T.I.A.

Miles and I returned to the same surgery unit that we were brought to yesterday. We surprisingly saw some of the same patients that we saw the day before; I hadn’t really thought that we would for some odd reason. It seems like common sense when I think about it now. We saw the lady with the cellulitis lower leg again, the man with diabetic mellitus, and we also saw the hemorrhoid lady, which was quite unfortunate. The hemorrhoid had popped out already! I think this was due to the doctor not doing a sufficient job yesterday. So, we helped with the procedure to get it back in today as well. This time however, the doctor (a different one) got it all the way back in and bandaged up, so hopefully that doesn’t happen again, the poor lady! We saw a man with a bad head injury. He was assaulted with a shovel, or a spade as they call it here, and brought into the hospital very intoxicated. He didn’t really have any memory and was kind of out of it. He had a huge wound in the back of his head that broke all the way through his skull and into his brain matter. He had bleeding inside of the subarachnoid space, a layer in between the skull and brain that is only supposed to contain cerebrospinal fluid. As a result, he was experiencing body weakness and slight paralysis of his left side. He needed physiotherapy, and they guessed it would take about a month for him to be almost fully recovered. Because of the extent of the damage to his brain, he would always have slight problems, but would regain most of his bodily abilities. The man across from him in the ward was an interesting case. He was very frail, you could see all of the bones in his upper body, and when we started looking through his files and saw the nurses changing his bandages, we noticed what was wrong. His left leg was amputated from just below the knee down, and his other leg was septic. He was a diabetic, and wasn’t taking very good care of himself. Septic pretty much means his leg was dead, and needed to be amputated. It was really huge, and black; it even looked dead. He had sores that were bleeding and almost rotting, with what looked like mold growing on it. The nurse described it as having an offensive smell, and she wasn’t joking. It was horrible. We saw a woman with a trache, but never saw her as a patient. But, we saw a woman who was in a taxi accident. The ‘mini-buses’ are quite dangerous and highly advised against, and crash often because of their erratic driving. She was in the mini bus during an accident, and had road burns all over her body; on her face and head, arm, elbow, shoulder and back. A nurse was trying to change her dressings, and it was really painful for her. I watched as she peeled the gauze and dressing off of her back and shoulder, and it was raw meat. There was no skin left, and quite a deep valley in that area, like a chunk of her shoulder had been gouged out during the accident. Blood was oozing through the dressing that was almost stuck to this raw area. As the nurse peeled it away, the woman winced in pain; I’m sure it wasn’t comfortable at all, and I know the air didn’t feel good on the wound either. The nurse had to clean it with sterile alcohol I believe, and the woman almost yelped. Then, the part that I think is the worst, she had to rub cream (I’m not sure what it was, but it was probably some type of sterilized antibiotic that helps heal the wound) on with a wooden popsicle stick all over the raw area, the kind you usually see doctors using to keep your tongue down when examining your throat. I cannot imagine the excruciating pain that must have caused her. The patient next to the car accident woman was an older lady that was in very bad condition. She looked as if she was mentally disabled in some form, had very scarred and pitted shins, what looked like gash wounds all over her body, and in poor general health. I was very intrigued for some reason, and headed to check out her file right before the doctor was coming to examine her. He told me he was coming to take out stitches that were in her eye, and that she wasn’t a very compliant patient. I read her file to find out that she was a stroke victim, which explains the disabled appearance of her body and of her mental state. I never found out what the leg sores were from, but I did discover the origin of the gashes; her SON had attacked her with a bush knife, which is a machete. I was in complete disbelief. How could your own son destroy you like that? She was already a vulnerable old woman. Now when I say stab wounds, in my following writing, I mean this man stabbed his knife into her quite deep, and then dragged the knife down, creating tons of wounds, probably three or four inches long on average, and there is no telling how deep. She had stab wounds on her legs, arms, hands, head, face and eye (the doctor was removing stitches that she needed here). She had a particularly horrible wound on the side of her head; it was very deep and wide, and was creating an inch thick tall scar. I was heartbroken by her, and wanted to know why the son had done such a thing and what was being done. This doctor explained to me that because of the already vast limitations the hospitals in South Africa face, they had absolutely no resources to worry about social or legal issues. He said that a social worker was assigned to the case, but what most often happens is nothing, either because of the lack of part by the victim or there are no resources for the case manager to do anything. The doctor didn’t even have a very detailed description about the events that lead to her massive injuries. The woman’s daughter had brought her to the hospital, but left without saying much or giving much information up. That was horrible to me, and the worst part is that this type of things is commonplace in South Africa. Can you imagine?? The last patient we saw had anal cancer, as well as of the organs close to this region. It was so bad and so progressed, that she had to undergo surgery to get these organs removed. She has no anus now, and I got to see what it looked like; it was all stitched up and crazy to see! Can’t say I see such a thing on a daily basis back home. Obviously her body still needs to get rid of waste, so they had to create a means for her to do so. They attached one of those bags that sits on your stomach (cannot think of the name) to her remaining organs so that it can be exited that way. She was in a lot of pain, and it looked quite gruesome, but at least she is alive and well. At some point of the day while in the hospital doing rounds, something on the floor caught my eye. I could have sworn I saw something whisk by quickly, so I casually bent a little to look down and forward under the table and bed before me, so as not to be noticed, and saw nothing. I figured my eyes must have just over exaggerated a small bug or something, only to a few minutes later discover that my eyes hadn’t tricked me, and I so wished they had! It ended up being a giant cockroach, in the hospital!!! Miles and I couldn’t believe it. The other nurses saw and were grossed out, but didn’t even try to kill or get it out, they just walked away because this is a normal every day finding. As Miles always says since his host family brothers enlightened him, T.I.A. man, T.I.A.! (This Is (most certainly) Africa)