The local nourishment

A number of people have asked about this and so I figured it was time to discuss both the traditional foods of Gabon as well as the foods that I eat here. Obviously, the two do not overlap perfectly.

Gabon is an equitorial country and as such it is relatively warm here all year long. Also there are a uniform number of hours of sunlight every day. This makes for a strange and poor growing season. Two things grow naturally here. Bananas of a great sort and variety and manioc, which is a tuber similar to a potato. Bananas are eaten raw, but more often cooked like french fries, deep-fried in oil. Delicious and treacherous to the waistline. Manioc can be eaten both as the root itself, in which case you boil it, or you can eat the leaves, which look like spinach, sauteed. On its own manioc smells and tastes like vegetal sweaty gym socks. The leaves are very tasty though. I thought of them as a richer version of sauteed spinach. As far as other things that are grown here—and there aren't many things, Gabon imports almost all of its nourishment—there are mangoes, grapefruits, passion fruits, peanuts, and taro. Basically tropical fruits. Some places are also trying to get cocoa and coffee plantations underway.

As far as what I eat, this is deeply influenced by living at a hospital encampment controlled by a French administration. In short, I eat a nouveau Franco-gabonese style cuisine at the refectectoire, or cafeteria on campus. We have coffee and baguette for breakfast every morning. Always. That is the only thing I have eaten for breakfast here. I may die a carbohydrate induced death. For lunch and dinner, it is always a salad, a main dish, a side vegetable dish, and a desert. The salad is often shredded cabbage, cut tomatoes, or some lettuce. Then we have a meat entree, or grilled fish (which I prefer for obvious vegetarian reasons). The grilled fish is delicious and caught locally (in the Ogooue River). Some people eat the whole thing, head and all, but I have not worked up to that point yet. The side vegetable is usually aubergine, corn, or leek, usually swimming in a sea of delicious palm oil. Desert can either be fruit, or occasionally a small piece of cake or pie. In sum, we eat well. Like when I lived in India, I may very well gain weight in Gabon. At the supermarket, they also have a tremendous array of little cakes and biscuits as well as two fine local beers, Castel and Regab. In sum, Gabon is not my ideal gustatory zone but I am holding up pretty well all things considered.

Adjustements

I am quickly adjusting to life in Gabon and at Hopital Schweitzer especially. I still feel a little tired and stomach achy, but it is going down. To me, this indicates that my immune system is adapting to all of the new antigens that are assaulting it. I have also been washing my hands like a crazy person which I think has avoided any giant gastro-intestinal problems thus far. Interestingly I had a lot of problems sleeping the first few nights because all the noises kept me up. Now I sleep like an old log at night and during my afternoon siesta. The sounds of animals, people, wind, water, insects no longer bother me. Speaking of insects, on Monday we had a migratory ant invasion. Apparently, a huge column of ants arrived at 7pm and invaded the house. According to my roommate (I was out at dinner) they covered the drapes and the floor. She fought valiantly against them with water and bug spray, and was able to get rid of them. By the time I got home they were much less numerous. Still you could sweep up giant piles of dead ants and the kitchen sink was full of drowned ants.

In terms of hospital work, there is a French medical student working with me in pediatrie and we are seeing patients all by ourselves all day long. We do the newborn visits in the morning, help with rounding, see patients in the late morning and develop the treatment plans together. We even admit our patients and follow them in the hospital now. Most of the cases we see are gastroenteritis and malaria, but even with the trickier things we are starting to head out on our own. It's a nice pace of work. Sometimes I worry that we are going to screw something up for a patient, but I remember that you can get antibiotics at the pharmacy here without seeing a doctor and that a lot of people use traditional healers still, so we cannot be doing more harm than those two avenues of health care. I do need to organize what I have learned and my work into more of a guide though. That way I will become more efficient and be able to help out even more. For example, today we saw 11 patients in total. I think within a few weeks I should be able to see even more.

My first real patient

Not Crocodiles, Waterfalls

One instructive part about living in a semi-jungle is that plans change frequently and that you have to be flexible and go with the flow (toaist if you will). My roommate and I had hoped to go out crocodile viewing with a friend of a friend who studies crocodile biodiversity. He was going to take us this weekend, hunt some crocodiles in a nearby lake, catch them, tie their mouths shut and then take samples and pictures. But he ended up leaving at the earliest possible morning light, without us and our eager virgin crocodile eyes. So we had to retool our plans. I ended up going to a goodbye party for a Gabonese/German student who had been here the past months. This was a great success and interesting for its good mix of people from different parts of the world and different parts of the hospital and research center. Then on Sunday my partner in pediatrie who is a super French med student and I headed out to see the chutes de Fugamou, or les chutes de l'Imperatrice, named by a French explorer after Napoleon's wife, the empress Eugenie. It was a good day trip, both for the experience of traveling in Gabon itself, always by taxi and in a big group of people, and for seeing all these small villages along the side of the road. People here are accustomed to white people and unlike in India, no body begs. In fact, the only reason people approach you in general is to try and pick you up. Polygamy is relatively common here and a wedding ring is not even a mild deterrent. Anyway, Eve and I, the French girl, made it to the chutes in fine form. We even navigated the jungle-dense terrain on our own on the way home. A good weekend all in all. Just sans crocodiles unfortunately. A toute a l'heure mes amis.

Drama in Gabon

One thing that has been interesting in my first week is how communal the hospital experience is for patients. (Sorry that I did not write for two days family, I just felt fluish and under the weather and slept a lot, apparently this is a common reaction to arriving in Gabon. It's a full on immune system attack so it takes a bit of time to adjust.) Patients are kept three to a room and everybody knows exactly what is going on with all the different babies in the room, they help each other out, they answer each other's questions from the doctor. There is little concern about health care privacy. Even clinic visits are done two to a room. There was a particularly dramatic example of this communal health care on Thursday when a 14 year old girl who had arrived 3 days earlier from a small village with a premature baby that she had just given birth to that was all floppy and weak asked to leave the hospital. She told us that her father had called from the village and wanted them to come home. The main pediatrician refused saying that the baby is too weak, which he is. He barely breast feeds and only takes 2ccs of breast milk every few hours through a naso-gastric tube. The girl insists. Then the nurse gets the father's phone number and calls. He has not asked for any such thing as the girl returning to her village. Clearly she wanted to get out and this was her ruse. Interestingly, the nurse (and nurses do a lot of public health type stuff her with what they say to patients) announces to everyone in the room what the girl wanted to do. All the moms start in on her about how she has to care for her baby, does she want a dead baby, what will she do when she shows up at the village with a dead baby. The other nurses start nagging her about staying. It was as if the small pseudo-village in the pediatrie waiting room rose up to issue collective advice and pressure. I had never seen anything like it in the US. And what did the young mom do? Of course, after all that, she stayed.