andrew&maddy

Umfolozi is a nearby Game Park where Geoff (a friend of Charlotte's) is a research worker. Geoff has been wonderfully hospitable and enabled us to watch TB testing in buffalo and to stay at a bush camp. He is also a fund of fascinating information about the wildlife.

TB is a problem in wild animals as it is in humans and they try to test the different animals at times -more difficult in some than others! For the buffalo they have to construct a special corral in the bush and then round up a herd using a helicopter; they are said to be about the most dangerous of animals. They sedate the buffalo one day to inject the test dose and 3 days later have to sedate them again to read the test, take blood samples etc. We visited on day 3. It was a very slick procedure. The buffalo were channelled through a passage and about 6 at a time, injected with a sedative. They then went into an enclosure where over about 5 minutes they became drowsy and lay down - except for the occasional one who had to be wrestled to the ground! The animals were inspected and the tests assessed. Then the sedative was reversed - this had to be co-ordinated with 1 person per animal finding a vein and being ready to inject the reversal dose when the lead person gave the signal; then we got out of the enclosure fast! Those which were TB negative were reversed first and sent to one enclosure for later release; those which had TB were then reversed and sent to a different enclosure for slaughter later (generally after a week so the drugs had time to wear off and some of the meat could be given to the community)

watching the buffalo

inspecting the bufflo

wrestling the buffalo to the ground when the sedative didn't work

stepping over sleeping buffalo

reversing the sedative

TB negative buffalos released

Another weekend a group of us from Mseleni stayed in a bush camp sleeping on the decking area and quite exposed to the wild. The camp was in a lovely spot overlooking a river. An elephant greeted us on arrival so we had to wait for him to move on; hyenas visited at night; nocturnal trips to the loo were a bit scary and the shower was interesting! One morning as we were driving around we saw 2 lions, a lame male who looked very thin and a female who looked in good condition and was presumably hunting for both of them and probably mating with the male. We also saw wild dogs and lots of other animals

bush camp

sleeping on the deck

Geoff heating the water

getting hot water for the shower

the shower

around the bonfire

watching wild dogs

lame lion

Another weekend we stayed at Tembe Elephant Park - safer in a camp with electric fence. We saw lots of eles but also one morning saw an amazing 11 lions. First we were looking at a group of wildebeest and noticed the pale shape of a ion in the grass behind - sitting, watching. We soon realised that there were 5 lions lined up and watched as 2 crept stealthily round to the sides, 1 on the left and 1 on the right until the lions formed a semicircle round the wildebeest. They started closing in slowly but then 1 lion ran too early and there was a half-hearted chase; the wildebeest got away and the lions were left sitting around wondering what happened to their dinner. We were told that the pride was probably a mother and 4 cubs who were not very experienced hunters but lions are apparently not efficient hunters and are only successful in about 20% of hunts.

the wildebeest got away

hungry lion

young male

We drove on and soon came upon another pride of 6 lions lying by the road; all had fat bellies and had obviously eaten well the previous night.

fat cat

Elephant family

mum and babe

old tusker

dung beetles are great

splendid horn

St Lucia

hippo mother and calf

sunset on the water

CAPE TOWN
It has been fun being in Cape Town this week, seeing Nico & Charlotte and experiencing some of the World Cup fever which has taken over South Africa.

Nico & Charlotte

watching World Cup Football in Cape Town

one of many big screens

Nand C at the Fan Park

watching World Cup with Nico & friends

We are now in Cape Town for a week with all the mod cons of the modern world including a hub so a chance to update our blog.
Sadly our time in Mseleni is coming to an end and we will be very sorry to leave; we love living and working there although there are frustrations. The medicine is fascinating, we see lots of extremely sick patients and on the whole the hospital provides a good service. Most people live in scattered homesteads and are very poor so it is difficult for them to get to a local clinic let alone the hospital. Mseleni runs 8 outlying clinics and we both visit a clinic once a week.

mums and babes at home

collecting water

washing day

There is a great belief in traditional Zulu healers; many people go to them as well as western style doctors. Sometimes their concoctions, given as medicines or enemas, are poisonous and outcomes disastrous; sometimes they make multiple small cuts in the skin over a problem part of the body.

