31 March 2011

A Blinding Light

I don't normally see patients on the OB ward.  Okay, so really, today was the first time.

Our visiting OB/Gyn approached me this morning and asked if I'd check out one of her new momma's.  She gave birth a week ago and hasn't been able to walk since.  So, I grabbed a translator and headed to OB.

Expecting the patient to be in bed, you can imagine my surprise when I found her crumpled over on the floor.  Now at home this would be an incident . . . it would involve a crisis team of highly trained professionals scooping the patient back into bed and praying no law suit would follow.   Here's it's an eval opportunity (and not to worry, she had been on the floor using the bedpan and just wasn't able to get up) and so I joined her on the floor.

Thanksgiving . . . A Little Early

Okay, time to be transparent.

Not going to lie . . . while I manage to find a lot of humor in my everyday life and I share many of those funny and interesting moments with you, in the past six weeks since I've arrived here in Galmi there have been just as many (some days it feels like more) discouraging, frustrating, and perplexing incidents that I often keep to myself.

30 March 2011

It Takes a Village

. . . to do crutch training.

One of the patients I've been working with for a while had a complication which resulted in the amputation of his right leg, just below the knee.  Before the amputation he had reluctantly agreed to walk using a walker.  Since he'd been in bed for nearly a month without getting up he was really weak, and the burns on both of his legs resulted in reduced movement of joints and immense pain.  Every day that he'd walk with the walker we'd have an argument first . . . which, considering he speaks no French and I no Hausa, our arguments were more like a game of charades.

29 March 2011

Not So Great Expectations

I'm a firm believer that disappointment is directly linked with expectations.

If I had expected a MichaelPhelps worthy swimming pool, I would have been disappointed when I arrived in Galmi to find a 4 foot-deep-in-the-exact-middle-but-mainly-it-comes-to-my-waist-oversized-kiddie-pool.

28 March 2011

I Give Myself Points for Trying

During the orientation last week in Maradi, we had a few sessions on Understanding Nigerien Culture (and I confess, I'm going to need MANY more!).  The last one was with the Personnel Director of our hospital, and it could have gone on for days.  What a wealth of information!

He started the discussion by pulling a Kola Nut out of his pocket (you'll remember my first introduction, just last weekend at the biki).  With this, he introduced us to the Nigerien way of Making Friends and Influencing People: the goro.  Giving a goro to someone is a symbol of 'good news', so they are often handed out not only at bikis and wedding receptions, but also as the invitation to such events.  Kola nuts are very common goros as are pieces of candy or bubble gum (talk about cutting down on the cost of wedding invitations!).

26 March 2011

Drive-By Shootings

No!  Not THAT kind of shooting . . . I live in Galmi, not The Bronx!  These were all taken from the bus window on the drive to and from Maradi.  Thought you'd like to see the view.
The round domes on the left are used for grain drying and storage,  on the
right children draw water from the local well.

24 March 2011

A Visual Perfume Shop

When I was in France, my very dear friend forced me to go with her to Sephora . . . a grand magasin for makeup and perfume.  We made it about three steps in when the nausea hit . . . another two steps and the migraine started.  I don't do well with perfume in general, but an entire Champs-Elysées store front wafting of mixing scents . . . well, it gives me a headache just thinking about it.

Shopping for fabric to have clothes made here in Niger has the same effect on me.  Walking into a shop stall the size of a closet that is lined floor to ceiling with clashing colors and loud patterns triggers my vagal nerve and sends my head spinning.  But after only an hour and a half in the fabric section of the market in Maradi (3-4 hour drive from home . . . I'm here for the SIM Niger orientation for a few days) I had managed to find two fabrics for clothing and another two for curtains in my bathroom and kitchen.

20 March 2011

More Random Facts About My New Life in Niger

1.  I have to cook everything from scratch . . . and even the scratch is from scratch.  For example, if I want to make wheat bread, I have to buy the wheat, wash it, dry it, then grind it.

