Bush Nursing

Eleven years ago, and quite possibly close to the very day, I had to suture my own daughter's leg on the same table this child (below) is lying on. Amanda was swinging too close to farm machinery from a rope in a tree with her friends when the iron edge of a flat bed trailer "got in the way" of an otherwise graceful sail through the air. Back then, there wasn't much in terms of where to seek medical help since the only hospital was across the border in Zimbabwe. And at that time of the day, the border was closed. There was only one thing to do: suture the wound myself. I had everything I needed on hand, so drew up the local anesthetic and told her she could yell as much as she wanted, but please, please, please…sit very still. A few tear-streaked cheeks and frazzled-nerve minutes later, it was all done. It wasn’t the kindest introduction to bush nursing.
Last weekend that same table came in very handy again. A young widow who works here showed up at about 9pm with her youngest in her arms all bundled up. Apparently, he had partly fallen into a pot of hot water 3 hours earlier and sustained burns to his entire left arm and chest. People here have no stoves, so they cook in the open yard on the ground with big cooking pots within easy access of young ones. Since it was a weekend evening and I wasn’t sure what attendance we’d find at the closest hospital, I decided to dress the wounds myself and set about to help rehydrate him with fluids. In the morning we headed to the Vanduzi Hospital where they admitted him for observation and dressing changes.
While mom and child went to the emergency room for the initial assessment, I sat in the open waiting area. It was a Sunday, so I was surprised to find the hospital’s director, Mr. Paz (Peace) and “tecnico de medicina” (physician’s assistant), Mr. Santos (Saints) seated there as well. There had been a head-on collision just a few hours earlier and they had been busy treating the wounded (thankfully there were no fatalities). While we sat together, we talked about the social and health issues in the area.

I told them about a particularly frustrating case I’d been dealing with over the past few weeks. An elderly woman who receives monthly support (food, clothing, etc.) from the mission had a bad fall about a month back. An xray ruled out hip fracture so she was sent home with an assortment of pills in mysteriously labelled little ziplock baggies. After a few educated guesses and chicken-scratch-deciphering, I decided to tweak her meds to bring her roaring blood pressure down and get a handle on the leg pain she was having.
Socorrista (Health Care Worker) Celestino, Liria, and I studying the xray--bush style.

Over the next few weeks she could barely walk with a cane, never mind manage to collect firewood or carry her own 20L jugs of water every day. Her neighbour was very helpful, but she needed full-time help. I asked her about possible family members who would be willing to care for her. This is where the story gets very long, so I’ll try to be brief.

1. Over the years, leprosy has debilitated her and she was sent away from her husband’s home since she was unable to work and contribute to the home anymore.
2. Her husband is a “curandeiro” (witchdoctor) which has something now to do with it not being acceptable for her to go live with her married daughter.
3. She decided to go back to her husband (who has other wives) in hopes that maybe they would take care of her (or maybe to talk with hubby about permission to go to her daughter).
4. After 4 days of being largely neglected, she made the slow, painful journey with her walking stick,back to her own home.

Liria, her Christian neighbour, warmly welcomed her back. Liria is a widow who cares for 3 orphaned grandchildren (also supported by the mission). They have taken this elderly woman under their wing to help care for her but can’t provide 24 hour care. When I explained to Liria that we were trying to get help from the woman’s family Liria shook her head and said, “We are her family. She has no one else. We will help her as much as we can.”

When I finished my story, Mr. Santos told me about a case of their own at the Vanduzi Hospital. The young man who cleans their grounds does so in exchange for a hot meal every day. He is “simple” and any time he goes home he is teased until he begins to cry and scream, so he prefers to just live at the hospital where people are kind to him. “He is our family now. And we have others like him.” Mr. Santos said.

He then wondered how we were managing with the widespread food shortage this year. “Well,” I said, “it is a challenge. Our family is pretty big right now! We provide food for +/- 200 kids at the mission’s school, over 20 orphan/disabled homes, and we have new requests coming in all the time. We can provide work for food, but we do need to watch our stock for our longer-term commitments. Thankfully, God helps us. We can only do so much by ourselves, so we pray and trust God to multiply our efforts. We could certainly do nothing without Him!” Mr. Paz and Mr. Santos nodded quietly.

We’ve developed a good relationship with the Vanduzi Hospital over the past 2 years and have had great opportunities to partner with them in different activities. This week we helped provide transport for immunization blitzes to a number of the surrounding communities. And so, our network of friends and family grows.

Socorrista Ernesto: giving mission staff a spiel on HIV/AIDS. A different health topic is covered each Friday morning and it always makes for a very animated discussion time.


Socorrista/Preschool teacher Simon: In our “old” health post rendering a critical service to the local people.
Simon and I going over antiseptic dilution mixes and burn treatment procedure. We have seen many burn wounds in the last few weeks.

Every workday starts the way it should: with thanksgiving and prayer for God's protection, healing touch and abundant multiplication of our efforts!