Lessons In African Healthcare

 

My education in the world of African health care continues. My teachers are very patient with me, answering all my questions and allowing me time to understand even the simplest procedure. It will be some time before I’m able to admit a patient to the unit on my own, but I’m okay with that. My teachers are enthusiastic for the day when I can be on my own. I don’t feel pressured by them to start working on my own. But I can tell they want me to learn and experience everything.

 

Something I didn’t expect to follow me to Sierra Leone from the States is the thing that gets on the nerves of all Pediatric Nurses: Coco Melon. For those of you who are not raising young children in this modern day and age, I envy you. You’ve never had to hear beloved songs mangled by whatever autotune voice modulator the site uses, and you’ve never had to watch creepy CGI babies and children sing and dance to those tunes. In the States, I would go home at night after work and hear those songs in my sleep. But the kids at the hospital always loved it. They could watch it for hours. I shouldn’t have been surprised the kids in Sierra Leone like it too. But I could hardly believe it when I heard that dinky little jingle coming from the Pediatric Ward. And lo and behold, a mother was using it the same way we used it back in the States; to distract her child from an IV placement. Again, it’s funny how many things are similar to things back home instead of being different.

 

My lessons at the hospital tend to get interrupted because I have other things I need to attend to, like getting a work visa and buying things that I need. The only way I’m able to get to the market or to church or anywhere is with my hospital driver. So sometimes in the middle of being taught something, someone will drag me away from my instructors and take me to perform another task. I don’t mind really. I’m happy to do whatever needs to be done so that I can live in this new country. But I can tell it frustrates my fellow nurses to have me taken away in the middle of their instruction. For their sakes I feel bad, but a break from their teachings is always appreciated because it helps me process what I’ve been taught so far.

 

I was able to go shopping for the first time today! My driver took me to a mini mart where I was finally able to buy dish soap, laundry soap, a lighter for my stove, and toilet paper! The driver came into the store with me, and he made sure I got everything I needed. It made me feel more comfortable having someone go with me. I like the driver a lot. He always picks me and Sister Peace up from Stocco Compound with a wink and a smile. His name is Sandee. I’m sure that’s not how you spell his name, but that’s how everyone pronounces it.

 

According to the hospital manager, I should be getting a Sierria Leonean ID soon!

 

I can’t wait!

Learning The Ropes

 

Being at the hospital has helped me feel less lonely. Every morning me and Sister Peace are picked up by our driver, Sandee, who always greets me with a smile and a wink. I’m greeted by nurses and other hospital staff every time I enter the hospital. Eating breakfast at the canteen has helped too. The cook gives me a hot meal and a smile. I no longer feel as isolated as I used to.

 

I’m already starting to shadow the nurses and learn how they do things at Holy Spirit Church. I knew things would be different in African hospitals even before I applied to LMH as a volunteer. So, it was no surprise to see nurses charting with paper and getting written orders from doctors. And of course, I knew resources would be limited and equipment would be used differently. But being trained in the States can make you a bit squeamish when it comes to certain things. My fellow nurses back in the States better strap in, I’m about to tell some stories that will make you squirm in your seats.

 

I’ve mostly been observing the nurses’ day-to-day routine and giving medications is a part of that. I watched one nurse take out a syringe and use it over and over to administer a medication to a patient. Then she accidentally dropped it on the ground. She picked it up and was about to use it to draw up more medication when I asked, “Do you not throw it away?” She replied, “No, our resources are limited. We use the same syringe for the patient until the end of the day.” I nodded, hoping my eyes weren’t betraying the internal screaming in my mind. I get it. I really do.

 

Other things shock me in completely different ways. I watched a nurse tell a 3-year-old boy to open his mouth. He then obeyed without complaint, she put medication in his mouth, and wonders of wonders, he swallowed. I can count the number of times I’ve seen a child that age take medicine willingly on one hand. I’m sure not every child who comes to Holy Spirit Hospital will be so accommodating, but still it was a beautiful sight to behold. I have never been this excited to start working at a hospital.

 

I love talking with the staff and learning from everyone. No matter where you go, it seems that what nurses talk about is the same. I was sitting with the nurses at the station and overheard a conversation in Krio that I could actually interpret. The basic discussion was about a pen. My fellow nurses out there will understand how necessary a pen is to a nurse working on the floor, and how often said pen gets lost either by leaving it lying around or by people “borrowing” it. One nurse I was sitting next to kept begging Sister Peace to let her borrow her pen and Sister Peace kept denying she had a pen. Both were laughing and nudging each other until the first nurse managed to cajole Sister Peace into letting her use her non-existent pen. It was a good pen too. I could see why the first nurse wanted to use it. It made me laugh because I’ve had the exact same discussion with colleges at my old job. Letting your fellow nurse borrow your pen is the epitome of trust in a nursing environment. It’s nice to see something familiar in a place that is different from what I’m used to.

 

The nurses have already taught me how to write morning reports in a paper chart and change of shift reports. Some protocols and medical abbreviations are different than what we use in the States, but it’s almost like learning words in Krio; some are similar while others are very different. I’m glad I’m starting slowly. I don’t feel overwhelmed yet. So far I’ve kept my promise to Dr. Turay and I’ve been patient with myself in the hospital. I realize I don’t know everything I need to know yet. One event today reminded me of that. While the doctors and nurses were rounding on the patients, one doctor asked me if I knew how to tell if a patient with a fever was more likely to have malaria or typhoid. I told him honestly, I wouldn’t be able to tell. He then explained that malaria patients tend to have intermediate fevers while patients with typhoid will have fevers that keep increasing gradually. I’m glad that I know that now. Any piece of information I get, I’m going to do my best to remember. I don’t feel bad that I didn’t know the answer. I’ve never worked with malaria or typhoid patients. They’re not very common in the states. I read up on common diseases in tropical climates, but it takes working in the field to truly learn and I’m grateful for the chance to learn. The staff in Holy Spirit are so nice. The nurses here are patient and do not let a new nurse drown in information. But they make sure new nurses learn lessons at every opportunity. From what I’ve seen so far, I think I will be happy at Holy Spirit.

