Carry on crutches!

I am currently preparing a blog entry that will outline a typical day for me here working in the pharmacy.  However, when working in a situation such as this, I am fast learning that I can’t just stick to medicines in my day-to-day work.  It’s all hands to the pump with whatever needs to be done.  If it’s possible for you to assist and carry out a task safely, then you do it, even if it’s not what a pharmacist usually does!

One such example happened a couple of Fridays ago.  Fridays here are half-days for most of the staff, as the afternoons tend to be quieter - most people are at the mosque for Friday prayers and so don’t come to the hospital unless really ill.  This particular Friday, a Chadian patient (who happened to be known to us expats) had been to see Doctor Mark because of a painful knee.  After she had finished seeing him, one of the things she required was a pair of crutches.  Crutches are stored in the pharmacy, as are a lot of other things you wouldn’t see in a hospital pharmacy in the UK, for example cannulas, needles, syringes, plaster of paris bandages, scalpels, sutures!  So I was called to open up the pharmacy and provide the lady with her crutches.  We can only source wooden under-the-arm crutches here (physio’s hold those gasps!) and so they are better than nothing at all.  They are hand-made to the specifications of an expat physio who works here a couple days a week.  They are fully height-adjustable and so I asked Doctor Mark for guidance on how high they should be made for the patient, both in terms of the hand-bars and the whole height of the crutches.  Typically, they weren’t the right height for the patient.  The screws required removing, the pieces of wood moving up and then the screws replacing.  Sound straightforward?  It wasn’t!  It was now 4.30pm.  The hospital handy-man who was my first port of call to do the adjustments had already gone home.  Cue a 10 minute search for a screwdriver and pair of pliers.  Then cue a search for people to help me.  Fortunately Malc was still in his office finalising the week’s figures and he agreed to help, as did Alain the local Chadian interpreter (who also happens to teach me French).  The crutches had been carefully made to a good standard, and then varnished.  However, the guy who’d made them had varnished *over* the screw heads.  Removing the screws proved to be a time-consuming task anyway but we had the added task of getting through the varnish before removal could begin.  We took the crutches to the consulting room where the patient was patiently waiting.  It took ages to remove all the screws, washers and nuts, with a few rolling onto the floor – good job the patient was alert and could tell us where they’d gone!  It then took three attempts to replace them all at the right height.  Darkness was fast approaching which didn’t help (no lights in the consulting room as they’re only used by day....normally.... and our solar energy is better conserved for use on the wards at night).  Other patients kept knocking on the door asking to be seen – I draw the line at extending my duties to consulting patients and making diagnoses!  Finally, after an hour-and-a-half, lots of laughter at our ineptitude at adjusting crutches and a comment in jest from the patient (‘je veux rentrer aujourd’hui - I want to go home today!), we had finished!! 

So that’s another string to all of our bows, should the need ever arise again!!

Things I miss and things I like!

I thought I’d document what I miss from home and things that I like here in Chad J

Things I miss:

·         Sleeping under a duvet

·         Fast broadband internet

·        Going to a shop and being able to get change - coins are in short supply here and most times at the shops they ask if you’ve got coins.  Which can be a bit annoying if you’re trying to save them to buy smaller value items such as bread or fruit from road-side vendors

·         Being able to easily buy meat that’s ready to cook

·         A more comfortable climate – although see below too!!

·         Looking like ‘me’ – I don’t normally have my hair tied up and under a headscarf for the majority of the day, nor do I always wear ankle-length skirts

·         Being able to converse freely and accurately in the native language

Things I like about Chad:

·         Blue skies and sunshine 95% of the time

·         Bananas that taste like banana – trust me, the ones in the UK are tasteless in comparison!

·         Colourful and busy markets

·         Fresh baguettes for the equivalent of 15p

·         Vibrant Church services

·         Meeting people from a wide variety of countries and backgrounds

·         Working alongside other expats and Chadians at the hospital

Cool water?

When it’s hot weather in the UK, we think nothing of taking a glass, turning on the cold tap and pouring ourselves a nice drink of cool water. 

Here in Chad there’s a slightly longer process we have to go through before we can pour ourselves a glass of cool water!   In the hottest weather we drink on average about 4-5 litres of water a day.  Mainly just plain water but we can get a sugary powder in a myriad of artificial flavours, which we can add to the water if we want to.  There are other ideas too for flavouring water, such as adding a peppermint or lemon teabag to a jug of water and letting it soak overnight.  When you’re drinking so much cold water you need a bit of variation!

