Ingwavuma Buffalo

The last couple of weekends have brought us very close encounters with two of Africa’s biggest animals.

A number of the local safari parks run animal projects. Sometimes these focus on the observation or reintroduction of an endangered species. For example, Tembe Elephant Park has just released a number of African Wild Dogs into their park. These have been eradicated from most of the parks in SA. And hence conservationists are trying to intervene. Success will depend on their ability to coexist with the lions in the park. This will require them to learn, very quickly, to stay clear of the king.*

Another local park is looking after two injured elephants – one male and one female. Both elephants narrowly escaped a culling programme in Zimbabwe. Their rescue as youngsters familiarised them with humans. They now live a nearly wild existence. They roam free with other seven tonne wonders happily grazing, sleeping, fighting and mating. But, each morning they come to a specific location in anticipation of some treats. Last weekend, we were able to go to the park and feed them.

On arrival, we were greeted by the sight of the two elephants waiting for food. And they had a surprise for us. For between them was a new addition. A nine month old baby. Their baby.

So began an hour of elephant indulgence. Holding food in our hands we watched as two of the elephants used superb trunk control to transfer large quantities of oats to their mouths. After a while of this, the elephants were commanded to stick out their tongues. Being very obedient, they did as asked. And so we put hundreds more pellets straight into their mouths. Jubulani, the calf, was less adept at using his trunk or at showing his tongue. He spilled much and consumed little. But fortunately he has a much smaller belly. And he still receives gallons of milk from mum. So his messy eating will not hinder his growth.

Almost exactly on the hour mark, having been given water, the elephants disappeared back into the bush.

This weekend we headed to a very secluded part of the coast for a weekend at a place called Thonga Lodge (only look it up if you want to feel extremely depressed). Used to trying to stay at places far out of our budget, Mosvold Doctors have become great hustlers. And so we were able to spend a night in luxury. Situated by a pristine beach, the Lodge is 100 metres from the ridiculously warm Indian Ocean (only truly appreciated if you began swimming on holidays in North Wales). A couple of miles away lies the biggest freshwater lake – Lake Sibiya in Southern Africa. Full of hippos, crocs and birdlife.

On Saturday evening, we drove to the shores of LS to enjoy sundowners (drinks consumed when watching the sun go down; isn’t South African English complicated.) Driving around, our guide looked for the perfect location. This took time. First we had to stop to watch an immature Fish Eagle eating the remains of its supper. Eventually we found a spot 15 metres from the water edge. The perfect location to watch hippos playing in the water.

There we sat enjoying the sunset. And the scene must have looked idyllic. For after not very long, we heard splashing in the water. And out came a hippo, keen to mow the grass in front of us.

Now ten metres from a hippo is less than the recommended safety distance. For, as everyone knows, the hippo is the mammal that kills most humans in Africa each year. And for this reason we were right to feel scared. But we were not in great danger. Firstly our vehicle was close-by to us. Secondly, we were not between the hippo and the water – an extremely dangerous predicament. Lastly, the hippo was completely oblivious to us. For though they have excellent hearing and smell, they can see less well than Mary (who, without contacts, struggles to see me lying beside her in bed; she, too, relies on hearing and smell).

For two or three minutes our hippo merrily chomped the grass. And then suddenly it heard a noise. In blind terror of meeting an animal larger than itself (something that can’t happen often for hippos) it turned and bounded into the water. Leaving all of us very touched by its great sensitivity.

Having previously walked with rhinos and lion cubs, we now have one last close encounter to engineer. The buffalo. But neither of us is overly keen. We think we might settle instead for the dopey Ingwavuman cow. We’ve passed them many times. And on a cloudy day they look vaguely buffaloesque. Time to fabricate a photo.

Bumper cars

Another depressing discussion topic in SA is road safety. I happened to buy a paper yesterday in Spar (in fact I was forced to buy it; I was told to wait ten minutes before being served at the meat counter; so I browsed a daily; apparently this is not allowed).

One of the articles in ‘The New Age’ was about road traffic accidents. Statistics have just been published on accidents and driving offences over the month of December across the country. They are chastening. Put simply, SA is by far the most dangerous place to drive in Africa (and therefore the world?). As evidence, it has 20% of the cars on the continent but 60% of road accidents.

The most terrifying time to drive in the country is over the Christmas period. This year the number killed over the month of December was 1551 or about 50 people everyday. This number does not include all those seriously and permanently injured. The only good news is that this represented a fall from the previous year – 1761. The highest rate of deaths this year was in our province – 232 or about 8 per day.

