Earthquake, leaving Mseleni and Africa calling...

It has been a tumultuous week. Frightening, desperate, sad, happy, anxious, stressful, exciting. The 6.1 New Zealand earthquake had as its epicenter our little village of Lyttelton next to Christchurch. We listened in numb silence and shock to the dreadful news and watched in horror the grotesque images of the beautiful town we know so well. Buildings and lives shattered monuments and cathedrals no more and we wonder if it will ever be the same again. And yet out of bad comes good and the rescue stories, community spirit and incredible work done by my Emergency Medicine colleagues and other medical staff in Christchurch demonstrates the courage, resilience and determination of the true Kiwi. We felt relieved to have missed it but somehow sorry not to be able to offer help and to experience this incredible New Zealand spirit. Our thoughts are with you.

Here far away in Africa our lives too have taken a turn. I am now unemployed having completed my year at Mseleni hospital in far north Kwa-Zulu Natal. We packed up our Park Home into trailer and station wagon and drove off into the sunset! It was with mixed emotions that we left. My farewell from the OPD/ED staff was deeply moving with lots of singing and prayers, moving words, chips and coke for Africa and a massive cake with “Fair well Dr Inglis” written on it. The staff showered us with gifts and my words of gratitude were choked with emotion. Ilda and the girls were able to sing in French in response to their beautiful Zulu song. It has been a spectacular year in which we have felt deeply privileged to have been part of this rich community and culture. We have learnt so much about life, about wildlife, about medicine, about Africa and I feel more a part of this country than ever before. Numerous excursions into game parks, diving in clear warm water, camping on beaches and on mountains of the Rift valley, historical tours to Zulu war battlefields, trout fishing with my Dad, school old boy gatherings, running the Comrades, canoeing down beautiful rivers, trips to Cape Town to see our family, wonderful visits from friends and family from around the world, the girls running barefoot, collecting bugs and getting excited about stars. This year has exceeded all our expectations. Then there was home schooling in which Margot and Zara thrived and Ilda excelled and my hospital work that made me realize how much more there is to do and know.

Take my last few days in the hospital. This 55yo man is dragged into OPD by his family. They tell me he has vomited up a lot of blood. He is sweaty and ghostly pale. We place large iv cannulae and hear that he has been a drinker. I suspect oesophageal varisces and, as if to confirm this, he throws up another jug full of bright red fresh blood. I feel desperate as we lack the usual special throat tube or drugs to stem his bleeding and a surgeon is over 2 hours away. We give him blood and, as a compromise, I pass a urinary catheter down into his stomach, blow it up and apply traction in the hope that this may stem the bleeding. It amazingly seems to work and he is still alive when I return early the next morning. Enthused, I refer him on again to the surgeons who remind me that the mortality for this condition is nearly 100%. Despite this we book transport and prepare him for transfer. But the stats prove right and soon thereafter another bucketful of blood and he breathes his last. That same night I suture up a scalp. He has been assaulted by the “community justice” with a “knobkerrie” (a stick with a hard rounded end) and has an extensive occipital laceration. He is conscious and only requires sutures but the process is awkward because he is unable to roll over because of the handcuffs that tie him to the bed. In the morning I am desperate to get away to the morning rounds but one more folder catches my attention. Green folder means obstetric and ignore it at your peril. She is 36 weeks pregnant, a little restless, BP 160/110 and has leg swelling and protein in her urine. Pre-eclampsia is a dire obstetric emergency and we treat her and transfer her urgently to the Women’s hospital over 2 hours away.
My last day at work is memorable too. After routine rounds we start in the operating theatre. An elderly man who has smoked all his life has a rotten big toe and no pulses in his leg. His vessels are irretrievably clogged and we amputate below the knee. Even without tourniquet only one vessel spurts briefly, confirming his wrecked circulation. Then on to the ED, where we have a young man who is restless and short of breath. A chest x-ray shows a massive heart and we are able to confirm this on ecg and Ultrasound scanning. We place a needle into his anterior chest over his heart and straw coloured fluid gushes forth. We drain off two litres of pericardial fluid and start him on TB treatment. He feels so much better that he asks us to discharge him! And so I finish at this delightful hospital, hang up my stethoscope and walk out the door.

We hope to be back. Right now we are surrounded by ammo boxes, camping gear, piles of Mefloquine and Garmin’s “Tracks for Africa” as we prepare for our nearly 6 month voyage around southern and eastern Africa. The all important “carnet” for the car comes this week-end and so we hope to set off early next week. The plan is to head up to Weenan for a touch of 4x4 tuition and then on up to the Drakensberg and into Lesotho via Sani Pass. From there we will go west to Namibia, follow the coast and then turn right at Angola. Then through, what in my childhood was a war zone, the Caprivi Strip, and on to Botswana. After that as far north as Rwanda and then back home along the east coast via Tanzania and Mozambique. It all seems a little chaotic now but things seem to be coming together.

Carpe Diem

Inglis Family