Kalen's perspective.....

This place is unbelievable. We are 1 block from some of the most beautiful beachfront I have ever seen. Its so amazing. There are literally mansions in my neighborhood. There is a Bently parked across the street from our place and there is also a Lamborghini dealership about 1 mile away.

In contrast, every morning we drive about 40 minutes East, to a city called Manenberg. It is a giant township of 1 million people. Townships are areas of "black" and "colored" people that are basically the poorest people in the entire world. They live in these self-constructed shacks made of metal scraps from the landfills. They are about 10X10 and sleep 5-10 people and are pretty much built on top of one another. There are also government built dorms in the townships and unfortunately the gangs take over the dorms and use them to traffick meth and other drugs. The hospital sits in gang territory and sees some of the most horrific violent crimes. These gangs won't simply rob someone, they will beat you to death for fun, or light you on fire, etc. We are instructed to never leave the hospital after sunset.

The emergency room is  chaos. It's basically this large open pit. Patients admit themselves, most of which are walk-ins, or by ambulance. There are no rooms, the beds are just out in the open and patients just scream or moan all day, you sometimes can't hear yourself think. Literally, everybody has TB and MDR-TB and HIV. I have only seen 1-2 patients who are not infected. Most of what we have seen so far are AIDS complications (that are really horrible), TB complications (i see one person per day whose lung has 100% turned to pus and goo) and violence. Everybody here would be considered homeless by US standards. Some of these poor people haven't showered in weeks, and that is the norm. The ER smells something awful. The doctors here only have the bare necessities. We don't even have gauze pads. There are only 4 mechanical ventilators, so if they are being used and a 5th patient comes in with respiratory compromise, they are simply left to die. Resources are limited and the diseases are ridiculously severe.

It has only been 3 full shifts and my first patient was a guy who walked in with a stab wound in his leg. As I was stitching him, he told me that he likes to smoke heroin and meth simultaneously and then he immediately asked me to hurry because he left his young child at home. Yesterday a 25 year old guy walked in with 3 stab wounds. He made it to the desk and passed out onto the ground bleeding everywhere. I got his IV started and gave him fluids. He finally woke up and Rusty and I stitched his wounds closed. He then told me that he got into a fight with his girlfriend and she stabbed him three times. The last patient I saw yesterday was a 76 year old woman who was left in the care of her son, who neglected her so poorly that 90% of backside was a bedsore/pressure sore that, when I looked closely past the festering wound and the smell of rotten flesh, was bone deep. Only God knows how long she was left lying in that position.

There are officially 20 beds and a holding area with 6 beds and a bench where patient just pile up. Once the beds are filled people just start sitting/laying anywhere and we haven't even worked a busy weekend yet (we are going to work a graveyard this Friday/Sat)!

Then, we leave the hospital, drive home and live in the lap of luxury. It is very very very difficult to wrap my mind around. We have been doing some sight seeing and touristy stuff. I am finally comfortable driving on the left side of the car (shifting with my left hand) and driving on the left side of the road. Even parallel parked last night! We have gone out twice...the nightlife is non-stop. The clubs don't close until sunrise.