Old Naledi Clinic makes do with limited resources.

Hello all,

Last week, I volunteered at Old Naledi clinic. There were many differences I observed from this clinic and Julia Molefe clinic. This clinic is larger in size and has two doctors at a time. One side of the clinic is dedicated to HIV positive patients- complete with intake, drawing blood, consultation, and dispensary. The other side of the clinic is the same except has an added weighing for under five years- babies get weighed every month (preferably on the same date) until their fifth birthday. The interesting part of baby weighing is that there are mostly mothers coming in for child weighings and it may occasionally be a couple and even less than that are fathers coming in for monthly child weighings alone.

Speaking of babies, the maternity ward at this clinic is respectable in size and in functionality. The Old Naledi area is rural in nature and is not as financially stable of an area as others in Gaborone. Due to this, the clinic observes power outages more often than not. This would be fine if the clinic had a generator but it does not. This would also be fine however, the maternity ward is harder to function without light and a proper heating system. Expectant mothers go into labor, give birth, and are observed here. It is one thing to give birth without proper lighting, but it is another thing for a mother to lay in a bed with a blanket with no heat during winter. The next ward that loses the most efficiency from electricity outages is family planning/ ante-natal care/ post-natal care. Women come in here to get full exams, vaginal exams, and pap smears done. If there is not proper lighting when conducting a vaginal exam, there is virtually no purpose in putting a speculum up a woman because there is no view of the cervix (There aren't even back-up flashlights for this purpose which is something I would highly recommend for these clinics to invest in).

 

Also, these woman aren't given the option of getting epidurals... So imagine that. There aren't even stirrups or lubricant for speculum. You spread your own legs apart during birth and other vaginal exams. Talk about discomfort. It's a wonder how so many women here still give birth willingly to multiple children. Imagine that.

Another thing I really liked about this clinic was how comprehensive the check up was to go back to using a form of birth control after delivering birth compared to the previous clinic I was at. A full exam must be completed. The materials to complete this exam are fully autoclaved and nurses double up their gloves when performing an exam. I also really enjoyed learning about the different types of family planning available and what is provided there. Most commonly, women were taking the three month injection as opposed to the standard combination pill. This was probably my favorite "learning moment" of the week but in family planning, the World Health Organization created a wheel with common problems such as hypertension or HIV/AIDS. This is a really helpful tactic because it promotes the idea that the same method of contraception isn't for everyone, which is very true. It was also interesting how family planning nurses told women of what they thought was best and rarely would a patient disagree.

Did I mention the TB cougher's area? Yeah, that's comforting. If you relapse on your TB meds, you have to get an injection (usually on your butt) for 60 days. Oh, and you're still contagious. TB just sucks all around.

As far as my experiences with the rest of the clinic, they were great. I saw a lot of abysses/ infection usually pus filled. They are very painful to squeeze out. There was a woman who had one the amount of pus that she had in her under arm- I don't even know how she was still functioning. Moreover, there was a man in dressings, where they clean and cover wounds as well as change dressings- daily until they heal. A man came in who recently got stitches out from a stab wound and there was so much dried blood when they un-stitched the wound. I'm not too sure if that much dried blood is normal but it made the wound elevated and painful for the patient.

Listed below are common medical services and the fees for them as dictated by the Ministry of Health. Note the 5 Pula flat rate- if only that was the case in the United States (5 pula= ~0.58 USD)!

From my observation, the doctors that work in public clinics here are mostly from the DRC who came in about 6 years ago. Their primary language is French- so they were forced to learn English and Setswana. They said the conditions of Botswana medicine and healthcare were much better back then and that it is unfortunate now. The doctors complained of a lack of medical personel- mainly a shortage of doctors, a major lack of medical equipment, and a shortage of medicines needed.

A woman came in complaining of painful and itching ears but there wasn't even an otoscope to look into her ears. 

 Doctors often complain of how little time they get to spend with their patients and that since healthcare to patients is completely free, most patients come in if they experience any symptoms. For the record, let me mention that over the counter medicines are a thing here too. People would just rather go to the clinic at any point of feeling sick and get a sick-leave from the clinic to avoid going to work.The power outages are so prevalent in this area and resources are limited so it's no wonder why a computer backup system seems like a waste of resources before obtaining a generator...or flashlights. 

