Emotions Running High

~ Friday 15th August

How is it already my last night here?!? Time has just flown by; I can't believe I touch down in the UK in about three days time.

My last day in the dental department was pretty eventful. A nine year old boy came in today; he needed two extractions and credit to him, he didn't utter a sound. Seriously, I rate that kid for being that strong. My heart went out to him though...he was hands down the most impoverished individual I have ever seen. And I've seen a lot. It's not my first time to Africa and I've worked in the hospitals of Malawi, the 9th poorest country in the world. But this was probably the highest degree of poverty I've seen first-hand. He was in his school uniform but his shoes were coming apart from the soles, so much so that they were almost in half. His clothes were covered in dust and sand and his school shirt was frayed with layers of fabric just peeling away. His mother couldn't afford to pay for the treatment so it went free and then she told Dr Grace that her son was meant to be in an exam but she couldn't afford the transport to send him from the hospital to his school so Dr Grace then paid for him to get to school because she couldn't bear to see him lose out on the little education that he has.

The really sad thing is that boy is one of thousands.

We then had a lady come in (she was a right madam - she threw a tantrum because of how long she had to wait outside, and then she asked me if she could have my handbag because she liked it, and when I said no because I need to take it back to England, she suggested I buy a new one. Don't even ask.) Anyway. She needed a filling doing but then the dental drill stopped working so Dr Grace, David and I went rushing to Dr Grace's car to get a portable drill machine that she keeps as a back-up. Clearly this happens often...?

Then the next patient needed an x-ray of his face looking at but when we put it against the lamp to study it, the electricity went. (It was bound to happen one day). Granted, it didn't affect us so much because Dr Grace had a good idea of what was wrong anyway and just wanted it confirming, but apparently in operating theatre when the electricity went, the doctors started taking out their phones and using the phone light to carry on with the surgery. Crazy, I know.

Our last patient was a 90-year old male who had temporomandibular joint dislocation. In simple terms; the temporomandibular joint (TMJ) is a ball-and-socket joint found just in front of the lower part of the ear and it allows the movement of the lower jaw. When you open your mouth, the "ball" (termed the condyle) comes out of the socket, moving forward and moves back into place when you close your mouth. The TMJ becomes dislocated when the the condyle moves too far back and gets lodged in a bony prominence called the articular eminence, and it can't move back into place. So the surrounding muscles go into spasm and the condyle is held in the dislocated position.

It means that the jaw is locked in its open position and it causes pain until the joint is returned to its normal position. The muscles would technically need to be relaxed first but we're in Africa and we didn't have muscle relaxants so we had to make do with local anaesthetic. Dr Grace then pushed downwards on his lower jaw, tipped his chin upwards to release the condyle, and then guided it back into the socket. Although she did say that if he had come a week or so later, it would have needed open reduction, where the temple region is cut open and the joint is pushed back into place.

In other news, OPD had an exciting day. They had a woman come in with gangrene on her middle finger; it was blackened and resembled dead wood. She had initially cut her finger and had left it untreated so she developed an infection. She was also diabetic which damaged her blood vessels and nerves because of the high sugar levels, and so blood flow to that region was restricted, causing gangrene. She needed her finger amputating. Oooh and they also saw a guy with a hole in his foot and they could see exposed bone and flesh. Silently thanking God I'm in the less gory, albeit less exciting, dental department.

After that long-ish morning we headed back to the house for lunch because the guys going for the safari this weekend had to leave at 2pm. So now half the house is empty and it's eerily quiet. And it's not the same without Aleks either. Although, check this, she's coming to England to study Medical Sciences at Uni of Birmingham which is awesome because we can meet up and still stay in touch, probably more so than if she was staying in Sweden.

And since everybody's left, I've not been doing much. I finally packed which was a mission and a half because I had all my Malawi stuff with me too so I quite literally had to sit on my suitcase for it to shut. (I had to cram all my junk food in my hand luggage because a) travelling without my sugar supply makes me feel lost in life and b) if I had made space for it in my suitcase, I'd be travelling home with a broken piece of luggage).

On that note, my laptop bag is broken. So I made a last trip to town to see if I could find like, a temporary £5 bag that would take my laptop from Africa to England to then be chucked in the bin, but no such luck. They were quoting me £22 for some stitched up carry case and I was like, mate, do you know the kind of laptop bags I can get in the UK for £22?

Jesus.

So when I see my mum tomorrow I'm going to make her carry my laptop for me. (Sorry mum).

And yeah, I think I'm all set and ready to go! In the literal sense of course. I'm not so sure I'm emotionally ready to leave this place :(