
Today I went to hectic Sani Abacha street and bought 90 packets of cheeseballs, 80 small packets of biscuits, 72 juice boxes and 2 big bags of sweets. Tomorrow I am having a small party for some of my dearest patients and I figured I should stock up for my last time with the Sunday School kids this weekend at the same time. The picture below is of the street. Yes, those are people taking up the entire street. Basically you drive through honking your horn and the people clear away. You just have to mind your side mirrors when passing other vehicles. Fortunately we found two shops that sell bulk goodies. And I now know where most of the street vendors buy their goods. Buy the goods at bulk price and sell them on the street for more. Good business you would think, except that everyone is selling the same stuff!
Thursday, July 09, 2009
Goodies from town...
Posted by Sandra's Latest... at 11:16 PM 2 comments
From 2 to 0...
No clinic for me today, I left my colleague to it.
I did go outside the gate to help sort out the patients.
And helped with the first one who was pretty anemic.
But other than that, no patients for me; how bizarre.
Fortunately I did not do admin all day either!
Although maybe I should have - so much to do still.
Instead I went out to Emergency Surgical Centre.
That is the hospital I've visited many times since 2005.
It is actually the NGO hospital I modelled 'my' outpatient clinic after.
And it is the hospital I most frequently refer the children to.
I have many fond memories there.
I think I spent every Friday there, working with the doctors, the first 6 months I was here.
The national doctors there helped me understand (to some extent) some of the cultural practices.
They helped me get the hang of treating some of the tropical diseases.
They were/are great!
Today however, I headed out to say goodbye.
It was fun to see people, hang out in medical OPD, visit the ward.
And I finally was able to see their supplementary feeding program up and running.
The program is every Thursday, but seeing as I usually have clinic, I've never seen it.
It was kind of fun to be able to do something different on a Thursday!
I then sat down and chatted with their medical coordinator for a bit.
It's always great to be able to share experiences and frustrations.
And be a part of the bigger NGO world.
It really is a unique experience and I find you quickly bond with others doing similar work.
Strange thought to not go back there again anytime soon.
After Emergency I made a quick trip into town to run some errands.
And then it was back to admin!!!
Posted by Sandra's Latest... at 10:01 PM 0 comments
Tuesday, July 07, 2009
2 patients only...
What? I only saw 2 patients today? On a clinic day? What's going on?
Well, I had decided before coming down to the office, that I should really use today to get administrative work done. I knew if I sat in my office I would be distracted and tempted to see kids anyway so thought I should sit in the admin office. However, when I got to work and went out to see the line it made my decision harder. There were just too many children for 1 doctor out there. So it meant that either I had to see patients today and leave the admin, or do the admin and leave the children. Tough call. And I almost feel a little bad to tell you that I chose to stick with my original plan; admin. I have to stop seeing the kids at some point (although I will see some on Thursday and Tuesday) and REALLY have loads of admin to get done. After getting over my guilt during the first hour, I actually managed to get a lot done today. There's still a ways to go, but I'm plowing forward. It's not until you have to write down what you do everyday, that you realize how much it is you really do, and how natural it has all become!
In the end I did see 2 patients today- my two reviews from yesterday. Both were moderately ill yesterday with malaria and so I wanted to follow-up on them. Thankfully they were both doing better today. One is still fairly anemic and the other has some malnutrition but they are on the mend. At least I still got a few patients in today...
Posted by Sandra's Latest... at 8:57 PM 2 comments
55/72...
Crazy Monday came and went.
As I arrived at the office I already heard it was noisy outside.
I went to the gate and told the moms to line up.
Which for some reason seems like a really difficult task for them.
I suppose everyone wants to make sure their child gets a ticket.
But really, all that yelling, screaming and pushing, is it really necessary?
Once again I had to threaten a little bit.
"If there is no single line in 5 minutes, there will be no clinic today."
It always works.
I go inside, and within 5 minutes the guard finds me to tell me they've lined up.
Perfect.
Unfortunately my next dilemma was the fact that there were 72 kids at the gate.
Oh bother.
Seeing as I was to spend a lot of the day training up a new doctor, we decided on 50.
50 children would be seen, and 22 sent away.
Sorry-o.
What can I say?
Still one of the worst parts of the job.
But, we did see the 50 kids and gave them the best treatment possible.
We actually saw 55, as there were some reviews as well.
All around a good day, despite the chaotic start.
And Praise God that I was able to do some clinical work with our new national doctor!!
Posted by Sandra's Latest... at 8:47 PM 0 comments
Race against the clock...
1 week to go.
And not counting.
Many people here count the days before they go on holiday.
I suppose since I am leaving for good, I'm not counting yet.
I'll miss this place.
All I keep thinking about is the enormous amount of work that still needs to get done.
Handover report.
Filing of documents.
Writing recommendation letters.
Midterm report to finalize.
June statistics to finish.
Case reports I want to write up.
A powerpoint to make.
Policies to revise.
A national doctor to train up.
A newsletter to write.
People to say bye to.
Teaching my new receptionist some computer skills.
Sunday school to prepare.
Small patient goodbye party to prepare for.
Bible Study desserts to bake.
Packing packing packing.
Lots of things to do that I can't get around to when seeing patients.
And seeing as I spend most of my time seeing patients, the list never ends.
I am hoping the time crawls by so that I can get everything done and finish well.
I feel like it's a race against time.
If only time would stand still and I'd keep running, just for one day...
Posted by Sandra's Latest... at 8:40 PM 0 comments
Saturday, June 27, 2009
Sound of music...
