April 8th& 9th, 2009
Last travel Day!
We left the lodge and transferred to the airport at Hoedspruit. A short flight to JoBurg and then a 5.5 hr. layover. We killed the time quite easily just shopping to spend the last bit of money we had and eating. We then had a 8.5 hr. flight to our stopover in Dakar where we re-fueled and got our plane searched. Another 9.25 hr. flight to Atlanta. In Atlanta we were able to switch flights so we then connected through Cincinnati and were able to arrive home at 3:30 p.m. where Boomer was there to great us.
It feels so good to be home!!
April 7th, 2009
Our last full day of honeymoon, Boo!! We got up for the early morning routine again and headed out on the rover. This morning was really exciting. We got to see an old kill of a cape buffalo that was being fought over by a lone mufasa (male lion) and a pack of hyenas (12 or so, and they’re bigger than you’d think). It was crazy; we were parked between the two and being looked down upon by about 50 vultures. The lion was looking pretty territorial and scary so we convinced our guide to leave him alone, since we were sure the 15 foot leap into our truck was probably a piece of cake for the big guy! (He was sure that the lion was more scared of us, but we begged to differ and headed out!) After leaving the kill we ended up seeing many warthogs out and about, as well as coming upon a breeding herd of Cape Buffalo. We didn’t count, but a random guess would be about 150 of these scary looking beasts walking and feeding about 15 feet from our rover. We heard there were leopards in the area that we started to search for, but our guide got a call over the CB radio and was told a white rhino had been spotted. Since this would complete our big 5 sightings he stayed out past return time and drove us to him. He was well worth the extra time, super cool, especially since we got within about 20 feet and they’re so rare to spot. After the drive and huge brunch, we lounged by the pool with giraffes, elephants, and impala in the distance. Our final evening drive brought leopards around a kill (young male impala), hippos, baboons, warthogs, elephants, grey duiker (a smallish grey antelope we hadn’t seen before), and a chameleon after sundown. Laura proved her spotter talents again finding another leopard in a tree, waaay in the distance. Our last dinner was warthog stew and lamb chops, both yummy. Off to bed for our last night in the bush paradise!
April 6th, 2009
Knock-on-the-door wake up call at 5:30 am for morning drive attendees, yikes. We headed to the Veranda for muffins and coffee at 6 before heading out at 6:30. Today could’ve been renamed Elephant day. We couldn’t get away from them, we must have seen over 60, even way up close. Most ignored us totally, some appeared friendly, some not so friendly and made us wet our pants a little bit. One 6000 lbs. monster was in musk (you could tell from his ‘parts’ and hind legs being swollen and the smell) and came rumbling across our path about 30 yards ahead. When he shot us a glance and veered towards us a bit, even the guide panicked a bit and threw the Rover into reverse and we shot out of there. The rest of us, needless to say, needed a change of pants. Other sightings this morning were a lone bull cape buffalo, waterbuck, warthogs, impala, and again many birds. We went back for our huge breakfast/brunch at 10 a.m. and then headed off for a much needed nap and shower. When we awoke, the small pond behind our bungalow had a momma warthog and 2 babies wallowing in the mud! There was an afternoon talk on nocturnal animals, (the bushbaby became our favorite, but we never spotted him) and then had lunch before heading out for night drive #2. Tonight we got to see the hippos in the dam and Laura also spotted a crocodile about 200 yds. away, even the guides were impressed! The herds of kudu, impala, bushbuck and waterbucks were out in force tonight, but not much more for the big game. After sunset we saw a jackal. When we got back we opened our bottle of wine that housekeeping had left for us for our honeymoon and then finished it up at dinner. On the way to Boma, we found 2 elephants drinking from our swimming pool, yep the water’s chlorinated. What a surreal sight about 50 feet from us! Being on foot is NOT like being in the Rover. Tonight’s dinner was wild trout and ostrich as the main dish. No entertainment, so we headed off to bed.
April 5th, 2009
An early morning pickup at 4:30 a.m. to head to the airport in Cape Town. We boarded our flight to Johannesburg without incident even though it seemed as if we’d miss our flight due to the crazy lines at 5 a.m. on Sunday morning! The flight from JoBurg to Hoedspruit was delayed by over an hour, but we finally made it in the early afternoon. We had a transfer waiting for us and then we had an hour drive to get to Motswari. Along the way we did quite well at spotting some animals: a cape buffalo, giraffe, rhino, kudu, and zebra. We arrived at the lodge and were shown to our bungalow for the next 3 days, called Cheetah. Lunch was served and then it was time to head out on our first gamedrive, that lasted from 3:30 until about 7:15 each evening. Our first drive was exciting and our land rover group consisted of 2 other couples, one from Denmark and the other from Australia. We ended up doing well for our first night and spotted two leopards, cape buffalo, steenbok, numerous birds, two lions at night drinking from a watering hole, giraffes, zebras, and just one elephant pushing over a tree after dark. At sundown, we stop the Land Rover for some snacks and cocktails right in the bush, very cool. We got dropped off at the room to freshen up and then were picked up by an armed guide because we couldn’t walk in the camp alone after dark as there were no security fences on the property. At the Boma, we had drinks and a delicious dinner of soup and Braai (South African BBQ) with grilled sides. All the dinners are cooked by local village chefs in rotation. We were pretty bushed by now and headed to bed in our rustic but luxurious bungalow. Unfortunately that meant we missed the after dinner entertainment: drummers and dancers, but heard them as we drifted off.
April 4, 2009
We woke up with the plan of heading to the beach before heading out on our ½ day tour, unfortunately it was raining on and off so we decided to start our tour earlier. We got picked up by Amelia and headed out to the winelands in Stellenbosch. The first tasting we did was at a winery called Thelema, second was Warwick, where we drank out of the two sided silver lady chalice for a tradition they do. The last and final winery was called Kleine Zalze that was known for their award-winning Pinotage, a grape specific to South Africa. We then saw a bit of Stellenbosch University which is an Africaans language school. In the evening we relaxed and packed our bags before heading out to a dinner at Café Paradiso just a few blocks from the hotel.