2.  We never know when the electricity is going to cut off . . . tonight I was mid-shower.  Yeah, that's fun.

Mecredi Sans Mots . . . a Little Early

I will be out of town this coming week and I'm pretty sure I'm the only one awake on the compound, which means the internet is functional . . . so I want to take advantage of the bandwidth and upload as many photos as possible.

So, here's Wordless Wednesday on Saturday night (or technically, early Sunday morning).

Qu'est-ce Que C'est, le SIDA?

It was a busy Saturday, here in Galmi.  I just came from taking a few photos at our very first  educational conference (for lack of a better term) for village leaders on AIDS.  HIV and AIDS are growing significantly here in Niger and after many years of a successful HIV treatment and counseling center here at the hospital, the staff have decided to forge ahead with community eduction. 

Today’s session is a bit of a trial run . . . to see what works and what doesn’t.  So far, after only a few hours the buzz is that it’s a great success. 

My First Biki

The guest of honor.
I didn’t know 6:45 existed on Saturday mornings.  It shouldn’t really.  But that is the time that five of us women left the compound to make our way to a home in the village.  The naming ceremony was to start at 7.  
Traditionally in Niger a baby isn’t named at birth.  For the Muslim cultures he or she is simply called ‘baby’ until day 7, when there is a ceremony and baby is given a proper name.  For the Christian community, they are a little more flexible with the date and seem to prefer Saturday mornings so that those working at the hospital will be more likely to attend.

19 March 2011

I Don't

Well, it’s only taken a month, but I received my first legit offer of marriage today . . . in the middle of a therapy session.  I’ve had a patient arraigned during a session once . . . but, a proposal, this was a first.  
It was my burn patient.   Normally, when he’s high on valium (so we can do his dressing changes and stretching) the only coherent thing he says is ‘oui cherie, c’est comme ça’ while I’m his knees and ankles . . . you can imagine the looks I get from the OR staff everyday (best part is, he’s not a French-speaker!).  

17 March 2011

Mecredi Sans Mots

 That's right!  It's Wordless Wednesday . . . well at least it was.  It's just taken this long for them to upload.
The family member of a patient waits to speak with a surgeon
during morning rounds.

15 March 2011

I Say Goodbye When You Say Hello

'Sai an jima!' I said with gusto to the guard at the hospital's back entrance this morning.  He stared at me, puzzled.  As did the three random Nigeriens sitting around nearby.  It was 7:30 in the morning . . .  and I just told him 'See ya later!' as if I was heading home for the night.  'Uh . . . Ina . . . Ina . . . INA KWANA!!' (good morning) I managed to finally muster.  They all laughed at me . . . I mean, with me.

Niger in the News

The ballots have been counted, and a winner announced!  After more than a year without a president (the former president was ousted in a coup when he exceeded his legal term), it has been months of preliminary elections.  Saturday was Election Day, and the first news reports are announcing Mahamadou Issoufou as the winner (and if I've got my candidates straight, he is from our region).

Check out the story:

BBC: http://www.bbc.co.uk/news/world-africa-12737230
Business Day: http://www.businessday.co.za/articles/Content.aspx?id=137193
Times Live: http://www.timeslive.co.za/africa/article966471.ece/Opposition-leader-Issoufou-wins-Niger-vote
Washington Post: http://www.washingtonpost.com/wp-dyn/content/article/2011/03/14/AR2011031401492.html
France24: http://www.france24.com/en/20110314-opposition-leader-mahamadou-issoufou-wins-presidential-election-niger

13 March 2011

Back at the Kids' Table

During church this morning there was no power.  Which means no fans.  After about 10 minutes, my skirt was so soaked with sweat I felt like I had wet my pants (but I didn't . . . I PROMISE!!).  After 20 minutes I had drunk 3/4 of my water bottle, and after 30 minutes I considered going home, unsure of how much more I could take.

I had determined to make it at least through the first half of the sermon . . . or at least the last quarter of my water before leaving.

But I never got the chance.

