Dear Friends,
I left the Abuja guest house at 5:30pm Saturday and walked into my Phoenix home at 10:30pm Sunday, (6:30am Monday Abuja time) 37 hours later. Brenda, Janet and myself were collected by Bashir, one of the IHV-N drivers, Saturday evening and taken to the airport, 45 minutes away. We were greeted by Segun, an IHV-N employee, who is responsible for shepherding us thru customs, ticketing and various other little stops in the terminal.
One of the subjects that I have not really mentioned but have alluded to, is corruption in Nigeria. Six weeks ago, I didn't think that there was any corruption because I didn't "see" it. Now, I think that it is so omnipresent, impacting all elements of daily life that it is just not seen anymore but always felt.
I mention this because Segun's "job" is to make sure that we are not hassled or delayed in the airport. He greeted and shook hands with ALL of the customs/immigration folks, intervened at the ticket counter when the obviously new KLM employee was trying to coordinate three sets of tickets for places this man had never heard of, carried our passports thru Passport Control bypassing a very long line and walked us thru every checkpoint to our gate, smiling and shaking hands along the way. Part of the IHV-N budget is "Segun/Airport Greetings" with an additional $10,000 US above his salary for the "Greeting" part, i.e.: everyone is paid off.
After saying our goodbyes and thank you’s, we boarded and flew 40 minutes to the city of Kano, directly north of Abuja, to pick up more passengers and then on to Amsterdam. At the beginning of this leg of the trip, they asked for a doctor and Janet proceeded up to First Class because a man had fainted. She did not return after a while so both Brenda and I went to sleep. I woke up 2 hours later and Brenda was gone! So, either the pilot was dead and they were sitting with the body or they were now in First Class. I wandered to the back of the plane and was told that all was well and my friends "were sleeping in First Class." Gee, too bad I had been asleep curled up like a pretzel in 2 seats! We landed 6 hours later, at 6am.
When I purchased my tickets and saw that there was a layover in Amsterdam, I thought "I'm here anyway, I might as well take advantage of it and see the city." And that I did. But my first impression when I deplaned was, "It's Christmas! When did that happen?" Halloween and Thanksgiving are not celebrated in Nigeria so there are no markers to signify the start of the holiday season. It is also such a poor country, and Christmas is a time of being with family, not of giving gifts, as we think of it. I left 80 degree humid weather and walked into 35 degree Christmas tree weather. Whoa!
I put on more layers of clothes than I had worn in 6 weeks, stored my carry on, bought a train ticket and with 2 hours of sleep, headed out to visit Amsterdam at 6:30am.
Sunrise was at 7:45 so when I arrived at the Central Station at 7am, it was still dark. I exited the station to misty, foggy, "see my breath" weather with damp streets and only a few people and cars. Priceless!
As wild and crazy as I had been told Amsterdam was, it was Sunday morning, so I just walked the streets, watching the pre-dawn sky lighten up and people on bikes appear along the canals.
I stopped at the Victoria Hotel and had the first decent cup of coffee in six weeks along with a chocolate croissant and watched the hotel and surrounding streets, wake up. I later had a breakfast of eggs and salmon, more coffee and a delicious piece of chocolate.
I could have visited the Anne Frank House or wandered by the Van Gogh Museum but I was fighting sleep and just happy to wander the canals and watch the people. I returned to the airport to wander thru some gift shops. I loved Amsterdam!
My next flight was a 10 hour flight on Delta to Memphis, Tennessee. But before we could get on the plane, each of us was individually questioned, at length, about where we had originated, why we were there, etc. Most people seemed to quickly move on but...not me. Now I am tired and having to explain why I would go to Nigeria for an extended period of time, have almost no purchases and stop in Amsterdam for 8 hours. The interrogation lady, a TALL Dutch woman, was very nice and very polite but sure had lots of questions. She wandered off to talk with her boss, a stern looking woman wearing sensible shoes, returned to me, thanked me for my service and let me board.
11 hours later, I arrived in Memphis, again explaining to the very nice Immigration man about my Nigerian trip. Collected my luggage, dropped of my luggage, went thru screening, blah, blah, blah, slept off and on, and landed 2 hours later in Phoenix to be greeted by my honey.
I saw the sun rise in Amsterdam and set somewhere over Indiana, 16 hours of daylight.
My initial thoughts on coming home: It is noisy here. For 6 weeks I did not hear or see anything in the sky so seeing airplanes or hearing helicopters over our house, has been startling.
We have very thick toilet paper here! I think that I must have been using 1 ply tp for 6 weeks!
