I have spent this week in Mpontshini Primary School teaching the year 7 children (aged 13).
I arrived yesterday to be given a set of lessons that I would be teaching – English, Social Sciences (mainly geography and history) and Life Orientation (everything from personal health to study skills). The head of year 7 was, thankfully, understanding when I suggested it would be helpful to observe the lessons for a day. This gave me a chance to see what and how they were being taught.
Most of my expectations have been fulfilled. Here are some examples:
1) The children sing beautifully.
2) Religion plays an important part in the day. All the children squeeze their eyes shut and bow their heads for prayers in the morning.
3) The classrooms are jam packed. I have 70 in my class. I can barely pronounce a single name as most are Zulu and are not pronounced phonetically. If I stay at the school I will have to come up with nicknames.
4) The classroom atmosphere remains very old-fashioned. The children greet a teacher that enters a room by standing up and chanting, ‘Good Morning Sir. How are you today?’ They stay standing until asked to sit down.
5) Teaching style is ‘chalk and talk’. It is difficult to do otherwise as there are almost no resources.
One misconception is that all the children are desperately enthusiastic and keen to learn. They are children. While their behaviour is much better than in the UK, and much greater respect is retained for the teacher, there are plenty who would prefer not to be there. For them, friendships, parental wrath and the promise of a lunchtime meal act as the determining factors.
The staff have been very friendly towards me. My lack of Zulu will be a barrier to getting to know them well. Nonetheless, they involve me quite naturally. Today I was given the ladling chicken broth (served at 11.00; the children arrive at school at 7.00 so the timing feels right). The pot was quite enormous. I stood serving for approximately 20 minutes as hundreds of bowls passed. I felt very mean with my portions but nobody asked ‘Please Sir, Can I have some more?’
Tuesday, 14 September 2010
Heroes in a half shell
As forecast, we did indeed go diving. We returned to Sodwana Bay. We are likely to be doing almost all our diving there as it is known to the be the best dive site in South Africa and it is only 90 minutes drive from Ingwavuma.
We spent Saturday on a refresher course so that we were familiar again with the basic techniques and rules for diving. We realised that we had forgotten almost everything since we were PADI certified. Our pool session took an age as we had to revisit all the skills with Johannes. It was made slower by our instructor’s inexperience and grasp of English. His thick Africaans accent meant it was easier to understand him under the water.
We rose obscenely early on Sunday morning for the dive proper. Nerves, tent discomforts and my snoring meant Mary wasn’t feeling well. I had slept like Rip Van Winkle.
We had beautiful weather for our dive. Having driven out to a top section of coral our diving group were invited to backwards roll into the sea simultaneously. In (what I took to be) revenge for my snoring, Mary dived backwards into ‘my’ water. Result = I smacked my head on her tank. As we both emerged from the water, Mary was frantically shrieking, ‘Something hit me’. Unamused, I enlightened her.
I enjoyed the dive tremendously. We were only at a depth of 9-10 metres and we had great visibility. The coral was stunning and tropical fish life surrounded us. The highlight was swimming with some giant turtles. There are five species of turtle off the SA coast. I am not sure which type we saw - probably leatherbacks - but they were very handsome. Leatherback turtles are drawn to the sandy beaches. We hope to time a visit for their nesting - done during the summer months.
For Mary, the dive was less enjoyable. She offered her critical assessment moments after surfacing vomiting several times. Sadly she had felt sick throughout. As a result we decided against doing a second morning dive. We will, though, return soon.
We spent Saturday on a refresher course so that we were familiar again with the basic techniques and rules for diving. We realised that we had forgotten almost everything since we were PADI certified. Our pool session took an age as we had to revisit all the skills with Johannes. It was made slower by our instructor’s inexperience and grasp of English. His thick Africaans accent meant it was easier to understand him under the water.
We rose obscenely early on Sunday morning for the dive proper. Nerves, tent discomforts and my snoring meant Mary wasn’t feeling well. I had slept like Rip Van Winkle.
We had beautiful weather for our dive. Having driven out to a top section of coral our diving group were invited to backwards roll into the sea simultaneously. In (what I took to be) revenge for my snoring, Mary dived backwards into ‘my’ water. Result = I smacked my head on her tank. As we both emerged from the water, Mary was frantically shrieking, ‘Something hit me’. Unamused, I enlightened her.
I enjoyed the dive tremendously. We were only at a depth of 9-10 metres and we had great visibility. The coral was stunning and tropical fish life surrounded us. The highlight was swimming with some giant turtles. There are five species of turtle off the SA coast. I am not sure which type we saw - probably leatherbacks - but they were very handsome. Leatherback turtles are drawn to the sandy beaches. We hope to time a visit for their nesting - done during the summer months.