12 March 2011

Good at Drawing a Crowd

Yesterday was a good day . . . busy, but good.  Thursday had been rough . . . really rough, but Friday redeemed the week (mainly it was because I got to watch a birth . . . pretty messy and gross, but REALLY, REALLY amazing!  One minute momma is fat and the next minute there's a brand new little life with ten adorable toes and an unforgettable scream . . . INCREDIBLE!)

Yesterday was also unusual because I didn't get to take my 1-3ish break . . . things shut down here daily at that time because it is just too hot to move.  But I was up in the OR seeing patients all morning and didn't notice the time until it was 3:15 (thank you Lord for an air conditioned OR block!!).  So after a wrestling match with a pair of crutches at 4 (that ended with a saw and power drill), I went home for a much needed shower.  At 6:02pm my phone rang.  There's a patient that needs crutches.

Learning to Get Out of the Box

One of the hardest parts about living and working abroad is having to make oneself fit in a new cultural context . . . especially as a woman . . . and a single woman at that, in a setting where a woman's position is given by being a wife and her value determined by how many children she has.

On one hand, it's exciting to jump into something so new . . . to learn new things and meet new people.  But when staying for a long time, the beginning comes with different challenges than when just passing through.  Strangers and beginners are often given much grace when messing up, but some of those mistakes can have lasting effects . . . first impressions are first impressions, regardless of geographical location!

10 March 2011

Language Learning . . . Take Two

It's 4am in Niger . . . I've been up since around 2 . . . unable to sleep because of the heat, I turned on my air conditioner . . . tried again, but to no avail.  So, what does one do at 4am in Galmi??  Write a blog post of course!  (Hey, I find it therapeutic!)

After a year and a half in a classroom studying French, my brain needs a break!  The hard part is, that while I can communicate with the nursing staff and most of the hospital support staff, I cannot effectively communicate with my patients sans translator.  So I've begun some 'independent study' to try to make sense of the Hausa language.  (I keep reminding myself that there was time in the very recent past when French was still unintelligible noise . . . and just yesterday I had a meeting with the hospital administration to explain who I am, what I do, why I'm here, what I foresee the therapy department looking like, my goals for the next two years, along with their expectations and desires . . . TOUT EN FRANÇAIS!)

09 March 2011

I Get By With a Little Help From My (New) Friends

My new job requires A LOT of creativity.  It also requires A LOT of outside-of-the-box thinking . . . research . . . problem solving . . . making something from nothing . . . and asking those who know more than me.  Good thing I'm an Occupational Therapist, and all these requirements sort of come with the territory!

On top of seeing patients with diagnoses I've never before encountered (today's newbie Dx was: multiple upper extremity fasciotomies for compartment syndrome secondary to a snake bite . . . I finally know why I can say 'thank You, Lord, for the scorpion!' . . . yesterday's was: camel bite on the hand--NOT PRETTY!) I'm still hangin' with my new buddy Ï.  . . . the little guy learning to write left-handed.

08 March 2011

Not For the Faint Of Heart

Disclaimer: if you have a low tolerance for blood and guts and all things yucky or a highly sensitive vagus nerve (that stimulates the gag reflex) continue reading AT YOUR OWN RISK!  This post may not be pleasant . . . don't say I didn't warn you!

When I tell people that my diagnosis of preference to treat is burns I usually get the same response: HOW CAN YOU DO THAT?!?!  I don't know what it is, but it's one of those areas you either love or hate . . . like psych.

07 March 2011

Vive la Mode!

Everywhere you go in the world there is a new definition of 'style' . . . and Niger is no exception.

Now I tend to be a pretty basic dresser . . . nothing too flashy . . . nothing too fashionable . . . basic black and deep solids (like navy, royal blue, aubergine, deep red, etc).  Unfortunately simple, solid, and basic don't fly here.  The bigger the print, the louder the pattern, the brighter the colors, the better!

