Archive for » September, 2010 «

Sir Emily
    Funny moments/ Firsts since I’ve been here

  1. I was called “Sir” for the first time in my life a couple weeks ago, and it wasn’t someone trying to be funny; he was actually trying to be respectful.  In Mandinka (not sure about all the other languages) there is no differentiation between he, she, and it.  Those pronouns are all the same word.  For this reason, men get called “her” and women get called “him” on a very frequent basis.  I usually hear this mistake several times every day.
  2. First time being away from home for so long (I passed the previous record a couple months ago)
  3. First time enjoying peanut butter since I was 5 (I remember the day that I decided I didn’t like it pretty vividly).
  4. First marriage proposal.  Actually, I’ve started to tally all the times that I get a marriage offer and I’m up to 11 so far since I arrived (or family members who say they have a husband for me).  No worries though, Mom and Dad, I haven’t accepted any of the offers.
  5. first time being called “mate” (by one of our Australian team members)
  6. first time being wished “Cheerio” without trying to be funny

line of people to get tickets and then I either weigh them or take their blood pressure inside the waiting hall

in the pharmacy; the pharmacists for our clinic

eating sour sop for the first time. looks funny but tastes much like an apple

Normal clinic day

Clinic starts with staff prayer at 7:40am in the OR (not used anymore obviously).  This means that I get up at about 6:30am to have a little breakfast with my malaria meds and do my devotions before I go to the clinic.  Then at 8, the clinic starts.  Usually I go with the doctors and nurses on the ward rounds (lasting about 10 to 40 minutes depending on how full the ward is – lately, it has been taking at least a half hour with the rainy season boom in patients). I usually learn a lot about treatment and culture norms.  The doctors and nurses have a wealth of knowledge (especially Dr. Jamie – he is a walking encyclopedia!).

After rounds are done, I go to the waiting hall to help the waiting hall nurse get started with the day.  We weigh screaming children and adults and take the blood pressures of all the adults.  About half of the children under the age of five scream bloody murder when they have to stand on the scale, hang in the hanging scale, and/or be near my strange toubob skin.  The ones who have to stand on the scale are the worst though because they will do everything in their power to not stand on the scale:  arch their back, move their feet away, or run (if they can escape the grasp of their mother).  I think it’s hilarious though because I’m not going to do anything to them.  All they have to do is stand on the scale for two seconds and let me look at the reading and then they are done.  I don’t even have to give them an injection or even touch them.  As a result, I’ve learned the phrase “kana silaa” (don’t be scared), though it doesn’t do much to calm down hysterical children.

At 10 or 10:30, all the staff go for second breakfast break.  We get tapalapa with the toppings and coffee or tea, and every once in a while, a bit of good fruit (like the sour sop in the picture).  It is a good break from the craziness of the clinic and gives a good opportunity to ask questions or learn more about my team members.  After break, I usually go to the pharmacy to break/wrap tablets or do work on the HIV database (see below for a description of how that project is going), or observe the doctors or nurses treating the patients.  Regardless of what I do, I always learn a lot.  Wrapping tablets is usually the most boring job, but it is really necessary.  To wrap the tablets I have to cut up scrap paper (usually from an old book) and fold the paper around the tablets and then label it.  As I’m wrapping I always read a little of what is on the pieces of paper and I always wonder if people who ultimately get them actually read the pieces of paper that their tablets are wrapped in.  The most recent book I’ve been using is an old history dictionary, and I’ve also used a book on treatment of sexually transmitted diseases.  Sometimes I hope they do, because it is good info, but most of the time, I’m not so sure I want them reading it (either because I’m embarrassed of the info or they might take the info out of context).

In the afternoons, I usually do a bit of reading or studying or other small things that need to get done in my room.  It is too hot to do anything else, so I try to use that time well.  Then around 4 or 5 when it is just starting to get a little less hot, I go out and visit people.  I have several compounds that I try to visit at least once or twice a week, and two days a week, I have language study for an hour.  I never know what I will do once I’m in a compound though.  Sometimes I have just sat and listened to conversations in Mandinka or Balantes and try to pick up a few words or phrases, and sometimes, I end up helping with shelling beans or cooking or keeping children occupied so that their mother can get stuff done.  They are always honored to have people come visit though, so this is the most important part of my day or week.

