ProHealth Outreach, Malaria and no electricity!

 I got back last week from a 6 day medical and surgical outreach with an organisation called ProHealth. I hoped on a bus in Jos and was driven 8 hours South East to Taraba State, to a small village called Takum. We, 60 Nigerian doctors, surgeons, dentists, anaesthetists, nurses, lab techs, pharmacists and health promoters spent the next 5 days giving free health care, medications, advice and surgery to the locals.  I was placed on the surgical team to help out in any way I could and in the end learnt how to run an African operating theatre!

On day 1 the ‘OR’ team as we were called, had to set up the sterile theatres. ProHealth has a huge orange bus that carries all the equipment needed, so after some furious cleaning and draping of walls, by 12pm on the first day we were underway with the first surgery. The surgeries performed by the 3 surgeons included hernia and hydrocele repairs, appendectomies, lipoma and ovarian fibroid removals, and the odd circumcision and tumour excision. The surgeons were such machines; they just kept going and going, we ended up doing 115 surgeries in 4 days! It was hard work and after being out of the habit of shift work and standing for long amounts of time, 10 hours on my feet had me wilting in the corner. But the team I had the pleasure of working with made up for the fatigue with their joking, good-natured banter, stories and songs throughout the day.  

The rest of the team split into specialties and set up clinics in a health centre attached to the church we were partnering with. By day 6 I didn’t want to go home! I had met so many amazing people and formed such close friendships in such a short amount of time; I didn’t want to go back to reality.  I think having a shared passion for helping people through healthcare and having the same heart for using their skills for
God, really knit us all together.

One thing that was a bit weird was that I was the only white girl on the trip, and even though I am used to people staring and wanting to get my number, even on the trip I had people wanting to snap pictures with me on their blackberry phones (yes even educated doctors) some of which I had hardly spoken to on the outreach. It was harmless, and I obliged them, I guess, if that's what's going to give them credibility with their friends back home then I’m happy to help!

One of the low lights of the last few weeks has been not having electricity for days at a time. We’ve been without for 2-3 days sometimes. Usually it comes and goes, but lately there’s been trouble with a transformer at the power plant and we’ve had nothing. It doesn’t affect other compounds as much as Challenge because they all have generators, but because we usually have such a great supply, and battery operated lights (which die if not recharged in 24 hours); there hadn’t been a need. This may have to change! Everything I owned with a battery died on me. My phone, laptop, Ipod, my fridge/freezer defrosted and then water ran out too as our water pump needs electricity to pump! BUT one good thing came out of it, it was a real wake up call for me about how dependent I've become on technology as a whole, for communication, but for leisure time too. I felt totally out of touch with the world during those few days when I couldn’t email, couldn’t Facebook, couldn’t Google…. it was a challenge to find other things to do. The girls and I played board games because we had no light and no way to watch a movie and I read a lot more of my book than usual. Having to eat and prepare a mal by candlelight was a lot less romantic as it may sound. I’m sure it would be a lot more romantic when it' done by choice and not necessity!

Another low light was the fact that I've been ill with presumed malaria for over a week. It started as a bit of a queasy, gurgly, crampy stomach (which I put down to eating Nigerian food all week on outreach) which is what the start of Giardia feels like from much experience, so I started taking medication for that, but by day four I had a headache, no appetite, nausea and no energy, all I could do for 3 days straight was sleep and feel miserable for myself! For those of you that no me well, I’m not good at resting, so to not physically be able to do anything except sleep was such a frustrating condition. The intense lethargy is very characteristic of malaria on prophylaxis I was informed by the missionary doctor so started on Malaria medications. I’m feeling stronger every day now and am starting to venture out. My big outing today was sitting in line at the petrol station for gas for 2 hours. At least I had time to spare!

I had another dilemma last Monday at the prison. There was a young girl there who had been picked up for being out on the streets at 2am (not much other than prostitution that keeps girls out that late here in Nigeria). She approached me quietly after the bible study and told me her bail was 5000N ($30NZD) and could I get her out. Her trial is set for 1st Nov. I took her details and then on my way out of the women’s compound one of the prison guards told me I should leave her in the prison for the next 6 weeks until her court date because it may be her only chance to hear the word of God and for God to work on her so she doesn't go back to her old way of life. Since then I've prayed a lot about it and I feel that they're probably right. It just feels so wrong that IF I can do something about it, then I should. But I guess I have had to remind myself that I’m not there to bring reform to the Nigerian Justice system, it's not my responsibility to get everyone out, I'm there to share God with the ladies and encourage them in their faith. It is my prayer that come the 1^st of November this young girl may be at the point of wanting to leave her old life at the hotel and come to Grace Gardens (our home for ex-prostitutes) and start afresh.

Fighting for justice and baking lessons

“… "Speak up for those who cannot speak for themselves, for the rights of all who are destitute. Speak up and judge fairly; defend the rights of the poor and needy." Proverbs 31:8-9.

