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