sWe’re getting busier! Now that the cautery machine (in case you don’t know—that stops bleeding during surgery) works, the surgeon has started performing the cleft palate surgery (the roof of the month has a hole that prevents them from speaking or eating normally). In addition to taking care of the kid’s post surgical incisions, all the cleft palates come back with a tube sutured to their nose and it goes into the stomach so we can feed them. They cannot eat for a week after the surgery. The staples of their diet are rice and bread and those are some of the worse things to eat since the grains of rice or bread get stuck in the incision and/or sutures in the roof of their mouth. So we feed them a very thin mixture of porridge, vitamins, oil, sugar and dried milk and the bigger kids get a different kind of porridge with bananas added to the above ingredients. Yesterday, we had an incident where the grandfather of our first patient, Abduman, who incidentally got an infection in his lip incision, was sneaking him out at night to feed him because he didn’t think we were feeding him enough. That is probably where he picked up his infection! Patients are kept in the hospital so long since their living conditions are not conducive to healing or getting the proper nutrition while they are healing. Abduman and his grandfather live upriver about as far as one can go and still be in Gambia. After a long talk with the surgeon and translators, the grandfather was assured that Abduman could eat all he wants, but it needs to be the porridge. So today, he ate, ate, ate bowls of porridge that we put a special honey into since he likes it, and his grandfather seems OK. I really don’t know why the Gambian helpers on the ward at night didn’t tell anyone that they were out foraging for food after the Mercy Ships staff left at night! (We are all out of the hospital from 9PM to 7AM.)
Abduman’s grandfather is a respected elder in his village and yesterday, there was also an incident with a young, female, Gambian helper. (Mercy Ships is an extremely well paying job for the helpers and there are lots of young English speaking people vying for the jobs!). He became very angry and basically threatened her. Number one, the Gambian men don’t treat women with much respect, and #2, village elders certainly aren’t used to taking orders from young Gambian females! The young women we work with watch our “liberated ways”; not realizing what is accepted from older white women is not acceptable from them.
Now that the kids are starting to feel better, we are encouraging them to play not only with us, but with each other. In the US, any group of same age kids would be playing together. Here that doesn’t seem to be the case. They gladly interact with us or their families, but not each other. They enjoy sitting around the table coloring, but don’t seem to know what to do with pencils/crayons/colored pens and paper that they can draw on. I played “puppets” with two of the kids and once they realized that the puppets were for everyone, they quickly lost interest in the game. Anything that we’re playing with—crayons, stickers, pens, pencils, pencil sharpeners, coloring books (we now tear out pages for them to color) just disappear. I put a bunch of crayons in a box to save them and they were all gone within a short period of time—I never saw anyone taking anything! This happens with the parents, too. Each child is given a bag with toothbrush, toothpaste, bowl, cup, syringe, feeding syringe if needed, and bar of soap when they are admitted. When I ask them to use for medication or feeding, some of the parents look at me like I must be mistaken and say, “no, I don’t have any”. I would assume they come from such “want” that to possess something is a big deal. Today, a parent wanted a purple crayon and her baby is 4 months old so I knew it wasn’t for her baby. We had a very detailed coloring book of the cottages of the English countryside with color pencils and I gave this to her, telling her she didn’t have to share it—they were for her alone. She spent the last 2 hours of my shift coloring and putting it under her blanket when she’d leave her bed so that it wasn’t visible to others! She looks to be about 16 years old and probably has never really been a child herself!
These girls grow up fast and accept a lot of responsibility early. A 30 year old woman on the ward who had a nasal septum repair has a little girl who looks about 11 and a one year old staying with her. The 11 year old is the primary care giver of the 1 year old, and she ties the baby to her back like all the mothers. The baby is delightful and staff member will play with him to give the little girl a break sometimes. Bonds are created along socioeconomic lines, but most of the mothers and grandmothers on the ward are a tight group—very different from the children. They will give each other food, take care of each other’s babies, and help the new people on the ward know what to do. Even though women aren’t treated very well in West African culture, they seem to be the glue that holds it together.
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