Summer is here

After the steady rain of yesterday, today was cloudy, turning to sunshine by afternoon. The hospital activities involved one 20 year old male who had SVC syndrome, which on echo I found was due to a mediastinal mass pressing on the left side of his heart. His LA was basically a slit. The tumor was >10 cm by echo. Another patient, 58 years old (looked 70) was thought to have heart failure, but I proved he had no important heart disease or likelihood of hf.

The hospital is complex and loaded with staff. What's missing is management. I am struck by the absence of soap for handwashing at the ubiquitos sinks on the wards, and that nearly all the paper towel dispensers are empty. I needed alcohol to wipe down the echo probe between patients and this could not be located. The only explanation I can think of is the lack of anticipation of supply needs based on use projections.

This afternoon, I played golf with 3 locals who are missing their fourth for a while (on a trip). The course is quite nice and pretty well maintained. The greens are interesting, contoured, and stimp at ~8. Ant holes turn up, with little mounds of red earth, and it is permitted to move your ball to avoid this unexpected and unwelcome hazard on the greens. The birdlife on the course was very impressive, with beautiful specimens No snakes or bugs to speak of.

An interesting custom is to stop after 9 holes and sit down for lunch! I had eaten already, so I just had my customary banana, but one of the men had beef and rice and another poached eggs on toast!

Barbara took a break from work today and went off the University of Botswana to meet with a law professor Rekha Kumar who teaces human rights law and is very interested in developing a course on HIV/AIDs law (there is no law on AIDs on the books, only policy). She has asked me to lecture to her class which should be fun and work with her on some research. UB is a sprawling campus, lots of random buildings spread over a large area. The class she teaches are tremendous - several hundred students with no TA or any help with marking etc. She will also introduce me to the faculty member who teaches health law which should be interesting.

Couldn't resist the Ethiopian buffet tonight at the local mall - fairly pricey for Botswana but quite tasty.