Final Week in Durban :)

Pictured Above: Larissa, Christie, and I posing for a self-timed photo during our hike through "The Burg."  Clearly we weren't worried about the news of an unfortunate car hiccup that morning ;) 

Hi everyone,

Well I've finally made it to the final week of my eight week stay in South Africa, and this will likely be my final post from overseas!  It's felt shorter than it has been, and yet we've still been getting out and seeing and doing a lot! When I return home, it won't be with feelings of regret about missing out on anything.

The second and final of our weekend trips out of Durban was to the Drakensburg Mountains.  We went on a much lower budget than St. Lucia and majority of us stayed at a backpackers' lodge, only paying a slight upcharge to upgrade to heated rooms.  It did get cold outside at night and in the morning, but luckily the snow we were fearing never materialized. 

There were a number of things to do at a range of costs and everyone found something they liked.  Some did a mountain climb up to some rocks with art drawn by the bushmen of centuries ago, while others took a 4x4 over the mountain pass and into the small mountainous country of Lesotho (Luh-soo-too), whose border is completely enclosed by South Africa.

As for me and a couple other girls, we went for distance on foot and completed an eighteen kilometer hike over the course of about six hours across the landscape by our lodge.  We climbed mountains and traversed wide flatland and plateaus.  The scenery was beautiful in its own way, and much more barren and open than the hiking trails in the mountains around Cape Town.  It apparently has a very similar profile to the Mountain West states: Utah, Wyoming,.... though I've never been to any of those.

Our cars were working well for nearly the whole month until we finally ran into a snag over the weekend, and of course, way out in the countryside.  Our automatic shift car (which I don't drive!) suffered a flat tire on Saturday morning, and the spare was put on for the rest of the day, before we were fortunate enough to find a service station on Sunday morning that plugged the hole before our departure.  I guess we were as lucky as we could have been given the circumstances!

As mentioned in my previous post, my final week is being spent in the smaller primary care clinics.  Monday and Tuesday I spent at Blue Roof, which is privately sponsored by the Alicia Keys Foundation, among others.  It exclusively treats patients who are dealing with HIV/AIDS by bringing them in for check-ups, logging their use of the anti-retroviral (ARV) drugs that Blue Roof provides to prevent the virus from destroying their immune system, and consulting them on the lifestyle they need to maintain to stay healthy while carrying the condition.  The people there have been very nice to work with and I've worked/observed in a few of the areas, crunching numbers to determine how well patients are taking their pills, observing consultations, and assisting in the pharmacy.

HIV/AIDS is the primary healthcare concern that is plaguing South Africa, and the circumstances by which it arose are complex and unsettling.  South Africa boasts the highest rate of HIV-positive individuals of any country in the world, and the KwaZulu-Natal Province contains the highest number in the country.  Many things have changed for the better since the country transitioned to democracy in 1994, but I cannot say that healthcare is a sector that has entirely benefitted.  The leadership after Nelson Mandela took steps to prevent the ARV drugs from reaching citizens, even to the degree of outright denying the existance of HIV & AIDS.  While they are finally relenting and doing better to deliver the drugs to clinics, much of the funding for them still comes from countries overseas like the United States. 

I wish I could spend more than a couple days at the Blue Roof Clinic, because their efforts seem to get at the heart of what is really preventing South Africa from emerging as a strong and prosperous member among the first world nations. 

But otherwise, it's only four more days until I leave for home :) Can't wait to see everyone and hear your stories from the summer.

Cheers,

David

St. Lucia Weekend Overview

Pictured Above: Posing with the Zulu dancers at PheZulu Park after their performance on Tuesday.  They re-enacted traditional dances and skits associated with a Zulu wedding.

Hi all!

As you might have gathered from my facebook statuses from the weekend, St. Lucia was all about the animals.  In our three day stay, we did three safaris, a river cruise, and visited a cat rehabilitation center. 

