Eric’s Blog

Back in the U.S.

After a short 26 hour travel itinerary back home, I’m slowly recovering from jet lag and starting to get readjusted back to wintertime!  My time in South Africa was certainly one of the best trips I have ever taken.  Living in another country is truly the only way you can get a feel for a place and really get to know the people.  I’m glad I was able to help out at the hospital given the shortstaffing issues they were having; they definitely needed the help given their large patient loads and logistically difficult to manage patients.  However, I’m taking away far more than I was able to contribute.  -Unforgettable patients with terribly unfortunate circumstances who had such a great outlook and attitude.  -Amazing times with good friends from all over the world.  -Outstanding sunburn lines which are now shedding like snakeskins.  -Immersion in a culture so soon out of racial segregation.  -Great trips to some of the most beautiful places in the world.  -Perspective on the health care system in the United States

 Looking forward to a return to South Africa sometime after residency!

Week 3 Update

Another busy week at McCord Hospital; we usually run about 15-18 patients on our service with one intern.  Not to mention that managing patients is just more difficult here with limited resources.  There is only one computer and one printer per floor, and both of them are more frequently down for repairs than they are up and running.   Progress notes, consultations, referrals, and essentially everything but lab results and radiographs are all on paper.  Ultrasound and simple radiographs are the only imaging modalities available.  CT and MRI must be done at outside hospitals requiring a complicated slew of scheduling, consent from patient/family, ambulance transportation scheduling to and from the outside hospital, etc.  That said, McCord does an excellent job managing HIV.  It has a comprehensive program managing the biopsychosocial needs of the patients including initial diagnosis, extensive education and anti-retroviral therapy compliance initiatives, close outpatient follow-up here at McCord, and inpatient care. 

I found out that I will be giving an international presentation on Tuesday to an audience of ~11 different hospitals around the world via teleconference – doh.  And if this week is like last week, I believe one of them will be Massachusetts General Hospital – doh.  One of these days I’ll learn to stop volunteering for things. 

As is custom in South Africa to celebrate birthdays for 4 days prior, Friday night was my 26th birthday bash as well as a farewell to our good friends Teruni and Jenna.  

We watched the Durban Sharks battle the Cheetahs in a game of rugby at the ABSA stadium. 

After that we first headed off to a fun open-air bar called Cubana’s and then to Clapham Grand, a dance club near the stadium. 

No better way to celebrate a birthday than in South Africa with good friends from all over the world.

I’ve somehow managed to beat up my body pretty bad while here.  It all started at the beach with ‘blue bottle’ jellyfish wrapping their tentacles all over my legs that has yet to fully heal up.  Then I made the poor judgement of running in a city with hills reminiscent of San Francisco with Karen from
Canada and Fayad the intern – both of whom are in far better shape than me - a mild case of rhabdomyolysis, I’m sure.  I found out that I have a latex allergy to the gloves at the hospital, so I have a huge rash on both hands extending from my knuckles to fingertips.  Friday night, I thought it wise to stay out until the sun decided to pop up and remind me that it is in fact time for bed at 5am.  I spent 6 hours at the beach yesterday so now I have a sun burn on my back to match the latex rash on my hands and my jellyfish rash on my legs.  Friday night was pretty fun, so I thought I’d stay out until 5am again on Saturday.  And here I am Sunday evening refreshed and rejuvenated ready for another week on the wards!

Last Day in Cape Town

Been a busy week so I haven’t been able to have much internet time.  Just now getting a chance to update on last Sunday’s adventures in Cape Town.  I woke up early and headed south without much of a plan aside from wanting to get to the Cape of Good Hope.  My first stop was at Boulder Beach where hundreds of African penguins have decided to set up shop.  And there were literally thousands of penguins lounging on boulders, hobbling off to another side of the beach, or protecting their nest of eggs in a burrowed out hole in the sand.  Their population has been quickly diminishing and they will likely be added to the endangered species list within the next several years.  

