Janie Hemphill’s Blog

The past week

Today is a call day for me.  My afternoon rounds were interrupted by a nurse telling me to go to the procedure room.  A young lady had a “moto” accident, wrecking her motorcycle.  I haven’t been very fond of motos lately, except when Yisah gave me a ride to the public health building on a moto so I could use the bathroom.  The lady had blood all over her face, a good portion of the bone in her forehead was visible, and her eye was so swollen she couldn’t open it.  I walked to get Dr. Faile because I wouldn’t have known where to start on sewing up her face.  I worked on the leg gashes while he worked on all of her facial lacerations.  There were many new admissions on the pediatrics ward.  One of them was a 2 week-old premature baby who has had difficulty breathing.  He was taking a deep breath every 10-15 seconds and his heart rate varied from 44-120.  Since the only 3 beds with O2 availability were taken, we had to double them up.  I will be surprised if he is still alive in the morning.  Many mothers here don’t name their babies until they are 1-2 weeks old because neonatal death is so common.

I was in the operating room a few times last week.  I watched Dr. Faile repair a cleft lip on Thursday.  Then I assisted on an above-the-knee amputation of an older woman’s gangrenous leg.  He let me do the sawing.  When I tried sawing on the next amputation case, which was a young man, I didn’t get very far through the bone before I had to have Dr. Faile finish.  Another case was a seven year-old girl who had a surgery several days back because her bowel perforated from a typhoid infection.  When she came back for a dressing change, her wound had dehisced and her intestines were coming through the open wound.  We suctioned little pockets of pus and reapproximated her fascia and skin.

On Monday, Wednesday, and Friday I was given my own clinic office to see patients.  I saw 149 throughout the week.  At registration their complaints are written on their chart, which is like a little stack of large index cards stapled together.  Some cases are straightforward.  Some completely stump me until my translator gives me hints, such as for a man on Friday who was telling me about his abdominal pain and other unrelated things.  I kept asking questions, but finally the interpreter told me that he wasn’t really having pain.  He just believed local witches cast a spell for him to get this pain and he wanted something for when the pain would come.  Tylenol it was.

Dr. Faile’s office is adjacent to the one I’ve been using.  Usually at least once during a clinic day he will walk in and ask if I’d like to see something interesting.  On Friday he walked in and asked if I’d ever seen someone who had been struck by lightning.  I walked around the corner and a woman was writhing with purposeless movements on a stretcher.  She had a 2-inch hole through the flesh on the very top of her head.  The bone was visible and the area looked singed.  Dr. Faile admitted her because she had stopped taking food at home and was slipping mentally.

I left a note on my door saying I was at 2nd Baptist Church this morning.  If there’s an emergency, the nurses can ride their motos to the churches to find the person on call.  The kids in the village that I’m familiar with found me before 10am and walked me along a thin dirt trail that winds through all of the mud huts.  There are goats and pigs in some of the yards, and tiny patches of corn here and there.  I get lots of waves wherever I go.  The kids are trying to teach me some Mampruli greetings, but I haven’t picked it up yet.  Church was in a one-room building that had 3 sections of plastic lawn chairs.  Men sat on the left, most women in the middle, and children with some other women on the right.  Yisah was there and told me to sit in the middle.  I was impressed by the music.  It was a lot of rhythm for one room.  Isaaku, the man who drove me from Tamale to Nalerigu and changed the flat tire, was a deacon there.  At one point when he was speaking, everyone turned to me and the few other white women sitting near me.  Yisah told us we were supposed to stand up and introduce ourselves.  We then got a big round of applause.  Everyone turned to us and laughed at one point in the sermon, but I’ll never know what that was about because most of it was in Mampruli.

 I didn’t think afternoon rounds would take as long as they did, and I was stuck at the hospital without a flashlight this evening.  There are no phones to reach the people I know in the guest houses, so I had to brave the dark to make it back home.  I stood in one spot for a few seconds hoping my eyes would adjust, but the trees are low and branch wide, covering the trail from the moonlight.  The whole experience was enhanced by the bats that fly low through the trees in the early evening.  I just took it slowly and made it by feeling whether it was grassy under my feet or smooth like the clay trail.  Lesson learned.