Traditional healer cuts on back

Children are often left with a grandmother when the mother is away working or is sick or has died. This baby was being well cared for by the grandmother but came in very sick and fortunately recovered.
thumb=http://photos.travellerspoint.com/259393/thumb_IMG_4753.jpg]

baby with grandma

Andrew has been helping with systems for TB & HIV patients in the Mseleni area; he is continuing the HIV project he started last year. The national TB guidelines are poorly put together; he is trying to agree guidelines suitable for Mseleni before we leave. He hasn't been paid yet, but we are optimistic that he will! (Maddy works as a volunteer).
Maddy has been helping to sort out the Out Patient department which doesn't always run smoothly! New directives have come out from FIFA about managing emergencies around the world cup; some nurses went to a training session and we did some training at the hospital- but it's best not to get onto FIFA and their demands for enormously expensive facilities and equipment - seems inappropriate when so many hospitals haven't got basic equipment.

major incident training

Rachel Fredlund continues to run the Mseleni Children's Home and the Lulisandla Orphan project which now supports about 4,000 children in the community. We went out with Nomvula, one of the orphan project co-ordinaters and visited some homes where orphans live and also after school clubs.

carrying bags of food

singing at after school club

making mats

At one home we found an old lady, aged about 100, sitting under a tree and very well cared for; she obviously was placed there for the day when the family went out and was happy with a pot of food and a bottle of local palm wine beside her. She enjoyed having visitors and was a good talker.

old lady under tree

gogo

The Drakensburg Mountains in central South Africa are stunningly beautiful. We stayed in a lovely little chalet with fantastic views of Champagne Castle and Cathkin Peak from the bed, living room and outdoor jacuzzi!

sunrise from our house

view from the jacuzzi

We walked in the mountains every day which was fun but hot and exhausting. Maddy has decided her thermo-regulation is defective so she gets heat stroke easily. She has devised 'the wet falnnel under the hat' cooling device as well as the wet neck tie which all seems to work!

Nandi falls

View from behind the waterfall

mountain stream

mountain walking

Maddy's cooling device - the wet flannel

On Easter Sunday morning we set out at 6.30 am to get up high before it got too hot. We were aiming for Blindman's corner on the contour path which runs along below the mountain peaks - and we made it! We were rewarded with spectacular views - a good place to be on Easter Day and difficult not to marvel at God's creation.

the path across the high grassland

Blindman's Corner on the contour path

delayed release at Blindman's Corner

enjoying the view from the contour path

flowers on the high grassland (for Lydia)

sunset from our chalet

We have now been in Mseleni for 4 weeks and it's great to be back; many hospital staff have been friendly & welcoming & said 'Thank you for coming back' which is really lovely. Many of the doctors have changed but they are a great bunch. There are now only 11 docs (last year there were 16) so everyone is having to work harder and some services have to be cut back. We don't do on call which is very civilised. Maddy is working as a volunteer; Andrew might get some pay; we don't know yet.
As before Maddy spends every day in Out Patients and loves it - most of the time. The variety of cases is amazing and very interesting. The local people are mostly very poor; unemployment levels are very high, even farming is difficult as the soil is just sand. We see some familiar problems like diabetes, hypertension and strokes but also malnutrition and various infections; at the moment there is a measles epidemic. Sadly we see vast numbers of patients with AIDS & TB, often very advanced, but more people have access to drugs for HIV so the outlook is not so bleak. TB is a huge problem with increasing resistance to the usual drugs so we are moving back to the old days of TB sanatoriums to isolate resistant TB cases. Tracking defaulters is a problem - which is where Andrew comes in as he is trying to set up systems to track defaulters more easily - also to help with the introduction of new drugs for HIV positive patients.

A flavour of our patients :-

Geriatrics - African style - gogo with sores on knees from crawling

snake bite - swollen arm

Maddy putting in chest drain and suturing head wounds

abandoned child

bullet removed from policeman's ankle

child with neurological signs

gallows traction in 4 month old

girl with airgun pellet in chest

Treatment/Emergency room

We both visit outlying clinics. Maddy goes to a very busy clinic once a week: there are always long queues of patients outside and inside; the clinic is very cramped but they are building a new clinic

outside Mbazwane clinic

inside Mbazwane clinic

We are living in the same little house outside the hospital grounds as last year. It is comfortable and has power and water most of the time. We have a balcony which is a wonderful place to sit in the afternoon and evening when there is shade and a lovely breeze; we have a nice view out over the airstrip and the countryside. We even have a phone this year which makes us feel less isolated. E-mail is more of a problem as we rely on the computers in the doctors office which don't work most of the time and updating the blog is impossible. This weekend we are in Cape Town visiting Nico and Charlotte, doing a bit of wedding planning and enjoying some of the joys of civilisation like an internet hub.

We have bought a car, a Nissan X-trail which has good clearance but is only 2 wheel drive so limits our travel options a bit. Last week we borrowed a Quad bike from Kobus (1 of the doctors) to go down the sand track to the nearby lake for a BBQ; Maddy was a little anxious as we lurched away at the start but the ride got smoother & more fun

our home

view from house

fun transport

playing with the quad bike

At the weekends we have a great time visiting Game Parks and the local beach, Sodwana about half an hour away

hold up on the road

pied kingfisher

At our favourite Game Park, Bonamanzi we met up with the old warthog who befriended us on Maddy's birthday last year; she was again grazing by the swimming pool and seemed very keen to get close to us and just look at us. We tend to keep our distance as her tusks are quite fearsome.

tree house bonamanzi

chatting to the warthog

gogo warthog

Sodwana Beach

We have had a great weekend in Cape Town with Nico & Charlotte despite Nico being ill. Poor boy is on anti-retroviral drugs (anti HIV) for a month after needlestick injury at work and these make him feel tired and nauseated; then on top of that he got a tummy bug (probably from his dad!) - must have felt bad as he didn't come to the rugby match with us & some of his friends on Sat night - Stormers (quality Cape Town team) v Hurricanes (NZ team) - good match and home side won convincingly .