The second through the ~20th pit stops included random pull-offs on the side of the road on my way to the
Cape.  I drove all the way through the southernmost point at Cape Point, the ‘most southwestern point in
South Africa’.  This bit of trivia seemed a bit stretchingly impressive like claiming to have the ‘largest bookstore in
North America between the 36^th and 39^th degrees longitude.’  It unfortunately could not claim the southernmost point.  Nor could it claim the westernmost point.  So, what the heck, southwesternmost sounds impressive, right?  Though it is popularly considered the dividing line between the Indian and
Atlantic Ocean, the actual geographic division is somewhere further east.  Nevertheless, the scenery was far more impressive than its tag-line.  I can’t imagine sailing centuries ago in the days when traveling to South Africa took months rather than 24 hours and spotting the
Cape of Good Hope.  Quite a beautiful site.  As I was scaling up the peak at Cape Point, I spotted several wild ostriches grazing in the bush, methodically alternating ‘watch duty’ ever 3 seconds.  One ostrich would raise its head on the lookout for a few seconds, and then another would take his 3 second watch and then another.  I snuck as close as I could get to them to nab a photo without scaring them off – and the notion of rattlers and various other poison-wielding creatures hiding in the grasses got the best of so I ventured back to the trail.  After scaling Cape Point, I drove over to the
Cape of Good Hope.  The best view of the Cape is certainly from Cape Point since standing on top of the Cape, you can’t fully see the cliffs and waves crashing at its base. 

  As time was running thin with a flight to catch back in Cape Town, my ascent of the Cape of Good Hope took all of 10 minutes running at full pace.  This is probably a good thing since I had somehow managed to overlook wearing sunscreen and got an excellent start on my annual ridiculous farmer’s tan, which really isn’t a tan at all and is more like a smoldering sunburn.  On my drive back to
Cape Town, I saw what looked to be a dog trotting in the bush off to the right side of the road.  Then I saw there were two creatures, one in front of the other.  Bonobo monkeys! 

I snapped a shot on the run as I had since become comfortable with driving on the left side of the road and operating cameras in the midst of cliffs.  I could hear Andrew telepathically passenger-seat nagging about safety, as he is prone to doing, from ~8000 miles away.

I will miss you, Cape Town. Hope you have fun at the World Cup and hope you don’t erode away by the trampling feet of millions of tourists this coming June.

Cape Town

‘Cape Town is beautiful.  You should go there.’  Those are the unassuming, unenthusiastic words of advice of the South African who has grown up in paradise.  He speaks of Cape Town in the way that an American might speak of red skittles over orange skittles.  But Cape Town is quite possibly one of the most beautiful cities on the planet; maybe more akin to my recommendation for filet mignon over worm infested carcass.  My room looks out on Table Mountain and Devil’s Peak.  The clouds roll endlessly over the mountains instilling life into the monolithic stillness of the great rocks. 

Arrived Friday evening too tired to negotiate with taxis, as is the norm here.  Ultimately made a last minute impulse buy to rent a car as it would save me money in the long run after all the taxi fares were accounted for.  I rented a small manual, right-sided driver Kia.  I was paranoid that the clutch and the gas would be reversed also, but was pleasantly surprised that these were in the same locations as they are in the states.  It was actually a bit of a rush driving on the left hand side of the street.  Totally like riding a bike for the first time, all over again.  Had to overcome all the instinctual drive-without-actively-using-your-brain mode that I have been operating on for the past 10 years of my life.  Turn signal with your right hand, not your left, shift with your left hand, not your right.  Drive on the left, not the right.  Stop at the ‘robots’, not the traffic lights.  Pay your parking fares on the right, not the left.  Pass on the right, not the left.  Pull over for cop cars on the left, not the right….

