Fieldset
Yemen: Good complaints

After a patient makes an astonishing recovery, Finnish surgeon Heidi reflects on the wider problem of providing medical care in places where resources are limited

Emergency surgery at Al Salakhanah hospital in Yemen

What does it mean to do what you can – to do your best?

When a young person decides to go and study medicine and finally become a doctor, they don’t know what they are doing. At least, I didn’t.

I did not know the profession would grow into me and become part of me, or, I part of it.

To me, being on duty means to put the patient first. Sounds simple, but isn’t always.

In MSF, putting the patient first may mean forgetting about doubtful relatives, the project you are working in or the challenging working environment.

Still, I’ve learned that sticking to this simple rule makes it possible to work effectively and humanely as a doctor in any circumstance.

Good complaints

As I put my golden rule into practice with the patient from my last blog – the elderly man with a blod clot in the abdomen – everything else followed quite naturally.

I administered painkillers and some IV fluids, and the man, on his side of things, quite astonishingly recovered.

When we came to his bedside, he always had some complaint - this meant he was doing great!

He started eating, but he complained of abdominal swelling as well as some pain and gagging, also. When we came to his bedside, he always had some complaint.

This meant he was doing great!

I tried to explain patiently: “See, you almost died. You just narrowly made it.

“You only have a third of the small intestine that you used to. It will certainly take some time for your system to get used to the changes.”

We were so happy. I thanked God for the decision I'd made in the operating theatre.

I had almost given up. I think the nurses had a lot to do with my decision-making. They poured trust and hope into me, they encouraged me to not give up on the patient.

In order to do your utmost best, you need others to cheer you up. To trust in you, and, sometimes, also to know better.

Limited resources

That was the happy part of the story of my most challenging case in Ad Dahi. Still, it is only one side to it. The other one is less encouraging.

In an MSF project, at least in my experience of the three I’ve been a part of, you always have to accept and deal with the problem of limited resources.

The reason we had to remove part of the man’s bowel was because of severe damage caused by thrombosis (blockage caused by a blood clot) of a major artery. However, the initial cause of this condition was not clear and we didn’t have resources to investigate further.

On every assignment you learn something new of the world and of us humans

Also, after such an incident, the patient should receive anti-thrombotic medication for some while – in his case, an injectable drug.

However, since the man lived far away from the hospital and had no fridge to store the medication in, we could only arrange this treatment for a short time, while he stayed with a nearby relative and came in to the hospital to get his daily shot.

Even this was stretching the system to the edge.

Finnish summer

Now, I’m home form Yemen and enjoying the Finnish summer, which I still consider the best summer in the world (childhood memories certainly have a lot to do with this).

I already know what my next assignment will be. I'll be coming to Yemen again, next autumn, and I can hardly wait to be back there.

One of the great things about MSF is that on every assignment you learn something new of the world and of us humans.

Also, after each assignment, you become a little bit more useful for the next one, too.

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Read Heidi's previous blog from Yemen

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Read more stories: From Yemen

Yemen diary, part one: The dilemma

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