"....may the groan of the prisoners come before you: by the strength of your arm preserve those condemned to die.” Psalm 79:1

Being able to be involved in fighting on behalf of people for their freedom was not something I anticipated doing in Nigeria, but has been one of the most rewarding and satisfying endeavors.  As most of you know, I have been leading a bible study in the women’s prison. This has allowed me to get to know the women and hear their stories. Over the months I have been visiting the prison and my work with ASPIR (Advocacy for the Support of Prisoners and Indigents Rights), I have heard so many stories of injustice that it breaks my heart. I have come to learn that the Nigerian justice system sentences people before trials and then again after if they are found guilty at trial. The sentence is terminated if found not guilty, but this happens for those ’lucky’ enough to ever be tried at all.

Prisoners are refused bail and kept behind bas for years without trial.  70% of prison inmates in Nigeria are awaiting trials, while 30% comprise those under trail and those already convicted. I have heard and read testimonies of those that have been detained and waited 9 years for a trial! Most accused will wait between 1 and 5 years for a trial date, whilst being treated as guilty. I have seen most of the suspects in the prison isolated, unable to contact family and friends and with few, if any visitors who remember them. In talking to a lawyer friend who works closely with the prison system, she expressed her opinion that in Nigeria, incarceration worsens the condition of prisoners instead of reforming them. She also shared the truth that most inmates awaiting trial did not commit the offences that they are accused of; they are mere suspects.  

Bearing all this in mind, when I heard the full story of one of the newer ladies last Monday, I decided to try and do something about it. Chindu is a mother of 3, recently widowed, and 3 months pregnant. She was accused of concealing stolen goods and sentenced to 2 years in prison or a fee of 10,000N (about $75 NZD).  In talking to her, she explained that she was given some curlers to use in her small hair salon, and was not aware they were in fact stolen. 2 years seemed like a long time away from her children for such a petty crime, even if she had committed it!

I made contact with a lawyer that another missionary had used previously to help in the process of paying the fee to free prisoners and she did some investigating, found the court she was convicted in and verified the validity of Chindu’s story and the facilitated the money transfer on my behalf. I saw her one last time before her release and even though I’d asked for things to be kept anonymous, she knew I was responsible and despite the language barrier I could tell she was grateful beyond expression.

On a very different note, Fiona and I hosted a birthday party for a Nigerian girlfriend of ours last Friday. She had never had a party before, so it was a great thing to be able to do for her. We ended up having over 50 Nigerians attend! Fiona and I along with 2 Nigerian girls spent the whole of Friday cooking and decorating, which was an exhausting job but well worth the effort. We would have been lost without the Nigerians’ as I’ve never had to cater for 50 before! Learnt a lot about Nigerian culture over the evening as well. In the West when we host ‘parties’ or gatherings in our homes, people who attend will stand around, mingle, meet new people, maybe dance a bit to the music that is playing in the background,  and generally just BE, but Nigerians expect to be entertained! They expect the party to have a programme, an MC, and a games master in charge of the evening.

We were busy playing games, had been broken up into teams and were planning songs and dances to perform for the birthday girl, but I was getting hungry. It was about 8pm and I was a bot concerned the food would be getting cold so I quietly suggested we eat (we'd prepared a full Nigerian meal for guests) but was kindly told that if we served the food, people would then leave! Sure enough, after we'd played games for  an hour or so and the men started demanding food we ate and by 9pm people were saying goodbye. Part of this of course is that the public aren't allowed out on the streets late at night for security reasons but it was just so bizarre to me because 9pm is when parties really get started back home!

Lamella and Nuhu dancing for rapping for Blessing 

We also had a cooking competition at our compound after church on Sunday. We had teams of about 5-6 people and split into 3 groups: mains, salads and baking. I was in charge of baking team and I had Nigerian girls in my team that had obviously never baked before (only very wealthy Nigerians own ovens) and didn't quite grasp the concept of following a recipe! They all make things by touch, taste and instinct, from having seen their mothers do it hundreds of times. They kept praising my ability and were in wonder of how I knew how to make cookies and brownies, I kept telling them all I was doing was reading from a book! After we'd iced the cookies, the girls then started asking me about how to make wedding cake icing…..I had to tell them that I actually had no idea and my baking repertoire really was limited to cakes, muffins, biscuits and slices! They have no scheduled me for baking lessons! More fun times ahead.

The Baking Team: Winners of the day!

Nigerian Drivers Test

See if you can answer the Nigerian driving test correctly, it will tell you if you could be a true Nigerian driver.....I'm almost there!

*Answers are in italic.

1. What is the most important part of any car (or any moving vehicle)?
1. tires
2. brakes
3. steering wheel
4. air conditioning
5. horn

2. Which of the following is not acceptable in a traffic jam?
1. driving (NOT "passing") in the 'opposite-direction-traffic-lane'
2. making a 2 lane highway into 4 lanes
3. hitting the vehicle on your left with your hand
4. having the passenger on the right hit the vehicle on their right with your hand
5. none of the above...they are all acceptable

3. What is another name for a pedestrian?
   Risk taker
4. What is another name for a traffic light?
   Wishful Thinking
5. How much space do you leave between your car and the cars on your left and right side?
   
