Andrew's intense first week at Red Cross Hospital

After a jam-packed two weeks of orientation, I started my internship in Red Cross Children Hospital’s Burn Unit on Monday.  I arrived at 7:30am and the resident gave me a brief introduction to the patients.  By 7:45am I was dressing up to scrub into surgery.  Shortly after we walked into the theatre (operating room), and our 8-year-old patient was on the table.  The patient was a survivor from a tin shack fire in one of the townships two weeks prior where his mother, male caregiver, and sibling all burned to death.  He suffered full thickness burns on 86% of his body, including all his limbs and his whole face.  This was the most graphic image I’ve ever seen.  I was put right to work making skin grafts with a special system (the Meek system by a Dutch company) that is designed to minimize the amount of the patient’s healthy skin that will be applied to full thickness burn areas.  Even with great care, the patient won’t have a great survival chance.  I had to get used to 95 degree temperature that we operated in because burn patients do not have skin, which is acts as a barrier to heat evaporation; it was so hot the first the day that I almost fainted.

On Tuesday I went to a township, Khayelitsha, with Dr. Rode and some of the medical interns to work at a clinic.  Afterwards, we drove through Khayelitsha and Dr. Rode explained how many people forget that even though Khayelitsha is stricken with such poverty and hardships, it is a community where these people live and work (not necessarily a home for the day laborers who work in downtown Cape Town)—it is not just a “wasteland” as many onlookers would believe.

Khayelitsha is also an opportunity for hope.  As we were driving, we came across a gorgeous hospital that was only built a year ago.  Since Dr. Rode knew some people there we went in for a tour of this absolutely beautiful facility.  This hospital in the middle of extreme poverty appeared to be equivalent to the beautiful hospitals in the U.S.  It had open courtyards for patients to walk around in.  The ER had about 40 beds with state of the art technology.  This gem gives me a little bit of hope that the government, even with its many (failed) efforts may be making some progress.  As the medical intern, George, believes, if these people start to feel good about the places they are treated in and feel like they have the proper dignity, they, especially children, will have impetus to break the cycle of poverty.

But after this glimpse of hope, we went back to Red Cross and saw a few more patients.  After seeing a burn patient in the ER, I overheard a case of a little girl (probably about five years old) who had a leg fracture.  The doctor (probably rightly) thought that mother had smashed her daughter’s femur due to the location of the fracture and the mother’s uncorrelated explanation of the injury.  I’ve never heard a doctor interrogate someone like a police officer before—he was viciously telling the mother to prove to him that she didn’t hurt her child.  Shocked by this, on our way home I asked George, “is this normal for doctors to talk to patients this way?”  George, the idealist and least likely person I’d ever expect to say this said, “that’s what you have to do because abuse is so common.  I don’t think I can ever chose a specialty like this.”  My hope from the brand-new Khayaletisha Hospital started to fade but I’m sure it will be revived.