Mama Laadi

I thought I would take this opportunity to talk about where I’m staying while I’m here in Bolgatanga.  I live in a Foster Home which is run by an amazing woman called Mama Laadi.  Afrikids met Mama when she was living off nothing and had a one bedroom shack full of children from the streets or orphans that she had taken in to care for.  AfriKids and Mama are now in a partnership called Operation Mango Tree.  There is 35 children who live here and she also cares for another 85 in the community that come to visit her regularly for money or food.

She is such an amazing women – she has devoted her whole life to caring for these kids, she is the most giving person I have ever met.  In fact she normally goes without to make sure the kids have enough.  An example from just last night: she wears 1 dollar jandles which have broken and as one of the straps have snapped and she was going on how she was going to fix them with a drill rather than buy new ones!  Ha ha … you can also hear her coming from a mile away dragging her one broken jandle!

At the moment she is paying a lot of money for some kids from the community to get operations – one child has ambiguous genitalia and his lower abdomen is basically all open with his intestines hanging out – he is now 5 and been like this all his life with no one helping.  She raised enough to send him to Kumasi (one of the bigger centres), so now he is down there with his mum… unfortunately they are still begging on the streets… but mama has given them money for medicines, and enough for nappies so he doesn’t leak faeces everywhere.

There is also another child who has retinoblastoma (cancer of the back of the eye) usually this is caught early, but this child’s eye was actually hanging out of his face and no one could afford to help him.  Mama gave them about 1000 of her own money to go to Accra and get surgery from the cancer specialists.  He had his surgery on Monday.

Every day I see new children come here and she will give them money for books and food.

The kids that live here come from varied backgrounds.  Most of the stories I don’t actually know but sometimes Mama will tell me and it makes my heart break.  Little one 'P', now 7 and an absolute darling… Mama found him in the market with his mum and grandma – they were begging, and the mum has mental health problems… she covered him in faeces from head to toe – he was only 7 months old, so Mama took him in and raised him.  Another child who is my special friend 'M'– she is 5, her mum got stoned to death for being a witch, and the community left her to die, mama found out and stormed in with all community watching, picked the child from her death bed….. and now – she is the boss of the house!

Yet as tragic as each of their stories are – there is so much love and laughter and singing and dancing in the house.  The children are just wonderful and playful and full of love.

Malaria and how fluids can cure everything

I have been here 20 days exactly and wo-behold I got myself malaria!  I have been doing better than ever with my preventative medicine; taking it everyday like clockwork, been using insect repellent, sleeping under a net and definitely not going outside after sundown!  But I got it! Grrrr

I knew as soon as I got it too – I was feeling quite good in the morning and biked to work… then the headache came….and didn’t leave.. despite panadol and brufen.  I also felt very strange and heavy in the head, which then became accompanied with a side of nausea.  Got the test and the whole lab laughed at me for about half an hour! Ohhhhh malaria!

I found out about 2pm and decided to close early.  I told the other medical assistants etc but people kept coming and coming and coming!  And of course I ended up closing last out of everyone – how?

I even dealt with two emergencies with my malaria on board; a one year old boy bought in in shock and unconscious.  Thank god for APLS – the drummed in A.B.C   He was peripherially shut down and cold and his capillary refil was about 7 seconds – I pumped him full of fluids and went to check on him in 2 hours and  he was up and breast feeding….. whew.

Because all the other doctors had gone I also dealt with an adult emergency – a lady 25 bought in because she couldn’t breath.  Her hands were all flexed up and stiff.  I knew as soon as I saw her she was hypocalcemic and was breathing fast due to acidosis – so pumped her full of Ringers Lactate and WA LA – hands and breathing became normal!

After that I called it a day – slowly managed to bicycle home and crawled into bed for 5 days solid!  My head just felt weird the whole time, dizzy and heavy and the nausea was ongoing!  I just slept and read books and slept and watched movies and sometimes sit with the kids quietly.  Even now when I’m writing this on Day 5 of malaria I’m feeling ready for another sleep and it’s lunchtime!  Ha ha – nighty night

Anniversary of being here for 2 weeks!

I celebrated my 2 week anniversary by having a night at Mama’s Guest House.  This is essentially a nice hotel at the edge of Bolga, where there is air conditioning, a working shower and some peace and quiet away from the kids.  Mama’s Guest House is part of AfriKids sustainability projects, where the money that gets made here goes towards Mama Laadis Foster Home kids.  I think it is fantastic and seems to be working well for everyone. 

