THE SUNSET IN SENEGAL

In Memory of Dr. Faye who sacrificed for medical development in rural Senegal

Author: Jun Xu, MD, Translator: Amy Guo

In March 2017, I went on my fourth service trip to Senegal, West Africa. During the 500-mile bumpy mountain road to a leprosy village, Dr. Faye and I talked endlessly on the bus. Maybe because of our career as physicians, we were not afraid of discussing life and death. During this lively conversation, I captured a photo of a rising sun, without knowing in two days it was the last sunrise we both saw.

In 2013, I met Dr. Faye the first time. He was a tall man with an amiable face that Chinese would call it the “Buddha Face.” He smiled to everyone and greeted us warmly. Maybe because his native tongue was French, his English had a strong French accent. His white coat pockets were filled with many pens, a stethoscope and a reflex hammer.

Although at the beginning, I doubted the training of doctors in Africa, I was soon impressed by his professional skills. A 3-year-old had a fever and diarrhea. According to my experience in the U.S., he should be prescribed anti-inflammatory medicine with oral rehydration. However, Dr. Faye prescribed the antibiotics. He noticed my confusion and explained:” the hygienic situation in West Africa is different from that in the US. Due to lack of water, many adults and children never wash hands before meals. They usually use their right hands to eat, left hands for toilet. Therefore, most children’s diarrhea is caused by bacteria and parasites. Only antibiotics can solve the problem.”

Although the treatment he gave was different from my training, his professional skill was superb, which, I later knew, was from the rigorous medical training in France. From then on, He was like my brother, teaching me patiently to cure many diseases prevalent on this West African savanna. I was lucky to have him as my mentor and friend, who accompanied me for five scorching dry seasons.

Chapter 1: Born in Prestige

Doctor Faye was born on July 7th 1959 at scenery Island Golae. Island Golae was the distribution center for slave trade 200 years ago. In the beginning of 20th century, only some prestigious Senegalese French could live with the European French at Island Golae.

Doctor Faye’s father was a dermatology professor at Dakar Medical School. He spoke fluent French and did both research and clinical practice, which contributed significantly to the dermatological research in West Africa. He used to go into the woods to see the poorest patients every week. Dr. Faye’s mother is a primary school teacher. She asked Dr. Faye and his younger sister, Fatimo to learn from their father to be a person with knowledge, integrity and compassion. The words of their parents are the seeds planted in the hearts of the Faye siblings: Life can be used to change life. Knowledge can be used to serve the poor. The sun and rain will surely grow the seeds of love to green rhizomes and bright pink flowers.

Chapter 2: The Best Doctor in Senegal

His family’s background and his own superior talent allowed Dr. Faye to soak up abundant knowledge. As his parents wished, he successfully entered the University of Dakar Medical School, the best university in West Africa. Seven years later, he became a well-trained physician. However, he didn’t stop at the position that everyone envied. He continued to training for neurology for five years and became one of the three neurosurgeons in Senegal. Everyone thought he would stop and start making big money. But for the sake of the people of Senegal, his heart told him that he needed better training. After fierce competition, he obtained the highest scholarship from Rotary International and went to the University of Bordeaux, France. He eagerly studied tropical medicine, nephrology, emergency medicine and all related topics in seven years. In 1998, he eventually completed the residency of all specialties.

He returned to Dakar, the capital of Senegal, right away. His superb medical skills, good service, and ubiquitous social relations soon made him the best doctor in Dakar.

Chapter 3. Founder of the Senegal Jungle Medicine Association

The life not serving the poor made Dr. Faye’s heart hurt. He saw so many starving people waiting to be fed and ghosts of death wandering everywhere in Senegal. On average, people’s life expectancy is only 50 years old; each woman has five children and the infant mortality rate is 50%. Many patients were ill advised before seeing Dr. Faye. Their desperate eyes were cast to Dr. Faye for miracles to happen. Doctor Faye’s heart was trembling and crying.

Although he had his family to support, he couldn’t only work for money and bear to hide his face from the cruel reality. The corpses of a dying child were like a pile of rubbish and were buried with no pity. He thought to himself: “Yes! I cannot give up my social responsibility! I want to be a person like father to help the poor. I must do better than him!”

