Surgery and Healing in the Developing World - Dartmouth-Hitchcock

CHAPTER 41
Medical Adventures in the Nigerian Bush
Glenn W. Geelhoed and Sally E. Geelhoed
It was January 19, 1968—a date usually celebrated in our family as the birthday
of one of us—as the single engine plane bounced down the airstrip at Takum Christian
Hospital. The date was celebrated this year, however, because it marked the end
of our long trip and the beginning of our Smith Kline and French Foreign Fellowship.
We had waited a few days in Lagos, the capital of Nigeria which we had not
intended to visit. We were en route from Rome to Kano in the north of Nigeria
when the pilot of the big VC-10 announced that we were going to overfly Kano
because the harmattan had hit, reducing visibility for landing to less than one hundred
yards. Theharmattan is the season in the first few months of the year when the
weatehr is dry and the winds bring the Saharan sands south to blot out the sun. We
had ample opportunity during our weather-enforced layover to observe the harmattan
atmosphere; in the early part of the dry season the air is a bit too thin to farm but
too thick to breathe.
But after waiting a few days we broke through the haze to land near the site of
our fellowship near Takum, Nigeria. Takum Christian Hospital was our foreign
sponsor where we had chosen to work during our University of Michigan senior
selective period, supported by the foreign fellowship awarded us by the Association
of American Medical Colleges. And the work started fast. An hour after my birthday
arrival we were making rounds on the wards, where the medical superintendent, Dr.
Ed Stehouwer showed us a few of the teaching cases he had been saving for us.
Before anything was done for the patients he had held for us, two patients with
incarcerated inguinal hernias presented themselves as emergencies and each of us
assisted in one of the repairs. We were to become a little more familiar both with
herniorrhaphies and with the pace of bush medicine before three months were over!
Dr. Stehouwer and his wife are the only physicians in the hospital compound,
and the mission hospital in turn is the only health resource in the entire district
where we were, in the eastern Benue River region of Northern Nigeria. There were
two other hospitals at a considerable distance from Takum, but one was without any
physician on its staff and the other converted into a military institution, both reflecting
the political and social disruption of the Nigerian civil war. Takum Christian
Hospital had quite a large population to draw from due to the circumstances of
the times, therefore it had reasonably adequate facilities in order to accommodate
these patients. There were male and female medical and surgical wards, maternity
and pediatric wards, contagion and private room wings, and a group of tuberculosis
patient huts for long-term inpatient treatment. Besides the space occupied by the
pharmacy, laboratory, administrative, X-ray, theater and outpatient rooms, the patient
space totals about 200 beds. Just how many patients are hospitalized at any
given time is only approximated by the number of beds, however, since the ward
Surgery and Healing in the Developing World, edited by Glenn Geelhoed.