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Published: July 27th 2013
A very wet and warm hello to everyone. We hope this finds you all well, and thank you as ever, to those of you who have left us messages. No one mentioned that Andy Murray had won Wimbledon though or that a royal baby had been born!
Life in Masanga seems to be flying by in a blur of ward rounds, teaching, management meetings, and groundnut based food, with the nights a blur of pregnant abdomens and febrile infants I am now diagnosing typhoid perforations of the terminal ileum at a distance of twenty feet….
So its been a while since we last blogged but we celebrated Jo's birthday week with a beach break on the first weekend, and a trip to one of the national parks, Tiwai Island, the following weekend. Home to 11 species of primate, it is the place to see monkeys in Sierra Leone. However, despite numerous sightings of red colobus and the rare Diana monkey in the treetops of Tiwai, seeing monkeys a few feet away outside our back window is a highlight of every trip to our loo!
Most of the Danish volunteers have now returned home and there
is a lull of three weeks before more arrive, so there are now only five Oporto's in Masanga, two Dutch doctors and an other half making up the numbers. Rhubarb the car has just had some new shock absorbers fitted, the very expensive Australian ones fitted before our departure lasting just three months on the dirt tracks round the hospital. Coupled with new brake pads, oil, filters and a linking bar, it has been our major expense out here.
We were the proud owners of a little kitten a few weeks ago, named Asaila, Temne for "lion". We thought she was a little girl cat but she has now grown some balls and Jo is still coming to terms with this gender reassignment. Especially as his temperament over night seemed to change with the emergence of these balls. He can jump from about 5 feet and then cling on with 2 inch nails embedded in your flesh. However he is now a fat cat as Jo insists on feeding him fish every day (the locals think we're mad), but at least he has stopped pooping in my shoes.
In an effort to save money, £8 per day to
be exact, we are now only lighting the hospital and surrounding houses for two hours in the evening, down from three. This results in a very romantic candlelit period from half six till eight in the evenings. However, the money saved, £250 per month, pays the salaries of 16 nursing aids. Unfortunately, we have also had to introduce charges for medicines and for my ultra-sounding so there is an incentive to improve! Sadly, just having the white doctor wave the ultrasound probe over you is deemed locally as a healing experience, with satisfied patients and family blissfully unaware of my incompetent interpretation of the grainy images.
Jo's physio aid students have just had their graduation ceremony and the new department has been officially opened. It is currently a shell, and the work to equip it has just begun. And there is now the money to pay the new physios with the savings from the lights.......!
The management meetings remain a source of interest as the HR stories remain a source of constant disbelief. Soon after we joined the management team, we had to dismiss a nurse for lack of respect to the senior nurses. This seemed quite a
harsh punishment, but at least the tone was set. However, over the following weeks, cases of drunkenness on duty, failure to be at work, using hospital cars as a taxi service, being asleep on duty and just plain old fashioned being a bad egg and neglecting to give medication or do vital signs, has always resulted in pleas for mercy from the senior nurse on the management team, as the individual concerned has always had some other pressing issue and these cases have been excused with a warning. An example is the story of Abdul: A high flying nurse who had started life in Masanga as a patient, then had gained worked as a guard, then as a nursing aid, and then finally trained as a nurse, recently rejoined the hospital having completed his training. Abdul became absent from work for a week, then two weeks. He had become unwell and had not improved after treatment for typhoid and malaria, so he had assumed that he had been shot with a witch gun so he was, reports told us, in hiding lest he be shot again. Witch guns are a local belief by which saying " I shoot you with
my witch gun" will result in illness and death for the target. The shooting can be done by anybody but there is normally some kind of object (stick/bunch of herbs) which is directed at the intended victim. The locals that we have talked to speak of 'bullets' that must be removed if the victim is to survive. These bullets apparently look like black couscous and are just under the skin so there has to be a small excision to remove them. This has to be done by a traditional healer but obviously comes at a price....somewhere near £200 which is a huge amount of money for them. People who have been shot and are not treated do apparently die, so there is either a very strong psycho-somatic illness at work, or more cynically, a very capable poisoner doing the rounds.... Unfortunately, western medicine in Masanga can often not offer a much more comprehensive diagnosis as our laboratory can only do certain tests. The diagnosis of strange tropical illnesses and more obscure internal medicine is impossible so convincing them that they have not been shot is never going to be easy. Apparently, white people can not be shot by witch guns
as they do not believe in them. Some of the locals admit to not believing in them, but this is a big step away from ones roots, so even educated people still worry about the guns. Abdul is one of these people and despite his recently acquired nursing education, does believe in the witch gun. As his illness was not improving, he assumed he must have been shot, even though he could not think of anyone who would wish to shoot him. So after a visit to the local healer and four weeks off work, Abdul is now fully recovered and has returned to Masanga with a slapped wrist and life goes on….
So all in all we are really enjoying our time at Masanga. Life is simple with limited electricity and no running water but it's amazing how little you need as long as you can make cake and crumble. We're now at the half way point of our year off and January '14 with return to work feels very foreign. Although the thought of the open road in October is exciting, we could easily stay here for a lot longer. There is so much to do and
not necessarily in our areas of experience. Jo is getting into the tailor shop and designing things to sell in Freetown!
So once again thank you for reading this far and if you have the time, please leave us a little note, as we love reading them! Love from David and Jo xxx
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