I walked swiftly down the path. Through the sunlight flickering off the rustling leaves of the guava trees I could see the kids slinking up. I felt the adrenaline surge. This was my time. The kids always stole our guavas. I knew how to stop them. All I had to do was catch one and beat him up like any good Nangjere man would do and the theft would stop. Unfortunately, for some reason beating up on small children has been something I‚ve never been able to do. Now, if it was the pigs that came scrounging for worms every morning. I could beat them up without a qualm. The only problem is they're too fast. You'd never think it to see them, but they're fast.
The kid in the tree saw me. Two things happened simultaneously: one, I kicked off my flip flops and began to lope towards the tree while, two, the boy almost fell out of the tree in his hurry to get down. His watchman took off and quickly veered left. I was hot on the tail of the second, the one who'd actually been in the tree.
A few days before I thought I'd found a solution. We watched from our screen window as a 12 or 13 year old took off one shoe, leaving the other shoe and both socks on, and climbed up the tree while his watchman stood casually by. Nathan went out the side door and ran up. Amazingly, for the first time ever, they didn't run. Everyone runs when Nasara comes anywhere close to where they are stealing guavas. They must've been new and didn't know the rules. So Nathan casually grabs his shoe. I follow close behind. I ask the boy how many guavas he's stolen. He looks confused. I explain that taking things that don't belong to you is called stealing. He nods and seems to understand. I notice two green guavas in his hand. I say, we'll keep your shoe here, you come back tomorrow to pay for the guavas and we'll give the shoe back.
He hangs around all afternoon with a small crowd of boys eager to see how the drama will unfold.
Nathan and I are on my side later that afternoon and see another boy up a tree. We pounce easily and take his hat. He follows us to the porch where we are soon surrounded by boys of all ages and a ritual dance of bargaining begins. He claims its not stealing. He claims it is only one guava and since when we caught him he dropped it to the ground he didn't really take it. I ask how much guavas go for. The boys say 10 francs (about 2 pennies). Finally, we bargain down to 5 francs and he pays for the two guavas of the other boy, they get their hat and shoe back respectively, and I explain how we don't like stealing so if they want our guavas all they have to do is ask for them.
This boy I'm chasing obviously hasn't been informed of that. He just knows someone is chasing him and he needs to get away. He's in too much of a hurry. I pace myself. I keep up with him easily with a measured stride. He cuts down a pit where mud bricks have been harvested and falls getting up in almost the same motion as I circle the rim. He ascends the other side with me know hotly on his heels. We enter an opening in a mud brick wall and circle around a hut into a courtyard. Â I can smell his fear. I know he's mine. He realizes he's in a dead end. He finds a narrow break behind a pile of reed mats. I cut him off. He stops behind the mats. Only the mats protects him from what he is sure is a severe beating. He begs for forgiveness then makes a break for it. I'm only a few feet behind. The pigs are his ruin.
You see, everywhere a small patch of water gathers, there the pigs will gather as well wallowing deep in with silly grins plastered on their snouts. When our outside faucet leaked last spring the melodious sounds of contentedly snorting pigs never ceased to freshen the airwaves as they kept it boggy. The pig's snuggling down keeps the wallow wet and slick even when all around has dried out.
Our friend met his wallow. With a look of surprise and terror he went down fast and hard skidding along the slime for a good 5 feet on his belly. I was on him in a second. I grabbed his wrist and pulled him up out of the bog. Come with me. He couldn't do anything but comply because of his fear even though I barely had his wrist with one hand. I had no idea what I was going to do with him but it had been good sport by the powers. He finally realized my weak grip and broke free only to trip and fall within 10 feet. By then the crowd has gathered and I explained again that while we don't like stealing we don't mind if they eat our guavas if they ask. I release him.
Between chasing them from our guava trees, playing basketball on our leaning tower of hoop and playing guitar and drums on the porch, we have gained quite a following among the local kids who never cease to tirelessly yell out "jay-mmm-suh, jay-mmm-suh, lalé, lapia, lalé" as they wave joyously anytime we pass or hang out. They are dirty, naked, barefoot, ragged, cheery, playful, mischievous, tireless, incorrigible and about the cutest to be found anywhere.
Since that day, one tiny little 6 year old boy never fails to come up every day and with a big grin ask in broken French, "Je mange les guyabes??" We of course say, "Oui, eat all you want"
James
Tuesday, October 19, 2004
Calloused Hearts or Just Feet?
The sunset that evening sank into the dusty earth as if in a trance. Just a yellow orb leaving only a tiny trail of pink...it was like a sticky yellow ball flung onto a wall of light blue and slowly sliding into the night with no dying breath or comment. How jipped I felt!
In the early hours before dawn of that same day, Sarah, another nurse, and I had lost a small baby boy to death. His small body was already too weak to live when the parents had finally brought him to the hospital as a last resort. His small round belly had the markings of local healing. That is, he had scars on either side of his stomach where the parents had tried to bleed the evil out. It hadn't helped.
His bone thin extremities barely moved, and his eyes stared up at me in an empty gaze. I lead his parents down the dark hospital hallway, holding his infusion of quinine and glucose high as if it would light my step. I remember thinking I should put him in a bed where the least amount of kids had died. Maybe that would help. It hadn't.
Some people have made light of death of small children at Béré Hospital. It makes continuing with life easier if they laugh about it- saying the parents have eight other kids to worry about. They'll just have another kid to make up for that one. Some have even gone so far as to say that the villagers don't feel much human pain or loss. How unfair that is!
It you could only see the way a worried grandmother looked over her small granddaughter. I watched the shriveled brown fingers of the grandmother's hand gently caress the baby's forehead. Then the grandmother hunched forward as if in extreme pain. I thought she was going to let out a wail for a second, but she just put her head in her hands silently. And people have suggested they don't feel pain?
It is true that most of the dark eyed women here are forced into marriage at an absurd early age. Even before their breasts are fully developed, they are soon sagging after only five years. They are uneducated about sanitation and mud-hut keeping, and trained to cower beneath their old decrepit husbands who already have four other wives.
However, I believe their hearts are calloused (if I should apply such a term) out of necessity of survival...like their mud-soiled feet, yet their motherhood (or fatherhood) seems to bring about a softening of that guarded heart. I guess I can explain it as the kind of life that keeps their feet tough and their brown faces smiling.
Today, for example, I observed an old man squish his face like a contorted raisin with whiskers, (he had extreme pain from his toe amputation,) then in the next second, he stuck out his hand grinning from ear to ear to greet me. Amazing!
I think maybe they have naturally discovered this Buddha thought that "the secret of health for both mind and body is not to mourn for the past, not to worry about the future, or not to anticipate troubles, but to live in the present moment wisely and earnestly." Or perhaps Buddha arrived at such a conclusion from watching civilizations similar to Béré?