We have had long chats on skype with Ollie & Lyds & Simon & Ollie and it has been good to catch up with them all.

Nico and Charlotte

Skypeing Australia

Back to the big smoke tomorrow!

The 30 hour journey to Cape Town via Kuala Lumpur wasn't as bad as we anticipated and we did get some sleep. We stayed for 12 days with Charlotte's parents, Duncan & Hilary who were wonderfully hospitable and it was great to get to know them better.

For our first weekend we went with Nico & Charlotte to Hermanus, on the Indian Ocean coast about 2 hours drive from Cape Town. We stayed in a lovely house near a fantastic unspoilt beach very kindly lent to us by friends of the McLeas; it had balcony on 3 sides with fantastic views of coast and mountains. We had the relaxing time we all needed; Nico & Charlotte were exhausted after very busy weeks at work (and play) and we were a bit jet-lagged. The beach was a great place to walk; the oldies even had a swim but not for long as the water was bitterly cold.

Maddy on Hermanus beach

enjoying a drink on the balcony

lunch on the balcony

view from the balcony

Charlotte and Nico

Andrew Maddy and Nico on Hermanus beach

silly games

Charlotte's winning!

Maddy lost the battle but won the chuckle (big malteser)

Nico and Charlotte outside Cypress Tree restaurant started by Maddy's great aunt Eda in 1928

Nico and Charlotte outside Cypress Tree restaurant, Hermanus

Back in Cape Town we visited the lovely Kirstenbosch gardens nestled at the foot of the mountains and walked on a nearby beach. Cape Town is the most beautiful city with sea or mountains everywhere you look.

Kirstenbosch Gardens

We visited Nico in his neonatal unit - rows of tiny babies in incubators -very scary. He started a Neonates job in January at Groote Schuur hospital and is enjoying the new challenges and learning a lot.
One day we went to work with Charlotte visiting 3 of the foster homes she supervises. She works for an organisation called 'Home from Home' which has set up about 12 foster homes in different townships - more are planned. Each home has a foster mother and 6 children and tries to be like a normal family home as far as possible. We were very impressed. We met one little girl who had been on Nico's ward for 3 months before being placed in a foster home.

Then came The BIG Weekend! We didn't know it was all going to happen til Thurs; then he had a half day and we went round to his house where he had roped in a friend to take a series of photos in different outfits for the treasure trail. On Friday we had to take the photos to be printed - twice as the first lot chopped off the top of his head! - but we still didn't know exactly what the plan was except that we had to be sitting in a garden with our envelope for Charlotte.

On Saturday Charlotte was woken by a friend delivering the first photo, and then followed a trail round Cape Town which included us and C's parents sitting in different areas of nice gardens at a winery. At each port of call she collected an envelope and in each envelope was a photo of Nico holding a board saying one word of 'Charlotte Caroline Tsholofelo McLea I love you will you marry me ?' - !. It took her rather longer than he anticipated so she was quite tired and hungry & he was a bit sunburnt when she eventually found him at a lovely spot overlooking CT where he had laid out a picnic brunch & he put a ring on her finger - very romantic - And she loves the ring - a simple platinum band with solitaire diamond.

parents in waiting

view from the bench

waiting by the old pool

receiving an update on progress

on the trail

recovering from the emotional stress!

Happy Couple

On Sat eve we went out for a celebration dinner with Nico & Charlotte & Duncan & Hilary. In good African style Nico gave Duncan 36 (toy) cows!

Celebration dinner

A 36 cow bride

Sunday was Charlotte's birthday; we went to Nico's church in the morning then had to rush around shopping & preparing fior Charlotte's birthday braai which became an engagement party at Nico's house. Should have shopped on Sat but some distractions!

Now we are in Durban, staying with our wonderful friends Wade & Jane who are always so accommodating when we pitch up and make use of their home & cars. Our first task was to buy a car and we went back to the salesmen who have helped us before and in particular have agreed to buy a car back from us when we leave. We wanted a 4x4 but that proved impossible in our price range as the car market (new & secondhand) is very sluggish at the moment and 4x4 vehicles are hard to come by. We settled on a Nissan X-trail which is 4x2 but is big & tough & has good clearence. For the girls - it's a silver/gold colour and comfortable! We should be able to collect it on Friday and then plan to head to Mseleni on Saturday.