The changing of the seasons

It has been a little while since we have updated you on life in Lesotho but things continue to go well.  I have found my role at work.  I have moved to the male ward which I am running on a day to day basis, with the help of a jovial 4 man team (1 from Cuba, 1 from China and 2 from the DRC).  Dr Cooper supervises, mainly from a distance, but does his ward round on a Friday.  I have also been given the responsibility of running our Friday educational meeting and supervising the intern.  I decided to take on the TB ward too as it was a little neglected and I enjoy the atmosphere on there.  This fills my afternoons which previously were not always that busy. I am now looking at focussing on my research projects.  I heard last week that I was successful in my application for funding, so am now awaiting approval from the Ministry of Health to get started.  I will have to free up some time during my now much busier working week to work on them, but am hopeful.  There are still frustrations with the system, but on the whole I understand how things work or more often don’t work.  Work life is looking up.  Kit is still waiting to hear about her work in the ENT department, but is excited by the prospect of becoming my research assistant!!

 

Everybody seems to be talking about the changing of the seasons.  I must agree that the evenings are somewhat cooler and the days are not as hot as they have been.  There are more Basotho blankets out and about and the mosquitoes are less prevalent.  I must say that I am enjoying this new, slightly cooler feel to things.  I have stopped having cold water showers but the shorts can still be worn at weekends.  At work I was being warned about the impending influx of respiratory ill health.  Apparently the change of the seasons (both now and in spring) is when we can expect more people coming in coughing and sneezing.  I was a little sceptical about this...  I know the winter months tend to bring about more respiratory infectious disease because people huddle together indoors but it is nowhere near that cold here yet. 

 

I was proved wrong this weekend.  We had planned to go up north to a park for pony trekking and a braai (BBQ) with our Welsh teacher friends.  Friday afternoon I felt a bit run down... I blamed it on the busy week... but by bedtime I felt proper poorly.  I ended up staying home with “sefuba” whilst Kit and Jeepy went off without me!  More about “sefuba” in a moment, but to continue with the weekend’s events first.  I’m sure Kit will give you a more detailed lowdown on her weekend, but the most important event was that Jeepy told all that she missed me.  I was woken shortly after 9 o’clock by Kit ringing.  They had just turned off the main road, 20 minutes from the last town (Butha Buthe) when Jeepy wouldn’t work anymore.  I got some phone numbers of garages etc. whilst Kit and co tried to establish the problem.  This was the first time Jeepy had broken down.  A mechanic was eventually summoned and diagnosed a simple battery problem but it ruined their morning.  I best not let Jeepy go off without me in the future!!

 

Back to “sefuba” which is the Sesotho word for “chest” but also refers to any respiratory tract symptom or illness.  A patient will complain of “sefuba” whether they have a runny nose or are dying of TB!  It makes assessing patients in hospital somewhat challenging.  Another example is the Sesotho word for pain can also refer to illness.  When I first got here I was quite critical of the histories documented by other doctors, but I have come understand that it is very difficult to get a precise story.  But generally patients are very vague when describing their illnesses especially the chronology of events.  I have wondered if this reflects on the attitude to health and death here.  On a related topic, I was given a brief summary of some of the traditional Basotho health beliefs by a colleague recently.  Apparently ill health is often believed to be a curse or the consequence of an external force, such as a wrong doing by a relative.  Even some very educated people, including nursing staff hold this belief... some in an interesting combination with scientific medical understanding.  It has made for some interesting discussions with patients and their relatives about why something has happened, especially if there isn’t an easy or adequate medical explanation.  In summary, it would appear that the Basotho mentality towards ill health is to not be as fixated on the details of symptoms and more concerned about “balance” in their family or community.  Very different from the UK where in the past where I have been subject to some very long conversations about the details of bowel habits!!