In between worlds
I’m in Benin, but not really. Many of my colleagues are Benin locals and some are from neighboring countries, but there is a barrier that I don’t often know how to cross. The hospital within the steel walls of the Africa Mercy is not touching land; we have a flowing cushion of water underneath us at all times. We live in a ship, but we don’t move. We have limited medical supplies due to reliance on donations, yet we live in a land of plenty compared to local hospitals.
The photo above is NOT from Benin. Rather, it’s a glimpse of an operating room in Madagascar (where we served 2015). My intention by showing that photo is not to give the impression that all developing countries are the same. Rather, I just want to give one visual example to explain how the world I come from compares to the countries I’ve worked in.
I’m hoping to give you a snapshot of our time here in Benin. My interactions with patients, my wandering strolls through the city, my interactions with the people of Cotonou that don’t work on the ship… it all combines to form MY picture of Benin. I acknowledge that my lens doesn’t capture everything.
Related Post: Snapshots of Life in Benin: The Seamstress
well that’s… different
Sometimes I ask too many questions, and sometimes my questions border on too personal. I’m just so curious! Luckily, the Beninoise ask a lot of questions too.
When I walk into the ward to visit, I don’t put on scrubs. Even without scrubs I put myself at risk of getting sucked into work-related problem-solving. So I arrive in my regular clothes, but that’s a risk too! If the patients like what I’m wearing, they’ll ask me for it! They’ll compliment me aggressively. I don’t think it’s aggressive to them, but they have no idea how mild the compliments at home are compared to here. Home sounds like, “Cute skirt. Where’d you get it?” From the patients in the wards I hear, “I like your shirt. Can I have it?” This takes some awkward smiles to get used to.
Even some of the translators I work with make funny comments that I never get used to hearing. As a few translators passed by me I heard one of the guys tell one of the female translators how fat she was. What the…?!?!?! Another time, a nurse was sitting in a rolling office chair while a translator pushed her around. “You’re so heavy” he told her. These comments are a normal part of life, as strange and rude as they come off. You just need to laugh it off, remember the cultural differences and let the comments roll off your back. Even just last night I ate my dinner, around 10 or 11 PM. A Beninoise friend from the ward reminded me not to go to bed too soon after finishing my meal. “Why? So I don’t get fat?” I asked –He laughed, “Exactly.”
foreign to each other
The patients we serve probably haven’t been inside a ship or a hospital before. Our world on board is foreign for them. I have a feeling they simply put up with our nonsensical requests while chuckling behind our backs at what the yovo (foreigner) is asking them to do. I always think of the teen boy who had securely fastened his hospital gown to himself. The tie to keep his bum covered was tight. In fact, he had it wrapped around his waist like a belt. He also had the neck tie looped entirely around his neck, which screams choking hazard to most nurses.
Of course we try to explain and educate (and then explain again), but we have to choose our battles. Our minds are so consumed with the “normal” ways from back home that sometimes we forget the environment awaiting them after discharge. (Truthfully, most of us never truly know what the outside world is like to begin with. I feel pretty confident that baby-proofing a home in Cotonou doesn’t look anything like the U.S… so maybe we don’t need to freak out when the kid starts chewing on something he found on the floor.
When patients go home with a wound, we give them supplies and instructions. We explain how to make sterile solution by boiling water, adding salt, and storing it in a covered container. Simple really.
Now picture me at a home miles from the city, fanning an open flame to keep the charcoal hot. When will the damn water boil? I will never make light of the suggestion to simply boil some sterile solution again! It takes some muscle, time and patience.
The other day a patient with a minor surgery laid in bed all day stark naked, with a bedsheet wrapped around her like a toga. What surprised us Western nurses the most is that no one seemed to care.
The language is different, too and I don’t mean with our African brothers and sisters. As nurses, we sometimes must repeat ourselves often only to realize we’re dealing with entirely different vocabulary words. Crook is a patient who is declining and/or quite ill (in Australia). Obs can be used interchangeably with “vital signs” because it’s short for observations (in the UK). A nappie is the same as a diaper, and the words “diarrhea” and “hemorrhoids” sound unrecognizable if English isn’t your first language.
Communicating with people who speak a different language has always been hard for me. I never anticipated how big of a difference this would make for me. I didn’t even pinpoint this as a contributing factor to my restlessness on board the Africa Mercy until 2/3 of the way through.
So many of those precious moments in my 2.5 years working at home were times when a patient said something moving to me. Or expressed dissatisfaction at something and I had a chance to encourage them. The times when I finally got a patient to trust me. The times when a patient and I would discover we had something in common.
I’ve connected with many beautiful patients while nursing with Mercy Ships and it’s the ones where we seem to transcend language barriers that are the ones that stick out in my mind. The little girl who speaks to me while we play a matching game as if I understand her. The boy and his grandma who call my name and speak to me in a mix of French, Malagasy and English and we just keep talking until we feel confident enough about the message. The women who speak, nod and gesture until they think I’ve gotten the message.
On the wards at least
There are many things on the Africa Mercy that are hard to really get until you come to experience it. But I hope you’ve been able to imagine what my days can look like in the wards. It always brings me joy to learn more about the people of Benin and what life is like here. I don’t want to leave this place!!
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