30 posts from 2008

Commentary is on the previous blog.

The blog has suffered in the last 2 ½ weeks from a combination of my burn-out, and too many things going on!  Christmas here unfortunately suffers from many of the bad things of the west – too much commercialism and pressure on people to spend money they don’t have – thefts, drunkenness, violence that always peaks at this season – and an upsurge in the already high rate of road accidents.  The US Embassy sends out an annual warning to their citizens in Cameroon warning them to be especially vigilant and careful, avoiding demonstrating their wealth, being out after dark, and taking taxis.  But it is also a time of genuinely festive celebrations, and we have had a number of these in the past couple of weeks.

 

                  Before I get to those though, we did have rain – 4 days of it!!  This is very unusual – and inappropriate – for this time in dry season.  David from OR is having mud bricks made for a new house;  he ran up the hill to his site the day the rain first came down hard, and was able to cover the bricks already made with plastic – but the water ran under the plastic, and he said the bricks “just dissolved” – 1000 of them.  But, he said, he heard about another fellow who had lost 5000 – so he felt less sorry for himself. 

 

                  OR staff had their morning to sing in chapel in the Christmas music weeks.  We practiced really quite hard on our 3 carols, and I think did a credible job – got off to a bad start on “We Three Kings” and had to start over, but then did great!  It is no easy feat to start on the right notes when there is no accompaniment.  The singing is not my responsibility, and I am just happy to be invited to sing with them.  The music has been really nice each morning; quite a few groups have done African choruses rather than the traditional carols, and that has been great.  As well, the hospital choir put on a whole concert of Christmas music last Friday, even including “Jingle Bells”!

 

                  Last Saturday, the wife of one of the expat doctors put on a Christmas tea for the other expat women.  Almost like home – and lots of goodies.  How to do Christmas day can be a bit of a puzzle on a compound like this, since all the expats are away from their families.  My neighbours in the duplex right now are a retired couple (from 40 years work as a missionary surgeon, mainly in Ethiopia), here for 5 months to help with the surgery – so they and I and a couple and another single woman will have dinner together.  All but me are very long-term (35 years +) in Africa, so it should be an interesting time visiting.

 

                  On December 16, this “anaesthesia” house (that is, this end of the duplex) was formally dedicated to the

 glory of God.  You really only have two choices here – invite a very select group, or invite the whole community.  The latter just was not reasonable given the size of the house, and my budget – so about 20 people came, mainly the anaesthetists, and some other good friends.  We sang as is easy to do here, where everyone has the ability, had a short program led by the head chaplain, and ate.  It was special to me, because this house began last January as a dream, when I realized there was no place for me to live if I returned for a second year, and became a truly beautiful reality, with thanks to various friends at home who helped with the costs, and to Thom and the technical staff for pulling off the construction against all odds.  I ordered food from the kitchen which makes a party like this so easy – and at the end, my five students cleaned everything up while I was saying goodbye to the other guests, divided up the remaining food for those who could use it, and took the dishes back to the kitchen for me.  About as good as it gets!

 

                  And yesterday was the party of all parties!  It was a combined Christmas celebration / retirement for 9 hospital employees, including our hospital administrator, the fathers of two of our anaesthetists, and the expat physio Pat (here since 1973!).  I went down to the kitchen at 7am to see how they could cook (over open fires) for 1000 people.  People had been working since 5am, most of them as volunteers.  My photos are all blurry because of the amount of smoke in the kitchen!  One can only be impressed at what folks here pull off.

 

                  The program itself was to start at 10am (prompt!) so got underway close to 11.  There were MANY people here, from all over anglophone Cameroon, so we kept getting pushed down the benches to get more people in.  I always seem to end up between two large men  - Ellen was sitting in front of me and periodically would turn around and laugh as she watched me getting more and more squished between them.  The program lasted until after 2:30!!  Some things would take me a long, long time to adjust to I think – and the length of time something like this can take is one of them!  Eventually though, all the speeches by every sort of dignitary had been made, the retirees presented, their replies delivered – and we adjourned to the refreshments, which were served in various venues all over the compound to accommodate everyone. 