Friday evening was our river cruise, where we went out and saw hippo herds on the banks of the river and in the water.  Yes, many of the townfolk do claim to see hippos walking the streets of St. Lucia at night, to get to their grazing grounds, but we weren't lucky enough (or maybe we were) to spot one.  Surprisingly, hippos are considered to be one of the most dangerous animals in Africa.  They walk the same routes everytime to get from the land to the water and if you're in the way of their charge back to the safety of the river, they don't simply go around.

We woke up early Saturday morning for an all day game drive.  It was exciting to see many of the animals  that we missed on our Garden Route safari, including giraffes, warthogs, zebras, and a cheetah.  We also tried to spot the ever-elusive leopard on a night safari that evening.  As much as we tried to spot the red reflective eyes, no luck :(

Monday was a public holiday, so we stayed in St. Lucia for the extra day and visited the cat rehabilitation center.  Our guide, the director of the center, spends all his time looking after wild cats that have been displaced, caring for them while they are in captivity, and releasing any offspring back into the wild before they are imprinted by a human presence.  These animals were super friendly and in many cases, willing to let us get close to and in some cases touch them.  We were actually able to take turns cuddling with a pair of cheetahs.

Our weekend was definitely fun, and I was pretty spent when we made it back Monday evening.  This week we are in a new location for clinic, St. Mary's Hospital, which is funded primarily by the government but also in part by the Catholic diocese.  It is smaller and serves a more rural community.  Tuberculosis infections are common, and all staff must wear respirators in a majority of the wards.  The first  couple days I have spent in radiography (X-ray and Ultrasound) and surgery, where I saw my first couple of Cesarian births. 

It is a short week, and we are thinking about our next weekend trip to the Drakensburg Mountains.  Our accomodations there will be much less luxurious which doesn't quite match up with the harsher climate.  Temperatures can dip below freezing at night and the air starts to thin out towards the tops of the peaks.  We'll have to be careful as we aren't equipped for serious climbing.  Things could get interesting!

As the weeks continue, I am still learning about the cultural background behind many of the cases that are unique to the country and uncommon/nonexistant in the States.  Early and frequent pregnancy, as well as unconventional abortion flood hospitals with complications and stress.  Smoking and other factors that lead to tuberculosis infections warrant x-ray after x-ray of the chest.  Nearly the entire men's surgical ward at King Edward housed victims of stabbings and other violence.  It seems that in each department we visit there is little diversity in terms of the cases that they see.  Each is filled with people having the same kinds of issues.

Well not to count down, but I return home in ten days :) I know a good few of you miss me! Looking forward to re-connecting again soon. 

Cheers,

David

Surgery then off to St. Lucia!

Hi all,

Just wanted to send off a quick post before leaving for the weekend!  We finish clinic early tomorrow (Friday) to get on the road to St. Lucia, a popular satellite destination here in the Kwazulu-Natal province, and about a 2.5-3 hour drive north up the coastline.  We will be going on a few safaris, in the morning, evening, and at night.  They will feature animals such as hippos, crocodiles, zebras, giraffes, and of course, the Big 5 (lion, rhino, elephant, cape bison, and leopard).  Kind of like the Durban equivalent of the Garden Route!

It was also a very interesting week in the medical field.  I have been in the surgical ward, much different than pediatrics.  The facilities are much older than before and seem to be on their final legs. A new hospital is actually in the works.  On our floor they divide the patient load between two surgical teams, and our team uses each day in a different capacity.  Modays and Tuesdays are in the operating theatre (OR), Wednesdays in "scopes" or the gastro clinic to do endoscopies (scope into the mouth, down the esophagus, stomach, and into the small intestine) and colonoscopies (scope into the anus and up through the colon).  Thursdays are in the clinic and Fridays a large round through the ward.

Monday was a bit of a let down because no procedures were scheduled, but we met our team and joined them in the round.  Also visiting in the team are two German medical student and an Austrian.
Tuesday was the highlight of the week, and Christie and I were in theatre the whole day, and saw four procedures.

