6 posts from May 2009

              

    This past week was the week of the projects.  I tried to get away from the OR early each day to come home and type, and find references, and proofread, and print off the 5 projects – 3 copies of each.  Since the shortest was 23 pages and the longest 32, they made up almost 500 pages in the end.  It was a huge relief to finish off the printing by Wednesday.  On Saturday, Julius went to Bamenda with them, carefully packed inside my bag that I use for the computer, and had them bound – and they look great, very professional, and we are all just delighted.  I keep going on about these projects, but they have been a big challenge for us all, and in the end, we are amazed that we were able to produce something this good!  The students now will have to present the studies and defend them before a jury on July 3 – but the jury is essentially made up of friends – the head anaesthetist John, a visiting surgeon from US who is a good friend of the OR gang, the principal of the training school, and myself – so I think everything will go just fine.

                  In Bamenda, Julius got money out of the instant teller for me.  This was a new experience for him and I think he was really quite delighted to have done it.  He said it was a technological experience akin to his ride a few months back in the helicopter.  Banking here is not like home.  When I came in 2007, there was an ATM in Bamenda, but it was very unreliable – and of course, I’m never in Bamenda to use it anyway.  This year however, I’ve had Thom get me money a few times, since otherwise, I have to send my money from home to the office of the American mission board chiefly involved with the CBC, they transfer it to the CBC here in Bamenda, and I am charged 5% for the privilege of bringing my money to Cameroon!  Then I have to apply on a Monday to the financial officer of this hospital to withdraw however much I need, and I can pick up the money on Friday, but only by going to the CFO to retrieve my request slip, then taking it to the bursar who will give me the cash.  Since it is quite a trick to find both of them in at the same time, getting money is one big headache.  Hence my joy at being able to find means of getting cash from my account at home.  The other trial is that the money I get from the hospital is always in 10,000 franc notes ($25).  Here in market, it is often hard to even find change for a 1000 franc note – so having small enough money to buy anything is a constant hassle.  How very easy plastic is!!!  We don’t realize how spoiled we are in the west.

                  Today started sunny and lovely, and I looked forward to a quiet day relaxing.  As I walked over to church at 9am though, Thom came up behind me on the quad, coming from the hospital.  Ellen had wakened with crushing chest pain, and was back in the private ward – and things were underway to medivac her out.  Thankfully it does not look from her ECG like she had infracted, and gradually her pain subsided.  They left here about 4pm on the little mission plane that came down from Banso and was taking them to Yaounde, complete with a large oxygen cylinder, obtained with some difficulty from the health center up the road.  (We don’t use tanked oxygen here because it is so hard to obtain).  In Yaounde, a medivac plane from South Africa would meet them, and so  I trust that by now she is in the little portable ICU of the plane and on her way to Johannesburg.  It was a hard day for the people here – everyone knows them and cares for them – but as I think about it, this may have been a huge blessing.  A full day of flying in a commercial jet (which does not have a normal oxygen concentration because it is not fully pressurized) 10 days from now when they were supposed to leave for home, might have brought on this attack, and that would have been far worse.  This episode confirmed the diagnosis too in a way the earlier attack had not – and yet it does not look like she has yet sustained damage.  So we are trusting that tomorrow sometime we will get news from Jo’burg of a happy outcome.

                  

It is 3 weeks since Jan left for home – it is hard to believe the time flies by so fast.  So it is time to get the final installment about our holiday written – and then fill in a bit about what has happened since.

                  Market in Mbingo is always on Saturday (unlike some villages that have a rotating market, usually every 8^th day) – and we were only here for one Saturday.  But we had a good time in market that day.  I bought the shovel blade part of my hoe – I’d bought the wooden handle on another market day from a little boy who had carved a number of them – and the old mamas in market got lots of laughter out of telling me how to use the hoe.  It really is too big for my little garden – it is meant for their “farms” which are large gardens growing corn and yam and beans – but it was worth buying for the mirth it 

created.  Jan bought fabric from the Pa who always comes to sell each market day, and took it to Edith, our seamstress in the hospital sewing room to be hemmed into wrappers for gifts.  And of course we did the usual shopping for produce.  Yesterday I finally kept track of my costs in market – I got a kg of flour and of sugar, a bottle of vinegar, baking soda, plus some veges (carrots, aubergine, tomatoes) and fruit (a pineapple, bananas, lemons)  - for about $7.50 Canadian.  Then I splurged on a new pair of flip-flops for $2.50.  And eggs for the week (10 of them) cost $1.40.  I still need to buy meat, which is quite expensive, and any “luxury” items like cheese, canned veges, lentils, jam, etc from Bamenda, at considerable cost.  But for an expat like me, you can see that life here is very economical.  Still, prices are up quite a bit from last year, and for the local people, whose incomes of course are nothing like those of a North American, food is dear.