It is not difficult to explain the reasons for the massive number of fatalities. The first, and most obvious, is the level of driving proficiency of many behind the wheel. Every journey we make is littered with near hits. Overtaking manoeuvres are regularly undertaken on the brow of a hill, round a blind corner or in spite of fast approaching on coming vehicles. Around Ingwavuma, we drive on mountainous roads with tight sharp corners. Drivers often seem unaware of the need to slow down for bends and so swing across the road. Estimates are that 80% of all accidents are due to driver error.

Thus bad driving is one big contributory factor. Poor visibility (particularly bad on some days in the mountains that surround us) and pot holes (especially craterous in KZN) are estimated to account for 8% of accidents.

Another big cause is unroadworthy cars. Understandably vehicles have much longer lives here. Though all of them should receive annual MOTs, many do not. For this is expensive. Many are old pick-up trucks. They can often be seen transporting 10-15 people – most standing up in the back. The doctors at Mosvold regularly treat patients who have fallen out the back.

The final noxious ingredient is drink driving. I’m told that motorist in the cities are randomly breathalysed. But it doesn’t happen in rural areas. As a result, there is little concern in rural KZN about driving under the influence.

And so we can now formulate the equation. Bad driving, bad roads, bad vehicles and alcohol = 1551 dead in December.

If the first stage of the solution is recognising the problem, then SA is making progress. Indeed, as already mentioned, they have reduced the number of road deaths from this time last year. And the police focus particularly hard on the problem. But the challenge is huge. Over December they stopped one and a half million motorist. One third of these were found to have violated the Road Traffic Act.

All of this has two consequences for us. Firstly, we wear our seat belts. Secondly, we are after a good medical kit for the car. Thus far, Mary has yet to be first on the scene for any road accidents – though we have stopped at many. This is almost certain to change.

Anyway, next blog entry I promise to write about something cheery.

Vile-ence

Having spent nearly six months in Ingwavuma, Mary and I have been completely won over by the people and the setting. We feel great warmth from the wider community. And, while remaining cautious, we feel safe when out and about. However, even in rural KZN, violence remains frighteningly frequent.

One of the most depressing aspects to working as a doctor at Mosvold, is the workload generated by sexual violence. Gang rape and attacks on minors seem to be particularly prevalent. Presented with the victim, the doctors investigate physical evidence of the crime on their body. The police then search for the perpetrator. The police have a good reputation for catching those responsible. Their work is visible to the doctors because the accused are regularly brought to the hospital for DNA testing. (This also presumably explains why so many rape victims come forward.) Nonetheless the assaults continue.

The depth of the problem is massive. A recent article in The Guardian Weekly contained details of a survey by the Medical Research Council. In this, 28% of men from KZN admitted to rape. In Gauteng (the wealthiest province) the rate is even higher at 37.4%.

This violence has its roots in rotten gender attitudes. These were also investigated in the survey. Of those asked, 55% of men thought that rape within marriage was a crime. Over 30% considered the promiscuity of a woman to be relevant in the assessment of whether rape had taken place.

Unfortunately, efforts to combat the problem currently seem doomed to fail. If there are public campaigns they are not heard in Ingwavuma or other rural areas. Very few people have access to the media.

Sadly, what is well known, even here, is that the President was accused of rape and acquitted. It is also common knowledge that his defence was partly built on provocation – the female involved was wearing a certain type of cloth. (Incredibly, Zuma also revealed under cross-examination that he had taken no precautions despite the lady having HIV. He felt it unlikely that a healthy man could contract HIV. He also had a shower afterwards.) Guilty or not, it makes public pronouncements on the issue by the ANC somewhat awkward.

The principal/only real vehicle for change is the education system. Written into the text books are lessons on achieving gender equality. These try to challenge traditional views. However their success depends firstly upon having an enlightened teacher. Otherwise they can easily be skipped. Secondly, they depend upon the school reinforcing the message within the school ethos. Does the school, for example, expect all the children to sweep the classroom floors or just the females. Finally, the lessons need to withstand contradictory messages being received at home.

Perhaps the education system can help to win the battle in the long-term. But not before many more badly injured women have been treated at Mosvold.

Ntabayengwe reopens for business

School restarted last week. The teachers returned a couple of days before the pupils. We had three things to sort out – the timetable, responsibilities and the allocation of stationary.

The timetable was drawn up quickly after a decision was taken to reuse the one from last year. Huge relief all round.

Discussion of responsibilities went well. I am now in charge of school excursions. Until now, we have never managed a school outing. The biggest obstacles are money and red tape. But I have ideas for overcoming these. I’ll let you know how I get on.

