If...

If I were an African, living in Koza, Cameroon, chances are my name would be Suffrance (named after the ‘suffering’ that my mother experienced while pregnant with me) and I would, at the age of 22 already be one of many wives of a husband who doesn’t do much of anything. He would spend most of his days sitting on the side of the road with his friends playing cards and slowly drinking himself silly with home brewed millet wine while I tended to our house, our millet, corn and peanut fields and took care of our four children, all under the age of 5. Yes, I would have 4 living children but more than likely I would have undergone 6 or more pregnancies, and I would be lucky that my four remaining children have survived thus far. My first born probably would have died at the age of 7 when he was bitten by a snake and my third, probably would have died at the age of 2 when she got a severe case of cerebral malaria/polio/tetanus/typhoid/cancer..... your pick.
Most likely my day would begin at 4:30 when I would rise before the sun and walk a mile with a heavy clay pot on my head to fetch water from a contaminated well, which will help me throughout the remainder of the day to clean and prepare food for my family. The rest of my days are spent with an 7 month old tied to my back while I bend at the waist for 6 hours picking cotton and peanuts in 100 degree heat, and chances are, I’m probably pregnant. If I read, write and have completed the equivalent to the 8th grade in America I would consider myself very lucky and I would be rare among my friends. I probably have never left the Extreme Nord of Cameroon and the farthest I have ventured from my house of mud is 12 miles south of Koza to the slightly larger town of Mokolo, and I probably haven’t been there since I was 16.
I’m probably suffering from Tropical Splenomegaly, a perpetually enlarged Spleen which would be just one of the many side effects of having persistent malaria for years. It will not be surprising when I come down with Typhoid fever for the third time in the past 5 months and whether I am aware of the fact or not, I have worms. I also probably have a Sexually Transmitted Disease which is constantly passed between me, my husband and anyone else he wants to sleep with whenever he desires. Inevitably I need to be on medication, but being that my husband calls the shots on everything I do, when he deems treatment worthy, we will see a doctor. I have a mass in my abdomen, it causes me pain and a bit of worry but being that it is only the size of a tennis ball I won’t bother having it looked at until it gets big enough to impair all that I do. An interesting fact about me is that I probably don’t have a uvula being that as an infant when I had a cough a local ‘doctor’ cut it off with a used razor blade, the same one he used to cut my seven siblings uvula’s off with and the same one he uses to cut his hair.
I go to sleep each night praying that a pack of bandits do not break into my house and slice my Achilles tendon, preventing me from chasing after them and the few belongings that they have just stolen from me. I have never seen the snow, I have never touched the ocean and for me, 85 degrees is a clear sign that the cold season has arrived. I am not aware that such luxuries as contacts, ipods, tampons, microwaves and deodorant even exist and I have never seen, touched or sat on an airplane. However, despite the life of difficulties that I face, I smile incessantly. I laugh easily. I give generously. I am strong beyond comprehension. I am kind beyond belief.

-Allison

Perspective

As our moto headlight slowly dimmed to nothing and we coasted to a stop, I couldn’t help but laugh as I peered inside our empty gas tank. At 11:30, on a moonless night, in literally the middle of nowhere I began to think of a hundred other more convenient places that our moto could have ran out of gas in and smiled as my eyes began to adjust to the utter darkness. Accepting my helplessness in the situation I lay myself in the middle of the dusty road, surrounded on either side by the comfort of two friends and gazed into the sky. Without a street light within a 100 mile circumference of us, with nothing but crickets and birds to construct the soundtrack to our lives, nothing but the sound of breathing and laughter to echo throughout the night and nothing but shooting stars to be entertained by, I couldn’t help but think that there was no place on earth that I would rather be.

In short...Bush Africa... Perspective.

In the past 10 days I have....

1. Cared for a little boy with over 85% of his body burned and who unfortunately died.
2. Operated on a woman who’s eye had been stabbed by the horn of a bull..
3. Operated on a man with a bowel obstruction, resulting in us draining over 6 liters of liquid from his stomach.
4. Circumcised a man suffering from Paraphimosis.
5. Spent 4 hours in the middle of the night operating on a 2 month old girl with a Perforated Umbilical Hernia and proudly closed the incision completely on my own.
6. Spent over 6 hours in the operating room doing 2 Hysterectomies.
7. Been awoken at midnight to run to the hospital to care for a stab wound victim with a knife entering one side of his shoulder and exiting the other.
8. Welcomed a screaming and healthy little boy into the world after performing an emergency C-Section on his mom very first thing in the morning.
9. Done two biopsies on two different potentially malignant tumors.
10. Read an ultrasound for a woman with malignant Polycystic Ovarian Cancer which has matastisized into her liver.
11. Learned how to do a Laryngoscopy, Bronchioscopy, Gastroscopy and Colonoscopy.
12. Sutured the head of a teacher who was beaten with a stick by a fellow teacher.
13. Run over 50 miles.
14. Read 3 books.
15. Never slept so soundly in my life.


In Short...Bush Africa... Exhaustion.

-Allison

TIA- This.Is.Africa.

1. A week ago Saturday morning, while the other two volunteers, Sarah and Lauren were at church and I was enjoying a lazy morning of yoga and reading, their house (which will one day be my house as soon as there is a roof in my room,) was broken into. Though we don’t know for sure, we have reason to believe that our thief was a child, being that he, or she for that matter unwisely left (a wet shower, used muddy bucket and little muddy foot prints in the bathroom) more than he or she took (cell phone and spare change). Unfortunate as it is to have our cell phone gone which really puts a damper on the weekly chats with our parents, we are quite thankful that it was the phone that was taken while their cameras, computers and ipods were spared and we really cant help but laugh at the thought of a little intruder capitalizing on the opportunity of cleaning up a bit while in our house........ T.I.A.

2.Not too far from our town of Koza there is a smaller town named Mozogo which claims the only forest in the Extreme Nord as its prize possession. Along with a new friend Marcel, (a peace corp worker who has been here for almost two years) to play guide for us, Sarah, Lauren and I headed our way into the thick of the jungle for a nice afternoon away from the hospital. Happening upon a tree fort that was built a number of years ago, we promptly climbed up and made ourselves comfortable high in the canopy of the forest while 20 wild baboons played for hours surrounding the tree house as we laughed and stared at them while they laughed and stared at us.........T.I.A.



3.With both doctors out of town in Boston for a surgical convention for a week, my personal position here at the hospital, which is usually to directly assist Greg in either surgery, clinic, or rounds was altered a bit when I was asked to work in the Pediatrics Ward with Eliza, the only female nurse on our staff instead. Usually one of the other girls would work with a nurse and I, a doctor, but since I speak French and they don’t and Eliza doesn’t know a word of English, we all thought it a better fit for me to work with her. The week in Peds was hectic, and had us admitting over 30 patients into a ward that reaches capacity at 24 which meant there was not much time to sit me down and explain how and when to do the things that were needed. Thrown into a flood of charting, diluting and calculating meds, giving meds in a timely fashion, giving shots, starting IV’s, and even prescribing meds while changing patients from IV feed to oral doses was brand new for me, but I am quickly beginning to grasp the fact that a lot in the medical field cant be taught in a classroom or from a text book. As I have stated before I am learning so much here, overwhelming amounts daily, yet have barely opened a text and have with open arms accepted Eliza’s motto for the week of teaching me the ropes, as my own.... “You are allowed to sit and watch only once, and then you simply do.” ........T.I.A.

