Stateside

I'm home! I'm tired, as I expected I would be, and not super motivated to get through all the things on my to-do list today. In fact, I haven't even ventured outside, but that may be denial in action as I come to terms with 5 degrees instead of the 88 degrees I got pretty used to this past month.

The good-bye was tearful as we boarded the SIL plane to begin the first leg of the journey back to Minnesota. Many of our colleagues and friends, and even Saliou's father, were at the airport to see us off and as I hugged Remi and William goodbye, I missed them already. In a few short weeks, I had not only grown to respect and admire them and the work they do so well, I had grown to love them as friends and brothers. I expect another trip to Ngaoundere will be in my future, to go back and see Remi and William, and so many others who have become a part of my life now.

Saliou's father at the airstrip

L to R: Emmanual, Duoada, Bouta Lambert, Saliou's father, William, Me, Remi

The SIL plane touches down in Ngaoundere.

As we waited for Darryl, our pilot to arrive at the airstrip, we were all pretty nervous that he would be able to actually fit all 5 of us and our luggage in this pretty tiny plane. As the plane appeared into view, and I saw how really small it was, I got even more nervous. Darryl weighed EVERYTHING, and we snuck in a few kilos under the limit, and then he magically fit the bags into nooks and crannies, and we got on board. A few last minute instructions about where the machete and emergency satellite phone could be found in the unlikely event that we would be making an "unscheduled" landing, (which only made me wish I had brought some ativan with me) and we were off! It was soooooooo fun!

Coming to Yaounde

Me with Darryl, the pilot, AFTER our smooth and safe landing in Yaounde. It's the first flight that I have been on where the pilot gathered us in prayer before taking off. I was cool with that! And that was before I was instructed on where the machete was located in case of an emergency. 

A view of Yaounde from the lower part of the city.

We were picked up at the small SIL airport (also the Cameroon Air Defense Station) by Felix, the driver who got Jared and I around Yaounde safely on our arrival a month ago. He was wearing his heavy, green, wool army suit, and smiling big. He brought us to Anne and Willie Landgi's, the ELCA Mission coordinators in Yaounde, to hang out until we had to catch the flight to Paris at 11:30 PM. It gave us a chance to take a nap, repack our luggage, have dinner. Felix came back in the evening and proceeded to get us through all 8 or 10 security check points. I think we'd still be there, bribing people to get on the airplane if we didn't have Felix. Everyone at the airport knows and loves him. It was like traveling with Moses through Egypt.

The road outside Anne and Willie's house. This is a totally typical scene, people walking with huge and heavy loads on their heads, like this lady with the suitcase. They must have the strongest necks and backs! 

The view from the other direction from Anne's home. Anne and Willie's home is surrounded by a 12 foot high concrete wall with barbed wire along the top and they employ a 24 hour security guard. Safety and security is really a concern. 

I thought this final posting would have more to it, but I'm finding I'm just kind of depleted today. Pictures are maybe the better way to end. I think back to over a year ago when I came home from a frustrating day at work and happened to read an article in the New York Times by Nicholas Kristof about healthcare in Africa. It was then that the idea that it was time to leave my comfort zone and see something different registered. It's been a series of conversations and connections and timing, on and off and on again, that culminated in what I would count in the Top 5 Most Significant Experiences of My Life.

Luck. Fate. Destiny. Blessings. Gratitude. Peace.

The door is shut and the plane pulls away.  With tears and smiles, I wave until I can no longer see the bright yellow and blue spots that are Remi and William.

Less than 24 hours now

My roomies, Karen and Donna. It's like being back in college!

The ladies and kids of the church. Remi's wife, Anasthasie, is in the red hat next to Donna and 3 of their 4 children are in front, Ghislain in the grey pants, and Lenah and Lyza in the blue and pink. 

I'm mostly organized and packed now, and I'm leaving with less stuff than I came with, but with many, many new friends, and hundreds of memories, images, and stories. We went to the Plaza Restaurant today for lunch, and as we made a toast, I said, "To new friends who feel like old friends." It's true. Everyone at the table I have known for less than a month, but we are forever connected. 

L to R around  the table: Hans Aas (finally didn't get cut out of the picture!), Martha Aas, Karen, Phil Nelson (who runs the EELC Mission Compound and lives in the house right next to ours), me, Donna, June Nelson (married to Phil and is a nurse who works  at the hospital when she's not helping Phil run the compound)

The day started out early with Donna and I joining Remi and his family at the Millenium Church where he is an elder. The church is at the edge of the compound and is huge, made from bricks from the red earth of Ngaoundere, with beautiful stained glass. One of the many choir groups came in leading the elders in song and it beautiful to hear their energy. 

