Today, when I arrived at the hospital, I discovered that the power was out. Sitting in in the dark, breathing in the stagnant, fan-free air, I laughed aloud thinking about the number of times I had tossed around the words "resource-poor settings" in my public health classes. When my laptop’s trusty battery finally bit the dust, I was left with little to do. I confided my frustration at the power outage (on top of the doctors' strike, the fierce rainstorm that prevented most patients from coming in today, and other hassles) to Dr. B., a plump and lovable Ob-Gyn whose favorite (and perhaps only) English phrase is “Doctors in Africa—big problems.” Below, I translate his response:
Oh, the electricity goes out all the time. Sometimes when I’m operating.
Really??? What do you do when that happens?
Oh, you know… I send someone out to get my flashlight.
Your flashlight???
Yeah, but one time I didn’t have it, so everyone stood around me with their cell phones so I could see what I was doing.
Doctors in Africa—big problems, indeed.
While I floundered about in the dark, Aicha (who, by the way is not only a nurse, but a midwife-in-training), literally had the experience of a lifetime. She witnessed a breech birth (that means feet first) of twins, delivered vaginally (that means not by c-section), by midwives (that means not by doctors). A breech birth is something you and I almost certainly will never see, and I am happy to report that two healthy baby boys ensued. How appropriate that the French word for midwife is sage-femme: literally, a wise woman.
Today I also said au revoir to my two closest compatriots at the CHR, the data manager and the HIV counselor (pictured below), with whom I spent most of my days. The counselor has done 108 HIV tests so far this month, 26 of which were positive, all with—you guessed it—the same pair of gloves.
Here pictured is Dr. B generously using his strike-time to help me review records:
Me with my leading ladies:
Hospital beds, IV poles:
Organizing a support group for HIV+ moms:
Monday I depart for Issia, a smaller hospital, to do the same assessment. P.S.: What do you think of my new complet=outfit made from panyas I found in the market (see 6/14)?
("Leading ladies" photo courtesy of Aicha Scott.)
Note on video posted 6/15: The mystery has been solved: it turns out that the jogging choir is actually none other than the Ivorien military in training. Onward, singing soldiers!
1) Learned the art of the “bucket bath.”
In spite of the comforts of our apartment building, which ironically includes a large and inviting swimming pool, we continue to suffer from a lack of running water. There are taps and showers—don’t get me wrong—but most of the time, when they are turned on, they yield little but the mocking sound of dry air. Running water does come for a few precious minutes a day, but it is impossible to predict when that will occur, and the chances of it coinciding with your desire to shower, brush your teeth, or flush the toilet are small.
This is where the garbage can full of water and spoonful of bleach, judging from the scent of it, comes in. When I confronted the building manager about the water issue, he assured me that it’s not just our building—that the situation is the same all over town. That’s why you have that reserve of water in your room, he said. Oh, you mean the poubelle (trash can)?, I asked. He laughed uncomfortably, but let’s face it buddy—that’s what it is. Yep, he said, that’s what we use. So I began to practice the ancient art of the bucket bath, using a plastic tupperware as a scoop and being careful to go “clean to clean and dirty to dirty”, as Aicha advised, so as not to contaminate my precious reserve of water. I learn something new every day.
2) Got famous.
Last night, as nostalgic for our friends as for the running water in Abidjan, we decided to suck it up and check out “King Discotheque” next door. It did not disappoint. The music was just as good as it was en ville, and the setup was exactly the same. The culture of going out dancing here has nothing much to do with pairing up—quite the opposite, actually. With my sample size of two dance clubs, I can now conclude that what you’re supposed to do is get dressed to the nines and then go dance by yourself in front of the full-length mirror that will inevitably cover one of the walls, staring at yourself. All night.
Also, the the music will inevitably be interrupted every few minutes by a DJ shouting something or other. Last night's interruption-shouting theme was “Aaaaaaaaicha!”, and some form of my name, alternately, “Maaaaara!”, “Maaaaaria!”, “Maaaaaariam!” or “Maaaaariama!” It’s the most famous I’ve ever felt.
3) Found the AIDS medicine in the market.
