This week I visited a XDR and MDR TB hospital. I spent the morning in a women’s smear positive ward and had the opportunity to speak with the nurses about their work and speak to the patients. Patients live at the facility for a year or until they have 2 negative sputum smears at least one month apart.
I have a new admiration for the perseverance of drug resistant TB patients. It takes an incredible amount of physical and mental strength to complete the ~ 2 years of therapies when the treatments are so brutal on the body and the end is not in sight. The side effects of drug resistant TB treatment include severe hearing loss, severe loss of eyesight, hallucinations, pain, and nausea. Patients may be taking up to 15 medicines at a time, multiple times a day, with injections 3-5 times a week. Beyond the difficulties of treatment and hospitalization, many patients have problems at home that compound while they are at the hospital. Many patients have families who are dependent on them, marriages that become strained and jobs that are lost.
I did not realize how difficult it is to ensure patients are continuing treatments when they go home, and incomplete treatments can lead to drug resistant strains and community exposure. Many of the patients are infected with tuberculosis for the first time, which is scary because it means they were exposed to drug resistant TB somewhere in their community. I could talk forever about what I learned at the clinic, but in summary, spending the day at the hospital made me realize drug resistant tuberculosis is something I want to study further.
Later in the week I followed a home-based care hospice worker around on her patient visits. I have so much admiration for the nurse’s work. We went around to different patients, and she spoke with them about their medicines, how they are doing, brought them food, educated the neighbors about their disease so they wouldn’t be afraid to help for fear of contracting the illness and more. She also has a patient facility that more able patients attend twice a week receive treatment, have follow up appointments, garden, relax, and address any issues they are having. At the same time, it was hard to see some of the patients, their living conditions, and health. I was unprepared for the first visit, I have never seen someone so sick and it was very tragic. The man was in the final stages of AIDS, in his early thirties and weighed no more than 40 lbs. The only person taking care of him is his 10 year old niece, who is no longer attending school.
Sometimes everything here seems very familiar. I am very comfortable in Cato now and I feel right at home. I’ll go to a friend’s soccer game on the weekend, share music with my brother, go to classes, play with kids, eat dinner with the fam, study in the evening. But every once in awhile, something will happen to snap me back to the reality that I am far, far, far from Corvallis and Tacoma.
For example, a cow was slaughtered across the street last weekend. I was doing homework outside when my little sisi ran up shrieking “hanny hanny inkomo! Inkomo!!” (while drawing her finger across her neck and sucking in her breath). I didn’t really know what was going on, except that inkomo means cow. I thought maybe my sisi was hungry or something. I followed her down the hill to a throng of about thirty excited children to see a cow tied to the tree, held still by 8 men. I turned to wave at my Mama and next thing I hear is a horrendous sound from the cow and a man spearing it in the back of the neck, to sever the spinal chord.
Cows don’t get slaughtered everyday in Cato, this event was for the unveiling of the tombstones of my neighbor’s daughter and husband. After the slaughter, the men skinned the cow, taking out the insides for the women to wash and cook. The immediate family members of the late father and daughter cut pieces of the skin from the cow legs and tied them as bracelets on their wrists, which is a part of the mourning process. The skin dries on your arm and stays until it falls off after about 5 months. After the slaughter, the men had a small barbeque with a small portion of the meat. I had a small piece and it was amazing, probably the freshest meat I will ever taste. I feel honored to have been given a piece. Afterward my Mama explained to me about Zulu traditional practices and the proceedings around slaughtering a cow, like brewing Zulu beer starting 3-4 days before the slaughter. The event was very exciting and a highlight of my week.