The Hippo says Hello

There he is. Yup, he's looking right at you.

The view of some houses from the river trip. We took a boat down (up?) the Ogooué river, into a giant lake, picnicked on the shore, saw hippos (see above), played soccer, took pictures, and celebrated the end of our roommates' (see below) stage (internship) at Schweitzer.

These are the triplets of the hospital. Not actually triplets, but they're all the same age, two have nearly identical names, they all lived (pretty much) on the same surgery ward, and they all have Buruli ulcers. I loved these girls so much, I will try to write a longer post about them. In this picture they are watching a video I took of them dancing on my bed. (No, they were dancing on the porch, but watching the video sitting on the bed. Goodness English is confusing.)

Two pictures I love of my roommates. L-R: me, the impossibly adorable Larry (girls get boys' names here), Narcisse, and Elizabeth A Point Sack.

new pictures

Some of the many birds' nests in the trees at the hospital.  I just liked this picture.

One of the many posters hanging around the hospital about AIDS ("Everyone together against AIDS").  

These roosters are so stupid.  I thought roosters were supposed to crow at dawn.  These roosters (and there are many of them, some mere feet from my head in the morning) crow at all times of day and night.  We now dream of coq au vin.  

A haiku, courtesy of my roommate:

Oh, stupid rooster. 

Crowing your virility

You're just a small cock   

Yay! Gabon's making headlines!

Oh wait, but not for anything good.  Please see the wonderfully-written nytimes article on the recent developments here.  In brief, the president of Gabon ("Africa's longest-entrenched autocrat") died this weekend.  The government has responded by closing the airport and borders and imposing a curfew.  But everything's just fine here, so please don't worry.  We are far from the capital, which is where things usually go down anyway.  Just wanted to write a quick note in case anyone was worried about me being in the middle of a politically-unstable central african nation.  And now back to your regularly-scheduled programming.  

New Pictures

Welcome, indeed. :) 

This is the hospital, outside the Polyclinique, where I spend most of the day.  This was taken on a particularly muggy morning, normally it's brilliantly sunny.  The yellow building is one of the surgical wards, but they all kind of look like that.  Those giant trucks are from the military hospital.  A large brigade of soldiers descended last week with ophthalmologists and otolaryngologists and their mobile exam rooms and ORs (the above trucks) and saw patients from 7:30 am until midnight.  People were sleeping overnight outside to have a place in line.  

Typical hairstyle.  Women are crazy about their hair here.  Everyone has an elaborate weave or a wig.  It's pretty awesome.  

We went to a culture festival in Libreville this past weekend, and this is a picture from outside the Senate building, where there were a bunch of different dance groups from all over the country.  It was pretty cool.  :)  (Gosh, I'm so eloquent this evening, eh?) 

Dr. J- Rant Of The Day

I work with a rather, uh, charismatic doctor here. He likes going off on rants about various subjects from time to time, that range from the incompetence of some staff to the living conditions of Chinese workers in Gabon. His chosen subject the other day was the state of medicine in Gabon. Which is: not good. The government has been unable (or unwilling) to pay its bills to the hospitals for quite some time, and the result is that all of the hospitals have been on strike since January. (Not this one, it’s funded mostly by international foundations.) So the result of the strike is that sick people are not getting medical care, then when they’re gravely ill, they come here (to the HAS: Hôpital Albert Schweitzer), where often it’s too late (Dr. J-: "Do they think we're magicians?!"). The HAS has also been relatively overwhelmed with patients since the strike started: the maternity service has patients on mats on the floor, because they’re out of both beds and mattresses (“Patients are on the floor, four to a room! That is no way to treat people”). The medicine service sometimes keeps patients in maternity and surgery because there are no medicine beds left. It is frustrating that the government is unwilling to pay for medical care for its citizens, and it’s easy to place blame on any number of factors for the fact that people are suffering and dying of treatable diseases simply because there are no resources available to them, so his next statement caught me off guard: “And who is responsible for this?? We all are.”

Weekend pictures

We spent the day yesterday going to see a old mission in Sindara, about a 1.5-hour drive from here, picnicked at a "waterfall," (really, rapids), then stopped at a swimming hole on the way home (N.B. ASF Boston: I didn't swim).

Good thing we were in a 4x4.

View from inside the chapel at the Mission at Sindara.

Yes! Just like the real ones.

The swimming hole where we got attacked by the fouroux, tiny insects (so tiny you can barely tell they're not specs of dirt on your arm) that are not, to my great distress, deterred by any amount of DEET.

What is it exactly that you DO do?

(those able to identify this quote win a travel-sized bottle of DEET)

So…what do I actually do here? Ok, a brief rundown of the day, if you’re interested:
1. Get up, thrash out of mosquito netting
2. Wait for shower (four people who all start work at the same time share one bathroom)
3. Have cereal (fake cornflakes…that’s all we’ve been able to locate) and instant coffee out on the porch (heaven…I’m telling you)
4. Go to the medicine ward, or the Kopp, as it’s known, which is maybe a 5 minute walk from here, depending on how hot it is outside, to start rounds at 7:30. (Actually on Wednesdays and Fridays there’s a grand rounds type of meeting/presentation, where someone presents a topic or case to the staff, which starts at 7:30, so then rounds are after that.)
5. Round with the team, which consists of two doctors, 1-3 nurses, and me. There’s a little cart that we drag around that houses all the charts (really, cards the size of half a sheet of paper in plastic covers that have seen better days) and order sheets (for labs and x-rays and such) and a bottle of alcohol for hand washing and a trash bin and even a little vase of plastic pink and flowers. Next to every bed there’s a wooden board hanging on the wall with a spreadsheet that includes the patient’s vital signs (with the temperature graphed, so you can see its trend with a quick glance) and medications. It’s so simple. Patients get taken care of, medications get ordered and given, vital signs get taken and recorded, and there’s none of the triplicate record keeping that keeps rounds at home dragging on till 1pm.
6. Off to the Polyclinique, which is a giant waiting room with small exam rooms off of it. It is normally anywhere from 90-110 degrees in the waiting room, but, blissfully, the exam rooms have window air conditioners. See patients until noon or 1.
7. Have lunch from 12-1, then a break from 1-2:30
8. See patients from 2:30 to anywhere from 3:30 to 5:30, basically until they’re all seen. (Top reasons for coming seem to be: hypertension, AIDS, fever and headache and/or body aches [treated as malaria, even if the blood test for malaria is negative], and tuberculosis)
9. Go back to the Kopp, where it is now approximately 95 degrees after the day’s sunlight has run its course, and record all the lab values that came back during the day, as well as see any new patients who were admitted.
10. Either do yoga, or run, or sit in a tired and hot heap on the chair in my room directly under the fan.
11. Dinner is at 7 exactly. If you’re not done by 8 there’s a stern talking-to from the ladies who work in the dining hall (who are, I must add, all very nice).
12. Putter around until bed, either watching 30 Rock (a favorite pasttime around here), or going to the lab to use the internet, or going to the nearest town to have a beer, or removing large bugs from one’s room, or duct-taping the screens down, or hand-washing clothes, or…you get the idea…there’s always stuff to do.
13. Go to bed, rinse, repeat…