They included:
1. Laproscopy to probe the abdominal cavity for tuberculosis (there was)
2. Excision of breast tissue (in a man) behind the nipple to check for cancer
3. & 4.  Removal of a hernial sac in the abdomen and repair.

After having great difficulty in the theatre a few weeks ago, I was surprised with how well I coped this time around.  Only on one occasion during the first procedure did I feel the need to sit down, and after was fine!

Viewing endoscopies and colonoscopies the following day was also quite surreal the first time.  It was very cool to actually view the inside of these organs in a living person.  It actually reminded me of the one "Magic School Bus" episode where the class shrinks themselves to see the inside of the body.

Medically, I think I've enjoyed this week more than the last.  The team has been fun and they are very willing to answer the many questions I've had.

Just a interesting fact: Surgeons in South Africa (and the U.K.) actually switch their title to "Mr." from  "Dr." once they have passed their final surgical exam and can practice independently.  Seems silly to get off the high of graduating med school, getting called Dr, and then a few years later, going back to Mr.  The reason has roots in historical surgery, where the physicians were not skilled enough with a knife and so the barbers who had much better control, but no medical degree, actually performed the surgery.  Since then, surgeons retain the title of "Mr."

Sorry for no new pictures today, but I hope to share some of the many I take in St. Lucia when we come back!

Best,
David

Getting Acquainted with Durban

The CFHI Durban group on the Observation Deck atop Moses Mabhida Stadium last Saturday evening.
Clockwise from bottom: myself, Alexis, Larissa, Jessica, Lindsay, Christie, Sarah, and Jennifer.

The inside of Moses Mabhida Stadium, the jumping platform is on the second highest horizontal from the arch. What a rush!!

Waving the flag to cheer on the Springboks! 

Hi everyone,

So already we've concluded our first week in Durban, the second site of my trip.  Since my last post, quite a lot has happened and I hope you don't mind me telling you about it :)

My clinical rotation last week was in pediatrics at the King Edward Hospital, a tertiary/academic/teaching hospital with over 1000 beds, under the instruction of Dr. Ramji, who has practiced there for over thirty years.  Tuesday and Wednesday we joined several interns in observing as he made his rounds about the 20-patient acute care ward (for new admits undergoing stabilization).  Because nearly all of the patients are under two, the main aspect that differentiates this kind of care from other forms of medicine is having to make conclusions from behavioral cues instead of verbal (Is he drinking water, why is she crying, are they smiling, etc.).  Thursday I moved over to the neo-natal ward, for premature newborns.  Some of these babies were born under two pounds.  Correct me if I'm wrong mom, but I think I came out at over nine, so there's some perspective.  It wasn't the easiest day for me, but it is incredible to think that many of these babies grow up to function just fine and live normal lives.

Thursday was also a big day because we finally solved our car dilemma and aquired two rentals, a manual shift (again, none of the girls know how to drive it)  and an automatic.  We took them downtown Friday afternoon to the stadiums downtown.  The soccer stadium, Moses Mabhida, has a gigantic arch spanning the length of the stadium over the field, and a cable car goes up and down along the top.  For about five dollars we were able to take the car up to the top of the arch and the observation deck, to look out and see an excellent view of the city.  The fact that the sun also happened to be setting made it quite beautiful.

Saturday was definitely the highlight of the weekend though.  Getting into town early, we arrived as the box office was opening to purchase tickets for an international rugby double-header in the evening, Scotland vs. Samoa and Italy vs. South Africa.  The South African rugby team (The Springboks) are one of the most storied teams in the country's post-apartheid history, and the subject of the film that came out a few years ago starring Morgan Freeman and Matt Damon, Invictus.

In the meantime, Jen and I felt like putting our lives on the line in attempting the World's tallest swing, under the arch of the stadium, and over 300 feet in the air.  It was 350 steps up to the jumping platform.  Leaping off felt like free fall until the rope tethered to the top of the arch brought us gliding above the soccer field.  It was an amazing thrill, and dangling there as I was pulled back up was almost as scary as the jump!

