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