Archive for » July, 2010 «

Learning to Live

sunset over Sibanor

the beach! lovely way to relax on weekends off

Internet Issues

I have to apologize because I have not been able to update as much as I would like.  Although I thought I would have dial-up internet in Sibanor, it has not worked yet for me for whatever reason.  I last checked my email since the 9th of July, so I’m sure I have ones that have been unanswered for that long, and I want to apologize for not answering them quickly.  The internet problems also mean that I will probably only be able to check my email every couple weeks when I make it down to headquarters until further notice, so please understand that this will be the norm for a while until we figure out how to get it to work here in Sibanor.

If you have a topic about life here that you’re dying to hear about, feel free to request!  :)  I’m trying to make sure that the info I post is relevant and not too long or boring.  I have a ton of info in a document with several suggested topics that I’ve already written about, but just need to post at some time (not all at once – you would get bored).

I also love to hear about how you are doing.  I love getting emails and especially snail mail.  It makes my day.  Thank you for those who have already sent me letters!


Although there may have been worries that I might lose weight while I am abroad, with the awesome food I’ve been getting here, I don’t think that will be a problem at all.  Right now, it is mango season, so we are enjoying them for breakfast or dessert or for a snack.  I did not know before now that there are lots of kinds of mangos like there are lots of different types of apples.  There are some that are more like candy and there are some that are a lot more citrusy.  Yum!  The other fruits and veggies I’ve had are awesome too.  I had jackfruit for the first time yesterday (they are HUGE – I’ll try to take a picture of one before I leave since my camera wasn’t working when I had it).  I’ve come to actually enjoy cucumbers and tomatoes and peanuts.  This trip has forced me to be flexible and I’ve found that I’m not as picky as I thought I was.  There are very few things that I have found that I did not enjoy.

The one thing that I haven’t liked is cola nuts.  They are a very cultural food that they serve at weddings and naming ceremonies (I had one at a wedding).  They are very bitter.  My language helper likened them to wine served at weddings in toubabadou (non-African world), though they don’t carry the intoxication power (I’ve heard of people trying to get high off of them – gag).

We get fresh bread called tapalapa every day.  I think I described it in a previous update.  One of the more unusual things that I’ve eaten and come to enjoy is tapalapa with a bean filling and a spicy sauce.  I will have to ask my language helper if I can get the recipe to take back home so you all can have a taste.  :)

In general though, we have to make our own meals in the evenings and on weekends.  I’ve learned how to be creative to make tasty dishes with less complicated ingredients than I’m used to cooking with at home.  Rice and pasta are staples.  Potatoes are pretty normal.  Tapalapa pizzas are pretty easy and good.  Hot dogs, SPAM, and fish are more normal than any other kind of meat.  I never would have thought that I could ever say it, but I’ve come to actually enjoy SPAM (as much as one can).

The schedule of meals is a bit different to get used to.   We usually eat supper/ tea between 7 and 9pm.  I’m used to eating between 5 and 7 at home so that’s a little different.


the kids love playing in the rain!

Although this is an entirely different part of the world, there are definitely days that I feel like I’m at home with the weather that we have.  Although I said that all the rain is preceded by a massive wind, this is not always the case we’ve had several gentle rains.  Robyn said that for being the rainy season, we’ve had less major storms.  It’s nice here to not have to worry about tornadoes and such here.  Storms still look impressive, but compared with SD storms, they are pretty wimpy.  Only the quantity of precip they can drop is impressive (though I’ve heard that SD is trying to rival the rainy season here).  Yesterday on the drive to the coast, we stopped in the market in Brikama, and there was water everywhere.  See pictures for details.

me in the Brikama market after a major rain

Gelly gellys

The major form of transportation here is by gelly gelly (also known as public transport).  There are only a few expats that have vehicles, and short term workers are not allowed to drive here (this is fine with me).  This means that if we want to go anywhere further than a few miles away, we take public transportation.  Gelly gellys are usually vans that carry about 15 to 25 people around the country.  They are inexpensive, especially when compared with the price of riding in a car with an expat, but less comfortable and take about twice as long (because of all the stops they have to make).  Any luggage beyond what fits on your lap goes on the top of the gelly (this can end up being a tower on top of the car – I’ll try to get a picture at some point).  This includes goats and sheep as well!  My first trip on public, a lady near me had a chicken under her seat too.  It looks a little comical, but it is the norm here.

I found it interesting to learn that the gelly gellys  do not honk randomly.  They only honk if they have space in the gelly for more people to ride.  This means that if you are looking to get a gelly on a busy road, all you have to do is walk in the direction you want to go and if a taxi honks as it passes, you flag them down and tell them your destination (generic; not always the place you are really going) and they will take you.  I think I’ve finally gotten the hang of the system so that I can even come down to the coast on my own.

Thank you all for all your prayers.  I appreciate you all a ton.  Please be continuing to pray for team unity, especially as we have staff who are going home on furlough or for a few weeks which will leave a gap in the work.  Especially since it is rainy season, the workload is increasing, so this will pose a problem for the clinic.  I’ve really been adjusting well to living here, but continue to pray for opportunities and boldness to get to know the people and the culture better.

the clinic

I started working at the clinic last week on Monday.  The weeks are relatively consistent.  On Mondays, we have outpatient day when all the adult patients come for mild complaints.  On Tuesdays, all the antenatal (pregnant) patients come for checkups.  On Wednesdays, we have a children’s clinic.  Patients who are acutely ill can come on any day, but in general these are the clinic’s working days.  There are two maternity rooms and they usually have one birth a day (usually around 400 births per year), but I haven’t gotten to observe there yet.

