A whole month

Well, it's been a bit too long since my last update. I've been getting a few prods and nudges from a number of circles (apologies to everyone I haven't e-mailed...), so I figure it's time to get typing... Hyunjoo and Ella joined me about 3 weeks ago. They'd been in Korea with her family, which was mostly good... Ella got to meet her brand new cousin Min-so, and Hyunjoo got to eat some home-cooking. I picked them up in Johannesburg, which was a long story in itself. I borrowed a van from the clinic, which ended up having major engine problems as night approached in Johannesburg, a city that is a little safer than Baghdad at night... Actually we were in a pretty nice suburb at the time, and the car managed (barely) to limp back to our B&B. The clinic director ended up renting a trailer in Lesotho, and drove it up to Jo'burg as we babysat the van for another night. The trailer suffered a flat tire on the way, and it was replaced with a spare that had a tennis-ball sized bulge sticking out of it... We bought new tires in Joburg and drove slowly back to Maseru without incident. We've also had a few more pleasant drives since then. Two weeks ago, we drove to Katse Dam, part of a scheme to dam water in Lesotho to provide hydroelectric power and water to South Africa. It's pretty impressive from an engineering standpoint, but it seems that the promised benefits to Lesotho haven't really trickled down, as is typical--at least not to the people who aren't well-connected. On the way back, we stopped at Bokong Nature Reserve, and hiked out to one of Lesotho's many waterfalls. We enjoyed a nice lunch with a view. Ella liked the views as well, but in the end, I think she preferred the gift shop. The road was pretty, climbing over passes higher than 10,000 feet. At one point part of the mountain had slid down over the road, so we had to follow the bulldozers through a makeshift detour. At another, we weren't able to avoid a rock, so we bent a rim and flattened a tire on the rental car, sending the hubcap flying off in the dark... It cost about $8 to repair the tire and rim, and we fortunately spotted the hubcap on the side of the road the next day on our drive back, so it din't turn out that bad. Being a pastoral country, Lesotho's rural roads are also occasionally blocked by animals. We gave them the space they needed, and in return, the shepherds were more than willing to pose for us. The guy on the left was a little too cool to wear his Basotho blanket for the picture. I somethow don't think he's a full-time shepherd like his friend on the right. I also drove with a couple of doctors out to Mokhotlong, the highest "town" in Lesotho, which has been described as the most remote town in Africa accessible by paved road. That may be an exaggeration, but it definitely has a Wild-west feel to it, with plenty of places to tie up a horse outside the stores. I'd desperately like to begin doing outreach and treating HIV-positive kids in Mokhotlong on a regular basis. But, it seems their hospital is still maybe one step too far away from being ready for significant scale-up, and transportation is quite rough. We'll see... Since Hyunjoo and Ella arrived, we've been staying at a little "cottage" on the clinic site which is sort of temporary housing for people who rotate through the clinic. It's been comfortable, but it's a bit isolated. Hyunjoo's felt like a prisoner at times since everything is gated, and we don't have easy transportation options. But, we've looked at a house today that we'll probably endup renting, and we're looking at cars as well... I never thought I'd buy a car in Africa, but having our own car will be so much safer and more reliable than the little combis (private mini-van busses full of people) that I think we're going to bite the bullet. Other highlights: Bloemfontein, South Africa. Imagine the red-neckiest small town you can, then increase it to 350,000 population, throw in a couple shopping malls and have all the white people speak bastardized Dutch. Finally add a hilltop park with some giraffes and big grazing beasties. That's, Bloemfontein. But, it's the best place to buy things within a 4 hour drive... Clinic. We're seeing quite a few patients, with a total caseload of over 600 now, and about 1/4-1/3 of those on anti-HIV medication. Most of the care is pretty routine--lots of pneumonias and ringworm, lots of TB, lots of malnutrition. It's always hard to tease out what's from HIV and what's something else altogether, especially since diagnostic testing is limited. We're treating a ton of kids for tuberculosis since it's so common in adults here and we see lots of kids with weight loss, fevers, and something abnormal on their chest x-rays. Who knows how many of them actually have TB, but it's too important to miss, so we treat them. We've also had some interesting cases--a likely cutaneous anthrax case in a baby who was wrapped in a sheepskin blanket. Today there was a 5 month old with large amounts of bleeding from his rectum... Good times. Well, I think that's it for now. I'll try to put together some more nice background stuff on Lesotho for the near future. Khotso (peace)