Adventures in African Medicine

As you can probably imagine, there are an overwhelming amount of visible, tangible needs everywhere we look here, and plenty of opportunities to get involved to try to address these needs outside of the work we originally came here to do.  Combine that with the fact that I am looking at a career change to nursing, and I found a perfect opportunity to try to help out and get some valuable experience at the same time.  And to clarify – this is the Mrs. speaking – the Mr. is eager to get back to work with the wonderful folks at POH when we get back (and also very ready for his wife to finish up another round of education and get a paying job!!). 

So since late last year when I found myself able to somewhat gracefully handle my teaching responsibilities, I started to volunteer at a local clinic called Kairos Medical Center in the nearby neighborhood of Namuwongo.  It has been interesting, to say the least!  Each time I go there, I walk away with some interesting cultural nugget – sometimes related to medicine, sometimes just related to life.  It has been such a rewarding experience!  Here are some of the highlights or just random things that I think are important…

·    I have learned that my name and Ugandan pronunciation do not mix well – it depends on where I go as to what I’m called, but at Kairos, I am “Eye-rin.”  At other places, I might be “Ee-rin,” “Eye-rene,” or some other totally unrelated name…  But when I walk into Kairos, I just love it, because they will see me walk in and call out, “Eye-rin!  You are most welcome!” 

Treatment Room

·    Ugandans’ tolerance for pain far surpasses that of your average person.  On one occasion, a woman came in after a taxi accident – she had a pretty bad gash on her shin that was infected.  So the nurse proceeded to unwrap a sterilized razor and cut out all of the dead and infected flesh while the woman just sat there with a forced smile on her face, never uttering a sound.  If it were me, the nurse would have needed a little fixing up herself after that torture!

·  The amount of compassion you receive is inversely proportionate to age.  Babies are cuddled and sweet-talked before undergoing any kind of treatment (which almost always involves intravenous medicine).  The older the child, the less tolerance for crying and complaints.  Adults who object to the harshness of a treatment get a stern talking to.  I’ve only heard this in English once, but I can tell by the tone when a patient is getting put in their place.  Mostly it consists of, “Stop moving.  You need to let me do my job.  Don’t complain.”  Talk about being blunt!

·  Best story ever and the reason I will never have children in Africa.  I walked into the clinic at 8am one morning just as a woman was walking out with her infant child.  The nurses were sitting in the dispensary talking about how they could not believe how much she carried on.  When I inquired, they explained that she came to the clinic in labor late the night before.  She was just carrying on, moaning in pain, and it was apparently very annoying to the staff.  So the doctor told her that if she continued to make so much noise, her baby would be hurt and might not live.  Worked like a charm – shut her right up!  And then she walked out with her newborn maybe 6 hours after giving birth.  If this was a “wimp,” I don’t even want to think about how they would classify me!

Treatment Room

·  I love that there are so few limitations to what I can do as a volunteer.  In the States, you basically have to have a degree to count pills, but at Kairos, I’m a regular pharmacist!  I watch every procedure from vaccinations to stitches to giving IV medications to the poor kid who came in with a massive head injury (presumably skull fracture and brain damage… she had to be sent to a different hospital for treatment and we never did find out what happened to her).  I set up injections and give them to patients after the nurse inserts the cannula.  And apparently I will be practicing inserting cannulas in the doctor’s hand this week so that I can start doing this on patients.  Yikes!  Good thing we’re leaving before I can do any damage!

·  The most common illness is definitely malaria – though this clinic does a great job of actually doing lab tests to confirm.  It is not uncommon at all for an African to self-diagnose malaria and then be perfectly fine after 2 days… leaving any mzungus who actually get malaria and find themselves sick as a dog for weeks feeling a little confused.
 

·  Other than illness, it is very common for people to come in with boda boda or taxi related injuries.  These can be pretty grisly sights.  A little girl was brought in after a boda ran over her foot last week – wish that was a rarer occurrence.

·  I don’t even sort of understand most of the treatments that patients receive.  For example, a baby who came in with pneumonia received IV antibiotics (ok, I get that part), but as she was leaving, the doctor made sure I gave her a little squirt of Vitamin A in her mouth.  In fact, Vitamin A is one of the regular “vaccines” that children come in to get.  And it is not uncommon for someone to come in with some random ailment and be prescribed  5 days of multivitamins…? 

·  When the clinic is not busy, we spend a lot of time sitting around and talking (or more accurately, I listen).  Some of the random, interesting conversations include discussions of how I can possibly wash my hair every day, how much they wish they could gain weight, and the roles of men and women in relationships (I listened during that one – my inner feminist was definitely stirred during that little ramble they had!). 

Dispensary

·  And I gotta tell about little Gloria who I met last week.  She is four years old, and while playing outside, she ran into a piece of metal, leaving a neat little gash between her eyes.  Her father explained that she had to have it stitched up, because if something was wrong with her face, they would never be able to marry her off – because that’s the first thing every father thinks about when getting his daughter’s face stitched up?? J  I was so impressed with Gloria – she was a perfect example of tough African lady, even if just a smaller version of one.  She laid on the table while the doctor fished around inside the wound to make sure there was no debris – didn’t move a muscle or make a sound as he injected anesthesia into the wound and then added 4 stitches (and let me tell you, he’s no seamstress!).  It was inspiring.  And humbling!  I gave her my fruit snacks before she left to let her know how cool she was.

So now when I go back to the States, they’ll probably be horrified at what I now consider to be common practice, and I’ll have to do dumb volunteer things like paperwork and cleaning instead of injections and pill-pushing.  I’m so thankful for that little clinic and the people inside who have welcomed me with open arms from the first time they saw me.