              The following Saturday, our youngest nurse anaesthetist, Sande Evan, was married in Ndop, about 50 km to the southeast of here.  A lot of the hospital people went, so Jan and I traveled in the hospital vehicle with a lot of other folk.  Ndop is over some rugged hills, beautiful country to pass through, and down on a large plain, where in fact there are 13 different tribal groups, each with its own dialect.  And I’m sure it is no more than 30 or 40 km across that plain to the next set of hills.  The wedding was the church affair – since Sande and Silvia had already done their traditional wedding, and had their court wedding the previous day.  Marriage here is no simple matter!  They were over to visit me last evening, the first I’ve seen them since the wedding, as Sande had his annual leave – and they both said it was such a stressful day.  There is enormous pressure on young people and their families, from the extended family and community, to have a huge affair to which EVERYBODY comes – and you can imagine the cost involved in this.  The church ceremony lasted 3 hours – and the reception which was in a large hall was still ongoing when we left after about 3 hours there.  So it truly is an all-day party.  It was quite western, with multiple attendants, in very western dress.  But there were lots of African clothes too – and of course the gift presentation was done with everyone dancing in a long line to greet the bride and groom, which is always fun.  But it was a long day, and we were exhausted when we finally got home – the moreso since all the talk in the vehicle coming and going was in pidgen which after a while wears me down – and Jan of course could catch almost none of it.  But it was an experience – and I am very happy to see Sande married to a lovely young woman who will be a good wife.

 

                 We had a day in Bamenda, visiting expats there, and going to several craft shops that have nice quality things made locally, as well as the big market, which is overwhelming – a bit like Superstore is to me at home.  And we hired a hospital vehicle and driver to take us the 40 km up the road to Fundong which is the chief 

center of this area, and site of the government offices.  Unfortunately my photos from that day will not upload, but that was a spectacular trip.  I think of this country around Mbingo as about as beautiful as it comes – but going to Fundong, the hills are even more beautiful.  We can actually see Fundong from the top of the hills right here.  What makes for the distance by road are the valleys in between.  In the 10km north from here to Belo, the road drops down into a deep valley.  Then you climb up to the town of Njinikom which is about on a level with Mbingo.  From there you drop into another very deep valley, on a road that does switch-backs over and over to reach the bottom – and then you have the corresponding climb up the other side.  I was glad I wasn’t in public transport with its questionable safety record – and also glad we had a driver, as it would be quite the road to drive.  It was interesting to be in a town – since there is no town here at Mbingo – and see the stores and businesses.  They are not like at home!!  We did take quite a few photos, and some video too – something one does not do in the cities like Bamenda, where folks are much more touchy about such things.

                  Since Jan has been gone, life has rapidly gone back to the usual here.  We are working mostly in OR these days, with the students doing cases pretty much on their own, and doing really well.  We still have a class day on Thursdays, and a quiz each week for review.  They are almost completed their big research projects so my biggest job right now is to get them typed in finished form – a job, since each is around 25-30 pages.  We were so fortunate to have help from an anaesthetist in Glasgow who had been here with his anaesthetist wife a couple of times in past to help with training.  He has a research degree and has done clinical research for years, and had also helped with previous projects done by the earlier anaesthesia students – so he took our data and did the stats, and emailed us back material that made our projects look terrific!!  We can never thank him enough – there was no way I could have got them through this on my own.

