helen weld public health

Two more sleeps…

It’s been another huge day with a wide spectrum of events and emotions. This morning we delivered one of the patients, J.A., who has been with us for 6 weeks, home to spend her last days. She had undergone fistula repair surgery in 2005 at another hospital and had been delivered to our ward by her family for assessment of her urinary issues thinking that she needed another repair. It became clear quite soon, that her issues were more medical rather than surgical. Her case was quite complex and seemed to be a bladder cancer resulting from the parasitic disease schistosomiasis.

Over the past few days she was weaker and expressed a desire to return home to her family and village, which is about two hours from Bo on very rough roads. Jenny and I made the preparations for her discharge, getting her all set and her take home pain medications in order. Joseph managed the dealings with her family and Ernest drove us very gingerly over the rutted roads to not exacerbate her pain.

J's home

Hospice care

Upon arrival at the village, we were greeted by a crowd of her family and friends who were shocked to see J. so ill, but Joseph was able to explain to them the situation and that J. had requested to come home. Getting her out of the vehicle, settled in and comfortable on the dirt floor of her house with a tarp, very thin pad and blanket was very poignant with a large gathering of onlookers. Hospice nursing in a remote village in Sierra Leone is still the same as anywhere else in the world; providing pain management, general comfort to the patient and emotional support for all. Jenny reinforced the administration of injections with a local health care worker and we made her as comfortable as we could by giving her sips of water from the bottle cap and keeping the flies away too. After we said our goodbyes and drove off we knew that we had done the right and best thing for the patient.

The afternoon’s activity was a more happy occasion, when Julia and I attended the elaborate engagement ceremony of Mr. Idriss, our landlord, and Fatmata, our head cook for the program here. It was quite the contrast of family gatherings from the village scene of the morning, but so interesting to observe the rituals of this Muslim ceremony. There were many introductions and speeches, as well as several “decoy” brides who were presented at the altar under veils. Fatmata was the fourth bride and when Mr. Idriss unveiled her, there were boisterous cheers and loud applause.

Engagement unveiling

Now I am in the midst of departure preparations and list making in preparation for my departure. Only two more sleeps here and tonight my mind will swirl with all the images of the day.