Pumui in Salone: Just Call Me Dr. Karen

My "Home" Away from Home - Morning Star Health Clinic in Bo, Sierra Leone
Today was my first day at the medical clinic/hospital that I will be working at for the next six weeks. I've helped at this clinic two other times, but this is the first time for me going alone and for such a long period of time. I walked in the clinic and immediately recognized familiar faces of friends who I left nearly two years ago. There are also some new faces, like two new nurses. 

Playing Peek-a-Boo with a Child in the Procedure Room
When I arrived at the clinic I instantly was put to work observing a contraceptive implant. Let me preface this story by saying that the sight of blood has no effect on me; I used to watch surgeries with absolutely no reaction whatsoever. However, today during the implant procedure, I noticed that I started to become overheated, my hearing ability completely disappeared, I lost feeling in my arms and legs, and I started to have tunnel vision. Thinking I was about to collapse on the spot, I pulled a chair up to the patient so that I could still watch the procedure but just sitting down. I realized I was having a heat stroke. I was too prideful to mention I was having a heat stroke, but at the same time I didn't want to be a patient in the clinic I'm helping at. The heat in Sierra Leone isn't that bad that it affects me all the time, but I realized that I hadn't drank any water all day and between that and being stuck in a tiny room that wasn't ventilated, my body was probably going into shock. I managed to not faint by concentrating with all my might on staying conscious. I got some water and began chugging and after about 15 minutes I was mostly recovered. But when another patient came in for an implant a half an hour later, all the symptoms came back, but this time even more severe. I started to lose my balance and got back on my chair. Again, I managed to not faint - but I worried that this would happen every time there was a major procedure. I guess my body wants more water...

On the bright-side, I survived heatstroke not once, but twice!

Dentist Tools used in Morning Star Health Clinic
The clinic that I will be working at during my stay here is called Morning Star Health Clinic. They do general practice, ophthalmology, and dentistry. They are also capable of taking care of minor emergencies and child deliveries if necessary. It's an almost-free clinic: patients pay the equivalent of a dollar to register and get their 'records' kept in a little book and they pay a significantly reduced price for their medicines. 

Marie Stropes delivers the family planning materials (which include the 4-year contraceptive implant, a 3 months injection, or daily birth control pills) through an organization call BlueStar. Almost every patient that I observed today came to receive the contraceptive implant. I always hear that Africa is too overpopulated for its own good - some people say that is why this continent is poor. Too many people and not enough food. All they do is have children. But really? Seeing these women come in and take matters into their own hands in deciding that they were done having children (at least for the time being) shows me that African women don't simply have children for the heck of it. I don't want to hear anymore that there needs to be 'population-control' in Africa, because to me, there already is. So don't tell me that famine and war are good for Africa because it controls the population - it's not needed. 

Morning Star Health Clinic has the bare minimum when compared to US clinics (obviously). But I am constantly amazed at how they make do with what they have. They buy special medicines as need so as not to purchase too much and have it expire. One patient came in today with an earache and the doctor used his phone as a flashlight to see in their ear. And they take care of patients all day without electricity! The staff here really is creative and ingenious when it comes to improvising!

The Beautiful Little Ama
Something I find funny (and sort-of sad) is that many of the patients assume that I am a doctor. They refer to me as a doctor and when they describe their symptoms in Mende or Krio they look at me and not the actual doctor. Little do they know that my medical training is zilch and I have no idea what they are saying. I nod my head to show them that I'm listening to their indistinguishable words and keep glancing at the actual doctor, Dr. Francis, who just keeps smiling at me. I think the patients assume that the only reasons a pumui would be here would be to train the local staff. Little do they know, I am there to learn from them. It's funny how that works. 

When we got home I chugged water like it was nobody's business. Dinner consisted of a warm salad, cold french fries, and Ramen noodles - in other words, not the typical African cuisine I was hoping for. There were still several hours of daylight left so Julie and I decided to spend time with the kids in the neighborhood. I think half of the children in Bo came to play with the pumuis. I soon became infatuated with one little girl: Ama. I'm not good at guessing ages, especially in Africa when children are way smaller than they are supposed to be, but if I had to hazard a guess I would say she was about 4 years old. Whenever I talked with her in English, she would look at me with the biggest smile she could give even though she didn't understand a word of what I was saying to her. I tried to speak Mende to her, assuming that she was Mende. I would say "Bua!" (hello) and she would respond "Bua". I would say "Kaawena?" (how are you?) and she would reply, "Kaawena?". I guess she doesn't speak Mende either. Either way, she just enjoyed talking to me and I adored having her around. 

We played with the neighborhood kids for the rest of the evening until it became so dark that I couldn't see them anymore. Once the generator came on I continued with my nightly ritual of writing in my journal and doing research for my courses. I laid under my single light bulb and listened once again as the guards conversed in Mende and Limba outside my window and watched as the night sky once again lit up with the lightening of the approaching rainy season storm. When I turned the light off in my room, the buzz of the mosquitoes and the hum of the generator lulled me to sleep. 


  1. Anonymous31.12.11

    Hey Doc Karen, thanks for sharing. I know that swimming head feeling, I once tried to politely observe Ramadan with my Sudanese colleagues. At about 1300 I got this awful spinning headache and that was the end of that experiment.

  2. Thanks for the support Al, glad to know someone else experienced the same thing! Yeah, I would assume that fasting in the Sudanese heat would not be the easiest thing to accomplish ;-)


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