Rondavel thoughts

While sitting in my rondavel, where I spend my weekends away from the hospital, just having whiped out the dust from the cow-dung and mud floor, and sipping some tea made on a paraffine stove, I start to think about the lives of the people around me. How they get by with absolutely nothing, and still manage to smile and just enjoy what life brings them. How they sometimes wait for days, weeks, sometimes even months to go and see a doctor in the hospital, because they cannot afford the taxi-drive to get there. How a 52 year old man presents himself in my consultation room with the deepest sunken eyes I have ever seen in my life, because ´he wasn´t feeling too good´. The man was HIV-positive, had been on antiretroviral medication for a few years, but defaulted because of ‘financial problems’. Now the public health sector in South Africa provides its citizens with free medication and treatment, so financial problems in his case would mean he just couldn’t afford the taxi-ride, probably worth about 3 euros up and down, to go to the nearest clinic and fetch his medicine. Unfortunately patients only get their stock of medicine for 1 month in the clinic, so they have to make sure they make a trip back to the clinic or hospital before they run out of stock. Now that is a challenge in itself, because This Is Africa, and something more important than making a trip to a clinic to fetch medicine can always come up. Like unexpected deaths, or sickness, or a huge wedding party that you just cannot miss. Or maybe it’s just a perfect day to finally do that huge pile of laundry that has been staring at you for days now.
I have been here for three weeks now. The responsibility that comes with being a doctor is very challenging. Especially if this is your first real job as a doctor after medical school. Lucky for me I did quite some internships in South Africa and other developing countries before graduating, so the ‘shock of the system’ has come over me a long time ago already. Nevertheless, when I am on call during the night or in the weekend, I am the only doctor in charge and cannot simply phone my supervisor to discuss a case with him or her, as would be the case in Holland. I have to do it all by myself. Which is, as I said, very challenging. I am learning as I am going. And I am loving it.