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to africa

a travel blog by theresa

I'm going to Africa to see my brothers and my sisters, to see where they've been living, how they live, and how I can help meet their needs. I'm going to learn what primary health care looks like in a rural, third world country and hopefully open eyes to the circumstances of others. I'm going to practice what little I know about love and medicine and hopefully learn more about both in the journey.
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2 weeks in!

Douala, Cameroon

wow. so what should i write about? the shortage of supplies in the hospitals and clinics? the professionals i find: intelligent, hard working, graduates with good degrees, while also jobless, or having a job and being cheated their pay? supposedly some nurses pay out of their own pocket to provide a patient with unaffordable care. while others have experienced nurses who won't care for them until they are 'tipped.' one blood pressure cuff shared by different departments (including the emergency room). lack of alcohol and cotton! three women who've given birth share one room with eachother and the respective newborns. scales that are broken (i know i haven't gained 25 pounds in 2 weeks!!!). the ambulance is more often used to carry the dead to their barrial site than the injured to the hospital. sometimes medications are unavailable. ...i'm not sure where there's corruption, someone sitting and eating the funds themself or perhaps the government really can't afford financing it's hospitals adequately. ...it's really unfathomable facing the difficulties that the population here have lived with all their lives. jobs are scarce, even with great degrees. preference is pushed to the wayside while necessity or desperation takes over. i'm humbled, hey? i'm embarrassed at times. embarrassed to see such deprivation when the world i know has such an excess. embarrassed that so often we look at inequality and poverty and call it culture.
i feel very blessed.
one thing is sure, these people...they are rich with family and friends. the people i've met are kind, generous, and hard hard workers. i've really been taken care of well! :)

hopefully more soon! love you all...

permalink written by  theresa on October 31, 2009 from Douala, Cameroon
from the travel blog: to africa
tagged Healthcare, Corruption and Shortabg
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plans

Douala, Cameroon


more flowers
so... i've been a big failure about keeping updated..haha. and this really won't make up for it i'm sure.

the clinic here is a very small private clinic. it's located slightly off the road. the town here has a few other large hospitals and several other small clinics similar to my own. patients are....a delicacy. they come in spurts...if they come at all. our busiest days are saturdays obviously since we are open during the week during normal business hours so perhaps (hopefully) these people have jobs that they are busy carrying out. but even saturdays run slow.

the typical patient presents with c/o reoccurring fever for the last 3 or so days. blood cultures are drawn, malaria is diagnosed (unless it's typhoid). they are given their medications and they are directed to rest if they can, and remember to use their mosquito net...because repellent and malaria prophylaxis medications are much to expensive for the average client. one university director i was speaking with about malaria imposed the question that: what if the majority doesn't consider malaria even an issue? what if the average patient considers malaria equal to the way the average american considers the common cold: somewhat preventable, but likely to occur at least once a year.
unfortunately, the sad fact is that even tho so many survive malaria and are cured so many more die from malaria. those people that die are likely the ones that perhaps don't have the funds for a mosquito net. perhaps they don't have funds for the medication needed to treat malaria. perhaps they don't have funds to even see the doctor about it. or they can't make it to a hospital at all...perhaps they don't know where malaria even comes from. most of these facts i think would be apparent for other parts of cameroon and africa. fortunately, in this area of cameroon there are facilities to cooperate with the poor public, like mine. but what about the rest of africa? really...how do we reach them?

sorry...that's all i can write for now... missing you all!

permalink written by  theresa on November 5, 2009 from Douala, Cameroon
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transfer

Douala, Cameroon

just for quick update. today we saw three patients. nothing very exciting really... i'm a bit discouraged at the influx of patients really. today was actually a busy day except that two of these patients had previously been seen and the responsibilities of the nurses (three of us) is very limited anyways...despite the shortage of patients. and the other discouraging thing was that today we had a patient that had been mugged down the street. her hand was bleeding. we had a couple cotton swabs and water only because the doctor had left and always locks the medical supplies away...even first aid supplies... so this is something i'm going to address tomorrow...hopefully it will go well...

besides that... africa is good. i'm learning a lot. i may be transfering to a very small clinic that hasn't seen a nurse before....so...more news on that soon hopefully!

permalink written by  theresa on November 6, 2009 from Douala, Cameroon
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here's hoping!

