4/11 – Full Range

It was a huge day at the hospital. There was so much to do every single minute that I was just dead tired at the end of it all. I really am so amazed that Jean does this by herself most of the time. Thankfully, Dr. Tabi is here to help now, but she won’t be here forever, unfortunately. There should be at least two doctors working at the hospital at all times. It’s just a good system to keep both of them from wearing out completely. There is definitely work enough for two!

Tabi and I started bright and early in the male ward today, to check on our moto accident patient. We had to watch carefully for stiffness in the neck especially, because that could be a sign of further injury. Since the patient had many open wounds that weren’t healed yet, we couldn’t give him dichlophinac injection to ease the pain; it has a nasty habit of decreasing clotting factors and could cause him to bleed profusely from his wounds. Instead, Margaret one of our most attentive nurses, suggested dichlophinac gel for massage on the neck. Awesome, problem solved. I love it when the staff works as a team to treat the patient. Tabi didn’t even know the gel was stocked at SMC, but Margaret had her back. I want to see more of this!

There were two patients in the male ward waiting for inguinal hernia operations in the afternoon. I was looking forward to assisting in at least one of those!

In the female ward, we had a few cases we haven’t seen too often–a patient with maniere’s  (sp?) disease and symptoms of vertigo, a patient with a 2-year-old anal fistula, and a patient with severe vaginitis. The last one was interesting to me because she had originally come in for some completely unrelated problem that I can’t even remember now. But when she saw Dr. Tabi, a female, she was able to finally disclose one of her biggest health issues. If she hadn’t been admitted, she would have only seen the male Medical Assistant in the consulting room, and would have never had her condition treated–she would have just gone home in pain. There should be a better way to go about these things, even if it’s as simple as having the M.A.’s ask their female patients if there’s something they’d rather speak to a female health professional about.

In the childrens’ ward, Pullsheet David noticed that one baby’s leg was bending in the wrong place. Yes… it was a femur fracture on a poor little 1-year-old. And how did he break his thigh bone, the biggest bone in his body, if he couldn’t even walk yet? The darn motos. He was thrown from a moto and now his leg was broken. We didn’t have any plaster of paris to set up his leg, nor a gutter splint small enough, so Jean looked up a gallows traction rigging in one of her textbooks, and Bob, Ishmael, and Tabi set to work making one for the little guy. They worked hard, and finally he was all tied up, with his leg hanging vertically while he lay on his back. The gravity would help the bone to set back in place, so another problem solved. He wasn’t even crying as much when they left.

In the maternity ward, it was the same thing as it is almost every day, since we’ve had these complicated pregnancies deliver. We scold the moms about wrapping their babies tightly in two dry cloths, and urge them to feed their babies every 2-3 hours whether they are awake or not, and then do cup top-up since the baby could be too weak to suck until it’s full.

One baby is jaundiced and seized right there as we were doing rounds. I don’t understand things like this–the moms have good nurse translators and are fully informed as to what they should do, but they don’t want to do it. It’s that patient compliance thing again. Tabi and I come into the maternity ward whenever we have free time to monitor these moms and ride their backs to take care of their kids. That’s the best we can do, but the rest is up to the moms. I suppose it’s one of those “You can lead a horse to the water, but you can’t make it drink,” things. It sucks majorly, and I hate it, but if I have to lead the horse to the water a hundred times to make it drink, I will. I know Dr. Jean and Dr. Tabi would do the same.

The worst part is when something terrible happens before that one hundredth time, like it did today.

I had just come back from assisting in one of the inguinal hernia cases and one ganglion cyst removal. Dr. Jean and Dr. Tabi were still in the theater working on the second one, and I was assigned to go check on the maternity ward and make sure all the recordings of the feedings and temperatures, etc. were being taken. Everything looked fine, but I couldn’t find the mom with the jaundiced baby. For some reason, they had moved her to the female ward from maternity. I asked the mom to cup-feed her baby because it wouldn’t suck. There wasn’t even any milk, so I got one of her nearby friends who was also nursing to expel some breast milk into the cup. I left the woman with John Manyan and Janet, and went to finish checking on the rest of the babies.

I was gone maybe 15 minutes when John called me back, and said that the baby wasn’t breathing. BAD NEWS. At this point, I can only think “Oh, #$*%.” I ran over, looked for rise in thorax, there was none, more expletives in my head, and I quickly called across the ward for Janet to get the manual respirator, except I only yelled “THE THIS THING!” and did the hand motion. In a flash, Janet had the device in my hand. I gave it to John and commissioned him to do one breath for every five compressions, I quickly checked for brachial pulse like Tabi taught me, and I thought I felt a small one. John was excellent and did as I instructed. When Tabi came, though, she confirmed the little girl dead. I thought the brachial pulse was still there, but I believe was feeling only wishful nothings.

It was one of the most terrible sights I’ve ever seen. The poor first-time mom was sitting there on the bed, watching us try to resuscitate her child, but we failed. Even though she didn’t speak English, she knew what the verdict was when Tabi removed the stethoscope from the tiny chest and turned away to tell us. She began to cry. I’ve never seen a Ghanaian woman cry, ever. I’ve seen them lose their babies, had their bodies cut open, suffered anxiety attacks, lose their husbands, and many more horrendous things, but I’ve never seen any shed even one tear. Knowing the strength of these women, to see this one cry was absolutely heartbreaking. Tabi tried to touch her shoulder for encouragement, but she tore away and turned her back. We were all devastated there in that room, but none more than her.

Tabi and I walked home in virtual silence yet another time. Those times are the worst, but as soon as we get back to the bungalow and report to Jean, she always says the exact right words to encourage us. But more than that, I think it’s her example of strength and trust in God that lifts the weight off us. Pastor Jonah was there also waiting for an evening chat. Even his presence there is calming to me, because I can feel the Holy Spirit in him. He was reading the Likpakpaln Bible that he himself helped to revise, and just seeing him there reminded me to trust in God above all things, and of Romans 8:18-21, about our future glory.

We ate Bob’s wonderful meal together, and then after our dinner, Raymond Aidoo and his wife Esther came over for cake and ice cream. Esther was leaving back to her Health Assistants Training School, and we wanted to “goodbye” her well. They are very jovial people, which definitely lightened the mood.

After this, I wanted to also “goodbye” Ishmael, since he was going to be leaving the next morning for a funeral, and I would be leaving “tomorrow next” morning and wouldn’t see him again. We went to Back Home Spot, and thanked each other for the past 10 weeks over some Alvaros. Again, Ghanaian generosity and hospitality just overwhelmed me. The way they treat guests or strangers here is beyond kind. I just felt so grateful for his words of encouragement and friendship. We continued to talk more about the hospital, his new goals for it and the emergency unit to be established there, and for his personal goals. As we finally wished each other goodnight, and I walked back to the bungalow, it hit me how much I am really going to miss my friend.

It had been a very full day, overflowing with a full range of emotions, and I was definitely ready for my rainwater bath and a hopefully a good night’s sleep. I am dreading facing the mom again in the wards tomorrow. I don’t know what will happen, or how she will react to our attempts to help her, but I will just pray that God would give me the wisdom to know what to do and the strength to deal with whatever comes.

-ATP

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