When It Hurts

Morning in the clinic starts really slow but it’s already full of people. They are not necessarily patients, also in the mix are relatives who stays with their sick but are staying on empty benches and hallways with their small sack of belongings. They come from different parts of the district and traveling around can be an excursion — there’s only one vehicle available per week and lucky if you could catch it on time.

But one set of patients come not far from the hospital. They are from the camp maintained by UNHCHR. They are Liberians in Sierra Leone land. They escaped from their country at the height of the civil unrest and settled there for good number of years and still no clarity if they will ever be repatriated. There are talks, but my staffs been saying it’s been talk for the longest time they can remember.

“Good morning Adama” I said when I arrived in the clinic. “What’s our case load today?”

Adama, was my senior physiotherapist. Very efficient, reliable and inquisitive colleague, replied “we have people from the camp coming” 

“I see, anything I need to know about them?” 

“One client. He’s been with us since a long time but we can’t seem to make him well”

“What’s the case?”

We don’t know really, hard to explain. It would be good if you could see him and make proper assessment and diagnosis, then you can tell us” 

I told you, she can be stern and direct and I like that. I am in the hot seat.

The morning preparation continued. We made plans for the week including technical training before it become a crazy day, I was there to provide that aside from practical demonstration and monitoring of rehabilitation treatment.

“Here’s Abdul D, he’s the one I am talking about” says Adama when a group of new clients arrived in the clinic.

I saw this tall, lanky man, with a permanent scowl on his face and a very straight back.  He walks as if a string is pulling him upright and someone is holding it from above. By this time I am familiar with the people in the hospital and of Sierra Leonean that I can see the difference in his feature. Abdul was tall, thin and his face is longer, Sierra Leone men are shorter if you are from the west coast and taller as you get closer to the border of Liberia and rounder face. He’s English was more clear though the manner was similar to my staffs, maybe from the long time being in Sierra Leone camp they adapted their way of talking.

“Hello, good morning. How are you today?”

He doesn’t respond. He’s looking at Adama as if waiting for her to translate what I just said, while he sat in front of me very stiff.

Adama intervened and introduced me instead. I was planning to do that myself but she sensed that the client was not responding to me so she decided to “break the ice” and get the conversation going. I explained who I am again and what I do and will do with him.

He seemed to relax and started telling me his problems.

” I have this pain in my back and it never go away. I’ve come here before (the clinic he means), but they cannot seem to cure me of my pain”

The usual thing I do would be to ask patients to point the area and to re-enact the movements that would elicit the pain and measure. Next would be to ask what he does to relieve it.

“I feel the pain all the time. Even when I am sleeping or when just sitting in front of my house. There’s no way to relieve it, it’s always there. Medicines have no effect.”

I started to ask the history, to better understand where the problem was from and see if it was a case for us or refer it to another specialist.

But remember I am in Sierra Leone, specialist don’t exist especially in the hospital where I worked. There are medical organizations like MSF and MDM but they also have their own case load and refer patients to us. Still, I have to be sure.

Abdul arrived in Sierra Leone during the height of the civil war in Liberia.  To escape with his family they crossed from the borders of Liberia to settle in Kenema, a good 1 hour away from Bo. They carried with them  their life’s possession and their young children, he has 5 and his parents and crossed dangerously, walking for days with other refugees until they reached the camp. Him and his wife with the family found refuge in the camps run by UNHCR and settled there for good.

He claimed that when they were trying to escape being caught he fell several times and as tradition in Africa, they also carried their life possession on their heads to free their hands to do other things. He thinks that because of the move and the difficult journey he got injured and continue to suffer. He was crying when he related his ordeal. I felt sad, really I don’t want to put people in that situation but it’s the “necessary evil” for me to understand more. I threaded very carefully, selecting my questions very well and kept a clinical view of everything.

Sierra Leone was also on civil war around the same time, so imagine how uncertain life was for everybody back in the early 1990’s and to maintain a camp of foreigners while people from Sierra Leone has to go to Guinea to take refuge themselves has to be difficult.

The war was over, the country was left in ruins and people have either been killed or maimed and those in Guinea returned and re-settled in their hometown while the people in the camp remains. Until I left in 2007, the talk of repatriation was still uncertain and that makes people living in the camp on the edge all the time.

After the interview, I asked Abdul to lie on his back and do special tests. He won’t do it, he said “it’s very painful, too painful”

“Can you lie on your stomach?”  “Yes” and he moved very very slow and his face was like paper being crumpled, I confirmed he’s really in pain. 

Upon inspection, you can see the muscles on his back being  taught and hard to touch. When I pressed on some part, he would either shout in pain or just simply cry. I also realized that the extent of the problem covers not just one part but the whole back including the hip area.

I pondered, pondered hard. The case would be very difficult, but something has to be done. And all my staffs eyes are on me waiting for me say the word they wanted to hear — a diagnosis. I have none.

Unless I see an x-ray, consult with a specialist, I can have a very clear diagnosis and therefore design a treatment plan, but we have none of those. Radiography services was available but patient cannot afford them if they are even working. There was no orthopedic doctor in the country (that I know of that time) and it would also cost money.

But at the back of my mind, the case I had in front of me was not a case for physical rehabilitation. I was even suspecting he’s faking it.

Is he?

