End of the Line

With less than a week to go here in Thohoyandou (pronounced "toy-on-doo" in case you're curious), it's hard to believe I've been here a full month. If I were on a class field trip, this would probably be about the time that the teacher would ask us to write a page reflecting on our experience and what we learned.

Unfortunately, when I attempt those sorts of things they always result in a series of exquisitely convoluted metaphors, and I'd almost certainly end up writing something along the lines of, "floating on a river of compassion, the hospital lights became rays of understanding that burned through the sunscreen of my heart." Exposed to this, you'd likely just fall asleep or, perhaps, vomit.

So I'm instead taking this opportunity to thank you for your support and to tell you a bit about what it has accomplished. If you're like me, you've probably spent money on some pretty dumb stuff in the last year or so. For example, a few weeks before departing for South Africa, a man dressed as a Buddhist monk approached me as I walked to class on West 4th Street. Despite the fact that I couldn't understand a word he said, we communicated just enough for me to gather that he wanted me to write the word "peace" and sign my name in a notebook he carried. Feeling supreme spiritual enlightenment, I obliged, and in return he did me the traditional honor of following me four blocks and gesturing towards my wallet until I gave him $10.

Now I guess you could argue that ten bucks is a steal to score a good dose of peace, but you get my point... how often can you look at a transaction and feel confident that your money was well spent?

Glad you asked.

Last week, Tshilidzini Hospital had to suspend surgery because it had run out of sterile gloves. For a 400+ bed hospital, you can imagine the impact this had on patients' health, and in some cases their chance of survival. As a public hospital, Tshilidzini relies on the provincial government supply depots, and this system failed them. So who could they turn to?

Gladder you asked.

The answer is... you. I realize that sounds hokey, but it is objectively, unquestionably, the truth. The money you donated allowed us to order 1500 pairs of gloves in addition to 500 crepe bandages and 400 syringes, all of which were urgently needed. We delivered the first shipment of the supplies directly to the hospital CEO and they are no doubt being put to use at this instant to perform operations that will improve and even save the lives of patients. And without your generosity, it would have been impossible. Without your donation, patients would have suffered needlessly.

Not kidding when I say this is the most exciting picture I've uploaded on my trip.

So thank you, thank you, thank you. You made an enormous, tangible impact for sick and dying people who were out of options. And for those of you who are reading this, seething with jealousy because you actually didn't donate, don't worry! There will be more chances! We are in the process of establishing a foundation to continue to support the hospital and hopefully provide some long-term solutions to improve patient care.

So that's all I've got. Thank you for reading this blog, it's been a real hoot to write. I fly out Monday for the big apple, where I am very much looking forward to starting the majority of my sentences with, "Well in Africa..." and proceeding to explain why I'm a better person than you. I wonder if they sell pedestals at the airport or if they'll just give me one when I clear customs. I'll keep you posted!

Go tribe

-Gates

I've had a busy month!

On the Cusp of Coherence

As my literary peer Ernie Hemingway once said, "I'm fresh out of things to write, try again next week."

I didn't want to leave you with nothing for the weekend, although you could make the argument that a post saying I have nothing to say is, in effect, nothing. It might even be worse... after all you're wasting valuable moments of your day reading this when you could have been doing something worthwhile like playing angry birds or making a remark about the weather to a coworker whose name you forgot long ago.

I promise I tried to think of something to say to update you. As a matter of fact, I swear at one point I was on the brink of something genuinely worthwhile. I even managed to capture this close brush with insight on camera:

So I guess for now there's not much more to say other than I'm alive, healthy, and happy. Also, these pictures make me look rather tired, but I can assure you it's just the lighting and the shadow cast from my neanderthal brow line. Not the most thorough update in the world but honestly, how productive are you going to be this Friday? At least I managed to squeeze a decent amount of words out of virtually no information. For another example of my remarkable talent for this, see my senior thesis.

Happy weekend!

-Gates

Law and Order

Traveling to South Africa, one expects to have his* fair share of new experiences. But there was one thing I was not prepared for… murder.

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I thought about posting nothing but the above and allowing you all to marinate on it for a week or so, but I thought better of it. So I’ll elaborate.

I killed a chicken. There I said it. God it feels good to get that off of my chest.

I guess with the right lawyer I could probably get the charges reduced from “murder” to “accessory to murder,” but there is absolutely no avoiding the charge of premeditation. That one’s going to stick like glue, because this was some cold-blooded stuff, my friends. Money changed hands, pictures were taken not only before and after, but during the very act. All in all, it was a pretty amateur job.

Amateur, and finger-licking delicious.

