'Hit the Wall' Day in Mboni

Today tempers flared and patience ran thin. There was a lot of confusion and some arguing about where to set up some of the stations. There definitely was a breakdown in communications, however in the end, compromises were made and we still set up in record time.  




Outside view of the church

    

There was a small crowd waiting for us inside the church (about 100) at Mboni.



View of a squatter toilet

 In every location that we have gone to, discussions start up about what the bathrooms are like. We have all begun to appreciate toilets with lids,toilets that flush, and toilet paper. It has become part of the logistics job to make sure that at least one roll of toilet paper is packed in the bins. Flush toilets are rare in rural Africa. The toilets that we encountered were more like Canadian outhouses, with the exception of the actual toilet. In its place is a hole in the ground. Women need to squat to go. Even in the Kili airport, out of the three stalls available, 2 were "squatters", one was a flush.

Besides being the day for tempers, it seemed to be the day that some volunteers hit their "wall". One staff was moved by a young girl who was suffering from depression-her parents and siblings were dead, she lived with her grandmother, they lived in poverty. She confided that she was contemplating suicide. On-going counselling was arranged for her and I believe that she was prescribed an anti-depression drug.

Another heart breaking patient was a sixteen year old boy (that looked maybe 8-10) who was starving. We gathered up some granola bars and discreetly stuffed them into  his pockets. Later when he was sitting waiting for his prescription to be filled, I realized that maybe he might not understand what we had given him, so I opened up one of the bars and mimed to him that he needed to eat it. He ate the portion and stuffed the rest in his pocket. I wanted to make sure that he ate at least one of the bars so I pulled the rest out of his pocket and waited until he was finished. It is quite possible that he was bringing the rest of the bars to feed other people in his family. There's no way to know for sure.

We had two positive pregnancies - a 16 year old and a 14 year old.



Whenever we close down triage, there are either quite a few people left to see or there are none and some trickle in after the fact. This time when we closed there were a few people who wondered into the church just after we closed. They sat the church, quietly expecting to be seen. When we decided to process them, a few volunteers from the other stations started complaining when they saw new patients appearing with triage forms. We were made aware of the complaints and became more strict about not letting people through...then someone else decided to process the stragglers. Again, the complaints flowed in. When our mission lead went up to stop the flow, she ended up processing a few more. I guess the lessons learned from this day were:

1. We do have to turn people away and its going to be hard to do
2. Some of the staff (made up of volunteers and paid staff) will not be happy with the decision to keep going. Different people have different tolerance levels and work ethic.
3. If people wander in who are sick, we will try to attend to them no matter what-even if we are closed and all the bins are packed away.

While we were finishing up, some locals pushed into the waiting rooms without having been registered. It became a challenge to sort out who belonged and who didn't. Sister Matildas (our Opthamology doctor) took in a couple of women after everything was closed up (she would work till midnight if she could!!).



Inside the church near the end of the day



One bibi (Swahili term for woman of grandmother age) stood in front of one of the vans yelling in Swahili (she wanted to be seen by the doktari). I think one of the medical staff saw her and handed her one of our drug kits. She danced away down the hill, singing!

Total number of patients seen:

Total HIV positive: