Sunday, May 30, 2010

Medical Emergency in the African Bush

I knew something was wrong by the way Musa, my Rastafarian host uncle, called me over to the compound. All the adults stood huddled around my porch with expressions of panic and confusion. Neyney (pulaar for mother) had to be lifted from the porch, unable to stand or see straight. I asked what happened. "Her whole body just went dead," Mbuna said. Egudou, my host mother and I piled on a donkey cart and headed into the bush toward the nearst hospital across the river, leaving the sun to set behind us. My body cramped under her weight as I struggled to make her comfortable and fan her, fighting the heat and stablizing her panting. She was not responding to my questions and her eyes rolled around her sweaty and tear stained face almost lifelessly. I was terriffied but pushed away any fears or negative thoughts. Baba (father in pulaar) was waiting at the riverside wth the boat. Musa lifted Neyney's body and stradled a slippery gap to lower her into the boat. Her shoes and fan were lost in the transaction, something that normally would have been upsetting hardly seemed to matter. Two young men brought a wheelchair on the other side of the river and we loaded Neyney once we arrived. They struggled past dirt and rocks on the way to the hospital. At one point they tipped her and I scolded them in Pulaar, frustrated with their wrecklessness.

It was dark now and the heat worsened in Kuntaur, which is located on the river. The humidity and mosquitoes were a lingering pain adding suffereing too the already unpleasant situation. When we entered into the hospital I thought I could vomit from the smell. Aromas of urine , puke, feces, and death were so potent you could almost taste it, unfortunately. A few lights hung from fans whose only purpose now was to host dust, cobwebs and insects. The 12 beds were lined up on opposing walls with no dividers, it reminded me of a make shift hospital room during ww2 or in a refugee camp. At the far end an old naked man lay on his bed swating mosquitoes away with a rag. A young teenage boy who resembled a skeleton flailed around in panic moaning from pain and sweating profusely. Under his emaciated body was the bare matress tattered from use and with many questionable stains. Next to Neyney's bed was a pregnant woman in a light pink complet. She threw up every five minutes in a dish pan she kept at the foot of the bed, I unfortunately became quite familar with that pan as the night went on. It was not until later that I realized an old woman was laying next to her. I literally thought her clothes and body was just a sheet on the bed, she did not make it through the night.

The nurse hooked Neyney up to an IV and I fanned her for about an hour before she fell asleep. Egudou was sitting with her baby on an empty bed making friends with the patients and their families. Chattering away as if we were in our compound. Baba bustled back and forth from the Bitik, or local shop. The sustained presence of the mosquitoes got the best of us that night, everyone was constantly swatting them away and scratching at their bodies like they were going through withdrawls.
The stray cats did not seem bothered by the mosquitoes, they wandered around the room drinking out of the dish pans at the edge of the beds.

Although disturbed by my surroundings I was able to maintain my composure. Neyney was neglected,, except for the IV, by the nurses and I was more than happy to step in and play nurse. However, as the night went on I grew more and more upset at the lack of accomodation or attention from the professionals. Someone whom I had grown to love and care about, who treats me as a daughter was ill and little was being done. Neyney somehow drifted to sleep and I decided to ask the nurse some questions.

All I wanted to know was what was wrong with her. She had been complaining about stomach, head and body aches and had also thrown up quite a bit before passing out back in Banni. The nurse did not even look me in the eye when she said "look at the chart" in english. Reading the chart just frusturated me further, it was filled with innacuracies. Age: 26, she was really in her 40s and it read she had an abortion when really it was a miscarriage. As far as a diagnosis, nothing.

Baba returned from the Bitik with bread and a Fanta for Neyney. She had a little and her checks blew up. She motioned at her neighbors dish pan. Without thinking I grabbed the dish from the pink pregnat lady and held it to Neyney's mouth. The vomits converged and my stomach turned. I left the room for some fresh air under the stars.

By this time it was after midnight and Kuntaur quieted, surrendering to the sounds of crickets, frogs and a lonely track on a distant radio. The other visitors of the hospital were spreading wrapskirts on the cement floor outside the hospital. Egudou, Baba and I joined them in setting up camp. The night was reminescent of a sleepover. We stayed up late chatting under the stars and checking on our sick loved ones periodically. The mosquitoes refused to let us sleep, waiting attentively for us to doze off before they attacked. Thank God I took my malaria pills I thought as I drifted in and out of an uncomfortable sleep. We woke with the sun a little before six am. Baby Metta (Egudous child) was laying on her back wide-eyed. She made no noise except for the sound of her nails ripping at her skin as she consoled mosquitoe bites on her belly.