I think the worst part about this week was that we experienced a few sad cases -an expectant mother in her first trimester's baby wasn't found when the mother got a check up, a person who had been on antiretroviral drugs for ten years was diagnosed with Tuberculosis and the x-ray showed it was intensive and one of my colleagues reported a case of HIV that was so far gone that virtually nothing could be done at this point because he had been off his medication and waited too long to seek treatment. Although this is Africa, this should not happen anywhere.

To leave off on a relatively happy note, the community here, although not wealthy, makes do with the resources available. People stay warm and still smile. This says a lot considering I was working in a rural clinic, in the winter, and around people who generally aren't feeling well. Also, people on our way out to the combi stop urged us to take pictures of the community. Enjoy!

Until next time,

Komal

Normal size house in Old Naledi. 

He purposely wanted a picture posing like that!

At the end of the day, some values cross international borders, race and socioeconomic status. 

Volunteering with kids: It's all in the details

Hi all,

 Hopefully, I'll have a few posts written in the next few days so that I can be caught up before Sunday- we are leaving for a weeklong village homestay in one of the largest villages in Botswana, Kanye (Sorry to pop your bubble but it's not in the West, it's in the Southern district...lolz). Anyway, two weekends ago (I promise y'all, I'm working on catch up) I volunteered at the Tlamelo Trust in Old Naledi, a relatively poor and rural community in Gaborone.

Most of the group went to Victoria Falls, but a few others and I stayed back and some volunteered at the Old Naledi Baptist Church community day sponsored by Orange, a popular phone company. I'm traveling to Vic falls in about a month, so it wasn't worth it for me to take another trip out again considering $$$ and I could be enjoying something else.

Anyway, I'm so glad I stayed back because I got a lot closer to the group that stayed back and volunteered to get an amazing experience!

From left to right: Me, Jordan, Mr. Matata, and Michelle

Mr. Matata is the project manager and coordinator for the community's homeless and orphaned kids. Man, does he do a good job. He was born and raised in the Old Naledi community and went to college at the University of Botswana. He decided to come back and help out his fellow community members. He said that he wants to give each child the best possible chance to succeed in life and have opportunities. He says the job of getting food for these kids can be very difficult on a daily basis because he gets food (usually donated or highly subsidized) for about 200 or so kids every day. Mr. Matata (who's name literally translates to Mr. Problem) says that sometimes he wonders if he should do something real with his life and get a "real job" but that if he gives up, these kids won't have a role model like he has been all of these years. 

You know, that's an interesting thought. He is literally someone who may not have been replaced by someone else because he created his position. If Mr. Matata didn't organize food for these kids on a daily basis, who would? Who would take charge? Who would feed these kids? Who would show them that it is possible to get to the top of the ladder? Who would show these kids that life isn't always handed to you? Where is the light at the end of the tunnel if it exists?

In life, it is important to become someone who you believe brings more to the table than what a replacement at your pace could bring. If you weren't here, would someone be leading your life? If so, would they be better at it than you are?

 I should get back to the day before letting all of these deep thoughts unveil. 

When Jordan, Michelle, and I arrived at the community center. A flock of kids headed our way. These two little girls were literally attached at my hip the entire day! Literally. Although it was super adorable and heartwarming when we met initially, there was also a sadness. What if they are so attached to me because people don't give them attention? What if these kids don't get the social interaction so necessary for development and growth? The girl above, kept holding my hand and wanting me to carry her and the one below always wanted to hug me and both were so adorable and precious. It's really a shame to have to play with these kids all day and then have to leave. It was also a sad sight because so many of these kids had runny noses and coughs/ you could feel the rough dirtiness in their hands. It's an interesting thought how your lifestyle can dictate how smooth, rough, or calloused your fingertips are. It's interesting how some of these kids have clothes with little rips all around- which may or may not be sewed. The thought of matching your clothes was as foreign as my nationality. Some of these kids would layer up and wear three or four layers in the morning and adjust throughout the day as needed. You could still see the stains in their clothing or the felt of clothing that comes from long term wear and tear. You could still see the residue of dirt in the hair of some kids suggesting they needed a bath. At the end of the day, it's about the details in the fabric. 

