And so my second week comes to an end.. While in the first week I spent much time getting settled in, and getting to know the people and places around me, in this second week I’ve tried more to settle into what I feel my role here will be, and therefore tried to apply myself to where I felt was needed and where I could be of assistance.
Some of this I’ve been able to do from home, such as applying for grants, researching materials for my project etc. This in preparation for what to come on the 26th, when my advisor arrives from Denmark, and my research here starts for real. But having gotten to know the projects operating here, and gained insight into some of the most common problems they face, I’ve also spent my time thinking of and implementing some more efficient routines and equipment at both the hospital and the project.
These include storage and organization of supplies, ordering Wifi equipment for network enabling printers at project and Simao Mendes Hospital (as most people now have to carry their computers into the printer room, and manually connect via USB or in some cases LPT1..), sorting MAC filtering access tables at project to remove old and unknown entries, researching sea cables connecting Guinea Bissau to the Internet in order to determine if a better connection may be set up at project, and centralizing Anti-virus updates for project computers on ISDN speed connection (ex. Update = 80Mb, x 10 computers all downloading at the same time => Will never finish (people only work at the project 4h in the afternoon), will slow internet connection to a halt, will start over every time computers reconnect to Internet..
In general I find that many of the technical solutions already set in place are rather fragile and unstable. This, as they were in most cases implemented by people now long gone, and now left in the hands of others, who sometimes do not possess even the required knowledge to maintain them, let alone the ability to understand and evolve upon them, and to see where improvements might be made.
Therefore, so far, much of my work here so far has been rather geeky in nature. But it’s actually been a great pleasure to be able put some of my non medical knowledge to good use, and in this particular case it also makes me happy I spent all those hours of my youth playing, and later working with computers.
This has actually been somewaht a general feeling that I’ve experienced down here, and one also I’ve had before in other 3rd world countries.. It’s that in places like this, where education is poor, and the luxury of seeing beyond the necessities of everyday life is not afforded to all, that every skill counts, and those possessed and willingly shared, are most often both needed and much appreciated by all.
For someone such as myself, who’s dabbled in a lot of different things over the course of my life, it’s actually a wonderful feeling to be able to fully apply one self and feel that privately as well as professionally, all the parts are allowed and asked to make the whole. I consider this as opposed to a feeling that I’ve had in both Denmark and the rest of what we call the western world, of our society becoming ever more inclined towards specialization in most fields, professional labelling and general conformity strived for with each fold that seperates the sheets.
To put it simply, where in our part of the world, a doctor is a doctor, and a mechanic is a mechanic; here the sum of both is a gift sent from the gods. – If you possess a skill and advertise it, you may almost count on being asked to apply it, as most often the alternatives are none.
But all has not been work, as the social aspects of our little colony are also a daily source of joy.
Recently while foraging through the storage room I was told of an old projector in the room, that apparently had made some computers crash when connected, or so I was told, and therefore had been discarded in favor of a new one. Now assuming that no major hardware malfunction would have crossed the wires connecting the unit to the computer, this seemed rather unlikely to me, and I figured the source of the problem more likely to be either the OS of the computer not configured for projector output, an issue with the display drivers, or a conjunction of the OS and hardware specific software needed for Dual/Extended display.
But as the new one was already bought and delivered, I managed to get approval for reassigning the old one to our house until needed (read: indefinitely), where it now serves as part of our new home-cinema setup, placed in the living room of the apartment across from me (where Thorny lives). Now all we need is an amplifier and a pair of speakers and we’re in business. But even without the Dolby Surround Sound experience, we’ve already managed to enjoy a personal selection of several good movies, and I’m counting on us enjoying many many more.
Speaking of said living room, it also doubles as our personal dance floor, for as I mentioned earlier, I’ve begun teaching Salsa to almost everyone here.. At first we were 6 in all (Thorny, Frida, Leo, Sanne & Grethe), later Sanne and Grethe left for London for a week, and at times it’s been only myself and the 2 girls. But still we keep going, and I’m very impressed with their speed of learning, as well as happy that they’re willing to share in what I do so enjoy.
