For the optically challenged patients of North Ghana, post-op day harbors a spirit akin to Christmas in the summertime. Everyone gathers early morning in a sun soaked corridor flush with emerald clothed nurses and a coarse drywall awash with russet wear, giving the appearance of superbly toasted bread. At the end of the corridor is a consultation room outfitted with blue beds and kidney bean pans ballasted with saline gauze, stacks of surgical gloves perched beside two metal examination chairs. The patients, sheepish in their plasters and morning gowns, are a varied bunch (at least as far as attitude is concerned). There are those who understand completely and without question that they have just undergone sight-restoring surgery, their perception unblemished by the fearful baggage attached to the term “operation”. Then we have the willing, but uninformed, surgical patients who are aware that their vision will be restored, though the method of restoration remains unseen. Last are the “eyewash” patients, who deeply reject the premises of surgical remediation and will only subject their eyes to a traditional washing. So we invite those patients for an eye washing, one complimented by syringes, scalpels, and local anesthetic.
And now, we take a short commercial break from the Unite For Sight Christmas Special to bring you an extra important topic for discussion: patient consent. Many of you, healthcare affiliated or otherwise, probably question the ethics of the “eyewash” strategy employed here. In the States, it would doubtlessly be considered poor form, and likely malpractice, to trick a patient into having an elective procedure once they’ve balked, save for choice instances in which the patient is unsound of mind or is unable to render edified communication on the matter (i.e., is unconscious). In rural Ghana it’s different, the game is rigged from the beginning. Finger wagging elders, power-endowed by the calcified austerity of their steel wool beards, warn villagers against the practice of modern surgical medicine. They brand the term “operation” with manifold images and anecdotes depicting surgery as a macabre, ungodly, and inferior form of bodily therapy. Imagine routine cavity patients refusing a filling for fear of the spirits melded into the alloy and you’ll get the picture. Instead, they swear by the familiar cure alls of local herbalists and medicine men— not that we necessarily disagree with the work of herbalists and medicine men. In fact occasionally, spiritual and traditional healing methods are given haircuts and called Western medicine. What we quarrel with is the scarlet letter drawn on our method that is proven beyond a shadow of a doubt to restore vision to the blind. And no matter how scientific, how thorough, and how persuasive we are in our quest to exonerate the “operation’ in the eyes of some of our patients, we are brow beaten by the deep driven stakes of African tradition. Then, for the time being, we play Jacob to sightless Isaac, albeit we aren’t quite as selfish or black hearted, out of necessity more than intentioned dishonesty.
Back to Christmas at the majestic King’s Clinic, where the girdered wheel cots are bountiful and the pace sluggish as a blood-bloated mosquito. But we’re a world apart, our lithe tones shimmying through the hinge of the consultation room door as we instruct, two at a time, the patients to kick off their sandals and “jzinema” (sit down) in one of the chairs. Gray edged tape and rosy gauze fly off like wrapping paper (I know, how much more predictable can a simile get?) and moments after we wipe the eye with saline, the patient can see. I won’t even posture as to what it feels like to regain sight after months or years without it, I’ll just tell you what happens. Patients over the age of 75 who formerly ambled taut-cheeked and stiff-eyed into pre-op now jumped up and down at the refreshed visage of color and light. “Sulaminga!,” one bilateral cataract patient shouted over and over again, identifying correctly each of the foreigners pulling bandages and wiping gunk on the other side of the room. The entire post-op process takes 30 minutes at most, but the resulting reactions are well worth the hours of screening, administrative tasking, pre-op, op, and post-op we all contributed to the process. And beyond the instant gratification of witnessing the patients take in the world I am very curious to see the longer-lasting results of our work–returning to the farm, greeting friends eye-to-eye, and most importantly, seeing grandchildren for the first time (Alhassan Iddrisu, I’m pointing at you).
***(The next part of this blog is about the other volunteers on this trip and is not critical or relevant to anything said above...so feel free to skip it...or read it in full if you have some extra time and a substantial latte on hand)****
On a soggier note, four of the volunteers shipped off to America yesterday. Someone once told me it’s always tougher to be the one left behind, and for the moment I’m beginning to understand what she meant. So I’m going to talk about them for a little bit and hopefully exhale any of the sadness lunged up from their departure. To Poy and Lynn, you two were a chimeric paragon of efficiency. Never in my life have I seen a two-woman team move so quickly, extensively, and bilingually as you both. You documented, formalized, created, dropped, refracted, visual acuitized (?), and played Wanye’s Angels to admirable degrees and as a result, I know the program, its contributors and its patients have benefited incalculably. To Laiyin, who had the most languorous journey on the planet from the States to Tamale and arrived jet, bus, and car lagged at her first outreach less than a day after landing in Accra, I was so pleasantly surprised at how quickly that mildly cranky Boston med student turned into one of the most capable, medically curious, and visibly compassionate people I’ve come across. You were like a mother to our group—I remember numerous instances when, mid-task, you would ask me or the nurse or anyone else around if he/she wanted something to eat or to drink or to take a break if we looked too sun beaten to function. On a very different note, I appreciated and admired your willingness to join the “boys-boys” culture created by the “A Lot of Tings” crew. Whether enduring the small and reasonable tussle at GIDDYPASS (Crest is passé, I’m telling you) or macheteing through the grove of cowlicky locks nesting atop Pietro’s head, you created an atmosphere of openness, positivity, and spontaneity, which is exactly what this trip is all about. So thank you! And to Chops, my brother from an endocrinologist mother and business partner in the newly christened African Rainbow Summer Camp, thank you for tolerating the multiform beast of witticisms, unnecessarily deep conversations, and nightblind fumblings I gestated and birthed in our time here. There are truly too many memories to count, so I’ll just reference a few on this blog, you know, for safe keeping:
- “I was not in Tamale”
- ‘pum pum pum pum pum’
- ‘Ok, so, you get a motobike...”
- Reviewing Joseph’s file
- Thinking I was a comic genius after “the pot calling the kettle black” and being Dagbani hustled by Mr. Dresses Like Rick James
- All of Salam’s comments indicating that things simply “did not happen”
- All of Pietro’s comments awakening our senses to a cleaner, funnier version of the way things did happen
- And finally a childhood milestone that I recently stuck to my mental refrigerator: Alot finished his first calabash and brought it to my room today to present it. At 7:30 in the fucking morning.
As I closed the door, he said, “So now, if I make it with the glaze, I can make it very nice, with the glaze, it is 5 Ghana Ce...”
I’ll stop now, but seriously, becoming friends with you over this short period of time was awesome and the diamond-flush coalmine of memories we’ve amassed in such short order is (hopefully) indicative of how many more we’ll create when we meet up for a reunion. Who knows, maybe you’ll even see me at Myrtle Beach again... (there are no winks large enough on this computer, but you can imagine how hard I’m winking right now).
Take care everyone and though you’re already re-exposed to the familiar patriotic oeuvre of American culture, please don’t forget the following:
It’s nice to be nice. Sharing is caring. Make fufu, not war.
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