The fame and status of Dr. Faye’s medical profession in Dakar enabled him to establish the “The Association of Medical Bushes” of the Senegal Jungle Medicine Society. He was elected to be the chairman and embarked on a path of no return for the poor.

Chapter 4. One-dollar doctor’s talent

A blue Toyota, rumbling in the blazing sun, rolled up the dust and raged on the wasteland. Dr. Faye was in that car. He started to get into the “bush” since 2000 and visited faraway villages three days a week. He received $1.50 per visit and spent two days in his own clinic in Dakar supporting his family income. Since then, many poor people regarded him as a savior with a title “one-dollar doctor”. Many patients treated him as “God for healing”. One day, he drove to a small village where garbage was wafted in the wind. One patient sat under the big tree at the entrance of the village, one foot tilted high. Many flies stopped at the wound from time to time and saw him as a prey. God, save him! Doctor Faye was about to call out. He immediately measured the patient’s blood sugar, 258, which was highly diabetic. The patient looked like he had suffered from diabetes for some time. No one had ever diagnosed him nor treated him.

In Africa, treating diabetes is a huge project. Patients know neither how to measure blood sugar nor how to inject insulin or how to take hypoglycemic drugs. Also, they do not know how to take care of their own wounds. In order to connect various types of cares to deliver effective medicine, once he went back to Dakar, he immediately contacted the nurses and other professionals to involve and established the Senegal Jungle Medicine Nursing Association. He also established the African Mothers Association to teach mothers health knowledge. Despite his busy schedule, he was not rewarded with a penny. To expand the scope of different cares, he also actively participated in the Senegal Children’s Smile Association to improve children’s mental health. He was an advisor to the Disabled Children’s Association of Senegal and a doctor of public health guidance for students in public schools throughout the country.

Fifteen years ago, when he learned that our team had built a small hospital at Dakar suburbs, he applied to become a doctor here. We hired some nurses and ordered some basic equipment together. Since that time, we had Dr. Faye, a nurse, two pharmacists, several nursing staff to build internal medicine, obstetrics and gynecology, pediatrics, and an inpatient department. The hospital’s business was booming. Dr. Faye also stipulated the hospital’s charging standard: general patients seeing a doctor for $1.50, a child seeing a doctor for $1, seeing a nurse for 50 cents, and a drug for 10 cents, since the salary paid to him was extremely low, we didn’t need to invest too much in subsidies.

In order to better serve the poor, in addition to his rigorous training in France, Dr. Faye tried to master all fields of medicine. During this visit, I brought Dr. Faye a color ultrasound machine. He immediately turned on the machine and scanned his liver. He told me he had no problem with his liver. I just told him how to connect the ultrasound probe; he could operate the machine and give a diagnosis. He poured his wisdom and talent dedicating to the poor in Africa, and did not take into account his own needs. Facing a hero who was as great as a mountain, a person like me was standing at the bottom of the hill and couldn’t discern his stalwart. Maybe until he left the world, people can see him from afar to understand this mountain is precipitous and towering to clouds.

Chapter 5. Ordinary people like us

Poverty was a journey of life. Not only did many African people have to face it with tears, Dr. Faye also lived in a life of poverty. The college tuition of Dr. Faye’s children per year was more than 20,000 US dollars. Dr. Faye saved every penny by saving on food and reducing self-expense. He never had a branded suit and drove a worn-out Toyota car every day. Obviously, the salary of 1,000 US dollars a month was far from enough for his family. He really appreciated his wife’s effort: “I have a virtuous and capable wife. She works in a bank. I do public welfare. My wife makes money to get our children to college.” The united effort paid by his wife without regrets allowed Dr. Faye to serve the poor without hesitation.

During the 17-year jungle trek, he drove 3,000 kilometers of stressful life each month. Dr. Faye suffered from high blood pressure, heart disease, diabetes, high cholesterol, asthma, and so on.

I remembered that in 2013, when I first saw him, I found him carrying a big icebox. “What is that?” I asked him.

