Ok guys, I have been here for almost a month now…enough time for things to really “settle in”…I am getting a clear picture of what life is really like in this part of the world. First and foremost, I am absolutely loving loving loving my experience here. I’m already sad that I am going to be leaving in seven weeks and am starting to feel that maybe I will come back…maybe I will come back on a longer basis, with a more leadership type role, or something like that…this place has a strangely addicting characteristic to it…I can’t explain it…but my heart, body, mind and soul are in sync in more of a way than I have felt in a long time anywhere else…and this is such an amazing feeling.

That being said, I know that most of my blog up until now has focused on the fun “touristy” aspects of my trip so far…I am incredibly blessed to be able to take opportunities to go to the mountains and to the coast, etc…anyway, this week has been a really difficult week for me…I am struggling with many complicated feelings, my self awareness has really been put to the test while I am here, in a very foreign place with very foreign people. Instead of beating around the bush, let me explain, as best as I can. In no way am I trying to take on a “holier than thou” attitude or place myself above anyone. I’m not trying to portray pity, I am just trying to externalize some of the thought processes that I have dealt with lately.

Two days ago, for the first time, on of my patients actually expressed pain and frustration with his situation (people are so stoic here and don’t easily show pain, perhaps that is a sign of weakness) . He is a 30-year-old man who was in a freak car accident last August. His fate is an incomplete cervical spinal injury, leaving his body painfully spastic and paralyzed…all he wants to be able to do is be able to walk again, instead he has been on his back in a hospital bed for the last 5 months. I can’t tell you how much I love this man, he has a beautiful soul and has taught me many Xhosa words and jokes, but when I do his therapy, it is heart breaking to see the pain in his eyes and imagine what his life is like. This guy is not much older than me, but he can’t live my life because of the circumstances he was given.

Another patient is HIV positive and is having a poor reaction to his anti-retroviral medications, leaving him paralyzed and also incredibly spastic. He said that the “witch doctors” at home told him that he is the way he is because he didn’t follow some secret code or crossed some boundary and therefore, is not able to walk. This man also has a beautiful soul and an indestructible spirit. He will do whatever I ask of him, no matter how much pain it puts him in. However, the CD4 counts don’t lie, he has a very very tough road ahead of him…and there is really nothing I can do about it. The other day he told me that he would really like to be able to have a radio…just simple music to listen to….I almost ran home to get my iPod to give to him…I still might do that. Another 15-year-old boy was stabbed in the head and now presents as a stroke victim, he can’t walk…but I try to help him…maybe someday he will walk…he has the spirit and conviction to do so. When I was 15 I was worried about which cute boys to ask to the school dance or how well I was going to do on my history test…I was running everywhere and sure as heck wasn’t depending on a make shift brace out of plywood and cheesecloth to stand and force my body to accept weight in a paralyzed limb.

Traveling to the ortho wards, you see people of all ages, even young children, as young as 2 years old, lying in skin traction for weeks and weeks at a time because the surgical schedule is so backed up and the doctors have no choice but to tell people to wait because there just isn’t enough time or resources, and so they wait, and wait, and live with he bed sores and the sepsis, their fractures begin to callous and heal the wrong way, because there is no other way to do it. The outpatient surgical clinic has to turn away traumas that would get first priority in the US because there is somebody many times worse off that needs immediate attention. Every time I go to the waiting room, I discover new and horrible things that these patients deal with, deformed limbs, broken backs, etc…toughening the spirit and perhaps dampening the soul. I can’t read their minds, but I can’t help but personalize what their life for them must be like.

The staff is doing the best they can, but on the other hand I can’t help but notice a feeling of apathy or lack of accountability among many of the full-time local staff. One of the doctors rounds with the spinal ward every thursday morning and it has taken weeks for the nurses to get correct blood counts, etc…it seems like the patients don’t have enough advocates to help their situation…they just stay here, day in and day out. And these patients graciously accept their situations, this is just the “way it is”…I’m not even sure if they totally understand what is really going on. If and when they do go home, how are they going to survive on their own? My roommate (there are about 10 americans here now) has said that “Africa is hard enough, even when you are not paralyzed.” This is a beautiful land with dichotomous hardship and struggle.

I wish that some of the staff and patients that I dealt with at home could come here and get a good healthy whopping of perspective change. Instead of whining that the patient in room 213 has rang his call bell every 20 minutes for the last hour, instead, maybe we should be thankful that patient has the capability and audacity to ask for help. Instead of crying because your knee hurts or you have back pain, perhaps being thankful that you can walk and have adequate medical care is a song sang to a better tune. I wish that my friends and family members who like to sit around and discuss how to solve the worlds problems, could actually find ways to put their great ideas to work.

Today I was lucky enough to spend time at Itipini, a clinic developed by Jenny McConnachie, a nurse from Scotland who has graciously devoted her life to bettering the lives of the poorest of the poor in Mthatha, South Africa. These people live in corrugated tin houses situated on shards of broken glass and heaps of garbage. They depend on the clinic for clean water, bread, TB meds, HIV tests, pregnancy tests, etc…and there is also a pre school on site. The children are your instant best friends, especially if you have a camera, and they are gorgeous. The have it tough but they are rich in love…so heartbreaking and incredibly inspiring at the same time. I have learned more from the brief interaction I have had with these people than I could ever, ever possibly hope to teach them in a lifetime.

Never have I felt so helpless or so motivated to try to help. Never have I felt so privileged, so rich, so embarrassingly well off. I have been brought to tears, brought to my knees, driven to frustration and left with so many questions. All I can think about is my expensive bike at home, the expensive car that I bought, the money I spend on food, beer, friends, etc…not only that, but I have the privilege of choice. I can choose where to work, where to go to school, what to eat, I can chose to go for a run, can chose to go to a movie, because my life circumstances have provided me the means and opportunity to do so. I never asked to be a middle class american with a supportive family, a fully functioning body, good health, intelligence and a strong education…but I have it. Richard told me not to reject my blessings and use what I have to help others…That was some of the best advice I have heard. It is so hard to walk the “fine line” between living on a soap box or falling into the trap of the “rich white kids syndrome” where I think I can save the world and instead devoting my time towards getting my hands dirty and perhaps making a connection with another human soul in this place, to affect their lives in a positive way, if only for a day or an hour…perhaps these people aren’t asking to be “saved” and I certainly know that they don’t want to be pitied or looked at as some sort of “charity” and it is not my place to judge them or to cast a downward eye upon them…that is not what I am here to do…I have so many conflicted emotions and difficult thought processes. I struggle with the fact that in the end, I can just hop on a plane and go back to my “extravagant” lifestyle….while there are people here fighting just to find a reason to make it through another day. I just don’t know how to explain it. It hurts my heart.

We fight all the time
You and I… that’s alright
We’re the same soul
I don’t need… I don’t need to hear you say
That if we weren’t so alike
You’d like me a whole lot more

Listen to me now
I need to let you know
You don’t have to go it alone

And it’s you when I look in the mirror
And it’s you when I don’t pick up the phone
Sometimes you can’t make it on your own
-U2