#startledbyagecko

[startledbyagecko]

Non-Silent Tears: Tonight I live-streamed my baby cousin's funeral from Africa. That's not something that I ever thought I'd have to do. Definitely not something that I'd ever wanted to do. Yet, I sat there, under my mosquito net, heart heavy, in the dark and trying to cry softly enough to not disturb my housemates. My 21-year-old cousin was killed in a car accident, when another car drove into oncoming traffic. I found out about it two hours after I arrived at Nyakibale Hospital in Rukungiri, Uganda. Had I been able to get home, I would have attended the funeral in person. As it is, it's at least a 3-day journey to get back from rural Uganda to the US. The next best option was to watch over the shotty internet connection that buffers every 2-3 minutes. Nothing is really private here, but I needed that time to myself. So, I sat in the dark alone at midnight to watch. I needed to hear the beautiful worship music and the messages about Jesus' love and faithfulness by the pastors. I lost my battle with silent crying when a tribute written by my aunt about her daughter was read. It was a beautiful epitaph from a truly remarkable and self-less heart. At the end, I watched from 8,000 miles away as my father, mother, siblings, nephews, aunts, uncles, cousins and grandparents proceeded out of the church. I was struck by just how important family is and how lucky I am to have them. Like any family, we have our issues. Yet, in the midst of a terrible devastating tragedy, their eyes are firmly fixed on Jesus. We will miss Hannah so dearly. My innate instinct is to try to say something that would make it better, but there is nothing in me to make this better. Yet, as the pastor said, "The Word is a wonderful place to go when our hearts feel heavy." We do not grieve as those without hope. Our hope is Jesus who now gets to enjoy our beautiful Hannah all by Himself. I would say that it was selfish of Him, but she was always His to begin with. We are so grateful that He lent her to us and grieve that it couldn't have been longer. Hannah, your beautiful smile and kind heart will be sorely missed.

[startledbyagecko]

Slow Day

It’s a slow night in the ER today: Septic baby. Boda-boda accident with head trauma. Malaria x2. The typical issues here in rural Uganda. One of the ECPs, emergency care providers (RNs trained to see patients on their own in the ER), brought her son for a social call. He got ahold of my phone and had some fun with my camera. Then he discovered an app that lets you record your voice and plays it back like a chipmunk. He proceeded to say the same thing two dozen times at sequentially higher pitches until only cats could reasonably hear the tones in the recording.  I’m not sure what he was saying but it contained the word “mzungu,” which means “white person.”  I’m fairly certain it was about me. Although, technically translated, “mzungu” means “one who wanders around aimlessly.”  (This is a holdover from the days when white people came to Africa and “explored” or rather got lost in the wilderness.) His English comprehension seemed pretty good. English is one of the national languages of Uganda, another holdover from the Brittish Empire.  Still, not everyone speaks it. He seemed to get what I was saying, but he was only 3. So, he might have just been talking despite me. 

All the staff members live on the hospital grounds, many families too. However, families can’t always stay together. Often families have to live apart because finding work for both husband and wife in the same place is hard.  Some of our providers' spouses and children live hours away and they see each other 1-2 times per month.  Nurses here make about 300,000 shillings per month. That equals out to less than $100. Doctors do better but still make less than $400 per month. The cost of a night in the hospital is 20,000 shillings + 20,000 per MD consultation. A major surgery is 50,000 shillings, roughly $15, plus the cost of any time in the hospital. 

We have roughly 1% of the lab tests that are available at home, no CT scan and X-Ray only during banking hours.  Yet, it’s good medicine that I see. The ECPs do ultrasound at the bedside and have great clinical exam skills.  There’s a lot of infections here. People tend to wait until they’re at death’s door before admitting they need help.  Sometimes it’s too late, but often their best efforts are enough.  

Right now the hospital is in an uproar about Rift Valley Fever. There were heavy rains last week and there seems to be an outbreak locally.  Typically, this virus infects animals but can be spread to humans via mosquitos or direct contact.  Most of the time, human infection is similar to malaria and self-resolves. In its severest form, it causes hemorrhagic fever.  The government lab is running our patients’ samples now to determine if the illness that has already claimed a life is, in fact, RVF. We’ll have to wait and see. Probably tomorrow, but maybe the next day. 

Currently, the ER has cleared out, reggae music is playing from the “educational use only” iMac next to me and the caffeine from my latest cup of tea has worn off.  The ER is open another 3 hours, but I’m going to go to bed now. I always tell them that they can call me if they need me. They’ll never call and truthfully, they probably don’t need to. The ECPs working tonight are highly qualified and have been doing this for years.  Still, I’m going to offer again, just in case.