Hospital Adventures (in pictures)

 

 

 

 

 

 

 

 

 

 

My fellow intern (Nicole) doing some paperwork in the nurse's station. Notice the TV on the right. Don't even THINK about bothering the nurses at noon when their favorite soap opera comes on.

Me in the radiology ward

Me and Nicole chillin next to the MRI machine.

Here we're facing the hospital and behind us is the entrance to the hospital (see the car coming in on the right side?)

Me and Giscard, another intern, near the exit of the hospital grounds.

Being a happy fool. (For those of you who don't speak French, "Urgences" means "Emergency") Every day I enter the hospital from the Urgences door.

"Interdit de stationner sur la pelouse" (translation: parking on the grass is prohibited)...and yet everyone parks on the grass lol

All it Takes is a Smile

It’s already been 2 weeks since I’ve been in the surgical ward, which means tomorrow I’m starting in the internal medicine A (infectious diseases) ward. At the end of my first week in surgery I went to the basement of the hospital with two other interns and the head nurse of the ward. He’s the type of guy (the head nurse) who LOOOOOVES to talk your ear off, so naturally he was giving us advice and telling stories during the entire trip. The other interns are all second years from nursing schools in Yaoundé. At one point the head nurse asked the other interns what makes me different from the rest of the interns (besides my skin tone and my American accent) and they were clueless…as was I. Finally, he told us that what sets me apart is the fact that I smile. He said it makes all the difference for the patients and the staff we work with. After he said that, I started noticing that the nurses here don’t really smile and that every time I smile at a patient, two things happen: 1) he/she has an incredibly surprised look on his/her face and then, 2) he/she smiles back, relaxes and his/her demeanor softens. That’s literally all it takes. I hadn’t noticed it before, probably because I smile all the time, but it all made sense to me because whenever I run into a patient or his/her family in the hallway, they always stop and talk to me. The head nurse made me realize that it’s simply because of my positive attitude that the patients feel comfortable telling me about themselves. For example, here it’s common for patients to give a little tip to nurses they like or feel are deserving of a reward. One morning I was changing one patient’s sheets as he was standing by the window. As I was working I said, “Bonjour, Monsieur Mahamat! Comment allez-vous ce matin?” (And of course I smiled). He turned to face me, smiled (was shocked that I was talking to him) and replied, “Bonjour, ca va très bien”. Ten minutes later, his brother came to the nurse’s station and gave me 1000 francs (about 2 bucks). He said that his brother was so pleased with the way I was with him that he wanted to give me a little something. It’s crazy how subtle culture differences can have such a huge influence on day-to-day life.

Livin The (Hospital) Life

First things first: I successfully killed my first roach! HUGE step for me and one of the tangible signs that I, in fact, have grown since I’ve been here :) 

For the past two weeks, I have been working in the General Hospital of Yaoundé in the internal medicine (cardiology, nephrology and psychiatry…I’ll explain the psych part later) ward with the nursing staff. I have learned an unbelievable amount about nursing, medicine and how public hospitals work in Cameroon. Every day I get to the hospital around 7:45am in time to start the 8 am rounds. There have been from 17 to 25 patients in the ward and there are only 2 nurses each shift (2 shifts: 7:30am-5:30pm and 5:30pm-7:30am). I’ve discovered that having only 2 nurses makes it extremely difficult to give each patient the time, attention and care they need. Luckily because two nursing students and I are here, the nurses have a slightly lighter load. An advantage to this is that I have the opportunity to learn everything from the nurses here. I’m getting used to doing EKGs (electrocardiograms) on my own, reading patient charts and administering the appropriate drugs.

Here’s the reason the psych ward is combined with the cardiology and nephrology ward: Awhile ago, there used to be an entire hospital devoted to psych patients. However, all of these patients are children of the richest and most powerful people in Cameroon -- who in turn get their way because all it takes is a little financial incentive – and they weren’t happy that their children were outcasts in the medical and social world. So, since the General Hospital is the best public hospital in Yaounde, the parents of such patients pay lots and lots of money to have their children (teens and young adults) hospitalized there. The problem is, there isn’t any room to have a completely separate psych ward, so they had to add it on to the cardiology and nephrology ward. Most, if not all, of these patients were at one point in Europe and then started using drugs or developing mental health issues and were sent back to Cameroon to the General Hospital. It’s sad because they end up spending most of their lives in and out of the hospital.