Douala, Cameroon

let's just assume i must be the most indecisive, confused person in the world...probably it's not true, but... i do have a difficult time deciding things. which you probably would find surprising, since i did at least decide to come all the way to africa...but i never planned on having to decide anything else for the next 4 months (which now it's about 3 more months...or so)...

i was sitting outside a friends home waiting for their return and decided to "beep" my mom. it's really too expensive to call her from my cellphone, so this was my attempt to get her to call me back...but i heard her voice for only a moment and couldn't handle it! speaking with her for only once in three weeks was too little! so i went to call her from an international call box (much cheaper, bad connection..always). was good to catch up...even if it was for only 15 minutes. i used to call her twice a day for triple that each time!!!!

NOTE: "beeping" is the cameroonian tradition of calling a person and hanging up the moment it begins to ring. this is a way to say many different things, including "hi" "call me back" "i'm waiting for you" "where are you?" "here's my number" etc etc etc. it all depends on the situation. one of the main reasons beeping came into existence is probably because of the expense of airtime. people have the tendency to speak on the phone for less than 2 minutes and to hang up without saying goodbye.

anyways ...my mom chewned me (scolded me) for not writing on this as much as i had hoped. the reason for this is mainly my discouragement with the work i've been doing. you see, it's nothing like what i intended to be doing. speaking with the program director and with the doctor, i had acquired images in plenty of what kind of medical care i would be given the opportunity to provide along side a quoted "amazing, dedicated" doctor. i honestly tried to have no expectations but after being here for 3 weeks i realize i very much had expectations. those expectations included joining in the assessments, providing nursing care, and visiting the difficult to reach poor to provide the same. the first two i've seen in VERY limited amounts....and the last...on no accounts.

i've been offered the opportunity to move elsewhere in cameroon, but even that position isn't what i was looking for. it would be very exciting to go to a very rural clinic as a health educator, but i would be the only medical professional...and my intention was to come to learn and be taught tropical medicine for the underpriveledged. while the excitement of travel intices me, i'm thinking perhaps i should remain in the place i have small community and access to some medical professionals who (while the experience has been small) can teach me SOME of what i came to learn.

the up side to all of this is that things may change. i had the opportunity to be uber honest with the doctor about my frustration with the lack of patient care and after confessing some of my misgivings about staying, it seemed that she also wanted somethings to change.

just to clarify, i do not blame her for the amount of patients that walk through our door. obviously she doesn't have much power in controlling who gets sick with what. what she does have in her control (so i assume) is putting 3 sometimes 4 nurses to work instead of allowing them to sit, staring at eachother for 8+ hours a day. so i have her some ideas about how to do that. for instance, setting up a booth on a busy street so that we can take people's blood pressures and educate them on heart disease and high blood pressure. another idea was to send us out to the community and allow us to knock on doors and do health education visits. and all the while we would be promoting our clinic facility...hopefully encouraging more patients to come. she liked some of my ideas and the beginning of this week already has been an improvement.

yesterday was promising. we drove (unfortunate...because i would've rather hiked through forests to find them!) out to one village and went door to door a little bit. not for any health education yet, but only to set up contacts and make plans for the future endeavours(hopefully sooner than later). this village is quite isolated, except they at least have water, electricity, and a road (tho very bumpy...and in the rainy season i hear it's impassable). so...it was VERY nice to be out of the office showing the people that we really do want to reach them and provide some medical care. in this visit i personally found the doc a little judgemental on how the people came to live in this condition. their houses were definitely run down and clothes were worn and ragged and babies ran around half dressed. you could blame all of this on alcohol if you wanted i suppose. i just like to know the facts though...before i make accusations like that. and even if it is alcohol that they spend the majority of their income on... to really understand them and their circumstances you have to ask why? and what? and who? i can only imagine the structural injustices they face each day. what circumstances of life and government have kept them in the position that they are? "grasshoppers don't have much hope in the face of hungry chickens. " -(something like that) from paul farmer's book Pathologies of Power

also i began to create some health education posters....and i always enjoy putting some of my creativity on display, so....it was fun for me!

so here's to looking up and hoping for more.
miss you all.




permalink written by  theresa on November 10, 2009 from Douala, Cameroon
from the travel blog: to africa
tagged Healthcare and Change
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5 am

