Photos from Cape Town

Here are some shots from Cape Point and Cape of Good Hope, the view from the patio at our inn, and the botanical gardens.

Photos from Hluhluwe . . .

Lesotho: Liberation Breast Pump

I never would have said it before, but the breast pump was an incredible invention. They don’t seem to exist here in Lesotho, and I never would have imagined the difficulty that creates for women.

Women in this country breastfeed, almost entirely. Even with the high prevalence of HIV here, breastfeeding is essential, because otherwise the rate of malnutrition rises in a dangerous way. Breastfeeding is free, and the 250 malutis (30 dollars) it costs to provide a month’s supply of formula is too much for most women here.

However, going back to work for a mother with an infant at home is not straightforward. If she goes back to work, she has to buy formula, which will eat up much of her paycheck. For a married mom, this is an easier option because there is dad’s paycheck coming in—so it is easier to either stay at home or buy the formula. For a single mother, this is very difficult. And, since the breast pump doesn’t exist here, continuing to use their own free milk isn’t an option. Hence—the breast pump could really liberate the single mom in Lesotho. (I suppose the lack of refrigerators could further complicate things as well, but I’ll ignore that for now).

The Scariest Haunted Hike

Rafe and I are at Hluhluwe-Imfolowzi, a game reserve in the Kwazulu-Natal state of South Africa. This reserve is 1/20th the size of Kruger (the HUGE park in South Africa that’s very well known), but has all the big five and has a “wilder feel”.

Big Five = Lions, Leopards, Elephants, Buffalo, Rhinos
“Wilder Feel” = Less fences, in particular around the resorts

On our drive from the park gate 15 km to our camp, we saw rhinos, zebras, giraffes, buffalo, and (Rafe’s favorite) an elephant. Our first morning we went on a game drive, and saw more of the same, but much more close up (minus the elephant). We did more driving and exploring ourselves throughout the park, and Rafe even spotted two lions!

But, we wanted a bit more of an adventure, and Rafe wanted to connect with nature, so we signed up for a guided walk. I’m not really sure why I agreed to such a preposterous idea. The moment we got out of the car, our guide loaded up his rifle. At this point, I probably should have just gotten back in the car. He then explained the rules:

1. Always stay 1 meter behind the person in front of you, and NEVER go in front of him.
2. Don’t talk.
3. If you have a question, you can shoot your fingers (he meant snap).
4. If you see dangerous game—do not scream, do not run. Shoot your fingers, and say Elliot, there it is. And you can ask, after you shoot your fingers, Elliot, what is going on?

Once again, why I didn’t turn around right then, I can’t say. Other than Rafe really wanted to do it, and I certainly didn’t want him to go out there alone with Elliot.

We proceeded to spend the next, longest 2 hours of my life, going in circles, walking through the dung of many, many animals, following tracks, and getting a little too up close and personal with a few rhinos. My own bowels never relaxed; I sweat through all my clothes. I never stopped scanning my surroundings for lion eyes in the savannah grasses or leopard tails in trees. Elliot, he told us later, is much more concerned about elephants (the closest we got to them was some freshly broken trees and dung).

I have to admit, it was quite amazing. But, I will never do that again.

Basotho Kindness

The people of Lesotho, the Basotho, are amazingly friendly and kind. Now that it is coming time for me to leave, all of the local Basotho who work at Baylor are coming up to me and telling me how I will be missed. Their smiling faces were such a welcome when I arrived, and now they make it that much harder to leave.

The Basotho also really want to make sure that you enjoy their country. I was telling one of the drivers what a wonderful time I’ve had here, and how nice everyone is, and he responded, “Well, I would hope so. We cannot call ourselves a Christian country if we are not kind.”

