When it rains, it…

Teaching others makes me a learner again.   This past month I’ve been experiencing a “whip-lash” education, listening with one ear to the Ohio-trained nurse who has spent the last 7 years practicing independently in rural Haiti and with the other to the diploma-ed emergency room RN studying for her Bachelors of Nursing degree at the University of Western Ontario.  Recently we were discussing the characteristics of different vaginal infections: the Canadian nurse admitted no experience with the evaluation or diagnosis of these since trained physicians diagnose and treat such diseases in her setting; the nurse from Haiti ruefully recalled only one PAP smear ever having been performed in her area of the country and that was when the local medical staff sent the patient to the latrine with a cotton ball to obtain her own specimen. The Canadian nurse speaks confidently of current nursing research and theory but is fascinated by her first microscopic views of live giardia, ascaris, and whipworm while the nurse to Haiti sighs in sympathy at my struggles to adequately diagnose symptoms in the absence of diagnostic tests or competent consultants…   But the nurse from Haiti freely samples local delicacies while the Canadian nurse abstains from all non-bottled drinks and raw vegetables and still suffers ill effects of local hygiene.

Being with these guests also reminds me of how much weather affects our lives here.  They came at the tail end of “summer” in early May, the bleakest, hottest, dustiest days in El Salvador’s annual calendar.    On their first Friday at our windowless clinic we were suddenly without electricity at 8:30 a.m.  Our backup generator died within 20 minutes of use, leaving us with taper candles for lighting and our swishing skirts for air movement.  Candles rapidly lose any romantic flair when they are used as the only light for diagnosis of skin diseases and when additional flame heat only adds misery.  The staff could obtain some of the patients’ histories outside the clinic but the physical examinations had to be completed inside that bleak oven of a facility. I drank copious amounts of water and finally resorted to wetting down my clothes (patients couldn’t see it anyway!) but still succumbed to heat stroke symptoms by the end of the day.  Someone asked me later, “Why didn’t you just close the clinic?”  I had briefly considered it but the patients’ pleading looks made that a pretty tough decision to make.

Then came the rains.  Less than two weeks after the above experience we needed supplies from Santa Ana.  The only time in our schedule to get them was after clinic hours in the afternoon when public transportation is unpredictable.  In order to improve our chance for getting home that night we decided to rent a friend’s pickup.   Unfortunately, the only available vehicle was one I thought was morgue-ready several years ago (at that time the owner smilingly told me that pickups don’t die in El Salvador).  Our decision proved to be a bad one because, after an additional half hour of trying to revive a dead vehicle now parked by the clinic, we ended up deciding to tow this beat-up piece of metal—with the unmistakable stench of non-viability!—back to the owner’s home.

Our only means of towing the pickup home and getting a ride to Santa Ana was a risky one.  The young dude driving the towing vehicle gets his kicks in fighting other vehicles on the road and in tearing over pot holes. But we were too grateful to have transportation to be very worried that day.

In Santa Ana we kept looking at the clock and at the clouds.  As I headed out of the last shop at 5:05 with 20 yards of chicken wire fencing tucked under one arm and a bursting backpack in the opposite hand.   The  store owners gaped at me, my load, and the deluge outside and gulped, “You’re going out in this?”  I smiled grimly and said, “I’ll flag a taxi if I see one.”  The taxi drivers didn’t like the storm either. As the rain waterlogged my backpack and immersed my shoes in street torrents I thought of the days of heat weariness and said,” I could be dusty hot or drippy cool…. I think this is better”.  Marietta and I were both embarrassed at the ponds our clothes created on the restaurant floor where we met but reassured ourselves that the owners were going to need to mop anyway in view of lakes already inside the restaurant where the rain was pelting under the doors.

We had less than 10 minutes to meet the last bus going to El Resbaladero that night so we shouldered our loads and headed out.  Service station attendants offered us their pavilion and chatted while we waited for the bus.

We expected the bus to stop when it passed as usually public transportation owners are eager for passengers; on this night, however, the bus driver wanted to get home as soon as possible.  Marietta darted into the rain to flag him down, leaving me with my load and hers as well.  A service attendant, now our friend, grabbed some of our things while I struggled with the rest.  Marietta and the visiting nurses managed to clamber through the front door of the old school bus before the driver pressed the accelerator.  The service attendant threw  my fencing through the back door of the   bus while people at the rear of the vehicle yelled for the driver to wait for me.  If the driver was deaf or driven I don’t know, but the friend from the service station yanked the bags from my hand to heave them on the moving bus while fellow passengers grabbed my back pack.  The bus was moving faster than I could run so I don’t know exactly what happened after that.  I do remember the service attendant attempting to physically hoist me on

(I do not toss as easily as groceries or fencing but the earnestness of the attempt was appreciated) and also remember struggling up from a crumpled, drenched crouch on the floor of the bus and trying to count bags.  I think the only thing I lost in the endeavor was the belt of my dress and a bit of tranquility

I’m grateful that it is almost time for several months in the US.  I sometimes identify with Pooh in thinking that there must be a better way of going through life than the bumping way we are going through it but, with him, often find myself at the bottom of the stairs before having thought of answers.  I’m so grateful for times away from the clinic to try to stop bumping and start trying to think a bit.  We are currently scheduled to be gone from El Salvador during most of the months of July and August (please promise me a cool and moist summer in Kansas….).

I would be very glad to pick up medication samples while I’m in the US.  Current meds the clinic needs are diabetic medications (by the truckload!), oral contraceptives, steroid inhalers and steroid nasal sprays. I will attach a response card so that you can let me know if you might have samples available.  Deepest thanks for all your care and support now and in the past!

Yours warmly,
Jana Nisly

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