Ndwedwe, South Africa

So I hope I'm not the last one to post but we had a bunch of assignments due at the end of October and this was my first week of volunteering. So my service placement is with the Ndwedwe Comprehensive Health Center, which about an hour north of Durban and a pretty rural area. A CHC is more than a clinic because they have a doctor on staff, they're supposed to have four at this one but right now there's one doctor and he's leaving at the end of November. The staff were surprisingly open to having American students (there are five of us from SIT working there right now). I settled into the IMCI (Integrated Management of Childhood Illness) department and by department that means one nurse in one room. But Sister Govender has been great so far, I do a lot of observing but have spent time writing labels for medicines and weighing babies in the immunization room. Ultimately, I'm planning to contribute to the CHC by creating an informational poster about diarrhea and dehydration in Zulu so that the nurse can use it to explain the situation to parents. As we become more comfortable I'm hoping to be of more help as a human resource but the nurse has been an amazing source of information and perspective.

My focus at the clinic is their treatment of diarrhea which is what my Independent Research Project will be on. One of the major challenges I've encountered is the language barrier; the sister that I work with is Indian but the community is exclusively Zulu-speaking. She has picked up a great deal of Zulu and is able to communicate almost everything but there are times she has to call in another nurse to help. Having taken Zulu for two weeks only gets me far, I am at least able to ask the toddlers to come when I want to weigh them on the standing scale. But the morning I was left to weigh babies on my own, I was scrambling with my Zulu-English dictionary to find some useful phrases to explain to the mothers what I was doing and what they need to do.

The most difficult thing internally I have encountered so far is the tension between my own interest/fascination and the reality of the patients' situation. I'm interested in every case and obviously more so on diarrhea because I"m hoping to write a paper about it, but in an ideal world babies would not be coming in one after the other with severe pneumonia and worms. It's difficult to balance my enthusiasm at being given this opportunity and the sadness of seeing some of the cases. On my first day, I saw a severely malnourished baby, the baby was dying, practically wasting away; it may have been incredible for me to see something I've been hearing and reading about for years but incredible in the saddest way possible because I know that it's horrible that this is still happening around the world every day.

Finally, one of the cultural issues I've encountered is privacy. While I know my intentions are not to take advantage of any of the patients or their parents, the nurse has such an incredible caseload that it's virtually impossible for her to ask every patients' permission for me to sit in on the visit. My Zulu is only good enough to explain that I'm a student but not to really explain about quoting and a researh paper, etc. The other students working there have encountered the same problem but it has not been completely resolved. Hopefully my next post will almost be on time, but we don't have Internet where we're living right now.

A poster I made for the clinic.

-Kimberley Ocheltree, October 2006