in to have their weight and umbilical cords checked. However, when we returned to the labor ward at approximately 8:07 (just down the hall), the woman in the bed had already given birth to a beautiful baby boy. It was in this moment that I realized the immense strength of Khayelitsha women. Each one of them gives a natural birth and most do it without more than a grimace. Most births take place alone with just one midwife and the mother but these women deliver with quiet strength. Honestly, it makes most American labor stories seem trivial. The sister in charge at the labor ward showed us how to check the baby’s reflexes and physical health right after birth. She also helped us examine the placenta and feel the soft sutures on the baby’s skull. For the first time, I saw life being brought into the world (touched a baby only thirty minutes old!!) and it definitely made an impact.

After some coordinating issues with the other interns from various programs, I was placed in the ante-natal (prenatal) clinic, assisting sister Tsepiso with pregnancy checkups. Most of these checkups consisted of measuring the baby’s height while in utero (top of the head to pelvic bone, called SF), checking it’s heartbeat, calculating the gestation time, and checking the mother’s health. While I started just watching Tsepiso with her explaining her Xhosa conversations with patients to me in English, by the end of the day I was helping. She taught me how to feel around the stomach to locate the baby’s back to find it’s heartbeat, arrange the baby and calculate its SF, and complete all maternity paperwork, including charting the baby’s growth. Speaking of paperwork, a copy of the Khayelitsha maternity leave form is in the photo gallery. I know in the last post I noted my concern about the lack of technology, but filling out this paperwork helped orient me with their patient filing system. Each patient has one folder that contains every appointment record as well as, for expecting mothers, a maternity book recording every bit of data from initial booking to six months after delivery. The folder is complete with ID stickers/barcodes to identify papers, blood samples, etc. The system works exactly how a computer would and just requires a little bit of penmanship from each of the sisters. Instead of comparing this facility to American hospitals, I’ve started to see it as a high-functioning machine in it’s own right that always seems to get the job done.

During Tsepiso’s lunch break, I went with a few Mercer interns and a sister outside to investigate some loud music and microphones we heard through the windows. Next to the clinic, the Western Cape Government was hosting a wellness competition for new mothers (and some fathers), promoting care for newborns in their first 1,000 days of life. The competition consisted of trivia for the mothers as well as informative interludes and rewarded the mothers with the most knowledge about caring for their babies. The winning mothers in different age categories were presented with tote bags full of supplies and big bundles of “nappies” (diapers). All mothers and children in attendance were in high spirits, dancing and cheering in the South African winter sunlight.

I returned to Tsepiso’s side discussing my interests, the concept of college + medical school vs. one professional school, and our plans for the summer (winter? honestly, I’m not sure at this point).  After we bid adieu and I waved at a few more newborns in the post-natal clinic, we headed back on the shuttle to Cape Town.

During my orientation, I was informed that the nearest laundry facility was right around the corner and doubled as a restaurant. As wary as I was, tonight I had my laundry washed and ate the most delicious pork + chive dim sum imaginable. If you’re ever in Cape Town, check out I Love My Laundry even if you don’t have anything to drop off. This trip was followed by another trek to the gym and another warm shower. Tonight, my roommates tried their hands at chocolate muffins using mL instead of tbsp and g instead of oz, but I’d say they turned out phenomenally. We chowed down while discussing the Taylor Swift v. Kanye West feud (#iykyk my opinion) and now we’re watching Brave. Merida quote to round out the day: “You control your destiny. You don’t need magic to do it. And there are no magical shortcuts to solving your problems”

New Xhosa word of the day: EyoMqungu – January (learned this while estimating conception and due dates… still not sure about the click in this one)

Day 1

This morning my alarm went off at 6:30 and I sprung out of my bed ready for the first day of work!! Just kidding… the alarm did go off at 6:30 but I struggled to tear myself out of bed before 6:45 when I proceeded to run around making my breakfast before racing downstairs to catch my 7am shuttle. I arrived at 7:01 only to realize the shuttle actually left at 7:20. Wonderful start.

After a packed ride to Khayelitsha (4 other interns in the clinic and 1 elsewhere in the township) as the sun rose, we arrived to the clinic. I’m not sure what I expected but it definitely wasn’t what I saw. The township of Khayelitsha has grown from 400,000 to 2.4 million people in the last ten years with 50% under the age of 19. Additionally, 70% of residents live in temporary housing (shacks). If you Google this township, the pictures will speak for themselves. It’s nothing short of devastating.

The six of us entered the clinic, eagerly observing our surroundings. After meeting the facilities manager, David, we were given a tour around the facility’s six units: Dental, Emergency, Maternity, Pediatrics, HIV/TB, and OPD (outpatient care). While the single-story buildings may seem small from the inside, they’re packed wall-to-wall, seeing 45,000 patients every month (one of THREE clinics in Khayelitsha). I was most struck by the differences in sanitation and technology. Sinks were scattered across the facility and some medical materials came in individual sterilized packages but, for the most part, it lacked resemblance to any American health facility where Purell dispensers are stationed every three feet. As for technology, all patient files are on paper. Throughout the entire clinic, I spotted five computers and only two of those were in actual units (the other three were in administrative offices). At first glance, I was shocked that a health center of this caliber had such a huge capacity, but I soon came to realize that the passion and drive carried by every staff member pushed this clinic beyond its physical boundaries.

After a quick introduction to some of the heads of departments, I was placed alongside Austin (one of the other Connect interns) in the Emergency Unit. After meeting the other two interns working in the same unit (from Mercer), they told us some stories from yesterday when they started working. However, yesterday all ten beds were full and today they were almost all empty. The first hour this morning were pretty much spent standing around and waiting for cases. However, around ten things picked up as we watched the one doctor on staff set three bones (humerus, tibia, and ulna) and put them all in casts. The ulna was actually a compound fracture with a puncture wound as well so she set him in two places as well as stitched up his wounds before putting him in a temporary cast and sending him to the bone specialist at the local hospital. On that note, most patients in the Emergency Unit are transferred to the hospital for further treatment after temporary care in the clinic.

After a few lunch breaks (everybody at the clinic takes lunch breaks as well as shorter ~tea breaks~), we continued to literally watch over the doctor’s shoulder as she did consultations and tended to patients. Most everybody who came in (all lovingly called “Mama” or “Tata”) received fluids or oxygen and had nurses (“sisters”) attending to them. One girl came in with hot water burns that needed to be dressed, another man had a stab wound that needed stitches, and, finally, a woman needing resuscitation (who lived!). All in all, I was pretty quickly thrown in the ring and was lucky to see some serious cases. The staff members were all so gracious to welcome in untrained interns but let us know what they were doing and taught on the go, even if that meant switching languages from the native Xhosa (a clicking language!! pronounced here) to English.

Around 3:30, we headed back into Cape Town all sharing stories about our days and the different cases we saw. Now, after a trip to the gym, a warm shower, and a viewing of Tangled, I’m ready to hit the hay and prepare for another wonderful day tomorrow. Sala kakuhle! (ya ok I had to look that one up but the Xhosa will come eventually)