04 August 2016

My Speech is the Impediment

We returned to Galmi a few days before July started.  At some moments it feels like we were never gone, at other points I have the sense that we just came back yesterday.

My first month back in the therapy gym was overloaded with referrals from visiting doctors who had heard that the OT would return and cases from B. that he felt were beyond his skill set.  So between playing catch-up on patients who are deserving-of-intervention-early-but-were-born-in-Niger and trying to remove the inches-of-dust-that-have-piled-up-because-of-differences-in-the-definition-of-clean and unpacking our finally-have-put-the-suitcases-away life I'm finding a moment to write a blog post.

But, some things never change and I've resigned myself to two facts:

  1. I love burn patients.  More than patients of other diagnostic categories.  I'm partial and I've picked favorites.  So there.
  2. My Hausa language capacity is so low that B. still considers my speech to be it's own dialect.

One of the first patients waiting for me when I started back to work was a young mom named H. who had been severely burned by the jealous other-wife.  The incident happened over 10 months ago, and H. was sent to Galmi Hospital after spending the first crucial months in a government hospital about an hour away from us.  While there she was treated for her open wounds, but no one spoke to her about the severe scars that were already forming.  

H. laid in bed for days at a time, trying to stay in a comfortable position.

But as we say in the burn-care-world "the position of comfort is the position of contracture".

That means when burned body tissue begins to heal, the scars that form will do so in a pattern that restricts future function.  And before the patient realizes that this is what is happening, it is already too late.

H. can no longer lift her head to a normal position nor turn her neck.  She has lost nearly all the mobility of one of her shoulders.  The corner of her mouth is being pulled down towards her chin, making it difficult for her to keep her lips closed.

But she is determined!

Despite the pain, H. comes to work with us every day.  We've pulled a mask for her and modified some compression garments that she can wear to combat these scars.

But our therapeutic-relationship isn't only one-way.  H. gives back as much as she receives.  

Recently that has been in the form of translation services.

You see, for the past year while I've been gone, B. has been pulled back into nursing.  He's been doing therapy too, but has been juggling several responsibilities at once.  And this is still the case.  So I've been mostly left to struggle through my communication with patients in my own.  Which works about 50% of the time . . . okay, fine, 40% . . . well, maybe 30.

Most of the time when I ask my patient or his family a question, they stare blankly at me.  When I change how I'm asking, I'm met again with more blankness. This goes on and on for a few more rounds until I begin miming a few actions I'd like my patient to try to perform and then we get somewhere.

But when H. is around doing her therapy, after about the third attempt, I'll hear a sweet voice from over in the corner and miraculously the patient I had been questioning understands!

H. is fluent in Hausa and Arabic.  She claims that she speaks no French or English.  Yet, she seems to understand everything that I say.

One day, B. returned to therapy gym as H. was explaining to another patient what I had been trying to say. 

"Do you really understand what Deb. says?" he asked her in Hausa.

"Of course." she answered.

B. laughed.  "No really, do you understand her or are you telling them what you think she says?"

H. smiled in reply, "I grew up with a sister that had a stutter!  I learned to understand some very bad speech!"

As they say, the Lord works in mysterious ways!

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