I have been working every day since I have arrived and seriously in a state of exhaustion and frustration which I’m trying to get rid of.  Change my attitude and start tomorrow like it’s a wonderful day.

The other day I was trying to leave my consulting room and had about 20 parents in my face surrounding me and screaming at me…. and I screamed back…..that’s pretty much the lowest of the low.  So I have made a promise…. ‘if I feel like screaming at a parent, then it’s time to take a break’.  Today I have had a day off but unfortunately it means that there is only the one hard working MA left doing my rounds for me as the other doctor has left again.  But I just can’t do another day in the place as I think I would probably go crazy.

Mama sent me off with mangoes and water and lovingly told me that the hotel is my home too.  She told me to come back with a renewed attitude about my work.  She said she has seen many abrunis (white people) not be able to cope with the frustrations of working here and leave.  The most important thing to remember is ‘your in Africa’ she keeps saying.  Yes, this is true, however I can handle and understand things like lack of resources, power, internet etc… but simple things like rostering so everyone can share the load is kinda inexcusable…. No?  Or is it just that because I am feeling the responsibility and working longer hours than everyone that I’m feeling hard done by?  Maybe it’s a personal affront.  I care about my patients and I essentially don’t want them to die, therefore I have to stay late to check my instructions were carried out….. did they get oxygen that I charted...... did they get they get the medicine I charted??   I wonder sometimes if this is the right thing to do, but in my heart I feel it is.

I have three examples of why I worry: a) baby of 13 days with severe malaria, I charted IV Quinine…. it wasn’t given, b) baby of 6 months with pneumonia and very low oxygen saturations.. I charted oxygen… it wasn’t given, c) boy 14 severe meningitis… admitted by a medical assistant, not examined, no medicines charted.. I saw him the next morning– his neck extended… poor consciousness…. I did a lumbar puncture (spinal) and pus came out… he should have had the medicines 24 hours earlier….that’s inexcusable…no?

Worn out on Day 5

I have been working in the medical centre now since Wednesday and already I’m worn out…. am I allowed to say that?  Hmmmmm.  I have been the only doctor with one medical assistant (who is great) out of essentially 7 doctors/Medical assistants since Thursday after lunch… and have been really feeling the long hours.

I am extremely privileged to be solely paeds while I’m here, I am really happy with that.  However the pressure is intense.  I arrive at 8am and start the ward round and usually there are about 100 people waiting in the outpatients department.  I have about 25 kids on the ward at the moment including newborns.  I go around each kid and have about 6 nurses watching me and laughing at how the kids cry when they see me!  They then watch me do my notes.  It takes a while. 

I have been getting to the outpatients department at about 11.30am, by then the kids are screaming and parents are getting upset because they are wondering where I am.  A couple of times I have to run to my room to grab a text book and the patients who have been waiting since 5am scream and beg me to see them.  Of course this gets worse as the day gets on and the pressure increases.

Interestingly the nurse who accompanies me in my room and translates constantly tells me ‘doc, go fast’.  And this is on a day I saw 60 patients!!  I can truly say that every patient I see I take a history, examine, do investigations, and even joke around with them.  I have a feeling she wants me to leave out the examining and joking around bit…. 

We also never stop… when one patient walks out another comes in… and so on.  So you never get a chance to stop and think… or eat lunch…

Where I work there is currently one other dr, and one medical assistant during the day, one in the afternoon and one in the evening.  Sometimes I leave my room and look around to find I’m the only one still seeing patients, yet there are many left!  They all scream ‘dr I beg you see my child’…  but at this stage I haven’t eaten lunch, it’s 6pm… and a tropical rain storm is approaching in which I have to bike 30 mins in….. “of course I will…..”

Then I go to the ward to check on my patients and make sure my instructions were carried out….and they weren’t.  One child is running a fever and not had any paracetamol despite it being charted regularly…. Another baby has low blood sugar which I charted dextrose which has not been given…. Another 2 year old is becoming more and more dehydrated while his fluids are sitting next to his bed….argh

Exhausted I bike home and wonder why I’m here…… yet I choose to come here and do this…. I love the kids here, they are absolutely gorgeous, I love their big smiles and laughter… I do really want to be here.