This blog outlines the process us expats go through on a daily basis in order to ensure a constant supply of cool water is available:

1.  Fill bowl with tap water

 

 



2.  Pour tap water into water filter

3.   Once water has filtered through to the bottom chamber (a very slow process), fill bottle or jug with the filtered water

 

 4.   Place bottle of water in fridge and leave for a couple of hours to cool

Once all that is done, there is a supply of cool water in the fridge!

Just for a bit more background, I thought I’d explain where the tap water comes from.  There’s no piped water provided by a national company here.  The tap water in our houses and also for use at the hospital is pumped from an underground source, using a generator, into a water tower on site.  It takes about 30 minutes for the generator to pump enough water to fill the tower.  Below is a picture of yours truly posing by the water tower!

The water in the tower doesn’t last the compound very long and so water is pumped into it about 3 or 4 times a day.  We often turn on a tap and find no water and then go and find a guard to put the generator on.

Sometimes the generator is out of action, although thankfully this hasn’t happened yet since I’ve been here!  Alongside the generator-driven water pump, there is also a hand water pump that can be used.  This sources water from underground, there’s natural water not far below the surface.  So if the generator is out of action, we use the hand pump to pump water into buckets, bowls (anything really!), to be used in the houses or on the hospital wards.  Below is a photo of me at the hand pump!

So there we have it, a brief description of water here!

Wimbledon: Arabic style!

Last Saturday a few of us expats went to our friend’s house.....cos she has cable TV and invited us to watch some Wimbledon!  So three of us from the compound here at Guinebor II Hospital went into town, armed with home-made scones and chocolate brownies.  After everyone had arrived there were three Brits, two Americans, a Dutch girl and a Swiss girl (who was very despondent that Federer had already gone out!!).  We enjoyed some lovely food that people had brought and sat down to watch a match.  Our friend’s cable TV is Arabic and so the commentary was in Arabic.  It was a bit strange not having the usually John McEnroe, Tim Henman and Sue Barker trio giving us the lowdown.  What was even more strange was the fact that the studio presenter on the cable channel was in full Arabic dress.  I suppose it’s not that strange that Arabic TV presenters wear Arabic clothing, but it was strange to see as a Westerner.  A few times they cut over to a correspondent at Wimbledon and had both presenters on the screen at the same time.  See picture below.  This is Wimbledon Arabic style!

We had a fun afternoon chilling out and watching a game.  Us Brits were sooooo excited when a shot of Sue Barker came on screen.....although she was muted!  So this was another slightly different experience here in Chad!

Au frigo

So I thought I would show you an interesting sight of Chad......the inside of our fridge!!  (frigo is the French word for fridge).  Just thought it would be interesting to compare and contrast to the inside of a fridge at home and give you an insight into my ‘Chad life’.

So we have a gas powered fridge, the gas bottle isn’t in the picture.  One bottle of gas last about 2 weeks.  There’s no warning as to when it’s going to run out, so you have to keep an eye on the flame at the bottom of the fridge to ensure it’s lit and the fridge is still working.  As you can imagine, if the gas runs out it’s only a matter of hours until all the food is ruined because of the heat.  Another thing you can’t really see in the picture are the two towels we have draped around the outside and which we keep wet all the time – this helps to keep the fridge cool.  We have to wet the towels with water about three times a day as they dry out really quickly.

Ok, so the main thing you’ll see in the fridge is water!  We can’t drink the water from the tap and even if we did, it’s luke-warm at best anyway.  All our water is filtered and the water that comes out of the filter is room temperature (i.e. about 35 degrees centigrade).  We therefore always ensure we have a continuous supply of water in the fridge.  I probably drink about 5-6 litres of water/squash/cold tea (bottom left of pic in jug) a day.  In the bottom right of the fridge is a bottle of d’jino, which I stumbled across in a shop the other day and was very excited about!  It’s made in Cameroon and I drank loads of it there, it’s kind of like Lilt.  I bought myself a bottle as a birthday treat!!

Next shelf up on the left is some left-over rice which we ate at luchtime, and on top of it in the bowl is some home-made crème fraiche type stuff, which my housemate made from gone-off home-made yoghurt (she’s very entrepreneurial!).  Behind that is a bottle of ‘chilly willys tomato ketchup’ – grerat name!!  Haven’t braved any of that yet...... On the plate to the right, with the pretty red doily is the remains of my birthday cake that Andrea made (it’s very yummy).   Ah, next shelf up is eggs, mayo, some salad dressing, in the bowl is a local lemon (the yellow/green thing, it’s kind of a cross between a lemon and an orange), also in the bowl are tomatoes, then some watermelon and behind that a mango.  Top shelf on the left is some cheddar cheese (yep, another treat, not always available so I buy it when I can!), in the blue food bag is lettuce, duly washed in disinfectant last night, then there’s a jar of home-made mango jam which we made a few weeks ago, then in the brown bag is my chocolate stash, given to me by the girls here for my birthday!  On top of the paper bag is half a cabbage. 

