from Betty: a bad fall

Betty’s Blog Entry Sep 28
My stay in Sierra Leone has been colored by a bad fall on the street where I hurt my back (compression fracture in the lower vertebrae), happening after I had only been in the country for 10 days. This meant that I experienced, not by choice, first hand the health care facilities of Sierra Leone. I came through it ok but I would not like to have had a serious life threatening injury. And I received some of the best care you can get. Even then it seemed very pretty haphazard. There are no ambulances or even stretchers at most clinics. So they pick you up and carry you, if necessary, to where you might get some help. I probably should have been lying down after the accident but the best I had was a wheelchair and some strong men half carrying me from the front seat of a car to different places. I did get a quick X Ray done at a radiology clinic with the films being developed in minutes and a diagnosis given by a very experienced radiologist/doctor. At that point it was decided that I needed to be in the hospital in case there were any other injuries. So I was carried back to the car and driven to the hospital. There they wanted a proper ID, which both Bob or I had and they wanted to be paid. An US Embassy doctor was with us but even that didn’t help much. But finally after a long discussion and a promise to pay I was admitted. By now I had been shuttled around for 4 hours, all the time in very serious pain, such that I was crying most of the time.

At the hospital I was finally put on a metal stretcher and given a pain injection. The needle was in a sealed container but somehow I kind of lost track of what was happening since most of my thoughts were on surviving the pain. When the Indian doctor who didn’t speak much English started rudely examining me I insisted that Bob be in the room. He seemed offended at that but I didn’t care. There were nurses there as well but still I just didn’t feel very comfortable with him. Finally he listened to my symptoms, which were mainly pain in the back. The rest of me was still ok fortunately.

Anyway to make a long story short it was a long two-day stay in the hospital. The pain was still pretty intense and I couldn’t sleep so the hours seem to tick by minute by minute. The nights were the longest because I felt very alone. During the first day I was told to stay flat on my back and not move at all. Finally I insisted on getting up to use the toilet, as my only other choice was a bedpan. The next day when Bob came he brought news from an orthopedic specialist in the US saying that it was ok to get up a bit and move around. That was a big relief but it also meant that I didn’t need to stay in the ICU unit any longer. So I was moved to another ward where I was in a room with 3 other women and one bathroom. The room was very hot and stuffy. The bed was quite hard for someone with back pain. My privacy consisted of a curtain around my bed, which made me a bit claustrophobic. I could hear the other women but I couldn’t really see them. One had a radio, which was tuned to an evangelical religious station so I heard a lot praying and singing from her. Another must have had a small TV or computer because I heard snippets of a soap opera drama. I kind of wished I could have joined her as it would have helped the time pass. That night was the worse because I didn’t take the pain medicine, which gave me bad dreams and an upset stomach, and so I was very uncomfortable and couldn’t sleep. The only thing that kept me going was knowing that Bob would be there in the morning to check me out. And I was determined to tell the doctor how much better I was so he would agree to discharge me. The nurses were all very kind and friendly. One thing they did on a regular schedule was taking my blood pressure and temperature and those vital signs were always normal. Also the food amazingly enough was very good.

Since the time went so slowly I really appreciated having visitors. Bob, of course, came several times a day. I didn’t know many other people, only a few at the embassy and our Fulbright colleagues, and so I wasn’t expecting many to come. But surprisingly the only other people who did come to see me were Sierra Leonean from our guesthouse, the owners Mr. and Mrs. Kai Kai and several of the staff people. Usually when you are in a foreign country people realize that such an accident can be quite traumatic and especially when you first arrive and don’t know anyone. Something for me to remember if this kind of thing happens to other people.

Bob did arrive early the next morning but it took him a while to slowly make his way through the bureaucracy to get me discharged. The only good thing about my hospital stay was there were some very kind nurses and it didn’t cost very much (less that $400) compared to a stay in a US hospital. The taxi slowly drove me home and I felt like I was entering paradise as I arrived at the guesthouse.

Now after two weeks of very limited activity I am beginning to go out for short periods of time. I am also trying to do some exercises to keep the muscles strong. Though I still feel a lot of discomfort, and some days I feel worse than others, for the most part I can feel myself returning to a normal life.