With their loads piled high on their heads, (the women anyway), and life shooting out of every sandy crevice throughout the village, the people keep laughing. No time is spent on burial...for life is alive and kicking around the corner. It is not their heartlessness or lack of pain that keeps them going each day. It is wisdom!
Becky Jarnes
In the early hours before dawn of that same day, Sarah, another nurse, and I had lost a small baby boy to death. His small body was already too weak to live when the parents had finally brought him to the hospital as a last resort. His small round belly had the markings of local healing. That is, he had scars on either side of his stomach where the parents had tried to bleed the evil out. It hadn't helped.
His bone thin extremities barely moved, and his eyes stared up at me in an empty gaze. I lead his parents down the dark hospital hallway, holding his infusion of quinine and glucose high as if it would light my step. I remember thinking I should put him in a bed where the least amount of kids had died. Maybe that would help. It hadn't.
Some people have made light of death of small children at Béré Hospital. It makes continuing with life easier if they laugh about it- saying the parents have eight other kids to worry about. They'll just have another kid to make up for that one. Some have even gone so far as to say that the villagers don't feel much human pain or loss. How unfair that is!
It you could only see the way a worried grandmother looked over her small granddaughter. I watched the shriveled brown fingers of the grandmother's hand gently caress the baby's forehead. Then the grandmother hunched forward as if in extreme pain. I thought she was going to let out a wail for a second, but she just put her head in her hands silently. And people have suggested they don't feel pain?
It is true that most of the dark eyed women here are forced into marriage at an absurd early age. Even before their breasts are fully developed, they are soon sagging after only five years. They are uneducated about sanitation and mud-hut keeping, and trained to cower beneath their old decrepit husbands who already have four other wives.
However, I believe their hearts are calloused (if I should apply such a term) out of necessity of survival...like their mud-soiled feet, yet their motherhood (or fatherhood) seems to bring about a softening of that guarded heart. I guess I can explain it as the kind of life that keeps their feet tough and their brown faces smiling.
Today, for example, I observed an old man squish his face like a contorted raisin with whiskers, (he had extreme pain from his toe amputation,) then in the next second, he stuck out his hand grinning from ear to ear to greet me. Amazing!
I think maybe they have naturally discovered this Buddha thought that "the secret of health for both mind and body is not to mourn for the past, not to worry about the future, or not to anticipate troubles, but to live in the present moment wisely and earnestly." Or perhaps Buddha arrived at such a conclusion from watching civilizations similar to Béré?
With their loads piled high on their heads, (the women anyway), and life shooting out of every sandy crevice throughout the village, the people keep laughing. No time is spent on burial...for life is alive and kicking around the corner. It is not their heartlessness or lack of pain that keeps them going each day. It is wisdom!
Becky Jarnes
Saturday, October 9, 2004
Moonlight and Guavas
The Tchadian sky stretches out expanding beyond what seems possible to give the effect of being in some circus mirror show where everything is distorted to become larger than life. It's a brilliant light clear blue sky except for one huge bank of stacked puffy white clouds on the horizon. We are escaping Bere and the hospital. Becky, our second redhead nurse leads the way down the small path away from the back of the compound. Nathan, our 6'7" student missionary, strides casually beside her. Wendi, the third redhead in the group walks behind me with Jennie, the second newly arrived volunteer nurse. Sarah, the first and final redhead, brings up the rear. The sun beats down fiercely as we enter the rice fields where the path disappears under water for long stretches at a time. The water is hot to our bare feet alternating between a fresh sandy and a sticky mud bottom. We occasionally pass locals on their way to or from who knows where carrying flip flops and wading purposefully through the water much as we are. Friendly "lapia's" are exchanged and repeated as befits local custom. Occasionally, a "lapia aye" or "lalay" will be thrown in for variety. Of course, Sarah has to always show off by actually carrying on brief conversations in Nangjere not just giving generic greetings. I found it's not really necessary as "lapia" repeated often back and forth seems to keep everyone content.
At the river finally we are surrounded as usual by half naked children with fishing spears or poles who are more than happy to leave what their doing to watch "nasara" swim. What could be more entertaining than watching weird looking strange white foreigners jumping, swimming, mud wrestling and tossing mud at them? Getting them to hum the tune of "Indiana Jones" is also a big hit.
Coming back the moon is reflecting perfectly off the still waters of the rice paddies as the sky is still pinked from the recently setting sun.
A few days later a baby comes in with a severe infection in her groin and legs and lower abdomen. Antibiotics help but then large black dead skin patches remain with yellow pus filled edges. They need to be debrided (taken off). I do. That afternoon Sarah comes to me to say she's unconscious. I come and find her recently dead. I desperately refuse to believe. She's pale. The bandages are red with blood. She's bled out and no one noticed. I do CPR furiously unable to let go and accept that I should have checked back on her several times before going home. I would've noticed. No one else did or seemed to be concerned about her at all. A waste. We have no post operative recovery room or any real post operative care. I see death all the time but this one gets to me. I should've checked more carefully to make sure all bleeding was stopped. Sarah is also devastated when I see her later. She feels it's her fault. I hug her and let her know it's not. I feel sick to my stomach.
Dimanche's sister comes in the next morning with abdominal pain. I first hear from the nurse that it's probably a urinary infection. I go to see her and I at first think it's appendicitis. She gives a good story and has peritoneal signs consistent with appendicitis. I decide I should do a pelvic exam first. Then I think it's probably an infection of the uterus or tubes. The pain has switched sides to the left. Then, her story changes too. I wish I had an ultrasound or other tests. I check a blood count which is normal. I put her on antibiotics and continue my work. I don't feel quite comfortable with the diagnosis. After work, the gang wants to go to the river. Right before leaving I decide to check on the patient again. She's worse. I look some stuff up in books and ask some more questions. I wish I had an ultrasound again. After reading I remember I should have checked to see if she was pregnant even if she hasn't missed a period. Matthieu comes in from home to do the test but says it probably won't work because it's not a morning urine sample. We do it anyway. The faintest of lines appears telling us it's positive. I feel relief. God has helped us come to the probable diagnosis even with our lack of equipment--ectopic pregnancy (out of the uterus). I know I need to operate but I'm always more nervous when it's a friend or a relative someone I work with everyday in this case. What if I'm wrong and I operate for nothing and something goes wrong? I'd operated a woman a few months ago who I'd thought had an ectopic pregancy and it turned out to be a simple pelvic infection treatable with antibiotics. Was I making the same mistake? I open up her belly in a low pelvic (Pfannensteil) incision and dark blood comes out of the abdomen. Sure enough there's a swollen mass in the left Eustachian tube. It was about to rupture. Despite some delays due to lack of equipment and my not having anyone to consult eventually with the help of books God led me to do the right thing in time to save her. What if I'd just gone to the river like I really wanted to? It's so hard to find that balance between doing what's right and needs to be done and not getting so overwhelmed and sucked in that you lose yourself and who you are in the incredible, never ending needs of a place like Béré.