The rugby was just as exciting.  The Samoans treated us to their tribal pre-game war dance and went on to beat Scotland.  In the stands, we heard some guys playing their bagpipes the entire time, still showing very much pride, with the crowd clapping along.  At the start of the second match, the Springbok players were greeted with thunderous fireworks and applause.  Theirs wasn't even a contest as they smothered the Italians, scoring try after try with superior speed.

This coming week may be a little trying for me, because I will be shadowing in the Surgical Department at King Edward.  The girls there last week had a great time, I hope I can get over my apparently weak stomach and really see some cool things.  There is still lots to do, and the next two weekends may be used for overnight trips to St. Lucia and the Drakensburg Mountains.  Each is about a 2-3 hour drive.

Five weeks in, and three to go, I'm very much looking forward to coming home again :)

Cheers,
David

First Few Days In Durban

New city, new challenges.  Last weekend I flew from Cape Town to Durban on the eastern coast of South Africa.  The most interesting thing: my plane was orange.  The seats were pretty cramped, but thankfully it was only a two hour trip.

My new host family consists currently of a mother and her two daughters.  They speak both Zulu and English.  With a group of eight students, the other seven of which are also girls, there isn't much of another male presence to be found.  But I'm getting used to it.  The other students are of a diverse range of ages and stages in their education as well.

Our first couple days consisted of driving tours of the surrounding townships and city.  The main difference between the landscape here and in Cape Town is that it is much more hilly in the suburbs.  Neighborhoods are built on the hillsides instead of the densely-packed townships in CT.  That doesn't mean a lack of people, the township of Umlazi is home to over two million, the second largest in South Africa.

My time here is divided by week: The first two I will be working in the gigantic tertiary hospital downtown, known as King Edward, the first in pediatrics and the second in surgery.  My first day there today was informative; the primary medical concern for children under the age of two is gastroentilitis(sp?), a condition causing diarrhea and dehydration.  The pediatrics facility was recently updated and seems much nicer than anything I've seen here in the country before.

As far as anything else to do around here, it's tricky.  The internet is even more difficult to come by so I can't say as to when I'll be able to post again. We're also still working on renting a car; it's hard to go anywhere inexpensively without one.

Into my fifth week away from home, I'm starting to miss it more and more.  I'm trying to repress the feelings of wanting to go back because I still have three weeks left here to learn and enjoy.  I know when I leave, that it will be uncertain as to if and when I can come back so it's important to keep that in mind.

Sorry for the lack of a photo today, I promise I am still taking them, but I'm working from a desktop in the library without an SD slot.  Hope everyone's enjoying their summer, it certainly feels like summer again here :))

Best,
David

Closing the Curtain on Cape Town

Pictured Above: In the stands of Newlands stadium (capacity 75,000) supporting Stormers rugby!  The SupeRugby league is kinda cool: it consists of three conferences (South Africa, Australia, and New Zealand), with five teams each.  They play matches domestically and abroad.

Hello everyone! Sad to say, this is my final week in Cape Town. The past week has been just as eventful as the rest, and we are starting to wrap things up.  I'll try to summarize it as best I can!  The rest of the week and today I spent in the Trauma/ER unit of the Delft clinic.  I was back with Dr. Lukhaski today, but also was able to shadow a couple other of the physicians.  With very little clinical background previously, I am learning a lot!  A large fraction of the cases are for chest pain, products of extensive smoking, asthma, and past history of tuberculosis. Yet I have been able to see cases that are more unique and interesting! Amputation, chest draining, and intubation are a few of the treatments I have witnessed.

Shifting gears a little, the past weekend was again packed.  After climbing Devil's Peak Friday, I had the chance to cheer on the Stormers, Cape Town's professional rugby squad, play against an Australian opponent on Saturday.  Stormers were definitely underdogs, but they held off the visiting Reds in a tight match and emerged victorious 20-15! It was very exciting, and followed by a very entertaining viewing of the European Champions League soccer final (Munich defeating Dortmund 2:1 in an exciting all-German final at London).  Sunday was much more leisurely as we explored the neighboring town of Stellenbosch: Afrikaaner wine country.

