HOLY WATER BOTTLES, GRASSHOPPERS AND DRUMS -3



Car trouble



              On Thursday morning we went to the car park and got in the car.  Kieran fired the ignition; it gave one graveyard cough and died.      We found a man, a jump lead and a willing motorist… nothing.   We found better jump-leads, the manager of the hotel, a better car… nothing.    One of the hotel staff fiddled under the hood and… yieeeeeeeha… the car started.       But Kieran was nervous about it.   We were going to Linda and, if we got stuck out there, we’d be badly stuck.   The S.M.A. Fathers came up trumps and lent us another car and off we set to Linda.

   

            The road to Linda is paved… for about 100 metres, after that, it’s orange-red mud.   March is rainy season so the mud is rutted and potholed and churned and you have no way of knowing how deep the ruts and the potholes are because they’re filled with water.    You cannot drive on the “correct” side of the road because you have to slow to 10k per hour and suss out the high ground.   Alex sat in front suggesting routes while Kieran wrestled the steering.   Martin and I bumped about in the back. 

 We arrived at the Catholic Church in Linda.  

The mobile unit was there already and people had gathered for treatment.    At least there weren’t the huge numbers we had had to deal with the previous day.    We set up the audiometers, hearing aids and mould-making equipment.   Inside the church, sound bounced about so much that if someone were more than an arm’s length away you couldn’t catch what they were saying.   Maybe when it’s full the people absorb the reverberations but, it wasn’t ideal for hearing tests. 
Ready for action.

            Then, just over the church grounds wall we heard a band blaring through loudspeakers.   It was the Marie Stopes Sexual Health Clinic.   The Marie Stopes Foundation is wealthy so it can afford to hire a band and a loudspeaker system powerful enough to let everyone in the village know where they were.   They had people in yellow t-shirts handing out leaflets and directing the locals to the clinic.   The incidence of HIV and AIDS in Zambia is very high so, on the one hand, we were pleased that the Foundation was doing something to educate and help, on the other, the noise wasn’t making our lives any easier.   And, I swear, we weren’t a bit jealous of their superior spending power!


The Marie Stopes  Fiesta



            We set up on the church seats and, once again, I was faced with the problem of how to condition the small children for a hearing test.   This time however, there was a solution.   It was International Women’s Day and there had been a celebratory Mass that morning which finished just before we arrived.    Below the altar stood an electric guitar and a drum-kit.   I liberated one of the smaller drums from its stand.   It was surprisingly heavy.   But what the heck, it did the job and I was able to test several small children successfully.    


Note drum at the back



me, pattison and  musical instruments

We had fewer patients than we had anticipated, probably because they were all dancing, over at the Marie Stopes shindig.   Just as we were thinking of packing up, a young woman dashed in.   Her ear was hurting.   She had decided to clean it out with a match stick but the match had broken and the red, business end was stuck deep in her ear canal.   Kieran removed it and she promised that she would never stick anything smaller than her elbow in her ear ever again.

Kieran at work

We braved the unpaved road once more and we even got back to our hotel in time to have a quick swim in the pool.    It helped unwrinkle the kinks we’d acquired bumping along on the Linda road.   And no, we did not swim with the crocodiles, they were happily basking in the decorative pool with the papyrus and the weaver birds next to the bar.   We even had time to go to the bar for a drink and watch them bask.
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Going home



HOLY WATER BOTTLES GRASSHOPPERS AND DRUMS - 2

ENT ZAMBIA -  WEDNESDAY.

            On Wednesday we went to Mazabuka, a two hour drive from Lusaka.   The plan was to get there as early as possible so that we would be finished in time to make the return journey in daylight.    While we were still  forty kilometres away I got a text.   It was from Sister Mariana, a Zambian nun whom I’d met here in Ireland. 

“Many people are here,” read the text, "they are waiting anxiously for you to arrive.”

            We arrived in Mazabuka and went to Nchete House, a community centre run by the Sisters of Mercy.   People were streaming towards the waiting area.    We looked in.   Holy Guacamole!    People of all ages were crammed into the waiting room and more were arriving.  Time to get cracking.  



Kieran in the waiting room looking daunted.













Alex, Martin and I set up in a circular thatched hut in the grounds.    Part of the space was a waiting area and the rest a closed off room.   

Audiology Mazabuka

Three audiologists working in one room is not ideal but, it was the best we could do.   Mutanta, our interpreter, was continuously on call so there were non-stop interruptions.  Outside, the waiting patients all talked at the top of their voices and, every so often, we had to go out and hush them. Besides it was very dark inside the room, so we were all frowning through the gloom at our audiometers.  



