Monday, April 27, 2009

SCENES FROM KHARTOUM - I

SCENES FROM KHARTOUM
Part I

THE HOSPITAL:
This is a glimpse of the things I’ve seen in the past 24 hours. And when I say “glimpse” I mean that literally because most of it was through my peripheral vision to avoid eye contact.

Yesterday, I went to the hospital. Generally, when you’re not sick, a visit to the hospital can be extremely annoying or highly amusing, I chose amusing.

Being in what I have estimated as the middle of my third pregnancy, I judged the time adequate to visit the doctor. Since beggars can’t be choosers[1], I drove to the nearest hospital and registered with the available OB/GYN.

If you know me, you will know that I’m not the type to chat people up in the waiting room. Being forced to wait my turn in a hot corridor, I thanked God and my husband for my iPhone which came equipped with an unlimited number of time killers. So, between various games of Domino and Chuzzle, in addition to texting an old friend, I sat – leaving only to complain to the desk about people cutting lines. The man assured me that the two offenders were the doctor’s cousins (welcome to Sudan) but he placed one firmly after me on the virtual list.

After about 45 minutes, which I considered reasonable by local standards, I entered the[2] treatment/consultation room. The doctor got up, but only to usher in the rejected cousin.
As the cousin explained that she got an unexplainable fever at night, as an avid fan of “The Doctors”, I was thinking “hot flashes?” “Pre-menopausal?” but in simple terms, the doctor told the blushing[3] bride that her body was getting ready to have babies “ovulating!” I agreed, but I’d never associated that with a fever. After discussing this fever at length, suspicions, times, intensity, locations, etc. and as the patient was getting ready to walk out, she added, “oh and there are these” showing the doctor her arm, “Herpes!” she exclaimed, “WHAT?!! WHAT?!!” went the silent me. “What’s that?” asked the innocent bride from behind her veil[4], “A type of virus,” was the calm reply from the doctor who had managed to collect herself”. She wrote out a blood screen for the lady and turned to me. I actually managed to avoid comment, and proceed with my exam. And to answer the implied question, I really don’t think she washed her hands but I didn’t see her touch the lesions either, but what do I know?

A few hours later, I found myself in another corridor equipped with powerful fans that were uniformly distributing the heat so no one felt left out. This time around, the virtual list had a myriad of people with one very vocal lady who had taken on the role of patient advocate/hospital watchdog/nagging whiner.

She explained to the world at large that she’d passed her due date by 2 days, and the doctor wasn’t doing anything about it. In her opinion, the doctor should induce labor, like the other doctors in Jordan did, when she had her first child. She wanted to know why the ultrasounds were taking so long. She wanted to know why there was only one machine in the hospital. She wanted to know why there were men waiting for the ultrasound. She wanted to know why there were old women who were clearly not pregnant waiting. She wanted to know the “month” and order of pregnancy of all the women in line.
She wanted to know when the doctor had started his shift and what he’d been doing before that. She wanted to know why the power extension cord went out of order, and, I quote, “what kind of doctor short-circuits an extension cord[5]?” when she heard the reason.
She wanted to know when everyone before her in line came to the hospital and where they’d been before they came to the waiting corridor, and why they were watching TV in the reception while others waited in front of the examination room.
After all the above, she would go back to her main theme that she was two days, TWO DAYS, past her due date, and the hospital wasn’t doing anything about it.

I was replying, mentally, up to a certain point that it got too much and I made the colossal mistake of speaking out loud. Okay, maybe it wasn’t a mistake, just me thinking I could entertain myself and kill the time since I wasn’t going anywhere in the foreseeable future.

I started by telling the lady that two days after the due date is perfectly normal, and the doctors will wait up to 2 weeks, “10 days, she tells me” not sure whether to brand the doctor or myself with ignorance. “10 days is reasonable, the main thing is to make sure that the baby is safe and not in any form of distress”. In Jordan (the equivalent of medical heaven in Sudanese culture), they found my water was 1cm less and they induced labor”. I am no doctor, but 1 centimeter? Where did that come from? “The doctors check the water[6] to make sure that the baby is getting nourishment, so if it’s good, the baby’s fed, if it’s not, the baby needs to come out”.

To emphasize my credibility and add a personal touch to my rhetoric, I also delved into my personal experience with the first two pregnancies, answering her queries about how late the deliveries were, who my attending doctor was, and what prompted induced labor.

“So, it’s all about the water?” she asked. “Well, your health, the health of the baby, pulse, etc.” I said. “What if the water is good and the baby comes out?” I actually managed to not scream. “When you’re ready to have the baby, your water breaks that means the baby is ready to come out”. At this point, the woman lost interest in the conversation, she was running out of comebacks and she wasn’t looking good to her audience of choice, so fell silent for a millisecond.

“I want this baby out!”
“Why?” I chided to everyone’s amusement, “It’s hot, there are daily blackouts, and the baby’s comfortable where he is.”
“I want to get this over with”

Any woman past her due date knows exactly how this feels but I wasn’t in the mood to sympathize, I was enjoying my unofficial role as medical expert and devil’s advocate – besides the woman had annoyed the crap out of everyone (meaning me). However, I understood that her anxiety stemmed not from the fact that she was desperate to see her unborn child or had grown tired from carrying the extra weight around but because she had a whole production in place that she wanted to get started.
Sudanese culture encourages birthing mothers to plan and execute an extensive presentation for the new arrival. This ranges from changing the furniture, curtains and flooring, buying a new wardrobe of lingerie to present herself in, changing all the gold accessories that she will wear 24/7, regardless of how painful they are and the potential harm they will cause the baby (in my humble opinion, rings and bracelets constitute the equivalent of razors waiting to slice), perfumes galore, ending this saga with the confectionary that will have been baked or purchased to celebrate this long-awaited event.
Please note that all of the above has absolutely nothing to do with the baby. The child will be lucky if he/she finds a crib in all these purchases. It’s absolutely ridiculous, and in this country, a game I refuse to play, another round of ammunition to those that accuse me of being “anti-social”.

Back to our veiled (hospital was full of them yesterday) patient advocate.

Now, she also imparted wisdom, let’s give her that. Some of my critics might argue that I can’t be in the same place as someone else imparting knowledge, but my response to this criticism is that there would be no problem if the woman wasn’t misinforming these poor defenseless people who had to sit through her tirade.

One patient asked if the machine was 3-dimensional, “Yes”, she replied, “it says ‘فوق الصوتية’” she explained, “that means, ‘three dimensional’[7]”.
“Actually, it means ‘ultra-sound’”, I interjected.
“No, it doesn’t”
Before this promising dialogue could go any further, my turn came up, and we will leave it there.

[1] Having missed three reservations with my specialist of preference since my mob frowns on my leaving the house in the evenings when they’re awake, and leave me too exhausted to go when they’re in bed.
[2] Wandered off googling the name of the check-up room, the architect in me took over, started downloading design briefs for reference.
[3] I use the term loosely, since we’re black here.
[4] Please note that in our part of the world, this is a personal choice and not mandatory.
[5] دة دكتور شنو بتضرب ليهو وصلة؟
[6] Amniotic fluid if you want to be technical, but don’t count on this conversation making sense anyway.
[7] To any reader that is not familiar with the language, she was saying “ultra-sound” in Arabic.