Yesterday we explored the market, a vast labyrinth of stalls and vendors, a veritable tower of Babel with local and foreign languages rising in a chorus of salesmanship. More than one person offered a bowl of dead frogs, sweating under the hot sun and covered in flies. More appealing to us were the cloth sellers, offering panyas, unfinished rolls of brightly printed cloth for tailoring. I bought two sets (enough fabric to fashion a top, a long skirt, and an extra piece for a matching baby carrier, headwrap, or bag, for the price of about $14. I've already met up with the tailor, who will deliver me a my new African costumes on Wednesday.
We also noticed a woman selling medicines--it was hard to miss her, actually, because she had one of the loudest salespitches going. We approached, and she showed us her dried leaves, berries, and re-used water bottles full of a muddy-looking liquid. This is for stomach ache, this is for fever... and so on and so on. What about AIDS?, Aicha interjected. Do you have anything for that?
Of course, she replied in a lowered voice.
Really?, Aicha asked. Do you know what that is?
It's a sickness, the seller supplied. You lose weight, and lose weight, and lose weight. I have this medicine, she said, waving vaguely toward a pile of plants, and progressed to an explanation of which ones were used for abortions.
4) Asked for and received.
I think I've mentioned before the breakfast bar that we go to every morning--$1 for rich bitter coffee or hot chocolate, and fresh bread and butter for the two of us. When I learned that the owner of the little shack was Senagalese, I had to ask about tchep djen, my favorite local dish to date (see 6/4/09). In typical African hosptality, he not only had his brother's wife make some the next night, but he served it to us in his breakfast bar at the time of our choosing, for free.
5) Made friends.
There is a bar behind our apartment, always empty except for the owners, with Ivorien reggae always blasting. We ventured over early this week to check it out, and made fast friends with the boss, a middle-aged lady with a husky voice and a steamy love affair with alcohol. Plainspoken and boisterous, Lili--as she is called--has taken us under her wing, and welcomes us as we come to visit for a few minutes each day. One night, she inquired which ONG (NGO) we worked for. I was surprised at the question, and even more surprised that she was familiar with ICAP. I asked her what she knew about HIV, and she launched into a scientific explanation, complemented by stories of her relatives and friends who had the disease. She knows her status. She knows that it's important to get tested, because the medicine works well and you can live fairly normally, as well as prevent infection to your baby if you are pregnant. Finally, she recommends a campaign to educate villagers en brousse, who are both the most affected and least informed. What could I say besides... great idea.
Aicha has dubbed Lili's place "the mosquito bar", due to its outdoor setup and the relentless feeding frenzy that occurs at sundown. Thank goodness for malaria prophylaxis!
6) Got two new names (as if I needed them).
Actually, an African name offer is something I’ve been coveting for a while. If someone gives you a name, in my opinion, it means two things: that your name is unpronounceable in the giver’s language, and that they care about you enough to want to fix that. My first new name, Adjua (meaning born on Monday, which I was not), was given to me by the pediatric nurses at the hospital. Aicha’s name rolls off the tongue (although it almost always invites the half-joke, Are you a Muslim or something?), but mine seems to get stuck in the back of the throat somewhere. So, sensing frustration, I put the idea forward that they find something else to call me. They jumped at the chance, and Adjua, a Baolé name, was offered and stuck.
My second name came about more naturally. Tantie Lili (Auntie Lili), the rough-and-tumble owner of the mosquito bar, looked over her glass of whiskey at my face one night and said flat out, “You look African to me.” Actually, before you laugh, this is not the first time that assessment has been made—the rasta man who owned the coffee farm I stayed on in Jamaica said exactly the same thing. Anyway, Tantie Lili continued on to say, “Yes, you are African. You are Bété. I will call you Yao.” I am guessing at the spelling of my name, because when she said it, it sounded approximately like Yaaaaaaaaooooooooooo, which is probably Yao with a whiskey accent.
French word of the day: Sensibilisation=No real equivalent in English, but encompasses education, sensitizing, and introducing an idea, as in Tantie Lili's idea to go out and discuss HIV in the villages.
Bananamobile:
No peeing: Fine $4.
More to follow, if I can ever get outside. Should have brought one of those underwater cameras...
