Sunday 18 August 2013

Yom al Sabit (the seventh day)

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
 

Saturday 3 August 2013

Casual Conversations


 
Earlier this year coming back from town through the streets of Guinebor  some women waved asking for a lift. They were carrying their shopping home and were happy to be helped the last mile or two home. The conversation was very limited

Me :    Assalaam alekum                            (peace be with you/hello)
Women:   Alekumm assalaam                  (peace be with you/hello)
Me: Tamci wen                                              (where are you going)
Women:   Namcu fi luptaan americanno  ( we are going to the american hospital)
Me: Arcaabu                                                   ( Get in)

Not much more to say really, about the limit of my Arabic, but they then decided to try their English on me

Women:   you american, you speak English
Me: I am English/ British
Women:   Grande Bretagne! Tony Blair, King Elizabeth

Lots of laughter and smiles,

And with that we arrived in GuineborII , and they got out
Women:  Chukran katir                                     (thanks a lot)
Me :   Afwan                       (thats OK)

 I never did find out what they thought of Britain, Tony Blair or King Elizabeth, but they seemed happy enough, at least they weren't scowling. As for the monarchy I  amazed that they knew it existed.  They are probably still laughing about the white man who stopped and asked a 3 women, where are you (singular) going as If I only wanted to take the first one. ( Tamci should have been tamcu). Or perhaps they haven't even thought of it at all.
A trivial encounter, but a point of contact all the same, Jesus knew how to take such a cross cultural situation , (asking for water at a well), and speak of something profound, the essence of life.

Can it be done  here without causing offence? Would it be understood?  We would need the language  first.

We are back in Chad after a visit to the UK for a holiday and a retreat. , Ruth and Rebecca are enrolled in a Chadian Arabic course 4 hours each morning for 5 weeks, the rest of their summer holiday,  We are trying  to  speak some Arabic each evening and are managing to do so as the hospital is very quiet due to the fasting month of Ramadan and the annual rains.
 Last week when I asked if there was anything to share at the morning staff meeting, Moussa a Muslim nurse congratulated me on the arrival of a new Prince In England. Thanks very much I replied, it was good to be informed  but I hadn't been looking for the news, because unlike the crowds outside the palace in London   I am more interested in royal babies that are born in a stable.

I wonder what Moussa made of that, and you?