Tomorrow we have one final goodbye at Chapel at 7:30, although from the sounds of the number of people who have told us they plan to see us off at the airport, I'm thinking the final, final goodbye will be as we wave out the window of the little bush plane. I am coming prepared with plenty of kleenex. I will run over to say goodbye to Saliou, who is still in the hospital, before going back home to finish up packing. 

So, my next posting will be when I'm sitting in my own kitchen, looking out at lots of snow, and trying to reorient myself to being back in Minnesota. I'm planning to take the rapid re-entry approach. Arrive in Mpls on Tuesday, back to work on Thursday. We'll see....I've asked my colleagues to have pretty low expectations for my productivity on Thursday. 

I've been looking through my pictures. Here's a few more taken over the past month:

$10 to the first person who can identify what this guy is holding. (Not really on the $10) This is an elephant hide shield that is  (if what he says is true) 1000 years old! This was at the mosque that we toured. For being such a relic, it was just kind of thrown in this anteroom, amongst skulls of cattle and antelope, a few elephant feet, and red plastic coke crates. 

Big football tournament last weekend on the compound.

On my last day, I am finally able to sneak up on a lizard and get a picture. This is a redheaded lizard (I know, self-evident but I did not make this up) and is much bigger than the one that met his untimely demise a few weeks ago. I have continued to give my poor housemate grief about that!

This lady was one of the first patients Remi and William saw about 3 years ago. She was in renal failure and wasn't expected to survive, but somehow, without dialysis, she recovered. Today she looks and feels great. She comes back to see Remi and William often. She told me, "I was as fat as an elephant!" Remi explained she had fluid everywhere.


See you in Minnesota!

Meet Justin

Last day at the hospital: The guys and I put the finishing touches on 2 applications for funding for Remi and William to pursue further palliative care education and training in Uganda, through Hospice Africa Uganda and Makerere University in Kampala. We had one last lunch at my favorite place, The Coffee Shop, (which also gave me one more unexpected ride on the motorcycle--I am going to miss that! Sorry Mom.) Remi and William have introduced me to Smirnoff Ice--kind of like a wine cooler only with vodka. For lunch. So, team at Abbott, don't be surprised next Thursday if I belly up to the round table in the middle of the office with reheated leftovers and a bottle of wine! There is definitely still the French influence going on here, and I can't say that's all bad.

Got home and Justin stopped by and then Paul Haman came a few minutes later, so I was able to finally get some pictures of them, like I've been meaning to.

Justin, Me, and Paul Haman. This is in my backyard--it's really not as lush as it appears.
We are actually standing in front of the garbage dump.

Everyone has a story, and I want to tell Justin's. Justin is 25 years old. He's the kind of guy who's outgoing and always has a smile and wave, but he's also kind of shy and softspoken. He was part of the entourage that went to the waterfalls a few weeks ago, which is when we first met, but I see him most everyday because he is employed by the EELC Mission and is the handyman/jack-of-all-trades, thus, he's my go-to-guy to replenish the toilet paper and matches, fix the water heater, etc. Justin also works whatever extra jobs whenever he can, like cleaning our house. And he's doing all this AND trying to finish his high school education by taking night classes. He had to stop school when he was 15. This will take him about 4 more years. He told me he hopes to go on to medical school someday. 

So, why does he work so hard? Well, his father died just a few months ago and as the oldest child with 9 younger siblings, he is now the head of the household. He himself was in the hospital with an abscessed tooth just before I arrived, and as I have explained before, there's no health insurance here. It's all private pay. Things are beyond tight for him.

We were talking the other day and when I asked him how school was going, he told me it's hard to find the time to do the reading, between having to get up early to walk to work and then when he gets done with school at 9PM, he has an hour-long walk to get home and then he's too tired and falls asleep. He can't really afford the 75 cents it costs to take a moto taxi home. He tells me all this very matter-of-fact. No whining. No trying to get sympathy. No asking for anything. (And it's easy to feel like a human instant cash machine here sometimes. I've had people knock on my door, holding out their health clinic record and asking me to buy their medicines for them.) I told him, "You are juggling a lot of balls in the air all at once." He smiles, agrees, and shrugs.

