Nor die for de poor

“NOR DIE FOR DE POOR”

 (A bumper sticker which is to be interpreted as “Folks shouldn’t be dying just because they’re poor”.  I definitely missed the meaning when I first read it)

A view of  part of Magbenteh (Physio unit on rt)

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women's ward...w/mosquito nets

We finally arrived at our destination 53 hours after leaving.  Visiting the hospital in Lungi, spending the night and plain ole traveling takes a lot of time, right?  It was 4 p.m. by the time we laid our eyes on Mallory and Kendall, two college girls who came a week earlier.  We had to hustle to unload, settle in rooms and look around a bit because being this close to the equator means a fairly consistent 12 hour day…6:45 a.m. to 6:45 p.m.  A generator runs from 7 p.m. to 10 p.m. so we can have lights, the hospital can pump water into the holding tank and life can continue.  Middle of the night surgeries require the generator to come on as well.  It is not a flippant thing to use this energy as every drop of fuel cost must come from someplace in an already taut budget.  Part of our costs as a group include providing money for fuel for vehicles and generator, food and water for our group (there is a cook, David who was wonderful to us), and the cost of surgery for the patients we serve.  Fees for surgeries and hospital stays vary according to ability, a process which I don’t begin to comprehend, but I do know that each surgery we did costs about $200.oo which includes meds and however long a person stays—AND 2 pints of blood from someone, no matter the type, to stock the blood bank.  (I think this is a brilliant idea…is there a reason not to implement it here?)    While there are nurses aides in each ward (a large room with, say 20-30 beds, no dividers) each patient’s family is responsible to provide food and care for the patient (and themselves) while they are in the hospital.  There is no hospital cafeteria, no call button, no meal provided.   And, get this, the hernia’s that hang to the knee?  That’s elective surgery.  Acute, life threatening surgeries (ex: if the hernia strangulates) are provided by the hospital, no matter what, but if you’ve been hoisting around a growing 5 pound cyst for years,  it is elective to get it out as long as it behaves.  The limits of care are necessarily different in Sierra Leone than in the States.  When I say the need there is overwhelming, these are pieces of information that feed that statement. 

One surgery that became acute in the first hours of our visit involved a woman whose uterus ruptured during labor.  Dr. Moosavi was called and I, only ever at the head end of deliveries, tagged along, anxious to see my first baby being born.  The C section produced a gray baby that didn’t cry.  She had been dead for hours. This perfectly formed little human lay there with no breath, no spark.  And I had nothing to offer.  The mother was bleeding and I watched as the team worked creatively and quickly to save her life.  When the final stitches were done and Dr. Moosavi left, the mother was alive, but at some discreet moment, as I stood there observing people working hard to help this woman, she died too.  This is my first comprehension of how poverty isn’t just  hunger…poverty kills.  Had this woman come in earlier, not waited so very long until there was nothing that could be done to save her and her baby, not been intimidated by how to pay for medical care, she would be walking back home right now.  But she is dead, as is her child, and though I did not know her, I grieve her even as I type.