Rebirth of a Hospital

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Rebirth of a Hospital by Andy Buhler, CUSO, 69-71

The gentle drumming of rain beats softly but incessantly against the corrugated tin roof. It is occasionally disturbed by a cheery splash and gurgle of rainwater slopping and frolicking along the rickety tin gutters.

A large green and orange lizard skitters in under my living-room door and cocks his head to one side. Satisfied that I’m asleep, he scurries across the linoleum to investigate a fresh pile of insects near the lamp. To his great delight he finds several sausage flies and a large moth roasted to 60-watt perfection. His dark eyes gleam and bulge in anticipation of the crunchy delights.

Suddenly the rattle of a key in the kitchen door sends friend lizard hurrying under the china cabinet and informs me that a new day has already begun.

I keep my eyes closed. Soon I know Steven will burst into the room with a loud, “Good morning, Sir!” However, until that fateful moment I want to just lie and pleasantly waffle between sleep and consciousness. A few minutes of waffling after a night’s rest is akin to getting the free gift in a box of Corn Flakes, an added bonus, something for nothing. I know some people who deliberately set their alarm clocks to ring ten minutes early in the morning, just so they can get full benefit of this twilight zone of consciousness. Today Steven bounds in almost at once -- it’s going to be one of THOSE days!

Reluctantly I acknowledge the dawn by opening a bleary eye. A soggy day always dampens my enthusiasm -- especially when it starts raining even before breakfast. Oh, for a nice patch of clear blue sky!

However, the rainy season is upon us until at least October. This is still only August. I suppose I’ll get used to it -- but I don’t have to like it, do I?

“Well, do I?” I say aloud.

“What, Sir?” queries Steven, unaware of the rationalizations being debated within my still sleepy mind.

“It’s OK, Steven. Please bring me some coffee and I’ll be fine.”

Come on limbs -- get mobile!

“Uumph!”

Finally the struggle ceases. The bed relinquishes its hold upon my body and I am allowed to rise.

Since my bedroom is situated between the kitchen and the dining room I am able to gauge the degree of preparedness of breakfast by the frequency of Steven’s trips through my room.

“Is ready, Sir.”

By 7:45 a.m. I’m lingering over my second cup of instant coffee and wondering what new methods of doing old tests my lads in the lab will have devised for me to learn today. There seem to be so many ways of doing a test -- each day I discover a new technique being tried. This helps to keep life interesting I suppose but at times I wish they were a little less inventive.

It’s nice to be able to see right across the compound again. Most of the elephant grass and rushes have been hacked down from their eight-foot glory to a more manageable eight inches. Still, even at this early hour, I see the labourers already attacking the fringes with their long knives. During this time of frequent rains the struggle to subdue the vegetation must be kept up constantly. The grasses seem to lurk in darkened corners, ready to run down the hillside to reassert their footholds as soon as the labourers leave. One can almost feel the eagerness of these wily plants, waiting, watching, until they feel no one is looking. Then up they jump, stretching and waving their arms in unison. Every day we must draw up new battle plans to reclaim lost ground and gain a few extra yards. I must still be sleepy -- sneaky grasses, indeed!

The walk to the lab in the cool air of morning has a bit of a sobering effect. To see the hospital as it is today and to remember how much has been accomplished (even during the short time since I arrived) provides me with an awe of what can be achieved by our daily small struggles. Actually, so much has been done since the hospital reopened that it is difficult to believe it was once closed. Although they may appear a little drab from lack of paint, the buildings are once again repaired and reactivated. The compound has lost its neglected look. The smell of disinfectant surpasses the former odour of decay. The buildings are functional, viable and full of people once again. Talk, laughter, and a scrubbing brush have dispelled the dust and silence of disuse. The spiders and the lizards must play outside the buildings as the insides fill again with people.

Staff are already in the lab sweeping out the daily collection of insects that have somehow forced their way through the slats of the louvered-glass windows. The lab is one of the older buildings on the compound but it is bright and clean inside. The building is cement-laterite block plastered with cement-sand and painted a pastel pink. Inside there are white ceramic tiles reaching about five feet up from the tiled floor. Originally the lab building was used as a surgery so it has yards of window space on every side. Both sun and breeze are used to full advantage. In June the room was empty -- just four bare walls. Now there are furnishings, chemicals, and even some equipment. Tests are being done and results are being sent out -- we’re functional again. And there’s always the hope that more equipment will arrive if the wheels in high places ever get rolling.

