Christina Munford Manguzi KwaZulu-Natal Province Language: Zulu - - PowerPoint PPT Presentation

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Aug 09, 2023 143 likes •310 views

Christina Munford Manguzi KwaZulu-Natal Province Language: Zulu Area: 2.2 Sq Mi Population: 5,534 Density: 2,500/sq mi One of the most HIV prevalent areas in the world Founded in 1944 280 beds Majority of

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Christina Munford

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 KwaZulu-Natal Province  Language: Zulu  Area: 2.2 Sq Mi  Population: 5,534  Density: 2,500/sq mi  One of the most HIV prevalent areas in the world

Manguzi

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 Founded in 1944  280 beds  Majority of physicians there for 1-2 years on required community service  Majority of patients are HIV + and many exposed to TB

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 35 Mobile Sites

 Physician/nurse visits about once per month

 11 Clinics

 Staffed by nurses  Physician visits 1-2 times per month

 1 Hospital

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 Traditional healers  Believe that body, mind, spirit & ancestry are connected  Believe that sickness is caused by witchcraft or punishment for disrespecting ancestors

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 There are approximately 200,000 Sangomas while only 25,000 trained doctors in South Africa  About 60 - 80% of the population will consult a Sangoma for their primary care  Sangomas provide care through a variety of ways

 Speak to patient’s ancestors for advice and guidance  Animal sacrifice  Curative medicines called Muthi  Cuttings

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 Muthi may contain:

 Animal or human products (bones, brains, skin)  Plants, bark, herbs  Chemicals, oils, minerals

 Concoctions can cause:

 Vomiting/diarrhea  severe dehydration  Hallucinations  i l

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 Sangomas will make multiple incisions on patients skin  They will then rub muthi concoctions into the cuts  This leads to infection, pain and multiple scars

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 During my time at Manguzi hospital I saw the many negative effects of Sangoma and muthi:

 Babies with severe malnutrition secondary to muthi  Patients stopping ARVs per advice of the Sangoma  Advanced diabetic feet that failed sangoma treatment resulting in amputation

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 Unfortunately not much.  The Sangoma is a very significant part of South African and Zulu culture  The hospital must work to educate the community and it’s patients while respecting their beliefs  I saw this being done through patient counseling and outreach clinics

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 Patient: 32 yo M with right hand tendon injury by machete  Procedure: Tendon repair under local anesthetic (the patient watched!)

 A tourniquet was placed on the patients arm and he was given lidocaine boluses for anesthetic

 The Mistake: nurses removed the tourniquet and all of the lidocaine went to the patients heart at once

 The patient went from unconscious to seizing to psychosis with severe tachycardia  The hospital had no lipophilic agents to bind the lidocaine, thus we had to just wait it out

Lesson Learned: Release the anesthetic a little at a time

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 I was able to assist in a “caesar” (c-section) in the

perating theatre (OR)

 During the case I started hearing singing, I assumed it was a nurse, but when I looked up the patient was singing in Zulu  The entire OT filled with both male and female nurses joined in. It was awe-inspiring. Lesson Learned: Culture is beautiful and unique, appreciate every single opportunity you have to be exposed to it.

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Sundown (sunset) on the Water Tower Pool Time! Our Grocery Store

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Elephant Impalas Monkeys

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Snorkeling! Estuary Baby Sea Turtles

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 http://www.southafrica.net/za/en/articles/entry/article- southafrica.net-traditional-healing1  https://en.wikipedia.org/wiki/Traditional_healers_of_S

uth_Africa#Beliefs_and_tradition