Izak gesels II

Voertaal het gevra dat ek iets skryf oor die Comrades en my kaal pote. Jy kan dit hier lees.

Ek is baie trots op die werk wat die Durbanville Kinderhuis doen. Daarom het ek Sondag 45 km sonder skoene gehardloop – ek vra dat enige een wat kan R45,00 sal skenk aan die Durbanville Kinderhuis.

Klik hier vir donasies – ek soek nie die geld nie, gee dit asseblief direk aan hulle.

To our English-speaking friends, Elma has hit the Afrikaans media recently because of the work she and a dedicated team of caring people are doing.

So we translated the interview which had appeared first, on LitNet. Should you be able to follow Afrikaans, do also look up the interview with Elma in Rapport; and the myth-busting interviews I have done with Awie Badenhorst and my sis, Marianne Lomberg.

COVID-19: The clinical manager of a 200-bed field hospital tells her story

Original article in Afrikaans at https://www.litnet.co.za/covid-19-die-kliniese-bestuurder-van-n-200-bed-veldhospitaal-vertel/

Elma de Vries is the clinical manager of a 200-bed field hospital that was opened at short notice to treat COVID-19 patients.

You are involved in a field hospital that can serve 200 patients who have tested positive for COVID-19 and are in need of care. It was established within two weeks. Why was it necessary to suddenly open such a facility?

The second wave of COVID-19 has resulted in an increase in the number of people needing hospital care, with hospitals bursting at the seams. The large numbers of COVID-19 patients in emergency units in hospitals contribute to patients waiting longer for a bed in a ward. The leadership in the Western Cape Health Department realised that it was necessary to make more beds available to accommodate the large numbers of patients who need hospital admission and oxygen.

Many people get Covid and then have to stay at home for a few days. Why then do you need so many hospital beds?

This is a strange virus. With ordinary flu, only 1–2% of people will need hospital admission, so 98% can recover at home. With COVID-19 it is different, with about 14% becoming seriously ill and up to 5% becoming critically ill, possibly requiring intensive care.

The Western Cape government also operates the Brackengate Hospital of Hope as a field hospital – which has been open since the first wave. How does the care that you and other field hospitals can provide differ from the type of care that can be provided in intensive care units, such as at Groote Schuur or Tygerberg or in the private hospitals?

Most patients who become very ill with COVID-19 can be treated with oxygen in a regular medical ward. Only a small percentage need intensive care. Intensive care requires many human resources, especially nursing staff trained in intensive care. The nurse-to-patient ratio in intensive care is very different from in a regular ward or a field hospital. With COVID-19 pneumonia, ventilation is not always effective, and high-flow oxygen is often the best treatment. Field hospitals can administer high-flow nasal oxygen treatment, but not ventilation. The advantage of high-flow nasal oxygen is that patients are awake and can eat by themselves while receiving oxygen, while someone on a ventilator is totally dependent on nursing care.

Let’s look at the term field hospital. It is usually a military term for a hospital that can be set up anywhere at short notice. In peacetime, the term refers to a temporary, specialised hospital that provides assistance for a short period of time. Is this correct?

Indeed.

The private hospitals are also full, not so?

Correct. Both public and private hospitals are under pressure at the moment with large numbers of COVID-19 patients and other emergencies that are not COVID-19 related.

You are a specialist in family medicine. How does your job in a hospital differ from that of someone who specialises in lungs (a pulmonologist) or someone who specialises in, for example, internal medicine who then runs an intensive care unit?

General practitioners, or family medicine specialists, are trained to treat anyone, no matter how young or old they are, or which organs are affected. Nowadays, palliative care is also part of our training (care for people with life-threatening illnesses). This includes care at the end of people’s lives. Specialists are trained in a specific field; so a pulmonologist, for example, focuses on lung diseases. The COVID-19 patients we treat in the hospital often have multimorbidity, in other words several health problems. An example is someone who is on treatment for HIV, diabetes, heart failure and depression. And now COVID-19 pneumonia as well. A pulmonologist or intensivist will be able to treat the pneumonia with great skill, but may enlist the help of other specialists, for example an infectious disease specialist for HIV or a psychiatrist for depression, while a GP follows a holistic approach and attends to all the aspects, including communication with the patient’s family. I have a great appreciation for my specialist colleagues and find that we are cooperating even better in the pandemic than before.