 

                  Then it was time for the celebrations on the family compounds of the retirees.  First I headed down the highway, probably close to 2 miles, to the Sande compound.  Sande Evan is our youngest nurse anaesthetist, and his Dad is retiring from many years of leprosy work.  The compound was full of people sitting around eating and visiting, while an amplifier played music, and children played everywhere.  The honoured person always seems to be inside the house, so I was ushered in to where Pa (the term of honour for an older man) was sitting and eating, and was sat down right beside him.  I drank my Fanta, managed to beg off eating because I could not face another huge fufu loaf, and then was able to go back outside and greet other people I knew.  This was the first time I’d met Evan’s mother and other family members, as well as his fiancée, so it was a happy visit.  They are a grand family.

 

                  Fortunately the Ngam compound is in the same neighbourhood, so that was the next stop.  Mr Ngam has been administrator at Mbingo for 10 years, a good and humble man of great integrity, with a wife who is a nurse and just a delightful person.  There was another great party going on there – huge amounts of food (the women had been up til 3am cooking), and the venacular church choir members were singing their hearts out, with assorted drums and shakers audible from half a mile away.  Once again I was ushered inside to greet Pa, and have my coke – and when I went out, the dancing had begun.  The singers were now dancing in a circle while the drummers were in the middle, and all the kids (some carrying infant siblings on their backs) were dancing in their own smaller circle in the middle.  More and more people joined in, and finally one of the older expat women joined and pulled me in too.  It was just so much fun – not much to it except moving your feet and going in a circle, but the atmosphere is what is delightful, just the sheer joy of being alive to recognize the goodness of God.  These people really know how to celebrate, and we westerners can learn so much from them!  The sun was sinking though, and finally I had to pull myself away so I could get home before dark.  It’s a stiff climb back up the highway to the hospital – I walked with a couple of fellows from the hospital which made me really trot along up the hill, but finally told them to go on ahead.  By then I was within sight of Mbingo market so I knew I was safe – and I arrived home 40 minutes after leaving the Ngams’, as dark settled in (6:30pm) – exhausted from the day, but exhilarated. 

 

                  That is probably the happiest day I’ve had at Mbingo (where life is often happy).  I’ve lived here a year in total now, and am getting to know more and more people, and getting more integrated into the community.  From working with international students at home, I know how pleasing it is to have them take an interest in our ways and activities – and I really enjoy seeing the pleasure on the faces of friends here when I go to their home or have them to mine, or walk with them instead of finding a vehicle, or join in the singing and dancing.  I will never be anything but western but it is really fun to live in a culture where the gap is not so great but what real friendships can be built across it.  (Photos are on a separate blog)

 

                  And so – Happy Christmas from Mbingo!                 

 

                  

                  Last Thursday my friends Thom and Ellen had another thief at their house, the second time in the last 6 months.  This time it was actually a young man who was living with their neighbours, and whom they had hired couple of weeks ago to work on their yard.  He tried to take Thom’s bicycle – Gladys who works in their house saw him and yelled, and Ben who works at the next expat’s place just down the road heard her and saw the guy run, and tackled him in the bush.  Ben is pretty small and walks with a limp from a crippled leg – but he has the courage of a lion.  He said the guy was BIG and fought like crazy and tried to bite Ben on the arms but Ben held on – in the end the thief just slipped out of his jacket and left it with Ben and ran.  Gladys had meantime phoned Thom who was in Bamenda – (Ellen was at the school working) – and Thom called security out here, and they alerted all their people, and in minutes the hospital compound was surrounded by people and by vehicles – the thief didn’t have a chance of escape. The jungle network is via the cellphone now, just like at home!  John who makes cane furniture (and was probably working on my 2 chairs at the time!) had a gun (why??? – mercy!) and he caught the guy in the field near the furniture workshop, and when threatened with a gun, the thief surrendered.  Security then took him to the reception office of the hospital – by then Ellen had reached there, to talk to the boy as well as give her evidence – but then the people (not security but others in the office) started to kick and beat the boy – she said it was terrible and she got out as soon as she could so she would not have to watch.  The assistant administrator was already trying to get a vehicle to get the boy off the compound and to the gendarmes in Bello up the road – so he would not be killed on our compound.  In fact he did get delivered safely – but death is the common fate for thieves in this part of the world – if they are caught, the people of the community will kill them.  The justice system here is hopeless – anyone can be bought off – and if a thief goes free, he remains a threat to the community where people have very little security to their houses, no insurance, and only a few possessions which they have obtained with great difficulty.  So it is a cruel system but not completely beyond understanding.  I missed this whole thing – was in OR and never even knew it was happening until I got home in the afternoon and my neighbour filled me in.  Various people have told me that this is the worst time of year – around Christmas – for thefts, violence, and accidents.  Sad.  There are several stories of attempted thefts over the years on Mbingo compound though, and they are all the same – there is always this massive and immediate turn-out of the entire community, bearing a startling collection of arms – and the thieves are always caught.  There is considerable security in living in such a community!

