Patients are Going Home

Our first patients are starting to go home. They stay in the hospital long enough that the concern about infection is over and that they know how to take care of the incisions. I don’t think I can tell you enough how grateful people are. The patients, the parents, people on the street—they are so happy someone is here to help them. Several of the patients obviously have resources and are used to a better environment than they have in our hospital ward, but many are from outlying villages and have never seen beds, much less sheets.  (We have one patient that slept on her mat on the floor instead of in the bed.)  Surgery just is not readily available in the Gambia, and if it is and the doctor finds out that the patient has any money, they will charge an exorbitant fee making going abroad the only option.
Post surgery pain medication consists of Ibuprofen and Tylenol and most don’t even ask for any pain medication. They are very compliant and stoic except for one little boy that Anita knows from 2 years ago when he had a cleft lip repair—he’s now back for a cleft palate. We’ve nicknamed him “the cryer” and it has become background noise that is easy to overlook in all the confusion and chaos of the unit. Yesterday spontaneously, several people started pretending to be crying.  He stopped dead in his tracks and just looked at them before resuming. His Mom has another baby strapped to her back and ‘the cryer” tags along crying. The kids don’t get a lot of attention from parents once they move to the ground from the mother’s backs where they are tied like in the photo. Adelia, the missionary, said they have so many children, and women and children are expendable in this society.Wives are easily replaced.  Many lack basic parenting skills and the unit next door has a feeding program for these “failure to thrive” kids hoping to bring their weights up to a normal.
Amie went to surgery this morning –she is 2 ½ years old, weighs 15 pounds, and is listless. I’ve never seen her walk and she doesn’t talk at all. She’s been canceled for surgery twice before. First time, her lungs sounded terrible and she was placed on antibiotics, worm treatments and high nutrition-vitamin-rich food . Yesterday, her lungs still sounded a little congested, but she doesn't appear anymore alert. Her Mom is thin, depressed appearing and pays no attention to Amie. Mom’s also been treated for worms and I have never seen her eat anything. Amie’s grandmother is also there and does most of the childcare except for nursing Amie. Most of the women here have hard lives.
There are other parents who dote on their child and the husband is actively involved and spend time in the hospital with them. The picture above is one of those couples—they were just darling and oozed love for their little boy. Both played with him, he was alert and interested in what was going on around him.  He was discharged from the hospital today.  As Anita and I were going back to the hotel this afternoon, they stopped us on the street to thank us again. That is their picture above with their son. The white stuff above his lip is a strong antibiotic cream that prevents infection and keeps the lip moist so the incision will heal better. Couples like this are the minority!