Donna (my housemate) and I were talking about Justin yesterday, shaking our heads over how so much can fall on one young person's shoulders, and he somehow maintains this gracious composure and resilience, and tenacity in the face of constant obstacles. But I worry about how long he can keep his head above water. You can't help but want to help, especially for a guy who's so sweet, but what would be most helpful for him? As I've mentioned in a previous blog, Donna lives in Sturgis, motorcycle heaven, and her husband is a motorcycle mechanic. They'll both be coming back to Ngaoundere in about 18 months, and they have talked about possibly being able to raise some money and be able to go with Justin to buy a used motorcycle when they return, so he can get around faster and easier, and be better able to take care of his family. This would be a huge thing. Having this possiblity in his future might get him through some tough days. I'm signing on. 

Justin

February 24th

I was a bit late in getting to the clinic today, overslept, having weird dreams, just a slow-moving morning. Today is home visit day, and we usually try to get out fairly early because it gets so hot by midmorning. As I'm approaching the clinic, I catch a brief glimpse of Remi waiting outside the office and I think, "Oh no, I'm holding them up and he's out wondering, where the hell is Kerstin?" So I pick up the pace and rush in to the office, and the first thing I see from the doorway is 6 legs behind the exam curtain at the back of the office, then Remi and William and Donna jump out and start singing Happy Birthday with much more gusto than I could ever muster at 8:30! I am laughing and red and we do a group hug. They are so sweet! 

It was fun to have Donna from Global Health Ministries along on home visits today. Remi and William had to put up with a lot more chatting and stopping to look at stuff than they're used to.  At one point as we were off the bikes and winding our way through very narrow paths and alleys to get to a patient's home, and Donna and I are chatting away. I notice William holds back so he can bring up the rear behind us and he explains that "good men don't leave their women behind, or they might turn around and find they are gone." We are well cared for here! Donna lives in Sturgis, SD, home of the famous Sturgis Rally. Her husband is a motorcycle mechanic, among many other things, so she's at home on the back of a bike. We stopped for gas and started taking pics of each other, her behind William and me behind Remi and I said to her, "We're motorcycle chicks," and she says, "We're the bitches on the back!" She knows motorcycle lingo. 

Tonight, Karen, my housemate, made a feast of meatballs and boiled potatoes, fresh croissants from Solange, the baker, and her new favorite creation borrowed from Jacalyn, avocados stuffed with chopped tomato marinated in fresh lemon juice. I am becoming an avocado addict. Truly, if you haven't had an avocado right off the tree, you haven't had an avocado. Manna from heaven. (I should stop eating them now in preparation for the weigh in for the bush plane.) We had 8 of us total for the soiree--very fun!

So, it was a really nice birthday in Cameroon. Thanks for all the birthday greetings that I woke up to this morning, sent right before you all were going to bed, and for those that came throughout the day. I'm feeling pretty lucky and very grateful. 

Oh, and a political update--nothing to update really. All is calm in Ngaoundere, and it appears this was a one day thing, for now. I will certainly be following the elections this fall in Cameroon! Makes a difference to actually know and care about people here now, and know that they will be directly affected by what happens. It makes me recall a conversation I had with a man a few weeks ago on one of the walks into town with Jacalyn. He and Jacalyn were speaking French but at one point when he learned we were from America, he said, "Minneapolis Minnesota." I could understand that, of course, and I pointed to myself and said, "I'm from Minneapolis Minnesota." Turns out he has a friend who lives in Minneapolis, and I shook my head and said, benignly, "Small world." I was taken aback by his  somewhat irritated response: "Small world for those who have means," and I felt momentarily sheepish. But then I thought, no. I certainly agree that those who have money can certainly do more, see more, travel more. But it is a very small world now. The fact that I am sitting here at 11PM in Cameroon writing this, and you are probably wrapping up your day at home, and you are reading in real time about what's going on on the other side of the world, and there's hardly a person I see without a cell phone here, and there are TVs and satellites in the most remote villages, then I would argue that this is, indeed, a small world, in a very good way. I can easily continue these relationships that have so quickly developed, and keep connected to people who are now very important to me, and I am very glad about that. 

My Birthday dinner with some of the people who are now very important to me:( L to R): Kulsumi (adopted granddaughter of the Aas'), Martha Aas,  the Birthday Girl,  Karen, the chef and feast coordinator, Jacalyn, Hans Aas (mostly hidden) Yurema, who works for the EELC and is a really nice guy.

Yurema and me. 

Kulsumi and Hans. Hans is wearing his brand new, gorgeous embroidered tunic that he bought from the tailor, Aboubakar, the day we went to the mosque.

Tick, tick, tick

I am striking while the iron is hot and my computer is functional for the moment, (again eternal thanks to Daouda!!!!!) And now I can post a picture of me and the guys!

Remi, me, William outside the Palliative Care Office
(Remi taught me, what I call, their secret handshake. I'm feeling like I'm in the club now!)

