I have been in Langano for 4 weeks now, and my time there could be described in any number of words. Challenging, amazing, frustrating, beautiful, pick an adjective and it would fit. The clinic is a great place to work, but each week seems to get busier. This week just gone our shortest day was 11 hours and we’re seeing at least 120 patients per day. I hate to think how long my longest day was!
My knowledge and skill base is growing faster than I thought possible. A lot of it is the stuff unique to this environment, like all the tropical diseases, but a lot of it is stuff that I just haven’t encountered in paediatrics or neonates. I have realised since I’ve been here that if I am to work in Africa long-term, I will definitely need to do some tropical medicine studies first.
Although a lot of it is new, my skill and experience is coming in extremely handy in Langano. The nurses’ eyes lit up when I told them I’m a paeds nurse! They have got me seeing all the kids and babies, which is fine by me, and the nurses are more at ease having me seeing them.
My experience in neonates turned out to be a lifesaver this week. Literally. A woman in labour arrived at the clinic just as we were closing up about 7pm on Wednesday night. She had been carried on her bed by her family from six hours walk away, and had delivered one twin on the way. Nancy delivered the placenta and ruptured the membranes of the second twin, and subsequently and hand and foot came out. That’s the last thing you want to see. She delivered the baby in record time with no problems, but the baby was flat as a pancake. Myself and another nurse started to resus the baby, but with apgar scores of 1 and 3, and no oxygen or suction, it seemed futile. We kept going for about an hour, and he finally started to pick up. He was grunting and working really hard for oxygen, but with no equipment there was very little we could do except pray.
I took him back to the house and we kept him overnight. He was slowly improving, but he had a long way to come. When I checked on him at 6am I could not believe I was looking at a new baby boy who appeared perfectly normal. He had no increased respiratory effort, he was pink and warm and was screaming at me to take him to his mum for a feed. Even in western hospitals with all their equipment and technology it’s rare for a baby like that to bounce back that quickly. I don’t use the word miracle lightly, but I have no doubt I had just witnessed one. We were all convinced of it. Even the family was shocked when I brought them their baby back. They were expecting me to deliver a body for them to bury, but when they heard it crying, you should’ve seen their faces! That look alone makes this entire trip worth it!
Unfortunately not all stories are successes. I have seen more death here in 4 weeks than in the last 2 years put together. Most of them are kids and babies and almost all are preventable. The killers are diarrhoea, malaria, malnutrition, and childbirth. The work being done in Langano saves a lot of lives, but too many still die. There is so much work to be done, and the most vital is education. They need to be taught about prevention, and early detection. Last week a baby died in our clinic who was so badly dehydrated she looked like a skeleton. She was brought to us after a whole week of diarrhoea! This is totally preventable. If she had come even 2 or 3 days earlier we could’ve saved her.
Of course not all are preventable. The day after the twins a woman came to us in labour and delivered triplets! That would be exciting any other time, but they were only about 25 weeks gestation, so they all died. That’s tragic, but it’s life. These people have an amazing ability to deal with death. There is a lot to learn from them.
I’m having a lot of fun too. On Thursdays we go out into the communities and do vaccinations. We always end up with huge crowds of mainly kids, so I try to play with them and kick a ball around. It’s always a very positive day. We also have nutrition day, which is aimed at malnourished kids under 5. It’s hugely successful, and again, a lot of fun to have crowds of kids around.
I am still struggling with the language and the subsequent lack of communication. It makes it difficult to assess and communicate in the clinic, but it’s also difficult to build relationships with the locals. I’m trying, but it’s easy to get discouraged. I am also struggling with being so freakin busy that I have no time to do what I came to do: share the gospel. I am becoming more and more convinced that in order to effectively do that requires a lot more time and long-term commitment than I am able to give at this point.
God is doing a lot of work on me though. It’s not at all what I expected, and it’s not easy, but I asked Him to, so I kinda had it coming! Dangerous prayer.
I have been asked to stay on for a further 3-6 months when I’m done in Langano. They want me to oversee the clinic down in Makki, which is where I was initially supposed to go. It’s a great opportunity and a huge compliment, but there are a few things I need to really take into account before I make any decisions. Someone has told me they would sponsor me, so that’s a big one out of the way already, and makes it hard to turn down. I’m really seeking God’s guidance on this one as He would need to make it happen.
I head back to Langano tomorrow or Friday, so this last week in Addis has been great. I am expectant of what’s to come. I have seen what God does when we are expectant!
Peace and blessings!
Rowan
