Monday, October 20, 2008

As Winona Ryder Once Said, So Cheesy, Please Read with Crackers

To atone for having compared Grace's eating mannerisms with that of a monkey (it was supposed to be a compliment), I'm going to talk about our patients, as per her request. Discussing patients is a bit sticky, given the stringent ethics surrounding patient confidentiality and privacy rights, so I'll do the best I can in generalities for now...
When I first met the women, I was completely exhausted, overwhelmed, and still hadn't figured out that I was actually in Sierra Leone. It was the same day that we'd bumped our way to Bo from Freetown, about six hours on a less-than-pristine road. The second I came in the room, they immediately began singing to welcome me. In the first few days, I remember, I was struck with the sadness behind their eyes. There is a strange dichotomy in them--they have largely created a new community for themselves, all 26 of them, in lieu of the communities and families that abandoned many of them. Just below every happy moment is loss, pain, and some anger for their pasts. But there is unspeakable joy and, unsurprisingly given the vast numbers of women (and very nice and non-threatening men working with us), a lot of uninhibited behavior. This is not to say that everything is perfect on the ward--there are disputes and cliques.
Sometimes I'll catch myself watching them and realize that many of them are younger than me--the youngest is 15 and others are not out of their teens. When this hits me, I can't believe that they've gone through what they have at such a young age. All the same, they usually act their age, giggling and joking around. Despite the fact that we have enough beds for everyone, some of them insist on doubling up so they can gossip and whisper all night, just as I did in boarding school and college. The older women look tired, but they still join in when there's dancing and singing. Everyone is always in on the joke. At our first staff meeting, the nurses left the ward unsupervised, and after about 20 minutes (we were just outside on the verandah), we heard them making a huge racket singing and dancing. One woman, Kaburreh, who has her teeth filed into points, is the lead drummer and picks up plastic basins and buckets to beat out the rhythm to the songs. The other day, as we were perparing for a visit from the First and Second Ladies, Jackie organized the women into two groups, based on language/ethnicity, to practice welcome songs and then started pitting them against each other to sing the best and the loudest, whispering to the group of Krio, Kissi, Kono, and others that she'd heard that Mendes were the best singers and then sneaking over to the Mendes to whisper the same about the Krios et al.
I don't mean this to sound stereotypical, but it's true that what strikes me most is their singing and dancing--there is always music in the ward, and we specifically chose the ward that we did so that we'd be a little separate, to be able to be loud and not disturb the rest of the hospital. I think what sums up the women best is the party the other day after the visit by the First and Second Ladies. We'd set up music videos on the ward TV and were blasting music. Almost every single woman, including one who is several months pregnant, the older ones, and those who had just undergone VVF repair surgery, was dancing. The VVF post-op women just chucked their urine bags in front of their feet on the ground and danced. It was wonderful.
Many of these women came in nearly dead, suffering from a host of other medical problems, and were often abandoned or maltreated. That they can find enough strength, both mental and physical, to be so enthusiastic and to create a new family for themselves can be a little mind boggling. At one point, the water got shut off at our old facility, and they marched down to the volunteer house to get water out of our well. Even the women with nerve damage, or foot drop, brought down buckets and carried them back on their heads, limping a bit but smiling and joking. When we moved them in a single day from our first facility to our current hospital, and had them double up beds in a not very comfortable temporary ward, no one complained. Many work incredibly hard at their studies and skills training classes, even women that are 35 or older, who might be expected to see basic literacy as a lost cause at that point in their lives.
Whenever I'm having a hard time here, I go to the ward and sit with them. And in very little time, I'll be soothed, through getting my hair braided or attempting Mende, or laughing at their jokes, and, though this also sounds totally cheesy and like one of those "I didn't teach them, they taught me" cliche moments, I'll remember that I'm here for them and that nothing else is important. And in a weird way, watching the post-op patients recover now is bittersweet because I know that nine of them will be leaving us behind to return to their families or to start new lives, hopefully a little fatter and a lot happier.

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