Post Global Health Year Thoughts

1. What motivations and experiences led you to apply and join the global health residency? I was interested in working global health environment long term, so I wanted to test it out and see if I'd enjoy it.  I had experience in working at a fairly poorly run clinic, so I wanted to see what it was like to work in a place that had a bit more resources and better well run. Maybe in the future even if I don't work in a global health setting, it would be helpful if I go into public health or education. 

2. What was your most meaningful experience during your year abroad and why?I really enjoyed seeing what healthcare could be like in a resources limited setting. It was good to see what components made up a well run clinic. It would be helpful in my future endeavors if I choose to work in a global health setting. I also really enjoyed having continuity with the patients at the COE where I was able to be comfortable with caring for HIV patients. 

3. What advice do you have for future GH residents and other pediatricians who want to do work abroad? What tips would you like to share that knowing would have benefited you at the start of your year?Some days get busy and tough, and it's easy to get down.  So it's important to get to know the staff and other coworkers at the clinic or hospital. People are more willing to work with you and help you if you do simple things like go through the greetings, keep a smile, ask them how their day is doing, including the nurses in your plan, etc. It's not possible to save every child, and you just have to focus on the kids that you were able to help. But also remember what your limitations are and continue to ask for help when you're not sure. 

4. How do you think your experiences abroad will improve your abilities as a clinician in Houston and in other resource-rich settings?Working in Lesotho required me to be much more independent in terms of problem solving and looking up information.  I couldn't just defer to an attending.  It helped me learn what my limits were.  I was more confident to make difficult decisions that required action as opposed to letting things go its course. The experience has also made me more eager to continue learning to increase my fund of knowledge.  I also had more experience with doing research - including coming up with a project, submitting an IRB proposal, gathering data, and data analysis.  

Cape Town - Good Hope, Boulder's Beach, Bo-Kaap, Botanical Garden

Cape of Good Hope

Not my best hairstyle at Cape of Good Hope because of the wind.

I am ashamed to say that I've actually never heard of Cape of Good Hope until I started looking up Cape Town.  History is not my forte.  But as I read more about it, the more I understood its significance in history.  It was not just a regular cape - it was a cape that really, truly gave sailors hope as they rounded the tip of Africa.  The weather and ocean just prior was unpredictable and dangerous, but as they came to Cape of Good Hope, they knew they have made it around and are on their way to their destination.

Dassie spying on the tourists

Unfortunately for AB and I, the day we went was extremely windy.  It was so windy that I felt like I had to be on all fours in order not to be knocked over by the gusts of wind.

Amazing look out point at Cape of Good Hope

Trying not to be pushed down by the gusts of wind

On the second trip, the weather was far more agreeable! I was able to hike from Cape of Good Hope to Cape Point lighthouse (one way 30 min to visitor center and then 5-10 min to the top lighthouse).

View of Cape Point and its two lighthouses

On the trail from Cape of Good Hope to Cape Point I encountered some ostriches - why did the ostrich cross the road?

Diaz Beach - so secluded and peaceful, and the water was really warm

Looking down at Cape of Good Hope and Diaz Beach

Short hike to the lower lighthouse

Cliff view at Cape Point

Hout Bay

Castle of Good Hope

The Castle of Good Hope is a 5 star shaped castle built in the 17th Century by the Dutch East India Company.  The purpose of the Dutch settlement was to replenish ships that passed the treacherous coast around the cape.  Today the castle is a museum and still houses the ceremonial facilities for traditional cape regiments.

During the Second Boer War, part of the castle was used as a prison.

The prison doors had writings on the outside of the door because they turned the door around - not sure what it all means.

The Torture Chamber was pretty spooky - not much in it except a dark room and some chains

Boulder's Beach
Home of 200+ colony of penguins, who supposedly started out as two penguins.  The second time around we were lucky to go at a time when baby penguins were hatching! They were so fluffy!


Bo-Kaap
Colorful town used to be called Malay Quarter.

Having some Cape Malay food - it was super sweet (I didn't particularly like it that much)

All the houses were so colorful - it was like something out of a Dr. Seuss book.