Today, I'm finishing up lunch and look out the window at our guava trees. I see three kids staring up. There must be another kid up them again stealing our guavas. If they'd just ask I'd give it to them but kids here have no sense of right and wrong or respect for what belongs to others (like privacy for example). It's not their fault. They have no boundaries. They are outside naked and barefoot with other kids with no regular meals, often dependent on what they find in order to be able to eat. Then at night they can be out until 2-3 in the morning dancing and singing and pounding on drums without any set bedtime. I'm talking about 3 and 4 and 5 year olds as well as the pre-teens and teens. So they get the idea they shouldn't be doing something but not because it's wrong; because they might get beat if they're caught.
So I sneak out the front door to the edge of the house. The three kids are absorbed in whatever's happening in the branches above them. I start running. About 15 feet away they see me and start to run. I arrive at the tree and look up. Sure enough, a kid is caught there. She's about 8-9 years old dressed in a rag wrapped around her waist with bare feet and chest. I look at her with an expressionless face. Then I feel a shock course through me as she lets out a blood curdling yell that doesn't stop as her eyes go wild with fear and she's starts swaying on the branch while holding on tightly above her. I tell her to come down in a flat voice. I feel cut to the quick by her unreasonable fear. She starts to come down howls filling the air.
Other kids start gathering and laughing hysterically at her cries and fear and that she'll probably get the beating of her life now from the terrible "nasara." A couple adults who appear to be relatives approach. She comes down and when I reach to help her down she goes ballistic hanging onto the tree for all she's worth while her screams make my blood go cold. I pull her off the tree and let her down to the ground. She collapses and tries to wriggle away. I grab her wrist gently but firmly. She has wrapped herself around the legs of one of her relatives. Â I pull her free and if possible her cries intensify. I have a sick pit in my stomach half-loving and half-loathing the fear I cause in her. I explain to her relatives that this is our property and that taking stuff from someone else's property is called stealing. They agree. The surrounding kids continue to chortle gleefully at the young girl's distress.
The relatives start to yell viciously at the poor girl. I interrupt to continue trying to explain reasonably why she shouldn't be in our tree. I ask what they will do about it. The young man says they'll discipline her. I let her go as the giggles from the kids continue. The young man picks up a switch as she takes off. I turn away hoping that they won't beat her if I'm not there--that they would only do it because they think I want it and that when I leave they'll all just laugh but somehow I just think the whole situation was sick. If the kids would just ask for the guavas I'd give them to them. But their parents have never taught them how to behave so they have no clue. They learn from their fellow children and that is the basis for the society and social structure and attitudes that leads them later in life to prefer to let their kid die than pay $5 for a complete treatment.
I return home subdued--life is hard here in so many ways.
James
At the river finally we are surrounded as usual by half naked children with fishing spears or poles who are more than happy to leave what their doing to watch "nasara" swim. What could be more entertaining than watching weird looking strange white foreigners jumping, swimming, mud wrestling and tossing mud at them? Getting them to hum the tune of "Indiana Jones" is also a big hit.
Coming back the moon is reflecting perfectly off the still waters of the rice paddies as the sky is still pinked from the recently setting sun.
A few days later a baby comes in with a severe infection in her groin and legs and lower abdomen. Antibiotics help but then large black dead skin patches remain with yellow pus filled edges. They need to be debrided (taken off). I do. That afternoon Sarah comes to me to say she's unconscious. I come and find her recently dead. I desperately refuse to believe. She's pale. The bandages are red with blood. She's bled out and no one noticed. I do CPR furiously unable to let go and accept that I should have checked back on her several times before going home. I would've noticed. No one else did or seemed to be concerned about her at all. A waste. We have no post operative recovery room or any real post operative care. I see death all the time but this one gets to me. I should've checked more carefully to make sure all bleeding was stopped. Sarah is also devastated when I see her later. She feels it's her fault. I hug her and let her know it's not. I feel sick to my stomach.
Dimanche's sister comes in the next morning with abdominal pain. I first hear from the nurse that it's probably a urinary infection. I go to see her and I at first think it's appendicitis. She gives a good story and has peritoneal signs consistent with appendicitis. I decide I should do a pelvic exam first. Then I think it's probably an infection of the uterus or tubes. The pain has switched sides to the left. Then, her story changes too. I wish I had an ultrasound or other tests. I check a blood count which is normal. I put her on antibiotics and continue my work. I don't feel quite comfortable with the diagnosis. After work, the gang wants to go to the river. Right before leaving I decide to check on the patient again. She's worse. I look some stuff up in books and ask some more questions. I wish I had an ultrasound again. After reading I remember I should have checked to see if she was pregnant even if she hasn't missed a period. Matthieu comes in from home to do the test but says it probably won't work because it's not a morning urine sample. We do it anyway. The faintest of lines appears telling us it's positive. I feel relief. God has helped us come to the probable diagnosis even with our lack of equipment--ectopic pregnancy (out of the uterus). I know I need to operate but I'm always more nervous when it's a friend or a relative someone I work with everyday in this case. What if I'm wrong and I operate for nothing and something goes wrong? I'd operated a woman a few months ago who I'd thought had an ectopic pregancy and it turned out to be a simple pelvic infection treatable with antibiotics. Was I making the same mistake? I open up her belly in a low pelvic (Pfannensteil) incision and dark blood comes out of the abdomen. Sure enough there's a swollen mass in the left Eustachian tube. It was about to rupture. Despite some delays due to lack of equipment and my not having anyone to consult eventually with the help of books God led me to do the right thing in time to save her. What if I'd just gone to the river like I really wanted to? It's so hard to find that balance between doing what's right and needs to be done and not getting so overwhelmed and sucked in that you lose yourself and who you are in the incredible, never ending needs of a place like Béré.
Today, I'm finishing up lunch and look out the window at our guava trees. I see three kids staring up. There must be another kid up them again stealing our guavas. If they'd just ask I'd give it to them but kids here have no sense of right and wrong or respect for what belongs to others (like privacy for example). It's not their fault. They have no boundaries. They are outside naked and barefoot with other kids with no regular meals, often dependent on what they find in order to be able to eat. Then at night they can be out until 2-3 in the morning dancing and singing and pounding on drums without any set bedtime. I'm talking about 3 and 4 and 5 year olds as well as the pre-teens and teens. So they get the idea they shouldn't be doing something but not because it's wrong; because they might get beat if they're caught.
