The infamous PU

Driving home from another day in rural Swaziland doing out reach I spy the infamous PU (aka public urination). This time the back is not turned and the teenager is at the top of a small hill urinating directly at the main road. Angela and I started hitting the roof of the car each time a PU is spotted, much in the same way that we hit the roof when a VW bug was spotted or a car with one headlight was spotted growing up in MN. PU does have its advantages though. It was perfectly acceptable for me to use the facilities directly behind the rural clinic I was visiting two weeks ago. Quite nice, I must say. So, if upon return to the US, I decide to PU when the urge hits me, please understand. I will write it off as “cultural re-adjustment”.

Today was a light day in Emkhuzweni because I only saw 16 patients, drew blood on about 10 including several jugular vein sticks on the small and febile. A few days ago was a bit tougher – probably 25 patients and more blood draws. There continues to be successes and failures, thus is the work here in Swaziland. For every failure or suffering child there is a smiling one behind them who used to suffer. The concept of “you win some and you lose some” applies and is the only way to keep moving forward. I have patients who die or are dying every day. These children are resilient and strong but they continue to suffer. The physical and emotional suffering is what both repels me and draws me to come back the next day to try again. There are so many that are benefiting from treatment and it is not at all doom and gloom. You just always have the feeling you could, should and want to do more. I can see how people in this field get burned out. Today I saw a 12 month old boy with the weight of a newborn who was benefiting from care. I saw him twice with a fever and got him a referral for TB work up. He was diagnosed with TB, started on TB meds, I treated him for oral thrush, malnutrition and diarrhea. Now he is eating and not febrile. Doing better but his skin still hangs off him like an 80 year old and his veins are difficult to access so I drew blood from his neck. I am always thinking about these children as I make them cry and scream. We make them suffer more in an effort to help them in the long run.

Angela is doing very well, still working at Young Heroes and seems to enjoy it. She has a trip coming up to Botswana and Zambia with her friend Jenny. Sounds fantastic. Jen is a travel agent and Ange is going along on a trip where they fly in to bush camps daily in Northern Botswana. The lodges look fantastic and it will be an opportunity of a lifetime to view wildlife. I am looking forward to hearing about the trip and seeing the photos.