Friday 28 May 2010

Tani

Tani is one of our hospital patients.  I'm not sure of her story, however, I believe she may have been burnt.  She has lost a couple of fingers on her right arm, one eye is covered over and deformed and she doesn't have a nose.  Or more accurately she didn't have a nose, because she does now.  Gary Parker is our resident maxillo-facial surgeon on the ship, and among the many surgeries he performs to reconstruct peoples faces, he has created a new nose for 9 year old Tani.  In an intricate surgery he has taken a flap of skin from her scalp, twisted it around and formed it into a nose.  Why twist is round rather than cut it off?  Well eventually it will be cut off from the scalp, but when the nose is first connected leaving the blood vessels intact to supply the moved tissue increases the chance of the surgery being successful. 

However, with such surgery it is imperative to make sure the wounds (both around the new nose and surrounding areas and the donor site on the scalp which is gradually healing over) are kept clean with regular dressing changes.  So fairly regularly Tani goes to see Alainie or Jane, our nurses in charge of the wound care of our patients, particularly our plastics patients. 

Now the inpatient treatment room, where Alainie and Jane work, is next to the Biomedical Technicians office, where I work.  And the other day as I walked past to the office I saw Alainie and Tani and decided to say hello, as Alainie was explaining to Tani that I was her friend.  Normally when Tani is having her dressing changed her father is also present, however, this time he was not around, this led to a slightly more boisterous and lively Tani.  So I stuck around to see her dressing being changed.  Gradually as Alainie unwrapped her bandages and then proceeded to clean the wound Tani started to mess about and play.  She looked at the opthalmascopes (used for looking at eyes) and turned on the oxygen flowmeter, and then started playing with me.  With Alainie's music going in the background I started dancing with Tani whilst trying not to make it too difficult for Alainie to do her job!  Every so often Tani would wriggle away, she wasn't upset or crying, she just wanted to play!  And each time I tried to find something else to occupy her that kept her in the right place for Alainie.  Alainie always chats to the the patients as she is doing her work (in a mixture of broken French and English) and tells them what she is doing.  Admittedly Tani can't understand all of this, but she does know one English phrase which she kept repeating, I love you.  Eventually the dressing change was complete and she was able to go back to the wards to continue the craft she had been doing.

Why did I enjoy this so much?  Well, not only was it good fun, but I got to spend time with an adorable child.  Many of the patients who come to us with such disfigurements, particularly to their faces are incredibly shy and reserved.  They are used to be ostracised and made fun of.  But Tani was still a joyful little girl, who enjoyed playing and messing about, who was mischievous and playful.  She hadn't been so damaged by peoples reactions to her to become timid, but still had the spirit of a young child.  It was a joy to see how happy she was, and to know that she will have a new nose when she leaves us.  Hopefully when we are in Sierra Leone next year she will be able to come back and get her eye fixed as well.

Saturday 22 May 2010

Apology

Just a quick note to say a huge sorry for the lack of posts over the last month.  This has been due to a variety of reasons, and I apologise for not keeping you up to date, however I will try and let you know a little of what I have been up to over the next few weeks.  Please enjoy the new post below about my trip to a village north of Lome.

Ando Bedo visit

On the ship we have day volunteers.  The day volunteers fill important roles on the ship, they are vital to our work here.  Some are translators, some do the hospital laundry, some help in the galley or in the dining room, others help keep the ship clean, and more still are in the engine room or up on deck.  They help us in all areas, supporting the crew and enabling us to do this work.  Most of them are Togolese, however, we do have a new other nationalities, Ghanian, Benoise, Nigerian etc and British!  Liz is a trained nurse from England, and works part time down in the OR as an anaesthetic nurse.  Liz moved to Togo at the beginning of the year with her Togolese husband and they are working as Crosslinks missionaries here with Meci doing children's ministries.

As part of their work they are doing some community development work with a village in between Lome and Kpalame, Ando Bedo.  With the village they are trying to work out where would be best to put in latrines (toilets) and a water source.  It is imperative to understand the dynamics of a village to know where to put these facilities.  Whilst their are places which may look very good to an outsider, if they affect the normal workings of the village, or go against the customs then they will not be used, no matter how much they could improve the lifestyle or health of the village.

As such they are working with the village to try to understand how the village works, and to help them understand the implications of getting a water source (they will be the only village in the area with one and will therefore get a lot of people coming to get water from them - this could have both a positive and a negative impact on the village).  About a month ago I went with Gad and Liz to visit Ando Bedo to do a mapping project with the village.  The aim was to get the villagers to draw a map of the village showing where the houses are, where people currently go to the toilet, where the church is, where the road is, and to also find out which houses have idols in as the village has quite a high prevalence of idol worship.  The village split up into two groups, the men in one and the women in another, and Liz and Gad set about encouraging them to draw the village on the ground using a stick.  They used twigs and leaves and stones to represent different things.

It was interesting for me to see a village rather than the capital city, Lomé, where we are docked.  In Lomé, there are many buildings and houses and there are proper (although rather potholed) roads and supermarkets and such like.  It is not a western city, but it is a city and it is more developed than the villages, and there is a higher level of education.  It was fascinating to see the difference in the ways the men and the women approached the mapping, and surprising to see how difficult the women found it and how they really did not know where the houses were in relation to each other.  It was sad to see women in the house next to where we were doing the mapping watching us yet not coming over to join in despite the fact that this was meant to be a whole community effort.  The village was mostly made up of very simple houses, made of mud bricks and thatched with palm leaves.  The ground was dusty and the paths were fairly ill-defined.  There is a church but it is mainly attended only by the children in the village and not the adults, and the nearby school that was built by an aid organisation (nice large brick building) is attended by the children but maybe only two days a week, the other three they farm for the teachers in 'farming school' even though they have to pay for school as well.

Hopefully in time there will be further development in this village, but it needs to be development which is owned by the village, so that they continue to use it way into the future, that they take care of it and look after it.  It needs to be something that works with their lives.  Hopefully unity will come to a village which has suffered from some form of disagreement which has separated people and caused hurt and isolation.  Hopefully true change will come and restore these people.

First a few pictures from around the village
Above:  The coloured line across the middle of the picture is the yarn from the loom where they are weaving scarf like items

Some of the children from the village; many were very malnourished with large protruding bellies.
The start of the women's mapping process.
The finished women's map (which was alot smaller and less detailed than the men's!)
My favourite picture from my trip to Ando Bedo.