Christmas in Gabs

It has been a very low-keyed Christmas season for me here, partly because Christmas isn't as visible and commercialized here - so there have been very few decorations or signs of the holiday in town - and partly because it is summer here - it was 95 degrees on Christmas day. Most people in Gaborone leave the city for the holidays. Shops close until the week (or two) after New Years and people either go back to their villages or travel to South Africa or any other nearby holiday destination. Lots of staff from the hospital have left until after New Years.

The two holiday-type things I did before Christmas were to attend a concert at the #1 Ladies' Opera House by the University of Pretoria Choir. They sing songs in each of the 11 languages of South Africa. They finished the concert with a few Christmas sing-along songs. Their call and response harmonies and dancing reminded me of one of the things I love most about this continent.

Nancy Chescheir took these pictures. She really captured how lively this group was. I only wish you could hear their singing.

The second holiday event I attended was the Hospital Employee Christmas Party. About 250 of us gathered in the large outside courtyard located in the center of the hospital for food, caroling and some great dancing at the end!

On Christmas Eve 4 of us went to a small local game park in Gaborone that I had not visited before. You can drive yourself around Gaborone Game Preserve so we had a leisurly drive and spent a lot of time watching monkeys.

We found one of the biggest termite mounds we've seen so far. Way too many termites here, which is why there are hardly any wood-based buildings.














Here I am with my buddies Abigail and Jane with a herd of warthogs in the background.

On Christmas Day a few of us left at the hospital staff housing held a Braai (BBQ) in our complex. It was small, but there was plenty of good food.

I hope you're all having a great holiday. I miss you!!!

Mock Drill

We are in high gear at the hospital, preparing for our opening on January 11th. There are 13 working days left before we open and in the midst of that are the holidays with lots of key people gone.

This past week we had our first hospital-wide "drill" with mock patients - to see how everything from registration to triage, clinic visits, transport of gurneys, the IT system, etc. are going to work. I was a mock patient in the Accident and Emergency Department coming in with a “suspected ectopic pregnancy.” I went through all the different things a patient would and wound up in the Operating Room to get an exploratory procedure and then ultimately surgery.















When they were “done” with the surgery they wheeled me on a gurney to the post-op area. On our way, wouldn't you know, a fire drill began! I was wheeled on the gurney outside, in my lovely cap, while we all waited for the “all clear.” Pretty wild.

Madikwe Game Reserve

Last weekend 6 of us went to Madikwe Game Reserve in South Africa. It was less than two hours drive from Gaborone. The game park was amazing. It really surpassed what I was expecting. We stayed at Buffalo Ridge Lodge, a beautiful, small resort in the bush.















They have a spectacular pool right at the edge of the mountain, overlooking the valley below.














The best part were the two game drives we went on with our guide, Israel.

From L-R: Nita (Biomedical Supplies Consultant), Jane (Midwife), Abigail (Nurse Practitioner), Israel, me, Becky (Nurse Consultant) - Mo is taking the picture

Early in the first drive we saw 2 endangered black rhinos. Our guide was amazed because there are only 50 in the whole expansive park. They rarely leave the protection of the bush, but we happened to catch them crossing the road right in front of our truck.















We also saw giraffe, wildebeest, elephants, zebra... and lions! The two lions we saw were a male and female. We were incredibly close to them but the truck didn’t phase them at all.














In fact they were mating! They mate on average from 3-4 days straight when the female is in estrous.














The actual "act" takes less than 1 minute (seriously). After it’s over they nap for 20 minutes. Like clockwork the female gets up after 20 minutes and goes over to the male and they do it again. Every 20 minutes. Our guide said they sometimes don’t eat for 3 days. It was truly amazing.

More animals: Here is a baby Zebra with it's Mom. Our guide told us that baby Zebra have legs almost as long as their mother's. They stand very close to the mother so that if predators come, the stripes just blend and the baby isn't seen.
















Here is a Waterbuck. I made the mistake of asking our guide Israel what the significance of the white circle on the backside was.

He promptly told me that someone had painted a toilet seat with white paint and the waterbuck sat down. OK how many times has he told that joke.

Happy Thanksgiving!

Most of the Americans from the Hospital (about 20 of us) went to the Phakalane Golf Course for a gourmet catered Thanksgiving dinner. It was really nice - turkey, ham, lots of sides and desserts. It was quite fun and made it a bit easier to be so far from family and friends.

(Tom, Julie, Craig)

(Julie, Patty, Richard)

Unfortunately no days off for Thanksgiving, which is OK because we are all in very high gear in terms of work. The hospital was supposed to open November 30 but last week it was pushed back to January 11. We are not ready to open, so the delay was wise, but it will still be a big push to make the January 11th date. We have lots of nurses yet to hire and train and supplies need to be distributed throughout the hospital.

















I moved into my hospital office last week and that has been so good. I'm managing the medical library (among other things) and it is a very nice, big space with 8 computer stations for staff - which they are already using every day. It's gratifying. The internet connection is pretty good at work and there are no flies(!) which there were an abundance of in the temporary offices.




















OK here's a picture of a very cool grasshopper on steroids I found in the bathroom of the temporary offices.














I actually love my job. I've been setting up trials for a digital medical library and have been doing a lot of networking, both to figure out how to establish a Continuing Medical Education program for the doctors and advance practice nurses at the Hospital and also networking in the community. There is no formalized CME program in Botswana yet, so I’m really working from scratch, although there are many people here quite interested in CME in Botswana, not the least of whom is our Chief of Surgery who was in Zimbabwe for many years and was very instrumental in setting up a CME program for that country’s doctors (although it took them 10 years).

