Friday, March 26, 2010

Thoughtless Thursday - The patients

Ok so I know it's Friday- but it's been a busy week and I figure it is close enough for a thoughtless Thursday - Enjoy








Giving the Very Important people a run down of the laboratory



Before surgery



Above: Awaiting swelling to go down post surgery

The kids- too too cute







Above: Premie twin bub mentioned in previous blogs. Such tiny little casts

Below: Screening days





Me trying to create or keep order during screening

Monday, March 15, 2010

Kpalame adventures



The Mountain we hiked

So please forgive me I wrote this earlier in the week but have only just found the internet to be working fast enough to post it. Sadly pictures are a luxury you'll have to have one of this week (slow internet connection)- which is a shame as the veiw from my adventures was spectacular:

Wow the election curfews are now over- Yay we are aloud off ship.

No mucking around we planned a weekend away at Kpalame- a village at the base of some mountains about 2 hrs drive North West of the port of Lome.

Scavenging bread and nibbles from the last couple of days we were prepared with enough food to go (can’t just duck into eat anywhere here).
15 of us met our taxi driver out front of the port. 19 of us crammed into his van about the size of a Tarago van. In true African style 4 random Africans jumped in with us for the ride. The drive north took us out of the busy city, past a rather large political demonstration into lush green landscapes dotted by small villages. The villages though so close to the city are very primitive mud huts with thatched roofs. We are stopped at countless check points along the road- though our driver familiar with the area charged straight through one apparent check point with rope across the road. Apparently it is a fake checkpoint locals set up to get you to stop and buy something at their village or pay them a toll/bribe to get through.

One thing I have learnt is that people are out to milk you for all your worth if your skin is white and sometimes it gets super frustrating. We arrived at our pre booked hotel only to find that they hadn’t booked our 4 rooms and that they wanted us to pay a much higher price (about 3 times the quoted amount). After much discussion they agreed we could pay the previously agreed price if we ate 3 meals in their restruant – not happening given we planned to be up a mountain for most of them. After much negotiation or frustration they found us rooms at a local hotel next door and once again tried to hike the price up- so we walk away and sure enough they came to the party. Actually we ended up at a very nice hotel with some lovely hosts so all the drama was a God send anyway. We soon discovered we had 4 rooms as booked and though each was supposed to bed 4 people they only had one double bed or king per room. 4 in the bed :). Borrowing sun-mats from beside the pool we made several beds on the floor and were set.

At midday we embarked on a 5 hr hike up a very steep mountain nearby. Our guide for the day set a flying pace and about an hour in 2 of us had nasty heat exhaustion and several others weren’t doing so well. After several discussions with the guide and a break (with some miracle electrolyte drinks) we were back on track. The view the whole way up was amazing. It was like trekking through the thick growth of the jungle – thankfully we had our guide. We passed through three villages on root. All the villages were built into the mountain side. Gatherings of mud huts in close proximity. Some village children joined our walk . They kept directing the guide to local landmarks like a cool stream where we could dunk our heads in water, an avocado tree, cocoa bean- which by the way when not ripe are really citrusy in taste to suck on though grossly bitter if you bite. The local man are constantly armed with either a machete (often used for farming purposes) or a gun hopefully more for hunting than protection but who knows- interesting world.

When the going got really tough and a few got sick the guide just found a random local in the bush who could walk a couple of us girls back to his village and then give us a motorbike ride to the hotel- that met a resounding NO from all of us- helpful though the guide was you can’t be serious or can you.

Continuing on we passed by many women with huge tin bowls on their heads and babies tied on the back- how they make it up the incline is a miracle to me. The kids continued with us to the next village where we stopped to relax. Kids came from everywhere and we whipped out some balloons I had thrown in- that was cause for some fun.

Continuing on we watched huge dark clouds roll in across the plains- within moments our guide was cutting us all banana leaves for umbrella’s. Seconds later we were drenched and sloshing in inches of mud. It didn’t take long for the mountain to turn into a slip and slide. At one stage there was no seconds between lightening and huge bangs of thunder. Yep we were right where you’re supposed to be in a storm- right in the middle of the bush. Been soaked to the skin with rain instead of sweat was a nice change J. The pictures speak for themselves of the view!!! And we didn’t even make it right to the top cause of the storm.

Saturday we wandered around the local markets before heading to a waterfall- even that was a hike and a half!! Again the pictures speak for themselves- and hopefully next week there won’t be any parasites to make this a bigger story- one can never be sure in the waters here :).