   Minimum space to leave: 1 inch (2.5 centimeters)
   Maximum space to leave: If the driver's left hand can not touch the car to his/her left, then there is too much space in between the cars. The same applies for a passenger on the right and the car to the right.
6. Who is at fault in a collision
1. the driver who changes lanes without using the signal or leaving enough room to merge.
2. the driver who gets hit because he/she didn't honk loudly when the driver above started getting into his/her lane. 

7. Which of the following are you LEAST likely to see on the road as you are driving?
1. A child selling items
2. The elderly selling items
3. Motorcycles zipping in and out of traffic
4. People fighting
5. Someone in a vehicle smiling and relaxed

From broken bones to Nigerian weaves

I was reflecting the other day, while walking down town to the open-air market for groceries, about how much fun it is to live in a smaller African city. I was thinking about the things that I now take for granted, that make my days so interesting, and the things I will miss once I’m home. I couldn’t help smiling as I listening to the men chatting and joking good naturedly, the women calling out to me for my custom, the constant honking of horns, the loud music being played from trucks parked in the middle of the road selling either Indomie noodles or Hypo laundry powder, the squawking of live chickens or the quacking of ducks tucked under the arms or vendors. Then there's the smells; the raw meat on huge chopping blocks (and the intestines shaped like honeycomb) and cows tongues, the dried fish (and some still alive, squirming in wheelbarrows of water), even the mud from the rain the night before smells of African earth. Then there’s the colours; the vibrant greens of spinach and okra, the red of tomatoes and hot chili peppers, the bright-multicoloured Nigerian wrappers, and the fluorescent shades of the younger generations clothing. You can't become distracted for one minute or take your eyes off your feet otherwise you'll fall down a gutter, stand in a muddy puddle, step on someones wares or bump into someone carefully balancing trays of fresh peanuts or ribena berries on their heads. Having to greet everyone that greets you is also exhausting, but makes for such a sense of community. Home is going to be so boring in comparison!

I got a phone call at 8pm last Sunday night from one of the Uncles out at Gyero. He went on to tell me one of the boys had been playing and had fractured his hand. I asked a few questions over the phone to ascertain the extent of the injury and learnt that the assumed break was “near his thumb and there is a small bruise”. After giving instructions over the phone for pain relief and immobilisation, I assured the staff I would come first thing the next morning to take Michael for an x-ray.  Once I arrived at Gyero, the real story came out! Michael had fallen, and was then seen with his arm bent in half and the bones sticking out! He had broken BOTH his ulnar and radius mid shaft and the bones had punctured the skin! One of the uncles had straightened the bone immediately and put on a very effective splint made of bamboo sticks, packing and a bandage (I commended his efforts and technique later). Michael, who usually has a very staunch countenance, even for a 14 year old, was sobbing quietly, which broke my heart; I doubt he’d slept much that night either. I took Michael for an x-ray and got to use my radiography skills practically for the first time since I’ve been here. When I explained the importance of good views (at ninety degrees from each other) for diagnostic purposes and planning for a potential surgery, he looked at me with a bewildered lost face and asked me to come and show him what I meant. I didn’t need anymore of an invitation that that! After we were back at clinic, I helped the surgeon in theatre as we sedated him, attempted to realign the bones, and placed him in a temporary cast. Time will tell if the bones heal by themselves or whether he’ll need some internal fixation.

Two days later on a routine visit to Transition House to check on the older boys health, after chatting with the uncle there for over an hour and him assuring me there was no sickness at present, Kelly and I were about to start the car to leave when he remembered one boy who had complained that morning about feeling unwell. We got back out of the car and entered the compound to find David unconscious sprawled on the concrete floor. He was febrile and unresponsive. I thanked God that Kelly was there at the time because of her experience with Malaria in Nigeria she recognised the symptoms and we rushed to the nearest pharmacy and got some IV fluids, some intra muscular Malaria medication and other bits and pieces for symptom control. Kelly herself had suffered the same symptoms including the Black Water Fever element (peeing coke coloured urine!) and so knew the importance of hydration. After an hour and a half and a litre of IV fluids, David had regained consciousness and was able to start taking oral fluids. I returned the next few days to give the rest of the medication, but by day 3, David was a different boy, still very brave while I jabbed him in the butt with needles, but now able to joke about it with me!

Another highlight of my weekend was a meeting I had with some Nigerian girls who will be fellow bridesmaids at the up coming wedding of a mutual friend. We discussed transport, accommodation, decided on a dress style, jewelry and shoes, then the conversation turned to hair…that was where it became irrelevant for me! Because Nigerian women ‘make’ their hair, i.e. they all wear extensions; they needed to decide on the colour, the attachment and the style once the weave was applied.  I’m positive the grass is always greener in this instance, but I actually envy the ladies having the opportunity to recreate their image each 4-6 weeks! From a short bob cut to long flowing curly locks or braids, the sky is the limit for possibilities. Apparently for the first few days it hurts a lot as the weave is so tight and I often wonder how a lot of the ladies sleep with their huge heavy braids, but combined with the amazing eye make up Nigerian’s can get away with on their dark skin, I anticipate walking into the church with some very stunning ladies indeed!