the edge of the earth

You probably think I fell off of it given my lack of any updates for the past few weeks.  It has been awhile. Part of this is because I was sick and in generally feeling low on energy and lazy. I also worked over Christmas week.  I also was having a hard time writing what I wanted to say.

About a month ago, I had a headache and felt exhausted. A few days later I got the most disgusting sore throat of my life, swollen lymph nodes, the works. Thinking this was strep and that I in no way wanted this to turn into rheumatic heart disease (which we see all the time here as a sequelae of the strain of strep bacteria) I took amoxicillin.  Six days later, I looked like a lobster woman.  My face was swollen, I had an itchy, red rash everywhere, and my skin was inflamed and swollen.  I figured this was the amoxicillin.  Turns out, nope. About 2 weeks later it was still going on. I asked everyone to help diagnose me.  The peace corps medics, my colleagues, random people on the street, telemedicine consults home. Everyone asked if I changed laundry detergent, which is a question that when we ask our patients with gross rashes back home, I am always thinking, “For reals? Like detergent can cause this crazy rash?!?!?!” Well, actually, it can. And its name is Toss.  Little did I know, our lovely lady who cleans for us bought a different laundry detergent.   According to the bottle, it is for babies and sensitive skin. But it smells like someone took every perfume in the sale bin at TJ Maxx, dried it, and mixed it with baby powder. 

Don't be misled, definitely not gentle

Shortly after this discovery, I went to Cape Town for a vacation.  The city is beautiful.  It is not intimidatingly huge, but has everything you need.  Good food, great yoga studios, beautiful geography and scenery, generally friendly people (if you are white).  I shopped more than I should have, took a million pictures, and soaked it in. I didn't realize how much I miss being in a big city and being able to walk all over.  One of the days I walked 10 miles just around the various neighborhoods, wandering in and out of places. 

Bo Kap

district six museum

top of lions head

woodstock street art

The culture in Cape Town is super interesting to me.  The history is insane. Not knowing much about apartheid in advance, I decided to learn as much as I could while I was there.  I was lucky to travel with a friend who is much more outgoing than I am and engaged a lot of the locals, starting conversations and asking questions. You can tell there is still a serious racial divide (unfortunately, all too reminiscent of our own race issues in the U.S.).  Because we were travelling, we interacted a lot with people working for the service industry. In South Africa, this means Zimbabweans, Malawians, black South Africans, Congolese, and the list goes on.  It is a melting pot of Sub-Saharan African culture.  Everyone we met was so kind and hospitable, despite the fact that they work extremely hard, are treated like shit, and are fleeing difficult conditions in their home countries where many of them still have family.  It is still crazy to me why we treat people the way we do because they are different.  I do it too.  But why is this something that seems to come naturally to humans?  It is hard to wrap my mind around apartheid being so recent. Even the Civil Rights Movement in the U.S.  How did we do this to each other?

blender lamp in a tiny township house

my fave color township house

I still wonder a little bit about my year so far in Malawi and how it could have been different if I had done something else. When I was looking for jobs/volunteer positions abroad, I considered a 2-year position in Columbia working with community health workers. I ultimately decided this was too remote and too clinic-based for me (loving the emergency room and acutely ill patients).  After the past six months, I question this a little bit.  I think there is something to be said about working directly with locals.  This is what I have enjoyed most about my prior global health experiences.  It is extremely uncomfortable at first as you find your feet in a culture and language that is not your own, but then as you are forced to put yourself out there, the rewards are indescribable.  Here, because there is a decent ex-pat population, I interact much more consistently with foreigners than I do with locals.  I wish I could have more of a connection with my patients.  The same social structures (and conflict) we see in the U.S. when groups of strong-willed people are put together are just as prominent here.  My favorite part about prior experiences abroad was this lack of drama, something that we as Americans (myself included) are obsessed with on every level.  The medicine has been the easy part for me to deal with emotionally. It is the politics and drama that are tough. 

I don't regret being here, but the challenges have not been what I expected.  Some days my heart is so full it could burst; other days I am completely disappointed in myself and the entire human race.  Today I helped a little girl in heart failure sit up to make her more comfortable. As I touched her, I wanted to cry. I wanted so badly to see her and the people of Malawi sit up and say, "It's ok. I can do it myself." Because everyday I ask myself when that will happen. When a country with no economy, so devastated by everything (those who came and went, those who came and stayed, the climate, the infectious diseases, corruption...) will be able to be self sufficient without foreign aid. If I, and everyone else here, is actually doing more damage than good.  Really lighthearted things to think about on a daily basis. On that note, here are some elephants and stuff.   

Liwonde

Creepy baby croc party

all the mango things: strawberry mango jam, vodka, even more vodka disguised as gin

Thanks for reading! It is nice to have this link to everyone back home :)