The First Week

I regret that it has taken me so long to write an update, but since I did not bring my own computer and started almost immediately working in the hospital, today is my first day to think and write (and cook!) since arriving.

From now on, I have decided that I will always travel with Katy.  God seems to give her special grace in the area of transportation, and all of our flights behaved well and our luggage arrived.  I was able to bring many of the things that the hospital had requested, although I was not able to bring some things because I did not order medications early enough to get the government clearances needed.  I did learn a lot that will help me to plan better next time. ;)  Katy and I arrived in the country of Niger on Sunday afternoon and spent that evening at a guesthouse.  I intermittently turned on the air conditioner in my room for 3 hours during my stay and it was glorious.

We flew to the hospital in the smallest plane that I have ever been on.  It is a 6-seater, but we took out 2 seats to accommodate the trunks we brought along.  We flew over the countryside at about 4000 feet and were able to see the faint green of the crops watered by the recent rains.  By the time I fly back, I am told that all the green will be gone.  This place is what most people picture when they think of Africa, although I have been to many places where the land is lush, with rolling hills and even cool temperatures.  Here it is hot.  110 today.  No air conditioning, only fans.  The temperature inside is in the 90s.  Because of the recent rains, the air is oppressively humid as well, so the sweat that drenches me can’t evaporate away to provide relief.  Culturally, as a woman I must wear a headscarf, which adds to the warmth.  I am missing the cool fall weather that began just as I left.

Malaria has been terrible this year and though the pediatric ward is supposed to hold up to 35 patients, the other day there were 115 pediatric patients.  They share the beds, with 2 to 3 children and their mothers sharing the same mattress.  Additional mattresses are spread in any available space.  The nursing staff are overwhelmed by the number of patients and with 2-3 per bed, often with similar names, it is frighteningly easy to get their charts and medicines confused.  They are all on the same medicines but at different doses.  Thankfully, most of the patients seem to be getting better, although one day last week 26 died between one day and the next.  The hospital staff is noticeably worn down. 

My first day was really difficult.  It is amazing how much variation there can be between different African mission hospitals and I arrived knowing almost nothing about how this hospital functions.  So on Tuesday I followed the other doctors around in the morning.  My French lessons didn’t get as far as I’d hoped, so I’m completely without any communication ability without a translator and there are only a few who speak English.  I write in the charts in mostly English with a few bits of French that I picked up.  But that first day I was reminded by everything including the other staff that I don’t know how to do things here.  At the same time, when I asked for help, I was told that I was slowing things down and when I didn’t ask, I was told that the things I did were wrong.  One of the doctors here hasn’t taken a day off in over 6 weeks, so I understand his impatience, but I definitely went home and cried that night.  First days are always hard. 

The rest of the week has been better.  I had one child die overnight that night.  They had come in too late.  I wrote “near death” on their admission note and unfortunately turned out to be right, but since then, all of my patients have survived.  A mother brought me her 6 year old daughter seizing from malaria.  Her firstborn son had died several years before, and her second-born, a daughter, had died when this daughter before me was born.  Now her only living child was dying and she was panicked.  I led her to the bench we call “the ER” and then had the mother hold her seizing child on the scale so we could know the proper dose of seizure medicine to give.  The needle on the scale bounced with every twitch of the girl’s arms.  But it was enough to get her the medicine.  The first dose didn’t help and after another very long 10 minutes we gave a second dose.  A couple minutes after that, she finally went limp.  I watched to see if she still breathed and was relieved to see her chest rise and fall.  We gave her malaria medicine and Tylenol, and I prayed that she would somehow live, though things looked bleak after at least 15 minutes of seizing.  By the next morning, when I came to round, that patient had faded into the back of my mind surrounded by many other children I had seen.  As I walked into the nurses room, a woman grabbed my hand.  This isn’t unusual, every mother with a child in the hospital wants their child to have the doctor’s attention, so I continued walking with just a brief smile at her.  Then she gestured to the child beside her: a lovely young girl sitting up with bright eyes and a smile.  I continued walking and made it another five feet or so before realizing it was the seizing child from the day before.  God’s memory is perfect.  Though I had forgotten her, He had not.  I pray that the joy in that mother’s face might direct her to the God who saw her distress and saved her child, rather than towards me.