April 3rd, 2009
Up early, as we had a full day tour ahead of us. The first stop was at Glencairns for Baboon Matters. This is a conservation effort started by a mother and son who are trying to raise awareness for baboons in the area and they do a nature walk with the monkeys to support it. The baboons are regarded here as our raccoons might be. Once they get a taste of human food, they become quite fond of it and are often found breaking into peoples houses and opening the fridges. Because of people shooting them, the numbers are starting to dwindle, so this company is hoping to help people understand that it’s because humans are encroaching on the baboons’ natural habitats that these problems arise. It seems like it is always an uphill battle for them! They even employ “baboon monitors,” who stand in the bush and scare them back up to the forest when they get too close to residential areas. Even with these efforts, we saw a couple of them walking down the sidewalk, completely unfazed by passing motorists, heading to the nearby Compass Bakery’s dumpster (which isn’t closed up at all, according to our guide) for a tasty treat.
The baboons didn’t cooperate with us when we wanted to see them. They were hanging out at the top of the mountain, and if we wanted to see them we had to bushwack up the hillside with no paths to find them. The vegetation was extremely dry and scratchy like walking through rose bushes. We finally caught up with the troop and got to hang out with a dozen baboons for 30 minutes watching them forage, groom and socialize. This was all good until our guide got a little too close to an ovulating female and the males didn’t like it. They all charged towards us grinning their teeth and chattering, so we thought this was a good point to exit! We continued south on our tour to Boulder’s Bay which is a natural community of African penguins living on the beaches. There were nearly 3-4,000 today, where the numbers were much lower about 5 years ago. The last stop on our tour was within Table Mountain National Park and the Cape of Good Hope, the tip furthest South in South Africa and we got the picture to prove we were there! We hiked around a bit and then rode the funicular to the top of the old lighthouse. We took the western shore up north working our way home. Along the way we were able to spot some bunkcoo antelopes, baboons and wild ostrich. Before we got home we drove through some of the township areas which really are like 3rd world Africa right on the doorsteps of Capetown, and are nearly shanty towns and breeding grounds for many many crimes. A sad site. We then drove through the Camp’s Bay area, which is about as opposite as it gets. A beach community with condos and huge houses overlooking the ocean! In the evening we hung out at Asoka, an Asian tapas restaurant near our hotel. The food was great and ridiculously affordable as it has been everywhere. By 11:30, the place was pretty hopping, but we were pretty beat from being chased by baboons and scaling up the Cape Point lighthouse hill, so went back to our apartment and crashed.
April 2nd, 2009
We woke up and went to the breakfast room above the hotel. There was a beautiful buffet each day and a menu to order a la carte, and we were the only ones there except for the last day. Amelia picked us up and we started off our city tour riding the cable cars up Table Mountain. We had lucked out because there was supposed to be fog and high winds that would have shut it down, but there was bright sunshine and not too much wind so we went up with no problem. Afterwards we went to the District 6 museum that commemorated the forced removals and uprisings of blacks and colored people during apartheid. We learned that in S.A. these two terms actually are quite distinct determining racial divides. We also got to see the company gardens that were the area for sailors trading with the Dutch East India Spice Company, to stop and purchase fruits and vegetables during the long journey, as to not get scurvy. These were donated to the city by Cecil Rhodes (Rhodes scholar & Rhodesia.) We wandered around a few of the african markets and then were dropped off at the V&A Waterfront for the afternoon. This waterfront was basically indistinguishable from one you would see in a North American port city, other than the steel drummers and African singers/dancers. We had a relaxing lunch at Quay 4 for some ‘hake n chips’ and drinks. We walked around the nice shopping mall for awhile before we headed off to the Aquarium for late afternoon. Around 5 p.m. we got out our map and decided a walking route back to the city centre and our hotel. Along the way we passed a new resort going up called the ‘One & Only,’ and learned it was just opening up tomorrow and Hollywood stars were supposed to be out in full force, unfortunately we didn’t see any! There was a restaurant called ‘Maze’ by Gordon Ramsey that we tried to no avail to get a reservation at before leaving. We also had a small encounter along the walk with two uppity teenagers, who were hoping for some money, but Nick’s flailing arms and loud shouts did the trick and we were left unharmed, just a bit on edge for the rest of our trip. Dinner was at 95 Keerom, but only after we drove around in numerous circles trying to locate it with our taxi driver. This was a great Italian/South African fusion restaurant. Nick tried the Springbok linguini and I had butternut ravioli along with a great bottle of wine.
April Fools Day!
We got up at 4:30 in preparation for our early flight out of Douala. We made it through the airport despite their being absolutely no signs explaining anything along the way. The flight out was delayed due to some paperwork and fees not being collected on time, but we made it to Jo’Burg just fine, only too late for our connection to Cape Town. After getting our bags, we were met by a rep from our touring company who helped us change to the later flight to C.T.. They wanted to charge us an upgrade fee and our bags were overweight for domestic S.A. flights, but our crafty guide caused enough ruckus and insulted enough ticket agents that we got through gratis (as we should have!). We made it to Cape Town and were met by our guide for the next 3 days, Amelia. She took us to the city and dropped us at the Cape Cadogan hotel, only to find out we had been booked in their sister company’s, MoreQuarters, apartments. We were shown to our room and surprised with rose petals sprinkling the bed, floor and drawn bath, along with chocolates and a bottle of champagne!
March 31st, 2009
We got up early again today to head back to chapel for our farewell, but we were overlooked again, which we preferred anyways. We said our final goodbyes to the anaesthesiologists and Margaret and then got picked up about an hour late! We met up with the others in Bameda that were also headed to Douala, did some craft shopping and then started our journey. We got a van that overheated along the way and had to stop and collect water to fill the radiator and cool it off. Then we stopped for street meat, street fried plantains and pineapple on a stick. We finally made it through the heat and humidity to the European Guest house and promptly jumped in the pool, ahhh what relief! We each got our rooms and showered up and then headed out for dinner at the White House with Kara Beth and the two men from World Medical Missions.
We played a game of cribbage and then went to bed.