This week has had some absolutely crazy days at work. Aside from the usual hospital patients and the new admissions we were inundated with screening patients on Monday. About 50 people with facial tumors came on board to be screened and scheduled for surgery. One poor women has about 5-6 giant tumours the size of a man’s fist all around her face. Cute little kiddies with cleft lips and palates rolled around under foot. Many were scheduled for surgery in the coming weeks. Some will likely get the news of cancer- looking at their biopsies today. If the cancer is contained maybe something will be done to remove it but if not they will be for palliative care. Some patients will find out they are HIV positive- it may not discount them from surgery but where metal plates need to be put in their body further tests need to be done first to determine how advanced their disease is and how likely their body is to reject the metal. One a 14 year old girl with a deformed leg will miss out on surgery – she is in the early stages of pregnancy where anaesthetic is too risky. By the time the baby is born the ship will have left- for her the bad news was probably a double whammy. But in all that little kids keep going home with legs cast from transforming surgery, cleft lips toddlers meander the wards with their little cats whiskers- sterry strips in a cross shape over their newly repaired lips, and adults admire newly created faces post tumour removal. Proud parents of the children lurk close by to encourage little ones with double leg casts who can’t stop trying to scratch through their casts- I can’t imagine how frustrating 2 cast legs must be- but then again I have never had my legs on almost reverse and tried to walk or had painful club feet. They have a road ahead but they have a hope they never imagined.

Well that'l do me- in usual ship style I have what is hopefully the flu and not malaria so i'm going to take my hot and cold sweats to bed for some ZZZZ.

Sunday, March 7, 2010

Discarded Treasure

Sometimes I feel I start my blog all too often with tragic stories. I hope you can see the joy in them too- but this is reality here far too often. Today’s blog is really no different.

Today I sat in ward church. Patients came in from the other wards to crowd B Ward. Some from the maxillofacial ward post op with nasogastric feeding tubes, dressings and scars from surgery already performed. Others sneak in faces draped with some form of head covering masking large tumours- awaiting surgery tomorrow. From B Ward the patients are manovoured into position for church- many have had bilateral osteotomies (bowed legs sawn through and repaired). There bare double leg casts of a variety of vibrant colors. Next come a group of mums from A Ward- there babies are in the infant feeding program. Some have cleft lips and need feeding up before surgery. There are tiny twins- apparently 10days old- though suspectedly born at about 32 weeks. All blanket no baby. One twin is fine and just needs feeding. The other had club feet and yes at 10days old and 8wks premature this tiny one has leg casts- caught so young casting should repair the club feet quickly.

The ward is packed- I sit next a little girl. She is 8 though only the size of a 5 year old. She is very non responsive. She has recently had both legs operated on and cast for bowed legs. I met her earlier in the week when a HIV test came back inconclusive- we hope it’s a false result as can be the case with inconclusives. She quietly cries- before conveying she is in pain from her legs. Like an angel she takes the pain medicine. She also has malaria and shivers and sweats throughout the service. She keeps looking at her hand- seemingly amazed by the IV lines going in even though they have been there for days. It is so beautiful to be able to sit and stroke her head to try and comfort her to sleep. So much more beautiful when you know her story. She was found dumped as a baby- the translator says in the trash- whether that literally means in the trash or dumped like trash we are not sure. We can never know her parents story as to why they discarded this little one- was it her deformatity- perhaps. Some nuns found her and she has been living in an orphanage ever since. The sisters brought her to the ship for surgery. She’s had a hard road and probably has a hard road ahead but to be able to have the function in her legs restored will save her much rejection and suffering in life.

The first boy to have surgery, a 14 year old with a large facial tumor which distorted his eye socket and cheek (about the size of a mans fist), left to go home today- excited to show his grandma whom he lives with his new face. All week he has had a small mirror beside his bed and when he thinks no one is looking he sneaks a peak at his new face- like a little child discovering themselves in the mirror for the first time. How much do we take for granted what we see in the mirror every morning- a little less than pretty though it may be before coffee and a shower .He looks great. Before coming to the ship he had dropped out of school- too ashamed to go. He snuck between his Grans house and his fathers house in the early morning or late evening when it was dark. Too ashamed to go into public he lived as a hermit. Today he looked confident as he walked down the gangway with his Dad looking very proud beside him. He can go to school, get a job and likely marry and have a family someday- leaps and bounds ahead of the boy who came to the ship less than a week ago.

The election here has been relatively peaceful. Both parties are declaring victory at this stage and a recount is underway. There are many road blocks and the borders to Benin and Ghana are closed as are most businesses in town. Large gatherings of people and protests are certainly going on in Lome where we are but we are told so far they are peaceful. We have been in lock down on the ship since Wednesday and continue in that phase. Enough patients were admitted on Wednesday to keep the operating rooms in action until next Wednesday when hopefully normality will resume. Prayer for a peaceful resolution would be great.

We had a bush dance (or barn dance or Kaile - many names many countries) on Friday night in our compound on the dock. It was lots of fun. The local dock workers and some Asian seaman from the neighbouring ship watched on in amusement. They probably wonder why on earth a couple of hundred people would want to work up such a sweat in the intense humidity. There wasn’t bush or barn in sight but there were plenty of cockroaches getting squished during our jig.