Border Crossings 3 and after….

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Have you ever paid a bribe? I think that I have, even if accidentally.

Some years ago I took 2 nurses and a fitter and turner with me to Benin. I was going to help  in a mission hospital there and they came with me for experience and short term service. Our trip took us through Rome then down to the Ivory Coast and across into Benin. The others were all young and had never been overseas. The French name of Ivory Coast is Cote d’Ivoire and the capital is Abidjan. The language of the country is French. The others of my group knew no French – I knew a little. On arrival there the airport authorities took all our passports and disappeared behind closed doors.

As departure time came nearer and nearer they did not re-appear, and all questions brought no helpful answers. Fearing that we would miss the plane, I went into forbidden territory and tried to get our passports back. For what seemed like eternity I was kept there and got nowhere in my desperate cause. Eventually some one came out and said that for US$10 he may be able to help us. Miraculously our passports appeared and we just managed to get on the plane and finish our trip to Cotonou the capital of Benin and then travelled up to the mission hospital in Bimbereke, where we spent some weeks.

Africa trip
Rome to Abidjan to Bimbereke

There were some of the foreign mission people who basically spoke only French but most of the hospital staff spoke had a sprinkling of English. The patients spoke their tribal languages and many some French. The foreign nurses were European and I found them difficult to work with. The Beninois hospital workers I found relatively competent and helpful. I think that the foreign nurses had been trained in situations where they were protected from overwork by ‘union’ rules. The Beninois workers were employed on a fixed time basis and so were, even without a union behind them, not expected to go beyond their hours. There was a plentiful supply of them. There were not enough foreign nurses to allow them to work for only 40 hours per week.

Previously I had worked with Aussies, New Zealanders, British and American nurses and they had all gone the second and third miles to help their patients. In this place I found myself often locked out of the ward office until it suited them to allow me in.

That geographic area has some pelvic tissue abnormality or weakness as I saw it. They had many patients with procidentias (uterine prolapse) even after their first delivery and I have never seen so many hernias of all varieties. They had been keeping people in hospital after hernia surgery for 14 days. This was ill-advised medically and tied up the beds when there were many waiting to jump into them for their surgery. It did, however, limit the nurses work load as a recovering postop patient needs less care than a new case. Of course some who had come in obstructed or worse needed to stay longer but I began to discharge routine patients on day two. I think that the nurses were glad to see my back when we left, but the young nurses with me had been magnificent, and the fitter and turner guy had succeeded in getting a lot of stuff working again. NB most hernia patients in the West these days are treated as day cases!

The hernia below was an abnormally  large long-standing umbilical hernia and some internal organs had to be resected to get it closed. He was a very satisfied customer!

hernia

The workers did need a little supervision and training. I remember coming into the hospital one morning and finding a young man with an obviously broken leg. He had neither had pain relief nor any splinting applied. When you examined the leg you could hear the noise (crepitus) of the bone ends rubbing on each other. Asking why they hadn’t been more active in their treatment I was told that they didn’t think that it was broken as he didn’t complain of pain. I wish that some patients were a bit more stoical but that takes guts to grin and bear it like that.

Dominic Cartier

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