We left as soon as everyone had done their ward rounds and headed straight for the shops. As Will was away we had to get a 'taxi'. We have a regular called Billy whose car can seat 6 passengers. We were 7 people so the back row was not overly pleasant! As has become the norm, we were stopped by the Police at the checkpoint until the usual cop and Billy could come to an agreeable arrangement about the bribe required to get us through. Apparently some of the other 'taxi' drivers drive a long way round off-road to avoid this particular inconvenience.
Shopping done we rushed into the hotel and Billy spent the afternoon ferrying more passengers surrounded by our bags!! We planned to relax by the pool. Just a few problems were evident - 1) there were more of us (the students had all come too) than there were sunloungers and there were other people there and 2) for some reason we were having difficulty getting the staff to bring us towels. This had never happened before and they assured us the towels were coming. All we could see was a man madly trying to pick up towels and running off. Surely they hadn't run out of towels?? After a while the man came back with 2 steaming hot towels which went to some of the students. We resorted to having lunch on their upholstered chairs damp - we had asked enough times. After a while, when the guy tried to take the towels back off us that had taken over an hour to come, it became apparent that they really do only have about 20 pool towels so on Saturday afternoons they are short!
This is OK later in the afternoon because the locals seem to bring their own towels and also their own take on appropriate swimming attire. The last couple of times we had seen small children swimming in underwear and thought that understandable - kids grow quickly, swim kit is expensive, it doesn't matter if they poo in the pool (OK, not the last bit). But today was different, today the Mums were coming swimming too. Nat and I watched a couple of them approaching. Surely the one on the left was wearing a skin coloured basque - that can't be right! It was harder to see the one on the right as she was wrapped in a towel (probably for the best as she wasn't the most svelte of ladies). She was wearing a white bra (we both whispered 'M&S' together) and white cycling shorts. This isn't going to go well - hopefully she has something on underneath!! We can already see that the shorts are on back to front. Thankfully, she is wearing something underneath - black spotty knickers!!
As is becoming standard, a small child jumped into the pool and had to be saved by Fi when it became clear she couldn't swim!!
On Sunday we just relaxed. [Well, after Geoff did his ward round and he was on call, so obviously the phone rang about an hour after we'd gone to sleep so that we both felt like we'd been called back from the dead!]
Communication
As part of the cost effectiveness study we would like to do, we are collecting the data on all the Caesareans completed in a 12 week period. For the past 7 weeks, Amy who is working in O&G has faithfully been collecting the data and providing me with the sheets. Her writing is legible and thus makes a nice break from Geoff's forms...However, Amy is leaving on Saturday and we decided that probably the best thing would be if I did the collection for the rest of the study as there's no one obvious to take over. On Sunday afternoon she showed me around the delivery suite and maternity ward and this week I am to do the collection alone but safe in the knowledge she can help if I get stuck.
On Monday I headed in at the agreed time, made my way into the office in the delivery area and found the correct book. I got the names I needed and headed out to the ward to try and find the ladies. The first was easy - right by the nurses' station so I could remove the notes quickly with a quick smile to her and her mum and complete my work away from the bed.
The second was in the middle of the bay and it seemed a little too far to drag the notes away. I already knew that the girl was 16 and unmarried (both very frowned upon here). She was also alone. As I got to the end of the bed she looked up at me with large eyes. I knew what they said 'I'm scared, I'm alone and I'm not sure how to get my baby to feed'. The last bit came from watching her actions. I froze because I knew I couldn't help. I can't help because I can't speak to her. I don't speak Nyanja and I can see from her consent form that she signed with a thumb print, so she can't write and therefore can't speak English either. It was a horrible feeling, not because I could have helped her breastfeed if we could speak the same language - I know nothing of that - but because I did have 20 mins or so to spare to talk to her, if it would have made her feel better, and I couldn't. I tried to smile and ask her how she was but she didn't respond - I guess I said it very quietly and don't pronounce it correctly so she didn't understand me. I looked at her notes quickly and left.
This evening I asked Amy what she does. She also doesn't have enough Nyanja to deal with that situation (unless you think that asking if she's bleeding would help!) but she said she just strokes their heads and that's what Dr Joop does too. Isn't that a bit personal? Apparently not, the patients touch her all the time she says and it seems to make them smile. Maybe I'll try that if I ever get stuck again, although I think that might feel even more awkward than not saying anything at all!
This isn't the first time I've experienced this but normally it's different and the meaning of a question can be worked out from the context. Old ladies on the way to the Chada with cupped hands are asking for money. Women yelling at me whilst I'm running are complaining about how I'm dressed or calling me foolish. Men yelling at me are, well, men yelling at me - standard. And occasionally there's someone who wants a conversation and who hopes that if they speak slowly and clearly I will understand. Unfortunately I don't - Nyanja is so unlike any European language in its form that you can't guess anything - you either know it or you don't.
On the way to Maternity on Monday a lady sat on the bench had held out her hand to me quite deliberately. This was unlikely to go well but I stopped. 'Hello' - good sign, we are starting in a language I understand. 'Are you Cairns?' Sounds confusing but is asking me if I'm related to the couple that used to run the hospital. 'You look like Cairns' - Faith had red hair too, although I'm told it's not as strong a red these days. I explain that I'm not related but that I have heard of them and that I'm also from England. 'How many years are you staying?' Ahh, this is tricky. I respond with 'not even one year, half a year'. 'Not even one year??' Today Abraham asked me why the muzungus don't stay longer - 'we need people to stay for much longer than 6 months'. It took a long time to answer talking about money, lost wages, difficulty taking breaks from training and the other things that might make people think twice about staying longer.
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