4.Well I think we all assumed I would eventually get pretty sick over here in Africa, in fact I think we all expected it, it was only a matter of time. The question was not ‘If,” but “When” and the answer is....”Now.” Unfortunately I think the ever looming malaria has begun to wrap her hands around me and things aren’t looking pretty. Never mind the fact that it is a nearly negligible amount of Plasmodium Ovale that are exponentially attacking the red blood cells in my body causing them to burst and die because it is not this bout of malaria that I am concerned with. No, I can handle a low count of malaria this time, it’s the next time that has me worried, because if waves of fever, chills, dizziness, cough, headache, stomach and chest pain, diarrhea, vomiting and loss of appetite all present themselves with even the slightest amount of malaria , I can only begin to imagine what the future holds......T.I.A.

In short...Bush Africa...Night running with a head lamp, sipping home brewed tea in a hammock, one day weekends, snakes, exceptionally dirty feet, missing coffee in the morning/noon/night, substituting a bucket for a washing machine, target practice on veins, living in fear of every mosquito, learning from your mistakes.

-Allison

The Frustrations of a Simple Life

This week is the first that I have felt consistent frustration with life in Africa and am realizing strongly that life here, plain and simply, is not fair. The more I slowly begin to better understand the culture the more I realize I don’t get it in the least. Life here holds little value, it comes and goes and easily slips away without many noticing or caring. Children aren’t given a chance to survive, it’s a total crap shoot who makes it and who doesn’t. Parents aren’t knowledgeable enough to care and nurture as they are supposed to and have replaced contentment with complacency in regards to their families. Children are raised with indifferent parents and thus they, without realizing the option to be different, grow to become apathetic parents themselves... it’s a vicious cycle and from an outsiders view, its hard to see an end in sight. At the hospital death knocks daily and unfortunately, too often we have to answer the door.
My heart, soul and mind are constantly trying to make sense of how it is that so many can be in so much pain while others don’t feel a thing. I curse my whiteness, my ignorance, and wonder how it is that I once was, and continue to be so naive. As much as I try not to get bogged down with the things I’m seeing, even more than that I don’t want to become desensitized to it either, but after weeks of seeing so many with literally nothing, it’s hard to try to get my head around why it is that so many others are so blessed.

In short... Bush Africa... Malnourishment, Inexplicable Convulsions, Anemia, Pneumonia, Scrub Typhus, Incompatible Blood Donors, Ascites, Still births, Liver/Kidney/Heart failure, Staph Infections, Bronchitis, Meningitis, Tetanus, Typhoid Fever, Snake Bites, Cerebral Malaria, 8 yr. olds with AIDS, frustration and contemplation, injustice.

-Allison

Notable things of the past few weeks....

- Attending- a traditional Mafa (Local Tribe) funeral for a woman I have never met and know absolutely nothing about. It took a lot to convince me that showing up to a random persons funeral would not be as rude as one would think and our presence was indeed graciously greeted by the family with local food and drinks. Funerals here are more like three day long parties, with family and friends (and complete strangers...) banging drums, singing, dancing and socializing throughout the night. I some how got talked into joining the local dance circle by a few pleading glances from small boys that wouldn't take no for an answer and quickly became both the laughing stock as well as the center of attention to the funeral. I initially felt slightly awkward but apparently the locals "love to see strange white people take part in their culture" as I was later told by a new friend Zara, so I laughed off the embarrassment and danced the night away anyway. (October 13)

-Scrubbing- into surgery for the first time ever. Though I have observed many surgeries in the past there is a big difference between watching from the side lines and working hands-on along with the surgeon. After nights of practicing "throwing stitches" (that would be surgeon lingo for tying surgical knots) that Greg showed me one evening after work, he decided I was ready to head in to the OR and do more than just observe. After a long and memory-challenging lecture on how to scrub in properly and keep a sterile field, we set to work on an elderly man in desperate need of a double hernia repair. Not really the most scintillating of procedures but being allowed to put your hands inside of anyone in my opinion is pretty darn cool. (October 14)

