I’m sitting in the quiet Canaan clinic in the early morning, going over the differences in our health care systems with the nurses there when the hum of a boda boda is heard entering the gates. We stand up and walk the few feet to the open front door where we are met with the boda boda almost driving in to the clinics waiting room. There is a young man driving with a woman pressed between him and an older gentleman, as the rear passenger gets off the woman flops to the side, clearly unconscious; but hey lets get her on a motorcycle and to the clinic right? She is quickly lifted from the bike to a wheelchair and brought to a room with a bare mattress. The doctor is right there to provide his assessment and make his orders. Supplies are quickly gathered to start an IV and provide some fluids and medication. The language barrier is getting to me at this point. I am unable to understand anything being said about the patient’s condition, thankfully there is a nurse there to translate for me. The supplies are my next annoyance, as they expect me to place an IV without cleansing the skin, without flushing the cannula, without so many steps that are demanded in the states. I was a bundle of nerves breaking from my training. It felt like I had stepped back to the days of Florence Nightingale. The next patient to arrive, who was also unconscious, thankfully was brought in a van. It took three men to carry him through the hospital and to another bare mattress bed. My stomach did more flips as needles were thrown in with no skin prep. Then my head spun with questions as the doctor made a quick and decisive diagnosis simply by talking to the family and getting the blood pressure. I was stymied that there was not a demand for more extensive testing on either patient to make the final diagnosis; which occurred within a matter of 5 minutes. The confidence or the doctor and nurses flabbergast me as these diagnoses are quickly accepted and treated. After we settled down again I tried educating again about the need to wash hands and wear gloves, a nurse replies, “We do not wear gloves because we have to cut costs somewhere.” At that statement I wanted to cry, the simple task of hand washing and wearing gloves can help stop the spread of illness and disease, and is a major way to protect the healthcare workers themselves. All I can do is lead by example and get my butt to Jinja ASAP so that I can buy a massive supply of gloves, alcohol pads and hand sanitizer.
Enough talk about cleanliness, let’s get dirty. When the kids returned from their walk home from school I joined them outside for some hugs and laughter. It was close to 5 at this time so we only had a few minutes of play before we made the mile long trek to the farm for more tilling and planting. On our walk, 9 year-old Enoch, grabs my fly spray and announces he will carry this for me and he is the boss and will take care of me so I must listen to him. He has stolen my heart, he proudly announces to the other children as they ask if I am tired “this is my soldier! She is fine!” When we arrive at the farm, little joseph scurry’s into the brush to tear off soft weeds and place them on the ground so that I have a matt to sit on instead of the dirt (atteka). We sit and watch the other children work tirelessly for a time and then I stand up and dig in myself. To plant a sweet potato, they pile up mounds and then throw their forearm into the mound as they grip the stalk of a sweet potato leaf. When I had done my share of planting, my hands and arms were bright orange from the clay, I looked like I belonged on the Jersey shore with the self tanner look I had going on. The rest of the night clearly wanted me to remain dirty as the water shut off mid shampoo. Oh well life goes on, time to go read some bedtime stories to the children I love so much!
Embrace the dirt!
Gypsy RN