Just downhill from the lab new activity has recently been started. A mason is preparing row upon row of the multi-purpose cement-laterite building blocks. Quickly he mixes a bag of gray-white cement powder with the rich red laterite sand, folding and turning them together like a careful chef. He adds some water and mixes some more. Finally he seems to have obtained the desired consistency and colour and he sets up his wooden block-frame on a level stretch of ground. The open side of the form is closed with two pinions and the center slat is dropped into place. The form is quickly filled and, with a final slap of the shovel, the mason levels off the tops of the blocks-to-be. After a few minutes wait to allow the mixture to set he tests the center slat. With a bit of wiggling the slat comes out leaving a smooth clean space behind. The mixture is good. The mason loosens the outer panels and two more blocks are ready to bake in the sun. The frame is shifted over a foot or so and the whole block-making process is repeated.

We will need a large number of these blocks soon for the construction of a new X-ray building. An old storeroom has already been demolished to provide a foundation. Gravel and rubble are being used to build up a floor level with the covered walkways so that patients can be easily and comfortably brought into the new building. Already the carpenter has started to prepare the wood for the door and window frames, and a boy has been sent westwards to a sister hospital for training in X-ray technique. Perhaps by Christmas we will be able to set bones by science instead of by touch. A portable X-ray unit in storage anxiously awaits its debut. Yesterday’s blocks are already starting to disappear. Some of the labourers are busy with head pans carrying away blocks and fresh mixed cement to repair the walkway between Wards Two and Three. It will be a great improvement to be able to roll a wheel chair between the wards and not bounce the patient out every two or three feet. The old cement was very rough and broken. Bits used to wash away with every rainstorm. The doctor’s examining room in OPD is being converted to a minor surgery/dressing-change room to relieve the congestion in the surgery proper. Doctor has been ousted to a room nearer the outpatient-waiting verandah.

Work on the walkways between Wards One and Two have been completed. They look very good with their new asbestos-sheeting roofs and cement-pipe supports. One doesn’t mind going to those wards in the rain. We do not have to be always on the lookout for a new leak appearing unexpectedly overhead. The lizards don’t approve of the new cement posts as they can’t gain a foothold on the smooth outer surface. They only have the water towers to climb up now. Still they cast sidelong glances at matron, hoping perhaps she’ll plant some vines on those slippery posts for their benefit.

Suddenly a diesel engine sputters and coughs like an asthmatic old man, then settles down to a steady snore. Doctor has started surgery so the small generator has been activated to put a little more light into the already bright operating room. Two girls in green wheel the first patient into the surgery while the doctor scrubs up at the sink. Another girl brings a fresh bucket of water for doctor to rinse his hands and arms with as water still does not flow from the town reservoir to our taps. Somewhere in the maze of underground and unmapped pipes is an elusive stopcock which has foiled any attempts by the local plumbers to locate.

The focal point of the hospital is, of course, the surgery. People can get pills at the pharmacists, the market, or at the local dispensary. Medical ills can be attended to by the local native doctors. Woman can have babies at home or in the overnight maternities. However, no place but the hospital offers the opportunity for surgical intervention into their disease processes.

We were indeed fortunate to have had an architect with considerable foresight design the present operating theatre. Long, louvered windows admit plenty of light for daylight surgery. The low profile, but wide roof, helps to keep the working areas reasonably cool. Since the re-installation of the small generator, the operating theater has had the added luxury of a small air conditioner. If the day becomes too oppressive, power can be turned on and work continues in relative comfort. The white ceramic tiles extending far up the walls give the place an aura of brightness and cleanliness. Seldom a day goes by without surgery of some description. Many days six to eight operations have to be done. Laparotomies, prostatectomies, Caesarian-sections, splenectomies, gastrectomies, hernias and thyroids all come under the healing scalpel. Blood for transfusions is so scarce as to be almost non-existent so relatively bloodless surgery must be attempted. It can be done, and it is done. Our surgical statistics have been excellent both for post-op recovery and patient discharge. People have been coming in from as far as 100 miles away to have their treatment here.

The wards have started to refill. People come again from nearby villages and distant towns. They remember the former reputation of the hospital; they are hearing good reports from today. The lineups at outpatients grow larger every day, antenatal patients come weekly for their checkups, and pot-bellied children have begun to smile once more.

So much has been done, even since my arrival. So much more since the hospital opened two months earlier. And so much still to do.

Work goes on, each day sees a new step forward.

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