Douala, Cameroon

...i'm giving out something, i'm not sure what...the details are fuzzy now. my eyes are open and i realize it was a dream anyways. i dream every night here. i never wake up and wonder where i am. maybe once. i recognize the sound of a rooster close by calling to the sun. this is my alarm typically. even though i set one, i find myself listening to the roosters. as i listen in the darkness (it's still dark so early), i hear an army of roosters; their calls sounding from every curve and bend of the mountain. i lie there, still. at times i will roll over and jot my morning thoughts. at other times i'll read with old oswald and consider my purpose for a while. yesterday morning i knew i had work to do so my time was shorter than most.

i first i gathered my dirty laundry together. while waiting for the water to boil, i checked my mail, hauled a few buckets of water from the tap to the house, and swept my bedroom out. to sweep we use a handful of little twigs tied together. nice. so when the water was hot, i added some detergent powder to my clothes and poured the hot water over it. then comes the scrubbing. i typically do this outside next to the water tap. i sit on a small wooden stool and rigourously massage the clothes til i'm sure their sore....at least my arms say they should be! i realize as i'm washing that mosquitoes have overtaken my body in various small red locations. i have to break for bug repellent and then back to work. i usually drain the dirty water and rinse them 2 or 3 times...wringing them out like twisty noodles each time. then i hang them to dry, displaying the white man's intimates for all to see. and due to the disturbing smell of my linens, i decide to wash them as well. bug repellent and sweat just don't let things stay clean long. i hope it doesn't rain.

(note: when it does rain...you have a bit of nature's own aura. a white mist that resembles ash starts drizzling from the sky. the first time i saw this i started to cover my face and squint my eyes. i tried to reach out and wave it away. my friend laughed and explained the situation. it's as if the entire town is encapsulated by cloud. and then the winds come, howling against the banana and mango trees, rattling the pans against the pots and blowing the african dresses to the ground. and then the rains come, sometimes in floods...as if God warmed His own pot of water and decided to do some scrubbing.)

after laundry, i warmed another pot of water. the dishes were stacked and begging to be washed. i'd leave them, but ants and gnats would have a festival and overtake the place thinking we invited them. as i washed, there's another pot boiling in preperation to rinse. and after rinsing i spilled some extra water on the ground to mop the traffic residue from the cement floor. then i filled up 8 of our water bottles with water from the outside tap. these fill my own water bottle and the doc boils them to use them for drinking water and lemongrass tea (some sort of malaria preventative).

this might seem like a lot of work, but it's normal for the average person. and probably it's easier, because many women have to do this for their entire family...AND they have to cook! (which i have not excelled at yet. my one attempt led to a smokey house and disgusting, unreparable mixture.)

the real work comes with washing myself! i typically boil some water, unless i'm in a hurry, in which case i suffer beneath a showerhead spewing less than comfortable cold water. with the boiling water, i dilute to make a larger amount of rinse less scalding. i use a bowl to pour it over me, washing and rinsing as i go. i've learned i have to scrub VERY well to get all the bug repellent residue off of my skin. ...and then i reapply after i return to my room (but not before i squeegee out the bathroom floor) i can't wait for the day i don't have to wear bug repellent.

so, that's what a work morning looks like. i have these maybe once or twice a week. surprisingly, my favorite thing to do is laundry. my least favorite...is doing the dishes. some things don't change.

permalink written by  theresa on November 12, 2009 from Douala, Cameroon
from the travel blog: to africa
tagged Africa and Morning
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healthcare/social life

Douala, Cameroon

even this small clinic, with quoted hopes to serve the underpriveledged, does not quite have what i think is preferential option for the poor. the ones i thought i came to serve can't afford the 1000frs (2 dollar) admission fee to see the doctor. they cannot pay the few hundred frs fee for the taxi. they are in villages who've known few doctors and little medicine. those who watch loved ones toil to their graves, their early graves made from deaths caused by treatable, preventable diseases like malaria, TB, and typhoid. those are the ones i came for. ..and i'm not sure where they are really. i was hoping someone would show me, especially here in a foreign country. i'd go myself to find them...
but i'm a nurse. i need a doctor. i need supplies.
otherwise what do i have to offer people but a caring hand...a hand that holds them as they die from causes i know to be nonexistant or rare in the luxuries of the US...the hoard of most of the world's finances.
hmm...i know they're out there.