“I have my insulin inside,” he sighed. I also noticed that there was an inconspicuous wound on his right foot that had become a little festering. It was a typical diabetic wound. If it were not taken care of, it would take less than a year to worsen and lead to amputation.

When I saw him this year, the wound was already as large as an American quarter, but he paid no attention to it. The amputation was inevitable. In order to protect the poor people in his heart, he would never let go his responsibility, even if he had ailments. Standing 5’10” tall, he stood on a crutch and his gait was awkward. Looking at him, I seemed to be looking at a strong baobab tree in the land of West Africa; after 500 years of scorching day and drought, it still stood on this barren yellow sand land, providing water and dry food to hungry people.

Chapter 6. Red Sun Sunk

On the first day of the trip to the leprosy village, I had a fierce quarrel with Dr. Faye.
“You can’t go to the leprosy village 700 kilometers away. We have to ride for 16 hours and you can’t tolerate it.” I said coldly to Dr. Faye.

“I must go, because you need me!” Dr. Faye’s dark-skinned face resembled a golden sun, and the light made me give in.

“There are 300 patients waiting for us in the leprosy village. You can’t see them all!” Dr. Faye said determinedly.
Dr. Faye was right. In the past, I tried to attend 282 patients a day. When I got home, I couldn’t eat and stretch my stiff, numb limbs but immediately fell to bed. Thinking of the miserable experience of that time, I wished secretly that Dr. Faye might not have any problems during the trip. I agreed with Dr. Faye’s request. I didn’t realize that selfishness caused me to pay a great toll. Satisfyingly, Dr. Faye made a quick move on the bus with his cane.

The first 400 km ahead is a brisk tarmac road, but unfortunately, the last 300 kilometers was a road to hell that caused us all to suffer. Only one-inch thick asphalt road, under the great pressure of dozens of big trucks weighted tons, revealed thin bones under it. There were big pits like potholes everywhere. The dust swept by our bus covered the sky and our windows. Our bus crawled like a long snake on the side of giant holes, jumping from time to time, shaking our luggage overhead. Only three to five workers were constructing along the way. Dozens of large-scale road-building machines were parked by the road and were empty. Dr. Faye told me that the 300 kilometers at the end had been under construction for more than 10 years. They were moving forward at a pace of a few kilometers a year. I thought in myself: “No wonder in the five years of service trips, this was still the same.”

Suddenly Dr. Faye closed his eyes and stopped talking. He opened his mouth widely and breathed painfully. I crutched my hands and silently prayed to God. Dr. Faye slowly opened his eyes and said weakly, “I’m not feeling well. Can you please measure my blood sugar?” “385” I was shocked and called out: “Glucose is too high!”

Dr. Faye gestured for me to take his icebox. I found him insulin. He declined my help for injection. In the buzzing noise of the car, he injected ten units of insulin into the abdomen. Suddenly his eyes turned red, and his deep voice shook me like a current, “I feel like I will die before I am 60. I am now 58 years old and there are two years. I hope I die on the battlefield like a soldier. I do not want to die at home. That’s why I must be with you. At the leprosy village, maybe I will get what I want.”

I wish I had a strong equatorial wind blowing away all the absurd ideas out of Dr. Faye. “This is not auspicious! You can’t say that!” His defiant attitude, facing life with daring calm, also inspired me. He was not afraid of the end of life, and it was his greatest hope that the benefit of death would take him away from the battlefield. I measured Dr. Faye’s blood sugar silently. “190, great, blood sugar has fallen!” I told him this good news. Dr. Faye’s face was still dark and pale. He closed his eyes, opened his mouth and inhaled; the carriage was quiet. Only the wind outside with the roar of the engine continued blowing.

At six o’clock in the evening, the bus, carrying a full trunk of fatigued people, eventually arrived in Kedougou after 16 hours. I nudged Dr. Faye and slowly moved to his room. Every step he took, he left a trailing mark on the ground. We took him to the room with a tow, and I was measuring blood sugar. “It’s unexpected. Only 45! Blood sugar is too low!”

I hurried to get him a bottle of orange juice to restore blood sugar. He drank a lot, nodded at me, expressed his thanks, and fell asleep. I also went back to my room, lying on the bed with my tired body. I was silently praying that my heavenly Father would take care of Dr. Faye.

