Half way there...

Margot at lake Sibaya

The pathology here and incredible cases never cease. What does cease, or perhaps mellows, is ones tolerance of what is going on and what one sees. Kaposi’s sarcoma, a rare cancer but common with AIDS, used to have me reaching for my camera every time, but now it is yet another of the horrific complications that we have on our ward every week. The sight of a psychotic patient, stark naked and screaming past the ward, grabbing bags and emptying them out on the ground, initially would have startled me, but now gets a grunt and an order for haloperidol and lorazepam. The call to the ward for the ‘gasping’ patient used to induce a sprint from our Park home up to the wards, but now the futility of it all is so obvious and the gasping AIDS patient is probably being released from his torment and suffering. This may sound callous but is necessary to ensure personal survival and one does ones best.

Post Caesar bliss!

Another psychotic patient that springs to mind started off as a trauma patient and appeared to be waiting quietly for an x-ray of his obviously broken lower leg. A frantic call to the x-ray department revealed a very agitated middle aged gent trying to walk on bilateral fractured tib-fibs. Now this takes some doing and certainly made him sweat. It appears that he had some sort of spiritual experience that encouraged him to leap from a moving vehicle and cause his injuries. We had a big battle with him and getting a needle near him was no small task. I have memories of grappling with him on the floor tugging at his broken leg (which did serve to get it into a fine position!) while he screamed out to the waiting room “Mlungu mena bulela!” (the white man is trying to kill me!) This did have the added benefit of emptying out the waiting room. Some very kind Orthopaedic surgeon accepted him for further management, poor chap!

Then there was the 18yo lad who was apparently evading the constabulary. In his haste he was impaled on a branch of some sort and managed to disembowel himself. He was amazingly quite well but was a sorry site with multiple abdominal wounds and his stomach hanging out limply. I was very proud of my general anaesthetic while Dawie did a sterling job at replacing his gut and suturing up all the holes. I discharged him from my ward 2 days later.

Bikes and the truck off to Swaziland

The Obstetric catastrophes never fail to impress me. Not much is meant to scare Emergency Medicine specialists but O&G stuff gives me the heebies. I think that I have had to manage a fair number of the recognized Obstetric emergencies but last Friday I had my first prolapsed cord. This is where the umbilical cord slips down the birth canal before the head. Obviously if it is compressed then it is game over for the baby. An astute midwife had made the diagnosis and she had mum in the knee-chest position and had her hand firmly up the vagina keeping the head off the cord. My colleague scrubbed for the Caesar and I got drugs ready, rolled mum onto her back and with that wonder drug Ketamine slipped her off to sleep. A very slick Caesar and a healthy boy was born. Some opiates, a bit of local to the wound and mum was happy too….no fuss! In fact we did 2 other Caesars under Ketamine last week; one a stroppy teenager who wasn’t interested in a spinal and another in whom the spinal had failed. What a drug….

A couple of Fridays back I did the flying clinics. This involves climbing into a tiny 4-seater and bouncing down the runway literally in front of our house. In fact the kids waved from the front door! It is a beautiful flight over Lake Sibaya and we were lucky to see a few Hippo down below wallowing in the clear blue water. The landing at the first clinic was character building and the pilot had a knack for avoiding mole hills, sand drifts and cow shit. I felt a little seedy as I started my clinic. That was tame compared to the next hop. My plan to eat my lunch between clinics was rapidly put on hold and the approach was hairy to say the least. The pilot said that he had been asking the electricity corporation to move the wire for ages and apologized for the fact that we had to leap frog this wire before plunging down to the runway and bringing us to a halt in front of the clinic. Let me do a Caesar any day! The flight home was relatively mild and a strong tailwind got us back in record time.

A swollen finger

.This was good because I was on call for the week-end and sadly my first case was one of two rape cases I was to deal with over the week-end. These are miserable cases to deal with, for the poor victim mainly, and the fact that they take about an hour of painstaking evidence collection. Apparently few of these cases ever result in a conviction but we are obliged to go through the motions. More importantly here is sorting out post coital contraception and HIV prophylaxis, which is a months worth of nausea and vomit inducing medication. Friday didn’t get any better and a few car crashes kept me busy. The worst off was a young woman who had been thrown from a bakkie. She was barely conscious and there was a boggy swelling over her occipit. Blood trickled from her right ear and that was enough for me to transfer her urgently to our base hospital for neurosurgical intervention.

