High fives and heartache: adventures in pediatric global health: we are more

sometimes the drumming is so loud it becomes your heartbeat
it becomes everyone's heartbeat
there is no you or me or them
only Us
and We are loud
We are so loud
if you want a wall
We will give it to you
a wall of sound
of voices
of music
of love
dynamic but unbreakable
We will pound eardrums
We will shake souls
We will dance into the night
the moon our only light
We will join hands
We will embrace
We take up space
so much space
We will move this earth
We will shatter history
a force so strong
you'll feel us in your bones
deep to the core
you thought you could quiet us
but We are Us
We are more

drums on drums on drums

I had a post started for about a week now and hadn't been able to bring myself to finish it. Then a couple of awesome doctors here had a celebration with lots of music, theater, art, tons of talent, and that poem just came out. It had been a long two weeks. I was on call last weekend so I worked 12 days straight. At the end of the party, I found myself dancing in the middle of a group of people of all backgrounds. A local hip hop artist trying to teach us some steps, a painter looking just as nerdy as I was trying to bust a move, doctors throwing up their hands with reckless abandon. It was exactly what I needed.

I've been frustrated. Before all of the election drama, I was already getting frustrated with the politics of my department and of the medical education system here. Coming into this position, I knew I wanted to be somewhere that I was doing both clinical work and teaching. But lately I have had the increasing feeling that I am up against a wall here. I run around trying to staff 30-40 patients per day (unable to actually communicate with them myself) and see the same things over and over. Babies infected with HIV who are supposed to be screened and followed up but aren't (even though HIV is probably the most well-funded disease here), children dying of TB with a known contact who aren't picked up for exposure, just an endless circle of terrible outcomes and preventable diseases.

So not hard to see why I often leave the hospital completely defeated. Plus the point of being here and Seed's mission and all that is to strengthen medical education. And I feel like I don't even have time to think let alone fit in teaching. I started feeling a bit more optimistic after working with the students last week. The students here in general are great to work with, but we had a particularly good group on the unit. After a couple of great days precepting cases with them, I was less cranky. Then started thinking about the health system here and how there is no money and they are in a hiring freeze so all of these fantastic students we are training will never get jobs here. They are forced to look for work in South Africa, Swaziland, Lesotho. If they are lucky they might find a job in a private clinic, or with an NGO, or on a foreign-sponsored research project. Despite this, they work incredibly hard. They are the ones spending the time to explain how to use an inhaler to a family, counseling mothers when their child dies unexpectedly, and chasing down lab results. So it is not easy knowing that the future for them is very uncertain. I question almost daily if I should be here, or if it would be more beneficial to just pay one of the many qualified Malawian doctors who would love a job in their home country.

I considered making some comments about the election, but I'm not really sure what to say. Although I'm still in shock that this man can be president, I am mostly depressed by the number of intolerant and angry people it has revealed, especially in the aftermath. I think I knew our country still had a lot of this, but maybe wasn't sure of the extent. I at first thought I am sheltered from it, living in California. But the truth is, I'm really not. It exists in my own family, on my street, all over my hometown. And I have made excuses because I know these people will not change their beliefs based on what I say, so I gave up arguing. But I could have done more to let them know that this is not ok, and I want to start doing that now. How I am going to have the courage to do this, I'm not sure. Something to think about.

Some less dismal things recently: