Archive for the ‘Health’ Category

CYANOSIS


Mrs Aderopo looked around her the room; marble tiled fourteen square feet furnished with a refrigerator, a thirty two inch flat screen television with cable channels, and a mahogany reading table. Only the quaint curtains and the mechanical bed reminded her that it was a hospital. The curtains served their purpose well enough; it is that way with hospitals – decor that always remind patients that they are not at home. She did not feel at home anyway, since she arrived, there has been no kindred spirit. The nurses just come in, do their rounds and draw Omosalewa’s blood endlessly; no one to spare a smile or empathize with her. Nobody to say a word of prayer with her, the things she often neglected when nurses at home did them for her.

Hospital room

She met some other Nigerians in the common room; she usually stops by on her way to and from the neonatal intensive care to see her baby. She conversed with three other women; Mrs Okonkwo who had brought her father for bilateral hip replacement, Mrs Belabo came with her husband who needed oesophageal stents after some road traffic injury and Mrs Agedah who was there for a common thyroidectomy. From their discussions, she realised there were more like them. Also, they were all referred by people who had been here before. They were all people of means, those who could afford health care elsewhere. She did not like their company because she did not belong in their group until recently. But they all had the same complaints – no shoulders to cry on, nostalgia for a country that could not provide what they seek outside and the wish to never return here. Omosalewa would finally have the surgery tomorrow, which was hope enough for now.

She waited in the common room again the next day when Omosalewa went into surgery. She sat there in silent expectation with Mrs Okonkwo, the hip replacement was also underway. Mrs Okonkwo was a different kind of woman; tall, graceful, beautiful and sophisticated. They talked at length, each describing their different lives and the paths that brought them here. Ann Okonkwo had left Nigeria as a teenager with her siblings when her father sent them to his brother abroad in search of greener pastures. They all did well and are presently scattered at various locations across the globe except Nigeria. While the old man who prompted it all never lacked money, he lacked the attention of his children, they seldom returned home to see him. She was forced to go back home when she heard that Baba had not walked for sixteen months because the arthritis had eaten into his bones! Finding solution automatically became her duty being the eldest and the only female. She heard they performed great surgeries here; she will send Baba home after the surgery and return to Dubai to man her business. Sade Aderopo brushed back her short hair, she might not be as beautiful as Ann but she knew her advantages. She turned the better side of her face to Ann and told her about her shop on Opebi road in Lagos where she sold clothes for the bourgeois. She talked about her husband’s flourishing private enterprise and the emerging social influence of her family. They exchanged details and Sade promised to visit Ann next time she was in Dubai to buy goods.  

They moved on to small talk, little chit chat about the weather and the different environment where they came to seek health. About two hours into their wait, a doctor appeared in his scrubs and motioned to Mrs Okonkwo. He explained some things briefly, they were far from Sade – their words inaudible but she saw her newfound friend slump slowly. She ran to her side to hold her, something had obviously gone terribly wrong. The doctor walked away slowly, Sade held Ann in her hands gentling consoling her as the latter sobbed uncontrollably. Thirty minutes later, Omosalewa’s surgery was announced successful, Sade was still holding her friend when the nurses came to ask Ann what to do with the remains of her father. They spelt out the options glumly; put the body in the morgue before going to Nigeria, bury at a land provided at a fee by the Catholic Church or make your own arrangements. For a moment, Sade thought she saw the young, beautiful nurses in their white sparkling uniform show some emotion, but they had turned around before she could confirm her suspicion. She felt cold, confused, she held Ann closer in a tight grip.  Graceful Ann, still genteel in grief shook herself loose and turned to her friend “Sade, I will bury papa here”

“Why?”

“There is nobody to go and meet at home and it would amount to a waste of money!”

“What about your brothers? Will they be happy about it?”

God's Angel

“I will explain to them, they have to understand, the village has not been kind to us and the only person that would have objected is mama and she died a long time ago. We cannot waste money carrying a dead body back to a hostile people.”

“I am so sorry” She consoled her friend endlessly.

Sade led her to her room, tucked her in bed and excused herself because she needed to see Omosalewa.

She cradled the baby in her arms, the surgery was truly successful. The child’s colour has changed, no more blue, pink had returned. She looked at the oxygen tubes going inside her baby; eager for them to be discontinued – they said seven days. She could not wait to go home, to tell her stories, to have shoulders to cry on and to cry and have people ask “why?”     