You and Brackengate use the logo of the Hospital of Hope that ran during the first wave in the Cape Town International Convention Centre (CTICC). The CTICC was a symbolic space to prove the state’s commitment, but am I correct that your team is modifying existing infrastructure so that it can finally, in a post-Covid world, be used again by the state’s hospital services?

Yes, we are also now called a Hospital of Hope. It is much more effective in the long run to utilise existing infrastructure, and it is part of the Western Cape Government’s legacy to COVID-19. The wards of Aquarius Intermediate Care at Lentegeur could quickly be set up as a field hospital. The infrastructure adjustments were mainly oxygen points, a large oxygen tank as well as spaces for the staff to put on and take off protective clothing (known as donning and doffing). When the second wave is over, the infrastructure will still be there for continued use by the Department of Health. The management of Aquarius Intermediate Care has played a major role in making it possible to have a field hospital ready within nine working days.

Doctors Without Borders, or Médecins Sans Frontières (MSF), often set up field hospitals. I think of their work in war zones, also more recently with the Ebola outbreak here in Africa. Is MSF involved with Covid?

We are very grateful for the help of MSF. With the first COVID-19 wave, MSF operated a field hospital in Khayelitsha. When, in December, the Khayelitsha MSF team heard that we were going to open a new field hospital, they made staff with COVID-19 experience available to help. Their technical support as well as the human resources made a big difference.

You used to be the first chairperson of MSF in South Africa, but that’s a long time ago?

MSF established a South African chapter in 2007. I was invited to get involved because I used to be part of RuDASA (Rural Doctors of Southern Africa) who are activists for better health care in rural areas. To my great surprise, I was elected chairperson, and was later succeeded by Hermann Reuter, who became known as the doctor who proved in Lusikisiki that people in rural areas can use antiretroviral drugs responsibly. Those were the days of a battle against a virus other than this one. MSF gets involved where the need is the greatest; one of my MSF colleagues at the field hospital was described as a “tornado chaser”.

You were on holiday in KwaZulu-Natal when you heard that you had been appointed as the clinical manager of the new field hospital. After that, things happened rather fast, in part because you received a lot of support from the provincial government. How did you get people, trolleys, oxygen, drip stands, needles, nappies, food … and much more together in days?

It was a big team effort. The team from Klipfontein Mitchells Plain substructure that had to start the field hospital was amazed at the support from all sides. A hospital is a complex system with many components. The management of Aquarius Intermediate Care has helped a lot with the logistics and human resource management, and their existing kitchen staff provide the food for patients. The province’s infrastructure team, medical technology department and laboratory services all contributed their share, and this over the festive season! Mitchells Plain Hospital’s pharmacy helped get the necessary medication ready. The emergency medical services have registered the field hospital as an ambulance destination on the system, and provided the inter-facility transport for patients. The management of Brackengate Hospital of Hope also helped us a lot, with both advice and supplies. The Klipfontein Mitchells Plain substructure has dedicated people who really went the extra mile over the Christmas weekend and New Year weekend, to make sure everything is ready to admit our first patients on January 1st. These are people with passion who serve the community unselfishly. The leadership of the Health Department has supported us in the process and is always available to listen and help when there are challenges.

You need scales, for example. Why? There are so many things I would never have dreamt of.

About 40% of hospital patients with COVID-19 have diabetes that is usually not well controlled. When calculating insulin dosages it helps to know how much the patient weighs. Fortunately, we were able to make use of Aquarius Intermediate Care’s existing equipment, such as beds, drip stands, monitors and indeed a scale.

How many staff members are involved in a 200-bed hospital?

It’s hard to say exactly – we’re still hiring staff so we can operate the full 200 beds. In addition to nurses, doctors, physiotherapists, social workers and dieticians, we also need clerks, cleaners, warehouse staff, kitchen staff and porters. A hospital is a complex system, and each category of staff fulfils an essential function.

