Happy Mandela Day From South Africa

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Happy Nelson Mandela Day to everyone! Today is his 95th birthday (and probably his last unfortunately), and everyone is asked to do 67 minutes of service for someone else today. The 67 represents the 67 years he spent fighting the Apartheid in South Africa. I am getting off work early today and going to buy an American Football, then going to the same orphanage that I was at a week or so ago and teaching them how to throw it and then giving it to them. Everyone is so excited about Mandela Day here, and I have seen so many baked goods and candy shared with patients and doctors.

Today is a short post without any pictures because I am at the hospital and don’t have my camera but do have a little bit of time to kill before my ride shows up. I can’t take pictures of patients at the hospital anyway so I don’t really have many new ones to share. My Pediatrics rotation has gotten more interesting since my last post. I got to see my first LP (spinal tap) on Tuesday, which was pretty cool but also very painful for the child. I spent Wednesday in the ARV clinic, which is for HIV positive patients to check how their medicine (ARV’s) is working. The goal of ARV’s are to lower the viral load and increase the CD4 count back to normal. Basically, CD4 are good cells that are damaged with HIV and the viral load is the amount of detectable HIV virus within the patient. If the ARV’s are taken daily, the risk of transmission to other people becomes very low and the rate of progression of the disease is slowed. ARV’s are not a cure for HIV, they just slow the progression and reduce the probability of transmission to others.

One thing that I didn’t realize is that all of these kids that came in under the age of 11 or 12 did not know that they were HIV positive. They have been taking the pills their whole life, their parents take the pills, so they think that it is a normal part of life. I was in the room when the doctor had to break the news to a 12 year old girl that she is HIV positive and try to explain it to her. Once the child becomes aware, there are support groups, counselors, and social workers available to help them out. I really thought that the deception regarding HIV and talking to children was unbelievable. There is still a lot of misinformation out there and an incredible social stigma surrounding HIV, so if a child is told before they are mature enough to handle it, there is a fear that they will be isolated and feel not worthy to live with other kids who are not HIV positive. The doctor had to explain to the 12 year old girl that she can touch her without being infected, and that as long as the girl takes her ARV’s and uses cautionary measures when it comes to blood and body fluids, the girl can live a relatively long and normal life. It is predicted that if a child stays on ARV’s for their entire life that they can live to be 50 or 60 years old.

Today, I was in the Neonatal wards working with premature babies. I had a little bit of knowledge going in due to both my siblings being pre-mes and my cousin having a premature child (who we are all glad is doing well right now!). I even knew more than the med students at times when the doctor was asking questions. The “sad case of the day” today was a child whose mother did cocaine while pregnant. The baby looked normal, had normal reflexes and an active, loud cry, but his entire gut was shot due to the drugs. They tried surgery but his bowels were determined to be unviable for life. Now the baby sits in the ward being fed and given morphine until it will eventually pass away naturally, and the doctor didn’t really have an estimate for how long that would take.

I have surprisingly enjoyed my time in Pediatrics. It is sad to see some of these children with terminal diseases or conditions by no fault of their own. I have seen children pass away this week both from negligent parents and incomplete care by the hospital, which is very sad to see. There is something special about helping these kids though, and it is really cool to see the fight and resilience that many of them have. Tonight I am going to a soccer match between a local team and Manchester City in honor of Mandela Day. This weekend I will be traveling 3 hours to St. Lucia to do an all day safari where I will see all members of The Big 5 (Lion, Elephant, Cape Buffalo, Leopard, and Rhino). I will also be doing a cruise where I will see Hippos and Alligators. I’ll try to get some good pics and post them next week. In the meantime, try to find 67 minutes to do something for someone else today. Happy Mandela Day!

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