Love made visible

As Derek mentioned below, last night we went out to dinner, and the servers' jackets' had the above message on the back. I thought it striking, and an appropos message to ponder as we embark on our nursing clinical work. Something like love is exactly why I'm going into nursing.

The note was all the more poignant at the very end of the night. As we were leaving, we mentioned that we were nursing students. The server stopped cold. "I'm glad you are here. Our people are dying." He went on to tell us that his cousin had just died; he was going to her funeral in a few days.

We were all humbled by what he said. On the way home that night, we talked about how interesting it is that wherever we go around the world, we tell people that we are becoming nurses, and they are suddenly willing to open up to us about the most intimate parts of their lives. In my opinion, that trust is one of the best parts about this profession.

Love, made visible.

Kamogelo Daycare Center

We took a long drive out to the Kamogelo Daycare Center today for HIV/AIDS-affected kids. 17% of these kids have HIV, and most others have one or both parents who are HIV+ or have died from AIDS. When we first entered we heard lots of singing and then shortly saw dancing of the kids with the teachers. I felt a sudden rush of empathy for what some of these children have been through, excitement for the smiles on their faces, and it basically changed my whole view of kids and pediatrics in one swoop or visit. it was amazing. just knowing what these kids have gone through, many of them taking ART (Anti-Retroviral Therapy) for their HIV at such young ages (starting at 6 months of age if they were born with it), or having lost parents to AIDS and the fact that these kids can still have smiles on their faces and laughing and dancing around. It gave me chills and tingles...

Most of the 6 and 7 year olds speak some english, and taught me their names. The one in the beanie in the pictures was one of my favorites, named Okaf. Another girl, not pictured, whose name was Amakgala, was also one of my favorites. They loved my shaved head, my tattoos on my feet (see pics below), and absolutely LOVED my digital camera to see themselves on it! they went crazy. we played with them mostly after lunchtime, which consisted of beans and semp (some type of veggie stuff) porridge, high in protein. I was ecstatic to have this experience, which had nothing to do with our clinical experience, because i will be mainly working with adults. We left after an hour of playing to go to the mall (weird transition) to get lunch, grocery-shop, browse, and.....

Pic #1: Kids playing around and singing with the teachers in traditional Setswana tongue....they were so happy!




Pic #5: We were all showing how old we were on our hands and fingers....most were 6 or 7, i was apparently 10.





Pic #6: They were obsessed with my tattoo. see he's pointing! the 6 and 7 year olds know some english. and in order to teach them, you say "Ere Tattoo" which means "Repeat, tattoo" so they learn new words.


Pic #7: they don't see boys often, so when a "strong" boy comes around, they flex and grab the boy's arm muscles, and hang off of him. you can kind of see it here, but behind the front row of boys, there's a couple boys grabbing onto my bicep as i flexed for them! it was cute!



Pic #8: Kgale hill behind me. it's famous, but apparently forbidden to tourists now due to high rates of mugging. i won't be venturing up there...

Video #1: kids dancing around when we arrived, it was amazing to see. check out the kid in the front, shakin his booty to the rhythm! awesome moves bud!

Botswana Days 2 and 3

Pic #1: Our grad dorms, suite-like space with the shower room on far left, toilet room in the middle, and down the long hall on the right is my small room with a heater, closet, bed, table, mirror, and bookshelf!

