Daily Life

I wake up early, the sunlight streaming through my mosquito netting. I sleep on a waterbed, which is strange, but the water displaces my body-heat and keeps me cool.

I make myself come coffee and then bike along the main road that runs north-south to the hospital. The Congolese are early risers. At 6 am I see men going to work and children walking to school. Every morning a motorcyle with a huge crate of fresh bread whizzes past me into town, leaving a wonderful smell in its wake. Most of the other smells here in Impfondo are less pleasant.

The hospital's first daily event is morning devotion. Hospital staff and volunteers meet at 7 am in the hospital chapel for a few songs and an scripture reading delivered in French. Sometimes Dr. Harvey translates, sometimes he's elsewhere and no one translates. I find that I enjoy these meetings without translation since I usually learn a few new words. 

Next comes morning report in the conference roomm of the admin building. Here we discuss new patients and developments in patients already at the  hospital.

After this the doctors go on rounds, visiting every patient in the hospital. 

Bugs are a very important part of life at the hospital. We share every room with ants, flies, and enormous, dangly-legged wasps that build their mud homes in the corners of the ceiling.

Here is a milipede I scooped onto my bible. 

Every day at 1 pm, the volunteers eat a big lunch at the Blue House, the central residence for volunteers and visitors on the hospital grounds. We usually have noodles or rice with some kind of meat (beef, chicken, wild boar, crocodile, catepillars), and on the side is a huge plate of papaya, pineapple, or fried plantain. 

In the afternoons I work with patients, help with a surgery, or teach my English class.

At first, teaching this class was not my idea. A few weeks ago some volunteer nurses from Mercy Ships offerred several classes for the hospital staff to practice their English. When these nurses left to go back to the ship, they volunteered me to carry on the class. I decided to teach a 1 hour class twice a week on Thursdays and Fridays.

The first day I had three students. The next day Dr. Harvey made an announcement over the hospital's radio broadcast and I found twenty-five students crammed into the conference room. The number of students continues to grow. I use teaching techniques I learned from my Latin teacher, Mr. Griffith, involving pictures and gestures to convey new words and stories. Yesterday I held my class in the chapel and told the story of Noah to over 70 students of all ages.

The second day of class.

And the next time. 

I usually back home before the sun sets at 6pm. The main danger is not crime but traffic. There are motorcycles everywhere and for many of the drivers, manuevering a two-wheeled vehicle is a newly acquired skill. 

Next week I'll do my best to describe the city of Impfondo.

Thanks for reading.

Impfondo

Impfondo is a thin stretch of city that runs along the Ubonga river, a tributary of the Congo. Across the river is the Democratic Republic of Congo, a country that sends many refugees to the hospital. Every morning, I wake up early and ride my bicycle from the south side of the city through downtown to the hospital on the north end of town.

The main road skirts the river and is the only well paved street in the city. This road is buzzing with motorcycles, Toyota cars and busses, and two-man handcarts. Father up the road and away from downtown is a quieter scene with giant abandoned buildings built by the government. I suspect that at some point the president had grand intentions for Impfondo, intentions that never became a reality. Every day I pass the ruins of a cement machine slowly being devoured by the earth and jungle.

A few times a week I go to the market. I am told that most of the shops are run by muslims who have connections to other countries and are able to import goods. Canned and dry goods are for sale at evrey store, but the market offers plenty of fresh fruit and produce and a lot of fish.

The pineapples are huge and very delicious. We have papya the size of large watermelon that will be served as a side dish for a dozen people at lunch. Once when at the market I was trapped in a tiny hardware store by a huge rainstorm. 

The people in Impfondo are not starving, but there are a lot of attractive products competing for their grocery money that I think keeps malnourished children coming to the hospital. As in the US, everyone has and is expected to have a cell phone. Keeping your phone charged and full of minutes is expensive but it is nevertheless a priority for these people.

Here is a monkey I saw. 

Another monkey.

These monkeys were pets. You don't see monkeys running willd around town. I'm told that to see one in the wild you have to hike a day or two deep into the jungle. Below is one of the two jeeps owed by the hospital. Both are diesel powered and have their peculiarities. One has almost no breaks, another has no first gear.

Impfondo is a messy place, and the mess often gets buried in mud with the falling rain and then overgrown by the jungle flora. 

In case you didn't see my previous post: I just got engaged to the most beautiful woman in the world. 

My Work

As a volunteer I have the flexibility to do a variety of things at the hospital. I do nurse's aid things like taknig blood pressures and pulses and doing exercises with the patients. I also do pre-med things like shadowing Dr. Harvey and Dr. Tenpenny  as they go on rounds or in surgery. 

The most useful thing I do is probably the physical therapy exercises. Many patients risk losing full mobility of some body part becaue of a surgery or wound. I did regular exercises, for instance, with a man who had broken his upper arm by falling from a tree. This is, I am told, a very common cause of injury. The man is 60 something years old.

In another case a little girl had fallen into a fire and received an enormous burn on the back of her left leg. The wound was healing without a skin graft, but she could no longer straighten her leg. Her leg muscles had begun permenantly contract. On her I performed a few leg exercises that I'd learned in my CNA training. They caused her a fair bit of pain, but I saw some improvement and, at the end, I think we were friends. 

I did similar arm exercises for a man named Theophil. Such a kind person, he taught me a lot of French as we did his exercises. I never learned his wife's name, but she was nice too.

