Sunday, March 20, 2011
March 18/19/20 from Nkoaranga Lutheran Hospital, Tengeru, Tanzania
We actually began this great adventure two days ago when Harriri, Ayako, Oddo and I headed out for Harriri’s pre-op blood work at a local government hospital in Tengeru where Dr. Lyimo had scheduled us to correct his umbilical hernia . . . BUT . . . we got “bumped”. Enroute, Ayako and I laughed hysterically at Oddo’s response to my query on why the road was paved. Truly, virtually no streets other than the Moshi/Arusha “highway” are paved, yet this one is. His explanation? “Bush visited this hospital once and so the government had to pave the road for him.” As in George W. If you were to come and see just how desperate parts of this country are, you would appreciate the irony we found.
Upon arrival, (and, if I may, it was HARRIRI leading the way down the walkway) Oddo stopped to ask about our surgeon. It turned out he had taken an “outreach” assignment (there are a lot of perks for these types of calls) and forgotten about us. Dr. Lyimo was not happy and I was disappointed for Harriri, as he’d “bucked up” in preparation for his operation! He had told me, “Mama, if doctor cut kidogo (small), hamna ugopa (no fear), but no cut BIG, Mama, O.K.?” Fearing that the same might happen again and knowing we wanted the surgery done this month (while our R.N. volunteer Ayako is here to care for him) we were advised to schedule with a private hospital. The fee would be a bit higher . . . thank you to “Uncle” Randy, Harriri’s sponsor for covering the cost of his surgery . . . but we would get in, they wouldn’t let us down, and Harriri would receive good care.
The road to this hospital, it turns out, is paved also and I couldn’t resist asking if Bush had visited here also. It was Oddo’s turn to laugh as he explained that no, this hospital had been very popular and very profitable at one time, (and it is quite an ascent heading up Mount Meru) and so they had paved the road. Ayako, Oddo, Harriri and I arrived last night around 7:30 p.m. at Nkoaranga Lutheran Hospital walked down an open air hallway and were settled into our room.
Oddo had taken the liberty of booking us a “private” room wanting Harriri and I to be as comfortable as possible. We were also, unfortunately, concerned about wizi (thieves). Don’t worry Uncle Randy, it was only 10,000 TSH. or about $7.00. The walls are of mottled cement and painted a beigy, gold colour. The floor is tiled. We had two beds, metal frames with plywood sheets for support, one good mattress and one “exhausted” one through which I could intimately feel the wood beneath. One had a pink and burgundy flowered blanket made of that synthetic material that never gets wet when you wash it, yet I believe incinerates before your very eyes within milliseconds of it touching a flame. The other “blanket” was a table protector. (Do you remember your mother/grandmother who had a thick, quilted “pad” under her table cloth?) We also enjoyed a private bath with a western toilet WITH a seat, which in this country is optional, although ours wasn’t made for the model of toilet in our room and unless one was careful could make a 90 degree turn and slide one’s wowowo (tushy) off the toilet and ONTO the floor before you could mutter, “Oh, susu”! I’m leaving you to figure out that translation . . .
There is a shower (cold, brown water) and a sink (same water situation) and a Kilimanjaro water bottle with liquid soap in it. One bucket and two bowls full of the same murky maji (water). One brings one’s own toilet tissue . . .
Harriri was excited and leapt up onto his bed . . . I had brought crayons, some paper for drawing and some stickers but . . . AYAKO . . . had brought a special gift for her little patient . . . she had made him some origami characters! Birds, cats, flowers, and especially a delicate, tiny box in which she had placed two origami hearts! Harriri was over the moon and began plastering his characters with peel and stick heart stickers! (BTW he would go to surgery with two hearts pasted on his forehead . . . no confusing who our child was!) Oddo and Ayako wished us a good night and were off and Harriri asked that we sleep together. (For those of you who haven’t visited yet, most of our children like to sleep with a partner. It has been a year with us for many of them and yet they haven’t adapted to sleeping alone, not having done so for their entire lives thus far. . . )
Our room, it turns out is directly next door to the bathroom used by all the patients who DON’T have a private bath with a swinging toilet seat and suffice it to say, “the walls are thin”. We could hear everything, and I mean everything, going on next door, until that is, the television in the open walkway was turned on, FULL VOLUME, which is customary here for some reason I haven’t figured out yet, and left on from about 9:00 p.m. until 6:30 this morning. I was bleary eyed but Harriri was just so excited . . .
The nurse came to tell us that the doctor was on his way and about thirty minutes later a very young looking man in a ball cap appeared and started asking questions. I would never have guessed he was a surgeon and couldn’t put a and b together until he explained who he was. He looked about 17. His name is Dr. Julius and upon announcing that he was ready to begin, we followed him to his “theatre”. No wheelchairs here, and once again, it was fearless Harriri who was up front and center in the lead. It was raining and there were a group of women gathered around a drip line from the roof filling cups with water so they could brush their teeth. This is Africa. The doctor paused at the door and invited Ayako, as an R.N. to observe the procedure. She told me later that the hospital really has virtually nothing in the way of equipment, not even a child’s BP cuff, and uses an antiquated anesthetic machine. Although told she would be only observing, once in the O.R. she was put to work. Ayako, like our friend, an E.R. nurse from Canada who escorted me on a doctor’s appointment with Liadi, teared up when she had to help hold poor Harriri down to insert the I.V. needle. She was reminded of why she is not a pediatric nurse.
