21 November 2006

District BAD

28 Sept 2006

The only way to describe my life, I think, is in particular anecdotes.Take yesterday.
(at this writing, have not slept in about 40 some-odd hours. take note)
Got up around 6:30 with the neighbors chopping wood (ususally it's at 6, so this was a bonus). Had a leisurely breakfast with the cat for company. Got dressed in my 'brousse' clothes (there are a lot of clothes relegated to that status, now) and set off to "work" with my hoe in hand. (Not the machete, this jeudi propre). For the next 2 hours, along with tall the hospital personnel - nurses, lab techs, the doctor, etc - I helped to clear the field we're using as a soy demonstration plot. As the lowest skilled membre of the team (when it comes to farm work), I got to clear brush for most of the time, though I did end up tilling with my trusty hoe. After two hours, thoroughly covered in dirt (which actually shows on me), I went home to shower and really get ready for "work." Work consisted of a few hours of action planning with the doctor, on STIs/AIDS, Malaria, Tuberculosis, Water and Hygiene....etc. As he said to me about a week ago, "Mvangan has been declared a district BAD!" "But what did we DO?"
BAD = Banque Africaine du Developpement, and they're funding us, apparently, specifically to do formations/in-services on topics related to family planning.

So all week we've been working on very detailed action plans on every possible topic in the district. Most with objectives of "by December 2007..." funny, cause, that's when I leave. Sortof like i'm writing out my own legacy, or my plans for one. And if we even do half of what we've set out to do, it will be pretty wonderful.

So, the power's been out in Mvangan for the past month. The action plan needs to be typed for BAD. We wrote everything by hand, with the plan to take our computer to the Catholic Mission hospital, Bimengue, 7 km away - they have a generator and it's on every night.
Sunday. We did this. And forgot to take our power strip which adapts to all plugs. Well apparently (we hadn't realized) we have an American plug monitor. And Bimengue, funded by Italians, has Italian plugs.
So, no dice.
Every subsequent night it was raining too hard to drive over there - and - the road is quite a walk from the hospital, with a computer...
Doc knew I was leaving Friday morning and we had to finish. So he proposed we go over THursday around 4 pm, ask them to turn the generator on early (it's usally at 6 pm), and work until we finished. We did go then, and luckily, because it was the only time all day that it wasn't raining. (In case it's not yet clear, it's rainy season now).

At the hospital, we found Desiree, one of the volunteer nurses at the District Hospital - in labor with her 5th child. She'd been in labor since early that morning, and it wasn't progressing very fast. Her husband is a nurse at Bimengue. As the Doc examined her, I entertained their 3-year-old daughter, Brenda...until he power returned and I tried to distract her with the very Western game of "draw me a picture." No dice.

At any rate, power comes on at 6:30, Doc and I set up the computer and begin to work on our 35 page (now) plan, while he periodically checks on Desi. The action plan, in very complicated tables I've only learned how to format here, details reproductive health, maternal and infant health, maternity at lower risk, vaccination programs, STIs/AIDS, family planning, primary care, malaria, tuberculosis, nutrition, water and hygiene, and pharmacy management. If we actually do half of this, this year....anyway.

We worked until 10, me enertaining Brenda/writing, the Doc checking on Desi/writing and brainstorming with me (we'd already written a draft of the plan, longhand), the other nurses running around...and labor not progressing. The child, by estimates, looked to be over 10 lbs.
Around 10 pm, the head nurse of Bimengue brought dinner for he "night crew" assembled. I didn't know it at the time, but we got special provisions of extra generator time due to the impending delivery (it usually goes off at 9).

So, 11 pm, Doc decides it's time to do an emergency C-section. The nurses are assembled and scrub in. And I...leaving my typing duties to my medical curiosity...follow, put on scrubs, and stand, fascinated, as the procedure is readied. Desi's husband also scrubbed in...able to work? On hand, anyway.

I'd been warned before...real-life, movies...that this was a fast procedure.
And yes, it was fast.

But the baby had already descended pretty far down in the birth canal, so it was work to bring him back up. Fast. Handed over to two other nurses, ready for reanimation.
One minute. Two minutes. Shaking him, suctioning his nostrils, doing mouth-to-mouth, shaking him upside down...
In the third minute, he cried.
And I started breathing again.
As the long, complicated closing procedure began, I followed the nurses with the infant. They weighed him, washed him, clothed him, and then, completely unsterile, I walked the floor with him in my arms. I tried to introduce him to his big sister, but she wasn't impressed.

The operation was finished at 1:15 am, with the action plan duly (almost) finished. Doc and I demounted the compuer, packed it in the car, and drove back to Mvangan. 1:45. We woke up the pharmacist to write a command for HIV tests for me to take to Ebolowa the next day, in preparation of AIDS week (Oct 16-21). 2 am, I'm home, finished packing. 2:30, the car arrives, and I leave for Ebolowa. ...to then go to Yaounde, arrive after running errands all morning in Ebolowa, and get straight to work preparing for the arrival of 30 new trainees.
The next evening, back at the airport. 365 days later, waiting for a new group.
African time.

As this is almost a month old, now, more to come soon.

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