Wow, guys, I'm really sorry I've completely abandoned this. If it makes you feel any better, I only just caught up in my for-real paper journal that isn't even my real journal on Wednesday. And by that, I mean that I got a nice journal to record my journey in, but I got really behind, and so I record notes about everything that happened in a day in this little notebook. Then this little notebook, which I also use for scrap paper, gets passed around among little kids and mango-slimed and dropped in the dirt, and the pages are all affected by the humidity so half the time my pen won't write on it. All in all, my record-keeping... well... sucks.
Almost exactly two weeks ago, we arrived here in Bwiam in the middle of the night. It was very dramatic. By that, I mean that there were BEDS. SERIOUSLY. And TOILETS. And (and this is incredible) one time, the toilet flushed.
We were tossed around in a lot of confusion for about the next five days. We tried to settle in at the hospital quickly by getting an orientation, but here in Gambia, that's not really how you treat time. When it happens -- if it happens -- it happens, whatever "it" may be.
Highlights:
Monday: we were invited to a baby-naming ceremony in the village. In this culture, a baby lives with it's mother in the maternal grandmother's compound (house and yard) for a week before it is officially named. When this happens, the maternal grandparents host a huge party for all the family friends. The men and the women (and most of the children) eat in three separate groups, and we ate A LOT of AWESOME food. We had goat. Later, we had the best chicken we've ever tasted, which we think they killed just for us. We also had a traditional celebratory drink, chakiri, which tastes like sour banana yogurt mixed with cous. I didn't like it and tried to give it to a little kid, but she didn't like it either so I had to drink/chew it all myself. We all had babies dropped in our laps (it's good luck if a traveler -- especially a white person -- holds a new baby) and at the end, we were pulled into the group to dance with the villagers. They laughed at us, because, as most of us are white, we can't dance.
Wednesday: we finally had our hospital orientation. we met with Mr. Badjie, the CEO, first. He's a small man, well-educated in the UK, and we all like him a lot. He's the Steve Jobs of this hospital -- it grew out of and because of him, and if he were to leave, it would collapse. He's also very well spoken. We went on a tour of the departments, too -- the hospital is both better and worse than I thought it would be. It is NOT what you think of when you see the word "hospital." There are goats and chickens and dogs wandering around, and at around 5 in the morning, there are some donkeys that sound quite clearly like they are making more donkeys. LOUDLY. We all hate the roosters. You think, from movies, that roosters crow at dawn and then shut up. THIS IS A LIE. IT IS A FILTHY, DIRTY LIE. ROOSTERS WILL NOT, EVER, SHUT UP. They even crow at NIGHT. We hate them all. However, they are very kang-kang (tasty).
Thursday: we all took an assignment to different departments, and I was placed in Eye/Dental. Which sounded a little boring and potentially very disgusting, but I actually really enjoy it. Here's the rundown of the units:
Dental: there are two dental chairs, one with a modern dental light. Since this doesn't work until the electricity comes on (which is usually does) at 10AM (or around there), the nurses usually sit around talking until then. There's Kaddy, the stylish youngest nurse, who is also in charge, and Fatou, who is older and very nice, and much bigger. She has 7-month-old twin sons, Hussein and Hassan, whom I have not yet met, but I have met Soma's five-month-old. Soma works in eye/dental, but she mostly just goes from one department to the other and talks to the others. She's not an RN -- only Kaddy is, and so she is more of an assistant than a nurse. When we do accept a patient, they file in, we record their name in the ledger, and then we pull out the tooth. Always. Rich or poor, young or old, abscess or cavity or residual roots, all roads end in extraction (sometimes preceded by a 5-day course of antibiotics in the case of a bad abscess). It's intense, too. There's a big curved chisel that they use to work the tooth loose, and then big pliers to rip it out. The pliers look a lot like wider, tong-like wire cutters, but they're actually specific in size and shape for each tooth. Before the extraction, the nurse applies a nerve blocker (painkiller) of 1.8 mL of 2% Lidocaine, injected from one-time-use vials and one-time-use needles into the jaw. As a result, most patients don't feel their teeth coming out. If they have an abscess, though, they feel it, and you can tell, because it looks like it hurts. A lot. (Two people -- one girl who refused an extraction, and one guy who came in for a routine cleaning, which almost never happens, got fillings. However, there are no dental drills to really remove all cavity-causing bacteria, so they will probably need extractions later anyways). Grossest case: a woman wanted dentures because she thought her teeth were ugly, so she asked to have all of them pulled. They hospital will only pull one side at a time, so she had almost all the teeth on her left side pulled out, one right after the other, until there was a little pile of ten yanked-out teeth.
