The Porch


What do you think of when you think of a porch? In the past, I have thought of warm summer days, squeaking rocking chairs, unhappy cats swishing their tails back and forth, remembering the last time those rocking chairs got their tails….a nice relaxing scene with a Grandma and Grandpa thrown in for good measure.

Our porch here is a bit different. It is still a cooler place to sit on a hot winter day, with cool, or at least cooler breeze blowing. There are geckos lurking high up on posts, and rats chewing contentedly on the walls. There is even a nice humming sound coming from the local bees nest in one of the porch posts. ( we had a clothes line hanging from post to post, but last week someone bumped the clothes line and all the patients had to flee the angry bees!)

Each morning, I try to beat the patients to the porch so that I can brush my hair before starting treatments.  Seldom if ever does that work…. my mother would be horrified!(clinic hours start at 9 a.m., but I have gotten there at 7:30 to find the porch full of patients)  The good news is that nobody even notices these things. The proper etiquette here is to get your hair combed before noon if at all possible. Once the patients start to gather, we pull out our patient books,  we grab our trusty stethoscopes and our little basket full of the essentials: paracetamol, sabumol, 3×3’s, cotton balls, scissors, tape, peroxide spray bottle, charcoal, and triple antibiotic ointment! We have lots of other stuff in the cupboard inside, but these are the things that we keep right with us. Then starts the fun. We have one interpreter who sits in the corner, usually strumming his guitar and singing about the patients on the porch… a little ditty that he makes up as it happens…. “this girl has diarrhea, for 7 days already, tra la law!” The patients laugh at him, and we desperately try to follow the song to see what we need to know about the patient! Other times, I will ask my interpreter what is wrong with the patient, and he will tell me, “you ask her!” Did I mention that my interpreter is also a great Karen teacher? He will not let me get away with not asking them myself if he has taught me the right words before. Even if I have thirty patients waiting, and everyone is talking at once! Actually, I don’t have trouble asking them if it is something that I have learned really well. But, I do have trouble with understanding their answers! Or, those who do not know us well just look at me blankly and I wonder how they could possibly not understand my excellent Karen!

Then there is the interesting part of being on the porch. Most of it stems from those mothers that have no diapers for their babies! And mothers seldom bring healthy children to the porch, only those with watery diarrhea, or vomiting or some such affliction! We do have a trusty mop, WITH A BUCKET OF DISINFECTANT, but still, it doesn’t make you feel all that wonderful since you still are barefooted, and you must sit on the porch to treat your patients! The mothers just smile and act totally unconcerned. ( plus, you must be very strategic as to exactly where you place your shoes in the morning. In Karen culture, it is unthinkable to wear shoes in any building.)

About noon, the crowd on the porch thins out, if not diminishing entirely. Then it is time to clean the porch, comb your hair if you didn’t get time before, and assess the damage to your ego. It is very common to be laughed at a lot, so it is a great idea to have a pretty good sense of humor, especially with yourself! The other day I was alone on the porch since Gayle had gone to the hospital with patients, and my interpreter was dealing with soldiers. A lady came, who we always refer to as the lady who stole the pumpkins. She tried to tell me all kinds of things that I could not understand. So, I got out my trusty pink book and started asking her the questions that I can ask. I found out that she had problems with the left side of her body, and she kept falling down! So, I was pretty sure that since she is older, she had probably had a stroke. So, I looked it up in my book and found that I could give her some things. So, I went and got all the stuff out for her and tried to give it to her. She threw it back at me, and angrily told me something! I was pretty bewildered by her behavior, but decided that I must have misunderstood what she had told me. She then indicated that she wanted a malaria test, so I dutifully got one out and administered it. She did not have malaria. So, I showed her the test and told her du may buh, no malaria! Then I gave her the money to go to the clinic in town to get checked for the other kind of malaria. Several hours later, she showed up again on the porch. I had so many patients that day that I was totally worn out, but I did have a student interpreter by that time. She told me that she wanted medicine that Gayle had given her before, yellow and black pills. So, I frantically searched through our supply of medication and looked for black and yellow pills! I found the black ones… iron tablets.. but no yellow ones! I was getting pretty frustrated since it is rare for a patient to tell me what to do, and a grumpy one at that! But, she finally left with just the black pills. When she had come back, Travis had stationed himself in the doorway remembering that she had stolen from us before. We finally realized that she was looking for an opportunity to get inside the house and steal some more things.That is why her symptoms kept changing.  So, not all our patients are pleasant to work with, but the great majority are wonderful.

One little patient that we had last week was a very sweet 5 year old, that always wore a very sober expression on her face. She had been there several days in a row with pneaumonia. I looked at her and she smiled the biggest smile at me, then she looked around her and resumed her very sober look. She did this twice and it just seemed to me that all the cranky grannies in the world could not chase me away from that porch!

In the afternoons, the porch is often the scene of impromptu staff meetings, or a hospital room for inpatients. Often, there are patients coming and going all day long. There is always activity of some kind going on at the porch. But, I have never seen a rocking chair there, or a cat! It doesn’t seem to matter though, the porch is still a very satisfying place to be!