To monsoon or not to monsoon

A few weeks ago it looked as though the monsoon had finally arrived, with the onset of daily storms and downpours (although this has now stopped and it appears the monsoon has, in my part of Tamil Nadu, failed). The Indians class this time as the "cool season", I call it the "fractionally cooler season"! The temperature still soars into the high 30s during the day, but it is slightly cooler at night and I no longer lie in a pool of sweat. The heat is probably the biggest challenge for me here. I have classified hand-washing as an extreme sport - the sweat streams from my nose like a tap. I used to do my washing in public, but it's a little daunting having an audience of six women discussing my technique, so I now indulge in naked hand-washing whilst in the shower. Most of the families where I live use a "dhobi" - a person who washes for a living. I'm sure they think I'm nuts doing my own washing but I feel that there are already too many barriers between me and the locals and I don't want people thinking I'm above doing my own dirty work. Anyhow it gives me something in common with the dhobi who gives me an enormous toothless grin when she sees me lugging my washing around.
With the rain came the dragon flies in their hundreds, all hatched out overnight and busy making their maiden voyages the next day. Also thriving are the mosquitoes, who have taken a particular liking to my feet, even the soles. Last count 20 bites. How they manage to bite there without being squashed is beyond me. Perhaps they are a new kamikaze breed! They certainly don't have a sense of smell that's for sure!
We have enormous thunder storms each day, which I absolutely love. They are the kind which make the hairs on the back of your neck stand up, you can feel the electricity in the air. I stand on the roof terrace and watch the lightning crackle overhead, it reminds me that we are very small in the grand scheme of things, little dots on a planet which is still raw and volatile. The rain falls in torrents, so heavy I can't see the other side of the street. The road transforms into a river half a foot deep in a matter of minutes - it's quite a sight. Life here goes on regardless, people wading about, bikes wobbling through potholes, whole families perched precariously on the backs of motorbikes, turds floating by.

Redundant!!

As far as nursing goes this hasn't turned out to be what I expected. I am able to do very little hands-on so spend most of my time observing which can be very frustrating. This is partly because of my inability to speak Tamil but predominantly because my role as a nurse in England simply does not exist here. A dressing here consists of covering or packing a wound with gauze which inevitably sticks and causes further trauma when removed. Dressings, catheterisations, removal of sutures etc are all done by the Drs. Injections are one thing I can do but for me there is an ethical dilemma attached to them. Literally every person, regardless of what is wrong with them gets at least two injections. Tablets are pretty much redundant. I tried to raise the subject with the Dr but he quickly gets defensive. His argument is that people are not educated enough to realise that they need to complete a course of oral treatment and therefore it is best to give a one off injection. He also says that people want a quick fix and that if he refuses to give them an injection they will just go elsewhere. My point of view is that as an educated Dr he has a responsibility to try and change atitudes and re-educate the many people he sees on a daily basis. If the patients then go elsewhere so be it. Injections should not be given on demand. Needless to say that he gets paid for every injection given. Even antibiotics and paracetamol are given by intra-muscular injection - it's unheard of back home. Needles are thankfully changed between patients but are used several times on the same person. Syringes are re-used for giving a specific drug and sit uncovered, in the heat with flies walking all over them. The gloves, which are used for internal examinations, are dropped in an orange bucket of bleach, given a stir and then pegged out to be used again. So as you can see I have a big dilemma over whether I should participate in potentially harmful practices. The language barrier means that I cannot begin to explain why I have a problem with what they are doing and even if I could communicate I don't think it would really sink in.

The two Drs I am assigned to are old school in the sense that they see the nurses as little slaves. The female Dr in particular seems to be incapable of doing anything for herself. As soon as she coughs (not covering her mouth, and normally in my face!) a nurse scurries to pass her a glass of water which is easily within her reach. The nurse checks the patients' BP before they see the Dr but she immediately checks it again because obviously nurses are too thick to do it accurately. It drives me demented and there are days when I would happily strangle her with her stethoscope!

Still it's not all bad. On Tuesday I went to a medical camp and actually did something productive! I was taking blood tests to check for HIV. One woman was terribly unwell. Her skin was taut over her skeleton and she could barely keep herself upright. She collapsed so I scooped her up off the floor and carried her like a baby over to a bed. She was as light as a feather. Thirty-three years old and probably only a few days left of her life. Her test came back negative but her family hadn't taken her to the hospital before now and medical attention had clearly arrived too late.