Friday 30 July 2010

First week at work

We’ve been at work for 3 days now and it’s been an enlightening experience to say the least. At 8am Monday morning we were met by the Social Worker, Clever, who gave us some brief information about the hospital – having fired lots of questions at him and receiving minimal useful information we hoped that there might be some sort of induction planned for us. However, we then found out that the Medical Rehab Worker, Josephine, who runs the rehab department and will be able to fill us in on the basics of what goes on is away on a workshop about 400km away all week…and there’s no phone coverage so we were unable to contact her…marvellous.

There’s a weekly Monday morning ward round where pretty much all the hospital staff trawl around the patients (we were introduced to 16 staff all together on the round), so patient confidentiality and bedside manner left a lot to be desired – it’s how we imagine it to have been 50 years ago in the UK, but with less of a grasp on basic hygiene. Some of the wards are pretty shabby – the ward marked ‘isolation’ has the door open and allows anyone in, and there’s a lack of water in the taps and no soap in sight! Despite all this the staff are really friendly and laid back - probably because they have a lot of time on their hands as the ratio of staff to patients is quite high. I think at the moment there are about 20 patients in the whole hospital so it gives you an idea of how small the town is.

For the rest of the day on Monday we had a number of frustrating conversations with various members of staff whereby people would give us information on a strictly need to know basis – i.e. unless we asked a very specific direct question we would get nothing, and even then it was hit and miss. We had several random patients just turn up in the department including a few children, a guy needing ferrell replacements on his ancient crutches, a woman with severe leg contractures due to being bed bound for 6 months in hospital….none of which we knew were coming, had any information on or spoke much English. As you can imagine, we went home that night feeling a bit deflated and wondering what on earth we are supposed to be doing here.


On Tuesday we took it upon ourselves to go on one of the outreach clinic visits to a settlement called Okondjatu, about 100km from Okakarara. It was an ideal opportunity to suss out the region properly. Initially the understanding of the Dr, HIV counsellor and pharmacist who we travelled with was that we would provide massage to people when we arrived. So we had to explain, in a diplomatic way, that 1 – we don’t really do a lot of massage, 2 – if we did then doing a one-off session once a month to people in the settlement would be a total waste of time, and 3 – it would take all day for the Herero ladies to remove their 10 layers of clothes anyway (we’ll post some photos soon – amazing outfits, they look like a cross between Victorian dress and a hammerhead shark!). We went along to observe (in the back of the pick up truck) and when we arrived all the patients were sat on the floor, spilling out of the clinic door. The Dr saw 87 patients in 6 hours – pretty impressive! – mostly heart problems, diabetes and OA, put down to the fact that they eat a diet of strictly no veg, meat, meat a bit more meat and soured milk. It really made us realise how little people have here, we saw donkeys pulling people along in carts, and again, lots of goats.

Wednesday was a better day. We were recognised by people at the hospital and our Otjiherero greetings are coming along well. We spoke on the telephone to another Physio volunteer working in the region who has given us some helpful information, putting us slightly more at ease, and we’re meeting up with her next week to find out more. We also met with the Principal Medical Officer who seems very down to earth and flexible which bodes well. It’s all a lot to adjust to, and as much as we keep telling ourselves that it’ll take a while to settle in, it’s strange not being busy and not knowing what to do….we’ll be learning a lot about patience!

Erwin, our friend and Otjiherero language teacher

Local fine dining

Okakarara main street at rush hour

View from our flat

Our flat at the hospital

Orientation

Kora (Otjiherero for Hi!)

We ended orientation week with a couple of impromptu visits to the Ministry of Health and state hospitals. In our short meeting with the Head of Division of Rehabilitation we were explained the Ministry management structure, and what seemed most important, the procedure for formal communication. It appears all communication is done by letter, which must gain approval from four tiers of management right through to the Division Director (gone are the days of email!). We were given hospital and physiotherapy department tours. The state hospital physiotherapy facilities here are surprisingly equal to, if not better than, facilities in the UK. We met two of the three state physiotherapists working in Windhoek who cover everything including ICU, a spinal unit, a cardiac unit and paediatrics. There are only another half dozen or so physiotherapists working in the regions, meaning we make up a significant proportion of Namibia’s physiotherapy workforce! There are no physiotherapists other than us in Otjizondjupa region. There is also only one Medical Rehabilitation Worker in the region. There is no physiotherapy or occupational therapy training in Namibia and the MRW training programme has recently been stopped. Therefore we have many questions regarding the sustainability of what we do here. Hopefully we will get some answers over the coming weeks!

We arrived at our ‘home’ on Friday. Okakarara is a small town/large village a short distance from Waterberg Plateau National Park. The plateau makes for an awesome sight as you drive along the road to the town. Other roadside attractions include warthog, ostrich, kudu and many friendly goats! Okakarara appears to have more bars than shops lined along the dusty main street. However we are yet to brave the local watering holes! There doesn’t appear to be much going on in the town, although we did catch a local football match today, so hopefully we will make some friends. We can see ourselves having many weekends away exploring.

Our one bedroom flat is situated on the hospital grounds next door to Ernest, the Principle Medical Officer, and Clever, a Zimbabwean social worker. The accommodation is very new, boasting a TV (although with one channel) and a shower (however currently lacking hot water!). No washing machine though – we have just hung out our first load of hand washed clothes! The flies that lay eggs on drying clothes which then burrow and hatch under your skin are apparently not an issue here – fingers crossed!

Tuesday 20 July 2010

The adventure begins!

Well, day 3 in Windhoek and all’s good so far. We got collected from the airport by Barney, a very friendly VSO employee who took us on a tour of the city before depositing us off to our home for the week during our in country induction programme. We’re staying with a couple of other volunteers, one of whom, Rashmi, has been here for 6 months so has all the local knowledge including how to make the most of the $8 (75p) taxis around town – there’s no bus service so this seems to be the way to travel! It’s all very civilised in the city. It’s clean, everyone stops at traffic lights, no hassle, friendly and reasonably safe (although we’ve been advised not to go out after dark alone, and all the houses have gates and electric fences and bars on the windows…other than that all ok).

On Sunday evening we met up with the other 7 volunteers who are starting at the same time as us; 4 of them are from Canada and the others from the UK doing a mixture of placements including education, IT, developing girls involvement in football and audiology. We were taken to a pretty cool bar called Joes (a definite must for those who are visiting) and sampled the local cuisine of Springbok kebab and Kudu steak and excellent local beer. This is a taste of things to come as we’ve learnt today that we’ll be eating a diet of Maize and meat for 2 years in Okakarara – they’re not really into veg!

This week’s going to be quite relaxed, learning practical tips such as opening bank accounts, child protection issues, a bit of Herero language training and network building with other volunteers. On Friday we get collected by someone from the Ministry of Health and taken to Okakarara where we have a 1 bedroom flat at the hospital – watch this space as we don’t really know what to expect. We do have a shower and electricity though so it sounds promising!

A big shock has been how cold it gets at night. Literally within half an hour between 5.30 and 6pm it gets dark and goes from being 20 something degrees to about 5 degrees – good job we brought our thermals!

There’s been a lot going on and there’ll be photos for the next update once we’ve sussed out the internet options in our new home. Hope all’s well back in the UK. xxxx