The Good, the Bad, the Nasty, and Funny of KMC

I was in the Child Wellness Center of Kanye Main Clinic, basically assessing children and giving them immunizations.  One family came in with 2 year old twins that you can see up there.  They both needed their measles immunizations, both of which I administered.  The first boy took it like a man and smiled at me afterwards with a little high five. :) :) so cute!

As the second boy climbed onto the mother's lap, the first boy was pulling his brother's pants down to prepare him for the shot.  I managed to poke the boy in a jiffy just like the first boy's, but this child started wailing instantaneously.  Of course the mother and I tried to console the poor child by patting the baby on the back while using our baby voices.  Then the first boy started doing the same thing!  He pulled up his brother's pants and started patting the brother on the back while consoling his brother with baby talk.  AND He reached out to wipe his brother's tears away!!!
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Precious, RN

Sitting: Dr._____ and Tabang, who like to be called Tabang and also wants to marry Mallorie, my roommate

Julie, RN. Me, RN. Summer, RN.

Inside the Child Wellness Center

Their wound care center.

There are 4 major stations at Kanye Main Clinic, and I was working at the station that sort of registered/admitted people and directed them to the appropriate stations for treatment. 

At the clinic, a pregnant patient came in with her husband for a maternity check up.  After her maternity check-up, she came back to me with her husband.  She pointed at her husband and said,

"He need to be a patient".  I gave her a very confused look.  She handed me a small card saying that she had an STI and said,

"The midwife told me that he needs to go to the doctor to get this fixed." While laughing and looking at her husband, the husband shyly waved his hands saying,

"No no.  Hahaha, I don't need!" The wife hesitantly insisted that he needed to get treated as well as the husband stared at the ground with a sheepish smile and repeated that he didn't need to get treatment.  "I am afraid of needles", the grown man said.

Finally understanding what was going on, I worked my persuasive/nursing magic and convinced him to see the doctor for treatment! :) I'm stopping the spread of STIs (Sexually Transmitted Infections) one person at a time! :) 
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Health care professionals in Botswana are not afraid to judge patients.

The second that the midwife at my clinic saw that her patient was a 17 year old, HIV positive, pregnant patient, she tsked three times while shaking her head.  She looked at me and said, "We have a serious problem here" right in front of the patient! (Many patients understand at least some English).  I learned a lot about the HIV epidemic and why it is such a difficult problem to solve in Botswana, but it was sort of at in the presence of the embarrassment and shame of the patient. 

With another patient with a similar situation, the midwife asked, "What makes you think this man will take care of you and your baby?".  She explained to me that men in Botswana empower their masculinity and pride with the number of children they can bear despite the status of marriage.  They don't really care how many women the impregnate (although greater numbers are always more to brag about).  They convince their prey that they will be there forever, that they would get married,  or that they love them.  After the child is born, the man has usually already pounced on another prey.  She explained that many women know this but they allow it to happen to them anyhow. 

The midwife tells women that their deeds are to be ashamed of and that they are responsible for the spread of the disease.  I have never witnessed so much direct discipline and retribution in the healthcare setting. 
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Today, I worked with the midwife of Kanye Main Clinic.  It was the second time I worked with her.
 Part of her work entails compare the fundal-symphysis pubis distance with the calculated gestational age, palpating women for the position of the baby, and listening for the fetal heart.  By the end of today, I was able to determine the position of the baby, find the fetal heart sounds, and assess the fundal-symphysis pubis distance all by myself without any electronic equipment or re-evaluation by the midwife!  I felt like an expert palpate-er  -- the midwife totally trusted my assessments and simply recorded my observations :) :) :)
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How we weigh our babies...

The Botswanan Wedding

Yesterday, we attended part of a wedding ceremony as we were invited by the Chief of Botswana to join them.  We were required to wear skirts and something to cover our heads.

