Friday, April 1, 2011

Goodbye Gambia

We’re cruising at 33,000 feet above West Africa on our way to London.  We were starting our take- off from Banjul when we had to go back to the gate since something was wrong with the plane.  Actually an easy fix and we’re in the air 2 hours late—not bad for Africa! As we arrived at the airport, there was a long line out of the airport doors since the baggage handlers were late for work!  We have our own handler—a missionary named Sam who greased the way to get us through until we got in line for our flight.  Then we had to wait like everyone else, but our patience chaos, inefficiency, and basic incompetence  has greatly improved over the last 4 weeks due to a lot of practice!
Yesterday was the last day of surgery with three patients, two of which had nomas—I’ve never heard of a noma before.  It happens after an infection in the mouth or face combined with malnutrition, poverty and filth, the infection doesn’t really heal and it eats the tissue away.  Both were quite disfiguring.  Both noma patients had their upper lips eaten away and the doctor fashioned a lip for both of them.  Not perfect, but much better.  The last patient had the last name of Kinte from Jufurreh—yep, Kunta Kinte’s relative.  He spoke no English, said ‘hospital” and “ship” on the street until he said it to a student nurse, who brought him to us at RVTH a couple weeks ago.  The people are certainly motivated to find help when they know it’s available.  Another young child’s father arrived yesterday with a new mattress.  He had been told that we had no more room  (or no beds) and took it literally and thought we had no bed for his child, not our medical slang, so he’d gone to the expense of buying a mattress, bringing it to the hospital  so his child would have a bed and could have surgery—it was too late to do the type of surgery that he needed.  The four weeks here have been quite an experience!  We have repaired about 60 cleft lips, cleft palates, and done surgical revisions on some pretty bad jobs.  Almost all of the patients are doing very well.  Several have been in the hospital the entire time because of their poor medical condition, infections, or too malnourished to operate on until they put on some weight.  Some of the mothers and grandmothers actually look better fed and seem happier, too.  I went to the ward to say goodbye this morning and was greeted by parens showing their children’s faces, shaking my hand, and hugging me.   As always, the appreciation is overwhelming.  I’ve been off the ward all week and it was nice to see how well  everyone was doing. 
This is the last entry for the trip.  I’ve tried to be honest in what I’ve written.  I haven’t written about a couple things that upset me greatly.  We were all told initially and reminded a couple times not to write anything negative about the president or the  government of the Gambia.  Peace Corps volunteers and humanitarian organization blogs are monitored for content.  An American missionary is in jail here because of an article in which he criticized the government, but I suspect, that was probably not his only infraction.  An Amerain doctor was deported for anti government remarks.  We met people who thought the president was doing a terrible job and others who loved him—kinda like the US!  Difference is that we can freely say it!  I did live with a little fear that I’d get in trouble or make trouble for Mercy Ships with some of the stuff that I wrote, but it was hard to white-wash the reality of what I saw and experienced.    
 Most of the time I left like we were spitting in the wind.  The living conditions are deplorable for many, education isn’t available to everyone and there are no jobs anyway.  Last time one of the children later died of malaria and I would think infections are    But now there are about 60 people who won’t have to go through life being shunned, enslaved to others, locked away in houses so no one sees them or die from malnutrition because they can’t drink or eat.  (A baby with a cleft lip can’t suck and we found several moms with malnourished children that they just didn’t know how to feed.  When showed how, they did a great job, the baby quickly gained weight and could have surgery.  Babies had to be 3 kg. to have surgery—that’s 6.6 pounds!)