Wednesday, June 25, 2008

becoming Buya...

So when you have been in a Gambian village for an appropriate period of time (in this case, 2 weeks), the villagers deem it appropriate to adorn you with a proper Gambian names (seeing as they cannot pronounce Sarah for the life of them!). So I have been given my official name and it is no other than....Buya (pronounced 'Boo-ya'). How awesome is my name?! I can't help but laugh every time they talk to me! I may never be Sarah again....I think I have found my true self in my new name =). Jess' name is Binta (not nearly as cool in my opinion).
So...it has been another crazy week! The weekend was nice and relaxing though. We were able to spend the day at the beach one day which was awesome. But the water is so warm here it is strange. You are in the sweltering heat, and then jump into the ocean to cool off, only to be swimming in what we would consider a nice warm bath. Not quite as refreshing as I would like. Sunday we spent the day in our friend Awa's compound, cooking traditional food and playing with her 8 children and sister's children etc. At no point were we not covered with children, babies, and food! There is absolutely no concept of personal space in this country, which I have gotten used to....but can be difficult on the 109 degree days.
Friday night we had a massive storm and many trees and houses were knocked down, so much of the weekend was spent re-building the village. Pretty crazy.
On monday we had the cook-off....american v gambian. It was great fun! We cooked spaghetti and sauce and made a huge fruit salad, and they cooked rice, fish and sauce. before we ate, the drama group did a play on nutrition which was actually fantastic! they covered all the 'public health' messages we would have asked them to and everyone really enjoyed it! they even had a song afterwards all about health issues and the importance of eating healthy now that the rainy season is coming (the time when they get all their sicknesses). After the drama we filled big bowls of communal food and everyone feasted! they seemed to have the best time, although i'm not sure how they felt about the spaghetti!! they have a particular way of eating with their hands here, forming a ball of food between their fingers. i think they were very confused with the noodles and had a very hard time trying to make the ball! it was actually quite comical to watch! the kids loved it though and i got some great pictures of kids covered head to toe in tomatoe sauce! =)
the work week has been extremely successful! We have been trying to figure out a treatment plan for malaria patients for a long time now and struggling to explain that the clinic should not give Chloroquine to the sick patients as this is a malaria-resistant area and that drug will not be successful in treating them. There is a new drug here, called Cloratem, which we have been trying to get into the clinic for a while now. Finally I was able to meet with a community nurse who works for the government here and explain to him the problem. It was so great to finally get to meet with someone who could help me as we have been chasing this problem in circles for a while. He helped me to get the paper work to officially register our clinic with the government so that we can begin receiving Cloratem! I have also talked to the ngo about sending the health care worker here to be trained in the administration of these drugs! I am very excited about these advancements and achievments as malaria is a HUGE problem for this village and many many people have died. Just in the past 2 weeks I believe we have been treated more than 30 patients for malaria and it's not even the rainy season yet! On friday we are going to Gunjur to further confirm this establishment and ensure that our application is received.
We are definitely starting to feel that we are getting some important messages across to the village and that they are excited to have us here and listen to our advice closely on health-related topics. I hope to continue my relationship with the organization and the clinic after I return home.
I saw a very bad case of breast cancer in the clinic this week. The tumour was so large that the breast had hardened and was ulceration and oozing blood and pus. It was very sad to see as I know how far advanced the case was and there was not much to do besides dress the sores and refer her to the hospital (although I doubt they will do anything as it has already metastasised to her lymph nodes).
There has been alot of vomiting babies in the clinic as well, so we are investigating a possible water contamination...
Oh....on that note....I'm sure everyone will be excited to know that I have successfully made the conversion to local 'borehole' water for 1 week now with no stomach problems!! I am very excited and feel almost as though I'm a true Gambian now =)
On that note....I'm going to go practice my drumming (i'm actually getting quite good! =)
Much love,
Buya

Saturday, June 21, 2008

did i mention that it is HOT?!?!

Wow….what a week! Not only has the temperature remained at a constant, sweltering, 105 degrees, but the humidity has risen more than 200% in preparation for the rainy season and it is HOT!!! It’s so unbearably hot that I tend to do nothing in the afternoon but lie around in my sweat-soaked clothes and dream of cool weather. When the wind is kind enough to deem us worthy of a soft breeze every few hours I begin to understand the concept behind polytheism and cannot fathom and god more worthy of worshiping than the god who controls the winds.