It is the community networking part of my job that I’m loving most. I met with the Executive Director of the largest women's organization in Botswana to talk with her about possible collaboration on a domestic violence initiative. I also met with the Executive Director of the only Women’s Shelter in Gaborone, maybe the country. Domestic Violence is a very pervasive problem here and there is only one women's shelter, which can only support up to 20 women & children. Funding seems to be a big problem for all the non-profits in the area, perhaps except for some HIV/AIDS funding coming in from outside. About 5 years ago or so Botswana was designated a middle income country by the World Health Organization. While that is great and means the country is doing very well compared to other African countries, one downside was that most of the non-governmental organizations lost their international funding. Last night a group of us went to a fundraiser for the Women’s Shelter. And a couple days ago I was invited to an event in town to commemorate the international campaign "16 Days of Activitsm on Violence Against Women and Children." I heard I was filmed in the audience and shown on Botswana TV!
















Things are definitely getting better here as time goes on. I finally got internet access in my apartment, which makes a huge difference in quality of life as does renting a car, which I did a couple weeks ago with Abigail and Jane. We live about 30 minutes (on a good traffic day) from the city, so getting a car was imperative. I'm getting the hang of driving.
















If you ever want to use ALL your brain cells and prevent Alzheimers, forget about Soduku and try sitting on the other side of the car and driving on the other side of the road for a while. In traffic. And on round-abouts. The inside rear view mirror is on the left and the windshield wipers are on the left. That means often when turning we Americans signal our turn by turning our wipers on (the Batswana just aren’t as responsive to that as I had hoped.) And it isn’t just driving that is “backwards” – even my circular birth control pill pack runs in the opposite direction! Then there are Setswana language lessons which I’m taking 3 days a week. It is not an easy language. There are about 8 or 9 ways to make a word plural (I haven’t gotten far enough along to know exactly how many ways yet) depending on the prefix. Is there no rest for the weary?

I hope you all had a wonderful Thanksgiving!!


















(Photo by N. Chescheir at Sanitas)

Monkeys - I Must Be in Africa!

Last Friday a group of us went to the Grand Palm hotel for drinks.

Sitting outside gives you a little extra attraction - Vervet Monkeys running around the grounds!

Pretty wild!

Ok, as promised, a quick tour of my staff housing apartment. It's quick because video takes forever to upload if it is too long.

Botswana Elections

Yesterday Botswana had its 10th election since Independence in 1966. The ruling party, the BDP (Botswana Democratic Party) has always won the elections and that will likely be the case this time too (results are not out yet). But the opposition parties were out in force prior to the elections trying to drum up support for their candidates.

The day before the election I was on my way into town and saw/heard literally dozens of trucks with horns blasting, filled with BDP supporters in red shirts, waiving flags, shouting and singing the praises of their candidate: Ian Khama. Here are pics:

That day, Thursday, was Jane's birthday and we went to the Gaborone Sun Hotel for a champagne birthday toast.

(Me, Nancy, Abigail & Jane)

I’ve hit the ground running here in Gaborone since landing. Jane, my midwife colleague, and I arrived Saturday afternoon, October 3rd -- and at 8:00am on Monday morning we started work for Bokamoso Private Hospital! Just for the record, I don’t recommend landing in a new country and starting work a day and ½ later – but that’s what we did. Here is a video, after 3 days of travel, of our arrival to the airport.

Here's a video driving from the airport into Gaborone.

Here's a view from the window of my staff housing apartment looking out at other apartments.















Monday, Oct. 5th we attended Orientation with all the medical and administrative staff who are currently hired and here – about 140 people. The docs alone are represented by 20 different countries. We’re quite the little UN – all here to start what everyone agrees is a very ambitious, state-of-the-art hospital in a country and region that has seen nothing like what we’re creating. I’m very inspired by what we are attempting to do: provide an extremely advanced and exceptional set of medical services that don’t exist in the country and do it in the highest-tech environment possible. Some of the high-tech initiatives are: paperless record keeping, virtual consulting with an international medical advisory board, and being a test site for an electronic bedside quality assurance monitoring system. OK, and then there was last Wednesday.

Wednesday there was no internet access at the hospital where all the administrative staff are located and Thursday it was mostly down. So much for high tech.

So what is Botswana like, you ask. Gaborone (called “Gabs” for short) is a very modern city with a few high rises, hotels, international restaurants and little shopping malls that have grocery stores similar to ours in the US. We even went to a Costco-type store last weekend that sells everything from small electronics, kitchenware, food and even Indian spices in bulk bins. The wine is great and it isn’t hard to find a good South African wine for under $10. But the contrast between modern and traditional is apparent everywhere. Driving down the road – in traffic, I might add – there are goats roaming free, women selling bags of oranges and little hard candies at makeshift roadside tables, and as soon as you are off the main driving roads, many of the streets are reddish dirt, not pavement. The past and the future meet in Gaborone.

I’ve seen no black mambas but there are plenty of bugs, especially after it rains which it has done for about ½ the days I’ve been here. Here's one I saw on the wall next to the door to my apartment. This baby was about 5" long. Anyone who can identify what it is wins accolades on my next blog post.

Next blog you'll get a little tour of my 500 sq. ft. staff housing apt!