I thought the eye unit would be way grosser, but it's actually just much more interesting. Mariama, the main nurse (who is actually not an RN either, but apprenticed the ophthalmic nurse because she loved it), it reall great. A tiny woman, smaller than I am, she diagnoses cases almost as soon as they come in. She assesses vision with an E chart (all E's, pointed different directions, rather than the different letters we use) and the patients, many of whom can't read the alphabet, use their four fingers extended to indicate the direction of the letter. There are a lot of cataract patients, and an eye surgeon comes from Brikama ("sometimes" to operate them for 500 dalasis (~$20). There are also a lot of cases of "allergic conjunctivitis" (basically pinkeye) and "vernal conjunctivitis" (not entirely sure, appearance is dark brown patches on the sclera). There are also patients with these nasty boils on their eyelids, and people who get dirt or soot in their eyes. I haven't seen a glaucoma patient yet, but I want to, because there's this cool little weighted device (which is apparently used in the states, too) that you put ON SOMEONE'S EYEBALL to measure they pressure. You put a painkiller on first, though, so you can't feel it, even though there's a scale resting on your eye. The hospital doesn't do glasses, though, they refer to another clinic for that. Mariama was very impressed by the power of my glasses. Grossest case so far: a young woman (late 20's) had continuously scratched her eye, which was itchy from vernal conjunctivitis, until she developed a pea-sized corneal scar. She's blind in her right eye, and there's nothing anyone can do about it.
On the weekend, we did a wonderful, wonderful thing. We went to the beach at Sanyang, and it was GORGEOUS. We stayed in this little (extremely cheap) beach house, which was 200D/person/night ($8) that was RIGHT on the ocean. There was also a shower, and I got the room with the fan that worked, so I was having a great time. We swam in the Atlantic Ocean and we picked up shells and tortured some crabs with flashlights and ate fantastic food (bennechin, a sort of spicy/sour sauce with rice and fish that had no bones in it!!!! FISH WITH NO BONES?!? CRAZY!!!) It's also about 20 degrees F cooler in Sanyang than Bwiam, so that was also a pleasant change. The only drawback? Rastas. It's a beach, and they were everywhere. In The Gambia, it's common during the holiday season (which is, not now) to see an old white woman with a young Gambian man. It's gross, but it happens all the time. There's a whole class of people (of Rastas) called "bumpsters" who are all ripped and smoke pot and hit on white women, because they all want green cards to get out and on to better places. They're also jerks, but they are all talk, and they'll leave if you tell them to.
There are two main drawbacks to being here, both of which we're feeling very acutely right now, as the initial luster of the trip has mainly worn off. The first is being white ("toubab, pronounced two-bob). The second is being a woman. Neither of which I can help.
Everywhere we go, people stare at us. All the time. White people are exotic here; we're the spectacles, the new things, and the rich ones. Everyone knows we're here, and everyone knows we're Americans. They point and they call us toubabs, kids (strangers!) swarm around us at the internet cafe (email? email? I can have? And then they ones you receive -- I tell them mine's broken, sorry, but others have given them spam addresses -- are all "I met you once and I think we can be great friends. Maybe you can write me and one day I will visit you in America?) and they walk with you, clutching your hands at the markets, pointing at things they want. I need a football! bag for school? Look! Shoes! Even here in the village, one little girl told Alex (one of my group members) that her father beat her, and then smiled hopefully, looking for a handout.
This has hit one of our group members, Heedoek, particularly hard. He wants to be a pediatrician, and kids follow him around in droves. He hates the idea that parents will hit a misbehaving child, and that they will physically fight one another to settle scores. It's even worse for him to have small gifts to give but one enough for everyone, and to know that a lot of these kids are just using him. It's really hard.
The other hard part is being a woman. Women in The Gambia are treated like crap. Part of it is lifestyle -- like in most developing countries, it is the woman's job to bear and raise the children, keep the house, fetch and carry clean water, tend the fires,cook the food, and do the laundry, and since most women have at least 4 kids, these tasks can commonly take 20 out of every 24 hours. Furthermore, having plural wives is not uncommon for a Gambian man. Most have two, since it's hard to support that many kids, but the limit is four. This limit is imposed by their brand of Sufism, a branch of Islam that allows for the incorporation of traditional animist beliefs, and is common throughout Africa. I mean this next statement in no offense whatsoever to any Muslims that I know -- you know me, guys -- Islam helps to treat the women badly, too. Women have a lower religious standing, and I don't think they're even allowed in the mosques at all. Most women have their hair constantly covered, and if a woman's knees are uncovered, she's stared at. Women are commonly beaten for breaking these codes, and domestic rape is common, but very rarely reported.
