Thursday, October 24, 2013

A day in Hawston

This week I am going to give you a glimpse into my daily life here in Hawston.  

How my day is shaped depends a lot on the schedule I am working.  The first month I was here, I worked day shift from 8 AM to 4 PM at the care centre.  For most of October, I've been working 2 PM  to 10 PM.  If I'm working in the morning, then I set my alarm for 7:20 AM.  I have some yogurt and muesli for breakfast, and I make coffee in my plunger mug that I inherited from Holly, the YASCer from last year who worked in Cape Town.  Then I head over to the care centre for the day.  One of the first things I do when I get there is move my car.  I park behind the patient van in the care centre driveway at night because it's a little more secure than leaving the car in front of my house, but that means I have to move it in the morning so the van can get out for the day.  By the way, I haven't shown y'all a picture of my car yet, have I?  Here it is:

It's an automatic, which is very lucky for the rest of the drivers in South Africa.

When I get to the care centre in the morning, Martin and I have a meeting with all the carers and assistants for the day to discuss how the patients were overnight and our plans for the day.  The carers change shifts at 7 am (they work 7-7 just like I used to in the hospital in the US), so they have already been at work for a bit by the time I show up at 8.  After our meeting, Martin and I get started on our tasks for the day.  If we have any specimens to collect for tests, we do that immediately after the meeting.  We send all our samples to the Hawston clinic, which is just down the road, and they send them to one of the labs nearby for testing, so all the samples have to be collected by 9:30 AM in order to be sent out that day.  Next, we usually do a walk-through of the patient wards.  This allows us to see all the patients, ask them how their night was, if they need anything, are having any pain, etc.  Usually by the time we're finished with our walk-through, several issues have come up that need to be dealt with.  I'm still adjusting to being somewhat in charge here.  At home, whenever an issue happened with a patient, I could ask another nurse, or the charge nurse, or a doctor for help.  Here, the doctor comes once per week for about an hour, assuming she doesn't have a meeting or something, in which case we may not see her for a couple of weeks.  So that means that when a patient's catheter isn't draining, or a patient hasn't eaten meals in two days, or a patient needs transport to an appointment at a hospital in Cape Town, it's up to me to fix the problem (with help from Martin, of course!)  So the vast majority of my time at work is spent dealing with issues like those.  You'd be surprised how many things like that come up in a day (or in a night!)  

There are also things that Martin has to do every week that I help with.  On Tuesdays we allocate medications for all of the patients for the entire week.  That means we check all of the patient's medication orders and put them into those little pill containers that have days of the week printed on them so that the carers can just take out all the pills that patient needs on say a Monday morning.  Believe me, this process can take a while, because many of our patients are on 10 or more medications that have to be given up to 4 times per day.  Not to mention that medications have different names in different countries.  It took me two weeks to figure out that paracetamol is just acetaminophen (that's Tylenol to you non-medical people).  I thought we were giving some super fancy South African pain drug!  

The medication cart

At least once per week, Martin and I go through all the patient's charts with a fine-toothed comb to make sure they are up to date and all the information has been charted properly.  This is more of a struggle than you'd think, since English is the second language of pretty much everyone we work with.  Some carers write their notes in Afrikaans, and even those who write in English use phrases I'm not familiar with.  And it's a constant struggle to remind the carers that they have to chart their work!  Nurses in the US are so used to hearing 'If it wasn't charted, it wasn't done', but that's not generally a part of carers' training here.  I will often look back at a chart and see that the medication page is blank for a whole day.  Does that mean the patient didn't get their medication, or someone forgot to chart it?  It's my job to find out!

Patient charts

There are all sorts of reports and records involved in all this.  Martin keeps a patient register, admission and discharge records, old patient files, supply lists, an attendance register, the carers' work schedule, a book that lists who 'borrows' supplies from us, a duty allocation book, and loads of other paperwork that I can't even think of right this second.  I help with all those also.

