Some Medical Emergencies

October 6, 2010 Friday

We received a couple of calls requesting help for an elder who has had some struggles here and wanted to return home to South Africa. He is serving in the most distant part of our area—the branch where we had such a frightening experience with the muddy roads. We were in Sacrament Meeting here in Kitale when we saw a flurry of activity within the small congregation. One of the elders assigned to the branch we were attending came to Neal with a message he had just received on his phone. At the same time, someone approached the branch president at the front with a message.

The elder in question was in “serious condition”, and people with him were very worried about him, and could we come at get him immediately and take him to the hospital in the town where we live. It would take us an hour to get up there and an hour back if the roads were perfect. We prepared to leave immediately.

Then we received another call saying they had found an “ambulance”. We’ve only seen one ambulance ???? since we got here…a rickety, rusty old van, and that was in Nairobe…never one out here. Nevertheless, the “ambulance” with the doctor, was to bring him down. We went home to prepare to meet him at the “hospital”….supposedly, the best hospital in this area as opposed to the District Hospital for poor folks, which the natives tell us is terrible. When I talked to our househelper about the District Hospital, and she said it was so bad; I asked her where she would go if she was sick. She said, “The District Hospital, because we have no money.”

Neal and I mulled that over for a long time. How do you live, knowing, if you ever get sick enough that you must go to the hospital, that you are going a place that may very well make you much sicker than before you went. Consequently, they go to the hospital very rarely and just try to live with cuts, and illnesses until there is no other recourse.

So, we are waiting to hear that they have arrived at the hospital. About an hour later we get a phone call from the elder’s comp (who is the District Leader by the way), who says, “We are in Sikhendu at the market standing on the road waiting for you. The ambulance just dropped us off! “ WHAT! Sikhendu is a good ½ hour away from us. Just another example that we don’t really understand what is going on. We think we do, but we don’t. So, we picture the sick elder to be lying prostrate in the mud in the middle of the market.

We drive like mad and sure enough there they are standing out like angels amid all the chaos of the market—white shirts blazing. We load them into our truck. We have no idea why the ambulance only came that far and then dropped them off.

The symptoms: fever, headache, seizure-like rigidity and curled, claw-like fingers, high heart rate. He had been treated for Malaria 2 days previously. He didn’t act very sick, but then what do we know. We drove to the “good hospital” according to the companion. “It is very good. Much better than the District Hospital”, he assured us. Only the rich can go to this one. We really had a time finding this hospital, traveling back through some really muddy, slippery, and deeply cut roads with great hills of mud and then big descents into potholes you could literally be buried in.

We pulled in about 1:00 PM. It was pouring rain and so muddy to get to the door. It rains every day here. The hospital was very dirty and dark, with wooden floors and moldy, peeling paint everywhere. The medical equipment in the one room looked pre-World War II vintage. The toilet was a sight to behold—however, better than the one in the Philippines, which had no seat. The hospital reminded us very much of the Philippines, except there were only I think, 2 patients in this hospital actually in beds. We were told it is because it is so expensive to come to this one so few patients come here. The District Hospital is packed, however.

There was a single, backless wooden bench, which had at one time had a cushion, but now had stuffing only on the edges with a ragged hole in the middle so the luckless patient who got that section sat on the wood. It was about a yard and a half long, and five of us crowded onto it. The others had to stand.

We waited probably ½ hour before the elder was taken in. We saw only 3 hospital personnel the entire time we were there. All were dressed casually. The doctor talked with the elder and wrote his diagnosis and treatment in a small notebook the elder had brought with him from his former treatment 2 days prior. The doctor told him he needed 2 shots and 3 kinds of medicine, to go get it at a chemist and then come back. Neal and the District Leader ran through the rain across the parking lot to the pharmacy/chemist nearby. They only had enough medicine for one shot and one dose of the one medicine. While they were gone probably another ½ hour, a young man came and grabbed the doctor, and they took off.

The nurse gave the elder the shot in his hand and told him he needed to go find a chemist somewhere else to get his other shot and medicine later and for him to go out and wait in the hall until the doctor returned. We then began to wait and wait and wait.