As many of you have heard and have emailed me about, there were demonstrations today in some cities (not Ngaoundere) in Cameroon to protest the current President, Paul Biya. He has been in power for almost 30 years, another "President for Life" that people obviously tire of after a while. Elections are scheduled for November this year. Rest assured, we have been keeping an eye on the situation. I registered with the US Embassy before I left the states so they know I'm here and I check the State Department website daily at least, and Cameroon is still not listed on the very long list of countries they warn against traveling to. I post this only because the world is small, and information is everywhere, and when people love you, they worry, and I want to assure you all, things are calm here, and plans are on for a Monday departure.

Speaking of departures, I have a really happy update on Saliou. He will be discharged on Friday! I was able to watch his dressings being changed today, the first time since almost passing out seeing and smelling his wounds in his home 2 1/2 weeks ago. The tissue is clean, and granulating nicely (non-medical folks--this means that pink, bumpy, healthy tissue is filling in), with only a smidgeon of bone showing through. He still has a mountain to climb in terms of the wound actually closing, but today I let myself feel some hope that it will. Saliou's father (who it turns out isn't his father, but that's a long story) came to the palliative care clinic yesterday to receive instructions for discharge on Friday. Remi will continue to see him at home and do the dressing changes, which is a huge relief because Remi knows what he's doing and he will be able to act quickly if things turn for the worse.

The day ended with an evening spent at Remi's home for a wonderful dinner with his family and a friend, and William and his beautiful 7 year old daughter. I laughed so hard when I looked up at the TV and it was Bart and Marge Simpson speaking in French. I'm watching the Simpsons in Cameroon!

The group at Remi's house

Remi's super cute son, Ghislain

So many stories and pictures in my head, so many new friends who I will always carry in my heart and miss when I leave, so many old friends and family (and my cat) that I miss and can't wait to see. I want to slow down and speed up the clock at the same time.

My friendly neighborhood artist, Must, who has "new and original" work that he brings to show me about
 every other day. It really is very good, I enjoy his style. He enjoys that I am an easy sell, although I am much better at bartering these days.

Wrapping Up

I return home in less than a week! The sign of a great trip: You can't wait to go and you can't wait to get home! But it will be hard to leave. I told my sister in an email yesterday that I had this pang in my heart as I walked up to the Palliative Care office yesterday and saw William doing the morning sweep of the perpetual dust out of the office and I thought, "Oh, I am going to miss him and Remi so much!" It will be odd to go to my real job and they won't be there. Shannon responded back, "I can tell that Cameroon has got it claws in you." Claws sounds a bit violent, but I would agree, I think I'm a bit hooked.

Yesterday was a very good day! One of the things we have been working on together is figuring out how Remi and William can take this program to the next level. It is clear that they need to pursue more formal education in Palliative Care and receive the credential that will make them the recognized experts in this region. It will also allow for Protestant Hospital to become a clinical training site for other palliative care students. Makerere University in Kampala, Uganda, offers an 18 month long distance learning diploma program for Remi, and several short courses for William in counseling and training. As always, the universal challenge would be funding. We are exploring some scholarship opportunities through Helping Hospices in the UK, and other places and putting applications together before I leave. We met with the CEO of the hospital system yesterday, Dr. Salpou, to review the "state of the palliative care program" and what is needed for ongoing support. The most gratifying development was to get a commitment from the administration to support Remi and William's salaries while they are away for their short stints in Uganda. This is huge! Usually, when staff goes away for continuing education, they do not collect their salaries, making it a very difficult sacrifice for them and their families. The 3 of us left Dr. Salpou's office with big smiles!

So, just an FYI, the pineapple juice spill on my computer continues to cause problems. I am using Remi's computer right now, but I may be limited in my ability to post much more, which really bums me out. Douda, the IT wizard, is looking at it right now, and he is a genius, but we'll see. I really wanted to post a picture of Remi, William and I together. I call us the Mod Squad.

So, the schedule for the rest of the week, in case this is my final post while here:
Wednesday: work with Remi and William and then at the end of the day, a hike up a different mountain with Jacalyn, The Adventurous.
Thursday: My birthday! And there is a big party planned by my pals. Karen is going to find ground beef, (this has been like the search for the Holy Grail for her) and make her famous meatballs and boiled potatoes. Kalsumi, who is the adopted granddaughter of Hans and Martha is coming too and she is going to make Krumkake. Yes, this is going to be a Cameroonian/American/Norwegian birthday party. If I can't be at home with my family, then I can't think of a better way to celebrate!
Friday: a final good-bye lunch with Remi and William. : (
Saturday and Sunday: who knows....Pack up stuff and make sure I don't weigh too much, luggage and body, to get on the bush plane on Monday.
Monday: take off in the SIL Bible Translator Plane to Yaounde. Spend the day resting and relaxing at the EELC Mission House and then our flight to Paris leaves at 11:35 pm.
Tuesday: Land in Minneapolis at 1pm!
Wednesday: Sleep, sleep, sleep.
Thursday: Return to Abbott. Wow. Seems weird....

