The driver arrived at our hotel before sunrise this morning and graciously waited as John and I scrambled to gather bread, cheese, and water from the breakfast buffet for the 8 hour ride to Berekum. We would crawl through the sprawling metropolis of Accra and then wind our way north and west to within 20 miles of border with the Ivory Coast. I was excited to see Ghana from the road and was most certainly not disappointed as every town seemed to offer some beautiful surprise. One of my favorites was the explosive flame tree blooming on the side of road that seemed to seamlessly fade from black tarmac to red dirt.
Despite being thoroughly engaged in the passing scenery and thrilled to soon experience my first fistula surgeries, I was quite excited by the prospects of getting to know John better on our day long car trip. I had heard that John traveled around to the most underdeveloped and instable parts of the world to help build fistula capacity, but had no idea he done so on a shoestring budget funded primarily by John himself. I learned that for three decades, John Kelly spent his annual holiday filing in for Reg and Catherine Hamlin at the Addis Ababa Fistula Hospital while they took their annual leave. Since retiring from his Birmingham-based OB/GYN practice in 1996, Kelly has spent more than half of every year contributing and sometimes driving fistula programs in Angola, Sudan (Darfur), Ghana, Pakistan, Zambia, and Uganda.
When we arrived at Holy Family Hospital this afternoon, all I wanted to do was get some food and find some shade, but John was ready to spring directly into action. Without haste, we marched directly from the car to the operating theatre, stopping only to drop off some foodstuffs John had brought that needed refrigeration. On the way, two things caught my attention. The first was this big sign leading people to the parts of the hospital focused on mother and child and the prominence and position of the word “Mortuary” on that sign. The word had top billing with a font that dwarfed anything else on the sign. To me, this sign symbolized the dire situation facing mothers in the developing world.
The second attention-catcher was two women sitting quietly on an out-of-the-way bench. Both women were dressed rather well, in traditional clothes, but neither uttered so much as a word, not even to each other. As we approached I noticed one had her gaze firmly pointed at the ground and the other was curiously watching us. I turned to smile at the woman trying to sneak a peak and she immediately looked at the ground, an unfamiliar response in the ever-friendly Africa I have come to love. We kept walking and only half an hour later would I realize that these lonely two were the patients who so desperately awaited John Kelly’s intervention.
During the examinations, I realized that John Kelly’s determined intensity had an incredibly patient and gentle side as well. Despite multiple language differences, an unfamiliar setting (for everyone save the nurses) and what appeared to be an incredibly uncomfortable examination, Kelly seemed to put the patients at ease as he searched for the small holes that had largely devastated these women’s lives. Throughout the examination, Kelly described the position and characteristics of the fistulas out loud, almost dictating notes to some unseen scribe, while also mixing in questions and reassurance to the patient. I was amazed at how seamlessly Mintah, the head nurse and interpreter, could distinguish between John Kelly’s two dialogs. After the examinations, Kelly sat down and penned a few notes and then we headed home to get a bit of food and some sleep after a very full day.