On Mondays, we usually have a meeting with all of the team members in Sibanor and on Thursday we have fellowship time.  Fellowship time is a couple hours set aside to pray together as a team or learn about each other’s home cultures.  I always enjoy this time to get to know my team members even better.

office where I work on the database for the care project.  Mami and Mama (foreground) work in the same office


As most of you know, one of the things I was expected to do while I’m here is to create a database for the HIV care team here in Sibanor.  It is mostly to make doing end of the month statistics easier, but initially they were hoping that it would be able to keep patient histories as well.  For that reason, when I started my project, it was more than a little daunting.  Since then, it has become more defined and a little less ridiculous guidelines.  I wasn’t sure what I would have to work with when I got here, so I brought my computer equipped with programs that I thought would be helpful, but it turned out that Dr. Jamie had a much more user-friendly program from the CDC that I could use.  As a result, I have been able to get the database up and running.  I just have to work out the bugs and make it more streamlined and teach the rest of the staff on the team how to use it.

Flying chickens and more adventures with animals

one of the crazy roosters running around the compound

Guinea fowl - crazy birds sound like a squeaky wheel

I didn’t think that I would ever see the day where I saw a chicken flying, but I have witnesses to attest to what we saw.  I first noticed something larger than a normal bird in a tree.  Then after some rustling, it flew down from the perch it had in the tree.  Not only that, I saw another chicken fly UP to the same branch that the other one had been on.  Wow!  That’s some major evolutionary progress.

Chickens are normally not kept in a pen here.  They roam freely around wherever they please.  I still have no idea how on earth the people here know which chickens are their own.  It’s pretty funny though because these roaming chickens come wandering in the clinic all the time.  I’ve had to chase chickens out of the ward and out of the waiting hall (while there were 50 people sitting in it – they have no fear).  The funniest chicken is a hen that has a brood of guinea fowl that are “her chicks.”  Guinea fowl are funny looking and sounding enough but this little family makes me laugh every time.

not in Kansas anymore
    Things to get used to/ vocab:

    home, aka. Blue House. Note the goats chilling on the veranda!

    the bathroom. don't be fooled by the shower head. I have to use that little green bucket to shower. yay for fun adventures.

    our lovely little kitchen

  1. Bucket shower:  when a shower head is not available, a bucket shower is a good option.  To accomplish this, one fills a large bucket with water, then using a cup, rinses, washes, shaves.  Even though in Blue House, we have running water, we have to take bucket showers because our shower head doesn’t work.  On top of this, although we have solar power, an animal in our ceiling ruined the wiring for the light in the bathroom, so we also take our showers by candlelight (or flashlight, if you so desire)
  2. Ironing:  although you may think you know why one irons clothes, you are only partly correct.  Here, after clothes are washed, they are ALL ironed.  This is not an OCD characteristic, it is out of necessity.  There is a bug (mango fly if I remember correctly) that lays its eggs in clothes while they are on the line.  If one doesn’t iron the clothes, the developing mango fly will worm its way into one’s skin and back out whenever it pleases.  I won’t ever complain about having to iron a couple articles of clothing back home again.
  3. Here in Sibanor, because we only have solar with a smallish battery, our fridges and stoves are kerosene or gas respectively.  I didn’t know before that you could have a refrigerator run by kerosene, so this was pretty intriguing when I arrived.  Getting used to cooking with gas has been fun though.  I’ve gotten very good at lighting matches (even in this humidity).  Cooking with our stove is complicated though because it has no real low setting- so you have to watch your food very closely to make sure it doesn’t burn!
  4. Solar power:  Having solar power with our smallish battery means that we have to be careful, especially during rainy season (b/c not so much sun) with using too much electricity otherwise the battery can die while you still need it (one of the Blue House girls that went home had the electricity go out when she was in the bathroom and had to find her way back to her room with the lights out)
    • Note that the power lines are going up around the country so Sibanor will have power soon and the clinic won’t have to rely on solar power so much (antenatal clinics on a cloudy day don’t work so well because the ultrasound machine takes a lot of power)!  Everyone in Sibanor is very excited for this progress!
the electricity is coming!!!

