Focus!

“It’s time to focus! All I ask of you is to focus. (...) When you go to the floor, focus on your core!” While looking straight into the camera, with his perfectly toned body and American enthusiasm (“How are we feeling? Amaaaaaazing!”) Shawn T from T25 workouts is directing our every move. When early sunsets and long shifts don’t give us the opportunity to go out running (which is more the rule rather than the exception), this is our way of clearing our minds from hospital matters. With the increasing heat and the humidity of nearly 100%, we look like two dripping monkeys jumping around in our living room. “Don’t run from the work, FEEL the work!”

Before our two-week leave, working was basically all we did. The doctors able to do obstetrics and gynaecology had reduced to just Inge and me, so we alternated 24-hr shifts without compensation and followed by busy days. During March a German gynaecologist joined us, but soon the word of mouth travelled and only more patients kept coming during the day. At night she was our back-up on call, but fortunately she did do some night shifts to relieve us a bit. Our focus was on keeping the labour ward running, little energy was left to do that little bit extra for patients. Or anything else but sleeping, really.

Although our focus was on the patients, too many times the focus of the family members wasn’t on their daughter, sister, or wife. A young woman with a pregnancy outside her uterus (an ectopic pregnancy) was bleeding heavily in her abdomen and in need for emergency surgery. However, to do a surgery on a woman it is not her consent you need, but that of a male relative. In this case her father refused the surgery, even when we offered it free of charge. He thought it was not necessary for his daughter to get such a treatment, especially because his son had broken his wrist, so she had to be home and take care of him. Though clearly she did want to have the surgery, and was well aware of her situation, I pleaded with the hospital owners to just grant her wish and do it. They agreed and I was standing ready in the OT, but eventually the woman herself decided that going against her family also meant having no life, so with tears in her eyes and a haemoglobin level far below the transfusion level they took her home against medical advice.

The same day the family of a woman who lost a lot of blood during labour refused to bring blood from a hospital a few hours away (we don’t have a blood bank, only a few pints in stock). It was not that they did not have the money, or the time, or... who knows what. They just did not care. Ironically, at the end of that day I realised it was International Women’s Day. 

In case some of you are still imagining a romantic life in The Tropics for me, including sunset drinks and lazy sunbathing, I would like to tell you that summer indeed has come. But summer in Makunda means not only heat but more so rain. And lots of it. And then even more. And then just a bit more. The tin roofs make it sound like it’s raining rocks instead of water drops, and make the whispering women inaudible. The roads to the hospital get washed away and turn into mud waterfalls, but nonetheless the women come dressed in their colourful sarees and look as if nothing has happened.  

It also makes the phone network very unreliable and often non-existent. And this is where Kaku enters the scene.  Kaku basically means ‘mister’ and can be said to any man, but in this context it is the watchman. If there is no network he will run to our house in the middle of the night with a small note from the nurses: “Dr. Geerte ma’am, we would be very pleased if you come. Thank you.” Then he runs through the rain to all the houses of the OT staff if we need to do a caesarean (fortunately I have not had severe foetal distress during really bad weather... don’t want to think about what will happen in that case), and lends me an umbrella to cross the uncovered corridors in the hospital on the way to the OT. Kaku saves the rainy days.

The rain also brings a lot of fungus. On the patient’s skin, on vegetables, on our clothes, and even on my laptop cover. But before you start to think life is grey and depressing here in Makunda, the good thing about tropical showers is that after the rain almost always comes the sunshine.

PS. see below for some pictures of our really nice holiday and Guido’s visit (yay! so good to have him here!)