mostly work..

      I am so funny.  I am chuckling to myself as I realize, here I am saying I am being in the moment, well yes being here in Sri Lanka and not in the US in my head, but what am I thinking about when I become conscious?  I am thinking about how I can't wait to go to Colombo tomorrow!  Those who have been reading the blog might remember that I couldn't wait to leave Colombo to get to Badulla.  Then, my perspective was let me start my wonderful new experience in Badulla, now my perspective is I can't wait to buy a decent set of sheets and meet my friends at the shops!  I think that is so funny to realize (again).  What have I missed of my life in these last few days?!
     Today most of the nurses, the OT, SWs, the attendant staff, Ancy and me, went to the home of Mahendra, the nurse who is leaving, to bring a baby gift for his 4 month old!  So we all arrive, it is a tiny rented house, not much different then the houses of a lot of patients we go to on home visits.  So we take off our shoes and go into his living room.  Everyone sits down, chats a bit, food is put out, we all get up and help ourselves, we all eat, some people outside or in the bedroom.  After eating everyone gets in a line to get to the sink and wash their own dish.  Then dessert is served in similar fashion.  Meanwhile, I have been taking pictures here and there and say when we are finished we can take a group photo. No one says anything. After dessert, rapidly after dessert, one, two then almost all the staff stand up and leave!  No gift has been presented, no chit chat, coffee or tea, hanging out..no, the Sri Lankan way is: come, eat and leave!
     I don't know if I have talked about the houses here.  I shall in greater detail some other time but for now I can say the walls don't come up as far as the roof and the roof is usually tin. There are few doors on openings.  almost everyone has a two burner stove top, few have ovens.  Sometimes there are windows but then there is an opening at the top which let's the mosquitos in.
     For the last month I have been going weekly with Mahendra and another nurse on home visits.  This is for patients who don't come to the clinic to get their medication so we go to them and give them Modicate (Prolixin injections) and whatever other medications.  I did talk about this before.  It is actually wonderful that this is done.  Most of the patients live on the tea estates.  Tea is grown on steep hills and mountains and has to be picked regularly; very, very hard work.  There is a lot of poverty, alcoholism, spousal abuse, suicide.  Ancy has an idea to train the few health workers who are on the estates in clinics to know a bit more about mental health so this is something we shall work on.  What I wanted to share though is a bit of what it is like to get to some of these people.  The other day we drove (we now use an ambulance for transport) to a location, we walked up a hill to the railroad tracks, we walked for some time on the railroad tracks, we got off them and walked down into someones backyard.  These lovely people live with a 90yo mother, her daughter, sister, kids etc.  These people served us tea and cookies. need I tell you were the store might be.  We then walked back up to the train tracks, back along them, walked up hill to another home with a 90 year old father and the rest.  I thought we should fix the two 90 year olds up, they were so lovely and so young and vibrant.  The problem is that one is Buddhist and the other Hindu.  oh well...  We then tried to get to another woman who I have met before on the estate and couldn't get to her because every lousy dirt road on that estate is being fixed at the same time and we couldn't get to the top where she lives.  This means that she will have no medication for a month...
     I am just telling you everything that comes into my mind because I shall be away almost a week and shall not have an opportunity to write.  Also obviously I feel better and am overwhelmed with projects to do having just found out that most of the attendants on the ward asked to leave and we got 6 new ones, never worked in psych before, the one attendant who is staying is the one that pushes and shoves patients so I am anxious to get them together in a group and talk before too much influence happens the wrong way.  By the way, I cannot thank you who read my blog enough, for all your wonderful ministrations to me and have saved them all should I need choochkeying(?)  again!  Anyway what I wanted to tell you is a continuation of telling you how frustrating it is to never know what is being said and I get so annoyed.  So I now know that the nurses are frequently talking about me, if they like what I am wearing, the fact that I have 2 earrings in one ear and one in the other, what I should do with my hair etc.  So several times I have asked what they are talking about and they vaguely say something about my smile or face or something.  Today I said in my tell me already fashion to let me know what else is said about me and Laxmi said essentially to stop worrying because they are talking about how pretty I am, my smile.  So I know this is just a stage they have to go thru, getting to know me and pick me apart until there is trust but I think they should just take their time about it!!!
     

Just a few things

I think I mentioned that my camera had fallen in the Indian Ocean but then worked for a while..well it now seems to be on life support.  No pictures til I can get it fixed.  I am somewhat in awe of myself, I have to say, I am washing my clothes in a plastic bucket and IRONING them when they have dried on my clothing  rack outside!  I even bought a big new iron!  Yes this is really me.  I put music in my ears via my ipod and I'm off.... Oh, I have to explain about this toilet paper situation.  They sell toilet paper here in the supermarket.  The issue is that they don't put it in the public toilets.  The toilets are either holes in the ground with a place to squat and then a tub of water and a pitcher to rinse yourself off or a western toilet with a bucket of water and a pitcher to rinse off.  Sometimes as in my own bathroom, there is a hose in the wall to use to rinse off.  I have taken to carrying toilet paper folded up in my bras.
 So, Ancy arrived, I was very excited.  The poor woman had been away for many weeks, had much to do and I felt more lonely than when there was no one here.  I had a good cry, felt awful for a few hours, laughed at myself, I must have been holding my breathe waiting for her to come.  Anyway, we are going to Ella tomorrow for the weekend.  Ella is supposed to be a beautiful little hill town people visit to hike and relax in.  Ancy is from southern India which she says is very different then northern India.  She is 36, lovely and a highly trained psychiatric social worker.  My experiences here are mimicking hers according to her.  I can see where the country mental health system  wants to go but there are no resources to get there.  Health care is free for all but there just is no money.  Wednesday I had a very nauseating (motion sickness) ride to Meedumpitiya Rehabilitation Center.  The Psychiatrist really wants us to work on getting the place truly functioning as a half way sort of house for chronic psychiatric patients.  The problem is that patients and their families don't want to be there, families are willing to take them home, patients are not required to do anything to stay there and mostly they have no resources, not a stick of wood to build a bookcase or a shelf..nada. They grow vegetables but half the time don't have enough water to keep the garden going. Right now there are presidential elections happening, lot's of campaigning, lots of promises so who knows.  Have I mentioned that I do not have a translator for work which is making communication fairly difficult.  What complicates matters more is that even those who speak some english can't understand my American accent.  I know it's just the beginning, and besides I need the time to investigate this entire new destination country.  As they say here, I shall go and come.  (never goodbye)