Some things that I will miss:
- meat pies
- shawarma's grilled Lebanese sandwiches that are made with chicken, pita like bread, wonderful spices.
- thunderstorms
- CNN International with the focus on Europe and the Middle East.
- singing and dancing at church
- goat stew
- the people of Keffi Clinic
- the people of IHV-N
- the neighborhood of the guest house. I felt safe there and became comfortable walking around by myself during the day.
Some things that I will NOT miss:
- litter
- undrinkable tap water
- men with really big guns
- power/water/internet outages
- constant horn honking with all traffic
- Nigerian food
- heat and humidity
What did I miss the most about home when I was there?
FREEDOM! Freedom, to go out alone and discover and enjoy. Freedom, to feel relatively safe without men with guns wandering about.
I loved this mentorship! I fell in love with this little clinic, in the middle of nowhere and no one was more surprised than me! I realize that I lived in a privileged "artificially safe" environment. The guest house was guarded and safe. We were driven everywhere in an air conditioned, safe SUV or car. We were accompanied everywhere and only went to places where kidnapping was not an apparent issue and our safety could be assured. In spite of all of this or maybe because of it, I really liked it here.
Nigeria has oil, land, people but is in danger of being a Failed State due to corruption and ineffective leadership. Malaria, TB and HIV are endemic to the country but TB meds are not being distributed because "no one has been paid off yet." Nasawara State, the state where Keffi Clinic is located, has a population of 1.4 million with a 7% HIV rate. The average age of a clinic patient is 29; the average lifespan in this State is 51. 29% of the children are underweight, 38% are physically stunted. I could go on and on.
The country is beautiful with lush vegetation, nutritious soil and high desert terrain. But the mounds and mounds of rubbish that are piled everywhere is crazy and outrageous! No wonder no one wants to visit here or is encouraged to do so. There is evident wealth but anywhere from a 50-75% unemployment rate. The villages are dusty, mud-packed clumps of lean-to's with no employment opportunities. The people look hot and tired. I hope that this country survives.
Thank you for traveling with me. Until next time...!
Kathleen
Thursday, November 12, 2009
Saturday, November 7, 2009
Week 6: You Are Welcome
Dear Friends,
"You Are Welcome" are the official words of greeting in Nigeria. They are the first words of greeting that I received when I arrived in Abuja and they will be the last ones that the IHV-N driver says to me on Saturday at the airport. These are the words that I am greeted with each morning by the guards, the driver and the Keffi clinic staff. In my Week 7 ramblings, I will attempt to share some thoughts on this entire experience but I can say now that this has been a profound experience for me and I will never forget it.
Sunday morning, I returned to Holy Trinity Catholic Church with Emilia, the woman who brought me here the first time; and Gambao Mendi, a physician from New Orleans, originally from Gambia, who was one of the last physicians rescued from Charity Hospital in New Orleans, during Hurricane Katrina.
I have enjoyed the Christian services that I have attended but I could never figure out the beginning and the end. The Mass I know so off I went. The music was beautiful, as expected and I found comfort in just being in the midst of the liturgy. BUT my favorite part was at the end when different groups of people danced up the aisle to present gifts to the priests. Emilia said that all of the gifts received, including money, are used towards feeding the priests and seminarians. There were cases of juice and bags of rice; yams and papayas the size of your arm and...A GOAT! A very live goat on a rope, being nudged up the aisle in the middle of the dancing and singing. Everyone laughed but the look of joy on the priests face's as DINNER walked up the aisle, was priceless! I wonder if the goat felt like a sacrificial lamb?
Later that evening, Gabao made dinner for several of us. Goat stew (different goat) in a sautéed like sauce that was to die for! With rice, a salad, and wine. Real food! Heaven!
This week has been a time of tying up loose ends and starting to say good-bye. Time is suspended here. I loose track of the date, sometimes even the day, because most days are the same and I am having fun! I have no real responsibilities except to submit some weekly reports, observe and assess and talk. Great job!
Treeny and I had the opportunity to go out on a home visit this week. I think the story is that a man presented himself to the Casualty/ER unit at the hospital, complaining of "being sick." He and the family left when they were told how much the bill would be(probably less than $10), went home and he died that evening. The Home Health nurse had been working with the family and had just found out about the death, 7 days after the fact. The nurse wanted to check on the wife and family and encourage the wife, thru the husband's brother, to be HIV tested.
