Where have I been? Where I am going?

Last Sunset over Camps Bay

I realize it has been WAY too long since I have updated this blog, so probably no one is reading it anymore ;)  The "why" is multi-factorial.  For one, there is facebook which makes it easy to just post a quick update and some photos and not feel like I have to write a whole story, but I realize not everyone is on FB.  Secondly, I have been having a rough couple of months from a work prospective and I like to keep the blog relatively positive so haven't felt like there is so much to write.  Lastly, I have decided to move back to the United States (for now ;) and planning that transition has been consuming a lot of time.

One of my last trainings at the "African Cave Lodge" in NW province South Africa, it is really cave like. 

We taught the nurses and lay counsellors to calculate the adherence of patients taking ARV medications

We also taught them a color coding system useful for patients who cannot read and write to make drawing up medications easier

After spending the last year doing mentoring and training of local nurses, doctors, and lay counsellors on pediatric HIV, I have realized how much I miss clinical work.  I do enjoy teaching and training, but I need more of a balance.  I miss having patients.  I also feel that while "capacity building" should be the gold standard of global health work, building true capacity is quite hard when many of the barriers are secondary to mismanagement of resources, lack of infrastructure, and shortage of health care workers.  It is also really hard to show that all this training and mentoring is making a difference.  Ask me about this next year and I may be able to give you a different perspective ;)  Regardless I have decided to return to St. Christopher's Hospital for Children in Philadelphia (where I did my residency) and work as a general pediatrician.  That patient population served by St. Chris is quite diverse and I am excited to serve those patients again and to be able to put my Spanish (which is now quite rusty) to good use.

Before going back to the US, I decided to take advantage of the fact that I was already in Africa.  For the next month, I will be traveling around and attempting to see more of this incredibly diverse continent.  I started in Ethiopia.  After a day in Addis Ababa, I traveled to Lalibela which is known for its rock hewn churches.  In the 12th and 13th century King Lalibela wanted to create a "new Jerusalem" in Ethiopia and apparently instructed workers on the construction of 11 churches.  The churches were carved from the rock with hammer and chisel - an incredible feat.  In the Ethiopian orthodox tradition, coming to Lalibela is just as holy as going to Jerusalem and during holy days thousands flock to the town to pray. All of the churches are incredibly crafted especially when you consider the tools that they would have had at their disposal.  Of course pictures are worth a thousand words so here are 50 or so of them....



Tomorrow I head to Axum for 2 days and then Saturday on to Gondar where I get to see Gelane for a few days (unfortunately my work permit ended and I had to leave South Africa during her already planned trip to the US) but we still get 5 days to see each other. Then I will fly to Tanzania where I hopefully get to see Tecla (my anatomy lab partner from first year of medical school!) and then Zanzibar for a weekend.  Finally I am joining a Nomad Adventure tour which will be an overland trip from Dar to Victoria Falls - 11 days of camping across Tanzania, Malawi, Zambia, and Zimbabwe.  Finally on 28 July I will fly back to the US and begin my transition back into life "that side."