Belated New Year's Greetings



The all too familiar "jump'n'shoot" pose at the top of Port St John's
 airfield with the UK student clan.
Left to right: Me, Mal, Dom (there's another Dom) and Georgie.

I must apologise: Job applications, a couple of flights to the UK, impromptu trips around the Wild Coast, falling in love, working like a dog, playing like a pig in roses and a lack of sleep has put this blog on hold for the past month or so.  However, it hasn’t been for a lack of tales. Oh no, there is plenty to be told, except that I do not want to bore my audience with pages and pages of script. To make things more palatable I shall write a couple of instalments on January.



The halo of clear fluid around the blood is CSF
(cerebrospinal fluid) that was leaking from a
 guys ear who had sustained a skull fracture
 following a road traffic collision.

I shall start where I left: in my last entry I was en route to the UK for a festive week at home with my beloved family. My first day back at Holy Cross was New Year’s Eve. Imagine my glee when I found out that I was to be on call alone for the ensuing 24 hours. Not that I don’t work by myself most of the time when on duty, but it is always nice to have that “phone a friend” option in times of crisis. My main concern, however, was the fact that there would be no anaesthetist for the C-sections. So, I planned ahead and called colleagues at my local hospital informing them that I would have to send any mother that couldn’t deliver vaginally to them. I don’t think they were too happy, but I didn’t give them a choice and in the end I only sent one lady.



One of the many mashed up hands: kids,
don't play with fireworks.

The day had an ominous start – at 9 am I put in my first chest drain into an elderly lady who had been beaten, bruised and stabbed in the chest: a grim and exceptionally sad tale, but something that isn’t uncommon. Fortunately, that was all there was for the next 24 hours of any real note. No knives to the heart, no blades through the lungs, no bullets traversing the skull. There were, like last year, several firework incidents that brought in a delightful selection of blown off digits and thumbs. I had to amputate the end of one guy’s finger whose bone had been squashed like a Panini and then chewed on by a very hungry teething child.

After the slight anti-climax of New Year’s Eve, Holy Cross threw a curve ball. All of a sudden we had gone from 7 to 3 doctors: one had left and three were on leave. It was a pretty cruel two weeks: dousing the fire, telling patients who had just travelled a day to see a doctor that they should return next week as their complaint wasn’t urgent; the wards were all but abandoned and left to survive on their own as we struggled to keep maternity, paediatrics and casualty going. Hence, there was little blog writing time for me.

A lot of children died in January, but I don’t think it was entirely because of the doctor shortage. There had been an alarming number of kids who presented in respiratory distress and renal failure as result of herbal intoxication. Traditional medicine is a very interesting subject, and when done well I’m sure is very good, just like the allopathic medicine that I know and practice. Both fields handle some exceptionally toxic substances. Unfortunately, some of the traditional healers have recently been using some exceptionally potent enemas (that’s right – bum is best over here) to cure a mild cough or a bit of diarrhoea. Instead of fixing the sniffle, children have been dying. When they get to us, with a bit of support and care, they sometimes get better. However on several occasions, as if there had been a massive communication breakdown in explaining why their child got ill, the parent repeats the enema and the child dies. For me, though, the most poignant moment during those hellish two weeks was certifying a beautiful little baby who had died as a result herbal intoxication. She wore a T-shirt with the inscription: “I’m not sleeping, just recharging.”

***



"Kiss me," the caption on one of the pairs of slippers that the
night staff were wearing.

It’s not been all doom and gloom though. There have been plenty of smiles, and even tears of joy, brought to my spritely face on a daily basis here at Holy Cross. They say it’s the small things, and when I looked down at the feet of the nursing staff running a busy Saturday night in casualty to see them all wearing pink fluffy slippers I couldn’t help but giggle. Although, it was a two way affair as they find the fact that I wear my wellington boots during the night shifts hilarious. However, I believe they are very practical: I get snake protection for the 300 metre walk from my house to the hospital; blood and other products can be wiped clean; I can pretend I’m at Glastonbury – not so practical, but it keeps me sane.




A gathering of "believers" collecting
 passers-by as they trundle down
 the corridors. To where though,
I have no idea.

During the end of that exceptionally exhausting and emotionally draining first two weeks of January I was greeted by a mass of people blocking my way to the ward. They were slowly marching down the corridor, banging their drums, dressed to the nines and singing the most sublime chorus. It brought a tear, well several tears, to my eyes. I have a real admiration for the faith that some of the people in this community have, even though I don’t share the same beliefs or attitudes towards life as they do. However, I could not help but be moved in a deeply visceral way.

***

I shall leave it there for now and write more on January soon where I had waterfall filled excitement with friends and a swell trio of UK elective students.

Myself and Mitch riding the wind atop of Port St John's airfield.

Myself in an extremely precarious spot above Port St John's.



Remember this guy? He came in weighing 10kg at 10 years old.
 Just over a month later and he now has life in his cheeks,
 a spark in his eyes and is now weighing in at almost 20kg.
 I didn't recognise him at first.