For Mary, the dive was less enjoyable. She offered her critical assessment moments after surfacing vomiting several times. Sadly she had felt sick throughout. As a result we decided against doing a second morning dive. We will, though, return soon.
Thursday, 9 September 2010
Coming to terms with paediatrics here.
Since last Monday (August 30th), I have been in charge of the paediatric ward. The ward only covers children up to 12 years old but most patients are under 18 months. It has four sections – high care (there are four beds which are usually all used up by very sick children), surgical care (this is mainly burns patients as well as minor surgical procedures), gastro bay (unfortunately, this is very common here for obvious reasons such as infants drinking water from the tap but also because many mums give their children enemas as suggested by the sangoma – the zulu traditional healer) and a large bay with all other patients.
I was thrilled (and scared) to be in charge of paeds as this is an area of medicine that I love. My days now involve starting the paeds ward round at 7.30am – completing it whenever I can – and then joining my colleagues in OPD for the rest of the day. This is usually after tea. Once a week, I spend the day in theatre so on that day I only see the new and sick patients between theatre cases.
The paeds ward is run very differently than I am used to. I work hand in hand with the top ward sister (her status is clear from the deference shown by other nurses). I took a few days to adjust to the set-up which involves each mum bringing their sick child, their medical notes, nursing notes to the sister and me. (I feel we should go to each cot where each infant lies (*) But at the moment I am scared to rock the boat. I do worry about confidentiality – as it is carried out in the middle of the high care bay – but sister usually asks the mums to leave. The other aspect that I am not used to is the constant cleaning by the pink ladies. I seem to spend half my time lifting up my legs or moving to one corner of the bay to avoid having a bucket thrown on me. I used to find it frustrating but now it is the norm. I also have stopped pointing out all the cockroaches that I spot. When I did, it caused huge hysterics. One aspect that I do enjoy on ward round is the constant giggling – most of the time I have no idea why all the staff are laughing but usually I join in.
My first week on the ward was good. There were less patients due to the strike and no one died. This week has been much harder, I have four times more patients and have had three deaths in the past two days. Yesterday was quite horrific – a 9 month old child - who I only met yesterday morning - had gastroenteritis (probably secondary to an enema but denied by mum and gogo) which lead to an aspiration pneumonia. When I arrived at the peri-arrest, things looked bad - the infant was gasping and the heart was beating slowly. I phoned my colleague Natalie to assist me and so pleased I did. Soon after Nat arrived, we started cardiac arrest. The arrest was similar to that in the UK except that you don’t have the same high tech equipment. There are of course no paddles/ electric shocks and we used a lumbar puncture needle to create an intra-osseous line (as we had lost the intravenous line). We tried for a good 20 minutes – and managed to get the heart back once – but with no ventilator there is not much we can do. I felt awful when I broke the news to mum (she was 20 years old and had also lost her first born – child mortality is far too common here). I held a debrief session in the afternoon which all the paeds staff attended – I explained why the child died and also did my best to ensure they did not blame themselves.
Today, my colleague Holger (who is in charge of maternity) asked for my help with two very sick twins who had been delivered by c-section just a short time before. I arrived and once again started CPR on one of the 32 week premature babies. We have no surfactant (which helps the lungs mature and work) and no ventilator so I ended up spending a few hours giving oxygen to the baby after we had secured a definitive airway (intubated). We were waiting for the helicopter to arrive. Unfortunately, the little boy died before the transport arrived despite all our efforts. The little girl was still alive when air transport arrived but then exhausted herself and died before they could fly her down to Durban. Luckily, the helicopter was used for a pregnant woman who lost her baby in utero and was bleeding extensively internally. I do not yet know the outcome for her.
Although at times the job is incredibly difficult emotionally, it is balanced out by the occasional good outcome and the hardworking staff who seem to always be giggling.
* At night the mothers sleep underneath the cots.
Back to School
The good news from SA is that the national strike has now been suspended for three weeks. Indications are that the strike is over but that the unions did not wanted to face the wrath of their members by declaring so outright.
And so yesterday I visited three schools – Ingwavuma High (secondary school), Mpontshini Primary School and Ntabayengwe Primary. My plan is to spend two days with the A-level students at IHS before they have their mock exams. Their exams will then last two weeks and students will only come into school to sit papers. During the two weeks when they are away, I will visit the two primary schools. I am then likely to settle at IHS.
My introductory meetings with the headmasters of each of the schools were entertaining.
1) Mr Njoko (HIS). He was very welcoming and introduced me to some of his staff. Each time he wanted a colleague, he would get out his mobile phone and have a long conversation. Then the person would emerge from the Deputy Principal’s room next door.