Peerubgthrough the gloom.



Outside there was chaos.   The Sisters had taken names and given everyone a number as they arrived but, when we arrived, Kieran asked for the patients to be divided in to three groups. Ear, Nose and Throat.   This meant that people were no longer being seen in the order in which they’d arrived.   And nobody likes that.  Mutanda and Alex had to keep going out and explaining.

 

 

Pattison at work



At one point in the afternoon there was uproar outside and I went to ask the people to quieten down.   I opened to the door to find Pattison. Our ear-mould technician cowering outside.   Pattison is young and slightly built and his outsized white lab coat made him look even slighter.   He held a chart in front of him like a shield and his eyes were wide and darting.   In front of him stood three, large, middle-aged women, feet planted apart, hands on hips, heads wagging, angrily giving out the pay.   I reckoned they were not happy with having to wait but   I decided, coward that I am, to withdrew discreetly and suffer the noise.

I don’t even know how many patients we saw that day because it was heads down test one and then the next. Next, next.   There must have been about 150 altogether.     Two patients stood out one was a little girl who had suffered malaria and been treated with quinine.    As a result her hearing was severely damage.   Sadly, I couldn’t test her properly partly because of the conditions and partly because I did not have a drum.   A drum is very useful for conditioning small children for a hearing test because, no matter how bad their hearing loss they get the vibrations of a drum.   I had the sense that she might have some useful hearing but she clearly did not know what I wanted her to do so I cannot be sure.    Her little face has been haunting me ever since.

Another patient was Beatrice, a woman in her thirties, wearing a nurse’s uniform.   I asked her if she spoke English and, although she appeared to hear me ,she folded over, collapsed in to giggles, twisted about in her chair and looked away.    It was such an odd response that I wondered if she had difficulties other than her hearing.   Was she mentally ill?   Did she have a learning disability?    As I was furiously thinking how I should proceed another woman in a similar uniform came in and sat beside her.

“I speak English.”  She said.  

Then she dropped her voice and leaned confidentially over the table.

 “And I am very familiar with her “condition”.”

Good lord. What “condition”?

            I explained the test to the companion.   She passed on the information in Tonga to Beatrice.    Very soon her “condition” became clear.   She had a very severe hearing loss.   Once I realised this, I spoke directly into her ear.  She seemed delighted with this and it turned out that she spoke excellent English.   Her initial response was just embarrassment.    As soon as she got her new hearing-aids she was delighted with life.

            Mazabuka was also the place where Kieran removed wax from a man’s ear which had a grasshopper embedded in it!   Yuck…. But kind of interesting too!   He also declared that he’d seen more pus in Mazabuka than he’d seen in his whole life.   Martin suggested we call him Pus in Boots.    At the time it seemed hilarious!

 

Grasshopper in ear-wax... mmm...delicious!







            We had hoped to leave Mazabuka in time to get back to Lusaka in daylight but that didn’t happen.   In Africa the sun doesn’t bother lingering about delivering twilight.   It plops down behind the horizon without a with-your –leave or by-your-leave.  

Sun in the process of plopping.

Alex had to sit up in front and warn Kieran of potholes.   She also had to watch for pedestrians because it’s very difficult to spot Africans in the dark.   Then there were the cars that whiz past us on the inside and the cars driving at speed with no lights.   I was glad I was sitting in the back and I dealt with my fear by chatting merrily to our two nurses, Evelyn and Mercy.

            We arrived back at our hotel wrecked and slept the sleep of the just.



The end of a hard day.



HOLY WATER BOTTLES, GRASSHOPPERS AND DRUMS-1

E.N.T. ZAMBIA.  

MONDAY AND TUESDAY.



Me, Alex, Alfred and Kieran



Martin, Alfred and Kieran.



We set off on March 3^rd and flew from Heathrow, overnight, to Lusaka, the capital of  Zambia.    “We”, were Kieran O’Driscoll, E.N.T. surgeon, Alex Fay, Senior Audiologist,    Martin Stone, Audiologist and hearing aid wizard and me.   

Sr.Bernard

We arrived crumpled and dazed and, before I could get my bearings, Sr. Bernard had whisked us through passport and customs.   Sr. Bernard is “a friend of the corpse” and she has free rein in Kenneth Kaunda Airport.   She is the airport chaplain and, as a woman of formidable presence, all the airport staff defer to her.   Besides, she got a hearing aid from ENT Zambia.  

            At our hotel we admired the weaver birds and crocodiles in the pool by the bar.   

