Star Fishes

Prior to coming out here to Jinja, like any other trainee on their first volunteering mission abroad. I was full of doubts, hopes, worries and more worries. At the pre- assignment training my fear was ever so glaring on my face that it prompted a pet talk from Global links Manager about my options at which point the popular story about the young man throwing in the starfishes was discussed.  After 5 months in Jinja this story continues to hold true.

Here is a reminder of the story… Once upon a time, there was an old man who used to go to the ocean to do his writing. He had a habit of walking on the beach every morning before he began his work. Early one morning, he was walking along the shore after a big storm had passed and found the vast beach littered with starfish as far as the eye could see, stretching in both directions. 

Off in the distance, the old man noticed a small boy approaching.  As the boy walked, he paused every so often and as he grew closer, the man could see that he was occasionally bending down to pick up an object and throw it into the sea.  The boy came closer still and the man called out, “Good morning!  May I ask what it is that you are doing?”

The young boy paused, looked up, and replied “Throwing starfish into the ocean. The tide has washed them up onto the beach and they can’t return to the sea by themselves,” the youth replied. “When the sun gets high, they will die, unless I throw them back into the water.”

The old man replied, “But there must be tens of thousands of starfish on this beach. I’m afraid you won’t really be able to make much of a difference.”

The boy bent down, picked up yet another starfish and threw it as far as he could into the ocean. Then he turned, smiled and said, “It made a difference to that one!”

adapted from The Star Thrower, by Loren Eiseley (1907 – 1977)

I present to you some of my starfishes-

 M & M! These twins were born at 27 weeks gestation; they weighed 700grams and 800 grams.  All we could do was give them antibiotics keep them warm via KMC and use our homemade CPAP.  5 months on they are both 2.8 kg and 3.1 kg respectively. 

Baby N- brought to hospital with severe pneumonia from an orphanage by a kind lady.  Needed oxygen for a few days and is now a picture of health.

Baby S- Admitted with severe malnutrition in shock, and tuberculosis. Now gained a lot of weight (maybe too much!)

It thus make a difference to that one starfish thrown back in the ocean.

Reflections

I haven’t written in a while, not because nothing has happened but because I find myself getting use to the order of things. I no longer count the amount of deaths we have each week as I did in my earlier months, neither do I complain about the lack of resources. It is the order of the day and lamenting never helped anyone; one just has to make best with what we have here.  My time here is slowly drawing to an end and I find that I have become very reflective about what these few months have taught me.

 At first I was worried that I have become hardened to mortality and that scared me, but this isn’t true as one of my favorite patient “passed” last week whilst we were away and I find that I feel such a great loss on the passing of this lovely 2.5 year old boy who has been in Nalufenya for over 4 months. I realize that doctors working in these situations are not hardened to mortality; they have learnt a way to cope with it without burning out. One of the Ugandan doctors once told me that she hardly cries at the loss of a patient now because she did all her crying when she was a Medical student. I can relate to this in my time here.

Lunch with work colleagues

On a personal level, I am overwhelmed by how far I have come.  It really is true that you do not know what you are capable of until you are pushed. Jinja has taught me to be patience and tolerance, in truth my character and identity as a person has been greatly tested over the few months and I feel a better person for doing this. The challenges I anticipated ahead of this experience seem ever so trivial in comparison to what were truly my challenges. More than any fancy clinical skills, I find that in these situations your relationships with people matters as well.

Apparently this baby looks like me

Professionally I feel more focused than ever, this is what I like doing.  This experience has taught me to rely on my clinical skills more than any investigation; I have learnt to think outside the box and find alternative, simpler ways to treat our patients instead of worrying about what I do not have. I now realize how ambitious some of my aims and objectives were and although I haven’t achieved every single one of them, in here lies a lesson itself. Patience! Rome wasn’t built in a day. In the last 5 months I have done more teaching than I did at home and this has also opened up another interest of mine. People ask me if I think I am a better doctor for doing this. I hope I am! I feel so luck to be able to do this job. 

Working on the special care unit

Lastly I have come to appreciate my life even more, I feel incredibly blessed for the opportunities I have had thus far. To have such great mentors, friends and family both at home and amongst the expat community here is incredible. Thank you to you all once again.  Will I do this again? The answer is yes, in a heartbeat.