It helps to have friends in high places

Another fun weekend! Started out with the power in the entire city being turned off at 8am on Saturday. I guess they do this every few weeks to do repair work, but there isn't any announcement. It just happens and everyone just sort of adjusts accordingly. Soon after, the water went off--dry pipes. Nothing. Luckily, we always keep a few gallons of filtered water in the fridge and there is a community well just across the street with unfiltered water that was built by the missionaries. For many people in the surrounding area, in and outside of the compound, this is the primary source of all their water, i.e. no faucets to turn on, no indoor plumbing, and they walk long distances with large jugs and tanks early in the morning to fill up for the day. Although power came back about 3PM, the water was off until about 9AM this morning. I realized that there are varying levels of "water luxury": being able to drink from the tap is something I'll never take for granted again. It occurred to me that the indoor plumbing we have here in the compound, although you can't drink from the tap, is still very luxurious compared to most people who live in Ngaoundere. Again, very humbling.

Karen and Donna and I went to the Petite Marche on Saturday, which is this large area of shops that tangle around through alleys and backstreets. We were warned by several people that it is easy to get lost inside.

There are hundreds of fabric shops. The colors and patterns are so beautiful. Eye candy.

The highlight of the whole weekend, and definitely on the top 5 list for my visit thus far, was the private tour of the main mosque in Ngaoundere, and being able to meet (briefly) the Lamidot, who is the leader of the Muslim community in the region; sort of equivalent to an archbishop, I think. This was really special--you don't just walk up to a mosque and ask to wander around the grounds, especially if you are a woman. But this is why it is good to know people in high places. Which it turns out, I do.

One of the first  people I met, on my very first walk into town with Jacalyn on my second day here, was Joseph, an embroiderer/tailor that works at a shop on the main road. Joseph is from Ghana and is English speaking, which was nice to be able to have an easy conversation with someone. I also met the owner of the shop, Aboubakar, who's business has been so successful, that he employs 15 people, which is pretty big here. Turns out Aboubakar  is also so successful that he is the Lamidot's private tailor.

The work they do in this shop is really beautiful and I decided that an embroidered tunic and skirt would be my souvenir for myself. It needed alterations, so I've been in the shop several times and have had nice conversations with Joseph and Aboubakar (more of a language barrier but with help from Joseph and others, it works). So on Saturday, I brought Karen and Donna to the shop, and it was really fun to be doing the introducing, rather than always being the one being introduced. In the course of the conversation between Donna, who does speak some French, and Aboubakar, he invited us back to the mosque and the Lamidot's compound today for a tour.

We knew this was a big deal, especially given women are not generally allowed in the mosque. And it is obviously a big deal to be the Lamidot's tailor, because as we walked up to the entrance, horns literally blew for Aboubakar. He arranged for one of the men there to give us a tour of the compound, including a quick bon jour and bow with the Lamidot.

Outside the grounds of the mosque and the Lamidot's compound.

The "band" that was playing as the ministers walked in to see the Lamidot. They are really loud, like your whole body vibrates from the beating of the drums. Note the guy with the loudspeaker. He is chanting/praying/etc while the men are playing their horns and drums and the whole scene is deafening.
I thought, "So you're the guy who wakes me up at 4 am everyday!"

The ministers filing in to see the Lamidot

I, of course, wore my new tunic, which was a way to thank Aboubakar for his favor to us, and a way to show off his work.

Me and Aboubakar at the mosque. Yes, I have my head covered....I would not be a good Muslim.

Below is Joseph, who actually did the sewing of my garment and the design of the embroidery. He told me he had to quit school at the age of 15 when his father left (which here means died), and though he always hoped he would get back to school, he figured out that  that probably would never happen, so he needed a skill and an occupation. He is a really intelligent guy, very sweet.
Also, that's Hans in the middle.

Back in the saddle again

Douda, the IT wizard here has resurrected my computer and I am eternally grateful! He told me it was very sticky inside, and he cleaned it and figured out that the pineapple juice shorted out the IC switch.  That can't be fixed really, but he figured out how I can use it if it is plugged into a power source and may be able to recharge the battery. It is at least very workable, and I owe him big time!