 

                  Today the workmen who built this house  - 34 in all - came for “chop” after they finished their workday at 3:30.  In two weeks, I am going to have a formal dedication of the house, but Thom and Ellen had told me that when they had their house dedicated, so many people came that the workmen arrived only after all the food was gone, and they had to be content with going down to the canteen and being fed there.  So I did not want the same thing to happen.  The party really was pretty easy for me.  Ennis the foreman on this job, did the organizing for me – bought 3 chickens, delivered them to the canteen with whom he had arranged the cooking of not only the chickens but also fufu corn and njamma njamma – and he bought the soft drinks – and the canteen supplied the plastic plates.  Since one eats here with one’s fingers, no cutlery is necessary.  The men arrived, I gave a very small welcome / thank you speech in pidgen, having composed it with much help from my student Grace, Mr Ennis gave a small thank you to everyone, one of the men prayed for the food, everyone filed either to the kitchen sink or to the tap in the back yard to wash hands, and they ate.  Ennis announced that things would be done in order, so two of the younger men served out the plates so everyone would get their share, giving plates to the older men first, then the younger.  The caps of the drinks were removed with teeth!!  In the end, the dishes were all piled up, and the place was left in order, and men just got up and left as they finished.  The plates were a bit of a job to wash as palm oil is used in cooking everything and it is very sticky thick stuff – but otherwise, it was about as good a way to throw a party as I can imagine!  These men are very nice, and although quite a few of them were working only during the time I was back home last summer, I knew many of them – and also see a number of them every Sunday in church but did not realize what jobs they did.  So all in all, it was a most enjoyable gathering, and I think they appreciated being recognized for their work.  I thoroughly enjoyed the whole thing.

 

This afternoon we had quite a bit of thunder and it looked like it would rain – a “Christmas rain”, so-called because it is a gift when it comes in December.  But it is now evening and there has been no rain, alas.  It is getting hotter each day and is very dry.  The garden is thriving with frequent watering though – fresh lettuce and swiss chard is a treat every day, and soon there will be beans.  We begin the “Christmas music” in chapel next week – otherwise I would scarcely know that Christmas is coming!!

   There have been a couple of “events” this week that were lots of fun – and generated pictures that aren’t part of everyday life for me. 

                  On Friday, class 6 (the final year) of the primary school put on a presentation of Noah’s ark with puppets and stories.  An American woman has been helping them with English this term, and this was her brainchild.  She is a journalist by training, extremely creative – came with her husband who is a hand surgeon for 3 months here, and brought all sorts of puppets and musical instruments and other props to help with her teaching.  This is so different from the Cameroonian style of teaching which is by lecture and rote learning, right from the 1^st grade.  The kids have had a great time with Marsha, and the presentation was great too.  Since we have a deaf school here too, the deaf kids came over, and there is one picture showing a teacher signing for them.