Doctors, and you are one, suffer from catastrophilia. I get the idea that many of the younger doctors in your team realise that they will never get an opportunity like this again and therefore approach the incredibly long hours with a degree of satisfaction. Am I right?

Yes, some people thrive when there is a catastrophe. It makes us feel needed, that we can make a difference. Some young doctors feel that this is an opportunity to be part of a historic moment. It is desperately hard work, but as a colleague recently said after an exhausting Christmas weekend: “I have a job.” We have the privilege of getting job satisfaction – more than 80% of our COVID-19 patients get better and go home, back to their families. The smile of a patient who is better gives us strength to keep going.

However, I hear that the younger doctors are suffering do to the high mortality rate. Why?

The interns are struggling. We older doctors have filled out many death certificates over the years, but for the younger doctors this is all rather new. The death rate at present is much higher than the average before the pandemic. Senior doctors do provide support to the younger doctors, helping them to accept that death is part of the picture, that we cannot always heal, but that we can always support. To me, this is the wonderful thing about a palliative-care approach, that we as health workers can make a difference to people’s last days and hours, to strive “to cure sometimes, to relieve often, to comfort always”.

John Nicholson lived in Lavender Hill, a rather poor suburb on the Cape Flats.

He lost his job at a furniture factory when the owners disappeared without paying their staff, so he took on freelance upholstery jobs.

John was a devout Christian and the need of the kids in his area bugged him. Alchohol abuse is rampant in their area; other forms of abuse too.

John and his wife Gail provided a safe space for kids in need. They began feeding the kids as well.

The project became a regular soup kitchen.

But, said John, what is the use of a full stomach when the head remains empty? So, in order to fill the minds, he began collecting books and started a library in his backyard.

In 2016 he was given an award by the ATKV for his work.

John passed away yesterday. It was a privilege to have known him.

Do read ths lovely article by Mandilakhe Tshwete in The Daily Voice.

***

Vir ‘n baie deegliker bespreking oor John in Afrikaans, ook ‘n video waarin hy praat, klik hier vir die huldeblyk wat ek op LitNet geskryf het.

Ek het vandag ’n fassinerende onderhoud met Solet Scheeres op Voertaal gelaai. In Nederland is die lees van storieboeke vir die lekker net so belangrik as Wiskunde, sê sy. In Suid-Afrika, daarenteen, is ons so behep met eksamens dat ons vergeet van lees. Eish.

Ons huidige skoolstelsel moet dringend plekmaak vir ’n uitkomsgebaseerde stelsel. In Australië werk dit, in Nederland werk dit. In Duitsland is daar voorbeelde wat werk. Hoekom wil ons nie wegkom van die onderwysstelsel en kurrikulum wat nog uitgedink is toe ek op skool was nie?

Moenie bloot vir my glo nie. Kyk bietjie wat sê Christien Neser oor lees. Sy beweer die regte boek kan letterlik iemand se lewe red.

Maar ek het ook pret gehad. Johannes Meyer het ’n fantastiese onderhoud met Fanie Viljoen gedoen oor Laaste lewe. Dit wys jou: Johannes is ’n leser en hy gebruik vaardighede wat nie uit die skool uitkom nie. Dié knaap bou nou al vir hom ’n reputasie.

***

If you are able to read Afrikaans, do yourself a favour and see how the Dutch school system favours reading just for the fun of it.

And have a look at the fabulous new Afrikaans graphic novel by Fanie Viljoen, as well as the interview by a thirteen-year old journalist.

Should you not be able to read Afrikaans graphic novels, do purchase the two stunning full-colour graphic novels by Luke Molver. At the beginning of the year, just before Covid struck, I gave a lecture to the history teachers in the IEB system, explained just how wonderful these two books will augment their grade 9 teaching.

Let’s make reading fun again!

***

Koop die papierboek.

Koop die e-boek.

Buy here.

Buy here.

