In March 2024, my daughter and I went to Senegal, Africa for the second time to participate in the  Africa Cries Out volunteer medical mission.

 Doctor Xiao Yang asked me curiously: Why do you want to go to Africa again?

 Yes, why? I also asked myself in my heart…

 

Dream Realized in Africa

Time flashes back to March 2023. Since I learned about Dr. Xu’s volunteer medical mission in Senegal, Africa in 2019, and saw the deeds of Dr. Faye and Pastor Anna on the ACO website, I have been looking forward to setting foot on that land and planned to participate in the volunteer medical action in March 2020. But my plans were ruined by the Covid 19 pandemic. During that time, I couldn’t even raise my head because of the overloaded SNF and outpatient work, and gradually lost myself battling with the insurance companies. It was not until October 2022 that I started to prepare for my trip to Senegal. This time I also got the support and participation of my husband and daughter. Before leaving, my daughter and I went to see Dr. White at a travel clinic. He waived all the vaccines fee for us without hesitation. He told me that his wife had been a volunteer doctor for 30 years, and he was willing to do his best to help us out for our trip to Africa.

In March 2023, my daughter and I finally embarked on our journey to Dakar, Senegal via New York.  We stayed in New York for a few days before flying out. Returning to New York gave me a lot of emotions. This is the city where I spent three years as a resident doctor. This city is full of memories, I had been trying to keep the beautiful side of this city in my memory. But no matter what, it seemed that I can’t escape the ironic luxury on Fifth Avenue and at the same time, the dirty subway entrances and the noise of sirens one after another. Before leaving, my daughter and I went ice skating at Rockefeller Center and had barbecue in Koreatown, just like we were on a vacation. It wasn’t until we arrived at JFK and saw the piles of travel bags filled with donated medicines, computers and shoes on the ground that the feeling of being on a vacation disappeared. When we put all the travel bags on the plane, it seems like we were going to a war, we were so tired that our mouths were dry and our heads were sweaty. But after seeing my good friend Dr. Yu, my junior Dr. Liu, and Dr. Xu, who were my fellow residents, I felt at ease.

                                                                  Baobab trees can be seen everywhere in Senegal

When we finally arrived in Senegal and walked out of Dakar Airport, we were greeted by the enthusiastic Pastor Anna. Because I had seen her photos on the ACO website, it was like meeting an old friend. We also were greeted by the heat, and the usual sights in Senegal – the red sand, half built houses, Baobab trees, as well as barren lands.

We took an air-conditioned bus to the base in Senegal, Africa. In the bus, I began to think of the patients that I would see in the next few days. In order to do my job better, I looked up and studied the common diseases, epidemics and infectious diseases in tropical areas before leaving. In addition, I had put the Washington manual and the Harriet Lane handbook in my suitcase, making me more confident to tackle conditions that I might encounter.

 

Realistic experience

I quickly realized the next day that the reality was not what I thought. Before breakfast, more than 100 patients had already lined up under the awning outside the clinic to wait for medical treatment. When I walked past the awning where they were, my heart tightened, but I calmed myself thinking, “Ah, no need to write medical records, no need to argue with insurance, how great!”

                                                    Patients waiting for the consultations to begin

 

After seeing a few patients, I felt hopeless. I had been completely spoiled by the American medical system. I asked a diabetic patient what medicine he was taking, what the dosage was, and what his blood sugar level was. The patient was at a loss. I screamed in my heart, “What?” At least tell me the first letter of the medicine name. I asked carefully again, when was the last time he took the medicine? The answer was that he couldn’t remember. I asked the patient if he had a blood test recently? The answer was no. There was no blood sugar level test, no kidney function test, no past medical history, no medication history. In Africa, with no laboratory work ups to base my assessment and plan of care, all my clinical experience, turned into a sentence of Hippocrates, “primum non nocere” (First do no harm).

So I threw away all my manuals and handbooks and started from the most basic. Before I prescribe medicine for each patient, I would repeatedly think about whether this medicine would be effective for the patient’s condition? Will there be any side effects? Because of the language barrier, I wrote the full name of the dosage; I changed it to as needed when I could write PRN; I wrote two times a day when I could write bid. I can only hope that my efforts can reduce the pain of patients and help improve their diseases.

                                                  Prescribing for patients

 

Because there are many patients and few doctors on site, we cannot carry out separate diagnosis and treatments like a hospital with different departments. We all became family or general physicians. As a geriatrician, I also saw pediatric and ophthalmology patients. Most of the time, I felt that my knowledge is insufficient. Fortunately, Dr. Andy and Dr. Chen in our team are experienced, and I can get quickly get their opinions regarding some cases.

A mother of twins asked me to save her only son in a trembling voice. I examined her baby and asked about the medical history, which seemed to be a viral infection. In order to confirm the medical history again, I asked about the situation of her other baby, and she told me that the baby was gone a week ago because of the same symptoms. I immediately invited Dr. Andy to consult together, and we both arrived at the same conclusion. It was a viral infection, for which the only treatment was fluid and electrolyte supplementation and supportive treatment. Fortunately, Dr. Andy brought packs of electrolyte powder. The mother of the twins could easily mix it with water for her child to drink. But my heart was heavy. If we had come a week earlier, would that other twin have had the opportunity to grow up with this baby?

Baby with suspected viral infection. The twin sibling passed away a week before with the same symptoms

 

During the days of volunteer medical treatment, several of us doctors would often summarize our experiences and remind each other. For example: seeing a big-headed baby or abdominal pain, we should think of parasites! How should we calculate the dosage of pediatric drugs? Before the end of the volunteer medical trip, many of the drugs we brought had been used up. We discussed what drugs we would need to bring next time, and reminded each other to prepare urine tests and A1C tests.

 

                                       We make special marks on the dosage of children’s drugs

 

Growth and gratitude

My daughter and the children in the team saw poverty and suffering in Senegal that they had never experienced before. Although they grew up in different environments, the Senegalese children they saw were happy, courageous and have dreams. The children learned from each other in their interactions.

We adults also became good friends. When we all got back to the United States, Dr. Chen and his family accompanied their daughter to San Diego to play in a game. We also made an appointment to have dinner together, watch the night view, and recall the comradeship in Africa.

After returning from Africa, for a while I couldn’t tell which was real life, and I had an inexplicable sense of unreality in my heart. Because the short week I stayed in that distant African land was an unforgettable experience for me. It not only rekindled my reason for studying medicine, but also regained the joy of practicing medicine. After that trip, I can sit side by side with my daughter, recalling the heartfelt smiles of Senegalese people, their joyful songs, and we were grateful for having been able to serve and contribute to their well being.

This may be the reason why I went to Africa for the second time.

 

About the author:

Shao Yuan, MD; Internist and Assistant Professor of Medicine at Scripps Clinic, San Diego, California; 2023, 2024 Volunteer for the Africa Cries Out

 

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If you feel moved to support our ministry in Africa, please contact us：

 

Jun Xu’s WeChat: jun9174343767

Email: Africacriesout@gmail.com

Public WeChat account: LifeExploring (人生天路)

Website: https://africacriesout.net

 

Editors in charge: Cao Juanjuan, Zhang Kun

Translator： Wei Peng

English editor: Xi Wang

Editor: Doris Cruz