We had driven out of Thohoyandou to the village where Vhuli (my host/co-conspirator) had grown up, and where her mother still lives. The houses in the village now have running water and electricity, but for most of Vhuli’s childhood they did not. As a result, the residents of the villages maintain a sort of self-sufficiency that has long been lost in most of the developed world, particularly when it comes to food.

Decidedly more peaceful than 2nd Avenue.

Vhuli and her sister told me that only recently had they begun to feel comfortable about buying meat from a grocery store, and they still avoid shopping in the produce section whenever possible. This seemed odd to me, until my trip to Vhuli’s village. Her mother’s property, like those surrounding it, boasted a dizzying array of highly productive plant life… avocados, strawberries, corn, passionfruit, apples, oranges, mangos, papayas, grapefruit, potatoes, spinach, bananas, macadamias, and a few extremely tasty fruits I had never heard of and won’t even try to spell. All of this and more, growing within just the acre or so of property on which the house sat. This isn’t recreational gardening, this is a reminder of how the village residents supported themselves before the advent of paved roads and Shop Rites.

On top of that, chicken, goats, and cattle roamed free around the village, which brings us to the scene of the crime:

It all happened so fast. There we were, sitting in the living room, when from somewhere I hear the phrase “slaughter a chicken for dinner.” My ears perk up. I know that sounds a little sick but come on, wouldn’t yours? I mean, I’ve seen “free-range chicken” on a dinner menu before, but how often do you get to look outside and actually watch said chicken as it ranges freely?

Vhuli’s sister agrees to make the pickup. Eli and I supply the cash. It was on. Flash forward 3 minutes; Vhuli’s sister is back. She’s got the goods. It appears she wasn’t followed.

Never get attached, it just makes it that much harder.

 I make the mistake of looking into the chicken’s eyes, and can feel it peering back into my soul, which I assume is turning black. I begin to panic. But at this point, I’m in too deep. This is who I am now. It’s time to do the deed.

In my defense, at least I'm not grinning like Eli.

As a single tear rolls slowly down my cheek, I realize it’s probably safe to assume that most of the chicken I’ve eaten in my life didn’t die of natural causes (though I guess I’ll never be totally sure). I console myself in this way, telling myself at least I did something to contribute to my meal. This line of thinking really helps ease the transition from the man I once was to the monster I’ve become.

Of course, all of this guilt washes away about 40 minutes later as I polish off a drumstick. Fresh chicken is just really, really good. While I’m not particularly anxious to do it again, it was uniquely rewarding to experience this tiny piece of what the daily life in these villages is like. I have a lot of admiration for the people there, who by now certainly have access to modern conveniences but choose to preserve this aspect of their cultural history.

Anyway, I’m tired now and can’t think of a way to really wrap this up. So here’s a picture of a sunset, although to you in the States it may look like it’s just mid-afternoon, what with the time difference and all.

Symbolic of something or other.

Goodnight!

-Gates

* or her, you whacky feminists.

Getting My Hands Dirty

In my last post, I took you through my adventures in the wild. There were pictures and everything. This week, I encountered an entirely different, but no less, shall we say, unique experience. Don't ask me how it happened, but this week I have found myself arriving every morning to the OB/GYN ward to do rounds with the doctors. There will be no pictures to accompany this post.

I'm a bit embarrassed by my reaction to this. First off, I'm 25, which by all metrics qualifies me as an adult and implies at least a modicum of maturity. And then there is the fact that I want to go into medicine. So I'm supposed to be cool, unfazed, scientific when it comes to every orifice, every fluid, every smell. On the surface, I think I pulled it off this week. I think that if you watched a video of my face as I made rounds, you would agree that I was successful in affecting an interested-but-not-terrified demeanor.

But inside my weird-shaped head, it was just bonkers, at least on the first day. Maybe by day three you could say the situation was downgraded from "bonkers" to "panicked", and perhaps by next week I might even reach "resigned terror." Given this projection, by the time I graduate medical school, I should have things down to a manageable "holy shit" level.

What really gets me is that, fundamentally, I shouldn't be uncomfortable standing there in the aftermath of labor. No one should. After all, weren't we literally born into this? The first air any of us breathed was saturated with those distinct aromas that accompany birth. In fact we were downright covered in the stuff. Maybe that's what all the crying was about. The point is, it doesn't make much sense that I was more apprehensive to enter the labor ward than I was to step onto a plane bound for the other side of the world. But I guess life's just weird like that.

Anyway, it's actually been very interesting. I've witnessed several surgical procedures including two Caesarean sections and a hysterectomy. The doctors have been amazingly helpful and informative. I know it's slowing them down to explain everything to me as we go from patient to patient, but they haven't uttered a word of complaint and seem to understand how beneficial this experience is for me. Though I'm just scratching the surface, I've learned a lot about the field.

