Screening days- The joy and the pain

Where to start???

It has been some time since I last wrote and life has been insanely busy, interesting and at times overwhelming.

Last weekend the ship was blacked out so we went into town to the markets. The roads are as crazy as in Benin – potholes, zimee johns, rust bucket taxi’s and people people people- balancing all manner of things on their heads.The market is full of handy crafts and everyone is offering you a “Good Price, Good Price”. Which is code for they are trying to rip you off- but who’d blame them when you see their homes etc.

The military are everywhere with the upcoming election. They have a very public display of artilliery just in case you think of getting out of line. We have been caught in more than one election campaign. They are loud events where many trucks drive through the market with horns blahing, people yelling on megaphones and drums beating. The election has been postponed until the 4th of March- Please pray for a peaceful outcome- some people are suspecting otherwise (to the point that they are leaving the country)but so far so good.

Screening has commenced for the surgery list. I went on Tuesday. We were anticipating large crowds (which have been forbidden due to the upcoming election) however much to our surprise when we arrived less than 100 people were lined up. The line was orderly (thanks to our security). We were at a handball stadium right next to one of the major political buildings so we are unsure whether that scared people from coming- additionally it is hard to tell if the media is giving good advertisements as the election is taking precedence. We set up a maxilla facial table, an orthopaedics table and a data entry table for all patients with other ailments.

Initially I was on the line escorting people we were unable to help to either the prayer area if they chose or to the exit. It was a sad line to be on but at the time you have a job to do and do it compassionately. It is only afterwards that you take it all in and realise that for some you were their last hope, a life line. The people take no so graciously- even though they may have waited many years in hope that we could help them. Not everyone we had to turn away had a life threatening issue (well not yet). There were many thyroid goitres and hernias, which whilst back home were huge, here in West Africa they were relatively small. If they weren’t yet life threatening we had no choice but to send people away. With so few surgery slots only those who struggle to breath or have toxic thyroids will receive surgery. Maybe those with small goitres will be alive next time the ship comes- or maybe their goitres will have prevented them from breathing- a sad reality.

I was rotated from the turn away line to the pre screening line where those patients who the pre screen team thought we may be able to help came. Translators took brief medical histories and I tried my best French to greet and direct potential patients to one of our 3 nurses who then decided if the patient was suitable to see the doctor or whether there was nothing we could do. Some adults came through with leg deformaties/injuries- but there is only time to do paediatric orthopaedics so regrettably the adults will go home. Some twins came through- so cute and yovo phobic (scared of white man). The boy twin was bilateral club feet and is scheduled for surgery this week from memory. Another child with bowed legs hidden under baggy pants is also scheduled. We saw a child and adult with large keloid masses behind their ears who will be scheduled. The last patient of the day was a 16yo boy who had a large maxillary tumor on his face. He was so ashamed he dropped out of school. It will be great to see him in the hospital for the first surgery of the year.

A baby with an encehpocele (hole in the skull through which the brain protrudes) came. His mumma was so happy that he could be scheduled- even though the risk is high as the skull is opened and the brain brought back inside and the hole sealed. Without surgery though he could not live to adulthood.

A lady with a fistula tried her best French to explain her condition to me- thankfully someone had written the word “gynaecological”in English on a piece of paper she brought with her. Fistula surgeons are coming later in the year so she will come to another screening where a surgeon can examine whether she will be repairable by surgery.

Over the morning the line of people grew slowly. The military came by at one point and the fear in the crowd was obvious. How blessed we are to live in a country where police and law enforcers are not to be feared. Many of the patients were cataracts and dental so they were referred to our eye and dental teams. There are many more eye spots available as the cataract surgery can be done in 7 minutes here. It is crazy to think something so debilitating can be fixed in 7 mins (though with a lot of skill too).

There are many more patient stories I could tell but i'm sure they will come over the coming months....

General surgical screenings will go on 3 times a week for the next 10 wks. Eye and dental screenings go on with similar regularity until about June. Time is not a concept the Africans are familiar with so we can’t give the patients notice of their surgery more than about 4-6wks prior to surgery or they loose track of time and fail to turn up or turn up too early.

Unlike Benin where French, and 2 dialects were spoken I am told up to 23 dialects are spoken here so confusion is common. Will I ever be able to communicate- mmmm not looking likely.
Please be praying for surgery which starts on the 25th and for wisdom for the staff who continue to select patients we can help.

My cabin is filling quickly and I ebb and flow with bouts of missing home. It is a very unique environment to live in- 6 people in my bed room, 400 people in my house with any number of those in the lounge room, kitchen, dining room and laundry at a given time. Add that to a street address that reads something like the craziest busy port in hot humid West Africa with men who eye you all the time and a never ending bombardment of noise, smells and sights.......sensory overload big time. Prayer for my sanity at this stage would be great :)

There is so much more I could write about the events of the last two weeks- but you have more to do than read a long long blog –so until next time......
Au revoir