12 Hours on the Road

I wasn’t on the road for the whole 12+ hours but we were away from the farm for that long. On Tuesday, after taking care of some details around the farm, Peter and I headed for Mbabane. Peter had a long list of things to purchase and things to drop off so I tagged along. We dropped off some Moringa seedlings, picked up feed, lumber and even bought a gas range for Mary Jean and a freezer for Bomber (one of the workers at the farm who has done most all the big building here.) It started off a little cool and almost drizzling rain. As we headed out (it takes about 45 minutes to get to the paved road and then a little under an hour to the city) it started to drizzle a little more and didn’t quit for most of the time we were gone. I felt like I had moved Swaziland to Washington. Haha!

The only item on my list of things I wanted to get accomplished was visiting the Baylor Clinic. I have heard so many stories about the work they have done for kids on the farm I wanted to see it in person. One of the 7 doctors, Eric, goes to Mbabane Chapel so I have been able to meet him at church a couple Sundays. He is from Michigan and attended Duke medical school. He is a great guy. I was able to stop by after lunch and spend some time getting a tour and hearing a little more about the clinic. It is primarily focused on children that are HIV positive. They do some care and treatment for adults but only if they are caregivers for kids that are patients. The clinic sees about 100 kids on average per day. Most are quick visits checking on ARVs and general health. Most kids that are staying on their treatment plan only have to return every three months and their weight along with general health and the number of ARV pills they have taken is monitored. There are essentially only two treatment lines for ARVs here so if you mess up one you are down to only one other option. If you mess up the second option, you have basically lost the battle. Smaller kids and adults usually do well with treatment programs but teenagers often struggle because they want to be in control and don’t want to be different. I don’t think it is very different from the US and kids battling things such as diabetes.

The clinic was started by Baylor and there are multiple clinics around the continent focusing on pediatric AIDS treatment. They work under the Ministry of Health here in Swaziland and have a goal of being running by Swazis so the foreign doctors can leave. The model has worked well in other countries so it can be all national doctors and staff people within 5-10 years. The problem they have found in Swaziland is the lack of Swazi pediatric doctors. Students have to go to South Africa for medical school and rarely return to Swaziland to practice. Currently, the clinic is staffed by 5 doctors from the US and 2 from Spain. They continue to search for Swazis but there has been no luck. The good news is there is a large waiting list of doctors that would like to work in the Baylor clinics all around the world. The doctors here have become the regional experts on pediatric HIV treatment so they have become a strong resource since pediatric treatment can be more complex than for adults. I was able to join a lecture/discussion on TB treatment with Eric and 3 medical students from the US here on a rotation (one of whom I met at church on Sunday.) The students were very nice and accommodating as I invaded their afternoon. At least I had my EMT training so I could follow along with the lecture. It was interesting to hear since I have heard so much about the TB problem here. It is amazing to hear the cocktails that have been devised to treat both underlying HIV and a current problem of TB.

Part of my discussion at the clinic was how to use my EMT training and my friends that are paramedics. It isn’t really a skill that translates to a lot of usefulness here on the surface. One possibility we discussed was doing first aid and EMT training of community health volunteers in the rural communities. This would allow them to triage folks in the field in addition to the information they provide currently. The training could also open an opportunity to do HIV testing and explain the importance to those receiving the training. One of the big issues still here is the lack of knowing your status. They continue to follow the “if I don’t know, I can’t be sick” mentality and therefore die earlier than necessary because they haven’t pursued treatment.

After the clinic tour, Peter swung by and picked me up and we continued our many stops for the day. We didn’t get back on the highway for home until it was getting dark. We wondered about the dirt road getting home since we had a heavily truck and an equally heavy trailer behind us. The drive went without any issues until we turned down the short driveway to the farm. There is a section where Bomber and his crew had been working building a culvert under the road along with a couple small retaining walls. The ground on the road usually holds up well but it was covered with the clay type soil in that small section. We quickly began slipping off the road in the rain and had to call MT at home to get the tractor and come help get us out. After some pulling with a chain and wiping out the new block retaining wall, we were free of the slippery section and heading home. This meant we didn’t get back to the farm until after 9 pm which is pretty late around here.

Please be praying for all those in the house that I’m staying in. The original plan was for me to stay in a different place but it worked out at the last minute this house made the most sense. It turns out this is exactly where the Lord needed me to be. There have been some issues in the house that have come to light this week and I am thankful I am able to be a positive light in the midst of it all. I won’t go into any further details but it has made it an extra stressful week for Mary Jean & Peter and others involved. It is always refreshing to see the Lord use me and this week has shown the positive influence of being nice, fun and trustworthy can have on a group of kids. God is working but please continue to pray against the enemy and his schemes to disrupt God’s work!

Today I am listening to:
Quiet. I have reached a point in my trip where I am trying to sit quietly and listen for the voice of God. So often it comes in a whisper and it is drown out by “good” things.