Saturday, July 26, 2008

The man on the mountain

Hello! Back in Usa River, regular internet access allowed me to post regularly, which really helped me to process my experiences as well as keep a journal for posterity. Now that I live on the side of Mt. Kilimanjaro my internet access has been quite limited. I've rather missed these exhibitionist soliloquies. I'm in Moshi at the moment, enjoying the hottest day I've yet experienced here, letting my poor mzungu skin get a rest in a cool, dark internet cafe...

I have no idea what to write. My world view has pretty much completely changed since my last post, and I'm at a total loss as to how to transcribe even a portion of that into any sort of intelligible paragraph within the next 14 minutes of my purchased internet time. What follows will be free-form and chaotic. My apologies.

Patience, patience, patience. One must be patient when working here. I knew this, I was told this, I was ready for this. I'm not a terribly rushed person, I enjoy working at a leisurely pace...but seriously! I nearly went insane after the first week as we attempted to complete an inventory of the hospital's medical equipment. We'd be told "come back later", and when we did, we'd be told "come back tomorrow", at which point we'd be told "come back later". We'd make appointments which wouldn't be kept, wait two hours for someone who wouldn't show, come back again and again and again until we felt like we were just being obnoxious. Lesson 1: multi-tasking doesn't work in a world with no schedules.

But this is their home, not mine. I've met several volunteers here from all manner of NGO's. The cranky ones are those who thought they could teach the folks here a thing or two, who thought that if they were persistent and kept showing up from 9 to 5, the Tanzanians would eventually start to as well. Cranky volunteers, these. The happy volunteers, like the nice Irish teachers from Kimmage University Dublin who have been coming back to teach NGO governance classes for the last 15 years - these folks are patient. They try to teach the Tanzanians values like fair pay for fair work, financial transparency, and respect for those under you (a big task in the face of the values system instilled on this country by a century of German and British colonization), but they don't force. The know that you can only teach someone what they want to learn. This is universal. If you don't believe me, ask a math teacher. Lesson 2: You can only help someone who wants your help.

Kibosho hospital is beautiful, a beautiful campus in a beautiful country full of beautiful people. A reward for patience is developing relationships. Among the many things that I was told before coming and thought I understood but realized how much I didn't when I got here: you can't just parachute into a hospital on the side of a mountain on the other side of the world and just start kicking butt and taking names, thereby single-handedly reversing the tide of poverty, oppression, and inequality in public health. I guess I thought that I would walk into the hospital on Monday morning and find a giant pile of broken equipment that I could fix as easily as that Shop-Rite scooter back in Arusha. For one thing, they've got a pretty good electrician at Kibosho (Wilbard) who fixes most of what they bring him. For another, there is a NGO medical equipment repair shop in Moshi that fixes what Wilbard can't fix. What really slowed us down, however, is that the hospital didn't tell everyone (or anyone?) "The Americans are coming, please bring out the dead instruments so the amazing wazungu can make your life better." It turns out that the needs actually were there, but we had to go looking for them. The staff here have gotten quite used to making do with very little, and broken equipment is not rare, so in order to find things to fix, Zev and I and our poor Swahili had to go looking and returning later (and returning later and returning tomorrow) and talking with people and making friends until we found the secret stashes of broken, 1950's era medical equipment that had been given up for lost. Lesson 3: you've gotta make friends.

What we have accomplished so far: finished most of our inventory (still coming back tomorrow for a few departments); repaired an infant scale by fabricating missing linkage pieces from Coca-Cola bottle caps (with the help of our new friends in the work shop); refurbished and repaired an ancient electric aspirator pump (the type used for sucking fluids out of baby lungs and surgical openings); and repaired the wiring on a dentist's chair, thereby doubling the number of available chairs at the hospital (from 1 to 2). And now that we've demonstrated our eagerness to fix things, our list for Monday is looking pretty good: we've been asked to (attempt to) repair and train the staff in operation of a sonogram, an anesthesia machine, and an electrosurgery unit. Lesson 4: be careful what you ask for.

Random crazy story: Second or third day here, we're trying to do the equipment inventory, frustrated and stymied by language barrier. We'd been scheduled to do maternity earlier in the day, but they got really busy when a woman began having complications with the delivery. We heard someone say "C-section". Wilbard finds us, offers to take us over the the main operating theater and help us out (he speaks English pretty well). We walk through the main door and see 3 nurses and a small, still baby. The baby is laying on a brightly painted wooden table under a hand written sign reading "resuscitation table". They chat and laugh as they use a foot operated suction pump to remove fluid from the kid's lungs, then proceed to perform CPR. The baby starts crying. I guess it'll live. We look through a large window into the OR - they're sewing up the mother from which the infant has just been extracted via C-section. Wilbard waves in to the head nurse, motions for her to come out and see us. We protest, already feeling like we're invading some place we're really not supposed to be, but he ignores us. The head nurse comes out, introduces herself (Lucy), checks on the newborn, and cheerfully tells us that she'll be right out as soon as they finish with the mother. I stare into the OR. I never realized how much, ummm, "stuff" they have to cut through to get a baby out that way. I've never seen anything like that in my life. I'm not sure that I need to again. We've been invited to scrub in and observe a surgery next week. Zev wants to do it. I'm going to go hang out in the lab. Lesson 5: don't look through the window.

Rest assured, dear readers, that I am keeping a detailed log of my exploits here and taking plenty of pictures which I will happily force upon you when I return home. Lesson 6: if you want someone to go away, feigning interest only encourages them.


Jolie said...

Wow. You communicated a lot in just 14 minutes. I'm impressed. Take care. We can't wait to see your pictures and hear all the other stories!

LisaKay said...

I'm interested!!! get back up here and show me the pictures!