Treeny and I joined Mrs. Morgan, the nurse and off we went in a van marked "FMC Keffi Hospital" to meet up with the brother who would take us to the house. Nobody has addresses here. The address is usually something like "near the mosques, ask for Mrs. Musa." We met the brother, on his motorbike, on the side of the road and he led us into the area of the house. A white van with hospital logo attracts attention. This same van with 2 white women in it causes people to start running after the van! By the time we went down rutted paths, around corners dodging the goats and dogs and came to a stop by another path, we had about 30 kids running and laughing after out van. When we stepped out, they all ran, because they had never seen a white person before! I just waved and smiled and they laughed and eventually a few kids would come nearer.
We were led into a small multi-room "compound" and welcomed into the living room, I think. It was small with teal colored walls and old carpeting, 2 small couches and a decent sized TV on a rickety looking stand. Sitting in the corner of one of the couches, was the 22yr old widow. The family is Muslim so the body was buried the day of the death. The widow will now stay in the house for the next 3-4 months, grieving, wearing very plain clothes, no make-up and will be attended to by her family. Several older women were sitting out in the cooking area, preparing to take the widow home to her village. The widow had a long tan scarf covering her head, looked downward at all times, as she fingered her prayer beads. After the official grieving period, the widow will be free to marry again.
All conversation was conducted with the brother of the man who died. He then would be responsible for speaking to the widow and relaying any pertinent information to Mrs. Morgan. Thru conversation, it was determined that the widow had tested negative for HIV 3 times and would be retested in 3 months. She does not know that her husband died of HIV, "the disease" and will not be told. "It is not necessary that she know this" said the brother-in-law. OK.
We paid our respects and left thru the cooking area where several women were mashing yams and cooking "things' in a large black kettle over a fire.
We drove out of the area with the same group of skinny children, raggy dirty clothes, barefoot, running, laughing and waving at us. There are approximately 1.2 million orphaned children in Nigeria and 29% of all children are malnourished.
There are no funeral homes here. When someone dies, an "ambulance' of sorts is called and the body taken to the morgue. The family pays for some type of a casket which is delivered to the morgue and the body put in. I don't think that embalming exists here but I am told that it does in Lagos. The casket is returned to the patients house for 'waking" then a funeral held in a church. The wake used to be held in churches but that was stopped because so many people were dying and interfering with regularly scheduled services.
Death is not really spoken of here. There was a woman who was brought to the clinic who looked to be near death. Dr. Umar, one of the clinic doctor's, would not tell the daughter that her mother was near death for fear that the family would abandon the lady "because nothing more could be done." She was admitted to the hospital with the words, "I hope that you will be well" by Dr. Umar.
This presented a real ethical dilemma for Treeny who felt that it was medically unethical to not tell the family. A fairly heated discussion took place with Treeny and 2 of the doctor's with no resolution and much misunderstanding.
This week, 2 nurses disclosed to me that they were HIV infected and I was stunned. It never occurred to me that this could happen to someone that I know and I felt so sad.
On a lighter note, Friday our last day in the clinic, the staff threw us a wonderful going away party! The matron, Ladi, had African dresses made for both of us which we wore. Even the headdress which is very hot, by the way. There was a program of department heads thanking us, including the hospital CEO who presented us with gifts. He is on his 3rd wife and was eying Treeny! Being an observant Muslim, he left early to attend Mosque. We received another African dress and the biggest yams and sweet potatoes that I have ever seen!
The clinic nurses arrived mid-program, carrying coolers on their head of homemade jollef rice and freshly killed and cooked chicken from the garden of one of the nurse's. There was also homemade chocolate cake! I may be the only person who has traveled to Africa and GAINED weight! Their gift to us was the party. Amazing!
Saying good-bye was difficult. There was much crying all around and the Matron sobbed as I hugged her. The entire staff walked us to the IHV-N van a half block away waving as we pulled away.
I leave tomorrow to begin my 36 hour journey home, including an 8 hour layover in Amsterdam. I am very excited about this!
Talk with you next week.
Kathleen
"You Are Welcome" are the official words of greeting in Nigeria. They are the first words of greeting that I received when I arrived in Abuja and they will be the last ones that the IHV-N driver says to me on Saturday at the airport. These are the words that I am greeted with each morning by the guards, the driver and the Keffi clinic staff. In my Week 7 ramblings, I will attempt to share some thoughts on this entire experience but I can say now that this has been a profound experience for me and I will never forget it.
Sunday morning, I returned to Holy Trinity Catholic Church with Emilia, the woman who brought me here the first time; and Gambao Mendi, a physician from New Orleans, originally from Gambia, who was one of the last physicians rescued from Charity Hospital in New Orleans, during Hurricane Katrina.