One of the major challenges in the ward is dealing with families that use traditional medicine in addition to (or in lieu of) modern/Western medicine. This causes even more problems with a patient who already has a severe renal insufficiency. There was a teenage boy in the ward last week that had already been hospitalized once before. He has a congenital kidney problem and has to monitor his food intake extremely closely otherwise his whole body swells with fluid and he becomes really, really tired because his kidneys can’t efficiently filter out waste. His parents had started giving him his meds but resorted to traditional medicine after awhile, which made his situation even worse, to the point where he almost died. So since he was in the hospital again, when all he initially needed was maintenance, he was in the worse condition possible and the nurses begged his parents to not give him traditional potions or lotions because they will not help him get better. Unfortunately, we have no way of following up with the family (there’s no time to properly care for the patients in the ward)…hopefully he won’t end up in the hospital again under the same conditions.

I had an “aha moment” the other day. I think I looked pretty stupid because I was smiling to myself in the ward. Anyway, I realized how useful I feel in the ward (especially with a shortage of personnel). I don’t feel like I’m doing much but every time I get a “merci beaucoup” from a patient, I can hear and see their sincerity. Even though I have seen a few people die in the ward, getting a thank you and/or a smile from a patient makes what I’m working towards completely worth it. Like I said, I don’t do a lot, but when someone (patient or family) feels like you care and are helping him or her get better, it brings about an indescribable feeling. This is the driving force behind what I think medicine should be about: seeing healthy, smiling people leave a ward who were at one point really sick, and knowing that you played a role in this improvement. Now that I’ve seen patients recover and others pass away, I have come to realize that although death is very sad, having patients recover and give you their thanks for helping them do so is absolutely worth it.

I’ll be working in surgery starting tomorrow so look out for another post next week!

Life As I Know It

The butcher at the meat stand cutting up some cow penis for us to enjoy

Hey blog friends!

Here’s what’s going on in my life right now:

1.     Last week we ate cow genitals

-       We went to the same barbeque place we were at in my last post, but this time, Collins, the driver told us we should try something else. So I asked him what it was and he said he wouldn’t tell me until we tried it…being one to try almost anything (what’s the worst that can happen? I have traveler’s insurance and ciproflaxcin handy for any potential stomach problems), I put a piece of unidentifiable meat in my mouth. I was staring him down as I chewed and finally, after I swallowed the piece (it was delicious!) he told me I had just eaten cow penis. Yeah, cow penis wrapped in intestines too. So, naturally we sat down at the restaurant and bought a bunch of it:

Cow penis with some condiments and chai on the side. Pretty tasty!!
 

Of course we made penis jokes throughout the entire meal...we couldn't help it lol. Things like, "Hmmm, I don't think my boyfriend would be too happy to find out what I just tasted..."

2.     People like to budge a lot (or cut in front of you in line, which ever you prefer)

- I’ve noticed this a lot here and it’s time for me to comment on it. There’s a lot of things I take advantage of in the States: fast Internet, drinking tap water, driving through traffic, etc. but something I didn’t know I take advantage of until recently is that people always wait their turn in line in public. Not the case in Cameroon, at least not in Yaounde. Plenty of times I have been VISIBLY in line for something and someone comes from behind and walks right in front of me as if they didn’t see me standing there when they walked up. It’s kind of a shocking phenomenon to watch. The first time it happened, I was sure it was just a mistake but it’s happened multiple times: at the bakery, in front of a kiosk, at the hospital… Who knew a simple concept that Americans are taught in elementary school, even preschool, could have such importance in my life when it’s lacking in a different society.  

3.     Customer service does not exist (as far as I’m concerned) in Cameroon

- This is very much related to #2… Another American concept that is extremely important in everyday work life, but clearly not here. I expect a smile and friendly service when I go to a restaurant or ask for directions at an establishment, but many times the smallest amount of customer service is non-existent. Again, I didn’t know how important it was to me, but apparently it is. I was at a restaurant the other day and I felt like I was bothering the waitress who was waiting on me. That seems kind of backwards right? The waitress didn’t want to wait on me. At least that’s what her face was saying. I never knew how uncomfortable I could feel going up to someone behind a desk that says “renseignements” (information desk) who has a stank look on their face the entire time. It’s pretty discouraging. Nevertheless, I’ve learned to ignore people’s negative-looking facial expressions and proceed with my question/comment.

