It seems that the more we go along in our life in Botswana, the more polarized things become. For every positive, a negative seems to crop up. To better explain this hopelessly vague introduction, I've divided the experience into "yins" and "yangs" in historical order. It also adds a pseudo-sophisticated angle to what can only otherwise be described as "good stuff" and "bad stuff."
Yin 1:
Our jobs here are fantastic. It's many of the great things about medicine without as much of the pain and paperwork. Matt spends 1-2 days/week attending at the main tertiary care referral hospital in Gaborone. The other 3-4 days/week are spent on community outreach, during which time he travels to district hospitals to teach, learn, and see patients with medical officers. The PEPFAR mandate that he works under is concerned with building local capacity to take care of complicated patients with HIV, TB, HIV/TB coinfection, and other chronic diseases. So most of the time, he rounds and sees patients with medical officers in both inpatient and outpatient settings. The work is exceedingly gratifying - as one colleague Dr. MH likes to say, "it's nice to be in a place where the goal is to work yourself out of a job."
Premal spends most days seeing adult HIV patients at the Botswana-Baylor Center of Excellence (COE for short). It's a sweet gig - she takes care of the primary care needs of adult HIV patients while simultaneously learning about how to manage complicated HIV cases.
Yang 1:
So this actually is a good thing. We just put it in this section because our friends Amy YANG and Shivani came to visit us a few weeks ago. Good times, game drives, and lots of great food - it was great to see them and reminded us about how much we miss our good friends back home!
Yin 2:
Our accomodations are great - we have a three bedroom, 2.5 bath place with a small backyard and a garage (with no car in it - see yang 3). A few of the other Baylor folks live in this complex, making for a nice community. We're also a short hop to one of the main shopping centers, replete with bars, restaurants, and supermarkets.
Yang 2:
There have been 4 burglaries in the past two months here (not including us...yet). Apparently the 24 hour security was sometimes dozing off at night after disabling the electric fences because "they went off too much." Guess we're all targets since we're foreigners, but I just wish someone could translate our collective amount of debt into local currency so they could understand that we don't exactly budget for another laptop computer!
Yin 3:
We bought a great car about a month ago. 1997 blue Honda CR-V with all-wheel drive for those muddy game drives, low mileage, and only a mild hint of the cigarette stench that pervades most Japanese imports here. It drove great (note past tense and see yang 3).
Yang 3:
We went to Johannesburg a few weeks ago to see one of Matt's jazz idols, Abdullah Ibrahim, in concert. He and Matt had been in touch over email and had recommended we come down to "meet." So down we drove on a Friday afternoon, only to find out that he actually had wanted us to join him at a concert. Well, Premal developed a nasty migraine and Matt barely made the end of the first half of the concert (maaaany hijinks trying to find the venue, let me tell you). The following day, we were enjoying ourselves in a nice Jo'burg suburb, commenting to each other that "Jo'burg really gets a bad rap" and that "it really isn't so bad after all - why do people freak out so much about coming here?"
That evening we went to eat supper around 8pm in a very busy, well-populated and lit area. At 8:45 we returned to the car only to find an empty parking space. Apparently going to Jo'burg without eight levels of security on your vehicle and with Botswana registration is "a bad idea." Stolen in front of a bar with a bunch of people eating and drinking outside - what balls! These guys are real pros. Mafioso types - not poor 'youts from the townships. And what a trip it was to drive down and fly back. Jo'burg: 1, Matt and Premal: 0.
Yin 4:
Matt has started to play with a local jazz guru called Socca Moruakgomo. He's a trumpet maestro who also sings his own tunes. Great horn parts, fantastic band, and amazing Afro-jazz energy. He's played three gigs with Socca's group now with many more to come. He's also been able to meet some of the other local musicians and is really starting to get known in the scene (for better or for worse!). It's really a musical renaissance, playing music in a style to which he has always felt a deep connection. (Don't worry - photos to be posted on picasa soon if you haven't seen them on Matt's FB page!).
Yang 4 (unrelated):
Of course after our car was stolen we had to start looking for another one. After looking at 10 to the 6th sub-standard 1997 Honda CR-Vs, we started to think about changing our expectations. Maybe since we do so much driving we should get one with airbags and safety features, right? So we started looking at vehicles with airbags. Shit if we weren't test driving an SUV on Wednesday and got into a SUPER nasty car accident.
