Thursday, September 30, 2010
La fatigue or WWASD?
It is getting HOT here; the saison de pluie has really made its inroads. The afternoons are starting to push into the high 80s with lots of humidity. And it is only going to heat up, according to what locals tell me. Along with a lot of work and the chaud politics at the hospital, I am totally exhausted. I wonder what Albert Schweitzer would do at this point? I think he must have frequently felt at his wits end. I haven't read his autobiography yet, but I am curious what he has to say about sustaining one's commitment to service in the face of physical and emotional overload.
La fatigue
It is getting hot here. The afternoons are starting to push into the high 80s with lots of humidity.
Tuesday, September 28, 2010
Road Accident
Traveling in a car is one of the most dangerous things you can do in Africa. More people die in road accidents than by any other cause of preventable injury. Usually it is the case of single cars crashing into each other, but every once in awhile very gory large vehicle collisions occur. The gore is compounded by the fact that people here ride in the back of trucks, which are already piled high with baggage, by the dozen. Sunday night and Monday morning we received 66 patients who were the victims of one such mass casualty event, which occurred at 50km from the hospital. Apparently they were riding in the back of a huge trailer truck, celebrating a soccer team's victory, when the truck skidded out and flipped. Four people died at the scene and the rest were transported urgently to Schweitzer. They were triaged, bandaged, and kept in waiting rooms, consultation rooms, and even outside. We did a lot of x-rays and a lot of wound debridement. And two days later, most of them have returned home cut and bruised, with whip lash, but surprisingly lacking major injuries. There was almost no abdominal or thoracic trauma (only one splenectomy!) and relatively few broken bones. All in all, it was a success for the hospital to manage a mass casualty scene like that and lots of luck that it turned out so well.
Another weekend sans arret
This week and weekend went by in an absolute blur. This is partly because I was in Libreville at the beginning of last week, which set off my internal weekday/weekend calibration and partly because the PMI trip on Thursday was brief so we had the afternoon off. My roommate and I used that time to go on a LONG walk and to pick up stuff at the tailor's. I had several things made: skinny jeans from flared jeans I got at the bins, pajama pants from elephant-print cloth, and a purse from fabric I found in the garbage. Even in Africa I like to dumpster dive! The tailor did a really nice job though, unlike the clothes I had made when I lived in India, so I am excited to get a few more things made as well.
Anyway, this weekend was completely fast and furious. Friday night we left the Schweitzer compound right after dinner to go a funeral/wake for one of the nurse's uncle who died earlier in the week. It was interesting to hear about how death is dealt with here: after an adult dies all of the women of the family who are free sit with the body for five days. People drop by all the time to pay their respects and visit with the family. You say “mes condolences”, not I am sorry for your loss, as we say in the US. After five days of sitting with the body, there is a vigil/wake the night before the burial. Everyone sits outside the house, men on one side, women on the other, and talks quietly or just sits. A lot of people spend the night with the family outside that night. Then the next day you wake up and the men start digging the hole for the burial. Burial happens, then lots of drinking and eating. Then one month to one year later there is a deuille, which is a celebration of the dead person's life and is basically just a huge party. After we sat with the family for awhile on Friday night we went to get a few beers with some of the family members.
Saturday morning we woke up early to go on a boat trip on the Oogue to the lakes that are upstream from us. This pirogue trip is kind of a classic Schweitzer experience, everyone has to do it at least once. Also you get to see hippos! I thought of my mother-in-law the whole time because she loves hippos and we were able to see several families of them swimming in quieter parts of the river. They were so funny, they would just surface with their big heads, blow off water and air, and swivel around with their ears. It made quite a racket when they would come up for air like this. Hippos can stay underwater for up to 30min, but they tend to surface every few minutes for air. We also saw monkeys, crocodiles, iguanas, and pelicans on the trip.
