Wednesday, September 1, 2021

Cultural Studies

Although we have lived here before and we have some experience with the culture and customs, it seems every day there is some new cultural lesson to be learned. Often it is simple and funny. Other times it is complex and sad. There have been a few funny ones happen since we got here. 

When Tab first started working, she went around greeting people. One of the people that she came to greet did not 'recognize her shape'.  Apparently, she is bigger than she used to be. I spent the first couple weeks here, sick with various things. I lost about 15 lbs. Someone remarked to me that I have shrunk to my familiar size. Yeah, I get it, we are getting older and bigger. 

One morning one of the ladies that helps keep our house clean, told me about how her daughter-in-law had a pain in her stomach. I didn't really think that much of it. Later on that morning she started a story about a trip she took to a local village that eventually involved her daughter-in-law having more stomach pain. I did suggest that we pray for her and so we did. She mentioned in her prayer that Tab would help her. I was a little confused. Slowly I began to realize that she was sick enough to see a doctor and was in fact scheduled for an operation that morning. Tab was to be her surgeon. I think there was an assumption that I already knew all about it. However, out of a respect for privacy and habit, my wife never actually tells me anything specific about any patient, here, or at home. So, unless you tell me about the surgery that Tab has done to you or your friend or family, I will have no idea that it has happened.  Anyway, she kept bringing it up because she was hoping that I would give her some time off to go take care of her grandson while his mother was in surgery and father was at work. I didn't really put all this together until she called her son, who speaks perfect English, to ask me if she could have the rest of the day off. Of course I agreed, and I would have happily given her the whole day off if I had realized at the time that she was indirectly asking for fear of insulting me or being rejected. Tab said the surgery was a success and she should make a full recovery. 


Saturday, August 21, 2021

Spinach Trees


During many months here it is difficult to find a variety of vegetables. Cabbage and cucumbers seem to be available almost year round, but can be expensive. Nigeriens use the leaves of various native plants and trees, such as baobab leaves, to add to sauces.  A few weeks ago, I learned from a friend that the leaves of one of the trees on the compound can be cooked and used like spinach. So, I decided to try it.

According to Wikipedia;
"Cnidoscolus aconitifolius, commonly known as chaya, tree spinach, or spinach tree, is a large, fast-growing and leafy perennial shrub. 
Chaya is one of the most productive green vegetables. Young Chaya leaves and the thick, tender stem tips are cut and boiled as a spinach. It is a tasty vegetable and is exceptionally high in protein, calcium, iron, and vitamin A. In fact, levels of Chaya leaf nutrients are two- to threefold greater than any other land-based leafy green vegetable."

The kids enjoyed gathering leaves from the several Chaya trees around the compound.

Unfortunately, the leaves cannot be use for fresh because raw chaya leaves are toxic- they release cyanide when eaten.  But, if the leaves are boiled for 5-15 minutes the cyanide is inactivated and the leaves are safe to eat. 

Boiling the out the cyanide!


I put some "spinach" in a tuna quesadilla for lunch. Juliet and I liked it- it doesn’t have a very strong flavor to me. However,  Luke strongly disliked the flavor. Too bad. I guess we will  have to continue with a mostly cabbage and cucumber diet for now...although I think I will continue to experiment a bit with the "spinach tree" to see if there is a better way to serve it.  

Sunday, August 1, 2021

Some Good News

It feels like we are witnessing miracles when some of our sickest patients survive.


Owen* is a severely malnourished boy with intestinal perforation from typhoid. He was so weak he couldn't even sit up in bed.  We fixed the hole in his intestine and closed his abdomen. Unfortunately, his tissue was so weak from malnourishment that his stitches eventually tore through and  a week after his surgery the abdominal wound opened up exposing his intestines. πŸ˜”We put a vacuum suction dressing on to keep his intestines inside.


With good wound care and nutritional supplementation he slowly improved to where he was sitting up when we came by on rounds.

Here he is a a couple of weeks later- ready to get his wound VAC removed and to be discharged to the nutritional rehabilitation center: 






Friday, July 30, 2021

One Day...Every Day

A typical work day in Galmi...