So I sneak out the front door to the edge of the house. The three kids are absorbed in whatever's happening in the branches above them. I start running. About 15 feet away they see me and start to run. I arrive at the tree and look up. Sure enough, a kid is caught there. She's about 8-9 years old dressed in a rag wrapped around her waist with bare feet and chest. I look at her with an expressionless face. Then I feel a shock course through me as she lets out a blood curdling yell that doesn't stop as her eyes go wild with fear and she's starts swaying on the branch while holding on tightly above her. I tell her to come down in a flat voice. I feel cut to the quick by her unreasonable fear. She starts to come down howls filling the air.
Other kids start gathering and laughing hysterically at her cries and fear and that she'll probably get the beating of her life now from the terrible "nasara." A couple adults who appear to be relatives approach. She comes down and when I reach to help her down she goes ballistic hanging onto the tree for all she's worth while her screams make my blood go cold. I pull her off the tree and let her down to the ground. She collapses and tries to wriggle away. I grab her wrist gently but firmly. She has wrapped herself around the legs of one of her relatives. Â I pull her free and if possible her cries intensify. I have a sick pit in my stomach half-loving and half-loathing the fear I cause in her. I explain to her relatives that this is our property and that taking stuff from someone else's property is called stealing. They agree. The surrounding kids continue to chortle gleefully at the young girl's distress.
The relatives start to yell viciously at the poor girl. I interrupt to continue trying to explain reasonably why she shouldn't be in our tree. I ask what they will do about it. The young man says they'll discipline her. I let her go as the giggles from the kids continue. The young man picks up a switch as she takes off. I turn away hoping that they won't beat her if I'm not there--that they would only do it because they think I want it and that when I leave they'll all just laugh but somehow I just think the whole situation was sick. If the kids would just ask for the guavas I'd give them to them. But their parents have never taught them how to behave so they have no clue. They learn from their fellow children and that is the basis for the society and social structure and attitudes that leads them later in life to prefer to let their kid die than pay $5 for a complete treatment.
I return home subdued--life is hard here in so many ways.
James
Friday, October 1, 2004
Nose Peanuts
Warning: no bloody, gory or otherwise crazy-nuts stories available at this time.
So I'm hauling sand what was left after construction of the wall. I decided to landscape a little around the house which is really ridiculous because now there's this one tiny patch of niceness replete with cactus, volcanic rock and a brick piece border on one corner of a tin roof house with peeling paint, cracked windows and moth eaten rafters harboring bats and rats. So anyway, the boys start gathering as they usually do anytime "Nasara" starts doing anything. Soon they have insisted on grabbing the shovels and hauling the sand in the wheel barrows as well--but you already know the story--this is really a tale about a boy--Fambe (think Thumper and Bambi crossed and you have an idea of the pronunciation). He starts dancing on the sand pile. He's only three, runs around naked most of the time and dances as if he was born to it. He's Lona's second youngest son. He loves to stare at "Nasara" with a blank look on his face. He won't smile, talk or do anything accept come up to you in church and want to sit on your lap until he rips your Arab robes. Then he'll run off to sweep up peanut shells off the floor. Occasionally, you'll be walking to work in the early morning fog and you'll see someone sitting in the dirt waving with a huge grin saying "lalé, lalé" but other than that it's all just serious, expressionless staring. I'm not sure if Fambe still likes me now after I circumcised him and he then got infected because, well he runs around naked and rolls in the dirt at every opportunity. Not to mention that he was quite proud of his new look and would show off to anyone. Oh, and there was the time I was tossing the football and accidently pegged him right on the head causing him to tumble off the porch railing he was perched on 4 feet to the ground. I got there quickly to find him screaming like a hyena with blood pouring off a tiny slit in his scalp. Lona just laughed and shook his head when I told him. As mentioned, Fambe has natural rhythm and likes to take one of my small drums, lay it between his legs as he sprawls on the ground and pound it--sometimes in rhythm with what we are playing.
Fambe's brother Henri on the other hand just stands around looking at you with the cheesiest grin all the time. I've never seen a kid so happy and with a bigger smile. Even when he was deadly sick with Malaria his smile never diminished--his eyes just looked a little droopy.
A boy with a huge Burkitt's Lymphoma on his right cheek (bigger than two huge grapefruits) who I've searched to world over to find treatment for comes into see me when I say I've found it. I first saw him walking down the street to market months ago and stopped the car to yell at him to come see me which he always has done everytime I've called for him. Now when I have the meds finally I set up an appointment to start chemo and he never shows up. I see him by the basketball court we've rigged up in a field the other day and he says he's coming tomorrow then never shows up. I don't get it--maybe he's afraid of getting his hopes up or what--I often can't figure out how people think here.
So, finally--nose peanuts. Never say never. You can teach an old dog new tricks. I never cease to be amazed. Sarah calls me to come see a baby with a peanut stuck up it's nose. I hurry over and see the baby comfortably in mom's arms. I walk down the hall to my office and gather my arsenal: Otoscope, nasal speculum, forceps, clamps, spray anesthetic. I'm armed to the teeth. I walk back balancing all my goodies in both hands. I turn the corner and see a strange man bending over the child. One of the other patients' fathers. I don't get it until I hear loud sucking noises. I'm frozen. He then lifts his lips off the baby's nostrils and there is the slimy peanut sitting right there. He nimbly picks it off and tosses it aside. I'm flabbergasted feeling a little foolish with my "modern" medecine. I tell Sarah to give them their money back and return home laughing and shaking my head. It's brilliant!
James
So I'm hauling sand what was left after construction of the wall. I decided to landscape a little around the house which is really ridiculous because now there's this one tiny patch of niceness replete with cactus, volcanic rock and a brick piece border on one corner of a tin roof house with peeling paint, cracked windows and moth eaten rafters harboring bats and rats. So anyway, the boys start gathering as they usually do anytime "Nasara" starts doing anything. Soon they have insisted on grabbing the shovels and hauling the sand in the wheel barrows as well--but you already know the story--this is really a tale about a boy--Fambe (think Thumper and Bambi crossed and you have an idea of the pronunciation). He starts dancing on the sand pile. He's only three, runs around naked most of the time and dances as if he was born to it. He's Lona's second youngest son. He loves to stare at "Nasara" with a blank look on his face. He won't smile, talk or do anything accept come up to you in church and want to sit on your lap until he rips your Arab robes. Then he'll run off to sweep up peanut shells off the floor. Occasionally, you'll be walking to work in the early morning fog and you'll see someone sitting in the dirt waving with a huge grin saying "lalé, lalé" but other than that it's all just serious, expressionless staring. I'm not sure if Fambe still likes me now after I circumcised him and he then got infected because, well he runs around naked and rolls in the dirt at every opportunity. Not to mention that he was quite proud of his new look and would show off to anyone. Oh, and there was the time I was tossing the football and accidently pegged him right on the head causing him to tumble off the porch railing he was perched on 4 feet to the ground. I got there quickly to find him screaming like a hyena with blood pouring off a tiny slit in his scalp. Lona just laughed and shook his head when I told him. As mentioned, Fambe has natural rhythm and likes to take one of my small drums, lay it between his legs as he sprawls on the ground and pound it--sometimes in rhythm with what we are playing.