On Sunday morning we were again treated to the opportunity to wake up early and do something African. One of the nurses who works with us invited us to go planting in her village. Here it is often referred to as going “en brousse,” which means going into the jungle, even if you are not walking very far away from the road. Planting is traditionally considered women's work and we only saw women and children out in the jungle. The African women we were with carried everything we needed out to the field in giant paniers, which are woven baskets that have straps threaded through them that you can either wear like a backpack or around your forehead. Most women choose the forehead method which I find absolutely stunning. It would put so much pressure on your neck. Anyway, the women loaded up the paniers with machetes, taro bulbs, and small banana tree roots and me and Annie put on our backpacks. And then we headed off down a steep path into the jungle. We walked for about 20 or 30 minutes to a clearing that had been burned the week prior to prepare the soil. Here you always burn before you plant bananas. You don't have to clear the jungle, because the banana trees will grow in between the other vegetation but you do need to prepare the soil with burning. Once we got there, we got to planting. You dig a hole about 6 inches deep—with a machete, mind you-- and plop the banana or the taro into the space. Then you cover and repeat. You try and plant the taro in between the banana plants. After we had planted the first batch we went back to another, older plantation to dig up more banana roots to go back and plant at the first site. You have to do this because banana trees only give one fruiting, they are not annuals, so you have to keep replanting them every 6 months to one year. Once we finished with the third round of planting, we headed back home, in the pouring down rain (saison de pluie!), which I loved because I come from a rainy city and rain makes me happy. When we got back to Schweitzer, I fell asleep almost immediately and complained loudly the next day about how hard the work was. The life of an African woman is so physically demanding, I do not know if I could do it. Maybe if I had been raised like this and was in the habit it would be okay, but after one day of mini learning, I am exhausted and sore!
Anyway, this weekend was completely fast and furious. Friday night we left the Schweitzer compound right after dinner to go a funeral/wake for one of the nurse's uncle who died earlier in the week. It was interesting to hear about how death is dealt with here: after an adult dies all of the women of the family who are free sit with the body for five days. People drop by all the time to pay their respects and visit with the family. You say “mes condolences”, not I am sorry for your loss, as we say in the US. After five days of sitting with the body, there is a vigil/wake the night before the burial. Everyone sits outside the house, men on one side, women on the other, and talks quietly or just sits. A lot of people spend the night with the family outside that night. Then the next day you wake up and the men start digging the hole for the burial. Burial happens, then lots of drinking and eating. Then one month to one year later there is a deuille, which is a celebration of the dead person's life and is basically just a huge party. After we sat with the family for awhile on Friday night we went to get a few beers with some of the family members.
Saturday morning we woke up early to go on a boat trip on the Oogue to the lakes that are upstream from us. This pirogue trip is kind of a classic Schweitzer experience, everyone has to do it at least once. Also you get to see hippos! I thought of my mother-in-law the whole time because she loves hippos and we were able to see several families of them swimming in quieter parts of the river. They were so funny, they would just surface with their big heads, blow off water and air, and swivel around with their ears. It made quite a racket when they would come up for air like this. Hippos can stay underwater for up to 30min, but they tend to surface every few minutes for air. We also saw monkeys, crocodiles, iguanas, and pelicans on the trip.
On Sunday morning we were again treated to the opportunity to wake up early and do something African. One of the nurses who works with us invited us to go planting in her village. Here it is often referred to as going “en brousse,” which means going into the jungle, even if you are not walking very far away from the road. Planting is traditionally considered women's work and we only saw women and children out in the jungle. The African women we were with carried everything we needed out to the field in giant paniers, which are woven baskets that have straps threaded through them that you can either wear like a backpack or around your forehead. Most women choose the forehead method which I find absolutely stunning. It would put so much pressure on your neck. Anyway, the women loaded up the paniers with machetes, taro bulbs, and small banana tree roots and me and Annie put on our backpacks. And then we headed off down a steep path into the jungle. We walked for about 20 or 30 minutes to a clearing that had been burned the week prior to prepare the soil. Here you always burn before you plant bananas. You don't have to clear the jungle, because the banana trees will grow in between the other vegetation but you do need to prepare the soil with burning. Once we got there, we got to planting. You dig a hole about 6 inches deep—with a machete, mind you-- and plop the banana or the taro into the space. Then you cover and repeat. You try and plant the taro in between the banana plants. After we had planted the first batch we went back to another, older plantation to dig up more banana roots to go back and plant at the first site. You have to do this because banana trees only give one fruiting, they are not annuals, so you have to keep replanting them every 6 months to one year. Once we finished with the third round of planting, we headed back home, in the pouring down rain (saison de pluie!), which I loved because I come from a rainy city and rain makes me happy. When we got back to Schweitzer, I fell asleep almost immediately and complained loudly the next day about how hard the work was. The life of an African woman is so physically demanding, I do not know if I could do it. Maybe if I had been raised like this and was in the habit it would be okay, but after one day of mini learning, I am exhausted and sore!