Most interesting is seeing how cultural norms affect the way that the doctors approach patients. For example, a woman who bears ten children is highly celebrated within her village, so getting to that mark is a legitimate goal for many women in the area. However, if a woman has given three Caesarean births she puts herself and her baby at serious risk if she falls pregnant again. The doctors strongly urge women to cut their tubes following the Caesarean birth of their third child. Therefore they are presented with the monumental task of navigating the waters between cultural influence and medical interests for women who often have such a low level of education that they can barely understand the implications of their decisions. Things like this have served to open my eyes to the enormous scope of the challenge of medicine, particularly in the developing world.

Speaking of the challenge, a few words about the hospital itself:

Tshilidzini is the largest hospital in the area with 530 beds. The hospital grounds are actually quite picturesque. The sprawiling one-story brick buildings of the hospital are surrounded by trees and green grass. In the mornings, monkeys climb the branches near the main doors.

Inside, however, is a very different picture. Wards are over-crowded with beds and even more so with patients, who often have to find room on the floor. If you've spent any amount of time in an American hospital, the differences jump out at you in various forms. After close contact with patients, I found myself instinctively searching the walls for hand-sanitizer dispensers, which are virtually ubiquitous in a standard US hospital. Here, I located a sink after a short search, but it had neither soap nor paper towels. When helping a doctor insert a urinary catheter, the lighting behind the drawn curtain was so dim that the doctor asked if my phone had a flashlight. A patient admitted to the emergency room with chest pains will not get an ECG here, because to get an ECG, you need a working machine.

It's things like that... things that don't even cross your mind at home. They seem obvious, as though it is in the very nature of hospitals to be well stocked and well lit. You notice a deficiency in a hospital at home, a malfunctioning piece of equipment, a leak in the ceiling, and you assume that by the next time you visit, some authority will have acted to resolve the problem. That assumption here would be viewed, at best, as fantastical thinking.

Woah, things got a little grim there for a minute. My apologies, but I figured I'd be remiss if this entire blog contained nothing other than smartassmanship punctuated by photos. So that's been what's going on in my life this week.

Anyway, how are you? Good, glad to hear it! You're looking great, have you been working out?

-Gates

A Day in the Park

Disclaimer: Upon reading this post, many of you might find yourselves thinking "hey wait a minute, didn't I give this kid money so he could go be of some use to people? Why was his weekend so blatantly superior to mine?" Honestly, it’s a fair question. But before you feel you've been hoodwinked, bamboozled, or otherwise screwed over, let me just say everything I did this weekend was due to the generosity of my host family the Obidas. That being said, yeah... pretty darn good weekend.

Before I begin, I just want to say a slightly delayed Happy Birthday to Wiz a.k.a. Lizzie Merriman, who is 23 as of last Friday! If I could say happy birthday in the local language, I would, but alas I can't understand a word anyone here says to me. But regardless, 23! Woah!

Anyway, the weekend.

It started Saturday with a 4:00am alarm, which in my experience is not an ingredient in the standard recipe for a great day. I thought it seemed a tad aggressive. But, stop the presses, I was wrong. It turns out that if you want to see lions in their natural habitat, you've got to stay away from the snooze button and get moving. We were headed to Kruger National Park, the pride of South Africa and essentially the best place in the world to see wildlife. 

We arrived at the park gates at about 6am and began our drive. You can sign up for guided tours but honestly, unless you happen to be Mr. Magoo, you don't need any help spotting your fair share animals; you can just drive yourself through the massive park. Case in point, within three minutes of entering the park, we spotted two lions sitting near the side of the road, guarding a carcass. The picture doesn't do it justice, but just in case you have the audacity to doubt me:

Simba himself.

The drive was pretty unbelievable, my rap sheet of animals spotted reads as follows: lion, giraffe, elephant, zebra, buffalo, impala, warthog, nyala, wildebeast, and baboon. See what I mean about my weekend? These animals aren’t behind fences or in designated areas. They’re just there, doing what animals do. I don’t have enough internet allowance to load all of my pictures, but here are a few of my favorites for you:

The size of the buffalo is exceed only by its ability to pose for photos.

Don't hassle them... they're local.

Oh hello.

Copyright Gates Merriman 2013

We stopped for lunch at a fenced in area and did some grilling for lunch and then continued driving all day, never going more than a few minutes without spotting our next animal. It’s a very surreal experience turning around a bend and finding the road blocked by a herd of elephants. But at least they move faster than the traffic in New York! Am I right?!?!

Really sorry about that. Moving on.

Let’s just talk about Sunday. Those of you who know me well will remember my stunning portrayal of “King Number Two” in the 2001 St. Paul’s Christmas pageant, so it should come as no surprise that this morning, I found myself in church. It was, however, a decidedly different church experience than my WASP roots prepared me for. The music was upbeat, the preacher was animated, and people danced as they sang. Historically speaking, I have had difficulty staying completely awake for an hour-long service at home. This service lasted two and a half hours, but it was so high energy that I never so much as yawned.

