In Llonda's Eyes

No internet for most of Sunday, but still It is hard to complain because it is the first time I have had it available here on the mission station.  Even when it is working well, it is about the equivalent of having one bar of service on your smart phone.  We are thankful for it when it does work, and it helps us to feel less isolated from home. 

The people we work with at the hospital are Christian and that is a requirement to be employed there. Each day of work starts with chapel.  Before going to your department to get report from the previous shift, you first go there. Some days it is packed in the chapel and on others only like 10% of employees show up.  It is a common way to start the day here.    Praying and singing together is not a bad way to start the day.  Some days we go, on others we don’t.

 The Muslim population is very high here in northern Cameroon.  Most of them, at least as far as I know belong to the Fulani tribe and speak Fulfulde.   All of the nurses speak French, but probably it is the second most common language spoken here.  Each day on rounds at the hospital, speaking with patients, 8-10 languages are spoken.  To be effective we must use interpreters.  Most everyone here is multi-lingual and our interpreters speak 10 languages, the only thing really different about them, is that they can also speak English.  A real problem with the multiple languages spoken is that for us, instead of just being wrapped up in and learning French we learn a few words from many languages.  How to say hello and how are you, how bad does it hurt…that is about it.

Even though I have met many Muslims and have been somewhat immersed in their culture, I do not fully understand their religion.  What I do know is that they are very dedicated to worship & prayer.  There are many mosques located everywhere and they have calls to prayer at least 5 times a day starting at 430 am.  These calls are played over loud speakers at all hours of the day and night,  and if one did not know better, you might think that at times it is a record playing that is stuck.  From those who can understand what is being said, they assure us that it is live and not a recording.  There is also a call to prayer at 1 pm every day and the whole town literally shuts down.  All the shops are closed, and there is no way to buy anything.  The mosques are so full that you see people all lined up in the court yards outside on their prayer mats praying.  If they have a family member in the hospital they do not leave there, but one can see them laying out their mats & praying wherever they are.  They use prayer beads and pray in a ritualistic style.  I do not know what it truly is that motivates them, be it fear or just love, but one cannot help but be astounded by their devotion.

Polygamous marriage is common among the Fulani and many men have at least 4 or more wives.  They typically have 20 children or more.  Their families of wives, from what I can tell all live in an enclosed compound, each with their own sleeping house, yet many common areas.  I’m not sure where the children sleep, but for sure the man sleeps where he chooses on what night.   The wife’s duty is to cook, clean, raise the children, pray and serve their man.  There is more to it than that, but that is more than enough for this story.  For certain not many of us American women could live this way, nor would we tolerate such a setting.

Work at the hospital is very challenging for us and we are expected to be experts on everything.  Of course we aren’t, but both of us have a lot more training than many working here.  Here it is reality that one must mostly learn from.  I guess the school of hard knocks.

Steph has been training workers in basic life support (CPR), and trying to get the store room full of goods sent from Global Health Missions & SMDC under control.  That alone is a job that one could spend a full year at and I do not even have the patience to attempt it. Her organizational skills go far there, and she is able to get the guys working there to at least do something,.  Global Health now sends containers twice a year to this hospital system, but there is a real tendency for them to hoard things as they never know when the next boat will arrive.  Those who run the store room do not work at the bedside and many valuable things lie there rotting. Many things are way past the expiration date, yet are very useful for patients in the hospital. Just knowing what is there will be a huge help to the nurse Majors in each department.

Tomorrow Steph will also begin special training for the ambulance workers.  The ambulance is only called when there is no other choice as it must be paid for out of pocket.  Many arrive at the Emergency department in a taxi as that is much less expensive.  So all I can really say about that is that when they are called, they are needed in a most desperate way, and the workers arrive on a bad scene with very little training or practice.  She has brought safety vests and other emergency equipment donated by the ambulance service she works for and it will all go far in helping them to do a better job at transporting patients.

I have mostly concentrated my efforts in the Burn/ICU department that I traveled here and helped them open back in 2006.  It is very interesting to see the transformation into an ICU specific for this area, but thus far certainly not what I envisioned it would become.  The burns they see are unimaginable and I wish I had refreshed my advanced burn life support and went to work some shifts in the burn unit before coming here.  Everyone cooks on open fires and use kerosene lanterns for light, so yes there are many burns.

We continue to care for the 2 small girls burned by tipping over the teapot.  They are our special cases.  Because of the wedding we did not work the weekend and so on Monday, we had to change their initial bandages.  The 4 year old with burns to legs, feet & bottom had gotten urine all over the dressings.   We wanted to insert a catheter to keep the burns from getting infected; Of course they have nothing of that size available even for sale at the hospital.  Luckily Steph finds one that is small enough in a box in the store room.  She brings it to the ICU when it is time for the dressing changes. We decide to put the catheter in first. Because the catheter is old and for sure not that sterile, we clean the area with lots of betadine first.  

We had many medications donated to us for the trip, and we gave this little girl a small dose of the narcotics before we begin.  We started to pull the dressings away and she is so brave.  The dressings are very dry and for sure they debride the wound as they come off. She barely cries and our interpreter says that he is surprised because even at her young age, she prays for strength for herself and for us.  Now any one of us would have been praying that we would just survive this and not really even think to pray for the nurse…  Another lesson learned, and this time from a 4 year old.  The skin on her legs, feet and perineum are badly burned.  What does not peel off with the dressings, must be cut away, with a tweezers and scissors.  Both of us are near tears, but again we do the best we can. With the next dressing changes, there will be little if any skin left.  For sure once the skin is peeled away we are all of the same color underneath.  The parents of these 2 little girls are Fulani and Muslim’s.  They are nothing but respectful of us and thankful to us.  They think that their girls are getting the best treatment because we are here. I don’t think that we know more but for sure we are more persistent at doing what we are capable of for them.

 There are German medical students at the hospital, they are watching us & learning.  We are starting to work with them & hope they will continue with the burn care once we go.

The head nurse of the ICU yells at us because we use too much ointment and Silvadene and too many dressings to treat the wound. “You will use it all up for this one patient and we do not have more for the next patient. We do not know when more will come!”  In our country we really have no concept of what she is saying as we slather the dressings with special ointments and use as many dressings as we see fit.  Who cares if one too many? Seeing some of the amazing burn recoveries here, I start to think that perhaps less is more.    I need to try harder to wrap myself around this concept.  God knows I want the best of everything, ask for even more and accept nothing less.

We all say that we want to help, yet when it is time to dig into our pockets there is no money there.  Most of us are not that good at putting our money where our mouth is.  Seeing what we see here, I am certain that we can do better.  Steph and I, have spent tons of money, burned up our vacation time and traveled over 10,000 miles to get here & I think to myself, perhaps we should have just sent a crate of medicines,  Pain killers and burn ointments.  Now this sounds good in theory, but I know that without managing to where things will go and teaching and training, that none of it will ever get to the very people we have set out to help!

Corruption is a way of life here, not just among the common people, but also the police, Army, Government etc..  Anyone can see how things will benefit themselves or their own family, but there is really no one looking out for the good of all.  Much of what is sent here, just as it is to other 3^rd world countries somehow just gets lost in the bureaucracy.