Jason Wolfe's Medical Elective Report

Mosvold Hospital, in Northern Natal, South Africa.

(14th Dec 1992  -  30th Jan 1993)



Hospital Address for Correspondence


Dr. Andrew Ross
Mosvold Hospital
Private Bag X2211
Ingwavuma
3968
Republic of South Africa

Telephone

038482 and ask for Ingwavuma 11


The Hospital


Mosvold is a 235 bed ex-mission hospital in rural KwaZulu which is in Northern Natal.  There are 4-5 doctors and 6 wards.


Doctors

Wards

Things to do



General Notes
The hospital is well stocked with drugs and sterile equipment, and the theatres are comparable to any in Britain.

Accommodation is in a guest house and food is available in the canteen.  Both are provided free.  Vegetarians beware: the caterers never provide any vegetarian meals, but a reasonable variety of food is available in the local supermarket.

Other students

Mosvold is popular with students from all around the world so loneliness is unlikely to be a problem, but Andrew Ross is likely to ensure that there are never too many students there at one time to prevent competition for activities.  To prevent rejection, beat the rest and apply early  -  At least 6 months in advance.  (I applied 12 months in advance)

Other LHMC students who have been there, should you want to contact them.



Flights

Airlines flying to South Africa include BA, KLM, South African Airlines, and Alitalia.
Try to fly direct to Durban because Johannesburg is an awful city.
(Return Ticket Cost = £550  -  £700).

Documents

Take


Equipment

Take
Vaccinations

You will need  Hep B, Hep A, BCG, Polio, Tetanus, Typhoid, Cholera.

If you are travelling through malarious areas  -  Malaria prophylaxis.

Clothing

Dress smart but casual.  No ties and no white coats.
No one really cares what you wear.  Once in the evening I went to see patients bare-footed and wearing only shorts and a T-shirt, but don‘t go to ward rounds like this.
Bring an umbrella or a decent waterproof - when it rains, it pours.
In the winter (around June), you will need a jumper for the evening.

Money

Bring money into South Africa as travellers cheques.
Spend money if you can using Access or Visa, as this is the cheapest way of spending money abroad.  If you can, put your credit card account into credit before your leave to avoid large interest payments building up.

Beware :  Cash is the only means of paying for anything in Ingwavuma. The bank at Ingwavuma (called Ithala) does not cash travellers cheques.  The nearest bank which does is in Mkuze, but you might as well get enough cash in the city which you fly into.

Bursaries
Ask Doris about the 'Henry Strakosch Memorial Trust'.

Travel Notes

Andrew Ross and his wife Glenys will tell you how to get there once you have been accepted.

There are well travelled routes passing by Mkuze every day, and the hospital will arrange to pick you up from there with a hospital ambulance.

If you can, ask Andrew about the hospital buses which ferry patients to and from Durban every day (Except Friday and Saturday), because if you can get one of these buses, they will take you right to the door of Mosvold.  Mosvold‘s referral hospitals in Durban are King Edwards hospital, Prince Msheni hospital, and Wentworth hospital, so the pickup point will be at one of these.

A car would be useful but the cost is very variable depending on where you are and what time of the year it is.  Expect to pay between £50 - £120 per day.  If you can, share the cost.

Links  ...


Zulu Dictionary  with words and terms useful if you want to learn the language.




Overview



The rest of my report will take the form of my diary during the time I was making my way towards the hospital and my stay in the hospital itself.  I believe that this will give the reader the best insight into the workings of the hospital and the feeling of South Africa in general.

Andrew Ross in his letter said that I shouldn‘t miss the opportunity to see some of the other sights in Africa, and I took him at his word: I flew into Lusaka in Zambia, and travelled 1500 miles south, through Zimbabwe, and into South Africa seeing the sights and meeting people as I went.

Very briefly, I started off in Lusaka (a big mistake - it is a horrible place), and then travelled 400km south to Livingstone where I met a christian missionary who became my travelling companion for the next week.  We then went to the Victoria Falls for a day and continued on into Zimbabwe to spend 2 days at Hawange National Park where we saw lions, giraffe, elephants, impala, baboons, vervet monkeys, warthogs, buffalo, wildebeest, zebra, ostrich, flamingos, spoonbills, vultures, eagles, hornbills, and cranes to name but a few.  The night I spent there I slept out in the open, but was told the next day that it was not such a good idea because lions and hyena have been known to roam the camp during the night.  Whilst we were there I met Liz Anderson and Rupa Maris who are also from LHMC doing their elective.  We then travelled south by train to Bulawayo, and spent two days seeing the sights and meeting Liz and Rupa by chance for a second time.  After that I had to part company with my friend.  I continued travelling south to the South African border at Beit Bridge, and further on to Pietersburg where I hired a car, turned east and then spent two days driving through the Kruger National Park again seeing similar animals to the ones I had seen at Hawange.  There were much greater numbers of animals there but it also had rhinoceroses, leopard, cheetah and hippopotamuses.  The next day I dropped the car off in Nelspruit, and then spent a day hitch-hiking 500km around the east coast of Swaziland, finally passing Mkuze to reach Jozini.  Here I radioed Mosvold hospital from one of the clinics and was soon picked up by one of the hospital ambulances.

The rest of the description is a word for word copy of my diary.



14.12.92 & 15.12.92  (Monday & Tuesday)



What an absolutely terrible start!!!

The flight from London to Paris left half an hour late and arrived half an hour later as well.  Then there was a four hour wait for the Paris to Lusaka: This left three quarters of an hour late, and arrived more than one and a half hours late, the whole flight taking about eight and a half hours.  I was unfortunately surrounded by people who were to annoy me for most of the rest of the flight: To my right were two rather crude and loud speaking Belgians who would periodically engage in a scuffle followed by a hissing match, punctuated by episodes of incongruously eyeing up other women on the flight, and the women in their copy of Playboy magazine which was left open to cause maximum offence.

The other person annoying me was a 5 year old French boy, who, despite the efforts of his mother, seemed to like to crawl under the airplane seats kicking anything in sight which unfortunately tended to be my feet and my hand luggage.  The seats were tiny and uncomfortable, and the food: I think I can genuinely say that that was the worst meal I have ever had.  The cooked vegetarian food ranged from tasting of absolutely nothing, to tasting quite horrible, while the salad was just simply horrible.

The film they showed was 'Nuns on the Run' with Whoopi Goldberg disguising herself as a nun to avoid the mob.  I missed the first quarter because I did not know that it was being transmitted in many languages, and when I put the headphones in their socket, it was broadcasting in French.  There was no information leaflet to explain this, and if it was announced on the intercom, I certainly would not have heard it: All announcements were far too quiet, especially under the din of the engines.

We had set off at roughly 10pm and arrived in Lusaka at 8.30am, but because of the two hour time difference, the flight actually lasted 8½ hours.

The travel guide I used said that Lusaka airport was the pinnacle of Southern Africa's airport achievement, so I would hate to see the other standard ones.  It was a tiny airport with a smallish building to house immigration and customs.  Outside that area were a couple of banks, a couple of bars, a bureau de change and a tourist information stand which had no leaflets and no-one there knew the price one should pay for taxis.

Taxis were the only means of getting from the airport to the town centre. The taxi driver I met wanted 7000 kwacha to get to the town centre, but luckily I had met two other medical students (Heather and Jerry) from St. George's so we decided to split the cost by sharing.  [Note: £1 = 500 kwacha]

They had to go to a different place to me so the price was set at K10,000 which we would divide 60/40.  After dropping off the other medical students we went to the town centre where I changed some more travellers cheques, thinking that I had underestimated the cost of living in Lusaka.  We then went to the bus station where I bought a bus ticket to Livingstone costing a remarkable K1770 (the equivalent of £3.40), for a journey of 400 miles.  I then asked the taxi driver to take me to the very cheapest hotel in town, so he took me to the outskirts on the other side of the town to the Mavbuto hotel where the price was K4000 (£8) for the night, a snip after what I had paid for the taxi.  Not surprisingly with all the extra journey and waiting time, the taxi fare had gone up to K8000.


I knew that I was only going to be in Lusaka for a day, and after consideration I decided that despite the price, I must go and see one of the attractions in and around the city.  I had already seen the centre of the city, loosely based on the 1 mile long 'Cairo Road' and that was a dump.  I had also seen the poorer side of the city because, on the way to the hotel, the taxi driver had stopped at his house to collect the Zambian version of the 'ghetto blaster'.  The make was probably some unknown Japanese company, the quality of the sound was terrible, and the machine had its own built in disco lights.

The poorer people lived in classical shanty towns: The walls of the houses were made from those ugly large grey mortar bricks, while the ceilings were corrugated iron sheets.  The children were invariably only half clothed, and what clothes they did have were dirty and badly torn.  Practically none of the had shoes.  The main market area of the shanty town was a field with hundreds of stalls, containing second hand goods and food.  It seemed that not even the smallest effort was being made to keep hygiene.  Most of the food stalls had a multitude of flies on them, but one stall which particularly surprised me was a pile of sardines which could only be described as a writhing sea of flies: there must have been 500 flies to the square foot.

Since there was nothing to see in the city, and the only place within teach of the city was Chilanga Zoo, I decided that I would go there, The taxi driver told me that there was no bus which went there (which I later found to be true), so I would have to go there by taxi.  The journey was 7 miles, and he wanted to charge me K7000 each way, so after haggling I got it down to K4500 for both journeys and we set off for the zoo.

To get into the zoo cost K200 (40p), but was K500 (£1) if you wanted to take pictures.  I said that I was not necessarily going to take pictures and so got in for the K200.

The zoo was in a pitiful state and any animal with enough intelligence was clearly bored and depressed.  There were a couple of lions and tigers, a single hyena, some monkeys, some crocodiles, and some free roaming storks and peacocks.  Rather surprisingly, they had some rabbits and chickens on display, which is odd because they can often be seen roaming the streets of the city.

When I was in the zoo, I started talking to other people about the price I was paying for the taxi, and all of then said I was being cheated.  The cost from the airport should have been K1000 or less, and the return trip to the zoo should have been K2500 or less.  I was due to be picked up by the taxi at 4pm, but when one of the people I had been talking to offered me a lift back to Lusaka, I jumped at the chance, especially as it was just starting to rain.  It rains during the summer months, usually during the day, and often the showers are short and very vigorous.  This shower lasted half an hour in which probably one to two inches of rain fell.  I think it is the most powerful downpour I have ever seen, but luckily I was tucked away comfortably in my lift's Toyota Land Cruiser.

When I got back to the hotel, I resolved to confront the taxi driver about the price he was charging me.  He had gone out to the zoo at 4pm to collect me, and obviously did not find me there, and so he had come back to the hotel.  I told him truthfully that I would have phoned his central office to stop him going out to the zoo for nothing, but the hotel's phone only took incoming calls and there was no other phone within walking distance.

Then I confronted him directly by telling him what I now knew to be fair prices for the journeys he had taken me on, and that he was dishonestly charging me exorbitant rates just because I was a tourist newly arrived in the country.  I told him that I had no intention of paying for his wasted journey to the zoo, and that I was willing to pay K3000 for my journey to the zoo, provided he took me the the coach station free the next morning.  I suppose that the taxi driver's strength lay in the fact that he steadfastly refused to accept that he had in any way been dishonest or overcharged me.  After about twenty minutes of argument, I said that I wasn't going to pay, so he better go and call the police.  He though a bit and said that it would be better if he took me to the police station, so I agreed.

As we started our journey it occurred to me that this was a potentially dangerous situation: he might not be taking me to the police station at all, but to a back street where I could be beaten up and robbed.  So I told him to stop the taxi and said that I would pay the K10,000 if he would take me to the bus station free the next day, and he agreed.

By the time we got back to the hotel it was getting dark.  I just had time to check my receipts for the day, and in doing that I found that the hotel had given me a double room.  What had probably happened was the taxi driver probably told the woman in reception that they can charge me anything they want, and a little bit more by putting me in a double room.  As soon as I found out what they had done, I went to reception and demanded that they put me in a single room which they reluctantly agreed to do, but they said that they could not refund the difference because all the takings of the day had already been taken away.  The difference in price was K500 (from K4000 to K3500) which seemed rather small, but I was getting tired of arguing.  When I said that I must get the K500 before I left, the receptionist promptly opened the till and game me the K500.

I immediately moved all of my things into the new room and when I finished, I found that the window was badly broken which would let a multitude of mosquitos in to bite me and give me malaria.  When I told reception about it, I had to move everything again.  This room had intact windows, but the mosquito mesh unit was not fixed in place so I could not leave the window open at night despite the extreme temperature and humidity.

By this time, it was getting dark so I tried to switch the light, but it wouldn't work, and when I told the people in reception, they said that in this part of town, the electricity is only switched on after 6pm, but the lights never appeared.  I had been writing this diary until about 6.30pm, until it became so pitch black that my only option was to have a shower and go to bed.  Naturally there was no hot water, although in Zambia this is a relative statement because whether coming from the hot or cold tap, the water is always luke warm.  Nevertheless it did feel cold and combined with the fact that I was in complete darkness, it was not an easy shower to have.

To end the day, a few more things happened: At about 7.30pm the lights came on, to which there was a resounding cry of glee throughout the hotel, which was prematurely cut short when they went out five seconds later.  I was unable to get to sleep until at least after 10.30, but as I lay there, I heard voices saying "what!!, we really gave a white man staying here?", or later when I was flashing my torch around to find something, someone walked past my window and I heard a voice exclaim "Oh my God, there's a white man in here".

Shortly after 8pm, there was a knock on the door, and a man, presumably from reception told me that I was probably lonely and that there were a couple of 'ladies' available if I wanted them.  I knew immediately what he meant, but intrigued I looked down the corridor, and sure enough there was the silhouette of two women in shiny skin tight clothing.  I politely declined, not only because I wouldn't have done anything like that on principle, but also because the rate of HIV infection in some parts of Zambia is about 70%, and among prostitutes, it probably approaches 100%.

I noticed the lights going on for a couple of seconds at around 10pm, and soon after I fell asleep.



Wed 16.12.95  (Day 3)



This was a much better day.

I woke up at 6am, and was ready to leave at 6.30, when the taxi driver arrived.  It was a relief because I wasn't sure whether he would still come after the argument of yesterday.  The 10 minute journey was conducted in complete silence, and he dropped me at he bus station.

I was later to find that he had indeed cheated me badly.  If he had taken me to the police station he would have been in trouble, not only because he over-charged me, but also by law he was supposed to display a list of prices relating to the various distances travelled.  He probably took home a weeks pay on that day which for sure he didn't declare to the taxi company.  In Livingstone, I thought of phoning Lusaka and reporting him to the cab company and to the police, but it would have taken too much time and effort and I just wanted to forget it.  The bus to Livingstone was large, but the seats were small.  I had the option of putting my ruck-sack in the luggage compartment, but I was not going to do that because there were a few stops on the way where anyone could have stolen it, so, like many of the other travellers, I took my luggage onto the bus.  Because of all the bags and cases being taken onto the bus, the middle aisle was practically full up and anyone wanting to get to the back had to play a particularly nimble game of hopscotch.

I wanted to sit next to the window, so to keep an eye on my rucksack, I had to put it in front of me, between my legs, which meant that they were squashed between the side of the bus and the person sitting next to me. There were no whites on the bus apart from me, and indeed, I had not seen a single white person in Lusaka from the moment I left the airport.

The journey was long and uncomfortable: For a start, I sat next to a sliding window which I thought would give me a comfortable breeze, but I found that even when the window was only slightly open, the air flow was an uncomfortably powerful stream right into my face.  To make things worse, the window did not lock and would quickly open with the vibrations of the bus.

The road from Lusaka to Livingstone was the worst road I have ever experienced: The bus had practically no suspension and that compounded with the fact that there was more pot hole than road meant that it was like travelling through a long violent earthquake.  The journey took 8½ hours travelling between 40 & 70mph and making three stops along the way.  I am told that the train journey would have taken at least 12 - 16 hours, there being more stops.  Cleanliness would be worse, but the price would be the same.

The scenery was mostly dry scrub-land dotted with small bushy trees.  The road passed many smaller river beds and three major ones, but all except one were dry.  It was not that there was a drought in Zambia; just that the rains give enough water for the crops to grow and people to drink, but not enough excess to make the rivers flow.  Out in the countryside the houses changed from grey brick walls and corrugated iron roofs to mud walls and thatched roofs.  The people were probably just as poor, but they had their own plot of ground to grow some crops, and probably kept more of their dignity.  Whenever the bus stopped, the windows would become a supermarket.  Most often the sellers were children offering up corn on the cob, or maize as they call it. The most popular drink in Zambia (and Zimbabwe) was Coca-Cola by far, with Fanta and Schweppes Lemonade coming in as distant seconds.

As I was finding out more and more, everything in Zambia was much cheaper: An average taxi ride was K300 (60p), soft drinks were K120 (22p) with money refunded for returning the empty bottle.  Buses in town were a maximum of K100 (20p) regardless of distance and a cheap hotel K1000 to K2000.

When I arrived in Livingstone, I knew that the first things I should do should be to find the tourist information office and to find a hotel.  As soon as I alighted, as usual, a multitude of taxi drivers came up to me and asked me if I needed to go anywhere, but before I got into a taxi in this town I wanted to speak to a few locals to find out the places to see and things to do.  I sat on the steps of a shop for a minute, recovering from the hammering my body had taken from the bus ride, when out of the blue someone said something to me.  I assumed that it was a taxi driver wanting a fire so I told him I didn't want a taxi, but he repeated "No, my name is Erik, and I think you need to find a hotel."

After some more questioning, I found out that he was a Christian missionary on holiday for three weeks over Christmas.  He told me that he was staying with some other Christian missionaries in Livingstone, but that he had been to Livingstone before and knew the cheapest hotels.  As part of his holiday, he was travelling as far a Bulawayo where he would stay with a priest he had met before.  While talking, he took me to a hotel which he had stayed at when he was previously in Livingstone.  The hotel was the 'Red Cross Hotel' and it did actually have something to do with the 'Red Cross'.  The price for the night was K1440 (£2.25) for a bed, sink and communal shower, and comparing prices with Lusaka I readily accepted.  As we talked more, I found that his home town was Mazabuka which was the first major town I passed through on the road from Lusaka.  His main work was in coordinating the Christian mission in Mazabuka which mainly served the patients of the local hospital, and the inmates of the local orphanage, although he often went out to preach in the local schools and wherever he though he might be needed.

After I got settled into the hotel we decided that we would take a look around town.  Livingstone is actually quite a small place centred around one street which contains the museum, police station, cinema, a building with civil servants and other assorted shops of the usual kind.  We decided to see the museum first which was conveniently close to my hotel at about 100m.

The museum was mainly divided into sections about the history and natural history of Zambia, although there was a small section displaying the wooden carvings of one of Zambia's most prominent artists, which was really quite impressive.  The natural history section explained about the various human settlements in Zambia, both in history and pre-history, and the various archaeological digs where the information had come from.  There was also a largish section of mounted animals and birds which were indigenous to the area along with warnings on some animals which it was illegal to hunt and kill.  The whole theme of the section was geared towards conservation and there were numerous poster both old and new with slogans promoting conservation.  The last section was dedicated to the history of Zambia which included trading with and exploitation by the dominant cultures of the time; namely the Arab, Turkish, Portuguese, English and Zulu influences.  The last part of the section had a detailed history of Dr Livingstone's life with various articles of memorabilia such as photographs, clothes, and genuine extracts from his letters and diaries.  I enjoyed the museum not only because it was good but also because I felt it was an oasis of culture in a land of chaos.

After the museum, Erik and I got a taxi to the house of the missionary where Erik was to stay that night.  We were both invited to dinner that night, and I, in accepting, hastened to add that I was vegetarian.  The taxi had been waiting for us, and took us back to the town centre.  The total charge was K500 (£1), very reasonable after my experiences in Lusaka.

We decided to see the film at the local cinema at 5.30pm, which left half an hour to relax with a cold drink in a near-by cafe.  The film was 'Prisoners of Conscience' with Michael J Fox and Sean Penn and it was the true story about a soldier in the Vietnam war who wanted to bring the rest of the members of his company to justice after they had kidnapped, raped and killed a Vietnamese girl while on a mission.  I thought the film was alright, but Erik thought it was very good.  This did not surprise me, as I was quickly learning that anything associated with western culture and civilisation was highly valued.  Shops often boasted that they had the latest articles and styles from Britain, America and Italy, even though in reality they were actually years behind in most things.

As a white man walking the streets, I was often set upon by people wanting to sell me things or change currency, and I quickly learned how to reject them effectively: This required me looking them straight in the eye, shaking my head and firmly saying "no".  On one occasion, there was a criminal type who wouldn't give up and tried to walk with us, calling us his old friends and putting his hands around our shoulders.  When this happened I repeatedly told him to go away, while keeping a very firm eye on my pockets and eventually he did go away.  He did try to follow us into the cinema, but Erik talked to the ticket checker and had him excluded from the cinema.

After the film, this time we walked to the house, which took 15 minutes, and then met the missionaries.  (*) The missionary who owned the house was called David Heart who was a black American, and he lived there with his wife and three children.  Also staying at the house was an Australian missionary (Peter Erikson) to add to the already full house of Zambian missionaries.   We had the meal first which was a delicious bean stew with rice, and then we sat around the living room talking.  They did not overtly talk about religious matters but there was always somewhere where religion came in. When happy events were being talked about, the sentence would often finish with "Alleluya" or "Praise the Lord".  When future hopes and aspirations were discussed, they would often say that "anything was possible with faith and the help of God".  When discussing converting people to Christianity, they said that the only way of guaranteeing a place in heaven was to hear the word of the bible and accept Jesus Christ as their saviour, and in the words of Peter Erikson, the Australian missionary "I've done that, so I'm safe".

During the meal, we were all given different names: Erik was called 'Matthew", David called himself 'John', I was called 'Luke', and David's son was called 'Mark'.  Peter the Australian kept his own name.  For the rest of the evening, we were addressed sometimes by our real names and sometimes by our newly acquired ones.  They all told about their best successes as missionaries, and Erik in particular was proud of the time he had sat down with a thief in a police station and talked with him for four hours in which time, he had not only converted him to Christianity, but also convinced him to actually become a missionary, and that person was now a missionary working with Erik in his home town.

When it was getting late and I had to go back to my hotel, David Heart was worried about me walking back to the town centre alone, so they all agreed to walk with me, Peter carrying a strong bamboo stick for protection.  There was no trouble on the way back apart from Erik and I almost stepping on a snake, but Erik saw it just in time and pushed me out of the way.  When I got back to the hotel, I had a shower with a hose and went to bed.



Thur 17.12.92  (Day 4)



The day we went to the Victoria Falls.

Erik had slept in the missionary's house, and I was in the hotel, so Erik had agreed to meet me at the hotel at 7.45 am, but he was delayed by 45 minutes, because he was praying with the missionaries and couldn't leave in the middle.  When he did arrive, we walked to the square where the taxi ranks waited and got into an emergency taxi to the Victoria falls.  I should explain that an emergency taxi is a taxi which goes backwards and forwards between two well visited sites, but the taxi will only ever leave when it is very full of people and I do mean full.  In Zambia, they use long hatchback cars, officially made for 5 people, but more often there are twelve people inside.  In Zimbabwe, they use transit vans with 21 seats, but it would be rare to find any of them with less than 31 people inside.  Needless to say, they are much cheaper than hiring a whole cheaper than hiring a whole taxi for yourself, usually K100 in Zambia and Z$1 in Zimbabwe, both equivalent to 20p.  The distance to the falls was only five kilometers and we arrived there in about 10 minutes.

There was a further 10 minutes walk to the falls themselves.  The falls are known locally as 'Mosi-oa-Tunya', or 'the smoke that thunders', but this was not our first view.  I was later told that because of lack of rain the river flow was the lowest it had ever been in living memory.  (*) The falls are the point where the Zambesi river, flowing wide from its flood plains, suddenly reaches a mile wide chasm 100 deep along its length.  Our view was of small waterfalls, dotted here and there along the length of the cliff.  We walked along the edge of the cliff facing the falls in a rain forest which is permanently there due to the spray thrown up by the explosion of water as it goes over the edge and hits the bottom.  At the bottom, the water flows away as a series of rapids, and it is possible for a fee to travel down the rapids in a special raft.  When the water is flowing at normal levels, some of the rapids are reckoned on being some of the most difficult in the world. If I had more time and money, I would have done it myself.

We walked along the full length of the falls on the Zambian side, over a kilometer, I with my rucksack, and Erik with his bags, and then we had to walk back again.  We stopped off in a tourist area still on the Zambian side close to the border post, and had a drink.  There were many stalls selling curios, which were cheap and of good quality, but were mostly too large and heavy to fit into my rucksack.  There were drums, masks, and wooden carvings of African faces and various animals.  Also there were some chess sets made from a polished marble / precious stone material which looked very good and were also cheap.  The man at the stall wanted K10,000, but I was sure that I could get his price down to less than K5000.  I didn't haggle very hard because I knew the chess set was very heavy, and in the end he was agreeing to K7000, but I wasn't going to pay over K5000 so I gave up.  I later found out that the same type of chess set would have retailed for £150 - £200 in Britain, so perhaps I should have made a further effort and bought it anyway.

We then passed over the Zambian side of the border, with no problems in customs or immigration.  (*) No-mans land was a surprisingly long 2km, which we wearily walked under the blazing sun in a temperature which was at least 32° in the shade.  The concrete was physically painful to touch, although throughout the day we saw children walking and playing barefoot, apparently without distress; their feet must somehow adapt to these kinds of conditions.

The Zimbabwean customs and immigration took a little longer but again there were no problems.  We walked immediately to see the falls on the Zimbabwean side.  Unlike the Zambian side, we had to pay to get into the enclosure.

At the time of writing, the exchange rate was around 8 to the pound. Therefore 1 Zimbabwean dollar (pronounced 1 zim dollar and written Z$1), was roughly equivalent to 12p.  With inflation at huge levels (like Zambia), this exchange rate wouldn't be valid for very long.  We each had to pay Z$4 to get in, and we then proceeded to walk the 1km to the falls themselves.  There was definitely more volume to these falls with clouds of spray actually thrown into the air with the violence of the water flow.  Throughout the 1km length of the falls, there were clearings in the rain forest with crazy paving leading to the edge of the cliff where the falls could be viewed clearly.

Photography required a bit of care, lining up the picture with my palm over the lens to prevent it misting up, and then briefly taking my palm away to take the picture and then replacing it as soon as the picture was taken.  At one point along the pathway, there were some steep steps which lead to a ledge half way down the falls.  Due to the time of day, this was the only place where we saw a decent rainbow.  It was pointed out to me by another tourist that there were two rainbows: the normal strong one, and a weaker one on the outside, but surprisingly the outer weak rainbow had its colours reversed.  I tried to think of an explanation for this but could come up with no satisfactory answer.

Away from the main waterfall area, the rain-forest changed into parched grassland.  From the cliff edge, one could see the main waterfalls in the distance and various other smaller waterfalls dotted around the cliff edge facing us.  We put all our luggage down and took each a turn at walking along the remaining cliff edge while the other person guarded the luggage in the comfort of the shade.  I was glad for the rest because I was getting quite tired and I had developed two very painful blisters on the 4th toe of each foot.  While sitting there together, we often talked to other tourists, and while talking to a German couple, we found out that they were hiring a car from Avis the following day, and were going to drive to Hwange National Park to see the animals.  I told them that we too were going to Hwange tomorrow and that if they like, they could take us along and we would contribute half of the cost of the car rental.  After a brief discussion in German, they agreed and told us to meet them outside the Avis offices at 11.00am the next morning.

When we had seen everything there was to see at the falls, we started to make our way towards Victoria Falls Town, a journey of about 2km up a hill which we naturally walked with our luggage and got very tired.  The town is quite small and consisted of the usual main shopping area surrounded by hotels and the camping village.  Also close to the town centre was the train station.  We naturally chose the camping site as our preferred accommodation that night, but when we entered reception at 4.30pm, all the chalets had been booked up.  However people were supposed to confirm their booking before 5.30pm otherwise the room would be made available for immediate use by those who waited for them.  I wasn't going to take any chances: 6 people had not yet confirmed, so I decided to wait there until 5.30 so I could get the first available chalet if someone did no confirm.  Erik left his luggage with me and walked around the rest of the town to see if there were any cheap hotels with available rooms just in case we were unsuccessful in the camping site.  However I was successful and was given a chalet at 5.30.

The chalet (*) was a beautiful building with walls of wood and mud and a very professional looking thatched roof.  There were cupboards and bedside cabinets and even a fridge with a jug of cold water.  The fridge had a rather novel design with the freezer compartment which was unseparated from the fridge floor which was the normal warmer compartment.  There were in fact three beds in the chalet, and since we were a group of two, we had only paid for the accommodation of two: ie Z$60 (30 * 2).  While talking to some other travellers from England, we found out that there was a Dutch traveller who need a bed for the night, and there were no more chalets available.  I suggested that he use the third bed in our chalet if he paid a third of the Z$60 which we had already paid.  When we met him (his name was Michael), he readily agreed, and gave us each Z$10, so that the chalet was now costing us Z$20 equivalent to £2.40 per night.

After the events of the day, and walking between 8 and 10km with my rucksack and two blisters, I had an invigorating shower, talked for a while, and while the others went to say good-bye to some other students we had met, I wrote some of this diary, but fell asleep before I knew what was going on.



Fri 18.12.92  (Day 5)



I had found out shortly after crossing the border from Zambia that the Zambian kwacha was not a valid currency on the world market, so any kwacha we had was completely useless.  I had K7000 (£14), Erik had K18000 (£36) and Michael had K2000 (£4).  I suggested that we pooled our money, and I would go over the border to change the money at a favourable rate on the black market, and they all agreed.  Erik and I had to be at the Avis offices by 11am, so we decided that if I couldn't change all of it, we would all keep an equal percentage of the money we had contributed in kwacha.  I was ready to walk the 4km to the other side of the border, but I was hoping to meet people from the Zimbabwean side who were going to Zambia, and therefore needed kwacha.  I met a few people who exchange small amounts of kwacha for zim dollars, but one person I met told me that I was going about it the wrong way: there was a train which should have arrived in Falls town at 8.30am, and although it was late, it would probably arrive before the deadline of 11am.  I was already 1km into no-mans land, but I decided to walk back and try my luck at the train station.  During the time before the train arrived I packed my things.  In Zimbabwe, there are very tight currency restrictions, and it is in fact illegal to change currency on the black market, and we were told by the locals that the police often go around in pain clothes to try and entrap people into changing currency.  We conducted the whole process with an intermediary who was a luggage carrier, and if we were caught, we were in fact paying the luggage handler for his services. There was no lack of people wanting kwacha for their zim dollars, and we easily changed the remaining amount of money we had in two transactions with reasonably favourable exchange rates.  Our second transaction was abruptly interrupted when another luggage handler who was a lookout gave the sign for a policeman.  This was the sign of the crossed wrists as if he had handcuffs on, and when the suspected policeman came up, he asked if he could change currency and we all said that we had none to exchange, but he persisted and after talking with him for a time, the others decided he wasn't a policeman and did in fact change some currency for him.  They weren't arrested, so presumably he wasn't a policeman.  The whole process took about 10 minutes, after which we happily walked to the Avis offices with no more kwacha left.

We met the couple at the appointed time, and after a short delay which I re-searched the chalet, because I incorrectly thought I had lost my binoculars, we set off towards Hwange.

The journey took about two hours, one hour on the tarmac and another along a dirt road to the Sinamatella camp.  We were told there that there were no chalets available, but that the main camp was larger, less isolated, and more likely to have chalets available., so we decided to backtrack and go to the main camp.  This journey was quicker because the road was tarmacked all the way to the camp and we arrive there at 3pm only to find that again there were no chalets available.  However the couple, Annette and Hubert, had a tent which they could sleep in and we decided that we were willing to sleep either in the open or in the car, so we stayed.  The prices were very cheap, Z$5 to enter the camp and Z$15 for the use of the camping site.  While we were settling into the camping site, we saw a mother warthog with its two children grazing on the grass between the tents (*) and apparently this was a daily event.  It was relatively tame and would come quite close for pictures, but if it felt threatened, it would charge at you stopping at the very last moment to avoid a physical confrontation.  There were also a pack of about thirty mongooses which could have easily have been mistaken for meercats because of the way they organised themselves, some of them acting as baby-sitters, and others standing up on their hind-legs as lookouts while the others scavenged the ground for morsels of food.  They would often congregate around the camp rubbish tip, but were tolerated because they generally kept the camp free of snakes.

