Mseleni Life

Mseleni Life:

Working at Mseleni has opened my eyes to the stark contrast that exists between practicing medicine in the “west and practicing medicine in a developing country. Resources are severely limited at Mseleni. It is not uncommon to run out of very important chronic medications for TB, HIV

and hypertenssion and needles, syringes, towels and gloves are in short supply. The computers that we have for patient regi

stration and more importantly patient tracking, work sporadically, that is if we are lucky enough to have power. We have one ultrasound machine from the early 80, but it works. Labs that take less than an hour back in the states can take days, and the results are somewhat unreliable. Death occurs daily. Those who are dying are not the old gogo’s but young adults and babies. The young adults die from HIV, TB, Meningitis, gunshots, stabbing, and complications with pregnancy. The babies die of malnutrition, perinatal infections and AIDS related illnesses. Death seems strangely more accepted here. Or perhaps the compounded grief of multiple losses has blunted the impact of any particular loss. More likely I am just not able to understand the gravity of their losses because of language and culturally barriers.

When a child dies the caregiver is more often than not the gogo (grandma) will wail for 2 hours. The wailing is as part of the expected grieving process as attending the funeral. When a young adult dies it is often alone. This is most likely because of transportation barriers, as our hospital serves almost 30,000 people in 50 square kilometers and only some have access to the funds for traveling. Transportation for critical cases is also very difficult.

We had a small 3-year-old child present to the emergency room after being hit by a Kumbi (public transport minivan). The child was obtunded, had fractures of her right tibia and left femur and humerus as well as la

rge skull laceration. She appeared to be in stable condition and continued to respond to us. But she urgently needed a CT scan to assess for intracranial hemorrhages and cervical-spine injuries. We stabilized her neck with two, 1-liter Saline bags and Tape…We had to actually convince the ambulance driver to pick her up within the next 3 hours for the 2 hour drive down to Negwazami Hospital for a CT and further assessment. It came in 4 hours… This is likely due to the lack of ambulances, the large area covered, and the state of the roads, many of which need a 4-wheel drive vehicle to transverse.

Despite all of these limitations, Mseleni supplies great care. Considering that in 25 years the hospital has changed from a one room emergency room and small-8 bed ward to a large Emergency room capable of seeing 300 patients a day, 2 fully functioning operating rooms, a 200 bed hospital, 16 bed maternity ward, a HIV/TB clinic and a primary clinic that both see more than 150 patients a day, and 8 tertiary clinics in the surrounding area, with 12 doctors… it is nothing short of a miracle what has happened here.

The beginning of this change started with Victor and RachelFredlund. They arrived here 29 years ago. Victor was the son of 2 missionaries and grew up in Nigeria and Benign. We he and his wife arrived he had just graduated from medical school in England. There was an existing Lutheran Missionary hospital and children’s home here. Both have expanded as I described above. The Children Homes cares for an average of 150 to 200 kids from birth to 18 years old. Many of the children parents have died, some are in jail or have really unstable homes.

The people of this village are extremely friendly. One of my friends Linda (a male zulu name) told me he thought it was funny (which he likely meant as rude) that Americans don’t say hi to strangers… I jog just about everyday here, and it is not uncommon that every person I run by smiles and states Sowabonna, Kunjanee? (hello, how are you?)… I find this quite awesome, and happily reply “Yebo, nGiyaphila!” (yes, I’m good!). As when I came to South Africa before, new friends will ask you over for tea, a brai (BBQ) or to talk, with hardly knowing you. Its just a very friendly, inviting place. Which, is amazing when you think of the hardships and difficulty of daily life here. Puts perspective when I stress about school work… I actually have the opportunity, money, and support to go school!