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Her names were Omosalewa, Omobolade, Omobolanle, Oluwabusayomi, Ayomipo, Mayowa, Tokunbo, and Elizabeth Aderopo. In this part of the world, we give children a lot of names, because the names have meanings. Usually they are prayers for the child and the parents or appreciation to God for the gift of life. When names are prayers, they can’t be too many in this rigorous journey of life; also you cannot thank God enough for the bundles of joy called children. Eventually the child only bears two of the plenty names; a first name and a middle name but the other prayers surely abide with the child through life’s journey. Omosalewa’s naming ceremony was especially grand and well attended. After the pastor performed the rites of naming, collection of offerings and the numerous prayers, the party began. The music was flowing non-stop from a local band that had set up their equipment in a conspicuous corner of the spacious compound of the Aderopos’. Food and drinks were surplus and inevitably well-wishers thronged eternally.

Happy couple with the newborn

She was the third child of the family but the first female, but she came at a time when business was booming. Mr Aderopo had just landed a juicy government contract a few months before the birth of the baby – the good luck she brought also reflected in her choice of names. She was delivered in England; to ensure she was a citizen of a more privileged land. A great gift to our children since the citizenship of our own country is without benefits! The Aderopos’ spared no expense in the birth and associated ceremonies of Omosalewa’s birth; there were pictures and much video coverage to remind them of the memorable moments. She deserved it; one of her names Omobolade means she came with the wealth.

The day after the elaborate celebrations, Omosalewa started turning blue, first at the fingers and toes. Then it became difficult for her to breathe and in two hours the blue hue had started to spread to the face. The Aderopos rushed to the hospital, they had absolute confidence in their hospital; a reputable private hospital in Lagos with a grand structure and multi specialist disciplines. Though expensive, it offered good healthcare. The paediatrician – a young and petit woman who looked more like a baby herself – put Omosalewa on oxygen immediately, the familiar pinkness returned to her skin.  She pored over the baby some more, poking her endlessly with a stethoscope. Mrs Aderopo grew tired of waiting, she asked “What is wrong? Why is my child turning blue?”

“Cyanosis.”The paediatrician turned and told her with a bland face, like she was supposed to know the meaning.

“What does that mean? Doctor Olaolu, please explain.” Mrs Aderopo was on familiar turf; she had delivered and nurtured two children in this hospital.  

“It is the absence of oxygen in the blood.”

The doctor further explained the condition to the bewildered parents; they discussed the causes and suggested that Omosalewa’s case might be related to a congenital heart defect considering her age, rapidity of development of the disease and her examination findings. The baby would need an echocardiogram to confirm the diagnosis. They would need to go to the general hospital for the test; the hospital machine just became faulty yesterday.

The Aderopos hated the general hospital, it was always too crowded with long waiting time and without the personalised service they were used to, but they had to go this time. After waiting for two hours at the hospital, they finally got to see the paediatrician. A petit woman who seemed quite disinterested, she introduced herself “Good afternoon, I am Dr Bodunrin.”

Can you blame them?

 She confirmed Dr Olaolu’s diagnosis but gave them a date for two months to come for the procedure. Mrs  Aderopo got angry “Do you think this child will be alive in two months if we don’t do the test? She is turning blue!”

“Madam, the test will only tell us what is wrong, it is not the solution. I can’t tell if your child will still be alive but I have a long list of people waiting to have the same procedure and they need it just as much as you do.” The paediatrician replied her, dangling a list of names nonchalantly.  

“You don’t even care and you call yourself a doctor, how can you talk like that?” Mrs Aderopo had started boiling over when her husband dragged her by her arm out of the doctor’s office.

“Calm down Sade, we will do it tomorrow”

“Where, how?” she was already crying. “I have been carrying my child around in an ambulance, on oxygen and these useless doctors don’t seem to care, why?!”

“Relax, tomorrow we’ll go to Unique hospital, I talked to Dr Olaolu, she says there will be no problem once she is on oxygen.”

Unavailable

Unique hospital is one of the most expensive hospitals in Lagos, a private enterprise that flourished because that dearth of efficient alternatives. It boasts of great equipment and knowledgeable specialists, located in a high brow part of Ikoyi, the hospital is a reserve for the affluent. The Aderopos did not care about money any longer even though the echocardiogram would cost ten times the price at the general hospital. They waited for only fifteen minutes before they were called in to see the paediatrician, none other than Dr Bodunrin. Albeit, a different one, she quickly apologised for the misunderstanding yesterday, curtseying severally “Sorry about yesterday, I just didn’t want you to waste your time and money. The machine at the hospital is not as good as the one they have here. You have come to the right place especially for this kind of emergency.”

The Aderopos were dumbfounded – an emergency that could wait for two months, apparently Dr Bodunrin’s pay check at the general hospital and at Unique differ in similar terms to the prices of the echocardiogram. She pored over the baby endlessly after the procedure; she even called in another paediatric cardiologist to give a second opinion.