When Annette and Hubert had set up their tent, we went off for a drive in the park.  That afternoon and the day that followed we saw baboons (*), buffalo (*), eland (*), elephants (*), gemsbuck, giraffe (*), hyena, impala (*), jackals, kudu, lions (*), reedbuck, sable, vervet monkeys, waterbuck, warthog, wildebeest and zebra (*).  We also saw many unidentified species of bird, although the ones which we could identify were ostrich, African spoonbills, flamingos, a secretary bird, vultures, eagles, crowned cranes, and red and yellow billed hornbills.  The most common animals be far were the impala (which were like deer), followed by zebra.  Late that afternoon, we saw three lions, one male and the other two females relaxing in the sun, We saw one pair of them mate, and later on when they had walked off into the bush, we heard the sound of a chase and then the last cries of some large game animal as the life was throttled out of it.

That evening an amazing coincidence happened: I met two other medical students from my year at The London Hospital, Liz Anderson and Rupa Maris. They had just finished their elective in the main hospital at Bulawayo and were doing a bit of travelling and sightseeing before they went home for Christmas.  They were travelling with a friend who was a freelance reporter who specialised in writing about HIV and AIDS, but worked generally for the Telegraph and Independent along with many other magazines.  Although she (Sasha Jephrey) was on holiday, she was looking for some story to write so that she could get tax relief on the money she spent, by passing the trip off as a business expense.  She explained to me the enormous amount of research a reported had to put into writing a single article, and the importance of becoming well known as a specialist in a certain field, her's being HIV and AIDS.  Her ambition was to become a columnist because that's where the money was.  Freelance writing was difficult and the pay was very erratic.

That night was quite warm and although I could have slept in the car, I resolved to sleep out on the grass under the stars.  The night sky around the equator is quite different: there are usually no clouds to obscure the view and the numbers of stars clearly visible is vastly greater than the number normally seen in Britain.  There must have been clouds somewhere because there was a flash of lightning visible every few seconds which I was later told was often cloud to cloud lightning, something I had not encountered before.

I bedded down on the grass and sand under a tree.  I slept in the inner sheet of a sleeping bag and used an inflatable cushion, both of which I had bought in London, but I was able to keep out the mosquitoes with a mosquito net lent to me by Rupa Maris.  I slept well that night, but I woke up at 3am because it was getting old, so I got into the car quietly and slept again until 6am.  I later found out that it was not such a good idea to sleep out in the open: lions and hyenas have been known to venture into the camp in the past, and although no-one had ever been attacked, hyenas are very curious animals and are known to be attracted by any noise, which they will bite at.  I was told that if I snored (which I don't), the hyenas might have bitten off my nose.  I still have my nose.



Sat 19th Dec  (Day 6)



The previous evening, the Germans had met another German hitch-hiker and it was decided that he would come along, and although it would be a little bit of a squash, our contribution to the car rental would be reduced from a quarter to a fifth.

The best times for seeing large numbers of animals is in the morning and evening when different species of animal come to the water holes or 'pans' in large groups.  The best way to see the animals is from specially constructed hides close to the pans in the morning and evening.  The hides (*) are not accessible from cars, and the only way to get to them is by paying a guide to walk you there.  Our group of five hired the guide for the 10 to 12 o'clock walk to one of the pans close to the camp.  All the walks for early morning and evening had been booked up, and we prepared ourselves for not seeing as much as the other groups would probably see.  However we did see some reasonably large herds of impala and wildebeest, along with a family of black-backed jackals , and the guide told us his well rehearsed stories about the times his group was attacked or surrounded by lions.  He told us how to act if we were charged by a lion: the thing to do was to stand in a group facing the lion and never look away or run away.  If you are facing a lion during a charge and you do not flinch, the lion will usually abort the charge, but the moment you turn your back, you are a goner. Despite having told a group of walkers a couple of months back what to do, they had scattered like frightened mice when they were charged by a lion. The lion had not stopped even with a warning shot from his rifle and was only frightened away when the guide had run towards the lion shouting and gesticulating madly.

In the afternoon and evening we went on a long drive into the park, where we saw a very large herd of wildebeest (*) probably at least 500 strong drinking and bathing in a pan.  We also saw a couple of elephants at very close range (*), along with the usual scattering of imapala and zebra (*).

When we got back, Erik and I settled the bill.  The hire of the car was Z$120 per day with Z$1 extra for each kilometre travelled.  Therefore the cost of the whole trip allowing for the fact that we had travelled 480km by that time was Z$720.  The calculations were not straightforward taking into account the fact that the cost would be divided four ways on the first day and five ways on the second.  Annette and Hubert took pity on us considering that Erik was very poor and I would have to pick up most of the cost of Erik's trip: they asked for Z$250, the equivalent of £30, so I paid Z$200 while Erik paid Z$50.  When I had first suggested the trip to Hwange, Erik had told me that he couldn't afford the cost, but I, in anticipation of how cheap it would be had said that I would pay a large percentage of the cost and he need only pay what he could afford.  I still consider £24 for two days in the park to be very good value for money and paid Erik's share without a grudge.

Erik and I now had the problem of getting to Bulawayo.  We were hoping to hitch a ride all the way to Bulawayo, but were willing to settle on am 18km lift to Dett station, where we could get to Bulawayo by train.  It was getting quite dark by the time we got to the gates of the camp and the chances of getting a lift anywhere were rapidly diminishing.  We were ready to give up when we met Liza, Rupa and Sasha who were just on their way to a different safari lodge which went part of the way towards Dett station.  They were also hiring a car so we offered to pay the full cost of the detour and they agreed to take us to Dett station.  We arrived at the station at 8pm and quickly found out that the next train to Bulawayo would arrive at 12.30am, but we were quite willing to wait.  There was a cargo train already waiting there, and when we found the driver, he told us that he would be happy to allow us to travel on his train free, but that passenger trains took priority and there may be so many delays that it was quite likely that the 12.30 train would pass him and be first in Bulawayo, so we decided to wait for the 12.30 train.

The 12.30 train arrived at 1.15am.  We had been quite determined to travel as cheaply as possible which meant going on economy class.  There are three classes on Zimbabwean trains: 1st, 2nd and economy class, the name of which had recently changed from 3rd class.  When we got onto the economy class, I realised that it was the railway equivalent of the shanty town: the carriages were packed full of people sitting and lying on the seats and even on the dirty urine-soaked floor.  The economy class cost Z$14, the 2nd class Z$22 and the 1st class Z$28.  It did not fully dawn on me at the time that these were the equivalent of £1.68, £2.64 and £3.36.  If I had realised at the time that it was so cheap, I would have gone straight for 1st class. Anyway, I was willing to sit in economy class as long as I could find a seat next to Erik.  The small of urine wasn't to pleasant, and Erik was worried about going to sleep in an area like that where anything could happen, so he went off to find the ticket collector to see if he could get a 2nd class ticket.  There were no 2nd class seats available anymore, but Erik had bargained with the conductor, who gave us a first class compartment for the price of a 2nd class one.

The 1st class compartment had obviously been grand at one time, and was probably grand to the average Zimbabwean, but it had obviously deteriorated over the years since the days of colonial rule.  The compartment had two seats which converted into two beds and there were two more beds which folded down from above our heads.  There was also a sink next to our window which surprisingly worked except that it was impossible to get ones hands under the stream of water because it was propelled against the side of the sink.  Erik and I shared the compartment with another Zimbabwean businessman, and it took the combined strength of all three of us to shift the lower and then move the upper bunk into the sleeping position.  After a half an hour delay in which we all talked with each other , I locked the door and we all went to bed.



Sun 20th Dec  (Day 7)



I awoke in the morning at 6.30 and spent the rest of the journey writing this diary and watching the scenery go by.

When we arrived in Bulawayo we had to find the missionary where Erik and possible I were going to stay.  Erik had only two pieces of information to go on: the name of a bookshop where the missionary was sometimes to be found (but it was Sunday and the bookshop was closed); and the name of the church which he worshipped at.  The church was called 'The Church of the Brethren of Christ', and we walked around the centre of town asking many people where it was, but no-one had ever heard of it before.  In the end we found ourselves at the main catholic church of Bulawayo, and after extensive questioning, Erik found a women who not only knew where it was, but lived very close to it and was going that way now.  We asked the woman how long the journey was and she said that it was about 1km.  Erik told me that he was sceptical and that whenever a Zambian or Zimbabwean person told you a distance, you should be prepared to multiply it by two or three.

He was right.  The journey was about 3km, past the bus station and the shanty town, and up a long steep hill in the searing heat with my 14kg rucksack and two blisters.  When we arrived at the church, the congregation, filled to about a quarter of capacity, was having a hymn singing rehearsal, but we were invited in and told by one of the congregation that the missionary would arrive in the church sometime between one and two hours from now, and that we would have to wait.  I sat in the church for half an hour listening to the singing which soon became quite monotonous, and Erik, sensing my disquiet, suggested that we wait for the missionary outside.

Outside, I sat on the steps of the church, took of my shoes and punctured my blisters with a hypodermic needle.

When the missionary arrived, he said we were welcome to stay, but that he lived outside the city limits and transport was very difficult.  One of the congregation, hearing of our plight suggested that we stay in his flat for free.  Erik readily accepted, especially because the house was within walking distance of the church and the centre of town, but I wasn't so sure and said that I would reserve judgement.  When we got to his flat, my reservations were confirmed: the flat was in the middle of a housing estate which was dirty and in a sad state of repair.  I would be staying in a one bedroom flat and sharing the double bed with Erik and the parishioner.  The window was broken and we were on the ground floor, allowing anyone to look through the window and to see my rucksack in the cupboardless room.  I knew there was the camping site, the hostel and numerous hotels in the city centre which I could use in preference to the flat, but I was quite tired of carrying my rucksack, so the parishioner suggested I leave my rucksack there.  He seemed like the religious type and I felt as if I could trust him, so I did as he suggested and Erik and I left for our first sightseeing tour of the city in an emergency taxi.

After the trip to Hwange and the various associated costs, I had practically no Zimbabwean dollars left, it was Sunday, and the banks were closed, so my only chance was to change travellers cheques in a hotel.  A shopkeeper directed us to the nearest hotel, and luckily they were able to exchange the travellers cheques for local currency.  We then walked to the camping site about 1km away to see what it was like and whether there were any vacancies. It was a lovely place in the middle of the park area, sheltered by tall trees with exotic looking birds.  The chalets looked quite reasonable and costed Z$40 per night (£4.80) so I decided I would stay the night there. With that out the way we decided to go to the natural history museum.  On our way we passed through what could only be called a 'multiple society wedding'.  We were later told by one of the ladies in waiting who we met outside the museum that there had been eight simultaneous weddings, but each of them had separate wedding parties and receptions afterwards.  Weddings are major events in Zimbabwe, much more so than in Britain, and people save up for many years for a really spectacular public wedding and probably spend the next few years paying off the remaining debt.

The natural history museum was extremely good.  There were very detailed sections on the indigenous mammals, birds, reptiles and insects of the area. They had the second largest mounted elephant in the world which was truly huge: it was about 12 feet high, and the tusks weighed over 55kg each. Another section was a section on the geology of Zimbabwe and there were hundreds of exhibits of the different rocks found there, and there was a section about mining with the exhibits suitable placed around a realistic mine.  The last section was a section on anthropology which explained the current beliefs about the rise of man through the ages from his primitive ancestry.  All in all, the museum was extremely comprehensive and would match anything in London, although the presentation was sometimes inadequately thought out.

After seeing the museum, we got an emergency taxi back to the area of the flat where I had left my rucksack, and luckily Erik's sense of direction was better than mine, because all the flats in the estate looked the same to me, and we soon found the correct flat.  The emergency taxi had agreed to take me back to the town centre, so everything was done in a great rush: I quickly checked my rucksack to ensure that all valuables were still there and had to say a brief farewell to Erik who had helped me so much on my travels.  Erik said that he would try to get back to the camping site that evening for a proper farewell, but in fact he never materialised.  It was a pity he did not come round, because I had promised to give him some money to live on. Because of our diversion through Hwange he had spent most of his money, and was left with only Z$30 to survive on in Bulawayo for 2 weeks, and this made me feel guilty.  I could have easily given him Z$50 and hardly dented my finances at all.

The taxi dropped my close to the camp site, which I rushed to, booked in, got my chalet, and then immediately ran a kilometer to a swimming pool which we had passed earlier that day on the way to the museum.  By the time I got there it was 5.50pm and the pool was due to close at 6pm.  It was still worth going in and it cost only Z$1.90 (£0.22), so I rushed in, got changed in one minute, and splashed into the water.  It was a severe shock to the system, but the feeling of having cold skin was wonderful after a very difficult, hot and humid day.  The pool was first rate, and was an olympic size outdoors pool surrounded by huge tropical trees and the sounds of tropical birds chirping.  All I could manage in the time was a relaxed six lengths, but I felt completely refreshed by the time I got out at 6pm.

When I got back to the camping site, I settled in and got talking with the people who were sharing the other side of the chalet.  Since I had arrived in Bulawayo, I had been asking peoples' opinion about my future travel plans.  I had intended to go tomorrow to the Great Zimbabwe Monument, but a few people told me that it was very difficult to get there by any form of public transport.  The only way to get there was to go on a tour, to hitchhike, or to have one's own car.  The tour and the car-rental would be too expensive and hitchhiking would be too unreliable, so I gave up on the idea of going to Great Zimbabwe.  People had also been telling me not to go on the route through Botswana.  The only part of the Kalahari worth seeing was the area of the Okavongo Delta and that was 500km out of my way.  The train journey to Johannesburg via Francistown and Gabarone was apparently extremely boring and the cities themselves weren't all that interesting as well.  With that in mind and not knowing what my future plans were, I went to bed.



Mon 21st Dec  (Day 8)



When I woke up, I started to read all the literature I had about the sights around Bulawayo and also about alternative routes to Ingwavuma and Mosvold Hospital.

There are about four tourist attractions in the areas surrounding Bulawayo: One is the Rhodes Matopos National Park which is supposed to have amazing scenery and rock formations.  There are also abundant game animals roaming free in the park and there are a number of caves with ancient bushmen paintings over 20,000 years old.  The other attractions around Bulawayo are the ruins of the 14th and 15th century settlements around Khami, Dhlo Dhlo and Naletale, which were the religious, cultural and trading centres in that region of Zimbabwe at that time.

I also started to read about other routes going south.  The obvious way would be the road south-east to Beitbridge and straight into South Africa where the obvious diversion would be a trip through Kruger National Park.  However, decisions about this could wait until later.  That morning I decided to go to the Rhodes Matopos National Park.  There was only one tour company I knew which took people to the park, but when I phoned, they told me that there were no tours that day because not enough people had booked and there was a minimum number of people they would take.  When I heard that there were no buses into the area, I resolved to hitch-hike there, so I walked across to the east of the city to the main road leading to Matopos.  I waited there for about thirty minutes, when someone past me and asked me if I was going to Matopos, so we could travel together.  He said that we could get there by a chain of emergency taxis, so we walked to the pickup point and soon caught a taxi.  The taxi took us to the first drop off point, but on talking further to him, I found out that the taxis were very infrequent, and there was a bus which supposedly went the whole way, so I took the next emergency taxi back to the city, and following his directions found the place where the bus should leave.  In fact everything he had told me since the moment I met him had been misleading or just plain wrong, although I still believe he had the best intentions.  In fact the place wasn't a bus station, but a tour company, but they did by chance have a tour to Matopos that day.  Unfortunately it was only a half day tour, and it cost Z$78 (£9.35), but at a loss of any other way to get there, I agreed to pay the cost.  I had to wait an hour before the minibus picked me up at 2pm, and I spent this time in the touring company office writing this diary.

The tour set off at the right time and the first place we arrived at was the grave of Sir Cecil John Rhodes (*), after which Rhodesia is named.  The grave is on the top of a mountain of solid volcanic rock which is dated at three billion years old, which is three fifths the age of the earth.  The rock is much harder than the surrounding soil, and the wind over millions of years had sculptured huge shapes out of the granite.  The name Matobo, the original name of Matopos means 'the bald headed ones' and the place is believed to be a 'malindidzimu' or 'a place of benevolent spirits', and they are probably right.  Rhodes and a couple of his friends are buried there in graves hewn out of solid rock and with metal covers with inscriptions short and to the point: "Here lie the mortal remains of Sir Cecil Rhodes" (*).