Thorny and Sara (who left just before I came) had also previously been in contact with an African dance group practising here, and been allowed to train with them and receive private lessons here at the house. The contacts phone number was lost though when Sara left for home, but I’m hoping that we can reestablish that connection so I can learn some African dances while here, and get some inspiration to bring with me home.
And while on the subject of dance, yesterday we (Thorny and I) went out to meet Anne, a danish medical student from Copenhagen currently finishing a 2 month voluntary stay at Simao Mendes hospital, and her 2 friends, to go out dancing Salsa, or at least that was the plan. Leaving the house around midnight we walked towards the Praca (town center) in the rain, and after passing down 2 taxis that demanded 10 x the normal fare for a ride downtown, we finally just got in the 3rd one without asking the price. But seeing the road he had to drive to get to Annes house, I certainly better understood the sudden increase.
The main road was fine as ever, but upon entering the inner areas, the road was filled with holes so deep and wide that the front end of the car would litterally scrape against the ground every time we hit a hole, all the way down, grinding as we tried to push on. I was really just waiting for the axle to break apart, like on so many cars I’ve seen simply left in the middle of the road, until towed off somewhere where they presumably weld it back together and send it on its way. – I was told that the drivers don’t usually go down the side roads in the day, but make exceptions at night while charging a higher price, understandably now.
But I was also very impressed with the way the driver navigated through the night in almost no light at all, steering by landmarks on the side of the street, apparently knowing the road by heart. One particular road, that we usually drive on every morning when heading for work (Hospital), has bumps enough to challenge the worst I’ve tried in Iceland, and successfully navigating it is a challenge we’ve not yet been up to, even in broad daylight. But this particular taxi driver somehow managed to navigate it flawlessly, in complete darkness, without a single hitch in the ride..
But we got to the place and picked up Anne & Guests (7 people in the car by then), and continued to the club. The club (called El Che), unfortunately offered no salsa tat particular night, but the doormen promised that saturdays usually had latin music, so it’s definitely worth a try another time.
Instead they offered us a concert with one of Guinea Bissaus most famous singers, which was very tempting to me, but unfortunately too expensive for our local friends. And having not brought nearly enough cash, we went to another club instead, where they played almost exclusively kizomba. It was a great experience, with Thorny, Anne and I being the only Brancos there, but while the girls had no problems being invited to dance by local guys, even through repeated attempts, I didn’t manage to get even a single dance with anyone not from our little group of friends.. (Probably a healthy change from being in Denmark, always getting a yes, when not simply sitting around being asked by others to the dance floor)-
I’m not too disappointed though, as I still got plenty of time on the dance floor with my friends, as well as time enough to seeing how the local dance both the basic steps they all share as well as the variations of those a bit more advanced – And besides, when factoring in the cultural issues and gender roles, while presumptuously assuming that it wasn’t because I moved like a stiff legged hen, I’m reminded that like in Denmark, most people don’t go to clubs and discotheques simply just to dance..
– But a lot more has happened this last week, so let me try to summarize:
Monday I bought my plain ticket home (DK) for christmas, and afterwards I had my Teva sandals repaired by a very thorough and industrious man outside, using some very ingenious tools that allowed him to easily punch through the soles and afterwards retrieve the thread. I was actually somewhat envious, as I’d recently spent the better part of 2 hours sewing up a bag I’d gotten in Israel, and I could see that with a tool like his, I could have completed the work within half an hour, minus getting my fingers all sore..
In addition to doing a very good job on the repairs, he also gracefully lent me a spare pair of sandals, as we (Thorny and I) went to “The Bakery”. A place run by a portugese baker it offers cakes that rival most danish pastries, and more importantly they sell bread that doesn’t look as white on the inside as do my legs. This is mostly an expat place though, as the prices, while very reasonable (~11kr for a whole bread with seeds and grains), likely keep most local away.
After work I decided to walk across to a local school located just next door. I’d heard some singing (very good) and wanted to check it out, so I left my ride home, and took the long way around. What I found was in addition to the choir pracicing inside, a football tournament of small children, which was partly interrupted by my presence there, as yells of “Branco Pelele (a reference to a brazilian (I think) cartoon, in which there are 2 characters named Brancu Pelele and Pretu (black) M’bao) rose up like a wall. Not yet having learned the proper response (Pretu M’bao) I simply waved and sat down on the steps of the local church next door, settling for a host of children drawing nearer to examine me up close and personal. My arm and leg hair in particular, was the object of much conversation, as this is not shared by many if any of those from these parts. But they were all very friendly, and I did manage to practice my Creole a bit while letting the time fly by.
