Every day here seems to be one of those days that lasts so long that you really can't even remember where you started. You can't remember what you did that morning or if it was today or yesterday. It all runs together. I've been wondering if that feeling would last for 7 more weeks. It's very hard to keep up with the day or the date or even the time for that matter. I feel like the only significance of time is when the sun will go down. With no electricity, sunlight becomes a matter of importance. Luckily, they have battery operated lights that are charged by solar panels. It seems they have thought of everything. I never imagined electricity would be so easy a thing to work around, but somehow they make it appear that way. I guess after a while you become accustomed to such difficulties and it is merely a way of life. Honestly, after only a few days, I've come to not notice it as much any more. The little inconveniences have already begun to wear away and I am becoming more thankful for the small things- shade, a cool breeze, cold water, a mosquito net.
I think today I sincerely began to appreciate the phrase T.I.A. (This Is Africa, for those of you who haven't seen the movie). Not only because of the horrific cases that we saw in wards or the two patients that "expired" today, but also because of the vast expansiveness that stretches as far as I could see. My eyes were blessed with many sights today that I shall never forget...
One particular case brought so much shock that I almost had to leave the room. A woman was brought to the hospital after receiving a surgery in Freetown. She had a dehiscence of the wound at the surgical site. Upon exploration, it was discovered that much of the site was necrosed. It was debrided to see the extent of injury and it was noted that the bladder was not excluded from the surgical involvement. It had been completely perforated (something that I learned early from Dr. Vaidya to fear at all costs in urology procedures). The lower half of her abdomen was now a gaping hole into her pelvis and the effects were starting to take their toll on the rest of the body. She was extremely cachectic and her muscles were so atrophied that you could clearly see all the bony structures of her small frame . She appeared to be about 60yo. Not old enough to look like this I decided.
Dr. Tom asked us to go into the OR to watch as the surgical staff cleaned her wound a second time. From the entry way into the hot windowless room, I could smell the scent of urine pounding against my nose. This poor lady, I thought...then I saw her. I don't think anything in school could have ever prepared me for this. There was no sedation used other than local anesthesia. She was writhing on the table, unable to hold still. I'm not sure which shocked me most, the extent of the wound or the lack of proper medications, but Dr. Tom noticed and offered to pick up my jaw from the floor. The combination of the two in addition to the general state of her body was almost unbearable.
After work, we went for a stroll through town up to the top of a hill to an abandoned building which is now used to house school classes. We climbed to the second floor balcony and looked out over the edge onto the beauty that is Africa. The swamps were so thick and green and you could see the layout of the whole village- it was such an amazing and spectacular view. One that could come only from the Lord above, and after the sights from earlier in the day, I think it was an even greater blessing to show how marvelous and yet complex His creation really is. Funny how something so simple as standing on that hill, can give you a moment of such clarity. I could hardly believe either sight as real, but will forget neither of them as well.
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