We were behind a large 18-wheeler and couldn't see oncoming traffic. Premal was driving. We slowed to see if anyone was coming. She signalled to turn onto a dirt road. No sooner had she begun to turn the wheel to see around the truck when a guy doing about 90 Km/hr blindsided us on the passenger (left) front side. Airbags deployed in P's face. Apparently his crew was fleeing after having stolen a guy's laptop, who was giving chase behind them. He ended up getting his laptop back, but then served as our ambulance so we could get a bruised, confused, and bleeding Premal to the hospital ASAP. In the end, it was an excessively frightening experience that left Premal with a concussion,a pair of nice shiners, and a night in the hospital for obs, but no major intracranial problems or fractures.
On the yin side of that story, everyone here has been nothing but amazing during this weird and awkward post-accident time. We are thankful for our friends and colleagues - we could ask for no better people to be around in a time of weakness and need. Everyone supports each other when it hits the fan - for that we are forever thankful.
So for now, the yins have it 5-3 (I counted Amy and Shivani's visit as a yin!). Stay tuned and we'll try to stay away from cliches for the next posting. Emails and facebookmails are of course welcome.
Matt and Premal
Friday, October 30, 2009
Sunday, October 4, 2009
We're baaaaack!
Wow. Last blog entry September 27th, 2008. How young we were then...
Honestly, though. Has it really been this long?
The great thing about having a blog is that you can assume that everyone who reads it is uber-fascinated with your life. To that end, I guess we've left most people in the dark as to what we've been up to this past month. It shouldn’t surprise you. I mean, living in Africa is totally crazy. We get up each morning early so that we can hunt food for the day. Our jobs take place in thatch huts with no electricity and no running water. We have to hitchhike with child soldiers driving ATVs through 80 kms of bush to get to the one electric outlet that happens to have a computer (an Apple IIE no less) with dial-up internet access. We are really “out there.”
Or are we?
If you believe the above then please keep reading.
We live in Botswana, which at last count was about the size of the state of Texas (let me just tell you how the Batswana looooove hearing that, by the way). There are about 1.9 million nationals in the country, and anywhere from 40,000 to 100,000 Zimbabweans (depending on who you read) living here, most of whom are undocumented. 3% of the population is white and another 1% is South Asian. There are about 5 of 6 thousand Chinese. The GDP per capita is almost $15,000, which puts it in the neighborhood of Mexico, Venezuela, Grenada, and Bulgaria.
Thank you Wikipedia and CIA Factbook.
The point is this: Botswana is a fascinating place. People are generally friendly. It is safe – there are no guns on the streets (even police don’t carry guns). The government is democratic, responsive, and non-corrupt. There was a non-violent transition from British colonialism in 1966, since which time there have been 3 peaceful transitions of power. The government provides health care to nationals, including comprehensive HIV care.
People in the burgeoning middle class here in the capital drive BMWs and Mercedes to work while chatting on iPhones, but go back to their respective villages during any national holiday. For the population of 1.9 million, there are 1.42 million mobile phones. English is an official language, but you get much farther with a little bit of Setswana. It is a country that has benefited from its natural resources and invested heavily in health and education. 80% of the population is literate, and 8.7% of GDP is spent on education (10th in the world). Most people are Christian, and prayer through song is a part of morning rounds in most all hospitals.
The modernity that Botswana enjoys is countered by real health problems. Ours is a sick country. The HIV prevalence is anywhere from 12-60% in some areas (second highest per capita in the world). The rural-urban gap of health resources is widening, despite a well-designed decentralized health care system. Most doctors are not Batswana – the brain drain problem is a real one here. Until this year, if you were from Botswana and wanted to go to medical school, you had to get sponsored to go study in South Africa, Ireland, Australia, or Russia. Not surprisingly, many students end up training and then staying in those countries. But it’s an interesting time now - the health institutions of the country are expecting great things from its first medical school, which just opened its doors in August (but have yet to build an actual building to house the classes).
So that’s our context.
To catch you up on what we’ve been doing since our arrival, we’ll do it in stream-of-consciousness top-10 list form:
1) We finished the draft of the book we were working on
2) Our place is nice, quiet, and safe. We have potable tap water, hot water 24/7, and high-speed internet – it’s a hard-knock life.
3) We got a car – blue 1996 Honda CR-V (every doc in Premal’s group has one so why should we be any different, right?)
4) Matt turned 30
5) We bought a grill because BBQ is tasty and it’s a man’s right.
6) Cuban rum is num nums
7) Our colleagues are becoming good friends – they are fantastic people
8) Setswana is a hard language to learn, but we’re doing our best
9) Work is proving to be both challenging and gratifying – we are working on strengthening partnerships with local health institutions to build health care capacity in HIV, TB, and primary care
10) In minutes you can be out of town and on a game reserve where giraffes, rhinos, monkeys, cheetahs, and zebras roam
Disclaimers:
1) This will not be a play-by-play of our lives. As this experience demonstrates, Premal and I can hardly be relied upon to actually keep everyone current. We want to include the good stuff and exclude the mundane.