On the way home (walked) I visited the “Youth for Christ” center here in Bissau, that I recognized from a YouTube video (The YFC Guinea-Bissau Training Center). It was late at night, and therefore dark, but I saw their facilities and peeked in on some english and computer lessons in turn. I found out that the school was not as I had thought free for all, but was though somwhat reduced in price, so that those who would prioritize, should be able to afford to send at least some of their children to learn english and computer skills, most often based on regligious content.
Tuesday I visited the Zones as they call them. Imagine the city divided into areas by the surrounding larger roads, the zones become the boxes identified by the larger groups of houses seperated by the major roads. One of the earliest landmarks of the Bandim Health Project was to identify and enumerate these houses, to enable registration and subsequent observation of their inhabitants. And it is this work that has become the foundation of most of the research carried out in Bissau.
The purpose of our visit (me, myself, Leo and an Assistant who’s name i regretfully cannot recall) was to visit certain houses to hear if any new children had been born since the last visit, and if so then to ask if they might be included in our studies. If so, we would register their idenity, their weight, their upper arm circumference (an established measure of nutricional status) as well as cranial circumference (this one had me stumped, and I’ve not yet ascertained it’s value or reason since then). The reason Leo and I were along, as this work is usually carried out by paid assistants, was to supervise the assistant, to make sure that values were obtained in the proper manner, that questions were asked in the right way, and that all data was entered in the proper manner to the fischa (the form made by the project, to which all the questions and measurements pertained).
More than once though, we could only stand by and question our purpose, as the assistant had obviously done this a thousand times before, and since neither of us had the proper understanding of Creole to properly detect any errors, nor the experience to question his methods, we were somewhat reduced to idle standers-by, somewhat like a couple of very white flies upon the wall.
But we (or I at least) didn’t really mind, as simply entering these areas and stepping into peoples homes, made me feel much more a part of what now surrounds me than I had felt the days before. Say what you will about the conditions, this was how they truly lived, the pople we meet in the streets, the people we work with at the project, the people that come our house and clean, and I was happy to be a part of it, even if only partly and for that very short time. – Simply being with the families and their children, sitting down and talking a bix of broken Creole and Spanish, was a heart warming experience that I look forward to repeating again.
Thinking of how they sit outside their houses, very often surrounded by neighbours and passers-by, it is easy to relate that to the stories I’ve heard from both Thorny and Frida, who have the two larger rooms of our house which facing the outside of the complex, each with a rather large balcony, only seperated from the street by a wired fence. As they’ve told me, it seems that every time they try to sit outside and read, or just enjoy a quite afternoon outside, they’d immediately be joined by almost everyone around, who’d then sit outside the fence and ask them questions, naturally assuming that they’d come out because they wanted to talk.
– This reminds of a funny anecdote I was told by someone recently.
A danish man had married a Guinean woman, and after some time they’d decided to move to Denmark. This woman, both intelligent and strong of will, had decided that she would not be one to sit at home and loiter, but that she would learn the language quickly, and make many danish friends to call her own
So one afternoon while her husband was off to work, she’d take a plastic chair from their yard, and placed it squarely outside their white picket fence in their calm suburban area, and sat there all day long, assuming that the neighbours would of course be curious, and come over right away to talk.
I found it to be a very cute and funny story, that very aptly illustrates how differently we interpret signs of social interaction, and reminds me how we in the north of today, have developed something of a social phobia in my view, that I do not remember as being present when I myself was a child.. Be it sitting next to the stranger in the bus, or knowing who your next door neighbour is, so many of us choose to shy away and keep to ourselves, clinging to that which is familiar and safe, in effect so isolating us from the world around us that many end up developing an actual fear of what now surrounds them, but they do not understand.
