March Madness

1. Loreana Bobbit Comes to Koza- Yep that’s right, that’s what happens when you get penile head cancer over here in the bush… (Most unfortunate for the patient, but fortunate for those of us who think that amputation, no matter the shape or the size, is pretty cool.)
2. Fleas, Crocs and Shist, Oh My!- At the moment, swimming in the local barrage seemed like a good idea because when it’s 110 degrees outside and you are sitting on the edge of a large body of water feeling the coldness lap upon your toes, taking a little dip is what you do. However, second thoughts were given upon Brenden and I returning home and telling of our adventures when we were strongly advised to preventively treat ourselves for Shistasoma , when we awoke to bodies covered with hundreds of water flea bites and when we were told of local crocodiles that also frequent our local swimming hole. They say hindsight is 20/20 and perhaps what we are seeing clearly is that throwing caution and abandon to the wind is not advisable.

3. Ovarian Cysts the size of Cantaloupes

4. Fete De Toro- Africa’s answer to Spain’s Running of the Bulls. One bull is locked away for four years in a little hut and on the day of its release, along with the help of perhaps too much local brew, it is let free while the villageoise attempt to trap and kill it. Meanwhile us onlookers run for our lives as this 800 pound steak bucks and horns it way through the masses. Yes, this is what we do for fun….
5. Leg Amputation- It’s an oddly surreal experience to finish up a surgery and to wheel the patient, in this case a 17 year old girl with a contagious smile, to her room while her leg, full of bone cancer and cut off 8 inches above her knee, is left lying on the table. However, it is another experience and operation I can claim to have been a part of…and an excellent way to learn leg anatomy.

6. Welcome to the Cruel World- What I said when I with my own two hands delivered a baby girl into the world. I have had the opportunity to assist on multiple C-sections while being here, but for the first time ever it was me helping pry open the walls while this stubborn girl slowly made her way through, me who caught the slippery little gal when she finally popped out, me who cut the umbilical cord, me who washed and wrapped her, me who handed her over to her exhausted but excited parents and me who has decided it is going to be never that I put myself through the same agony of having children. Birth control at it’s finest.7. In sum- Africa continues to be an awesome ride, never a dull moment and the coolest experience of my life.

Over My Head

It was Friday morning, the end of a long week and thoughts of a carefree Saturday, of sleeping in and spending the morning doing yoga and passing the afternoon running and reading were not far from my half attentive brain that was going through the motions of lab work. Sauntering back into the lab after drawing blood from tearful children in the pediatric ward, I was greeted by the Hospital Administrator, Yves, who asked if I had free time to run down to Maternity to quickly test the hematocrit levels of a young woman in the process of giving birth. I said sure, grabbed my things and headed outside thinking to myself that I hoped this wasn’t anything too severe being that both Doctors had taken the day off.

The first thing I saw walking into the door was blood. No, not tiny droplets of red and not small smudges here and there… but pools of blood that were covering the entire floor of the delivery room and dripping off the delivery table. On the floor, slipping in and out of consciousness and writhing in pain was a small woman, 9 months pregnant, and soaking in her own blood while she steadily added to the expanding pool of red that surrounded her. Her hand was cold when I held it both to test for her blood type and to comfort her and her eyes were empty, unable to focus on anything. After briefly discussing with a local nurse, Ganava about what he thought had both happened and should be done, we came to the conclusion that her placenta must have ruptured and that there wasn’t much more that we could do other than make her as comfortable as possible for as long as possible.

I hung her first bag of blood donated from Sarah, another SM here and added Oxytocin to her IV drip in hopes that it would help her to eventually expulse the baby before it was too late and then stood back and waited for the medicine to kick in. (If the doctors had been there that day we would have immediately done an emergency C-section in hopes of being able to save both lives, but being that they were away for the day and no one at the hospital is trained to do operations, there was little that any of us could do). It is a surreal feeling to stand beside someone while their life is literally slipping away from them and to watch in horror as your heart tells you that you need to be doing something but your mind knows that there is nothing to be done. But that was all that I could do… just stand and watch, holding her hand, thinking that while the responsibility of this situation lay partially on my shoulders, the severity of it was way over my head.

