ARVs, long walks, and cheetahs

I don't even know where to begin! Thursday was my 2nd day at the clinic and was ARV day also. On thursday every week, patients come in to consult the doctor, look at blood work results and refill ARV medications for HIV. Rachel (another student) and I were able to spend the morning working with the doctor while he saw patients. Each patient would come into the room, then we would look at their lab results, figure out if they needed blood work at the next 3 month check up, fill out some paper work, then the doc would write prescriptions. It might sound a little boring, but once I figured out the appropriate ranges for viral load and blood cell counts, it was really interesting to see how different courses of medication effected different people. It was also great to see how well some people were doing. For those of you that don't know, ARVs are free to any Botswana citizens. With their ARV program, they have incorporated many prevention education campaigns and counseling sessions. When each patient starts their treatment, they sit through a counseling session to learn about protection, medication, adherence, etc...I sat in on part of one of the sessions, but unfortunately people speak mainly in Setswana so I only caught what was going on every few sentences. The country also has a great PMTCT (prevention of mother to child transmission) program. Mothers are counseled about how to have a child and not infect him/her and are also given free milk formula so they don't have to breast feed.

Although there have been great strides against HIV/AIDS, there are still many issues as well. We saw a few sad stories of people not adhering to treatment, or mothers who had just tested HIV+. We also came across a girl with a viral load 10X greater than it should have been and their was also confusion with her medication regiment. Although the clinics have really adjusted to treating people who need it, the way doctors rotate creates problems in terms of who wrote what prescription and why. The physicians rotate so they do not always see the same patients, so when they come to a chart like the girls above, they wonder why the previous doctor switched medicine so early in the treatment.

After I got home, I noticed the puppies weren't looking so good. The night before my sister said that they might have eaten rat poison. So luckily my dad was on Skype so I could have a 1-800-dial a vet. THANKS DAD! After lots of searching we couldn't find the medicine we needed so we had an emergency run to the vet. They're looking better now but we're still crossing our fingers!

Friday morning started out early with a visit to the landfill. sounds fun right? Surprisingly it wasn't too smelly and kinda interesting. For my environmental health class, we've been discussing waste and the issues in Botswana. With such a rapid growing population and increasing consumption, Gaborone is having trouble keeping up with the demand. The landfill was opened in 2009 30km away and is very well run, but still has a lot of progress to make in terms of recycling and keeping up with the flow of garbage. There was also an issue for a while because there has been a strike going on for many governmental workers so trash trucks weren't running. The day we got here they thought the strike was over, but then negotiations failed. After many weeks of strikes we think they have finally resolved the issue this week, Although many workers on strike were fired, they are encouraged to re-apply for their jobs. But no worries, it was a very peaceful few weeks of strikes in Gaborone, mainly just a bunch of people gathering in one place, people in Botswana are very peaceful (don't want to worry anyone!)

After the landfill I visited the Baylor's COE clinic with Zoe. It's an amazing pediatric HIV clinic which has gone to great lengths helping HIV+ children. They treat people very holistically making sure they are not only sticking to their meds but also doing their homework and getting involved in sports/activities. They have a great teen club that in a few years has gone from 4 to over 600 teens by just word of mouth and doctor referrals. It is a very positive atmosphere enriched with education. Adolescents born with HIV are taught how to live positively instead of thinking that the disease is a death sentence. The teen club has also started 7 satellite sites all over Botswana!

Zoe and I then took off for Fresh Cafe again then headed to Main Mall. We wanted to explore a little bit so we took the round about way to get to the mall and walked passed a bunch of embassies and my favorite...a telephone pole disguised as a tree. Eventually we reached the mall and walked around, lots of local vendors and great music. We ran into a few of our classmates and grabbed a few beers, then headed home at dark. gets so dark here so early which is really unfortunate.

Today I was up and out the door at 6:30. Zoe, Sierra, Alyson and I headed to Mokolodi Nature Reserve for a great day, starting with giraffe tracking at 8. We drove around with our guides for a little over an hour and saw some kudos, impalas, and warthogs, then we headed out on foot into the bush when we saw some fresh giraffe tracks. Being in the Bush with only the 4 of us and a guide was a great feeling. So peaceful. We followed fresh tracks and droppings around for a while until we sighted one. So tall, so pretty! We stalked a group of giraffes for about 45 mins or so, getting closer until they'd walk away then we'd follow them. There were probably about 7 or 8 of them including a few babies (calfs?). There was also the dominant male who was really dark in color who we saw a lot (cant wait to show you pictures!). Apparently the darker they are the older they are. No wonder the ones in zoos are so light.

After we found our way back to the jeep, we rode down to see the cheetahs. In the early 90s, 2 cheetahs were orphanged when their mother was shot, so the reserve took them in and bottle fed them. Releasing them into the wild didn't work because they hadn't learned any of the necessary life skills to hunt/kill prey. We were lucky enough to get to go in and pet them...yes i said pet them. I was the first one of us the pet one of them and instantly he began purring. We spent the next 30 minutes in awe, petting and walking around with the brothers.

After cheetah visiting, we headed to a picnic site, what I thought would be a basket of cold sandwhiches and soda.But instead We pulled up to a gorgeous site on a lake with tables covered in table clothes, a plate of chicken, fish, fresh fruit, and tea. We sat and talked to our guides learning about the reserve and the animals, best lunch ever. When we got back to the main gate, we had a few hours to kill until the rest of our group got there for a night drive. We sat down for a few drinks at the restaurant, met the main chef and restaurant director, and had a great time. They told us that the night before a rhino had come right up to the restaurant and was just grazing. The rest of our group showed up, we went on a dusk/night drive, ate an amazing dinner at that same site, this time in awe of all the stars in the sky.

Great day and i know plenty more to come.

sorry for all the spelling mistakes but its time for bed. Go siame!