In December, Naankuse ran a Conservation Medicine course and then the clinic closed for a few weeks at Christmas. The start of my month therefore included a mad dash around the desert finding the TB patients that are least enthusiastic about taking their pills, refilling their medications for the time that I was away.
The Conservation Medicine course was great fun for me to be part of. It was a mix of animal conservation, remote medicine and desert medicine. Activities included helping dart then transfer a cheetah between enclosures, seeing a deadly Black Mamba snake from a metre away, and a desert hike with medical trauma scenarios. One of the nights was spent sleeping next to a low burning fire (to keep the leopards and hyena away) in a dry river bed in the Namib Desert, looking up at the shooting stars. Magical.
My part of the course was to talk to them about TB, HIV and remote healthcare. In the afternoon I brought in the patients I thought were interesting, to discuss and examine. A recurring theme came up in discussions about whether it was worth investigating certain patients. One young female had difficulties with co-ordination and walking due to a problem in the cerebellum of her brain. We agreed that whatever it was caused by, was unlikely to have a cure so the weeks she would spend in Windhoek hospital were not in her best interests. Another had a badly deformed ankle and lower leg, possibly after childhood polio. He could still walk on it and wasn’t in significant pain, so again the consensus was that it was unlikely to be worth the investigations and surgery at the moment. It doesn’t help that I still can’t find a way to track my patients once they’ve gone into Windhoek hospital. They become lost on a mystery ward there and I can’t find them until they turn up in the village weeks or months later.
Closing up the clinic for a few weeks meant that I had to give my translators their wages in one lump sum while I was away. They generally aren’t the best with money, and certainly not with saving any of it. I was slightly concerned giving them all this money at once, so spent ages one afternoon giving them basic financial education. The theme was along the lines of ‘These are your normal wages. You have no more money than usual. Don’t spend it all at once.’ I was all smug about this foresightedness and my successful intervention, until one translator came into work the next morning telling me she had just spent 2 weeks wages on a dead goat and was inviting the village to share it tonight.
In the middle of December I found out we were successful with the bid for funding from the STOP TB organisation. Only 7% of applications were successful and most of these were huge organisations such as the Clinton Health Access Initiative, or Partners in Health (which has 18 000 employees compared to our 8). Our award was for US$ 100 000 to expand the TB project that I’m currently working on. It allows me more time and resources to work in the rural farms and villages, including overnight camping in these remote settlements. I can’t wait to start and I’m so excited to see all the interesting places that were previously too far away. The end outcome is hopefully going to be a big increase in our TB diagnoses, with the aim of breaking the cycle of reinfections.
I’ve been away from home since March 2016 and it felt strange being back over Christmas. The difference in priorities was obvious straight from the airport. I was on the bus passing a Gucci shop and was pretty upset by a woman carrying multiple bags of Gucci products. How could she justify to herself that there was literally nothing else in the world to spend those thousands of pounds on? The best possible use of her money was to buy some clothes to show off how rich she was to other people. I imagined her going to the children in my village, looking them in the eye and saying that the money that would change their lives, was better spent on a new handbag. I am aware that this is obviously stupid as she hasn’t met the children of Epukiro and she is just a product of her surroundings, but still…
I really want a new iPhone. A brand new, gold, top of the range one. I want a new pair of Nike trainers and a new Ralph Lauren shirt. Why am I any better than the lady at the Gucci shop? I’m not I guess. I’m a giant hypocrite, left with more questions than answers about what’s important in life from my time in the village. It’s also certainly not fair to judge people for living the way that society in the U.K expects them to. I’m not going to start judging the life choices of my friends or I’ll end up a lonely old man, swimming in a sea of self-righteousness (as if I’m not bad enough already).
I worked for some time in the Orkney Islands over Christmas to earn some money to afford my flights. While I was there I put an appeal in the local paper for second hand football boots. Over 50 pairs of football boots and trainers were donated and most of them will get out to Namibia with me in my excess luggage. There is my team and then three others that we play against regularly so I should be able to provide shoes for most of the players. Also, my 8 year old neighbour donated me his Christmas present of a new pair of football boots. He calmly stated ‘They don’t have as much as I do, so I’d like someone in Namibia to have them’. There was no way as an 8 year old I’d have given my Christmas present away. What an ace child he is. Hopefully the boots can reduce the amount I have to stitch up cuts on the players’ feet from glass or sharp rocks.
I’ve also had a generous cash donation from Canada. I’m still planning the most effective way to use the money, as the problems the San face are complex and simply throwing money without thinking doesn’t work. Supporting the San secondary school kids as much as possible is one idea. When I’m back I’m going to speak to the headteacher to find out which San children failed the year and dropped out of school. At the weekend I’ll be driving round the countryside to try and see them, find out why they dropped out and see whether I can persuade them to go back to school. I see little improving for the San community at the moment and these secondary school children (only 6% of San kids make it as far as secondary school) are where I see some potential successes.
Lastly, a new doctor is starting work with me in January so I’m excited to meet her and show her the bright lights of Epukiro.