We arrived in Banjul two days ago. The trip from the airport was our first site of chaos. Cars, donkey carts, bicycles and all kinds of vendors share the road and roadside. People are everywhere, in addition to the plethora of vendors, people are waiting for buses, walking, some just hanging around. Because of it's location at the mouth of the Gambia River, it became a British city, Bathurst, in 1816 to control the slave trade and to protect the River Gambia, the main entrance to the interior of Gambia. The population swelled and it became a busy port city until independence in 1965. As the Atlantic coastal cities grew as a tourist spot for winter weary British, newly named Banjul started a steady decline that persists. The macadam of the streets is visible under the constantly swirling sand and trash. Like the trip in from the airport, people are everywhere. Women in ankle length, vibrant colored costumes carry babies strapped to their backs and children of all ages are everywhere. Men loiter in the streets and comment to all white passersby, especially women.
Between Mumammar al Gadhafi Ave. and Independence Drive sits the mammoth Queen Victoria Teaching Hospital (RVTH), the main hospital complex in Gambia. According to the tour books, you can do better by going to the private clinic along the Atlantic coast. RVTH must have been something special in it's day, but now it’s more than a little tatty with peeling paint, the ever present sand blowing in open windows and again, people everywhere. It bears no resemblance of what any of us think of as a hospital. The operating room that we'll be using was dirty beyond imagination. Walls and floors had to be scrubbed, blood was cleaned from the operating table, patient’s stretchers had torn, thin pads with no sheets. No oxygen was available in the operating room. Nitrous oxide which is a common anesthesia in the US is too expensive, so Halothane and oxygen are the only anesthesia available--once there is a source of oxygen. The anesthesia machine leaks so hopefully our surgeon and OR nurses won't get put to sleep also! Broken equipment was pushed against the operating room walls. Hallways were littered with equipment and people sitting and sleeping along the walls as we walked by. The lighting is so poor that the surgeon needs to use a headlamp.
The room that Anita and I will be working in to admit the patients and where they will recover had doors hanging off their hinges, the toilet didn't work, no running water, one electric plug worked and wires were hanging from two others, in addition to being filthy and dusty. BUT the color TV hooked into the one usable outlet was tuned to a Gambian soap opera with the mothers and grandmothers avidly watching. Most of these children, parents, grandparents had never been out of their home villages upriver as much 300 miles, of which less than half of that one road is even paved.
When Mercy Ship team members started arriving last week, the scrubbing and cleaning began. The admit area where we'll be working was also painted and using a Disney coloring book as a pattern, a local artist painted Mickey Mouse, ABCs, Roadrunner and other Disney characters on the walls. . Once the team found mattress for the WWII style metal beds in a room downstairs, the area was furnished with 24 beds in the one room where all patients will be not only admitted and recovered but since their families have no other place to stay, they are all sharing the narrow hospital bed with the patient. Everyone was excited that the beds have siderails that hopefully still go up and down!
It's still not recognizable as an American operating room or admit/recovery area, but 1000% better than a couple days ago. I have to keep telling myself that this isn’t the US or Britain and these kids will probably die if something isn’t done to close their cleft lips and palates since it’s very hard to eat and keep their bodies nourished to grow. Some die anyway from malaria or the many disease that are endemic to the area even after successful surgeries. It’s not a great situation, but it’s the only chance for most of these kids. First day of surgery starts at 8 AM tomorrow. Send good thoughts and prayers for all the people involved—they’ll need it!
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