Monday, July 21, 2008

Gambia Pictures, part one: THE JOURNEY

JFK airport: We still smell okay at this point, and we don't want to gouge our eyes out yet. Really, we have no idea what we're in for.

Dakar, Senegal: two flights and a billion hours later, we arrived in Dakar. We stopped at this home to eat and rest for the long bus journey ahead. This is before we were attacked by approximately 400 village children (slight exaggeration).


...after the village kids heard about the 8 Toubabs. It was insane!

Our new Senegalese friends made us dinner! Nonspecific red meat with greasy rice. It was delicious! With full bellies, we boarded the bus and headed toward the border.

Hours later, we had crossed the border, switched buses, and made it to the North bank of the Gambia river. Ferry time! This is our bus (aka "gele gele") on the ferry, with all of our luggage on top.

As if we really needed another test of patience, the bus' front axle broke on the ferry. Add 2 hours to journey.

We arrived at the hotel hours after the gele-gele tragedy.
And were greeted by monkeys!
more pics to come!
I'm back in the U S and A!

The journey back was long and tiring, starting with an extremely frightening plane ride from Banjul to Dakar at 6 pm Gambia time (2 pm Florida time) on Wednesday. The plane was small but clean and modern looking. I'm sure there are scarier planes out there, but relatively speaking, this was the scariest plane I've ever been in. 30 minutes later we were in Dakar, Senegal.

The rest of the trip:
Dakar to Brussels: 6 hour flight
Brussels airport for 6 hours
Brussels to New York: 7 hour flight (I think)
JFK airport: NINE AND A HALF HOURS!

Our flight to Miami was delayed. So close, yet so far! It was frustrating. Our patience worn thin, we ran out of things to do, card games to play. We did some yoga at the gate (we looked psychotic).

We finally got to Miami International Airport at about 1 am or so. 36 glorious hours of traveling. The rest of the group had it worse, however, since they still had to drive to their homes in Tampa, Sarasota, and Orlando afterward. Sheesh!

And now it's time to enjoy air conditioning, warm water, fresh vegetables. It's time to enjoy not being the only white people around. It's time to miss the pungent odor of Gambian armpits, and the aroma of fly-covered-fish in the marketplace.

Despite the nasty stuff, It was an amazing experience, and I do plan on revisiting the Gambia sometime in the future. In my future visit, however, I can count on this past experience there to guide me. I now know that I can trade old t-shirts and crappy watches for paintings and carvings at the marketplace. I know now that based on the color of my skin, I will get charged prices that are up to 15 times the actual amount. I now know that the only way to travel is via bush taxi, but that I should anticipate a very hot journey that will take about 4 times as long as it should, and that I will likely encounter something stinky everywhere I go.

Other valuable nuggets of knowledge:

-The Gambians believe that fish are part of the food group "vegetables." The vegetarian in the group learned this the hard way when, even though he had been told the dish he was about to eat was "vegetarian," he found pieces of fish and a nice fish bone in his okra.

-Medicine is highly valued, even when they don't know what it does. A man at the craft market nearly gave me his left leg for the container of tums I had in my bag. I got a nice painting instead.

-Gambian children often assume that white people poo money out. On more than one occasion, I was approached by a little snot monster who exclaimed "Toubab, give me five dalasi!" Translation: White person, give me 25 cents. At first it was kind of cute, but quickly became annoying.

-The Gambians are a reasonably happy group of people, and violence doesn't seem to really be an issue there. Nice!

-Gambians LOVE the United States. They are obsessed with American clothing, Barak Obama, and Fifty Cent (do they call him 10 Dalasi? Bad joke!)

That's all I can think of for now.

Saturday, July 12, 2008

My time here is coming to an end...

And by "here" I mean both the internet cafe and Gambia.

We have stopped working and are now just being tourists, and it's been fantastic.

We will leave on Wednesday, July 16.

I will miss this place, I will miss the people, I will miss our beautiful hotel. I will miss actually being able to do medical stuff (back to the classroom and library... poo).

I am, however, ready to go home and process what I have learned, medically, culturally, and spiritually.

I bought a lot of nice artwork to hang up in my room and future new apartment, and it will help me remember the amazing time I had here.

Saturday, July 05, 2008

A business that would fail in the Gambia:

A titty-bar.

Women pull those things out at the first notion of a baby whimpering. They are just everywhere. And BOY do I appreciate bras now.
The fourth of July- in Gambia

Friday was the 4th of July, and it was coincidentally a day that really made me appreciate our country. I spent the day in the maternity ward at one of the bigger clinics, Birkama.

The maternity ward was, to say the least, disgusting. Dirty floors, blood everywhere. Women bring their own sheets to give birth on top of. Often times, they defecate as a result of pushing (this happens everywhere, but is dealt with in a much more sanitary way in developed nations). They also bring the blanket to take their child home in. With no mention of sterility or sanitation, the baby is born, wrapped in a blanket, weighed, then placed in a little basin next to mommy. Was this little basin cleaned out before? Probably not.

I guess it's been done this way for years, and, based on the amount of children running around, it's been working out just fine. It just shocks the spoiled American medical student to see this.

Besides the uncleanliness, one of the cases we saw also turned our stomachs. it was a very sad case I would rather not write about, but it was possibly the most sobering thing I've seen here thus far.