At 12:40 a.m. in the evening, someone knocked at my door and yelled. “Dr. Faye is no good!” I rushed to his room and he was left with a bowel movement. The smell of the full room made me wonder what to do. He told me that he needed a bath. I held his hand and measured the blood sugar. “74. It is not too bad!” I cheered in my heart. I fed Dr. Faye a few sips of orange juices. I was secretly happy that the hardest time of Dr. Faye might have passed. Together with my fellow brother Ergang, I took him to the shower. He sat on the ground and let the water pour over his exhausted body. After drying his body, he slept again.

I was too worried about Dr. Faye to sleep at all in the evening. At the dawn of the next morning, I came to his room again. I saw him sleeping on a bed with his head slanted, next to a pile of vomit, and the stool was uncontrollably excreted again. I quickly called him and he was still conscious. I immediately measured the blood sugar for him. The meter displayed an error message. The meter did not work! I checked his pulse. The pulse was barely audible. His heartbeat was 111 beats per minute. I knew it was dehydration-induced heart compensation. We must go to a local hospital.

We sent Dr. Faye to a local hospital. I reported the condition to local doctors that Dr. Faye had diabetes, high blood pressure, and high cholesterol. I told them that Dr. Faye might be experiencing diabetic ketoacidosis. Maybe because their training was limited, they did not know what ketoacidosis was. I instructed for IV immediately. The doctor told me that the hospital did not have it, so they needed to go to the street pharmacy to buy them. I said, “Please buy it immediately and rehydrate him intravenously as soon as possible. The patient vomited and had diarrhea yesterday and today, and the dehydration of diabetes was severe.” The doctor said, “Well, I’ll write a prescription and ask you to go to the pharmacy to pay for it. Then, we’ll start rehydration.” In a hard way, I learned that some local hospitals in Africa had no stock medicines and canteens, and all medicines and food must be purchased at the spot.

The sun rose high and rose like a wheel, radiating a never-ending glow. My heart was twitching. What should I do now? Should I leave Dr. Faye here and go to see patients? Or should I leave patients alone and secure Dr. Faye’s life first? I hesitated for a moment, while my heart was tangled.

The heat of the sun was getting stronger and stronger. The air was lit up like a gas stove that was shining brightly. A wave of hands would catch several sparks. In this deep part of the savanna, 117 degrees Fahrenheit is the common daily temperature. I wiped my sweaty forehead and got close to Dr. Faye’s ear and said, “I should go. There are 300 patients in the leprosy village waiting for me.” He nodded weakly.

I quickly arrived at the leprosy village, and hundreds of patients crowded at the entrance of the hospital like dark clouds. I immediately got into the stressful work. More and more patients, in order to see the doctor as soon as possible, requested to be at the front; noise sound like thunder stroke my eardrum. However, some seriously ill patients could not be diagnosed from this consultation. We would always give money to let them go to a bigger hospital to do examination, but they often left the money and did not go to see a doctor, because of various family responsibilities. We had no way to make them go.

More and more patients were blocking the door tightly. I knew that I wouldn’t leave if patients waiting did not see me. I only had to speed up steadily and fast. Fortunately, a local nurse helped me to measure blood pressure and heart rate, which greatly speeded up my pace. In one hour, I could see more than 20 patients. Fortunately, most of them were only having fever and headaches, without very difficult complications that made me worry.

Suddenly the phone cried out. My nerves were fragile, and my heart was pounding up and down. I anxiously looked at my translator, sister Anna. She picked up the phone that was called from the hospital. She suddenly turned pale, dropped the phone and said to me: “Dr. Faye died, myocardial infarction.”

In a flash, I had a mental breakdown. The thing that I was most worried about eventually happened. A painful scream came out from the bottom of my heart: “Dr. Faye, Dr. Faye!” The tears rolled like a Senegal river and washed me away. Why is this? Why? I laid my head on the table, tried to use both hands to block the endless waters of regret, and my shoulders kept twitching. “Dr. Faye, how did you go? I shouldn’t have let you come. I really shouldn’t be here! Don’t we mean to come together and come back together?”

