Monday, December 13, 2010

Summer times and the living is easy.....

On our way to the top of the Amphitheatre, Drakensberg

Summer, warmth and rain are here in force. Everything is growing prolifically and Africa is now a rich deep green and life abounds. Our mango tree is literally dripping with fruit and eating under it has now become a serious liability. We only have to reach up to enjoy the exquisite sweet taste and get our teeth flossed in the bargain. Ilda’s veggie patch is bulging and I think if we eat spinach again the girls will rebel! Alas our pool seems to be growing too and is also a rich deep green with an abundance of life! With a potential ending date in site we still love exploring this beautiful country and have had a number of fabulous adventures.



Amphitheatre, Drakensberg

A camping trip to Banga Neck was unforgettable for our turtle experience. Full moon, spring low tide and a breathless night made for perfect conditions for our guided walk along this remote beach in search of laying loggerhead turtles. We had spectacularly good fortune with no less than half a dozen turtles spotted with egg counting and close observation of two of them. The girls were enthralled by this marvel of nature where the turtles travel hundreds of kilometers back to their original beaches. Then, under cover of darkness, laboriously crawl up the beach, dig a deep hole with their flippers beyond the high-water-mark and deposit around 100 ping-pong ball size eggs into this pit, firmly cover them up and then struggle exhausted back and away into the sea. The minute turtles hatch about 2 months later but only about 1% will survive to adulthood thanks to all the predators that lie in wait for this scrumptious treat.

Then we experienced the drama of the Natal Drakensberg ( Quathlamba in Zulu meaning ‘Barrier of Spears’) A long drive via Pongola and Northern Natal and then around the lower part of the Orange Free State and into Qua Qua (one of the old “Homelands” from the apartheid era) deposited us at Sentinel Car park at about 2500 meters elevation. This is spectacular in that it provides the idle or infirm an incredible advantage with a gentle 2 hour walk putting one on top of the Drakensberg at well over 3000m and what one author describes as “the best view in South Africa”. We set off before 6 (including my 75yo Mum and 7yo Zara) and enjoyed dramatic black sky with a magnificent rainbow. The walk was relatively easy going and culminated in two chain ladders of 30 and 10m which Margot, Zara and my Mum made light work of. The view from the top of the Amphitheatre and the lip of the Tugela Falls is indeed phenomenal and left us breathless and weak-kneed. After the descent we drove round to Royal Natal National park and again enjoyed dramatic views of the Amphitheatre and one of the best camp sites we have ever had the pleasure to stay in.


Thatchers cottage; we stayed here on our way to the Berg

Last week Ilda planned a mid week break to celebrate the end of the school year for the girls. She has had a spectacular year with them and I sometimes wonder how they will ever adapt back into conventional school, such is the richness of one-on-one teaching from Mum. We bundled everything into the trusty Pathfinder and bounced down the 3km to Lake Sibaya, the biggest fresh water lake in South Africa. We enjoyed some fishing and a braai on the lake edge but unfortunately swimming is discouraged because of Bilharzia in the lake, not to mention the odd croc and even hippos! Our night was punctuated by the incessant grunt of hippo and I was slightly concerned that they might just pay us a visit. I was up with the dawn soon after 4am and enjoyed some more fishing, a golden sunrise and a marvelous parade of birds including Giant heron, kingfishers and even a Fish Eagle. Then we enjoyed a mug of tea and toast on the fire, made by the girls, before I trotted the few kilometers back to the hospital and a shower and work. Now that is the sort of commute that appeals to me!

And so it goes on; diving again at Sodwana with the usual array of spectacular coral and marine life, a trip up into the hills to Ingwavuma where the girls took part in a fun run with Margot completing 10km and Zara 3; camping at Ndumo game reserve, famous in South Africa for the magnificent bird life and a drive to a lookout point where we could gaze into both Mozambique and Swaziland, on the banks of the Usuthu river; and finally this last week-end where we took a crowd from the hospital to Hluhluwe-Imfolozi game reserve and stayed in a little private hut completely unfenced and exposed to the drama of the park. We enjoyed game viewing like never before seeing lots of young animals including six gorgeous brand new warthogs and lots of fragile new Impala; lion, elephant, rhino for Africa, majestic Kudu, no less than six Cheetah and some in our party were lucky to see a Leopard.

