non turkey day

Thanksgiving in Swaziland did not involve any turkey for me this year. I worked in the hospital in Piggs Peak, Swaziland. I am very much enjoying my time there. The staff, doctors, nurses etc that I work with are fantastic. They are competent, friendly and accepting of our presence. For now, I have been doing a little bit of everything in an effort to orient to the hospital and clinics there. I have been rounding on the maternity ward – seeing women in labor and post-partum, counseling on maternal and pediatric HIV, seeing patients in antenatal care and the out patient department. Starting in January, I will mainly be seeing pregnant HIV positive women in antenatal care and then following up with them when they deliver on the ward and seeing them and their babies in the clinic after delivery. Many women live far away and never make it to the hospital for their delivery and thus often do not get the recommended treatment for prevention of mother to child transmission. Bridging that gap will be one of my primary objectives. I will part of a program implementing new World Health Organization guidelines. I anticipate many logistical bumps in the road but have confidence that a lot can be done.

In other news, a couple of weekends ago we took a trip to the coast of South Africa about 5 hours southeast of here in a place called Sodwana Bay. It is a beautiful, fairly undeveloped, warm-water bay area which is a haven for an incredibly diverse population of sea creatures. Scuba diving was quite nice with so many things to see. The guide book says the reef there is second only to the great barrier reef in Australia in biodiversity. I went scuba diving while there and really enjoyed it. There were many things I had seen before but many I had not. We saw large grouper, snapper, lion fish, pineapple fish, eels, parrot fish, crabs, trigger fish etc. We also saw a hump back whale from the shore. Frequent in the area that I did not see are also leather back turtles, whale shark (not dangerous mom!) which can be 40 feet long, ragged tooth shark (also not dangerous mom!), large rays and many more interesting things. I am looking forward to going back!

Finally, we are in our last week of escrow on the sale of our house. It is not final yet but if all goes smoothly will be final on Nov 30th. Keep your fingers crossed for us! Angela has been packing up, selling the car, arranging travel etc. We are hoping she will make it here for Christmas as I have some time off and we hope to do some sight seeing. I have not felt fully here yet without Angela. I haven’t hung things on the wall, had people over to my house much or felt fully settled yet. Besides, I know she will like to look at the local handicrafts and help in the decoration of our house. They have amazing wood carvings, paintings, bamboo furniture, floor mats made out of dried grass etc. Our place will morph after Angela arrives.

Everyone is welcome for a visit here. It is a lovely place with great game parks, mountains, ocean nearby and a great climate. Its just quite far away! We are expecting some visitors in February that I am totally psyched about. It looks like Gigi, Michelle and Doug will be coming (hopefully wearing wigs) and then separately Kevin and Jolaine are planning a trip. It will really be an energizer to have such great friends visit.

Missing everyone. Happy birthday to my nephew Ben! He would love to see all the animals I have seen here.

Dan

trip to malawi

I just returned from a 9 day trip to Malawi. We had a BIPAI (Baylor International Pediatric AIDS Initiative) network meeting. It was an interesting week of meetings and catching up with friends I had met during the Houston training. I was very impressed with what the program is accomplishing thus far. The cadre of PAC physicians are of extremely high quality. We all really believe in what we are doing and are eager to push the boundaries of pediatric care in Africa. It was inspiring to hear what everyone is doing – from research to outreach to developing community programs to improving hospitals. The list goes on and on – very motivated and passionate individuals. I have been the type of person who usually becomes annoyed with too much work talk and enthusiastically endorsed any social rules that limit work talk (i.e. a shot of Don Julio for work talk compliments of Michelle and Doug). In this job I am easily drawn into passionate debates about how to improve the prevention, care and treatment of Africa’s children. There comes a passion and love for the thousands of innocent children that makes you want to fight for them. Occasionally, I want to scream because there is so much we can all do that would result in immediate improvement and prevention but there are many silly obstacles that stop us. That drives you to argue, fight and pursue solutions – the glaring fact that we have the ability to STOP pediatric HIV infections but yet it goes on. Then, you see teen age children being teased, stigmatized, getting sick, feeling isolated and often depressed for what? For something they had no control over, we did and didn’t prevent it. Any sort of passive action tends to hit a nerve when you fast forward in your mind what that means for the life of an innocent child.

Anyway, that is not what I intended to write about but it is what has me hook, line and sinker into this business. Malawi is much poorer than Swaziland, one of the poorest countries on the African continent. The also have a fairly high prevalence of HIV. The people of Malawi were absolutely wonderful – vibrant, full of life, smiling, welcoming and warm. It was a pleasure to interact with them. “The Lake” – lake Malawi is a huge part of the country and is beautiful. We spent our two weekends in Malawi at the lake at different locations. The first weekend we went for a hike that allowed us beautiful views of the lake then went to the beach and had lunch at a hotel before returning to Lilongwe. The second w/e we traveled to the southern part of the lake to a place called Cape McClear. We stayed in a thatched roof cabin right on the lake. The beach was quite nice - hot and the water quite tempting. We relaxed, played beach volleyball and some went swimming. I went for scuba diving with Adrian – a friend posted in Tanzania. The lake is known for cichlid (spelling?) – small fish that are sold all over the world for fresh water aquarium tanks. That is mostly what I saw diving. The water was clear and the fish bright but there wasn’t too much to see. Swimming in the lake can be a bit of a hazard. Some areas of the lake have bilharzia, aka schistosomiasis. It is a fluke (small worm-like parasite) that co-exists with snails and can do nasty things to the body. It can cause an intense swimmers itch type reaction then later set up shop in various organ systems in your body. That probably has adequately freaked out the enough people so I will stop the description there! It like is slow moving, shallow weedy waters where snails are found. I was diving in deep, no snail water! No itch for me but I will take a dose of Praziquantal just for good measure. Oh, Africa….so many bugs, so little time…I have been very healthy the whole time here. Swaziland, being more temperate, has much less “tropical” diseases than central/east Africa.

I could have good news that I may, in fact, see my lovely wife before 2007. More on that with the next entry!