Friday, June 27, 2008

The Gambia Healthcare experience, take one.

This week I was at the Royal Victoria hospital on Wednesday and today (Friday), and at a small clinic in a remote area known as Kubunheh.

The hospital is impressive considering we are in Africa. There are lots of fancy machines and facilities I did not expect. On the other hand, it is still a hospital in Africa. Sterility? Not so much. Air conditioning? Forget it.

On Wednesday I sat in the Emergency Room. Just like in America, there were lots of people waiting. Just like in America, there were people in there that didn't need to be in there. The only cases I saw were: a woman with hypoglycemia, a woman with hyperglycemia, and a highschooler who appeared to be having a panic attack (or was possibly faking it). So, sugar, insulin, and xanax or something like that were the treatments. *Yawn*

Thursday at the small clinic was completely different. First of all, this clinic is in the middle of NOWHERE, right next to expanse of nothing and field of grass; we arrived there via random dirt road. None of the patients spoke any English (many Gambians in the city do). I saw a child with malaria, two children with Yaws (skin infection common in children here), a pregnant woman who had headaches, a child with bad eczema, a man with a gaping arm wound, and a young boy with a large, infected burn on his right leg that he had gotten several days prior (who knows why he didn't come in sooner). I left the clinic nauseous and doubting my choice of career. I assume I contracted several illnesses from working there just one day. Nothing is clean, nothing is really sterile. I know that I'm a spoiled American who has only seen the over-precautious medicine practiced in developed nations, but this was a bit much for me.

The woman who owns the clinic is a retired British nurse who lives in a compound 10 minutes away on foot. We got to see it, and it was incredible. She had about 30 cats, 5 dogs, 3 birds, a monkey (!), a bunch of donkeys and goats, and some ducks and chickens. I mean, it was a zoo. She retired here and loves her life. Truly remarkable!

Today I spent the half day (it's a half day here on Fridays) at the neonatal unit. Tiny babies with tiny hands and little help or hope. We were told that most children born before 32 weeks gestational age do not make it. There is no surfactant, there are no ventilators. The neonatal unit was far from clean (as is everything here).

Must leave, no more time at internet cafe!

Tuesday, June 24, 2008

Greetings from The Gambia!

Things are... sweaty! I'm sitting in an air-conditioned internet cafe, however. Air conditioning is rarer here than 8 American medical students + one premed + one faculty advisor.

When we walk through the markets people stare at us, a huge group of people in scrubs, sweating like hell.

Some background:
The group consists of 6 of my classmates and myself, one fourth year medical student, one pre-med, and our faculty advisor. My classmates and I are here for two main things. 1- To conduct research on the emergency care here and try to create and execute a plan to improve it. 2- To bring medical supplies and our clinical skills (which are almost nothing) to a place that is full of people less fortunate than ourselves. We are also going to be doing some arts in medicine work, which involves helping patients, mainly children, feel better by bringing them art supplies and helping to distract them from their pain/boredom. The art supplies, which include origami and lots of crayons, have already proven useful outside of the clinical setting. When we stopped in Senegal to rest, our guide here brought us to a neighborhood where we were swarmed by about 40 children, yelling "Too-bab" (means white person). We origamied our lives away, and they absolutely loved it.

That's it for background. The trip thus far has been incredible in so many ways.

The journey to get here was really long, but served as a good primer for the next 30 days of hanging out with the same people. We all talked a lot, learned about each other, laughed, and slept. The flights were: Miami to New York to Brussels to Dakar (Senegal). I don't remember how many hours that was. Then we had to take a bus from Senegal to The Gambia. First, we stopped at the neighborhood with the 40 children and ate some delicious meat and rice. We were exhausted and stinky. The rest of the journey involved a very bumpy ride from Dakar to the Gambian border, which took a good 7 hours. At the border we did all that official government bullcrap that took another hour. Then about 2 hours from the border to the north part of the river, then a 30 minute ferry, then the axel of our bus broke and was stuck on the ferry and we waited an hour, then another hour to get to the hotel. Needless to say, we were exhausted. And cranky.

The sight of the hotel helped us breathe one big collective sigh of relief. Although far from the Hilton, this place looked pretty decent to us, despite our exhaustion.

We've got one "villa" where 6 people are staying now and one bungalow where the other 4 of us reside; the villa has a kitchen and living room. It's almost like a home back in the US, except there's no microwave, no air conditioning, and drinking water from the sink may very well be the end of you. The bungalow is smaller, like an apartment.

The hotel is *really* nice, though. I guess it's a resort by Gambian standards. Will post pics soon enough. There are beautiful trees and flowers everywhere, and you can see the beach from the roof of the villa. Coolest part of it all: there are MONKEYS everywhere.

Besides the monkeys, this is not what one would expect from Africa. But once you drive for about 10 minutes and leave the tourist area, you see the real Africa. You also SMELL the real Africa.

Speaking of the real Africa, there's no toilet paper anywhere.

So far, besides wandering around looking for food, we've seen one medical center as well as the hospital we will be working at. I'm still unable to put into words the vast difference between these locations and what we are used to back home.

We also walked around some of the markets in some extreme heat, which hindered our ability to appreciate most of the sights.

Everywhere we go, people ask us for money, as though the color of our skin indicates wealth and riches. Once we say we're American, this effect is amplified 10-fold. We're not really "white," though. There are two Indian girls, and Indian guy, one half-Indian/half-Palestinian, two middle Easterns (myself and my future roomate), a Vietnamese guy, and that leaves only 3 real-life whites. What a multicultural group! Either way, white or not, the people can tell we're all not-from-around here, which automatically means we must have money I guess.

The food is delicious but pretty heavy. Lots of rice and meat dishes. I haven't had a fresh veggie in what feels like ages. We've been cooking back at the hotel, but still not crazy enough to toss a fresh garden salad.

For now I must leave the internet cafe, because I only paid for 30 minutes and spent most of the time emailing. Will write again soon.

I'm so grateful to be here.

With love,
A very sweaty, stinky, Mariana

Tuesday, June 17, 2008

You know you're really busy when...

There are things on your to do list that you don't even understand anymore.

My to-do list says "email Mike"

Who is Mike, and why should I email him? I know about 2084 guys named Mike.

In other news, and probably the reason my to-do list has been ridiculous lately:

I'm going to Gambia tomorrow!

The Gambia, actually. We will be spending one month there, providing medical services and supplies, and just hanging out with sick, poor people. It's not quite backpacking in Europe, but when else would I get the chance to go to Africa?!

I'm in a state of excitement/fear/nausea. It's great. I would love to say "I'll post pictures while I'm there" or "I'll blog while I'm there" but chances are their local Starbucks doesn't have wireless.

Ok, time to go run around doing last minute things at the last minute.


Smallest country in Africa, here I come.