Haha….but I am somehow handling it…although I wouldn’t say very well. That all being said, we did have quite the amazing week this week at the clinic and in our health education groups. Our mother’s and babies group this week was quite the educational course, Maureen (the volunteer nurse), Jess and I each gave separate lessons on various health education topics which included games and demonstrations and all sorts of fun! The women loved the games we played and seemed very interested in the topics we covered (nutrition, dehydration and how to make oral rehydration solution, and breast care and signs and symptoms of breast cancer). We are becoming close to them, especially the ones who speak a bit of English, and they have invited us to their compounds for a traditional Gambian meal and a drama next Monday nite. We are also having dinner at the health worker, Awa’s, compound on Sunday and spending the day with her. It’s very nice to start feeling so accepted by the villagers that they are inviting us into their homes and showing us their lives.

On Tuesday night we went out to the ‘futbol pitch’ to play a game of soccer with the boys of the village. It was great fun! Afterwards we held an education class with them about sexually transmitted diseases and HIV/AIDS, prevention, testing, and signs and symptoms. I’ve never seen a more captivated, interested crowd in my life!! They had so many questions, were enthralled by the book of pictures that we showed them, and thanked us profusely, asking us to please come again and again to teach them, saying that they had never heard of any of this before and were so excited to learn about it! Think about how scary it is for these guys when they contract an sti…never having heard of any of this and having no idea what’s wrong with them!! And they were all very excited about condoms and using them! Which is so great to see. I thought that maybe they would refuse to use them or think them weird…but that was not the reception we got at all….they all wanted handfuls of condoms and asked how they could keep getting them when the supplies ran out!!

The clinic this week was quite busy as I believe there may be some kind of stomach bug going around and many babies have come in with vomiting and diarrhea. Oh….speaking of stomach bug….it was only a matter of time right?! I got VERY ill on Sunday…possible food poisoning that I got from picking up a sandwich at a street vender on our way home last Sunday. It was miserable!! I was vomiting from both ends all night Sunday. So weak I could barely move, and couldn’t even get out of bed to make it to the bathroom! Luckily, as my fellow travellers know, the terrible, deathly illness, leaves after about 24 hours of hell and I spent the rest of the week slowly recovering, drinking lots of water and eating bits of food until I was well again. But I have been back in full force the past 2 days, which has felt great!!

So….back to the clinic. This week was kinda crazy bc the guy who runs the clinic felt that it was appropriate to leave the clinic wed, thurs, and fri morning in MY hands when he popped off to a meeting here of there (Jess was ill and so still in bed). So….here I am in the Gambia, after only 1 year of medical school, and I am completely responsible for the health and the well being of every sick villager who comes in! talk about scary!! Luckily I am armed with a few good strong books (mainly…where there is no doctor, great book!). so every time a patient came in, I would asses their problems, listen to their chest, take their temperature and then frantically search through my books to see what drug I should dispense for the illness I thought they may have!! It was a pretty intense, humbling, scary experience….I hope that I did an okay job and that people will get better! I made sure to tell them all to come back in 3 days if they weren’t improving…so we will see! One baby had a very nasty eye infection with her eye completely swollen shut. I had to pry it open to apply an eye antibiotic and then force her to take medication while her mom held her. Let me tell you…being a doctor is a scary thing!! Especially when you pretty much have no idea what you are doing and very little resources to work with!! One elderly woman with a history of CHF (congestive heart failure) who I think may have had an MI (myocardial infarction/heart attack) the previous day. She was having pain in her chest radiating to her arms, and numbness in her fingers. I sent her straight away via ambulance to the hospital in Gunjar. And a pregnant woman who I think I calculated to be 38 weeks along, and was having massive pain in her lower abdomen and her blood pressure had risen 22 points above normal. Did I mention that this is scary??!

One thing that was really hard for me this week was a 3 year old boy who came in with nasty cuts all over his back, stomach, legs and arms from being beaten with a stick from his father. Some of the wounds were fresh, but there were plenty of other wounds that were starting to heal and still others that had formed scars. It was so sad to hold this tiny boy and clean and dress his wounds and send him home, knowing that this will just keep happening to him again and again and there’s nothing I can do about it. I was trying not to cry as I cleaned the boy’s soars and he looked up at me with pain and fear in his eyes. It literally broke my heart. I wanted to find out who is father is and go over there and give him a beating of my own!! Pick on someone your own size!! It’s ridiculous what he’s doing to this tiny little boy and I felt so helpless not being able to do anything to help him. He’s come in every day to get new dressings and I have spent much time holding him and hugging him and trying to make him feel loved. I don’t know what else to do….it’s the worst feeling.