I have enjoyed the Christian services that I have attended but I could never figure out the beginning and the end. The Mass I know so off I went. The music was beautiful, as expected and I found comfort in just being in the midst of the liturgy. BUT my favorite part was at the end when different groups of people danced up the aisle to present gifts to the priests. Emilia said that all of the gifts received, including money, are used towards feeding the priests and seminarians. There were cases of juice and bags of rice; yams and papayas the size of your arm and...A GOAT! A very live goat on a rope, being nudged up the aisle in the middle of the dancing and singing. Everyone laughed but the look of joy on the priests face's as DINNER walked up the aisle, was priceless! I wonder if the goat felt like a sacrificial lamb?
Later that evening, Gabao made dinner for several of us. Goat stew (different goat) in a sautéed like sauce that was to die for! With rice, a salad, and wine. Real food! Heaven!
This week has been a time of tying up loose ends and starting to say good-bye. Time is suspended here. I loose track of the date, sometimes even the day, because most days are the same and I am having fun! I have no real responsibilities except to submit some weekly reports, observe and assess and talk. Great job!
Treeny and I had the opportunity to go out on a home visit this week. I think the story is that a man presented himself to the Casualty/ER unit at the hospital, complaining of "being sick." He and the family left when they were told how much the bill would be(probably less than $10), went home and he died that evening. The Home Health nurse had been working with the family and had just found out about the death, 7 days after the fact. The nurse wanted to check on the wife and family and encourage the wife, thru the husband's brother, to be HIV tested.
Treeny and I joined Mrs. Morgan, the nurse and off we went in a van marked "FMC Keffi Hospital" to meet up with the brother who would take us to the house. Nobody has addresses here. The address is usually something like "near the mosques, ask for Mrs. Musa." We met the brother, on his motorbike, on the side of the road and he led us into the area of the house. A white van with hospital logo attracts attention. This same van with 2 white women in it causes people to start running after the van! By the time we went down rutted paths, around corners dodging the goats and dogs and came to a stop by another path, we had about 30 kids running and laughing after out van. When we stepped out, they all ran, because they had never seen a white person before! I just waved and smiled and they laughed and eventually a few kids would come nearer.
We were led into a small multi-room "compound" and welcomed into the living room, I think. It was small with teal colored walls and old carpeting, 2 small couches and a decent sized TV on a rickety looking stand. Sitting in the corner of one of the couches, was the 22yr old widow. The family is Muslim so the body was buried the day of the death. The widow will now stay in the house for the next 3-4 months, grieving, wearing very plain clothes, no make-up and will be attended to by her family. Several older women were sitting out in the cooking area, preparing to take the widow home to her village. The widow had a long tan scarf covering her head, looked downward at all times, as she fingered her prayer beads. After the official grieving period, the widow will be free to marry again.
All conversation was conducted with the brother of the man who died. He then would be responsible for speaking to the widow and relaying any pertinent information to Mrs. Morgan. Thru conversation, it was determined that the widow had tested negative for HIV 3 times and would be retested in 3 months. She does not know that her husband died of HIV, "the disease" and will not be told. "It is not necessary that she know this" said the brother-in-law. OK.
We paid our respects and left thru the cooking area where several women were mashing yams and cooking "things' in a large black kettle over a fire.
We drove out of the area with the same group of skinny children, raggy dirty clothes, barefoot, running, laughing and waving at us. There are approximately 1.2 million orphaned children in Nigeria and 29% of all children are malnourished.
There are no funeral homes here. When someone dies, an "ambulance' of sorts is called and the body taken to the morgue. The family pays for some type of a casket which is delivered to the morgue and the body put in. I don't think that embalming exists here but I am told that it does in Lagos. The casket is returned to the patients house for 'waking" then a funeral held in a church. The wake used to be held in churches but that was stopped because so many people were dying and interfering with regularly scheduled services.
Death is not really spoken of here. There was a woman who was brought to the clinic who looked to be near death. Dr. Umar, one of the clinic doctor's, would not tell the daughter that her mother was near death for fear that the family would abandon the lady "because nothing more could be done." She was admitted to the hospital with the words, "I hope that you will be well" by Dr. Umar.
This presented a real ethical dilemma for Treeny who felt that it was medically unethical to not tell the family. A fairly heated discussion took place with Treeny and 2 of the doctor's with no resolution and much misunderstanding.
This week, 2 nurses disclosed to me that they were HIV infected and I was stunned. It never occurred to me that this could happen to someone that I know and I felt so sad.