As we get closer to departure, our touring is near complete and we've hit all the important spectacles, except for Robben Island.  The former Apartheid prison for Nelson Mandela and his fellow political prisoners was one of my top destinations in Cape Town, yet with recent mismanagement the attraction is apparently not what it used to be.  Nevertheless, I still find myself immersed in the relics of Apartheid every single day.  It's not something I have to visit, I'm very much living in it.

As I look forward towards my flight to Durban on Saturday, I've been thinking a lot about my time here and if it met my expectations.  It has, and also exceeded them.  I've gained a perspective of the country through my medical work and service that I don't think any casual tourist could ever attain, yet still found the time to enjoy the city as much as anyone else.  Four weeks has been the perfect length of stay.  Not surprisingly, I will have to keep a closer eye on my cash flow next month...

I also think about what Durban will be like.  Likely more consistently warm for a start.  It also has the largest population of Indians outside of India.  Mahatma Gandhi even lived there for a period of time.  I have my new host family assigned, and Christie, one of my fellow students here in Cape Town will be traveling to Durban as well.  We will be staying in the same household.

It's as much to think about as it is to write about!  I'm glad we could catch Cape Town's last summer days, but we are seeing increasingly more rain.  I hope to hit the beach in Durban often!

Hope everything's well in the mitten, keep cheering on the Red Wings to close out the Hawks!!

Best,
David

More Exciting Sights and into the Third Week

Pictured Above: Mr. Basil's 6th grade class at the primary school in Genadendal after our discussion on substance abuse.  Can you pick me out?

From Tuesday 5.21.13

Back in the city!  We wasted no time after our return to Cape Town last Friday.  The weekend was packed with activity. After going out that night, we got up to drive down to the Cape Point, also named by the early Portuguese explorers such as Bartholomew Diaz and Vasco de Gama as the "Cape of Good Hope."  Cape Point is the tip of the Cape Peninsula and often mistakenly believed to be the southern tip of the African continent.  The actual southernmost point is much farther East, but the view isn't as good!

The Cape of Good Hope was named as such because it is the geographic point where the cold Atlantic Ocean current and warm Indian Ocean current intersect.  This collision creates conditions of extreme wind and rough water, which have driven countless ships to a watery grave as they try to round the Cape.
The drive along the Indian Ocean side was more than pleasant as we followed the road along the sea.  It is lined with beach towns, each with all sorts of shops and places to buy and eat fresh seafood.  Besides taking in the view from the tip of the peninsula, we stopped at a penguin beach (that's right, penguins!) on our way back.  We were able to get very close to a few nesting birds.

The next day we made it over to the Clifton beaches.  It seems as if the Devil's Peak/Table Mountain/Lion's Head chain are a fence.  To the East lie the townships of the Cape Flats region where we are staying, dominated by poverty of the townships and settlements, yet rich with culture of the black and coloured peoples.  But to the West is the very serene hillside coming down from Lion's Head and Table Mountain down to the beaches, where the views are unmatched and the real estate as expensive as ever.  It is also very much populated by whites.  Driving from one side to the other it's like living in two completely different cities altogether.

But anyways, I did come here for service learning, and that should probably be addressed at some point too. Today and yesterday we started our rotations in the Delft Community Health Center.  This is a facility that was built for the Delft community several years ago of around 90,000.  Today it services over half a million.  Nothing I have ever encountered matched the amount of crowding and stress on this small and understaffed medical center.  Patients schedule their appointments ahead yet must still arrive as early as six in the morning to wait in the ques to receive their file and go through the prep room before moving on to the doctor.
Monday I assisted the two nurses in the prep room, taking the blood pressure (They luckily had two automatic devices) and weight of every patient in line, while also having to learn their filing system on the fly to make sure their files got where they needed.  It was stressful work as we serviced a never-ending line for several hours.  I must have gone through a hundred people.

