Ons planne

Ons vertrek oor 2 dae weg uit Manguzi. Ons sal vir 2 maande in Pretoria en Johannesburg wees en dan die uitvlug via Kairo na Engeland noord- ooste!

Ons sien nie uit na die interim periode nie, maar die eindpunt lyk heel rooskleurig. Ons het skool plek vir die kinders en blyplek vir ons lywe, so ons sal maar moet sien...al is die blyplek een met n dispuut dak oor sy kop.

Ons vertrek Vrydagoggend en dan gaan ons oornag by Cathy(in Pongola) en dan by Mariette en Theuns op die plaas(boereplaas). Tyd vir brug speel!

Ons sal vir ouma, Julie, Jaksie et al sien...

Ons beplan om te gaan kyk wat aangaan in Hoedspruit, in die suide van die Kruger Wildtuin en in Malalane(ek hou daarvan om die woord uit te spreek!) Dan hopelik n kort trippie Kaap toe om Lukas te sien.

Later... hierdie lyk hoogs onwaarskynlik want die finansies knyp.

Die seuns is baie mal oor Sannelies se hondjies: Roxy met die klein koppie en watsenaam met die rooi vel.

Vrugte /Fruit

Die vrugte seisoen kom aan die einde van die jaar. Eers die mangoes, (en hulle val op die aarde en maak die wereld vuil en taai - die wat nie deur die patiente opgeeet word nie word deur die verpleegsters of werks personeel bygekom) dan die erg wilde passion fruits, dan die maroelas...(snaaks genoeg niemand eet die maroelas nie ten spyte van hul heerlike smaak en potentiele effekte-'funny people') en dan die avos en guavas. Ek het heerlike vrugtesappe gemaak met die vrugte in die juice lady en ook so nou en dan suig ysies vir die kinders met 100% mango juice(en n bietjie ginger).
Die ortopediese aanslag is nogal dramaties na n mangoe seisoen want almal klouter en klim om mangoes te kry.
Ek het een laat middag omtrent 20 mangoes gesqueeze en in die juice lady gesit met ferm instruksies om nie die knoppie aan te sit nie(die seuns hou daarvan om die knoppie te druk en te sien hoe die sap gamaak word). Die deksel was af en ek het gou uit die kombuis uitgegaan. Klein Ralphie het ingekom en voor Ceri se oe die knoppie gedruk. Die hele kombuis vloer, tafel en muur was vol geel slym! En Ralphie se verstommende gesig was soos iets uit n paint ball eindstryd. Hy was regtig vol mangoe van kop tot tone!
Cecily het omtrent 5 piesang brode gemaak in haar tydjie hier by ons. Ons het dit Kers oggend, Geloftedag en as ek reg onthou oor Nuwe jaar ook geeet. Sy het nou regtig die resep vervolmaak en die bladsy se oortjies vuil gesmeer.

Durban

Ons het tot siens gese vir Kevin en Hilda. Hilds is links op die inlas foto. Sy het met n retailer prys weggehol vir haar initiatief met die nice winkeltjie vir vrouens (en hopelik vir mans) in Umhlanga Rocks-'the bedroom'. Dit was so goed om weer ou tye op te vang en weer bietjie tyd saam te spandeer. Hilds is n favourite met die seuns. Geniet die lang trippie om die stert van Afrika en laat weet ons wat jul aanvang.
Ons was gister in die wildtuin(later meer hieroor ) en ons het carmine bee-eaters gesien tot dit by ons ore uitloop.
Ons gaan bietjie op die rots le buite die Strydom tonnel saam met michael om die Taitai-valkie(spelling!) te sien.. sal dink aan jy en Kevin. Later...Ons het toe nie hierdie ekskursie meegemaak nie, maar die intensie was daar!
Kevin, you will be pleased to know that Ceri has finished the adult version of Financial IQ and she is now bringing it into the bedroom. Hopefully some of the info will spill onto me. She is now very busy and wants to open business after business. Very exciting.

