So, I suppose it’s time to update everyone on the true reason why I’m here. Discovering cultures is awesome, but I’m here to work and study. Don’t worry dad, your voice is still in my head.
I have an internship for the first 5 weeks or so with the Service Sociale dans l’Hôpital d’Enfants Albert Royer (HEAR). In case that wasn’t clear… Social Service. The basis of our office is to handle the patients who cannot pay for their treatment; or rather, the parents of patients who cannot pay. After the children have their consultations and receive whatever treatment they need, the question of finances is then brought up. If the parents have problems finding funds, they are sent to our office. There is a registration book the size of my torso in which we record the following:
Name of the patient; dates of entry and exit, age, total cost of visit, parent contribution, net total, and the CI (Carte d’Indigene) number. The CI is crucial because there are only a handful of first names used here, with lots of common last names. Thus, a verified CI is one of the essential components of identification. To obtain said CI, you have to present your ID card at a different office, then take a slip of paper with an official’s initials to a prefecteure who then stamps your CI. All this paperwork is brought to our office where you then fill out a yellow Fiche form. This states most identifying information as well as the description of the social and financial status of the family in question. If the story of the family seems unreliable, we conduct domestic visits to assess their living situation. However, visits are very rare because so many people pour in from outside greater Dakar, and even outside Senegal. HEAR has the kind of reputation where people do come seeking treatment for their children from across West Africa. The problems that stem from this are organizational, financial, lingual, and social. Usually these families don’t have a lot of money in the first place, and thus don’t have the resources for lodging in the city. And even if you are from outside greater Dakar, you cannot leave your child. As a result, hospital rooms are not only crowded with children but also families who don’t have the resources to go elsewhere. It can also be challenging if there is no common language between patient and doctor. Translators can usually be found, but a rural family from Mauritania might have difficulty.
What we (my partner Quincey and I) actually do is not definite. While we speak passable French, enough to get good grades in classes, the dynamics of a hospital and the language they use are beyond our capabilities. Direct contact is limited to playing with the kids on some mornings, or participating in weekend enrichment activities. Sometimes we help conduct the financial need interviews. Mostly, however, we have accompanied two other interns while they interview different department heads of the hospital. They are doing their own research project, so Quincey and I have begun to think of our time in the hospital as research as well. We’ve talked to everyone from the head radiologist to the Chef des Materials (aka the head of the storage room). Several things jump to mind:
First, we were interviewing the Chef des Materials on Monday, and I started to scan the pictures that were posted along his walls. One or two were of family; some were of the president shaking hands with some of the hospital administration (which is pretty common, as much as he’s unpopular), and one of the founder of one of the Muslim Sufi brotherhoods. Then my eyes hit the one right in the middle: Osama bin Laden. Now I’m not jumping to conclusions or anything, I’m just noting the presence of a picture. You know you’re not in the US anymore when someone casually hangs a picture of bin Laden in their office. That was interesting.
Second, was our two days in the pediatric surgery building. We were waiting to conduct an interview with the head nurse, but in the waiting process we learned an immense amount about the surgery. And just a side note, Quincey and I have decided that we are getting an accompanying Bachelors Degree in Patience because we do a lot of that: in this case: spending two mornings in a cramped reception room waiting…that’s two and a half hours on Monday, and two hours on Tuesday. Anyway. I digress. The time spent waiting was actually very informative. We learned that this building has their real surgery days twice a week- Monday and Wednesday. This is due to a shortage in funds, personnel, and materials. They do procedures in the meantime, but most of them are scheduled for those two days. We saw all the paperwork being stamped that would soon end up in our office. Watching the families come in and out was an experience. We asked Lamine (one of the Senegalese interns) why most of the little boys around four years old were wearing white outfits with gris-gris around their necks (charms of protection mostly seen in rural areas). “Ah yes, those boys are about to be circumcised,” he said, as one giggling, bouncy (and white-clad) mess was playing peek-a-boo with me around the door. Quincey and I got the chance to wave good-bye to him as we muttered, “good luck pal, see you on the other side.” 15 minutes later he emerged…crying his eyes out and holding his pants away from himself. We finally talked to the head nurse, and she told us the schedules of the doctors, and which surgeries were common, etc. Then we got a tour through the facilities. With the exception of the actual operating room hall, we saw the whole thing. It’s a two-story building with about 4 rooms which can fit 7 beds, and a handful of more private rooms. Those were quite expensive, so most people slept in the hallways. Keep in mind, this is the only children’s hospital in West Africa.
Third, was the radiology department. The Chef told us their problems were in shortage of funds, personnel, and materials. Sound familiar? I worked at a vet hospital for two and a half years in high school, and I can safely say that animals in America have far and beyond the resources that children do in here in Senegal. There were huge cracks in the walls because one of the machines broke, and now the building doesn’t have good enough protection from the radiation. Keep in mind that this is translated from rapid French, but I pointed to the cracks and asked, “this is from radiation?” and she responded, “oui.” Fabulous. The building probably glows at night for Pete’s sake. We spent the rest of the morning hanging around in the radiology rooms. They’re still developing their film in dark rooms, but the red light doesn’t wok, so they are masters of navigating that room in the pitch dark. It was pretty impressive. No one wears protective gear, like lead vests, you just sort of find a wall and get behind it. They don’t have warning words like we did in the vet hospital, so someone who knew when patients were being exposed would regularly snatch me into a corner. That was awkward, but that was still the best morning I’ve had at work. There were two other interns there helping the doctors, so the five of us had a good time while trying to avoid becoming some kind of irradiated experiment. But after that morning, I think at least a handful of cells in my body spontaneously mutated.
Working at this hospital has made me more sensitive to reality than I ever thought possible. I’m sorry if you are tired of hearing this, but reality of this kind is very hard for me to accept. I can honestly say that remembering how life was like in the US sounds and feels strange to me now. Not because I’ve been gone for long, because I haven’t, but there is just such a difference in the assumed norms. I see everything here through a lens, and right now I’m having a hard time figuring out just what kind of lens it is. It’s like witnessing a real life model of the collapse of compassion. This model has been in all my International Studies courses and pretty much highlights why people give up caring. Whether it’s because we are highly individualistic and thus cannot relate with any cause larger than one person, or because after a couple months of headlines we think a problem should be fixed. (True story, by the way) At what point to people accept that this is more of a “them” problem, not an “us” problem? I hope I can come away from this program knowing that I’m on my way to solving the “us” problem, and keep a human lens focused on my year here. The last thing I want is to leave, telling myself I can’t do anything to help. People working at this hospital are extremely innovative, and can do anything. If there is anything I have faith in the most, it’s the people here.