20 minutes later I was running back to the lab to argue with unwilling donors in hopes of finding more much needed blood which is always a bit more tedious than necessary. Yelling and perhaps shocking a few I finally convinced an unwilling husband to allow me to poke him. Frustrated and shaken from the futile situation, I returned to the delivery room and was told that during the 30 minutes that I was away, fortunately the baby had just been delivered, dead, and that the mother was beginning to stabilize a bit. Hanging her second bag of blood, and checking some vitals I walked to the sink to wash the blood off of my hands and as I looked down for the soap I saw lying, without consideration in the sink, a fully developed baby boy, limp and lifeless, disregarded and overlooked. With tears welling in my eyes I reached for the baby, wrapped him in a towel and headed outside to face his family. Handing over this little life that never even had a chance to start, I turned away from his father’s disappointment and turned away from the hospital having seen and experienced too much for one morning.

That evening, I set out on a walk in attempt to clear my mind from an overwhelming morning and as the sun was setting over the mountains, the village still and my mind racing, two little girls joined me. As we walked in silence, their smiling faces looking up at me, their laughter the only sound I could focus on and their small hands in mine, it dawned on me that the thing about Africa is this; When things are hard, you’re shaken to your core, but when things are good… things are indescribably great.

-Allison

They call it Typhoid FEVER for a reason…

Sunday was a long day at work, longer than usual with lots of things to get done, so work was quick and efficient and we called it quits at about three. Nothing too out of the norm for the day, a slight headache when heading home but after long hours of concentrating in the heat, a headache isn’t really anything too noteworthy. After lunch my head was hurting just a bit more so I decided to lie down for a quick hour nap or so which to be honest, happens pretty frequently here. When I woke up from my nap I was feeling increasingly groggy, so as usual, I headed out on a nice evening walk to wake myself up. Well a half hour into my hour walk I realized that I had chosen to be out for a half hour too long because at my turnaround point, in the middle of nowhere, I was feeling quite light headed, I almost fainted from dizziness a couple of times and I had to take things very slowly in order to get home.

At 6, about the time I got home from my walk I could feel a pretty decent fever settling in so I hopped in a cold shower in hopes of “cooling” myself down after the walk. I managed to crawl into bed by 6:30 but before I could even close my eyes the chills and night sweats were rockin and before I knew it I was in the midst of a pretty gnarly fever…. I’m talking 105 degrees… I’m talking fever induced hallucinations… I’m talking drifting in and out of consciousness…I’m talking the worst headache of my life… I’m talking misery. Four very torturous hours later my fever finally broke (settling at a mild 102) and I was able to drift off into a half sleep/half drug induced slumber for the next 18 hours. When I woke to use the bathroom or to drink water I was so weak I could hardly manage getting out of bed or sitting up… and so went the next three days.

At one point while lying in bed thinking about just how miserable I was I thought “How would I describe how bad this was to someone if they asked me?” and the only answer I could come up with was; ‘Imagine that someone repeatedly beat you in the head and body with a baseball bat until you were unconscious and then the jerk locked you in a Sauna turned up on high. When you regained consciousness, splitting headache included as well as a bit nausea and feeling hotter then you have ever felt before in your life…. That is exactly what having Typhoid Fever feels like.’

So there you have it… now none of you need to get Typoid to find out how bad it really is. Anyhow the damage is done and practically over with by now. I’m still not feeling awesome and I’ll be on Cipro for the next two weeks but I suppose that just like Malaria, it was not a matter of IF but just a matter of WHEN I could add having Typhoid Fever to my list of Been There and Done That in Africa…

-Allison

Update....

