Saturday, May 17, 2008

2 posts in one day!

Since I haven't posted in a while, I figured I'd try to make up for lost time.  

Well, actually I just had a lot of great experiences in the last two days and wanted to share a couple of them with you.  

Yesterday I had what may be one of my favorite moments since moving to Tanzania.  I visited an HIV+ client in a rural area around Kilimanjaro and the late afternoon light made the inside of the small mud house even darker.  As we finished the visit and began to file out of the house there was an elderly woman standing in the outer room and greeted us each as we walked by.  I was the last one to walk through and I greeted her with the standard Swahili greeting for an older person.  She started to speak but then did a double take as she pulled me closer to the light coming from the front door and with genuine surprise said “wewe ni mzungu!” (you are a white person).  She couldn’t believe that there was a white person in her house and she didn’t even know it (unlike the children who had gathered outside the small window to peer in and look at the white woman).   Then she said in English “Good morning, how are you?” (a phrase she may have learned from her grandchildren)  She was so tickled to have a white person at her house and even asked me to stay and sleep over for the night.  With my hand in hers and, still in a bit of shock, she went on and on talking about the “mzungu” at her house.  She walked back to the vehicle with us, still holding my hand, and invited me back again.  

I hope that I can take her up on it one day.  

hospital visit

I went to the hospital today.  
Don’t worry, not to be treated, but to visit someone.
This hospital was in Marangu, a town literally at the base of Mt Kilimanjaro frequented by tourists planning to climb. It is a beautiful, lush area, especially now during the rainy season. Everything is very green, many trees and flowers are in bloom, and numerous fields are full of maize 6 feet high.

As soon as I walked into the hospital I commented on how clean and well maintained it was. As we entered the different wards I also noticed how empty it was, which seemed very strange to me. I was informed that the hospitals in the rural areas are often not full. However, during holidays, when people in the cities return to their traditional homes, the hospitals are much busier.

The purpose of our (Imara staff and local volunteer) visit was to see a HIV+ client we had hoped to visit in his home. He had recently been treated for malaria but was readmitted to the hospital for continued problems of fever and vomiting. As we entered the ward I saw him on the far side of the room in the bed against the window. I knew it was him because the other 5 beds were empty and he was the only patient in the big room. Although at first glance you might not have even known that a person was there. He was curled up in such a tiny ball with his head tucked under the sheet that you might have thought there was a pile of sheets sitting on the bed instead of a grown man.

As we walked up to the bedside I could see vomit on the floor and couldn’t help but note the strong smell of urine in the air. And, it soon became clear why this man had tucked himself so tightly in the sheet, he was cold! It was also apparent, even with the sheet on top of him, that he couldn’t weigh more than about 70 pounds.

During the past 5 years I have spent a lot of time in hospitals. It has become a bit of a comfort zone for me, it’s a place where I feel like I have some control over certain things and it’s where I’m empowered to do certain things as a nurse. Today I felt like I was so far from my comfort zone I really didn’t know what to do with myself. My heart broke for this man lying in the bed in front of me on sheets too small for the bed and wearing a shirt that used to be white and crisp many years ago. I wanted to do nothing more than bathe him, make his bed using fresh clean sheets and do whatever else I would normally do to make a patient in his condition more comfortable. I started to cry when I saw his condition and realized there was nothing I could do for him. I was definitely not in my comfort zone!

There were no staff members around because they apparently take breaks during visiting hours since friends and family members will be present to attend to the patients’ needs. But what about the patients who don’t have visitors coming to see them? Who will empty a bedpan or clean the face of a man who has vomited if he doesn’t have a devoted wife or child at his bedside? I started to get angry.  The answers I received in response to my questions only made me more angry.  

But then I saw something beautiful. I saw this volunteer, a man in his 30’s whose face literally shows the scars of a hard life, a man who looks like he’s trying to maintain a certain image (the "I wear my sunglasses at night" sort of image). I saw this man empty the bedpan which was sitting under the bed (which I didn’t even see and wouldn’t have known where to empty it if I had). I saw him hunt down a blanket from the seemingly nonexistent staff and cover the man as he spoke gently and compassionately to him. And I was even a little tickled to see him teach the patient how to hold his hand and wrist to ensure that the IV fluids continued to flow through the IV in his wrist. 

It was clear that this volunteer cared a great deal for the man in the hospital bed. This encouraged me more than you can imagine. Not only because this particular man was comforted but because this volunteer represents so many others who have been trained as community care givers. People with AIDS are being loved and cared for! This made my heart swell. We all prayed for this man before we left and I walked out with a renewed sense of hope.

Quite a range of emotions in a span of 20 minutes.