13. Feb. 2023

The Longest Night

I writhed in pain throughout the night, tears trickling down my face. Mummy was really angry (at least that was what I thought), yet she was perched at the side of the bottom bunk of the bed I shared with my twin brother, trying to get my right arm in a position of comfort. I didn’t understand why she was angry. “It’s not my fault,” I thought. I had told her I wanted to wear cardigan to school that morning because I was cold and she simply said no, without an explanation. I guess she thought I just wanted to wear it because others were coming to school in cardigans too. She was called to the school that afternoon to come take me to the hospital because I had gone into a sickle cell crisis. We didn’t go straight from school, we went home first. It took us a while to leave for the hospital. At the time, I didn’t understand why I had to wait for so long; every minute seemed like an hour and I felt like we were never going to set off. I just wanted to go to the doctor so the pain goes away. I later found out she needed to go to my grandparents’ to get some money… that’s the thing with medical emergencies in countries with out-of-pocket health financing systems.

We ended up at the Accident & Emergency Center of Korle-Bu teaching hospital late in the evening – I still cannot remember the exact time – and were sent home on oral analgesics to return the next morning because the doctor on duty was in the middle of an emergency surgery. I’m guessing that as a tertiary hospital, they probably wouldn’t want to “officially” refer us to a polyclinic. The only other tertiary hospital they could refer us to at the time was 37 Military Hospital and that wasn’t exactly practical. She knew the drill. She’d need to be with me every day during my admission and 37 MH wasn’t within the province we stayed in, so it wasn’t really feasible. Besides the doctor wasn’t even available to write the official referral letter. This is me trying to guess why we couldn’t go anywhere else if there was no doctor available at the hospital we went to. Whatever the reason was, it resulted in the worst of the many sickle cell crises I had as a child. It was the longest stretch of time I had had to endure a crisis before getting an intervention. The whole situation had my mum so frustrated that you could easily misconstrue that emotion for anger at me. We did not sleep and I couldn’t wait for morning. It’s funny how subjective the perception of time can be… when you’re trying to get an extra two minutes of sleep after your alarm goes off in the morning, it seems so short, yet when you’re in a bad position it never seems to move. After what seemed to be forever it was finally time to get ready for the hospital. She tried to bathe me and get me ready. That bath was a nightmare, because she had to move the arm. I really thought we could skip the bath that morning. “Who would even know?” I wondered. She tried her best to keep the arm as stable as possible during the bath, making a conscious effort to not move it so much, but with the moment of other parts of my body, it was unavoidable… and every micro movement was excruciating. Then it was time to wear my outfit. I remember that outfit vividly. It was a tailored tie and die two piece – a front button shirt and a pair of shorts. I had to stretch out the arm and put it through the sleeve. That part of getting ready was indescribable.

We got to the hospital very early. It was almost 5 am and there was already a queue. Looking back at the situation from a doctor’s perspective now, I’m not sure why we didn’t go back to the Emergency Center; at least I don’t recall us doing that. My mind seems to tell me we went to the Out-Patient Department that morning – I hope I’m not mixing it up with another hospital visit. But I remember a queue and a long wait… Or could it be that we went to the ER alright but the pain had me perceiving a relatively short wait (probably for my folder to be retrieved) as a wait for my turn in a long queue?

I was finally attended to. I didn’t want the canula and I was dreading the injections, but between that and what I was going through,there wasn’t even a choice to be made there. They were the lesser of two- or should I say, three evils. That day was the first day of what would be two week stay at the children’s block. I missed school terribly, I missed my friends, but the children’s ward had a library. Those of us who could, were allowed to go there around midday to read. I made a new friend during my stay there. She was a little older than me but couldn’t read. I used to look forward to teaching her how to read. I don’t think we made much progress with that, but it was fun nonetheless.

This was about twenty four years ago. Fortunately there has been a lot of improvement in waiting times in public hospitals in Ghana now. Though the doctor: patient ratio is still unfavorable, I don’t believe a child in a sickle cell crisis will have to be sent home due to the unavailability of medical staff (in the tertiary hospitals at least; I can’t confidently say so for the primary care facilities in the rural areas). The bed:patient ratio seems to have gotten a lot worse though, and I sure hope no child will have to go through this because of that.

Though not as common as that of genotype SS, Sickle Cell patients with genotype SC can equally have severe phenotypic expressions of the disease. Carrying the haemoglobin C trait does not exempt you from being cautious; the fact that you’re genotype AC doesn’t mean you should take the risk of bearing offspring with a partner whose genotype is AS or SS.

NON-FICTION   |   BELINDA ATTA LARWEH

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