Fambe's brother Henri on the other hand just stands around looking at you with the cheesiest grin all the time. I've never seen a kid so happy and with a bigger smile. Even when he was deadly sick with Malaria his smile never diminished--his eyes just looked a little droopy.
A boy with a huge Burkitt's Lymphoma on his right cheek (bigger than two huge grapefruits) who I've searched to world over to find treatment for comes into see me when I say I've found it. I first saw him walking down the street to market months ago and stopped the car to yell at him to come see me which he always has done everytime I've called for him. Now when I have the meds finally I set up an appointment to start chemo and he never shows up. I see him by the basketball court we've rigged up in a field the other day and he says he's coming tomorrow then never shows up. I don't get it--maybe he's afraid of getting his hopes up or what--I often can't figure out how people think here.
So, finally--nose peanuts. Never say never. You can teach an old dog new tricks. I never cease to be amazed. Sarah calls me to come see a baby with a peanut stuck up it's nose. I hurry over and see the baby comfortably in mom's arms. I walk down the hall to my office and gather my arsenal: Otoscope, nasal speculum, forceps, clamps, spray anesthetic. I'm armed to the teeth. I walk back balancing all my goodies in both hands. I turn the corner and see a strange man bending over the child. One of the other patients' fathers. I don't get it until I hear loud sucking noises. I'm frozen. He then lifts his lips off the baby's nostrils and there is the slimy peanut sitting right there. He nimbly picks it off and tosses it aside. I'm flabbergasted feeling a little foolish with my "modern" medecine. I tell Sarah to give them their money back and return home laughing and shaking my head. It's brilliant!
James
Monday, May 17, 2004
AIDS in Bere
As most people realize, AIDS is a huge problem in Africa. At first I didn't think it was that big a problem here but as it turns out that's just because people don't want to know, don't get tested, and if they are seropositive everyone hushes it up because to them its a death sentence and the health care workers feel like there's nothing to do either.
I felt the same way at first because all I saw were advanced cases who ended up dying.
Now I've started to identify and work with a group who I've tested because of various risk factors or exam findings (or often when they come with a kid at the end stage then I identify the parent as HIV +) This group is healthy and I've discovered that there are things we can do.
1. We can educate to prevent transmission (fidelity, if there are several wives and some are negatif...condoms, etc)
2. We can treat pregnant mothers to prevent transmission to the newborn (if we have the medicines which we hope to soon...transmission can also be reduced by elective c-section) We are trying to start a program to test pregnant women for HIV (very rarely done here)
3. We can see them at regularly scheduled monthly visits for routine physical exams and lab tests to identify and treat infections early
4. We can identify and treat Tuberculosis or give primary prevention with Isoniazid
5. We can provide emotional and psychological support...especially if they end up abandoned by their families (as unfortunately happens only too often)
And, if we can identify a group that is trustworthy and comes to regularly scheduled visits and is reliable we could hopefully start some of them on Anti-retroviral therapy (anti-HIV meds) if we could find some donors or if the government comes around to decreasing the cost.
We have somehow found a little hope on this dark continent that is at the point of an epidemic. Pray for us and if you can in anyway give us other suggestions or help in any way...
I felt the same way at first because all I saw were advanced cases who ended up dying.
Now I've started to identify and work with a group who I've tested because of various risk factors or exam findings (or often when they come with a kid at the end stage then I identify the parent as HIV +) This group is healthy and I've discovered that there are things we can do.
1. We can educate to prevent transmission (fidelity, if there are several wives and some are negatif...condoms, etc)
2. We can treat pregnant mothers to prevent transmission to the newborn (if we have the medicines which we hope to soon...transmission can also be reduced by elective c-section) We are trying to start a program to test pregnant women for HIV (very rarely done here)
3. We can see them at regularly scheduled monthly visits for routine physical exams and lab tests to identify and treat infections early
4. We can identify and treat Tuberculosis or give primary prevention with Isoniazid
5. We can provide emotional and psychological support...especially if they end up abandoned by their families (as unfortunately happens only too often)
And, if we can identify a group that is trustworthy and comes to regularly scheduled visits and is reliable we could hopefully start some of them on Anti-retroviral therapy (anti-HIV meds) if we could find some donors or if the government comes around to decreasing the cost.
We have somehow found a little hope on this dark continent that is at the point of an epidemic. Pray for us and if you can in anyway give us other suggestions or help in any way...
What I wish...
Tout le monde,
Well, here's to disappointment. If you expect this to be inspiring or moving, please just delete and move on. All I can think of now is what I wish was different about the situation I'm in. Basically this is going to be one big "poor me" session. Here's my wish list:
1. One night to not have to sleep in my own sweat (or someone else's), to be cool enough to cover up and snuggle down in my own comfortable bed. While I'm at it how about sleeping inside instead of out on the porch because it's even hotter inside.
2. One day without having to eat rice, beans or lentils. One day where all I eat is fresh stuff (fruit, salad, yogurt, a sandwich,...)
3. One afternoon at the beach. One surf session even if there are no waves. I just want to paddle out and sit on my board and feel that anticipation that no matter how flat it is a great wave with my name on it is about to roll in. If it could be cold where I had to where my wetsuit and my fingers were so cold afterwards I couldn't hardly get out of the wetsuit or zip up my pants...that'd be sweet...
4. One meal without flies...
5. Grass...one day without staring at, walking on, and breathing dust.
6. Air conditioning
7. Flushing toilets all the time
8. Electricity just one full day when I could plug in my computer when I needed to use it or turn on the fan or listen to music besides 6:30pm to 10pm.
9. Water I could drink from the tap. One shower when I could just throw my head back and drink up some cold fresh water straight, unfiltered, un-partially-refrigerated-with-old-cabbage-smell-on-the-bottle
10. One day of speaking only English with everyone I met...no French, no Arabic and definitely no Nangjere.
11. One day when I could actually have at my disposal all I needed to make the diagnosis.
12. One ICU stay for one patient so one patient who should live...could.
13. One consult with a specialist, any specialist I wanted.
14. One day when I could give the patients all they needed without worrying about whether they'd paid for it or not.
15. One day when I could trust that what I'd ordered would actually be done by the nurses as I ordered it.
16. One of mom's home cooked meals.
17. A game of hoops...with a few weeks ahead of time to get back in shape for it.
18. One day without seeing armed soldiers.
19. One day without being stared at.
20. One hour of privacy without kids standing outside my windows staring in.
21. One trip to town in anonymity without hearing one single "NASARAH"...
22. A vehicle I could take anywhere I wanted, anytime I wanted.
23. One church service with music that moved me.
24. One email session without bugs on the screen.
25. One less trip to N'Djaména for administrative business.
26. One hospital administrator so I didn't have to be it.
27. One guy friend I could just hang out with, shoot hoops with, laugh with, etc...Sarah's great but she is just a GIRL after all.