Birds

Die jaar was nie net opwindend in die diere afdeling nie. Ons het geleer om voels te bekyk en dit is aangehelp deur ons Robertson's geillustreerde boekie oor SA voels en die ongelooflike hoeveelheid voels in ons tuin en in die nabye area. Ndumo is een van die amazingste plekke om voels in Suider Afrika te sien en ons is juis gereeld soontoe vir n bietjie 'twitching'. Ceri het n groter geillustreerde bird boek gekry vir haar verjaarsdag so daar was baie 'referencing'.

Ons het aasvoels gesien in die Pongola reservaat, Kingfishers op die St Lucia mere en reiers en arende langs die mere en op die strande. Daar was uile in die bome in die tuin met regte hoot-hoot geluide en bee eaters en suikerbekkies in die grys/wilde strelitsia net buitekant ons kamer venster.

Twee jong 'kanienies' het baba hoepoes by die huis aangebring en ons het n geelkeelkalkoentjie een keer in die grasvlakte gewaar.Dis n tong knoper-se dit vinnig: GEELKEELKALKOENTJIE.

Scabies, tick bite fever and malaria

The payment for the walk around the lakes was that both Louis and Ralph(who were in the back pack most of the time) developed tick bite fever (and Ceri yet again made the diagnosis). Louis needed some heavy antibiotics and Ralph cleared it after a 10 day up and down illness. Cecily (despite wearing only swim wear) managed to dodge the bugs but suffered scratches and 'possible scarring' due to very prickly grass tufts at the beginning of the walk.
We developed many different types of rashes and at some point Ceri dosed us all with anti scabies lotion(with no real evidence based improvement). It was probably some sort of tropical thing because we are now all ok and I believe Cecily's skin is also good.
During our stay in Africa we had a few malaria scares. We didn't take any profilaxis / anti-malarials so needed to be cautious and act on unexplained temperatures. Ralphie had 2 tests in the year(which was a highly sensitive finger prick test-done in casualty) and Ceri had one malaria test which turned out to be tick bite fever.
The public health agency sprays all houses and medical wards twice a year with some or other chemical(not DDT). We missed the 1st spray because there was no warning and they arrived at 06h00 one morning announcing their intention... dressed in atronaut type clothes looking like forensic specialists...very frightening!

If anyone knows how to remove an unwanted picture-please email me! The picture is of a braai with marshmallows -not suitable for a slide on diseases.

The walk around the lakes

We took Cecily and the boys on the walk around the lakes. We walked down towards lake 1 and then through the forest over towards the lake crossing. The grass is quite thorn- like so we suffered some scratches on the legs.The road was thick with hippo shit and the day was mild. We crossed between lake 1 and 2 and it was almost shoulder depth with the possibility of hippos, but none were spotted(we had to carry Ralph but Louis swam in his life jacket). We then walked through shallow, crystal clear water towards the path that leads over the forest- covered dunes to the sea. This is a very beutiful walk and is in a mangrove swamp with bright red coloured crabs and millions of stranded sea shells. We walked over the forested dune in a narrow path and saw hornbills with their very specific crying and flying method.
We finally reached the coast and had a dip in the sea. Ceri burnt her stomach(yes, very red) and we continued the round trip to the mouth. In order to finish the last leg of the walk we needed to cross through the mouth of the river(or turn around and walk back).
But the mouth was higher than ever. We crossed in the way the cabbage, the goat and the lion crossed...
I walked with Cecily , Louis and some of the equipment -we had to swim the last few metres in the strong current. Cecily waited on the other side with Louis and I went back to fetch Ralph. Ralph then also stayed with Cecily and I went back for Ceri and the rucksacks. It is quite tricky to swim with the rucksacks on your head in a strong tide. Ceri managed to keep her rucksack dry! This was quite a nerve racking experience.
the last leg was up the sand forest path back to the car. Cecily and Louis seemed to get more energy as the walk progressed and Ralph was weighing on Ceri and my shoulders.
We did well on this walk, but 2 soldiers developed complications 10 days later...

Swimming with sharks

We took Cecily to Rocktail beach camp for a couple of days. Cecily and Louis had their own room whilst me, Ceri and Ralph shared.
On our arrival the sea conditions were not great despite it being a very beautiful day. We all spent the whole day swimming in the pool and just relaxing. I had several mugs of coffee. That evening we went on a turtle walk but it was more of a 'turtle charge' because we were all literally running up and down the beach. We didn't see anything and crawled into bed quite tired. This was not such a good experience compared to our previous experience where we took our time, had a long walk and saw loads of turtles.

