Our ward is on the second floor and we go up a flight of stairs to get there. The steps are tile same as the floors in the halls and on the unit. There are broken tile everywhere and repairs are made with whatever is a readily available and the front of many of the steps are broken off showing old tile, concrete and adhesive. One day when we arrived in the morning, two workmen were busy filling these holes with fresh concrete. They carefully leveled off the top of each stair and the front. People continued to walk up and down the stairs and actually step in the fresh concrete! Before they were finished with the entire job, the very sandy concrete started to crumble and fall off. As this crumbly mixture fell on the stairs and floor below, it mixed with water from mopping, leaky water bottles, and other liquids to make a muddy mess. Gradually over a week or so, all the mud was mopped up and it was clean again. After walking on the stairs for another week, the steps look exactly like they did in the beginning—with big holes in them. There is also one stair in the middle that is 2-3 inches deeper than all the others. That doesn’t seem like much, but just try getting used to the rhythm of going down a set of stairs and have one in the middle that’s out of whack! Several people fell on the stairs and finally someone wrote in red, “caution, dangerous” on the vertical side below, but it wasn’t visible from above. So going up was much safer than going down. I solved the problem by using another set of stairs! On the north side of the river are stone circles that date from the 3rd century BC built by ancestors. They are worn down, but still standing much like Stonehenge. Too bad they didn’t keep the mortar recipe!!!!
There are about 60 people on the ward daily with lots of comings and goings. Our ward is kept as clean as is probably possible by hospital personnel who come in daily, sweep up a mound of trash and the ever-present red dirt. They then mop the floors by shooing us out of the way and within minutes, it’s dirty again—but it’s been cleaned. The Gambians seem to have no sense of keeping the place clean.
The bathroom is especially disgusting and I won’t go into detail, but they have stopped pooping in the shower thinking it’s a toilet! (Apparently until recently food was served on banana leaves and when they threw them on the streets, goats would eat them—so no trash-and plastic bags for everything are relatively new. Trash of all sorts is still thrown on the streets, beach and around their houses, but now instead of banana leaves, there are wrappers. There is garbage everywhere and occasionally it is swept into piles that, when left by the side of the road to blow around and redistribute itself during the following days) Our Wolof speaking missionary will occasionally come in and yell—I mean yell- at the patients and families to keep the hospital clean and keep themselves clean. I can only imagine how they live at home and what their houses look like. Which brings me to the point of my story—There are all different socioecomonic levels to our patients. Some have never been out of upriver villages and we also have an obviously well-off father who flew in to be with his daughter. But….
The bathroom is especially disgusting and I won’t go into detail, but they have stopped pooping in the shower thinking it’s a toilet! (Apparently until recently food was served on banana leaves and when they threw them on the streets, goats would eat them—so no trash-and plastic bags for everything are relatively new. Trash of all sorts is still thrown on the streets, beach and around their houses, but now instead of banana leaves, there are wrappers. There is garbage everywhere and occasionally it is swept into piles that, when left by the side of the road to blow around and redistribute itself during the following days) Our Wolof speaking missionary will occasionally come in and yell—I mean yell- at the patients and families to keep the hospital clean and keep themselves clean. I can only imagine how they live at home and what their houses look like. Which brings me to the point of my story—There are all different socioecomonic levels to our patients. Some have never been out of upriver villages and we also have an obviously well-off father who flew in to be with his daughter. But….
Amy was one of our first patients and is 2 ½ years old, looks 12-18 months, was so underweight and full of worms that her surgery had to be put off a week for feeding her and giving worm medicine. She had her surgery last week and is doing fine. Her anorexic, depressed mother, and overweight, friendly, but demanding grandmother and Amy have been on the ward for the last 3 weeks. Like all patients and family, they all sleep in one twin bed. Yesterday, several of the other women started yelling at Amy’s mother and grandmother and all I could see was a colorful throng surrounding their bed. Apparently Amy urinates and poops on the floor by her bed whenever she wants and they don’t clean it up! Other people have been doing it. Several patients have been discharged and new patients are next to Amy and I guess they don’t find this acceptable. It is amazing to me how these women control their own, feed the people who don’t have food and take care of each other’s babies. This morning, one of the nurses presented Amy with a little potty seat of her own and we’ll see if she uses it!
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