 

                  Today was the wedding of George, our ortho nurse in OR, and Hilda who works in pharmacy.  It was sort of an OR party – the best man Amos is another of our nurses and the groomsmen were both anaesthetists – Julius my student, and Sande.  And most of the OR staff were there.  The wedding started just 15 minutes late – but it lasted almost 3 ½ hours in the church – and then food to follow.  Although the church was only 1/3 full when the wedding party entered, by the end of the service, it was overflowing.  The ushers deal with this by commanding people where they will sit, and shoving a large number of bodies into each bench.  I spent the last 2 hours of the time squished between two quite large people, fortunately both my friends, but it was still claustrophobic!  The fun part is the presentation of gifts – everyone sings,  with the drums of course, and all dance up the aisle to greet the bride and groom who also are dancing – the bride was just having a great time!  What a party!  We ended in the church by everyone singing (unaccompanied of course) "To God be the glory, great things He has done" - and the wedding party filed out.  Then there were multitudes of pictures – and then the food which the women had been cooking all yesterday and last night.  The logistics of making and transporting food for that huge crowd (at least 3 – 400 I am guessing) and have dishes – it’s mind-boggling to me.  It would be hard at home where we have facilities, and cars to carry things, and can rent dishes and have someplace to wash them for reuse if necessary.  The pictures will give you an idea of what it was like.  I had a wonderful time – they don’t have a lot here, but wow, do they know how to celebrate what’s good!

(Sorry - the pictures won't load where I want them to - so this is a bit disjointed)

It’s really dry season.  The temperature is only 24 degrees, but it feels much hotter in the sun which is really scorching.  Thank goodness we are under cloud cover for the part of the year when the sun would be straight overhead (we are 5 degrees north of the equator here).  The humidity is down to just over 70% today, even inside my house where the floor is still wet when I lift the grass mats – from the cement still trying to dry after construction.  I guess I should take the gauge outside and see how humid – or not – it is there.  There is a wind today – typical of dry season – and a heavy haze blocks the view down the valley.  It will get much worse of course, but this must be the start of the dust.  Many people are sick with colds and coughs, and malaria is hitting many people too – it’s the mosquito season with standing water now that the daily downpours have ended.  The clothes dried on the line yesterday though, and one can go walking without fear of a drenching, or being caught on the wrong side of a flooded stream. 

 

                  This wasn’t a great week at Mbingo.  A medical residency began here in July, with two local doctors as residents.  One was expecting her first child, and since she is well known, there was considerable anticipation.  Monday she delivered a stillborn baby – baby fine during labour but she delivered quickly and the cord was tightly around the neck several times.  Care here is not quite like the west but it’s pretty good, with a fetal monitor and all.  So it was devastating for not only Francine and her husband, but for everyone here, especially the midwives, and for the American GP who was caring for her, as well as being her teacher in the residency program.  Over the weekend another staff wife, also well known, delivered a baby at 25 weeks and of course without any neonatal unit, that baby also died.  On Tuesday, a very sick 30-year-old woman was brought to theatre with a perforated bowel from typhoid fever.  She had delivered a baby 4 weeks before, then was unwell and treated with medication but perhaps not the right thing for typhoid.  She must have delayed several days after the perforation before coming to hospital.  My students were discussing the reasons for delay – often money is the issue, and in her case, there would have been costs for a new baby, and because she was sick, the family had to buy “artificial milk” – and perhaps there was just not enough money for transport and for a hospital fee.  Or maybe the family went first to the traditional healer.  In any case, she died shortly after the surgery – and it was probably amazing that anaesthesia got her through it alive.  We have a visiting anaesthetist from US who was quite shocked at the death like this of someone so young – unfortunately, we see it not infrequently, always for the same reasons.

 

                  On the plus side, my friend Comfort had a number of us expats over for supper one night to share her thanksgiving for being alive one year after a very serious illness that almost killed her.  She has terrible allergies to just about every known drug, and must have an autoimmune disorder.  But she is quite a marvelous woman and keeps going.  It was a happy get-together – and very typically Cameroonian, to celebrate with your friends anything worth celebrating.

 

                  Our youngest nurse anaesthetist has just become engaged too, and that is a very happy event.  The whole process of marriage here is complex and I still don’t really understand it all.  The traditional part of his wedding will not be an “event” open to friends, but simply delivery of the bride price to her family – and the public wedding will be the church one, sometime early in the New Year.  Our OR nurse who heads the ortho team is being married next Saturday here in Mbingo – this will be my 2^nd Cameroon wedding and I’m excited about it.  His traditional marriage was while I was home unfortunately – that would have been interesting to attend.  His church wedding will be quite western, if the wedding I attended last year is anything to go by.

