Some cool clouds over the wing of the King Air that looked a lot crazier in real life. A few minutes ago there was a sweet sunset that I unfortunately didn't get any good pictures of. Sunsets and sweet clouds are some of my favorite things about flying here, at least during the summer when there actually are clouds around.

Aaron Hoffman, a short-termer from Flying Mission in Zambia, helps install a new leading edge for a STOL kit on the 206 they flew down from Zambia. Aaron stayed with us in the short-termer house for two weeks, and his haircut is my handiwork (of which I'm very proud). We had a good time playing chess, talking airplanes, and watching the occasional movie. A part of my work for the past weeks has been helping the Zambia guys find parts and get everything figured out for their work here.

Dan and Matt return from a mercy flight at the end of the day.

Circle of Life

The last week was quite a busy one, with at least one flight every day until Friday. The last flight of the week, however, was probably the hardest and most tiring flight that I have made yet. Francistown is usually where we take patients from all over the country, but if they have a patient that is too serious for them to deal with, we sometimes fly the patient to Lanseria airport in Johannesburg, South Africa where they have specialists and more special equipment. On this particular flight, we picked up a car accident victim in Francistown who was in a very critical and unstable condition. I’ll spare you the details of how he looked, but the patient was on a ventilator and completely unaware of what was going on around him. We took off for Lanseria, staying low to keep the cabin pressure from dropping. About 30 minutes into the flight, the paramedic tapped me on the shoulder and said we needed to turn around immediately and descend to get the cabin pressure as low as possible, which we did. When we landed back in Francistown, we learned that the paramedics had lost the patient and begun resuscitation, and by the time we landed they had revived him and he seemed a bit more stable. The paramedic deemed him too unstable to fly and took him back to the hospital. As we were getting ready to leave to go home to Gaborone, the paramedics got a call from a doctor at the hospital and a bit of conflict ensued, with the end result being that we were told we needed to fly the patient anyway. So the medics went back to the hospital to pick up the patient, we helped load the (very heavy) patient for the second time, and we took off again for Lanseria. This time, the patient died about 40 minutes into the flight, and all the paramedics’ attempts at resuscitation were unsuccessful. The paramedic let us know, and said that since we were under doctor’s orders to take the patient to Lanseria, we had to continue the flight even though we knew the patient was dead. So we continued to Lanseria and landed there, hoping to be met by a morgue vehicle that would take the body so we could fly back home. We quickly learned it was going to be a lot more complicated than that, however, as the South African police told us they couldnot accept the body. We sat in Lanseria for several hours, talking with the police and anybody we could think of who might know what to do. At one point, it seemed like we were stuck because the police couldn’t take the body and we thought that it would be illegal for us to fly back to Botswana with the body. It was quite a mess. Finally, Brandan called a doctor friend of his in Johanneburg somewhere who did this sort of medical flying into the country quite regularly, and learned that since the patient had died before clearing customs into South Africa and was technically still “in transit,” we needed to take him back to Botswana. So we ended up flying back to Gaborone with the body, arriving just before the airport closed at 10pm. It was a long day. That was the first patient to die on a plane I was flying, so I guess after the baby born on the plane, I’ve sort of brought the cycle of life full-circle. Or something like that. The most difficult part of this medical flying is seeing some of the patients in such a painful condition, and especially seeing some of them pass away. While this was the first patient to actually die on the aircraft, this past week has seen two other patients dying before we were able to reach them, so it’s been a rough week. The last couple of days, however, have slowed down quite a bit and it’s been a bit more relaxing, which is nice for a change. Peace, and keep well.