On a brighter note, I saw the births of two baby boys. It was really exciting and cool. First two live births I've ever seen!

For some stark contrast, we saw a private hospital early this afternoon. Beautiful architecture, clean floors, real bathrooms. No air conditioning but still a palace compared to the other places we had seen.

Thursday, July 03, 2008

More Gambia

There is so much to say about this place. I can't really organize it all in my mind while sweating at this internet cafe, so I'll just recount the events of this past week and work on a "Slice of Gambia" entry later.

Saturday we went to the home of a doctor who has been guiding us at the hospital. We ate some spicy okra with fish. The fish here is not delicious. The okra was doused in oil. I enjoyed it in a weird way.

The fish here, is just... so... fishy. But I'll write more on Gambian cuisine later.

After politely gagging our way through the meal, we got to see a show with drummers and people singing loudly (and a little bit obnoxiously), and then some guys in crazy costumes came out and danced and harassed us for money. Pictures to come.

Anyway, at first, we were excited to be seeing some culture. We were told this was some sort of show for children (and there were tons of children around), and we were like "yeah, Gambian culture!" And then, slowly, we all started to notice that attached to his elaborate costume, one of the dancers had some little stuffed animals and toys attached to his crotch area. He started air humping, we were confused, we laughed a lot, got harassed... it's all a blur kind of. But it was funny as hell. And weird.

Sunday we went with our guide, Sana, to his village, where we were expected to bring medicines and cure everyone's ailments. We were dreading this, mainly because we know so little and couldn't bring much meds. Also, the pressure was just insane. When we got there, they all gathered in a circle, thanked us for what we were doing, and played some music. An elderly woman sang to us in Mandinka (one of the tribal languages here), and made a coughing gesture in the middle of her song to indicate to us that she wanted us to cure the ailments. Talk about PRESSURE.

Then we set up three rooms in a compound and the entire village came through. Name, age, complaint? Written down. Blood pressure and glucose levels tested and recorded. Then the translators helped a few of us find out what was wrong. Then we wrote down the name of one of 4 or 5 drugs we had. Then, the patient came to the pharmacy, which was a table under a tree where we had the meds. We rotated and most of us got to experience all parts of this insane assembly line. There were so many people there that we needed someone to act as a bouncer at the door.

So many people just wanted to take advantage of the clinic despite being perfectly healthy. "I had diarrhea 3 months ago." "My knees hurt." It was like "The doctors from America are here, and they're giving stuff away for freeeee!"

This is not real medicine. This is not true healthcare delivery. We all knew it. But we couldn't help but feel good about what we were doing. Some of it was actually legit, but most of it was placebo.

The people were so grateful, and it felt so nice.

Monday I spent in the ER of the hospital looking through records. Nothing remarkable.

Tuesday I went to the smaller clinic and worked on their records. The handwriting here is terrible. It was very labor intensive.

Some of us spent the second half of Tuesday at a primary school. We came to teach the teachers about common illnesses in children, some tips about what to do when a child is sick, and proper hygiene. The children first greeted us with songs and some of them danced. It was heartwarming. Again, everyone was grateful for what we did, and it felt so nice.

The only downfall of that day was that our bus broke down.

About our bus: Known as a "gele-gele here in Gambia, ours was a certified piece of shit. We were paying about $65 a day for the gele gele to take us to where we needed to be and pick us up. When we arrived in Gambia originally, the gele gele picked us up and then its front axle broke on the ferry, creating a 2 hour delay we really didn't need after spending a million hours traveling.

The axle was fixed but the problems didn't stop there. Every time we needed to go somewhere, 4 or 5 of us had to push the giant gele gele in order to get it started. This was supposedly fixed and then on Tuesday the damn thing just gave up on us. True piece of shit. I would describe the actual gele gele but once I can post pictures you will understand what I cannot put into words.

Wednesday I went to the small remote clinic in Kubuneh. It was a slow day but fulfilling, since this is the place we get to do the most stuff (interview and diagnose patients). Since our wonderful gele-gele was broken, 4 of us took "bush taxis" to get there. It took three taxis, some walking, and a lot of waiting to get there. Total time spent: 2 hours each way. The bush taxis take lots of people, it's like a public bus in the US, except no AC, and 90% of the people are not wearing deodorant.

On the plus side, we got to do some shopping at the market and worked on our haggling skills. I got some nice presents.

And today is Thursday, and we got the day off, kind of. No clinics today, but we're working on our paper. Well, we're supposed to be.

On a personal achievement note: this is the first time I've used the internet since Friday, which means I lasted 6 days without visiting an internet cafe. Part of this was willpower, and part of it was circumstance, but either way, it feels kind of nice to be detached from the world I left behind when I came here.

I do miss warm showers and air conditioning. I miss fresh salads. I miss my friends and family.

This is so worth it, though!

I already see myself returning to the Gambia in the future, hopefully with better medical skills and more knowledge. Also, next time I'll bring more clothes to wear, and perhaps some make up. Days upon days of scrubs, ugly shoes, and messy hair = not really my style. I guess that's what my third year of medical school will be like. Also, it has been kind of nice not having to spend extended amounts of time asking myself "What should I wear?"

And on that note, I've exhausted the Gambia update.