So far, I’ve become proficient at taking blood pressures.  My third day, the few adult outpatients that came needed their blood pressures, so this was my first real experience with trying to do manual blood pressures.  I wasn’t very good at them though.  Last Friday, I practiced on Dr. Margaret since the clinic wasn’t so busy, and that was helpful for getting the technique down.  This Monday and Tuesday, I had to take hundreds of blood pressures and now I feel confident about doing them.  Whew!  I even got a blister on my ring finger from pumping up the cuff so many times and got sore ears from having the stethoscope in my ears for so long!

My first day I was on the ward, observing what the nurse does on duty and what the tasks are that are associated with that part of the clinic.  Mostly doing vitals, giving out drugs and prescribed food (milk, sardines, sugar, peanut butter – mostly for the AIDS or TB patients that have funding available to give them this food).  There are thirteen patient beds on the ward.  During the dry season, the ward is relatively empty.  When rainy season comes around (now) there are many patients that go in and out.  At the moment, the ward is completely full, but on my first day, there were only four patients on the ward.  Since my first day of orientation on the ward, I’ve been accompanying Dr. Jamie on rounds in the morning after prayer, so it has been a learning experience already.

The second day, I helped wrap drugs in the pharmacy.  The general stock of drugs is too large to keep all of them right by the dispensing counter, and only a few tablets are given out at one time.  The typical dose and course for the drug given out need to be wrapped in separate papers and labeled in order to hand out in a timely fashion.  For example, I was packaging iron tablets in sets of 6 and 12.  The pharmacist has arthritis and cannot wrap the tablets very quickly, so I was sent to package lots of drugs so that all the pharmacist had to do was hand them out.  The job is incredibly boring, but necessary for the smooth functioning of the clinic.

The third day, I helped in the waiting hall with weights and blood pressures.  Since it was children’s day, there weren’t as many blood pressures that needed to be taken, but lots of weights for all the children.  I find that Wednesdays are the busiest in the waiting hall because we have to call up several children up at the same time so that we can read the weights in a timely fashion.  This also creates a very hectic scene because we have three scales that the children can be weighed on depending on their size.  For this reason, I have to be paying attention on all sides of me to figure out which baby I am supposed to  be recording the weight for.  This makes for a very stressful morning.  The bright part of the  morning is that all the women who come with their children (as well as on Tuesday with the antenatal clinic) all come wearing their nicest outfit so it makes for a very colorful and festive-looking place.  I haven’t had an opportunity to take a picture yet, but I will post one soon so that you all can see how amazing it is.

Friday morning, there were few staff back at Sibanor (we had prayer day down at headquarters the day before, and many people stayed to finish up business or to just have the weekend off), so I was with Dr. Margaret seeing patients in the doctor’s room.  It wasn’t very busy; we only saw four patients, but they were all very interesting.  There are about three or four nurses who see all the patients and they refer patients to the doctor only if they don’t know what to do with them.  We drained two abscesses:  one behind the ear of a five-year-old girl, and one on an older woman.  Both patients were put under general anesthesia, so we had to watch them while they woke up as well to make sure that they didn’t try to get off the table before the anesthesia wore off.  Then we saw a boy with bilateral juvenile arthritis in his elbows.  This is too rare and complicated for our clinic, so he was sent down-country to the research center.  There was also a woman with undiagnosed diabetes with an enormously abscessed foot.  This one was too big to drain at our clinic, so Dr. Margaret sent her down-country as well to have it seen to.

This week Tuesday, blood pressures and weights were done early so I was placed in the lab to watch what they do on a daily basis.  I observed their phlebotomy station and learned how to do hemoglobin, HIV, pregnancy tests, and malaria smears (they used to have 40 patients in a ward at a time with malaria, but now see about two cases per year)

Today, I helped a little with the storeroom organizing.  We just received a shipment of medical supplies so they all needed to be accounted for and put in their proper places.  The clinic has to order supplies once a year and has to be thorough so that the supplies will last that amount of time.  It isn’t like at home where you can get a shipment of supplies from the company in a couple days; it takes months to be ordered and shipped here.  Wow!

Well, I think that’s probably enough of an update for now.  I hope you all are enjoying your summer.  Please continue to pray that I would be able to find my place here at the clinic and feel a part of the team.  There are a lot of transitions continuing to play out so we will need your prayers as we navigate those issues.

Random note:  For any of you who enjoy animals, the cows, sheep, dogs, goats chickens, lizards are wandering around all the time.  It is uncommon to see them tied up or fenced into an area so they wander freely in and out of the clinic compound (I have to chase chickens and goats out of the waiting hall a few times).  This also means that they are free to give birth on the compound.  Yesterday, I was walking back to my house and saw a goat giving birth to twin kids.  I couldn’t grab my camera fast enough, but got some pictures (and one video) of them in their first hour after birth.

the main part of the clinic (the treatment rooms). The pharmacy is to the left of the picture; the waiting hall is behind me; the ward is behind the treating rooms

Life at Sibanor

Wow! What a crazy week. Not that it has been exceptionally busy, but I’ve been somewhat overwhelmed with all the new sights and sounds and experiences. I have been blown away by the gorgeous landscapes and am enjoying meeting new people.

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