The next places we went to were two prehistoric caves: Pomongwe ('The Small Melon') and Nswatugi ('The Place of Jumping').  The caves were not big, the deepest about 5 metres into the rock.  The walls inside were covered with pictures of animals and humans in various scenarios such as feeding and hunting.  Some of the paintings were up to 20,000 years old and apparently the preservatives added to the pigments were egg yolk and animal or human blood.

The wildlife which we saw in the area were baboons, vervet monkeys, and some small mountain deer which I think were called 'Klipspringer'.  After seeing the second cave we went to the camping site in Matopos to see if there were any vacancies in the chalets, bet there weren't.  It would have been nice to stay a day there, because it would have given me a chance to see more of the wildlife, and go out on one of the long excursions on horseback.  After that we were driven back to Bulawayo, where I asked to be dropped at the train station, so that I could arrange a train journey to Beitbridge either that night or the next day.

A railway official (although only a ticket collector) told me that there were two trains a day, one at 1.30pm and the other at 8.30pm, but that the 8.30 train was all booked so I would have to wait to get one of the trains the next day.  I was all ready to start making my way to the camping site one the other side of the city when I met Liza, Rupa, and Sasha again, who were also trying unsuccessfully to arrange a train to Harare which is where they would fly out of.  They were also staying at the camp site where I was staying the previous day, and where I would have to spend another night. They were also going past the camping site, so they gave me a lift there.  I re-booked into the camping site, and I would have liked to have gone swimming but it was already after 6pm, so the pool would be closed.  I met my new neighbours at the camping site and promptly stopped them going to the swimming pool which they thought was still open.  They wanted to go out for a meal and to a casino for the evening, and they invited me along, but I declined because I wanted to do some reading and write this diary which was getting severely behind.

They went out at about 7pm, but camp back an hour later not having been able to find anything open.  Apparently Monday evenings are when everything closes for a rest, so for the rest of the evening we sat around a table, talking and generally having fun.  At the beginning we talked about our adventures during our travels.  Their names were Andrew and Craig and they had taken the opposite to my previously intended route coming up from Johannesburg to Bulawayo via Botswana.  (See Map) they agreed it was not a good route because it was hot and humid, mostly boring, and they had experienced some anti-white racism.  They thought my alternative route south-east to Beitbridge, and the south to Louis Trichart and then into Kruger National Park, travelling its whole length was a much better route altogether.  This clinched it for me and I decided to do that for certain.  For the rest of the evening we just talked generally, starting off the evening eating pecan nuts, then going on to scotch whisky and finishing off by smoking pot. Towards the end of the evening we got onto playing pub games, some of which were number games, but the highlight of the games was the progressive repetition of more and more poetic tongue-twister rhymes.  If you got the rhyme wrong then you had to drink the appropriate number of sips of whisky, or drags of marijuana.  The rhymes went as follows:

1. Brown bear.
2. Running horses.
3. Fat females.
4. Queer choirboys.
5. Slimy Sicilian sailors solemnly sailing the seven seas.
6. Punting down the river in a punt cut flat, not a flat cut punt, but a punt cut flat.
7. Peter pipers picked 7 pecks of pickled peppers, but where are the 7 pecks of pickled peppers that the 7 Peter pipers picked.
8. Rugged rascals ran around 8 ragged rocks, but where are the 8 ragged rocks that the 8 rugged rascals ran around.
9. I'm not a pheasant plucker, I'm the pheasant plucker's son.   If you want the pheasant plucker, you should wait until the present pheasant plucker comes.
10.   How much wood would the wood chuck chuck if the wood chuck could chuck wood.  If the wood chuck could chuck wood, then the wood chuck would chuck wood.


Needless to say, one got quite drunk and high if one made a mistake on one of the later rhymes.  Most of my mistakes were earlier on in the game and I managed quite well later on the later ones.  One thing which surprised me about marijuana was that it was extremely easy to inhale, being as far as I could gauge just like air, and had no after taste.  It worked quite fast within a minute, and its only effects were to make us a little light-headed and a little less restrained.  My feeling now is that I am not sure which is the worst of the three evils: smoking, drinking or marijuana.  Smoking causes heart disease and various cancers.  Alcoholism causes cirrhosis of the liver and various psychological and sociological problems.  Marijuana use causes the user to feel a little drunk and light headed, but the effects are short lived.  There are disputed reports that long term use causes a sort of chronic apathy, loss of concentration and maybe a reduction in memory capacity.  I think that if governments were given the chance to start again from scratch, they would probably ban tobacco and allow marijuana.

I figured that it was one of those experiences that would should have at least once in you lifetime, but also many psychiatric patients I have talked to have taken marijuana, and it is useful to understand the feeling of release from their tortured inner world which they so often crave for.



Tue 22nd Dec  (Day 9)



This is the day I was going to travel to South Africa via Beitbridge.  The first thing I did was walk to the town centre and look around the department stores, and I bought a pair of shorts to act as a replacement for the ones I left back in London.  I then got into a taxi and told him to take me to the train station.  When I got talking to him and told him where I was going, he told me that there was no railway line (and therefore no train) to Beitbridge, and so the only public transport there was the luxury bus or the economy bus.  I got off the taxi and tried to find the luxury coach station (to find out the price), but I never found it, and not being too bothered how I travelled, got into another taxi and told him to take me to the economy coach station.  I had passed the station once before when walking to the Church of the Brethren of Christ, and it was the bus station equivalent of a shanty town.  I asked someone to direct me to the bus going to Beitbridge, and a man said he would take me there.  When we got there, he waited around expectantly obviously wanting a tip, but I thanked him politely and got onto the bus.  The bus was hot and cramped, and naturally I was the only white person.  There was going to be a long wait before the bus set off which was slightly confusing because the bus was completely full a quarter of an hour after I boarded.  The most annoying thing about waiting there was that there was a continuous stream of street sellers getting onto the already packed bus and trying to sell the passengers various things such as food, drinks, sweets, watches and bracelets.  It was particularly tiresome because I had to keep my rucksack on my lap while they walked past.  After about forty minutes of this, when I was getting quite annoyed with it and my feet could hardly feel the pins and needles any more, I made a decision that I wouldn't let anyone else past me.  When the next seller got onto the bus, I put my rucksack very deliberately in the centre of the aisle, looked him in the eye, and said "you're not going past".  He looked rather amazed, and tried to reason with me that he had to sell his goods, but I replied that this was a bus, not a market place and he was still not going to pass me. The other passengers were also amazed and many of them burst out laughing, but none of them appeared to object.  Obviously what I had done got around outside the bus, because in the half hour which remained of the wait, no other sellers even attempted to board the bus.

When we set off, it wasn't towards Beitbridge: we were going to a garage where we had to wait a further thirty minutes while some repair was carried out on the bus.  After asking a number of other passengers what the delay was, I ascertained that it was either a flat tyre, or to top up on the oil. When we finally set off, I could finally place my rucksack in the central aisle.  I soon discovered that the bus kept on leaving the main roads to go to small towns, and it was clear that I had got the bus which zigzagged between towns on the route to Beitbridge.  It meant that I kept on having to lift my rucksack at each stop.  It was very hot, humid, tiring and squashed, and I soon wished that I had made more of an effort to find the luxury coach stop which would have done the journey in about four hours.  As it was the whole journey took 8½ hours (including the waits), and I arrived at Beitbridge at about 7.30pm.

It took about half an hour to be processed through customs and immigration because there were queues at both cubicles, and then I got a taxi to take me over no-mans land, which traverses the famous Limpopo river.  My view at that time wasn't very good because it was getting quite dark and it was raining quite hard.

The river at that point was about 100m wide, and although it could have been described as 'great, grey, green and greasy', I didn't see any areas 'set about with fever trees'.  I still had about Z$50 which I needed to change, and the taxi driver was able to change about half of it into Rands.  I'm sure he made a smacking profit out of me, but only on the equivalent of £6.

I was processed quickly through customs and immigration, and I chose not to tell them that I was studying there, because I am sure that it would have complicate matters, and besides, I would have had to search deep inside my rucksack to find my study permit.  I just told them that I was a tourist, which was partly true anyway.

As soon as I was through the border, I waited immediately on the other side to hitchhike with people driving through the border.  Soon I was approached by a nice young South African soldier on duty at the border.  I told him my situation, and he said he would see what he could do.  He came back shortly saying that he had found an off duty taxi driver who was willing to take me to Messina, so I agreed to come along.  The taxi was the South African equivalent of an emergency taxi, but here they were called 'combe's', and were minibuses rather than hatchback cars as in Zimbabwe and Zambia.  In the time between leaving, I changed the remaining zim dollars to rand with another taxi driver.

The combe took me and a few other travellers to Messina, and I asked to be dropped off at the cheapest hotel, which he did.  The hotel wanted R25 for the night, but I had only R21, which they accepted.  The night was hot and very humid, which I later found out was normal for Messina.  As soon as I got into my room, I had a shower and then washed all my white clothes in the sink with soap, because I had no washing powder.  The room had a good fan which I kept on all night to facilitate the drying of the clothes I had just washed.  Finally I went to bed at about 12am, inside my cotton sleeping bag inner sheet, because the sheets they supplied were completely synthetic. Before I fell asleep, I had to move the bed slightly to avoid the drips of rainwater coming from the leaking roof.



Wed 23rd Dec  (Day 10)



When I woke up, I got dressed and then threw all the sheets off the bed to ensure that nothing of mine had got entangled within them and then I packed my rucksack and left.  What I had neglected to do was realise that one of the sheets I had thrown off the bed was my own, so this was the first article I lost on my travels.  I would have phoned the hotel from within Kruger Park the next day and got them to send it to Mosvold Hospital, I of course paying the postal charges, but my receipt did not even have the telephone number let alone the address.  I also found that I had lost my shampoo somewhere between Messina and Kruger Park, and since I did not open the bag where it would have been contained between Messina and Kruger Park, I probably lost the shampoo in Messina also.

After I left the hotel, I walked to the town centre, and asked someone to direct me to the nearest Barclays Bank, and the directions lead me to a bank called the 'First National Bank".  When I asked someone else to direct me to Barclays Bank again, they pointed to the First National Bank and said that it was the same bank under a different name, and the teller at the bank confirmed this.I had to get some money because I had absolutely no currency of any sort left, so I used my Barclaycard to get out R400.  The current exchange rate was 4.6 Rand to the Pound or R1 = 22p, so R400 was equivalent to £88.  I needed to get a decent amount because it might be the last bank I passed until I reached Ingwavuma, which anyway does not have a proper bank to speak off.  I then went to the train station and asked when the train to Louis Trichart would leave, and they said at 2pm, which would mean a five hour wait, so I asked when the bus would leave, but I was told that it had left and hour ago.  When I asked him what the other alternatives were, the white man said there were the taxi combe's, but rather nervously added that they were for black people.  I replied that I did not mind and that I was in a rush, so he directed me there.  I quickly found the right combe to Louis Trichart, which cost only R10 and luckily left within 15 minutes.  The journey was 94km and took just under two hours over the mountains and through the mist and the clouds, to arrive there at about 11.30am.  The two South Africans in the camp site in Bulawayo had said that I would find everything I would need for my trip through Kruger Park in Louis Trichart.  I had arrived in the Indian township, so I walked the two kilometres to what was a very small town centre.  There were a few small shops, and the library and town hall.  I went into the town hall and asked for the department which dealt with tourist information and they directed me upstairs to a woman who was in fact the mayor's personal secretary.  Her name was Rose Olivier (pronounced 'Olivi'), and she sat me down in a comfortable chair and got me a choice of cold drinks from the fridge in the mayors office.  We talked for a while and she gave me the bad news that Louis Trichart was such a small town that there were no touring companies, and not even a car rental company, so I would have to go 120km south to Pietersburg where they would have all the facilities I was looking for.  She did not have information about the touring companies offering tours into Kruger Park, or about the prices of different car rental places, but she made about ten phone calls to Pietersburg to find out.  We had to wait until after 2pm to find out some of the information, because the people in Pietersburg were mostly on their lunch breaks, but in that time she ordered me a toasted sandwich from a local shop.  After 2pm she offered to take me to the main road towards Pietersburg where I could hitchhike or get a taxi and I gratefully accepted. There was a brief delay when we unsuccessfully tried to run start her car, and then successfully jump started it, because her husband had been rather absent minded and forgotten to turn off the headlights.  She dropped me off at a petrol station where I quickly found a taxi on its way to Johannesburg, but it was passing through Pietersburg.

The cost was R11 (£2.40) and the journey was reasonably comfortable taking a little over two hours.  Rose Olivier had given me the address of SATOUR (the SA tourist board) om Pietersburg, and as we drove through the town centre, I watched the roads go by and finally saw the right road where I got off.  It was 5.15pm already and the people at SATOUR were preparing to leave, but they kindly showed me all the relevant information on tours to Kruger and car rental.  None of the tours were suitable, so my only choice was to rent a car.  They told me that all the car rental places were at the local airport, and that to take out the car that day would probably be the same cost of taking it out the next morning, because the day on practical grounds had already finished.  There was a man and a woman working there, and the man said that he lived close to the airport and offered to give me a lift there, so I gratefully accepted.  When we arrived there, it was 5.25 and most of the places were just starting to close up.  There were three companies, so I quickly went around asking them their prices, and they were mostly around R145 per day, but Avis had a Christmas holiday special at R107 per day for two days, with unlimited mileage and a full tank of petrol.  The price for the two days would be R214 (£47) all inclusive, which was a good price, so I took it.  I paid with Barclaycard and showed my international driving licence and they gave me the keys.

The car was a Volkswagen Golf Citi which was yellow, and had done 16,000km. I sat in the car for five minutes and reminded myself about how to drive.  I only had 16 hours driving experience which was during my driving lessons, and then I hadn't driven at all for the 18 months since then, so I was understandably rusty.  My first manoeuvre was to reverse out of the parking space, and then I eased the car forward and out onto the main road, which like most of the South African roads I had experienced so far, were mostly deserted.  For the next 15 minutes I drove up and down the road practising starting, stopping and gear changing.  When I felt a little more confident, I drove back to the town centre and then towards the road leading towards Kruger Park.  I did ask someone if there was an area where hitch hikers waited, because I would have like to take along someone to Kruger as a companion, but also to split the cost of the car rental.  I went to the place where I was directed to, but there was no-one waiting there, so I gave up and started my journey east to Kruger.

The total journey was 185km, passing over the Strydpoort mountains and through the Magoebaskloof valley pass.  The journey was the most treacherous I have ever experienced including all the times I wasn't at the wheel.  The area was extremely mountainous with very steep rises and falls and very sharp hairpin bends on the edges of cliffs.  To add to the danger, I was driving after dark, mostly without the assistance of cats-eyes; it was raining heavily, and one the higher roads I was driving through mist which was the bottom of the lowest cloud layer; it was very humid which meant that the inside of the windscreen was thickly covered with condensation which was stubbornly resistant to the hot and cold air being blown onto it through the air vents.  It meant that I was almost blinded by other cars' headlights, even when they were dipped.  The icing on the cake was the presence of literally billions of flying termites, which on a clear day would still have brought visibility down to 200m.  For about 15 miles, especially on the highest parts of the mountains, there were about 5 - 10 termites per cubic metre which crashed constantly into the windscreen and were then wiped off by the next strike of the wipers.  I don't know where they were flying to, but a good few hundred thousand never reached their destination because of me.

In the midst of the mountains was the town of Tzaneen which I passed through and then onto the roads leading down the mountain and onto relatively flat ground.  At the point where the smaller mountain road joined the South African equivalent of the motorway, I stalled on the wrong side of the motorway and couldn't re-start the car for at least ten seconds.  Being on the fast lane, and realising the danger of the situation, I got out of the car ready to frantically wave to any car coming towards me and run out of the way should they not see the car in time.  Fortunately no other car was coming my way at that time, and I pushed the car quickly onto the right (correct) side of the motorway where I stopped to gather my thoughts.