Worst of all is the high prevalence of FGM (female genital mutilation). Look it up if you don't know what I'm talking about; I don't really feel like getting into it. Many men don't want a woman who hasn't undergone the procedure since she's "unclean." This is the issue that's really hurting our group member Tammy, who is a nursing student in New Orleans. She's in the maternity unit this week, and she says it's absolutely horrible. I'm really excited to be in the maternity unit -- they let use catch the babies when they pop out -- but I'm also really dreading that particular part of it.
Our group, being toubabs, are not treated like that. The girls are, however, treated far worse than the boys. Meeting a man's eyes is a sign of being a loose woman, so since we naturally look at people when we're talking to them, we either get a lot of unwanted attention, or we have to stare at the ground. Men hiss at us to get our attention -- I threatened under my breath, once, to cut the man's face off, and Tammy offered to help, we can't stand being treated like animals in that way -- and we are patronized. If our knees are showing, they come over and stare at us -- inappropriately. When we shake hands in greeting, as customary, they hold on FAR too long and their eyes wander. They try to talk to us one-on-one and keep us from having conversations with others, and they fight over who gets to vie for our, attention, too. They compliment us in ways that aren't really compliments, they insinuate, and they will go further, too. One guy in Jambanjelly tried to make out with Alex (who has a boyfriend), and she slapped him. One man stripped for Ling Ling. Those two get the most attention -- Alex because she's the whitest and wears makeup, Ling Ling because she's Asian and even more exotic than us white people. Tammy gets a lot of attention, too, because of her dreadlocks. "Come here, Rasta Lady! Share the love with us!!!" And all of us: "Come here! Now! I want to talk to you! Why do you walk away from me?" Because you're an asshole. Excuse my language.
Worst of all, you know they only do this for two reasons: first off, to sleep with a white woman, and second, to get a green card. That's all they want. Even married men have asked us to join their "nice nice compounds!" insisting that their other wives "won't mind if I have an American wife." One of Alison's (our group leader) friends married a Gambian man, a really good guy named Modou (but we call him Ras). He's fantastic. However, she says that he's the only guy in the country she actually would trust with her life. She's lived here for a year, and she only completely trusts one man. that's horrible.
Anyways, that's really long, and I left all the depressing bits to the end, where I thought only the really dedicated people would read anyways. I'll leave off with three happier things:
1. This weekend, we're all going back to Jambanjelly for a celebration of the Birth of the Prophet Mohammed. Then, we're going to Brikau, the really nice resort area, and we're staying at a hotel on the beach that has AIR CONDITIONING. It's the white-people area, so we won't be stared at, and people don't bother the toubabs on hotel property. We're going to buy ice cream and be very American all weekend in celebration of the 4th.
2. I think I'm assigned to OPD -- outpatient -- for next week, which is the most interesting department. All the cases come through there, and it's very busy. the doctors are very nice, and are from Cuba. I'm excited.
3. My group that I'm with, and I've said this before, is fantastic. We even have a guy, John, who is the comic relief, and another Russel, who is there as eye candy. Molly is my roommate, and we get along really well. We work well as a group, and since we all have similar interests -- seven of us are pre-med, Alison is getting her Master's in Social Work, Russel is doing international relations and I'm doing international development -- we get long intellectually, too. We're reading books and then trading them around, so we expand our libraries, and since the food all affects us the same way (badly) we have a Diarrhea Club, occasionally nicknamed the Poop Troop, composed of whoever is feeling badly on that particular day. This afternoon, we sat on the veranda (yesterday was dreadfully hotm I was feeling really sick, and then at night there was a storm that was literally as strong as a hurricane -- my only comparable experience was Ike, so today was cooler) and played Mafia and charades all afternoon and read books. I'm reading Rushdie's Midnight's Children, which is fantastic. Whenever we have a particularly intense experience, we all share it, and it makes this whole trip both more fun and a lot easier.
Maybe I'll be better about updating this from now on. No promises. Congratulations if you read this much, I salute you for it. Particularly if you're not related to me.
