this weeks hospital rotation

this week i have felt every possible emotion i have ever possessed. neil would probably ask"what else is new?" ha ha. i love it here, it is true. i feel like i have been here for month not just mere weeks. i feel comfortable and happy  all of the time - barring the few times i cry when i talk to my mom or husband. :)

this week i worked in substance abuse services with a social worker and had a chance to really see the people that suffer from poverty and how they have developed coping skills that involve substance - sounds like home. amazing how addiction doesn't discriminate, eh? its so sad. people here are obsessed with "tik" which we at home call crystal meth. it is cheap and burns holes in frontal lobes of these people - they are dangerous and in need of money to get their drugs and they don't care who will give it to them or how. this becomes an issue because people don't have much of anything here.

for the last two days i've been working in infectious diseases (still at jooste hospital which i have come to love and feel very comfortable in). the patients who come to this department are referrals because the normal doctors need a specialist to see these people. the patients they see are young (but not children) and they are HIV positive, TB infected and usually many other things. today a patient came in and i couldn't believe how old she was - most of these patients die before they are 50 so to see an old woman was exciting to me. She could barely walk, bent over in pain as she came into the office to be seen. this woman was turned 32 next week. i thought she was in her 70's - i am heart broken for her.

there is a psychiatrist that come into deal with hiv dementia and psychosis that comes in stage 3-4 HIV approximately. today we were speaking about how it must be such a high rate of depression with this group of people and she told me that the difference is that her clientele die before they get the chance to become depressed. When you are diagnosed with HIV it might not even get a chance to really set in mentally because it is a struggle to feed your family everyday, when you live in a city where there is one well pump for 100's of families and you have to worry about your children not eating for days then when will you have time to get depressed about yourself? hmmm. she got me. i'm so moved by this place. every day something happens that stops me in my tracks - wow -

World Health Organization has HIV guidelines that all patients should receive anti retro viral medication when they have a CD4 count of 350 or less. South Africa gives ARV's when the CD4 count is less than 200. hmmm... these people are already so sick when they start ARV Treatment that the prognosis isn't great, this is better than before 2003 for sure but there is still a LOT of room for growth.

I have seen some amazing things - lots gross and sad, but many beautiful and wonderful.
Today I went to Sarah Fox Convalescent Hospital for children and signed up to volunteer there. This place is breathtaking. wow. there are so many babies and little people that need to get healthy and return home, or wherever they can go to. I can't wait to work with them. yes!

tomorrow I'm heading out wine tasting with my program coordinator for the day and sunday my hopes are to rent a car and tour some beaches or beach towns that are too close to miss out on.

I hope all is well at home and miss you all!
all my love,
katrina