On Wednesday we had our girls group for the girls about 8-15 who spend their days caring for the babies of the village. The point of the group is just to let the girls be kids for one day. We played all sorts of silly games like musical chairs (where I had to bang on an old broken xylophone-toy to make the ‘music’), follow the leader, duck-duck-goose and all sorts of other silly games! I had the best time acting like a kid with these girls and really felt quite a bond with them. They are such sweet girls and it was great to have them out laughing and being so carefree when I know they have so much more responsibilities than any girl of their ages would have in the US.

Thursday night was the soccer match of Germany v Portugal an one of the workers (Malang) invited Jess and I to his compound to watch the match with all the boys of the village! It was so much fun to sit outdoors and watch the game with 50 of the village boys all huddled around the small TV. They went crazy when each goal was scored with much screaming and jumping, mocking the ones going for the other side (I was going for Germany). The game was so exciting….3-1 Germany into the 2nd half, when….the president interrupted the program to show a video of himself farming and ‘working on the land’ just like a commoner!!! I couldn’t believe he interrupted the soccer match that he knew everyone would be watching to show off how great he was and throw in a little propaganda!! And the bloody video went on for about 20 minutes!! I felt like I was in Nazi Germany, I’ve never experienced anything like it!! It seriously blew my mind that the government could and would do something like that….

After the match we went to the baker’s house to watch him making the nightly bread. He lines up all the rolls of dough and then throws them into a huge stone oven and fishes them out with a long stick when they are ready. It was pretty awesome to watch and then we got some delicious freshly baked bread!!

Today after work Jess and I borrowed 2 of the organizations bikes and road down the road through the next village to the boarder of Senegal. It was really fun to get out and explore on bikes, never mind the fact that we were literally soaked with sweat!! (Dad, I’m training here so I can beat you when I get home! =) ) What a workout!!

Tonight I think we may be attending a village disco…not really sure what that will consist of…should be interesting!! And tomorrow we’re headed to the beach with Emily and Jemma, the 2 English girls who work here. Should be a fun weekend!! Hope you are all well, love hearing from you!! Much love, Sarah

Sunday, June 15, 2008

the adventures 'upcountry'

so....jess and i thought we'd get out of the village for a weekend and go 'upcountry' to visit baboon island, where they rehab chimpanzees! little did we know what we were in for....17 modes of transportation, 30 hours of traveling, and 0 meals in 3 days, left us more than exhausted!!! after breakfast friday morning, we headed out. it took the average 5 hours to get to town and take the ferry across the river, and then we thought we had a 3 hour bus ride from there. WRONG!! 6 hours later, we were in a small crowded bus with 12 men who spoke no english, it was getting dark, and no one could give us a straight answer on how much longer it would take. we used our peace corps contacts to get more info...only to find out that the 2nd ferry that we need to take to get where we were staying for the night stops running at sun down. so....we were given a village name where one peace corps guy resides, shouted the name to the driver, and were promptly dropped on the side of the road in the middle of NOWHERE!!! luckily, we soon saw another tubob strolling across a dirt field to meet us! brain (our peace corps saviour) works in a rural village in upcountry gambia. and when i say rural, i mean rural!!! there is NOTHING even remotely close to the tiny village he lives in! quite a crazy life...
it being ridiculously hot here, we decided to drag his 2 flat mattresses outside, rig up some sticks to hold the mosquito net, and have a campout! it was quite an experience....very beautiful and very hot!
the next morning, we hiked back up to the road and hitch-hiked to wassou, where we managed to grab a ride down to kuntaur...an abandonded down that consisted of many empty buildings built with good intentions, and 3 fishing boats. after bartering with one fisherman for about 30 min, we were able to negotiate a price for him to take us to baboon island!! finally the moment we had been waiting for....
but by the time we got there, it was 'rest time' (the gambians rest from 12pm-4pm every day because it's too hot to do anything else), so we laid around by the river until 4pm, when they would take us to see the chimps.
and....it was worth it!! it was sooo amazing to see all the chimpanzees in their jungle environment, jumping, swimming, and swinging from the trees grabbing at the food the men were throwing them. they are so human-like it's amazing! and so many babies and little guys! they were so adorable! we went to 4 different feeding sights because the different 'families' or clans live at different places around the island. and they had to fight off the baboons, who kept creeping up to grab their food! it was so fun to see all of them and learn their names, and about how they got to be here and everything. quite the experience! it felt like we were in Jurassic park, and sounded like it too with all the screeching and screaming!
after we left the island, we hitch-hiked back to another little town on the way back to our village where we got very little sleep and got up early to finish our journey back today!! what a weekend!! we are so exhausted, hungry, and dirty!! but it may have just been worth it. that being said, i am NEVER going upcountry again!!
hope you are all well! great to hear from you! much love, sarah

village life has begun....