On a lighter note, Friday our last day in the clinic, the staff threw us a wonderful going away party! The matron, Ladi, had African dresses made for both of us which we wore. Even the headdress which is very hot, by the way. There was a program of department heads thanking us, including the hospital CEO who presented us with gifts. He is on his 3rd wife and was eying Treeny! Being an observant Muslim, he left early to attend Mosque. We received another African dress and the biggest yams and sweet potatoes that I have ever seen!
The clinic nurses arrived mid-program, carrying coolers on their head of homemade jollef rice and freshly killed and cooked chicken from the garden of one of the nurse's. There was also homemade chocolate cake! I may be the only person who has traveled to Africa and GAINED weight! Their gift to us was the party. Amazing!
Saying good-bye was difficult. There was much crying all around and the Matron sobbed as I hugged her. The entire staff walked us to the IHV-N van a half block away waving as we pulled away.
I leave tomorrow to begin my 36 hour journey home, including an 8 hour layover in Amsterdam. I am very excited about this!
Talk with you next week.
Kathleen
Sunday, November 1, 2009
Week 5: Every Day is an Adventure
Hi,
Sunday morning, Ladi, the matron at Keffi Clinic, and her 10 year old son Danny, took 2 buses and a taxi to visit me and take me to church. We attended ECWA, the Evangelical Church of West Africa which seems to be very close to the Baptist church as I know it.
We arrived 30 minutes into a 2 hour service so sat outside under a canopy with all of the other late folks. Many of the latecomers had little ones who had never seen a white person before, based on what I could hear behind me. After the kids were initially startled and clinging to their mothers skirts, they would wander over to stare at me and touch my skirt. All women are required to wear some kind of head covering and because I did not have a scarf with me, Ladi took off the thin white scarf that she had around her shoulders and I loosely wrapped it around my head. I looked like I was reporting from Kabul! So not only were the little ones looking at this oyibo, they were also staring at this funny scarf, in stark contrast to their mother's beautiful headdresses. At least no one screamed!
The sermon lasted 65 minutes and I THINK was about Jesus, holiness and worthiness. I think. I was half in the sun to sitting under the canopy, it was blazing hot, at least 95 degrees, the sweat and my mascara, were dripping off of me and all I could concentrate on was the family of gecko's/lizards that were playing in front of me. Mr. Lizard was about 12 inches long with a yellow head and dark green/pale yellow tail. Ms. Lizard #1 and #2 (? 2 wives?) were slightly smaller and slimmer than Mr. L and were scurrying about with 2 little ones. They kept falling off of a concrete ledge. Quite entertaining!
We returned home via taxi and had a lunch of papaya, bananas, cold rice pudding (yummy), tea and juice. Danny watched cartoons and at one point I looked towards him he was doing a Michael Jackson moonwalk across the living room floor. All children are alike!
After a few hours of visiting, they left for the 90 minute return trip home. I will miss both of them when I leave.
A "perk" of this mentorship is the free admission card that we have to use the fitness center at the Hilton Hotel, which is walking distance from the apartment. The Hilton is looked upon as the center of Abuja, the happening place where all major guests stay and the Nigerian president addresses the masses.
Treeny walks there at 6:30am most mornings, to swim or work out; and Brenda and Janet faithfully go there everyday to swim, lay by the pool or work out. I don't do mornings and I am not a sun worshiper so I go occasionally on my own. Last Wednesday, I finished working out and received a call from David, one of the IHV-N auditors, to join him and some IT folks at the bar. It was pouring rain, traffic was at a standstill, so I repaired to the bar. The rain continued, traffic sat, and more friends joined us.
Nigeria is hosting the FIFA U-17 (under 17) World Cup soccer games with games being played throughout the country for the next month. The "adult" World Cup is next June in South Africa. All of the teams that are playing in Abuja are staying at the Hilton, so sitting next to us in the bar area, were the teams from Brazil and Argentina. All tall, lanky 15-16 year olds who were kicking small soccer balls all over the place and chasing them into the rain. We eventually asked them for group photos, which they sheepishly obliged, so now we have pics of some future stars! Great fun!
Later, as we were standing outside of the lobby, we saw lots of police with their really big guns, a UN truck, really big cars and a red carpet. Suddenly, a man with a bugle appeared, and played in the driveway as the King of one of the northern Nigerian states(there are 36) walked down the carpet and was helped into a car. He looked to be in his 70's, had long white/gold robes on and was accompanied by other men with different colored, expensive looking robes. The bugler stopped and the cars sped away. We were only about 10 feet away.