The final verdict in layman’s terms as the Aderopos demanded it; Omosalewa has a hole in her heart that would require surgery.  The surgery cannot be performed here because even Unique does not have the needed equipment. However, they would liaise with their partners in India to have the surgery done. The cost was unthinkable but the Aderopos had to save Omosalewa.

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Mrs Aderopo was at her shop just a week after she returned from India when she noticed that Omosalewa was turning blue again. She picked the baby up, called her husband and headed for the hospital.  She sped past every moving thing on the road, casting side glances at the baby as the hue increased towards the lips. At the last traffic stop before the hospital, she noticed that the baby had stopped breathing; Omosalewa was cold when she picked her up. The baby died before getting to the hospital, she was tired of a healthcare system that did not care for her or perhaps her names were not many enough.

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IN BETWEEN


In Between

The intrigues of being in the middle have always been with me, although I thought they had ended during my childhood and early teenage years. They came back to haunt me recently in a strange manner. I was born into a family of three children as the second child; I have an elder brother and a younger sister.  When we were children I felt the pain and frustration of being in the middle. My brother would return from school with tales of his new class and we would all listen with rapt attention. When it is my turn to recount my ordeal, I usually notice the attention waning gradually. Then the story usually ends-thankfully I guess for my parents- with “Oh, just do what Dele did when he was in that class”. I don’t blame my parents; I guess new stories just attract most humans more than repeated tales with a change in a few of the characters. They could recite the nuances of all the teachers now, their best clothes and even their favourite hairstyles. My mother especially tried to allow me air my stories happily by feigning audience but I always see the glint in her eyes when my brother starts to talk about the class that none of her children have attended before. While I feel neglected and ignored, my sister is right there with a mess for a lunch box, she only has stories of silly things she did with her friends during the break period. I guess they make for good entertainment too because my parents want to listen and the glint is back in my mum’s eye.

Classroom

I only sit and wonder at why she cannot grow up and stop talking about silly things. Then, I conjure ways to match my brother either in the act of storytelling or in doing something new for the first time. That is the life of the man in the middle; the one or those ahead seem too far away while the ones behind really need help. I want to bring my sister up to where I am whilst aiming for where my brother stands. It is like running forward with your face turned backward. However, I realised it is not always blissful for the guy ahead, he bears responsibilities. My brother was the only one who had the privilege of knowing why daddy would not come home the night he had an auto accident. I was too young to be told. My sister meanwhile was fast asleep. I was too old to sleep because I knew something was wrong but too young to be told what was wrong! Who said I did not want those responsibilities, but will I be able to handle them if given? I don’t know. It has always been that way. It is like a spectrum of drunken men, the guy ahead is clear-eyed, everybody depends on him and he is sure of himself. The man in the middle is tipsy while the last man is drunk. The tipsy man wants to behave like the clear-eyed fellow and he also seeks to help the drunken man. The first man will seek to help the last man because obviously he needs the help the most; he believes the second man can take care of himself. He should be able to anyway, if he concentrates on only one path but he is torn between two ways. When it is time to apportion blame the tipsy gets all the blame since he is liable to making mistakes and he is considered by all to be in his right mind. The drunken man is blameless; he is too influenced to be held accountable for his actions! The man in between always has the greatest dilemma.

Recently, on a mission for an international organisation to help curb the meningitis epidemic in northern Nigeria, I was paired with another doctor as part of a team. Richard is a European, we became friends quickly. We share certain interests and it also helped to work as friends. Habitually, our conversations revolved mostly around medicine, we compared the practice of the profession in our different countries of origin. He respects the knowledge of Nigerian doctors, their ability to manage patients without some investigations which he considered essential. However, he mentioned the disadvantages of this kind of practice which includes wrong diagnosis and increased resistance to drugs that are prescribed carelessly. He was quick to add anyway that Nigeria is better than many other countries. He mentioned some that don’t even have a healthcare system. “Nigeria does not need aid” he said, “She has enough doctors and abundant resources to provide proper healthcare for her citizens”. “Nigerian doctors do well in foreign countries thus they have no excuse for below par performance at home”. Richard obviously did not have enough facts to comment appropriately on Nigerian doctors but he was not condescending; it was professional conversation with candour. I imagined working in an environment with adequate facilities. I also wondered how people in the countries without healthcare have managed to stay alive. It was not difficult to identify the problem; Nigeria in the middle.

