Being on the ship during the Togolege presidential elections is underscoring for me yet again just how isolating this life can be. I've always felt that we were living next to Africa rather than right in it, and the feeling has never been stronger than right now.
I mean, I understand why we're laying low, restricted to a very small radius of ship and dock. I understand the need for canceled shore leave and daily updates on the Captain's Board. In 2005 during the last presidential elections, there was widespread violence when the opposition party felt the vote was rigged. There are still refugees from that time living in a camp in Benin, so I fully understand the potential gravity of the situation.
What I can't wrap my head around is how disconnected I feel.
There are Togolese patients sitting in beds in the ward exactly forty-six steps away from me. (I counted on the way to work the other day.) I'm sure some are for Gnassingbe and others support Fabre, but we're on the ship, where politics can't touch us. The opposition party started to protest yesterday when it was getting obvious that Gnassingbe was going to win again, and police threw tears gas into the crowd and arrested several people. While all that was going on, I was sitting in my cabin, munching on fresh, homemade garlic bread and watching an episode of American Idol.
Because I can't be out on the streets right now, I can't seem to really fathom what all this means for Togo. I should care more. I should pray more. I lived in (or next to, at least) Liberia for ten months. I've seen what happens when democracy fails, when power corrupts.
But I'm lulled into this false sense of complacency, encased here in the steel hull of my world. The whole situation loses it's urgency when it's filtered through handwritten updates on a whiteboard. I'm right here, not halfway across the world, and still all I can do is read articles pulled down off a Google search. I want to be safe, but I wish it could be more than that.
As of a few hours ago, it seems that the official results are in and Gnassingbe has indeed won another term. The opposition has promised violence if this were to happen, so we'll hunker down for another day. We'll watch movies on our laptops and eat leftover pizza and drink tea with our friends.
Somewhere in the midst of all that, I'm going to try to actually understand that I'm right next to history being made. And I'm going to pray.
Here are a few articles about the elections:
From Wednesday, explaining how people have prepared and some history of the situation.
From Saturday, when both parties were claiming victory.
From Saturday, the tear gas incident.
This morning, the results are in.
Friday, March 5. 2010
be strong
We couldn't do it.
The discussions went on through the morning, with doctors weighing pros and cons and reviewing x-rays and trying to see their way clear. But at the end of it all, the message was delivered to me in the ward. It's a no. We can't do the spinal, and her condition's not bad enough to risk it under general.
And yet again I'm faced with the reality that where you are born so often determines the course of your life. Because this little girl was born in a village in West Africa, there was nothing that could be done when her parents saw that her leg was twisted. Because Togo has just one doctor for every twenty-five thousand people, there was nowhere to go, no way to have it corrected.
It feels so wrong that we started to show her a way out, allowed her to hope maybe for the first time and then were forced to pull that hope out from under her and pray that she doesn't break when she falls.
I could see the tears in her eyes when she left today, dressed in her Sunday best, the clothes she had picked out to come to the ship for the surgery that she isn't going to get. I watched her walk slowly down the hall, her head weaving side to side with the broken rhythm of her walk, and I wanted to scream. To beat my fists against the walls and rail against the unfairness of it all. But instead I watched her, watched her walk away with her strange, jerky grace, and I prayed that I could learn to hold my head just as high as she did in the face of disappointment and pain.
And as her hand came to rest for a fleeting second on her still-flat belly, I prayed that she would teach her baby to be just as strong as she is.
The discussions went on through the morning, with doctors weighing pros and cons and reviewing x-rays and trying to see their way clear. But at the end of it all, the message was delivered to me in the ward. It's a no. We can't do the spinal, and her condition's not bad enough to risk it under general.
And yet again I'm faced with the reality that where you are born so often determines the course of your life. Because this little girl was born in a village in West Africa, there was nothing that could be done when her parents saw that her leg was twisted. Because Togo has just one doctor for every twenty-five thousand people, there was nowhere to go, no way to have it corrected.