Friday evening, 7 of us went to the 30,000 seat Abuja stadium, to see Brazil and Switzerland play to qualify to move on in the playoffs. We had VIP seats, about $20, because we weren’t sure where the $5 seats would put us. I have never sat in VIP seating and just like flying First Class, there is something to be said for the finer things in life. A “First World” bathroom A/C in the bar/lounge and seats with backs. Switzerland won 1-0 so Brazil goes home.
The clinic has been great fun. The nurse's are now doing a full set of vital signs on all patients and not just their blood pressure. I bought a clock for the triage room so the nurses can count the pulses and respirations because no one owns a watch. All patient charts now also have a written note by the nurse as to why the patient has come to the clinic. Some progress.
I presented a Power Point presentation on Management and Leadership to 25 members of the senior nursing staff including the director, etc. But, in order to present Power Point one must have electricity or at least a computer battery with some juice. There was power and then there wasn't. Windows opened and closed and bugs flew about. The hospital owns one projector and the man who knows where it is, was 'off" so I just read from my screen and moved about the room. But the battery was running down so I had to repeatedly reopen the program. In the middle of the presentation, the man who was "off' wasn't anymore and he rigged a cord coming from somewhere outside the window into the room, and a couple of cords later, Voila, there was light! Gotta love it! There was a brief Q and A with the group and the final question was, "Did President Obama win the election because he is a black man or because he is a great leader?" I shared a few of my personal thoughts and everyone laughed and applauded. The presentation was a lot of fun and seemingly well received.
I also gave a presentation to some of the general hospital nursing staff on Documentation, Critical thinking, etc. and will repeat it sometime next week. Day/place/time to be determined, I just show up.
Electricity has been a big issue this week in the clinic with power only about 50% of the time. The clinic is dark, hot, humid and miserable with only open windows for some relief. Terrible! But on a lighter note, I was told that the clinic will be getting some type of a water cooler so the staff has access to drinkable cool water. Yes!!!!!!!!
Another issue for the clinic has been the lack of TB meds. TB is endemic here with many of the HIV patients co-infected with it. The hospital TB clinic is in the HIV clinic to make it easier for patients to access their meds. Of course, with the lack of clinic space, frequently the medication adherence counselor also shares this same 8'x8' room with the TB nurse, so 2 staff and 2-3 patients/family are in this space. But that is another story.
Several NGO"s like the CDC, procure TB meds, but the meds are frequently "detained" somewhere with only a trickle of meds being shipped to the clinics. Not "detained" in the US or another country, but "detained"(?) on Nigerian docks waiting for some "financial reimbursement" from "someone."
While the "boys" collect their money we turn away 3-5 newly diagnosed TB patients A DAY and ask all stable patients to return every 2 days to receive their medications. And we wonder why the Default rate is so high. Unconscionable. It is not unusual for meds to be "detained" for at least a month.
I have developed a past time here: looking at school uniforms. I know it sounds funny but the daily 2 hour round trip commute gets a little boring after a while. Dr. Chizoba prays or reads the Bible, Treeny sleeps and I look out the window.
School is "free" and strongly encouraged but the parents must buy the uniforms and all school supplies which means some children never attend school or do so for only a few years. I, see these children running and playing in the dirt or helping their mothers split rocks for home building. So sad.
All school children wear uniforms and no two schools are alike. The Pritish Prep Academy boys wear red checkered shirts with beige pants; the girls wear beige jumpers with red checkered blouses. The Bill Clinton College wears navy blue pants with light blue shirts, haven't seen any girls. There are also: navy blue/white, tan/yellow/, olive green/yellow/ chocolate brown/yellow or tan, red/pink. And my two personal favorites: magenta pants or jumpers with pink shirts, and royal purple pants/jumpers with chartreuse tops! Looks like they could glow in the dark! All girls wear jumpers and if you factor in the Muslim girls wearing their veils, usually white but could be a third color, the roads are rainbows twice a day!
Today, the last Saturday of the month, is the national Environmental Clean-up day. This means that ALL people must stay home and clean their homes/huts, etc. until at least 10am. No one is allowed out between 7-10am and if you do go out, the police will ticket you! Swear to God. I am told that Abuja is bit lax on this because it is so clean here, ????, but still no one goes out. In honor of honoring cultural customs, I slept in! And it was so quiet around here, I could hear the birds.
This is the end of the 5th week and I have had ONE very small cup of coffee since arriving. There is Nescafe but...so I have an occasional cup of green tea or a Diet Pepsi but I WOULD DIE FOR A CUP OF COFFEE RIGHT NOW! I just finished some reheated tasty pizza with green tea for breakfast but "it just ain't cuttin' it" so it must be time to go.