4.     The presidential election results came out almost 2 weeks after the election…with a result that everyone already knew

- One of the Supreme Court justices of Cameroon spent 9 FULL HOURS on TV (no breaks) announcing the election results in each department of each town in Cameroon…and with 23 candidates to list off (including their percentages in each department) that can take a loooooong time. I started watching it at 11 am last Friday expecting to get results within an hour or less, but after an hour and a half, I gave up. 9 hours later, Paul Biya was still the president (as he has been for about 3 decades).  There has been talk of a “revolution” but I don’t think Cameroonians want that for their country. That said, if anything happens, I will be on the first flight back across the Atlantic! :) 

The front page of the newspaper, Cameroon Tribune, the morning of the election results

My random comment of the day: 

The last time I saw a donkey was in the island of Lamu off the coast of Kenya...who knew the next time I would see one would be in the bustling city of Yaounde just frolicking through traffic, without a care in the world. Donkeys are living the life.

Oh, hey Mr. Donkey.

 

Venturing Through Different 'Hoods

Yaounde and all of its neighborhoods.
Can you find Essos? That's where I live :)

The advantage of having a flexible work schedule is that there's time to be a tourist. This past week there wasn't that much work in the lab because the medical students are at the end of their research projects and getting ready to defend their theses. This meant that on Thursday and Friday we had time to travel around the city. We went to Briqueterie (the Muslim neighborhood) for some soya (grilled meat) and dackere (yogurt from Northern Cameroon). Walking and driving through Briqueterie reminded me of what Northern Cameroon is like (we visited Garoua and Maroua, two cities in the north when I was here last Christmas): lots of mosques, Muslims and beautiful fabric. The only difference was that the yogurt did not have the rich quality in Yaounde as it did in Garoua.

Here's a Google image of the Briqueterie neighborhood...Too bad you can't see the pretty mosque I saw (but didn't have a good angle for a picture).

Akaila and me at 50/50 about to enjoy some grilled beef kebabs (soya). There was also liver, but that wasn't as good.

Google image of the Bastos neighborhood. Stuntin at its finest.

After Briqueterie, we went to Bastos for some chicken and fried plantains and then ice cream for dessert (tasted more like gelato/sorbet). Bastos is one of the neighborhoods that is known for the embassies and the expats who call it home. You can tell when you're in Bastos by the change in houses, people and restaurants. For example, driving through the neighborhood we saw a bright green Bentley. Stuntin'. Last week, we went to Pizza Roma, which is like an American-style restaurant with (really good) cheese burgers, pizza, salads, chicken nuggets, HEINZ KETCHUP (this was a big deal lol)...you know, typical fast food. The burger and fries were delicious, depsite the 5500 FCFA price (about $10...kind of steep for a burger, fries and a drink but it's a once in a while type of luxury) and it was nice to have to have some American comfort food. Don't get me wrong, I LOVE the food here, but it's nice to mix it up from time to time.

 

Yummy, greasy deliciousness!!

More on Elections and the Irrationality of Fear

Elections happened this past Sunday in Cameroon. It was interesting to be able to go to the polls with my aunt and witness how the process runs here. That morning we were going to go to church, but because of the rules on Election Day (no assembling in big groups from 8am until 6pm when the polls close) there was no way any of us were going to church at 6am that morning. Also, all the businesses were prohibited from opening during voting hours, even though some were secretly open and only let people in when the police weren't patrolling the area....Instead of going to church, we went on a run around a soccer field near the house. On our way back home we stopped at the polling place in the neighborhood, which happened to be my cousins’ old elementary school. There were lists in front of each classroom that were partly divided up alphabetically and partly randomly. Voters have to have their ID and voter card. I asked my aunt what the significance of a voter card is if everyone is required to vote with his or her national ID card also. She said that voter cards used to be relevant but now it’s just another formality. The problem is that many citizens’ voter cards have typos. For example, the voter’s first name is spelled wrong, their mother’s maiden name is wrong, or even their birthday is wrong. Not only does this produce false information, but in an effort to correct these mistakes, some people have multiple voter cards and the inaccurate ones are still distributed. So, yes, people vote multiple times since they actually may have different voter cards under their name. We asked one of the election officials from ELECAM (Elections Cameroon, the organization in charge of conducting elections) how they control people from voting more than once and he said that since they take everyone’s fingerprint after having voted, the ink left on their thumb is proof that they have voted. However, my cousin and me discovered that the ink is very easy to remove…so the system isn’t exactly foolproof. Nevertheless, we came back later that day and my aunt and her mother-in-law voted. In each room, the voter was given 23 sheets of paper, one for each candidate in varying colors, and an envelope. Then the voter goes behind a curtain and places their favorite sheet in the envelope and then put the sealed envelope in a clear box. Akaila and Dominique (my cousin) were allowed to take pictures of them putting their ballots in the clear box (given to ELECAM from the EU to reduce corruption during voting). Although it should only take 24 hours or less to count all the ballots, ELECAM announced that results would be announced 15 days from the election. One of the technicians in the lab said facetiously that the 15-day period gives them enough time to produce a desirable outcome (aka Paul Biya remains president). So at this point everyone knows what the result is going to be, it’s just a matter of officially announcing it.