there's so much blame in the world put on the poor for being responsible for their own circumstances. i find myself repulsed by this especially when it comes from a healthcare provider. DESPITE all the structural injustices, i know too personally the ease by which a person can make choices harmful to themselves as a result of difficult circumstances in life. what i dont' know is what it would be like to have no choice. to be born into poverty, where at times it seems the only escape is through one immoral decision or another, whether it be drug use or prostitution or crime. where healthcare is inaccessible or unaffordable and you know the rest of the world is turning a blind eye while you die. how can a person born into one of the wealthiest families of the world, who's never known hunger or thirst, who's never lacked...how can i judge them? ignore them? forget them?

"rats and roaches live by competition under the law of supply and demand; it is the priviledge of human beings to live under laws of justice and mercy."
-wendell berry
.....

at work i've been making posters. so far i've made four. while i'm slightly enjoying being able to express a bit of creativity, i'm very uncontent with the work. especially when i see patients (what few that we have) go behind the doctors door and recieve medications that i could administer myself. i'm very displeased with the responsibility of the nurses, which mostly has been writing down a patients name and carrying water...until now....now i'm making posters.

....

i've discussed with the doctor my ideas of sending two of us nurses out to the community to do a sort of door to door education program. this isn't what i really would love to do, but i'm sort of desperate to do something...and i feel better walking about this town speaking with strangers rather than sitting in a mostly empty clinic all day. even when it's not empty i feel there's not much point to me being there. it doesn't seem the doctor trusts her nurses to do so much as an IM shot, much less start one of the few IV administrations she's ordered. anyways...there's always excuses about why something won't work, can't work...and if there's no excuses then my prodding seems to typically be ignored. and my mother will tell you how well i feel to being ignored.

...i'm not really sure how all this is going to work out really.

......
BESIDES that...
the social life of cameroon is vey busy...well...mine is. the tradition is that if someone invites you out then they buy your drinks AND they feed you...i've been invited out quite a bit by work friends, friends of those friends, and often by complete strangers. please trust that i'm making wise choices and i hope you can believe i only go out with the ones i know...despite the temptation of grilled meat & onions, fish, plantain, boiled egg (all served with a side of a hot pepper mixture), and free beer. i'm really amazed at the generosity, but every time i go to thank them they seem utterly confused.
it's really enjoyable to go out though. i enjoy watching everyone, seeing everyone interact and talk and rest. the people are very free. by free, i mean that they dance, eat, dress and enjoy freely. i love to watch them dance!it seems the music enters their blood and their body responds. i'm amazed that even the babies can move their booties like professionals. it'd take years for me to acquire the skill of some of these three year olds, i'm telling you! but since i only have a few months to learn, i'm trying to make the most of it :) it's not very difficult to let go though, because their music is GREAT! i'm definitely going to have to get some cds....or something!

oh! and if i'm out later than 630 (close to dark) i'm always seen directly home by at least one or two friends. i hope this comforts a few of you :) a girl i met from belgium was telling me about all the different crimes she has heard of since being here, and since that one day at the clinic with the girl who came in who'd been mugged midday i've been properly scared of being out after dark alone...which probably is wise anyways. i just always wish i could be brave...be above all of that crime business... no worries, family. i don't think i'll overcome my fear of the dark anytime soon.



permalink written by  theresa on November 13, 2009 from Douala, Cameroon
from the travel blog: to africa
tagged Healthcare, Friends, Africa and Poverty
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hopefull

Douala, Cameroon

wow...things seem so hopeful. today seemed like an EXCELLENT day. another nurse arrived from the US and ive been very anxious to meet her and discuss the details of the oncoming month or so...and our equal experiences of healthcare. i've been VERY happy having this opportunity.

chin chin and ground nuts (peanuts) ..our daily snack

mostly though i've enjoyed finding out about all the things we're going to do (even tho it's slightly frustrating we haven't already started some of these ideas already) .... theres' a lot of possibility for what we might do so i am eagerly awaiting. it seems with my eagerness and the presence of another volunteer the doctor has been incline to press for things to happen. some of these weekends we will be speaking on a radio talk program about public health. tuesday of this week we are supposed to begin a door to door blood pressure and sugar screening program which will hopefully enable us to educate are public about diabetes and high blood pressure . i'm looking forward to these opportunites...eagerly awaiting the chance to work.

an HIV poster from work

i feel SO SO lucky to have someone so like minded next to me in my adventures. it's SO encouraging!!

permalink written by  theresa on November 14, 2009 from Douala, Cameroon
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the beach!

