Illness and Doctors

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22 October 1963
VSO [Mick] came down with a kidney infection and went to the hospital. The doctor ordered a bunch of medicine and an injection a day for four days. The second day we went at two pm and the nurse said we should come at eight in the morning because they sterilize then, and don't sterilize again all day! The doctor is a young chap, and must he a bit discouraged, since he doesn't know if his patients take their medicine or not. He says many patients come, and the line is so long they don‘t get to see the doctor, so they return for a few days and then just die. It would be interesting to work in the hospital over a vacation period—maybe as a surgery nurse or something.

15 December I963
Doctor said my illness was a fever like Dengue fever, spread by sand flies. There were no parasites in by blood sample. I did not stay in the hospital, but at home. Much more pleasant. I was only down for two days. [But I felt terrible, so I decided to let my beard grow out again so I would look awful for a while and people would sympathize.]

1 January 1964
The PC doctor came last Friday with my trunk. He also brought the news that I may help the new arrivals with training in maintenance of Jeeps and Motorbikes. That means a free vacation in Enugu. I think I will return the Jeep. The doctor here goes out very often, as do the Irish fathers at Ututu.

I have changed my work at the hospital. The lockers for patients belongings are filthy. I don't think some of them have ever been washed. So I decided to wash them and paint the top surfaces, which are too dirty. At least they give the appearance of white rather than black, now. The hospital does not prepare food. The patients must have family or friends bring food to them. The hospital does provide milk to mothers in maternity (given by the USA) but I haven't seen too much of it being given out in other wards. The place is divided into maternity, men’s, women's wards and a couple of cubicles. The wards are each 12-bed.

Because the patients feed themselves, there are always dirty visitors around, and the lockers have bits of gari and popo stuck to them and banana peels in the corners. I think I have persuaded the attendant in the male ward to wash one each day, which, if it keeps up, means each locker will be washed every two weeks. I had to work to get him to use Ajax.

The out-patient clinic operates from 8 to 2:30 each day, continuous, with only one doctor. On operating days, Tuesdays, the doctor usually has about 5 hernias, then goes to the clinic until 2:30. Surgery is about the best-run part, probably because that is the doc‘s favorite field. He says almost everybody here has a hernia, and often bilateral. He thinks it is hereditary. Most other surgery is emergency, often at night. At night he must use light from two Tilley lamps, about as bright as one Colman lamp. These are often obstructed deliveries. Doc dislikes and will not perform administrative duties: the wards only get attention when something bad goes wrong, such as the nurse does not shake down the thermometer or give medicine to out-patients without prescription.

28 January 1964
I’m sick again—this time some kidney infection. No out-patient clinic today, so I’ll have to see the doctor tomorrow.

12 February 1964
I went to Enugu last weekend. The Doc said I had a virus, complicated with pleurisy. I also ended up with amoebic dysentery (not yet confirmed by lab test) for which I am taking pills. No wonder I had no appetite! I was exhausted after I arrived. I went up in Peugeot taxis—at 70 miles an.hour. They are new station wagons, sometimes known as flying coffins. The only route to Enugu is thru Onitsha, 60 miles out of the way. Taxis don't travel the shorter road, as Onitsha is a very big trading center and the head of the road to the west. I returned by rail, which took 5 hours, altho I had the express train and the rail road is direct. Plus, of course, 2 hours by lorry to Arochuku. The train cars are open window varieties, and the engines burn coal, so the ride is very dirty with ash and cinders. I came second class, and there were only two in the compartment. 3rd class is cheaper than lorry, tho slower.

I take my chloroquine regularly. There have been no confirmed cases of malaria in patients who have taken chloroquine regularly.

9 March 1964
There is no schistosomiasis in this area of Nigeria. At least the doctor has never seen or heard of a case. In the western Region, yes, but not here. I have had no trouble with worms, either, tho by rights I should have. I don't have any medicine for parasites, but the local hospital does. The doctor was given a chance to intern in surgery, which he very much wants to do, but his replacement refused to come out to the bush, and Doc has chosen to stay, rather than abandon.the hospital to its fates. Brave for a Nigerian doctor.

