Week Two

It was another week in the Casualty and See & Treat clinics, and a very full week at that.  The first week I think I was still adjusting to seeing some of the diseases and medical conditions that present at Jooste, but this week I think the shock was more about the volume of patients that are seen on a daily basis.  In the See & Treat clinic alone there are 3 physicians at any one time and the load is usually pushing 40 patients before lunch! 

Most of the visits in See & Treat are nothing spectacular: DVTs and cancer diagnosis, but occasionally there was a patient that would stand-out.  One in particular was a 26 year old female who hobbled into the exam room with a leg brace and a scarf around her neck.  The brace was for a deformity caused by childhood polio (something I hadn’t seen until now), and the scarf was to cover bulging TB nodes.  The patient had been on TB treatment for 5 months already, so this flare was likely a sign that she had become drug resistant – a strain called MDR (multi drug resistant).  To be sure though, one of the nodes needed to be aspirated and drained; so I assisted the physician with that procedure and saw the milky TB fluid first hand.  Compounding the situation is that the patient is HIV positive.  For me this patient was so memorable because she is not so much older than myself, but on the spectrum of patients in South Africa she is not so unique: her myriad of medical problems are the same problems of the majority of people in the Cape Flats and represent the overall health crisis of this country.

We also watched a film on Tik that features one of the doctors at GF Jooste; it was a sobering look at the addiction of many of the patients we see - an addiction terrorizing the neighborhoods just outside the hospital walls.  This weekend Tik hit close to home when our home stay house was broken into.  There are metal bars and gates and padlocks everywhere in the Cape Flats, but in this case the kids on Tik cut the padlock to the garage gate and stole all of Mr. Snyders power tools.  They also tried to take the copper pipes from the water heater, which resulted in no hot water last night.