Soon I continued on my way, but I was continually noticing people flashing their headlights at me, so I stopped again, got out and had a look around the car to see if everything was alright.  I noticed that the headlights were on high-beam, so I started experimenting but I couldn't find any way to dip them.  I though of reading the car owners manual, but I couldn't find a car reading light, and I also couldn't find my own torch in the pitch darkness. When a few more people had flashed their headlights at me, I stopped again and resolved not to continue until I had had a look though the manual.  I knew my medical torch was in my toiletries bag, so I rummaged through my rucksack and found it.  I had a look through the manual and while flicking through to find the section on headlights, I noticed that there was a reading light in the car, but in stead of the usual positions at the centre of the front of the car, or on the sides of the car at the junction of the front and back seats, the light was in fact directly above my head.  With that light on, things were much easier.  I found out that the headlights toggled between normal and high beam by pulling the indicator lower towards the steering wheel.  I also discovered that there was a rear window windscreen wiper and how to operate it.  This was useful because I had long since given up using the central read viewing mirror because the rear window was so covered with rain drops and impacted termites.

Feeling more confident with the extra information I now had, I continued safely on my journey past Gravelotte and finally to Phalaborwa.  When other cars approached me, I now dipped my headlights to avoid blinding the other drivers.

I arrived in Phalaborwa at about 11.30pm, after about six hours of driving. Phalaborwa in a town which is about 2km west of the Phalaborwa gate of Kruger park.  I talked briefly with someone in a truck, who told me where I could sleep and asked me what I was doing there.  When I had told him, I asked him the same question, and he told me that he was a plain clothes policeman on duty in that area at that time.  I realised that he had in fact been probing me to find out whether my reasons for being there at that late hour were genuine and harmless.  After that, I settled down close to a petrol station, and slept the night in the back seat of the car.



Thur 24th Dec  (Day 11)



I awoke some time around 5.30am to the deafening sounds of the cock crowing in the garden which I was parked next to.  I lay on the seat for a while and then washed my face and brushed my teeth in the garage toilet.  Finally I left for the Phalaborwa gate, arriving there at 6.15am.

At the reception, I asked for a day pass, thinking that it included the charge for staying in one of the camps for the night, and immediately went into the park.  I should have read the leaflet I got more carefully because it would have told me that in fact the camps open their gates at 5.30am and not 6.00am as I thought.  More importantly it would have told me that the park and camp gates close at 6.30pm and not 7pm as I thought.  Other rules which I did know were the speed limits (50km/h on tar roads, and 40km/h on gravel roads), and also that I shouldn't get out of my car except in areas which were clearly marked.

The Kruger Park consists of a 350km long and 60km wide strip of land bordered on the north by Zimbabwe and the Limpopo river, on the east by Mozambique, on the west by eastern Transvaal, but it is also close in the Swaziland border.  There are nineteen rest camps inside the park of which nine are large.  Some of the larger camps are the size of a small town and have their own shops, banks and hotels.  The camps are generally located on the banks of rivers with a good view of the landscape going off into the distance and animals can be seen walking or swimming by, from the river-side restaurants.

Some statistics about the animals in the park are as follows: (*)

(The numbers in brackets are the approximate numbers of a particular animal that I saw).

Impala  -  125,000   (Hundreds)
Zebra  -  33,000   (Hundreds)
Buffalo  -  30,000   (Hundreds)
Wildebeest  -  14,000   (Hundreds)
Hippos  -  ?   (20)
Kudu  -  10,000   (20)
Elephant  -  7,500   (4)
Giraffe  -  5,000   (20)
Waterbuck  -  3,500   (?)
Warthog  -  3,000   (7)
Antelope  -  2,000   (?)
Lion  -  1,500   (1)
Rhinoceros  -  1,500   (1)
Leopard  -  900   (2)
Cheetah  -  250   (0)


In my two days there, I saw all of the animals mentioned above except the cheetah.  Impala are the most common animals by far, there being more than all the other mammals put together, and might also be called 'lion fodder' because they are the staple food of many of the carnivores in the park. Zebra and buffalo are the next most common, and the zebra generally keep to groups of two to ten, but buffalo are often seen in herds hundreds strong.

The terrain in Kruger park is very variable depending on the site.  The very north part (see map) which I did not go to is more desert-like, the area around the Phalaborwa where I entered is dense scrub-land, which clears to form a riverine area around Letaba and Oliphants.  Further south there are larger areas of savannah.  The most southerly 30km includes riverine areas around Skukuza, forest and savannah areas around Lower Sabie and Crocodile Bridge, and hilly or mountainous areas rising to 800m from Skukuza to Pretoriuskop.

That day I took the Phalaborwa, Letaba (*), Oliphants, Satara, Tsokwane, Skukuza route.  I saw elephants, zebra, giraffe, buffalo, wildebeest (*) and also some hippos (*) on the 90km journey between Letaba and Skukuza.  Close to the Phalaborwa gate there is an archaeological site (*) where a tribe had been living for 1000's of years right up until the 19th century.  The tribe was important because it was the only tribe for hundreds of miles which knew how to smelt and purify iron from its ore.  The tribe lived on a mountain with huts of varying sophistication depending on the seniority of the tribesman and also on what age in the tribe's history one is considering. The whole area is still in the process of being investigated, and the different huts are being rebuilt or renovated to show progressively the development of the tribe from the early to the late iron age.  The main architectural development was the use of mud walls to raise the conical tipi like thatched roofs off the ground and form the modern thatched houses which are seen everywhere in Southern Africa.  The tribe was apparently very secretive about the techniques they used in smelting the iron ore, and women were not allowed into the smelting area because they might marry out of the tribe and take the secrets away with them.  A guide took me up the mountain explaining the different points of interest and playing a cassette tape elaborating on the points he was making.  It was still early in the morning and I was the only person there so he took me around alone and it was a good start to the day.  For the rest of the day, I progressed south towards Skukuza, but stopping at all the main camps on the way to look around the curio chops and stock up on drinks.

As I mentioned earlier, I neglected to read the leaflet which told me that time the gates of the camps close.  I was all set to arrive in Skukuza just before 7pm, when in fact the gates had already been closed for about half an hour.  However, when I was 14km away from the camp, there was a diversion from the main road which I was intending to take.  The diversion was a completely different route towards the camp although it was only 4km longer than my original intended route, but either the new route was not well signposted or it was the approaching darkness which caused me to miss a sign and get lost.  I have no idea on which read I got lost but after about fifteen minutes, I found a couple in a car who were watching a lion.  The showed me where the lion was, and it took me about two minutes to find it because it was getting so dark.  When I had found it, I pointed out that we were supposed to be back in the camp by 7pm, and therefore were already late.  They were either German or Dutch and hardly understood any English so I couldn't get over the point I was trying to make, so I said "Skukuza" whilst shrugging and pointing one direction and then the other, and they pointed in the same direction as I had been going, so I left them there and drove towards what I hoped would be the camp.  I drove very fast for about five minutes, and after seeing no signs, I though the couple had been wrong so I turned back and again met the couple in the same place.  This time I somehow managed to get across my point, so they left towards Skukuza and I followed them.

We arrived there after about ten minutes of quite fast driving (80km) along the twisting roads in the dark, but I did feel confident after a full days driving and I safely kept up with them.  When we arrived at 7.25, as I had expected, the gates were closed and the security guard answered our calls. We had to fill in an incident form to explain why we were late.  I had to wait rather a long time while the couple tried to understand what was going on.  They did not understand the fact that they had to be in the camp at 6.30pm and also they didn't understand the incident form.  In the end, all they did was fill in their name and address and the guard gave up.  I was processed quickly, and the guard took away my day pass so I would need to buy another one tomorrow and I then I went into the camp.  I had a quick look around the camp and a more detailed look st the camp museum and library which had details about the history of the park and various exhibits showing the more famous events which occurred in the park.  One of these was 'Jock of the Bushvelt': Jock (also called Wolhuter), was a hunter in the early 20th century who was attacked by two lions and dragged by one about sixty metres by his shoulder.  He kept his cool however and playing dead for a while he managed to reach over to his other side with his good arm and get hold of his hunting knife, which he used to stab the lion twice in the heart.  After a brief run, the lion died, but its mate came after Jock, so Jock had to climb a tree with only his good arm, and managed to suspend himself from one of the higher branches out of harms way using his belt.  He then passed out and was found a little later by the rest of his party.  He suffered from a fever when his wound got infected but he eventually recovered to continue his hunting.  The site where this happened was about 25km south of Skukuza.

The museum also had formalin preserved animals in pots such as the foetuses of various animals like hippos and giraffes, and also snakes and scorpions. There was also a strange mounted head of a buffalo which was a genetic abnormality where the horns curled under the head rather than over it.  The only way it could have fed would have been to flex its neck and eat the grass between its legs, but it obviously managed it well because it did grow to full size before it was killed and mounted.

That night I slept the night in the car in the camping site part of the camp.



Fri 25th Dec  (Day 12)



Once I was up, I went to the main camp reception and bought another day pass.  Then I went to the camp shop to have my camera seen to.  I had been having problems with the film since Hwange National Park when despite loading the film normally, the camera started winding it on to the first picture, but never got there and indicated on the LCD that there was an error.  I had no choice by to rewind the film, and then used one of the other films I had.  The next Monday in Bulawayo I took the film to a camera shop for them to look at.  They said it was the film box which they changed for free.  However when I got to use the film in Kruger, the camera motor seemed very laboured when winding on the film, and then finally half way through the film on the 24th, the camera gave up winding the film on and wouldn't take any pictures at all.  Luckily the shop in Skukuza had a "dark room' which was in fact a small box with two snug fitting double layered black gloves penetrating inside it.  The assistant in the shop tried to move the film first, but it was hammed and she didn't want to force anything, so I tried.  I managed to move the film and close the camera.  I took a few test pictures but the camera motor was still laboured, so I gave up on that film, rewound it manually in the dark box and bought another one.  This one worked perfectly and I used it for the rest of the day in Kruger.

Realising it was Christmas day, I decided to give myself a treat, so I bought myself a packet of sweets and two packets of crisps which I devoured over the course of the coming day.  The experience taught me a new skill: driving a car with one hand whilst eating with the other, or driving the car with my knees while eating crisps with two hands.  This is easy enough on a straight road but it does get difficult (but not impossible) when taking corners.

That day I was intending o travel a huge circle 100km around the south-east of the park, through Lower Sabie, Crocodile Bridge, and then zigzag west to hopefully reach Pretoriuskop and the Numbihek gate by 6.30pm.  I set off shortly after 8am, travelling about 50km next to the Sabie river, and seeing many monkeys (*) and a few hippos (*).  There were only two roads which could complete the circle and as I came to each of them, I found that they were both closed, so I had to reluctantly double back over the seventy kilometres I had already travelled.  The last twenty kilometres were not very good because the road was thickly shut in by tall trees which obscured anything that was behind them, so I decided to take a diversion.  The road was supposed to be closed, but the no-entry sign had fallen down allowing me to enter.  I was confident that I wouldn't get stuck in any mud because the road did not pass over any rivers or streams, and it had not rained for at least two days, so all the mud would have dried up.  I was right, and I was lucky to have taken that route because I saw the only rhinoceros that I saw in the park on that little diversion.  Unfortunately, although the rhino was very close to the car and I did get a very good look at it, I was going 50km/h, and by the time I braked and reversed, the rhino was already starting to trot off.  I looked carefully around that and other close-by areas but I never saw another rhino that day.  I then had to travel all the way back to Skukuza which took over an hour, even breaking the speed limit for most of the way.  When I got there, I went straight to the reception to ask them why all the roads I had wanted to use were closed, and they replied that they had not got round to opening them after the rains of two days ago.  I then asked them to check if the roads along the new route I had worked out were open and fortunately they were.  The extra distance I had to travel meant that I was going to run out of petrol before Nelspruit, so I filled up the car with R10 worth of petrol to prevent this happening, and immediately set off.

My previous experience of travelling on the minor dirt roads made me less nervous about travelling on them again, so I zigzagged on the dirt roads in the general direction of the route which I had been told was open.  During this time, I had my first opportunity to actually have some fun when driving the car, so I did some fast swerves, some fast 180 degree turns, some very sudden emergency stops, some wheel spinning starts, and some skid stops using either the front or back brakes.  It is only by doing these kinds of things that one is able to get an idea of the limitations of the car and the functioning of some of its parts.  I was especially struck by the relative ineffectiveness of the back brakes in stopping the car and how easy it was to swerve the car using the back brakes.  My time on the dirt roads passed without incident, but I was at one point forced to turn back because one of the roads which was particularly low in the ground was, at the point of the bridge, overrun by two feet of fast flowing water from the river which was still swollen from the raids of two days ago.  This slightly disorientated me, and because the roads I was travelling on didn't seem to be on the map, I was forced to use my compass to decide which road to take.  I took the road which looked as if it was going further west, and fortunately I met the main road after a while.  It was already 4.30pm, so I started my journey towards the gate.  It was 55km to the gate, which I travelled swiftly.  This didn't seem to matter because there were hardly any animals to see anyway.  I did drive up a small mountain for a short while which have an excellent view of the park for probably 15km.

The last twenty kilometres were a gradual rise up the Lebombo mountain range which I later found out was the same range which Mosvold hospital and Ingwavuma were situated on.  I stopped off very briefly in Pretoriuskop to buy some more drinks.  In that kind of weather, one had to drink between three and four litres of fluid a day although that is nothing compared with the six to eight litres of fluid I drunk on my walk around the Victoria Falls.  I finally arrived at the gate at 6.20pm, ten minutes before it was due to close.  The officials checked my day pass and then let me pass.

I now had a 50km drive to Nelspruit which I achieved in less than one hour. On one of the roads which was sufficiently empty and steep, I put the accelerator to the floor and attained a speed of 140km/h.

It was already dark when I arrived there and I had a brief look around the own to find the bus and train stations, and even by asking the locals, I only found the train station, and I then left for Nelspruit airport, which is where the Avis office was.  This was 10km from the town centre and was not well signposted, and at one time I thought I was lost although I later found on the road that I was not.  It was also worrying that the petrol gauge was already at the bottom of the red danger level, and most of the journey was up-hill, but luckily I got to the airport before the petrol ran out.

The Avis place was obviously closed and the only person at the airport was the security guard.  The was no-one to take me back to Nelspruit so I was prepared to sleep again in the car, but the security guard wasn't happy with this so he called his superior who said he would come round.  Just on the off chance he would take me back to Nelspruit, I decided to pack.  It was not easy to pack with the car's reading light, the security guard's light and my torch, and the process took at least twenty minutes.  When the security guard's superior arrived he said I should leave the car at the airport and he would take me back to Nelspruit, so I agreed.  He was in fact the chief of police for the while of Nelspruit and the surrounding areas but he was off duty and giving his father (who was head off the security firm) a hand when the firm was short-staffed.  I asked him to take me to the cheapest hotel in Nelspruit, so he took me to the 'Three Figs Hotel'.  He obviously didn't take into account the fact that I was willing to sleep in a "black hotel", because the one he took me to was reasonable smart, and the price for the night was R92 minimum.  I made out that I was a hitch-hiker and I did not have much money, and I asked jokingly if they had a broom cupboard somewhere which would cost R30 for the night.  The woman phoned her boss and came back to me saying that they were willing to give me a normal room for R50 (£10), so I accepted.

The room was luxury compared to what I had been used to for the last week and a half.  It was reasonably sized, but it had air-conditioning, a TV, an inside shower and toilet, and walls which were solid enough to be reasonably sound proof.  For the rest of the evening I relaxed in the room and watched TV with the air-conditioning on at full blast.  I also had time to ponder the events of the previous three days from Pietersburg to Nelspruit: The journey in the park and the car rental together had encompassed times of great danger and great excitement but had cost the equivalent of less than £80.



Sat 26th Dec  (Day 13)



I knew that that day I might be able to reach Ingwavuma but there was no obvious direct route there.  I could either travel through Swaziland where roads passed within 10km of Ingwavuma itself, but there was no border post there, so I would have to go to the southern border of Swaziland, do a U-turn, and then come all the way back to Ingwavuma.  (See map).  Another choice was to follow the main road routes to a large town called Middleburg where I could get a bus which passed through Mkuze.  This route would take me on a 300km detour away from the direction of Ingwavuma so it wasn't very attractive.  My other choice was to zigzag my way down the minor roads which pass close to the west border of Swaziland.  I had no idea which route I was going to take, and it was all going to depend on the advice I was given on the way and what transport was available.  My first bit of advice on leaving the hotel was to go to the taxi combes which it what I did.  I was told that I would have to make at least six connections if I went by combe, and as in Zimbabwe and Zambia, the combes can wait for hours until they are full before leaving.

