first day of work

im so tired. got up at 7am partly cuz i couldn't sleep and partly cuz i had to get up anyway. was supposed to be picked up by gabby, the program coordinator at 8:15am to drive to work for my first day...but she was late by 45 minutes. yay polychronic cultures!

we picked up sarah whom i met at the airport and dropped her off at the university of west cape, where she is working. the place was pretty bomb. then i finally arrived at the tygerberg hospital.

the entire hospital complex is GIGANTIC! but unfortunately, it looks more like a prison or military base and the pouring rain didn't help its gloomy look. unfortunately, the interior was way worse. there were bars everywhere...i don't understand why you would have bars inside a hospital. the paint jobs were terrible, if there were any surviving ones. basically, it was a hellhole.

i don't know if anyone knows what silent hill is...but if you ever see the movie or play the video games, you'll understand. it was that depressing. my supervisor, dr. zaier, wasn't in to meet on my first day...hooray miscommunication. wasn't my fault though, i had no contact w/ her.

another doctor took me in and i sat and watched her interact w/ the patients. unfortunately, many of the patients spoke afrikaans, which is the second most spoken language in the cape town area. it's basically dutch, the name is misleading. so i had no idea what the conversations were about until she translated. but i got to see some cool things like super-TB-infected patients.

one girl had an entire lung pretty much destroyed...when she breathed, you couldn't hear anything through the stethoscope it was that bad. and because of poor circulation, the ends of her nails were completely rounded and swollen. and if you look at your nails, you'll notice the half-moon shaped lighter part at the bottom...well her nails were fucked up and that lighter part was the whole nail. it looked like she had painted them that color. yikes.

the saddest part of the day though was this old lady who was just diagnosed w/ HIV...she came in and they have to sign these consent forms if they're going to receive the HIV antiretroviral treatment (ARV for short from now on). this is to ensure that the patient will do everything in their power to make sure they do NOT ever miss a dose of the treatment...cuz if you even miss one, the efficacy of the ARV treatment decreases a metric fuckton cuz HIV is a little shitbug and mutates and becomes resistant very very easily. anyway, she was signing the form and just started to completely break down. i guess she had finally realized that yes, she was pretty much signing her life away to these drugs...the small pills that would hopefully keep her alive for a little while longer amidst the many horrible side effects they bring.

i tried to imagine what it must be like...finding out you have HIV. imagine the gravity of hearing something like that. i mean, the treatments are much more effective nowadays and life spans are increasing but still, it's just like being diagnosed w/ cancer. except its worse. with cancer, there's a chance you can come out of it alive and well if diagnosed early enough...with HIV, it's a never-ending uphill battle; a ticking time bomb if you will. you can only contain it for so long. sooner or later, you won't be able to afford it, or the virus will mutate. and then you're done.

the ARV drugs they use here in south africa aren't used in the US. the hospital i work at gives these drugs for FREE to anyone who is diagnosed w/ HIV because the state sponsors them. unfortunately, this means that the drugs are somewhat outdated and are known to cause some nasty side effects and they're the cheapest the government can afford en masse.

it's a really shitty situation...the hospital's rundown, they don't have state of the art equipment like we do in the states...but everyone makes the best of it. even the doctors understand the shitty situation. they recognize the need for better facilties, better drugs and better health care.

i didn't get to find out what exactly my research entails because dr. zaier wasnt in today, but maybe ill find out tomorrow.

but for now, i'm exhausted. the cab ride back took 2.5 hours cuz of traffic and the driver getting lost and having to pick up 2 other interns.

OH! i saw the world cup stadium they're building for 2010. it's huge. i can't post pictures throughout my trip cuz i forgot to bring the computer connector, so everything will go up when i get back :\