Not viewing guests as dinner

No, they’re not man-eaters; they’re moved into the wild before they’re old enough to start viewing the guests as dinner.   We unpacked, had a shower and went off to the E.N.T. unit in Beit Cure Hospital, Lusaka.  

Beit Cure is our base in Zambia.   The E.N.T. operating theatre was built and supplied by Irish Aid, and their mobile clinic was supplied by Gorta.  We met our Zambian colleagues, Alfred, the Audiologist, Charity and Evelyn the nurses, Pattison, the ear-mould technician, Daniel, the maintenance man and mobile clinic driver and Ute, the resident German E.N.T. surgeon.   The rest of the day was meetings, checking equipment, organising the coming week.  

            On Tuesday we were up at the scraic of dawn and off to Chainde in the four-wheel drive lent to us by the S.M.A. fathers.    The mobile unit travelled with us.   Chainde is just outside Lusaka.   It is where the S.M.A. fathers have a church and a community centre.   Kieran and the nurses set up in the mobile clinic and we audiologists set up our audiometers in the sacristy.   

While I was waiting for the patients to be sorted out, I took a look around.   There were classrooms for vocational training and a class for  special needs children.   I  went to visit the class.   It was a mixture of children with physical disabilities. hearing loss and social deprivation.   The kids gathered round clamouring for sweets.   I had none but I suggested that, instead, they might like to look inside my handbag.   Children love looking in handbags.   I showed them my purse, my comb, my packet of tissues and the shiny purple case of a lipstick.    I took it out and opened it .

“Would you like some?” I asked one little girl.

Me!   Me!   Me!   Me! Me!

Of course she did!  

I put a little lipstick on her lips and next thing I was mobbed by a jostling chorus of “ Me. Me.  Me.  Me. Me.  Me!”   And that included boys.   I got them to queue up… sort of… and the more enterprising boys  came back for a second application!

            My first patient was Francis, a young man in his early twenties.   He was frowning with the strain of trying to hear.    He had a significant hearing loss.   Some losses can be medically treated others can’t and his was the untreatable kind.   However  I knew that he’d benefit from a hearing aid.    He went to see Kieran, just in case, Pattison made the ear-moulds and Martin fitted him with aids to match his hearing loss.   Later he returned to my room with a big grin on his face.   Now he could hear.  

Francis with his new hearing aids.



            There weren’t too many children at the Chainde clinic so most of the time I was testing adults until Mary arrived.   She was four.   The problem with hearing tests is that the you need the full co-operation of the patient.  With adults, you ask them to raise their hand when they hear the whistle, put on the headphones and off you go.     But children are different.    They get easily distracted.   They get squirmy when  their legs are dangling from adult-sized chairs. They may not understand the instruction.      They may raise their hand when they hear the first sound and then leave it up and not  know what to do when they hear the next sound.    They get worried, lose confidence and, in an effort to please, they  give false responses and you have to start all over again.   So, when you’re testing  children you need a child-sized table and chair.   You need a box of bricks and you need a drum.    You demonstrate what you want by banging the drum and getting the child to put a brick in the box each time she hears.    But we had no child-sized furniture, no bricks, no box, no drum and not even a  common language.   Mary only spoke Nyanga and so did her mother. 

I just had to hope that Mary wouldn’t get too squirmy.   I decided to get her to tap the table with something each time she heard the sound.   I searched the room for something she could use.   There was a rack of Mass vestments.    But you can’t tap a table with a chasuble!   There was a shelf with a large missal and some books.    There were some missionary magazines, and copies of a parish newsletter.    Then I spied some small bottles.   Jackpot!


Note bottles on bottom shelf.

     One was labelled “Chrism”, it was very sticky.   Another was labelled  “Oil of Catechumens”, that was sticky as well.   The third was labelled “Holy Water.”   Okay, I thought, let’s go with the Holy Water.  Then I had to find an interpreter.   I found a Zambian nun who had come with another patient and commandeered her.

            Maybe the Holy Water performed a miracle or maybe Mary was a sensible, intelligent child.   She copped on immediately and, despite the fact that her four-year old legs were dangling, that she spoke no English, that I spoke no Nyanga and that we had no colourful, child-friendly toys, she didn’t get squirmy and she didn’t lose focus.   She listened, responded perfectly and performed a successful hearing test.   She had a hearing problem but it was of the treatable kind.    She went to the mobile clinic and Kieran looked after her.



Kieran at work in the mobile unit.



            At the end of the day we went back to our hotel tired but happy.