Hlabisa

Take the stats I just posted and compare them with this...

24% of the world population lives in Sub-Sahara Africa
1% or less of health professionals are serving in this area.

Hlabisa (the HL is pronounced by pushing air into your cheeks. Think of Eeek The Cat's lisp...) is the name of the 300 bed hospital where we have spent the last two weeks. It is the only hospital for hours in any direction, and there are about 20 clinics scattered throughout the countryside that feed into it. It is in the province KwaZulu-Natal, which is considered the global epicenter of HIV/AIDS. Statistically, the most reliable source of HIV infection rates has come from antenatal clinics, where there is now compulsory testing for mothers - 56% of them are testing positive here.

The doctors that work at Hlabisa are either South Africans who are obligated to one year of community service after completing med school, or young doctors from European countries wanting a year of experience with infectious disease before returning home. The doctor who had been there the longest had been there barely 18 months (and had also just adopted an orphaned infant).

While there, we were able to tag along with the doctors through all of the many workings of Hlabisa. We observed rounds in the medical, surgical, tb, pediatric, icu, and neo natal wards. We were able to assist in surgeries and deliveries. I sat in on counseling sessions for patients being initiated onto ARV's. The out patient department was always busy and understaffed. People would wait all day, sometimes having to stay the night on the benches, in hopes of being seen in the morning.

As I think of Hlabisa, a few stories come to mind:

*Almost every night we were there, we were either without water or electricity. It made for a fun game of resource roulette as we made dinner plans.

*The women here are insanely quiet while giving birth. One afternoon, two other girls and I were in the labor and delivery, hoping to observe a few deliveries. We were reading books while we waited, and on the other side of a CURTAIN was a woman in labor. There was no nurse or midwife in the large room that had capacity to hold 4-7 laboring women. We looked up when we heard the woman calmly call, "nurse", then jumped to our feet when we heard the baby wail. She had delivered on her own, without making a sound. We laughed, thinking of how we would have been screaming for help, and expressed gladness for the baby not shooting off the end of the bed.

*I have been fortunate in life to have very limited contact with death. At Hlabisa, it is a daily occurence. A morning priority many days is filling out death certificates for patients who did not make it through the night. One day we were doing a lumbar puncture for a man in order to confirm the suspicion of meningitis. He was clearly in the final stages of AIDS, with skin stretched over his once tall and probably lanky frame and eyes receding back in preparation for his final sleep. The doctor inserted the needle, and I stood, hands on his back, collecting his cerebrospinal fluid. During this simple procedure, he slipped away. The profoundness of being the last touch this man encountered has spun through my head for a week now. What other sensation should he have been encountering at this moment. Bouncing a child on his knee, smelling his wife's simmering curry and rice, calloused hands holding a garden tool...

We have spent a good part of our time here trying to unravel the complex nature of disease in South Africa. The struggle is not just against illness though. It is so much more. I am hoping to write about all that I am learning in an attempt to process through it better myself. That will be another day though, I'm out of cafe minutes! Hope all is well in the west. Love.