2) Mrs Mngomezulu (Principal of Mpontshimi). She was equally affable but slightly distracted. She could not get phone reception from her office. Instead her mobile was placed on a wall ten metres from her office. Each time it rang, she excused herself.
3) Mr Mkhumbuzi (Principal of Ntabayengwe). A very kindly man. On my arrival he halted classes by summoning all the staff. In trooped a group of formidably built ladies. They took chairs to form a semi-circle. Immediately they each struck upon their best ‘bored’ facial expressions. Mr Mkhumbuzi took me through each of their names. He prefixed each introduction by saying – ‘this one is very difficult to pronounce – but you will learn it quickly’. Then it was time for words from the Deputy Principal. First she was handed a piece of paper with my name written on it. She immediately fell about laughing. Hysterics ensued. The spelling of the name was passed round the semi-circle for each to laugh.
I spent today at IHS. I am likely to be helping with year 12 English classes and life orientation (things like sex ed; so plenty of scope for future blog entries). I looked over the text books for most the morning. The one English class I attended had about 70 pupils. The classroom was no bigger than many at Ashlawn School. Facilities were very ‘Victorian’. Despite the challenges, the teacher was excellent and clearly well liked. The bird on top of the blackboard particularly enjoyed the lesson. It chirped throughout.
This weekend we are likely to go diving. Watch this space.
And so yesterday I visited three schools – Ingwavuma High (secondary school), Mpontshini Primary School and Ntabayengwe Primary. My plan is to spend two days with the A-level students at IHS before they have their mock exams. Their exams will then last two weeks and students will only come into school to sit papers. During the two weeks when they are away, I will visit the two primary schools. I am then likely to settle at IHS.
My introductory meetings with the headmasters of each of the schools were entertaining.
1) Mr Njoko (HIS). He was very welcoming and introduced me to some of his staff. Each time he wanted a colleague, he would get out his mobile phone and have a long conversation. Then the person would emerge from the Deputy Principal’s room next door.
2) Mrs Mngomezulu (Principal of Mpontshimi). She was equally affable but slightly distracted. She could not get phone reception from her office. Instead her mobile was placed on a wall ten metres from her office. Each time it rang, she excused herself.
3) Mr Mkhumbuzi (Principal of Ntabayengwe). A very kindly man. On my arrival he halted classes by summoning all the staff. In trooped a group of formidably built ladies. They took chairs to form a semi-circle. Immediately they each struck upon their best ‘bored’ facial expressions. Mr Mkhumbuzi took me through each of their names. He prefixed each introduction by saying – ‘this one is very difficult to pronounce – but you will learn it quickly’. Then it was time for words from the Deputy Principal. First she was handed a piece of paper with my name written on it. She immediately fell about laughing. Hysterics ensued. The spelling of the name was passed round the semi-circle for each to laugh.
I spent today at IHS. I am likely to be helping with year 12 English classes and life orientation (things like sex ed; so plenty of scope for future blog entries). I looked over the text books for most the morning. The one English class I attended had about 70 pupils. The classroom was no bigger than many at Ashlawn School. Facilities were very ‘Victorian’. Despite the challenges, the teacher was excellent and clearly well liked. The bird on top of the blackboard particularly enjoyed the lesson. It chirped throughout.
This weekend we are likely to go diving. Watch this space.
Monday, 6 September 2010
Richards Belly
A mixed weekend in Richards Bay.
On the plus side we managed to get a new battery for the car meaning that the mule will now start. Unfortunately we will have to put up with its numerous other annoying quirks. These include 1) a malfunctioning air conditioning system. Obviously a car with AC is highly desirable in Africa. Worse than not working, our ACS blows extremely hot air straight into the face of the driver and passenger for at least the first hour of a journey. 2) A previous owner of the car thought it a great idea to fit it with fancy alloy wheels and fat tyres. These are far too big. As a consequence, whenever we go over bumps (i.e. all the time) they rub against the car body above. 3) The petrol cap is nigh on impossible to remove. Petrol stations in SA all have service. Teams of young guys immediately rush round incoming cars to do different jobs – a la Formula 1. Our pc problems have led to ‘Sword of Excalibur’ scenes as the pump guys vie to be the one strong enough to remove the cap.
Also on the plus side we managed to buy some things for the house. Duplicitously, I managed to convince Mary of the importance of being frugal as we went through the home ware shop. We made lots of excellent savings. This created some budget space. I then assured my beloved wife that buying a speaker to allow us to play music at an audible level from our laptop was high priority. I’m extremely happy with ‘our’ purchase.