I am entering into the final week with mixed emotions but leaving will be OK. I think that there will be some kind of celebration on Friday for me and Treeny and there is a possibility that the two of us will meet with the Health Commissioner to share some observations and thoughts on the clinc. I MAY have opened my mouth to the IHV-N Country Director about the clinic space issues which prompted the suggestion that we tell the Commissioner. OK. It is too much trouble to revoke our visa's before we leave next Saturday so I guess that we are safe!
Halloween doesn’t exist here so I keep forgetting about it. Hope it was a good one.
Take care,
Kathleen
Sunday morning, Ladi, the matron at Keffi Clinic, and her 10 year old son Danny, took 2 buses and a taxi to visit me and take me to church. We attended ECWA, the Evangelical Church of West Africa which seems to be very close to the Baptist church as I know it.
We arrived 30 minutes into a 2 hour service so sat outside under a canopy with all of the other late folks. Many of the latecomers had little ones who had never seen a white person before, based on what I could hear behind me. After the kids were initially startled and clinging to their mothers skirts, they would wander over to stare at me and touch my skirt. All women are required to wear some kind of head covering and because I did not have a scarf with me, Ladi took off the thin white scarf that she had around her shoulders and I loosely wrapped it around my head. I looked like I was reporting from Kabul! So not only were the little ones looking at this oyibo, they were also staring at this funny scarf, in stark contrast to their mother's beautiful headdresses. At least no one screamed!
The sermon lasted 65 minutes and I THINK was about Jesus, holiness and worthiness. I think. I was half in the sun to sitting under the canopy, it was blazing hot, at least 95 degrees, the sweat and my mascara, were dripping off of me and all I could concentrate on was the family of gecko's/lizards that were playing in front of me. Mr. Lizard was about 12 inches long with a yellow head and dark green/pale yellow tail. Ms. Lizard #1 and #2 (? 2 wives?) were slightly smaller and slimmer than Mr. L and were scurrying about with 2 little ones. They kept falling off of a concrete ledge. Quite entertaining!
We returned home via taxi and had a lunch of papaya, bananas, cold rice pudding (yummy), tea and juice. Danny watched cartoons and at one point I looked towards him he was doing a Michael Jackson moonwalk across the living room floor. All children are alike!
After a few hours of visiting, they left for the 90 minute return trip home. I will miss both of them when I leave.
A "perk" of this mentorship is the free admission card that we have to use the fitness center at the Hilton Hotel, which is walking distance from the apartment. The Hilton is looked upon as the center of Abuja, the happening place where all major guests stay and the Nigerian president addresses the masses.
Treeny walks there at 6:30am most mornings, to swim or work out; and Brenda and Janet faithfully go there everyday to swim, lay by the pool or work out. I don't do mornings and I am not a sun worshiper so I go occasionally on my own. Last Wednesday, I finished working out and received a call from David, one of the IHV-N auditors, to join him and some IT folks at the bar. It was pouring rain, traffic was at a standstill, so I repaired to the bar. The rain continued, traffic sat, and more friends joined us.
Nigeria is hosting the FIFA U-17 (under 17) World Cup soccer games with games being played throughout the country for the next month. The "adult" World Cup is next June in South Africa. All of the teams that are playing in Abuja are staying at the Hilton, so sitting next to us in the bar area, were the teams from Brazil and Argentina. All tall, lanky 15-16 year olds who were kicking small soccer balls all over the place and chasing them into the rain. We eventually asked them for group photos, which they sheepishly obliged, so now we have pics of some future stars! Great fun!
Later, as we were standing outside of the lobby, we saw lots of police with their really big guns, a UN truck, really big cars and a red carpet. Suddenly, a man with a bugle appeared, and played in the driveway as the King of one of the northern Nigerian states(there are 36) walked down the carpet and was helped into a car. He looked to be in his 70's, had long white/gold robes on and was accompanied by other men with different colored, expensive looking robes. The bugler stopped and the cars sped away. We were only about 10 feet away.
Friday evening, 7 of us went to the 30,000 seat Abuja stadium, to see Brazil and Switzerland play to qualify to move on in the playoffs. We had VIP seats, about $20, because we weren’t sure where the $5 seats would put us. I have never sat in VIP seating and just like flying First Class, there is something to be said for the finer things in life. A “First World” bathroom A/C in the bar/lounge and seats with backs. Switzerland won 1-0 so Brazil goes home.
The clinic has been great fun. The nurse's are now doing a full set of vital signs on all patients and not just their blood pressure. I bought a clock for the triage room so the nurses can count the pulses and respirations because no one owns a watch. All patient charts now also have a written note by the nurse as to why the patient has come to the clinic. Some progress.