    

              My house seems to be grand central station a lot of the time.  A lot of kids come by each day, and the interruptions when I’m home are many – except in the evening, but by then I’m worn out myself and not too keen to work.  Things do get done, mostly, though, and I have a lot of fun.  Last Sunday, Mother’s Day, some of the bigger (10, 11 year olds) kids from Middle Quarter behind me, and a couple of English med students, climbed Mbingo hill.  The kids love it, and we all had fun.  Parents here seem too busy to do fun things with their kids, and children just love to have attention, and to do things with an adult, even grandmother ones like me.  Today we have another trek planned, for 3pm when it is cooler, and we hope it won’t rain then.

                  I had a small, unneeded adventure this week – an allergic reaction to something unknown, but probably some sort of bite, -  I’m wondering if a spider thought he’d try injecting me with his toxin and then sucking my insides out which I just learned is what spiders do with their prey.  Thankfully the reaction came up over several days, rather than acutely, but by the 4^th day of itching on my arms and neck and face, my face looked like a red balloon.  I am very thankful that I didn’t develop any edema of my airway, as all my students told me I was a difficult airway, as indeed I was, with my puffed up face.  We of course study anaphylaxis (allergic reaction) so I guess I was exhibit A   - they probably won’t forget the look, and it will stick in their minds better than just going over the topic again in class!  I’ve learned that prednisone is a wonder drug, and after 3 days on whopping doses, my head has returned to normal size, and the itching is diminishing.  I’ll look for a mosquito net though as I don’t really want to encounter any more creepy-crawlies of this sort again, sneaking up on me in the night.

                  The pictures will tell more about the last few weeks than more writing…..

 

 

 

 

                 I live in a great place to meet kids!  Behind me in Middle Quarter are many children, the youngsters of various staff members.  Some are older and I see them outside, but don’t have a lot to do with them.  But there is a contingent of 5 2 to 5 year olds who have become my friends, as long as their parents let them loose to roam!

                  As well, the house is on the main path to Mbingo 2, where many staff live – so their children up to class (grade) 6 all pass by my house going to school in the morning (any time after 6:15am!) and going home in the afternoon (from 1:30 to 2:30 depending on the age and grade).

                  Jan quickly became a favourite auntie, especially when kids discovered she had balloons.  Those balloons were a tremendous draw for the Middle Quarter contingent.  And they burst with amazing speed, so many trips back to my house were required to maintain the balloon supply. 

                  Jan came on Monday afternoon.  What she soon learned was that “sleeping in” in Mbingo means not getting out of bed until 6 or 6:30am.  Tuesday morning I had to go to work at 6:30.   Wed morning I think was quiet.  But Thursday am the doorbell (which was designed to waken the dead) rang at 6:35.  That was the papaya salesman, arriving after a 3 hour trek in from the bush!!  On Good Friday morning, the doorbell rang at 6:15am.  And it rang – and rang.  I stuck my head out my bedroom window – and there was 4 year old Fervant.  “Fervant, GO HOME!!!  We’re sleeping!”  “But I want ballou ballou….”  Plaintive look, unbelieving that an auntie can be so bad-tempered and lacking in comprehension.  He did go home, clearly completely devastated.  And when Jan got up, she took apart the doorbell and disabled it – and I am so grateful!

                  Godlove is the ringleader of the Middle Quarter gang.  He is 5, talks constantly (or sings) in a very large voice for a very small boy, is very bright, remembers virtually everything you tell him, and is altogether a real character.  He is usually followed by his little sister Treasure, age 3, who mimics everything Goddie says and does.

                  Last Saturday when I got home from Douala, I was not feeling very well so fell asleep, to be wakened by Goddie at my window.  “Auntie….auntie……AUNTIE……AUNTIEEEEE…. after about 15 tries with ever-increasing volume came “DR MANNING!!!   Dr MANNING!!!!!”  I guess he figured the time had come for some real authority to be exerted to get me to come to the door!  Sunday after church he informed me that he had come to see me, and I had not appeared, so my negligence had been noted and remembered!

                  There is an expression in pidgen that I’ve just learned, to describe an extreme.  I heard Julius using it with a patient who was waking from ketamine anaesthesia, talking incessantly – and he said to her “Madam, you de over-talk!”  Since then I’ve heard the “over-“ term used in a number of ways – very useful!  One day Goddie was leaning in my unscreened window, as the kids do all the time, and he had my hand between his – and he said to me “Auntie, your hand is over-white!”  And then he looked up at my face and said “But that’s because you are a white man!”  It all was so logical.  I have been thinking of that story, and the look of “well, of course!” on his little face, and I start to laugh out loud every time!  He is priceless!

