Cato Manor

(written 26 September, 2006)

After a week at KwaMashu, Cato Manor was like a different planet. This clinc is brand new. Returning to maternity, I spent time in the first place that remotely resembled an American hospital. It was squeaky clean, with shiny white floors and a well aerated breezeway between departments where patients could come in from the rain, or weather even before the clinic opened it’s doors. The delivery rooms were private and had blue plastic lined squishy delivery beds, complete with detachable stirrups and could be set to any angle of incline. Mothers were counseled in PMTCT (Prevention of Mother to Child Transmission) at their first appointment.

In the four days I spent at Cato Manor, I only saw one mother come in the beginning stages of labor. She was taken to King Edward hospital to deliver, because her CD4 count was 5.

Cato Manor looks like a well funded facility. It is clean, and the doctors, nurses, and midwives who work there, are very good at what they do. They have an operating theater, but it is used for storage, because they cannot afford to hire surgeons. They have capacity to house some of the overflow from KwaMashu, but their hallways are empty by noon. They have an x-ray and ultra sound machine, but cannot employ technicians or radiologists. They have the facilities for a fully running lab, but they send their blood and sputum cultures out, increasing the waiting time for lab results. The labor ward was mostly empty except for twenty or so mothers visiting for their first appointment.

The sisters at Cato Manor offered to let me draw blood. They handed me the needle, and pushed in tightly into the end of the syringe. Breathe, I thought to myself, don’t shake. I gently tucked the needle under the skin. The vein bulged and the top of the mouth of the syringe changed color as blood flowed in. I placed my thumb over the needle and re-positioned my right hand to pull back on the stopper, I pulled gently and blood flowed in. I let it rest and the negative pressure continued to fill the syringe, I pulled back some more to fill it above the 5cc mark, Done. I pulled off the tourniquet with one hand and brought a cotton ball to the needle entrance sight as I released the needle from captivity under the skin. I then ejected the blood into two test tubes trough clay plugs, and into both preliminary HIV antibody tests.