I know working in developing countries are frustrating, and I’ve been down this road before….. but I need advise on how to make it ok to survive….anyone?

I have arrived and an inspirational man.

My flight to tamale was booked for 6am in the morning. So I arrived at 5am with plenty of time to settle in....... But when in arrived and went to the desk the women just shook her head and said 'no something is wrong with the flight, we are not flying today' ...... What?

I turned to the guy standing next to me ... he was a very kind man called Ayane,  who then turned to another guy and introduced me. Turns out he was the owner of the plane and explained that something happened to the plane, they are only taking the small plane, which fits 12 people and no luggage. He also promised to get us on a later flight. Whew!  

So back to the hotel for more sleep!!! 

Felt much better when I woke up later and had breakfast.

Was the first to arrive for check in. 

Saw Ayane, who came and sat with me. This is part of his story - someone needs to write a film about it! 

He was born 1959 in tamale. When he was 7 his father died, so he was raised by his uncle. His uncle took him out out of school to work the farm (even though his own children went!) so he never learned to write. He used to sing on the street for money, and one day was discovered and taken to Nigeria to do a show. After this show he bought some sandals and tee shirt and promptly sold them when he arrived back in Tamale.  With the money he received he bought more stuff and so his business has started. Now he owns a travel agency, organic mango farm, factory, been a politician,  speaks 15 languages, buys and sells goods,  and has many many other businesses. He has travelled around the world many times and says that that travel is his education. 

When sept 11 came he did a peace walk from Chicago to new York. He has also walked from Ghana to Libya across the Saharan desert. He told me he only had two problems on his walk: one, got followed by a family of chimpanzees in burkino faso and two ran out of food and water in the Saharan desert on day 7 out of 10. Luckily he met Italian motocycle tourists who helped him. 

Ayane was an inspiration. He also knew everyone at the airport, and was extremely helpful to me, even helped carry my bags! 

Not much to report. 

Long ...... Long ...... And did I mention  it was long!

Feels like you are stuck in limbo for a whole 30 hours. Time is sucked into a black hole and I will never get that time back (bit of a bummer now I'm 35 and needing all the time I can get! He he)

First leg to Sydney developed wicked hot flushes and was like a little beetroot during the flight. Watched Made in Dagenham which I loved. Very moving and amazing it was not very long ago that women were not getting equal pay ..... Oh hang on .... Evidence shows this is still happening! Anyway, im not going to get political on you just yet! It was a reminder to me to keep standing up for things I believe in. 

Next leg the whole plane was completely full!!! Managed to down a sleeping tab and get some shut eye, and avoided the old 'is there a dr on the plane'.  Which I was worried about!!

Last leg sat next to a charming ghanian flight attendant who taught me all about the medical knowledge they have. Even showed me their manual. Quite interesting really, they actually can look after many minor incidents that we would never know about.  Great conversation about the world and luckily he knew everyone at the airport so I was well looked after .... even helping get my visa!  The hotel that was meant to pick me up never arrived (actually didnt even have me booked in... Sigh) so he even gave me a lift!!! Thanks Divine! You are great :)

Prior to leaving

 

I happened to be very organized, why thank you very much.  Even back in February I arranged leave for a week and a half to pack my stuff and sort my life out. 

But what happened? I hear you cry. 

Why oh why were you having only 4 hours sleep week prior and cramming stuff into your storage unit like a mad women 20 mins prior to the biggest trip of your life? 

Two Things happened which were extraordinary.

One: I bumped into a French man one night. 

And two: my passport and Ghana visa got sent in the post to the wrong address in the middle of a field  in a non couriered envelope. 

So back to me bring very organized! Is that you laughing Amy? I sent my passport to Canberra, insured, couriered with a hefty cheque for the visa PLUS 100 aus dollars to mail back to me safely. Ahhh the irony. A couple of weeks later lovely lady calls me and says 'Amanda you have paid us way too much for the mail, we will send you back the money'. 

Little did I know she was to send me the cash, plus my passport and visa in a non couriered envelope to the WRONG address. Ahhhh the irony. 

Anyway the long and the short of it is - I paid a shit load of money to delay my flight, get an emergency passport, however it did extend my knowledge of French somewhat ;)

Was it worth it? Yes it was tre bien ;)