Archive for June 2012

Unexpected Challenges

Posted by givinglearningdoing ⋅ June 27, 2012

Abbi an ever loyal companion in all my adventures, even if it is the stuffed version.

I often joke, “I am a medical disaster,” having a laundry list of stupid things and ailments I have had. Broken bones, sinus infections, allergic reactions, and tick fever to name a few. For all those that were casting bets on when this year’s mishap would strike, it is time to cash in. It has been a turbulent couple of weeks playing out a saga of events that I have yet to still process completely.

What initially seemed like minor stomach aches, and adjustments to being in a new country quickly evolved into frequent bouts of being ill and finally just not getting better. I had just gotten done with an awesome week of working at the hospital: we had a blood drive, I did some health sessions, I went on my trip to Kwakwani, and topped it all off with a memorable weekend with my house mates.

No Monday is ever pleasant, but this Monday in particular was one to forget. I got up and went about my usual routine coffee, shower, get dressed, breakfast, and off to work. I got set up with my to do list for the day, and then found myself doubled over in my desk chair with stabbing pain in my abdomen. It passed and I sat up just to double back over in pain. I made a beeline for the bathroom, which I frequented multiple times over the next hour. After debating for twenty minutes in my head my ability to “suck it up” and work that day I headed home to bond with my bed and bathroom. Now if this was the first time I had been sick I would have attributed it to a bug and bad food, but this was the third time in less than two months. I called my PCMO and was swept off to Georgetown for a myriad of tests. The severity of symptoms, location of pain, and acute onset put up some red flags. A quick diagnosis was made, and I had an answer to what had been afflicting me for the last couple months – gall stones.

Except everything in medicine isn’t always black and white, and the diagnoses doesn’t always fit all the symptoms. There are always those patients that have other factors and possibilities to consider. Peace Corps monitored me for a week, let me go back to site and see how things went. Maybe the gall stones weren’t the problem, maybe I did have a parasite, or maybe the medication I was taking was messing with my GI tract, or who knows maybe it was food poisoning. Things didn’t go well at site. I found myself back in the PCMO office a week later desperate to feel better.

Packed and ready to go to Panama

For about two weeks I lived on a peanut butter and toast diet, I tried “real” food occasionally, just to feel sick again. At this point the decision was made to send me to Peace Corps Panama, the SA/CA medical hub for non-emergent cases, for further evaluation. To try and shed light on what was going through my head at this point is challenging. I was experiencing a flood of emotions: relief I was going to feel better; frustration of wanting an answer to the problem; sadness that I was leaving my site; fear that I wasn’t going to be able to continue to serve; loneliness being away from the familiar and comforting; exhaustion from trying to maintain an optimistic and realistic perspective; apprehension that the problem wouldn’t go away…the list continues each emotion manifesting itself differently.

My departure from site was abrupt and few knew I was leaving, and no one knew when I would return. Guyana volunteers joke that getting a medivac to Panama is a “Panacation.” Yes I saw some sites, ate some food, and made the best of my surroundings, but at the end of the day I was still sick and had doctor’s appointments to go to and tests to be done. I applaud Peace Corps on their thoroughness of making sure they have the right diagnosis and not doing any major procedures without all the facts. But in the midst of all this it was challenging for me to maintain my mental sanity as each day passed by and I didn’t have an answer if we were going to surgically remove the gall stones and gall bladder. There were many distraught Skype conversations home, moments of wanting to quite, lots of conversations with friends seeking words of encouragement. I know I wasn’t dying, I know that one day I would feel better, but when I was alone at night laying in my hotel room in horrible pain, in a foreign country, far from a solution, exhausted and desperate for a sound night of sleep, I felt hopeless.

