Est-ce qu’elle parle seule? Does she talk by herself?
You’re sitting on a
mat in a small church building. It’s 43 degrees outside and the pastor’s son
has just handed you a small glass of boiling hot, sugary tea. Opposite you a
man nods an affirmative response which for once doesn’t need translating. Sat
next to him a lady, probably his sister stares into space with wide eyes. Hmm…says
the doctor, then the cycle starts again, is she ever violent? Est-ce qu’elle
est violente? Hi tidawwis walla?
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| Consulting |
For the past three
weeks I have been in Abeché, a city on the other side of Chad, not far from
Sudan. I’m here to help with translation
for a conference on psychiatry. Two American psychiatrists, Mary and Bryan, who
are working in Cameroon, were invited to Abeché to teach the MHGAP, a guide
created by the World Health Organisation to help people treat psychiatric
problems in areas with limited resources.
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| Patients waiting at the Health Centre |
Since August last
year, Ann Fursdon a British doctor working with AIM has been seeing mentally
ill patients in Abeché. She has been doing one day a week at a health centre
and one day at a local church, helped by Sarah, a surgeon from America. On the
first day there were 9 patients. Last Thursday, we saw 60. As her reputation has grown, more and more people
have been coming from all over Chad to receive care that isn’t really available
in any other place in the country. There is just one trained psychiatrist
working in Chad, at the central hospital in N’djamena and even he isn’t around
a lot of the time. So Ann, having always
had an interest in psychiatry decided to start seeing patients, she has been
getting more and more people over the past 6 months, people who have been in
chains for the past 25 years, others who have been having untreated epileptic
fits for 10 years, children with developmental delay which their parents just
can’t understand… As more people have been coming Ann can’t cope with the
numbers and wants to help other Chadian doctors and nurses to know how to
provide this care. So she has organised this conference.
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| Many patients are brought in in chains |
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| The church where Ann also consults |
My parents happened to
hear about it while they were in N’djamena and mentioned it to me. I am
particularly interested in psychiatry and never imagined I’d be able to see
what providing psychiatric care is like in Chad. The conference was meant to
take place last week but a few days before the flight to Abeché, Ann rang me to
say that they had had to postpone it as the government had organised a
vaccination campaign that week which meant that most of the health care workers
that she had hoped would come would be busy. As our flights were booked we came
to Abeché anyway and for the past few weeks we have been seeing patients at the
two clinics, four days a week from 8 till 5. It’s been an amazing experience
through which I have learnt a lot. I have been translating from English (the
two American psychiatrists only speak English) into French and writing the
medical notes and others have been translating the French into Chadian Arabic
so that the patients can understand. Hence the three way conversations. My Arabic
vocabulary has improved a lot; yesterday when the other translator was busy I
was even able to translate a few consultations from English into Arabic. Though
I still make lots of mistakes, I have now extended my skills of greeting and
introducing myself to doing a short psychiatric consultation and telling people
how to take tablets in Arabic. Useful skills!
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| Henna! |
Being in Abeché has
also allowed me to spend more time with Arab women, which I have really
enjoyed, it reminds me of Guinebor. I spent a couple of hours last Saturday visiting
Mariam, a lady who has been helping with translation at one of the clinics. We
drank sweet coffee, laughed at her three year old son and then I helped one of
her friends set up a face book account. It’s an interesting paradox; she was so
excited to eventually be “joining the world” that we had to entertain her baby!
Today, after the Arabic service at the church where we have been running the
clinics, Mariam invited Mary and I to have henna put on our hands (and feet for
Mary as she is married!). I have also been able to see the amazing Chadian
mountains and rocks again, I’m preparing for the next 3 and a half months in
flat N’djamena!
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| With Mariam and Mary after a day at the clinic |
It has been great to
be able to be here for a 3 weeks, even though it seemed frustrating to miss
even more time at the centre in N’djamena to start off with. I am very glad and
thankful that Naomi and Anne were able to spare me at this busy time, I will
write more about what’s happening when I get back. It has meant that Mary and
Bryan have been able to get an idea of the culture and the care that can be
provided before teaching and it has also meant we have been able to see and
then follow-up patients and I have seen how they get better. There was one lady
in particular who had been repeating the same phrase all day for 6 months. She
was insulting people, calling them dogs and donkeys nonstop. We saw her in the
first week and adjusted her medicine slightly, the second week she was no
better and so we changed it again and then last week I saw her waiting outside,
thought I recognised her and suddenly realised who she was. I hadn’t recognised
her because she was silent! She shook my hand and greeted me normally. Even
with limited resources it’s still possible to really help people!
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| A lady arriving at the church in a "rackshaw" |
This experience had
made me even surer about wanting to study medicine next year which is good as whilst
I have been here I have also been hearing back from the different medical
schools that I applied to! I am very excited to have received offers from
Liverpool, Bristol and Edinburgh and am really hoping to hear from King’s soon!
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| Counting medicines at the church |
Next week will be very
different, translating the lessons at the conference from English into French. We
did a practice run today, it is extremely tiring. We really hope that the nurses
and doctors taking part will understand, be interested and inspired to start
helping people with these problems themselves as Ann can’t do all the work by
herself. The course will be from Monday to Friday and then we have a 10 hour
coach trip back to N’djamena on Saturday, one day before Mary and Bryan’s visas
run out! It has been a brilliant opportunity, I’m really glad to have been able
to take part in this amazing work.
