I spent the morning doing rounds downstairs and following up on a few cases I was interested, particularly a woman whose family brought her in this morning. She gave birth by normal delivery in a small hospital in a rural area, and 4 days later developed a severe fever, at which point she returned to the hospital. There, they removed a piece of gauze that was left inside of her after the delivery and sent her home, where she remained unwell. About six days ago she became "unconscious" by the family's report. Today they brought her in, and she was diagnosed with puerperal sepsis--childbed fever--or, possibly, puerperal psychosis. She's been started on antibiotics and fluids, but as you can imagine after 11 days of raging infection, caused by a pretty silly mistake, she's not doing too well. As Atul Gawande's pretty spot-on book The Checklist Manifesto suggests, the counts routinely done in delivery rooms in many places could have easily prevented this lapse. For now, though, it's damage control. On the other hand, there are two wards full of healthy mothers and their sweet, healthy babies who were lucky enough to deliver here, without a doubt the best hospital in the country!
Things slow down in Hargeysa between 1 and 4 pm each afternoon--a kind of siesta time--before picking up again until 7 or so (though this will change when Ramadan starts tomorrow, I think). I was in my room working on some statistics stuff (!!!!) when another volunteer Joanne stopped by. Did I want to go to Edna's farm at 3? Yes I did!
The farm was her uncle's and when he got too old to manage it all, she and her brother and sister bought some it. She now has plots there with vegetables and fruits and goes out regularly to check on it and pick some for the hospital to eat. It's about 30 km outside of town on the tarred road to Berbera, then another 8 km on a dirt track. We drove through the heart of Hargeisa, which has the vibrant, chaotic feeling of many African towns, especially the area around the market, then out through the edges of town to the "Police Chack Point" (so the sign says). If you aren't from Somaliland and cross this checkpoint you must, by law, have an armed guard with you. Here's ours:
We drove through the countryside, dry with low scrub bush and the Golis Mountains (really, more low hills) running parallel along the right before turning off on the dirt track. Along this track, you can see where nomad families have set up their homesteads and see their camels roaming around grazing.
Her farm is an oasis of green in the desert, with vibrant crops and some interesting animals.
Okay, so a cow isn't so interesting. But the (wild) tortoise that crawled out of the peppers was pretty interesting.
He was less than pleased to see us and curled up into his shell, making a growling noise (turns out it is him deflating his lungs to fit into the shell). I didn't help matters:
Dude was heavy.
I swear this isn't what it looks like...he just crawled under the car while we were picking peppers and didn't want to come out, so our guard pulled him out. Then this beautiful girl, a gazelle, showed up. Apparently, she's quite tame from hanging out around the farm
Then we picked some peppers:
And some grapefruit:
The mandarins weren't ready yet:
And then we followed the goats and black-headed, white bodied Somali sheep home as the sun set:
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