In the middle of a consultation about a week ago my ears suddenly tuned in to "raindrops on roses and whiskers on kittens..." So I poked my head out of my office and glanced into the waiting area. Sure enough, there was Julie Andrews singing away in Austria to the Von Trapp kids. So, here I was, in Sierra Leone, in a Krio speaking country, in a children's clinic and we were showing "The Sound of Music" to the families while they were waiting for their chilren to be seen by me. Love it. I stood in the waiting area for a few minutes, not watching the TV screen, but watching the faces of the many moms present, smiles appearing on their faces while they were watching an unknown musical on television. My face lit up as I realized how much they were enjoying the film. A film I have watched over and over as a child now seen for the first time by many of these moms and making their wait in the clinic a little more bearable. Fun! However, after hearing the film 4 days in a row I did hope I would not get tired of hearing it. But even on that fourth day when I went out and again saw the glow on the moms faces I thought it was worth it. As long as the health education videos and Life of Jesus videos are shown everyday, I am fine with The Sound of Music being shown everyday as well!
Posted by Sandra's Latest... at 11:10 AM 2 comments
Friday, June 26, 2009
Friday fun...
Fridays are always a bit random from seeing patients for follow-up in the clinic to administrative work to visiting children referred to other health facilities to restocking the dispensary drugs to picking up vaccines to sorting out lab issues to expat morning prayer to whatever needs to get done really. I like Fridays; a day that is not as chaotic with patients but can still be a bit hectic trying to juggle the day’s activities.
This morning was a bit frustrating when the plan to leave for the Children’s Hospital at 10:30/11:00 quickly became 11:30 and when we finally got around to leaving the compound another patient walked through the gate; 3 hours late for their appointment. AAAHHHHHH. I had already spent the morning running around trying to get all sorts of things done, trying to speed things along. Well, we couldn’t really not see the child, so it was another 20 minutes later before we were through with that and on our way again.
We made a quick stop to pick up the monthly supply of vaccines and were then on our way to the Children’s hospital. I visited one of my TB patients on the ward. He’s 11 years old and probably weighs as much as a 7 year old. He’s been admitted for a few weeks now, taking his TB treatment. It was great to see his big smile and speak some encouraging words to his family. We also went to the therapeutic feeding center, where we now have 5 patients (all referred this week. Praise God they all went for admission and most are already looking a lot better. They are a bit more active and not quite as miserable.
At about 2:30pm we left the Children’s Hospital. What to do next? Well, seeing as I am almost leaving, and the Kenyan clinical officer has only been here for a few weeks, we decided to go to the fabric street. One of our nurses thought it would be fun to go along. I figured, we’re in town, why not? So that’s just what we did; a little fun and games during the work day. It was fun walking along a street I’ve been to so many times and looking at the thousands of different fabrics available. After that it dawned on me that none of us had eaten since morning. So, what to do, go back to the office (in an hour of traffic) and forget eating, or spend a little more time in town and grab a bite to eat there. I was feeling a little guilty about staying out to play longer. But a number of the other expats often/regularly will go out for lunch on a Friday, combining it with team house shopping or another work activity, so I thought I could do the same. Why not actually sit down and have lunch during work time! So, the clinical officer, one of the nurses, the driver and I sat down in a place called ‘Delightful’ and enjoyed chicken shwarma sandwiches and cokes. After about 30 minutes we headed off again
Arriving back at work at 4:15 pm there was still more work today. And so for the next 2 hours I sat in my office replying emails, sorting out the week’s finances, writing a case report and completing some patient charts. Another eventful Friday come and gone. Time for the weekend…
Posted by Sandra's Latest... at 11:08 PM 0 comments
Tuesday, June 23, 2009
Pekin don die...
My Monday morning started off in the worst possible way this week.
I was handing out tickets to the children waiting outside the gate.
Half way through the line our security guard walked towards me.
He was holding a child and said “Doctor, look at this one”.
I glanced at the child and said “Oh no, emergency”.
I took a better look and saw that the child was not breathing.
In Krio I said “this pekin* don die”.
I quickly realized I had said this aloud in the midst of a crowd.
And I had not yet seen the mother.
I told the guard we needed to go inside with this baby and the family.
Once in the clinic, it was confirmed that the little girl had died.
Resuscitation with bag and mask was attempted but quickly seemed pointless.
I then proceeded to tell the mother her child had died.
She wept and kept talking about the operation she went through.
I guess the child was delivered by C-section.
Was she thinking of the pain/effort she went through for this child?
Apparently they arrived at the gate at 4am.
The child came because of difficulty breathing.
And stopped breathing shortly before the gate opened.
The mother’s aunty and aunty’s husband were also present.
Why so many adults?
It is usually a sign of serious illness.
For some reason multiple family members show up when a child is near death.
All of a sudden everyone is concerned.
Unfortunately sitting outside of a closed outpatient clinic was not helpful.
4 hours of sitting and waiting.
Why didn’t they go to the Children’s hospital?
The child should have been admitted in the night!
Instead they chose to come to see a doctor here.
And in the end all I could do was confirm the child had died.
The next hour was spent sorting out a death certificate.
And a permit for burial.
Meanwhile the waiting room was full and other children were being sent away.
My colleague and I proceeded with the consultations.
Later, after paying $5 for the certificates, the paper work was done.
And the family could head home.
Due to a transport strike we decided to take the family home.
As I followed the family out to the car I held a little bundle in my arm.
Earlier that day a bundle of life and joy now a lifeless little girl.
One month and two days old.
Very sad.
Yet I was comforted that the mother asked to hold her baby.
It showed me that actually she did love her little girl.
But I could also tell she knew this would be the last time she would hold her.
*pekin = krio for ‘child’
Posted by Sandra's Latest... at 8:40 PM 1 comments
