A little upside down, southern hemisphere style

It’s my intention to be as transparent as possible given the appropriate precautions of writing about medical (mis)adventures here in Bots. Feel free to ask any question that comes to mind and leave your email address. I’ll either answer it in the blog or privately.

Where to begin; how about WE’RE HERE!!! We had a simply delightful time with our family on coastal Florida, punctuated as it was by T.S. Fay. That made three tropical storms I had experienced throughout my stay in TX and the South. It was a mixed blessing as it made for some indoor fun and closer proximity for catching up and laughing. We tearfully said our goodbyes on Sunday morning the 24th and arrived here on Monday night. Currently we’re housed in the home of Rev. Jones, the father of Gill Jones out administrator. He is a Brit that has spent most of his life in sub-Saharan Africa and who has gone to visit family in Britain for a month. So we are blessed to have his house in which we can arrange our lives and begin as expats with a solid home base.
Last week was simply a blur. I sat in on morning report twice and it was better that I remember from the Fall. Lots of good natured ribbing and quality teaching from 0730-0845. Then rounds begin on the wards here at Princess Marina Hospital. Shortly there will be five of us expats that will function as attending, teachers, and outreach docs.

The week has been full of visits to immigration for exemption papers to stay for the duration of my three year (so far) contract, visiting the Ministry of Health to register and therefore be able to practice in Bots, a fair amount of driving to places to shop for ….you name it. We now have rented a town house that is perfectly located near the students, the office, the hospital, and downtown. We move in early October.
It occurs to me that some of you might read “town house” and wonder exactly how hard a gig this is. Botswana is a developing nation, make no mistake. The economic dichotomy here is stark and very real. Yet the country has wealth and is struggling to distribute it. This nation is far away from the resource poor situation that was Darfur and Akuem in Sudan, but is 1 ½ -2 generations removed from true emergence. In the mean time the hospital is thick and teaming with pathology, the internship has just started and the med school will invite its first class next year. I admit to some “survivor guilt” as it is easily the sweetest gig I have done but I’m here to teach and teach in rural areas where things are different than here in the capital. So after one week, we’re here and in fine shape.

One unexpected factor is having Lynne here. This stuff is a little like breathing for me as I have done it many times before; but never in this context, never as a team, as husband and wife. I find myself preoccupied about her well being and adjustment and am teary and tired by day’s end as a result. And, this will come as no surprise, she’s thriving. She has the place wired, has learned Satswana to a fair-the-well and hasn’t met anyone who doesn’t immediately love her.

I have taken the tentative first steps into the land of left sided driving and have been flipped off just once-by a guy in a Benz, in a damn hurry, a situation that would have happened in the States to be sure. Otherwise I’m getting the hang of it although I consistently try to enter the car from the left side, look around to see who may have seen me, and act like I really meant to do that…

Today we went south to Madikwe Game Reserve in northern South Africa. It’s about 45m from here not including the third degree we got at the border. At the reserve we met up with Gill Jones, her husband, Tim, and Steve and Pat Gluckman. They had stayed at the Tau Resort for two night and we went there today for lunch. So we’re sitting on a deck overlooking a river when along comes a herd of elephants to take a long slow drink, followed by springboks, kudus, a fish eagle, and wildebeests. Unbelievable and truly in the wild as they completely ignored us from 75m away! Amazing.

This week I take a class in HIV to qualify for a test such that I can treat HIV patients in this country. Then it’s onto the wards where I’ll lead a team of one attending, one Medical Officer (a doc with a single post grad year of training), and several med students. When I’m not studying as fast as I can I’m simply scared spitless.
Time to go, I’ll update a little more often. We have dial up here so it a little difficult to get everything up and running, but we have it which separates this place form every other place I’ve been. Thanks to all who posted. Best to you all……Mike