The allocation of stationary proved most problematic. I didn’t get too involved in the discussion. Instead, I spent the time browsing through new text books sent by the education authority. And I quickly became depressed.

Each year we are sent a random selection of slightly revised text books. Typically we receive ten copies of each book – far too few to use with classes of 30-40. Anyway, we never ask for these text books. And most we do not need. Often, they replace text books received the previous year of similar quality and still in perfectly good condition. As a result our out buildings are overflowing with bonfire material.

I am convinced that we, and all the local schools, are victims of a giant scam. There must be private publishing companies making a huge amount of money from contracts with the educational authorities.

A superficial glance through some the new text books creates a positive impression. The new grade 7 English book is beautifully presented. Each page is full of colour. Unfortunately, the content has been thrown together with no thought. There are a few very random grammar and vocab lessons. These are interspersed with a huge number of idiotic sections that serve no purpose. For example, one of the early chapters requires the children to identify correctly letters from different world alphabets – Arabic, Japanese, Hebrew, Mandarin, Hindi and Russian. There are no clues given as to how they should go about doing this. Many other chapters belong in other subject text books – e.g. identifying circuit symbols, classifying animals into kingdoms and species, matching up flags to countries.

Other text books are slightly easier to follow. But many are very dull and pitched far above the ability of the children. Few children even in the top year at primary school have a reading age above 6-7 in English. Yet, for example, the citizenship text book encourages the children to analyse the merits of the South African constitution and to consider the different clauses contained in the Bill of Rights.

And now to the crux of the problem. A large number of teachers in South Africa do not have degrees. A teacher is only required to have passed their matriculation (equivalent of A-Level). This creates a heavy dependence on the text book. Where it goes, they follow. Believing whole heartedly in the importance of the knowledge contained in their teaching aid. Even if it means exercises in distinguishing between Arabic and Hindi.

Time for a South African version of the Pink Floyd classic. ‘Text books, leave those kids alone.’

Male Ward

I have now been the doctor in charge of male ward for three weeks. We have twenty five beds and after my first three days on the ward, the ward has been full and remained full. Last Friday, the ward was so overfull that I had eight men waiting outside on chairs. I was a bit overwhelmed but managed to

o transfer two to bigger hospitals (one had large bowel obstruction which is a surgical emergency and another one had not been able to walk for six weeks and was awaiting an MRI scan),
o discharge three
o give two pass outs (which means they go home to take care of things for a few days)

Unfortunately one patient died (my first death on the ward and completely inevitable). This movement freed up sufficient beds to empty the hall way.

So far, my patients on Male ward are a huge mix – neurology problems (a few unable to walk), severe gastroenteritis (usually Stage 4 AIDS and therefore very close to death), surgical problems (two men with the worst smelling feet I have ever experienced – one waiting for a below the knee amputation and one with gas gangrene), orthopaedic injuries (lots of people chasing cows and fracturing bones) and young HIV men with bacterial meningitis.

I am really enjoying the ward. My nursing colleagues are great and the work itself is very challenging. Everyday, I find myself laughing about something. Here are just two examples:

When I took over the ward, I also took over the care of a psychiatric patient. As a doctor working in Africa (both South Africa and Ghana), I have encountered far fewer patients suffering from mental illness. This is partly explained by the link between affluent societies and increased stress levels. However it is also because of the limited medical resources in Africa. Here, very few patients with invisible illness/injuries are admitted.

Anyhow, back to my story, which is that my patient was admitted due to an episode of acute psychosis (he is a known schizophrenic who is not on any treatment). He smokes too much dagga (marijuana) and drinks too much alcohol. He is a very intelligent man who is quite bored with life. I kept him in as a patient until last Wednesday (I was waiting for the Psychiatric Nurse to see him). During this time, he explained that he was using the time wisely. To find a wife. Predictably he quickly became a menace. Anything female was a target. Except for me. Thankfully I was exempt from his charm. For I was his doctor. What a relief!

2) One of my young men with bacterial meningitis was desperate to go home having received only one day of IV antibiotics. I told him, very assertively, that he would be staying for minimum seven days. Immediately he looked very upset. Now there is no such thing as confidentiality on wards in Mosvold. Everyone gets to listen in as a patient is spoken to by the doctor. On this occasion, the Umkulu (old man) who was on the opposite side of the ward and seven patients away, shouted out that ‘Even though she is a woman, you must listen to her.’ Feeling greatly respected, I looked back at the patient. With back up from an elderly male, the patient acceded.

The Game

As forecast, we returned to Tembe Elephant Park for the weekend. The park isn’t one of the most prestigious in SA. But this adds to its appeal. It is always quiet. And it is run by the local community. This creates a much easier atmosphere.

