I’ve discovered a few truths since being here. The most important so far is as follows; How an outreach jaunt goes doesn’t depend so much on the plans made, or the place you’re visiting, but on factors totally out of your control. In fact you could spend days and days in planning meetings trying to organise everything to the finest degree and still find something like the weather, or water waiting with an enormous spanner to throw gleefully in the works at the last moment. Anyway, I’m getting ahead of myself.
The week had started with a nasty jolt. The team opening the base clinic had been working very hard to get things moving again, with great success. After the initial rush of opening, things were starting to settle a little, though the pace of work was still frenetic. As I was kicking my heals a little I offered to cover the night shift. This didn’t mean very much except that if any of the patients deteriorated overnight I would be summoned by one of the national staff. I had just drifted off to sleep when I was woken up.
The three month old little girl was lying under a mosquito net on the examination table. She had been admitted for malnourishment and a slight chest infection but had begun to feed. She lay motionless as I approached the table. I lifted up the mosquito net and was confronted by a still warm, but sadly departed, baby. With only a head torch as light I conducted a fairly rudimentary examination. No chest movement. No response to pain. A few murmurings from the heart but nothing that could be called a 'heartbeat'. In Europe this would mean action stations with state of the art intensive care facilities and assorted paraphernalia and, if I’m honest, probably the same result, just a bit delayed.
Here anything like that isn’t an option, so I removed the feeding tube, the IV line and closed the baby’s eyes. I then took a deep breath, emerged from the mosquito net and sat on the floor with the mother and the health worker. I began, what has become a now oft repeated paragraph, starting with my condolences, the sickness of the child she had lost and it being Gods will (which is how things are viewed here). Oft repeated but it doesn’t get any easier.
The next day we assembled the runners who would help us carry the things we needed to our outreach location. It’s only recently that I’ve discovered that the word ‘runners’, when translated, actually translates as 'woman of ill repute', which goes some way to explaining the quizzical looks I got when I asked someone to organise eight of them to turn up at the compound at six thirty in the morning.
This theme of the seedy continued when we arrived. The front door of mud hut we were staying in had the words “Welcome Brothel” scribbled in felt tip pen on it. Closer examination revealed the ‘L’ of brothel to be a poorly written ‘R’. A huge relief all round as I’m not sure that the former is the kind of image that any aid agency would want to portray.
The walk to the clinic had been uneventful except for a very large river that required wading through with my worldly possessions held above my head. To everyone’s huge amusement I was savaged by a leach as I emerged. The only method of dealing with this effectively was to stamp on my own foot where the annelid was making very successful efforts at veinapuncture. This, in a single effort, scattering the unfortunate leach in three different directions.
The fact there was a clinic to visit at all was remarkable, the fact it was actually thriving was humbling. It was another that had been looted and damaged by fighting and hadn’t had a visit since May. In fact no-one I knew had ever been there. Many of the staff had ‘run away’ (a term used rather, in the same way as Chile's 'Disappeared') and it was operating with half the number of workers that it should have been. One member of staff was doing three jobs all at once (My friends still working in the NHS are entitled at this point to exclaim “... and ?”) staff were running from one hut to the next and then back again in a giddy whirl.
First job; Employ more staff which was easy until we came to the job that required the person to count the drug tablets into bags for the patients. We weren’t able to find anyone who was able to count above fifteen in the village, who wasn’t already working for us. A work in progress that one. We'll try again next time.
The week was spent rebuilding the clinic fence, seeing a variety of patients and having meetings with various chiefs, headmen, and village elders (and yes there is a BIG difference between them!). I’ve become more attuned to the body language they will adopt if they like what I’m saying and when they don’t. Generally, spitting on the floor is good news, clicking with the back of the throat is excellent, and falling asleep means their bored. I’m not surprised if some of them fall asleep as they always insist on having the meetings outside, in the middle of the day and they always go on for hours.
However at the end of it all we’ve normally agreed something and we normally get something for the clinic out of it. Generally, the longer meeting, the more things the clinic aquires. The marathon meeting of Wednesday, which lasted nearly three hours yielded help with a fence and airstrip clearance. But at times I found myself trying to avoid joining some of the junior headmen in blissful slumber.
The week took a bit of a downturn next. The water quality in this area is abysmal, leading to many of the diseases we treat at the clinic. Despite the fact that the water we drink is filtered, boiled, chlorinated and blessed (OK, I lied about the last bit!) occasionally some little nasty can slip through.
Unfortunately it did on this occasion and I became another health statistic. Hence the week was cut a day short and I find myself back in the missions’ headquarters on a few antibiotics and replacing what the week has taken out. Did the man who invented oral re-hydration salts get a noble prize for science? If he didn’t, it’s a fallacy!
I’m much better now looking to get back into the thick of things early next week. It is all a bit frustrating. But I guess you can’t work somewhere with so many diseases wafting around the place and not expect to pick up one or two along the way! Still no contact from Rhonda.