So there we have it, an insight into my Chadian fridge!!  This has got me thinking about what I miss from my UK fridge and the first few things that spring to mind are – proper milk (we only have powdered milk or UHT), sausages and bacon!!  I guess my Chadian fridge is more healthy, apart from the chocolate!

My new surroundings

OK so I thought I would try and describe my new surroundings as best I can. I am living in the Guinebor II area of N’Djamena, at the hospital there. The hospital has a 10 foot (ish) wall around the perimeter, with barbed wire running around the top of it. There are two entrances, one for vehicles and one for pedestrians. People coming to the hospital to consult a doctor or nurse usually arrive by taxi or motorbike which drop them off outside the pedestrian entrance. It’s usually just us missionaries going in and out of the vehicular entrance and trades-people such as the builders or the solar-panel engineers.

The hospital is situated in a very dry and dusty, fairly barren landscape (although I am told that most of the sand/dust turns to mud in the rainy season, which should be interesting!).Since the hospital was built, more and more private houses have been built in the area. These are typically one room mud-brick buildings with galvanised iron roofs.There are also a few small shops (boutiques in French, although they’re nothing like you would expect a ‘boutique’ to look like!).These shops sell basics like bread (fab baguettes, a hang-over from French colonisation) and milk powder (the only way to have milk here apart from UHT that doesn’t last long).Oh and also Coca-Cola!Oh and mobile phone credit, which is really useful as else it’s a 20 minute trip into town. There’s a mosque about 500 metres away from the compound and we often hear the call to prayer.Below are 2 photos.  One is of the main hospital entrance and the other is of the area outside the hospital compound. The second one was taken at 5.30am one Saturday a few weeks ago! It was fab to see the sunrise and it was so lovely and cool at that time of the day – about the same temperature as at midday on a sunny summer’s day in the UK!


Main entrance to hospital



Area outside hospital (compound wall is on the right of the pic)
 

Inside the compound is a carpet of sand. To the right-hand side are the houses us expats live in. Single storey houses with tiled floors. All have solar panels and we generate enough electricity to mean that that is our sole source of power. We have gas-powered fridges and cookers. To the left of the compound is the pedestrian entrance to the hospital and triage area. Then there are gates through to the admin office, payment desk and pharmacy and a waiting area for the outpatient consultation rooms and the laboratory. Behind the pharmacy are the maternity rooms and operating theatre (called the ‘bloc operatoire’ in French, it took me ages to work out what people meant when they said ‘they’re in the bloc’!!). Via a link pathway are the 4 hospital wards – around 8 beds in each – and 3 private inpatient rooms. Just outside the compound is a covered area where the carers of the patients stay and prepare meals for their relative who is an inpatient.

So there we have it, a brief overview of my new surroundings! Add the daily temperatures that are still around 40 degrees by day and 30-35 degrees by night and you have a bit of a picture of where I’m currently living!



Chad life one week in!

Well I have arrived in Chad and have now been here a week!  The journey from the UK was uneventful thankfully, apart from my debit card taking a massive bashing whilst in transit at Paris Charles de Gaulle airport.  What was I buying I hear you cry?!  Some expensive perfume or a haute couture piece of clothing?!  Nope......lunch!  Expensive was an understatement.  Suppose it contributes to the free 15 minutes of internet I got!  I’d never been to Charles de Gaulle airport before and I have to say it was a large, rambling, pretty soul-less place.  I spent the 4 hours of transit eating; reading a newspaper and watching the same piece of newsreel on the TV go round and round.  Time seemed to pass quite quickly though and I was soon on the slightly delayed plane to N’Djamena.  Have to say I was impressed with Air France on both legs of the journey.....even if the air hostess on the way to N’Djamena spoke to me in English, obviously knowing from my attempt to order jus de pomme that I wasn’t a French national.....hey ho.....still some way to go on the old Français I guess!  The flight was good, had loads of films and TV series to watch albeit mostly quite old, plus lots of different genres of music to listen to.  Those of you from Torbay will be slightly astounded to know that a Metronomy album was available to listen to and so, in tribute to my homeland, I listened to ‘The Bay’ as we touched down in N’Djamena!!  Slightly surreal!  I loitered on the plane for as long as I could to enjoy the air con and then wandered out of the door to be hit by the wall of heat I was expecting (mid 30s centigrade at 9pm).  However it wasn’t anywhere near as humid as Cameroon was so I was glad not to get the ‘wet blanket’ sensation we always got in Cameroon.  The airport was efficient (we were the only plane in sight so I guess that wasn’t too difficult to achieve).  A bus took us the whole 100 yard to the arrivals room where they had air con!!  I was so pleased!!  After what seemed like ages.....my queue was definitely the slowest, although I didn’t care as I was stood by the air conditioner.....I was called up to present my passport and landing card.  I was expecting a barrage of questions in French that I couldn’t answer however I was not subjected to anything other than where I was staying (easily answered) and directed to put my fingers and the thumb on the electronic fingerprint-taker.  All very smart looking, even had a digital camera/webcam thingy taking a photo at the same time!  As soon as I was through immigration (two stamps later....only two stamps?!  Not a lot for Africa I’d say!) I was informed by another official to register at the police station within 3 days and then I was in the baggage reclaim area.  Cases were already going around and there were mine.  Yes both of them!  A porter helped me – they both had ‘heavy’ labels on them, there’s a first time for everything – we passed the girl checking the baggage labels against the stubs I’d received way back in Heathrow and then both were chucked (literally) through anther x-ray scanner and then that was it, I was outside!  All very quick and easy, I was very fortunate.  I walked out into the African night and felt strangely at home.  I wasn’t the least bothered by numerous blokes trying to flog me mobile SIM cards, tissues, sweets, the usual African street-sold stuff.  Have to say they are very polite here, one ‘non merci’ and they leave you alone.  Quite refreshing!  Found Mark and then we were on our way out to Guinebor II and the hospital compound that will be my home for the next year.

