Doctor Amber, Part I

Medical school, sch-medical school. I got promoted from RN to MD by Dr. Frank, after a 10-minute crash course on tropical medicine. With 300 children to see, and only myself, Dr. Frank, and Dr. Stella from Arusha, we had to pool our resources. Thank goodness for 9 years of experience, and the wonderful physicians I have worked with over the years who have taught me well. Thank goodness as well for Dr. Frank’s patience. African medicine is medicine in its simplest, yet most-honed (is that a word?) form. There are no labs, no x-rays, no diagnostic tests. You have your patient and your intuition. As for meds, you have what is available, what was donated, what was cheapest, what the government will allow. It is not ideal medicine, but it IS the only medicine some will ever receive.

There was a group of 8 of us, including other volunteers and Susan, Frank’s wife. We headed out Sunday afternoon to a little village about 3 hours from here. We were met there by Paula, an American and Occupational Therapist, who has an organization to spy out different needs and arrange for services. We stayed at the “Guest House” in the village, which is usually occupied by prostitutes when not filled with mzungus (white people) such as ourselves. This place made camping look like the Ritz Carlton, and the orphanage seem glamorous. The toilets were holes in the ground, and we had dirty buckets of questionably clean water with which to bathe. I didn’t pee or poo for 5 days. We all have come back with suspicious bites all over out bodies, which I am guessing to be bedbugs. We ate the native ugali (maize type grain), goat meat, and bananas. It was a taste of life as many know it here. Aahh, the price of adventure.

Monday: Day of Hope and Anticipation

We headed out for the first of three days to do wellness checks on approx 300 children at the local school. On our 40 minute ride down a “road” equivalent to driving over cement blocks, six giraffes amble across the road in front of us! Such elegant creatures. Then another 10 minutes off-roading to the school. By the time we arrived my bones were in a different anatomic order. Fungus, worms, and malnutrition were prevalent. Throw in the occasional bug in the ear, wound abscess, malaria, and welcome to African medicine. We powered through about 100 children, while Dr. Frank saw the local adults who filtered in to see the white doctor. Our much needed comic relief came in the form of a 84 year-old man complaining that he was only able to “be with his wife” three times a day instead of his usual 9. We appeased him with some Tums. We had a focal group of seizure patients, most with epilepsy due to cerebral malaria. It didn’t take long for me to recognize the glassy look of malaria versus the gray look of worms. How do they even survive?

Tuesday: Day I Cried

It was overwhelming. The day started off well enough, with a young lady with a snake bite on her foot swollen twice the size, After lancing it, (skip ahead if you are faint of heart) pus came pouring out, and I wonder how she managed to walk for 2 weeks on it. I met an 8 year-old girl with a broken elbow that was casted wrong at the hospital, so it “healed” at an odd angle, and would never have full use of her arm. The family did what they could to get help…Life is not fair. She already has odds stacked against her.

Monday I had managed to be resilient as child after child came through with complaints of stomachache. Ask them what they had to eat that day, and they hadn’t….even at 3pm in the afternoon. Every single child. I don’t know what it particularly was about this one 10 year old boy, but he was my breaking point. He had the usual complaint of stomachache from hunger, but also had a cough at night. I asked if he was cold at night. Always cold. Asked if he had a blanket at night. No blanket. Asked if he had more clothes to put on. No more clothes. And he answered with his head hung down, as if he was ashamed. Not asking for more. He was simply being honest. His humility was heartbreaking. The futility of what I was doing just overcame me. How could we even put a dent in this poverty and sickness?
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