I shared the bench with a woman I’m positive must have had pneumonia. She sounded like death and looked it. I tried to commiserate with her, but she didn’t understand me. After about 2 hours, she and the 3 people with her, plus another patient with her partner, who had been waiting before us, eventually all left because no doctor appeared.

We tried to call the doctor over and over—but no answer. The nurse said, “The doctors do not answer calls from new patients.” So, we tried to get her to call. She did many times, still no answer. So here we are in a dark, dirty hospital with no doctors available, and 2 female attendants to help us, who can’t read the diagnoses nor the medicine the doctor wrote down. Finally, we decided to leave about 5:00PM. The doctor never came.

We drove again through the rain down into town to try to find a chemist open on a Sunday night. The market closes regularly at 6:00 PM, so the town dies at that time. We fortunately found a chemist open. The pharmacy looked like a hotdog stand with an outdoor counter running the length of the storefront and medicine lined up on the wall right behind the counter. The elders hugged this counter to get inside the overhang so they wouldn’t drown with the rain pouring in torrents on top of them.

When they finally got back into the car, the sick elder was moaning and really acting like he was in excruciating pain. Apparently, the clerk had taken him back behind the counter and given him a shot in his upper arm that was absolutely terrible. He moaned all the way home with the pain and still suffered with it later. We were shocked again by the way the medicine…a shot…was dispensed right there on that filthy, dirty street. The next day, we received word that the elder was going home.

He and his companion called us that night and asked if we would either come up and get them then or come up the next morning to get them so he could catch the 8:20 AM bus to Nairobe and there get a flight to Johannesburg. We are very nervous about that road—particularly in the dark. (It is against mission rules to drive in the dark here). That road is terrible in the light because of all the big deep holes and sliding in the mud, add to that the donkeys, chickens, dogs, people, parked vehicles , and moving bikes, motors, and cars –some without lights….It is just terrifying. So, we opted to get him in the morning.. It is an hour drive one way in good weather.

We left at 5:15 AM…It was still dark, and we just prayed the rain to be slight, which it was. We were able to get him down to the bus station on time. We were so thankful, but so saddened to see him leave. The President had really worked to try to keep him here. I think the straw that broke his back is that it had been raining and raining and raining for several days, and the elders travel by being pedaled on someone’s bike or by riding on the back of a motorcycle. They tried to get a ride in the rain back to their apartment one day prior to the medical episode, and no one would take them because it is too scary on those muddy roads to ride a motor.

Finally, they found someone who took them, but charged them a lot more, and then would only take them about half way back to their digs. Then they had to slog through the rain and sticky mud for a long, long distance to get home. The elder entered the house, already having been discouraged for several months, and just said, “That is it. I’m going home!” Then he had this medical episode the next morning.

ANOTHER MEDICAL EMERGENCY About 2 weeks after we arrived in the mission, we were attending Church, and the 2^nd counselor in the branch presidency asked us to come to his home. His wife was home sick (pregnant), and he really was adamant that we go home with him. We didn’t understand why. We couldn’t really understand him very well, but because he was so strong about it, we took him home, still wondering what he wanted. He is about 28, very nice looking young man, convert of about 5 years.

We finally decided maybe he wanted us to come out to see his home because it is cement and nicer than some of the others, although it is very, very small…again no place to walk in the room, just furniture in a very confined space. When we got there his wife, Nancy, was sleeping on one of the couches. We still didn’t know why we were there, and I finally asked if she needed a blessing. Neal and Nashon (the husband) gave her a blessing, and we left. It was very difficult to get to their home. You must go up a short , very muddy incline that is entirely ripped up with great gashes and almost a stream running down it. The incline is very narrow and frightening to get up. Once on top, it is just a swamp of mud. We did remember that trip up.

Last week (this is about a month later), we saw Nashon far across town from his area while we were visiting in the home of another member. We asked about Nancy and her impending delivery.

During this conversation, we were sitting in the middle of one of the Kitale slums, in a clay house in an alley with 10 of us in a teeny room, sitting on top of each other. There was no light in the room except when the cloth hanging from the door blew open. We could not see each other’s faces because it was so dark. Loud music was blaring down the alley (I kept thinking,”This sounds like the midway of an amusement park,!” This loud music goes on all day long, and people from the village quietly stood and stared at us all the way from the car to the opening of their home.

