Winter is Coming

Jun 4, 2015

“Winter is coming.” Dr. Corless pronounces sweetly with her usual charming smile. Marian and I exchange glances and laugh because she evidently has no idea of the joke she just inadvertently made, which only adds another layer of humor to the statement.

Winter is coming to Lesotho. Rain, wind and chill have replaced what we have come to know of the dry and arid countryside. The air smells sweet and shrived of debris, and the skyline vista from our little cottage illuminates the clouds with robust colors of pinks, purples and blues when the misty rainfall breaks and skies clear. We take advantage of those fleeting moments to get outside and walk about.

Boys play soccer when the rains break under clearing skies by Maluti Elementary School. Boys play soccer when the rains break under clearing skies by Maluti Elementary School.

We had a nice relaxing weekend here on the compound discussing research objectives and ideas amongst ourselves to prepare for Monday's meeting with faculty from five of the six nursing schools in Lesotho. Church on Saturday was an unabridged show of holy performance art with a chorister leading the congregation in polyphonic harmony, followed by a beatific quartet singing a cappella and ending with a vibrant sermon that had parishioners bursting in laughter.

Tuesday we were able to visit our first country clinic in Pitseng with hospital staff who make the 2-3 hour drive each way every week. It was surprising to see by map how close Pitseng is in proximity to the hospital, since it took us so long to get there by mostly dirt and gravel roads, many of which were under construction. The group was composed of a doctor, a pharmacist, a nursing assistant, one nursing student (who was also making the trip for the first time), and a family planning counselor. We stopped several times on the way, at one point to pick up an amicable 21 year old son of a fellow nurse who was hitching a ride with us to bring his mother her hospital ID.

“Miss Trista,” he refers to me with bright eyes and an illuminatingly white smile. We discuss and compare similarities and differences of Lesotho and America, and I ask him about his future plans. He tells me he hopes to become a doctor, but since there are no medical programs in Lesotho, he plans to study nursing at the National University in Maseru and then go to South Africa to study medicine. When the driver stops and yells at him to get out, he scrambles to jump out of the van quickly but then turns and hovers in the door to say, “It was so nice to meet you! I hope you enjoy your time in Lesotho!” I want to pinch his sharply whittled dimples but I keep my hands to myself.

We arrive at the clinic where 20-30 people are already waiting outside seated on the ground. As we unpack the van of medications and water, many patients make cell phone calls to friends and family to let them know of our arrival and more people trickle in. The pharmacist opens a side window of the van, and a long line develops alongside of patients who need to refill their medications. Each patient carries with them a small blue booklet, called a bukana, which the doctor and pharmacist use to record medical information. Inside, the clinic quickly becomes crowded with patients waiting to be seen by the doctor or by the family planning counselor. I decide to spend some time with the doctor and the nursing student as they see patients, one by one. I try to make myself useful by taking blood pressures and vital signs. Most patients at the clinic have come to check up on their high blood pressure, diabetes mellitus or to receive birth control. But not all. A few small infants have come with peculiar and unidentified skin conditions, some sort of suspected contact dermatitis, most likely Staph the doctor speculated, of pink nodules that had developed on a 6 months old scalp. An 18 month old with painful sores on her tongue and lips. “Come back Tuesday,” the doctor would say after an assessment and note in the patient's blue book. One women came in with what looked like a rat bite on her hand. The doctor explained he thought she must have eaten meat and not washed her hands before going to sleep; not uncommon for a rat to mistake the smell for a snack. I was amazed how efficiently the doctor assessed patients, and how quickly the day passed with all the patients being seen.

The ride back to Mapoteng was full of chatter and the grazing of tidbits we acquired from a modern grocery store on the ride home. As we neared Maluti, we watched the sunset in subdued silence, daydreaming and reflecting, with murky shades of reds and orange flooding the sky.

Today, two of us had the opportunity to tag along to another health clinic just a 15 minute ride from the campus. We arrived at what appeared to be a small one room school house with a side kitchen. Due to the cold and the rain, only about ten women and four small infants were waiting for us inside. The concrete building had no heating, and the women huddled together on benches facing a chalkboard, wrapped in wool blankets for warmth. Outside, the wind and rain pounded against the windows. The two nurses we rode with split up; one in the small kitchen would be administering rapid HIV testing and the other stayed in the main room to administer immunizations to the infants who were due. They came to this clinic once a month for HIV testing and to provide maternity and child health care. The mothers carried yellow booklets that included the babies birthdays and a list of immunizations to be given. One 18 month old was due for a measles vaccine which was administered, another 6 month old was given the contents of a vitamin A capsule to drink. One infant was early for her vaccine and would have to return next month. Three women had HIV testing done in the kitchen; the nurse had called me in to help take blood pressures. Then she also did HIV testing for an 18 month old. The baby cried when she pricked his finger to collect blood, squirming on his mothers lap. I have never felt more anxiety waiting to read a rapid test. It was negative.

Less than an hour later, we packed up and headed back to campus. “You see the snow?” one of the nurses points out the window at white capped mountains in the distance. The rain had stopped and the clouds were subsiding, the far reaching warmth from the sunlight finally peaking its way through. “Yes.” I smiled.

Snow capped mountains of Lesotho in the distance. Snow capped mountains of Lesotho in the distance.

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