Sunday, April 12, 2009
Monday, March 30, 2009
March 30, 2009
Last Mbingo blog entry! Have to say we’re pretty excited to head to S.A. for some R&R NOT in a cricket and ant infested 10 foot by 10 foot concrete room. We went to ‘devotion’ at Chapel (we have to, on the last day) to say farewell, but they held us over until tomorrow. Another visiting surgeon who’d been here for 6 months was leaving too and he and his wife had a long speech and song prepared to serenade the crowd, so we were out of time. We did clinic today and left Henry, the resident from Nigeria who’s been on ortho the whole time, do the cases. There was one excisional biopsy, and then a poor husband and wife couple (she’s pregnant to boot) who wiped out on a motorcycle Saturday and both had bad open tibia fractures. So we did clinic with Dr. Nana and mostly said our good-byes to the clinic staff, anesthesia team, OR nurses, etc. We handed out a few gifts and brought a bunch of clothes and stuff we’re leaving behind, for them to give out to needy patients (which ones aren’t?). Since the last clinic day had to be as crazy as the rest, we saw a 9-yr old boy with bone sticking out of his arm that had been there over a year (chronic infection), and an older guy with a 30-year old (seriously!) gunshot wound to the ankle, with it wrapped in sticks and cardboard. He was immediately booked for an amputation tomorrow, based on the stench of his leg which made almost all of us pass out. One guy had a dislocated jaw for 20 days, and Dr. Nana tried to put it back in (you have to stick your thumbs in the mouth and lower the jaw, push it back and it pops back up and in), but he had to stop because his teeth were so bad the molars were crumbling and cutting his thumbs. Yay for preventive care! After pictures with the clinic crew, we finished packing and had chicken and bean burritos for dinner. Donuts at the Sparks’ again tonight and our last night deciding between cricket-song insomnia and ear-plug headache. A bittersweet departure as everybody’s been super nice, but we are so ready to go!
Last Mbingo blog entry! Have to say we’re pretty excited to head to S.A. for some R&R NOT in a cricket and ant infested 10 foot by 10 foot concrete room. We went to ‘devotion’ at Chapel (we have to, on the last day) to say farewell, but they held us over until tomorrow. Another visiting surgeon who’d been here for 6 months was leaving too and he and his wife had a long speech and song prepared to serenade the crowd, so we were out of time. We did clinic today and left Henry, the resident from Nigeria who’s been on ortho the whole time, do the cases. There was one excisional biopsy, and then a poor husband and wife couple (she’s pregnant to boot) who wiped out on a motorcycle Saturday and both had bad open tibia fractures. So we did clinic with Dr. Nana and mostly said our good-byes to the clinic staff, anesthesia team, OR nurses, etc. We handed out a few gifts and brought a bunch of clothes and stuff we’re leaving behind, for them to give out to needy patients (which ones aren’t?). Since the last clinic day had to be as crazy as the rest, we saw a 9-yr old boy with bone sticking out of his arm that had been there over a year (chronic infection), and an older guy with a 30-year old (seriously!) gunshot wound to the ankle, with it wrapped in sticks and cardboard. He was immediately booked for an amputation tomorrow, based on the stench of his leg which made almost all of us pass out. One guy had a dislocated jaw for 20 days, and Dr. Nana tried to put it back in (you have to stick your thumbs in the mouth and lower the jaw, push it back and it pops back up and in), but he had to stop because his teeth were so bad the molars were crumbling and cutting his thumbs. Yay for preventive care! After pictures with the clinic crew, we finished packing and had chicken and bean burritos for dinner. Donuts at the Sparks’ again tonight and our last night deciding between cricket-song insomnia and ear-plug headache. A bittersweet departure as everybody’s been super nice, but we are so ready to go!
Final Weekend in Cameroon
March 28 & 29
It’s our last weekend in Cameroon! Started off with breakfast and then saw one girl in clinic who had rickets; first case Nick has ever seen. Afterwards we went to market and then waited for the seamstress to come back to the hostel. She had made some adjustments so I could finally get my skirt on. You can see our pictures attached of our matching African gear that she tailored for us, which could come back at Halloween this year, so consider it a sneak peak! For lunch, Dr. Harvey and his wife, Margaret, from Holland, MI, had a going away party for themselves with the surgical residents and we were invited. It was a traditional African lunch with fufu and jamajama, probably our last time to get it before we head out! In the afternoon, we did some reading and welcomed another med student who will be here for one month. After dinner it finally started raining again, so we were inside reading and watching “heroes.”
Sunday we ate breakfast and then headed out on a hike to beat the heat before noon, but the humidity is back in full strength so we lasted just shy of 2 hrs. We washed up the rest of our laundry and started packing our bags, deciding which clothes and supplies we will leave behind. We walked over to Christine’s house for a short visit before dinner. A quiet night finishing up “heroes,” finally!
It’s our last weekend in Cameroon! Started off with breakfast and then saw one girl in clinic who had rickets; first case Nick has ever seen. Afterwards we went to market and then waited for the seamstress to come back to the hostel. She had made some adjustments so I could finally get my skirt on. You can see our pictures attached of our matching African gear that she tailored for us, which could come back at Halloween this year, so consider it a sneak peak! For lunch, Dr. Harvey and his wife, Margaret, from Holland, MI, had a going away party for themselves with the surgical residents and we were invited. It was a traditional African lunch with fufu and jamajama, probably our last time to get it before we head out! In the afternoon, we did some reading and welcomed another med student who will be here for one month. After dinner it finally started raining again, so we were inside reading and watching “heroes.”
Sunday we ate breakfast and then headed out on a hike to beat the heat before noon, but the humidity is back in full strength so we lasted just shy of 2 hrs. We washed up the rest of our laundry and started packing our bags, deciding which clothes and supplies we will leave behind. We walked over to Christine’s house for a short visit before dinner. A quiet night finishing up “heroes,” finally!
Saturday, March 28, 2009
March 27, 2009
We went to rounds before breakfast to make sure we saw all the pending consults including a nasty case of infected tendon sheaths in a 20 yr old’s right side thumb and index, which ended up being our last case of the day. After cinnamon rolls and pineapple, we did an excisional biopsy of a strange thigh mass (in the muscle) that looked like TB and an ankle fusion. The thumb/finger case was an add-on and there was a ton of general surgery cases booked today, so no room in the OR. We decided to do it in the treatment (clinic) area under a local wrist block. The block didn’t work at all and I ended up basically slicing open this poor kids thumb and index fingers cold. We gave a bunch of morphine when it was clear the block was ineffective but the pus had to come out, as they say. We had dinner at our neighbours’, The Palmers. He started the internal medicine residency here and she works at the MTCT+ (Mother-To-Child-Transmission, HIV) clinic. Yummy stew and cornbread. We were then invited to Christine’s, the visiting Canadian anesthetist, for dessert and tea. Yummier papaya cake! Then off to bed. T-minus 4 to South Africa.
