Life in Gasmalla

Life has a special rhythm in Gasmalla a village about a two hour walk from Doro. On my second weekend trip there I was asked to make a detour into a village where an older woman had been sick for five days. I found an elderly woman with sunken eyes, wrinkled, tenting skin and extreme weakness laying on a mat on the ground, moaning "wor-re i, wor-re i". This translates to "body bad". They often say this when they are sick or in pain.
Literally 25-30 village men, women and children (as well as some goats, dogs and chickens) gathered around me while I assessed her condition and made my recommendations. I was not "working" on this trip so I had no medications with me--and certainly did not have an IV set and IV fluids to give her--which was what she really needed. For several minutes I talked with she and her family members to impress upon them the seriousness of her condition and stress that she could die at any time if she did not get fluids into her body--she had been vomiting all intake and also having diarrhea for five days. Frankly I was surprised she has survived to that point. She did not want to be carried into town--a 2 hour walk-- for treatment. I felt that she had given up. The family said they would decide what to do with her after I left. That was frustrating--but that might just be me projecting my Western ideals on a very different culture. You see, this condition should not kill a person. Dehydration is very treatable with relatively little trouble or expense. However, in Africa, many, many thousands die each month because of dehydration from vomiting and or diarrhea. This is a difficult reality to accept.
Leaving her I went to another nearby village to check on Jadin, the father of Joseph, one of our Water Project employees. He has been mostly bedridden for a few months due to severe back pain. He also suffers from mal-nutrition and probable depression. The rainy season prevented Joseph from hiring a donkey cart to bring him into the clinic to get medical care and he is too weak to walk. Without diagnostics beyond my physical assessment it was impossible to be certain of the problem, maybe sciatica, maybe compressed or bulging discs, maybe TB of the spine, etc. However, later that weekend I gave him some ibuprofen to take every eight hours for two days to see if it would make a difference.

Three days later I learned that he was up and walking more than he had in months. Amazing what a simple OTC medication can do for someone who has taken little to no medications in his life. When a person is not accustomed to medications--they work more strongly in that person. For Jadin, it was kind of like getting his life back. Difficulty, pain, poverty, death, hunger and loss are such a part of life that in my limited understanding of the life here, it seems to me that they have low expectations and do not "fight" for easier or longer lives or better quality. I'm sure I'll understand this attitude much better and even find I was completely off possibly when I've been here much longer and understand the culture better.