                  One more Goddie story.  All the kids here yell, all the time.  Adults often talk very loudly too, and I wonder if the kids yell because they are always having to make themselves noticed, whether in adult company, or with a mob of other kids.  It is pretty much an “every man for himself” situation, especially for the smaller children.  But I get tired of them yelling in my ears all the time.  The maternity ward is within sight of my house, so I said to them that they must be quieter, or they would wake the babies, and that would not please the mamas.  This has stuck – Goddie informed the others of this this morning, that the mothers would not be pleased with them – and then commenced to yell again immediately.  I guess it is human nature – we easily enough know what is right – but to do it is quite another matter!!  I will keep using the baby story, but I suspect it is futile!

                  The MBH painter, Charles, stopped by the house (which he had painted) to greet Jan.  I think there were kids here then – there usually were with Jan – and he said what is so typically African – that people are the real riches, not money – because money cannot talk.  So it is good to be blessed with the real riches!

The Grassfields area – in NW Region – is, I’m told by people who have seen much of the country, the most beautiful part of Cameroon.  We live at 4500 ft here, which accounts for our lovely temperate (relatively at least) climate, and the relative lack of mosquitoes and other noxious bugs.  Mbingo Hospital is on a large tract of land that was given to the hospital 50+ years ago by the Fon (local ruler) when most of the medical work was caring for leprosy patients.  We are about 40 km north of Bamenda, and 40 km south of the regional center Fundong – on a paved road (since about 1998) that runs up the middle of the “Ring Road” that circles the main Grassfields area.

                  April is probably the nicest time of the year here.  Until a few days before Jan arrived, we were still engulfed in harmattan dust.  And as soon as she left, the mist and cloud moved in and the view once again disappeared, until this afternoon when once again we could see quite a distance.  But for the 3 weeks she was here, the air was so clear, everything had turned green with rain, and we were able to do some great hikes using the African mode of transport (our feet).

 

                 Mbingo Hill, with its sugar loaf shape, is right behind the hospital compound, to the north.  From its top, there is a good view down on the compound, and in all directions as well. 

                  Immediately east of us is another wall of hills; following that ridge, you come to a couple of streams that drop over the edge and form high waterfalls  - they are just starting now but will become quite dramatic as the rains continue and streams grow.  Going back into the hills to the east, you come to Back Valley, which is the end of the hospital property.  My students and I went there last year at the end of our term, and they were very keen to take Jan there before they began their break this time.  I think they do not do a lot of this sort of thing for fun, as adults at least, and they seemed to get a lot of pleasure from the outing.  We left at 6:10am (normal for them, a bit early for a jet-lagged Canadian!) and reached a Fulani compound several miles back in about 3 hours.  There we were invited in to sit and rest – and we managed a bit of conversation in pidgen, in response to their hospitality to us.  Coming back we sat on the hillside for a while near a waterfall, using the binoculars to look down at Belo town, which by highway is 10 km north of Mbingo.  We got home about 11:30, as rain was starting to fall – and had – what else? – fufu and njamma njamma!  While we were eating, the rain began to just bucket down – 3 ½ inches in less than 2 hours.  It was a pretty Mbingo-ish start to her visit for Jan!

                  A couple of days later, we went back up the same path and along the ridge to the big waterfall.  The hospital has a large herd of cattle there, the African type with the long horns, and we met a lot blocking our path.  They look pretty ominous, but they moved away as we came – there was really no option for us, as the cattle were on one side, and a sheer dropoff on the other.

  

                Then we hiked toward the west, to another knob almost as high as Mbingo hill, from which there is another dramatic 360 degree view of the whole area.  We had a beautiful day, and could see so far.  We made a loop back into the valley where the Fulani people live, and then back through Mbingo 2 village area.  As it happened, there had been a cave-in of soil around the start of a water project for Mbingo 2 village and we met our friendThom and some of the workmen there.  Water supply in dry season is a big problem in this area, where there is an ever-growing population because of the hospital providing employment.  But there are many springs flowing constantly out of the hills, and it is a matter of piping it into storage tanks, and building the distribution piping.  The site we saw has a year-round flow of 47 cubic meters a day, which makes a good start on water for the village.

