Today was my first glimpse of Alpha hospital, my work home for the next 3 weeks. Dr Wiafe is easing me in slowly which is appreciated due to the jet lag. I was given a book written for Indian eye hospitals on counselling eye patients and asked to read it. It is designed for training high school graduate counsellors to assist the medical team. It includes basic counselling skills but more importantly for me explains the basics of eye disease, the type of thing I need to know for working with Dr Wiafe’s patients. Already I have read about cataracts (a clouding of the lens), myopia and hypermetropia (both problems with refraction) and pediatric counselling for eye conditions. I observed Dr Wiafe with about 10 patients – they are moved through quickly – there are about 30 more in the waiting room. I arrived at 11 a.m. Dr Wiafe sees about 40 patients a day. On Thurs he does surgeries and I hope I can observe that as well. His assistant, Opuni Daniel takes patients out of the clinic into another area to educate them about the doctor’s diagnosis. We see a variety of conditions, including a foreign object attached to the cornea, a cyst above the eye, and so on. Two are slated for surgery. Dr Wiafe tells me how important counselling is because the general population is not trained to question medical professionals and they can go into surgery without knowing what it is for. This is quite a problem if they wake up with an eye removed! Dr Wiafe also has two young women in pink uniforms (ward aids) assisting him. The examination room is small and I am soon sent off for a tour of the hospital proper of which Dr Wiafe’s clinic is just a small portion (and the only portion with AC as far as I can tell). Rose, a nursing trainer and part of the administration team of the hospital, gives me a tour of the facilities. There is a large group waiting under a makeshift roof – this set up keeps the large number of patients out of the hot and crowded indoor waiting rooms. At the outdoor clinic patients have their vitals taken prior to seeing the doctor. Before taking a seat in the waiting area they are registered at three windows. I am surprised to see the four young people conducting registrations have flat panel monitors and computers at each station. I realize instantly that this hospital is in a different league than the ones I visited in eastern DRC. However, as with hospitals world-wide there are funding challenges. In this case it is the slow turn-around time for insurance payments. When the payments are delayed, so are salaries for non-government workers. I am introduced as a counsellor and asked jokingly if I do marriage counselling. I look forward to getting to know the staff.
As we round the corner of the building we hear a ruckus, a sharp bang on a wall and shouting, and Ruth is called to assist. She motions for me to stay back and deals with the issue. She says the problem is a man having an apparent psychotic break. We continue our tour to another outdoor waiting area with 20 – 30 pregnant women waiting for vitamins, counselling, and medical attention. Inside, we see another 20-30. It is a smooth system of different stations to received vitamins, counselling etc. but the demand is great and people wait all day. I meet the counsellor I will be working with. She is a nurse with a community health graduate degree who does HIV/AIDS counselling. Each pregnant woman in the clinic receives counselling and is given the option of HIV/AIDS testing. If they choose this option, they are also given the results in the privacy of the counselling room. Other HIV patients are seen here as well – a male client is in the room when I am introduced. I learn that the number one means of  HIV infection world-wide is heterosexual intercourse.
I am asked to present a seminar at the large teaching hospital in Accra – I am happy to help where able. I suppose I will learn more about the topic in the days to come. I continue to consider the request to give a public lecture in Tanzania. $1600 is a lot of money for one lecture, but the potential for future partnerships is appealing. I’m also drawn to the possibility of visiting Dr Mukwege in Bukavu. I think the time will go very quickly.