Wednesday 17 February 2010

No place like home?

Yesterday on the way back from clinics I tagged along with the social worker on a home visit (well, when I say tagged, I was driving). Was all a bit of a sad tale; the patient was a 29 year old lady who had been seen with abdominal pain, but the doctor felt that there was also a psychological element, due to the stress of looking after her nieces and nephews following the death of their mother. All 8 of them, ranging from 3 to 21, in addition to her own 2. The older ones have been misbehaving and causing her a lot of grief and so we were visiting to see what help we could provide.
Arriving at their thatched hut after a 20 minute drive through bushes and down sand tracks, we were greeted by her husband and two friends indulging in some home-brewed amarula beer. They offered us a drink but we declined (and having since learnt that it is fermented with human spit, I am glad!). The lady reported that she was feeling much better but that older children were still being troublesome. They weren't home so we set off in search of them. This turned out to be a bit of a quest which involved picking up countless people along route who were of unclear connection to the case but guided us on to more and more remote locations. Just when I thought I couldn't possibly fit any more people in to the car, we came across the boys minding cows and playing soccer. They were hauled in to the 4x4 and given a firm talking to in Zulu by the social worker, whilst I nodded sagely in the background as if I understood. They apologised and promised to be better behaved, but pointed out that they weren't the only trouble-makers. Their father (her brother) is still alive and recieving a disability grant, but refuses to use any of this money to feed and clothe his kids. The social worker assured them that she would be looking in to that.
The whole experience was really interesting. Not just seeing how some of our patients live but also seeing how the community interacts together. There are definitly some things that we in the UK could learn.

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