(I guess that's a good place to stop...27...where have I heard that number before?)
Paix et tranquilité á tous...et que tous vos reves soivent realisés...
Well, here's to disappointment. If you expect this to be inspiring or moving, please just delete and move on. All I can think of now is what I wish was different about the situation I'm in. Basically this is going to be one big "poor me" session. Here's my wish list:
1. One night to not have to sleep in my own sweat (or someone else's), to be cool enough to cover up and snuggle down in my own comfortable bed. While I'm at it how about sleeping inside instead of out on the porch because it's even hotter inside.
2. One day without having to eat rice, beans or lentils. One day where all I eat is fresh stuff (fruit, salad, yogurt, a sandwich,...)
3. One afternoon at the beach. One surf session even if there are no waves. I just want to paddle out and sit on my board and feel that anticipation that no matter how flat it is a great wave with my name on it is about to roll in. If it could be cold where I had to where my wetsuit and my fingers were so cold afterwards I couldn't hardly get out of the wetsuit or zip up my pants...that'd be sweet...
4. One meal without flies...
5. Grass...one day without staring at, walking on, and breathing dust.
6. Air conditioning
7. Flushing toilets all the time
8. Electricity just one full day when I could plug in my computer when I needed to use it or turn on the fan or listen to music besides 6:30pm to 10pm.
9. Water I could drink from the tap. One shower when I could just throw my head back and drink up some cold fresh water straight, unfiltered, un-partially-refrigerated-with-old-cabbage-smell-on-the-bottle
10. One day of speaking only English with everyone I met...no French, no Arabic and definitely no Nangjere.
11. One day when I could actually have at my disposal all I needed to make the diagnosis.
12. One ICU stay for one patient so one patient who should live...could.
13. One consult with a specialist, any specialist I wanted.
14. One day when I could give the patients all they needed without worrying about whether they'd paid for it or not.
15. One day when I could trust that what I'd ordered would actually be done by the nurses as I ordered it.
16. One of mom's home cooked meals.
17. A game of hoops...with a few weeks ahead of time to get back in shape for it.
18. One day without seeing armed soldiers.
19. One day without being stared at.
20. One hour of privacy without kids standing outside my windows staring in.
21. One trip to town in anonymity without hearing one single "NASARAH"...
22. A vehicle I could take anywhere I wanted, anytime I wanted.
23. One church service with music that moved me.
24. One email session without bugs on the screen.
25. One less trip to N'Djaména for administrative business.
26. One hospital administrator so I didn't have to be it.
27. One guy friend I could just hang out with, shoot hoops with, laugh with, etc...Sarah's great but she is just a GIRL after all.
(I guess that's a good place to stop...27...where have I heard that number before?)
Paix et tranquilité á tous...et que tous vos reves soivent realisés...
Sunday, May 9, 2004
La guerre...et la paix
War and Peace could've been written here in Tchad...except not much about peace. It's just routine to here in the morning report of the activities of the "Gard" that a woman came in who'd been beaten by her husband, or her brother or uncle, or her husband's other wife, or her sister, etc. As I mentioned before, about a month ago, tribal warfare broke out in N'Djaména near where the Busl brothers were staying as a whole quarter was shut down by armed police shooting tear gas and bullets while inside the warring members bludgeoned each other with clubs, machetes, bush knifes, tools, bicycles and anything else they could get there hands on and swing at someone. That same week a man was walking near the Busl's house and was jumped on by thugs from a tree who knifed him and left him for dead. The next morning he was still alive surrounded by curious onlookers who when asked why they didn't help him shrugged and said, "we don't know him." Another was stoned to death on a close side street. You remember well the knife fight that happened inside our own hospital right outside the door where I was trying to take care of an infant with Tetanus and another with seizures from severe Malaria.
So, where's the peace? Not yet. This last Thursday I was suddenly called from rounds by shouting. Our chauffeur, Bichara, had just driven up outside the halfway built hospital wall. He'd been out with the district vaccination program at the same time as some of the agricultural community decided to retaliate for what they felt was an unfair decision in a land dispute with the arab nomad cattle traders. A bunch went to the nearby Gendarmerie and when the Gendarmes pulled out their guns one tried to wrest the rifle away only to be shot in the stomach. Then the other Policemen went crazy leaving at least two dead and multiple wounded. All this happened right in front of Bichara who then helped load five wounded into the back of our pickup and bring them to the Bere Adventist Hospital. By the time I arrived a huge crowd had gathered as usual to gawk. Dr. Eric Davy and Dr. Cathy Castillo are visiting from Ventura where I trained so it was just like being in residency...except we were unloading dirty Tchadians with blood soaked clothing from the back of a beat up truck instead of a well equipped ambulance with paramedics who'd already started IVs and applied dressings. No, this was raw carnage, the casulties of war straight from the battlefield.
I quickly questioned the wounded--who were all conscious--where they were injured (at first I thought they'd all been stabbed as knifings are more common here) and three had been hit in the legs, one in the belly and the last in the arm. Blood smeared the bed of the truck as I commandeered several staff to bring stretchers and take away the one shot in the stomach first. All seemed pretty stable on first look and listen to heart and lungs before being carried away. We actually had gloves which was a bonus.
We took Belly Boy to the OR while I grabbed IV catheters, tubing and IV fluids from the Pharmacy. Eric had just taken one shot in the leg to the Salle de Gard (ER). He was bleeding pretty profusely and looked like the bullet had gone through the femur shattering it. Anatole was with him and they were in good form so I moved on. In the Minor Procedure room we had two others who'd been shot in the leg. On the procedure table was a man who'd been shot through the front of the thigh bursting out the back of his knee with some fat and a shredded nerve or tendon hanging out. He couldn't move his foot and was writhing in pain as Cathy washed out the wound. Dr. Claver was there assessing the other who'd been shot in the hamstrings but seemed to not have hurt anything serious.