We were told to walk into an office first.  While waiting in the office, many passerby came around to greet us, shook our hands, and asked us for our names or where we came from. 

The women were required to sit on the floor and the men were allowed to sit in chairs.  Not only that, the men sat in front of the women, so the women really could not see any part of the ceremony. 

One of the couples standing in the center of a semi circle of people, receiving permission to marry.

Apparently, there are two steps in the wedding ceremony.  The first part, the one we attended, is when the chief grants permission for marriage.  Many couples receive their blessings within one ceremony.  Each groom must bring 8 cows to present and give to the bride and her family at this part of the celebration.  One couple at a time walk up to the chief and receive their blessing.  Then the women on the floors shreek at the top of their lungs "YEYEYEYEYEYEYEYEYE!!!" which is the only way I could tell that the ceremony was progressing from where I was sitting.  Once they are granted permission, they go home and continue normal life for 3 weeks.  The three week trial is for testing the fidelity and trust of the male.  Ruth mentioned that men are not to be trusted until they are able to prove themselves during this period.  At the end of three weeks, they have their real-white-gown wedding and whole day of food, drinks, and music.  Their feast includes a slaughtered cow from the dowry given three weeks ago.  All the people of the village join in the celebration, dressed in their best clothes.  We, unfortunately, did not get to attend any actual weddings yet. 

The women standing in the blue blankets are the brides waiting to walk up with their future spouses.

Our tour guide for the wedding :)

Livestock is everywhere.  8 of these cows were probably being collected for the pre-wedding ceremony we were attending

The Chief of Kanye

--Andreia

Sleepless nights because...

Last night... was the epitome of cold.

I wore two pants (one was fleece), three long sleeves and a sweatshirt, a beanie, a thick pair of socks...


Then, I had three blankets on top of me.


It took 30 min- 45 min to warm my bed.  And then... the most horrible thing happened.



I had to pee.




At first, it wasn't so bad.  I thought I could wait til morning, but after another 30 minutes or so, I decided that I just needed to go.  After counting down from three, I rushed out of bed, tried to cover my bed up again to prevent excessive heat-loss, ran to the bathroom, and ran back, only to find that my bed was as cold as it was before I even jumped in the first time!

It took another 30 min or so to warm it up... but for some reason, this time around, my toes would not get warm -- :(

Usually, I wake up with warm toes, but the next morning, my whole feet were frozen!!! Inside my socks!

I didn't want to buy a heater, but today just did it.  Mallorie and I made up our stingy minds to invest in little heaters.  (It's not really investing for Americans, but it's worth a whole day's work for a cheap laborer here in Botswana)

Experiencing this cold described poverty to me on a totally new level.  

My new best friend.

Picture Book Part 1

Mallorie and I on our way to LAX :)

Waiting inside Frankfurt, in front of our gate.

GERMAN SUBWAY :)

Dr. Sandy and Kim :) inside a First Class Car of the subway in Frankfurt Germany!

 

Lindsey :)

Sarah and I treated ourselves to SCRUMPTIOUS GERMAN PREZTELS! OOOH SOOO DELICIOUS!

 I asked if there was the sweet mustard that I had last time I was in Germany, and the lady said, "You Americans... We Germans don't use sauces with our Pretzels"

Cool bridge in Frankfurt, Germany :) Andrew is the only male in our grp and his beautiful fiance, Summer, is right behind him :)

Kristen and me: arriving Gabarone, Botswana from Johannesburg, South Africa

A Kanye SDA College of Nursing Bus

My FREEZING ROOM.  I think, lately, it has been below 50 degrees in this room.

Each room has two beds and a dividing wall between the two beds.

I sleep with 3 layers over my body from neck down, a thick pair of socks, my blue beanie, and three blankets.

Pointsettias actually grow on trees!

Most of the Public Health RN Students at the administrative offices of Kanye.

Street vendors in front of Kanye Hospital.