Such a brilliant day today.  Perfect sunny weather to explore the town.  Started off the day at Quay #5 at the Waterfront.  Took a ferry out to Robben Island.  Saw the famed cell where Mandela spent his 27 incarcerated years as a political prisoner.  Our tour guide was a member of the African National Congress who was imprisoned for over 6 years of his 25 year sentence.  He was a member of the Spear of the Nation group associated with the ANC, who effectively carried out the armed resistance efforts.  As a member of a 12 member team who were exiled to Mozambique and Botswana, his team was deployed back into South Africa to destroy an oil refinery.  His job was helping to orchestrate the explosives.  One of the 12 was playing both sides and defected to the South African government.  They had a team of police waiting for them.  He was hoodwinked, stuffed in a ‘boot’(trunk), and held in jail for several months prior to being convicted.  I didn’t get all the details of his mission, but I did wonder if civilian casualties were to be expected.  Ending Apartheid was a noble cause, but potentially at the expense of innocent civilian lives.  His story was a perfect example of how Mandela’s mid-career resolve that non-violent means of protest had become ineffective due to censorship, unlawful detainment, and harassment of suspects, family, and friends had become a reality. 

Then Camps Bay!  Nestled between Lion’s Head Mountain, Table Mountain, and the Atlantic Ocean lay Camps Bay with a warm sandy beach to catch some rays.  I forgot my towel so I had to run into a Pick & Pay to pick one up.  Unfortunately, they didn’t carry any.  Rummaged around the store long enough until I determined that my best option was 3 dish towels 40cm x 70 cm each.  That was about enough to cover my head, part of my back, and a bit of my rump.  Not ideal, I’m sure I was being judged, but it did the trick!

Then cut through in between Lion’s Head Mountain and Table Mountain to stop by the aerial tram.  Hitched a lift up to the brisk peak of Table Mountain.  Speechless views of the city, ocean, bays, and mountains.  Caught glimpse of some crazy fool rock climbing up the near 90 degree incline of Table mountain on my way back down the tram.  I’ll leave that for the next trip.

Just now finished up some drinks with my hostel-mates from Zambia and Switzerland, as well as some fellows from Scotland.  Still deciding about the itinerary tomorrow: 1) wine country 2) Cape of Good Hope/Cape Point tour or 3) chill at the beach before another week at McCords.  Leaning towards 2 at the moment, but we’ll see.

Good night!

Pics from this past weekend

uShaka Beach with Mahbida Stadium in the background

Valley of 1000 Hills

Young Zulu Student Fortune Teller

Giraffe and baby giraffe - pheZulu Game Park

Gasa Tribe and Jelly Fish

Feeling settled in at Durban now.  I’ve gotten to know all the other medical students well, and we’ve managed to get into a fair amount of trouble by now. 

First weekend update:

Friday: Billy the Bum - Pictures pending.  Fun local bar for Durbanites featuring several bums on the wall.  Finished out the evening at Origin - a techno happy dance club.  I was cool enough to wear shorts and tennis shoes, as I thought might be appropriate in South Africa when it’s 90 degrees and 95% humidity.  The only reason I made it in was because I was with a possy of beautiful female medical students who they didn’t want to leave.  And I pulled the foreigner excuse. 

Saturday: uShaka beach on the southern end of the Golden Mile.  Jelly fish were everywhere!  They come around a couple weeks per year and they were in full force much to my legs’ dismay.  Beautiful beach and a sunburn to match.  Sea World uShaka was great too.

Sunday: a trip out to the Valley of a 1000 Hills and pheZulu.  The Valley of a 1000 Hills is fairly self-descriptive.  1000’s of flat-topped African hills that had been eroded as the seas slowly receded leaving tropical large game inhabited Savanna behind.  At the top of one of the hills (pheZulu means ‘on top’ in Zulu), was a Zulu tribe that has started offering public access to their huts.  The tribe, called Gasa tribe(’blood tribe’) had about 10-15 reed huts which housed their sleeping quarters, kitchens, performance/ritual halls, storage, etc.  They showed us how they prepared their food, beer, socialized, celebrated weddings(a festive occurrence amongst the polygamous peoples), consulted their fortune tellers prior to weddings, their clothing, and how they slept on wooden pillows.  They performed tribal dances for us as well.  I got a picture with a girl training to be a fortune teller; simply amazing.  Then we took a safari through an adjacent game park and saw giraffe, zebra, impala, wildebeast, crocodile, and snakes.  Our tour guide was a veterinarian-in-training so he had plenty of interesting factoids to share about the animals. 

