Monday, February 6, 2012

Clinic in Nakyot

Here is a journal entry from my most recent time in Nakyote (with extras to make reading more easier.)
Due to circumstances outside my control I’m staying around camp this morning . Actually, this time of rest if nice and I think I need it. Yesterday afternoon/evening a bit of a “clinic” formed. I’d brought a few meds because I know the need is always there but I’m quickly learning there is no such thing as just helping those who really need it. It seemed like every person who walked by yesterday just joined the line to see what they could get from me. They know I can’t really argue with them when they say they have pain and as I give things away free they will most likely get something. I’ve fallen into the trap of trying to communicate that I care by giving them medications so I rarely send someone away without something. Only they refuse to stay in line and just keep pushing closer and closer then start grabbing me to get my attention even if I’m assessing someone else. It isn’t uncommon that I’m completely ignoring two or three while trying to take a history in a fourth. They get increasingly agitated and angry as I ignore them and they don’t get it ever that I’m more likely to try to help if they are waiting patiently. Only I’m always trying to keep my eyes open for the one who is genuinely sick and they get pissed quickly when I pick that one out and give them more than two minutes. It is really hard to calculate a weight based medication in a three week old baby who is feverish with crackles and rales in both bases when an old man is grabbing my forearm and another is repeating some phrase in k-jong that I don’t understand over and over within a half inch of my cheek. Then add to that I have to start telling them the medicine for pain is gone or that it is getting dark I’m only going to see one or two more….

Whoa, all that to say I’m glad for an extra hour or two of quiet today. I was just told yesterday that the clinic building here in this village is nearly finished. It hit me like a ton of bricks that until the VHT’s are adequately trained (whatever that means!) or until the government sends someone (probably not this current regime) they are expecting me to run this clinic. I have to be honest. This both excites me and overwhelms me simultaneously. If I’m 100% honest this is the kind of missionary I pictured myself to be. But I’ve been told that it isn’t how missions’ works anymore and I’ve seen for myself that this old paradigm of missions failed. But yet…a part of my brain says it is a need, I’m looking for a way to live in this village, what better way to teach the gospel with flesh on, this isn’t something I’m putting together- others think this will work… so many hopeful thoughts.
But I know I’ll be inundated with people demanding to been seen every day. And we’ve been giving health care away free for more than two years now. It is time to start charging a tiny bit because they don’t understand its value. But then what do I do if someone comes genuinely sick and doesn’t have the money? How do I explain to one that another was “more sick”? They see themselves as always sick. How will I teach the VHTs to do a REAL triage so the bad ones don’t get missed? How about immunizations? Or HIV tests? Proper use of medications? For this question I have a snapshot of my frustration:
At least 4 times since my arrival here in the village “Teddy” has grabbed my arm chattering in K-jong. I know enough now to tell that she is telling me she has back and waist pain. But I’m not proficient enough to tell her I understand and I’ll get her some Tylenol or motrin when I unpack the meds. So a few hours later she grabs me from the middle another project and drags me over to where a translator is and I get it again and this time I establish she is 7 months pregnant and can I please give her something. I ask her to wait and she tells me how bad the pain is. (Meaning she can’t wait but meanwhile she is literally fighting 6 other women for the job of working in our kitchen so I know she isn’t really that bad off.) She interrupted two more times and out of sheer frustration I broke away and found Tylenol for her and counted out 12 and gave her the directions to take 2 when the pain is there and not more than 6 in a day. Then this morning I’m in the midst of another conversation of a want-to-be patient when she boldly interrupts and begins speaking loudly about her pain. I ignore her and try to focus on the other patient. Later in the day I’m giving some Tylenol to another person and like she was waiting for this moment she descends on me and here is our conversation:
Teddy: You give me.
Me: I gave you.
Teddy: You give me also.
Me: I gave you. (I have mad language skills if you haven’t gotten this already.)
Teddy: It’s finished.
Me: All?!
Teddy: Yes.
As I was now at the end of my language ability and I’m ticked I pull a translator into our conversation.
Me: Did you take it as I told you?
Teddy: Yes
Me: Then there are more than 6 pills left.
Teddy: None
Me: So you took too many.
Teddy: No
Me: Two pills, three times a day.
Teddy: Yes
Me: It is only midday. I gave them to you yesterday in the evening. There should be more than 6 pills left.
Teddy: None, give me more.
There is a lie in here somewhere. If she really took them all I’m angry that she didn’t follow directions as she is 7 months pregnant. If she is just lying to get more I’m ticked because of the lies. Honestly, if she had told me she had given them to someone else I would have given her more but when I ask my translator if that could be the case he laughed and asks why she would do that? It dawned on me to ask if she could have sold them and he says it is possible.  I hear these kind of things over and over in this village. This is like handing random medications out to junior-highers. Disobedient, dishonest junior-highers. And this is just one of the many, many issues I'll have to deal with. What am I getting myself into?!

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