One of the ladies who works around the hospital is a refugee from when a genocide was happening in Rwanda. While she was here she met another Rwandan man whom she married and they started a family. Some time ago he went back to Rwanda to look into moving their family back. He was murdered and she was left with 6 children here in Kenya. With no land of her own she rents a small farming plot (shamba) and works as house help for one of the missionary families here.
She needed a fence to keep the neighboring cows from eating her garden as it grows. A visitor bought the supplies and some of us joined up with her kids and a few other locals to put in a fence for her. The many hands made light work as we dug fence post holes, put in the posts and put up the barb wire around her whole property in just one day! The only picture I got, though, was one of my sunburn afterwards...
Working in orthopedics in the developing world can be especially rewarding. Often people have long standing pain or difficulties than can be alleviated with surgery. In ortho we get to see our results right away and, in general, the patients are otherwise healthy. Patients often feel good and really comprehend that they have been helped. We all work hard and put in significant hours living for God by serving other people in orthopedic ways. It's not unusual, though, to see and evaluate cases for which we can provide limited or no help at all.
Yesterday was clinic day and there seemed to be quite a few of the more difficult cases. At clinic we see all those whom we've treated and are returning for follow up care. We also see those who come for independent check up's as well. Here are a few which stuck with me. The first one case was of a woman who returned with her foot biopsy result which was positive for cancer. She needs an amputation to stop it from spreading. But amputations cost money and she has none. Traveling from far she had to leave her baby with her husband (who doesn't work and is a drunkard) only to find out she has cancer and can't afford the less than ideal treatment. All this and she is only 23 yrs. old! We went ahead and scheduled her anyways and told her to come back regardless of whether or not she could pay....we'll work it out we said.
Often we see problems that would have been prevented or treated far earlier in the developed west. One such case was of a young boy with scoliosis which was progressively getting worse and worse. Dresses in worn out clothes that hung off his thin frame he stood there while his dad was told of the potential for surgery. "There is a spine surgeon coming back in some time...evaluated for the possibility...can't do anything for you at this time..."
Another was of a women who has progressive problems with her pelvis. Barely able to walk she explains that she recently had a baby (yes, through that pelvis) and must also walk long distances to get water, carrying up to 20 litres at a time. She's having a lot of pain. Her pelvis isn't going to get better and her options for treatment are limited.
One of the challenges working in health care is infection. We do our best to prevent it but some patients are more challenging than others (by no fault of their own). Here is a picture of classic "shamba foot" as we like to call it in the O.R. A shamba is a small personal farm and those who don't own shoes have feet with callous and dirt permanently ingrained. Almost like a dirt tattoo on the bottom of the foot. Difficult to clean, shamba foot is an excellent vector for infection in distal leg wounds. Pictured here is a middle aged woman with a dirty open tib/fib fracture and classic shamba foot.
I hope that, after reading this blog, your impression isn't that everything is sad, hard, or heartbreaking. Some things are but there is a lot which isn't. The cases I included are just ones that have been on my mind recently. There are others which I could have written about, such as the guy who had a horrible leg fracture that walked in, healed, without a limp. The child with a painful bone infection who is now healed. Another kid who had a fractured femur which is now healed smiles and giggles when I shake his hand every day as I walk past him in his wheelchair...
The hardship and suffering observed reminds me of what matters and what doesn't. It makes me incredibly grateful for the unnecessary but nice things I have in this life. It questions my priorities and reminds me of how self-focused I can be. It makes me look forward to a day when all suffering will be gone and done away with.
Revelation 21v4 "He will wipe every tear from their eyes. There will be no more death or mourning or crying or pain, for the old order of things has passed away."
The challenge is to live for that day. To love God first and other people at an expense to ourselves.
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