Anyway, enough gore. We have also had a lot of fun lately. A steady stream of visitors has ensured lots of activity and we have had a number of great trips away. I attended the Rural Doctors conference in Swaziland and Ilda and the girls came along too. We stayed in a fabulous game park called Milwane and had fun riding horses, mt bikes and looking for game. Then we had a week-end in the Natal Midlands when Ilda had some down time and I went off with the girls. We did some more great riding but the trout fishing was not successful! Then last week-end we flew down to Cape Town to see my sister and Mum. Cape Town is always a blast and we had a cultural extravaganza visiting the Planetarium, Gardens, Kirstenbosch, Art gallery and even went to Mama Mia. There was lots of wining and dining, catching up with varsity mates, beautiful drives along the coast and walks on white beaches. This week-end we camped on Lake Jozini and came home via Mkuzi game reserve. So much fun that there are murmurings of extending the African experience…..

A Weekend in Swaziland

Princesses performing

Swaziland is only 1 ½ hour from home. It is the HIV/AIDS capital of the world with most of the population infected and a life expectancy of about 43 years. It is a kingdom and people pay respect to their king in various ways.

This weekend was a special occasion for the King to choose a new bride amongst 60,000 bare breasted maidens who were putting on an impressive show of dances and singing in the King’s new stadium in the Ezalwini Valley. The occasion is called the Reed Dance Festival.

Before entering the premises, I got stopped by a police officer pointing out my trousers and saying that women visitors needed to wear a long skirt to be allowed before the King. I quickly went to buy a piece of material at a side stall to wrap round my waste and I was allowed in with the officer smiling!

The place was full of excited young maidens all gathering in groups, each of them carrying a piece of reed. The reed is a gift to the King’s mother to help with the yearly repair and maintenance of her residence's thatched roof.

We waited expectantly for 2 hours before the King’s warriors appeared, leading the King and his mother to their thrones, his many wives following as well as all the official delegates. The stadium’s grounds finally started to fill up with the maidens coming in groups according to their geographical area in Swaziland, all singing and performing in beautiful harmony. The one that stood out were the “princesses” with their beautiful red feathers in their hair all dressed up in traditional clothing. The “princesses” are all the descendants to the King and his family. I must say that there seemed to be a lot of them!

It was a great show of youth, colours, beauty and traditions in a country so stricken by HIV/AIDS. How many maidens are going to make it through?

Ilda

Stadium with 60,000 maidens

Traditional Beehive Huts at Mlilwane
Foot shakers for reed danse
Traditional Swazi women

Life in the African bush

What is life like in the African bush? It is like:

Using mesh bag from packaging of oranges for scrubbing your skin in the shower,

Drinking sea water to make one vomit…the Zulu do that to purify the “body”,

Having all you seedlings eaten by the neighbour’s rabbits,

Being woken-up by the resident croaking frogs at night,

Having our septic tank overflowing every 3 weeks,

Looking at mangoes growing in the garden trees,

Looking at Zara talking to a shogololo (big millipede) and making it her “friend”,

Seeing Zara and Margot role-playing “Zulu ladies” with their dolls attached to their backs with a cloth,

Seeing the kids glued to their reading books,

Finding the loo paper unrolled in the toilet because Zara is designing a rocket with the inner tubes!

Hearing a little child’s voice while running saying “mlungu” (white person)!

Storing bottles of water at home in case of a power cut,

Never worrying about the weather when doing washing…clothes WILL dry outside,

Wondering when you will see the first (poisonous) snake in your path,

Never letting your petrol tank go below ¼ full,

Waiting to be in the big city to download documents above 1Mb from internet,

Having children racing with you on their single speed bike while MTBiking around Mseleni,

Being woken-up by the ward matron phoning you in the middle of the night and saying “Tell the doctor to run!”,

Driving 1hour to go to a restaurant,

Worrying about cows on the road at night and cars without lights,

Being excited to see city lights at night,

Noticing the city noise, hearing the sounds of the bush,

Worrying whether you have been bitten by a mosquito with Malaria,

Having a husband that comes back from work announcing “I’ve done my first leg amputation today!”