Tuesday I started in the same role, but not long into my work one of the general care doctors pulled me aside.  I told him me and my fellow students were volunteers from America. "Why would they put you here in this sh*thole?" he asked me.  "Come, let them do their jobs here, I will bring you to where the action is."  He brought me over to the ER/Trama center where I shadowed the senior physician, henceforth known as Dr. L, because I cannot spell or pronounce his name. He came to South Africa to practice after studying in the Congo, and spoke French as his first language, though he was able to explain things and answer my questions in English fine.  With Dr. L I observed as he saw all sorts of cases that occur in a primary care ER: broken joints, asthma exacerbations, genital infections, and a man with his left lung almost completely filled in with fluid and scar tissue after having three bouts of tuberculosis.  I feel I satisfied both ends of my expectations in my work at the Delft clinic.  Working strenuously in the prep room gave me great appreciation for the amount of care they are trying to provide with so few resources, whereas working in the ER with Dr. L provided insight as to what ailments are dealt with on a daily basis, and how primary care facilities must often refer their patients to a secondary or tertiary hospital facility to provide the patients the care they really need.

Tomorrow and for the rest of the week we will be moving onto new facilities in the Cape Flats area to see what sort of health care they provide.  It's a little hard to believe that we only have a week and a half left here in Cape Town, but sometimes I find myself starting to think about moving onto Durban.  I'm still very glad I have that opportunity.

We heard about the tornado in Oklahoma today, and our thoughts go out to all affected by it.

Hope everyone's having a good week otherwise, I'll be sure to write again soon.

Totsiens,
David

The Week in Rural South Africa

Pictured Above: Taking a patient's blood pressure during a home care visit last Tuesday

Well everyone, seeing as it’s been over a week since my last post, and so much has happened since, I thought it might warrant two: the first about our weekend on the Garden Route, and this one about our week in the rural town of Genadendal.  We arrived here on Sunday evening and stayed here until Friday, when we returned to our home stays just outside of Cape Town. 

Here in Genadendal we did quite a variety of things, each day was different.  There are other students staying here in the town as well, a few from the University of Western Cape who practice physical therapy, but also sixteen students from Holland all studying various fields and applying them here in the town as a study abroad project. 

Our lodgings have been quite pleasant; we are staying in the guest house in the historic church square.  It is furnished almost completely with antique furniture and a woman named Maureen from the town is in and out all the time, cooking three meals a day for us.  We’ve used the fireplace every night to beat the cold nights. Overall, fantastic accommodations!

After all the orientations in Cape Town and sight-seeing, it’s been great to finally get into the service component of our trip.  Monday morning was spent at the clinic which is sadly understaffed.  Two general nurse practioners service everybody on most days.  The doctor comes by only to volunteer two hours at the clinic every week when patients are referred to him by the nurses.  The dentist, the most popular (many of the public are missing teeth and some older individuals have none), only comes by once a month. 

Tuesday, we teamed up with about 15 young women with the health department who go into the surrounding residential areas and literally go door-to-door to check up on the inhabitants who are dealing with any sort of condition (very frequently high blood pressure or diabetes).  That morning, I accompanied two the women and visited about twelve homes.  At each one, we usually took blood pressure and/or tested their glucose level.  After coming in with virtually no nursing experience, at least I got good at those!

Wednesday was similar, except in the nearby town of Greyton with the local chapter of the South African Red Cross.  They also offer kids care in the afternoons so the three girls and I have gone over a couple times this week to see the kids and play with them.

The final days are more geared towards introducing health-themed topics in the education system.  This morning we assisted the UWC students in introducing the topics of bullying, drugs, and nutrition to young students in the 4^th, 5^th, and 6^th grade.  Tomorrow, we will be splitting up to each talk to a different group. The girls will discuss hand-washing and other hygiene with preschool children while I plan to speak to older kids, 6^th and 7^th graders, about substance abuse.  We’ll see how they take to it!