March 26, 2009
We got up and packed our bags as it was our last night at the Sparks’ house. After breakfast we went to theater where there was a big case that got started a bit late and went into lunch. It was 5 day old accident victim who had dislocated his hip and also fractured both the femur and tibia. By the time Nick got done he was soaking wet, head to toe. After lunch we went back for just a few clinic patients as Dr. Nana had already started on removing a plate from an infected tibia. When we were finished, we walked around to take some pictures of more of the hospital grounds and then came back to the hostel. I ventured back to aerobics class and Nick read until dinner. When we were done with dinner, we read a bit, uploaded our blog and then watched more of “Heroes.” The countdown has begun. Only 5 more nights!!
We went to rounds before breakfast to make sure we saw all the pending consults including a nasty case of infected tendon sheaths in a 20 yr old’s right side thumb and index, which ended up being our last case of the day. After cinnamon rolls and pineapple, we did an excisional biopsy of a strange thigh mass (in the muscle) that looked like TB and an ankle fusion. The thumb/finger case was an add-on and there was a ton of general surgery cases booked today, so no room in the OR. We decided to do it in the treatment (clinic) area under a local wrist block. The block didn’t work at all and I ended up basically slicing open this poor kids thumb and index fingers cold. We gave a bunch of morphine when it was clear the block was ineffective but the pus had to come out, as they say. We had dinner at our neighbours’, The Palmers. He started the internal medicine residency here and she works at the MTCT+ (Mother-To-Child-Transmission, HIV) clinic. Yummy stew and cornbread. We were then invited to Christine’s, the visiting Canadian anesthetist, for dessert and tea. Yummier papaya cake! Then off to bed. T-minus 4 to South Africa.
March 26, 2009
We got up and packed our bags as it was our last night at the Sparks’ house. After breakfast we went to theater where there was a big case that got started a bit late and went into lunch. It was 5 day old accident victim who had dislocated his hip and also fractured both the femur and tibia. By the time Nick got done he was soaking wet, head to toe. After lunch we went back for just a few clinic patients as Dr. Nana had already started on removing a plate from an infected tibia. When we were finished, we walked around to take some pictures of more of the hospital grounds and then came back to the hostel. I ventured back to aerobics class and Nick read until dinner. When we were done with dinner, we read a bit, uploaded our blog and then watched more of “Heroes.” The countdown has begun. Only 5 more nights!!
Thursday, March 26, 2009
March 25, 2009
Today I am feeling much better, and Nick is starting to kick his sickness as well, things are looking up! We had our breakfast and then headed to the OR. Nick started off the day doing a wedge osteotomy to treat a club foot in a 40+ year old patient. There were only a few patients to see in clinic and then he casted a foot that had an equinus contracture and heel burns. The last case of the day was an ex-fix on a tibia that was broken near the ankle. We had a late lunch and were done for the day so we worked on my models for awhile to start finishing them up. We headed back to the Sparks’ house and found out the house help had baked us chocolate chip cookies, what a nice surprise! We read for awhile, did our laundry and then took Archer up to the field at the school to run around. We watched a movie fighting with the electricity on and off all night and then one episode before turning in for an early bedtime.
March 24, 2009
The “bug” got Nick now! We had our breakfast at the hostel and then went up to theater. Due to poor X-rays, and not providing enough blood for surgery, 2 patients had to cancel today. All that was left was a bunion and Nick made clear his intentions of not touching it to Dr. Nana, so we headed off to clinic. The lack of organization was really starting to get to us today! Yikes, the approach to medicine here is just impossible to get your mind around so we just sit back and chuckle to ourselves while the nurses and patients carry on. It’s usually discussing payments options, or figuring out why patients seem to think they can miss their surgery date then show up to expect a pleasant welcome back, and of course, their name written in the schedule book for another date! Even figuring out past procedures is a challenge as charting is not a forte as far as we can tell. After lunch there were a few more patients in clinic and then we went to the craft hut to pick up our “country bags” that we had made. We also visited and supported the embroidery shop making some Cameroon gift purchases. After work we went back to the Sparks’ house did some laundry, took Archer for a walk then watched some more “heroes.”
Today I am feeling much better, and Nick is starting to kick his sickness as well, things are looking up! We had our breakfast and then headed to the OR. Nick started off the day doing a wedge osteotomy to treat a club foot in a 40+ year old patient. There were only a few patients to see in clinic and then he casted a foot that had an equinus contracture and heel burns. The last case of the day was an ex-fix on a tibia that was broken near the ankle. We had a late lunch and were done for the day so we worked on my models for awhile to start finishing them up. We headed back to the Sparks’ house and found out the house help had baked us chocolate chip cookies, what a nice surprise! We read for awhile, did our laundry and then took Archer up to the field at the school to run around. We watched a movie fighting with the electricity on and off all night and then one episode before turning in for an early bedtime.
March 24, 2009
The “bug” got Nick now! We had our breakfast at the hostel and then went up to theater. Due to poor X-rays, and not providing enough blood for surgery, 2 patients had to cancel today. All that was left was a bunion and Nick made clear his intentions of not touching it to Dr. Nana, so we headed off to clinic. The lack of organization was really starting to get to us today! Yikes, the approach to medicine here is just impossible to get your mind around so we just sit back and chuckle to ourselves while the nurses and patients carry on. It’s usually discussing payments options, or figuring out why patients seem to think they can miss their surgery date then show up to expect a pleasant welcome back, and of course, their name written in the schedule book for another date! Even figuring out past procedures is a challenge as charting is not a forte as far as we can tell. After lunch there were a few more patients in clinic and then we went to the craft hut to pick up our “country bags” that we had made. We also visited and supported the embroidery shop making some Cameroon gift purchases. After work we went back to the Sparks’ house did some laundry, took Archer for a walk then watched some more “heroes.”