It was at this point that I resolved to do my first bit of serious hitch-hiking so far on my travels.  I walked two kilometres to the main road which would start my journey either into Swaziland or on the roads around it.  I quickly worked out that the best way to get a lift was to look as if I meant it, which meant looking each driver in the eye, putting out my thumb, and indicating by the expression on my face that I wanted a lift from 'them'.  In this way, I got my first lift in ten minutes towards Barberton by a couple who had been on a shopping trip.  Just before Barberton was the road which lead towards Badplaas and I got off there.  I was picked up within five minutes by a man in a white Mercedes.  He said he would take me to Lochiel which was the place where I would have to choose whether to go through or around Swaziland.  As we talked, I found out that he too had been in Kruger the previous day, and when I told him that I had been in a rented yellow VW Golf citi, he said "Oh, were you the yellow golf we kept on passing around Oliphants two days ago in the afternoon?".  On reflection, I remembered a white Mercedes which I kept passing as we started and stopped while watching animals around Oliphants., so probably this was the same Mercedes and the same man.

The car was air-conditioned and during the journey I had to turn it down because my nose was beginning to run and my face was beginning to get uncomfortably cold, whilst outside it was stiflingly hot.  We also talked about the political system in South Africa and the amazing twists and turns which have taken place over the last fifty years.  In the 1940's, black people had the vote, but generally they were so uneducated or ill informed they rarely ever used it.  Then the Nationalist party had got in, and by some rather devious legislation they had removed the vote from the blacks.  Their justification was that the whites had developed South Africa from nothing, and if the blacks were given the vote, they (outnumbering whites five to one) would soon take everything away from the whites if they were given the opportunity to do so, and their suspicions were almost certainly not without foundation.  The Nationalist party had tried initially to change the constitution, but did not have a sufficient majority to do so, so they managed to pass some legislation which gave the rural population who tended to by Nationalist, a larger percentage of their version of MP's in the house of commons.  In this way they got the majority they needed to change the constitution.  From that time onwards until now, there had never been another election where the Nationalist party could be booted out: only elections to choose between different Nationalist candidates.  They also experimented with having a prime minister which they soon gave up.  The post of president was surprisingly, or perhaps not so surprisingly a life post given to a Nationalist person.  Meanwhile the Nationalists tightened their control of the country.  They divided no-whites into different categories such as orientals, asians, colours and blacks, and generally the darker your skin the less rights and privileges you were entitled to.  Blacks were not allowed to go to certain schools, or to live in certain areas, or to work in certain positions of responsibility or authority.  They carried forward this philosophy in many ways such as the reasoning that blacks would never hold positions of responsibility so there was no point in giving them then an education geared towards making them managers and directors when all they would ever be doing is mining and sweeping the streets.  That is all the history I got into on that journey.

I had originally asked him if he was going to Lochiel and he said 'yes', but he later told me he was going to Durban, but that he was passing through Piet Retief.  We had already gone 50km, and Piet Retief was an extra 150km on my way to Ingwavuma passing along the route outside Swaziland, so when he offered to take me there, I happily accepted.

He dropped me off at Piet Retief on the road going towards Mkuze which was now only 150km away.  I was ready to hit-hike again, but an emergency taxi stopped for me as I thumbed a ride.  It would have been nicer to hitch again, because the conversation is better and it is generally more comfortable, but one generally takes the mode of transport which is immediately at hand so I took the taxi.  The Taxi was going to Pongola, a distance of 100km and the charge was R11 (£2.30).  The journey did not take long on the straight flat empty roads and I was already 75km from the hospital at 2pm.  The roads at Pongola were very empty and I seriously doubted by ability to hitch a ride from there.  There was a taxi which was going to Mkuze, but it was less than half full and there was no telling how long it would take to fill up and leave so I went out to the road to try and hitch in the meantime.I took a short break after 15 minutes to get a drink and try to phone the hospital to tell them I was on my way, but the only public phone in sight was broken, so I went back hitching.

I was lucky this time.  A lorry driver who was taking a small load of construction materials to Jozini offered me a lift.  He told me that the ride would be slow because he had a punctured rear tyre, but I said it would not matter.  Jozini was better for me because it was 20km closer to the hospital than Mkuze.  Since both towns were in Mosvold hospital's catchment area, I could be picked up by an ambulance from either place, so I took the first transport to either place and it happened to be Jozini.  The truck indeed went slow, but that gave us ample time to talk about the continuing history of South AFrica and the different peoples that live there.  He thought that the Nationalists would never turn over the country to the communists of the ANC, and that if they did, all the Zulus in the country (8,000,000 in total, compared to the 2,000,000 supporters of the ANC) would rise up, and there would be a full scale civil war in which the government would support Zulu Inkatha.  He said that even if the country was not turned over to the ANC there would still be civil war, and he was so sure, that he was moving out of the country in anticipation: He had already bought a farm in Peru and was moving out there in three months.  He said that the Zulus were normally a peace-loving, or perhaps a quiet-loving people, but they have a tribal system, and on the orders of their leaders they would unhesitatingly have an all out war.  On of the first Zulu leaders ,in the 18th century called 'Shaka Zulu' had taught that you should not keep alive an enemy prisoner, because one day he will return to kill you, and this mentality does tend to run through the Zulu people.  He said that if a Zulu hates you, he will happily take a stone and smash your skull to a pulp: "The sense of proportion which would normally stop a person beating someone else over the head with a stone after one or two strokes doesn't occur in Zulus: They will just carry on hitting you until there is nothing left of your head".  I don't know if his observation / judgement is correct or fair but I suspect there is some truth in it.  I don't know what percentage of Zulus are Christians, but there is certainly a very strong religious core, and the above mentality wouldn't apply to them.

There was a final steep climb to Jozini up the steep roads which were dug into the 'cliff like' edge of the Lebombo mountain.  The lorry went extremely slowly (about 5 - 10 km/h) up the really steep roads and a little faster along the flat or down sloping roads.

I arrived in Jozini at 3.30pm and tried to phone the hospital, but the phones had no dialling pad or dial.  They only had something on the side of the telephone which I think you rotated to get the operator, like the old style telephones.  I was just about to give up trying when the Lorry driver (Les Westraaq) who I had said goodbye to a few minutes before shouted to me to come.  He had found the Jozini clinic a little further on in his journey, which is one of the outlying clinics of Mosvold Hospital.  He took me there where I radioed Mosvold Hospital on a CB, and eventually spoke to a doctor who said he would arrange for an ambulance to come and pick me up after they had finished their business for the day.  I waited in the clinic for 4½ hours passing the time by looking at the surrounding flora, fauna, and also writing some of this diary.

Just before 8pm, the ambulance arrived and took me on an extremely bumpy ride over the dirt road to Ingwavuma, and the hospital.  My first impressions were favourable with the buildings laid out sensibly and were reasonably well maintained.  There was a 100m walk to one of the doctors houses where everyone was having a drink and a little snack, and I joined them there.

The names of the doctors and their wives were:



The other student there at the time was called Hugh Jones and he was from University College Hospital.  Amazingly I found out that he lives only about 200m away from me in Muswell Hill.  That evening, only Duncan, Mimi, Karen, Duncan and Hugh were there, and we talked about my travels, where I was from and about the hospital in general.  After about an hour or more of talking, Hugh took me to the guest house where my room was to be.  The building looked well maintained, and it had a kitchen, living room, bathroom ,toilet and four bedrooms.  Hugh was the only person occupying a room at that time, so I had choice of one of the other three.  One of the rooms had three single beds in it, and looked rather bare, another room had a single bed and sink in it, and the last room had a double bed with a nice bed post and matching drawers, and a window which faced east (for the sunrise), so I chose this one.  None of the rooms had any keys, and the front door, although lockable from the inside, was not lockable from the outside.  Also one could not lock the door from the inside during the night, because other guests in the house might be on call and it might be locking them out.  Hugh assured me that it was completely safe and that nothing of his had been stolen even when leaving both his door and the front door open during the day when he was working in the hospital.  I said that I hoped he was right, but that could he close the front door when ever he left the house, and he agreed.  I spent the next hour unpacking and then went to bed.



Sun 27th Dec  (Day 14)



It was Sunday, so luckily I had a whole day to settle into the hospital.  In the morning, Hugh took me on a guided tour of the hospital.  There are six wards: Male, female, TB, maternity, paediatrics and isolation, although there is a nutrition ward totally staffed by nurses who deal wholly with malnutrition.  The two other departments are the Outpatients Department (OPD) and the operating theatres (OT's).  I did not see enough of any of the departments to describe them in detail here so I won't.

In the afternoon, Hugh took me for a walk to the local supermarket, called the Spar, which had the same symbol as the Spar has in Britain, then showed me the direction of the post office, and finally took me on a 1km walk of the local dam.  This was practically dry at the time because of a serious drought which has lasted for a whole year.  The summer in South Africa is the time of the rainy season and there has hardly been any rain this summer.  I heard later in news reports that many of the key dams in South Africa were between 10 and 20% of their normal capacity.  Because the Ingwavuma dam is practically dry, the water has to be ferried in special trucks many times a day from Pongola at a cost of R100,000 (£20,000) a day to the KwaZulu government.  There is an amazing waste of water in the hospital, and for the price of one days water transport, the government could save much of the waste by installing long drop toilets and repairing numerous rain water containers: Many of the houses around the hospital have huge water containers which are 6 to 10 feet high and 3 to 4 feet wide, which are directly connected to the guttering of the roof, and often fill to overflowing after a moderate rain.  This water is often used for watering plants and crops, but is often good enough for household use and even drinking.  The problem is that most of them leak so fast that they are generally empty after only one to two days.  There are many other examples of the KwaZulu governments backward looking policies which will be explained later.

That evening Hugh, Karen and I were invited for dinner and Duncan and Mimi's house, and having pre-told them that I was a vegetarian, they had a meat curry while I had a vegetarian curry.  It was extremely hot from an overdose of chilli and I had to drink a lot of water with each mouthful just to get the mouthful down.  When the evening finished, Hugh and I went back to the guest house.  Hugh told me that the phone in my room was broken, so it would be difficult to be on call if no-one could contact me.  We agreed that this was a pity, because although neither of us enjoy being woken up in the middle of the night, we wouldn't mind being woken up occasionally if there was something particularly interesting to see.  After that I went to bed.


The Hospital and My Work in It



As I said before, there are six wards and four doctors.  Each doctor takes one ward, although one of them has to take on TB ward in addition, and everyone helps in the running of isolation.  After six months, everyone rotates to another ward which ensures that everyone gets experience of all aspects of medicine, and prevents any one doctor from taking one of the more busy wards for too long.  At the moment, Duncan has female ward, Kierce has male ward, Karen has paeds ward and Andrew has maternity.  Kierce is the one who is currently also looking after TB ward.  All doctors go to out-patients department (the hospital's equivalent of casualty), the clinics outside the hospital, and the operating theatres.

OPD is the front line for all patients coming to the hospital from the "outside world".  This includes all accidents and emergencies to the hospital, all referrals from any of the external clinics, and any follow up visits from previous problems.  The OPD department is open 24 hours a day, 7 days a week, but is only manned by doctors during working hours unless there is an emergency.  Otherwise, there are nurses there 24 hours a day.  There are two doctors on call all the time, although there is a '1st on' who takes all emergencies in normal circumstances, and a '2nd on', who only comes out when it gets too busy, or if there is an emergency which requires the presence of two people, for example a caesarian section.  Luckily for them, the 2nd on is only rarely called out, and it is even quite rare for the 1st on to be called out during the night, because the nurses try to get any burning problems out of the way earlier in the evening.

Because of the relative lack of doctors, much more power is delegated to nursing staff for some of the more mundane and straightforward tasks, which doctors in Britain often find themselves doing.  These include stitching of wounds, repeat prescriptions for chronic patients, new prescriptions for acute straightforward problems, and of course a multitude of baby problems. This is especially true in the external clinics.

There are four major clinics: Gwaleweni, Ndumu, Shemula and Manyseni, all within two hours of the hospital by the dirt roads, but the journey is so bumpy and uncomfortable that the last three in the list are usually visited in a light aircraft in a circular route, each clinic having its own runway. The four major clinics are usually visited once a week by one of the doctors at the hospital.  The clinics are fully run by nurses the rest of the time and the nurses only refer to the doctors the problem patients.  The buildings are moderately well equipped, having consultation rooms and beds for particularly ill patients, or more often for mothers giving birth.  All of the buildings are getting a bit run-down and privacy is sometimes a problem with too few rooms or broken windows.  The other two problems which affect the clinics are lack of water and lack of drugs.  There is always enough water to drink, but the reserve tanks were empty all the times I visited which meant that one couldn't wash one's hands in the sink, because no water came out of the taps.  No hospital in South Africa should be lacking in any of the essential or even specialist drugs, but because the pharmacy at Mosvold is run rather inefficiently, this quite often happens, and the clinics being that much more isolated are usually worse off than the hospital.  There are also a number of mobile clinics (53) held at various points around the hospital's catchment area in places as diverse as shops, churches, inns or even under trees.  The clinic points are visited usually once a week by nurses in their 'bakkies' (the Toyota equivalent of the Land Rover) in a circular route covering many clinic points.  By going every day of the week it is possible to visit every clinic point in one week.  The hospital has 5 bakkies for the nurses visiting the mobile clinics, 2 bakkies for the nompilos (community health workers), 2 ambulances for emergency use, and the use of a plane to get to the more distant clinics.

Some other statistics are also enlightening when compared with the relative abundance of health resources in the UK:

No of population in Mosvold's catchment area  -  80,000
No of doctors at Mosvold  -  4
No of nurses at Mosvold  -  about 50
No of nompilos based around Mosvold  -  about 70
(Note : Two years ago there were only 2 doctors: Andrew & Kierce)

Hospital Beds:


Total number of hospitals beds at Mosvold  -  235
Av No of patients seen in OPD / week  :  200  -  500
Av No of operations done in OT's / week  :  20  -  40
Av No of patients admitted / week  :  10  -  30
Av No of patients lodged / week  :  10  -  30
Av No of babies born at maternity / week  :  10  -  20

Notes :


The diagnostic facilities available to the doctors of the hospital are the same as any other major hospital, except that sometimes the patient or sample will have to be sent to another hospital for the test.  On the hospital site they have facilities for X-ray, FBC (Full Blood Count), U+E (Urea & Electrolytes), Creatinine, LFT's (Liver Function Tests), serum proteins, blood or urine microscopy, ESR (Erythrocyte Sedimentation Rate), pregnancy tests, sputum for AAFB's (=TB bacteria).  There are also serological tests for syphilis, malaria and typhoid (Widal).  Notable tests which cannot be done in the hospital are arterial blood gases, virus analysis, or any sort of culturing of samples.  These tests have to be sent to Ngwalazan in Empengeni, which is the nearest referral hospital.  The other pieces of equipment which the hospital does not currently have are an ECG (Electrocardiogram) and a defibrillator.  The ECG has been broken for a number of months, but is supposedly to be replaced soon because the hospital has been given some money to spend unexpectedly.  The hospital has never had a defibrillator, and this is one of the things the hospital is considering getting with the new money.

There are three other hospitals of similar size to Mosvold in Northern Natal: Manguzi, Umshaleni and Bethesda, and they are all within easy contact of each other by telephone or radio.

There are four main referral hospitals for Mosvold -
(One in Empengeni and the other three in Durban)



My work in the hospital



The working day starts at 8am with a ward round.  This may seem early, but in fact it does not feel that way because it gets light very early in South Africa and the wards are only a 20m walk away from the guest house.  (On Monday 8am there is a short meeting of all the doctors to discuss any pressing matters).

In the past, elective students have taken on a ward for 1 to 2 weeks, and rotated through the wards as the weeks of the elective go by.  I took on female ward for the first week, male ward on the second week, a combination of male and TB wards on the third week, and a combination of maternity and paediatrics in the fourth and fifth weeks.  Most ward work is completed on the ward round in the morning (between 8am and 10am) where patients are examined, assessed and the management decided on.  On a rota, one of the doctors goes to OPD before the ward round to try and keep the waiting time in OPD down, and then does the ward round after the 10 o'clock break.

