Monday, October 27, 2008

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

Tuesday, October 14, 2008

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