A silver lining in it all was a fellow Guyana volunteer came to Panama for some minor and nonexistent issues. We deemed each other our “registered emotional companions”, there to make each other get out of bed, eat some food, have some fun, and enjoy TV show marathons together. A new friendship formed and I am grateful for the memories I shared with her in Panama, and the words of wisdom she gave me, “Don’t chew it, suck on it, it makes it last longer.” I will be sure to implement this technique the next movie I go to in order to make the popcorn last the whole movie.

Post-op goofiness, pain, and confusion.

Five weeks after this saga began on June 23, 2012 I packed my bags and checked into Clinica Hospital San Fernando to have surgery to remove my gall bladder. I will openly admit I was nervous, my Spanish is passable, but to be in a hospital where someone is about to cut into you, I hoped I answered all the questions right… I am recovering well, rediscovering my love for food (even if it is hospital food); minor pain from surgery and the incisions, but stomach ailments gone. Now a new set of emotions overwhelm me as I contemplate the unexpected challenges ahead of me returning to Guyana. But those are things to think about when the time comes…

To Kwakwani we must go!

Posted by givinglearningdoing ⋅ June 15, 2012

Persistence pays off. No matter how far the journey, how difficult the obstacles, or how challenging the problems – persistence pays off. I recently took a trip to the remote logging and mining town of KwaKwani. Linden Hospital Complex, the facility I work at, is made up of three hospitals: MacKenzie Linden Hospital (where I will be working primarily), Wismar Upper Demerara Hospital, and Kwakwani Hospital. I thought it was important to gain a familiarity for all the communities my hospital serves. Once a month they run outreach clinic trips up to Kwakwani Hospital to offer services that are not regularly available at that hospital. I was determined to find my way onto the Kwakwani bus.

KwaKwani Hospital

Initially I was supposed to go Kwakwani the first month I was in Linden. I was so excited I was going to get to see this remote town of Guyana! Unfortunately, one too many people were supposed to be on the bus, and I fell ill that morning and rather laid in bed dreaming of what Kwakwani was like. I had heard stories of the journey to this small town, and descriptions of how different it was from Linden. People would entice me with descriptions of the dense rainforest, and the beautiful river. The next trip comes around and nothing is stopping me this time from going! I arrange with my supervisor to go, I check in with the gentleman in charge of arranging the trip, I get everything in order. Then I am told the day before I am supposed to go the bus is too full. I didn’t care strap me to the top of the bus I am going. They tell me to check in at the end of work day to see if anything changes, I get the same response, too full. This wasn’t stopping me though, I said I would still show up the next morning bright and early and if it really was “too full,” then I would go next time.

It was a Wednesday morning, and fog consumed the streets. I rolled out bed an hour early and went into auto pilot. Hot water for coffee, ice cold shower, semi-matching outfit, eggs, toast, pack bag…I was determined to get to Kwakwani and see a new part of Guyana. Six rolls around there are no hire cars running so I decide I will walk to the hospital, the bus for Kwakwani Hospital is supposed to leave at 6:45, which in Guyanese time means 7:30 at the earliest. It was a dreary day and the sun was slow to rise. I meandered past the miners waiting for their work bus to pick them up. Linden has a different feeling early in the morning, the streets are silent, the routine good mornings are few and far between. Though this particular morning one man did make me smile. In Guyana as a white female there is a large amount of unwanted attention, sometimes it is humorous, sometimes it is vulgar, and occasionally it is decent. This morning a young man yelled out to me, “Good morning miss, good morning, you look beautiful, you must be a movie star, you jus ah I…” he began stumbling over his words and then just repeated, “you look beautiful.” I smiled and continued on my way to the hospital, it was a nice change of attention from the usual, “I’ll take a piece of that white meat.”

