A heavy week

Olivia came to visit last Sunday afternoon.  She is the “housegirl” for the head of pastoral counseling and his wife, a couple who lived in Edmonton for a couple of years, and have twin girls born there, so “my fellow Canadians”.  Olivia’s father died when she was about 14.  In the Kom culture, when the head of a family dies, someone else in the family assumes responsibility for his dependents.  Often this is the eldest son, as is the case in Christian’s and Julius’s families.  Olivia was just finishing class 7, the end of primary school, when her father died, and her mother was unable to support her in secondary school.  And sadly, the new family head did not take his responsibilities at all, and cheated the mother and children on sale of their farm produce.  For 2 years Olivia did nothing, but stayed at home.  Then she was able to get this “job” as a housegirl; usually in this sort of situation, the couple who take the girl in become like parents to her, and indeed, Olivia refers to Godlove and Eunice as Dad and Mom.  She does most of the cooking in their house, and has cared for the twin girls, who are now 7 and have just begun school.  Olivia is now 20 and hopes in January to go to Bamenda to a private “college” where she can learn some skills – knitting and decorating and cooking.  She is a very mature young woman, who understands her situation very well, knows that she will never be able to get her secondary education which limits her options badly, but has chosen a route that will at least gain her the ability to support herself.  She is wise beyond her years, an inspiring young woman to visit with. 

 

Further to the per diem controversy at the maintenance conference last week  – oh my, this was a big cultural palaver.  On Thursday in our anaesthesia rounds, all the anaesthetists and my students aired their views on how unfair it was that the 6 people who attended, sponsored by the government agency, got a substantial amount of money which was far more than their costs of attending – and the CBC folks got nothing.  I can understand their frustration, since everyone here is struggling financially – and it is a system that to me too is bribery, and unfair, and is very destructive.  But I was upset too, because I had had no knowledge it was coming either, and felt like I’d been tripped up by this big cultural offence in complete innocence.  In any case, I am very grateful for the group’s openness about their anger, and I’m told that now it has been expressed and understood, it is over and will not be mentioned again.  They aren’t the sort to hold grudges.  And I have certainly learned a lot about the way things work here, and am unlikely to fall into this particular trap again – although I’m sure there are dozens of other cultural landmines out there waiting to trip me up.

 

This week we did a huge case in theatre – an attempted resection of an aortic aneurysm.  You probably know that this is a very large and high risk surgery even in North America where every monitor and drug is available and the patient will go to an ICU post-op, and so on.  Here we have a very limited blood supply, limited monitoring ability, and a post-op ward with 60 patients and about 3 nurses.  Hardly ideal.  The case was a disaster surgically.  Amazingly, we were able to keep up with massive blood loss at the anaesthesia end and finished the case with her alive and even in not too terrible shape.  But she bled more in the evening and died.  She was relatively young, with her youngest child only 5 years old, and we all felt upset about the outcome.  The question is – should a case like this even be attempted here?  I don’t know the answer.  But my students and I are all pondering.  David, the anaesthetist on call this past week, told me about a man in his late 50’s who came in during the night with an acute abdomen.  He was very ill, and very dehydrated as is the usual here, because people tend to come so late to the hospital, after being ill for several days.  He had consented to surgery, but David knew he needed fluid resuscitation before it would be safe to go ahead with an anaesthetic and surgery.  And so while they were talking, the man said to the surgeon “I signed for surgery, but I am now refusing.  I am going to die.  If you do a big surgery on me, it will just cause lots of trouble for my family.  It is better that they just carry home my corpse.”  And indeed, he did go on to die that night.  The story is sad, but he was probably right.  Many of these patients are past the point of resuscitation and survival; if they have surgery, the family is presented with a huge bill, and they still carry home the corpse.  It is a tragic situation, but the reality of life here.

 

On the positive side this week, Gideon has made me 2 garden plots and planted seeds, and we transplanted some little lettuce plants which so far are surviving – and I look forward SO much to salad – one thing that is sadly missing here.  The flowers are doing well in their beds.  Thom picked me up a wheelbarrow and spade in Bamenda.  The spade is an "Elephant".  Both Richard and Gideon informed me that Thom really knows how to buy a spade - the Rabbit is weak, just soft metal - but the Elephant, now there is a spade that will work!  The workmen have made a most elegant drainage gutter, all lined with cut stones, with concrete holding them in place.  Work around the compound as a whole has been on hold because, as is usual, the ordered load of concrete from Douala has not arrived.  The work on the gutter here is being done with a few bags borrowed from somewhere else.  The eavestroughs are all up now.  So apart from window screens and protectors (to keep out thieves), my house is pretty much complete.  It is now mosquito season – with the rains diminishing, there is some standing water, so the next month or so is the worst for malaria risk. I really look forward to those screens.  One of my most prized things brought from home this time is a pill box with a place for each day of the week – finally, I am able to remember whether I took my doxycycline or not.  Last year was just terrible – I never could remember if I’d had my dose for that day or not.  Amazing I am still malaria free!  We are now going a couple of days at a time with no rain – and I don’t think there has been a real downpour in a week.  The temp during the day is going up to 24C – still not hot, but the sun is VERY hot – I got a bad burn on my back in only about ½ hour last Sunday walking Philemon home up the Fungeh path.  And it feels very humid (it’s about 70%), so not as comfortable as when we were under the cloud cover of rainy season.  But it is a lot easier to dry the laundry, and to go out and walk, and both those are good!

 

And a funny story to end this week - A lady at church told Ellen that she was “looking very good – no wrinkles!”  This does not seem to refer to the face here.  In fact the comment seemed to relate to Ellen’s aerobics class – so we decided it means no rolls of fat!  So I am continuing to go to aerobics in hopes of avoiding “wrinkles”

Since I still can't get on the net from my own house, I'm sitting on the veranda of the other end of the duplex.  This is grasshopper season - big, slow, rather stupid grasshoppers, that people catch and fry and eat.  Yuk.  I'm told they are delicious!  The neighbour kids are all out hunting and putting them in plastic bags - even the 5 year olds.  So several of them have been here on the step with me, reading what I'm writing, and looking at the photos, hanging over my shoulders as I try to type.  They are cute kids, and fun.  But the grasshopper hunt seems to have won out, and they are gone.  Just me and the bugs attracted to the light of the screen - and it's time to quit and go inside.