I went into the OR. Belly Boy had a soft belly, a fast heart rate, a normal blood pressure and a bullet hole entering his right lower quadrant of his abdomen exiting his right posterior flank. I started an IV quickly and started fluids pouring in, shot him up with antiobiotics and Valium, arranged the instruments, scrubbed and about 25 minutes after his arrival I opened his abdomen. I sliced from sternum, around belly button and down close to his pelvis. The small intestine came pouring out but there was no blood or fecal material. I fished around his lower belly identifying a hematoma where the bullet had passed by without entering his abdomen. Then I checked carefully the colon, appendix, liver, spleen and finally ran the small intestine from end to start without finding any injuries. I then sewed the fascia and skin closed and unscrubbed.
While he woke up I went to check on the others. The two in the minor procedure room had IVs running, antibiotics in and dressings in place. They were sweating like crazy in the stuffy tin roofed chamber so I had them moved to hospital beds and went to see the one in the ER. Eric had placed a sandbag on his leg to stop the bleeding but the table was still covered. We lifted off the sandbag, removed the dressing, packed it with gauze in the small anterior hole where the blood was pouring out of and placed a pressure dressing with the sandbag again. We snagged a bed from the medicine ward, rolled it outside under the porch and moved the patient there while a crowd of about thirty gathered around to see what the three "Nasara" docs would do. Since we don't have any equipment for traction or orthopedic surgery (nor an xray for that matter) we placed a plaster cast around his lower leg, tied a rope around it, looped it over the end of the bed and lashed the sandbag to it. The leg was out to length and didn't look rotated so we left it assuming it was reduced. The pressure dressings had managed to stop the bleeding.
I'm starting to wonder why I said it was ok for Cathy and Eric to come. It had been so calm here with just some nice easy malaria cases, a couple of hernias, etc. The first night they arrived was right when I'd decided to take a young man to surgery who had severe pelvic pain with peritoneal signs and vomiting I thought was either vomiting or appendicitis. Unfortunately, Eric scrubbed with me and it transformed from and easy appendectomy to a Sigmoid Volvulus (when the last part of the colon twists around itself causing obstruction and compressing the blood supply sometimes causing gangrene) requiring a partial bowel resection and reanastamosis. Even more unfortunately, due to lack of appropriate post-op care he died two days later. We have no ICU, not enough nurses, and not a good system to make sure the patients family get the treatments prescribed so the nurses can give them. For example, IV fluids and antibiotics where not bought and therefore not given for the first 24 hours. Afterwards, I donated a few and even bought some antibiotics for him but it was too late and he died of sepsis and dehydration. It can be very frustrating and discouraging when it's something so "simple" over there but so "complicated" here.
But seriously having colleagues here has been great. Docs I can trust, consult and conspire with and discuss things with. Not to mention Cathy's a chef and Eric is my surfing buddy who taught me how to catch waves two years ago when we were working together at the Ventura County Medical Center. He even brought a surfing video! It's good to be inspired even though I'm in a country without a coast about as far as one can get from the ocean. Eric also shares my passionate hatred of the rooster who wakes us up every morning way too early. He actually pegged it yesterday with a well aimed shoe thrown from where he was sleeping on the porch.
I've been learning some Danish as Sarah and her mom talk constantly in that little known tongue. For example, Gootmorn means good morning. Tak means thank you. "Coon Girl" means could do (and has become Sarah's new nickname)!
So, Sarah and I headed out to the river yesterday. Me on the pedals, her relaxing easily on back. I'm so out of shape and the bike's tires are flat. Needless to say I was struggling. The over 100 degree weather didn't help. Sweat was pouring off. My thighs were burning...and my butt...let's just say that a bike seat here is really a torture device. Lona's oldest son and one of Pastor DeGaulle's sons caught up to us and passed us easily...you can tell I was working hard and getting no where.
We finally arrived. It was so good to plunge into that muddy, warm water. I gave a bried introductory swimming lesson to DeGualle's son and went off to play in the current. As I rested under the shade of the opposite bank, my feet and legs in the water still, Lona's son called and asked where Sarah was. I didn't see her. I got a little nervous when Lona's son yelled back that he thought she'd headed downstream. He and I took off. The stream got shallow quick and we crossed and climbed the footpath to the side. Up ahead the stream wound around a corner with grassy banks sticking into the meandering stream in between volcanic rock and scrub trees leading to the African plain. No sight of Sarah. We rounded another corner and there she was. She was striding nonchalantly in the ankle deep but wide stream with here long curly red hair flowing and her bright white skin reflecting the sun off her baby blue bikini. All along the banks were scores of very dark, curious children. Ahead was a ford where groups of Arabs gathered in long robes and turbans while similarly attired boys herded cattle across. Sarah seemed to be oblivious to the stir she was creating.
I ran up to her and joined her as we passed the groups of Arabs (who I'm sure approved of her "modest" clothing). We continued around the bend as she asked some of the kids if there was deep water and they said it was just ahead. We had to detour to the bank as a boy running along above the stream warned us of fishing line marked with white plastic waving in the breeze off of sticks stuck in the sand. He also said there were hippos ahead so we decided to stop. I faced downstream on my back and she faced upstream on her tummy. We just sat and talked as I stared at her thinking how improbable all this was to be in the middle of a stream in Africa with a beautiful redhead surrounded by Arabs. I turned around on my belly and but my arm around her. She had goosebumps (from the cold not from me...) and we sat and talked for about half an hour watching huge cargo trucks gun it across the ford followed by pickups packed with turbaned arabs splashed, sprayed, spun and twisted across. The cattle were sometimes obstinate running from the water just right before entering sending the arab boys running and shouting and waving their sticks. Finally, as the sun started to go down we had to go back...uneventfully (except for my almost dying trying to pedal the 7 kilometers while being completely out of shape).
War and Peace...
So, where's the peace? Not yet. This last Thursday I was suddenly called from rounds by shouting. Our chauffeur, Bichara, had just driven up outside the halfway built hospital wall. He'd been out with the district vaccination program at the same time as some of the agricultural community decided to retaliate for what they felt was an unfair decision in a land dispute with the arab nomad cattle traders. A bunch went to the nearby Gendarmerie and when the Gendarmes pulled out their guns one tried to wrest the rifle away only to be shot in the stomach. Then the other Policemen went crazy leaving at least two dead and multiple wounded. All this happened right in front of Bichara who then helped load five wounded into the back of our pickup and bring them to the Bere Adventist Hospital. By the time I arrived a huge crowd had gathered as usual to gawk. Dr. Eric Davy and Dr. Cathy Castillo are visiting from Ventura where I trained so it was just like being in residency...except we were unloading dirty Tchadians with blood soaked clothing from the back of a beat up truck instead of a well equipped ambulance with paramedics who'd already started IVs and applied dressings. No, this was raw carnage, the casulties of war straight from the battlefield.
