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.
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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.

Wednesday night

I'm very excited for my first dinner party tomorrow night! I'm having Paul Haman (my angel and navigator on the train trip north) and his wife, Solange, Jaqueline, (my insider guide to all things Ngaoundere), and Martha and Hans Aas, who have been so sweet and encouraging when I come to them with that "deer in the headlights" look, saying for the hundreth time, "I have never seen (fill in the blank)." They have also been so generous with sharing their rides into town to get wine and other essential items and letting me use their washing machine. I am working with pretty limited resources but tonight I made a homemade marinara sauce and just as I was getting it simmering, Hans brought over fresh basil and garlic to add to the mix. I found fresh, really good parmesan in town, so it will be great!

The dry season is in full swing. I had heard about the hazy skies from the dust, and today was the first day really that I experienced it. It's sort of like smog, leaving the mountains in the distance looking foggy and gray.  The mornings start out on the cool and comfortable side, but by 1pm it is HOT, like intense, dry heat that makes you just go into slow motion. It won't rain until April now.

Right away this morning at 8 am, William and Remi and I were picked up at the hospital by the father of a young man who had been paralyzed when the truck he was fixing fell on him. He took us to their home to see this 27 year old guy, knowing only that he was paralyzed and needed pain control and dressing changes to wounds on his back. If I posted the pictures of this man, I would have to preface it with a warning, so I've decided against sharing. Suffice it to say, after 2 hours of changing dressings on this man's wounds, and addressing many other issues, we strongly encouraged the father to bring him to the hospital. Remi is amazing, as is William, as they approach these situations with a calm and accepting demeanor, seemingly unfazed. I told them that I was in awe, total and complete awe.

OK, this is pretty mild, so I'll include it. 

So, to end with the daily lizard report: The lizard was waiting for me in the hallway to my bedroom when I got home today, so he promptly ran directly to my room and under my bed, and then I would find him on the wall, on the bed, on the other bed throughout the day. I think he's under the bookcase right now, but the only light in my room burned out, so I'm literally in the dark except for the light from the computer. We are still both in panic mode when we get close to each other and as much as we try to avoid each other, he seems to always go straight for my feet, then I squeal like a little girl and jump on the bed. I am such a wus about this. It's embarrassing. It's not like he's a cobra or anything. I am accepting suggestions for names for the lizard, but please no Lenny's. Way too predictable and pedestrian.

Did I say that I had made peace with the lizard?

I think I had mentioned my increasing comfort level with the lizard (or perhaps lizards) that consider this home. That was until I came home today and found one on my bed, trapped under the mosquito netting. I shooed him out of my room with a broom and last I saw him, he was hiding safely under the stove. They're not poisonous or anything, but I still don't want to sleep with them.

So, obviously, if you're reading this post, I survived my first day out on the back of a motorcycle without a scratch. (Again, thanks to Michelle!) Remi is a very careful driver, and I think he also knew that I was nervous. It was a breeze though, and actually kind of fun. I also think, if you are a careful driver, it is much safer to be on a motorcycle on these roads than a pedestrian.

We saw 3 patients at home, and did 2 bereavement visits to family. At the end of the day I wondered out loud to William how they possibly find these patients for the first visit. There are no street signs, no house numbers, and there are many you couldn't even get to in something larger than a motorcycle. They get really good directions and the cell phone of a family member who can meet them at a more recognizable spot, then they are escorted in.

The home visits are filling a very critical need here, but they are limited to the palliative care patients. I can't imagine how the people I saw today would be able to make it in to the clinic or hospital in their conditions. Most people get around on foot or motorcycle, either owned or hired, and only the main roads in town are paved. There are potholes here that would make the potholes we complain about so much in Minnesota after the thaw look like little dents in the road.

I am continually amazed at the situations that people are living with. Poverty has a whole new meaning to me. There is not a lot of preventive medicine (any is more accurate), and given the cost, many/most people begin with traditional/homeopathic approaches to treatment, then as they get worse, they come to the hospital in very advanced stages of their illness.

And though dealing with serious illness is obviously very different here than in the states, there are some similarities. We were visiting a patient with very end stage lung cancer. She has a son who is a physician in Germany and he has instructed the palliative care staff to NOT inform the patient or his family caring for the woman that she has cancer. (Sound familiar, team?) Remi talked about how difficult it was to not be able to say anything, when it is so obvious that she is dying and the family is around her bed crying. The son wants to explain things when he comes in April. She will be lucky to make it to Friday, much less April.

I'm pretty pooped today. I'm skyping with Colin in a few minutes--yeah!

This is the Palliative Care office and clinic space.

This is Omar, who is 18 months old. He is quite intrigued by the camera and love looking at his own  picture. We were there to see his grandma on the far right. His mom is against the wall and that's William on the left. 

OK, this is not Cameroon, but I was missing, for a moment, winter in Minnesota, and my most favorite place in the whole world, the North Shore. 

It's like summer camp--sort of.

My new home for the month. It's called the Green House. Not sure why. It's white.