Tuesday, March 24, 2009
March 23
We got up early and had coffee and toast before Nick headed off to early rounds. Archer and I went to the hostel and laid down until he was back to eat breakfast. I still wasn’t feeling well so I had a quiet day of model making and reading, bur I’m sure Archer didn’t mind the company! Nick had long rounds and then a big day in the OR. He did a tibia ex-fix, S.I.G.N. nail for a subtrochanteric femur fracture, sequestrectomy of a tibia, revision amputation of a thumb, drilling for osteomyelitis. He also saw patients on and off all day in clinic. When he was done we headed back to our house and did some laundry outside and then showered before we walked back for dinner. After dinner we had another marathon of “Heroes” and almost lost the dog we are supposed to be watching. While he was outside after dark we noticed something on the corner of the house and apparently he did too, because he took off like a rocket and seemed to vanish, no barking and no visual of him. We decided he would probably come back on his own rather than us venturing off in the dark to search. One hour later he was at the doorstep, thankfully!! That was enough excitement for the night so we headed off to bed early.
March 21 & 22
The Sparks left for Yaoundé at 5 am. We got up at 6 to meet our Eco-tour guide at the hospital gates at 7 am. So this so-called eco-tour turned out to be, … uhh well, a treacherous walk through the forest/farm/jungle, up and down steep slopes, through muddy streams, … We saw one bird, a guava tree and ‘maybe’ heard some monkeys. Thank goodness for the bamboo walking sticks they chopped down for us, we thought nothing of ‘em at first but we would NOT have made it through the bush without them.
Once it was over, we were brought back to the home base you could call it. After wondering what the heck was going to happen to us for a half hour, we finally convinced them to bring us home. We walked back to our “house” for the weekend and relaxed for the day. On the way back there was this cool rainbow like halo around the sun (see pic).
I gave Nick a haircut on the porch and he got stung by a bee. We started watching season one of “Heroes” and Nick watched X-Men III while I collected some food from the pantry and put together a spaghetti casserole for dinner and made jell-o with fruit for dessert, it was nice to have a kitchen again! We watched quite a few episodes and then ate dinner. We had power outages all night on and off. Real diet coke, yay! Coke Light actually, but we’ll take it.
Sunday was much more relaxed, some laundry and playing with Archer the beagle. In the afternoon, we entertained some deaf kids for a few hours playing basketball and foosball (this happens every Sunday at the Sparks, so we just kept up the deal). Later, we watched a bunch of Heroes episodes (at least as addictive as Lost and 24), made brownies and had the med students over for ‘Groundhog Day’ after dinner.
Unfortunately, this is also the day Laura got traveler’s, booo. After the third trip to the head we decided she should kick off the Cipro we brought. Stay tuned.
We got up early and had coffee and toast before Nick headed off to early rounds. Archer and I went to the hostel and laid down until he was back to eat breakfast. I still wasn’t feeling well so I had a quiet day of model making and reading, bur I’m sure Archer didn’t mind the company! Nick had long rounds and then a big day in the OR. He did a tibia ex-fix, S.I.G.N. nail for a subtrochanteric femur fracture, sequestrectomy of a tibia, revision amputation of a thumb, drilling for osteomyelitis. He also saw patients on and off all day in clinic. When he was done we headed back to our house and did some laundry outside and then showered before we walked back for dinner. After dinner we had another marathon of “Heroes” and almost lost the dog we are supposed to be watching. While he was outside after dark we noticed something on the corner of the house and apparently he did too, because he took off like a rocket and seemed to vanish, no barking and no visual of him. We decided he would probably come back on his own rather than us venturing off in the dark to search. One hour later he was at the doorstep, thankfully!! That was enough excitement for the night so we headed off to bed early.
March 21 & 22
The Sparks left for Yaoundé at 5 am. We got up at 6 to meet our Eco-tour guide at the hospital gates at 7 am. So this so-called eco-tour turned out to be, … uhh well, a treacherous walk through the forest/farm/jungle, up and down steep slopes, through muddy streams, … We saw one bird, a guava tree and ‘maybe’ heard some monkeys. Thank goodness for the bamboo walking sticks they chopped down for us, we thought nothing of ‘em at first but we would NOT have made it through the bush without them.
Once it was over, we were brought back to the home base you could call it. After wondering what the heck was going to happen to us for a half hour, we finally convinced them to bring us home. We walked back to our “house” for the weekend and relaxed for the day. On the way back there was this cool rainbow like halo around the sun (see pic).
I gave Nick a haircut on the porch and he got stung by a bee. We started watching season one of “Heroes” and Nick watched X-Men III while I collected some food from the pantry and put together a spaghetti casserole for dinner and made jell-o with fruit for dessert, it was nice to have a kitchen again! We watched quite a few episodes and then ate dinner. We had power outages all night on and off. Real diet coke, yay! Coke Light actually, but we’ll take it.
Sunday was much more relaxed, some laundry and playing with Archer the beagle. In the afternoon, we entertained some deaf kids for a few hours playing basketball and foosball (this happens every Sunday at the Sparks, so we just kept up the deal). Later, we watched a bunch of Heroes episodes (at least as addictive as Lost and 24), made brownies and had the med students over for ‘Groundhog Day’ after dinner.
Unfortunately, this is also the day Laura got traveler’s, booo. After the third trip to the head we decided she should kick off the Cipro we brought. Stay tuned.
Saturday, March 21, 2009
More pictures for your viewing pleasure
This is not the dog we are watching, but one we saw on the walk to the air strip, he was too cute to pass up. The others are self explanatory- enjoy!
March 20, 2009
Quiet Friday. We started off the morning rounding on some patients on the wards before breakfast, then we ate before heading off to theater. Nick had 2 cases today, only one of which he scubbed in for. The first was a removal of a K Nail from an infected femur as a result of a gun-shot wound. The second was another removal of dead bone in a small child. Only a few patients showed up for clinic so we had most of the afternoon to ourselves to read and take a walk down to the air strip to see if any birds were flying around. We ran in to Tom and found out we finally got our eco tour set up for tomorrow at 7 a.m. We cleaned up and then packed our bags and headed off to the Sparks’ house for a weekend of dog sitting and movie watching! We got to see our first African sunset as some of the dust has subsided (see pic.). They had prepared dinner for us and then Nick and I were assigned dish duty. We finished season 3 of 24 and then headed to bed in a real bed, what a treat!
On a sad note, we found out our housekeeper/cook, Margaret, found out she had malaria this week, but only missed a few hours of work to have her testing done, then back at it.