I have a few projects I'm working on in my down time.  I've finished a first draft of the policies and procedures manual I wanted to write, but it's short and sweet right now.  I'm sure I will expand it as time goes on.  I am also working on updating the nursing care plans we use and writing some new ones.  Organization is one of my ongoing tasks.  Our supply cabinets just never stay neat for long!  I should also mention that I got in trouble with HOPE Africa recently because I don't check my office email very often.  So now I'm trying to find time in my day to do that at least once or twice a week!

Organizing the medication stock.  That took a while!

Again, the hours that I'm working greatly affect what I might be doing there.  You can't do things like make appointments for patients or collect specimens after business hours, so I have some more time for administrative tasks when I'm working the evening hours.  One of my most important jobs in the evenings is to oversee the carers' change of shift.  When the night carers come on, we do another report like the morning report.  If any of my old coworkers from the MIU happen to read this, you will probably think it's funny that I'm trying to implement bedside reporting at night.  I'm turning into one of those people.  It really makes sense here, though, because none of our patients have ID bracelets or bed numbers or anything like that.  You just have to know who they are, which isn't too hard since we have less than ten of them and most of them are here for several weeks at least, but it's still all too easy to get confused about which patient we're talking about, especially when most of the staff members are operating in their second language.  So yes, bedside reporting is in!  I'm calling it the nightly 'walk and talk' because I just can't bring myself to say 'bedside reporting'.

After work I head next door to my house.  What do I do with my evenings?  Well, I go for a run at least 5 times per week, usually 6.  I have the most stunning running routes around Hawston.  Here are some of my favorites:

This little path by the sea is called the Plank Hous trail.  That means wooden house, and apparently there used to be one somewhere along here.

Sometimes I run on the beach, but only when I'm in the mood for a good calf workout.  Running on wet sand is hard.

By the time I finish my run and take a bath, it's dinner time.  I'm a little bit of a lazy cook since it's just me.  I'll talk more about common foods in South Africa in a separate post soon, so stay tuned for that. Some nights I have dinner with different folks I've met here.  When I'm home alone, I tend to leave the radio on a lot for some noise while I'm cooking and eating (did you know that Ryan Secrest comes on in South Africa? He does!)  I admit that I've been a little bored around my house at times.  My TV only gets one channel, and the vast majority of the programming is in Afrikaans.  So I've been reading quite a lot.  In the 9 weeks I've been here, I've finished two 1,000 page Ken Follett books, a short novel by a South African author, a bad paperback romance that I picked up for a couple of rand, an even worse Nora Roberts romance, and an actual nonfiction book (which is really out of character for me).  Given how slow I read, that's quite a lot!  

I almost always end my day by skyping with Jacob.  I'm very lucky that my internet connection has been pretty good so far, and that Jacob and I have found a time that works for both of us.  He gets to celebrate the end of his work day by talking to me, and I get to climb into bed and hear his voice right before I turn out the light for the night.  It's a good deal for both of us.

So there you have it.  That is a typical day for me in Hawston.  Nothing too mind-blowing, but I find myself very happy here.  I have a fulfilling job, I'm spending time with interesting and charming people, and I really believe that I am living where I'm meant to be right now.  It's a pretty good deal.

Friday, October 18, 2013

DON'T call me a tourist!

It might just be me, but it seems like people have been trying to call me a tourist recently.  Most of my blog posts show pictures of me doing things like hiking or sight seeing in Cape Town, and not working.  The people I've been hanging out with outside of work joke that I know more things to do in the area than they do (and that would be because of all the time I spent reading Lonely Planet).  I'm obviously American, and why do Americans come to South Africa?  As tourists, of course!  So it makes sense that people would assume I'm a tourist.  Even if I'm here for a year, you could still argue that I'm just a long-term tourist.