Oddo left to go to Tengeru market and then to town to finish the canvas for the back of the truck and I went back to our room to wait until the surgery was finished, laid down and closed my eyes, and, it felt like thirty seconds, but was actually just over thirty minutes later, was awakened and informed that I could see “your boy” in post op!
Ayako was sitting with Harriri who was still dead to the world. The amount of sedative given Harriri was a surprise to Ayako but that is procedure here. He slept until almost three, stirring occasionally, one time an enormous smile breaking across his face and making us laugh, a second time he opened his eyes, looked up at us (still unseeing) and stuck out his tongue . . . Ayako and I talked about her family in Japan (she lives and works in Seattle, WA, USA) the earthquake, tsunami and fallout, children, our common objectives for coming to Africa and then, returning from her lunch she gifted me with my own little zawadi (gift), an origami octagon made from a beautiful, multi colored paper . . . thank you Ayako!
We were chatting to ourselves waiting for our little man to awaken when someone near started vomiting. (I neglected to inform you that Harriri’s surgery was done in the maternity ward of the hospital.) Approximately thirty minutes later someone knocked on the door (Harriri had been parked in the “hallway” leading outside from the O.R. and we kept getting up to close the door so he wouldn’t get a chill. A woman passed me a file and I gave it to Ayako to deliver to the matron. She knocked on the door of a room, stuck her nose in and explained a file had been delivered. The matron asked that she put it down in the next room which Ayako did and then returned to Harriri and I . . . less than two minutes later we heard some panting, I translated that the nurse had said the head (kitwa) was coming and then, the sound of a baby crying! While waiting for our little guy to awaken we had overheard the delivery of another life . . . Doctor Julius returned and gave us permission to take Harriri back to our room.
The afternoon passed quietly with a heavily sedated Harriri napping and, exhausted myself, I joined him. Ayako was kind enough to stay and observe Harriri, there are no side guards on the beds, and while sitting quietly at the foot of his bed she saw a panya (rat) scurry across our floor and under a cabinet . . .
Oddo returned in the early evening with soda (Tangawizi) and chips mya (eggs and French fries) for me, Harriri is still on only liquids, salad and more fruit. He and Ayako headed home and will return in the morning to take us home.
My phone doesn’t work in our room and so I had to step outside to “send” the texts I had written - by the way, thank you all for your well wishes - and was gone just a minute but when I returned I discovered our little man, sitting up, having removed his net and clutching himself. HE NEEDED TO GO! He didn’t say anything to me except “ah, ah, ah” but I knew. As I explained earlier his bed has no side rails so I had pushed the second bed up beside his. Climbing over it, I stood him up, unhooked his I.V. bag (he is still taking fluids intravenously), put the bag in my mouth and picked him up . . . we didn’t quite make it. Suffice it to say I have been christened by our little patient in a “golden” way . . .
We experienced a relatively uneventful night. Harriri slept fairly comfortably . . . Cecilia, our night nurse kindly chose to insert Harriri’s morphine dose into his I.V. instead of injecting him (he’s had enough of needles) but that meant a trip in to our room every two hours. He did very well until Cecilia’s last visit around 6:00 a.m. when he was startled awake and thought she was giving him another injection. He wasn’t happy. Further, he had had an accident in his sleep (his only) and we needed to change the sheets. Thus far Harriri has been sleeping naked ensuring that nothing rubs on his belly so clean up for us was easy, except (I would discover later) as I grabbed his I.V. bag and picked him up in the same fashion I had previously, this time I hurt him.
Like the other times we had headed to the bathroom, I carried Harriri “baby” style, cradled in my arms. I think the incision is beginning to ache (or his ribs are beginning to hurt from the gas built up from his anesthetic) because this time he cried out. Initially, I thought his pain medication was wearing off, but he continued weeping and moaning, anaumwa (sp?) “it hurts”, until the nurse returned and gave him an injection . . . this didn’t help - his disposition that is - it would however allow him to fall asleep again.
I would learn of my mistake later, when, needing to urinate again, Harriri opened his eyes and called out, “Mama, kujua (sp?)”, “I need to pee!” followed by, “hamna bebe” “no carry me baby style”. I lifted the poor little guy down and he “waddled”, naked, to the toilet, he did his business and we returned in the same fashion. It is now 9:02 a.m. and he is resting comfortably. It is cold today and it is pouring . . . I only hope we are getting the same at home.
Dr. Julius will make his rounds badaye (later) and we expect to be released. Harriri’s second ½ liter of I.V. “juice” was just finished and hopefully, we’ll get the okay from the doctor to remove his sindano (needle). The nurse is hopeful we’ll be permitted to give him his antibiotics and pain meds orally and so can stop poking the little guy. He has been a genuine trooper and we are all very proud of him!