The Hospital

 

I finally got to go back to the hospital today. Me and Father Gabirel had a quick Krio lesson before Vicar General Dominic drove me to Holy Spirit Hospital. I met Dr. Turay and Sister Juliana again. I also met the administration manager of the hospital. We had a meeting about the best course of action going forward. Today, we started slowly by showing me around the hospital and introducing me to the staff.

 

Sister Juliana, the head nurse or matron, showed me where the different wards are, where the surgical theatres are, where physical therapy is, etc. The hospital is much smaller than other hospitals I’ve been to. All the wards and clinics are split between many different buildings. It will take me a while to know where everything is. I met other clinicians, nurses, the pharmacist, Human Resources, Finances, and lab techs. It’s going to take me a while to remember everyone’s names too. But no one seems to have any problem with my name. Everyone is so surprised to hear the name Sally is an American name and a Sierra Leonean name.

 

Sister Juliana told me that she is from Kenya, and it took her a while to get used to speaking Krio and how the hospital is run too. She says I will get it, I just need to be patient with myself. For lunch, Sister Juliana took me to the canteen. It’s called the Hastine Restaurant, where we were greeted by a woman wearing a green apron with a logo belonging to a coffee organization that shall remain nameless. Sadly, the restaurant does not have a coffee shop, though they do serve instant coffee.

 

The canteen has a pretty good menu. I ordered chicken, cuscus, and a veggie salad. They even had cold sodas! For some reason they also served me pasta with ketchup on it. I don’t know why. Maybe it just comes with the cuscus. Next time I think I’ll order something that’s more local. I was thinking the cassava leaf stew. Most of the staff eat there for lunch. I think I’ll like eating there. It’s clean and pretty with purple and gold decorations on the walls and tables. And there are no doors, only light flowing curtains with roses on them. It keeps the canteen nice and cool. I plan to have breakfast there tomorrow morning.

 

My work schedule for now will be Monday through Thursday from 8:00-2:00. I think that’s a good place to start. I know I’m going to be learning so much from everyone while I’m there. And the best part about working there is the air conditioning!  I’m looking forward to spending more and more time at the hospital!

Sunday At A Different Parish

 

I didn’t get to go to the Holy Spirit Church for mass today because there was no driver available.  It was okay though because Sister Veronica made me breakfast and for the first time in a long time, I had something besides cornflakes and powdered milk for breakfast. She made me an omelet with bread and, praise the Lord, hot coffee! I haven’t been able to boil water in the electric kettle to make hot coffee because the power has been out every morning, and I need a lighter for the stove to boil water. Hopefully I can buy one soon. Any way the food was so good!

 

After I got dressed, two Sisters walked with me across the street to a different church called St. Guido Conforti. It’s a much larger congregation led by an Italian priest called Father Jerry. Everyone greeted me and all the children would come up to me to grab my hand. During the mass I sat in between the two Sisters. One little girl chose to sit next to me. She loved holding my hand and playing with my hair. Most of the children here seem fascinated with my hair.

 

The church choir sang beautifully. They were led by a young man whose voice range is a tenor. I told him later how beautiful his voice was. The music was a lot of drums and other percussion instruments. That day was also Father Jerry’s birthday, so the congregation sang to him and gave him gifts. After the service was over, one of the Sisters took me to a community hall next to the church where they were celebrating children who were becoming altar servers. They served everyone lunch (chicken and rice) and passed out fruity sodas I had never seen before. I had one called a “Tik Tock”. After only having water to drink for the past week, a cold soda was heavenly. At one point, the little girl who had been sitting next to me began dancing in the middle of the hall, making everyone laugh. I believe her name was Vanya, but I think that’s wrong.

 

Later, some more priests joined the group. One was another priest from Italy. He introduced himself as Father Brioni. At first his name didn’t sound familiar, but then he told me his first name, which is Luigi. It turns out, he knew Janice England who was in Sierra Leone when she did her mission. Janice had told me about Father Luigi when I was still in training. Father Luigi and I exchanged contact information before the Sister and I went back to Stocco compound. I hope we can meet up sometime and talk about mission work.

 

When we got back, Sister Vivian had made me lunch as well. I felt bad because I had already eaten at the church, but the food she made was so good I had a second lunch. I told her I would take the rest to my house for dinner.

Sports Day

 

Today I had another lesson with Father Gabriel. This time it was about grammar and the culture of Sierra Leone. Afterwards, I went back to the parsonage headquarters, where I met up with Monsignor John and an IT worker who helped me set up my phone and my Wi-Fi. Later, Monsignor John took me to his home next to his church and gave me lunch. It was another fish stew with rice, but this one had chicken legs and meatballs in it too. I got a chance to practice my Krio with his housekeeper. I’m still shaky on some words but I’m getting better.

 

I could hear an announcer on a loudspeaker outside and I asked Monsignor John if there was an event going on. He said that next door there is a school sports field, and two schools were competing in running and jumping, like track in America. He asked if I wanted to go over and I said I would absolutely love to! The children were divided into four teams (though they call them houses): blue, pink, white, and yellow. The children (or pikkin) would choose one person from each house to run the race. For the first event, the competitors had to run around the field 3 times. While I was watching them, I wondered how none of them were passing out from the heat. Then one girl on the pink team passed out in the middle of the race! Luckily, Sister Peace, the sister who will be going to the hospital with me every morning, was there to check on her. I got hot too and very tired, so Father took me back home.