The final preparations for our STOP TB project are in full swing and I’m super excited for it to start. It looks like because of delays out of our control, I probably won’t be implementing any of it. I’ll have to be content with just planning and preparations. The main idea is to diagnose patients with TB in their own communities, in areas that they would otherwise struggle to access healthcare. It is similar to what I have been doing this year but fully funded and resourced. The only worry I have is that I’ve stitched up the next doctors, setting the targets for new TB diagnoses too high. I’m sure the new doctors will be great though.
The STOP TB project also includes camping trips to increase the distances away from the clinic that we can reach. Recently I went on a trip into one of the most rural areas of our region, called Eiseb. We drove for hours down sand tracks, finding pockets of San working on the remote farms there. About an hour before dark the workers at a farm we were visiting allowed us to stay overnight within their rickety fenced compound. We collected firewood and cooked a rice and meat based meal in a potjie pot over the open fire.
The farm worker had told his mates from neighbouring farms that they had guests, so by evening we had a circle of sixteen people around the fire. There were rumours of cold beer being sold in a shack up the hill so we drove in the dark to find this mystical place. It did indeed sell beer but sadly not cold. The temperature reminded me of the water temperature I have my hot showers set at. Even so it was a fun evening, eating, drinking, listening to music and talking in slightly limited English. The farm we stayed at, Okaripuri, was 3 hours drive to the nearest road, 5 hours drive from the clinic, 7 hours from the nearest hospital and 9 hours from Windhoek.
A recent positive outcome I had was with a 5 year old girl that I had taken to hospital a few times trying to get her diagnosed with TB in her elbow and lymph nodes. The actual clinical history was quite complicated but in the end she was started on TB treatment. Since then her elbow has massively improved, her lymph nodes have disappeared and her body weight increased by 15% in a few weeks. Sometimes I think that my TB work here is futile as the causes of TB in the San (malnutrition, overcrowded housing, poor access to healthcare, poverty) mean that there will continue to be many TB diagnoses for the foreseeable future. Small successes like this girl remind me of the importance of clinical healthcare in remote settings.
An interesting thing that I have been reading about recently is Namibia’s close link to North Korea. I read a half page advert taken out by North Korea in one of the Namibian national newspapers that was extolling the virtues of Kim Jong Un and railing against the aggression of the USA. Talking about Kim Jong Un in the national newspaper: ‘True to their expectation and desire, he became the shining star adding glory to Korea. Adding glory to Korea and carrying forward Kim Il Sung’s cause – This was his lifelong mission.’ There is also a really weird Namibian history museum in a giant gold teapot of a building, towering over Windhoek that is a bit of a running joke. It was built by the North Koreans for an unclear reason, with the inside being a strange homage to the Namibian war of independence. It has no clear timeline or information except crazy murals of battle scenes and random war memorabilia. I left the museum more confused about Namibian history than when I entered.
I read slightly more about the North Korea/Namibia connection. There possibly was some support from North Korea for SWAPO in the war of independence, though other sources say it was mainly a close personal friendship between Kim Jong Il and Sam Nujoma (the first president of Namibia). As recently as last year, Namibia was very close to breaking UN sanctions, working with the North Korean army in shadowy arms deals. Check out these interesting articles here , here and here. A final UN decision cleared them of violating UN sanctions on what appears to be a technicality about dates. One of Namibia’s main exports is Uranium, I do hope there is no connection.
I took my football team to the farm of the wildlife charity that is the parent charity of the clinic I work at. They employ mainly San workers and have a San football team as well. We transported my team of 14 players in a Toyota Hilux 4×4 to Windhoek (to which many of the boys had never been). On the Friday we were taken around to see the animals. On seeing the lions, the noise level from the boys was a tiny bit too high and a lion roared and fake charged at the fence. Three of the closest boys ran off terrified, one of them running off into the bushes so fast that his hat blew off behind him. After a final football training session on the Friday evening we slept in a tent in the San workers’ village.
On Saturday we were kindly sponsored to take them to the cinema. The film we watched was King Kong in 3D and they loved the silly glasses they had to wear for the 3D. When they came out, one of them asked me whether King Kong was real and whether it could come to Namibia. Perhaps I was ambitious thinking that my San school kids from remote villages, with variable levels of English, were going to enjoy the cinema. A week later I asked two of them to explain the storyline of the film. I laughed so much as they worked together trying to explain King Kong with their limited vocabulary of English, arm movements and sound effects of the monster and the planes. The thing that made more of an impact than the cinema were the escalators. A few of them just watched people going up escalators for a while, then were too scared to go up themselves. They also really loved the changing pictures of the digital adverts in the mall. A couple of the guys wouldn’t let us leave the mall until we had seen it change one more time.
The football match on the Saturday was amazing. I had managed to get my best team together and the match with Naankuse (the wildlife charity) was very even. Before the match, the staff that I knew at the farm were making fun of how small and young my team was. After the match they were full of praise of how skillful and good for their age they were. The game was 1-1 at full time and sadly we lost 2-1 in extra time. One of the boys on my team apologised to me afterwards, saying sorry for wasting my time in bringing the team all the way to Windhoek just to lose. I tried to explain that it was the taking part that counts but he wasn’t having any of it. I asked each of them a few weeks later which was their favourite part of the weekend. A really popular part was Saturday lunch in Windhoek which was a hot dog, popcorn, and a can of coke. The lunch was in a lovely setting on hotel grounds and they said that they felt like they were ‘posh’.
I can’t really describe how much fun it was with the team that weekend, playing the football match. It’s certainly up there as one of the best weekends I’ve ever had. I love spending time with the team of school kids (most are 16-18) though they still all insist on calling me ‘Doc-Tah’ in their amazing accent.