The sea conditions the next morning were good despite a light drizzle of rain... :
My first snorkel with Louis and Cecily in the sea was at Manzingwenya beach off the Rocktail -beachcamp boat. We saw loads of fish in a quite deep(8m) reef. The visibility was not great and Louis got quite cold, but he saw an amazing new world down below! Cecily took an underwater camera and hopefully there is a picture of the ragged tooth shark down below. It was such a nice experience with the four of us(Ceri, Riaan, Cecily and Louis) suspended in the water watching sharks and other fish darting down below.

The pictures are of me and Ceri snorkelling at the mouth(the sun is intense, hence the protective gear)

Maputo again

We took Cecily to Maputo just after Christmas. The Christmas rush of 'valies' to Ponta d'Aura caused quite significant delays at the border post. We drove to Maputo and again experienced some pretty large downpours. We stayed in Hotel Africa 2 and went back to Costa del Sol, the museum of stuffed animals and the fort in town.
Costa del Sol was slightly disappointing this time but it was nice to have fish and drinks and just to spend the time in Maputo.
Travelling back was again a bit of a task with heavy rains and a time limit to get to the border.

Christmas in Africa

We spent a quiet Christmas at home in Manguzi. I moved the wooden Xmas tree(pictured ) from outside to inside and we decorated it with shiny stuff. It is difficult to make a Xmas tree shine in the day in Kwa Zulu because of the immense sun- generated light compared to the cozyness/ darkness in Europe over the festive season. In Europe the lack of light allows for a bright Xmas tree.

The kids were awake before the crack of dawn and we were awake the night before until late watching a Cristian movie (I think called 'faith like potatoes'; which we really didn't enjoy but couldn't stop watching...)and wrapping presents. We were tired and I think I had a very sore ear(which went on for days unfortunately). This was due to excessive swimming and therefore an achievement in itself!
We had tea and Cristmas cake in the morning after the usual session of stockings and whats under the tree?

Ceri made the Christmas cake and Cecily made banana cake.

Eunace spent Christmas at home.

The unwrapping of presents was followed by a nice period where all the vegetables(brussels sprouts in UK) are peeled and there is plenty of activity in the kitchen. Ceri and Cecily were competing and twittering in the kitchen and the boys were playing with the new gifts.

Cecily arrives

Cecily arrived before Christmas. It was nice to share some of our experiences and favourite places with her. The weather was not great but we had some pretty standard, very hot days... There was lightning in the skies one night and plenty of rain on our trip to Maputo(torrential really because we were driving through what seemed like dams of water with the old red 4x4). Many other vehicles broke down because of the level of water.

As you can see, the boys were very pleased to see her.

Cecily and Ceri went to Mkhuze game reserve and spent time in a spa lodge near the town of Mkhuze.

We booked a couple of days at Rocktail beach camp. We spent a whole morning just lazing around the swimming pool, then lunch, then tea, then dinner, and then we joined the group from the beach camp for the fastest walk ever, looking for turtles...up and down the beach like a squadron!

Turtles come onto the beach to lay eggs at night and you may see 2 types: the loggerhead and leatherback. If you are lucky you can also see hatchlings (2 months after eggs are laid- we have seen a leatherback laying eggs, a few loggerhead turtles and loggerhead hatchlings -all in the same night! on a previous trip), but not if you are charging down the beach! Turtles are light and sound sensitive. Any noise will make them do a U -turn back into the sea. But, when they have started laying eggs, they will continue, even if disturbed, because they then just have to get on with it(quite human like).