Friday, September 24, 2010
Best Weekend Ever, Part Deux
Practical life in Libreville and how the people helped us:
One of the tropes of life in Gabon is that Libreville, the big capital city, is not a friendly place. Maybe people say that about any large city or gathering of people, but the intense animosity sometimes expressed about the capital is surprising here. Thus it was with heavy, somewhat anxious hearts that Annie and I set out to accomplish practical life matters Monday morning. We had been appropriately warned about how bad things can be here. But it was nothing like that for us! Annie was welcomed and attended to heartily at the Guinean embassy. And though I was passed from one tourist agency to another, when I finally found out where to buy train tickets, an older woman actually took me in a taxi, paid the taxi for us, and walked me to the street of the train ticket office. I got a little lost on the way back home and a newspaper salesperson walked me to the taxi stand. Our experience of the big city was actually quite welcoming, a pleasant surprise.
Sweethearts:
Along our travels we have managed to make some very kind friends in Gabon. One of them is a young female university student who we met at her parent's hotel at Cap Esterias. We hung out with her during our time in LBV and she was a darling showing us her city and friends. The other is a French military officer, friend of a friend, who also took us under his wing, showed us the city and offered to help with anything that was tough or going wrong here. Total darlings. When you are traveling having kind people as your friends makes a world of difference.
One of the tropes of life in Gabon is that Libreville, the big capital city, is not a friendly place. Maybe people say that about any large city or gathering of people, but the intense animosity sometimes expressed about the capital is surprising here. Thus it was with heavy, somewhat anxious hearts that Annie and I set out to accomplish practical life matters Monday morning. We had been appropriately warned about how bad things can be here. But it was nothing like that for us! Annie was welcomed and attended to heartily at the Guinean embassy. And though I was passed from one tourist agency to another, when I finally found out where to buy train tickets, an older woman actually took me in a taxi, paid the taxi for us, and walked me to the street of the train ticket office. I got a little lost on the way back home and a newspaper salesperson walked me to the taxi stand. Our experience of the big city was actually quite welcoming, a pleasant surprise.
Sweethearts:
Along our travels we have managed to make some very kind friends in Gabon. One of them is a young female university student who we met at her parent's hotel at Cap Esterias. We hung out with her during our time in LBV and she was a darling showing us her city and friends. The other is a French military officer, friend of a friend, who also took us under his wing, showed us the city and offered to help with anything that was tough or going wrong here. Total darlings. When you are traveling having kind people as your friends makes a world of difference.
Wednesday, September 22, 2010
Best Weekend Ever, Part 1
This past weekend and surrounding days have been absolutely delightful. This explains why I haven't had time to blog--life has been too busy and fun. Allow me to tell you about the past five days in easily digestible separate blog entries:
Some interesting patients from clinic and hospital on Friday:
1.Two year old boy who presented two months ago with difficulty breathing, chest x-ray shows cardiomegaly (heart is 75% of the thorax diameter) and probable pneumonia, previous chest x-rays normal. We treated the pneumonia and the wheezing has somewhat ameliorated, but at all the follow-ups the cardiomegaly persists and he has now developed generalized lymphadenopathy including some huge lymph nodes in the armpits. Serology is negative. Next appointment in one week, let me know if you have thoughts or suggestions.