Donna Wright, who has been here several times for Global Health Ministries and is arriving in about a week, described staying in the compound as akin to summer camp and it is a very accurate description. I arrived home from the hospital a bit after 3 and from then on until it got dark, it was a steady stream of visitors. Paul, my guide on the train, stopped by to check in, Solange, the woman who bakes bread here came with her delivery of still warm bread and croissants, Jacqueline stopped by to say hi. A few produce vendors and artists selling their works came by, and the guy collecting money for the hen house tried to get me to donate again, still unsuccessfully.
Tomorrow is home visit day. I will put the motorcycle helmet and jacket donated from sweet Michelle to good use!

This little girl is 11 and fell out of a tree, got a thorn in her heel, which became infected and, from the sounds of it, spread to the heel bone, which has now been removed. She gets around on crutches. 

The little guy in the middle had an inflammatory bowel condition and had a colostomy done some time ago.  He's here now to have it reversed tomorrow. His dad is on the left and William, the social worker I am working with is on the right. I wish I had access to a printer here, because everyone wants a copy of the pictures I take. 

Remi on the left, William on the right. Paulina in the middle is 3 weeks out from abdominal surgery for gastric cancer. She looks to weigh about 50#. When she began to have belly pain in November, she was treated in her village for probable witchcraft being committed against her. Her son is a nurse in the ED here, and when he saw her, brought her to the hospital immediately for care.

OMG, the internet went down! Will life go on???

I probably jinxed myself yesterday when I wrote to several people, "Thank god for the internet!" It went down right after that and has been off most of Saturday and all day today until my one last try right now before bed. Made me think of the South Park episode when the internet goes out across the country and it turns into the “Grapes of Wrath” search for the internet.  Such a dependence we have! The greetings today were consistently, “Hello. Say, is your internet on?”

Today started out with church service. I went with Martha, Hans, and Karen, primarily for the cultural experience and to hear the several choirs there sing. It was packed, and what was most fun was to see very colorful and beautiful dresses on the women and tunics on the men. But it was long and hot and we were packed in like sardines, and of course, I am not understanding a word of it, so when Martha said we were going to scoot out after communion, I was cool with that. I told them, “Well done, just like any Catholic would do it!” You Catholics out there know what I’m talking about, the skipping out right after communion, the sort of “eat and run” approach to the holy day. Gets you a table sooner at Perkins if you can get there before all the other church goers!

OK, here’s how much progress I have made in less than a week:

1)        I no longer turn the light on the kitchen and yell out to the resident lizard that I’m about to enter, which I believed would encourage him to hide from me before I saw him. This doesn’t mean that I enter dark rooms yet, without waiting for the light to finally come on (takes up to a minute sometimes) but passersby won’t hear me talking to reptiles any more.

2)         I keep my backpack and sundries bag unzipped, no longer afraid that Madagascar cockroaches will crawl in and take up residence. For one thing, I don’t think they have Madagascar cockroaches in Cameroon. I’ve only seen one small one crawling up the wall next to my berth on the train in the middle of the night. I had kind of wished I had not turned my flashlight on at that very moment.

3)        I got through today only washing my feet twice!

4)        I know now NOT to give any money to the deaf/mute beggars that knock on the door. They seem to know immediately when someone green has arrived. Also when the guy came by collecting money to build a hen house next to the hospital and had his very official logbook showing me all of the people who had already donated, I noticed there were people in the logbook from 2008.  That must be one fancy hen house to still be collecting money for 3 years later! (No, I did not donate.)

5)        I’ve got the mosquito net process down to science. I think I have not had any mosquito bites either. Seeing that one patient with malaria last week in the middle of rigors quickly convinced me of the benefits of using my DEET. Although with each squirt on my skin I still think “cancer, cancer, cancer.” 

I still am afraid of snakes, but that is a reasonable fear to have here, though they don’t hang out in urban areas a lot. The most common poisonous snake in these parts is the cobra. Today, Jacqueline, the nurse/pastor took Karen and I to Mountain Ngaoundere (see pictures below) and just about the time snakes crossed my mind, Jacqueline says, “You do want to be careful of snakes. They’re  not real active this time of year, but keep an eye out and if you see one, run in the other direction. If you see one coming at you, run very fast in the other direction.” Sage advice. I saw lizards but no snakes, and some really nice vistas.

The day ended at a restaurant Hans and Martha love called the Coffee Shop. It was great and fun to go out. Delayed my having to cook the chicken I bought yesterday that looks very different than the deboned, skinless chicken breast I get at Lunds. 

Miss you all. One of the last things I threw in my bag before I left was a rock in the shape of a heart, given to me by a friend many years ago. It's a reminder of the people who are so important to me everyday, and how much love I am supported by, and how much I love you all.

Thanks for reading and for your comments. It truly helps me process everything I'm seeing and feeling.  Love, Kris/Krisy/Kerstin

Some of my neighbors.
It's cute--there's always 1 or 2 brave kids who venture out and ask to have their picture taken...

...and then they are immediately joined by a bunch of their pals. 

These guys were playing football on Saturday. I was watching from the end field and all of a sudden the ball starts getting kicked out a lot, towards me and I'm running around getting their ball for them, and they're laughing and saying, "nasarra" which means white person. Cute. 

Jacqueline, our adventurous guide in front, Karen in the back. Doesn't Jaqueline look like a modern day Moses?