 

                  The garden is growing quickly, with small flowers on the Sweet 100 tomatoes, and beans ready to flower.  Gideon mulched it all yesterday with grass, since the sun dries the soil in just hours.  So far nobody has picked me up the requested hose in Bamenda, so I feel like a real village woman, carrying bucket upon bucket of water to the flowers and veges.  I should have just walked to Bamenda and got the hose!

 

                 

 

                  

There is still the sound of falling rain on the zinc roof – not so often now as dry season approaches, but since Thursday evening, we have had a couple of short downpours (the sort when you can’t hear anything BUT the pounding on the roof) and some long gentle rains too.  Earlier in the week, we went 4 days without rain, and with the hot sun, and the light soil, the garden and flowerbeds were dry in no time.  Gideon and I carried many, many buckets of water (I felt like a real village woman) – I hope before the next dry days that we will finally get a hose sent out from Bamenda.  On the other hand, it will be nice to let the house dry out some.  I spent part of Saturday morning scrubbing 5 grass mats that have been on my floors for less than 2 weeks – and were covered with black mold!  The concrete is going to take all the months of dry season just to finally dry out.

 

There is the sound of crying and wailing and singing in the night.  A couple of nights ago, I wakened about 4am, and someone had obviously died and the relatives were mourning.  I am somewhat protected in theatre from death – we do have the occasional one there, but nothing like on the medical wards.  There, so many of the patients have AIDS and resulting complications, and death is an everyday event.  The man who does the stonework here, Pa Amos, a very gentle kind man, just lost his 18 year old daughter.  I remember her coming through theatre for a biopsy of an ugly big tumour on her shoulder, a sarcoma probably – and the poor kid was dead within a couple of weeks.  There is so much sorrow here.  For Pa, he not only lost the child, but now is burdened with a bill that will take him years and years to pay.

 

We do have the sound of crying in theatre too though.  On Thursday, my students and I had just come back to OR after our morning of classes when a woman was pushed in on a stretcher.  She had just been brought to the hospital from a motor vehicle accident.  She had a terrible gash that lifted most of her forehead, and a few other smaller facial lacerations, and a broken forearm.  But she had no life-threatening injuries.  We heard the next day that she was the only survivor of a terrible accident between here and Bamenda.  The vehicle she was in, either a van or a bus, hit a big truck, and 18 people died.  No wonder people always ask for prayer when they have to travel in this country.

 

This week there was the sound of many vehicles coming to the hospital – many with patients and visitors of course, but also bringing an influx of expat visitors.  An anaesthetist, a surgeon, and an orthopod, plus wives, all from the USA, arrived this week.  The expat population is very high now – I have lost count.  It is nice to have people come to help.  It is also a bit of a job to integrate them, especially when the visit is only for a couple of weeks or so.  We struggle to get by when we are on our usual routine; I wonder how many of them feel we aren’t utilizing them very well, after all their effort an expense of getting out here, and it’s true, often we aren’t.  John Mbah as head OR nurse does a great job with all these people who pass through the OR each year, but there is no question, it takes skill and organizing and graciousness.  I’m glad it is his job and not mine!

 

There is the sound of greetings – always, everywhere!  Greeting is one of the central facets of life here.  On Thursday evening, I was invited to the home of the most senior chaplain here at the hospital, who is also my neighbour in Middle Quarter.  He is a very nice gentleman, the father of one of our nurse anaesthetists.  His wife speaks only their own dialect, so she and the daughter and daughter-in-law had eaten on their own, and another young Canadian girl and myself ate with Pastor.  It was the usual fufu corn and njamma njamma – very nice.  It is just that there is SO much, and one is expected to get through it all.  I am always defeated, and come home feeling absolutely stuffed.  The ladies joined us after we’d eaten, along with 2 beautiful grandsons, one 8 months and the other just 10 days.  We held the babies and played with the older, and it was a lovely evening.  It is a touching part of this society that they see it as an honour to be visited – whereas we see the honour more in being invited to another’s home.