It feels so wrong that we started to show her a way out, allowed her to hope maybe for the first time and then were forced to pull that hope out from under her and pray that she doesn't break when she falls.
I could see the tears in her eyes when she left today, dressed in her Sunday best, the clothes she had picked out to come to the ship for the surgery that she isn't going to get. I watched her walk slowly down the hall, her head weaving side to side with the broken rhythm of her walk, and I wanted to scream. To beat my fists against the walls and rail against the unfairness of it all. But instead I watched her, watched her walk away with her strange, jerky grace, and I prayed that I could learn to hold my head just as high as she did in the face of disappointment and pain.
And as her hand came to rest for a fleeting second on her still-flat belly, I prayed that she would teach her baby to be just as strong as she is.
Thursday, March 4. 2010
fourteen
What do you think?
Dr. Gary asked me that question so matter-of-factly, standing in the hall outside the OR office. Like my opinion would count in all this confusion. Like I would somehow know what to do. Like anyone could really know.
What do you think?
The day had started out less than desirably. Today is the presidential elections here in Togo, and as a result there are travel restrictions and the potential for civil unrest. We worked with a skeleton crew of translators, only one for each ward, and brought all the patients we wanted to operate on through next Tuesday onto the ship yesterday. The result was somewhere around fifteen or twenty admissions, all in various stages of paperwork with no fixed plan as to when they would be going to the operating room. It's usually a big jigsaw puzzle around here; the elections just magnified that exponentially and the result was something that felt vaguely like chaos.
Among the things that slipped through the cracks from the admissions process was a pregnancy test on the little fourteen year-old girl in Bed Seventeen. Since everyone was pitching in and helping out, her nurse sent off the sample to the lab this morning, expecting to be able to call the OR and get her scheduled for surgery to straighten her leg when the results came back.
The lab technician slipped through the door a little while later, her face ashen. I just need to make sure this is the right patient. Please tell me it's not. We compared ID numbers with what was marked on the slip and confirmed the truth. My little teenaged friend was going to be a mama.
Which is where it all gets heartbreaking and where I'm not sure I'll sleep well tonight, thinking of her down there on the wards. Normally we'd just say no. It's incredibly risky to give a pregnant mama general anesthesia in the first trimester, so sometimes for small procedures we'll hand out an appointment card and some multivitamins and tell them to come back in a few months. But in a few months the orthopedic surgeons will be long gone and this little girl will be sentenced live life a cripple, her foot twisted and her leg bowed inwards.
So when I stood in the hall and explained all this to Dr. Gary, our Chief Medical Officer, all I wanted was an answer from him. Yes or no, just don't make me be involved. Don't make me weigh a little girl's future against the future of the baby inside her. Don't make me give an opinion when I can't see straight through eyes blurred by these tears. Don't let me help you decide, because what if we decide wrong?
What do you think?
In the end, I don't know what will happen. There are doctors and anesthetists and surgeons all consulting with one another, trying to come up with a way to do the surgery without general anesthesia, trying to find a way to give both these little ones a future.
And tomorrow, when I go back to work in the morning, we're all going to have to sit down together and decide.
What do you think?
Dr. Gary asked me that question so matter-of-factly, standing in the hall outside the OR office. Like my opinion would count in all this confusion. Like I would somehow know what to do. Like anyone could really know.
What do you think?
The day had started out less than desirably. Today is the presidential elections here in Togo, and as a result there are travel restrictions and the potential for civil unrest. We worked with a skeleton crew of translators, only one for each ward, and brought all the patients we wanted to operate on through next Tuesday onto the ship yesterday. The result was somewhere around fifteen or twenty admissions, all in various stages of paperwork with no fixed plan as to when they would be going to the operating room. It's usually a big jigsaw puzzle around here; the elections just magnified that exponentially and the result was something that felt vaguely like chaos.
Among the things that slipped through the cracks from the admissions process was a pregnancy test on the little fourteen year-old girl in Bed Seventeen. Since everyone was pitching in and helping out, her nurse sent off the sample to the lab this morning, expecting to be able to call the OR and get her scheduled for surgery to straighten her leg when the results came back.