2) We feel privileged to be here at this stage of our careers, working with passionate and interested people.
3) Facts and opinions disclosed in this blog do not represent our employers, our country, or our respective tribes. For that matter, they may not even be facts or opinions - just a bunch of bullshit.
For the next entry, we promise fewer factoids and more thoughts/insights about our lives and work. We hope that this site becomes a place for our friends, family, and colleagues to take part in our experiences (for better or for worse!).
Oh yeah, and come visit!
Honestly, though. Has it really been this long?
The great thing about having a blog is that you can assume that everyone who reads it is uber-fascinated with your life. To that end, I guess we've left most people in the dark as to what we've been up to this past month. It shouldn’t surprise you. I mean, living in Africa is totally crazy. We get up each morning early so that we can hunt food for the day. Our jobs take place in thatch huts with no electricity and no running water. We have to hitchhike with child soldiers driving ATVs through 80 kms of bush to get to the one electric outlet that happens to have a computer (an Apple IIE no less) with dial-up internet access. We are really “out there.”
Or are we?
If you believe the above then please keep reading.
We live in Botswana, which at last count was about the size of the state of Texas (let me just tell you how the Batswana looooove hearing that, by the way). There are about 1.9 million nationals in the country, and anywhere from 40,000 to 100,000 Zimbabweans (depending on who you read) living here, most of whom are undocumented. 3% of the population is white and another 1% is South Asian. There are about 5 of 6 thousand Chinese. The GDP per capita is almost $15,000, which puts it in the neighborhood of Mexico, Venezuela, Grenada, and Bulgaria.
Thank you Wikipedia and CIA Factbook.
The point is this: Botswana is a fascinating place. People are generally friendly. It is safe – there are no guns on the streets (even police don’t carry guns). The government is democratic, responsive, and non-corrupt. There was a non-violent transition from British colonialism in 1966, since which time there have been 3 peaceful transitions of power. The government provides health care to nationals, including comprehensive HIV care.
People in the burgeoning middle class here in the capital drive BMWs and Mercedes to work while chatting on iPhones, but go back to their respective villages during any national holiday. For the population of 1.9 million, there are 1.42 million mobile phones. English is an official language, but you get much farther with a little bit of Setswana. It is a country that has benefited from its natural resources and invested heavily in health and education. 80% of the population is literate, and 8.7% of GDP is spent on education (10th in the world). Most people are Christian, and prayer through song is a part of morning rounds in most all hospitals.
The modernity that Botswana enjoys is countered by real health problems. Ours is a sick country. The HIV prevalence is anywhere from 12-60% in some areas (second highest per capita in the world). The rural-urban gap of health resources is widening, despite a well-designed decentralized health care system. Most doctors are not Batswana – the brain drain problem is a real one here. Until this year, if you were from Botswana and wanted to go to medical school, you had to get sponsored to go study in South Africa, Ireland, Australia, or Russia. Not surprisingly, many students end up training and then staying in those countries. But it’s an interesting time now - the health institutions of the country are expecting great things from its first medical school, which just opened its doors in August (but have yet to build an actual building to house the classes).
So that’s our context.
To catch you up on what we’ve been doing since our arrival, we’ll do it in stream-of-consciousness top-10 list form:
1) We finished the draft of the book we were working on
2) Our place is nice, quiet, and safe. We have potable tap water, hot water 24/7, and high-speed internet – it’s a hard-knock life.
3) We got a car – blue 1996 Honda CR-V (every doc in Premal’s group has one so why should we be any different, right?)
4) Matt turned 30
5) We bought a grill because BBQ is tasty and it’s a man’s right.
6) Cuban rum is num nums
7) Our colleagues are becoming good friends – they are fantastic people
8) Setswana is a hard language to learn, but we’re doing our best
9) Work is proving to be both challenging and gratifying – we are working on strengthening partnerships with local health institutions to build health care capacity in HIV, TB, and primary care
10) In minutes you can be out of town and on a game reserve where giraffes, rhinos, monkeys, cheetahs, and zebras roam
Disclaimers:
1) This will not be a play-by-play of our lives. As this experience demonstrates, Premal and I can hardly be relied upon to actually keep everyone current. We want to include the good stuff and exclude the mundane.
2) We feel privileged to be here at this stage of our careers, working with passionate and interested people.
3) Facts and opinions disclosed in this blog do not represent our employers, our country, or our respective tribes. For that matter, they may not even be facts or opinions - just a bunch of bullshit.
For the next entry, we promise fewer factoids and more thoughts/insights about our lives and work. We hope that this site becomes a place for our friends, family, and colleagues to take part in our experiences (for better or for worse!).
Oh yeah, and come visit!
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