As I used to say to my kids, "You can also learn from other people's mistakes." So, let this be a lesson to you, do NOT have anything liquid in the vicinity of your computer. Really.

The Board of Directors for the hospital is meeting today, so there are many people here from around the region and the world for this. I was invited by the CEO, Dr. Daniel Salpou to join some of the medical staff and board members for dinner last night. Dr. Salpou's wife is also a chef and certified caterer and she prepared a feast that was fabulous; grilled fish and chicken, several fresh salads (the avocados here are to die for), fried plantains and potatoes, rice, couscous, sauteed spinach, and a caramel flan for dessert. It was fun to meet people, and socialize.  We walked back to our house, admiring the brilliant full moon, and picking out constellations. Star gazing here is stellar!

Update on Saliou: he looks better everyday, in large part to the care and attention he is getting now, and has he has even started physical therapy with Madam Danke, the new physiotherapist here. She is married to Dr. Danke, a surgeon from Cameroon who just returned here to practice after completing his surgical fellowship in Germany. (her pic is below). Per report, his wound is filling in. I hope he can stay for a while here, just to give him a better chance for a better recovery. My fear is that he will return home and his condition will deteriorate, just due to the conditions he lives in.

The patient we finally found yesterday. Very end stage cervical cancer. Very little support at home, being cared for primarily by her elderly, frail sister and her son. 

L: the guy who heads up the pharmacy (I think), the patient is someone Remi and William see at home who has a paraplegia from TB, and on the right is Nicole Danki, the physiotherapist. It is huge that she is here. There is a great need for her expertise.

Computer is (probably) dead : (

Well, bad news. My computer is on death row, or probably dead. It's my own damn fault, with a juice spill, not directly on it, but obviously enough splashed into some critical area to cause it to go black immediately, despite my dive to rescue it. I went through all the stages of grief in about 2 minutes: shock, denial, anger, tears.  Then I moved into my favorite life philosophy so many of you have heard from me: oh well. I have the IT guy here looking at it, but I'm not hopeful. Graciously and generously, Remi and William are letting me use their computers, so I may be able to keep posting a few blogs here and there. I have also retrieved that old fashioned method of documentation: paper and pen, so I am still writing down thoughts, ideas, stories.

I am at the 10 days to departure mark--can't believe it. I haven't felt homesick at all, but will be glad to get home. The longer I stay though, the more attached I feel. I expect I will need and want to come back in a year or two.

I had an opportunity yesterday to try millet wine--a traditional drink here. We were leaving a village where we had seen two patients and the woman who operates what could be described as a small business/bar, motioned us in to the hut. OK, this was sort of a stretch for me, but I did try it, and they all laughed. I wish I had snapped a picture.

I thought you all might enjoy my comparison of how men handle getting lost here in Cameroon, compared to men in America. They actually stop and ask for directions! We were seeing 2 patients in a neighborhood on the outskirts of town that Remi and William had not seen at home before. As I have written before, I am amazed that they know where and how to find people anyway as there are no street signs, house numbers, and lots of winding roads and paths. We stopped about 4 times to ask people on the side of the road if they knew where this woman lived, and on 2 of those stops, the guys got on the back of William's motorcycle to take us to where they thought the patient lived. We finally found it and as I disembarked from the bike, I explained that men in the US have a reputation for never stopping to ask for directions if they are lost.  William explained there is a saying here: "The only man who gets lost is the man without a mouth."

Just a few pictures and a (sad) lizard update

I have some bad news about Sali, the lizard (the winning entry coming from Lars). He made the wrong choice when he ventured out of my room and in to my housemate Karen's. It wasn't intentional, more of a case of manslaughter, but when she found him resting on top of her suitcase, she whacked him with a pair of slacks. Sadly, he didn't survive. I really did feel bad. I had kind of grown fond of him.

Not much more to say. Just a few pics:

Me and Saliou. Some very good news today: the hospital is soon to receive a large carton of donated supplies and will be replacing some worn equipment, making it possible to arrange for Saliou to be able to use one of the old hospital beds when he goes home. It will make a huge difference from his prior situation of a thin foam mattress on the floor, both in cleanliness and in his caregivers being able to turn him and change his dressings easier. I told him today that there were many people on the other side of the world who have heard of him and his situation and were wishing him well.

A lady we saw at her home on Tuesday.
She has beautiful eyes.  

These are the medical wards of the hospital. 

Happy Valentine's Day!

