Epilogue 1, As I begin to reflect on my time in Mseleni it is easy be rose tinted about it all, but the truth is that there are certain things I wont miss. And to be honest, there are three things that I’m amazed I managed to avoid during my stint there.
The first is a needle stick injury. In terms of practicing medicine anywhere in the world, this is always a risk. With hospitals in South Africa not being set up in the most safety conscious of manners it is not surprising that most of my colleagues had to be on courses of post exposure prophylaxis (PEP) at some point. I had anticipated that through my stay there would be at least one instance where I or someone loses concentration and a mistake is made.
The transmission rate of HIV through needle sticks does not have a lot of hard evidence and there is little real proof regarding the efficacy of PEP therapy, even so I was glad not to have contributed to the statistics. Forgetting the anguish of thinking the worst for 6 weeks, the debilitating gastric effects of the ARVS are substantial and thus I am fortunate not to have wasted any time being ill with the medications.
The second great avoidance was the cows on the road, but this was not for a lack of trying. In Zulu land cows roam freely, particularly on the roads. With no lights on the road and opposing cars flashing their brights, conditions are ripe for bovine collisions. Most of the MVAs (motor vehicle accidents) that come into the hospital have been cow related and the results vary from minor injuries to major trauma and even several deaths. When its cow versus car, I’d usually place a bet on the car to come off worse.
On a couple of occasions I came pretty close. Driving in the darkness it can be quite difficult to pick out the shape of a dark cow crossing the road. This becomes especially so after a long drive back from Durban or a late night in Sodwana. It has only been through the quick reflexes of my friends’ driving, some well maintained cars and simply dumb luck that has prevented me lying on the road like so many every day.
The third great escape is of course snakes. Locals find this a great source of amusement but I find it hard to call it an irrational fear when Mozambique Spitting Cobras, Boomslangs, and Black Mambas are common place. Though the tamer puffadders are the most common culprits, I’ve seen a multitude of patients writhing in agony from the bites and I’d rather not experience it firsthand.
The one afternoon coming down to my park home I found a slithering creature creep underneath the house. I could only really think one thing, this clearly gives credence to my ideas about keeping an army of mongoose pets. It didn’t really matter that it was probably a harmless (relatively) brown house snake, the incident was unsettling nonetheless. The important thing however, is that through a healthy combination of paranoia, diligence and a predilection for closed shoes I got away without a bite.
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