A Trip to the Hospital

After breakfast two Sundays ago, Ann and I set out on the 2 km trek to the Peace Corps Office to do some computer work.  We generally walk single file on the first half of our trip for safety reasons - too much traffic on the roads and no sidewalks. I am usually ahead and Ann trails behind wiping the sweat off her face, keeping an eye on the  motorcycles that zoom by and trying to keep one foot in front of the other on a hot journey.  Our walk becomes a little less hazardous once we cross Hangha Road, the busiest street in town, onto Reservation Road.  The Peace Corps regional office, many NGOs and some guest houses are located in this largely residential area.  On Sunday morning Reservation Road was busy with a lot of okadas dropping people off at St. Paul's, the big Catholic church and its next-door neighbor, the First Apostolic Church, so we continued walking single file.  Just as we were passing by St. Paul's, I heard a clunk behind me.  I turned around and saw Ann on the ground, blood oozing from a gash in her head. Busy plodding along and lost in thought, she had hit her head on the corner of the Milo Diamonds sign that we pass on this walk. The sign would not pass any safety regulations in the U.S. as it is centered just head height in the middle of a sidewalk, but Sierra Leone has safety violations galore, and she had just become the victim of one.

The infamous sign is at right in the picture.

I helped her up, wiped her face off, and she pressed her ever-present bandana to her wound as we hurried off to the PC office another half km down the road for some first aid. At the office about ten minutes later I had a chance to inspect her head.  It looked to me like a half inch long cut.  Junior, one of the Peace Corps staff, helped us find some antiseptic which we liberally applied to her cut.  The bleeding seemed to have stopped, and except for feeling foolish about walking into a sign, Ann seemed OK, so we continued on with our work as planned. We worked for a few hours and headed home in the afternoon.

When we got home I took another look at Ann's head.  The cut looked a little longer than I had initially thought and was in a difficult place to bandage, so we talked about having someone at the Government Hospital take a look at it.  Since it is just a block away from our house, it seemed like the prudent thing to do.  Ann called Dr. Jo, the Peace Corps physician, and he agreed a hospital check might be a good precaution.  We pass the hospital every time we go to town, but we had never been inside the place.  Typically, there is a crowd of okada drivers dropping off and picking up passengers at the gate.  This Sunday was no different.

Okada drivers waiting for some business.

The sign by the door says, "Put U Dorti Na Dust Bin."

We walked in the main entrance (it fortunately was during visiting hours) and found a nurse who took us to the Minor Theater. The room resembled a doctor's office in the U.S. circa 1930, but it was mostly clean and our options for medical care are few here, so Ann got up on the gurney and presented her head to nurse Josephine who took a look and immediately said that the cut needed stitches. We called Dr. Jo as instructed and the nurse described the injury to him in Krio and what they planned to do.  Dr. Jo then explained it to Ann though basically we had understood the conversation. He had already told us that money would be involved, so it wasn't surprising to us that the nurse brought the subject up before the stitching was done.  Her initial assessment was 50,000 Leones, but after Ann's scalp was shaved revealing a one-inch long cut that was deeper than I had thought, the price was upped to 100,000 Leones.  Nurse Patrick, assisted by another male nurse, stitched up the cut in a very professional manner.  Five stitches in all made it 20,000 Leones (about $3) per stitch.

The OR.

After the minor operation was completed, a real doctor was phoned to come to the hospital and check the work.  I joked with the nurses that it was the same in America, the nurses do most of the work and the doctors come in and collect their "consulting" fee.  This doctor was known affectionately as STP because his name was hard to pronounce.  The young doctor arrived in about five minutes and took a look at Patrick's work.  Everything seemed to be in order.  Ann was instructed to not wash her head for a week and to come back to the hospital in three days to have the cut inspected and re-bandaged. STP pocketed some of the cash that I had given to Josephine. The nurses had said that STP stood for Surgical Team Practitioner (or something like that). I told the room that in the US, STP was a gasoline additive that made your car run better and that he was making Ann's body better. They liked that joke.

Dr. Jo drove all the way from Freetown to Kenema (10 hours round trip) just to have a look at Ann's head on the following Tuesday.  He said that head injuries could be serious and he wanted to have a first-hand look himself.  We feel we are in relatively good hands with the Peace Corps looking after us.  Among the PCVs there have been at least four cases of malaria, one of typhoid and many other thankfully minor ailments among the volunteers, but the medical team is ready to assist us.

Nurse Josephine.

This past Sunday we made our third trip to the hospital to get Ann's stitches removed.  Josephine did the honors this time.  She asked if we had any children.  When we said yes, she wanted to know if we would introduce her to our son whom she was hoping would fall in love with her and take her to the U.S.  We had to shatter that dream of escape from Sierra Leone when we told her we only have two married daughters and two grandchildren. On a side note, it's highly unusual to have only two children in Sierra Leone, so we get quizzical looks when we tell people we have two daughters and that's all we wanted.

So this week brought a blog topic and a view into Sierra Leone medical care.  We can't complain at all about the service and the cost, but we hope not to have to make any kind of return visit.  Ann has learned her lesson about the hazards of signage.

Ann finally got to wash her hair this past Tuesday.  My take-away from all of this experience is that minor medical care in Salone is more than adequate in the large cities.  Also, it is refreshing that affordable medical costs are discussed up front in a reasonable matter. No surprises from the insurance company coming in the mail weeks later. I love the fact that I can pay directly to the medical practitioners and there is no middle-man involved.