Miracle Worker ?

Currently there are 3 very junior and very advenist medical students in town.  They are all from the deep south and all very out of their depth.  The urban myth purveyed by the visiting U.K. near graduate is that they are so frightened of ‘germs’ that they have stuck paper from an exercise book over the place that they keep the loo paper so it will not get germs on it.  As the hospital cess pit is very close to them and overflowing, this being the rainy season, germs I suspect abound.  This is by way of introduction as I have probably unwittingly now increased their faith evermore.  As first year medical students, their exposure to the thud and blunder world of obstetrics had yet to occur until their arrival and their first visit to the OB room (labour ward to you and me but best described as a ‘birthing shed’) coincided with some previously undiagnosed twins in the late second stage.  The first delivered easily but then our problems started with a high but undefined presenting part, lots of limby type things to be felt through the membranes and a fair amount of blood as the first placenta was trying to come away.  The portable scanner was unequal to the task and the fetal heart difficult to detect, in fact not detected.  After a lot of thought and not wanting to rupture a uterus or possibly maim or kill a baby, together with a request to permanently put a stop to any more babies (if this one survived it would be 7 all told) I opted  for the abdominal route.  I explained to the young visitors that this baby may well be born dead so they immediately asked permission to pray (something that one could hardly refuse particularly in this environment) and they asked for divine intervention in this case when the heart could not be heard.  Yes you have got it, the baby came out asleep with a lot of ketamine on board but has survived to tell the tale and to confirm the hand of the Lord, Sister Susie, the nun from Ecuador happened bye with some visitors from California, thus confirming the ecumenical nature of this miracle.  The Lord works in mysterious ways……., but for some with faith I am sure it is strengthened.

I am hoping that divine intervention will help in another direction as in an attempt to introduce some sustainability into the cancer project I set the two Ethiopian’s up to do the next case, so they could carry on the good work, one helping the other, etc. etc.  Disaster as in macho efforts the uterine and ureter got confused and cut, not good in this cancerous field and with the cervix beginning to disrupt.  So trying not to be too snarly I made them finish and finding, surprisingly that there was enough give, have stuck the ureter into the top of the bladder.  So far, no leak, no loin pain and no temperature, so far so good.  However I am concerned that the sustainability of this project is uncertain.  Given that we are completely dependent on a small funding stream sustainability is dependent on funds, who knows what will happen.  However as proof of concept we are to a degree winning and it is something that I would like to continue doing. 

This may prove a little difficult as job opportunities are in smooth private hospitals that want laparoscopic surgery and the primitive rural life, and local scandals are taking their toll on those around me, who are now looking forward to a return to the land of Waitrose and kettle chips.

The tediousness of petty pilfering is also taking its toll as once again the light bulbs that light my path and shine on any waiting Hyenas, as I trail up to the hospital in the shades of the night have once again been purloined to light up others rooms, particularly irritating as the supply of AAA batteries is beginning to dry up too and the uneven steps have the added hazard of being muddy and slippery. These are however minor irritations as is the inability to keep a biro for more than a day.  We came out with hundreds but are left with but a handful, the others like most of our possessions being sold on in Gimbie town.

Meanwhile the usual politics have been accentuated by the decision to put all the guards into quasi military uniforms (olive green) and restrict visitors so the wards are half empty and disgruntled visitors are now another loose fingered rabble through which one has to pass as one enters or leaves the hospital.  The ‘big cheese’ from the Adventists has also flown in on a damage control mission and the staff have already been writing him anonymous letter saying how awful it all is, as they are undervalued, underpaid and under resourced, two of which are almost certainly true and he too is in for an interesting time as ‘e-relations seem to have broken down between him and the current medical director, whose sojourn here is now going to be short lived and his wife escapes next week leaving him to bachelordom and hopefully when he moves into smaller quarters (ours) the company of two chickens providing they survive the ovicidal attentions of Camilla’s puppy who spent the day either chasing them or nibbling me, the latter requiring corporal punishment, which seems to have done the trick.  Camilla, now the new temporary acting project leader, Mosisa being off to pastures new, though at what personal cost I know not,  was persuaded to take on an anarchic puppy which was spending a lot of time here, biting me and chasing chickens.  However with a week in the U.K. and a disastrous attempt at rehoming with the Ethio-American couple (sh*t all over the house) has now gone to the recipient of all that is in need of succour, Mackebie, so we will be inspecting Jabba for bites on his Saturday visit as well as for signs of his continuing Tinea Corporis (ring worm).

Sustainability, a failing dysfunctional hospital, a factional and riven NGO, venal idle and incompetent health centres and surgeons who cannot be let loose on their own, divine intervention required here too I think.