I quickly questioned the wounded--who were all conscious--where they were injured (at first I thought they'd all been stabbed as knifings are more common here) and three had been hit in the legs, one in the belly and the last in the arm. Blood smeared the bed of the truck as I commandeered several staff to bring stretchers and take away the one shot in the stomach first. All seemed pretty stable on first look and listen to heart and lungs before being carried away. We actually had gloves which was a bonus.
We took Belly Boy to the OR while I grabbed IV catheters, tubing and IV fluids from the Pharmacy. Eric had just taken one shot in the leg to the Salle de Gard (ER). He was bleeding pretty profusely and looked like the bullet had gone through the femur shattering it. Anatole was with him and they were in good form so I moved on. In the Minor Procedure room we had two others who'd been shot in the leg. On the procedure table was a man who'd been shot through the front of the thigh bursting out the back of his knee with some fat and a shredded nerve or tendon hanging out. He couldn't move his foot and was writhing in pain as Cathy washed out the wound. Dr. Claver was there assessing the other who'd been shot in the hamstrings but seemed to not have hurt anything serious.
I went into the OR. Belly Boy had a soft belly, a fast heart rate, a normal blood pressure and a bullet hole entering his right lower quadrant of his abdomen exiting his right posterior flank. I started an IV quickly and started fluids pouring in, shot him up with antiobiotics and Valium, arranged the instruments, scrubbed and about 25 minutes after his arrival I opened his abdomen. I sliced from sternum, around belly button and down close to his pelvis. The small intestine came pouring out but there was no blood or fecal material. I fished around his lower belly identifying a hematoma where the bullet had passed by without entering his abdomen. Then I checked carefully the colon, appendix, liver, spleen and finally ran the small intestine from end to start without finding any injuries. I then sewed the fascia and skin closed and unscrubbed.
While he woke up I went to check on the others. The two in the minor procedure room had IVs running, antibiotics in and dressings in place. They were sweating like crazy in the stuffy tin roofed chamber so I had them moved to hospital beds and went to see the one in the ER. Eric had placed a sandbag on his leg to stop the bleeding but the table was still covered. We lifted off the sandbag, removed the dressing, packed it with gauze in the small anterior hole where the blood was pouring out of and placed a pressure dressing with the sandbag again. We snagged a bed from the medicine ward, rolled it outside under the porch and moved the patient there while a crowd of about thirty gathered around to see what the three "Nasara" docs would do. Since we don't have any equipment for traction or orthopedic surgery (nor an xray for that matter) we placed a plaster cast around his lower leg, tied a rope around it, looped it over the end of the bed and lashed the sandbag to it. The leg was out to length and didn't look rotated so we left it assuming it was reduced. The pressure dressings had managed to stop the bleeding.
I'm starting to wonder why I said it was ok for Cathy and Eric to come. It had been so calm here with just some nice easy malaria cases, a couple of hernias, etc. The first night they arrived was right when I'd decided to take a young man to surgery who had severe pelvic pain with peritoneal signs and vomiting I thought was either vomiting or appendicitis. Unfortunately, Eric scrubbed with me and it transformed from and easy appendectomy to a Sigmoid Volvulus (when the last part of the colon twists around itself causing obstruction and compressing the blood supply sometimes causing gangrene) requiring a partial bowel resection and reanastamosis. Even more unfortunately, due to lack of appropriate post-op care he died two days later. We have no ICU, not enough nurses, and not a good system to make sure the patients family get the treatments prescribed so the nurses can give them. For example, IV fluids and antibiotics where not bought and therefore not given for the first 24 hours. Afterwards, I donated a few and even bought some antibiotics for him but it was too late and he died of sepsis and dehydration. It can be very frustrating and discouraging when it's something so "simple" over there but so "complicated" here.
But seriously having colleagues here has been great. Docs I can trust, consult and conspire with and discuss things with. Not to mention Cathy's a chef and Eric is my surfing buddy who taught me how to catch waves two years ago when we were working together at the Ventura County Medical Center. He even brought a surfing video! It's good to be inspired even though I'm in a country without a coast about as far as one can get from the ocean. Eric also shares my passionate hatred of the rooster who wakes us up every morning way too early. He actually pegged it yesterday with a well aimed shoe thrown from where he was sleeping on the porch.
I've been learning some Danish as Sarah and her mom talk constantly in that little known tongue. For example, Gootmorn means good morning. Tak means thank you. "Coon Girl" means could do (and has become Sarah's new nickname)!
So, Sarah and I headed out to the river yesterday. Me on the pedals, her relaxing easily on back. I'm so out of shape and the bike's tires are flat. Needless to say I was struggling. The over 100 degree weather didn't help. Sweat was pouring off. My thighs were burning...and my butt...let's just say that a bike seat here is really a torture device. Lona's oldest son and one of Pastor DeGaulle's sons caught up to us and passed us easily...you can tell I was working hard and getting no where.
We finally arrived. It was so good to plunge into that muddy, warm water. I gave a bried introductory swimming lesson to DeGualle's son and went off to play in the current. As I rested under the shade of the opposite bank, my feet and legs in the water still, Lona's son called and asked where Sarah was. I didn't see her. I got a little nervous when Lona's son yelled back that he thought she'd headed downstream. He and I took off. The stream got shallow quick and we crossed and climbed the footpath to the side. Up ahead the stream wound around a corner with grassy banks sticking into the meandering stream in between volcanic rock and scrub trees leading to the African plain. No sight of Sarah. We rounded another corner and there she was. She was striding nonchalantly in the ankle deep but wide stream with here long curly red hair flowing and her bright white skin reflecting the sun off her baby blue bikini. All along the banks were scores of very dark, curious children. Ahead was a ford where groups of Arabs gathered in long robes and turbans while similarly attired boys herded cattle across. Sarah seemed to be oblivious to the stir she was creating.
I ran up to her and joined her as we passed the groups of Arabs (who I'm sure approved of her "modest" clothing). We continued around the bend as she asked some of the kids if there was deep water and they said it was just ahead. We had to detour to the bank as a boy running along above the stream warned us of fishing line marked with white plastic waving in the breeze off of sticks stuck in the sand. He also said there were hippos ahead so we decided to stop. I faced downstream on my back and she faced upstream on her tummy. We just sat and talked as I stared at her thinking how improbable all this was to be in the middle of a stream in Africa with a beautiful redhead surrounded by Arabs. I turned around on my belly and but my arm around her. She had goosebumps (from the cold not from me...) and we sat and talked for about half an hour watching huge cargo trucks gun it across the ford followed by pickups packed with turbaned arabs splashed, sprayed, spun and twisted across. The cattle were sometimes obstinate running from the water just right before entering sending the arab boys running and shouting and waving their sticks. Finally, as the sun started to go down we had to go back...uneventfully (except for my almost dying trying to pedal the 7 kilometers while being completely out of shape).
War and Peace...
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