2.Kwashikor (protein deficiency that causes swelling because you don't have enough protein in your blood to keep the water in your vessels) baby!! This baby's feet and abdomen are hugely swollen for lack of protein, even as we try to refeed her protein. Did you know that Kwashikor means second baby because it is often observed in the older child when a new baby arrives because the mom starts nursing the new baby and not feeding the old one? In this patient, it actually happened this way with a new baby arriving in the family and her getting malnourished over the course of several months.
La journee d'acronymes, or I finish ERAS and FAFSA:
The world is really a small place. I can sit in the research lab at Albert Schweitzer hospital and turn in all the required documents for financial aid and residency applications! I turned in the majority of my residency documents two weeks ago, but I just put the finishing touches on programs that I applying to and uploaded a photo Sunday morning. And as I had forgotten to fill out FAFSA for this school year, my school's financial aid office kindly reminded me of this error with multiple emails and I was able to remedy that situation Sunday morning. Now all I have to do is sit back and wait for the residency decisions to roll in. It's amazing to think that I applied to residency, which is this huge process from an African country.
My other in-laws:
After I turned in my remaining official documentation to America on Sunday morning, my roommate Annie and I headed to Libreville, the capital city to take care of business there. A few weeks ago an American medical evacuation pilot/Christian missionary left a message on my blog telling us to come stay with him and his family at their guest house if I were in Libreville again. The combination of America and medical stuff made me jump at the possibility. It was a complete delight staying with them. They had American food like cheesecake (I ate it and liked it Owen!), buttered microwave popcorn, and grape jelly at their house which they generously shared with us creating us a little America in Gabon the likes of which I have never experienced. They also took us to the clinic that their church runs and helped us with a bunch of practical details. So sweet! They remind me of my in-laws who are also really good Christians, though not missionaries, which was extra nice to have that feeling of being around familiar people. And unlike all the old jokes, I love my in-laws greatly, so it was a very positive association. What a provident surprise to find each other in Gabon.
One year of marital bliss sans divorce, yay!
Speaking of in-laws, Sunday was my one year anniversary of marriage. Unfortunately Owen, my husband, is in the US working but I celebrated here in Gabon with my lovely rooommate as a stand-in. We went out to a romantic Italian dinner on the water in Libreville (Dolce Vita at Port Mole) and then watched Princess Bride when we got home. Owen and I got to gchat a little bit about our first year and agree that it has been super fantastic and we want to renew our promises that we made to each other last September 19th. We'll eat our ceremonial frozen piece of wedding cake when we are back in the US together...
Some interesting patients from clinic and hospital on Friday:
1.Two year old boy who presented two months ago with difficulty breathing, chest x-ray shows cardiomegaly (heart is 75% of the thorax diameter) and probable pneumonia, previous chest x-rays normal. We treated the pneumonia and the wheezing has somewhat ameliorated, but at all the follow-ups the cardiomegaly persists and he has now developed generalized lymphadenopathy including some huge lymph nodes in the armpits. Serology is negative. Next appointment in one week, let me know if you have thoughts or suggestions.
2.Kwashikor (protein deficiency that causes swelling because you don't have enough protein in your blood to keep the water in your vessels) baby!! This baby's feet and abdomen are hugely swollen for lack of protein, even as we try to refeed her protein. Did you know that Kwashikor means second baby because it is often observed in the older child when a new baby arrives because the mom starts nursing the new baby and not feeding the old one? In this patient, it actually happened this way with a new baby arriving in the family and her getting malnourished over the course of several months.
La journee d'acronymes, or I finish ERAS and FAFSA:
The world is really a small place. I can sit in the research lab at Albert Schweitzer hospital and turn in all the required documents for financial aid and residency applications! I turned in the majority of my residency documents two weeks ago, but I just put the finishing touches on programs that I applying to and uploaded a photo Sunday morning. And as I had forgotten to fill out FAFSA for this school year, my school's financial aid office kindly reminded me of this error with multiple emails and I was able to remedy that situation Sunday morning. Now all I have to do is sit back and wait for the residency decisions to roll in. It's amazing to think that I applied to residency, which is this huge process from an African country.
