Bamako, Mali 10/01/2010

Fridays are usually lighter days to avoid having patients needing close attention over the weekend. Most of the team is planning a trip to Mopti and area NE of here; I am staying back with the coordinator Chuck (or Jacques) and the hand therapist Pam. We are planning to roam the city and go to Oumar's wedding. I wouldn't miss it!




One of the patients today especially struck me. He had a bad burn on his foot, but the good care under the guidance of our nurse educator Katie (at left, with PACU nurse Vicki) gave him a clean wound that could be skin grafted. This patient is five years old, and like many of the children, sat quietly on his parent's lap, but upon closer inspection I could see a tear brimming over and running down his cheek. He could not speak English or French, so we could only mime to him what to expect, and I could never erase the look of confusion and fear on his face.

When the time came, he climbed off his father's lap and started to hobble with me. I immediately realized that it was painful for him to walk and picked him up for a ride, but not before I could tell that if he had to walk into the OR, as little as he wanted to, he was going to do so. Such a brave little guy, and we are not even using the pre-operative sedation that we do in many other situations.

These kids are amazing. They spend most of their early life wrapped close on their mothers' backs, and have such a close sense of personal space. When we hold them in our lap to breathe them to sleep, rather than kick, push away, and have a tantrum, they give in and lean into us much sooner and closer than I am used to in U.S. They wander all over the neighborhoods as soon as they can walk, and have large extended families that include neighbors and friends. Very different sense of trust and community. There really have been very few children who have fought us, and it humbles me to watch them be so stoic through this experience.

There is an anesthesia resident who comes and spends time with me and I am learning so much about how they do things. His fund of knowledge is very good, but what they have to use is very limited. He asks very many good questions, and in the process it provokes me to think about how we do things, and especially if maybe we need to approach the patients here a bit differently than we do.




The chief nurse, called Major, has been very helpful with care on the ward. There are many here who function with us as part of the total team, and without whom we could not do the job well. It has been amazing to come together with them and partner for better care of the patients.






Everyone leaves in the morning at 5 a.m. I'll report on their trip when I hear about it, but for now it will be the three of us having adventures in Bamako.