More to come next time! That's all I have to upload today... :)

Today, I went on a Safari Adventure -- I am not a missionary here.  LLU School of Nursing designed this trip to Botswana designed this trip for the American consumer.  In that light, I am having a blast :) I will post Safari pictures soon!

Testing Pictures :)

 This is my Botswana roommate: Mallorie! She's awesome :)

 All twelve of the undergraduate nursing students eating at our cafeteria of the hostel.  This is where we eat all of our meals. 

 We have to keep track of and clean our own utensils. 

All 12 again but inside the Kanye SDA Hospital, waiting for our tour guide, Ruth.

I'm enjoying fatbread. Linguina in Setswana (the language of the Botswana people)

 Now that I figured out how to post pictures, I will post more! That's all for now :)

<3 Andreia

First Day at Clinical

Getting out of bed is like jumping into ice water with a fever.  Mallorie, my roommate, and I got a room on the side of the building that doesn't really see the sun very much thinking that we would be able to handle it.  We are handling it, but we definitely miss heaters and heated places. 

I am stationed at Kanye Main Clinic.  On the way there, the fresh, crisp winter air + nasty smoke and fog fill our lungs.  People here burn their trash.  As we drive down the hill, you can see the smoky haze rising from each household.  While walking by, smells alternate between burnt plastic, rubber, trash and smog from unregulated car exhausts, and of people not showering.  For those of you who went to Haiti, it's the same body odor. They do not have a regular or well established waste collection system.  People throw trash everywhere.

The clinic was freezing, too! Heaters are definitely uncommon here.

Nobody washes hands: not between patients, not after touching specimens, not after injections or wound dressings.  If they do wash hands, it's only with water.  No soap.  The only time I saw someone wash hands with soap was after a midwife inspected a patient that was menstruating (she was wearing gloves of course).  During wound care, they also wear gloves, but otherwise, they don't really use gloves either. 

The government pays for all healthcare needs, to my understanding, with the exception of rare and expensive procedures.  People get their HIV meds, hypertension meds, and give birth to babies all for free.  The recent strike is causing a huge inconvenience for the people.  Health care workers at the clinic I am stationed at are only conducting work within their scope of practice (before, they used help with the phlebotomist, pharmacist, and the lab techs) so that the government knows that they are underpaid.  Patients that take a trip come a long ways with injuries and illness seeking medications that the nurses refuse to dispense because it is not "within their scope of practice".  Or the nurses will not draw blood even though they know how to because that is technically only what MDs or phlebotomists can do.  In turn, the doctor ends up having to do many consultations and blood draws for all the clients that come by that day.  

For Public Health Nursing class, we have to do a health-related community outreach activity and my group wants to educate the people about alcohol abuse; the consequences, the need for responsible drinking, etc.  While walking on a hike, a car stopped off the side of the road recklessly, and the passengers rolled out of the car to greet us.   To our pleasant surprise, they reeked of alcohol and wobbled their arms while staggering their way towards us.  We saw many unemployed people hanging out at bars all day long.  It seemed to be a problem, especially for the unemployed.  However, our lack of a alternate activity makes me worried that our project may do nothing to shape the decisions of the dangerous drunkards of Kanye.  Any ideas would be nice... :) 






Random facts I forgot to mention:
-People drive on the right side of cars and on the left side of the road.

-I don't know how to post pictures on this blogsite!

-Fatcakes are so delicious!

-I discovered Cadbury chocolates (an Australian chocolate) -- SOO GOOD!

-Coconut flavored marshmellows are coming home with me to share with you all... :)

The Sabbath

The church here is right across the street from the Kanye SDA Hospital.  It was week 12 of the quarter and they had a communion service that weekend.  The thing is, it was freezing cold and some of us had multiple layers over our feet.  I felt bad feeling this way, but I didn't really want to participate because of how inconvenient it was and how cold the weather was.  However, Kristen needed a partner, and I thought that I should, so I did :)

Over 300 people came to church.  The service was in English and Setswana (so it was really long).  Again, for some reason, I bit my tongue over and over again to stay awake.  The singing was beautiful except when the pianist started playing.  The hymnals were never more beautiful because of their voices and harmonies.  Otherwise, the church service seemed exactly the same as any SDA church service.