Globalization: It is so weird. There are poor people everywhere, people riding in cars with 12-14 people were van (not enough seats), people trying to sell things on the street in the HIGH UV indexed sun with signs that read "talk to me", meanwhile those who have money go to the Riverwalk mall, where there is a 4-theatre cinema playing Dark Knight, WallE, Hancock, and Wanted (all new movies!), places to buy imported smoked salmon, ALL electronics needs (like a HUGE warehouse best buy, called "Game"), and high-class dinners and lunches served to those willing to foot the bill. Last night, we went out to Dinner at Primi, this awesome Italian Restaraunt, with the 8 students and our instructor, Jodi (who rocks cuz she knows SO much about botswana!). I ordered a HUGE serving of Frutti di Mare seafood pasta, and 4 dark chocolate brownies with cream/ice cream for dessert and it cost me 90 Pula, and it's about 6.75 Pula = $1, so it was about $15, which was NOT BAD. i was so surprised. After spending a good 3+ hours there, our waiter, Timothy, (pronounced Te-mo-tay) wanted a picture with us, so we took one with him and promised to get a developed photo back to him. He spoke to a small group of us afterwards, and we told him we were nursing students and his response was almost heartwrenching: "Thank you, our people are dying of AIDS". You could see the humanity behind his dark brown eyes, this waiter, clad in a bright orange uniform with "Work is Love Made Visible", opening up to us as we give him his tip. Jodi, our instructor, was explaining that tips in Botswana usually are around 10%, which was like 90 Pula or $12, which wasn't a whole lot. She said she likes to give more because many of the service workers go home to places with no running water, none of the amenities that we are luxuriously granted at the dorms. Timothy said his cousin died of AIDS last week and that he is going to her funeral next week, that he is raising 3 kids at home and trying to save up to install running water and a water heater. this was a huge reality check for me, coming from America. I rag on America all the time, but i am realizing it COULD be worse. I mean, some things here are all "westernized": Ford dealership in the main downtown area, people driving Mercedes all over, traffic jamming the freeways during rush-hour, self-proclaimed hip-hop booths at the mall, etc. It's all very interesting and eye-opening. Basically, White = Money = Power, and it's more apparent here than anywhere else i have seen.

IDCC: So, we are here for my community clinical experience for nursing at Penn. I will be working with one other student at the Infectious Disease Control Center clinic near the Princess Marina Hospital. Supposedly, 70% of patients have HIV with 50% of those co-infected with TB. The hospital doesn't turn any patients away, so there are apparently many people lying on the ground, some dying, and it can get very intense, from what i've heard. i don't start working there til next week i think (this week is more orientation, buying things to settle in, technicalities cuz some people still don't have luggage or working keys to their room doors). This is pretty much EXACTLY what i want to do, so i am SO excited at this prospect. I was asked to wash hands frequently, wear a mask, and don't get near people who sneeze, to prevent myself from acquiring a latent TB infection, for which i would need to get chest xrays instead of PPDs to be tested for TB for the rest of my life :(

Pic 2: Best sign ever! They have these random postings about healthcare all over campus, and of course, this is my favorite one! There is another one about Cervical Cancer and Testicular Cancer screening for students, which we don't have anything like on Penn's campus or any campuses in america!


Pic #3: I hate to get political in my postings, but EVERYONE here wants Obama to win. I have seen 4 guys wearing Obama shirts already here, and this awesome bumper sticker with the "O" as a globe! UH!!! I mean, Obama has heritage from Kenya, so the whole african continent wants him, as well as all of us, so we were HELLA excited to see Obama supporters here!

The first 12 hours!

12 hours after I got off of the plane in Botswana, I was walking down a dusty road in a major slum settlement, headed to church with a toddler on my hip.

I suppose I should back up for a second and explain.

We arrived late last night, exhausted from over 24 hours of transit. There was some confusion over rooms and room keys, but finally most of us got settled in. We were lucky to meet some fellow international students who were living in the dorms as well; they did an amazing job helping us get oriented to the area - they even invited us out for the night. Despite being unshowered and road-weary, a few of us decided to venture out with them, and miraculously made it until about 4am.

A few of the our new friends were telling us about the children they had been working with in a settlement called Old Naledi. The settlement is the poorest and largest in Gaborone, and we heard reports that the HIV rate is over 90% there. Our fellow students invited us to come visit - to attend a church service with them the following morning.

So we got up with just a few hours of sleep, put on our Sunday best - something I haven't done in ages - and hopped the crowded combi busses for the edge of town. When we got to Old Naledi, our student friends took us to visit some of the homes of the kids they have been working with. Little by litte, young children started to gather around us. A little girl walked over to me, looked up at me with her big brown eyes, and gave the international symbol for "please pick me up."

After we gathered a number of kids, holding our hands and riding on our shoulders and hips, we headed to the church - a tiny, double-wide trailor on a large empty lot.