The lab technician slipped through the door a little while later, her face ashen. I just need to make sure this is the right patient. Please tell me it's not. We compared ID numbers with what was marked on the slip and confirmed the truth. My little teenaged friend was going to be a mama.
Which is where it all gets heartbreaking and where I'm not sure I'll sleep well tonight, thinking of her down there on the wards. Normally we'd just say no. It's incredibly risky to give a pregnant mama general anesthesia in the first trimester, so sometimes for small procedures we'll hand out an appointment card and some multivitamins and tell them to come back in a few months. But in a few months the orthopedic surgeons will be long gone and this little girl will be sentenced live life a cripple, her foot twisted and her leg bowed inwards.
So when I stood in the hall and explained all this to Dr. Gary, our Chief Medical Officer, all I wanted was an answer from him. Yes or no, just don't make me be involved. Don't make me weigh a little girl's future against the future of the baby inside her. Don't make me give an opinion when I can't see straight through eyes blurred by these tears. Don't let me help you decide, because what if we decide wrong?
What do you think?
In the end, I don't know what will happen. There are doctors and anesthetists and surgeons all consulting with one another, trying to come up with a way to do the surgery without general anesthesia, trying to find a way to give both these little ones a future.
And tomorrow, when I go back to work in the morning, we're all going to have to sit down together and decide.
What do you think?
Wednesday, March 3. 2010
like, totally
The day started off a little strange today. It wasn't even eight in the morning when the orthopedics team started wandering into the wards. The surgeons decided that they wanted to do a few things before starting rounds, something we don't necessarily encourage because all of a sudden it's nine thirty and we're only rounding on our third patient. When they grabbed handfuls of casting supplies I was naturally curious as to whether they would really have the time for all that so early in the morning.
Following them over to the corner to find out what they were planning, I was more than a little surprised when Doctor Frank handed me a pair of gloves and a roll of fiberglass casting tape. You want to wrap some casts?
Not entirely sure whether he was serious or not, I accepted the gloves and headed to the side of Stephane's bed. The casts little Stephane had had put on in the operating room were split neatly down the sides to allow his legs to swell a bit without causing too much pain. Before he went home, he needed new material wrapped around the outside to pull the halves together and make the casts strong enough. Today turned out to be the day I would learn how to do that.
As Doctors Frank and Gary coached me through the process, I had that stupid grin on my face that comes when I get to do something new. It was when I opened by mouth to express my excitement that I made my fatal error, the one that was going to get me laughed at for the remainder of the morning.
This is totally awesome. Totally.
It was at this point that Doctor Frank underwent a sudden personality change and began talking like a valley girl. Every time he addressed either me or my friend Jenn, who was orienting to charge nursing with me today, he did so with a lift at the end of every sentence, his speech liberally sprinkled with likes. He spoke normally to everyone else on the team; only Jenn and I were treated to his head tilts and raised eyebrows, which naturally had us practically rolling on the floor with laughter.
I wasn't planning on learning how to cast this morning. I was also not planning to hear a grey-haired surgeon suddenly transformed into a valley girl.
If nothing else, this life isn't boring.
Following them over to the corner to find out what they were planning, I was more than a little surprised when Doctor Frank handed me a pair of gloves and a roll of fiberglass casting tape. You want to wrap some casts?
Not entirely sure whether he was serious or not, I accepted the gloves and headed to the side of Stephane's bed. The casts little Stephane had had put on in the operating room were split neatly down the sides to allow his legs to swell a bit without causing too much pain. Before he went home, he needed new material wrapped around the outside to pull the halves together and make the casts strong enough. Today turned out to be the day I would learn how to do that.
As Doctors Frank and Gary coached me through the process, I had that stupid grin on my face that comes when I get to do something new. It was when I opened by mouth to express my excitement that I made my fatal error, the one that was going to get me laughed at for the remainder of the morning.
This is totally awesome. Totally.
