I have officially finished my first week in Soddo. It has been, well, interesting. The cases have not been “normal”, but neither has anything else. I may need to redefine normal. I am frequently told, “Your not in Kansas anymore.” I cannot tell you how true that is! Let’s see if I can paint a picture of my week.
It all started with the excitement of finally moving into my new home. I had a few days to get organized, go shopping and figure out where a few things are in this metropolis (about 50,000). January 7th is the Ethiopian Christmas. All the women dressed in tradition white, families gathered to share meals and love on each other. All of the bajajs (tuk-tuks, little transporters) had palm branches on their windshields. One of our language school teacher’s mother lives here, so we celebrated with them. The other missionaries in town threw a potluck dinner to welcome the Karnes and I to the area. It was a beautiful welcome to Soddo!
Imagine with me that you are a female… (guys, hang in there! It isn’t so bad). A friend told you there are two new doctors in Soddo that take care of womens needs, so you travel to the hospital. (The farthest any patient has come, so far, is a four day drive for an infertility work up). You check in and pay the $1.50 to see the specialist. That may not sound like a lot, but you and your family are living on $30 a month. You do not get an appointment, but wait in a line to be seen. It is finally your turn. You go in and this man and woman try to talk to you in broken Amharic, but you only speak your tribal language, so your husband has to translate to the nurse and then she translates to these ferenges (foreigners) and then it comes back. It is a slow process. It doesn’t help that the doctors don’t seem to know where anything is. It took them about 10 minutes just to find a thing that looked like a midevil torture device. They were jibber-jabbing away about something, but you have no clue what is being said. Your husband is given a paper. He leaves and returns with some blue gloves….
The majority of this week has been spent figuring out the system. You can assume nothing! The way it is set up now, if you need gloves to examine a patient you give them a prescription and they go to the pharmacy to get the gloves. And KY jelly… couldn’t find any for the first 3 days. We used water. How would you like that ladies? If you have a patient in the hospital all medications are bought by the patient or their family at the pharmacy and then kept at their bedside (IV or pills). If the medication is IV the nurses will give it, but the other medications are the responsibility of the patient. The ward we are in is an obstetric ward that is not used to taking the gynecologic patients, so as we learn the system the nurses are learning gyne.
There are so many things we are working on. We started with the bare basics, as in rearranging a room to be used as a clinic room… exam table, lights…. There are only four trash cans in the entire ward. No worries, more have been ordered. You can never find soap. If it is left out, it will be taken within an hour. So, some of the nurses carry soap in their pockets. You have to find a nurse with soap to wash your hands or carry a bar in your pocket. They plan on installing liquid dispensers on the wall, but the last time they did that they disappeared. And there are no towels to dry your hands because they, too, will get taken. And the lab slips… if it is a blood test you use the red/pink form and urine the yellow form. I thought for sure the stool
cultures would come on a brown slip, but it is green. There is a wheel to figure out a woman’s due date for her pregnancy, but it is in the Ethiopian/Julian calendar and our ultrasound is in the Gregorian (what you are used to) calendar, so we have to translate everything over from the Julian calendar then back. The charts were in a pile without any sort of organization. If a patient arrives you just dig until you find the file. I could really write about four pages on all the things we have been trying to figure out the last week, but I think you get the picture! And one small thing I forgot to mention is that we do all the ultrasounds and are the pediatricians. When a baby is born they are ours to take care of.
Now for the cases. I thank God everyday that we haven’t had any catastrophes come our way. It may take some time to figure out where the things we need for each patient are, but we are offering the best care we can. Here are a few of the things we have seen….Three pregnant women with typhoid fever; Two pregnant women with HIV; A woman who had bled down to where she is in shock, but her family was too afraid to allow us to transfuse her with blood so they opted to go home. I don’t know if she will make it; A pregnant women with, I think, a severe case of malaria. She left without doing the labs we requested. Her spleen could be palpated to about halfway between her belly button and pubic bone. It is normally under the ribs and hard to feel. She was also in shock, had a hemoglobin of 6, yellow eyes, enlarged liver and dilated kidneys; A pregnant woman with an ovary that twisted on itself and was necrotic; The first baby I took care of had spina bifida occulta, and anemia from (I believe) a subgaleal hemorrage (bleeding on the head from birth trauma).
The nursing staff has been wonderful. They always come in with smiles and are trying to help us get organized. We have a lot to learn and a lot to teach, so keep us in your prayers. I look forward to the the lessons I am going to learn and the challenges I will face. I rest in knowing that God is in control. Another thing is that, I found out that my medical license has been denied. In order to have a license here you have to have worked independently for one year outside of Ethiopia. The ministry of health said I had to move back to Addis Ababa and work a year at one of the two teaching hospitals. So, for the time being I can’t do anything without Dr. Mark Karnes. That means we are on 24/7 together. (I did take today off though, since it is my birthday.) We do not have enough patients at this time for this to be a big issue, but it could be if the volume increases quickly. This weekend the head administrator is in Addis appealing the decision and requesting I work under Mark instead for the next year. Please keep this issue in your prayers. If this is denied, I will probably have to find another missions hospital (and country) to work in.