                  Next was a hike that headed south, over the hills to a village back down in the hills, called Baitcham.  I have heard a lot about it, as Thom and Ellen are helping get a church started there, and Thom has been working with the villagers to build a water system, tapping into springs coming out of their hill.  Baitcham is said to be 6 ½ miles from Mbingo, and we were told it was not possible to walk there – but in fact, the path went through very nice rolling farm land (planted with yams, corn, and beans now), and did not fall or climb much until we were almost in sight of the village.  It is deep in a valley, 1500 feet lower than Mbingo (it was noticeably warmer even where we stopped, perhaps a mile above the village) – we decided we would not give ourselves the work of climbing back up that hill.  The views to the south from that path were great too.  And in the forest behind Baitcham, there is no road, and almost no habitation – but lots of wildlife and birds and interesting flora.  But you have to walk and bushwack to see it.  I was happy we got as far as we did.  And many Africans were surprised (and I think pleased) to hear that the 2 white women had trekked there on their feet, just as most of them must do.

                  And as a finale, we went back to Back Valley.  If you go over the hills at the head of that valley, you will (in about 2 hours we were told) reach a big tea plantation, and we had hopes of getting there.  But as is the norm, the instructions we had were vary vague, and we in fact got on a path that kept disappearing.  We compromised by climbing one of the hills at the valley head – to be rewarded with the best view I’ve had here – we could see back to Mbingo hill, and could clearly see Fundong, and the two major villages between.  As well, in addition to the Fulani compound we had visited the previous trip, we saw three more (apparently there are 7 compounds back there in the hills), all in the most beautiful peaceful pastoral settings.  My students had commented that this would be a great place to live to have no traffic noise, and clean air, and that is certainly the truth.

                  We had hoped to see monkeys, which do live back there, but they must have seen us first, and hid!

 

                 And finally, a little episode from one hike that is a 21^st century story of life off the beaten track – I have never seen a Fulani woman on a horse, although the men ride them down from the hills all the time. Jan and I had just been talking about this, when who should ride by my house but a Fulani girl, with her horse led by 2 men.  She got off near here and walked toward the hospital, so our guess was that she was ill.  A few hours later, we were hiking up the path to the waterfall, and met another Fulani woman walking quickly down the hill.  With my feeble pidgen, we figured out that her sister had borned a pikeen (had a baby) and she was on her way to see the babe at Mbingo.  She had this instant news thanks to the technology of the cell phone, certainly!!   So I guess that was our girl on the horse!  (We have been told since that the women do ride when they are back in the hills). 

                  

                 

                 

                  

Where do I begin after 5 weeks of not writing?  The reason for the silence was a good one – my good friend Jan came to stay for 2 ½ weeks, and we had such a great holiday, just around here at Mbingo.  I saw more and did more that was fun in those 2 weeks than in the entire other 14 ½ months that I’ve lived here!  So I’ll divide it up into several blog entries.

                  I’ll start with the end of the holiday.  A week ago, we were driven down to Douala by the CBC driver, for Jan to catch her flight home.  We are an hour from Bamenda, and it is then a 6 hour drive from Bamenda to Douala.  Altitude drops all the way, but about half way south, the road descends quickly in switchbacks down the escarpment of the grassfields region of Cameroon, and then you are down on the plains that lead to the coast.  The temperature rises dramatically there – and Douala is one hot, sticky, big city (about 3 milllion people, we have been told).

                  The plains are quite different from up here – flat of course - with many large plantations of pineapple, bananas (with the fruit encased in blue plastic bags on every tree, to protect from insects, we are guessing), rubber trees, palms for oil and wine, papayas.  All the produce would be for export I think.  But there are local farmers too, so there are many small markets set up along the highway and anyone who goes south tries to bring back pineapple and papaya especially as they are so good and so cheap there.