At the end of the service, the preacher announced that there were two visitors from the US and invited us to stand. The congregation greeted us with cheers and applause. Afterwards, Eli and I were swarmed by people hugging us and thanking us for coming. I don’t think they get many Americans or (and I’m just going to go ahead and say it) white people at their congregation so we were something of a novelty. I was incredibly gratified by the outpouring of kindness and the warm welcome… the people in this town have been amazingly warm from the moment I arrived and it really goes a long way in making me feel comfortable and glad for having made the journey.

The day capped off with a drive to a place called “Big Tree.” The Big Tree is 3000 years old. It’s so large that its roots stretch over 3 miles underground. If you’re feeling environmentally friendly and want to give it a hug, you better bring 29 of your buddies with you in order to wrap completely around the trunk. There’s a cave inside of it. In short, it’s a really, really big tree. It may be the biggest tree in the world, but that’s hard to say because for some reason I’m having trouble getting onto Wikipedia right now. Anyway, here are some pictures:

For scale, please refer to the person under the tree on the right hand side.

Can't tell you how often I used the phrase "I'm gonna go out on a limb here..." while this picture was taken.

So, as I said, REAL solid weekend. Just tops.

But this week we’re getting back to work. Monday, we are meeting with the CEO of the hospital to present him with the supplies that we brought here to donate and to discuss the development of our foundation. My experience in the hospital so far has been great. The doctors and nurses are incredibly passionate, but are handcuffed by their lack of resources. So hopefully this will be a productive meeting in figuring out the next stages of our collaboration and support of their efforts!

Thanks for reading! Hope everyone is happy and healthy!

Heading North

Good Morning from Thohoyandou!

I’m sorry I haven’t been able to update the blog very much so far! I must say though, it is refreshing not to be constantly connected over here.

Our day in Johannesburg was well spent. Truthfully, all I wanted to do was sleep, but in a heroic effort to beat the jetlag we decided to do some exploring of the city. We went to the Apartheid Museum, the entrance to which, fittingly and somewhat shockingly, looks like this:

Having been only 6 years old when apartheid ended, I knew next to nothing about it before this visit. I highly recommend it to anyone visiting the area… it provides a very poignant glimpse at the history of South Africa and the factors that continue to influence the social and cultural makeup of the country today.

The visit to the museum was, of course, a pretty sobering experience. Afterwards we decided to explore near our hotel and get a few beers, which were considerably less sobering.

I only meant to have one of these but got confused by the currency conversion and had seven instead.

The next morning we left Jo’berg to head north to Thohoyandou. The drive up took about 6 hours. Fortunately, the radio station we were listening to kept me up to date on everything happening back in the states, which is to say they spent about 2 hours talking about Miley Cyrus.

Arriving in Thohoyandou, we were greeted by our hosts Vhuli and Martin and their sons Kevin (14) and Feni (10). Vhuli is a project coordinator for the VHEMBE study that I am helping out with and Martin is a family practice physician at the Tshilidzini Hospital. They are incredibly nice people and have been amazingly generous in opening their home to Eli and me. We had brought them some gifts, including a box of chocolate chip cookies baked by the incomparable Julie Green. The picture of Feni really says it all.

That bowl literally had five cookies in it to start

There’s a lot more to tell and hopefully now that I have a little more regular internet access during my days I’ll be able to update more frequently. But I’ll leave you with a final video of yours truly, trying my first ever worm… a staple of afternoon snacking here.

Made it!

Greetings from Jo'berg!

So it took a bit to get here. Six hour flight to London, ten hour layover in Heathrow, and a ten hour flight to Johannesburg. However, it just so happens that I'm reading a book about the Lewis and Clark expedition, and it took those famous bastards like 3 days just to get from Philly to DC. Am I comparing myself to Lewis and Clark? I'm just saying there's evidence to suggest that I'm a much more efficient traveler than they were.

But I digress. You want to hear about Africa. Well, it's only been a couple hours so not much to tell yet, besides the fact that we drove past the tallest building in all of Africa:

Carlton Centre, tallest building on the African Continent (50 Stories).

Don't believe me? Wikipedia it.


Anyway, Eli (a fellow Friends of Tshilidzini co-founder and my travel partner) and I are going to go check out the Apartheid Museum during our time in Joberg today and then tomorrow morning it's off to Thohoyandou! More pictures to come, but here's Eli, as well as proof that all roads lead to Cleveland:

Eli, hour 6 of layover. Calm as a monk.

Our taxi driver couldn't understand why I started weeping at this site.