Its Sunday morning 8 am and I am lying in bed relaxing, It's
difficult to doze as although the sky is blue there is a persistent roar of not
too distant thunder. Military jets are exercising, probably French as they are
the noisiest, circling over the city.
You would think they would take one day off each week and why not the Sabbath?
In fact Yom al Sabit (
Chadian Arabic ) was yesterday, its timing in the week, and the words themselves
make clear the Semitic roots of the language. Sabit is so close to Sabbath and when you hear Yom Kippur ( the Day of Atonement)
do you think of warplanes , always
butting in as above or goats? Google it and see what you get.
So if today Sunday is not my Sabbath rest, (I am on call and
have to do a ward round), what did I do
with the actual Sabbath yesterday?
At 7:30 Andrea woke me to let me know that she couldn't
contact the anaesthetist, his telephone was clearly resting and not
available. The wife of one of our guards
needed a caesarean and I stood in to put
her to sleep. The 4 kg baby boy was
delivered and by 10 o'clock I was back at
the house having a quick breakfast and coffee before getting on with the day's
work.
On the mens ward there
was only one man with heart failure ready to go home, he left and was replaced
by semi conscious man with malaria from the Emergency Room. Another
man who had a definitive amputation of
his hand a week ago came in for a dressing ( he was trying to prise open an old
hand grenade with a knife, don't ask why, he initially claimed it was an
exploding cigarette lighter). There were five empty
beds, the sixth bed had been put on the children's ward.
There were three
women on their ward, one with heart
failure due to rapid atrial fibrillation , a second with liver disease (cirrhosis
and bleeding varices) needing a blood transfusion,
and the last after a mastectomy for breast cancer. There should have four empty beds , but there was only one. Another had been taken into the children's ward, and once that room really was full the children's ward overflowed into the women with the presence of a new child
with malnutrition and one who was getting better quickly from her severe malaria.
This month children's
health is at more serious risk than ever, and this year we are prepared for it. Last year's
autumn harvest is a long time ago and the next one is keenly awaited, the rains
fall a source of benediction. in the
meantime food is short and malnutrition common in the under 5's. But the same
rain makes the puddles and the mosquitoes flourish in the puddles stagnant
water becomes a curse.
There were five more severely malnourished children on the children's
ward, some wasted and stick like, others bloated with retained water and
peeling skin. All are on the intensive
feeding program, and if the families can spare the time they can be cured. An
older girl who had been profoundly unconscious for 5 days with cerebral malaria
had amazingly opened her eyes and said a
word to her mother. Another 7 year old clearly had tetanus, all his muscles
have gone stiff, it wasn't obvious the
day before. So he was immediately
transferred to a single room for ant tetanus serum, antibiotics and sedatives.
Finally there were two surgical cases from earlier in the week a girl with a
perforated gall bladder and peritonitis which
I presume occurred during the convalescent phase of typhoid, she was doing well:
and the other another with a bowel
obstruction due to an internal hernia through the small bowel mesentery.
It's an unusual and interesting
mix of cases for one doctor and it is
great to see so many getting better.
By 2:30 I was home for lunch and I got a bit of rest between
calls to the Emergency room and checks on the sickest patients. . The evening
was calm and we sat down as a family to watch the current favourite ,Call the
Midwife, on the computer. I am not sure if it counts as recreation or continuing medical education
after all the day had that started with 'Call
the Anaesthetist'. So the Sabbath was a
quieter day with no non essential work but not exactly a day of rest. It was our 6th consecutive days of 24 hour on call, only six more to go until next Saturday which
really will be a day of rest , Yom al Sabit.
PS A little time for Arabic,
I think I'll learn the days of the week