Already getting excited for Cape Town next weekend!

Semi-settled in Durban

I’ve arrived in Durban after countless obstacles including but not limited to snowstoms, missed connections, improperly rescheduled flights by United Airlines which forgot to inform South African Airlines of the changes, and a completely overlooked rescheduling of a connection from Johannesburg to Durban once again by United Airlines.  I finally arrived 28 hours after departing Columbus.  After months of 20 degree weather in Columbus, the warm, humid South African air was a refreshing welcome. 

I’m staying at Doctors Quarters, a boarding house for medical students, interns, and residents who are fulfilling their work obligations at McCord hospital.  The room is a cozy studio bedroom with shared bathroom and kitchen.  Everyone is very friendly and accommodating; I can tell it is going to be a great month.  The ‘house mother’ who runs the Doctors Quarters greets everyone with a charismatic smile and a warm hug.  A nice mother away from home.  I was also happy to hear there are 4 other students here from Michigan, Canada, England, as well as Ireland.   If our schedules align, we may try and work out a group safari through one of the game parks over the coming weeks.  I had a portion of my orientation today and attended an HIV pharmaceutical update as well as a morbidity and mortality meeting this morning.  Tomorrow will be a full day on the men’s medicine ward, where I will be working for the remainder of the month. 

Excited to get this month underway! 

Delayed!

The snowstorm on the east coast would have resulted in me missing my connection in DC.  So, I have had to just camp out in Columbus one more night and do the same itinerary tomorrow.  Thankfully, they were able to hook me up with an earlier flight in Columbus to make a buffer just in case there are delays tomorrow as well. 

Bummer.

Chillin’ in the ‘port…literally

Amidst the high for the day here in CMH which is 23 degrees, I am a mere 23h59m away from landing in summertime.  Thus far, I haven’t had the dreaded shocking moment when you realize you’ve forgotten something critical.  I suppose I have a bit of healthy obsessive personality traits; my excel spreadsheets and compulsive checking of luggage has thus far paid off. 

Challenge #1 has been surmounted.  My itinerary claimed that I was flying South African Airlines out of CMH despite the fact that SAA does not fly out of Columbus.  My itinerary conveniently did not specify which associated airline will be getting me from CMH to Dulles, but of the three flights that leave Columbus around 2:20pm to Dulles, I picked the right airline to ask first, and I am at the terminal waiting to take off.  I am mourning the next 28 days which I will be divorced from my iPhone.  Farewell, good, humble pocket-sized friend; I will miss you dearly.

Wrapping things up…

It’s now less than 48 hours before I board a plane here in Columbus, OH and venture off to Durban, South Africa for an international health elective. 

I’m excited to have the opportunity to study medicine in another country and gain perspective on the way things are done here.  I will be spending most of my time on inpatient wards at McCord hospital, though I do not yet know exactly which services I will be working on.  I have requested to work on an infectious disease service in the hopes of gaining experience with treating HIV, tuberculosis, as well as some of the less common things like filariasis, tapeworm, etc.  All of these are serious problems in South Africa as they have one of the highest prevalence of HIV in the world as well as epidemic rates of multi-drug resistant strains of tuberculosis.  Though Durban is an urban metropolis of nearly 3.5 million people, as a tertiary hospital, they will have referrals from the rural outskirts of the city which should provide a diverse spectrum of disease for learning purposes. 

I’m anxious to head off, but have quite a bit of last minute planning and packing to do.  I will have intermittent access to internet while abroad and will try to post pictures and updates when I get a chance.  I will try and post updates on Facebook with a link to this blog so you will have easier access to new entries.  Otherwise, you can just add http://inmedblogs.us/ericshamo/ to your favorites list.  Stay warm, everybody.  I’m off to cross the equator and find some summertime heat!