Portrait of the Mission

I've been referring a lot to "the mission" but realize that I haven't given an idea of what it's like. The Mother Theresa Mission is located down the street from Sidist Kilo. Keep in mind that there are only about 10 streets in the whole city with names so it is difficult to give good directions.

The Street

Both sides of the street are lined with storefronts selling laminating-copying-faxing services, camera film, fruit, convenience store items, and restaurants (and that just what I can see out the window of this internet cafe/office supplies store). Parked blue Toyota Taxis (think 1980 style sedan) line both sides of the street waiting for passengers and dumptrucks (sometimes filled w/people sitting on the rim), buses, SUV's, personal sedans, and donkeys/cows/goats share the road. The sidewalks consists of uneven bits of broken concrete, jagged rocks, and dirt. There is a gate with the words "Mother Theresa Mission" and inside a little driveway.

Layout

There is a 2-story building on the L w/a chapel and a ward upstairs for the male 'severe' TB patients. The driveway is lined with a rose garden and at the end, another gate. Enter and you are inside the compound. A long walkway runs between the outpatient clinic/wound dressing/pharmacy/triage/red cross ambulance unloading area (they pick up injured people off the street during the night and bring them to the mission) and the rest of the mission. There are about 800 patients @ the mission and then 200 children at the orphanage across the street. The walkway is lined with men in wheelchairs sitting in the sun, boys on crutches missing a leg, and old men who slowly shuffle with their iron stakes/canes. The men's ward consists of 6 rooms w/about 50 beds in each room (lined up touching side-by-side and against the walls...no such thing as privacy). Behind the men's ward is a 3 story structure for the younger boys. If you keep walking down the walkway, there is a 3 story building that houses all of the women and girls, physical therapy, and the severely mentally handicapped children. In between the men's and women's wards there is a small playground and courtyard separating the two, and below the women's ward is a small library/classroom.

Medical Supplies in the dressing room

Nearly all of the medical supplies have been donated by visiting med school students. The room is about 15' X 15' with linoleum tiled walls, bare cement floor, a window that doesn't open, and 1 fluorescent light overhead. There is 1 examining table (of course w/o the butcher paper but at least it's wiped down w/alcohol between patients) and 1 metal chair for patients to sit in. Cabinets line the walls and shelves filled with donated supplies stick out above the cabinets. There is small roll away table in the middle of the room - my station. A tub of gauze, a box filled with forceps, and bottles of hydrogen peroxide, alcohol, and other odd, assorted wound-cleaning liquids sit on top of the table. The two drawers are filled with packs of sterilized gloves, sterile razor blades, and bandages.

A quick note about the gauze - turns out that not all gauze comes in sterilized packages from Johnson & Johnson. I spent all afternoon yesterday folding big sheets of gauze into small squares, old school style...I told the other nurses that in America all gauze came individually packaged and they thought that was crazy.

Wound Care

Patient's wounds are washed, sterilized, bandaged, stitched, drained, and bled over a small metal trash can, with the extra liquid (of all kinds) decorating the floor. If too much blood or other fluid spills onto the floor it is mopped up w/some alcohol. Nurses constantly move in and out getting supplies for their rounds to patients unable to leave their beds. Scabs are pulled away by gloved hand or forceps, dead skin is cut away with a scalpel, bandages so encrusted with pus and dried blood that they are stiff are soaked with IV fluid until they agree to budge, and men missing eyes, lips, ears, and scalps (all b/c of cancer...or so I'm told) have their unnatural orifices irrigated with the IV fluid. The system and materials and level of care is very old school, but it's the best we can do under the circumstances, and it seems to work.

The clinic is foreign to nearly any western doctor trained post-WW II, but the people are grateful for the care given, their injuries improve, and many severe crises are averted every day.