Our ending date is yet to be finalized but likely to be end February and I feel satiated. This year has exceeded all our expectations and we feel privileged and enriched to have been part of this wonderful land that is South Africa. I have seen my children grow and love the raw nature of this country and all it has to offer and I have seen Ilda’s apprehension evolve into enthusiasm and then passion. We wish you all a wonderful Christmas with those you love and may the New year be a great one.


On call again.....

I feel a little bit jaded. It has been a relentless week-end on call and eating and sleep have been a luxury. Three caesarian sections, the third of which was complicated by a failed spinal anaesthetic, morbid obesity, a uterus tied down by meteor-like fibroids and comet-tail adhesions and a big 3.8kg baby! The entire hospital ward rounds between two of you and the inevitable surprises like the chap with the sore knee. Pulling back his blankets revealed a hot swollen knee from which, in theatre later, warm yellow pus gushed in a volcanic torrent. I have referred many septic knees to Orthopaedic surgeons before but I had never done a knee wash out myself. A quick visit to our library put me right and their instructions worked perfectly. The chap looks much better on the ward today. Then on the women’s ward another snake bite. The foot that looked a little puffy yesterday was now massive and blistered with swelling extending right up to the thigh. This is common tissue destruction from snakes like the Puff adder. The dilemma was whether to give anti-venom, which is almost as bad as the venom itself with a huge risk of anaphylaxis, and/or to do fasciotomies on her, which involve large incisions up either side of her leg, to relieve the pressure. For the moment we watch and wait. The HIV + man with kidney failure so bad that he is unable to produce even a drop of urine and his body rapidly swells like a balloon as his heart and lungs follow suite. Pressed renal units will not accept him for dialysis if his CD4 count is <200 and some even if he is HIV+. Then the neonate, pushed into the world by her sullen 16yo mother, gasping for breath, blue and floppy. We ventilate him with ambubag and oxygen, thrust needles into his hair-like blue veins and carefully drip neonatal fluid and a concoction of antibiotics into his circulation. He rallies but remains poorly responsive and we wonder whether some more sinister insult has befallen him. Maybe we will be able to get a CT scan next week. So these are the sort of challenges that are woven into our day interspersed with all the other ward patients waiting patiently for their few minutes with the Dokotela.

Runners at the Mseleni Fun run we organised


Then of course there is the perpetual queue waiting in the OPD. The police attend with a 5yo girl. She has allegedly been raped by a 15yo boy. We painfully sift through the forensic rape kit subjecting this little mite to a multitude of swabs and invasive tests in a vain attempt to gather evidence for a conviction that we know is unlikely to ever happen. The process takes nearly an hour which is agonizing on a busy Saturday. We have no counselors, youth workers or support and so simply send her off with her grandfather, clutching the fluffy little white teddy supplied in the kit. Then we ponder whether we should have provided her with HIV prophylaxis. Sometime in the middle of the night I am called for a man who has been attacked with a bush knife. He has a large hole in his elbow. Under local anaesthetic I explore. The cavity is impressive and extends deeply into his elbow joint. The knife has neatly cleaved a slither of bone off his humerus. I copiously wash out the joint and suture the bone back in place with the joint capsule and secure him in a plaster cast. He reluctantly agrees to an admission for iv antibiotics and possibly further intervention. Another knee aspiration, a few miscarriages, the usual AIDS patients with diarrhoea and coughing, kids with fevers, broken bones, psychotic patients with desperate families, chancers hoping for a shorter queue on the week-end, stabbed back with a broken bottle, asthma, snake bites, confusion, abdominal pain. On it goes and the week-end disappears in a blur.


