Copyright 2021 - Bem Vindo

martin peter

Martin Peter, aged 68, general practitioner, worked for four weeks in the Tarrafal de Monte Trigo health centre in March and April 2015.

Annette Helle asked him about his impressions.

Annette: Martin, you’ve just spent a four-week working holiday in Tarrafal. How do you feel now you’re going home?

Martin: I have mixed feelings. On the one hand, I’m looking forward to going back home and seeing my family again after such a long time. On the other hand, I feel rather melancholic at the prospect, because I have met so many people I’ve grown fond of, I was given a very warm welcome and I know my presence was appreciated. It will be hard to say goodbye to the people and the village.

Annette: How would you characterize life in Tarrafal?

Martin: The people convey the impression they have all the time in the world. They are not in the least impatient – for instance, they didn’t mind the long waits outside the health centre at all: that’s perfectly normal to them. The patients came to me without any expectations or demands, they were just happy for me to examine them or take their blood pressure or give them advice or medication. The people are very chatty among themselves, greeting each other and exchanging a few words at every street corner. In the case of the fishermen or farmers, their work is physically hard and demanding – the boats have to be dragged over the pebbles, the fish dried, and all the rest of it. But I still sensed a certain degree of contentment and serenity. I have encountered a completely different approach to life here.

Annette: What’s the healthcare situation like?

Martin: There are two main aspects: the material infrastructure and staffing. I was pleasantly surprised on both counts – my expectations were exceeded on both fronts. Sufficient dressing material and medications were available, especially for those with chronic conditions. There are examination tables, blood pressure and blood glucose monitors, and so on. The staffing situation was an even bigger surprise for me. Ilídio, the chief medic, is highly capable and a great guy; there’s hardly anything he can’t do. He is proficient at minor surgery, he pulls teeth, he places catheters and puts in intravenous lines, he carries out gynaecological examinations, he does general medical check-ups and follow-up examinations on mothers, and so on. It’s quite amazing what he can do. Jair, his assistant, is also very competent, and did a particularly good job in diagnostics and in administering medication.

Annette: How and where did you work?

Martin: I worked in the old health centre for the first two weeks and then for another two weeks in the recently opened health centre (opposite the old one), at which the facilities are quite marvellous. And I made quite a number of house calls, one of which involved climbing – equipped with a syringe – with Jair to the foot of the mountain, where I had to give an injection to an old man who is no longer able to leave his home.

Annette: What were the commonest conditions and complaints you had to deal with?

Martin: Many patients had stomach ache, and I had to treat flu-like symptoms and high blood pressure; skin conditions and parasitic diseases were frequent as well.

Annette: Were there any serious, difficult or complicated cases?

Martin: Yes, two. There was one young fisherman who I referred to the hospital in Porto Novo with suspected pancreatitis, and a 10-year-old girl with severe abdominal symptoms actually had to go to the hospital on the neighbouring island so that further examinations could be made.

Annette: You have been in Tarrafal during a time of great changes. How did you experience these events?

Martin: It seems to me there were two eras: before electricity and after electricity! On 30 March, the entire village was in a state of excitement: Cape Verde’s prime minister and other political heavyweights were here to pull the lever, both literally and metaphorically. From that moment on there was power round the clock, the new health centre and the headquarters of the Fishermen’s Association were opened, and the foundation stone for the road improvement project was laid. I just happened to be there to witness these important happenings.

Annette: What special experiences stand out from your time in Tarrafal?

Martin: The personal encounters with the patients and the warmth of the welcome wherever I went. I remember an elderly lady who gave me a very friendly hug and thanked me with such humility; I was really touched.

Annette: Were there sobering impressions or incidents?

Martin: I wouldn’t say sobering; it’s more a case of expectations being confirmed. Grogue (an alcoholic beverage made from sugar cane) is a problem I kept coming across – both in my surgery and when walking through the village. While there are quite a number of severe alcoholics, there are also lots of people who have simply quit from one day to the next.

Annette: Did your working holiday in Tarrafal achieve anything?

Martin: Yes, it did. I’m now familiar with the situation on the ground and am better placed to assess what’s going on. To make genuine and lasting improvements to medical care, we mustn’t impose an inappropriate and unhelpful solution from outside. If the system is to be improved, it needs to grow in a suitable manner. The prime need is to maintain the necessary standards, including the supply of medication, and I feel that educational work is also very important. If I am to help with this, however, it’s vital that I speak the language better than I do at the moment.

Annette: If you heard of other doctors intending to work in Tarrafal, would you say “it’s not for everyone” or “anyone can do it”? What would other medics need to prepare for?

Martin: Well, this is Africa, after all; it’s important to keep reminding yourself of that, and the isolated location makes it quite different from anywhere else. And you’re very close to the people – right amongst them, in fact – so you need to be a ‘people person’. And if you can speak Portuguese or a related language, that’s a great advantage.

Annette: Would you do this again?

Martin: Oh yes, I’ll be back!




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