As the name suggests, the park is renowned for its elephant. One hundred years ago, there were few of these left in South Africa. The last handful ‘hid’ (elephants are amazingly good at hiding) in pockets. One group was the Tembe elephants – able to conceal themselves in the thick forests of the surrounding areas. Elsewhere Addo elephants and Kruger elephants also managed, just, to survive the era of the game hunter.

There are now nearly 300 elephants in Tembe.* This makes it possibly the most densely elephanted area in the country.

Understandably Tembe’s big trunked survivors were initially very unkeen on game viewing vehicles. In close confrontations, they quickly became very aggressive. And so the rangers made sure to keep a large distance. Over the past ten years, they have become much more trusting. Elephant with young remain extremely protective and therefore volatile. But Tembe’s single bulls are now very friendly. And polite. Looked after by the park’s most experienced guide, we spent much of our weekend in close proximity to a number of enormous bulls. Knowing most, and being very familiar with their behaviour, he allowed the elephants to walk right up to the bonnet and then past our vehicles. Each time, the elephant approached. Stood in front of the car. And then, with great courtesy, walked round to rejoin the road.

Elephants are not alone in the park. And we saw so much else. But it was a very different experience to Tembe in August (our first weekend in SA). In August (towards the end of the dry season), there was a distinct water shortage. And the bush was relatively sparse. This combination make the winter months the easiest time of year to view the game. Visiting in January means the opposite – the bush is very dense and waterholes are all around.

Though it is harder to spot the animals now, there are also big advantages. One of these is that there are lots of young animals to be seen. Another is the change in bird life. The scenery takes on a different kind of beauty. And, the skills of the guide become much more apparent. Invisible animals must be found using other senses. Here our guide for the weekend was brilliant. For Tom used absolutely everything to track the animals.

We found all sorts of animals and birds hidden among the bush. This included the depressingly rare black rhino – our first sighting in SA.** We saw our first jackals (the rare side striped variety). And we found four different eagles including the elusive Southern Banded Snake Eagle.

Despite being more than satisfied with seeing so much, Tom was very keen to find some of the lions. Excitedly, he picked up their tracks. Then he heard an unusual warning call of the Nyala, usually indicative of a major predator being close to us. Driving on he saw a number of yellow billed kites sitting in a tree. A very good indication of a recent kill. Then the arrival of jackals – keen scavengers. Finally we picked up the scent of death in the air – the distinct smell of carcass. Using the signs Tom stopped the car. ‘The lions are here.’

And there, or there abouts, they remained. For most of the weekend. Very close to the road. But out of sight to us. We returned several times. Each time we returned we saw new lion tracks – showing some activity. One set of paws led to a water hole. But each of their excursions was perfectly timed for our departure. By the end of the weekend, and numerous trips back, Tom had brought electronic signalling equipment. The last recourse of the desperate guide, he was able to show us how close we were to them. Still they kept their anonymity.

But our failure to view lions again did not matter. Tom had provided much more entertainment. And so we had discovered the joy of being able to find an animal. And for a moment I wondered. I wondered. Perhaps it will be a let down. Perhaps I am more satisfied without. Maybe I don’t now want to. Except I do. I still want to see a bloody leopard.

* In fact the numbers in the herds are growing too fast. To combat this, contraceptives are being used to control the numbers. One of our group (to remain nameless) asked what form this took. Disappointingly, despite regular sex education classes, the male elephants are not good at putting on condoms. Instead, females receive the ocp.

** We thought we saw this on a previous self-drive in Hluhluwe. But photographic inspection by a Mosvold expert revealed the rhinos to be white.

No you are not!

Here is a little secret. I quite enjoy checking my junk emails. I only do it once a week or so. It doesn't take long to sift through - despite the mountainous quantities.

I'm not sure how I managed to become such a popular target. Mary hardly gets any. I have two possible answers. The first is that I give my email address to the likes of spurs.com. And my beloved sells on personal information. The second is that I'm a guy. And therefore more of a target for e.g. body part enlargement products.

Among my recent junk, I'm receiving lots of emails from Steph and Becky. Fortunately, I have yet to be fooled into opening any of their correspondence. For they need to improve on their entrapment scam. The title of their emails are 'new in town'. Now a title like this might work on peeps living in a big English city. But it ain't likely to fool me out here. If only Steph and Becky knew the excitement created in Ingwavuma when somebody new arrives. No need for modern communication devices. Word of mouth does the job.

It so happens I'm just off to do a very quick shop in the only Ingwavuma shop - Spar. I tell you if I meet either Steph or Becky (or both).