We snorkelled over a lovely reef and again became fascinated by the underworld. We then plunged into the sea right above the ragged tooth sharks(you can see their shark bodies underneath you jerking and turning in a shark fashion...)

pre Xmas party at house 5

Prior to Christmas the morale at the hospital seemed to be low with all the doctors leaving; so no better way to up the moods than a party at the house! We had a sit down dinner in the garden. I made an eco-Xmas tree from wood and we lit it (not the tree, the lights on the tree) in the garden. Louis and Eunace made a star for the top(to replace the usual angel) and we( me and the 2 boys) had a 'turning on the Christmas lights' event just prior to the guests' arrival. We had some loud music(Ceri had a music-selection - shuffle -system with all her favourites but I now realize no Afrikaans songs!) I note that the blog photos' dates are all wrong and this is very annoying because Christmas parties are not in March!
We had a fire in the garden and Ceri's poached pears in red wine and cinnamon sauce was the taste that really announced Christmas.
Ceri should think about creating a Manguzi recipe book because she has created some true star dishes on a shoe string budget. I really liked the chicken liver pate, bruschetta, bierbrood met eier en kaas op, basil-tamatie sous en lemon drizzle cake.

Primary health care, HIV and TB

I worked in primary care for 9 months. This involved visiting the 10 clinics(each clinic is visited approximately twice weekly). One visit would be a general health clinic which consisted of mainly diabetes and a rather nasty strain of hypertension. It is the type of hard core blood pressure that does not respond to adjustment of lifestyle, anti-hypertensive treatment or education. It usually boils down to adherence or perhaps a cultural clash of treatment. These patients are often tiny, very well seeming, old and smily gogos(grannies) with big bottoms...

The other health visit would be a very busy HIV/ ARV(anti retroviral) clinic where we start patients on ARV treament, review the treatment by looking at side effects, address adherence and general well being. These clinics were often very stressful due to the sheer amount of patients attending(waiting on the stoep from the crack of dawn). They have a first come first serve type service and the majority of patients are really thin, hungry and ill. There is always a clash with infections in these patients where the HIV seems to dominate TB in one patient and the TB seems to dominate in the other, or just sometimes not at all clear which infection is causing the problems and which one is top dog.

HIV in South Africa:

South Africa has the highest caseload of HIV with an estimated 5.7 million affected individuals. Most of the infected patients are aged between 24 and 34 years. There are on average 600 - 1000 deaths per day due to HIV. One in three pregnant women is HIV positive.

3% of households are headed by children. Life expectancy for men is now 39 and for women 37 years.

TB and MDR(multi drug resistent) TB and now XDR(Extremely drug resistent) TB is a real threat and common amongst HIV sufferers.

Photographs: They include 2 nurses who manage a clinic daily and who refer patients to doctors . They work independently and have alot of responsibility, especially at night(they treat anyone that comes through the door). The 2 nurse practitioners are from Zama Zama(Zama2) clinic and there is a photo of the old oven or placenta burner(not in use anymore.) I regularly bought peanuts(straight from the field) from the counsellor at Zama2 clinic. They were organic and delicious. they make it into a paste and eat it as a sauce for pap(maize). I also fried them in beer, which is nice.

This little girl came to clinic with her mother wearing a rather amazing fairy dress. She was very shy but managed a smile when I showed her the picture on the camera.

The next picture is Mboza store which is next to the clinic(approximately 1 hour from hospital). I bought 2 chickens from the counsellor at Mboza clinic for 30 rands each. Chickens and goats do very well in this area and I think all the money to be made in this area would be with the goats and chicks. it is very difficult to run over a chicken or goat. Cows on the other hand are not streetwise. Donkeys are popular, but more expensive.

The next photo is a weighing scale for little children at Phelendaba clinic. They literally hang the child in a bag from the scale!

The next photograph is a cupboard of ARV's. It is amazing how much budget and time is spent on HIV and ARV's. It is almost as if other illnesses have disappeared in the face of the HIV epidemic.

At one of the clinics there is a large pink penis for condom demonstration.Very effective! Condom usage is very poor. I think they are not big enough...as simple as that(tried and tested). A good reason why they are not used perhaps.

Condoms are freely available at all clinics. They are discussed at each ARV visit but there is a culture here where the man wears the pants(and what is inside) and the women have little say. Most women are simply infected because their husbands don't agree with condoms... and the men are not at home. They work in distant areas because there is hardly any employment locally. They get infected and then bring the infection home. What is more, most men still follow the culture of many wives...this clearly is a ticking time bomb.