Seeing and hearing sick patients in the outpatient waiting room singing morning prayers,

Skipping with a bunch of pregnant ladies waiting to deliver,

Having domestic help 2 mornings a week,

Planning the next art session with the girls,

Eating an ice cream at the mall after doing the monthly shopping,

Being two hours from the nearest dealer’s garage,

Wondering when it will rain,

Having more books than toys for the girls…

Ilda

Spot the croc? Zara and Margot at Mlilwane Game Reserve, Swaziland

Kosi Mouth

Horse Riding at Mlilwane Game Reserve, Swaziland

Zara's July-August writing

Zara with French friends Alizee et Loanne

7/07/10 If I was an alian

On Monday I wold (would) go to the ice-cream shop.

On Tusday (Tuesday) I wold go to scool (school).

On Wednsday (Wednesday) I wold go to the zoo.

On Thursday I wold go to the disco.

On Friday I wold play whith (with) my frendes (friends).

On Saturday I wold fix my hous (house).

On Sunday I wold cut down trees

Lake Sibhaya

Rhino baby + mum (Hluhluwe)

12/7/10 Phinda

We went to Phinda and we saw cheetahs. It was awesome.

We saw the two cheetah brothers. We also (also) saw a lion. We saw tuns (tones) of elephants. We saw a tiny, tiny (tinny) elephant.

Zulu women umama

Zebra with two heads!!!

14/07/10 Animals at the hide

At the hidewe saw tertles (turtles). They werr (were) lying in the muddy water. One of the tertle werr upsiydown.We saw worthoges (warthogs). And soon after the baboons came running down like they were all late for school. Then a dazzle of zebras came all in a pack. Then a black figur (figure) approached. We saw it was just a gnu. And sudntly (suddenly) a baby rhino aperd (appeared) with its mother. The mum rhino settled (settled) down and the baby rhino lay down on the thick grass, and started to suckle his mum. The end.

Rhino at Mkuze hide

21/07/10

I went to Kruga (Kruger). I liked it there. We were driving along and then we saw six lion cubs.

Spider?

Warthog family

26/07/10

I went camping at Hluhluwe (Game Reserve). We saw wiled (wild) dogs and hyheenas (hyenas). When the evening came, we all went to sleep very erly (early). The next day mum and dad went very erly for a (MTB) race in the game reserv (reserve). And then the evening came again and we had a Bok drolokies spoor competisi: I put an impala poo in some beer and then I put the impala poo in my mouth and I spat it out whith (with) a “ptoo!”

Impala male

28/07/10

We had quite a funny compitesion (competition). We had to sing in the shower and then we would win a small bottle of pink bubble bath. I sung: “In the Jungle, the mighty Jungle the lion sleeps tonight x 2 eeeeeeee eee ee eeeee owomboway eeeeeee eee ee eeee owomboway blab la bla ¶¶”

Margot 10 year old birthday

10/08/10

We went on a cool game drive at Tembe game reserv (Game Reserve). We didn’t see a lot (a lot) of game, we saw impala, nyala and some dieka (duikers). Then we shot into an opin airia (open area). Dad said “this is igsactely (exactly) where we saw the lions last time”. He stopped the car and said: “Here pussy pussy pussy pussy. And here they are.” We looked at them for a long time and then it was getting dark and so we went back home. The end.

Egrets at Lake Sibhaya

Mardi 17 Aout

Moi jệvu un gro krapo. Apra jệ vu les oeufs tous noir. Just au mommon ou gặlai partir jệ vu la femell desou le male. Can les oeufs seron des tétares ons va peutệtre les adopter.

(C’est le premier texte en francais ecrit par Zara toute seule a part le mot oeuf! Pas mal quand meme!!)

Morning mist at Hluhluwe Game reserve

20/08/10 The Moon

The moom dossint (doesn’t) shine on its own, it shines with the sun.

The moon has craters, which are holles (holes) made by astroyds (asteroid) that hit fly the moon.