The crowd of visitors who slept outside flocked like zombies to the river to wash the sweat and stress off their faces from the preceding night. Back in the hospital room Neyney was awake and feeling a bit better. She was still throwing up any little food she swallowed but was more talkative and could walk, slowly, on her own. That morning the "doctor" (head nurse) was in. I introduced myself in Pulaar but he was a Wolof and chose to speak englsih. I polietly informed him that some of the information on my host mother's chart was incorrect, and that maybe I could get some answers as to what was wrong with her. When I said that she had a miscarraige and not an abortion two months ago his response was shockingly rude and condescending.

"Is it not the same thing," he said. I replied no. He then made me explain the differences to which he responded, "you are wrong, to a lay person one might think it would be different, but if you look in an English dictonary you will see its the same." This guy is going to be diffiult to work with I thought. After hours of asking the "Doc" to run tests on Neyney's blood and urine I had nothing, I was only denied in a rude tone time and time again. Frusturated with my helplessness in the situation I asked Musa for help. All he had to do was ask once and I was holding Neyney's hand as blood was being drawn and carrying her urine to the lab.

When the results came back I was shocked, but alone, in my reaction. She was pregnant. Baba and Musa were happy with the results. I explained that her illness was not just simply being pregnant, that bleeding to the extent one thinks they had a miscarriage is not a normal side affect of pregnancy. Wondering out loud who was going to inform Neyney, Musa nominated me. Entering the hosppital room I found Neyney resting. Her body, wrapped in a blue and orange skirt, lay atop a green plastic covered mattress. Flies jumped around her feet and Fanta botle. I took a seat and she rose up. In Pulaar I explained we have the results, you dont have malaria but you have a stomach (which is how you say pregnant in Pulaar). She sid "Ok" without changing the expression on her face. It was as if I had told her something as simple as the time or that a friend greeted her. Something did however switch inside of her. After refusing food and water for a day she instantly asked me to go to the Bitik and buy her something to eat. She knew that it was not just her she had to look after but a baby as well.

Neyney had to stay another night until they were done giving her medicine to kill any possible infection in her uterus. I wanted to stay again but needed to get somethings fom home. After Aliji and his small boat paddled me across the Gambia river I hopped on my bike, racing through the dusty dirt road that wound through the bush. I quickly greeted my village and explained Neyney is recovering with out revealing she was pregnant (its taboo to discuss). I got to my mud hut and lay on my bamboo bed, and attempted to relax. My mind was replaying little clips of the past two days like a trailer to a movie. The young boy's wails in the night, Neyney's heavy panting on the ride up, the cobwebs in the hospital room, the old lady who had died, the old naked man in the back who peed in his dishpan, Neyney's suffering and the heat. Then I remembered one more detail which summed up my feelings perfectly, An HIV campaign poster hung on the hospital door with the words "We can do better".

Lumo (market ) Day

Hey all, thought i would give you a little more insight on my life here. So much happens its hard to organize into blog posts but here are a few posts on recent/ reoccuring events in The Gambia. I my area every Monday is Lumo day in Wassu, a bigger town acorss the river from my village Banni. Here is an entry I wrote in my journal describing it:

The sun falls heavily on the covered shoulders and heads of the women waiting by the riverside for a boat to arrive. Today is Lumo day which means, if you have money to shop, you dress ip in your finest complet (traditional outfit) and paint your face to perfection. Once across the river horse carts line up in a row, waiting to transport people through the rice fields to the town of Wassu.

Amonst the tangled sandy paths of the marketplace, animals, colorful merchants and endless fruit stands, the lumo is the place to see and be seen. The market culture is reminist of how it was hundreds of years ago. North African merchants with their lighter skin and long robes lay on mats selling gorgeous fabrics. Around the corner meat hangs on wire scraps as the vendor swats flies away while he negotiates over the price with a client. Young school girls help their mothers and walk around the enchanted maze balancing plates of bananas or peanuts on their heads. Horse carts continue to shuffle people around kicking up the dusty earth of the dry season. As a result, men and women adjust their headscarfs so that only their espresso toned eyes are revelaed.

After four months of attenting as many lumos as possible I have become quite familar with the streets and merchants. There is my tailor Yaya Jallow's shop which is located in the middle of the market. It is my home base along with the rest of the people from Banni. Its where I leave my bike, get water and sit to chat with friends over attaya. On the main road is my "mom" Mariama who is an older woman that sells fruit. She likes to refer to herself as my mother and gives me free bananas which is nice. In between the meat and animal area is a collection of small resturants one of which is ran by my work counter part's in-laws. In the fabric section is an elder North/East African man who sells me fabric. At first meeting he thought I was just a normal Tubab but when I called him a theif and demanded he reduce his outlandish prices in Pulaar he realized his mistake, apologized and now gives me local prices. Among the familar faces that operate the lumo are many family and friends from my village and ones near me. However the biggest population of people I run into are my "customers". Last lumo day I counted 20 strangers who I didnt know saying in Pulaar, "Binta where is your sour milk" Not the most glorious thing to be known as, no, but still it always brings a smile to my face to talk about my sour milk with strangers...