On my first two weeks there I followed the doctor around on the ward round, but as I became more familiar with the routine, we would go through the ward seeing alternate patients, and I would only refer to the doctor if there was a problem or if I wanted to confirm my management.  On the last two weeks, on a couple of occasions when a doctor was away, I conducted the full ward round on male and female wards on my own.  Doing this kind of thing is especially difficult, firstly because I still felt that I did not know enough medicine to make informed decisions, secondly because I hardly knew any of the patients from before, and thirdly because all questions and answers had to be channelled through an interpreter.  When I had finished the ward round, I still had to call Karen to check up on the management of about a third of the patients who I wasn't sure about.  The whole process took me four hours when it would normally have taken the regular doctor between one and two.

The patients in the beds encompassed the whole range of medical problems, because there was only one ward where men could go, and only one ward where women could go.  (Unless she was pregnant or had just given birth, when she would go to maternity).  There were often a couple of psychiatric patients in the far end of the ward conveniently placed as far away as possible from the nurses station.  These would uniformly be in one of two categories: schizophrenia and depression.  The schizophrenics tended to be quite disruptive to the ward, even when they were drugged up to the hilt: they would often escape from the ward and could be seen wondering aimlessly around the hospital grounds both day and night.  One female patient in particular had a habit of walking the hospital grounds during the night, completely naked, and going through peoples' kitchens looking for food.  One night she went into Andrew and Glenys's house and ate a collection of about 40 sweets which they had been given for Christmas.  Glenys heard the noise and just arrived in time to see the last few of them devoured one after another.  She had to donate one of her T-shirts for the sake of decency before calling security.


Other work in the hospital :



On my third week, I was asked by Andrew to do a project on TB ward.  One of the problems with TB ward was that the effectiveness of the TB management protocol had never been evaluated to see if the patients were finishing their treatment and whether they were being cured.  My project was to gather data on all the patients admitted in the first half of 1992, and find out how long they were in hospital for, how long they were taking treatment for, and their discharge status (whether they had finished their treatment and were cured, whether they died, or absconded, etc.).  When I had collected all the data, I would analyse all of it, and present it graphically in a meaningful way, interpret the data, and finally put forward comments and recommendations to try and improve the running of TB ward.

The protocol for managing TB is as follows: The patient is admitted to TB ward on the evidence of AAFB's (TB bacteria) in the sputum, and sometimes on radiological evidence alone, and the patient is immediately put onto isoniazid, rifampicin and pyrazinamide.  The patient needs to be on these drugs for a full six months, primarily to cure them, but also to prevent the emergence of drug resistant strains of Mycobacterium tuberculosis. Compliance is a serious problem because many patients, even after mind-numbing education and brainwashing, stop taking their drugs when they feel better, but before the full six months are up.  In an attempt to prevent this happening, the hospital admits all patients for supervised drug taking for the first three months, and then discharges them to their nompilo (community health worker) for a further three months of drug taking. Supervised drug taking means that the nurse or nompilo actually gives the patient the drugs and watches him or her swallow them on the spot.  In the hospital this is simple enough to do, but when the patient has been discharged to the nompilo, he or she has to go to the nompilo every day to get the treatment, which may mean a walk of many miles.  When the patient has had a total of six months treatment, he goes to see the doctor again who will discharge the patient from the hospital based on the clinical and radiological findings.

The collection of data was always going to be a problem.  For a start, the data was held in four locations around the hospital: the admission data was held in the admissions book, while the details about length of stay in hospital, length of treatment and discharge status were rather haphazardly found in the nompilo folder and the patients' notes.  To make things more difficult, the patients' notes were divided between the ward and medical records.  To cap it all, the nompilo folder and patients' notes were filed not just badly, but actually randomly: the nompilo folder was supposed to be filed chronologically but wasn't.  The patients' notes in the ward were supposed to be filed alphabetically but weren't.  The patients' notes in medical records were supposed to be filed by in-patient number but weren't. The reason for this is particularly mind-boggling: when the old medical records room was refurbished with new shelves, all the notes which were already there needed to be taken out, but instead of piling up the notes in a way which could be easily retrieved, most of them were piled up haphazardly in random places around the hospital and an appreciable proportion of them were actually thrown in a store room to form a mountain in its centre.  When the notes were retrieved, they were of course in completely the wrong order, and now the doctors hardly ever ask for old notes to be retrieved, because they are so rarely found.  I asked the clerks to retrieve the notes of about 100 patients, and they only found about 15 of them.

I quickly realised that it was going to be impossible to gather all the data, with the mess the TB ward's nompilo folder and patients notes were in currently.  The only solution was for me to sort out the ward filing system for both the nompilo folder and the patients' notes, so I took all of them to the guest house, spent half an hour searching the hospital for cardboard boxes to file the notes in and use as dividers , and then spent the next nine hours sorting them into the order they should have been in when I first went to the ward.

Once the notes and the folder were in order, I spent the next five hours of the project extracting the data, the next ten hours reading the manual of 'Quatro pro' (the spreadsheet program which was going to analyse all the data and produce the appropriate graphs), another three hours entering the data and getting the program to produce the graphs, and finally two hours thinking about the results and producing the recommendations for TB ward. This was 30 hours in total and took two full weekdays and a Saturday to complete.  My conclusions in general were that the current system made information gathering far too difficult, as was demonstrated by the fact that of the patients I studied, there was no way of finding out the discharge status in at least a third of the patients.  My recommendations were that the ward should get a new admissions book which would be able to contain all of the information which had taken me so long to gather on one line, so that in future, the information would be easy to gather and would never be lost in the way that it had before.  I discussed this with Andrew Ross and the rest of the doctors and in the end it was decided that all my recommendations would be adopted as soon as possible.  The results and recommendations are attached at the end of this report.

Another project which I took on myself was to produce an   English to Zulu dictionary  concentrating on simple words and phrases which someone new to the language could use when they came to the hospital for the first time. Andrew agreed that it would be a useful thing to give future students, to instil in them more confidence and encourage them to become less dependent on the nurses as interpreters.  My first introduction to the language was from Annette, a Christian missionary who had a house on the hospital site.  She had written a number of award winning Zulu children's books and some religious books, and she gave me the first details about Zulu grammar and pronunciation, and the translations of the words which I had already thought up.  Zulu grammar and pronunciation are notoriously difficult to get the hang of: the words have prefixes and suffixes not just relating to whether the noun is masculine, feminine or neuter, but a total of eight different situations, and the language is supposed to flow smoothly, so prefixes are added to words depending on what the previous word was.  Zulu pronunciation is also very hard to get to grips with because some of the consonants simply don't exist in the English language.  These include 'c' which is pronounced as an inward (implosive) sharp 'tska', 'q' which is a sharp implosive 't' using the roof of the mouth, and 'x' which is an implosive 'tcha' using the side of the cheeks rather than the tongue.

My dictionary took about two weeks to complete.  I worked at it on and off in bursts in the evening by going around the hospital asking nurses when they had spare moments.  The finished dictionary starts off with a section on grammar and pronunciation, and then has sections on greetings, nouns, verbs, instructions, questions, and finally a detailed section on medical terminology.  For beginners, there is a core dictionary of the words it would be most important to learn first.  Since Zulu is an ancient language only recently introduced to a modern world, some medical terms are rather prolonged descriptions which sound a bit comical such as 'cyst' which is 'Isikhwama esikhulayo emzimbeni wumuntu siphethe into engamanze' which translates literally as 'A bag inside the body filled with fluid'.  I finished the dictionary off with a copyright to my name and the fact that I was an elective student from LHMC.  If anyone wants lessons in pronunciation, then by all means contact me.  Ask Doris.  The dictionary itself is attached to the end of this report.


My work in the Out-Patients Department :



The outpatients department is a combination of accident and emergency department, specialist clinic centre and general practice surgery.  This means that you have literally no idea what type of patient will next come through the door.  It is probably the best place in the hospital for learning medicine because of the sheer variety and volume of patients which you see and because they are presenting with acute symptoms and signs.  The symptoms and signs are often very severe and gross because Zulu people are rather stoic and this makes them wait rather longer before seeking help.  This is not helped by the relative lack of readily available medical facilities: There is only one hospital and four permanent clinics in 30 square kilometres.

There are five consulting rooms and four doctors, so there is always a room free for a student to see patients on his / her own, and nurses are always available to translate.  The consulting rooms are next to each other and connected by a corridor, so it is easy to slip into the next room to ask for advice.  By the time anyone reads this, another doctor will have joined the hospital, and there may be students from the University of Natal at Mosvold, but this shouldn't necessarily compete too much with elective students because at least one doctor normally has to be somewhere else, or it they don't, I'm sure they would be happy to take a rest from seeing patients.  The university of Natal students may clash a little more, but they are often busy doing projects and going to the external clinics, and it is nice to have some company in the guest house, especially because I was the only student there for two weeks before the Natal students arrived.

As I said, the range of conditions seen there is extremely variable.  Some of these are listed below :-

Most common
Other conditions
Interesting but rare


On one occasion, a patient was brought in by a policeman and I was asked to examine him to assess his fitness for corporal punishment.  I asked Andrew's advice, and he said that I should examine him and he would sign the form.  I did this, but all through the examination I could not keep a straight face and I was half choking to prevent myself from bursting into laughter out loud.  The prisoner also seemed to see the funny side of it, and he seemed to have already resigned himself to a lashing.  It is probably better that he got a lashing than prison, because prison sentences are often very long compared to British sentences and the conditions are much worse.  Needless to say, he was fit and the form was duly signed in quadruplicate.


My work in the operating theatres



Theatre is on Tuesdays and Thursdays, starting first thing in the morning and continuing until the list for that day is finished.  All doctors and elective students take part, and there is ample opportunity to do anything you want to do.  The only prerequisite is that you go through the procedure one or two times, first with you as the assistant, and then with the doctor as the assistant.  After this, provided the procedure isn't too complex, you are usually allowed to do the procedure on your own.  Students are also allowed to administer spinal and general anaesthetics, although general anaesthetics were always done under supervision.  The theatres themselves are remarkably well equipped with two theatre rooms and one recovery room, although the recovery room is often used for doing minor surgical procedures.  The equipment is mostly modern and all in working order and all the drugs which are normally needed are readily available.

The most common major operations done were caesarian sections, tubal ligations, and skin grafts.  The most common minor operations done were I&D's (Incision and Drainage of abscesses), removal of lumps, D&C's (Dilatation and Curettage), ERPC's (Evacuation of the Retained Products of Conception after a miscarriage), and chest drains.

Operations which I personally carried out:
and I watched many more.


The External Clinics :



Every week day, two bakkies leave the hospital to go to the clinics, one to go to the general clinics, and the other to go to the under five clinic checkups.  These clinics are entirely run by senior nurses (ie.  sisters), who do their own consultations, diagnoses, and management, and only rarely refer patients to the hospital for hospital care.  It is worth going along with them for a day or two, but because they are so independent, and hold all the consultations in Zulu, it is quite easy to feel left out of the whole process.

Every Wednesday, one of the doctors goes to the permanently staffed clinics along with a physiotherapist (often Glenys Ross) and a few nurses.  There are four of these clinics: Gwaleweni, Ndumu, Shemula and Manyesini.  Gwaleweni is reached by bakkie because the journey is relatively short, but the round trip of the other three is over 100km and the trip is so bumpy and unpleasant that it is usually got to by light aircraft, each of the clinics having their own small airstrip.  The trip to Gwaleweni is a journey along the escarpment's top edge and there is a magnificent view of Swaziland 700m below.  I also went on the round trip to the other three clinics, but John the pilot was out of action with a bad back, so I had to do the journey in the back of bakkie, a rather exhilarating / bruising experience.  It is much better to go to these clinics than the 'nurse only clinics', because the consultation is held in English, you do the talking, and the doctor is there to supervise you.

While I was at the hospital, it seems that all of the other doctors were taking other departments of the hospital by the horns.  After I took on TB ward to try and improve its running, Karen took on the pharmacy, Duncan was starting to take on the laboratory, Andrew continued his long running battle with the KwaZulu bureaucracy, and there was a concerted effort from all the doctors to reorganise the isolation ward.

Karen took on the hospital pharmacy because there had been a number of serious lapses of proper procedure in the last weeks, months and years: The head of pharmacy was ordering huge amounts of drugs which would be impossible to use up by the 'use by' date.  More seriously, he began to run out of some of the most important drugs in the hospital.  The situation came to a head when the hospital ran out of paracetamol and a number of the more important antibiotics (including penicillin).  More amazingly, he ran out chloroquine in the middle of the malaria season, ran out of two out of three of the most important intravenous fluids which the most ill patients need, and ran out of Oral Rehydration Therapy (Salt Sugar Solution) in one of the most serious gastroenteritis epidemics in many years.  There were two patients on female ward with cerebral malaria, and there was no intravenous chloroquine except for a few vials found at the back of one of the shelves and these were 18 months past their 'use by' date.  Both patients died, and although cerebral malaria has an extremely high mortality rate, one cannot help but think that they would at least have had a better fighting chance if they had had fresh chloroquine a day and a half earlier.  Karen started her assessment by doing a stock take of the whole pharmacy which took her two days.  She found various odd combinations of drugs, such as three cases of aspirin, and 4000 tablets of alpha-methyl dopa which were probably enough to last for over two years, but the use by date was only five months away. After this Karen started to re-educate the pharmacist, as well as supervising the paperwork, including the ordering of new drugs before the old supply ran out.

Duncan was starting to look into the running of the laboratory, mainly because there was some question about the reliability and reproducibility of some of the tests.  Particularly on the spotlight were the tests for malaria, bilharzia (schistosomiasis) and the tests for urea and electrolytes (U+E's). The lab staff also had an irritating tendency of not returning test results if the result was negative.  To remedy these, probably all that is needed is some education and supervision.

In some of the recent mortality meetings, it had been noticed that young or middle aged otherwise healthy adults were being admitted to isolation ward for gastroenteritis, and were dying unexpectedly for unknown reasons.  It was thought that one of the contributory factors was the fact that isolation ward is generally packed full of people who are mildly ill, and if there are any seriously ill people there, they were being lost in the crowd.  Another contributory factor was thought to be the lack of a named doctor who was responsible for the patients on isolation.  At the moment, if the patient is a male, then he should be looked after by the doctor in charge of male ward, and likewise for females and children.  Around the time I was leaving, the current thinking was that the solution was to partition off four beds which would be the equivalent of an ITU (Intensive Care Unit).  Here patients would be watched more closely, and would be clinically assessed more often.  Also the psychological reaction to seeing a patient in one of those four beds would immediately draw the doctors attention (whether consciously or subconsciously) more closely to the patients future management.

Andrew, as the hospital superintendent, is always involved in battles with the KwaZulu bureaucracy, and he has ample justification: He is constantly chasing money which has been promised to the hospital and the community, but which is always late in coming.  Administrative delays can be astonishingly long: He once wrote to the authorities asking where one of the grants he had been promised was, and he got a letter back nine months later acknowledging receipt of it, but the main content of the letter was a rebuke for not having referenced his original letter.  Andrew said that he had never been told that he had to reference letters in the first place, and even if he did know that he had to do it, he would not know how.  Another example of the ridiculous rules which he has to put up with is in the ordering of new equipment.  There is a list of things which the hospital is allowed to order, but there was no medical input into the panel which drew up the list, so things were chosen by virtue of their price rather than their functionality. This is demonstrated by the electric weighing scales in the hospital.  About ten of them were bought cheaply less than a year ago, and now only one is still operational.  They had to get the electric one because that was the only one on the list, despite the fact that the mechanical ones are more proven and last longer.  The last electric scale is used by the nurses going to the external clinics, and the only other functional scales in the hospital are two mechanical ones in OPD.

One other oddity occurs if you try to order something which is not on the list: the people who make the rules insist that the article should be put out to tender, and you need a list of two alternatives to the article you want, and you need to justify why the article you want is better than the other two.  This rule applies in all circumstances, including the true example where the hospital wanted to get a new probe for their ultrasound machine: There was only one probe on the market which would fit onto the current machine which was not surprisingly made by the same company who made the rest of the machine.  Andrew said that the solution was to go ahead and give any two alternatives he could find, but explain that they weren't suitable because they would not fit onto the current machine, but the important thing was to have the two alternatives.