So, this morning I joined more than 35 000 people in running a virtual Comrades. I have run eleven real Comrades Marathons; seven up, four down. I run barefoot for the 144 kids in the Durbanville Children’s Home.

(Afrikaans friends, there are a few personal notes in Afrikaans below.)

Part of this morning’s the fun was being able to run in my green number. It was official. But why run a short, virtual race?

The Comrades started as a remembrance run for fallen war comrades. It has since grown into the world’s biggest ultra-distance race. It is not the toughest by any means, but it is tough and due its size it has come become known as “The Ultimate Human Race”.

The real Comrades is tough.

The real Comrades also shows one so much about camaraderie, or comradeship. That is why I chose not to do a long run today. I chose to run 10km, and I have asked many others to join me in running 5 km.

I know I can run 90 km without shoes, my green number is proof. I so wish to have more people be aware of the spirit of Comrades. This morning was an act of Camaraderie rather than Courage.

Getting up

I got up at 05:40.

This is unusual. Race day normally means getting up between 00:30 and 01:30 – yes, just after midnight – depending on whether it is an up or down run.

For a real race one has to check everything: Time chip, bus ticket (to the start or back from the finish), race numbers, everything has to be checked with precision, then rechecked.

Getting to the start

I jumped into my little car and drove to the parking lot across the road from the Durbanville Children’s Home.

Normally it is quite a trek to get to the start. I have been fortunate to have a chauffeur (my mom) over the last few years. She lives close to Pietermaritzburg and knows the backroads well.

For a down run one has to get relatively close to the Pietermaritzburg City Hall (meaning about a kilometre.)

For an up run, one has to get to the bus in Pietermaritzburg that will transport you to the start.

The start

I asked permission to start and end my run at the Durbanville Children’s Home.

Normally, at a real start, one waits in holding pens according to your seeding. And waits. The wait before the start is cold on a down run.

My first run in the green number was cool, but it was only when I was allowed into that special holding pen for green-number athletes that the enormity of it all hit me: I was surrounded by legends.

I guess I will never be a Comrades legend, but that is why I supported and encouraged so many to run this virtual race with the legends. “Race the Comrades legends” was the idea behind the race.

And so, with a selfie I was off. All alone.

Normally there are 20 000 runners and thousands of spectators, TV crews and drones. The helicopters take off at first light.

We normally fill both carriage ways of the street. This morning I had the start to myself.

No cock crowing.

No national anthem.

No Shosholoza.

No cannon blast.

The few minutes before a real Comrades starts make for an amazing experience. If you are physically capable, do it at least once.

I am off

With a small tap on my Strava App, I got going.

Normally it takes about 5 minutes after the gun to get to the start line.

This morning I was able to run circles around the Durbanville Children’s’ Home. Nobody was in my way, nobody, but the satellites tracking my cellphone, there to be a witness.

The run

I circled the Children’s Home once and set off into the surrounding suburbs. The home owners in this area often support the Children’s Home. Many of the kids in the Home attend schools for which the upkeep is paid for by those living in this suburb.

Many decades ago the relationship was more problematic. Durbanville was where the up-and-coming Afrikaners took root, and the Home was an eyesore to some. That wonderful chef and restaurateur, Michael Olivier, once told me that he was at school with the kids from the Home and they were known as “kaalvoetkinders” (barefoot kids).

Guess why I now run barefoot?

The real Comrades is between 87 km and 90 km, depending on whether it is up or down.

On the down run you exit Pietermaritzburg via the notorious Polly Shorts. At Polly Shorts we normally get some first light.

Then we run through Camperdown and start climbing towards the highest point of the race – close to the “Lion Park” – they do have lions there!

From there we run a long way with a bunch of uphills to towards Drummond, which is halfway.

My halfway this morning was close to Durbanville’s race course (horses). I chose some off-roading for fun.

I checked in on the Children’s Home again and took a picture of the local Dutch Reformed Church. The Home is massively supported by the NG Kerk community.

Another loop took me to heart of Durbanville where this beautiful set of art works has been placed.

