Not in Kansas anymore

This week I began caring for post-surgical patients on the wards, the moment I have been waiting for. I have enjoyed the work very much, so much is different. My first day on the job I was laughing at myself, very much out of my element and comfort zone. My female patient was in the operating room having surgery and left there in her place on her bed was her baby! The baby was crying and crying and I learned that I would be looking after him until mom returned. He was very hungry indeed and would be staying here with mom as he was breastfeeding. I picked him up and carried him around with me as I tried to look over patient charts and get oriented on my first day. He continued to howl, anxiously awaiting mom's return. Someone suggested I attach him to my back using a cloth, that he might be comforted by this West African traditional carrying method and it would allow me to continue my work. Thankfully mom soon returned from surgery. I felt a bit forward giving her baby back to her to breastfeed soon after her arrival back on the ward after surgery but this did not seem to surprise her in any way. Mom and baby were reunited. My patient then asked if I could give her baby a bath. I was surprised when the patient in the next bed offered to bathe her baby. We had been taught during our training that the care of children in this culture is quite a communal effort. Soon after the bath, one of the male translators was sitting on my patient's bed, holding her baby and feeding him some of my patient's African traditional dinner using his hand. All of these practices were quite culturally appropriate but I confess I found myself wondering what Florence Nightingale would think of all of this, knowing that from a Western perspective, multiple breaches of infection control and HIPPA violations were taking place all around me!
I have encountered some other cultural surprises during my first week. The expression of pain is often communicated with an, "Aye yi yi!" while shaking one's wrist in the air. Patients under age 15 are required to have a guardian present with them on the ward. This guardian may be a parent, older sibling, relative or friend. The guardian spends the night with the patient and sleeps on a mattress under the patient's bed. Mothers will often sleep in the same small twin bed with their child and may have a second younger child who they are looking after staying with them on the ward. I had the opportunity to care for 4 year-old twins who had surgical repair of bowlegs. They and their mother all slept together in 2 twin beds pushed together.
The national languages of Benin are French and Fon. Many other tribal dialects are spoken as well. Translators are an essential presence on the wards as rarely do patients speak any English. Translators are also responsible for laundry, mopping and cooking a traditional African meal for the patients at dinnertime. They will often play with the children as well. This makes for a very busy ward with people on beds, in beds, under beds and playing down on the floor. The nurse must step carefully so as to do no harm as people and toys are everywhere! Sometimes it is difficult to know who is a patient, patient's child, visitor or translator! I am definitely being stretched here, not having cared for children since nursing school. It's Pediatrics 101, African style. Some things are culturally universal such as the fun one can have drawing on his leg casts with markers and crayons or playing with Legos or throwing teddy bears around the room. I feel like I am in a scene out of "Curious George Goes to the Hospital (in Benin)". (a fine read, but you don't have to take my word for it, da da dunt! Courtesy of Reading Rainbow. Thank you LeVar Burton.)