Quiet Friday. We started off the morning rounding on some patients on the wards before breakfast, then we ate before heading off to theater. Nick had 2 cases today, only one of which he scubbed in for. The first was a removal of a K Nail from an infected femur as a result of a gun-shot wound. The second was another removal of dead bone in a small child. Only a few patients showed up for clinic so we had most of the afternoon to ourselves to read and take a walk down to the air strip to see if any birds were flying around. We ran in to Tom and found out we finally got our eco tour set up for tomorrow at 7 a.m. We cleaned up and then packed our bags and headed off to the Sparks’ house for a weekend of dog sitting and movie watching! We got to see our first African sunset as some of the dust has subsided (see pic.). They had prepared dinner for us and then Nick and I were assigned dish duty. We finished season 3 of 24 and then headed to bed in a real bed, what a treat!
On a sad note, we found out our housekeeper/cook, Margaret, found out she had malaria this week, but only missed a few hours of work to have her testing done, then back at it.
Friday, March 20, 2009
March 19, 2009
Thursday
No big developments today. It’s been raining on and off every day now for the past couple of days. Short OR day on my own, residents have teaching on Thursdays. Achilles tendon repair, a tibial sequestrectomy in a poor 9 y.o. boy and a thigh abscess drainage. Everything here seems to be about pus! A sequestrectomy is removal of all the old dead bone in an old infected fracture (or infection without a fracture), and then it is all left open wide to heal from the inside out over 8-12 months. The body is pretty good at isolating dead bone (sequestrum) and trying to grow new bone (involucrum) around it but at some point it wants to get rid of the sequestrum and pushes pus out of one or more sinuses in the skin (that’s how we know where to go in and dig out the dead bone). It comes out like a dead tree branch hidden inside the healthy bone, but not attached to anything, and then you just scrape out the pus, YUM!
Laura stayed back for the morning to meet the seemstress who will be making her African outfit with the fabric she bought at market – should be pretty fancy (and funky). She built a heart model in the meanwhile and joined me for clinic in the afternoon. We then went to market for drinks and got “grenadine” pop that tasted like cherry cream soda (awesome actually!). Cabbage rolls and shrimp toast (that’s a first) for dinner. Lazy rainy evening with no internet.
Thursday
No big developments today. It’s been raining on and off every day now for the past couple of days. Short OR day on my own, residents have teaching on Thursdays. Achilles tendon repair, a tibial sequestrectomy in a poor 9 y.o. boy and a thigh abscess drainage. Everything here seems to be about pus! A sequestrectomy is removal of all the old dead bone in an old infected fracture (or infection without a fracture), and then it is all left open wide to heal from the inside out over 8-12 months. The body is pretty good at isolating dead bone (sequestrum) and trying to grow new bone (involucrum) around it but at some point it wants to get rid of the sequestrum and pushes pus out of one or more sinuses in the skin (that’s how we know where to go in and dig out the dead bone). It comes out like a dead tree branch hidden inside the healthy bone, but not attached to anything, and then you just scrape out the pus, YUM!
Laura stayed back for the morning to meet the seemstress who will be making her African outfit with the fabric she bought at market – should be pretty fancy (and funky). She built a heart model in the meanwhile and joined me for clinic in the afternoon. We then went to market for drinks and got “grenadine” pop that tasted like cherry cream soda (awesome actually!). Cabbage rolls and shrimp toast (that’s a first) for dinner. Lazy rainy evening with no internet.
Wednesday, March 18, 2009
March 18, 2009Today started off sad because after waking up to still no electricity (heavy rains last night) we found out from the med students that a child, who needed to be on oxygen, died because the generator ran out of gas and O2 was on power supply. T.I.A. as they say… this is Africa. A pretty slow day all around. A biopsy of a mass on a teenager’s chest wall, and removal of a SIGN nail from the tibia were the only OR cases. There was a no show for the afternoon. After lunch there were only a few clinic patients, one of which included a finger from a patient who caught it in the zipper 4 months ago and now the skin seemed to be peeling off it…ewww. It was a slow day so we took some pics with the clinic staff and resident on ortho. After work we took a long walk further exploring Mbingo 2, the name for the part of town across the road, where we got taunted by little kids “Hey white man!!” Today was a big, hot dust bowl so we opted for this flatter hike, rather than heading up the mountain. At dinner we welcomed a few new guests including an oncologist from Cape Town whom we hope to hit up for some good info for our upcoming honeymoon destination. He told us that Krueger Park is going to be great this time of year so we are even more stoked. Also check out our 6-legged guest from last night on this pic.
March 17, 2009
After breakfast, Nick went up to the OR and clinic and I stayed back and started working on another model of the heart and lungs for school. He saw a few clinic patients and also removed a SIGN nail from the tibia. I met up with him for break and then changed into my scrubs and watched him remove a very aggressive GCT (giant cell tumor) from the distal radius. We came back for a quick lunch and then there were only a few patients to see in clinic in the afternoon. We washed out the material we bought for some outfits and did some laundry then went for a walk to the market. We stopped by the craft hut and talked to the teacher who vocationally educates disabled ppl. how to build chairs, cupboards, baskets, bags, etc. and then sat on our stoop reading until dinner. We had another short walk after dinner and then were back to the room by 7 pm.
Tuesday, March 17, 2009
March 16, 2009
Unspectacular Monday. Monday rounds are depressing because we see ALL the in-house patients, so each terrible situation (that it seems would take about 5 minutes to fix properly in “the west”) times 40 makes for a sad start to the week. Dr Nana is away this week so I’m flying solo with the resident. In my brain, I had all the answers on how to take care of the patients’ problems, but of course none of those solutions are available here (see ‘depressing’ above). Only one case in the OR, a saucerization of a chronically infected ankle, so I let the resident handle it and covered the large Monday clinic. Wacky wacky stuff, like a one year old open distal femur fracture with the bone still sticking out of the skin. Laura followed me for most of rounds and watched in clinic, I think she quite enjoyed herself. The nurses did too, because she’s so much more social than I am. The resident joined us later but left again because one of the anesthetist had a testicular torsion – OUCH! Stat to the OR.
Went for a walk after work wandering the paved road up the hill to Baingo. We saw goats, chickens, a pig, and a crazy blue bird with a call that sounded like a freaky robot voice right out of Star Wars. Also, dude carrying a giant chain-saw by the blade. Awesome carbo-loading dinner of potato casserole, buns and cake. Still no rain yet.