Besides being the minority gender in the group, I have also been working through the challenge concerning the decisions for my future.  Many of you may know that I study biomedical engineering at the University of Michigan, a very rigorous field of study technically, but also with a significant number of students who plan to go into medicine.  For a while, I’ve been on the fence about what I may choose to pursue after: either medicine; or research, something a little more technical and science-ey. 

The three girls I’m here with are all pretty stuck on the pre-med track, and in that way also, I feel like the odd man out, still trying to figure out if clinical work is something I enjoy and would like to take further.  At least here in South Africa, I feel like I’m starting to understand the essence of being a clinician and what the mentality behind care-giving is. 

Well, I suppose enough rambling. I’m looking forward to returning to Cape Town to see what our clinical duties will be there, as well as continue on our impossible task of seeing everything there is to take in.  We still have intentions to catch the view from Signal Hill, tour some wineries, and see Cape Point, the bottom of the peninsula to the south of the city and the accepted point where the Atlantic and Indian Oceans meet. 

Hope everybody is enjoying their summer! Even here in the southern hemisphere it still feels like it most times, though some of the trees are starting to change color.

Totsiens,

David

Our Garden Route Weekend

Pictured Above: Standing next to one of the many elephants on the Knysna Elephant Reserve on Saturday.  We were able to touch them as well as feed them by hand. As gentle as they are, their size and the strength of their trunks still made them a little intimidating!

I sincerely hope the posts have come often enough.  The difficulty of getting reliable internet access has definitely taking some getting used to!   Today I am writing from the small town of Genadendal (pronounced "huh-NAH-tin-dal") where we recently arrived last Sunday night.  We will be staying here for the next five days working in the clinics and traveling with the clinicians to some of the homes to visit patients who are treated at home.  This town has a proud history centered around its establishment as the first mission and church in South Africa.  English is also apparently a little hard to come by so it might be a good chance to really learn some Afrikaans.  We're all really excited!

We were able to get out and have some real fun this past weekend as we toured the Garden Route, the coastal region between Cape Town and Port Elizabeth to the East.  The main road is studded with towns, restaurants, and countless attractions and activities to see and do.  Our Friday itinerary included touring an ostrich farm and the caves of Cango.  The farm allowed us to ride on the back of the flightless birds for about a lap around the enclosure which was definitely a highlight! The caves were interesting too: dark, spacious in some places, tight in others, and humid everywhere (reaching up to 97%). 

Saturday was even busier.  We took a zip-line tour, visited an elephant reserve and enjoyed a short cruise at dusk in the estuary near the town of Knyzna (niz-nuh).  Our final day, Sunday, was filled by our day safari on the Botlierskop Game Reserve.  Though a little unpleasent from the horde of obnoxious Argentinian tourists on our vehicle, we were still able to see quite a variety of African wildlife including wildebeast, impala, cape bison, lions, elephants, and rhinoceruses.  The safari was capped by a wonderful meal in the main lodge.

For the fee that we paid to do the Garden Route, our money went a long way.  Since the coordinatiors for CFHI Cape Town, Marion and Avril, have been doing the Garden Route with their students every month many years, they are well known by the businesses with which we organize our activities.  They have done an unbelievable job pulling strings, getting us great deals and really maximizing our mini weekend vacation! 

My first week here seemed to go by quickly, but staying here in South Africa for seven more weeks still seems like a long time.  With each passing day, I feel myself becoming more accustomed to the culture here, and it's really cool!  Because of its many influences it is truly complex and unique.

As always, thanks for reading and check back in a few more days!

Totsiens,

David

May 7th Cape Town Update

Pictured Above: Me and my three other fellow students here in Cape Town this month for CFHI, posing during our decent from the top of Lion's Head (other photos from the hike will be posted later!). The city bowl descending from signal hill and the bay is visible to the right.

Clockwise from top: Kelsey, Christie, myself, and Lindsey.

Hello everyone, Howzit?

Sorry for the delay between posts, I had written this in the McDonalds last night but lost my 1hr connection before I could post. Still, the first couple days here in Cape Town have been great!