 

There is still the sound of the grasshopper hunt!  Down at the yardlight not too far from my house, the kids congregate for several hours in the evening, and they are still shouting and hunting when I fall asleep.  Fortunately the season only lasts 3 weeks or less.

 

This week there were lots of sounds of  “jubiliating” as Obama won the US election.  Many of the fellows in OR stayed up all or most of Tuesday night to listen to the results.  People here are very aware of the importance to all the world of what happens in the US.  Most of them were backing Obama;  they were delighted when Kenya declared a public holiday.  They are also very interested in how an election is held in a democracy, since, although they have elections here, they have never been part of one that was not hopelessly corrupt. 

 

There is the sound of complaint.  We are terribly short of nurses in OR.  Three have moved elsewhere, and now one is on leave, and with no replacements, we do not have a scrub and a circulator to cover the 3 rooms that we have cases to fill.  So the anaesthetists are helping to fill in (it’s universal!!!) – David, one of the nurse anaesthetists kindly offered to scrub one day last week.  The guys are able to do this, because they have all worked for years in theatre and have done all the jobs in past.  This led to a lot of discussion during the case though.  They are my friends now and tell me a lot of things about colonial attitudes that persist to the present, and other things that really irritate them.  I can’t do much about any of it, but I am learning such a lot – my world is constantly being stretched.

And there was also the sound of much discussion this past week too, this time on a lighter note.  My gang got talking about joint accounts for a married couple.  It was really very funny – the girls thought it was the only way, a couple of the fellows were dead against it (neither is yet married).  They always have their reasons, and the arguments are heated.  Julius who is not married then began telling us a whole list of “advice” that he has been given over the years regarding how to conduct one’s marriage.  It was just too funny.  We are now calling him our “man of ideas”.  The group are so much fun, and I enjoy them so much.

 

There is the sound of a new slogan in OR.  We just seem to have had so many issues to deal with there in the past couple of weeks.  Anaesthesia is easy, all this other stuff is hard work.  John one morning came out with “Every situation is manageable!”  and that has become our frequently repeated slogan when yet another problem arises.  I have made it into a poster and it will now hang at the door of the OR.  And almost certainly, the expression is going to be a frequent sound of the coming weeks as well, unless there is a drastic change in life here at Mbingo!!

 

And finally, there is the sound of thanksgiving.  The 6 weeks or so around this time of year, at the end of the big growing season, are the time of thanksgiving in all the churches.  Each Sunday, a different part of the community leads in the thanksgiving (giving the offering), often bringing produce like yams and corn and chickens and even a goat one week (he was tied outside the church and let his protestations be known through the whole service) – and these are auctioned off after the service.  The whole congregation joins in the singing and clapping and dancing up the aisle to the offering container.  This part of Africa is by no means the worst off – but neither do people here have a lot by our standards in the west.  But they do know something about being grateful – and it is neat to be part of their thanksgiving season.

                  IIt’s Sunday afternoon – hot (only 24C but feels hotter) and muggy – there are clouds in the sky, but it is definitely the start of dry season, so whether anything will fall from them is uncertain.  There are hundreds of small yellow weaver birds around in the shrubs and trees.  And yesterday I noticed the white cattle egrets in the trees down near the cattle yard - a sure sign of dry season.  We are going several days at a time now without rain.    This means there is now standing water that is not being replaced on a daily basis – and mosquitoes are around.  I’m trying not to forget my anti-malarials.  (On that note, one of the best things I brought with me is one of those little pills of the day boxes for old folks –  last year was a disaster for remembering whether I’d taken the doxycycline or not on any given day).  The house still does not have screens – I’m really hoping they are done and on soon, because it is too hot to sleep with all the windows closed.

 

                  On Monday, Rene from the carpentry shop brought me a drying rack that I’d asked him to make.  It is a lovely little thing, made without any metal parts, of – naturally! – oroko wood.  When ever in my life will I again have a tropical hardwood clothes drying rack!!  Apparently one of the career missionaries years ago brought a rack bought at Walmart and Rene copied it in wood, and has been making them for Mbingo folks ever since.  I should not need it much more this season, but when the rains come back in April, it will be an essential in the house – clothes almost never get a chance to dry completely in one day outside.

