Appendicitis in Africa???

My second last week has not gone entirely as I'd planned but that is truly the least of my worries. Early Sunday morning (2am), one of the volunteers woke me up complaining of incredible abdominal pain. She was visibly ill but due to the lack of tro-tros at 2am, we had to wait until about4:30am to get her to a hospital. And from there, the long and frustrating experience of appendicitis in Africa began. Although the volunteer has been extremely open and happy to share her experience (goes with the culture - nothing is kept a secret here), I still wish to preserve some confidentiality and privacy so I will not go into too much detail and instead, will share more of my personal experience with it than hers.

When I first spoke with the doctor at the Keta Government Hospital, he wished to keep her on observation for 24-48 hours which worried me, as I discussed normal treatment with a physician in Canada and it was recommended that she be on observation for 12-20 hours. But of course the cultural "relaxed-ness" took over and the doctor was neither concerned nor in any rush to send her to a different hospital (in case she needed surgery). As I've described before, the mentality here is very laid back and that is an excellent and stress-free way to live but in an urgent situation, it is truly the most frustrating aspect of culture to deal with. I discussed as rationally and spoke as slowly as I could to the staff at Keta Hospital but it was a solid 24-28 hours before the phyician in Keta agreed to transfer her to Ho and his reason for the transfer is more ludicrous than anything. It was not because he agreed that she needed surgery or that the possibility was really there - it was because he wasn't planning on coming to work the next day so he didn't want to be responsible if she became more ill. By this time, though, any reason for the transfer was good enough for me. After waiting for a ride to be set up (again, everything takes forever), we set off for the Volta Regional Hospital in Ho (3 hours away). On arrival, she was looked at by another physician and immediately prepped for surgery. Although I describe it as a smooth transition, it was definitely not but it would take me hours and hours to depict the frustrations and tribulations of being a foreigner in a hospital in Africa so I will leave it for another time, another day. A few hours later, I dressed into some MASH looking scrubs (remember that show?) and made my way into the OR, or as they call it here, "the theater." One hour and ten minutes after she was put to sleep, her appendix was removed and she was on her way to the recovery room. Since then, she has made small but progressive steps towards recovery and is being cheered on by all the volunteers here and a her family at home. Again, the ordeal has been indescribably testing for me, as I am taking care of her in the hospital, but all of that is starting to fade as I see her the progressions she makes day to day.

One small story that ought to make all of you at home a tad bit shocked! After surgery, I was sitting with her in the recovery room when the surgeon walked in to speak with me. I asked many questions on her projected recovery plan and when all was said and done, he handed me a small white plastic container and said, "take this to Accra." I glanced at the container and on the opposite side there was a large bandaid-type piece of tape with her name and age written sketchily in pen. I asked him what it was and what I was supposed to do with it and he replied, "it's her appendix. Take it to a lab in Accra." Apparently there isn't a lab in Ho that can analyze the appendix so I've got it in a jar of formaldehyde in my backpack. We've arranged for someone from CCS who is going to Accra in the next few days to take it with them but until then, I am responsible for it. Weird, no?

I will go back to Woe sometime soon and another volunteer (who is a physician from England) from the house in Ho will help take care of her for the last couple days in hospital. Thankfully she is doing much better and has made some really big improvements even in the last 12-24 hours! To everyone at home, take care of yourselves and I'll see you soon! Cheers!

Kels