We were talking about labor and deliveries. The mother of this home was explaining to Nashon that he needed to be prepared to deliver his soon-to-be born baby, and that she and her husband had delivered one of their children right there in that room. I asked how this was done. I couldn’t see a place where anyone could lie down there. The husband said, “Oh, it is easy. You just get two pegs (clothespins) and place them here and here…”(he demonstrated) “and then you take this razor…” it had been sitting on the arm of the chair in which he sat, “and cut between them.”

Nashon shook his head and said, “that isn’t going to happen. She is going to the hospital.” Sister K. said, “You can’t be sure. You don’t know when it will happen. You may not be able to get her there.” He strongly disagreed. I said, “Do you know how to deliver a baby, Nashon?” He shook his head and just wouldn’t consider any other alternative. Then he said Nancy was due any time, and that “you (pointing to us) will come and get her and take her to the hospital when she needs to go.” “WHAT!” We said, “We don’t know where you live.” He said, “Oh yes, you do. You were there before, a few weeks ago.” Right! We don’t have a clue where he lives. We always marvel that we THINK we understand what is going on, but we really don’t. There are always expectations that we don’t understand nor even realize.

So, we took him home that day and tried to remember where they live in case we might have to return some time on the off-chance that there may be a midnight ride. Yeah right! That will never happen!

Last night, we got a phone call at 12:30AM. It was Nashon saying Nancy was crying and could we come right now and get them because they had no way to get to the hospital. No bikes or motors or matatus run anywhere close to their house. It was pouring rain and soooo muddy!

We hurried and began driving….it is so scary at night. We were really nervous about his inclined hill. It was every bit as bad as we had remembered, but the Lord blessed us to get up it. We drove past a couple of mud walls unsure of just which one was theirs. Then we saw him.

He was standing by his gate in the rain. As we pulled up, three women approached the car with him. He kept yelling that he would get in the back of the shell of the truck. Nancy got in first, crying and moaning and gasping…then a woman with a wash tub and some towels got in and finally Nashon because we couldn’t get the back open, and it was pouring….the other lady must have gone back in the house.

(In fact it was so dark, I didn’t know there was another woman until Neal told me later). It was a rough road back down, slipping and sliding in the rain and mud , and Nancy crying and moaning and speaking loudly with the woman in Swahili or their native language which may have been Luao. We finally got to the District Hospital, an awful place…dark and dirty…only one fluorescent light in the entry. They got out and we left them knowing if we went into the building, they would be charged 3-4 times what the fee would have been ordinarily for them. We are still waiting to hear what happened. We called the branch president this morning, but he hasn’t called back.

We couldn’t sleep when we got home. We kept wondering what it would be like toanticipate labor and not have transport to get to the hospital. To worry about what delivery will be like and know that you will either have to face it alone in your home or go to a facility that may cause you more harm than good. How much faith these women must have to face those odds…. It just is beyond us.. Absolutely beyond us.

It reminds me. The same day we were in the slum area (THEY call it the “slum”. It is not a derogatory term for them as it would be for us, even though it looks like parts of New York City in that there is garbage everywhere and dogs, etc.) visiting the family with the razor blade, we were leaving town and Nashon said, “There’s Sister R______ bending over in front of her house.”

We had visited the R family the week before. Neal wanted to stop to go talk to her, but there was no place to park on the edge of the path where we were driving because of the big deep drop offs to ditches on either side of the narrow, muddy road. People stood everywhere watching, watching our every action.

We had a young girl in our car, so I stayed in the car with her, while Neal and Nashon ran back to see Sister R., just to say,” hi.” They were gone for about 15 minutes, and when they returned, Sister R. came with them, a little upset with me. We shook hands, and then, “Why you refuse to come to see me! Why you stay in the car!” she demanded. I tried to explain because we had the girl with us. She was clearly a bit miffed with me. Then she explained that she hadn’t been feeling well because she is suffering right now with Malaria and Typhoid. There we go again, expectations that we don’t understand. We THINK we understand, but we HAVEN’T a CLUE!