September 17, 2007

Stay off it for the weekend

On Friday, a woman came into the clinic with severe swelling in her left ankle. I managed to gather, from her hand motions, that she had twisted it and likely sprained it. She had limited motion in the foot and was walking with the help of a stick.

I immediately thought, "Oh, this is fairly easy to treat. Put ice on it and stay off it for a few days." Then I thought, "Where’s she going to get the ice if she doesn’t have any electricity?" Then I thought, "She’s a woman and has so many responsibilities keeping her household running – getting water, getting firewood, cooking, keeping track of the children – how is she going to stay off it for the weekend?"

So I went to our propane-fuelled fridge and got one or two ice packs we use to keep our immunizations cool and propped her up in a corner for 15 minutes. Then I wrapped it as tight as I could with a bandage, gave her a pain-killer, and sent her out the door. Not an ideal solution but I guess it was the solution that was culturally practical and feasible. When you live at the margins of society, "staying off it" doesn’t seem like an option.