But I would argue NO!  I am NOT a tourist!  I LIVE in Hawston.  I work here, I eat and sleep here, my car is here, my LIFE is here.  Maybe my life is only here for a year, but while I'm here I'm committed 100%.  A tourist comes to a place to see it, to do things, to consume.  I came to live, to work, to be. So what if I spend my free time exploring the area I'm living?  That's just my nature.  I'm an experience junky.  When I leave South Africa next year, I want to say that I KNOW South Africa, and to me that means seeing and doing as much as I can in the next 10 months (yes, 10 months... 2 months are already gone!  I can hardly believe it!)

So why are all my blog posts showing me doing touristy things?  Well, the main reason for that is I can't post a lot about my job.  There are confidentiality laws in South Africa just like in the US, so I can't tell you anything about my patients.  I have posted some pictures of the care centre, and next week I am going to write a 'day in the life' post so you can see what my typical weekday is like.  But other than that, I can't really show you a lot of pictures of my work, because that would require showing pictures of patients.

I CAN show you what happened just now.  Literally 15 minutes ago, Wendy, one of the 'Boss Ladies' came into my office and said, "You're missing the CANSA event!"  CANSA is the group that we refer cancer patients to.  I'm not sure what it stands for (obviously Cancer something something of South Africa), but they are involved in coordination of care for our cancer patients.  So anyway, I didn't know anything about this event before hand, but apparently October is breast cancer awareness month in South Africa, just like it is in the US.  So, I followed Wendy outside and found a group of pink-clad ladies decorating our yard with pink ribbons, and they were about to release the pink balloons.  I was just in time to catch this!

Our trees are now decorated!

The Pink Ladies get ready with their balloons.

There they go!  Of course, it was windy today.  It's always windy here.  So the balloons ended up in our yard, but that's OK.

Some of the kids had fun chasing the balloons.  They were just making sure we didn't litter.

So yes, there is a post that is not at all about touristy stuff!  See?  I can do it when I want to!

Tuesday, October 15, 2013

I made you this video

Please excuse my butchering of the word 'panoramic'.  I was just so excited to show you the Rhodes Memorial that I forgot how to talk.

Tuesday, October 8, 2013

Hiking in the Elgin Valley

During the last weekend in September, I went on a little holiday.  My friend Hananja and I joined a group from the Cape Union Mart hiking club in Grabouw.  Hananja and I met at work.  She is a dietician, and she works with students from Stellenbosch University who come to the care centre as part of their clinicals.  Hananja has become a good friend, in no small part thanks to this awesome weekend we spent together!

Grabouw is in the Elgin Valley, about a 40 minute drive inland from Hawston.  It's a lovely area, known for its apple farms. We stayed in a nice little backpackers lodge called Pippins, after the apple.  When we arrived on Friday evening, it was overcast, drizzly, and quite cool outside, but the view was still lovely.  I took this photo from the Pippins back porch.  My favorite thing about Pippins was the friendly critters who live there!  We were greeted by two dogs and a cat.

On Saturday morning, we set off for a hike around the Eikenhof damn.

It was still a little overcast and cool, but that makes for good hiking weather in my opinion.

Poor Hananja thought I was just snapping a photo of the view, but now she's on my blog!

We saw lots of prety wildflowers, including these spiky white ones...

... and some yellow ones, my favorite color.

We stopped for lunch along a mountain stream.

The stream happened to have a downed tree lying across it.

Which meant of course I had to climb on the downed tree.  I got my pants pretty dirty doing this, but that's the point of a hike, right?

By the way, do you notice anything strange about the water?

No, that's not a trick of the light, that's actually the color of the water!  I was a little grossed out by the strange tea color, but my companions assured me that this is natural for a mountain stream in the cape.  The color comes from the roots of the fynbos, which are the scrubby plants native to this region.  Many types of fynbos are thought to have medicinal properties.  Rooibos is a good example.  It's a type of fynbos that is most commonly used to make tea, but I've also seen rooibos beauty products and even rooibos flavored yogurt!  (Rooibos tea is wonderful, by the way.  However, I don't recommend rooibos yogurt.  It's a little weird to have your yogurt taste like a plant.)

