Weekend Adventures Part 2: I like the beach and ostriches are weird.

Dear friends,

The beaches here are spectacular. Crystal water, white sand, palm trees, cool breeze, all make for an amazing beach. However, the water is fah-reeze-ing. Like, I only go in up to my knees. This weekend I was quite lucky and got to go to the beach twice! On Saturday we traveled up the west coast to West Coast National Park. The landscape was beautiful with a lagoon, beaches, sand dunes, and some fine bush type vegetation covering the hills. We saw many different types of birds including flamingos and ostriches! Ostriches look weird. They’re SO BIG and their necks move like elephant trunks. The flamingos were not pink like I wanted them to be. Alas. The beach just outside the park was beautiful and full of adventurous athletic people going kite surfing, which was fun to watch. I’d like to learn sometime! That might be a disaster, though… On Sunday the new CFHI students and I went to the Kirstenbosch Botanical Gardens, which were fabulous. They had a whole garden full of medicinal plants, there was a canopy walk through the tree tops, and a beautiful view of Table Mountain. Following that, you guessed it, more beach time! This time to Camp’s Bay, a popular destination for tourists and such here. There is a lovely beach across the street from a strip of shops and restaurants. I had the most amazing pasta with roasted veggies, sundried tomatoes, feta… mmm. To end the evening, we walked around the Victoria and Albert Waterfront (the V&A), a wharf with a big shopping mall and many outdoor restaurants and shops. We discovered a fantastic food market that is on our list to do again. Food markets are my jam, pun intended. This upcoming weekend is allegedly a long one due to Easter, so hopefully I’ll have more exciting adventures to share!

Peace,

Ray

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A day in the life…

I thought I’d write a post to give you an idea of my daily life.

At 0530 my alarm goes off. I’m grumpy, obviously, but thank goodness for coffee. The coffee here is instant and everyone drinks it with milk and sugar. It’s actually quite good for instant coffee! Around 0630 there my transport arrives and honks to let me know. Honking is a universal sign meaning “Hello!” “STOP” “MOVE” and “WHAT ARE YOU DOING.” My driver is known as Uncle. It’s common practice in some of the many cultures existing here in South Africa to call older men and women by Aunty or Uncle instead of Mrs/Mr <Insert Last Name Here>. We battle traffic for around 1 hour to arrive at the hospital around 0730. My day begins then with either ICU teaching rounds or seeing patients in the medical wards. I do my best to sift through the massive paper files, see patients, write notes, and try to be generally useful. My usefulness is questionable at best… There are scheduled educational sessions throughout the day called “tutorials”, either a large group lecture or a small bedside case discussion. Some afternoons offer outpatient clinics for conditions such as asthma, diabetes, COPD, etc. Usually by around 3pm we’ve wrapped up our work for the day and the students start to thin out and head home. My transport picks me up and we have a much shorter drive home. I live in a neighborhood outside of Cape Town that is relatively small and safe. My host mom is an excellent cook and I feel like I am eating a Thanksgiving meal every evening. We have had curry, stir-fry, pot roast, shepherd’s pie… all delicious. The diet here seems heavy on meat, which is unusual for me, but plenty of fresh fruit is available too. Apparently there is an infamous sandwich that one must try here called a Gatsby. I think it is supposed to feed several people because they are GIANT. Many of the foods here go by their British names, fries are chips, chips are crisps, cookies are biscuits, muffins are scones…¬† For the past two weeks my evenings were quiet with some reading and crawling into bed by 2130. Two new students have joined me at my homestay now, and a couple more down the street, so I predict my evenings may be less quiet from here on out… No complaints there! I’m looking forward to getting to know them and exploring more of the city and surrounding area. The weather here has been fabulous. It’s autumn and going into the rainy season, but it really only rains at night. The mornings and evenings are cool with the days being warm and sunny at about 75 degrees. It’s basically perfect.

Ciao for now,

Ray

Weekend Adventures Part 1: Climbing mountains is hard.

Hello everyone,

Now for a non-medically oriented post. For my first weekend in Cape Town, I wanted to go out and sight see a little bit. No big deal, right? One word: TRANSPORTATION. Everyone here travels by car, much like the States. However, renting a car or hiring a taxi are both expensive methods for traveling when you’re a poor, indebted medical student. I have a ride to and from the hospital each day, but not for errands or sightseeing. I’d stayed home all week after my rotation and was really itching to get out of the house, so I bit the bullet and rented a car for the weekend. I’ll just say this about driving in Cape Town: driving on the left is weird, traffic is crazy, horns are blaring, pedestrians are everywhere, and the streets are narrow. Someone will be paying a fee for scraping the rental car tire on a curb… oops. Saturday morning took me into the city. I toured the Castle of Good Hope, the first structure of Cape Town and oldest building in the country, built by the Dutch. If you’ve seen one fort, you’ve seen them all. As I walked through the rest of the city I started to forget I was in Africa. I could easily have been somewhere in southern California. Shops, restaurants, churches, parks, gardens. I sat for a while in the Company Gardens outside the government buildings and listened to a free jazz concert. I had ice cream. I randomly became friends with a student from Jo’burg studying bioinformatics. All in all, solid afternoon of city walking. Saturday evening took me and my German medical student friend Amja to a fundraiser hosted by the University of Cape Town students at a local bar.

