B ward

Over the last few weeks I have continued to mainly work in B ward, where our patients are all VVF ladies. I really enjoy working on this ward as these patients are here for much longer than many of the other patients, so I have a chance to get to know them. They are a fun group of ladies. There is Elise, who came several weeks ago and barely cracked a smile for the first week. Now, she is always smiling, and likes to have one sided conversations, where she will rattle off to you in her own language, and walks away content, having unburdened herself, somehow expecting that you have understood everything she said. She started to leak urine a few days after her surgery, and sadly the follow up tests showed that her surgery had failed. Then there was Bed 11, a one-armed, deaf and mute woman, who nevertheless managed to always be in the thick of things and who also did not let these considerable communication barriers stop her from getting her point across. What this woman could say through the use of her one arm, and an amazing array of facial contortions still amazes me. Once or twice a week a dress ceremony is held on the ward. The women who have been discharged and whose surgeries have been successful are given a dress, and some jewellery and then they come clapping and singing and dancing onto the ward, and after some singing and a message from one of the disciplers they each have a chance to tell their story. It is a joyful time, a time to celebrate, and a chance to say goodbye.

However, the women who are discharged whose surgeries have failed just quietly leave. We had one patient, Josephine who has been on the ward for weeks. I remember her always smiling and laughing and helping out in little ways. Our conversations mainly conisisted of Ca va? Ca va bien! and a smile. She had the habit of praying under her sheets in the wee hours of the morning. When I came to work for my last night shift this week she had been discharged. I will always wonder how her story ends. Will she have the chance for a repeat surgery? (the Africa Mercy is going to Togo next year, which is next to Benin, and some of the women whose surgeries have failed have been referred to come back next year, if they can make it to Togo). Even though I did not have the chance to say goodbye, my prayers go with Josephine.

where the streets have no name

Ok, if you look at a map the streets do have names, but when walking around Cotonou, I have yet to see a street name. I am slowly becoming familiar with the layout of the city near the port. I have two routes down pat, one route to an icecream shop, and the other to the Hotel Du Lac, which has a lovely pool and a restaurant on a terrace overlooking the river. I ventured off to the craft market the other day with 2 of my roommates, one who had a pretty good idea of where it could be located...we wandered through some nicer areas of the city on our way there. Here you can always tell when you are in a more prosperous area or passing a pricier shop by the guards posted outside. I also visited the main market in this city, Marche Dantokpa. This market is absolutely enormous and easy to get lost in. On the way there we wandered along the main fabric street in Cotonou where there are oodles of fabric shops, and as you walk along each store owner waves you to come in and see his goods. I was surprised to see that most of these shops were owned by Lebanese. Apparently,there is a very large Lebanese population in West Africa. We spent over an hour on the fabric street so by the time we arrived at Marche Dantokpa we had to head back to the ship as I was working that afternoon. I did barter for some fabric though (from 18000 CFA to 13000 CFA...pretty sure I still overpaid but I am still a fledgling at the bartering game). To get around on foot anywhere in this city you must become adept at darting through traffic. My trick is to attach myself to a group of locals crossing the road as they seem to have a better idea of when to safely cross the road. The odd thing is that you might be standing on a median thinking you are quite safe from the traffic when someone will decide to park where you are standing and come flying at you anyways. Ah, for the days of crosswalks and pedestrian lights.

Night Shift

I've just finished working 4 night shifts on the VVF ward and think I may have reached my quota on emptying catheter bags (8 patients with 8 catheters x 4 nights...alright I'll stop my whining). Work can be busy and often feels just like back at home but every once in awhile something hits you to remind you that oh yah, I'm in Africa. Like a set of bongo drums in the corner of the ward, or the fact that everytime the women get out of bed to go to the toilet they cover their hospital gowns with a wrap skirt. There are less translators around on the night shifts plus many of the women speak languages that the translators do not speak also, so I am rapidly expanding on assessing my patients using gestures rather than words...facial grimacing with lots of nodding and pointing. Some of the more unique habits some of these women have include a lot of spitting into paper towels or kidney basins they keep at their bedside...haven't quite figured out why they don't just swallow. I have found that flip flops are more comfortable on the night shift...but I may again have to reassess that as I managed to step into somebodies spit dish on the floor as well as dribble far too much urine upon my feet while emptying those catheters...but on the positive side feet are easier to clean than runners! But despite the little night to night hangups it has been a privilege to spend the past 4 nights caring for these women who have been through so much. I had a chance to sit down and read a little more in their charts about their histories, and it is quite incredible what many of them have had to cope with. I have already written before about how many of their husbands leave these women once they develop fistulas, but also a lot of the women were in labour for 5 to 7 days ending in a c-section and the death of the child. Yet still they smile and sing and pray and are a lot of fun to care for.

Sisters of Charity

This morning I went with a group off the ship, once again braving the Cotonou traffic, to visit an orphanage run by the Sisters of Charity (if I remember the name correctly). There were about 20 toddlers and 2 four week old babies here. Many of the children are abandoned children and also a few handicapped children that the parents were no longer able to care for. On the positive side about 60% of these children are adopted by people within Benin! When we arrived a lot of the kids come running up with their arms in the air waiting to be picked up. The challenge is they don't want to put down again. Some of these children are HIV+. I think I found that the hardest part of this visit. I have cared for HIV+ adults before but there is something so sad about seeing a tiny child bearing the same burden. We spent a few hours playing with the kids and helping to feed them lunch before, dripping with sweat from the lovely temperatures here, we called it a day and returned to the ship. It is supposed to be the rainy season here now, but so far we have not had much rain at all. The air conditioning on the ship wasn't working for part of the day yesterday, and boy am I ever glad we have air conditioning, as it is stifling on the ship without it! Ship life definitely is a unique way of life, but I love just sitting by a window relaxing and watching the ships all around. There is always a group of ships on the horizon. Apparently these are ships waiting to dock in Nigeria, but as Nigerian waters are not as safe and do have some incidents of piracy, these ships prefer to wait in the waters off of Benin!