Botanical Gardens
One of the top Botanical Gardens in the world!

Canopy Walk

Really really huge aloe tree - didn't know aloes grew into trees!

Last tree of its kind! So sad! Apparently there is no female version of this tree, so it can't reproduce.

Victoria and Albert Waterfront


Robbin Island
Maximum security prison where Nelson Mandela was imprisoned for 27 years.

Query where Nelson Mandela worked.

It was surreal to listen to our tour guide talk about his experience in the prison.

The last one was Nelson Mandela's cell:

Cape Town - Shark Diving, Table Mountain, Franschhoek Wineries

I envy all those who get to live in Cape Town - such a picturesque, unique town! My time there with AB flew by in such a blur, I never got to record it, so I'll have to do a mesh up with my 2nd trip.

1) Shark Diving:
Not really what I expected, but still a lot of fun and excitement. I suppose knowing that I'm in a cage and there's pretty much no way for the shark to eat me is reassuring, but then you see the 3.5 ton Great White Shark circling the boat, and it all gets real, fast.


Shark Zone took us out via a boat 15 min to this beautiful area off the coast of Gansbaai (1.5hr from Cape Town). They used huge tuna heads as bait to draw the sharks in. We didn't even stop for 5 minutes before we spotted a shark circling our boat. The captain was trying to give us diving instructions but everyone was busy snapping pics of the shark.

Getting into the cage with the enormous wet suit (thank goodness for the wet suit or else I would've been frozen).

It was amazing watching the Great White Sharks go for the tuna heads at top speeds. The water would seem so serene, and then at a moment's notice, the shark would bare is enormous jaws and come flying out of the water. It was amazing just watching it from above, and then being in the cage, having the shark literally knock into the cage was a definite adrenaline surge!

We had 5 female sharks and 1 male shark circling us at the end. The males have claspers on the underside of the belly that differentiate themselves from the females. Apparently no one has ever seen Great White Sharks copulate - our guide encouraged us to take a video if we ever do see that because that's worth a million dollars.  The largest Great White today was 3.5 tons, but apparently they can get up to twice the size! The size of this bus:

I got a little sea sick towards the end when the boat was saying in the ocean, but it was totally worth it! Plus on the way back we got to go whale watching at Hermanas - although we didn't spot any whales b/c it wasn't the right season.

2) Table Mountain
First time up table mountain we went via cable car, but the 2nd time I got to hike up (usually 2hr up, but took me 1.25 hrs).  It wasn't too strenuous, and the view was beautiful! It required a couple of rest stops, and was mostly in the sun, so it could be a bit draining.

Quarter of the way up

 

Along the way we some protea flowers. They only exist in the cape region of South Africa, and belong to one of the most varied kingdom of plants:

 

 


We also hiked to the highest point on Table Mountain: Maclear's Beacon. The view was amazing! You can even see Cape of Good Hope.

Maclear Beacon

Cape of Good Hope in the far distance

The hike back from Maclear's Beacon was beautiful - right along the edge of Table Mountain.

Lion head on the left, Cape Town proper in the middle, Robbin Island in the distance (Nelson Mandela imprisoned there)

On the edge!

Closer to the visitor center, toward the south is a nice view of the Atlantic.

Looking towards the 12 Apostles and Cape Point.

Camps Bay

Toward the North is the view of Lion head (left), Cape town proper, Stadium (white oval), Robin Island (Nelson Mandela was imprisoned there)

 

Alan with a dassie

Going down the cable car

Tableview (North coast) where you can get a good view of Table Mountain.

View of Table Mountain from the plane

3) Franschhoek Wineries.
Cape Town is known for its enormous collection of wineries. Unfortunately, I'm not much of a wine drinker, but that doesn't mean I can't enjoy the beautiful scenery and eat delectable food!

The favorite food we had in Cape Town was at La Haute Cabriere in Franschhoek. It felt like we were eating in a cellar, and they were probably the best lamb chops I've ever had. Tender with a cripsy coat.

Grande Provence Winery

Huguenot Monument in Franschhoek is dedicated to the French cultural influences that Huguenots have brought after their immigration during the 17th and 18th centuries: