Beauty in the broken

My first day of work at both 1000 Hills and the Respite are complete. And more importantly I didn't screw anything up, huuuuge sigh of relief. They were both uniquely amazing and rewarding experiences and both also presented interesting unforeseen challenges.

A little explanation of what each job entails:

1000 Hills Helpers

1000 Hillis community care centre is a health and wellness clinic, children’s infirmary, educational resource facility and development facility. There is a clinic, feeding scheme set in place, crèche (daycare), and home-based care. I will be able to help in any of the aforementioned as well as the on site pharmacy or accompany paramedics on home visits and the transportation of patients tothe facility, hospitals, or hospice care in the ambulance.

Yesterday, 5 minutes after being there I was asked to help in the children's infirmary. The morning flew by. I think between Becca and I we took stats on probably upwards of 50 babies. A large majority of the women do not speak english and as hard as I try I only know 5 words in Zulu (Hello to one person-Sawubona! Hello to more than one- Sanbon! How are you- Unjani? I'm fine-Nygiphilla Thank you-Ngiyabonga) It became very frustrating and then very awkward not being able to communicate. I had to try and mime do you breast feed, does your child have diarrhea, and does your child have a rash. Thank God for Katie and Kendra telling me stories about their ESL adventures in the Bronx last year - I used my hands, I danced, I made motions and awkward sounds I didn't think I would ever feel comfortable doing. It became quite a little joke. They basically all laughed at me and probably were just saying yes or no because they had no idea what I was doing, but their charts got filled out.

Mid morning a Gogo- grandmother of sorts, not necessarily blood related brought her very sick child in. He hadn't eaten in days and was extremely dehydrated. He was so weak he didn't respond to pain (we pinched him to keep him alert and he didn't even flinch when we put his IV line in). We wound up putting him on oxygen to pump up his veins because we couldn't find one for the IV. His poor little body was quivering and he was in an absolute daze. Once he was pumped with IV fluid he became more alert. I brought him sugar water and he drank aprox. the equivalent of a bottle and a half in about two minutes. Poor little tyke was so thirsty. The whole thing happened so quickly that I didn't really have time to think I just held him down, attached the oxygen and thankfully he turned out peachy keen.

In the afternoon Becca and I played in the nursery and outside with the toddlers...we were quite the celebrities. They LOVED my hair and got quite a kick out of my nail/toe nail polish. Four of them sat and braided my hair for a solid 20 minutes, mind you these are three and four year olds. The rest kept touching my nails and piling my lap with 15 soccer balls. They thought it was hilarious when I was trying to say Sawubona - hello, because clearly my inflection and accent totally botch the word. It was an exhausting day, but ending it with them was so precious.

Funny moment of the day: The nurse not only asked me to give a child a suppository, but expected me to. This poor child had terrible diarrhea and a rash on her vagina. I put on my gloves and made it happen. It kept coming out because I was too nervous to really put it up there. I guess I'll soon learn that poop is poop and body parts are body parts.

Uncomfortable moment of the day: I suppose the suppository could fit into this category as well, but that was more awkwardly funny. I was told that if I went to the kitchen I could get a cup of tea. Considering I still haven't fully adjusted to the time change mid morning hit and I was getting tired and needed a caffeine boost. Not only did the cook stop making lunch to make me tea but she insisted on bringing it to me. She carried it across the property on a platter, with milk, sugar and a saucer. I was shocked and mortified. I don't want to be treated like royalty because of the color of my skin. I was to uncomfortable to even drink the tea so I let the Gogo who brought the sick little boy in drink it. Although I know she thought I was a crazy person for miming "are you thirsty, do you want the tea, do you want milk, do you want sugar, drink the tea" she drank two cups loaded with sugar and was very happy :)

Hillcrest AIDS Centre - Respite Unit

Hillcrest is a home away from home run by 14 caregivers with registered nurse backup where patients can be cared for in a loving environment. Patients receive a bed, food and whatever medicines they have been prescribed and either recover from acute illness or die with dignity and in peace.

My job as I learned today is very flexible and I will be doing a great variety of tasks each day; all levels of patient care including feeding, bathing, changing wounds and assisting with other daily tasks. I will also bring patients to appointments, transport them to clinics, and go with rescue workers onhome visits.

Mary-Kate and I were thrown into work the moment we stepped foot in the door of Hillcrest, 6:45am. We were paired with a nurse who showed us around, I was put with Happy. Happy is a wild woman. The first thing she asked was "you married?" I said no. She said "You date american?" I said no. She said "Ahh you find man here and marry and then have Zulu baby and be my friend forever" I was like uhh... um, sure...I don't know? She burst out laughing, hit me and said "I funny!" willlld woman.

There is a very high learning curve at Hillcrest, and she among others insisted we jump right in. No easing ourselves in on the first day. She had me fully body bathing patients, distributing meds whose dosage was in milliliters which I double, triple and quadruple checked.

Besides Happy there were two other people who made a huge impact on my first day at Hillcrest. Kevin, the only white South African patient who I believe is mid 40's spoke perfect English - turns out he knows Zulu and Afrikaans as well. Kevin quickly became my saving grace. Every time I was overwhelmed he seemed to catch my eyes. He made me laugh by telling me I could remember his name because Happy was Happy and His name is Sad. And I made him laugh when I gave him extra sugar in his Custard (somewhat of a protein shake) and told him i was going to call him Sweet instead. He got hysterical when I yelped because a monkey sitting in the window a foot away from me and he scared the crap out of me. The windows don't have screens and apparently monkeys get mad when they can't steal your food.

I appreciated the fact that in a predominately Zulu speaking facility I could have a conversation with him, but I also genuinely enjoyed being around him...he is witty and personable.

When I walked over to him at one point during the afternoon he said "do you notice anything about me?" I quickly checked his med chart to see if he needed meds, I checked his bedpan and water cup, I checked his blankets...all to no avail. I must have looked at him so puzzled. He finally breaks the silence and point blank states "I'm also white" giggled and rolled over and took a nap. I think he'll give me a run for my money and also a sincere friendship.

The third person who impacted my day was a man whose Zulu name I one can't remember and two couldn't spell or pronounce even if I tried. Friday I will learn it though! Happy and I bathed him - his head, stomach and feet and then she brought me to get gauze, cotton balls and medicine which I thought was to replenish the stash in his room.

(this part is graphic and I apologize, don't read it if you have a weak stomach)

She warned me that he had a wound that we needed to clean, but nothing could have prepared me for what I saw. She pulled down his sheet and from his mid back to upper thighs was a gaping hole. His bum was completely gone. i could see inches into his body. His spine and hip bones were both exposed and blood and puss were everywhere. The smell of bacteria and rotting skin was overpowering. I know he was embarrassed; he wouldn't even look me in the eyes until I had cleaned and dressed his wound, put his clothes back on and pulled his blankets snug around him.

It took all that I had in me to keep composure during the 45 minutes it took us to squirt the wound with salt water and then inch by inch soak up the puss, blood and quarter sized pieces of his skin that were peeling off. I couldn't get the flies to leave him alone which infuriated me. Patients in the States have such better facilities and it just makes me sick to think that this man during his last days has to worry about the flies on his wounds. ughhh....

When it was all over I realized my mouth was filled with my own blood from biting my cheeks the entire time. Every time I stopped I thought I was either going to throw up or cry. It wasn't the sight of his wound that got to me...I hurt for him. Every time I put a cotton ball in him I saw his eyes fill with tears and his face with pain. I wanted to treat him with dignity and respect so I couldn't allow myself to show emotion other then consideration and love and a gentle hand on his back.

I don't think I have ever taken a deeper breath then when today was over. I'm proud that I didn't give up but it is paralyzing to think that a third of the population of Embo, the town directly below my house has HIV/AIDS. And that is just those who got tested and reported it. Overwhelming. I know that the days will get easier as I get hardened to the injustice and devastation that these patients face, but in all honesty I don't want to get to a place where I'm that 'used to it'. I don't want to be tough. I wan't this to get to me every single day so I continue being compassionate. Hopefully I will learn to be more constructive with my emotions instead of crying for the past hour while typing a blog, but if not then a soggy keyboard we'll have.

Sorry this was such a downer post. Good things have happened too! Pat left today, and yes that is the good part. Nah just playing, I will actually miss him a lot, he has been a great resource and we have the same sense of humor which is always great. I drove him to the Durban airport which is like 25+ minutes away and made it back safely and without getting lost. Quite a feat!

Also, we made our first dinner for the priests and they loaded us up on wine, good conversation, many laughs and a little picking on us. I think they will be an excellent outlet and a great source of friendship. Benjie from the Philippines (which he calls the pillapines which I love) insisted on calling me MIG like a figtree and after hearing that I made the salad dressing told me that I will make a sexy housewife. Outrageous.

Again, it is far past my bed time. I need to recognize that I am not on US time anymore.

Lalani kahle! Good night