Beyond Gaborone

This was a busy day. I was picked up at 0640h by Matt Dasco, MD, one of the UPenn clinical faculty who has an important role both in hospital teaching at Princess Marina but also in outreach. Today was our outreach day, spent in Mochudi, about an hour north of here. We arrived at the Deborah Retief Memorial Hospital in time for morning meeting in the Willie Neethling Hall, a room the size of a large dining hall. We sat around a line of finely finished tables with inlay, the medical staff and nursing staff all meeting together at the beginning of the day. The woman next to me, a soprano, began a song with Christian motif and Setswana harmony, with all present joining in. Thereafter, she led the morning prayer. Once these were completed, the nursing matron read the previous day's report: how many patients were admitted, how many infants were delivered, and, in great detail, the details of a stillbirth ("macerated infant") which engendered a great deal of discussion, including suspicions by the physician in charge (a Ugandan with a great barotone voice and intuitive questions) that the baby was in trouble as much as 3 weeks before delivery. Thereafter Matt presented an excellent talk to the staff on HIV infection and bone loss.
A petient was brought to the OPD for me to examine, a young woman who I suspect had primary pulmonary hypertension. We made rounds on the female ward, doctors and nurses reviewing findings in concert. I was struck by the communal approach to patient care, much different than the somewhat strained relationship doctors and nurses appear to have at Princess Marina...they seem to exist in different orbits and intersect primarily through written communications in the patient's chart. The Mochudi hospital seemed to have its act together better than Marina, including the fact that the beds were numbered, so patients could be identified by bed number, as opposed to the Marina approach of calling out the patient's name within the cubicle (hoping the patient was awake or able to communicate back!)
This evening, we attended the Ladie's #1 Opera House (a local theater company in southeastern Gaborone founded by Alexander MacCall Smith). We dined outdoors on wart-hog stew (called "venison") and lasagna under the stars. Thereafter, we trooped into the production (about the size of the Waynflete auditorium): the only seats available were in the front row. We lucked out and sat up close! The performance was a depiction of the wildlife of the Makgadikgadi, the salt pans of the Kalahari 7 driving hours north of here. Five men danced, played inventive instruments, and imitated giraffes,flamingos, elephants, wart-hog, kudu, leopard, lion, hyenas, vultures, and the people of the Kalahari. We were greatly entertained and enthralled. The dancing and singing were excellent.
Coincidentally, we are traveling to the Kalahari this weekend, and will be staying in Makgadikgadi; we hear that at this point we hold the only reservations, and so should have the full attention of the staff and guides!