'Tubob!!!' is all I hear as I walk through the dusty roads of our village. the kids here have become accoustomed to the occasional 'tubob' (white person) roaming around the village, helping out in the clinic and the school. They get very excited at even the sight of a camera, which leads to terrible pictures of squished faces as they all vie for the closest spot to the lense. but they are so great and loving and i have had so much fun getting to know them this past week in the school, and the tough little ones who come in for dressings in the clinic. i clean and dress their wounds with alcohol, knowing full well that if i was in their seat i would be screaming bloody murder....but they just look up at me silently with an occasional single tear rolling down their cheecks. tough little guys!
so....the village life is quite different than anything i've really experienced. we have no electricity, no transportation, but cold running water, which is key in this heat!! when we want to get to town to use the internet, buy anything, charge our camera or phone batteries, attend school classes that we are assisting our peace corp buddies with, or anything of the sort...we have to walk for an hour to the next village where we wait until the bus to town is full (anywhere from 1-4 hours) and then take the bus into town...and it's the same in reverse. So, although we ventured into town 2 times last week, the trips have left us exhausted and so think we may be hankering down into village life a bit more and leaving behind the amenities we have grown so accustomed to.
last week we laid out the plan of the work we hope to do during our time in the village. we proposed a number of health classes we would like to hold and met with the leaders of the NGO and the village council to discuss. many of our ideas were turned down or we had to compromise on our talk because they didn't want us to come into their village and try to 'empower women' or 'make their boys more promiscuous' by offering condoms. the great thing about the latter was that after we left the meeting and went back to the clinic a number of the boys who work with the organization and had heard about what was spoken about snuck into our compound and asked for hand-fulls of condoms!! guess we didn't have to make a public announcement of it after all!!
so we agreed on 2 classes and training the health worker in the clinic. this means that every morning we are in the clinic...which is great fun! we mostly clean and dress various wounds and spend our free time training Yusafa (who runs the clinic but is only trained as an assistant pharmacist). the highlights of last weeks clinic are as follows...
1. boy came in with very bad cut on his toe, and toe nail has to be pulled out and would cleaned and dressed as the child kicked and screamed! i got the fun job of cleaning and dressing the wound while the 4 other workers present held him down
2. 8 year old girl sticks bead all the way in her ear. i tried to flush it out with a syringe, but was too careful and ginger and the bead would not budge. so we all climbed in the ambulance and drove her to the closest hospital where the doc did the exact same things as i did, and out came the bead! i guess i need more practice in ear flushing....
so...other than that, we held our first class of the week!! it was a mother's and toddler's group where all the mom's come and bring their little ones to play. we taught them some fun games to play with their kids, which they all thought we hilarious!! and then we did a little shpeal on health issues in children and when to bring your child into the clinic, when to give oral rehydration syrup, and when to get medication. all the women seemed to be listening intently, but i believe some of the message may have been lost in the triple translation (in our village, some speak mandika while others speak woloff). we offered boaboa juice as a refreshment afterwards, which they all loved...so all in all i would say it was a success. our next class is monday, where we are teaching the mothers about nutrition, when they can tell a child is dehydrated, and how to make oral rehydration syrup at home for a dehydrated child.
the other class we helped out with this week is the peace corps class on 'current events in the world' at the local city high school. it was a fantastic class! all the students were very involved, bright, eager to learn. both males and females voiced their opinions vehemently about democracy, the corruption in the government, what the people of zimbabwe are going through and what can be done, and the violence in south africa. it was great to see the students, especially the girls, speak out with such confidence about what they believed was right and wrong and what they could do about it.
so...that wraps up our first week in Madina Salaam...stay tuned to hear about our terrible disaster of a weekend next blog...
much love.

Sunday, June 8, 2008

Solo in Senegal...