                  We arrived in Douala at the worst possible hour, 4pm on a Friday afternoon.  There is one bridge across the wide river that runs through Douala.  Ocean-going ships come right to the city, which is Cameroon’s port.  Getting on to the bridge is the first ordeal.  The road from north toward the bridge is the most amazing mess of potholes (we at home have NO reason to complain about our streets, let me tell you!!), so all the multitude of cars and motorcycles are trying to avoid those – plus there is no such things as lanes.  It is strictly every man for himself, and you go wherever you can get ahead the fastest, whether that is on your side of the street or not.  And if anyone hesitates to move forward, he can be sure someone else will butt into the space, however small, and nobody is about to budge for anyone else.  It is quite common to see two cars nose to nose, and neither driver willing to back up – somebody must in the end, but I’ve never actually witnessed this happening.

                  Sitting in the traffic gives time to look around at least, while you swelter, and get dizzy-headed on diesel fumes.  That area of town has a long section of what we named “Furniture alley” – where carpenters build the most enormous easy chairs and couches, and china cabinets too.  All this sits out along the dirty road, and one wonders what happens to the elegant upholstery with the dirt, fumes, and even worse, the rain.  It did pour rain Friday night, and when we drove out Saturday morning, much of the furniture was covered with plastic, some looking very old and fragile, but many sheets had been partly blown off by the strong wind that accompanied the storm.  The other issue is how on earth do people get this stuff home, when almost nobody has a motorcycle, let along a car.  Apparently you just have to rent a truck, which is possible…

                  There are lots of funny signs too.  Barber shops and hair stylist shops abound – for example, Frizy Hair Stylist, God’s Grace Barbering, and Chicago Bulls Barber Shop.  (Our local barber in the market at Mbingo is Adam and Eve Barbing).

                  Taxis and small buses that are the means of public transport all have names too.  I should have a notepad to write names down, as I can never remember them for long – but here the common bus lines are Guarantee Express, and Patience Express (probably more accurate I think).  In Douala I saw one called Family Progress – I guess if the company is thriving, it would mean progress for the family! 

                  When we got near the bridge, there was a very small but very tough looking woman gendarme, directing traffic with a look that would freeze even the most brazen driver.  So eventually we got on the bridge, with one lane going our way – and 2 the other way, out of the downtown.  Motorcycles just went wherever, mostly down the sidewalk, some zigzagging between cars.  On the bikes are all sorts of combinations – often 3 people, or a family of 3 plus a pushcart hanging over the mother’s back, or a driver with his wheelbarrow on behind him, or a very large box for cargo, or various veges and fruit plus a huge wicker carrier filled with chickens (live needless to say).  You can imagine that biking there is desperately dangerous – people are often killed or maimed (virtually all our fractured legs here, and there are many, are the result of motorcycle encounters with cars or buses).   Suddenly Vincent, our driver exclaimed “And WHO is this Big Man??”  Coming toward us was a SUV carrying only the driver, led by a police motorcycle – so everyone in our lane had to go up on the sidewalk to let him by.  How very, very African!!  Then we met a funeral procession traveling the other way (but at least in their own lane) – the hearse, a few cars, and many motorcycles, with palm fronds attached to their handlebars to mark them as part of the procession.  The drivers were shouting and demanding to get through – as though that would be possible….. it did seem like an unfortunate time to plan a funeral crossing of that bridge.

                  As we inched along the bridge, there was lots of time to look at people traveling the other way.  We may have been hot, but in the small taxi vans were an unbelievable number of people packed – it made me think of stories of the cattle cars headed for the death camps.  I could not begin to imagine how uncomfortable they were.  It looked to me like walking was by far the best way to go – but I’m sure many of these people had a long way to go to get home, and a taxi was the only option. 

                  After 50 minutes of inching along, we did get past the bridge and the packed cars, and soon were at the guesthouse.  The street we went to for supper at a restaurant looked modern and very nice – but it is not safe to walk about at all after dark.  So we were grateful to have Vincent taking us to eat, and then taking Jan to the airport.

                  I could not wait to get back up home to Mbingo.  It is very quiet here, with not much to do but work, but it is quiet, friendly, safe, beautiful, and cool – and for me it is far, far better than a big, noisy, dirty, unsafe city!  Maybe the best part of getting out and seeing more of the country is that it makes me so grateful that this is where I work!

                  People are also much more likely to be touchy about photos in the city, so this time there are no photos to show you Douala.