(This is a day late posting--spotty internet yesterday)

Hi and Happy Valentine's Day! (or as I tell my children, it is also the "10 More Shopping Days Until Mom's Birthday Day)

The day has flown by! It started with chapel at 7:30 and then I had been asked to give a short talk about my impressions of the palliative care service here. Just like any new service, there is a learning curve for staff about what palliative care is exactly, and who would be referred, etc. It was a chance for me, an outsider, to highlight what Remi and William do, and promote the ongoing development of the service. I think that perhaps my role here is to support connections and partnerships that can be established with the Palliative Care Service here and other programs and services on a national and international level.  Their service does have the potential to become a regional center of expertise. Afterwards, one of the biomedical techs came up to me to share that he had spent 2 weeks at Abbott a few years ago. Small world!

William on the left, Remi on the right with his Certificate of Attendance at a recent
2 week Palliative Care training in the city of Banso. 

I was in a good mood today: I was more open to the knocks on the door and so when a local artist by the name of Must, stopped by to sell his oil paintings and cards, I didn't immediately dismiss him with a "non, bon soir, merci." His work is really very beautiful and I bought several things from him. Although I would love it if there was just a nonnegotiable price on things here, I am kind of getting the hang of bartering and no one here expects that you would pay what they ask for initially. In fact, they feel badly if you don't negotiate, But also, when it's hand crafted and well done, I am very willing to pay a fair price. 

Paul, my train companion, stopped by.  Conversation with him is always lively and diverse. He is the person who got his degree in business administration at Augustana in Sioux Fall and he always has several ideas circulating for entrepreneurial opportunities, so I suggested to him that he get in to the recycling business here in Cameroon. Although plastic bottles are re-used, everything else is trash, burned, buried or piled in heaps along the road. He was actually interested. I also learned from Paul that getting malaria here is kind of like getting a cold. He casually mentioned his daughter had been feverish and that it was malaria again, and that when he wasn't feeling well on the train trip up here a few weeks ago, that was because he had another bout of it. I'm scared stiff of getting malaria! I count the number of mosquito bites I've gotten (3) and take my Lariam religiously. Before he left, Paul reminded me that I promised that I would download "Born in the USA" for him--he talked on the train about that being his favorite song when he was living in Sioux Falls, but he hasn't been able to get a copy. Paul does not forget a thing! Better get on iTunes.

Ended the day by making a huge pot of really good coconut curry chicken and squash stew, so I invited Hans and Martha over for dinner, along with Karen, my housemate. It's nice to end the day with others, sharing a meal. 

Some of you have emailed me asking for an update about the young man with the spinal cord injury and terrible wound on his backside.  His name is Saliou and I have a picture of him below from today. 

Saliou in his bed in the Intensive Care Unit. William at his side. 

Saliou did have surgery last Friday, mostly just to clean out his wound, not only on his butt, but both heels had huge ulcers too from the pressure. The typical treatment, if the resources were available, would be 6 weeks with a wound vac and meticulous wound care, give it time to allow it to heal in some and then see if a graft would be possible. No wound vacs available here though. The surgeons have no expectation that this will ever heal, before he succumbs to more complications, primarily infection. The best we can do right now is to try to get his home situation improved, which would include getting him a real bed off the floor, regular turning so he is not just laying on his back all the time, and regular dressing changes. Saliou is so sweet, so quiet,  and again, like so people I have met here, so gracious. My heart hurts for him and his untenable situation. 

A Wonderful Day at the Waterfall

It was a stellar day! 6 of us got in the Rover and headed to Chutes un Tello for the day. It was, I think-best guess, about 50-60 miles but with the roads, took about 2 hours to get there. Jacqueline who you have met in previous postings was driving, one of her many talents that takes about 95% sheer guts and courage, and 5% total craziness. Hopefully the pictures can speak better than my description.

I can speak about my companions though. Everyday I meet such amazing people, who have such interesting stories. It is so fun how our paths cross on the other side of the world. I am intrigued by what drives individuals, how each of us choose to live our lives, some with more choices than others, some with more determination, some with sheer courage and hope for a better life, a better world.
.

Here's the best picture of all of us. We are situated behind the waterfalls, which is another story.

Top row, L to R: Hans and Martha Aas, Justin, Jackie
Bottom: Me, Mackenzie

You know Hans and Martha and Jacqueline from previous postings. Justin is a friend of Jacqueline's who is in school and is picking up extra jobs around the compound to make some extra money. He loves to rock climb and was always on the look-out for a good wall to free climb. Mackenzie is from St. Paul (small world) recently graduated from University of Chicago and is a Fulbright scholar here to work on her project that looks at a new government sponsored attempt to do large scale corn crops. She has been in Cameroon since October learning the Fulani (?) language, and will be heading to the village in a week to focus on her research project. Her mom worries about her too (a nod to Dar here). (Hey Mom--I shared the story of your giving me the magazine with the blown-up picture of flat worms on it, warning me that this would be just one of the many dangers I would encounter.) 