Placebos and stuff

While I guess I always sort of believed that the placebo effect existed in sort of vague and flimsy way, I was given a pretty convincing demonstration of it on a flight we had the other day. The patient was a young man who was being transported because of apparently undiagnosed severe stomach pain. Either the paramedics or the doctor in Kasane, I’m not sure which, gave the preliminary diagnosis that the patient was experiencing symptoms of opiate withdrawal. Right from the get-go, the patient was continually asking for morphine or other pain-killers, and at points throughout the flight I could hear Brandan, our usual flight paramedic, explaining to him why he couldn’t give him the painkillers he wanted. The patient was very restless for most of the flight, getting up and down, hanging over seat backs, and continually asking for painkillers. All of a sudden, near the end of the flight, he became very quiet and lay down on the stretcher underneath a blanket. As I was wondering what brought about this change, Brandan passed up a note saying that he had told the patient that he was injecting him with morphine and actually just gave him a harmless anti-nausea drug. The patient apparently thought he was high and immediately relaxed and passed out on the stretcher. It was a pretty impressive demonstration of how much of a mental thing addiction is and how strong the placebo effect can be at times.

It has been quite a busy week, and we’ve had at least one flight every day the past week from Monday to Saturday except one, and several days we’ve had multiple flights. In fact, on Thursday we had four calls for flights in one day. Two of them got cancelled, so we only ended up doing two flights, but it was still a pretty long day. So I’ve been keeping busy and not doing very well at keeping up on emailing and all the other little things that crop up outside of work. I’m also advertising my vehicle to sell now, and have been spending some time getting it ready for sale and dealing with the advertising companies and all of that jazz. Anyway, that’s a quick update on what’s going on here…more to come someday later, with a few pictures even. Til then.

SOS Children’s Village

The SOS Children’s Village is large complex in Tlokweng (a few minutes southeast of Gaborone, near the border) where 200+ orphans and vulnerable children live together in community houses, each of which has a house mother. Deborah and Sarah, two other Flying Mission volunteers, have recently been hatching the idea of offering after-school homework help one or two evenings a week. Last week, I had Wednesday off and was able to go along with them for their first evening of work there. We got there early, believe it or not, and so sat around waiting for them to be ready for us. Eventually, we were introduced to about four kids who apparently had somehow been selected from their houses or volunteered or something, and were supposed to have homework for us to do. They led us by the hand to their various houses, where we sat down with them and started working (more or less) on some homework they needed help with. My little boy, Thabo, resisting stubbornly all of my attempts at conversation, led me to his room, opened his backpack, closed it again, and indicated that he had no homework to do (again not speaking, communicating instead with the common upward-facing open palm wave that he had nothing). Well, I wasn’t sure what to do so I hung out in his room for a while trying unsuccessfully to chat with Thabo and chatting a little more successfully with some of his housemates. To my relief, I discovered that one of his housemates needed some help with math homework, so I helped him do some metric conversions for a while and then left when we were finished to see if any of my compadres had had any more luck. I found Stefan on one of the house porches surrounded by a loud and animated group of kids. There were three homework books open on the table but very little homework getting done, as the kids were much more interested in asking Stefan questions and generally having a good time. I sat down with them and soon found myself helping Thapang with his math homework. He is a fun kid who really seemed to enjoy doing his homework when someone paid enough attention to him to appreciate what he was doing (before I came and sat down with him, he was very distracted by the other kids and didn’t seem to be getting much done). Every time he got an answer right, he would give me a high-five and the African thumb-press handshake that the younger people here give to each other. We had a lot of fun, and I enjoyed getting to know Thapang. After we finished, we joined the rest of the kids in talking about all kinds of random things from Germany and the US to dancing and music. You could tell they really enjoyed the attention and were having a grand time. After meeting Thapang’s older brother and running around in the rain with Thapang on my shoulders, it was soon time to leave. We had a great time there, though, and I look forward to being able to go back on days when I’m not on call. I have really enjoyed catching these glimpses of Flying Mission’s ministry here and getting involved on a hands-on level with some of the people of this country. In some ways, it makes me wish that I was a normal short-termer like Stefan and Christian who get to do things like this several days of the week. At the same time, though, I’m loving my work here and wouldn’t give it up for anything. Well, that’s enough writing to poop me out for the time being…keep in touch and stay well.