Flat tire on the way to Kwakwani

I arrive at the hospital and it is deserted of staff, but patients have begun to line up, hoping to be one of the first to get in to see the doctor. I sit patiently on bench waiting for the group of people who are going to Kwakwani, the bus arrives and I just stick my bag on it in determination that I AM getting on this bus. Slowly and surely people meander in, it is 7:00, half of us are there, it is 7:15 a few more have shown up, but a few have wandered off. It is 7:30 and by some miracle we have all found our way onto the bus and begin the bumpy journey down a long dirt road. Now for those of you who know me I am not a morning person, and often require a a significant amount of coffee to become a functional human being, as we bounce down the dirt road I drift off into sleep and become a bobble head entertainment for the rest of the bus as every five minutes my head would encounter the side window I would jerk awake and then slowly nod off again. This lasted for the first hour hour of the trip until we arrived in the small logging and mining town of Ituni. There is another Peace Corps volunteer who works in this town at the heath post and in the community. It is a quiet town with houses spread out and forest surrounding it. Here I take the opportunity to chug down the rest of my coffee in hopes of keeping my eyes open the rest of the journey. Before I know it we are back on the road again and on our way to Kwakwani.

Crossing the River on the way to Kwakwani Hospital

We weave through the forest on the bumpy dirt road. The only sign of man is this road cutting through dense thick trees that tower on either side. It seems to continue endlessly. We speed along getting closer to our final destination. We come around a bend into an open field, when suddenly there is a loud POP, and our vehicle comes to a halt. We have a flat tire, as soon as we all unload from the mini bus the driver is quickly changing the tire, this shouldn’t be much of a delay five minutes flat, there is a new tire on the bus. One minor detail though, there is no error in the spare. We are stuck and the nearest town is a 45 minute walk either direction, and there is no cell service. Plan A was to leave on time get to Kwakwani at 9:00am and get to work. Plan B was leave a little late, but still get there at a reasonable time. Plan C was…The point is in Guyana you need to be flexible, patient, and creative, things don’t ever go according to Plan A, there are a whole other 25 letters to use and plans LMOP may be much more exciting than plan ABC. Our predicament sounds like the beginning of a bad joke, “There is a white girl, a Guyanese, and a broken down mini bus in the middle of the rain forest,” or maybe the is the beginning of a…never mind. Next thing I know there is a logging truck roaring down the road, we flag it down, and luckily they have an air compressor on the truck and are able to fill us up and let us get on our way.

A Guyanese Arc

The landscape has now changed instead of dense forest it is rolling hills with grass and trees here and there struggling to survive under the hot equatorial sun,occasionally there would be a dense oasis that thrived in a valley where a supply of water settled. The mini bus treks along swerving around bumps and holes, avoiding anything that may threaten the structure of our precious tires. Then we come to a halt. There is a river in front of us. I think we must be here, and peer out the window looking for the hospital, only to see a few houses and an arc. I don’t know what the arc is for an I don’t know where we are headed. We all unload from the bus yet another time and stand on the shore of the river. A large flat wooden ferry pulls up and the mini bus backs onto it, we all load on the craft and, next thing I know we are floating down the river. I had heard stories of how long the trip to Kwakwani was, but I thought they were over dramatizations, people wanting to make it sound more grand than it really is, but now I know the journey to Kwakwani is a test of perseverance, a journey of crossing sand hills, weaving through forest, trekking across plains, floating down rivers, and wading flooded roads. At the end of it all is a small quaint white building with enough rooms to make it work, a simple courtyard, and one ambulance.

Checking a patient’s eyes

Not having a exact role on this trip I find myself working in the eye clinic with a wonderful young woman. I would take the patient history, while she meticulously measured the prescription of each patient with the fancy glasses and lenses she had (far beyond what I had used in eye clinics in Guatemala in the past). Her line was never ending and we saw as many patients as we could, taking small breaks here and there for a delicious lunch, and some small snacks. The day finally came to an end and we began the long journey back to Linden. The journey back was much less exciting as everything around us was pitch dark. I finally got home 10:00 at night exhausted and welcoming my comfortable bed and mosquito net. Persistence paid off, I slept well, and did some good.

Other moments on the journey to Kwakwani: