A Day in the Bush with the Nursing Team

I am sitting on a bench in the back of an ambulance with a nursing sister and a nurse’s aide. In the front, the head nurse and the driver – who is also a qualified medic – lead the way into Sundumbili Township. There we stop at the small nursing station where the nurse gives injections to the locals who are infected with tuberculosis before we are on the move again.

Our next stop is another small, poverty-stricken house. The care team knocks before they enter through the unlocked door. We walk through a tiny kitchen and enter a bedroom at the back of the house. Lying in the bed is a young woman who is obviously in terrible pain. The care team know the woman from her earlier visits to the hospice where her condition was stabilized before she was discharged. They know, too, that she has AIDS.

The nurse’s aide takes her blood pressure and records exactly how high the woman’s raging fever is while the head nurse checks the medication supplies and dosage. The patient’s condition has deteriorated so badly that the nurse decides the patient should be brought back to the hospice.

Info: Educating a fully-trained nurse in South Africa takes six years. They are hugely qualified and competent professionals. They can examine patients and administer medications both inside and outside the hospital. 

We take the woman’s medication with us. The only item she has for her personal care to bring with her is a tooth brush. With the help of two aides, the patient can walk with small, slow steps to the ambulance. We are taking her back to Blessed Gerard’s Hospice. There, she will be examined by a doctor and admitted to one of the wards.  

We have to continue on to Mangete. This time the route travels over gravel roads and dirt paths. Small woods give way to wide views if the sugar cane fields along the way. Zulu housing estates are scattered through the softly dropping hills in the distance. Palms are everywhere. The ambulance forces itself through this hard-to-travel landscape, bumping and swaying. I hold onto the seat with both hands all the way to our destination. We take countless turns until we arrive at our destination.

I used to worry about my back because my bed was too soft, then I met a woman who had to lie on the ground because she had no bed at all.

Our next stop is in front of a hut made of broken stones. Inside, the room measures 2 by 3 meters at most. On the floor behind the open door lies the desperately poor woman wrapped in a blanket. She too has a wracking cough from a secondary infection caused by AIDS. I am taken aback by the poverty. The sum of her possessions is a few dirty clothes, a piece of broken mirror, two cups, two plates and a few pieces of aluminium cutlery. In one corner, there are a few stones to mark the fireplace. There is a tin can holding cooked cornmeal. The pot the woman used to own to cook in was stolen. The aide spreads a blanket out on the ground in front of the house and they help the woman outside to lie under the sun. The sunshine and fresh air seem to help. Together, we empty out the hut and put everything out in the sun.

One of the nurses calls the care centre. One of the aides sprays a small amount of water on the dirt floor of the little dwelling. One of the nurses starts sweeping out the dust and I take the broom to replace her. At first, she resists, but I explain that I have three children and no servants or household help and am used to working. We shake out all the blankets and clothing outside as well as we can before we put everything back in the hut. One of the aides arranges the bedclothes so that they will be as comfortable as possible before helping the woman back inside. She smiles opening at everyone. Now the team can take her blood pressure and temperature and speak with her about her condition. The nurse informs me that this woman has already been to the hospice, but wanted to go home so her eight year-old son wouldn’t be at home alone. Right now, he is at school. When we’re finished, I go to see the woman one more time to wish her well. I stroke her arm gently. While I know she doesn’t speak my language, she understands the meaning of my words. She gives me a smile.            

From Sundumbili to Physiotherapy

We bring an AIDS patient who had an aneurism and now has partial has paralyses in the ambulance from Sundumbili to the Physiotherapy clinic, so that his muscles can be strengthen and recover. I sit beside him for support since he is not able to hold himself upright. A nurse’s aide helps too. The therapist has trained the aide to do these strength-building exercises with the patient on a daily basis. The patient is given an exercise plan with illustrations to help him remember what to do.

The man who receives on-going assistance from the physiotherapist sits with us in the ambulance on the way back to the hospice. He has a relieved look on his face. He feels that the therapy has helped and it helps him to know that his health is important to others. The atmosphere is pleasant and the patient chats with the nurse and the aide. I wish I could participate in the conversation, I don’t understand anything but the basic words of courtesy and a few prayers in Zulu and most Zulu people don’t speak any English.

The Huge Outpouring of Love Becomes Visible to Me

We load a cardboard boy into the car. Another colleague holding a clipboard climbs in too. Where we are going is a complete surprise to me, but I know we’ve already been this way today. I am truly pleased when I see we’re going back to the hut where the woman without a bed lives. This time, her eight year-old son is standing in the doorway. He is wearing the torn blue trousers that I shook free of dust and folded this morning.

 The whole team enters the little house. Now I can see that the cardboard box is full of corn meal, rice, sugar, oil, beans and a few other grocery staples. This is provided by Blessed Gerard’s direct-help funds. The woman with the clipboard who came with us is a social worker who works with the care centre. She spends a lot of time speaking with the little boy. He is worried that his sick mother is alone for so much of the day. He shares his fear that the groceries will be stolen just like their cooking pot was. 

The sick woman makes eye contact with me while the other members of the team speak with her son. Her eyes move from her son, back to me. I can understand that he is all she has. I realize how much the boy has hanging on him, how much depends on him. I will never forget this moment. He will remain in my heart forever. Meanwhile, everyone packs the food into the only plastic bag they have and hide it under a pile of clothes. Some of the sugar is placed in a small plastic box.          

Everyone files out of the hut. I try to find the woman’s eyes again, to tell her with my own gaze that there is hope for her. Her smile widens. I find leaving very difficult. The nurse reminds me that there are more patients to visit. The boy tells me that the groceries are safely hidden.

We arrive in front of a house and meet with the family. We explain the state of affairs and leave the supplies with them. The nurse makes a note of the telephone number of the woman’s acquaintance. After a brief negotiation, a woman and her almost-grown daughter agree to come with us to the home of the patient. We drive on.    

Later, I come to understand that the patient’s acquaintance has agreed to visit every day to keep an eye on her. Now, she really needs to be admitted to the hospice for treatment, but the timing is bad. She doesn’t want to leave her son at home alone. The social worker will try to find out if anyone can care for the boy while his mother is in the hospice. It is never too late to begin anti-retroviral treatment, but without treatment she will soon be dead. If she starts treatment, it could extend her life for years – long enough for her to see her son start working and move them into a better house.

Patients with HIV who start to decline often feel better almost immediately after they start treatment with anti-retroviral medication. It can extend their lives for 15, 20, and 25 years of good health. The medication must be taken regularly and without interruption to ensure a good outcome.

Now we wind our way back to the main highway and then back into the scrubland before we enter the bush to find the home of the next patient. A man with many wounds on his back is waiting to be examined. His condition has improved substantially since the team’s last visit and only the scabs remain. The nurse writes her report down in the patient’s treatment file. The man has plenty of reason to smile and that is the most important thing.        

We are on the road again when the nurse gets a call. We turn around and go part of the way back. We head down a dirt track where a man is waiting in a pick up truck to show us which way we should go. Obviously, someone needs our help. After following the dirt track for a relatively short distance, we come to a house. The man with the pick up is already there and leads us into the house. His mother is lying in bed and the nurse pulls the covers back. The woman has a second degree burn on the ankle of her left foot. The nurse cleans the big open wound with a disinfectant, covers it with a burn salve, applies a compress and dresses it in sterile bandages. She measures the patient’s blood pressure and temperature as part of the routine examination. The nurse also does a blood sugar test and recommends that the patient be brought to the local clinic so an anti-biotic can be dispensed. The team gives its recommendations and we are on our way again.  

On the way back, I look out the ambulance window into the distance of the hilly landscape where the light of the setting sun plays with the blades of grass. I am full of wonder at the compassion and strength of the whole team. They helped indefatigably, competently and humanely at every turn. In the end, it is their humanity that stays with me, becomes my lasting picture of them.  

This page is part of the Newsletter No. 29 of the Brotherhood of Blessed Gérard

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This page was last updated on Tuesday, 15 January 2013 12:49:55