-Helping- with a C-section. With a half hour left of my first hands on surgical experience Greg and I were notified of a 15 yr old girl whose first soon to be child was in the breech position and trying to push itself feet first into the world whether anyone was ready for it or not. Quickly finishing up our hernia repairs we changed gloves, gowns and mindsets and headed into the room next door to tackle a C-section. It is truly remarkable how quickly a proficient surgeon can have a girl open and
a baby out and screaming... I was left holding a squirming little girl, with my jaw dropping to the floor before my brain could catch up with what my eyes were soaking in. (October 14)

- Draining- 10 liters (yes, you read that correctly, I said 10...) From the abdomen of a woman who had recently given birth. She has been a patient at our hospital since the day I arrived and each day her stomach has been distending more and more as we regularly examined her in bewilderment until finally Greg had finally had enough. Inserting a small catheter into her lower left abdomen we proceeded to watch in amazement as ten liters of jello yellow fluid drained out of her for over two hours.
Due to the jaundice found in the should be whites of her eyes, under her tongue and on the palms of her hands as well as the bright color of this liquid we suspect chronic liver failure but to make a diagnosis of the such in this type of a limited medical field is difficult. (October 17)

-Closing- up a patient after a prostatectomy. 5 hours of back to back double surgeries, both of which I was lucky to assist with. It is looking more and more that my more permanent position for the year will be in the OR, which I couldn't be happier about. The first of the two procedures was a mass removal on a younger guy who had a large mystery lump on his right abdomen. However, after opening him up, pulling his intestines out and setting them on his chest to offer a clearer view of the mass, we discovered that his mass was too wide spread to remove and was most likely abdominal tuberculosis rather than cancer so we spared our patient as well as our backs a painstaking nine hour surgery and let the mass stay. Our second patient, an older man whose prostate was severely enlarged was a pretty interesting case to assist on, especially at the end when Greg stepped back, handed me the needle drivers, a string of suture, pulled his gloves and gown off and proceeded to do paper work, leaving the closing of his skin to me. After watching surgeons easily fly through surgery I figured I would do alright at closing. However, I was pleasantly humbled when it took me almost as long to close as it took Greg to do the entire procedure :) I will be needing much more 'sewing' practice and thankfully am in the perfect place to get just that. (October 20th)

-Running- daily in this heat is notable enough in and of itself but unbeknownst to me, my set aside alone time of the day to think, debrief, release frustrations etc. has quickly turned into a group activity. It is proving to be impossible to head out on a quick run without a pack of children running along side with me. However, I am grateful for the company, the language lessons, the laughter and the incentive to push a bit harder up a hill to keep up with jumping, skipping, giggling children
who seemingly effortlessly run in flip flops while I have to constantly resist the urge of falling over in the middle of the road. The ease with which these kids keep up with me is all the motivation I need to get out the next day and brave the heat once again. (Everyday)

-Contemplating- buying a baby goat as a pet. (Everyday)

In short....Bush Africa.... abbesses that test the strength of your stomach, rice, rice and more rice, spiders, frogs, lizards and bats around and in your house, enjoying books more than you ever liked TV, bug spray perfume, crystal clear night skies, cultural norms that aren't so normal, wearing flip flops while operating, living in a world outside of your box.

- Allison

Getting Situated...

After:

-2 sleeping pills

-24 hours of sitting on 4 different planes

-2 nights stay in Ethiopia

-6 hours of driving

-3 visas

-5 countries

I have finally arrived in Koza, Cameroon, or as I've quickly come to refer to it as, home.

The culture shock, the jet lag, the constant pinchces and reminders that I am indeed here, the many months of anticipation are beginning to fade. I find myself already slipping into a pattern of how the following nine months will unfold...

Awake and in a cold shower by 6:30, breakfast of oats by 7:00, at the hospital by 7:30 for daily worship and updates on the previous nights happenings. In the hospital (so far switching between a pre-natal clinic, shadowing Audrey in the Pediatric Ward, shadowing Greg in the Open Clinic, Maternity Ward, Emergency Room and Operating Room, fetching meds from the stock room, delivering urine/blood/stools to the Lab, and attempting to translate when needed (or possible) by 8:00 and home for lunch by 3:00. Run, read, do yoga, take pictures, wander to the market, play pick up soccer with local school boys, or explore the surrounding area until about 8:30-9:00, when I happily crawl into bed to dream about doing the same thing the following day.