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Audit My Brand

Since Blogging 101 I’ve been tweaking my site — a widget here and there, font that never get to change, a page and my header. Fell in love with picmonkey (www.picmonkey.com) that’s why I find it easy to change headers now 🙂

I like you to get involve in the process PLEAASSEEE … take the poll and see which among the 4 I’ve done suits best my kind of site — assuming you’ve read my MORE OF ME page or any of what I’ve posted so far.

So here are the choices

photo grabbed http://www.sunrisemarketing.co.uk/

CHOICE A Inspiration: I love sunrise (and sunset) and vast horizon

cropped-sunrise12.jpg

CHOICE B Inspiration: I love mountains and sunrise

cropped-banner11.jpg

CHOICE C Inspiration: Let go of any planning just played with the app and got this – first header ever!

cropped-banner5.jpg

CHOICE D Inspiration: to blend in the theme 2014 black and green motif

Take your pick by choosing the best header based on COLOR – FONT – AUDIENCE IMPACT 🙂 and you can leave me comments too if you want.

Thank you very much for taking the time to do this.

The one with the highest vote (if there will be votes) will be the header I will use until the change of the year.

Dhidhak1

Koko

October 20 today.

It’s my 2nd brother – the 3rd sibling birthday.

But he is dead. He died 21 years ago this year.

He died tragically but we had accepted it and continue to celebrate his LIFE.

We fondly called him Koko.

My Kuya Koko

He was an artist.

He was a rocker, a drummer.

He was an environmentalist.

He was a friend.

I miss him. We miss him.

We still remember him and celebrates his birthday.

That instead of singing, we say a solemn prayer of remembrance.

Rock on Kuya Koko!


More story about him in Growing Up With Koko (Part 1)


His favorite music


Dhidhak1

Humanity Begins in You and Me

When I saw this photo the message of St. John Paul II came to mind

Heart

      "The worst prison would be a closed heart"

Then, as I was browsing through the net I came across this article by Erin Cory talking about his friend A.R. Kassig  captured by ISIS in Syria.

The article spoke of true feelings of a friend as she tries to make sense of why of all people who is serving the poor and wounded, serving with all his heart would find himself in that situation. I am sure other people who are friends of aid workers who are victimized by terrorists feels the same.

Because, even though I don’t have friends in the same situation similar to A. R. Kessig, I feel bad, I feel sad and I feel angry. I know people, friends even,  who put their lives on the line everyday for others and I pray nothing worst could happen to them.

I was angry when I wrote The Perils of a Chosen Life after the beheading on David Haines — a senseless killing of the innocent.

Still there are no reasons to explain everything that is happening and I am afraid that the old adage of “terror begets terror” will hold true again in this fight against them.

My only hope is that to be truly free, you have to open your heart to love one another the way you want to be love.

That is the way to be human in the 21st century.

Reflection at the End of the Broom

This is an old post I salvaged from blogs I closed. It was written after I cleaned my house during a long holiday in 2013.

It is funny how one can find meaning and be reflective on simple chores like house cleaning.

When you live temporarily as an expat, you meet people in all aspect of your stay there and all of them are transient like you. You gain friends and acquaintances and some maybe enemies but still they are part of your circle. When they start moving on and you’re staying you start to think that the cycle of friendship will start over and over until it was your time to move on. It can be sad.

Selfish thoughts I guess, but then again like many of us we are all just passing in this world might as well celebrate everyone you meet and cherish the time shared. Agree?

Reflection at the end of the broom

broom

How many of you become reflective when doing household chores? Maybe 1 or no one … but yesterday, I became one, to not only tackle the dirt under my bed or the webs along the walls and ceiling but I also tackled what had become of my life in the last couple of years at the end of the broom.

As I sweep all the dust, my life came flashing back … all the events, the people I encountered and the WHO I am now.

Maybe it’s part of being in the fourth decade of being alive that one becomes emotive and contemplative, thinking what am I here for or what is my “purpose in life” kind of thoughts … what is really my purpose?

Twenty-eleven and twenty-twelve was a year of goodbye of people I met when I first arrived in Timor Leste in 2010. Slowly they moved on … life was full for the good two years and now it’s slowly trickled. It is hard when you became attached to things or people, it’s hard to throw them away or to forget them because of the good times. The short time you are together it was all good times, no pretensions, no hidden agenda, all in one clean slate and it was fun … but they have to move on and I opted to stay.

As I continue with my chores making sure I get all the dust from the corners … I moved furniture’s and moved them back or re-arrange them for a fresh start,  just like with the people I meet in my life: move them closer or out of my life.

I made lifelong friends, a handful of them while living in a transient world as I did, but I also met people who remains to be names or images in my collections of photos of the happy times and will never prosper to become “close” friends after we cross the path in this part of the world, but its fine, at least they have been part of your life and that is all that matters.

As I continue cleaning, I realized that how we clean and re-arrange our house is like with our life really … you get to a point where you can’t stand it anymore, that you have to take down the drapes or pick up the broom and start sweeping. Everything seems new because now you can see over the dust. It’s time have a fresh start. The same with your life … you get to a point where you have to see what’s important and what’s not and start pursuing a better life, with less clutter and more clarity.

Now I am done. The drapes are up, the sheets are flat, pillows are puffed and furniture are re-arranged, the house is clean! So is my life. I am ready to embark into the world of people again after the holidays … to meet, to mingle and create again memories of new people I will encounter and establish lasting friendship of those that stayed on.

Till the next time I am tempted to clean my house … but for now I have to be satisfied with what I have!

Boas Festa do Pascoa! (2013)

For the Daily Prompt: Sweeping Motions