It was at this point that Doctor Frank underwent a sudden personality change and began talking like a valley girl. Every time he addressed either me or my friend Jenn, who was orienting to charge nursing with me today, he did so with a lift at the end of every sentence, his speech liberally sprinkled with likes. He spoke normally to everyone else on the team; only Jenn and I were treated to his head tilts and raised eyebrows, which naturally had us practically rolling on the floor with laughter.
I wasn't planning on learning how to cast this morning. I was also not planning to hear a grey-haired surgeon suddenly transformed into a valley girl.
If nothing else, this life isn't boring.
Tuesday, March 2. 2010
the fake-out
Little five-year old Jean Claude has more trouble than just the twisting of his left foot. We're not sure why, but he suffers from cerebral palsy. It's not always easy to get an accurate health history here; in North America mamas would be quoting Apgar scores back to us and citing down to the second the time their children were without oxygen. Here, it's a little foggier. We don't know if something happened at birth or before, but the result is our little boy in Bed Fifteen.
One look in his direction, and his face is transformed by the biggest, toothy grin I've seen in a long time. He shrieks his joy when toys are placed before him, rising up from his classic indian-style pose to rest on his knees and reach for whatever you're holding. He unabashedly grabs pens and cups and hair, and will nestle into your embrace like you're the love of his life.
We sent Jean Claude off to the operating room this morning knowing that he'd be much less pleasant when he arrived back. We're so used to seeing our happy, smiling kiddos transformed into growling bears, flat out on the stretcher when they're wheeled back from the recovery room.
Jean Claude tried to fake us out.
When the recovery nurses rolled through the door, my little friend was perched in the middle of the stretcher, sitting straight up with his newly-casted foot crossed over the other one. There were tear tracks down the sides of his face, but he was looking around at all of us, sharing small smiles from underneath the blue operating room cap that some kind nurse had tied around his head. From all appearances, he was absolutely unconcerned with what had just happened to him in the operating room.
His fake benevolence was short-lived. As soon as we got him into bed and left him in the charge of our pediatric orthopedics nurse, he took the first opportunity that presented itself to let us know how he really felt. With a small sigh, he flung himself face-down, his little body half off the side of the bed. His little blue hat floated to the floor, and I think it was only the new weight of his cast that anchored him to the mattress at all.
We posted a stricter watch over our little friend after that, and by the time I left the ward, I had only to call his name from across the room to be rewarded with his familiar wide smile.
I think Jean Claude is going to forgive us after all.
One look in his direction, and his face is transformed by the biggest, toothy grin I've seen in a long time. He shrieks his joy when toys are placed before him, rising up from his classic indian-style pose to rest on his knees and reach for whatever you're holding. He unabashedly grabs pens and cups and hair, and will nestle into your embrace like you're the love of his life.
We sent Jean Claude off to the operating room this morning knowing that he'd be much less pleasant when he arrived back. We're so used to seeing our happy, smiling kiddos transformed into growling bears, flat out on the stretcher when they're wheeled back from the recovery room.
Jean Claude tried to fake us out.
When the recovery nurses rolled through the door, my little friend was perched in the middle of the stretcher, sitting straight up with his newly-casted foot crossed over the other one. There were tear tracks down the sides of his face, but he was looking around at all of us, sharing small smiles from underneath the blue operating room cap that some kind nurse had tied around his head. From all appearances, he was absolutely unconcerned with what had just happened to him in the operating room.
His fake benevolence was short-lived. As soon as we got him into bed and left him in the charge of our pediatric orthopedics nurse, he took the first opportunity that presented itself to let us know how he really felt. With a small sigh, he flung himself face-down, his little body half off the side of the bed. His little blue hat floated to the floor, and I think it was only the new weight of his cast that anchored him to the mattress at all.
We posted a stricter watch over our little friend after that, and by the time I left the ward, I had only to call his name from across the room to be rewarded with his familiar wide smile.
I think Jean Claude is going to forgive us after all.
previous page
(Page 2 of 2, totaling 20 entries)