There was a buzz of noise from the doorway, and the patient’s quarrel brought me back to reality from the abyss of the sadness. At this moment, the most important thing was not crying. What was the purpose of Dr. Faye to the leprosy village? It was to give them medical treatment and serve them! I raised my head and said to Anna: “We have to continue to seeing patients.” A 40-year-old patient arrived and I listened to her lungs. It was full of mucus noise, and she had fever for five days. My diagnosis was pneumonia. I would like to give her fourteen days of antibiotics, Amoxillin, but I could not calculate the total number of drugs for fourteen days. “How did I give it previously?” I thought for a full five minutes, still unclear, and I choked, “My brain isn’t working, it’s not working!!!” But I couldn’t stop here. I forced myself to continue seeing patients, one by one, seriously and conscientiously. I asked the medical history mechanically, prescribed medicine like a piece of wood, but my numb work. I was fulfilling the wish for Dr. Faye, serving the poor until my death day.brain forced itself to work and continued to work. I was fulfilling the wish for Dr. Faye, serving the poor until my death day.

After an hour, the telephone rang again. The health department chief of Kedougou said, “Stop seeing the patient immediately. You are disrespectful to the dead!”

“No, this is Dr. Faye’s wish. He wanted me to do it! He is dead, but I have to continue to look at the patient on his behalf!” I rubbed my red eyes and said.

“No, stop immediately! We are very uncomfortable. He is our hero, but please stop immediately! If you do not stop, people in the village will feel that you do not care about the death of Dr. Faye!” They argued.

Authorities had played a huge role in the most remote and the poorest places. The prestige defeated us against the hero’s last wish. We had to tell the grouchy chief of the leprosy village, we must stop seeing patients. The chief seemed to be calm and said, “Death is a milestone in life’s journey. Don’t be sad!”

The next day, the hero set off and returned to where he came. Dr.Faye finally repented on the hardships of the world and went to heaven. He no longer had to drive in a rush to the wilderness, nor face the purgatory on earth. He worked with our team for more than ten years and worked with me for five years. We talked together about God’s forgiveness and grace. We prayed together. Now we covered our face and pleaded with God’s grace. In front of the great white throne, God, please forgive all of his past, admire his love, and accept him without any conservation and let his soul be peacefully rested in heaven.

When I wrote here, Dr. Faye, a doctor with a wide smile, still seemed to stand in front of me and said, “Dr. Xu, ‘Very truly I tell you, unless a kernel of wheat falls to the ground and dies, it remains only a single seed. But if it dies, it produces many seeds.’ Come, you are the new grain of wheat, and you will sprinkle wheat on the vast African prairie in place of me.”
The hero did not leave, and the sun did not fall. I was about to carry a rising red sun, covered with fiery enthusiasm to carry out the hero’s wishes.

In one’s life, one can leisurely enjoy the cherry blossoms in the Central Park alone; one can confess his or her love to the closest and dearest person at the Hudson River; one can also watch the bright lights of Manhattan with the children in the Rainbow Rotary Restaurant of Empire building. I admit that all these are extremely beautiful and enjoyable, which is a legitimate pursuit for each of us. However, when we see with our own eyes, many people suffer from severe diseases, cannot eat a full meal, and beg for food in the hot sun, and when seeing heroes like Dr. Faye, I felt my heart was burning like the sun in West Africa.

Everyone wants to experience real wonderful life. In fact, they must truly love and enjoy life. They must climb the summit of life. If we can devote our life like Dr. Faye to the poor, we will really enjoy a beautiful life, the greatest happiness and glory of the human being are to change somebody else’s lives through our own life. ! The meaning of life cannot be measured by the length of time. When our heart is full of love, one moment will be an eternal. If there is no love, no warmth and no hope of life, a long lifespan is just like plain and tasteless water.

I secretly dreamed that one day, I would build a “Doctor Faye Memorial Hospital” where the hero had worked. I know he did not expect and ask for it, but I’m going to build one someday. This hospital will be like a monument of serving the poor and make all generations of people know him, admire him. A new hospital will make the hero’s dream become true, and the hero will always be in people’s hearts!

Written by Dr. Jun Xu

Translated by Amy Xinruo Guo