Wow, all I can say is…  Wow.

 I and a Penn medicine resident, Monika, arrived in Hukuntsi on Monday afternoon after a 400km drive from Gabs. Hukuntsi is on the western frontier, literally at the end of the road. Or at least where it turns to sand and really gets out into the bush. In the town is a primary hospital that is incredible. It is staffed by about 100 people with medical, maternity, surgical, and pediatric wards and as many beds as PHRMH in Hood River. It is spread out much like a California elementary school.

 The first order of business was where we were going to stay. There is a single guest house in the town and it was full the last time we checked so we were prepared to stay in the car or on a bench in the outpatient department.  Monika is, amazingly, lower maintenance than I and game for anything, a well seasoned traveler. Well this wasn’t OK with our host, Dr. Kalenga, a 54y/o doc from DRC who has the ability to get things done like no other MO I have seen, hence his presence in Hukuntsi. The hospital was under major remodel, and he and just two other MOs both unseasoned, are the medical presence there.  So the short of it is that we stayed as his guest in his home in the staff compound of the hospital. His wife was in SA at the graduation of their son from university in Jo’burg.

 It was a rare treat to spend a day and a half in his presence and teach, learn, mentor in the in and out patient confines. What is great at these places is how the entire staff enjoys a presentation, not just the docs and the conversation is amazing. I literally had to remind myself where I was many times. The last night we went on a walk to an area about 1km outside the fence of the compound where he tried to reassure me that predators only like dark skinned prey, hilarious.

 We bade farewell on Wednesday and travelled 300km to Ghanzi, in the NW of the country to another primary hospital where the reception and for that matter the hospital design was very similar. It was run by a man, Dr. Simwanza, from Zambia with his wife also a doc. The staff there was bigger as the population was from the largest area in the country. They see patients from as far away as 250km to the NW and E.

 They also see members of the San, an ancient people that use a click dialect that requires an oropharynx that is hinged differently than mine!  A smaller and very open faced people that are genuine and loving. A mother of five brought in her fifth child, three days old, with an imperforate anus, patent urethra, and vestigial or absent vagina. At the same time we were discussing a patient that Monika tool to immediately who had new onset liver masses and needed a CT scan. Here in Bots we are good at building hospitals but haven’t yet decentralized imaging so we spend obscene amounts of money to fly or drive people to Gabs for tests that could/should be done locally. At any rate Flying Missions was called and flew in to Ghanzi that evening and took both patients back to Gabs for definitive diagnosis and hopefully therapy.

 Yesterday morning we took off at 0730 and drove 675km back here, arriving at 1530 through monstrous African rain storms. I am convinced this is for me, that this is the best way to do outreach (at least a day in the location), and that I’m a lucky guy. What a beautiful country, beautiful people, beautiful opportunity.