On the down side, I ate a dodgy burger the evening. My system responded with ‘great anger and furious vengeance’ (Bible/Pulp Fiction). I didn’t sleep much and felt very sorry for myself. (No photo to be included here.) Fortunately the misery was short lived.
My back is also playing up a lot. I have been seeking out help from our resident physio and popping Marilyn Monroe like quantities of pain killers. Hopefully it will come to realise the futility of resistance.
Tomorrow we host supper club. This is a monthly event. Huge pressure to deliver a culinary experience. I am still trying to win Mary round to starting with beans on toast on small triangles of toast. What’s not to like about that?
On the plus side we managed to get a new battery for the car meaning that the mule will now start. Unfortunately we will have to put up with its numerous other annoying quirks. These include 1) a malfunctioning air conditioning system. Obviously a car with AC is highly desirable in Africa. Worse than not working, our ACS blows extremely hot air straight into the face of the driver and passenger for at least the first hour of a journey. 2) A previous owner of the car thought it a great idea to fit it with fancy alloy wheels and fat tyres. These are far too big. As a consequence, whenever we go over bumps (i.e. all the time) they rub against the car body above. 3) The petrol cap is nigh on impossible to remove. Petrol stations in SA all have service. Teams of young guys immediately rush round incoming cars to do different jobs – a la Formula 1. Our pc problems have led to ‘Sword of Excalibur’ scenes as the pump guys vie to be the one strong enough to remove the cap.
Also on the plus side we managed to buy some things for the house. Duplicitously, I managed to convince Mary of the importance of being frugal as we went through the home ware shop. We made lots of excellent savings. This created some budget space. I then assured my beloved wife that buying a speaker to allow us to play music at an audible level from our laptop was high priority. I’m extremely happy with ‘our’ purchase.
On the down side, I ate a dodgy burger the evening. My system responded with ‘great anger and furious vengeance’ (Bible/Pulp Fiction). I didn’t sleep much and felt very sorry for myself. (No photo to be included here.) Fortunately the misery was short lived.
My back is also playing up a lot. I have been seeking out help from our resident physio and popping Marilyn Monroe like quantities of pain killers. Hopefully it will come to realise the futility of resistance.
Tomorrow we host supper club. This is a monthly event. Huge pressure to deliver a culinary experience. I am still trying to win Mary round to starting with beans on toast on small triangles of toast. What’s not to like about that?
Sunday, 5 September 2010
Random pictures of our life in Ingwavuma
Just a few pictures of our new life here ...
1. Mary standing outside our house in a lunch break (this is our temporary house as our other one gets fixed). We enjoy waking up to more chaos outside.
2. Some Africans washing their hair ...
3. Mobile clinic van which has been parked directly outside our house for quite some time. I have a feeling it is not going anywhere soon ...
Friday, 3 September 2010
We have to spend some time in Richards Bay
Ingwavuma is situated at the top of a mountain. In one direction are views over Swaziland. In another are views into Mozambique. The borders of both countries are only a few miles away.
On Wednesday night, after Mary had finished work, we took a drive a couple of miles up the road. We had been invited for ‘sundowners’ (drinks while watching the sun go down). The vantage point chosen looked over miles and miles of Swaziland.
Theoretically, we didn’t pick the best evening to watch the sun’s disappearance. A slight haze covered the land making it harder to pick out details. However, we still got to appreciate the amazing changes of colour as the sun slowly vanished. Sitting on rocks on the hill edge we sipped our drinks and toasted the beauty. At some point we will put up a picture or two to make you jealous (still having problems doing this). It was one of my favourite experiences here so far.
We had planned to visit both Swaziland and Mozambique. I have been particularly excited about visiting the latter. Most of all I looked forward to walking around singing, ‘I like to spend some time in Mozambique, the sunny sky is aqua blue, and all the couples dancing cheek to cheek it’s very nice to stay a week or two, and maybe fall in love just me and you’. The words come from a lesser known but highly commendable Bob Dylan song about the country (helpfully titled ‘Mozambique’ for those wishing to look it up).
Sadly all is not well in the country and we will have to wait and hope things calm down. The country is in the top 5 poorest in the world. After winning independence in 1975 it spent the next 18ish years in civil war. Since 1992 the country has become more peaceful. Nonetheless most of the people remain horrendously poor. Escalating food prices in recent weeks have driven people into protest on the streets of Maputo. Police clashes have led to deaths. The BBC carries more about the situation at http://www.bbc.co.uk/news/world-africa-11173112. Fingers crossed, Dylan’s words will ring true again soon.
In the meantime, this weekend we visit Richards Bay. It gets a kicking from our guide book ‘there are better places to spend your time’ and has no Dylan song to defend it. However, it is the nearest city and we need to visit a garage to fix our car. We’ll let you know what they think of our mule.
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