Transferring this to the roles of immigrants and locals, I find that by so strongly holding on to that which we say is and always has been, we only serve to isolate us from the gifts that are there to be shared. Obtusely refusing to acknowledge that the feeling that perhaps we are seeking from our youth, that one of safety and a sense of belonging, truly comes from being part of society as it is, one of a childs acceptance and curiosity towards the wonderous world around it, wanting to taste (quite literally in the case of very small ones) of everything that it holds – instead of so strongly fasting on a faded image of we feel is “right”, and expecting all who come, seeking only a place to call their home, to adapt and adhere unerringly to that image of what once was, but never again will be, be there immigrants or none. People will perhaps ever carry with them, a instinctive fear change, of that which is unkown. – At least there is always hope for the generations to come.
Wednsday we were joined by 2 additions to our little group; Kristoffer and Sofie. Both are previous students of this project, who after meeting down here ended up sharing much more than just memories when back home. Now both have finished their studies, and decided to come back to Bissau where they plan to spend the next 3 years doing research. Kristoffer has studied Biotechnology at DTU, and will be working on the HIV Vaccine Trials, while Sofie is a master of Public Health who will be doing her work with the Low Birth Weight study, amongst children monitored by the project.
Sofie is a particular friend of the cat that claims this house as its home. Named dBase (named after an old DOS based database program we still use at the project), it has long been and remains a constant source of discussion amongst the group. You see, apparently some time before my arrival, it had been badly ridden with wounds and somewhat disgusting sores, and only though the pleading and curative efforts of the more cat-friendly members of the group was is slowly nursed back to health, and not sent off to a peaceful sleep as suggested and maintained as the firm opinion by the larger part of the group.
As I was told, dBase was actually born on a pile of Sofies clothes shortly after her first arrival here some years ago, and while its siblings did not survive long, and the mother has since passed on, dBase remains a survivor. The cat now, thanks to sofie and partly myself, enjoys almost daily meals of leftovers as well as canned and actual cat food from a can. Meals who’s values somewhat superseed that of many a local food budget I am shamed to say..
Oh and there’s also a dog here, named Alfonso, that mostly lies around in the yard. Perhaps through the lack of need to perpetually rub its head against our legs, it has not yet asserted itself into our lives quite as well as the ever persistent and attention seeking cat.
Enough about our household animals, which also include an army of ants and cockroaches that cleverly hide until the night, at which time they stream out in search of whatever food items we may have dropped during the day (I must say though that I’m rather impressed by the cleanlieness of our kitchen floor).
Now, I want to share with you my Saturday.
I’d made arrangements to go with the team that registers low birth weight, to a nun driven hospital called Kumoa, located in the area of Quinahmel just outside of town. The purpose of the team to visit on that particular day was that child vaccinations were to be carried out for free, which happens once a month, for which many many mothers from all of the surrounding areas and the inner city as well, would bring their children. This would be a perfect chance for the team to weigh and recruit newborn infants and children for their study, and was actually started up by newcomer Sofie, last time she was here.
I’d heard about the place before, and even seen it in a YouTube video, a documentary called Dying for Treatment. There, they said, would-be mothers would come from all the areas around, to give birth with the nuns. This often as opposed to going to the national Simao Mendes hospital, where, I am told, the process of childbirth regularly involves the midwifes forcefully pushing down on the mothers stomachs in order to speed up the birth, as well as hitting the mothers in order to stop their screaming out of pain..
But returning to the day at hand, upon our arrival many of the mothers were already there, and stood ready and waiting in line, which streched out way beyond the gates of the facilities.
I was given a quick tour of the place, then led into the main vaccination room, where I began drawing up syringes of what they called Penta, the WHO newly reccommended vaccine for Africa, that combines the regular DTP (Diphteria, Tetanus and Pertussis) vaccine currently in use in most western countries, with Hepatitis B and Haemofilus Influenzae (Hib, also given in west). This was to be the main vaccine given to almost all of the children, along with the oral Polio vaccine, with the exepction of 2 groups. Those newborn, who would only recieve the oral Polio vaccine as well as the shoulder scarring BCG vaccine against Tuberculosis, and those at the end of their vaccines, who would recieve a measels vaccine along with that against yellow fever.