To the "upside" of that, some of these kids kept asking for money or some of our belongings (and some really expected it to be handed over). Is it because they get things handed to them? Or is it because they expect us to have money? So after getting trampled by over a hundred beautiful little community kids, they kept playing with my hair. What's funny though is that none of the kids believed my hair was real...they kept saying it was plastic. I told them that my hair was real and one girl pointed to her hair, which was coarse and a lot shorter than mine and said this is hair! That's not hair! I even pulled out a strand of my hair to prove it wasn't a weave because the kids kept looking for my "real hair" where my roots are. This was probably the most interesting part of the day to me because I hadn't realized that some of these kids had never seen hair like mine.

After playing with these kids for nearly three hours including games such as ring around the rosie and duck duck goose, the three volunteers helped the other volunteers who came from Orange to hand out snacks. The snack they had was half a hot dog and orange punch. After we passed out hot dogs to 200+ community kids and members, which was just as crazy it sounds, Jordan, Michelle, and I helped prepare lunch. Preparing lunch was...intense. So one of the dishes that these kids love is potato salad...with LOTS of mayonnaise. I don't think I'll ever be able to look at mayonnaise the same way after smelling so much of it. We went out to the kitchen to prepare food with other volunteers from Orange. While preparing, most of the crew was day-drinking, cooking steaks, and having a party...and the three of us felt slightly out of place. It was an odd thought for us that people were drinking...while at a volunteer event...before lunch... so confused. Meanwhile, these kids still stayed super adorbz. They asked us to stay for a futbol game after lunch with the kids but we were so exhausted that we had to head out. It's crazy how tiring playing with so many kids for hours upon hours can be!

Volunteering with kids gives you an entirely different spectrum of joy. Spending time with these kids brought to me a different sense of joy, happiness, hope, love, and appreciation. Joy to see so many precious smiles. Happiness to be able to spend some time with these kids. Hope that  programs like these will in turn to prove bright futures for these kids. Love in its simplest form stemming from quality time spent together and appreciation for the lessons I have learned and the motivation I have gained. I didn't teach a class, I didn't save a life, nor did I provide food for these children but these kids seemed to be so attached to me for simply providing my smile and my time.

Honestly, it's a different world out there. It's not as easy to even say no to a kid that asks you for your tennis shoes or jacket or money but what does that teach these kids if I do give them my things? Yes, it would make me feel better about myself knowing that I kept someone warm for the night or kept feet from being calloused but it teaches these kids to get what they ask for. A few other local volunteers helped me understand this concept when Orange provided these kids with new shirts. It was amazing giving clothes to these kids (and acted as a great publicity stunt for Orange) because that was all that we could do for them today. It's tough but in the end what helps the most is stability and earning the clothes and food that you get. This was when the volunteer informed me that they also have after school learning sessions and sports activities to keep the kids involved. They also have the older ones help the younger ones learn there ABC's! How cute is that!? Learning this made me really happy because I didn't know how much detail went into transforming these kids into adults who can make a real living in the world outside the doors of the community center.

I had an amazing time volunteering and meeting these adorable, sweet, and energetic kids. It touched my heart when Mr. Matata thanked Jordan, Michelle, and I for coming out and volunteering but there is no comparison to what he does on a daily basis. Mr. Matata had all of the community kids learn each of our names and publicly thanked us by giving us a round of applause. I was pretty taken aback because I didn't even feel like we had done anything to deserve such thanks. That day I learned so much about society, a sense of community and the behaviors of children. I saw the innocent kids, the divas, the top-dogs, the quiet ones, and the criers too. Spending some time with these kids has really taught me how to appreciate having a loving family, having a quality education, and access to good health care. It also taught me how many people are capable of helping others in the simplest of ways. I can't wait to go back and volunteer with these cuties again!

Hope you enjoyed it and until next time,

Komal

Hook em' in Africa- grab em while they're young!

Take the world by the horns.