I am also allowed to observe surgeries and today I played a helping part in a C-section. Unfortunately, for today's surgery, the child was dead in the womb- a sober operation. Most of the surgeries are pretty gruesome, but here are some not-so-gruesome pictures to give you an idea of the operating room and its staff.

Above is Marie-Rose, the head nurse and woman-in-charge of the operating room, or "The Bloc," as we call it. Marie-Rose is Dr. Harvey's most trusted nurse, and for good reason. She is incredibly competant and very big hearted. Just today she taught me to insert an IV into the hand of a patient who needed more fluids. Then she offerred her own hand and insisted I do another for practice. Such a giving person.

Above, moving left to right, are Dr. Tenpenny, Dr. Scharrer, and my buddy Ben who is a pre-med student like me.

Another way I am able to help is by giving blood.

After donating my blood, I watched it drip down into the veins of a little girl who has been crippled by polio and terrible wounds.

But the way I've been able to help the most people is probably through my English classes, but I'll tell you about that next time.

I miss you all.

The Hospital Grounds

The hospital occupies 17 acres, enough land to house a small University campus. Every ward, which in a normal hospital might be made of a hallway or a floor, is comprized of a cluster of buildings, cabins built for communist youth. These building clusters are very spread out. From the front gate to the emergency room, for instance, is a hundred yards, and another hundred and twenty to the first set of patient-wards.

The hospital's wide-spread condition is perfect for African style health-care. The patient's family is responsible for feeding the patient, taking care of linens and laundry, as well as keeping track of their records (cheap composition books with handwritten notes). All this family activity takes a lot of room, and the hospital has plenty.

This man, whose name is Joachin (Zwa-say), has a broken humerus that is not healing correctly. He is a friendly man, but whenever the doctor comes by, he says he feels "very, very bad."

The little girl on the left is Peya. She has a pretty bad burn on her leg and I've been doing exercises with her to restore full motion.

Here are some of ghosts of the hospital's past: play equipment for good communist youth.

Friday

Dr. Tenpenny drew the hot blade across the back of the little girl's skull. Dr Harvey looked on. The patient was fully sedated, but I helped the nurse hold her legs down, just in case. The blade sizzled in spurts, cutting a red canyon in her black skin. It smells like burning plastic army men with matches. Then from the gash leapt a sudden parabola of blood. It made a crimson line before Dr. Harvey's face. Two more followed. The doctors looked at each other. "There's pressure alright," said Dr. Harvey. Dr. Tenpenny nodded and kept on cutting.

I have observed surgeries in the United States, but never before have I seen the entirety of a patient's journey through a hospital. And Pioneer Christian Hospital is not normal, at least, not compared to where I've been. It is not a big building, but a group of small ones spread out over at least 15 acres, a medical facility stuffed into the skeleton of a Communist Youth Camp

The ambulance was a green and yellow Toyota taxi-cab. I was walking out of the administration building when I saw it pull up to the ER. Inside was a young man with skin lacerations on his legs and face. They looked like continents of pink surrounded by oceans of black. He had fallen off his motorcycle, the most common accident in Impfondo, but he had done so from hitting a little girl. 

The girl wasn't responding. Kacie said she was five years old. When I first saw her she was lying on a stretcher, her eyes closed and her head swelling up from the trauma. Kacie, Tammy, and Becky, volunteer nurses from a hospital-ship in Point Noir, told me the head-wound looked grim. It would continue to swell for 48 hours after the collision, increasing the pressure on her brain. The little girl's lump already looked the size of one of the papyas sold in the market. Kacie rushed off to find the doctors who had just begun their rounds. The others began wheeling the little girl's bed toward the Surgery building, or "The Bloc," as most of us call it. I pushed the bed from behind, and I cursed every bump in those narrow, communist-made sidewalks. But I shouldn't have worried; the little girl was nearly unconscious. 

Watching a surgery in the United States is like sitting in on a college faculty meeting. This was a little more like attending a party: a very serious party. Everyone wore brightly colored scrubs, some with crazy stripe and lizard patterns. The radio played cheerful Christian music, the words in French and Lingala.  Above us was a sky-light. In it I saw a few cobwebs drifting in the jungle sun.

Dr. Tenpenny peeled back a thick layer of skin and Ben, a pre-med from Oregon, used a sterile towel to soak up the blood that was blanketing the bone. Ben lifted his towel and revealed the skull, severely cracked with several islands of free floating bone. Tenpenny removed these loose fragments to relieve pressure.  The brain oozed up around the newly created opening. Tenpenny then made a quick incision in the dura mater, and out came a gush of clear liquid.

I'd seen cerebrospinal fluid before, but that was in a lab dissecting the brains of genetically mutated mice under a magnifying glass. This, of course, was very different.

The girl was still breathing and her vitals read normal. Dr. Harvey mentioned that when no vital monitors are available some surgical teams in the Congo tape a piece of paper to the patient's nose. If it keeps flapping, all's well. 

Everyone had started cleaning up as Dr. Tenpenny began to suture. I followed Dr. Harvey into the next room for another surgery, this time a woman with severe abdominal pain and swelling. We drained a brownish fluid from her abdominal cavity for a good 15 minutes. We looked back through the glass into the previous room. Dr. Tenpenny gave us the thumbs up, his eyes smiling from behind his surgical mask.

Harvey went back to his office to visit a crowd of outpatients who'd been waiting since early morning. Tenpenny continued making rounds. A few hours later I saw the little girl back in the Emergency Room. Her head was all wrapped in white bandages, her eyes wide open.