Monday, March 7, 2011

Every Year

It seems that every year when I come to Sierra Leone with one of WMT's medical trips there is at least one patient that really gets to me. Some people might even say that I have a tendency to tear up (ok, I cry like a baby) when I meet one of these patients. I was wondering if it would be the same this year...being that I live here now. Yup. Still the same. This year the patient's name was *Ali (names have been changed for HIPPA purposes). Ali was carried to the clinic by some friends and family. I learned later he came from very far away.
The story goes like this. Ali was playing soccer with some friends the day before when he collided with another player. His leg snapped in half. He came to us in a great deal of pain. We didn't have an x-ray machine but from the cracking in his bones that we felt when we were assessing his leg, it appeared that he probably broke both of the bones in his lower leg and probably broke them in more than one place. Shoot.
When I asked him how old he was, he said he was 22 but when I asked him again later, he admitted that he didn't really know his exact age (very few people here do) and to me, he didn't look like he could be more than 17.
In the States, this kid would have been x-rayed, splinted and then probably taken to surgery to have pins or plates placed. Then he would have been in a cast for several weeks, gotten his cast taken off and continued on his merry way. That's not what's going to happen here.
I felt utterly helpless. After two unsuccessful attempts, my friend Katie and I were finally able to splint his leg with old school plaster. During each attempt he would cry out in pain as we shifted his leg. We couldn't even offer him crutches because we were too far away from anything to buy him a pair. He left being carried by some friends with his leg on a pillow, some Aleve for the pain and instructions to stay off of his leg for 4 weeks.
As I saw him leave....I kind of lost it. It wasn't the pain that I caused him that affected me. Maybe I've grown cold, but I'm used to having to hurt patients at times to ultimately make them better. It killed me that most likely, if his leg heals, he'll never walk normally again....never play soccer again. He was such a strong, healthy kid and because of this one accident that would be so easily treated in the States, his life is changed....forever. It killed me. And I cried.
BUT! Fortunately, that's not the end!! We held a team meeting and decided that we wanted to do what we could to help this kid! I called my friend who was in Freetown and asked if he knew of any options. I didn't even know if there were any orthopedic doctors in Sierra Leone so I didn't know where to even start. I explained the situation and he went to see what our options were.
After chasing down a bunch of leads, our two options were an emergency hosptial that only deals with emergencies and a private hospital that would be pretty expensive. The emergency hospital was full so our only option was a private hospital. We took up a collection and that was that. By this time, it was the end of the week and we were leaving for Freetown in the morning.
The next morning we went to church and then a few of us went to find the boy to tell him our plan to bring him to Freetown.
We found his home and there he was, lying on the ground with his leg on a pillow (the splint that we made nowhere to be found....they said it got too tight.) His leg was significantly larger than when we originally saw him a few days ago but he was in good spirits. We gathered his guardians (his parents were in another village) and explained our plan. He didn't love it. In fact, he said he wanted to stay where he was. What??? So we explained it again. We explained the severity of what we thought he had...the fact that if he didn't get it fixed he would probably never walk right again and wouldn't play soccer again. We didn't want to bully him, but we also wanted it to be clear that this was very serious. He became very solemn and finally nodded his head that he would go. My dad told me that I should tell him that we were going to pay for the treatment if the community would provide the rice for him while he was there. I thought "I don't think we need to do's assumed that we're going to pay for it." But I decided to humor him and told him that we would pay for his treatment...etc etc etc. All of the sudden his face lit up and all his family and friends started smiling.
I'd been wrong. I'd been giving them a dismal prognosis with little hope because they knew they wouldn't be able to pay to go to the hospital. Oops! So we discussed some more details and told them we would be contacting them once we had everything arranged to come to Freetown. It was a good moment. :)
The next morning was "Beach Day" and I went to pick up the team at their hotel. And who should be there but the doctor of the hospital that I'll be working at in a couple months. I spoke with her about the boy and she said that they would be able to take care of it at that hospital!! For $300! Awesome! What an amazing "coincidence."
So after lots and lots of calling around, we arranged a ride for him (I dreaded that ride for him....the roads are less than ideal for a normal person, set alone someone with a busted up leg!)
and the driver went to pick him up.
And he refused to go. He and his family were afraid that they were going to cut off his leg. So we spoke with several people, assured everyone that they definitely wouldn't cut off his leg...and off he went.
He arrived safely, if in quite a bit of pain and they took his x-rays. I haven't heard anything but am going to call tonight and check on him.
There is a lot of hopelessness here.....especially in terms of medicine. This is one case that I'm praying will turn out awesomely!!!

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