After church, we had a delicious lunch and then hiked to a lake of a dam.  The weather finally warmed up to a nice 65F, I'm guessing.  The lake was nice, but there was so much trash there.  There was a lot of trash everywhere in general.  I love how people passing by always say "Hello" but it is scary at the same time.  I'm such a scaredy cat!

After dinner, the whole team of students played Charades, Catch Phrase, Black Magic, Psychology, and a motion game that Frances taught.  It was a blast to say the least :) I think we have a fun and creative group of girls and boy.

The stars are amazing out here.  It's weird because there are different constellations down here than there are up in the US.  I don't know my constellations, but I can tell that the arrangements of stars were different than I am used to.  We saw the "Southern Cross" - a constellation you can only see apparently in the southern hemisphere.  

Getting enough rest is definitely a challenge, but I guess that's normal. 

On Sunday, we did our machine laundry (wahoo!) and went shopping in Kanye.  The stores all of really similar products.  A lot of the products are really cheap.  I saw Converse for P50 (~$8) and Nike sweatshirts for about the same price.  They look real to me, but I'm the last person in the world that can discern the difference between real and fake products.  Food, however, generally is the same price as they are here. 

During our little hike to Kanye today, I totally stepped right into a fresh load of cow pie.  It was nice a smooshy. 

P.S. I totally forgot to write about the hospital and clinics in the last entry.  All of the clinics that we've seen are run by WHO (the World Health Organization).  Their signature is bright orange.  All the building funded by or run by WHO is bright orange (like my orange pants-bright). 

One annoying part of eating at the hostel is that we have to bring our own utensils from our rooms for every meal.  So after we come back from a trip to town, we can't directly walk into the cafeteria, but we have to climb up the stairs to our rooms and bring them back down to eat.  After wards, we have to clean our own utensils too.  I suppose that isn't really much to complain about...

Tomorrow, we start our clinicals.  I'm scared because I feel like I forgot all of my nursing skills and knowledge.  I hope that I am not completely useless there...

WEEK 1...

Hello Hello!!!

It seemed like a few of you guys wanted to know what was going on over here.  Thank you for caring and being curious.  I decided that a blog might be easier and more fun to share my joys, tears, and pictures, so here it is!







DAY 1 AND SOME...

We left LAX at 7pm on Monday and arrived Botswana at 6 am Wednesday (in california time) ....35 hrs of no showering, aimless wandering, and sleeping upright.  We were on 3 different continents and 4 different countries within those 35 hours.  Luckily, we got to explore Frankfurt, Germany during our 8 hr layover.  It was so refreshing to see the cobble stones and unique architecture of Europe again :) :) -- I bought a German pretzel + Haribo (my favorites) and then there were train tickets and baggage storage fees =/ Sooo expensive...



The South African Airport is a super shady place.  First of all, the clerks told us that we had to pay 25 Ren for every kg over 20kg of luggage... However, when I went up, my luggage was 24kg and they didn't charge me for the extra weight while a couple of my classmates paid over $50 for the extra weight of their luggage.  I couldn't believe it.

Also, people called "Porters" were really helpful with our luggage and guided us through the airport so that we could make our next flight.  At the end of our security/check-in/gate-finding escapade, the Porters skillfully confused us and asked for tip.  I knew already not to tip them (from my experience in Haiti -- these men get paid by the airport but demand tip- and some porters are not even employees of the airport).  Some of my classmates were conned into paying FORTY DOLLARS in tip -- I couldn't believe it.  They said that the Porters demanded $15 for tip per person, but my classmate only had a $20, and of course, the Porters saw the bills.  The Porters even managed to convince some of my classmates that they were actually saving them money!  The things people do/have to do for money...