Farm

Today, we visited some settlements; they had earlier refused to be vaccinated. We were to find the reasons for their refusal and convince them about the importance of the vaccines. Our first stop was a little village of about two hundred inhabitants; they had a spokesman who could speak some English. They welcomed us without reservations. The spokesman explained immediately we asked that they were very grateful for the offer but they would not partake because they do not believe it will make any difference. His speech was garbled but we understood him perfectly. We tried to make a case for immunization but there was no common ground, they were adamant. The spokesman told us his story, he is a farmer, and not lazy he claims. He tills his land once the rains start; he plants enough crops for his family to eat. He has three wives and fifteen children, they help with the farm. The male children herd his cattle and sheep.  He has friends at the village square where they gather to play games and drink cuddled milk. The village is made up of families like his; they have a satisfied life, they do not want external influences like our vaccines to corrupt their children. The disease will only kill their children if God allows it.

I looked around him, children in tattered clothes struggling over our empty can of coke, lean women carrying gourds filled with water, definitely from far distances. Signs of poverty surrounded him but he did not know it! I told him the correct order would have been for him to get an education, start mechanised agriculture, build silos and barns then he would have food in and out of season. He could feed his family, sell more for good money and drink cuddled milk all day. He looked at me and laughed, his teeth were stained yellowish brown with kola nut. He asked my age, I observed him before answering; he should be about five years older than me. I told him my age, “Are you married?” he asked immediately, “No” I replied. He laughed again, longer this time. I cringed, who should be laughing at whom? He recovered “you can chase after the books forever” he said “but you will eventually have to do the necessary things”; he closed with a little more laughter. I felt stupid, why not? I was laughed at, but this man does not reason like me, we are different. The things I consider important are trivial to him and vice versa. I wanted to continue the dialogue when Richard nudged me “we should go” he said. We bid our hosts farewell, we shook hands and waved long enough to reduce the friction.

On our way, we conversed about the encounter. I admitted I made a mistake trying to solve a century’s problem in a minute. Richard told me to calm down; “the man does not feel any pain about his situation”, he explained “because he does not know any better, he is so innocent”. How could he not know it? I think some things just feel better. Then I realised that he was better than me. I know my situation, I know it can be better but I cannot make it better! He does not know so he does not need to make it better. Moreover, unlike me he feels no pain. I feel the pain for my own circumstances and also for his too. I want to work in a perfect hospital and I also want to turn a subsistent farmer to a plantation owner, even against his wish. The farmer thinks I’m too ambitious. Richard thinks his innocence is beautiful. If I decide to revert and become like the farmer I will be seen as complacent. Can I even replenish my ignorance? I have to stand where I belong. It is my life, my burden and my identity; to be the man in between – for now.

MENINGITIS


We expected the rain for different reasons this year; usually it’s because of lack of water. The world is like a gourd; half filled with water, it is tipped on its side. We reside on the side where the water is leaning away from thus when we dig a well; we have to reach almost to the end of the world to get water. It gets worse when the rains refuse to come. When there is no water, the cows become lean and the crops refuse to grow.

This year, the baobab and guinea corn in the store could still sustain us for a year and the cows could still survive on streams turned puddles. However, the disease has come with terrible strength. It has killed a lot of children and some adults; we know it is only the rain that usually stops its rage. It killed Aminu my immediate junior one, only thirteen! The adults say the last time it got this angry was ten years ago, then I was still a little girl. They say I was lucky to escape the decimation. Nobody knows the cause, but my mother once said something while scolding me for not fetching water; “you little rat, only fifteen, you have refused to obey your mother. God punishes disobedience with meningitis!”It is a terrible punishment indeed; I think somebody needs to speak to God. The disease makes them so hot and makes their necks stiff, they cannot say yes or no, it takes away their choices. Our village doctor at our little hospital tried but people still died; maybe God does not really hear his voice!

Haruna lost two children to the disease. He is the one who has asked for my hand in marriage. I overheard him telling my father that he will come for me after the rains; he surely needs the money from the harvest for the marriage. That is my own little reason for waiting for the rains. I have become the envy of every little girl in the village. They all know about the impending marriage now even though I told only one of them, my best friend.

The coming of the baturi(white people) made a difference though. They came with some black friends, they all seemed very happy together; like they had known one another for ages. They brought drugs to treat the ill victims together with injections which they gave everybody to stop the spread of the scourge. Their coming also created excitement in the village. All the little children gathered around them, not me, I’m old now. Sometimes however, I move closer to observe them. They seem to speak through their noses, I noticed that some of them were speaking to each other and could not understand themselves.  Are they not from the same place? They are a strange lot, these white ones with skin like pap and hair like horsetail! I did not take the injection though, if it passes from person to person, I nursed Aminu throughout his illness, what about ten years ago? I guess God is afraid of punishing me in spite of my many sins. Anyway, the white man can surely talk to God, perhaps their black friends too. The disease lost its power when they came with their injections.

The rain is falling now, heavily, seems like cats and dogs. If we cannot speak with Him, I think God really wants to talk to us now!