The moon isen’t (isn’t) a plant, it is a natural satellite of Earth.

You can’t live on the moon because there is no oxegen (oxygen).

I would love to go on the moon one day.

Zara at Nibela

24/08/10 How to grow a carot (carrot).

I have a carot seed, I put my carrot seed in a hole of soil.

I water my seed every day. First tinny tinny leaves come out, then the leaves come out, then the leaves grow bigger and bigger.

The carrot grows under the earth.

The carrot is ready. Just wash the carrot and eat it.

27/08/10

I saw a nyala just next to our house. The nyala was waching (watching) me whith (with) his big black eyes. I went a little closer to the nyala.

I put my hand out infront (in front) of me and the nyala sniffed me. The nyala started to lick me. I steped (stepped) back because I was scared of his horns.

Margot's July-August writing

Left: Propaganda in front of hospital. We've had 3 weeks of strike so far. Below: Margot and Zara at Kosi bay with the fish traps

30/6/10 Problems at Mseleni

Problems always happen from time to time but they basically happen every day at Mseleni. We have had at least 5 problems at our house.

One of the worst is that the garden tap is exactly outside my bedroom but the pipe has a leakage and all night or wherever the whole house is quiet (which it never is in the day), you hear a irritating “pssst pssst pst pst” because the water splashes onto the paper-thin wall of the house. I keep telling dad to try and turn it off but he never does it.

Also, our washing machine wouldn’t work so I had to recycle my clothes for at least two weeks!

No 3 problem is that our car broke down so we had to get a tow truck all the way to Richards Bay.

I also think that our house is too small but I am grateful that I at least have my own smallish bedroom with a double bed because some Zulus only have a grass mat to sleep on.

One of the worst things is that we have a part of the septic tank system in the middle of our garden and it is overflowing!

Some problems get fixed and some don’t!

Crested Guinea fowl

7/7/10 If I could fly…

If I could fly I would visit every country, feeding the poor and over seas, calling the whales and through the desert, dropping buckets of water for the camels.

Through the sky I would soar, helping injured birds to their feet again.

If I could breathe underwater, I would live with the mermaids and the mermen and the seahorses would be our way of transport.

If I was an ape, I would swing through the jungle eating bananas and chasing my friends. I would have to be careful of poachers.

If I was a lion, I would creep through the long, dry African grass after a zebra or a warthog having a morning graze.

But I can’t or I’m not any of those things; I am me and I am quite satisfied with that.

Cheetah at Phinda Game Reserve

12/7/10 Phinda

Last week-end, grandpa and his partner Merle came to visit us. We met them at a nice private game reserve called Phinda. We were supposed to arrive before them but we didn’t.

The next morning, we went on an amazing game drive. Some of my favourite parts were the cheetahs. At first we saw a lone female lying next to a decimated termite mound. Her coat was covered in orange with small black rosettes and she had a patch of blood on her cheek (a sign that she had had a kill).

Second was when we went through the sandforest and saw kazillions of elephants and the matriarch turned to face us flapping her ears and Merle was petrified!

Also, on the night drive we saw two more cheetahs hunting for some food. The one cheetah was always marking its territory while the other one was desperate for food and when he spotted a nyala, he raced after it for ages until we couldn’t see him any more. It is the first time I have seen cheetahs in the wild and it was amazing!

14/7/10 Good bye

Last night it was some nice doctors called Martins and Zhera’s goodbye party. They were going back to posh England to live. They were both very nice so everyone was sad that they had to leave. I especially like Martin. He was one of the most hilarious people I have met. He called us “egg leg” or “egg head” or something like that. He liked to play “tackle” girl way and he would always win soccer with us. Zhera is a nice girl too but she is much more relaxed. Once we took funny photos of ourselves with her computer! Most of the party we played with our friends. For dinner we had lasagne. It was so scrumptious my mouth watered. The mince was so perfectly cooked and it even had tomatoes to add to the taste (even so it would have been the same exquisiteness without !). And for dessert we had chocolate cake with chocolate icing, cinnamon cake and vanilla custard! I felt extremely sad when we had to go to bed! I am going to really miss them!