In 1938 the centenary of the Groot Trek (Big Trek) was celebrated at this spot. The original Trek happened when a group of rebels moved away from British rule and tried to take the lands occupied by the local African peoples.

Fighting was inevitable. Many black Africans were killed, many settlers died too.

In 1938 the nationalist movement was firmly in place and fuelled by Hitler’s rise in Germany, the Groot Trek was celebrated as an exclusively white and Afrikaans thing – something it never was.

Here at this spot the Centerary Trek held an important stopover with all the Nationalist rhetoric.

This lovely group of sculptures, in the form of clay oxen – seemingly made by a black boy, but representing the rainbow of a modern-day South Africa, is wonderful. It embraces the spirit of the Trek, but not in an exclusive, acerbic way, much rather it celebrates South Africa.

I stopped and took these pictures three quarters into my race this morning.

Normally, at three quarters, I would be approaching Pinetown and my entire body would be sore. The pain associated with Comrades is hard to describe. By 60 km everything, absolutely everything, in the body is sore.

At this stage of the real Comrades stopping for a picture is dangerous as one may not be able to start running again. Exhaustion and confusion sometimes make people do odd things around this time. The spectators are amazing, though. Fellow runners too.

As the sun started rising over the last quarter of my race, I saw a few more fellow virtual-Comrades runners.

TK here was doing the 45 km. This would have been his third Comrades.

As I closed in the Durbanville Children’s Home again, I realised that I’d need to plan my last kilometre carefully to make my 10 km end at their gate.

I carefully chose a route around the local convenience and suddenly was hungry.

At 10 km I ran up to the gate.

Job done.

Virtual race run. Not quite the same as the real thing, but in the spirit I loved it.

Should you ever get the change, you should experience the end of a real Comrades. It is overwhelming. No matter how sore and tired you are – those last few hundred metres on the grass is an experience I am not capable of describing.

With one last selfie I walked to the car.

The Home needs old cellphones and tablets, as the kids are also doing virtual classes during Covid. Anyone able to help, please write to [email protected].

Post race

I had breakfast and helped my darling in the garden. Normally, especially after a down run, it is nearly impossible to walk for 24 hours.

Post mortem

I salute the Comrades Marathon Association for this initiative. I’d suggest that it should happen very year on Comrades Day. Those who can, should do the (real) 90km. Everywhere else in the world I would love to see 5, 10 or 21,’s races being run in the spirit of Comrades.

Iets persoonlik

Die wat my goed ken, sal weet dat ek in die Comrades tyd gewoonlik na my ma gaan.

My ma, wat self al ’n hele aantal kort padwedlope voltooi het, doen tans iets heeltemal anders. Sy en my twee sussies loop die virtuele Camino de Santiago. Elke dag stap sy en my sussies in drie verskillende stede op twee kontinente en registreer hulle Camino-afstande.

Dan kry hulle ’n aanduiding waar hulle op die roete is. My ma was Vrydag iewers in die Pireneë.

Toe ek Saterdagmiddag my klere regsit en alles nagaan, stuur ek vir haar ’n foto en sê dis vreemd om voor te berei vir ’n Comrades sonder haar. Haar antwoord? Wel, soveel is virtueel deesdae. Verbeel jou ek is virtueel by jou al is ek virtueel in Spanje!

Mary Treat was a scientific genius.

Who? Yes, exactly. So were Jeanne Baret, Ynés Mexica and Marianne North. Who?

Mary Treat was held in high esteem by Charles Darwin, yet she is not on the A-list of international celebrities.

I have recently read two books about explorers of the truth whose gender made it impossible to excel in a world where people operate beyond truth, where questionable morals superseded scientific fact.

***

Vir Afrikaanse leser. Daar is ‘n brokkie laer af oor ‘n fantastiese kinderboek.

***

The two books cannot be more different. One is a heavy, fascinating novel, the other a delightful, thin children’s book in full colour about a polar bear who sets off to the Amazon in a rowing boat. Yet, at the core of these two books lies the fact that an ice bear in the tropics may have a better chance of succeeding on a mission than women who seek the truth in a world that cares only for convention.