Limbe, Cameroon


the new girl, shaye from new york, hellen and i
so yesterday we took the trip to the beach. it was SOO nice! ..except for the initial taxi ride, in which the emergency stick was prodding affectionately against my tail bone the entire time.

unfortunately, i'll have to write more about this later...enjoy the pics!


a boat

permalink written by  theresa on November 15, 2009 from Limbe, Cameroon
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...

Douala, Cameroon

again my blogs have become somewhat lacking, haven't they? ashea (AW-she-aw{sorry})


our formal invitation to paaarrtttayyy
saturday night we were invited to a celebration party. it was some kind of formal "passing on" of the leadership positions in a formal school group, while also welcoming the new freshmans into the roles. the invitation declared that the time frame was 8pm til dawn. we were VERY curious how this would play out. i wore a dress that i got here in Africa as did Shaye, the volunteer from New York. everyone there looked SPLENDED, dressed finer than anything i ever wear. girls wore beautiful cocktail dresses, while many guys decked themselves out in fine suits and ties. we were served a 'refreshment' of popcorn, dried fish, peanuts, and a white breaded sandwich of sardine paste, which was surprisingly enjoyable. after the ceremony everyone was served some wine. the red heaven was sweet but not quite as sweet as my manichewitz from home. soon...the dancing began! and might i say that these cameroonians if they can do anything, they can dance! i've seen 3 year olds shake their booties better than me and apparently they only become more skilled with age. quite impressive. so, all night we danced. i met some people, enjoying their company... enjoyed some castel...some more sardine pasted white bread... and i was surprised at how quickly the time passed. before i knew it 5 am was there and our escorts were waiting to take us home. we strolled still dancing to the roadside to catch a taxi. in the wee hours of the morning, fit cameroonians were beginning their morning 'sports', running up the mountain roads like machines. the new lab scientist, papa joe, was in rare form, wildly directing the taxi in our direction, rushing everyone into their positions, being quite the comedian in his probably state of exhaustion. we were seen safely home by papa joe and two other friends. as happy as i was to see my bed, i was sorry the night was over...we had too much fun! ...so i lied there repicturing the dancing cameroonians until passing out from my own definite exhaustion...
looking forward to the next day (or the same day!) when we would visit muna market....if we ever woke up!

permalink written by  theresa on November 22, 2009 from Douala, Cameroon
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a good day

Douala, Cameroon

wow. today!

an HIV poster from work
the doctor didn't show up to the office until after noon. enough time to tell us that "someday" we'd be going to schools to educate some kiddies about the risks of contracting HIV, so I ought to recreate another copy of the HIV poster I made to hang on her bare, blue clinic wall. so i did..thinking how nice it was to travel all the way to africa to make posters. anyways...maybe some kid would show some self control after staring at the 'white man' in the front of the room holding up a shiny poster.

in between drawing lines and letters and various pictures displaying the avenues of infection, shaye and i sat roasting in the hot african sun...enjoying the short time of warmth while it's available. i'm sure to miss it.

the doctor left early...before 3 this evening. as usual, if she goes the atmosphere turns slightly more relaxed. laura (another nurse) was curiously out behind the clinic disturbing a fire and pushing around through some of the brush. in a few moments she came to us, wordlessly chomping on her own cob of roasted corn and handing off another to us to share. we were VERY excited! some of the kernals had even showed early signs of yummy popcornness. we enjoyed. we enjoy a lot here.

a patient came in and because the MD was incognito we didn't think we could do anything for her, but apparently there were orders made prior to this day (great communication).
omeprazole IV push stat
we pulled out a vial of omeprazole and searched the information sheet within the box to figure out the proper rate of administration. we also had to do this with no IV. the woman kindly had disappearing veins, but i was happy to see them and more happy to stick them as this was the first stick i've done in 2 months! she thanked us for the administration, and i thanked her for needing medicine...and coming when the doctor wasn't there.

so, since the doctor had left and we can't really do anything much without her or her keys there, it was our chance to escape the clinic and explore. we had no other engagements and, as it's rare for our schedules to be so free, we (shaye and i) set out with a few goals in mind. first on the agenda: Beno Bakery.