Lion cub at Kruger National park while on a morning drive

21/7/10 Cubs at Kruger

Last weekend we drove up to Kruger National Game Reserve. Kruger is the biggest game reserve in South Africa. At Kruger we met our French aunty and uncle. It was so much fun! We saw lots of bucks: impala, nyala , kudu, klipspringer and steenbok. We also saw some big animals like: rhino, elephant, hippo, cheetah, giraffe and buffalo. But one of my favourite sighting was…well first sit back in your seats/chairs and relax, grab a drink or go to the toilet before I tell you the adventure of the cubs at Kruger.

We were driving along on a Sunday morning at about 7:00 when a work truck zoomed past us. There was a turnoff to the main road but we went straight. Mum was looking at a small lilac breasted roller. It’s breast sparking in the morning dew. Suddenly it screeched and flew a little bit further on dad’s (the driver) side. I asked dad if he could go forward a bit so I could see it and as he was getting back into his seat I think he accidently stepped on the accelerator and with out any warning the car zoomed on nearly crashing into a tree. “Stooop”, screamed mum. I thought the air bags would pop out but thankfully they didn’t but what did happen was that my very own skull flew forward and hit a hard water bottle someone had put in the front pocket. “Back, back, back”, whispered mum. Dad reversed the car a little bit and there, sitting in the sun was…2 little lion cubs!!! As we came closer we saw 4 more lion cubs in the shade! They were so cute. Their little yellow coats sparkled in the morning sun. I am going to remember this all my life and I hope my head gets better!!!

Dung Beetles rolling their dung

26/7/10 Bok drolokies spoor competisi

Last weekend mum and dad took part in the Imfolozi Mountain Bike Race. It was to raise money for the wild dog foundation. The day after the race there was a big party in the marquee. One of the games was a buck droppings spitting competition. It is a competition where you have to try and spit impala poos the furthest. Zara had a try and she spat her poo about 1 metre! The droppings taste like card-board but we soaked them in orange Fanta or dad’s beer! It was really funny.

29/7/10 Sports day

Yesterday was sports day and Gerda (our friend’s mum) offered to take us. We do sports at Sodwana Bay School and so I have made lots of friend there. Our friends Wentzel, Annalou, Uju and Lize are quite young and they are lots of fun to play with but I especially like listening to their funny Afrikaans conversations. Their car is a small light blue chaotic car and there was a lot of shouting on the way I was really relieved to get there. I saw all my friends waving to me from the other side of the fence so I suddenly flung open the door and ran to meet them. They were so happy to see me again. “Hello Margot”, said Sindihle, “Welcome back!”

Before we have sports we always do a 1km run to the soccer field. I was at the back because I had to wait for Uju. It was a steaming hot day and I could feel the sweat starting on my forehead. It kind-of felt like the soccer field was 100m closer but I haven’t done sports since the “exciting” World Cup Soccer.

The school has 3 main sports to pick out of: Junior soccer, Senior soccer, netball and Karate. I really like netball. It is my second favourite sport. I am a little bit small for netball but I really like it. I am Goal Attack and my job is to pass the ball to the goalie so she can score. It is so fun!

Dad's "sandy" birthday cake

10/08/10 Hyenas @ Hluhluwe

Last week some French friends came all the way from France, for a 2 week holiday. Just to get them started, we spent 2 nights at Hluhluwe Game Reserve.We arrived very late and when we eventually got to our hut I collapsed into my bed and instantly fell asleep. The next morning we woke up very early to go on a morning game drive. We had only been driving for at least 20 minutes when Max (our friend’s dad) said “stop, hyena” “STOP! HYENA!” Of course he said it in french which is “arête, une hyene”. Mum stopped so suddenly that, because the back seats were down, we all went tumbling forwards! I though it was the most hilarious joke but as mum reversed there was a mustard coloured dog-like creature with a hunch-back and dark black spots. It was a most extraordinary thing I had seen since I have been in Africa (6 + ½ months!) I had seen other hyenas before but they had been far away. This guy was actually on the road walking along like he was totally relaxed and couldn’t care less about us! I most adored his face, with his wondering black eyes and his cute little nose. I can’t wait to go back to Hluhluwe to see the hyenas!.