***

Animal explorers: Lola the Plant Hunter

Sharon Retta sends a polar bear, Lola, into the rain forest to look for a rare plant.

The second last page of the book holds a sobering reality check: Lola merely represents real-life female scientists who had had to overcome severe prejudice due to their gender.

The title of this wonderful book is Animal explorers: Lola the Plant Hunter. I read the Afrikaans, beautifully translated by Jaco Jacobs, called Diereverkenners: Lola en die singende orgidee.

***

Unsheltered

The other book is Unsheltered by Barbara Kingsolver.

I am a major fan of Kingsolver’s and this book did not disappoint. After reading it, I phoned my mom and said: Get it! She got her copy a few hours before lockdown.

One could write a thesis on this book, but I’ll try not to bore you.

The book explores the lives of families from Vineland in New Jersey.

First, in the present, we meet Willa Knox. She is a typical middle-class woman for whom the American Dream seems to be fading. Knox’s husband is a college professor and they are struggling to make ends meet, for tenure is something most academics do not get in the USA. She discovers that a little-known scientist, Mary Treat, who used to live in the same town – possibly even extremely close to her own home.

We then jump back to the 1800s. The reader then meets Treat’s neighbours. Thatcher Greenwood is a teacher at the local high school. He desperately tries to teach science, but his stubborn headmaster wants none of it. Science, the headmaster says, is for people who do not believe in God. Thatcher also tries to educate girls, and that seems preposterous.

Thatcher lives with his young wife, Rose, who desperately wants to be a society girl, like her mother once was. Rose’s sister, Polly, is the one who understands Thatcher’s quest and she really turns into a delightful character. I adored Polly.

Mary Treat’s life and scientific pursuits provide elastic bands that hold these two worlds together.

Treat’s scientific mind and her friendship with an ever-more desperate Thatcher, is juxtaposed with shallow pursuits of his wife and those who want to be seen to be in the correct circles. Truth means nothing to the men in high places; in this world even a deliberate murder can happen with little consequence to the perpetrator.

In the present Willa Knox has to deal with en egotistical megalomaniac with an orange skin who runs for president. In the past we meet a feeble president who cannot keep the rampant capitalists at bay.

The book explores how politicians get away with disregarding the truth in order to make more money. In opposition to them are the “unsheltered” scientists who go out on a limb to find the truth.

So we find one part of the title unfolding.

The other part of the title is more ominous. In the present Willa Knox lives in crumbling house. In the past Thatcher Greenwood and his family did as well.

The book is a delightful interplay of past and present, with figures seemingly leaping across the decades. Polly, the delightful young women in Thatcher’s household, finds a present-day match in Tig, a four-foot tall woman who refuses to bow to society’s demands.

Tig is short for Antigone, and that of course unlocks an entire intertextual world to the Greek feminist texts; as does the fact that Willa’s husband is Greek and knows the myths. Mary Treat had little recourse to resources, but she succeeded despite her gender. In the ancient times and in the present we find her experiences sandwiched by the two Antigones.

Mary Treat was a woman in a time when her gender meant that her scientific work would not be recognised by most – even though she was held in high regard by the likes of Charles Darwin.

Unsheltered is not an easy read, but is a really good book. I loved it.

So we return to the delight polar bear who rows to Amazon in search of an singing orchid. Fantasy? The orchid is not, but spare a thought to real-life female explorers whose passions and careers were trashed simply because of their gender.

***

Diereverkenners: Lola en die singende orgidee.

Hierdie wonderlike kinderboek is ’n inspirasie vir grootmense ook.

Lola hou van blomme. Sy wil, soos haar oupa, die wêreld gaan verken. Haar oupa moedig haar aan en só beland Lola in die Amazone.

Hierdie fantastiese boek is te koop by alle goeie boekwinkels. Ondersteun hulle asseblief wanneer ons nie meer ingeperk is nie. Jy sal vind dat Bargain Books en Graffiti dit sal hê, of dadelik sal bestel. Die ander groot winkels sal dikwels ook moeite doen as jy ’n boek soek.