Sunday a group of us braved the climb to the top of Table Mountain on the Platteklip Gorge trail, a 600 meter elevation climb. We made it in about 2 hours. I thought I was going to die. It’s a trail almost straight up with lots of rocks to climb. The view from the top was beautiful, though! As we were walking on the top of the mountain, the clouds started rolling in bringing a cold mist with them. It was amazing to see this bank of clouds approach and envelop you. We cheated and took the cable car down. After something so strenuous, some beach time was in order. The beaches here are beautiful, but holy cow, the water is cold! I am sufficiently tired and sunburnt today.

Sorry I can’t post photos, I don’t really have a way to upload them from my camera here.

Til next time,

Ray

A note on education and hospital structure in SA.

In this post I’ll be addressing how the medical education and hospital structure differs here in South Africa as compared to the US. Like many other countries, SA students enter medical school immediately following high school. They complete 6 years of university, with the last two in clinical training (akin to our 3rd and 4th year clerkships). After graduation they complete two years of “internship” which are similar to our year of internship. Internship is followed by a year of community service, in which the doctors are required to spend a year serving the community wherever they are placed. After this, they doctors are now called “medical officers” and can practice independently. Some choose to then become “Registrars,” which from my understanding is similar to a resident in the US. Fellowships can also be completed if one wants to become a specialist or “consultant,” as they are known here. Physicians in the “medical officer” stage of their career are trained in general medicine and basic surgery, which could include cesarean sections or appendectomies if necessary. In the hospital, students see patients and report to the intern or registrar, who reports to the medical specialist or consultant. Students and interns here perform many of the tasks and procedures that would normally be completed by nurses in the US. My colleagues are all competent at drawing blood, starting IVs, taking ECGs, etc. Nurses here are known as “nursing sisters” or just “sister,” but apparently this has nothing to do with the religious version of sisters.

The medicine practiced here is much more “clinical medicine” than is seen typically in the states. The physicians here give us flack, probably deserved, for relying on CT scans and other technology to make our diagnoses. They discuss a lot of clinical signs that I’ve never heard of. That’s ok, though, I’m sure I’ll learn something! If you want a CT scan here, the patient must be transferred to another facility. Strokes are diagnosed based on clinical presentation alone. I really need to brush up on my neurology! There also doesn’t seem to be such a push for a quick discharge as there is in the US. I’m sure I’ll uncover more differences as I go along.

Cheers,

Ray

Initial impressions.

Goeie middag!

That’s good afternoon in Afrikaans… one of the 11 national languages of South Africa. I’m just popping in for a quick update on my activities since arriving. I’ll try to do more detailed posts later on. During my first full day here CFHI graciously provided me a guided tour of the Cape Town area. This was not your typical “touristy” tour… but an overview of the history/culture/social issues that previously and currently affect the country. We discussed Apartheid / District 6 / and the “townships” where many of the Cape Town residents live. Although I was aware of the apartheid government and its basic history / I was unaware of the lingering effects. Entire areas of town are still – unofficially – divided by race. District 6 was a black/coloured neighborhood from which all residents were evicted and the entire neighborhood bulldozed to the ground by the apartheid government. The “townships” are areas outside of the city that provide either “formal” (i.e. a real building) or “informal” (i.e. a make-shift dwelling usually made out of sheet or scrap metal). These exist mere kilometers from the beautiful and well maintained downtown area. If you aren’t aware of these topics I suggest giving it a quick google. I have to say it was an eye-opening experience. There is much more to Cape Town than the beautiful ocean/mountain scenery that one sees on TV. There are social issues abound.

Today was my first day in the hospital. I haven’t been so lost since my first day on psychiatry in 3rd year. Oy. Things work differently here. The doctors – however- are brilliant and caring. I’m at Victoria hospital – a public hospital (vs private). It has 50 beds and 4 critical care beds. There are male and female wards with several beds in each. Say goodbye to your private rooms Americans. Here we have curtains with messy paper charts and x-rays on film.

Things I miss: 1. My phone/the internet. 2. My car. 3. My comfort zone.

If you’re wondering about my funny punctuation – the comma on this keyboard is broken.

That’s all for now.

Cheers

Ray

Introductions

March 9, 2015

Hello everyone,

Please allow me to introduce myself. I’m Rachel, a current 4th year medical student studying at Ohio University. My travel alter-ego shall henceforth be known as Ray.¬†Thanks for sharing in this journey with me!

I am writing to you from the comfort of my sofa with Alias on Netflix in the background (2001 throwback, anyone?). Four days from now I will be leaving this comfortable existence to embark on what I hope to be a grand adventure. The first month of my travels will take me to Cape Town, South Africa, where I will complete a global health clinical rotation entitled “Healthcare Challenges in South Africa.” Through this experience I hope to broaden both my medical and cultural horizons. Afterwards, the next three weeks of my travel will take me to Germany, Austria, Italy, and France for strictly touristy activities. This blog will serve as a medium for me to share my experiences with you, whether you are a fellow medical student, friend, or family member. Wish me luck, and I hope to see all of you when I return!

Cheers,

Ray