It just so happens that we finished our hike just in time to catch the rugby match!  We had parked at a country club that had a public bar... the perfect place to watch the Springboks kick the Wallabies back to Australia!  This was my first rugby experience, and let me tell you, I thought it was pretty awesome!

It was so fun to see all these local people cram into this bar.  They brought in all these extra chairs, and people just lined themselves up in front of the TV.  Everyone was really into the game!

Well, almost everyone.

On Sunday morning, we had another great hike in a different area of the valley.

This spot had these cool pointy rocks poking up in different places.

We followed the ridgeline along and got some great views of the valley on one side...

... and occasionally a glimpse of the sea on the other side.  Then, all of a sudden, you round a corner and get this:

A fabulous view of the ocean from up high on the ridgeline!  Turns out we were hiking in the mountains you can see from my house!  In all those sunset pictures I've posted from my back yard, the mountains you see on the right side of the frame are where I was standing when I took this photo.  So the villiage directly below you in this photo is Kleinmond.  Halfway back along the coastline, you will see a white streak that breaks the brown and green shoreline.  This is actually the opening of the Botriver Lagoon, which separates Kleinmond on the west side from Hawston and Fishershaven on the east.  Further away in the photo is another mountain.  At the base of the mountain lies Hawston.  You can probably see my house from here, but it would be really tiny.

After the hike, Hananja and I headed back to Pippins, packed up our stuff, and said goodbye.  Then we enjoyed the rest of our day by stopping at a farm stand that had a lovely little cafe with excellent quiche.  On the way back to the Hermanus area, we drove past A BREWERY THAT MAKES ALES.  Sound the trumpets!  This was a HUGE discovery!  Lagers are the staple in South Africa.  It just isn't very easy to find a good ale.  I was overjoyed to discover that this place is about a 15 minute drive from my house.  Of course, we had to check it out.

Honingklip Brewery specializes in Belgan-style beer, but they also make a good IPA.

And they have two big yellow labs!

Hananja makes friends easily :)

What a great view!

So you can see, I had a really fabulous weekend exploring a slightly different area of the cape that is still very close to my house.  I hope you enjoyed all these photos, and I hope you learned something new about region where I'm living.  It's a pretty awesome place!

Sunday, October 6, 2013

The Opposite of Faith

I've had another busy week here in Hawston!  Last weekend, I went on a hiking trip to Grabouw (pronounced Hchhrawbow... that's my attempt to capture the phonics of the guttural Afrikaans G), which was wonderful.  I will be writing a whole post, complete with lots of pictures, about the weekend soon!  For the entire month of October, I'm working evening sift (2-10 PM) at the care centre so that a nurse will be available for most of the day.  It's actually been really nice.  I can get up and run in the morning, enjoy some sunshine, and have a nice lunch before heading in for the day.  At work, the evening tends to be a little quieter than the day shift, so I've had time to work on some administrative projects for the care centre that I've been wanting to tackle.  Last week, I created a first draft of a policies and procedures manual for the carers.

In between all this business, I've been thinking about the real reasons I'm here.  In talking with the other YASCers in our Facebook group, I've realized that we're all starting to have some questions about the impact we're having in our placements.  Many of the YASCers have found themselves quite busy in their jobs, as I have.  And all of us are starting to make relationships with the communities we're serving in, which we believe is one of the most important parts of YASC.  But some of us still have some doubts about our time abroad.  For example, last Friday, I got a call from the care centre at 5 AM.  The night shift carers were in the middle of a medical emergency and they needed my help.  I won't elaborate about the details of the situation, but let me just say that it was serious enough that I jumped out of bed, put on my glasses, and ran next door in my pajamas.  While we were waiting for the ambulance to come for this very sick patient, I realized for the first time exactly what I'm up against in terms of my job here.  In the United States, I would have had a doctor asleep in a call room 10 feet away from me.  I'd be the one waking him up, and as soon as he jumped out of bed and ran down the hall, I would be relieved of making medical decisions.  That's not the case here.  You'll be glad to know, as I was, that this particular situation turned out OK.  But it made me wonder whether I really have enough experience to do my job here.

