Shalini’s Guyana Blog – Week 4.5

Essequibo river trip – Aug 28th

Our weekends here in Guyana have been pretty amazing and I want to share this one with you too.

On Sunday, I took a trip up the Essequibo river that is the largest river in Guyana. It is more than 1000 Km long but does not even make to the list of top 10 of South America! The estuary (the uninformed me had to look up what it meant) is 20 km wide. Can you imagine? All rivers in Guyana (read South America) are either muddy due to silt or black/brown due to the plant tannins. They do not originate from glaciers so the waters are not clear.

I boarded a small bus, crossed the Demerara river and after a short halt in the town of Parika, reached a place called Roed-en-rust. With 30 other people, I boarded a ‘jet boat’ which was a larger version of a speedboat. 15 min of boat ride at 30 km/hr, we reached the Fort island, the house to ruins of Fort Zealandia, the oldest structure in Guyana and a UNESCO heritage site. It was named after Zeeland, a Dutch province. The history of the place is so interesting, the rulers changed from Dutch to French to British with the baton moving back and forth a few times! There is a Court of Policy building where apparently slaves were traded and our guide told us that they were probably beheaded too! Such a shameful part of the past. The island does not have electricity or fresh water, houses about 30 families and believe it or not, there is a medical centre and a school too. I would have loved to get into the medical centre but unfortunately, it was closed.

There are many islands (364 to be exact) in the river Essequibo, some of them larger than the country of Barbados. One entire island is owned by Eddy Grant, the founding member of the British pop group ‘Equals’. It is rumoured that it was sold a few years ago but no one can be sure.

The country’s maximum security male prison is where the Mazaruni river joins the Essequibo. Though it is on the mainland, one needs to access it via the Essequibo river so even local Guyanese are surprised when they learn that it is not on an island. I was told that jail-time may not be a deterrent but rather an attractive option to desperately poor people as they get free meals, paid work and a roof over their heads.

The flora and fauna of the area are wonderful. The country has a raw beauty that the tourism industry has not messed up, at least not yet. There is a variety of fish including monster fish Piraiba, the newly discovered air-breathing fish Arapaima and crocodiles in the river so I heaved a sigh of relief when my feet touched the ground and the bus had returned to Georgetown. Back to work, last week in Guyana.

Last week in Georgetown – Aug 29th

This is my 5th and last week here in Guyana. I am having mixed feelings as I have got used to the 7.30 pick up by the hospital driver Noel, on the way to the OR, buy lunch of roti and either chicken or pumpkin curry (Beth’s favourite and mine too) and then go and change into scrubs. I am usually lugging the Sonosite on my shoulders so the first stop is the Anesthesia room to park the machine and put it for charging. Morning 8 am is usually still early so there is enough time to peek in all ORs and check the list. The list almost always changes so there is no point in checking it the afternoon prior.

OR matron Sister Gill asked when I will come back and I was surprised when I heard myself saying ‘next year’! The nurse in charge of the OR is called matron and when I had asked her name, she very clearly had articulated ‘SISTER GILL’ with emphasis on the ‘sister’.

Today I cleaned the anesthesia cupboards that had supplies brought in by various visiting teams over the years and the sterility date was long past (10-12 years past!). Dr Martin, nurse Debra and I sorted out the stuff so that the supplies can be accessed. This was such an accomplishment. Even though I am not OCD, today I felt like one.

Tuesdays are the days that I looked forward to. It is the pain clinic afternoon and patients are so thankful for us seeing them and hearing their story. They are usually non-complaining, God-fearing and just there to know if we could help them. Most of them have chronic health issues, hypertension, diabetes, coronary artery disease. None of them is on any opioids. So different from the typical chronic pain patient of North America! Today I felt sad when the physiotherapist brought Ned (not his real name) who was shot in the spine in 2009 and has used a walker since then. His pain was more of diabetic neuropathy type but he wanted to know if I could help him walk though he has not walked since 2009. He had heard that I have done epidural steroids and wondered if that could help him walk. I am not sure who was more disappointed, he or I? He just said, ‘don’t worry Doc. This is life’.

Not all was sad this Tuesday. Epidural steroid patients from the past weeks came for a followup visit. Daisy (not her real name) has been coming every Tuesday since her epidural steroid just to tell me that it was ‘night and day’. This Tuesday she came to say goodbye as she knew I was leaving. Don (again not real name) came as a followup. He had an inadvertent dural puncture during the epidural teaching process. He was walking better and smiling. He said he could do their physiotherapy much better and promised me to that he will take his blood pressure pills and statins. Thank God, no PDPH! AnnDee has had a good response to gabapentin and acetaminophen and that is wonderful news as there is nothing else available.

I will miss the Tuesdays clinics.

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