Thanks to my experience in Haiti and mom's skepticism towards extra fees, I didn't pay an extra dime... :)

There is hot water, warm food, cold food, and nice and clean bathrooms with flushing toilets  ... it's a hostel -- not really that bad. not really a mission trip.  The men here are really forward.  One man pointed at one of my classmates and said, "I like that one!".  Another man said, "You want to get married in Botswana".  Yet another man still said, "Give me white babies."

THE NEXT DAY

The hostel that I am staying at is part of the Kanye SDA School of Nursing.  The village is called Kanye.  I am still very jetlagged.  My professor, Dr. Wright, was talking, I fell completely asleep... next to all 5 other students.  I felt terrible.  I guess I didn't sleep too well on the plane. 

There is limited hot water, which means we must tactfully shower on some kind of schedule.  Not going to lie, on the first night, we were all so nasty from the 35 hours of traveling that there was some competition.  But, no drama after that, I think.

The food served at the School of Nursing cafeteria  is so goood.  I love that the food tastes so simple and organic.  For lunch, we had mashed butternut squash (mashed potatoes - except that it was incomparably more delicious), a collard green salad, and other stuff... but the mashed butternut squash was amazing!!! And it's so healthy! I want to try making it at home.  Even their fried eggs taste amazing.  

There was a non-violent strike here in Botswana that ended a week before we arrived.  Apparently, health care workers are not happy with not getting a raise.  I think all health care workers work for the government.  The government stated that any employees that strike will be fired and lose all benefits that accumulated with seniority.  Having heard that, I expected few to strike, but some clinics lost nearly half of their staff due to the strike.  Many clinics closed because of the strike, and now- due to the loss of workers, there is a decline in patient care.  That means we may have a less supported clinical experience as student nurses, but it is also going to be interesting to be working in the midst of their financial crisis and social unrest.  I hope that we can be of good use to them. 

At night and early morning, it gets pretty cold, but I haven't had to use my red ski jacket yet.  

THE NEXT FEW DAYS AFTER THAT

The mornings are freeezing!!!

I learned that Botswanaians speak Setswana.  Their speaking voices are very musical.  When they speak English, they have a rhythmic and tonic quality to their sentences.  I love it when they actually sing.  Their harmonies, tones, and rhythm are amazing.  I love morning worship because of their singing.  I don't really understand their messages, but their singing, I understand.  Absolutely pacifying.

We found out that we don't have to do hand laundry this week.  Yay for machine laundry!

Yesterday, I worker thought I was a boy.  She said, "It looks like there are two boys here in this group" and all of us were confused because we only had one male.  Sensing our confusion, she pointed at the other male, Andrew, and then at me!!! Hahaha.  I immediately took my hat off and let my hair down to show that I was a girl.  

For the most part, Botswana seems like a very peaceful country.  A woman named Alice said that Botswana is one of the most peaceful African countries.  People are truly poor here, though.  I saw many old women walking in house slippers as shoes.  Children run around without shoes at all and there are broken bottles of beer and trash everywhere.  So many people asked me for food and money as I walk around the town

For the school part, we have projects and papers to do.  Our project has to do with educating or planning an activity with the Botswanian community regarding health.  We also have to write a group paper (25 pages) about our project.  I don't think it'll be that hard.

In the last two days of our trip, we are going to a Safari adventure.  I'm not sure what that means, but I think it involves looking at a land reservation and petting cheetahs??? :) 

The exciting cheap delicacy is FAT CAKES.  They are exactly what they sound like.  Fried dough.  It's kind of like a doughnut but it's not clothed with a blanket of sugar.  It's a little sweet on it's own, but so soft and chewy at the same time.  It costs 1-1.5 Pula and ~6.5 Pula = $1.

 

:)  Until next time!!! ;)