100 km  27 Hours (Our Trek to Semonkong)

1. Estimated time of Departure = 3pm, Actual Time of Departure = 6pm
2. Flat tire in the middle of pitch-black mountains—never knew the flashlight my dad so carefully picked out at Target would be such a lifesaver (that and the men with a new jack who stopped to help).
3. About 10pm: with 25 km to go (of a windy dirt road in the mountains, so about 1 hour time), we cannot proceed any further . . . a semi-truck is jackknifed in the road and partially hanging of the edge of the cliff.
4. Since no one will be moving the truck tonight, we head back to the nearest lodge about 30 minutes back—it’s full.
5. So we backtrack about another hour, to a lodge in Roma. We are lucky, and they have rooms available because people cancelled at the last minute. We get in bed around midnight.
6. We head out the next morning because the lodge heard word that people were trying to move the truck. The truck, however, had not been moved, and we have to back track to get to cell phone service (at the top of a different mountain) to update them on this predicament.
7. The lodge plans to meet us on the other side of the truck, and we will carry our luggage and all the frozen meat and groceries (did I mention we were traveling with the lodge’s chef?) around the truck and up the mountain and leave the car behind.
8. This is successful, but by the time this all happens, we need to wait a bit more for a few more guests.
9. Rafe and I have a couple beers in the mountains and appreciate the view while we wait.
10. We all pile into the back of a very large truck bed, and finish those last 25 kilometers as the sun is setting beautifully over the mountains—As tired as I was, it was beautiful.
11. About 6pm: we pull into the lovely Semonkong Lodge and have a wonderful time pony-trekking, hiking, meeting fun people, and eating delicious food.

Update

Rafe and I have been traveling since my last post, and this is the first that I've had internet (or much electricity, in fact). So, I'm going to intermix some old posts from my work and some currents from traveling . . . hope you enjoy!

Spacers

In the States, patients who use inhalers are supposed to use them with spacers (a chamber that you attach to the inhaler to ensure that the medicine gets to your lungs, not just the back of your throat). In Lesotho, they do not have commercially made spacers, but that doesn’t mean that their use isn’t important. So instead, patients have to make them out of water bottles or plastic cups. One day, I worked with a wonderful translator. Beyond interpreting, he would help me understand when my recommendations or suggestions were impossible in this setting with these resources (which was really helpful). He also made spacers, of his own volition, for each asthmatic that we treated. He understood the importance, and knew that these homemade ones probably didn’t last from one appointment to the next, so he took it upon himself to send kids home with one.

Heat

Our cottage, like all buildings in Lesotho it seems, does not have heat. However, at this high altitude, it gets quite cold at night (and inside cement buildings during the day). So, we rely on space heaters to help heat our toes.

Now, I’ve heard space heaters were dangerous, but I have very little first-hand experience with them. This morning I woke up to go to the bathroom around 6:15am, and I saw smoke in the hallway. I followed my nose, and walked into the living room to find our space heater in flames! As one of my roommates was packing to leave early this morning, she put her jumper on the back of the space heater and went to the bathroom, intending to speed up the drying process for only a couple minutes. Well, that was all it took. It must have been a funny sight to see three girls in their pajamas beating at a flaming space heater with a frying pan and a wet towel.
Needless to say, our cottage is now filled with smoke, despite all the windows being open and the fans on . . .

(Hmmm . . . What will Rafe say when he arrives today?)

Thaba Bosiu

Yesterday, I climbed Thaba Bosiu, a important historical site for the Kingdom of Lesotho. It is the site that King Moshoeshoe I (pronounced Mah-shway-shway) defended against multiple battles, and is buried at. It was really steep, but not that high, and I feel like I can't blame how out of breath I got on just the altitude : ) My quads sure hurt today.

Our "tour guide" insisted on shaking my hand over King Moshoeshoe's grave . . .



This is the mountain that the hats the Basotho wear is modeled after (so I hear).

ARG!

My computer hates me. It is currently paying me back for the hundreds of times that I have declined to update my computer with the software updates it offers me each time I turn it on.

I wanted to watch a movie tonight. I hiked up a steep mountain today, and I wanted to rest and relax on the couch. I had a hunch that I could rent a movie on iTunes, which it turns out was correct.

However, when I tried to rent the movie, my iTunes told me in order to rent and play it, I would have to update to the latest version of iTunes. So I said okay, and sat outside while the sun was setting with my slow, slow internet connection for the 30 minutes it took to download.

Then, when it was done and I restarted my computer, the iTunes told me I couldn’t access the iTunes store in this version without the newest version of Safari (which of course I didn’t have). So I had to download that, which took another 30 minutes.

