Strikes, Bites and commuting in style.

South African World Cup hangover


Today our nurses are on strike. The fact that the labour dispute going on in the country has nothing to do with them is irrelevant. Actually the teachers and other government employees throughout South Africa are on strike and nurses have sort of tagged on and, to be fair, many have been intimidated by the toy-toying picket outside the hospital gate. We live within the hospital grounds so have been relatively unscathed by the activities outside, although the protests have been somewhat peaceful. The hospital itself has struggled and although all the doctors are here, there has been a severe paucity of nurses with only a handful onsite bravely manning the wards, OPD and theatre. There has been the usual drama and the patients, as always have suffered. The young first-time mum with her massive post partum bleed and coagulopathy survived but her baby didn’t. She was transferred by helicopter. The young man with his distal femur shattered by a bullet was less fortunate. The road ambulances were unable to access the hospital and we have been unable to refer him on for tertiary level care, so have admitted him to our ward. He is being well resuscitated and I am very proud of his leg traction which is weighted by a discarded sack and five bags of iv fluids. Yet another adolescent Mum with a placental abruption and dead baby has done ok despite minimalist nursing input. We have had to be strict in OPD/ED with only those in dire need being admitted. Tonight staffing is better but we know not what tomorrow brings.


Mseleni Hospital from the Chopper

Despite this inconvenience Africa and Africans are resilient and life goes on. The doctors remain upbeat and the team work is fabulous. I have had some wonderful cases lately and was so proud of my first amputation that healed and went home. His below knee amputation rotted and so I amputated again, this time above the knee, and thankfully this healed well, with smiles all round. Yesterday I did a twin caesarian section. What a thrill to deliver, not one but two, bleating infants and for it all to go well. Then on Friday a 10yo lad comes in with a day history of sore throat. He can’t talk too well and has laboured breathing. His tongue, lips and throat are swollen. Incredibly his mother presented 5 days earlier and needed a Bic pen to her airway to save her life. She is still struggling in a Durban intensive care unit and we suspect some allergenic ingestion. Despite the usual anaphylaxis remedies he fails to improve and we elect to intubate him and secure his airway. As he drifts off into a propofol induced slumber I slip the laryngoscope between his teeth and over his dusky tongue and gasp at the sight I behold. His airway looks like a cervix! No sign of the vocal cords at all and I go for the os rewarded with a misty tube and improved oxygenation. Unfortunately it is now late and we need to ventilate him in our operating theatre overnight awaiting chopper retrieval in the morning.

Me and Joseph off to work!

Speaking of choppers I got to fly in one last week. One of our neighbouring hospitals in the ‘mountains’ and about 2 hours drive away has been desperate for staff and we were volunteered to help out. To our amazement one of the NGO’s came to the party and just happened to have a very neat little Robinson Helicopter available and offered to fly us there. What fun it was to walk out of my front door onto the runway (literally 25 m in front of our house!), buckle in and get whirled off into the hills! We were dropped off on the lawn in front of the OPD and sauntered up into the building with stethoscopes idly draped over our necks. Unfortunately the second week the chopper wasn’t available and we had to settle for the fixed wing!

Ilda's nasty tick bite

The girls have been well and with a long string of visitors have enjoyed a long 5 weeks of holiday. They are now itching, I hope, to get back to work. Ilda has been acting as a professional guide for French friends and she too is fired up to get the teaching on the road again. The girls have been in fine form but Ilda had a bit of a scare recently. On our trip up to Kruger Park she was hot and had a headache and a nasty black bite on her forearm looked suspicious for Tick Bite fever. A quick stop at a chemist in Komatipoort for some Doxy went well and the astute pharmacist flogged me a neat quick-test for malaria which was thankfully negative.

Thankfully it was negative!

Last night we ran down to the Lake for sundowners. A Giant Heron waded in the shallows and Pied Kingfishers dive-bombed their unsuspecting prey. The warm copper sun cast long shadows across the dappled lake and we laughed at the joy of it all.