26 September 2005

First Day as Gone-Gougou doctor

9/5/05
Maiga and I had morning bread (no butter, jelly, jam, spread of any kind) and tea (some Lipton-like brand but with Arabic writing on it, with sugar), talked a little on how the clinic worked and such, and then we were off. I remember thinking “Holy shit, how does one use a stethoscope again??” as we walked to Maiga’s office to get our equipment. He had seen my short white coat, and said that wouldn’t do, and handed me a crisp, freshly clean LONG white coat for my use in Doneguebougou. I remember the first time I tried it on, I had these strange thoughts of “Holy Shit, I am a doctor now,” anxiety, and pure fear. I also remember thinking that John Carter would be jealous. Maiga had an extra stethoscope for me because like a dumbass I had forgotten my own back home in Hippodrome.

We walked the short 50 feet or so from the vaccinations clinic to the other clinic, and greeted a mob of anxious mothers and their babies. The scene was truly one of utter chaos. Mothers wearing one part traditional Malian garb (multi-colored sarongs with hair scarves), one part Western t-shirts that ranged from football (aka soccer) apparel to I Love New York to Best Grandma in Texas. Their children were either at their side, looking up at the Toubaboo (White Man) with a look of both fascination and fear, or on their backs, wrapped with a thin sheet-like material to secure the baby to the mother. The mothers looked at the two of us, and appeared relieved, but I had the suspicion they were not too sure about the Toubaboo. I received all kinds of stares: puzzling, infatuation, scorn, wonder, indifference. The clinic “guide” (aka the village elder who assists the clinic as a nurse and pseudo-purveyor of order while we are there) had already made a list of names, and handed it to us. We walked in, saying the traditional “Ini-Sogoma,” found our chairs, and started seeing the patients.

The clinic building could not get more basic if you tried. Imagine if you will a building made of concrete. The front area is the “waiting area”; there are a few benches that align its walls, and some scattered chairs. Directly behind that is the “treatment” room. There is a bed in the back left corner for patients that require procedures. A shelf and a metal closet is on the back right filled with medicines and basic equipment. I have not had a chance to explore what resources are at hand yet; that I hope to do soon. The room immediately to the right of that is part storage, part second treatment room. It is rarely used, which is a shame, because it has a lot of potential use.

The consult room is in the front right. It is exactly how I had pictured it. It is small, about 10 foot x 8 foot (aka 3 meters by 2.5 meters), and is rather spartan. It is painted a deep color blue, and dirt is caked on the walls in varying patterns that make it appear as if it were part of the design. There is a desk along the back left wall with various notebooks, stethoscopes, a BP cuff, a ruler, antibiotic cream, plain white paper, and other things which I have yet to really look at yet. There are two chairs on either side of the desk, and fan in the far part of the room near the door that leads into Treatment room 2/storage room. There is an exam table with a thin single foam mattress with a floral pattern on it, and a thin orange sheet that covers the mattress. The table looks and feels old, and it is too high up for patients to get on and off. We hardly ever use it, as the physical exam is a joke: quick listen to the lungs and heart, feel the belly, and order the usual regardless of what we find. I find the whole thing very frustrating sometimes.

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