Wild Wild West Africa

My sleep wasn’t as good as I hoped. The night was hot, and my mosquito net needed extensive repair. Duct tape worked as usual, but the holes in the net were pretty big!

The building is comfortable, there’s a dining table, a lounge area, a small kitchen, and a bathroom. There’s only 2 hours of electricity here each day, in the evenings. Running water has been broken for a few weeks now. The pump from the main town has stopped working, so water has to be fetched from the well. Francis, a local man, is paid to look after the house, and do all the other things. Thankfully, this means he fetches the water for the day, and does some cooking. I think if I give him money for ingredients he can buy it and cook it. There is a fridge that runs on kerosene, and a kerosene stove too. Somewhat seemingly out of place, there is also a fire extinguisher, and about a dozen bicycles (made in China). These bikes are destined for the community health worker volunteers.

I met with Dr Tom Asher today, with some of the nurses, and other important people from the Kamakwie Wesleyan Hospital, and other Health Unlimited staff. We chatted about my research project and when I’ll be starting clinical work.

I don’t think I’ve really mentioned what my research project is about, but here it is in a nutshell:
I want to find out what the local Limba people know and think about obstetric fistula, and what the barriers are to them seeking timely emergency obstetric care when they undergo prolonged childbirth. I’ll be conducting 18 interviews with people of the town, 9 women, 9 men. I’ll also be interviewing health staff, and maybe people who have had obstetric fistula.

To the non-medics, obstetric fistula is a problem, which occurs when the baby doesn’t come out of the mother very easily. The pressure from the baby’s head damages the tissue separating the vagina and bladder/rectum, and can create an artificial channel that does not heal. Women become constantly incontinent, isolated and ostracised from their communities. It really is life destroying. The research outcomes will better inform ways to educate women on this in the future.

In the evening I went to a village not far from here to pick up a goat, randomly! On the way back, the driver, Saidu, took me to get some palm wine! The place we went to was the chiefs house, which was a hive of activity, even in the night. People (mostly children about the age of 7) were drying locally grown tobacco leaves in a smoke room. The smoke room had rows and rows of tobacco leaves, strung up on wooden poles. It was housed a large thatched roofed building. Just under the thatched roof ‘veranda’ was a fire that was built to be very smoky, and the smoke was channelled into the room with the tobacco. The children were just stood there inhaling all this smoke in. Stanley, one of the guys hanging out there also runs the dispensary at the hospital. He spoke about the lung diseases that the children get, whilst producing this growing public health scourge, which is cigarette smoking. The other thing is the land taken up by this cash crop could be devoted to something more useful, such as rice, or cassava – but unfortunately, if this was grown, it probably wouldn’t be sufficient to sustain them through the year. I get the feeling there is a bit of a food shortage up here. The wet season is described as the hungry season because crops just aren’t ready to harvest yet. Groundnuts are always in season though, and many people head into the hills in the local gold rush. That’s another blog entry though. The palm wine when it arrived was a bit sour, and deceptively, didn’t taste as alcoholic as it probably was! I’d much rather a glass of malbec to be honest!