Well, my trip in the crazy continent of Africa began with 18 hours on various planes and in various airports, finally arriving in Dakar (capital city of Senegal) at about 4am. The people not taking the plane on were instructed to de-board and get on a bus to take us to the terminal. There were 5 of us...
So I managed to get into a taxi and tell them the hotel I had picked out of the lonely planet. Only to drive around for 2 hours with the driver trying helplessly to explian something to me in French and me, exhausted and confused, trying to remember the little bit of french I learned in high school to understand just what he was trying to tell me. I suppose we decided that the hotel was 'under construction' and he tried to drop me at a different hotel. Well aware of the many scams I refused to get out of the taxi and demanded he take me to the next hotel in the lonely planet. eventually he did....and the hotel ended up being ridiculously expensive for not very much. I bet about $65 a nite!
after sleeping off my jet lag I decided to explore the city....which was large, hot, crazy busy african city. it was hard to get around as people barely speak any english and my french is so poor. but i managed enough to get a bite to eat and arrange to leave the next day to go to a beach town 30 mins away...hoping that maybe there may be other tourists, or some english-speaking people. I took a taxi the next morning to N'Gor, the small village by the ocean, and a boat out to the island of N'Gor, where I planned to stay for the next few nights while I waited for Jessica to arrive (the girl who I working with in the village). The island was deserted...I was definitely the only tourist staying there, and only about 10 locals were anywhere to be found. it was strange...
but in the afternoon, after school got out, all the senegalese high school children came to the island in boat after boat, packed in like sardines! 100s of them showed up for a swim! and they brought with them a few tourists from europe...who, as i was to find out is why people come here, all had a local boy/girlfriend with them! i started to realize that i was the ONLY tourist on the beaches of Senegal who had not come to particpate in the sex tourism! and the locals thought I was strange for not wanting a senegalese boy-toy while vacationing here. it was all very strange and disturbing. so i ended up spending a few relaxing days on the beach, reading my book, swimming in the ocean, and exploring the deserted island where slaves were once imprisoned before being brought to america. it was quite an interesting experience.
jess arrived on thursday and we started our long journey down to the gambia. after many gestures and my broken french, which was starting to come back to me, we were able to find sept-place taxis (a bus/taxi service) and negotiate a price to take us through the desert to the boarder of the gambia. the journey was quite interesting and ridiculously hot!! we drove for about 6 hours through the desert on sand/dirt roads, passing many random villages on the way. the village houses were mostly huts made of mud and hay, built into mini 'compounds' of family areas, all close together to form a village. in the middle of the desert with little resources around we tried to speculate on how these rural villages were able to maintain the basics of water, food, and health care...
finally arriving at the boarder we had to unload our bags and walk across through customs and passport checks. we then got another taxi on the other side, which drove us about an hour to the river. then we got a ferry across the river into Banjul (the capital city of the gambia), and another taxi from there to the beach area hostel we had chosen to stay at for the next 2 nights. finally arriving, we were so happy to head down to the ocean and cool off!!
the sex tourism is also rampant here in the gambia and we remained the only westerners in our hotel and surrounding hotels without a local boyfriend....and the harrassment is out of control! it's hard because after just 5 days here we have become so hardened and unfriendly to the locals who follow us around....it's very out of our characters and we feel uncomfortable, but have been told by our peace corp friends that it is the only sensible way.
so...through a friend of a friend we ended up meeting a group of ex-pats the other night. they were peace corp volunteers, teachers, and diplomats who have been here for 1-5 years. it was great to meet them and learn all about the country where we will be spending the next month of our lives.
there is so much corruption here....the president has declared that he can cure HIV, asthma, and infertility and so the country need not worry about these diseases. when a UN official spoke up and stated that this could be trouble because it may cause teens etc to be more permiscuous and use less protection...she was given 24 hours to leave the country.
the villages are still very male-dominated communities where the women are not allowed to say no to sex, are circumcised as children, and are often beaten at home. there's also alot of corruption with the food programs, the children are supposed to get free meals at the schools provided by the world food organization, but the head masters are selling the food they get and not giving it to the children. so many are underfed and have kwoshiokor. the peace corp volunteers have tried to intervene by setting up youth clubs to start encouraging the teens to be more self confident and empower the girls. and have begun reporting the food issue to the food organization, but it is all alot to deal with and they face many risks and road blocks along the way. I am going to try and implement the same programs in my village and see what I can do to fight against these problems. i just know that i may need more time to make these changes, one month is not enough. but we will see what we can do....
today we are going to a soccer match of senegal vs the gambia (#1 rivals!) should be a crazy match...
tomorrow we head down to the village where we will be working for the next month. There is no electricity, so I will only be able to update my experiences on this blog on the weekends if we go to a nearby village that has internet. I am very excited about the possibilities to help in the village, but also nervous that there will be too much to do and too little time.
Thank you for all your love and support of me! Can't wait to tell you about my time in the village! Much love.