It only took about 20 minutes to drive to the hospital.  We drove on paved roads around the perimeter wall of the airport – not a pothole in sight on the paved roads, very impressive – and then we turned left onto a dirt road.  Good job they have 4x4 here that’s all I can say!  Another 10 minutes or so, after a few ‘hmmm I’m not exactly sure where I am’ comments from Mark (really difficult to get your bearings in the dark on a dirt road dotted with houses and the odd tree and obviously no signposts) we arrived at the hospital compound.  Cue a blow on the car horn from Mark and the guard duly opened the gates with a greeting of bonsoir. 

I’ll explain the layout of the compound and the surrounding area in another blog. However I am staying in the ‘guest house’ which is where those who are only here for a relatively short time stay. It is a comfortable place to stay, my room is fairly big actually and –get this – I have an ensuite bathroom!! Yup, I’ve arrived!

Guest house where I'm staying

The heat here is unimaginable.  I cannot even begin to explain how it feels.  Imagine yourself in your house on a hot summer’s day with the doors and windows closed and the radiators on max.  That’s kinda how it is, although there is usually a bit of a breeze especially in the mornings.

Ah mornings, my new favourite time of day (those of you who know me well can pick yourselves up off the floor now!).  It is the only time in the day that I feel semi-cool and comfortable.  I’m there wishing the temperature would stay as it is at 7.30am but alas, that doesn’t happen and it regularly hits 40 degrees plus around midday at the moment.  Consequently by the evening I’m shattered from just ‘being’ in the heat.  I’m in bed around 9.30-10pm and sleep for a good 8 or 9 hours (again, people who know me well should pick themselves up off the floor!).   

At the moment I’m spending most of my days adjusting to the heat, learning how the hospital functions on a day-to-day basis, getting to know the other missionaries here (Mark & Andrea and their two daughters Ruth & Rebecca, Malc & Sue, Rebecca and a Swiss medical student called Salome who's here until July) and continuing to learn French.  Not many Chadians speak English however there are a couple of interpreters here at the hospital who work alongside the medical staff as they consult patients who may not speak French but who speak Arabic or another local language.  One of these interpreters also speaks English and so he is my new French teacher, taking over from the lovely Justine who taught me in the UK!  I have lessons most mornings with him, mainly conversation so that I build up my confidence in speaking French.  We had a 3 hour lesson this morning which was really useful but quite draining!

I can’t believe I’ve been here a week already.  I’ve been into N’Djamena about three times so far and been introduced to all the sights.  There’s a really impressive public space opposite the president’s palace called ‘la place de la nation’ (see if there’s a picture on Google images!) which even boasts grass – very unusual here and it has its own sprinkler system.  That’s the main sight of N’Djamena really apart from some impressive sculptures on a few roundabouts about town.  I’ve been to the central market, really big compared to the one I was used to in Cameroon but similar layout.  Most of the fruit and vegetables here are imported from Cameroon as they don’t have a great climate for food growing unfortunately.  This importation means prices are higher than I was used to in Cameroon.  Also been to the craft market and also L’Amandines.  More about L'Amandines in another blog but something tells me I may spend quite a lot of time in there......!!