17/08/10 Lion fish

Last week-end we went to stay at Mabibi Beach Camp site. We were eight people (counting our friends from France) so we had to borrow the Viljoen’s tent (the other family here at Mseleni), We also had our tent and my birthday tent so we had plenty of space. We arrived there quite late and the man at the gate of the camp was half asleep but he managed to tell us our campsite number. It was Number 6. At the camp there was a braii, a tap and a big open area. The Viljoen’s tent was a 2 room tent and it was quite hard to put up because we only had the headlight of the car.

The next morning, I got straight into my snorkeling gear and ran down to the beach. Mum was already down there and when I arrived, mum called me over to see something in the water under a big rock.

…And guess what it was?.A LION FISH!!! It is the most amazing thing I have seen with its orange and red and black stripes, I can’t wait to see him again.

Left: Near Kosi Bay with Loanne, Max, Bisou et Alizee from Paris. Below: Nudibranch at Sodwana

19/08/2010 If I was an Egyptian crocodile

If I was an Egyptian crocodile I would roam the Nile River looking for food. Of course I wouldn’t be a normal croc because I wouldn’t eat small children; I would only eat fish and potatoes. Instead of eating them, I would take the Egyptian children on my back for trips down the river. I would only be able to take four kids at a time because I am not as strong as the male crocs(I am a girl). The kids would probably have to bring extra soft pillows to sit on my back because of my really scaly and bumpy back. I would go slowly down the river for the small children but I would flow with the river for the bigger ones. The only condition of riding with me is that you have to bring me a potatoe. But potatoes are quite easy to grow in Egypt so basically everyone has some. On the weekends I would go to visit the village and sometimes steal a potato or two!

24/08/10 Nibela Lake Lodge

Chapter 1:

“Are we there yet?”, I called from the back of the car. We were on our way to the lake and I desperately needed the loo. “I feel car sick!”, I added. “Open the window, silly”, giggled Zara, my little sister who was seated beside me and was drawing weird faces on a portable whiteboard. As the window went down I felt the soft breeze on my hand that was still tightly pressed against the button urging the window to go down more. When it eventually came to a stop I jerked towards it but the seatbelt held me tightly back in my seat. I tugged hard at the belt many times and it eventually gave way. I turned towards the open window…what a joy It felt to be out in the open again! I felt like a free bird! I think I had my head out of the window for half an hour because I must have fallen asleep on the arm rest of the door. When I woke up I had a brain freeze and we had already arrived.

Chapter 2:

Nibela Lake is part of the St Lucia Wetland Park. Last time we went there the water from the lake was much closer, but this time it was at least two miles away. The beach is not really a sand beach it is more a dry and muddy one. As we got there Dad told us that Zara’s friend and mine were coming. They were also bringing their families along too. We were going to stay two nights but my friend, Aby was staying one extra night. That night when everyone had arrived we had dinner and then ran to our huts, cuddled up in our warm cozy blankets and sailed off into a world of dream.

The next morning we woke up, got dressed and rushed to the dining room to have breakfast. When we got there, there were monkeys everywhere! I think they were after the sugar. The waiter and the waitress had lots of stones and a long stick to scare them away. But still with them (the weapons) they still manage to steal a lot of sugar and a muffin! They were so cheeky!

Chapter 3:

That afternoon Dad sudjested that we could go on a quad bike trip. I thought it was a fantastic idea, but nor Calum (Zara’s friend),his Dad or my Mum was so keen to come. We had booked it for twelve O’clock so Aby and I sprinted up to the games room, table tennis rackets and balls in hands. I’m not so good at table tennis but I would have done anything to get away from the monkeys as they give me the kreeps!

At last the time came to ride the quad bikes. We were all so exciting. I jumped on with dad, Zara went with Calum and his dad, Aby when with her mum and her big sister went with the guide. Dad told me to turn the key and as I turned it I felt the purring of the engine under me as the whole bike shaked. It was very comfortable on the bike but I don’t think it would be too nice hearing them if you were on a peaceful walk or watching birds. After a while on the bikes dad let me drive. It was really amusing going faster and then stopping and zooming off again.

I would really like a quad bike of my own and I think after those few days I am getting better at table tennis!

Margot making "crepes"