I am still a little unclear as to what my specific job or role will be at the hospital but am soaking up the all-around exposure as it presents itself. I have already learned more about malaria, typhoid fever, worms, STDs, pregnancies, infections, anesthesia, sutures, general medical terms in both English and French, and cultural norms in a week then I did in four years of college. The questions never stop streaming from my mouth as the amount of things I don't know here is never-ending. Luckily, Greg and Audrey are great mentors and encourage me to ask about anything when I am lost, and offer helpful advice on cultural, medical and general life inquiries. I've already been lucky enough to head to the OR twice (with many more times soon to come...) with Greg and am constantly amazed by the drastic differences between practicing medicine here compared to the small amounts I've been exposed to in the States. Here, you do what you can with what you have, compromise when you don't have something, and make the most of the things you are fortunate enough to have.

Its incredibly hot here: sticky, humid, and we're all constantly sweaty. The days are often over a hundred degrees, the nights a cool 80, and fans are more of a luxury and necessity than one would think. However this heat is nothing compared to what we have to look forward to in March, as all of the local hospital workers frequently like to remind me of when I mention just how hot I am midday.

Apparently March-June is unbearable for even the most acclimated of native Cameroonians, challenging human tolerance by reaching 130 degrees during the day and only cooling to around 100 while we all try our hardest to fall asleep. Oh how nice the spring will be....

The people here are very friendly, welcoming, and excited to have some many white people in Koza.... there are now six of us. Some stare quizzically, others shy away; some feel personally honored when spoken to or visited by a "Nasara" (white person in Mafa, the local tribal language), others cry and scream. They are hard workers and are beginning harvest, primarily of their staple food, millet; also have large harvests of peanut fields, tomatoes, potatoes, eggplants, and guavas. Cows, goats, sheep and chickens are often seen making their way through the market, our backyard, the soccer fields and anywhere there is greenery. French is spoken almost fluently by all, and English is a rare luxury to hear. Polygamy is practiced and accepted nonchalantly, STD's and pregnancies widespread. Local accidents and burns make for interesting medical cases but offer a heart-breaking view of frequent and casual misfortunes that happen daily. Death is viewed as unfortunate, but a readily accepted and expected part of life.

In short....Bush Africa... mud huts with straw roofs, women who amazingly carry everything on their heads, children who are delighted for hours by nothing but bare feet and a deflated soccer ball, miles upon miles of millet fields, nauseating heat, mosquito nets that nightly aid in the perpetually silent battle against diseases, broken rules of cookbook medicine, smiles that could cure the world.

-Allison

The Adventure begins...

Wow. Its saturday night and the packing has begun. I think i have enough meds to personally support a small medical clinic on my own and enough antibacterial hand wash to literally drown someone. The mosquito net and spray are set out and the scrubs, neatly folded.... the excitement is building and the nerves have yet to come. My flight leaves at noon on Monday, Sept. 29th. I will meet Emily Wilkens (a great girl who I first met while studying abroad in France while she was teaching in Prague. She will be spending six months at the Bere Adventist Hospital in Chad doing similar work to what i will be doing in Cameroon...) here in Denver and together we will voyage our way across the world. Denver. Washington DC. Rome. Addis Ababa, Ethiopia. N'djamena, Chad. 36 hours later our trek ends and our adventure begins. I will part ways with Emily there and stay the night at the Catholic Mission. The following morning i will be met by a driver from the Koza Hospital who will take care of my papers and deal with getting me (hopefully safely :) across the border. Together Adama, the driver and I will travel six hours into Cameroon where the adventure truly begins.... Until then.....

Allison