The last saga was the mysterious case of the long drop toilets.  These are toilets based over holes in the ground, but smells are kept to a minimum because there is another hole close-by and a connecting ventilation shaft. The advantage of them is that they do not require water for flushing, which is important in the current drought which has lasted a year.  Andrew arranged with the authorities to have a few of these put up around the hospital. Eventually a mechanical digger came to the hospital and dug huge holes in various places around the hospital, but the workers said that they couldn't continue because there were no materials to build the actual toilets, and there was no prospect of getting them soon.  The holes were dangerous, so the hospital workmen had to fill them in using only spades and the sweat from their brow.  Ironically, if the authorities bothered to fix all the water tanks around the hospital, then this would save much more water, and prevent the need to bring it in from Pongola at a cost of R100,000 (£20,000) a day.


The rest of the hospital and Ingwavuma :



There is not much to see in Ingwavuma apart from the hospital.  100 metres away is the Spar supermarket, and 300 metres away is the post office, police station, prison, various other shops and some street sellers.  About one kilometre away is the shanty town where many of the hospital and village workers live, and about one kilometre west is the top of the escarpment, which is the view over Swaziland from 700 metres up.  On a clear day, it is probably possible to see 15 kilometres or more into the distance.  Facing the other way from that viewpoint, it is possible to see the king's house which was only recently completed, but has never been used.  It is the law that the king must have a house in every region that he governs, so that he can stay there in the manner that he is accustomed to, should he ever visit.

Elsewhere in the hospital are the other doctors' houses, the nurses' homes, the expectant mothers' houses, a church, the works and stores departments and the canteen.

Expectant mothers who the doctors are worried about are usually told to wait out the last part of their pregnancy in huts at the edge of the hospital. This means that when they go into labour, a doctor or midwife will always be close at hand, whereas if they were still at home, there would be no easy way of alerting the doctors, or getting them to hospital in time.

The doctors and nurses houses are on the hospital site and are quite respectable to look at.  They have to pay a nominal rent, but this hardly makes a dent in the doctors' pay-packet, especially as they are always saying that they have no choice but to save money in Ingwavuma, because there is nothing they can spend it on.  Doctors working for the Natal health department get about half the money they would get in Britain (on the basis of exchange rates only), so no-one goes there for the money.  This is balanced by the fact that it is cheaper to live in South Africa, especially in Ingwavuma, but it does make the move back to Britain that much more difficult, because of the difference in currency values.

All the doctors were very kind and hospitable, and I went to meals at all of their houses.  There were some especially good meals / parties on New-Years day and the day before I left, with food brought in from Pongola (30km away) and further afield, by friends of the doctors who were visiting.

There is a church within the hospital grounds just left of the entrance.  The hospital used to be a mission hospital and this was the church which the missionaries built and used.  When the hospital was taken over by the government, the missionaries moved out, and a new priest moved in, but unfortunately the links with the hospital were mostly lost.  Nevertheless many of the hospital staff are quite religious and the church services are never lacking in people.  Also, someone (I don't know who) does come to the hospital and preach to the patients on the wards and OPD.  The church has a piano and pedal operated organ, but the piano is so decrepit from lack of maintenance that half of the notes don't play and the other half are out of tune.  It was possible to play the piano for a short while, but the notes which come out were so distracting that I almost always got lost in the more complicated parts of the piece.  The pedal organ works well enough but it has only five octaves, so the possible repertoire is severely curtailed.  When I was there, there was a wedding at the church which was a real spectacle to watch: The wedding lasted all day starting off with lots of shouting, singing and laughing from everyone except the bride.  Traditionally, before they have actually been pronounced man and wife, the bride is not allowed to express even the tiniest bit of emotion, because this is considered bad luck, so while everyone else is dancing and singing and generally making a fracas, the bride sits alone in the car, with her head bowed and a solemn (perhaps even melancholic) expression on her face.  I did not see her expression after the wedding but presumably they are allowed to look happy after it.  The canteen provides breakfast lunch and supper free to all hospital residents and this would probably be fine for the majority of people but I am vegetarian and throughout the whole time I was there, there was never a vegetarian main dish.  All the meals consisted of a main meat dish with vegetables only there to complement it and of course finished off with a meat sauce to pour over the whole dish.  This meant that I was largely limited to sandwiches, sometimes with jam, and sometimes with cheese, but only very rarely with any salad.  The Spar bread was better than the hospital bread and was also very cheap (35p for a large loaf), so I often ate the Spar bread instead.  The only fresh vegetables / fruit available in the Spar on a regular basis were potatoes, butternuts, squashes, tomatoes and sometimes apples.  However the Spar does have a large supply of non-fresh groceries.

I was unlucky that while I was at Mosvold, the only car suitable for going on long trips (ie: Andrew and Glenys's 4WD) was broken, so trips to the coast and game reserves were out of the question.  In my first four weeks in the hospital, I did not get out at all.  There might have been an opportunity to get out to Sodwana Bay National Park in my third week, but Karen, Duncan, Mimi and Hugh had booked the trip a number of weeks before I had arrived and there were no more available spaces in the camp.  The trip apparently went very well until they started to return home: they broke down in the middle of nowhere, somehow managed to get to a phone,and then had to wait in one of the most ferocious storms this year while Andrew drove out to tow them back. They arrived back in the hospital at five in the morning.

In my whole time there, I got out of the hospital twice: One time was the one kilometre trip to the top of the escarpment over Swaziland which I have already mentioned.  The other trip was to Kosi Bay which is on the coast, five kilometres south of the border with Mozambique.  It has been designated as the South African equivalent of an 'area of outstanding natural beauty'. The whole area is an esturine system with three linked lakes which eventually flow into the sea (or the sea flows into them).  The trip was only made possible because three of Glenys's friends from her university days came up to Mosvold in their own car.  All the other doctors' cars were still broken.  When we arrived at Kosi Bay we decided to do one of the guided walks.  There were three walks available: one to the third lake (2km), one to the first lake (10km), and one to the other side of the lakes (22km), and we decided to do the ten kilometre one.  Before we left, we had a delicious picnic on a pier over the third lake, and after finding our guide, we set off on the walk.  The guide was taking his twelve year old son on his first walk in the area, and by a coincidence they lived only a couple of miles away from Mosvold hospital.  The temperature was quite hot at 39 degrees Celsius in the shade, but it wasn't humid and there was a slight breeze blowing, so it did not seem so bad.  I had a small rucksack, so I was delegated to carry the two litres of fruit juice for the others, but I also carried a litre of water in my own water bottle.  The walk took us through some of the most widely varying environments but all in very close proximity.  It varied from desert to grassland to tropical forest to esturine all within about three kilometres.  It took two hours to get to the first lake and when we got there, we all went for a swim.  It was amazingly warm and the guide said that the water was 30 to 35 degrees Celsius, depending on the depth of the water, but anyway it felt just like the temperature of a bath, and was extremely refreshing after the five kilometre walk.  We swam for about an hour and looked at the strange but effective fish traps built by the local people.  They were in the shape of a rapidly diminishing spiral with a cage at its centre, all made of wooden stakes.  The fisherman would spot a shoal of fish and then frighten them towards the mouth of the spiral by beating the water with sticks.  Once past the mouth, the large fish were as good as caught.  Small fish could easily escape through the wooden stakes, so their method was quite environmentally friendly.  I had my goggles, so I did see shoals of small fish swimming in and out between the wooden stakes. All of the juice was consumed when we reached the lake, so we had to walk the whole distance back without any drinks, and when we reached the car, all the shops selling drinks were closed.  We quickly left Kosi Bay desperately searching for places where we could buy a drink, but they were all closed, so we took a little detour and went to Manguzi hospital and bought a drink there.  I drank a litre of fizzy orange in two minutes, and one of the other girls downed four cans of coke in five minutes.  Our thirst finally quenched, we resumed our journey back towards Ingwavuma.


My last day at the Hospital :



I had hoped to go on the plane to the clinics at some time during my stay there, but John the pilot had been ill the whole time I was there with a bad back, and so I didn't fly.  My flight out of Africa was on Friday, and it was already Wednesday, but I had calculated that I could get to Johannesburg via Durban in two days, provided there were no hitches.  The main reason I had waited until Wednesday and not left earlier was to see whether John would have recovered, so I could fly to the clinics and take aerial photographs.  I did the normal ward round until 10 o'clock and then went for the normal tea brake with all the other doctors.  By this time, still nothing had been heard and I was finally resigning myself to the fact that I would not fly, when Andrew came in with someone and introduced him as John the pilot, and that they had found a way for me to fly.  They would go off to the clinics as normal, and when they returned, John would pick me up and take me to Bethesda Hospital where he is based.  My original plan was to get the hospital bus which goes to Durban every week day from Mosvold.  However a bus goes every week day from Bethesda hospital to Durban as well, so I could take that one instead.  I immediately agreed, and as from that time, I had about six hours to get ready to leave.

I still had not finished my  English to Zulu dictionary,  so I spent two hours finishing it off and then went immediately to pack.  I had not even started to pack until then because I did not expect to leave that day, and it was made more difficult because my room was in a real mess.  It took me three and a half hours to pack, and my rucksack wasn't tidy when it was full, because there hadn't been time to pack things neatly.  The last half a hour I spent rushing around the hospital finding all the doctors, their families, and the nurses and saying good bye to them, and thanking them for all their help and kindness.

Then right on schedule, I heard the hum of the plane flying overhead, and soon it was time for me to leave.  The runway is literally next to the hospital, so I walked there and met John surrounded by a crowd of locals admiring his plane.  John did the usual pre-flight checks and soon we were ready to take off.  I asked him if he would fly once around the hospital so I could photograph it, and he agreed.  I had already used up 35 pictures of a 36 exposure film, but luckily the film gave me 37 pictures, so I got two aerial photos of the hospital.  We then set off south towards Bethesda.

For most of the journey we were flying just above the escarpment of the Lebombo mountain range, so we flew low using the updrafts of warm air (thermals).  This made it quite bumpy, but that made it all the more exciting.  The whole journey took only 17 minutes for a 50km distance.  On the last part of the flight he gave me the controls and I flew towards the landing strip for a couple of minutes.  When we were getting close, I gave him back the controls, and he, remembering that I had earlier said that I like a little bit of turbulence, decided to give me an overdose as a practical joke: the moment I gave him back the controls, he pulled back really hard on them, and we went zooming up, and he carried on so long that I thought we were going to do a 'loop the loop', but at the last moment he pushed the controls as far forward as they would go and we took a dive towards the ground only levelling out the plane at the last moment.  The feeling was ten times as bad / good as the best rollercoaster I have ever been on.  He took one low flight over the runway to try and frighten two cows off the runway, but when this failed, he landed anyway, the wheels touching down just a little in front of the cows.  I helped push the plane into its garage, and watched him fill up the wings with aviation fuel ready for his next journey and we left for a short ride in his land-rover to Bethesda Hospital.  When we were there, I met two students from St.  Bartholemew's Hospital also on their elective (Robert and Heidi) who I had by chance also met on a previous visit to Barts.  They found me a room for the night and for the rest of the evening we watched Michael Palin in the video of 'Around the World in Eighty Days', and it reminded me of my adventures in reaching the hospital.


Towards Durban and Johannesburg



By the time I had reached Bethesda and settled in, it was too late to find any of the day nurses who could confirm that I had a place on the transport to Durban, so I had to wait until the next morning to be sure.

The next morning (Thursday), I was ready and packed by 8am and I waited an hour and a half by the road before the driver and a party of patients arrived.  Luckily there was a space available, so I took a seat in the front. The journey to Durban took five and a half hours and I was dropped off on West street where all the major shops are situated.

I had no idea how I was going to get to Johannesburg, but I knew the four alternatives: hitching, renting a car, getting a train, or getting a coach. Hitching was out of the question, because it was not reliable enough and I had only 26 hours to reach Jan Smuts airport.  The next thing to do was to get to the car rental places and find out their prices, because this would be the most important factor in deciding whether to allow myself that luxury.  It took me an hour of walking and asking to find the car rental places, but when I got there, I found that the cheapest for 24 hours rental was the equivalent of £120, and even allowing for the fact that I would sleep in the car, it was still out of the question.  So next I went in search of the bus and train stations.  There was an information stand at the central Durban city bus station, and they told me that there was a computer booking shop in a close by shopping centre.  There were in fact two computer booking places there, but unfortunately both coach companies (Translux and Greyhound) were completely booked up for the overnight journeys, so I would have to book the coach leaving at 8am the next morning or risk taking the train that night.  I had been told that the trains were quite dangerous because of the risk of being mugged or being caught up in political violence, and anyway I was tired after walking around for so long with my rucksack, so I opted for the coach journey.

The morning coach would leave at 8am and would take 8 hours to get there, leaving me with only one hour to travel the 15km from central Johannesburg to Jan Smuts airport in good time for my flight.  Strangely, the morning journey was R20 more expensive than the overnight journey, and when I had paid this off with cash (R115), I had only R12 left which I hoped would be enough to get me from central Johannesburg to Jan Smuts without forcing me to look for cash machines.

It was now 5pm, so I had the rest of the evening and night to explore Durban.  I walked to the coast, and just at the point where I met the beach, there was 'Durban Seaworld' so I went inside, and saw numerous small and large aquaria demonstrating many of the types of sea life indigenous to South Africa and to Durban in particular.  The largest tank was particularly good with three species of shark including a pair of saw tooth sharks.

The hotels in the centre of Durban and especially next to the shore are known for being expensive, and I was not going to go out of my way to look for a cheap enough hotel.  Besides it was warm and I did not mind spending a night out on the beach  -  it was all part of the adventure, so this is what I decided to do.

As an after thought I wondered whether I could perhaps sleep in the casualty department of the Addington hospital which was only a kilometre south of where I was, so I went there.  Unfortunately, the doors of casualty are locked and you have to have a reason for getting in (ie: being ill), and needless to say my reason was not good enough.

The coach station was five kilometres away so I had the evening, night and morning to get there.  I spent until 12am sitting outside a 24 hour cafe talking to a drunk who had approached me for a conversation.  He genuinely had an interesting life story: he started off his life by having a drunkard father and he made the mistake as a child of drinking his father's alcohol to stop his father getting at it, and from then on he was an alcoholic as well.  He was reasonably intelligent and now could speak six languages: English, Africaans, Zulu, Shona, German and Dutch.  He had been in the army during a couple of wars in Rhodesia where he was even in a plane crash, but then had left to become a qualified mechanic.  He had married and had a child, but the alcohol problem kept on catching up with him, which broke up his marriage and got him fired from his job.  Interestingly, he knew how to solve his problems, ie.  to stop drinking, but he said that he had been through the whole list of programmes and organisations such as alcoholics anonymous and none of them had come up with a satisfactory method which had helped him to give up.  I pointed out to him that he was the most important link in the chain: it was he who must really want to give up, before he would be able to give up.  He said that he really did want to, but that it had not made any difference.  Amazingly, he now had a part time job as a lorry driver driving building materials to construction sites.  Presumably he is sober enough in the morning to disguise the fact that he was stoned out of his brains the night before  -  some drunks are able to do this, and indeed he seemed to get more sober as the hours of our conversation went by.  We talked for a while longer and I told him some of my life story and eventually parted at about 12am.  Before he left, he gave me some advice to stay in well lit areas and not actually to go to sleep, because muggings were common on the beach front after dark.

After he had left, I initially tried to lie down on the grass in front of the 24 hour cafe, but there were tiny ants there, the pain of whose bites were completely out of proportion to their size.  I sat for another hour at the table of the cafe,and then started to make my way slowly north along the coast towards the station.  I spent much of the early part of the night looking out from the piers, watching twenty foot waves crashing around me. Later in the night, I found a police station which was still on the beach front, so I lay down on a low wall and dozed in front of it, thinking to myself that here was the place on the beach front that I was least likely to be mugged at.  Anyway the rest of the night passed without incident, and I made my way the last three kilometres towards the coach station at 6am.

The coach left on time, and the journey was uneventful, except for a ten minute wait while a lorry which had spread its load was cleared from the road.  I hoped it wasn't the drunk that I spoke to the previous day.

I arrived in central Johannesburg at 4.30pm in the middle of an astonishingly severe thunder storm  -  the kind which deposits 2cm of water per hour, and it lasted two hours.  Luckily there was a bus just leaving for Jan Smuts, so I got on it immediately almost forgetting to take my rucksack off the coach, and arrived at the airport around 5pm which was comfortably in time for my 7.55pm takeoff.



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   Last Modified : 5th July 1999