My other in-laws:
After I turned in my remaining official documentation to America on Sunday morning, my roommate Annie and I headed to Libreville, the capital city to take care of business there. A few weeks ago an American medical evacuation pilot/Christian missionary left a message on my blog telling us to come stay with him and his family at their guest house if I were in Libreville again. The combination of America and medical stuff made me jump at the possibility. It was a complete delight staying with them. They had American food like cheesecake (I ate it and liked it Owen!), buttered microwave popcorn, and grape jelly at their house which they generously shared with us creating us a little America in Gabon the likes of which I have never experienced. They also took us to the clinic that their church runs and helped us with a bunch of practical details. So sweet! They remind me of my in-laws who are also really good Christians, though not missionaries, which was extra nice to have that feeling of being around familiar people. And unlike all the old jokes, I love my in-laws greatly, so it was a very positive association. What a provident surprise to find each other in Gabon.
One year of marital bliss sans divorce, yay!
Speaking of in-laws, Sunday was my one year anniversary of marriage. Unfortunately Owen, my husband, is in the US working but I celebrated here in Gabon with my lovely rooommate as a stand-in. We went out to a romantic Italian dinner on the water in Libreville (Dolce Vita at Port Mole) and then watched Princess Bride when we got home. Owen and I got to gchat a little bit about our first year and agree that it has been super fantastic and we want to renew our promises that we made to each other last September 19th. We'll eat our ceremonial frozen piece of wedding cake when we are back in the US together...
Thursday, September 16, 2010
Should Poor People Pay for things?
Bonjour equipe-- I have been thinking about something recently due to a spate of really poor mothers that I have met on PMI trips. Should poor people have to pay for medical care at all? It kills me when a mother says that she cannot afford the 2000 CFA (about 4 dollars) for a consultation and medicine on the PMI trips. There have been some extremely sick kids that we have not seen because of the barrier enacted by the consultation fee. It makes me feel like we should see everyone for free. But when I offered this idea to the PMI nurses, they were vehemently against it because they said it would overwhelm the system and it would cause mothers to prioritize/value health less because they would be able to get it for free. Although this idea is a bit unpleasant, there are studies (even put out by the World Health Organization) to support the idea that there should be small fees associated with health care. For the time being, I wish that I could give things for free to all my patients but I recognize that I have to respect the rules of the system that I am working in. Otherwise, if it is only me who gives things away that will only disequilibrate the hospital and community health services of the hospital even more.
Monday, September 13, 2010
Organization of Hopital Schweitzer
As I was walking around the hospital grounds today, I realized that I don't know if I have ever explained to everyone how the hospital is organized. Excuse my error in not laying the groundwork with a good expose. Let me try and paint a picture of how things work here.
The Schweitzer compound is situated on the banks of the Ogooue River, but not right along the river as it originally was. Schweitzer built his house and the first hospital wing literally abording the river (probably to save time and energy from hauling everything to a higher location), but in the 1970s or 80s they moved all the hospital buildings to higher ground. Now everything sits about a quarter mile from the river on a hill overlooking the water. The hospital consists of a cluster of buildings organized into wards. The wings of hospital are internal medicine, surgery, pediatrics, maternity (where childbirth and the first few days of life happen), “cas sociale” (psychiatric cases), and a big classroom. There is also a huge building called, appropriately enough, “la grande salle” where adults are seen as outpatients, the pharmacy, radiology, ER, and laboratory are all found. I spend most of my day in the pediatrics ward, with sproadic trips to maternity, radiology, and the laboratory.
The hospital set up is straight forward enough. The weird thing about the rest of the grounds is all political. There is a giant laboratory run by the University of Tubingen (German) that does research on malaria and TB. They have a lot of money, grants, Gates Foundation backing, so they have a lot of sway. And they bring a lot of Germans to roost here. This sets up the potential and sometimes realized inter-European conflict between the lab Germans and the French who run the hospital, as well as adds to the subtle anti-American spirit that courses throughout Schweitzer. Finally there are other random European-Swiss, Spanish, and Austrian--folks who wander though rounding out our ragtag international ex-patriot community. I have had good relations with just about everyone that I have crossed here, but I had no idea that the scene at the Hospital would be as politically charged as it is. My naivite strikes again.