Unspectacular Monday. Monday rounds are depressing because we see ALL the in-house patients, so each terrible situation (that it seems would take about 5 minutes to fix properly in “the west”) times 40 makes for a sad start to the week. Dr Nana is away this week so I’m flying solo with the resident. In my brain, I had all the answers on how to take care of the patients’ problems, but of course none of those solutions are available here (see ‘depressing’ above). Only one case in the OR, a saucerization of a chronically infected ankle, so I let the resident handle it and covered the large Monday clinic. Wacky wacky stuff, like a one year old open distal femur fracture with the bone still sticking out of the skin. Laura followed me for most of rounds and watched in clinic, I think she quite enjoyed herself. The nurses did too, because she’s so much more social than I am. The resident joined us later but left again because one of the anesthetist had a testicular torsion – OUCH! Stat to the OR.
Went for a walk after work wandering the paved road up the hill to Baingo. We saw goats, chickens, a pig, and a crazy blue bird with a call that sounded like a freaky robot voice right out of Star Wars. Also, dude carrying a giant chain-saw by the blade. Awesome carbo-loading dinner of potato casserole, buns and cake. Still no rain yet.
Monday, March 16, 2009
Weekend #2
March 15, 2009
Well today the rains were supposed to start, but despite the clouds there was no moisture falling. We already got two rains last week, so maybe the rainy season has officially been pushed back 2 days. We got up for breakfast and then decided to immerse ourselves in more culture by heading off to Sunday service. There are strict Baptists here and the 2.5 hr. service reflects that! The singing was entertaining and we were able to easily understand the pastor, but the wood benches were not doing it for us for that amount of time, and we ducked out 15 min. early. Afterwards we had a relaxing afternoon filled with reading and watching the ‘Bourne Identity.’ We have new guests here so the dinner table was really full. We headed over to the Zimmerman’s house in the evening for some ice cream and socializing. Came home and watched 24 before bed.
March 14, 2009
Our morning started off with breakfast then Nick got a call about a patient in out-patient clinic so we ended up at the clinic and saw 3 patients only. We had a good internet signal so we worked on sending out some emails and updating our blog until lunch. After lunch, Kristin, Ann, and us went down to market and I bought some material to have an African outfit made. There should be enough to make a skirt, shirt, and wrap and maybe a head band, we’ll see what the tailor says this week. The afternoon was a lazy one lounging on Dr. Palmer’s stoop reading and listening to music. We had dinner and then went for movie night screening Ice Age at the Sparks’ house complete with buttered popcorn and wine coolers that tasted like liquid gold, or maybe it was just that we haven’t seen ice cubes for 2 weeks! If we are lucky, it sounds like we might get to house sit this coming weekend for them in order to care for their dog while they are away. We are looking forward to the possibility of a comfy bed.
Well today the rains were supposed to start, but despite the clouds there was no moisture falling. We already got two rains last week, so maybe the rainy season has officially been pushed back 2 days. We got up for breakfast and then decided to immerse ourselves in more culture by heading off to Sunday service. There are strict Baptists here and the 2.5 hr. service reflects that! The singing was entertaining and we were able to easily understand the pastor, but the wood benches were not doing it for us for that amount of time, and we ducked out 15 min. early. Afterwards we had a relaxing afternoon filled with reading and watching the ‘Bourne Identity.’ We have new guests here so the dinner table was really full. We headed over to the Zimmerman’s house in the evening for some ice cream and socializing. Came home and watched 24 before bed.
March 14, 2009
Our morning started off with breakfast then Nick got a call about a patient in out-patient clinic so we ended up at the clinic and saw 3 patients only. We had a good internet signal so we worked on sending out some emails and updating our blog until lunch. After lunch, Kristin, Ann, and us went down to market and I bought some material to have an African outfit made. There should be enough to make a skirt, shirt, and wrap and maybe a head band, we’ll see what the tailor says this week. The afternoon was a lazy one lounging on Dr. Palmer’s stoop reading and listening to music. We had dinner and then went for movie night screening Ice Age at the Sparks’ house complete with buttered popcorn and wine coolers that tasted like liquid gold, or maybe it was just that we haven’t seen ice cubes for 2 weeks! If we are lucky, it sounds like we might get to house sit this coming weekend for them in order to care for their dog while they are away. We are looking forward to the possibility of a comfy bed.
Saturday, March 14, 2009
Friday the 13th!! No black Cats here!
March 13, 2009
It’s Friday!!! We started off our morning with a pancake breakfast and then headed up to theater. Today I decided I’m going to spend some more time shadowing Nick and easing in to watching more cases. Nick ended up having to see a handful of patients in clinic and then had to do a below knee amputation. This time I had a chair and just watched through the window and made it through the entire case, baby steps for me! When I couldn’t see the patients face it was easy enough picturing my dad hacking off legs of deer and just thinking that this was all Nick was doing as well. If anyone could develop a way to sharpen the saws you’d have business for life here! Afterwards he had one consult on the men’s ward and then we headed down for some lunch. In the afternoon there were just a few more clinic patients to see and then we were done early.
A 3-hour hike to the waterfall’s source pond wiped us out! Some steep hills and down slopes to navigate with a 7-year old kid and a beagle, which we almost lost after he went sniffing under the fence towards a cliff in thick brush. We really thought we’d lost him and he re-appears out from the grass just at the cliff’s edge. Little late for pizza dinner but plenty starved. Some reading and 24, then early to bed for our tired legs.
It’s Friday!!! We started off our morning with a pancake breakfast and then headed up to theater. Today I decided I’m going to spend some more time shadowing Nick and easing in to watching more cases. Nick ended up having to see a handful of patients in clinic and then had to do a below knee amputation. This time I had a chair and just watched through the window and made it through the entire case, baby steps for me! When I couldn’t see the patients face it was easy enough picturing my dad hacking off legs of deer and just thinking that this was all Nick was doing as well. If anyone could develop a way to sharpen the saws you’d have business for life here! Afterwards he had one consult on the men’s ward and then we headed down for some lunch. In the afternoon there were just a few more clinic patients to see and then we were done early.
A 3-hour hike to the waterfall’s source pond wiped us out! Some steep hills and down slopes to navigate with a 7-year old kid and a beagle, which we almost lost after he went sniffing under the fence towards a cliff in thick brush. We really thought we’d lost him and he re-appears out from the grass just at the cliff’s edge. Little late for pizza dinner but plenty starved. Some reading and 24, then early to bed for our tired legs.
