My area of the Kalahari Desert has become super hot in the last month. I know some of you may be thinking ‘you moved to the Namibian desert, what did you expect?’ but this is on a whole ‘nother level to Scarborough on a sunny, summers day. It was 41°C yesterday and still I’ve had friends say to me ‘Oh, it’s dry heat, it’s fine’. It’s not fine. The heat and wind evaporate the sweat so quickly it’s easy to forget to drink enough. That leaves me at about 3pm with a mouth so dry that I feel like I’m chewing the sand I’m walking on, and my pee a rich mahogany colour.
Life is tough for the San here. The children at school tell me the stories of how badly they are bullied, another one of our female patients was raped the other day, and the uncle of a guy I hang out with was killed in a fight over a pack of matches. I feel guilty that I can’t do more for this community. I feel guilty that they let me enter their lives and I choose to leave again a year later. I feel guilty when I buy an ice cream for my paediatric patient who is in hospital with TB. It feels pathetic that this is all I can offer a child with a disease with a 15% death rate, an alcoholic mother and no formal education. Buying the ice cream really just allows me to distance myself from the difficulties of her life by providing a small moment of happiness.
The photo above is from a farm about an hour and a half away that had a number of San people there and possible TB cases. We had an awesome adventure there in October that involved some great off-road driving, a rare sighting of traditional San huts and a couple of new cases of TB. At a follow up visit there with Anaki, my usual translator, all the older San there recognised her. They were her mother’s family but hadn’t seen each other for 15 years.
My favourite patient died last week and it was the most upset I’ve been since becoming a doctor. She was in her early twenties and was the most amazing person. She was funny and kind, spoke excellent English and had avoided all the pitfalls that young San succumb to: alcohol, smoking, teenage pregnancy, dropping out of education. She was fascinated when we talked about my blog and how people in the U.K were reading about life in Epukiro. She was everything that was positive about a young San person – yet still she died.
Maybe things would have been different if she hadn’t lived in a tiny, remote village. Maybe a different doctor would have requested different investigations and found the cause of her disease. Maybe nothing would have changed the outcome. Previously when I was working as a doctor the ultimate responsibility for a patient was always with someone more experienced, but here there is no-one else. RIP Sara, I feel like I failed you.
My football team has won its first match! It was a revenge 5-2 win against Pos 13, the team we played in our first ever match. (Previous losses of 5-3, 3-0 and 7-1 to three nearby villages). The original team from when I started has changed as the players have gradually moved away. One of the previous doctors performed population surveys on the San in my village one year apart. The population remained stable but only a third of the people were the same. Two thirds had moved on to live in different places. They move to remote farms to find work, as well moving to visit friends and family in different settlements. This mobility is almost unique in Southern Africa and makes for difficulties providing healthcare, as well as my attempts at managing a San football team. The options for the San guys once they drop out of school here, involve drinking alcohol at the shebeen every day or manual labouring on remote farms. Neither of these is conducive to creating a formidable San football team.
I absolutely love the days out when we visit the local villages to play football. They’re such fun days, despite the fact that I’ve been demoted to linesman now since our team improved so much. Jose Mourinho here also sent on all my substitutes in the last game at half time, wanting them all to get a fair time on the pitch. One of the guys was promptly injured so I had to change out of my flip-flops, short shorts and sunglasses, and into the team kit as a poor attempt at a left back.
We also have a new recruit that hitchhikes 70km from where he lives to join the team at the weekend. He was invited for trials for the Namibian under 20 team last year but his family couldn’t afford to send him to the trials. He’s by far the best football player I’ve seen since I’ve been in Namibia despite his tiny, half-San half-Herero frame. A highlight for the team recently was playing against the local wildlife lodge that employs San workers. After the match I was able to take them round to see the lions, leopards, cheetahs, wildebeest and various other antelope. My San ‘bushmen’, renowned for their knowledge of the plants and animals of the Kalahari, had never seen any of those animals.
Excitement for November includes running the clinic on my own, teaching on a course about conservation and wilderness medicine, and finding out the result of our STOP TB funding bid.