Then, once Safari was downloaded and I went to put it on my hard drive to access it, I was informed by my stupid computer that I needed the newest Security Update in order to be allowed to use this new version of Safari. This download is currently in process (estimated at 40 minutes), my butt is numb, it is cold and dark, and once this is finished, who knows how long it will take to download the gosh-darn movie . . . ARG!

I’m beginning to get the impression a movie was not meant to be.

Hard Worker

Many people take their work home with them, but some people never stop working.

Empo is an HIV counselor. She is employed by Baylor for the Mokhotlong district. Each day, she comes with the Baylor doctor to the clinics and does counseling and testing. She is also in charge of all the testing done at the hospital, and sets up “Screening Days” to get more children tested in her area.

Most of the people in Mokhotlong use a horse or their own two feet to get from place to place, so when we were driving to the clinics we would give rides to some people along the way, in particular women carrying babies. When we picked them up, I noticed that Empo immediately would strike up a conversation with them in Sesotho, and find out if they had been tested, and if not she would encourage them to come to clinic to get tested right away. Some people would get really uncomfortable asking what could be interpreted as such personal questions of strangers. Empo, however, is doing a wonderful job in her country, with an HIV prevalence of greater than 25%, trying to get every baby that she can tested so they can get on medicines. For an HIV-infected mom not on treatment or prophylaxis, there is a 40% chance of her baby becoming HIV-infected. Of those babies, 40% of them will die before 12 months if they aren’t started on treatment. Those are sobering numbers, and Empo is doing an inspiring job in her fight against them.

Living Life

I am currently living about 8 minutes from South Africa. However, to get into South Africa I have get my passport stamped twice—in two different buildings with two different lines. The first stamp says that I am exiting Lesotho; the second stamp says that I am entering South Africa. This process repeats itself in reverse on the return trip back home to Maseru. I find this less than efficient.

But, a few kilometers across the border is a cute town called Ladybrand, with a lovely restaurant that is worth all the border-crossing hassle. It is called Living Life—and it is a delightful way to spend a weekend afternoon when living in Lesotho.

The restaurant has a farm associated with it, and they grow many of their fruits and vegetables on site. They also make their own soaps, preserves, compotes, bread, and amazing desserts (including the most delicious chocolate truffle with this dense fudge cake-like filling that makes my mouth water just writing this thought).

I cannot figure out what type of food they serve at Living Life. Various items on the menu include:

1. Pesto Chicken with Chickpeas and Pineapple Sandwich
2. Calzone filled with mushrooms, eggplant, olives, tomato, and feta
3. Scones with cream, jam, butter, and cheese
4. Pancakes (that are really crepes)
5. Potato rosti
6. Fresh raspberry juice

Basically, it is this wonderful schmorgasbord written on a chalkboard that doesn’t fit it any ethnicity or style. I love it.

The café has this wonderful outdoor eating area with fresh flowers on your table, fresh flowers all around in fact, and a “playground” with a trampoline, a rope swing, and area to play bocce ball, and swings. It just makes you want to relax and wile away the time.

This restaurant isn’t in guidebooks. You find it by knowing someone who knows about it who takes you there, and you thank them profusely for the favor.

Blankets

This is my kind of country. One of my most embarrassing secrets is that I have a baby blanket that I refuse to get rid of, and I sleep with it every night. I guess it’s not really a secret anymore, and I actually don’t think it’s that embarrassing, but Rafe sure does, and he HATES it.

In Lesotho, everyone has a blanket-- it’s a part of the culture and tradition here. Children get a blanket, and they wear them like capes. In the villages, I’d often see a child wearing his blanket like a superman cape and without skivvies on down below. Women wear the blankets around their waist before they have children, and above their waist after they become a mother. At this point in a woman’s life, the blanket becomes multifunctional. They provide warmth in the form of a poncho, and they replace strollers and are the main mode of transportation for babies and children. Moms simply swing their kid over their shoulder like a monkey, the child opens his legs in preparation, and then he gets wrapped in the blanket and snug tight to his mom’s back. I have seen many a crying baby get swung around and swaddled in tight and immediately stop crying once snug in their familiar position. It’s amazing.

A New Word

I learned a new word. When discussing family planning with one HIV+ mother we were seeing at clinic with her HIV+ child, she quickly responded, “Oh, Dr., don’t worry, I CONDOMIZE every time!”