I sat with that little girl on my lap during the entire church service. Without a stethoscope, I could hear that she had an intense respiratory infection - the wheezing was just that loud. I hugged her tightly as we listened to the sermon and I could actually feel the crepitus from her lungs. I wondered about the type of medical care that was available to children like her. How could she get the help she needed? Are there antibiotics? Could her mother afford them for her? I spent half of the service patting the little girl on the back with my cupped hands, respiratory-PT style, while these questions were brewing in my mind.

I'd love to come back and work with some of the families in Old Naledi. The great news is I think I may be able to - one of our clinical sites, the Holy Cross Hospice, is located in this settlement. I won't know until later in the week at the earliest about my placement, so for now I'm left with a lot of questions... and a vague understanding that there is work to be done here, if we can find a way to do it.

We're HERE!

After 24+ hours of transit, we made it to our new home for the next five weeks: the University of Botswana Grad dorms. Half of our bags didn't make it with us, and we've had a lot of complications with our housing, but those are other stories all together. Our first day in Botswana has been very eventful - stay tuned for more posts!

Our first adventure...

... and we haven't even left the country yet!

It all started a few days after our meeting with our clinical instructor. Jenny was browsing the Craigslist "Free Stuff" postings earlier this week, and she came across a posting for "Free Medical Supplies."

She got in touch with a woman who said they had "cotton balls and gauze" and some other things. Envisioning a few small boxes of supplies, I picked Jenny up early on Thursday morning, and we headed towards the heart of West Kensington to go pick them up. (For those of you not familiar with Kensington, it's perceived as one of the poorest, most dangerous neighborhoods in the city of Philadelphia.)

Once we got the the address, we realized we had been directed to Prevention Point , a non-profit organization that focuses it's efforts on injection drug users and sex workers. The organization runs the only clean-needle exchange program in the city; they also run a drop-in center and help connect their clients to vital services like HIV testing and drug rehabilitation services.

The employees were excited to see us. They were working on cleaning out their storage room, and wanted to get rid of boxes of extra supplies that had been laying around for a long time.

We were shocked when they showed us all of the stuff that they no longer had a need for. Cases of gauze, cotton balls, syringes, medical tape, gloves. They gave us a hand truck and told us we were welcome to whatever we wanted. In three trips, we filled up the entire backseat of my car with cases and cases of supplies.

Jenny and I were completely wowed by their generosity. In my experience, I've had a hard time getting medical supplies donated from the huge University of Pennsylvania Health System, but here we were in the basement of a Kensington non-profit, filling up my car. It was hard not to laugh at the irony.

The moral of this story is: We now have a TON of medical supplies - everything from gauze 4x4s and 2x2s to respirator masks and urine sample cups - to bring with us to Botswana. All we'll need to get are more gloves and hand sanitizer, and I think we'll be all set!

Two weeks to go!

In exactly two weeks, we'll be boarding an Africa-bound airplane. Two weeks couldn't be further away - and at the same time, it seems way too soon. So much to do before we get on that plane!

This week we began the lecture portion of N340, Community Health Nursing. While our classmates started their Community Health clinical rotations, the students going to Botswana have Tuesday and Thursday clincal days off for the next few weeks.

We're not worried though - with three clinical days a week (instead of the standard two), we'll more than make up for lost time when we start at our clinical sites in Gabarone.

We also were fortunate to meet our clinical instructor this week - the School of Nursing brought her out from Oregon spefically to meet us and the other course faculty. She's had a lot of expereince working in Botswana, and she seems as excited as we are for the experience. I think she's going to be a great resource for us.

That is vital, considering we're heading to a place where resources of all kinds can be scarce. Case in point: in our meeting, one of the things we discused was the possiblity that some of our clinical sites will probably be low on vital supplies like gloves and bandages. Our instructor suggested that we bring our own gloves and big bottles of hand sanitizer.

We're entertaining the idea of reaching out to friends and family in a sort of mini-fundraiser, in order to purchase extra supplies to take with us and leave at our clinical sites. More on that soon!