Thursday, September 9, 2010
Life is like this here, or La Vie au Gabon
One thing that people seem to like doing here is to compare various nationalities and their dirty habits. In my eavesdropping on conversations around me, it seems as though every Central African country has a slam for every other Central African country. This funny habit the Gabonese have of trash-talking other countries is also tempered by a heavy dose of self-criticism.
When I go on PMI trips one of the constant topics of conversation is the ways in which Gabon is screwed up. Most of it has to do with the sexual morays here. Men and to some extent women are allowed and expected to have multiple sexual partners. Polygamy is also legally permissible. I have tried to figure out exactly how many wives a man can take, but peoples' responses vary from 4 to 8. En tout cas, people are not expected to be in committed monogamous relationships. When a child is born from one of these multiple unions, quite often it is raised by just one of the parents. Or by the parents alternating who takes care of the kid. Or by the grandparents. This infidelity and instability is much maligned but also much joked about and serves as gossip fodder.
There is a tradition of trash-talking the younger generation in Gabon for having children too young, for not going to school, for turning away from the values of their parents. This type of criticism of the young is a cultural constant in my opinion, but here, people insist, it is really true. Maman Sophie pinpoints the age of adolescent decline in Gabon as 1990. Why, I don't know, but she is sure that something changed after that year and all the babies born then or later are wild children.
Spirituality is also a big topic of conversation and even joking, especially in reference to the above two issues. Everyday discussions are liberally peppered with Jesus and “Dieu merci” interjections. Of course, all of these topics sound so much cuter here because the Gabonese add -o to the end of most sentences or paragraphs. So you might say “bonjour-o” and your conversant partner would say “ca va-o” onwards and upwards to -o infinity.
How fun it is to listen to these discussions as people bemoan the habits and morays of Gabon, while also secretly, I think, being fiercely proud of their country.
When I go on PMI trips one of the constant topics of conversation is the ways in which Gabon is screwed up. Most of it has to do with the sexual morays here. Men and to some extent women are allowed and expected to have multiple sexual partners. Polygamy is also legally permissible. I have tried to figure out exactly how many wives a man can take, but peoples' responses vary from 4 to 8. En tout cas, people are not expected to be in committed monogamous relationships. When a child is born from one of these multiple unions, quite often it is raised by just one of the parents. Or by the parents alternating who takes care of the kid. Or by the grandparents. This infidelity and instability is much maligned but also much joked about and serves as gossip fodder.
There is a tradition of trash-talking the younger generation in Gabon for having children too young, for not going to school, for turning away from the values of their parents. This type of criticism of the young is a cultural constant in my opinion, but here, people insist, it is really true. Maman Sophie pinpoints the age of adolescent decline in Gabon as 1990. Why, I don't know, but she is sure that something changed after that year and all the babies born then or later are wild children.
Spirituality is also a big topic of conversation and even joking, especially in reference to the above two issues. Everyday discussions are liberally peppered with Jesus and “Dieu merci” interjections. Of course, all of these topics sound so much cuter here because the Gabonese add -o to the end of most sentences or paragraphs. So you might say “bonjour-o” and your conversant partner would say “ca va-o” onwards and upwards to -o infinity.
How fun it is to listen to these discussions as people bemoan the habits and morays of Gabon, while also secretly, I think, being fiercely proud of their country.
Tuesday, September 7, 2010
La Saison de Pluie Commence
Good news first: my intestines seem to be getting back into some kind of order! Yeah for not having greasy pale stools all day. This is something to be celebrated. Although it would have been fun to see those little smiley faces under the microscope. I can always hope for next time.
Medium news: la saison de pluie seems to have started today. It was hot hot during the day and there was more blue sky to be seen than I have seen in my six weeks here. Then at about 7pm the skies opened up and it began to pour like all craziness for several hours. It just stopped actually. The return of the rains is a good thing because the river level will rise thereby preventing further boat accidents from occuring.