I presented a Power Point presentation on Management and Leadership to 25 members of the senior nursing staff including the director, etc. But, in order to present Power Point one must have electricity or at least a computer battery with some juice. There was power and then there wasn't. Windows opened and closed and bugs flew about. The hospital owns one projector and the man who knows where it is, was 'off" so I just read from my screen and moved about the room. But the battery was running down so I had to repeatedly reopen the program. In the middle of the presentation, the man who was "off' wasn't anymore and he rigged a cord coming from somewhere outside the window into the room, and a couple of cords later, Voila, there was light! Gotta love it! There was a brief Q and A with the group and the final question was, "Did President Obama win the election because he is a black man or because he is a great leader?" I shared a few of my personal thoughts and everyone laughed and applauded. The presentation was a lot of fun and seemingly well received.
I also gave a presentation to some of the general hospital nursing staff on Documentation, Critical thinking, etc. and will repeat it sometime next week. Day/place/time to be determined, I just show up.
Electricity has been a big issue this week in the clinic with power only about 50% of the time. The clinic is dark, hot, humid and miserable with only open windows for some relief. Terrible! But on a lighter note, I was told that the clinic will be getting some type of a water cooler so the staff has access to drinkable cool water. Yes!!!!!!!!
Another issue for the clinic has been the lack of TB meds. TB is endemic here with many of the HIV patients co-infected with it. The hospital TB clinic is in the HIV clinic to make it easier for patients to access their meds. Of course, with the lack of clinic space, frequently the medication adherence counselor also shares this same 8'x8' room with the TB nurse, so 2 staff and 2-3 patients/family are in this space. But that is another story.
Several NGO"s like the CDC, procure TB meds, but the meds are frequently "detained" somewhere with only a trickle of meds being shipped to the clinics. Not "detained" in the US or another country, but "detained"(?) on Nigerian docks waiting for some "financial reimbursement" from "someone."
While the "boys" collect their money we turn away 3-5 newly diagnosed TB patients A DAY and ask all stable patients to return every 2 days to receive their medications. And we wonder why the Default rate is so high. Unconscionable. It is not unusual for meds to be "detained" for at least a month.
I have developed a past time here: looking at school uniforms. I know it sounds funny but the daily 2 hour round trip commute gets a little boring after a while. Dr. Chizoba prays or reads the Bible, Treeny sleeps and I look out the window.
School is "free" and strongly encouraged but the parents must buy the uniforms and all school supplies which means some children never attend school or do so for only a few years. I, see these children running and playing in the dirt or helping their mothers split rocks for home building. So sad.
All school children wear uniforms and no two schools are alike. The Pritish Prep Academy boys wear red checkered shirts with beige pants; the girls wear beige jumpers with red checkered blouses. The Bill Clinton College wears navy blue pants with light blue shirts, haven't seen any girls. There are also: navy blue/white, tan/yellow/, olive green/yellow/ chocolate brown/yellow or tan, red/pink. And my two personal favorites: magenta pants or jumpers with pink shirts, and royal purple pants/jumpers with chartreuse tops! Looks like they could glow in the dark! All girls wear jumpers and if you factor in the Muslim girls wearing their veils, usually white but could be a third color, the roads are rainbows twice a day!
Today, the last Saturday of the month, is the national Environmental Clean-up day. This means that ALL people must stay home and clean their homes/huts, etc. until at least 10am. No one is allowed out between 7-10am and if you do go out, the police will ticket you! Swear to God. I am told that Abuja is bit lax on this because it is so clean here, ????, but still no one goes out. In honor of honoring cultural customs, I slept in! And it was so quiet around here, I could hear the birds.
This is the end of the 5th week and I have had ONE very small cup of coffee since arriving. There is Nescafe but...so I have an occasional cup of green tea or a Diet Pepsi but I WOULD DIE FOR A CUP OF COFFEE RIGHT NOW! I just finished some reheated tasty pizza with green tea for breakfast but "it just ain't cuttin' it" so it must be time to go.
I am entering into the final week with mixed emotions but leaving will be OK. I think that there will be some kind of celebration on Friday for me and Treeny and there is a possibility that the two of us will meet with the Health Commissioner to share some observations and thoughts on the clinc. I MAY have opened my mouth to the IHV-N Country Director about the clinic space issues which prompted the suggestion that we tell the Commissioner. OK. It is too much trouble to revoke our visa's before we leave next Saturday so I guess that we are safe!
Halloween doesn’t exist here so I keep forgetting about it. Hope it was a good one.
Take care,
Kathleen
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