The journey was quite a ride, which included no less than an hour flight to DC (with a 6 hour layover), a 17 hour flight to Johannesburg (with a stop in Dakar, Senegal) and a final 2 hour leg to Cape Town, overall, about 29 hours of travel.  I met a few interesting people during the flights including a young woman who was half-Senegalese, half Italian, and spoke French and worked in a French school in the Ivory Coast teaching biology.  Plus she could talk to me, so that's a total of four languages. Pretty impressive! Needless to say, I'm glad I made it.

The weather has been wonderful, Mediterranean-esque, with strictly sunny days so far.  Yet of course here in the Southern Hemisphere we approach the winter months, which really means rain and temperatures dipping to around 15-20C (50s and 60s F).

I am living in a middle-class suburb with a host family of retired teachers and their youngest son who is 24 years old.  They have been friendly and show a good knack for cooking, though I haven't tried anything too exotic yet.

I have also met a few of the program coordinators, who have been able to discuss with us the history, demographics, and health care system of South Africa and the Cape Town region.  Instead of jumping right into our clinical rotations we spent the day riding in the car of a social worker friendly with CFHI who was an expert on the history, neighborhoods and people of Cape Town.  It was fascinating listening to her endless accounts and stories.  Already having a significant portion of my 10th grade history class devoted to studying exclusively South Africa, I was already familiar with much of the history (snaps to you, Dr. Greenspan), but it was certainly interesting to hear it again.  Most of the neighborhoods we toured were exclusive to one of the main ethnic groups: black african, cape coloured (a mixed race of asian, indian, black, and white), and white.  Nineteen years after the end of apartheid, the racial divisions in Cape Town remain strong, a division that wasn't as evident when the world's eyes were turned to South Africa for the previous World Cup.

By the end we were exhausted. After a good night's sleep, we set off today for the University of Western Cape to be registered as students, enabling us to do the tours and rotations we will be experiencing.  We then succeeded in transporting ourselves to the other end of town to climb the Lion's Head peak. A bit of a challenge, about the same-more rugged than the ladders in Acadia.

Other highlights to look forward to include the Garden Route from Friday through Sunday, which transitions straight into our rural encounter the following week. Sadly, no posts may come during (expect no McDonalds restaurants), but there will be plenty of stories after!

Hope all are well, miss you and thinking about you!

Totsiens,
David

Pictured Above: Cape Town, surrounded by the rock formations from left: Lion's Head, Table Mountain, and Devil's Peak.  Foreground--Green Point and Green Point Stadium, built for when South Africa hosted the 2010 World Cup.

Hello everyone! Crazy as it is for me to think about, I will be departing Friday for South Africa to spend two months, May 4th through June 29th, volunteering for the global health education program Child Family Health International.  The month of May I will spend working in Cape Town and the month of June in Durban, a city some 2000 miles east, right on the Indian Ocean.  In each of these locations I will be working in clinical rotations at the city hospitals, working in numerous specialties including general care, HIV/AIDS treatment, and surgery.

Additionally, in each of these locations I will be spending a week outside of the city in a more rural location to learn how healthcare is approached in those communities.  I was recently informed that this portion during my stay in Cape Town would take place during my first week.

For each month, I will be staying with a host family.  During my time in Cape Town I will be staying in a suburban community of Athlone in the Cape Flats region that is southeast of downtown.

Traveling from the United States with me are three other students, one from the University of Michigan.  We will be staying close to each other, and possibly work in some rotations together as well.

I will be leaving from Detroit around 10:00 am Friday, and arriving in Cape Town around 9:00 pm Saturday, local time (6 hours ahead).

Well, I should get back to packing, but I can't wait to share my first adventures with you!  If you have any other questions or short messages for me, you can leave a comment! This will be something that is challenging, but life-changing, and I hope to learn as much as I can to expand my outlook on the state of healthcare around the world, and where it could be headed. Until next time!

Totsiens,
David