Today I'll get straight to the French Word of the Day, of the month even: en brousse=in the bush (meaning, out in the middle of nowhere, and everything that comes with it). We're up in Daloa, working in the smaller nearby towns of Bouafle, Issia, and Bonon, and though we're not really en brousse, after Abidjan's comsopolitan comforts, it feels that way a little. It's great though, because I always regretted not doing Peace Corps, and now I feel like I'm getting a chance to experience the living conditions (as well as the service aspect).
We went into the hospitals for the first time. I don't think anything could have prepared me for what I would see there.
I'll just give the one example that has stayed in the forefront of my mind for the past few days. HIV counselors routinely wash and re-use gloves, and when the gloves run out, they do HIV tests without gloves at all (which is always a risk, but it is seems especially salient after looking at the records, which reveal that maybe 1/3 of the results are positive). I report this situation not to criticize or embarrass anyone. On the contrary, the counselors' dedication is astounding: "We know the risk. But when someone comes to be tested, we don't want to miss the opportunity, so we do what we have to do, and put our trust in God that we won't get infected." I reflected on how many pairs of gloves I throw away in the course of a 12-hr shift... it must be several dozen.
The lack of basic protection for those on the front lines is echoed by the lack of basic comforts for patients. For some reason, I feel that it's a bit of a betrayal to describe them in detail, so I won't. Suffice it to say that it's about the farthest thing imaginable from the hospital settings that I am familiar with. Some of the health centers here are without electricity or running water, even.
The silver lining to the situation is the dedication and competency of the workers, which is really something special to see. Nurses and doctors work tirelessly to empty overflowing waiting rooms at a pace that can only be described as American. And the education for both professions is thorough, to say the least. Nurses do 3 years after bac (which is an extra year after high school) plus a thesis for their degrees. Doctors, I learned, go to med school for a minimum of 8 years after the bac for general practice, plus specialty (obstetrics is 4 extra years). They are paid by the state, and not paid well, according to the gynecologist I spent the day with yesterday. Which is why there is going to be a nationwide strike, starting Monday. No doctors (except for emergencies) in the entire country. I hope that next time I'm able to report that it has been resolved quickly and with good outcomes.
This is Aicha posing with the snakeskin that adorns our apartment lobby. The proprietor assures me it was not caught and killed in the building.
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