A Big Ship and Palliative Care...: Challenges of many kinds

There are many challenges with living and working in Africa. We are lucky to have a large, self contained Western environment in which to live with reliable electricity, regular meals, hot showers and air conditioning. We take the ship for granted too often. I know I do. After returning from a hot, dusty, sweaty day there is always a cool breeze awaiting me as I walk on board.

However being in Africa means that we have to rely on local resources to keep us afloat (pardon the pun!). One of these resources is water. Water is supplied to the different areas of Freetown on certain days of the week. In our area it is on a Monday, Wednesday and Friday. But being Freetown, this is not a given. Because of the antiquated nature of the pipes, sometimes the water just does not come. And that is when we are reminded that we live in Africa. A couple of weeks ago the water did not arrive on Monday or Wednesday. By Friday, when we received a small amount, our water reserves on the ship were pretty low. Now if you can imagine water for 400 + crew, the Operating Rooms, hospital, galley and laundry rooms we get through a huge amount on a daily basis. By Saturday our water had got so low that all showers, laundry and non essential water use was postponed. Thankfully I had decided against a trip to the beach that day...I'm not sure if trying to wet wipe salt and sand would have been a pleasant experience! Over the following few days more water was obtained, showers were re started and we are now back to full working order.

Certainly a wake up call to the challenges of Africa but also a wake up call to all those in the city that have to cope on a regular basis without any water at all. As I drive around the city and see women gathered at the pumps filling their containers I am thankful for all I have, for all God has given me, and for all I take for granted both here on the ship and at home.

One of the other challenges facing me is getting to all my patient's homes. Normally it requires driving up a very small, rutted road and maybe a short walk to their house. But for one of my visits we actually have to do a mini hike in to a valley (because the car can only be driven so far). On our first visit we started up the hill, climbing ever steeper. After a few minutes of silence Esther asked the family member where the house was. 'Oh, over there', she said, pointing across the other side of the valley and further on up the hill. Great. So now every week we make the (quickly becoming) familiar hike up the path walking past life being lived. I think may people are surprised to see an 'opoto' (white person) hiking up a path that has probably never seen a white person before but they do not show. Instead they shout greetings all the way up and all the way down the path. That is why, some days, my job makes me smile.