I think doubt is a normal part of life for everyone.  I also think it's fair to expect that, when you choose to leave your country for a year of mission service, you'll pack some doubts along with your suitcase.  But a missionary is supposed to have faith in God, sort of by definition.  So I find myself wondering, how does doubt fit into this picture?

Shortly before I left for South Africa, I remember hearing someone talk about faith.  I believe it was in a sermon at St. John's, and although I can't remember exactly when this happened or the exact wording of what was said, the overall message was this:  Most people think that doubt is the opposite of faith, but that's wrong.  The opposite of faith is certainty.

There are lots of things in this world that are certain.  The sun will rise in the morning.  If I forget to put gas in my car, then eventually the engine will die.  If you put a cupcake in front of me and come back 10 minutes later, the cupcake will be gone.  These things are facts.  They don't require faith.  I suppose you could argue that God causes the sun to rise, and believing that takes faith, or that I eat the cupcake because I have faith that it will be good, but you'd be missing my point.  Lots of people don't believe in God, and the sun still rises for them.  Also I'd like to point out that there is no such thing as a bad cupcake.  So these things don't really require faith after all.  In fact, when you are certain of something, there's no room for you to have faith in it.  That's why certainty is the opposite of faith.

In order for you to have faith that something will happen, there HAS to be at least a bit of doubt involved.  A good example is the story of how I arrived in South Africa.  A few days before my flight over here, I emailed Donna, my contact a the HOPE Africa office.  I asked her what I should do when I arrived in Cape Town.  Would my car be waiting at the airport?  If so, how would I find it and where should I drive to?  Would someone meet me?  How do I find them?  Do they know what I look like?  What if I miss a connection?  Who should I call to tell them that I'm late?  The reply Donna gave me was (unnervingly) simple:  Someone will be there to meet you.  I decided to look at this reply as a chance to practice having some faith in the universe.  Donna said someone would be there, so there someone shall be.  Sure enough, when I got off the plane in Cape Town, I cleared customs, collected my suitcase, and walked out to the waiting area of Cape Town International.  There stood Jenny and Donna, waiting patiently for me, and they recognized me at first sight.  There was no certainty about that situation, and I suppose it's OK now to admit that I had a few doubts.  After all, I had no idea how big or crowded the Cape Town airport would be, or whether my flight would be on time, or anything like that.  But I had faith, and lo and behold, all was well.  

Faith isn't the absence of doubt.  They can coexist.  I think of it like light and darkness.  Light isn't the absence of darkness, darkness is the absence of light.  When you turn on a light, the darkness doesn't GO anywhere.  It's just not noticeable anymore because the light is on.  

We YASCers may come to find that the answer to the question 'Why am I here?' becomes clear by the end of our year of service.  It would be great to be able to say I made some huge change at the care centre, or I saved the lives of 20 patients, or my presence in the local Anglican parish strengthened the church and brought in more people.  It also occurred to me this week that maybe this year isn't about what I'm doing for Hawston, but what Hawston is doing for me.  Maybe this year is strengthening my marriage by reminding me how much I love my husband.  Maybe it's all about me learning how to be a nurse in a resource-poor environment. Maybe thirty years from now, something will happen to me and I'll think back to my time here and understand how it changed me into the person I will be.  Or maybe none of those things will matter, and that's OK too.  I may never be able to point to a single reason why I'm here.  And I'm OK with that because I have faith that Hawston is where I'm supposed to be right now.

We have a choice every day to worry about our doubts, or to accept them as a part of our faith and move on.  

Finally, just because I hate to write a post without a picture when I have so many great ones to share, please enjoy yet another Hawston sunset photo taken from my back yard: