First field trip

It’s been a full week. As we try to decide what course we want to take as an organization here, it looks like we have a bit more autonomy from Philly. Our boss was able to hear our concerns and the student rotation will change to accommodate the present situation here on the ground. Interestingly I’m not sure what the program I do (outreach) will morph into/look like as I bring a different skill set to the table. 

Whereas Daniel is a highly skilled internist with certification in Infectious Disease and is now back in Australia pursuing and ID fellowship, I’m a primary care doc. He rounded with the medical staff at local and distant secondary hospitals and saw challenging adult medical cases. I can round in any ward, on any age, and see consults a little faster than he as that is what I did for my career to date. I am not as comprehensive as my predecessor but am a touch more broad in scope. As such I now meet with the local district primary care docs each Monday and Tuesday in their clinic settings and teach there. Then give a talk on Tuesday afternoon that is interactive and hopefully as amusing as it is informative. The rest of the week is a little less defined and therefore anxiety provoking.

As the subject was seizures this last Tuesday, I related the episode early in my career in Hood River where I invented “Seize-ON” and “Seize -OFF”, based on a lecture I had heard in Portland, to “provoke” seizures in a very skilled charlatan. The details are sworn to secrecy but the end result was hilarious and instructive.

On Thursday and Friday I was in Bobonong, a community that is in the NE of the country and about 400km from here. It has some of the worst statistics regarding HIV, TB and combinations thereof. I went there with a section of our program that is very well organized and had a chance to see what should be involved in initiating a new program in a new site. We first met with the local chief’s council, the Kgotla. This is where all the village politics and traditional politicking are carried out. Here in Gabs it is of less importance but in villages throughout Botswana it is the first place to stop and the true portal of entry into assessing the health care system. Then we met with the District Health Team, analogous to our own County Health Department, to inform and gain approval, and then with the hospital. All this was done with an eye to the politics of the situation and with a sensitivity that I need to acquire if I intend to be of any effect in small community primary health care settings.

On the way over and back we passed camps of tents that were made of bent sticks covered with sheets of carpet, plastic, what have you. The people were collecting caterpillars off a specific tree, the mapahne tree, hence the name mapahne worms, which are flash boiled and dried. Then they are sold as a delicacy along the roadside by people holding up cups full of them, for about P5.00/cup, weirdly reminiscent of salmon season or morel season. I have had them in a tomato-based stew and they are a little like tofu in that they adopt the taste of whatever they are mixed with. Alone they are a touch tough and tasteless.

All for now, best to you for the season!