 

                  In OR on Monday, our first patient was a 5 week old baby with a bowel obstruction.  Fortunately for me, Sande, our youngest nurse anaesthetist, has become very good with the small babies, so it really was his patient.  Grace, my student, did a lot of the work and did pretty well, for her first tiny one.  The child had Hirshsprung’s disease of his colon which had to be completely removed, so he has an ileostomy, and I hope will be ok with it – it is not quite the same here as in the western world.  He was a rather different looking tyke, with a long face – but when I went to the ward later to see him, he was lying by his mom on the bed, both of them sleeping, and he was JUST like her!  She perhaps has some Arabic blood.  He is just the cutest little fellow, and seems to be doing well over the past week.

 

                  Friday started as a big catch-up day.  Our slates are not very well organized, and we were so backed up.  This is terrible for patients who have spent  every bit of money they can earn, beg, or borrow to pay the surgical fee, and then they and their carers still have to eat for all the days they are here, and it is not cheap.  We had our first patients already in theatre when we were told that there was not a bit of morphine or other narcotic in the hospital.  Central Pharmacy which is in a town way down south had been warned a week ago, but nothing had arrived.  So – hold everything!  We did a few small cases, but otherwise it was a wasted day.  There are so many frustrations here – to get everyone on the same page seems almost impossible.  The day ended on a much happier note though, because 8 beautiful little monitors – for blood pressure and oxygen saturation, and one even for EKG – arrived from Dr Lees in Glasgow.  She has been in Mbingo more than once, helping to teach previous classes of anaesthetists, and she had found these being discarded by a Scottish hospital that was upgrading.  They are just perfect for us here – and we were desperate for them, being down to just 2 aging monitors for 4 OR tables.  A great gift.

 

                  Yesterday morning I went to market with my Cameroonian basket / backpack.  It provided a source of entertainment and amusement for a lot of people in market, but it worked well for carrying home by produce – easier than a heavy bag weighing down just one shoulder.  The rope shoulder straps do cut in a bit, but most of the weight rests on one’s lower back so it is not too uncomfortable.  Giideon says I have become more or less a Cameroonian – but I think it is still “less”.  I still live with way too many luxuries that I am not at all willing to give up!

 

                  There are now 3 garden beds planted with lettuce, beans, tomatoes, swiss chard, a few peas, cucumbers, and carrots.  Things germinate in just no time, with a stable temperature around 20 degrees day and night, and enough moisture.  Gideon has also done a lot more work on the flowerbeds and the rockery looks lovely for people going by on the path.  When I came back, I brought cabbage seeds for Gideon’s wife, and last weekend she sent about 20 seedlings down with him – (a 4 hour walk from up in the hills) and he planted them in the rose bed when he came to work on my compound Tuesday.  They seem to be taking root, so we hope to have cabbages (in abundance) before the roses really get growing big.  Last year a number of things in the garden got diseased and were a disappointment, but I do hope for some good produce this year – especially some greens which I badly miss.

 

                  Yesterday I sewed the curtains for the 2^nd bedroom, finishing off that sort of work for the house.  I borrowed Ellen’s sewing machine, and a transformer.  Electricity here is a menace, as there are both 220v and 110v lines around the compound.  My dread is that I will get confused – and for one awful moment, I thought that I had blown the insides out of her lovely little machine.  I called her to check on how I was plugging the machine into the transformer, and I know that her first thought too was that her machine was dead!  But all was well, and the curtains are done. 

 

                  Grace’s husband was able to take a couple of days this past week and come down from Oku to see her.  As is the polite custom, they came to greet.  Both my girls are married to very nice men, who are most supportive of their  wives’ endeavours.  For anyone who donated to the fund for the students’ 2^nd year here, I wish you could have seen his face as he tried to thank me – he says he just does not have the words to express the joy in his heart – and  I don’t have words to express to you either what a significant difference some Canadians have made to some people out here.  So thank you once again!

 

                  

 

                  

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.