More teachers than students

12/2/22

Yesterday, I had a bit of a lie-in as I was knackered post Friday, before heading down to NICE after breakfast. There were 3 new babies, so it wasn’t as quiet as it had been the few days prior. Two of them were pre-term and were between 1-1.5kg, while the third was a full term biiiiig boy at 6kg, and was admitted for hydrocephalus. Hydrocephalus is sadly really common here, mainly because antenatal care is not seen as essential, so mothers do not know about the importance of taking folic acid, nor is folic acid part obtained as part of a typical Somali diet. This lack of folic acid can cause spinal bifida, hydrocephalus and meningitis, which in turn causes the family a lot of stress and a lot of money. This is frustrating not only because now the baby’s life will be more difficult, but because folic acid is very cheap as a preventative measure, whereas all the surgeries and post-op care required to manage any of the conditions I have mentioned above are expensive, and since the mother stays with the baby, it also takes the mother away from her other children at home.

Anyway, I read up on the notes for the babies, checked their drugs and fluid prescriptions and did some obs and personal care. A newborn was brought in by a doctor, Abdulahi for monitoring and suctioning. A little while later the new baby was taken back to her mother, once Abdulahi was sure that the airway was entirely patent and the baby was taking sufficient breaths. The way NICU runs here is to me, a little odd. There is one staff nurse in charge and then lots of students who do bits and pieces for all of the babies, instead of getting each student to manage one patient each, with the nurse overseeing them. Apparently, this is cultural and due to the fear of being blamed for a mistake – one of the long term nurses here is American and wanted to change this practice before so nurses are more accountable, but the idea was not liked, so it was dismissed. What happens if a patient is neglected in some way and only one nurse is accountable?! The nurse in question will feel solely responsible and may feel so guilty that they may be unable to practice as a nurse any more, instead of reflecting on the situation and learning from it as we try to do in the West.

In NICU, I bumped into Emily, an American nurse who has lived here for nearly a year, who invited me for coffee with her and Amanda at Nomad. Since NICU was chilled, I went. We had interesting conversations about life here, religion – Muslim vs. Christian vs. nil, as well as just regular chit-chat. After coffee, we headed back as a C-section was about to take place.

I was due shortly to meet with Kenny across town in Jijiga yah (which means little Jijiga), so I got a Dhawaaye (taxi) and headed over. I wasn’t too sure where I was going so kept checking that we were heading the right way on Google maps – so much easier when you have data! I directed the driver a bit, before we found the restaurant Sultan. I told the driver, that this was it, but he continued to drive on. I told him, ‘stop here, finished’ and he asked did I want to go faster! Eventually he understood that I wanted to be let out and that he had gone past where I needed to be. I paid and left, stressed!

Inside Sultan’s gate was fancy, the floor was paved, the outdoor chairs were comfy, there were flowers in the hedgerows and a waiter in a waistcoat welcomed me in perfect English. Kenny spotted me and we went inside. I ordered an iced lemon tea, which was definitely lemon, not lime and was gloriously refreshing, and a lamb biryani which was a special. It was pretty good! Afterwards, we tried to pay, but after waiting over half an hour for the receipt to be printed, Kenny told them we would be in the cafe next door and they could bring the bill there! They obliged and we headed over to Cafe Mocha, which also had a chilled vibe. I ordered an alcohol-free (obviously!) passionfruit mojito, which was SCRUMMY and we chatted about all our experiences in Somaliland. We paid and left and I taxied back to the hospital in time for our 16.30 English class.

On my way back, I got a text from Mohammed, who is a paid teacher, who is meant to be in charge of the class told me that we had another first language English speaker joining the class to help teach. While this normally would have been very helpful to practice speaking and listening, we were going through a mock exam so it seemed a little pointless. Luckily, Mariette, a South African, who I had met once before was friendly and relaxed and didn’t mind mainly observing and joining in where she could!

After class, I wanted to go for a walk, so I asked Amanda if she fancied a village walk via the chapati lady. She joined me, and we headed through the village. We reached the top of the hill around sunset and got the last couple of chapati from the lady near the top of the hill. Then we walked back to the main road and back to the hospital in time for dinner. The walk was mildly eventful with boys pretending to kick a football at us and more stones being thrown, but that’s a story for another post!!

After dinner, I watched another film with Mubarak who was keen to restore his film reputation after I said he had crap taste in films in a previous post! Today we watched a worthy film, The Boy Who Harnessed the Wind, which is based on a true story about a boy in Malawi who builds a turbine and uses it to pump water across his fathers farm in the dry season so they can grow crops, and therefore survive. It was a good film – can’t argue with it!!