We walk into this tiled, tin-tabled heaven with it's crossiants, hamburgers, sodas, and sweets lining the glass display and try to hide the fact that we're drooling. we had spotted pizza and quiche here the day before and knew a sooner-than-later visit was a must. we carefully selected some of the juicier looking pizzas and the last quiche assuming it was last because it was something to be desired. wow. were we in for a surprise. we sat and attempted to keep our cool, but our eagerness over took us. wow. the pizza looked so delicious. juicy. it didn't exactly look completely fresh, but...stale pizza always tasted good at home, right? ....so.


the soggy, wrinkly cardboard pizza
the first bite. hmm...mine resembled a bit of soggy cardboard with dry, wrinkly "veggies" and ancient cheese (not properly aged). i debated on setting the piece down before i finished, but the shit cost a whole dollar so i was like..hell no. not wasting that! (you can buy two beers with a dollar!!) ...and inside i was having some high hopes for the quiche so i figured i'd suffer through it.
and..the first bite: for me, i took the tip of the creamy triangle delicacy with memories of my mom's on my taste buds....which quickly were put to rest. i soon realized i was not in my mother's kitchen enjoying her fresh quiche but rather found myself in some sort of food hell. slime stretched from the product to my mouth and the mush sort of violated my senses. as i breathed out, hoping maybe the aftertaste would be somewhat sufferable, i found myself publicly gagging. i didn't take another bite and neither did shaye. we managed to take down some crust, but...it was a failure and "possibly one of the worst food experiences of my life" (claims shaye)...like taking candy from a baby, but not even that. it's like...giving a kid something that's supposed to be candy and it turns into shit as they put it in their mouth. BUT...as much as it was a failure, it was a success. we sat a bit longer wondering how to dispose of our garbage a.k.a. what they tried to call food...enjoying the sunshine, the african people, and the dance beat ringing out to us. we were alone. we were in africa. and it was excellent.

next we tried to check some internet, but the place was packed. we decided to undo the wrong that had so cruelly been done to us, and went in search for some proper african dish to satisfy our cheated bellies. we walked...and walked....and walked. twice we asked people where we might find a "restaurant"....they would then ask us if we were speaking german. no...we're speaking english. just like you. seriously? they have signs with "restaurant" in various places.. maybe we say it weird. anyways. finally after some vague directions we saw some people dishing out on some eru and decided to give the place a try. thankfully. we pounded a rich plate of ndole (in doe-lay), yummy sweet soft plantain, and some gordon sparks (a fine citrus gin fizz)...all for three bucks. luckily shaye and i have similar appetites and interests...it's been a LOT of fun today. i'm sure these african people must think white girls only know how to smile and laugh too loud.


going to a 'football' match
NEXT...we went to watch some dudes playing some fine football (soccer). maybe it wasn't just the soccer that was fine. we met some fit african ladies who encouraged us to start doing some sports while we're here. one of these girls was so fast she could beat some of the boys and keep a close second to the others. while we were watching i had this STRANGE sensation. i was watching this girl climbing over the fence and then sitting on it: her long sleek legs dangling, her face shining from the activity, bush grasses blowing behind, and sun setting to the side. all of a sudden i was born in africa, grown in buea, and i came here nearly everyday to play soccer on this dusty field and enjoy my friends. i was standing alone on the plain of this cameroonian city. i would go home to my family that night. i would cook my eru and say hello to my brothers or my sisters. the world felt so small and yet so so big. it was like i was made here...my blood became the water and my heart became the dust and my mind was caught somewhere between them and the sun....kind of a weird feeling actually...i honestly don't think this is where i belong forever, but i'm so happy to be walking on this part of the earth. i've been so blessed to know these people, see their homes and their families, feel the sweat they put into life, the passion they put into love...the desperation with which they look to their futures. it's inspiring. i'm humbled. i'm honored.

and i'm still in africa.

permalink written by  theresa on November 25, 2009 from Douala, Cameroon
from the travel blog: to africa
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"For me, an area of moral clarity is: you're in front of someone who's suffering and you have the tools at your disposal to alleviate that suffering or even eradicate it, and you act. " (paul farmer)

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