Paul Biya, the incumbent presidential candidate. Every main road has about 4 billboards like this...that's a lot of the same thing, especially downtown.

On a completely different note…

For those of you who have seen me around bugs, you know that I DO NOT cope well in their presence. So far, Akaila and I have already have our fair share of roach and spider attacks (ok, maybe attack isn’t the right word but if you saw the sizes of these insects, you’d understand). Apparently roaches fly…and come in mutant-like sizes. Who knew. They also are not really bothered by intense roach/mosquito/ant/etc. spray unless you spray them for at least a full minute. No matter how much time I spend here, I don’t think I will EVER get used to seeing roaches, especially mouse-size roaches (I’m not joking). On the spider front, we saw a spider (while we were visiting my grandma in Edea) as big as my palm (again, not joking) and usually I can bring myself to kill a spider with my shoe, but this one looked like it could eat me. Akaila was having a panic attack at this point as well. So I called my cousin to come kill it for us; she laughed at us and killed it like it was nothing. Slightly embarrassing, but that’s why fear is irrational, right? In our apartment we have a pretty nice agreement: I (muster up the strength to) kill the spiders and Akaila tackles the roaches. So far it has been working pretty well but I’ll keep you posted on any abnormal insect encounters…

Random Thoughts: Elections, Rain and Marriage

Elections are approaching (October 9) and it’s interesting to listen to discussions people have about the various candidates. Paul Biya, the current president (and has been for almost 30 years) is clearly going to win because that’s just how things are. However, there are over 20 other candidates running for office and there were originally over 50. I asked my aunt if all the other candidates sincerely think they have a chance at beating Biya and she said they don’t but they hope for positions in the presidential cabinet after elections (which is better than nothing). When I talked to one of my cousins about the election and all the debates going on, he said that the debates on TV are just for show, to prove to the world that this is a “democratic” process.

            Each candidate received 60 million FCFA (about $ 120,000) for their campaigns. So far though, I haven’t seen any of the candidates’ (except for the incumbent) campaigning. A lot of people I have talked to (family and co-workers) really want someone other than Biya, but they know that is impossible…he’ll be in office till death. Cameroon is a stable country in terms of internal conflict (there are WAY too many tribes to start conflict among them) so there most likely won’t be any violence surrounding the election.

            On a random note, I will never understand why cabinets are placed high up in houses here…there are cabinets in my bedroom and bathroom that are completely useless because I can’t reach them, in fact you would have to be 7 feet tall for them to seem at a normal height.

            At the time I wrote this post (I write it down in a journal or on Word and then upload it online later), I was writing from work and it had been raining all morning. It was almost 9:30 and no one except a medical student was there with me. Because of the rain, life stops. People have an increasingly hard time getting to work in the rain when they have to rely on walking, taxis and/or bad roads. There wasn’t any traffic that morning and usually we get stuck in traffic jams most of the way to the lab. I ended up waiting for about an hour and a half until the technicians showed up (after the rain). I need to start operating by a Cameroonian mentality (that day I was 15 minutes late which was still too early). The only thing is that the more I lollygag at home, the more I feel like I’m wasting my time.

            I had a really interesting conversation with the girls in the lab the other day. We started talking about dating, marriage and divorce and the differences between practices in the United States and Cameroon.  I told them about the insanely high divorce rate and they were shocked to hear it. We came to the conclusion that in Cameroon (and a lot of African countries) the two people getting married are also getting married to each other’s families; both families not only meet but also become one cohesive unit through the dowry ceremony and various family events leading up to the marriage. This allows for an almost inseparable bond to form between the families. For example, my cousin's grandmother (on the other side of the family so not blood-related to me) is essentially my grandmother too; she is close with all of us and it is as if she is my biological grandmother, there is really no distinction. Therefore getting a divorce is very difficult because it is not just two people getting divorced, but two whole families. Whereas, in the United States, though the two families meet, they don’t (as often) become one family. Instead, it’s just the two people getting married that have a contract, making it easier to break. I had never really considered this difference between the two cultures, but it does make sense to me. There is more pressure here to stay together, whether it is religious, cultural or familial than in the United States (even though those pressures do exist in the States). Something to consider. Let me know what you think about this.

Until next time!