Teaching

As I mentioned previously... during the months of April and May, I was invited to be a clinical instructor for a medical school in a neighboring city. The people I met and the opportunities this experience afforded me were equally wonderful and heartbreaking.

The first four weeks, I worked with nursing students doing clinical rotations in a busy hospital. The school gave me a white coat, a pen, and pointed me to the various departments. I was working in the pediatric department and the malnutrition center.

Needless to say, what I saw was...

Stressful: Each morning I had to rush from where I was staying (my commute was anywhere from 40 to 90 mins one-way) to get to the hospital in time for roll call. The hospital was crowded. The needs were overwhelming.

Disconcerting: The manner of teaching was very different from my own (educational) experience. I felt like I was wading eyebrow-deep in murky waters for the first few days. Every day brought new challenges with no cultural insider to ask if I was making a fool of myself or standing tall. Sigh.

Heartbreaking: No one forgets the gaunt and wasted face of a 8 year old boy dying of AIDS. It's hard to silence the wails of a mother who just watched her two year old die.

Fascinating: One day a 4 day old neonate was brought in to determine the sex. The genitals were ambiguous. After the examination the doctor explained the mother had an hermaphrodite. The news was not well received.

Overall, my time there was...

Exhausting: Most days turned out to be 10 to 12 hr days. Speaking all day in Portuguese was a challenge as well... mentally and physically.

Expensive: Though friends let me stay with them for free, the public transport was either cheap or inconvenient. Getting back and forth from work took an hour and a half in the morning if I went with 'cheap' (costing less than a dollar). But if I needed to get there quickly (30 minutes or so), it cost 8 dollars. Sigh.

Insightful: After two years of stories about policies and practices in governmental hospitals, I was finally able to see first hand that they are true. I saw corruption, neglect, abuse, and incompetence. But I also saw many who did not fit the mold and strived to do well.

Blessed: I was able to make lots of new friends and learn how the medical system works in this country. Often I was impressed by the caliber of medical professionals in this country despite the obstacles they must face to care for their patients.

Tuberculosis...

This last week, I peeked in on Dennis to ask him about something. What I saw was very unusual. A young boy lay twisted on the bed, crunched a little with a protruding bump on the center of his spine. When he sat up, Dennis showed me two very enlarged lymph nodes. He was struggling for breath because of the pressure they placed on his airway. He was small for his age and looked very unhappy. He knew he was sick...

I had never seen anything like it. Dennis explained that he had tuberculosis of the spine. He added this was the first case he’s seen in the year and a half he’s been here and that it was well advanced. We had no choice but to refer him to Wau. The mother seemed to appreciate the gravity of the disease. I can only pray she went.

Charcoal and Goat Hair

A woman walked up to the clinic holding a lethargic boy in her arms. She didn’t hurry. She didn’t scream. In fact, she barely even asked to be seen. Saturdays are reserved for emergencies, so I went to assess her. The translators standing by explained that the child had been sick and in town for the last three days.

One of them asked her as to why she was just now coming. I saw no hope in her eyes. That worried me.

He was feverish, lethargic and severely pale. I called for Dennis as I have no experience getting IV lines in 8 month olds, and started on a paracheck (test for malaria). I was pretty certain it was malaria. It was.

When the translator asked her how long he had been sick, she explained that she had come from a far village. She had been in Tonj three days but... was being treated by the witch doctor.

The witch doctor diagnosed him with heart problems and even withdrew ‘charcoal and goat hair’ from it. But it didn’t help.

So, as a last resort and even as a bit of an after thought, she brought him to us. When we got him the quinine he needed, he immediately started getting better. We kept him overnight... but he was able to go home the following day.

Doctors one! Witch doctor zero!