I just arrived in Lubango, Angola a few days ago. The first few days in the hospital have been quite humbling. I feel as if I have “back-tracked” in my knowledge base. The variations in culture, pathology, availability of medications, beliefs and language makes it quite difficult to follow a typical patient history. Multiple boils on the legs of a female patient were not from shaving or uncontrolled diabetes but rather wading through contaminated water. A headache could be from stress, a migraine or hypertension but meningitis or malaria are also quite probable.
I was surprised to learn that diverticulitis, appendicitis and biliary colic are very rare. Liver failure or liver damage from traditional medication appears to be a fairly common problem here but the offending agent(s) are unknown. The wards are full of women with fistulas secondary to obstructed labor and men with osteomyelitis secondary to traffic accidents. It is lovely to see how the women with fistulas help each other and offer advice to new fistula patients.
Yesterday, after a morning at the hospital, Bridget took me to the impressive Tundavala cliffs. It was an extremely peaceful place. The swallows that lived in the cliffs seemed to be doing their best acrobatics in the last few minutes before sunset. The rock formations near the cliffs seem almost like cairns made by some sort of playful giant. I felt so lucky for having the opportunity to come to Angola.