Pics, 03/11 & 03/12
Model built for school, paint still not dry, 4 days later!
Thursday night volleyball league.
FuFu and JamaJama with beef stew. Typical African dish.
Playful deaf boys putting on a show for us.
Wheel game.Thursday, March 12, 2009
Wed and Thurs.
March 12th
Early coffee courtesy of the recently installed burner and old rusty propane tank (yay for us!) just added to the dining room so 7am rounders can get some breakfast, which until now was 7:30 to 7:45 or so, and tough noogies if you missed it. No residents in the OR (teaching on Thursdays) and Dr. Nana felt stuffy, so on my own for 3 cases. The kicker was a 45 year old man with a 1-year-old both bone forearm fracture (we try to fix those in less than 5 days usually) to fix with a small plate and screw set missing about 80-90% of sizes and screw types. We also had to repair about 6 tendons on a man’s foot who had fought with a machete and lost. Laura headed back to the library at school, but it was filled with teachers grading final exams so she came back to the hostel and finished her wet paint nose/mouth model and then read until I was done at the hospital. I came late for lunch. We had our first African lunch today of Jama Jama and Fufu. Some mixed greens with veggies that you pick up with a ball of this Fufu (cornmeal) with your fingers and eat. It wasn’t bad at all, but you could tell the ball of fufu had one purpose, to simply fill your gut, it really didn’t taste like anything, wet cardboard maybe. See attached picture. After lunch, I was left with a below knee amputation. I came back and Laura headed off to aerobics class while I read. When she got back we headed over to a field where the Cameroonians play volleyball on Mondays and Thursdays, with Kristin, a med student. We watched for awhile and then were invited to play. To our surprise we were playing with what seemed to be ultra-strict adherence to Olympic rules. The men were so into it, and we never understood most of the calls that were called against us. Even though our team won, the next game, Laura and Kristin were told they could “rest!” but I was invited to continue playing. Typical for their culture I guess. We walked back for dinner and then had a lazy evening.
March 11th
First major highlight: Donut night. The Sparks, a vascular surgeon and his wife from San Diego who came here as missionaries 5 years ago to start a general surgery residency and built a ginormous house, had all the volunteers and missionaries (read: white people) over for homemade donuts. Think Krispy Kreme when the glazed’s are hot off the presses. We didn’t really need more carbs, but they were SOOO tasty! 25 or so people socializing, a cute beagle and lots of donuts and decaf made for the first night we didn’t check our watches every 5 minutes to see if it was late enough to go to sleep.
This was really a nice treat after 2 really tough cases in the OR: a retrograde (into the knee up towards the hip) femoral nail for a low fracture in a very obese leg, even good sized for Iowa standards; and bending then pinning at 90o the straight elbow from yesterday, which was not fun at all! It was like breaking a solid bone in half, there was so much scar, poor kid.
Laura had tons of fun building an anatomic nose and mouth model for the school using PVC pipe glue that’ll knock you down with one whiff at 30 yards and oil-based paint that still hadn’t dried 36 hours later. Just before dinner we played with a handful of deaf kids in the front yard of the hostel and took pictures of them. Rolling a tire with a Y-shaped twig isn’t as easy as it looks (ask Laura), but these lil’ tots were masters. So dinner, then donuts and chats with all the vols.
Early coffee courtesy of the recently installed burner and old rusty propane tank (yay for us!) just added to the dining room so 7am rounders can get some breakfast, which until now was 7:30 to 7:45 or so, and tough noogies if you missed it. No residents in the OR (teaching on Thursdays) and Dr. Nana felt stuffy, so on my own for 3 cases. The kicker was a 45 year old man with a 1-year-old both bone forearm fracture (we try to fix those in less than 5 days usually) to fix with a small plate and screw set missing about 80-90% of sizes and screw types. We also had to repair about 6 tendons on a man’s foot who had fought with a machete and lost. Laura headed back to the library at school, but it was filled with teachers grading final exams so she came back to the hostel and finished her wet paint nose/mouth model and then read until I was done at the hospital. I came late for lunch. We had our first African lunch today of Jama Jama and Fufu. Some mixed greens with veggies that you pick up with a ball of this Fufu (cornmeal) with your fingers and eat. It wasn’t bad at all, but you could tell the ball of fufu had one purpose, to simply fill your gut, it really didn’t taste like anything, wet cardboard maybe. See attached picture. After lunch, I was left with a below knee amputation. I came back and Laura headed off to aerobics class while I read. When she got back we headed over to a field where the Cameroonians play volleyball on Mondays and Thursdays, with Kristin, a med student. We watched for awhile and then were invited to play. To our surprise we were playing with what seemed to be ultra-strict adherence to Olympic rules. The men were so into it, and we never understood most of the calls that were called against us. Even though our team won, the next game, Laura and Kristin were told they could “rest!” but I was invited to continue playing. Typical for their culture I guess. We walked back for dinner and then had a lazy evening.
March 11th
First major highlight: Donut night. The Sparks, a vascular surgeon and his wife from San Diego who came here as missionaries 5 years ago to start a general surgery residency and built a ginormous house, had all the volunteers and missionaries (read: white people) over for homemade donuts. Think Krispy Kreme when the glazed’s are hot off the presses. We didn’t really need more carbs, but they were SOOO tasty! 25 or so people socializing, a cute beagle and lots of donuts and decaf made for the first night we didn’t check our watches every 5 minutes to see if it was late enough to go to sleep.
This was really a nice treat after 2 really tough cases in the OR: a retrograde (into the knee up towards the hip) femoral nail for a low fracture in a very obese leg, even good sized for Iowa standards; and bending then pinning at 90o the straight elbow from yesterday, which was not fun at all! It was like breaking a solid bone in half, there was so much scar, poor kid.
Laura had tons of fun building an anatomic nose and mouth model for the school using PVC pipe glue that’ll knock you down with one whiff at 30 yards and oil-based paint that still hadn’t dried 36 hours later. Just before dinner we played with a handful of deaf kids in the front yard of the hostel and took pictures of them. Rolling a tire with a Y-shaped twig isn’t as easy as it looks (ask Laura), but these lil’ tots were masters. So dinner, then donuts and chats with all the vols.
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