More pictures from the day: 

The waterfalls from the front. We hiked up to the top of the falls and found a bridge to get to the other side of the river,  then hiked down the other side to the bottom of the falls and then, the most treacherous part, we hiked behind the falls. ( I would always yell at my kids to not climb behind the falls at Gooseberry--and now I was doing it!) It was really slick, with these moss covered rocks and I kept praying that when I put my hand down on a rock to steady myself, that there wouldn't be some inconspicuous and venomous snake coiled up there. Snakes really do freak me out here.  Behind the wide expanse of the falls, there was a powerful backdraft, with the water coming at us horizontally--we got kind of drenched but it felt really refreshing because it was about 77 degrees behind the falls and 100 degrees above them. (Jackie had her handy dandy compass and altitude and temperature doohicky with her.)

Cows we met along the way. Aren't they pretty? They never moo though. A huge herd, and quiet as mice.

Justin and Jackie finding the bridge to get over the river to get to the other side of the falls--yeah! I'm am really glad we found it, otherwise it would not have been beyond Jacqueline to insist that we wade across. I am figuring out that I am  an adventurous FOLLOWER, not such an adventurous leader, and I probably would have done it at her suggestion. 

On the top at the other side, you can see the falls in the background. 

The drive back home. Isn't it spectacular? 

So tomorrow, I am going to the shop that sells beautiful dresses and tunics. I met one of the men who designs and does the embroidery and his work was gorgeous.  Jackie, Mackenzie, and I are going together. If they don't have something "ready made", you go to one of many fabric shops, buy the material and they sew it up for you in a few days. I also need to get a floor mat to do yoga on. I'm kind of in yoga withdrawal, but it is so dusty from the red dirt, that laying on the concrete floor here in the house is kind of gross. 

Oh yeah, lizard update: Thanks for all your suggestions for names. I'm reserving judgement until I hear from my nephew, Ben. However, I have not seen hide nor hair (or scales) from him today. I'm actually getting a bit concerned about him....

Can't believe I am half way through my time here. It is flying by, which I guess is a good sign! 

Ready for a day off....

The dinner party went smashingly! Great food, great company, great conversation. Paul, grew up here and he is so well informed about local, nationals and international politics. I learned so much about Cameroon listening to him talk. My take away is that I really don't want to be here when they have elections again (this fall) or when the current president dies, which ever comes first. Paul does not think this will be pretty. Tomorrow is National Youth Day, but Paul explained that Feb 11th was originally a day of mourning for the country of Cameroon as the country was split on that day. It has been sort of bushwacked to take the attention off the real issue and focus on the kids. I might go to the stadium to watch some of the festivities. Or I might go shopping for this tunic I've had my eye on. Jacqueline introduced me to the guy who does the design and embroidery and they are gorgeous.

Updates on a few patients:

This is one of the original palliative care patients seen almost 3 years ago after he had a stroke. His wife (one of 3) explained he finished his hypertension medicines and then they either had to buy the medicine or food.
His BP was 185/113. 

These are some of the man's 12 children and 30 grandchildren. The little girl in the front was so cute, so engaging, just stood in the doorway to her grandfather's room and smiled and waved. 

The family of the paralyzed man finally agreed to bring him to the hospital today. I got to ride along on the ambulance ride to get him. Don't be picturing those nice, sleek, fully equipped things we have at Allina or HCMC. Picture something maybe left over from WWII. I spoke with the orthopedic surgeon, Falker Roth, visiting here from Germany and he will be seeing him in the OR tomorrow, but is not hopeful that this man will recover and survive from the extent of the wound. He referred to the tough choices they have to make here, and I said, "What choices? They have nothing." His point was that this is the setting where people on the ground, docs and nurses and hospital administrators need to look at their human and material resources and make choices about who should get what based on who has the best chance to survive. If this young man is not going to make it, then you don't put a bunch of resources into his treatment, because in this country, it isn't a philosophical debate. There will literally people who will not get medicines or tests or immunizations because they spent an inordinate amount on this man. Falker said, the best thing to do is provide best supportive care.

I've been asked to speak with the large staff meeting after chapel on Monday to impress upon them the importance of supporting Palliative Care in their hospital. I have so many stories and examples just from my few days shadowing Remi and William that demonstrate the excellent care they provide and the impact on the patients and families. It's the long term planning and sustainability that I see as the challenges they face.