Bad news: There is none! Life in Lambarene is always pretty spectacular for me. We continue the fight here for the health of the region and for inter-national cooperation. Good night mes amis where ever you may be!
Medium news: la saison de pluie seems to have started today. It was hot hot during the day and there was more blue sky to be seen than I have seen in my six weeks here. Then at about 7pm the skies opened up and it began to pour like all craziness for several hours. It just stopped actually. The return of the rains is a good thing because the river level will rise thereby preventing further boat accidents from occuring.
Bad news: There is none! Life in Lambarene is always pretty spectacular for me. We continue the fight here for the health of the region and for inter-national cooperation. Good night mes amis where ever you may be!
Monday, September 6, 2010
Giardia!?
Bonsoir tout le monde. I apologize for the long break over the weekend. There were a bunch of things going on: I took call with the pediatrician on duty on Saturday and Sunday, one of my favorite people here left so we had to fete her, and I feel as though I might have gotten Giardia last weekend in Libreville. Not to be too graphic, but I have all the tell-tale signs. I have yet to look at a stool sample under the microscope but I may just start empiric treatment to get rid of some of the symptoms. Its such a close call as to whether I just have bad traveler's diarrhea and it will go away without a harsh antibiotic or whether I need to jump on the Flagyl bandwagon. As this is my first real gastrointestinal derangement since I have arrived, I will keep everyone updated as conditions progress. For the meantime, wish my intestines luck in battling whatever it is that ails them.
Thursday, September 2, 2010
Thankful
Yesterday I went out again with the PMI community health nurses. This time we took a motor boat (although they still the traditional word, pirogue, to describe it so I thought we were going in a dugout boat by paddle, which was really exciting until I saw that it was a regular boat). Traveling by boat was an adventure in itself because we are in the dry season right now and the river is quite low. This makes for lots of sand bars. One of those sand bars caught the boat's motor and we almost flipped over in the river. Mercifully just the boat driver fell in, but judging by the cries of "Jesus sauve nous, dieu sauve nous" emanating from the nurses you would think that we all drowned. We organized ourselves and made it to the village though. Even today at the hospital everyone was gossiping (congossa in the local dialect) about our plunge into the Oogue and how dramatic it all was. That is the culture here though, that information/gossip is very theatrical and communal.
Once we got to the village it was very interesting to see how a village that is only accessible by boat is so much more communal and basic. There were really sick babies (hydrocephaly for two months! malnourished to the point of exhaustion!) there whose parents were taking care of them the best that they could, but were in bad shape because their families were too poor to take them to the hospital. Can you imagine the thoughts and decisions that go through a parent's head as they grapple with the health of their child in a village like that? It's almost unbearably complicated.
As I was sitting on a bench under a mango tree seeing baby patients, eating fried fish a la chocolat, and riding in a crazy motorboat through a gorgeous tropical rainforest, I was struck repeatedly by how lucky I am. Lucky that I live in this beautiful place, that I get to speak French and German everyday, get to take time out of medical school to experience how people live in equitorial Africa, and think about the choices that I face and that my patients face. If I were more religious I would ascribe this all to divine providence, but I will say instead that I have been given a great deal of chance dans ma vie.
Once we got to the village it was very interesting to see how a village that is only accessible by boat is so much more communal and basic. There were really sick babies (hydrocephaly for two months! malnourished to the point of exhaustion!) there whose parents were taking care of them the best that they could, but were in bad shape because their families were too poor to take them to the hospital. Can you imagine the thoughts and decisions that go through a parent's head as they grapple with the health of their child in a village like that? It's almost unbearably complicated.
As I was sitting on a bench under a mango tree seeing baby patients, eating fried fish a la chocolat, and riding in a crazy motorboat through a gorgeous tropical rainforest, I was struck repeatedly by how lucky I am. Lucky that I live in this beautiful place, that I get to speak French and German everyday, get to take time out of medical school to experience how people live in equitorial Africa, and think about the choices that I face and that my patients face. If I were more religious I would ascribe this all to divine providence, but I will say instead that I have been given a great deal of chance dans ma vie.
Wednesday, September 1, 2010
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