How to alleviate middle-class guilt?

The other emotion complicating things is guilt. When I first came out, a year seemed a really long time, but now that it is nearly over, I can see how short it really is, and how I am only just getting settled and beginning to understand how life here works. And I feel terrible that just as I get to this point, I leave, abandoning patients and staff.
What this rural community needs is doctors who can commit to them for a long time. Young foreign doctors aren't the solution.

Fortunately for me, someone previously had an idea for a solution and set up "Friends of Mosvold", an organisation that sponsors local kids through health-related courses at university, on the proviso that they commit to coming to work at Mosvold in their holidays and for a set period after qualifying. These are the staff who not only understand this community (literally speaking the language) but are also the most likely to settle here.
It's an amazing organistation that I have personally seen benefits from (our lovely social worker is a graduate of the scheme and due to marry and settle here in a few months time).

Watch this space for a way for me to alleviate some of that guilt...

End of a year-a.

The day after our leaving braai, and our final day (bad combination?).
Last night was a lot of fun with all the nurses, doctors, therapists and security guards coming round for a braai. It was Zulu-style, with plenty of meat and pap, quaito music pumping and some serious booty shaking. Some serious heaadaches today too.
As today is a public holiday I only worked until 12 but what an almost final case; an imminent pre-eclamptic with a blood pressure of 211/143. Yikes.
Once that was sorted and she was rushed off to theatre (luckily I'm not on for that) I just had a few dog bites to vaccinate against rabies and I was done.
And now I am finished at Mosvold (with only the procrastination over packing to get through).

I have quite mixed feelings about going; I shall really miss some aspects of life here (my two minute commute, people just popping round unannounced, everyone saying hello to you). But it's time for me to come home. I miss family and friends and realistically, coming here has meant putting life on hold in many ways, and it's time to come back and restart it.

Feel it, it's here.

So, the World Cup has begun. And how.
It felt like it had started some time ago with all the countdowns, huge numbers of distinctive yellow Bafana Bafana tops (mostly fake) and Wednesday's "5 minutes of blow your vuvzela for SA" (with lots of warm up going on in the days before...). However, on Friday I realised that I hadn't seen anything yet.
We made a last minute dash to Nongoma to watch the opening match on a giant screen erected in the college, with a hall full of thousands of yellow-clad Zulu fans screaming and blowing their vuvuzelas like crazy. The atmosphere was incredible; so friendly and happy and just bouncing.
On Saturday we moved on to a rural fan park in Mtubatuba which did not live up to the dangers predicted, helped by there only being about 30 people there (and about half of them were security). Not sure if it was a lack of interest in Korea-Greece or in the fan park.
It was on to Richard's Bay for the Nigeria-Argentina match where we were taken aback by the lack of interest in the football from the Afrikaaners (at one point, someone was sat in front of the screen). I think rugby is more their game.
So in the end we headed to Durban for the England match where we were joined by thousands of Australians in town for tonight's game. The vibe was incredible, the whole town alive and pumping.
The next month looks to be amazing, and I'm excited to be here for it.

Oh, and I found that blowing a vuvuzela is a lot more difficult than it looks.

Ups and downs.

The end of our time here is rapidly approaching and I'm surprised at the very mixed feelings I have about it. A year ago when we arrived, I couldn't imagine lasting 6 months, let alone a year. Let alone be feeling in any way sad at the idea of leaving.
Driving back from clinic yesterday, sun shining, bumping along a red sand road and waving to all the kids running alongside I realised that London will seem very grey in comparisson to life here. I also feel very settled; last night we had "xmas in June" and as we sat in our party hats eating xmas pudding, I realised that I will really miss a lot of the people I have met here and the social life we have.
Fortunately, when I got in the shower, I was reminded of some of the downsides of living here; not only did I have to manouvere myself under a small dribble of hot water but when I reached for the shower gel, I had to have a stand off with a preying mantis.
I lost.

Not quite feeding the world.

Like parents, doctors probably aren't supposed to have favourites, but I do.

Nkosinphile is a 13 year old boy with learning difficulties who had a prolonged inpatient stay back when I was running male ward (oh yes, anyone over 9 years is no longer a child- if they can't sleep in a cot, they have to go to the adult ward). He'd come in with severe burns to his legs requiring skin grafts, but it then transpired that there was a fairly dire home situation. He and his 3 younger siblings were orphans under the care of an uncle who found Nkosinphile too difficult to manage so had farmed them out to an old gogo who wasn't really able to take care of the kids.
The social workers spent a long time negociating with the family, during which period Nkosin charmed everyone in the hospital, getting them to play ball games with him and eating so well that we had to find him some new clothes when he went home as he had gotten too fat for his own.
Eventually it was agreed that the family would build a hut about 200m away from the family home for the kids to live in, and they would pay a slightly younger gogo to stay with them and cook for them.
I visited the hut with the social workers as it was being built. It was a concrete two room affair, each about 4x4 metres, one large bed and some cooking utensils and a separate hole in the ground out the back to serve as the toilet. Quite a nice place by local standards. Once it was completed, the children moved in and a week or so later I saw Nkosinphile at his local clinic. He looked happy and well and was keen to play ball games.

When we drove by his hut today it was a very different story. He was sat outside, dirty and dishevelled with weightloss to make a WeightWatcher envious . He was with his younger brother who had had to stay home from school to look after him as the gogo hired to do so had gone off to visit someone. They told us that she only stayed with them during the day, leaving Nkosinphile in charge overnight. They also showed us their kitchen area where there was an array of empty shelves, their uncle who is supposed to buy food for them apparently isn't.

It was heartbreaking to see the dramatic changes in Nkosinphile and even more so when he, who had been desperate to come home to his family, asked me to take him back with me to Mosvold.
The social workers have made a plan to find a place of safety for him but in the short term, all I could offer him was my lunch for the day, which he gratefully took. It's not really a solution ("give a man a fish...") but faced with a child who is literally starving, it felt like the best thing I could do.

All fired up.

This weekend we headed down in to Swaziland for BushFire, a three day music festival. Essentially it's a mini-Glastonbury but with African bands and a much better shower:camper ratio. It was a lot of fun, lazing around in the sun listening to local bands and then dancing until dawn in the crop circle, before crawling in to our tents.
It also lived up to the ultimate festival expectation by pouring with rain on the Sunday.

Smelling a rat.

This week's issue is that of unwanted house guests. Or more specifically attic guests. Rats.
We've been gradually aware of increasing noises from above our heads but this week it has got to the point where it is waking us up in the night (and I'm living in fear that the ceiling is going to give way and they'll come crashing through) and on Tuesday night's braai, one of them made an unwelcome appearance in our paw paw tree. At head level.
Fortunately the hospital kitchen also has some unwanted guests; a cat and her 4 kittens. And I think I can see a solution to both of our problems.