Learning Mandinka

Here in Gambia, there are four major people groups:  Mandinka, Wolof, Fula, and Jola; Mandinka and Jola being the most common people groups in Sibanor.   Mandinka is spoken by about 70% of the people and it is used as the main market language.  In Sibanor, as you leave the main road, you run into a lot of Jola villages (Sitta, Kiemo, Gifunga – the closest villages that we have anything to do with on a regular basis- I will probably refer to these in other updates).  Anyways, since I’m only here for short-term, Mandinka is more useful for me to learn while I’m here.   Learning the language is incredibly important for people trying to work in another culture in order to show that you are not too proud to learn another language, and makes communicating a lot easier in more rural areas where most people do not speak English fluently.  Although

In the last couple months, I’ve come to understand that I’m not so good at learning languages as I thought.  We learned some phrases in Korean as practice back in the US that I failed to really learn.  Here, I’ve been completely overwhelmed at how much I would have to learn to become fluent.  I am now completely comfortable with the greetings (don’t scoff, they are quite long and involved compared to our greetings back home).  I’ve learned a few commands and a few objects, but that’s about where my skills fail.  I can catch a few words, but I have still failed all the tests that my language helper has thrown at me.  Arg.  I think if I was more focused and practiced more outside of my lessons that I would do much better, but I don’t feel motivated enough.  I’m learning domanding domanding (Md. slow slow) even though I want to understand saaying saaying (Md. now now).

Since it is Ramadan now (see the section later), my Mandinka teacher needs to cook the evening meal which is a lot of work, so my lessons have been suspended until the end of the fasting month.  Hopefully I’ll be able to learn some from other people.  My American friend, Jessi is good at Mandinka and knows a lady, Kaddy, who was really helpful for her, so I will be able to practice my Mandinka with Jessi and Kaddy.  This makes me excited.

“change, even change for the better is always accompanied by drawbacks and discomfort”

I’m really having to rely on God the last few weeks to maintain the strength to go and get to know the people here more and learn the language.  It’s really easy to stay in the “safety” of Blue House and make excuses about the weather or things that I need to do.  I find that I’m always better off when I venture out and greet people in their compounds and work on my Mandinka learning, but it is hard work.  I always feel a little overwhelmed, but know that my effort was worthwhile.  Keep praying for the courage to go out and sometimes get laughed at, but learn from the experiences.

I’ve been considering trying to live outside of the clinic compound with a Gambian family in another compound.  There is no difference in the safety level, but it would give me more opportunity to get to know the people and the language better.  I feel like I live in a bit of a bubble because I live in the same compound that I work in.  It was nice to get used to living in this environment, but I didn’t come to live in a bubble apart from the people.  Contact with people in the clinic isn’t enough – they don’t want to be there, and it is only a short contact.  There are other team members who have or are living in the village, so it is for sure doable and the rest of my team is supportive, but I just need to find a place that has a space that I can live in.  If nothing else, I will try it for a week and see how it goes, and we’ll see where I go from there.  Please be in prayer that I will find a space that not only has the space and is willing to house me, but also speaks Mandinka so that I can get more practice.

Ramadan (take a pic of a mosque – Sib or Pipeline)

For those of you who are not familiar with the Muslim practice, we are in the middle of Ramadan.   Ramadan is the fasting month in Islamic tradition and since 90% of the Gambian population is Muslim, this month is a big deal here.  All Muslims fast from sunup to sundown from food AND water (I’m REALLY impressed considering the climate here).  People who are sick, children, and pregnant or nursing mothers are exempted from this practice if they feel that they cannot do it.  This makes treating people in the clinic a little tricky.  Many times the common practice would be to give the patients the medicine they need when they come, but in order to keep their fast, they have to wait until sundown to take the meds.  For those who take regular meds who want to continue to fast, we have to figure out how they can take their meds only in the morning and at night.  Managing diabetes during Ramadan is ridiculously hard.  Dr. Jamie gave a seminar previous to Ramadan on the topic; what the patients should try to eat in the morning and the evening and how to take their medicine to try to keep their blood sugar in a decent range.  Extremely complicated, but I’m always amazed at their endurance during this month.

As I’ve learned from fasting back home, I can get pretty crabby when I’m hungry.  The same is true here.  We have to be careful not to do anything to frustrate those who are fasting.   It’s also important not to emphasize that we as Christians are not fasting so that we don’t make it harder for them to keep their fast.  Since almost all of our Gambian staff at the clinic are Muslim, we try not to remind them when we take breaks for second breakfast or lunch.  We are trying to be as respectful as possible of them all.