Sorry for the delay in getting another one of these posted, as you will see things are busy as usual but here is briefly what has been going on over here in Cameroon during the past month or so…

-Vaccination Campaign- A week sponsored by the Cameroonian government saw us setting out on moto’s with coolers filled with vaccines against Polio, Tetanus, Hepatitis B,Measles and Yellow Fever into the surrounding areas attempting to vaccinate all women and children. Setting up camp under a tree and sitting on a stump, we created an assembly line as the children lined up with smiles and laughter and walked away in tears. (December 8-14)


-Allison vs. Malaria Round 2- Nothing too severe like the patients we see daily in the hospital, but let me tell you, Malaria is quite the kick in the pants. I was pretty miserable in bed with a headache that wouldn’t stop and a fever for 4 days and it was bittersweet when the malaria symptoms morphed themselves into a rockin Sinus Infection that lasted for another 10 days. (Dec 12-16)

-Change of Inhabitance- I am officially out of Chez Medecin and am living in a house that is three times too big for the three of us SM’s. We have a kitchen which we are slowly getting into working order, a bathroom with running water and in comparison to a normal home here in Koza, we are living in a mansion. It is fun to be in our own home though and we look forward to being able to cook for our friends and enjoy having visitors over whenever we wish. But keeping the house clean and dust-free is quite the task and thankfully the burden is greatly lifted by the help of four local boys who love to come over when the music is blaring and help us clean for the small price of a coke from the market and some pocket change. (December 18)

-Becoming a Lab Rat- When one of the hospital’s two lab tech’s notified administration that she would be leaving Koza around the first of the year I was asked to cover for her until a permanent government replacement was found. Thus, for the past few weeks I have been learning the tricks of lab-trade and have this week, as she has now officially left, taken over her rotation of working in the lab. Therefore I spend my days poking patients of all ages to test for malaria, drawing blood for typhoid, looking at urine samples for leukocytes, stool samples for worms and amoebas, sputum for tuberculosis, spinal fluid for meningitis, and doing pelvic exams to test for STD’s. Lab work isn’t really what I would call my forte but I figure that with how long I am here for it is good to try my hands at everything and learn as much as I can. Plus, I’ll admit that there is a small part of me that enjoys seeing the many years of Chemistry and Biology Lab’s come in useful. But even though this is technically my new ‘job’ I still get to see lots of the inside of the OR which is good, because that is what I continue to enjoy the most. (December 17- Current)

-Christmas- This was my first Holiday season spent without my family and I am not even going to try to pretend that it wasn’t hard because it was. With a family as awesome as mine you take every excuse available to spend three nonstop weeks with those crazies. However, spending Christmas here, alone, where the presents I receive daily are wisdom, appreciation, perspective and generosity are proving to be the most valuable presents I have ever received and have made this Christmas invaluable. I more now than ever can say that my eyes have been opened to how much more pleasure one receives from giving rather than getting and I would gladly spend every holiday alone if it meant seeing the smiles that simple things like pencils, barrettes and candy canes can produce, over and over again.

-2009- New Year’s Evewas spent across the street at the Hospital Administrators house with the entire staff of the hospital where we ate, we drank, we danced, we were merry until the wee hours of the morning. New Year’s Day came a bit too quickly however, after a few short hours of sleeping when we were awakened by singing children and banging pots… Cameroon’s answer to the American Trick or treat. Groups of children go door to door singing “Bonne Annee” (Happy New Year) a bit too loud for that early in the morning and refuse to quiet down until you have given them candy. A cute tradition that maybe isn’t as appreciated as much as it should have been.

-The Cold- Within the past couple of weeks we have welcomed winds from the Sahara which blow in every year for a few months and cover the area with a thick cloud of dust which can almost be mistaken for fog and which thankfully lowers the temperature significantly. Nights and mornings are actually cold… cold enough for a light jacket at least, the days are bearable and we are spoiled with cool temperatures before The Heat, with it’s daunting reputation, arrives in March.


Well that’s what is new here in a nut shell. Hope that all of you are enjoying the New Year and have had a wonderful Holiday season. Much love - Allison

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