Then there was that on call when I was covering labour ward. Actually I am an ED physician and am not designed for this sort of stuff! It went like this. 16.00; called to LW for a primigravida who has a prolonged latent stage, is on maximum oxytocin infusion, screaming with pain and her cervix is only about 4cm dilated. We settle her with some Pethidine and she delivers 3 hours later. 20.00; back in LW for a prolonged 2nd stage. We contemplate the vacuum but she delivers about a minute later; baby is blue and lifeless and requires vigorous resuscitation. While we are at this a call from next door tells us of a delivery, but the first of undiagnosed twins. Then a second call….”come quick’ something feels odd. A vaginal exam reveals that the 2nd twin is coming down the birth canal with his arm first which potentially will obstruct him. I try in vain to replace the arm and then elect to deliver. Thankfully a healthy 2nd twin is delivered. Then return to flat baby who requires an umbilical catheter to supply fluid and antibiotics. We package him off to the high care nursery. Then to finish things off the twin’s placenta has failed to deliver. We take Mum to theatre and under Ketamine remove the placenta, repair the episiotomy and call it a day. As I trundle off home I suddenly wander if there might have been two placentas!




Wednesday, December 1, 2010

Margot and Zara: November writing

Margot with Camille the chameleon
Margot's November Writing

8/11 I like chameleons because…

I like chameleons because they change colour.

I like chameleons because they look in all directions and they can change colour.

I like chameleons because they grip onto you tight, they can look in all directions and they can change colour.

I like chameleons because they climb trees, they grip onto you tight, they can look in all directions and they can change colour.

I like chameleons because they are all nice and soft, they climb trees, they grip onto you tight, they can look in all directions and they can change colour.

That is why I like chameleons.


Yellow stripped and painted reed frog at Lake Sibhaya
Brown-headed Kingfisher outside our front door

3/11 There is a bird…

There is a bird called a kurrichane thrush, a hurricane thrush or an orangetape thrush.

There is a bird called a fork tailed drongo, a rockpale drongo or a lork nailed drongo.

There is a bird called a brown hooded kingfisher, a down nooded kingfisher or a bangle booted kingfisher.

There is a bird called a crested eagle, a pested eagle, a nested eagle, a lullaby eagle or a bedtime eagle.



Traditional Zulu hut

10/11

Yesterday Zara, Mum and I went to Richard’s Bay mainly to get our car serviced. It was a very nice day because in the morning we stopped at the “Bonjour” petrol station and got yoghurt. Then, we went to the Nissan dealer to drop the car off and had Weetbix for breakfast in the waiting room. From there, we took a taxi to the movies and had a jumbo box of popcorn followed by delicious Italian style ice-creams. We did some shopping and then visited to the pet shop where we saw some very cute puppies. We stayed and played with the puppies for a while until it was time to go to our dentist appointment. I am very lucky because the dentist said my teeth were the best out of us 3. After that we went to have lunch at Ocean Basket and ate some sushis before going to have another appointment at the doctor. I got my wart on my foot burnt off. First the doctor injected some anesthetic (a liquid so it doesn’t hurt) into the area around it and then the doctor got a little electric metal straw that made the top of the wart go black. Then he got his tweezers and took the sticky-out part of the wart off and burnt it once more so that it was completely dead. That evening after the car service was finished, we went to visit our friends who gave us our hamsters. On the way back in Hluhluwe dad sent us a very sad text. He said that when he got home from work, he looked into the hamster’s cage and they were dead! We will burry them this afternoon when dad is here. I am soooo going to miss them!


Buffalo at Hluhluwe Game Reserve

17/11 Snakes

Last weekend Mum, Dad, Zara and I went to Ndumo Game Reserve. There aren’t big games there but there certainly are a lot of birds!

Afterwards we went to visit a herpetologist. A herpetologist is someone who studies snakes. He was very nice. He even let us hold one of his non venomous rat snake.

