"Relationships, relationships, relationships"

This morning I had to get all my “paperwork” in order. I definitely feel for those that were not born in the United States, but live and work there. There is a lot of governmental red tape to cut through, and it isn’t easy. And for how “difficult” I am finding it, I can only imagine the process is 100 times more daunting, complicated, and time consuming in the U.S.

Don’t worry. I am in the country legally. I can be here for thirty days before I need to exit. Then I can come back for another thirty days, and so on. So I have my calendar marked! It is a good thing Swaziland is so small, as I can be in South Africa in very little time to get the passport stamped.

Rather, the paperwork I am talking about is my “Swaziland Medical License”. Jono (pronounced “John-O, and short for ‘Jonathan’) assures me that, for how complicated it may seem here, this is the easiest international medical license I will ever obtain. Anyway, on Friday I went to the hospital office to turn in my papers (notarized copy of medical license, notarized copy of medical school diploma, notarized copy of passport, notarized copy of residency completion certificate…you get the picture). Anyway, apparently I needed “police clearance” from the U.S., which I never obtained. I was so frustrated because on the front page of their application, they have a list of the “necessary documents”. And there is NOTHING listed about obtaining “police clearance”. Apparently what this translates to in the U.S. is “background check”. So I went home on Friday very frustrated. It was my first “bad day” in Swaziland. I ended up calling the U.S. via Skype (thank goodness when it is nighttime here, it is working hours at home), and was able to contact a person at Dean McGee, who was able to scan a copy of my background check and send it to me today. (Isn’t the internet amazing?!)

Meanwhile, this morning, I had to purchase two “stamps” that are affixed to my paperwork, which then needed to be signed and stamped with an ink stamp by a commissioner. It all seemed very complicated. But the job is done, all the paperwork finished, and I think I can turn everything in tomorrow.

 

Paperwork!

After I finished running around to these different offices in Siteki, Jono picked me up in the truck and we drove to Manzini to do surgery at St. Theresa’s. At any rate, on the way there, we had our “entrance meeting”, about my goals and expectations, as well as his goals and expectations. During this time, he made it very clear that he would like me to spend some time at the Mbabane Government Hospital, and he would like to set aside every Monday for me to travel to the city. Mbabane is the capital of Swaziland, and is located on the western side of the country (Siteki is on the eastern side). Luckily, since Swaziland is only 115km across at its widest point, one can drive from Siteki to Mbabane in about 2 to 2.5 hours.

Well, there is no time like the present! And since it was a Monday, Jono felt like today was the day to get started on my work at the government hospital, by driving in and introducing myself to the eye clinic! About ten minutes before we arrived in Manzini (about 2/3 of the way from Siteki to Mbabane), Jono proclaims that I should drive myself into Mbabane. I was just a little nervous for a few reasons: they drive on the left side of the road here with the steering wheel on the right, I am great at driving a manual but every car is different and this was a big truck AND all the shifting is done with the left hand, I had no “google maps” to navigate me to the hospital, nor did I have a paper map. So Jono whips out a piece of paper and starts drawing me a homemade map. Now, I must tell you Jono draws incredible maps. I swear he has every stoplight memorized in this country. So his map was actually quite good, and I made the trek without much difficulty. (All the while thinking, “What would my mom think of this? It sure is a good thing she has no idea what I am up to today.”)



The Map
(the dots represent all the stoplights!)

 

The Ride

The City (Mbabane)

When I arrived at the eye clinic in Mbabane, everyone was very nice. They asked me if my “navigator” was good in helping me get to the hospital. I pulled out the little piece of paper that was Jono’s hand-drawn map, and they started laughing. I think they thought I had a GPS or something.

 

Mbabane Government Hospital. The eye clinic is the building located directly in front of the blue car.

 

At any rate, I met with Sharon, who is an optometrist and also has her MPH. She is very intelligent and capable, but I get the feeling that her creativity has been quelled by government inefficiencies. There are a lot of problems with funding for eye care here in this country, and it all stems from the fact that Swaziland does not have a National Eye Care Coordinator. Apparently no one wants to donate funds unless they know there is a specific person in place to account for all the money. Which, makes sense. I guess awhile back, the government (Ministry of Health) was interviewing people for this position, but the position was not filled for some reason. And now, it can’t be filled because the government is broke and there is a hiring freeze (or something to that effect). So the position is not filled, but no longer available, which makes everything difficult.

I see it as that cyclical problem: we can’t get funds until we get a National Eye Care Coordinator in place. We can’t get a National Eye Care coordinator in place because the government is broke and we have no funds. Therefore: WE HAVE NO FUNDS!

I have to realize that this problem has been a long time in the making, and I am not going to solve it during my three months here. There is a lot to be done though and most of it right now involves making connections. As Jono puts it, “there are three words that are the most important words to know when dealing with Swazis. They all start with ‘R’ and end with ‘ship’. Relationships, relationships, relationships.” So, I will be an ambassador for the Dean McGee Eye Institute, which is committed for the long haul for helping Swaziland develop their eye care system. I know this will take time and we are talking on about “years” as opposed to “weeks or months”.

But the “problem solver” part of me wants to just “fix” everything now. And I am realizing that change takes time. Progress takes time. And for now, I will just have to do my best with the resources that are available.

The plan for Mondays at this point is for me to drive into Mbabane every Monday and help the Government Hospital Eye Clinic work out some of the kinks in their system. I will help them however I can, and I will work on building “relationships, relationships, relationships” amongst the different groups here: Jono at Good Shepherd Hospital, myself/Dean McGee Eye Institute in Oklahoma City, and the Government Hospital Eye Clinic. After all, we are all working for a common goal.

After my meetings, I drove back to Manzini to pick up Jono and Sister Senani, who were finished with their surgeries for the day. We did some quick shopping (much more selection in Manzini grocery stores compared to Siteki), and then made it back to Mabuda Farm by 4:30. It was an exhausting day!

As I was getting out of the truck, I asked Jono if he ever got frustrated with all this red tape, government inefficiency, lack of infrastructure, etc. He really is doing more than his fair share of the work here in Swaziland in regards to eye care. And he basically has built the whole program himself. And he said, “No. I just don’t give up hope. We must never give up hope.” This will be my mantra here.

After work, Angela and I went on a walk around the farm to decompress and talk about our days. She is so great. We took some great photos from the horse pasture as the sun was setting.

Animals grazing on the farm at sundown

 

That is all for now. More soon.