I had originally expected to be simply helping out with paperwork or weighing of children, but upon Sofies reccommendation, I talked to the nurse (nun) in charge and was given a post in the vaccination room, 3 seats to be precise, where I would take turns, from 1 to 3 (rinse and repeat) of reading from their vaccination card, what the children were to recieve, and drawing up if neccesary and administering the proper vaccinations. – Not many pictures from here, as I was far to busy to think about anything resembling a camera.
Of the 3, the BCG vaccine is the hardest to get right, as it has to be placed intradermally (within the skin), to have the poper effect. Putting it too deep will risk abcesses and large scarring, while laying it to superficial will, well, just put it on top of the skin with no effect. As this is one of the first given, many of the children to whom I would administer this vaccine were only a few weeks old, their skin still wrinkly fresh from their mothers wombs, and my mission therefore a daunting task at best. My first attempt was not as good as I’d hoped for, although the nurse said it was okay, but all the ones after that succeeded to a very high degree, and I am now confident in the technique and grateful for the experience.
For over two hours, the process would continue, with only 1-2 minutes pr. child if not less, and after a while some of the other nurses left, leaving me with 12 seats to cover instead of 3 (I took it as a vote of confidence). In all I am told that we vaccinated ~520 children that day, and in all modesty I would wage guess that my hands were responsible for somewhere around 200 of those.
It was in some ways a humbling experience, as I could not properly speak their language, and felt I could express neither the greetings or the kindness I would have liked to towards the mothers or their other children who had sometimes tagged along. Also, for every child involved that sat there smiling when I came, I knew I see crying when carried off.. – A funny thing I noticed though, is that while almost all the children were very curious when their sibling were being vaccinated, many mothers could really not bare the sight and would actively turn away and even yell, every time they saw their own or the neighbours children being stung..
Afterwards, I took a walk around and got to see their maternety ward, which was very different from the conditions I have been told of at Simao Mendes. Here, each expectant mother was given her own bed (as opposed to 3-4 to a bed), with a mosquito net above, and surrounded by childrens drawings in paint that decorated the walls. The atmosphere there was one of peace and happieness, so foreign from the harsh realities of what I’d seen so far, that it’s hard to imagine why anyone who’s seen it would be able to accept and return to the practices carried out elsewhere.. But it’s easy to judge from a distance, and I would rather first hear from those in charge of the lesser fortunate places, how they feel about the way things are carried out.
Afterwards, when talking to the nun in charge (who told me her name was Irma – which I later discovered is creole for “Sister”), I was invited to return on the 23rd of Oktober, to help again with the next round of vaccinations at the hospital. I will definitely be looking forward to that, even though I know that the pressure will be somewhat stronger (apparently, the wrong date had been passed many of the mothers last time around, so only about half of them showed up), and the situation a bit more hectic. But looking at the flock of mothers sitting with their children, I can’t imagine anywhere I’d rather be on that day, and I will also be well prepared, armed with both experience and confidence of a job well done, as well as hopefully the creole language words for all the necessary body parts.
Oh and finally, while on the issue of practical medicine carried out, in my week as chief medical officer in charge (a title officially passed on this night, when the real doctors arrive..), I’ve managed to treat a burn injury from a baking oven (we had pizza that night I believe) and diagnose a possibly broken (chipped is more like it) toe, resulting from a bathroom sink falling down upon a foot. The person in question, had in the middle of the night gone to the bathroom, and was suddenly surprised by a particularly fearless cockroach that decided to march straight across her foot, at which point she decided to jump up and put all her weight upon the bathroom sink. – Consequences were as told before..
Hmm.. – I do believe that’s all for this time, and it’s certainly grown a bit longer than I’d thought.. Maybe I’ll try some shorter more frequent updates, instead of storing up, or perhaps just filter out what might pass as the wind for people standing by. At least for now I sleep, for tomorrow waits another day and an in depth tour of the hospital area with Anne, which I’d prefer not to see only trough the lids of my eyes.
I’ll leave you with these final pictures taken outside our house, of the small hut inside which our gards spend much of their time, our laundry drying in the sun, and the shop of Mammado, located in the shade of a tree just outside our door.
Goodbye for now!