Snakes aren’t my favourite animals but I do like them! Afterwards he invited us to come and see more snakes at his house. They were a bit more scary. One of them was a baby boa constrictor. He feeds his snakes rats. In the rat box, there were some baby rats who were a few minutes old! They were pink and tiny!

When I grow up I would really like to have a pet snake!


Turtle track left on the beach at Bhanga Nek

Turtle laying eggs at Bhanga Nek

24/11 Turtles

Last week-end our friends Jeanne and Lourence invited us to go and sleep at Bhanga Nek. Dad said that we might be able to see the turtles laying on the beach cos’it is the season for it so we went. For dinner we had a braii with steak, some potatoes and some green soup. After dinner they suggested we all took a walk along the beach and maybe see some turtles. As we got there, two men stopped us and said we couldn’t walk on the beach and so we just turned back and decided to try again tomorrow.

The next day, dad and I went all the way to Empangeni to collect Granny who was comng fromCape Town. On the eay, we went to collect two more hamsters from our friends. Zara named hers Bibbi (again) and mine is called Wiskas. We drove all the way back to join up with Mum and Zara and stayed in a lodge owned by one of mum and dad’s friend.

The next night, we went back to Bhanga Nek to see if we could get a guide to see the turtles. It was quite late and mum and dad had another argie bargie with the guards but in the end they let us past with a guide. During that night, we saw five turtles in total but only two from up close. The turtles eggs were exactly like ping pong balls. I really think I should be a marine biologist when I grow up!


Bearded Vulture with moon in the Drakensberg
Shell at Lala Nek

Zara's November writing


3/11

I discovered a nest up our mango tree. Two little brown birds were having some tea.

Their parents were there and cleaning their hair and sisters were there dropping a tear.

With a loud “peet-peeoo” they all set off to get a beakfull of worms and sac full of berries.


Chameleon on book

8/11 Camy the chameleon

My mum was pulling out weeds in the garden while we were in the pool when sudently (suddenly) mum saw something green on the gate. She cried “a chameleon”! We rushed out of the pool and shor anuf (sure enough) it was a chameleon! It was green and when I picked it up it turned stipy and spotty like an army outfit. We kept it for two days to observe it. He alwase (always) climbed my hair when he was happy!! We let him go in our mango tree. I hope he’s happy.


Locals on the beach after collecting sea food at Black Rock

10/11 Julia’s birthday party

One morning my mum asked me if I wanted to go with Herda to Julia’s party or if I wanted to snoukle (snuggle) with them. I said: “Julia’s party” so I got dressed (dressed) and set off to Herda’s house. After fifteen nimuts we lefed (left). When we got there we saw it was a Christmas party! Five minuts later we had to do the pinyata when Farther Christmas came. It took one owrar (hour) to open it. I loved it there.


Zara completely zen with a rat snake around her neck!

16/11 Snakes! Snakes!

Snakes are reptiles. Snakes lay eggs but some snakes don’t lay eggs. I’ve held a snake. It was called a rat snake. Its tail was the most sencetive (sensitive) place on its long body. It kept sticking its spicky (spiky) tongue out at me and that meens (means) he was sniffing me. He slithered around my neck. He felt slimy. I love snakes!

A Loggerhead Turtle laying eggs at Bhanga Nek

24/11 Turtl Torres (Turtle Tours)

We went to Banga Nek. We stayed there for two nights so we deceided (decided) to look at turtels. We got stopde (stopped) by one of the parksboard people on the beach. He said: “you are not alowd (allowed) to walk on the beach whith out a giud (without a guide)!” Mum was not happy so she called a giud to help. The giud took us to see the turtles. The turtles werr (were) all sandy. They do not have a tail but they do have back legs. There were two girls called marine biologists who were measuring (measuring) the turtles. The turtles cover their eggs and go back to sea. They were so happy when they cold (could) swim!