Cassava Leaves

With the help of a ward nurse, I guided the stretcher with Mabinty toward orange ward. She was our second patient today in theatre and I opted to take care of her in recovery while the other nurses ate lunch. On Mondays, the kitchen prepares cassava leaves for the patients and staff; and on Mondays, I find something else to eat. I still have not mustered up the courage to try the greenish brown slimy substance. It is a local favorite, but once you get a whiff or a look of it- your hunger pains cease. 

So Mabinty and I missed out on lunch today, but she got the better deal because she had her fistula surgery. I went to the ward this morning to check on her paperwork and walk with her to theatre. She was a little nervous and even more so when her blood pressure skyrocketed while the spinal was going in. One moment, I stepped away to tie the scrub nurse’s gown and she grabbed my arm. I held her hand until the spinal was over and she was positioned for surgery. Mabinty is only 16-years old and her life changed forever just three months ago when she tried to deliver her first baby. Sadly, it’s the same story for these ladies with losing the baby and leaking urine for a long time. However Mabinty heard on the radio about our fistula hotline and called AWC to speak with a nurse. She came just after the fistula formed and received surgery three months to the date. Mabinty was all smiles in recovery and I tried the krio and Temne I knew, but no response- just a smile. I looked over her chart and under language was “Limba”- that was a new one for me. With both of our broken krio- I learned how to ask, “How are you?” – Sounds like “wall-e, walle” and the response of “fine” is the same!

After surgeries wrapped up for the day, I found myself at my desk working on an assortment of projects. Today, like most days, is catching up on data entry. Once a lady is discharged home, their chart is inputted into the computer. It’s tedious, however I remember each of these ladies as I look over their charts and am thankful they are going home. Once the five o’clock whistle blows (in my head) and my eyes are going cross staring at the computer, I leave the charts for the next day and walk out to greet the ladies. They are patiently waiting for their dinner and tonight, its leftovers, cassava leaves. I notice there is only one kitchen lady dishing up dinner, so I head over to help. I hold my breath as I pour the slimy mixture on to bowls of rice. I manage through the twenty-five servings and I start to head toward the exit, but one of the ladies Fatmata calls me over. I sit down on the bench between Fatmata and Hawa. All the ladies giggle, as I practice different greetings. Fatmata drills me every time we cross paths on my Temne. I then try Mende, Lucia taught me in recovery when I took care of her. I thought she was motioning with her hands that she was going to be sick, but instead “Ka ya Gorama” really means, “Thanks to God.” Lamrana, I notice sitting across from me and I greet her “Jarama”- this is Fullah spoken in Guinea. Last week, I wheeled Lamrana back to the ward after surgery, while passing the other ladies at the craft tables they sung songs of celebration for their fellow sister.

I was brought back to the present moment when I was handed a bowl of cassava leaves and rice. I thought about it- I never really tried the concoction, so with all eyes on me, I made the plunge. First impression: oily (hence the slimy appearance), peppery, and then the burn came soon after. I enjoyed a few more spicy bites and then Isatu noticed I probably wouldn’t finish my portion. She asked for it and I happily shared since she is the one that needs to put on more weight before she has surgery. As I sat with the ladies, this evening, I couldn’t help but smile, I was happy just to sit there and watch them eat their cassava leaves. 

Dry and without shame...

Fistula camp is finally wrapping up here at AWC. Although, camp surgeries ended two weeks ago, the ladies are still here recovering. While some think March Madness has to do with basketball, for me it had to do with one thing: beds. I would go bed to bed each morning with the doctors on rounds to check on all the patients. For camp, we tripled our numbers and quickly we ran out of space. At one point, we had 80+ women staying overnight and that was a number I had hoped we never reached. The wards- orange, blue, and green- all added another bed. The classroom was converted into a ward with 15 beds. The team house dining room was literally a camp with mosquito nets draped over mattresses on the floor. Excel workbook became my best friend as I moved ladies around the five wards based on acuity and the surgery schedule. I knew each lady by name and where each was sleeping. One day, as I stared hopelessly at my color-coordinated charts, I thought we might not have enough space. Then the door between the doctor’s and my office opened- and out came a patient. Adama was dancing and singing tenki to Papa God because for the first time in ten years she was dry. She came over to me and gave me a great big hug- at that moment, I realized, I would make bed space wherever I could find it for these ladies.  

So, I’ve shared stories of young girls that have come for fistula surgery and the majority are teens to twenty-somethings. However, there are ladies that have suffered from fistulas longer than I have been alive. Galleh came all the way from Guinea in hopes of finding help in Freetown. Her chart was nearly blank- she did not know how old she was and she had lost count how long she had been leaking. The top of her head wrap would reach my shoulders as I gave her a hug everyday. I called her my Fullah (Guinea tribe) grandmother. Galleh had her surgery during camp, but unfortunately we could only do a little to help the leaking due to the extent of her injuries. She would tell us on rounds that her leaking was lessening everyday and even the surgeons were amazed with the outcome. I couldn’t help from smiling whenever Galleh flashed her toothless grin.

When I first met Yeama sitting on the clinic benches, she gave me a quizzical look- probably the color of my skin. Yeama looked like any other seventy-year old women, however, when she stood up- she was bent at the waist almost to ninety-degree angle. (Think back to geometry- right angle) I questioned if it was just severe osteoporosis. Her story brought tears to my eyes. Yeama could only remember she was a young girl trying to give birth for two days. She eventually delivered a stillborn baby; this would have been her first and only child. Her husband left and abandoned by her family because she was leaking urine. Yeama did not feel worthy to look into people’s eyes so she bent down to avoid their judgment. Over time, possibly 40+ years, the shame crippled her so much she could not stand up straight. As she recovered on the ward, I saw her transform as she interacted with the other ladies and even gave me a smile when our eyes met. Although, Yeama will never stand perfectly straight again, I could see that a weight had been lifted. As her name was called out at the Gladi Gladi, Yeama stood up for the first time dry and without shame.