Patients

We had an old guy come into the clinic who was very weak, had a rattle in his chest, and low blood pressure. We told them to go to the government hospital or the private surgeon. Maybe four hours later our volunteer nurse from Canada went to the surgeon's on an errand. The old man was waiting there and in considerably worse condition. She recognized it this time as congestive heart failure. She asked the nurses why he hadn't been seen especially since his blood pressure had dropped to 60/40 (and at that point you can stop calling it blood 'pressure') and asked them to give him diuretics to force the fluid out of his lungs. They said the doctor was not in and they would not do anything without the doctor's order. The nurses had the professional knowledge and skill to help the man and just weren't doing so. He died later that day.
I've asked myself so many times here, "Why won't they take reasonable courses of action?" The clinic has received over 10 boxes of donations that sat - many for well over a year - unopened in the clinic - useful items taking up space, becoming termite-eaten and expiring. How could they not open them?
I have absolutely no idea. Just a sense that it's an important question. All I can figure is that these are people whose lives have been so brutal for so long that an old man's trouble breathing just doesn't seen urgent. And almost everyone's authority in any given situation is somehow severely mitigated. Women aren't quite fully people here; so for the female nurses to defy clinic policy and administer medicine without the male doctor's consent probably would've been quite extraordinary. Abd because they lived such brutal lives for so long, that actually would be more extraordinary than an old man dying needlessly suffocating in a doctor's waiting room. But why didn't his family advocate for the nurses to do something? The doctor's office is such a foreign place I doubt the family knew the nurses had the medicine to help. They may have fully accepted the need for a doctor's order as the nurses did. And living without any control of any aspect of their lives, arguing with the nurses would have possibly been the first instance in their lives that they stood up to a system and demanded their rights. Or even the first time they had witnessed such. And all Sierra Leoneans live with such a deeply felt sense of inferiority. They do not believe they have the capacity to do things for themselves.