04 March 2011

A Somber Morning

On my way into work this morning, I was informed that the 5 year old son of one of the men who works in the workshop died unexpectedly this morning.  Yesterday this little one appeared to be very healthy, in fact, it was his baby brother who has been sick for months, but he's been very well . . . so well actually, that when the doctor read his chart, based on the child's weight he was skeptical that he could actually be five . . . as most 5 year olds that are treated in the hospital are severely malnourished.  He had diarrhea throughout the night, and by 6am this morning had died from septic shock.
Because of the extreme heat here, there is a very small window of time for a burial.  So while we were at Friday Morning Staff Devotions, a coffin was being prepared at the workshop and a hole dug at the cemetery.  

Scorpion:1 Deb.:0

That's right.  The sucker got me!  So much for thinking he was gone.  When he disappeared, he must have fallen onto my skirt.  So a little while later, when I went to sit down, I was met with the sharpest pain I've ever felt.  He stung me on the back of my knee . . . just at the top of the gastroc muscle.  So it burned when I stood still, and every time I would take a step it was as though someone had rammed a steak in between the muscle fibers.  EXCRUCIATING!!!!!

Once I realized what had happened I stripped off my skirt and managed to find a pair of shorts.  I hobbled over to my neighbor's and whimpered like a little girl.  Thankfully she knew what to do: ice, then find a doc who could give me a shot of local anesthesia and adrenaline.

No One Said Anything About Scorpions

Okay, so that's not true.  I knew there would be scorpions in Niger . . . but in order to get on the airplane back in February I had to tell myself I would never see them.  Like spiders, we would be able to exist peacefully . . . they'd agree never to enter my house and I'd pretend like they don't exist.  Well, today, one broke our truce.

I was just standing in the kitchen, pouring myself a nice tall glass of ice water.  As I was pouring, I saw out of the corner of my eye a little tan blur on my blue scrub top.  I looked closer, and there, perched on my right breast, was a baby-sized scorpion smiling up at me.

03 March 2011

Left Handwriting 101

One of the ongoing obstacles that we face here is a delay of treatment.  Often, our patients will come to the hospital after several weeks or months (sometimes years) of the onset of their illness or injury.  There are many reasons for the delay: distance, finances, hope that they will just get better (insha allah -- as God wills), and traditional medicine.

Traditional medicine in Niger can include herbal medicine, incantations, 'bone-setters', divination, and mediumship.  What we often see in the hospital are complications, infections, and secondary affects.

02 March 2011

Cultural Differences in Value

Everyday I learn something new.  Somedays it's even several somethings.

This morning my lesson was: Value has a cultural context.

For the YAMmies

This morning, at 2am local time I had a nice little skype chat with the FBC Young Adults Bible study.  One of the things they asked me to share was a 'funny story.'  Lets just say, the only part they found funny was at the end when I said 'Well, it was really funny for me.'

So, in an attempt to redeem my story-telling abilities, here's a new one for you.

01 March 2011

Random Facts About my New Life in Niger

  • I wash my feet at least four times a day (minimum).
  • I have fallen in love with my daily siesta when it's just too hot to do anything but lay still (and they tell me it's only going to get hotter).
  • I don't care if my clothes get wet . . . it actually cools me down . . . at least for the 45 seconds before it all evaporates.

Untitled (I have nothing clever today)

One of the tricky things that comes with keeping a blog like this is knowing how much is okay to share 'with the whole world'.  I have so many stories (already in just a day and a half) about patients that I want to share in order to paint a realistic picture of the ins and outs of life here, but they aren't necessarily my stories to tell, nor is this necessarily the best venue to share everything.

So I'll tell you what I did this morning.  After rounding with our chief of surgery, he asked me to see two patients in particular: a guy who just had a flexor policis longus (one of the thumb muscles) repair and another guy who was severely burned in a motor vehicle accident about 11 months ago, and is now here for another contracture release surgery.  I was reluctant to see the guy's thumb, as his diagnosis didn't fall into my will-see-in-the-first-six-months diagnostic categories . . . but I have issues with boundaries, especially when those diagnoses have names, faces, and contexts.  So I caved . . . but hey, sometimes rules are made to be broken.