Food for Thought...

Food for Thought...

Monday 3 February 2014

Doing, Being, Becoming

The need to express my thoughts and feelings in order to understand them aligns with the heart of what I learnt during my time at university. I was taught to reflect until it came out my ears and just when I thought I was no longer able to express myself anymore, I couldn't help but continue this seemingly mindless activity. I now have this ingrained desire to share my stories, capture real-life experiences and allow others to understand the world I see.

Now before I get carried away with myself, I need to explain the title of this post and underlying reason for this blog. ‘Doing, being, becoming’ are three core foundations of occupational therapy. As OTs, we focus on what and how people do the ordinary and extra-ordinary things in their lives; we assist them to learn to be who they are with whatever disability they may have and seek to become all that they hope and dream of. However, I believe in order to achieve these principles, God must be at the centre of it all. He is in my life and yours, whether you choose to believe it or not. This blog serves to assist me in understanding how God, OT and me (in that order!) can become a cohesive unit in order to carry out the Lord's divine purpose in my life through this amazing profession. This blog is a finite journey: one that takes place in my community service year in the heart of rural KwaZulu Natal, South Africa. I will spend the next year living and working at a little hospital called Manguzi, a stone's throw away from the Mozambique border and Kosi Bay. While the reason behind my writing is purely selfish (I write to understand and develop myself as a person), I would like to invite you to be a part of my journey. It is my hope that maybe my thoughts may challenge your own, or assist you to ponder (just as I do) the link between spirituality and professionalism. These are the simple reflections of a Y-generation South African young adult, entering the world of employment within the context of rural health. I invite you to be a part of my journey...

January has passed in a bit of a blurr of panic-stricken moments at the hospital, many late nights around our dining room table (good food and good wine make a formidable combination) and outrageous fitness classes in the lounge of the house I am sharing with 8 other (now) friends. Life in the bush is a huge adjustment!

My first day of employment at my rural hospital left me feeling rather incompetent and completely mentally and physically shattered. While my casual uniform (slops, shorts and a t-shirt) oozed contemplation and serenity, my head screamed otherwise as I walked into the therapy department on Monday morning. With my supervisor out at clinics for the day, the other OT com serve (community service officer) and I were left to man the Out Patients Department (OPD) and all the wards. We were given a day’s grace to see all our patients together in order to “find our feet” however we soon realised that the policy of “getting thrown in the deep end” is adhered to without hesitation in this place. The first two patients to enter the OPD happened to be 2 hands patients (my least knowledgeable area) – one with a healing radial-ulna fracture; the other with a congenital finger flexion contracture that had been surgically released and had gone horribly wrong. While my head continued to scream profanity at me, I attempted to remain calm as I nervously started making a splint of which I had no idea how to construct. With feelings of incompetence at an all time high, I successfully managed to make the worst splint I have ever seen and prayed furiously that it would be beneficial and not harm the patient even more. I finally found a spare moment for a lunch break at 14:30 and ran home in search of food and a potentially cooler room. With the temperature reaching the 30 degree mark early in the morning, the walk around the wards had left me covered in sweat and feeling rather faint – KZN humidity is no joke!

I entered my room for some spiritual solace and re-read the devotion I had read that morning – clearly God had something to say because one line kept running through my head the entire day...“Only as you walk will the waters of adversity be parted before you.” While the challenges of what I am expected to achieve are great, I realised that it is only if I gracefully tackled them head on that God would really reveal His power to me. The day grew a little more bearable after that and I was slowly able to take in the workings of the therapy department. While I know I face many challenges ahead of me in the coming year, I understand now that it is not worth hesitating; it is time to walk into the waters of adversity and realise that God has been there all along.

In reflecting on the past month, I can’t escape both the high highs and low lows amidst it all. It has been 31 days filled with a concoction of anxiety-provoking, yet inexplicably exciting moments. I have already met such a variety of people that it is difficult to know where to start and what to explain.

Let me unpack a general day at the hospital for you. (Taking into consideration that I am usually out at a clinic at least once a week seeing patients who live on the outskirts of our health district). I arrive at 07:30, sign in and connect with the other 20 odd staff in the therapy department (we have one of the largest rural therapy departments in the country). After a while, I settle into the few admin tasks for the day (usually involving a whole bunch of procrastination as I try to avoid writing reports, updating my stats, researching diagnoses, talking about patient programs with other therapists and preparing for important group therapy sessions. Soon after, the inevitable "hands patient" will be found on the therapy bench and I will somehow always be required to assess and treat their hand condition (ranging from De Quervains, to tendon repairs to the oh-so-common cellulitis). Most often, I sweat my way through the session, attempt to ask other people their opinions and try to provide as comprehensive a treatment plan as possible. After that I will see a flurry of OPD patients ranging from intellectual disability school assessments, to high risk babies returning for developmental follow ups to malingering disability grant seekers to cerebral palsy children with their overwhelmingly committed care-givers. If the department is quiet, I may have a chance to take my tea break at 10:30 but I most often work straight through it until lunch at 13:00. 

After lunch I head off to the paediatric ward to start my in-patient duties. I run a stimulation group for any children in the ward who are feeling up to it. These range from gross motor activities to fine motor tasks to school work to general play stimulation. The group allows children who have been in the ward for long periods to get outside, move around and continue to develop. Mom's (or gogo's, aunts, sisters and nannies depending on who happens to be there) are also invited to join the group and learn more about the importance of play in promoting development. If there is more than 1 malnourished baby in the ward, I will then run a developmental group with the babies and mothers in order to promote the importance of reaching milestones and assisting one's child to develop. Then I head off to the Multi-Drug Resistant (MDR) Tuberculosis (TB) ward where I am met with copious amounts of demotivated and depressed patients who have made the hospital their unwanted home while they receive their TB treatment. With the help of the com serve physio and OT assistants, we run exercise groups for both the male and female patients. I also see a few people individually in order to assist with their own personal challenges. I finally make my way back to the OT department at about 16:30 where I sign out feeling warn out but satisfied. The busy days are the best as I don't notice the hours fly by and really feel as if I'm contributing to the life of the community.

Although my heart has repeatedly fluttered with anxiety throughout January, I have realised that while my reality is scary, the burdens bared by the patients in the hospital are far greater than the emotional weights I carry. From a 12 year old with multi-drug resistant TB who has fallen so behind on his school work that I doubt he will ever catch up to his age group again; to a gogo who has experienced a stroke and has had no one come to visit her. There are the clusters of men in their mid-thirties who are so emaciated and riddled with AIDS that when they pull the sheet over their faces, it looks as if there is nobody in the bed. These are the burdens of others that I witness everyday. It makes standing up to my own fears a lot easier when I am reminded of how my Saviour is working in my life. Jesus, the ultimate burden-barer can do all things: in Him I place my trust.

However, while my clinical knowledge has increased a hundred fold since my arrival in January, I have come to realise that I am here for a much higher calling: the need to love. This love mission started when I realised that the time I spend with patients listening, talking and connecting with them, is so valuable to their recovery process. To share one's journey with another is one of the most uplifting and powerful experiences, particularly in a hospital environment. If I can just take time to love all those I encounter, I will have feel like I accomplished something far greater than general clinical skills at the end of the year. Human connection, unyielding love and genuine concern are by far the most powerful tools within the healing process.

While most of the time the reality of my own incompetence and others' daily sufferings weighs heavily on my shoulders, it has done little to dampen my enthusiasm to engage with patients. I have encountered old gogo’s with seemingly debilitating osteo-arthrisitis who still manage to plough their homestead’s farm lands, cook for 10 people and carry 25 litres of water on their head every day. I have met young teenage mothers who don’t know the first thing about child development but are so in love with their new born babies that I am inspired to give advice despite my disappointment at their outrageous ages. I have enjoyed spending time with active mothers of Cerebral Palsy (CP) children who know far more than I do about stimulating and assisting in their child’s development. I have met health professionals who don’t care and one’s that possibly may care too much. I have met people for whom working in a hospital is just a job and others who have made a career out of working in rural health. I have been built up, and broken down. I have been overwhelmingly de-motivated and completely inspired. I have realised that this year is going to be a challenge, but one that I know I am ready for. God has called and equipped me. I am to be the light in the darkness. And boy, I cannot wait to get started!

A verse I have held onto this month:
"But seek first the kingdom of God and his righteousness, and all these things will be added to you." (Matthew 6:33)

January's Magical Moments:

1. Learning about what the community experiences on a daily basis in order to provide comprehensive therapy

Learning to make peanut soup
Learning to plough
    Picking up 25 litres of water (and failing horribly!)

    2. Heading out to clinics in the 'bundu's'
    Packing the "magic school bus"

    A normal home stead on our drive to clinic

    3. Engaging with patients
    Working on developmental milestones in paeds ward

    4. Enjoying the chilled rural lifestyle
    Friday morning adventure & swim run to Kosi Bay Mouth

    Heading to a bush braai during spring tide

    Celebrating bush life at a local hang-out