19 May 1964
There is no schistosomiasis in this area of Nigeria. At least the doctor has never seen or heard of a case. In the western Region, yes, but not here. I have had no trouble with worms, either, tho by rights I should have. I don't have any medicine for parasites, but the local hospital does. The doctor was given a chance to intern in surgery, which he very much wants to do, but his replacement refused to come out to the bush, and Doc has chosen to stay, rather than abandon.the hospital to its fates. Brave for a Nigerian doctor.

17 September 1964
We've had it now. There is an epidemic of smallpox in the areal The Vice Principal's wife had it while she was 8 months pregnant, and came so close to dying that it is amazing. The doc says she would have died if the baby had not delivered. Said her pulse rate was 165 at one time! So everyone on the compound was vaccinated, as Mrs. Igboko taught most of the girls cooking and probably exposed many. New her husband has it. [See wedding invitation from Wedding Tradition] The vaccination was less than a week ago. The doctor went out for more vaccine and they are having mass vaccinations in the markets. The people around here love to get ‘injections’ so it is no problem to get them to come. Some are apathetic, tho. Doc says that the rain we are having helps clear the air and slows down the epidemic. I certainly hope so, as we are having more than our share of rain.

Look up in Gray's anatomy and tell me if the incidence of albinos is greater in Africa than in European countries. It seems that I see an awful lot of albinos, tho it may be that they are just more apparent. Many dye their hair black and, at any rate, the people around here don't have the usual Negroid features, so they look just like Europeans, except that they are usually somewhat grizzled. The little albino kids look like old men. Speaking of colour, the people in west Africa are not black, but all shades of brown. Some are so light as to look like white men, and they have reddish brown hair, altho it is kinky. In fact, one doesn't have to be especially light-skinned to have red hair, but I understand that is from protein deficiency in childhood. And the women are always pregnant. Now I know why they wear a wrapper (two yards of cloth wrapped around them and tied)— It is easily expanded when they expand.

15 October 1964, Thursday
I was medically examined in Enugu with injections for hepatitis, typhoid, and polio and ejections for blood tests. I’m OK. Also got my ears washed out! Boy were they plugged—took two days to clean ‘em.

Boy, the VP looks horrible, all pocked with smallpox. It will be no loads if that disease goes from the face of the earth.

11 February 1965
There is much grumbling among the volunteers about the Regional administration and poor contact with volunteers. For all their talk about grass roots, their heads are in the clouds and some disasters have resulted. Last term we sent three volunteers home because of breakdowns. I went to have a talk with the Doc about mental health and see if we can’t find a solution to the psychologically isolated volunteers. All three boys would have terminated within two moths of their breakdowns!

16 May 1965
The doctor [Rob Chapman] has spent about a third of his time this last term carrying people home. We had two very bad motorcycle accidents and a number of strange illnesses. Many of the people who have swum in the Hotel pool have contracted ear infections, one is in Lagos now with a burst eardrum. Another has migraines. But most are just going home because their tour is up. The University teachers are finishing up now and they are filing thru the office for Cholera shots and medical exams. I don't know how the doctor is going to do all the medicals and take care of routine stuff and emergencies as well. There are only two PC physicians for 650 volunteers in Nigeria. And when an emergency arises, if the kid cannot be treated in Nigeria, the Doc must fly out with him to Frankfurt or New York, usually taking a week each time.

14 July 1965
I've had a cold for a week, started off with a good case of dysentery. Today my nose is flooding. By tomorrow I should be OK if it doesn't move down to my chest. Think I had a touch of pneumonia last weekend but there was no doctor around so I just stayed in bed.

22 July 1965
I'm slowly recovering from my virus. Seems to be a popular item these days. Another fellow here has one in different form. Often the lungs get congested. I cancelled out of going to Cameroon for fear I might get pneumonia and not be able to leave Nigeria.

Jim Ludden

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