Lifeskills

I like to think that living in a one year old country has given me certain survival skills that will equip me for the rest of my adult life. How to clean out one’s nostrils for example, after a day breathing in 60% faecal air. Or how to walk in one-foot deep mud and still turn up to work looking respectable. And how to avoid ingesting parasites in the shower, salmonella in eggs and E.Coli on carefully prepared salad. One of the compound cleaning ladies gave me a good tip on removing weevils from rice. Turns out you just pour the rice on to a plate, leave it in the sun for a day, and the little blighters run for it. Amazing! Then there was the genius suggestion that inspired my underwear washing ritual. Rather than spend my Sundays soaking, scrubbing and wringing out the weeks wear (invariably for 2, me being such a saintly wife), I now simply throw them on the shower floor with some ‘suds’ and trample them underfoot. Dancing improves the effect. Aside from becoming au fait with baby wipes and chlorine tablets, adapting to resource ‘limitations’ in the hospital, is a whole new challenge, often requiring a level of invention and improvisation beyond my well-resourced mind’s experience. Empty water bottles are useful. Cut the top off and you have a commode or portable urinal, sputum and vomit container or a bowl for bean stew. Cut a hole in the end and you create a life-saving device for a severe asthma attack. Spray an inhaler into one of these and breathe through the top and it will have the same effect as one of the fancy nebulisers that connect to the wall and infuse drugs into your lungs in A&E in the UK. When it comes to other procedures – drains for fluid in lungs or abdomens or spinal taps, it is pretty much a case of what needles or tubes happen to be lying around that day. A drip tube held upright with the top cut off replaces the engraved glass manometers I used at home for measuring the pressure of CSF coming out of the spinal space, a urine catheter bag collects any kind of fluid it turns out. Plasters also come in handy for fixing broken equipment such as our oxygen machine – patching together the ‘disposable’ mask which has been used on every breathless patient I have seen in the last 5 months, and the dodgy plug connection which sparks and smokes when you turn it on. Finally, like nowhere else in the world Africa has taught me the art of religious diplomacy. I was deeply impressed by the way the issue of mixed-faith prayer was dealt with on the ultrasound course I am attending in Kenya. Obviously the first thing our Kenyan instructor asked us to do on this completely secular training program for East African health workers was to commit the course to God in prayer. ‘But we are not all Christians’ one of the participants pointed out, ‘there are Muslims amongst us so what should we do?’ Ouch, this is awkward I thought to myself as the instructor looked around for ideas, we’re obviously gonna scrap the prayer idea now, or ask the Muslims to leave and use a ‘prayer room’ like we might do at home. But ‘It’s ok’ another student pipes up ‘we’ll have a Muslim pray for us this morning and a Christian this afternoon’. I looked around to see the response to this joke, but everyone was nodding, relieved at this solution and bowing their heads while one of the Muslims asked for God’s blessing on our day.