Days 1 & 2

Starting again with days 1 & 2 at the hospital. This is overdue because there have been many, many problems with the internet and technology in general. I reached the point of frustration last night and just finally gave up. Tonight (1/5), I am sitting here in the dark because the power is out. I think God is trying to teach me something, but I am not quite sure what it is exactly. No power again means no internet… so, I am hoping this problem rights itself. The lesson I have learned so far is not to hold on to anything too tightly when I have NO control over it (although I am still learning that every day)… and the other probably more important lesson is that family and friends are more valuable than anything in this world, and while it is very easy to take them for granted, it’s times like these where things are put into perspective.
Thank you all for your prayers, support, encouragement, and for just being you!!

Ok, so here are a few things about what it's like here that I must mention before I start to tell you the details of the hospital. First of all, the stars here are incredible!! (Bryan, you were right!) When it is clear at night, you can see so many, and it is breathtaking. I wish I could capture it somehow to bring it home. Just one more thing that proves there is a God who loves us enough to provide intricate details like that just to make us smile.

This really is an interesting place- more so than I may have imagined. There are a wide variety of cultures contained in this hospital staff, and it is interesting to see how they all work together. Whoever said that English is the primary language was wrong, though… They do typically speak at least some English, but when they have conversations, it is generally Setswana. I have to remind the nurses to try to speak in English when I’m around so that I don’t have to wait for interpretation : ) The other thing is that it is often very difficult to understand their English. It gets easier the more I hear them talk, but it still requires a lot of concentration. We have discussed that probably it is just as hard for them to understand us, so I am also trying to speak slowly and clearly. Language barriers are an interesting challenge to overcome, but this one is at least not a complete barrier.

For those of you who have been asking about the weather, it’s been a mix. It’s their rainy season here (summer), so it generally rains once or twice a day. However, unlike Pittsburgh, when it is done raining, the sun comes out!! The temperature has been high 70’s- 80’s and usually a breeze blowing. We have eaten dinner outside every time so far- it’s wonderful. I wish I could enjoy more of the sun during the day, but the hospital is lovely too haha


DRIVING… what an adventure! First of all, they drive on the left side of the road here instead of the right, and they are also on the opposite side of the car. That’s pretty common in foreign countries, right? Well… here in Botswana, it is more of an adventure. The road typically is slightly wider than a one way street in the US, and there are always (and I mean always) people on both sides of the “road” standing or trying to cross- waiting for public transport or walking. There are also times when the car or bus in front of you will pull over on the “side of the road” (there is no such thing as a side of the road here) and you will have to go around them by driving half in your lane and half in the oncoming traffic lane. Sounds like fun, huh? You can pass pretty much everywhere too- there are many dotted lines because it’s flat and straight, so that adds to the drama of driving. I have some good pictures of the traffic and roundabouts they have here. There are also goats randomly roaming the street, and apparently, they do not believe in getting hit by a car- they think they are invincible. Some of the roads are under construction because they are still dirt. Those of you who know me well know that I love to drive, but here I am quite content to leave the driving to Rich because he has mastered the art. In fact, he even boldly made it out of the nearby Mokolodi Game Preserve last Sunday morning in order to pick me up at the airport. They had stayed there for the weekend. This was after a several hour torrential down pour that caused the dirt “paths” through the preserve to turn to mud/quicksand/holes/waterfalls/rivers. Marcee and Michele both said it was quite an adventure in a non 4 wheel drive vehicle- a Honda coupe to be exact. We are calling him the bushman driver these days. The car was completely covered in mud when they got to the airport. Oh, and after they told me that story, they told me my surprise for the trip is that Rich will take me to Mokolodi this weekend after we drop the other girls off at the airport. We will go on Saturday- out on an afternoon and a night game drive, and spend the night. Sunday morning, there’s another game drive at 4:30am (you have to get up early to see the animals!!), another one Sunday afternoon, and then come back after lunch on Sunday I think. I am beyond excited- you should see how close you get to some of the animals! I have only seen pictures up to this point, but soon I will be there!! Hopefully, the weather cooperates a little better for us.

Ok- so here’s the hospital scenario. I really can’t go into the amount of detail it would require to completely fill you in, so I will just give you the basic rundown.
They started to build it in 2007, and I am told that the first 3-4 months of “construction” basically involves using huge compactors to press the dirt down and form a viable foundation. They have to do that for so long because the soil here has a very high sand concentration. (The Kalahari Desert may have something to do with that…) In any case, once they finally felt it was compacted enough, they started to build. I believe the project was finished in October 2009, and the staff started moving into this building and out of their crèches (as they called them) around that time. The building is two floors, and there is staff housing on site. There is an ED, OR, Outpatient clinic, Urgent care clinic, a couple of med/surg wards, OB, Peds, Chemo, Dialysis, Radiology, Lab… I’m sure I am forgetting something. It’s a very nice facility as far as the building goes- there is an interior courtyard set up similarly to Mt. Lebo (for those who have seen the high school). There are a lot of outdoor seating areas, which is really nice. There is a cafeteria for the staff and hospital guests and a small café in the reception area.

Now, for the bad news. If you walked in here and just looked around, you might guess the hospital will be opening in 3 months or maybe 2 months. There is very little done as far as stocking the clean utility rooms, the medication rooms, and the wards in general. In fact, most of them are completely empty except for furniture. There is a lot of equipment missing- vital equipment like EKG machines, cardiac monitors, oxygen tanks, suction equipment, OR instruments (yeah, unfortunately that is a true statement), crash carts, and the list goes WAY beyond what I have mentioned. I don’t really know where the break down in ordering occurred, but pretty much the only part of the hospital that is ready to go when we open on Monday (1/11) is… the pharmacy!! I know, it’s shocking, isn’t it? The only reason they are ready to go is because Rich has been here.
If we are all honest, we would say that it will be interesting to see how things go on Monday, but that it not up to us. All we can do is try our best to educate, help, train, implement, and listen…

Things in the Peds unit are good. The nurses for the most part seem to be open to teaching, and engage in conversation and group discussion. There are a few who sit there with arms crossed, but oh well. I haven’t actually done formal teaching yet because there has been a drill going on for the past two days which obviously took up the staff’s time. It also split them between shifts, so I would only be able to teach 6 at a time or whatever. I am hoping to teach tomorrow and Friday and then next week spend the time circulating on the floor (if we do open) and creating a complete unit-specific for pediatrics orientation plan. It is as exhaustive as it sounds, unfortunately. All of these things are invaluable experience even though it is a lot of work. I am optimistic about developing more of a relationship with the nurses and hearing from them what they think should be included in the orientation for the newcomers. I have already had a couple of them ask me to leave my power point files here with them (on their personal flash drives) so they can use them to review. : ) I have made friends with one of the pediatricians on the unit (there were only two until today, and they rotate day and night shifts, so she has been here with me). She and her husband are Americans from Michigan originally, and they have been here for quite some time. It’s nice to have someone to talk to who knows about things in the US.

We’ll see how things go. I am really not sure at this point what next week will bring. I will try to write again in the next couple of days, but again, there are no guarantees. Thank you again so much for the encouragement and the prayers. This has truly been a once in a lifetime experience so far, and I have a feeling there is much more to come. I hope you are all doing well- please hug Jonathan for me if you see him! Love to you all
~A