Most days start with an hour-long resident teaching conference, followed by rounding on the surgical patients. At any time, there are about 80 surgical patients in the hospital, divided into three teams. So, I end up seeing about 25-30 patients, which takes 1-3 hours depending on how sick the patients are and how much time is spent teaching. Next, work starts in the operating room and clinic. 

Following are three of the OR patients from one day this week: 


Three-year-old boy with bilateral neck swelling, left neck abscess. We drained the abscess, which turned out to be mostly an infected tumor- likely lymphoma.πŸ˜”


35-year-old man with bowel blockage. He had been in the hospital in another country, but refused operation there so he could be seen at Galmi Hospital. He was actually feeling mostly better by the time I saw him in clinic a few days later, but since he had no prior surgery, an operation was needed to figure out the cause of his recurrent obstruction.  

A mass blocking his intestine. Likely cancer. πŸ˜” He recovered quickly from the operation, but unfortunately his prognosis is quite poor since chemotherapy is not available. 

25-year-old woman in labor with severe heart failure of pregnancy. She couldn’t tolerate spinal anesthesia because of her heart failure, so her twins were delivered by C-section using only local numbing medication. Both babies were beautiful, perfectly formed, and appeared full-term but hadn't survived the labor. They had clearly died several hours before the mom made it to the hospital. This was her fourth pregnancy. All three of her other babies were also deceased (I don’t know the reasons, but, death in children under 5 is not that unusual here).   πŸ˜©πŸ₯ΊπŸ’”

Typically tragic. 

Saturday, July 17, 2021

Small Happenings

It’s been a fairly busy last couple of weeks. We have now gone about one week without any serious illnesses. Yay!  

Following are a few pictures of random happenings over the last week or so:

It’s rainy season and the rains have come just in time. The plants that were starting to wither away have come back to life and are flourishing. We are planning to plant some beans in the garden space next to our house. To get the space ready, or neighbor’s cows and sheep have been coming over to munch down the grass. 

Can you guess what food our kids miss the most? Hot dogs.

The kids (especially T) were very excited this week when, by special request, some friends procured a few packages of frozen hot dogs from the big city a few hours away. They were a big hit. We now have some stored in the freezer for special occasions. 

Chicken hot dogs- imported from Brazil, apparently! 





Weaver birds are busy making nests in a tree right outside the surgical ward. They are very noisy and fascinating birds.

You can't really see the birds well in this picture- but there are dozens of bright yellow birds chattering away and building their "upside down" nests. You can read more about them and see a better close up picture on Wikipedia here. 

Tuesday, July 6, 2021

Community Barbeque

We have been settling in at Galmi for a few weeks and, unfortunately, most of that time one or more of us has been sick. I guess that comes with the territory. Tab had a full week of work last week and I did a day or so, but, unfortunately, we keep getting interrupted by our kids vomiting on stuff. We have been taking prophylactic anti-malaria medicine for several weeks now but that did not stop one of our kids from getting malaria. We also had some sort of food contamination issue the other day. I was lucky enough not to eat any of the offending food and, therefore, I got to be the one that ran around with buckets and rags cleaning up while everyone else was sick. Thankfully, everyone seems to be on the mend and we should be back to our regularly scheduled programs soon. 


One of the more interesting activities we have participated in lately is a community barbeque. One of our friends has a herd of sheep and one of the lambs got the bloat. There is no vet here and they tried several things, but nothing worked to cure the problem. It was clear the animal was going to die, and the only real option was to euthanize it. 

Typically, the customs here do not allow for eating animals that are dying. In fact, there are quite a few things one must do before butchering an animal for it to be acceptable to eat. There are some good reasons not to eat an animal that is sick especially if you don't know why it is dying. However, in this case, it was just an animal eating the wrong thing or too much of it. I don't think that poses a danger to our health. So, our friend set up a butcher to come cut it up and take it to a man who would cook it. It was all a very interesting process. 

One of the more interesting processes is the cooking part. Back home, there is barbeque culture where people use charcoal or propane or smokers to cook and finish meat. Often people have very strong opinions of what is the best way to cook a hamburger or steak or brisket on a barbeque or a smoker or what-have-you.  

Here, there is also a serious meat cooking culture. They set up a fire very spread out on the ground and put sticks and rods through the carcass making it flat. sometimes they have a grate or grill to lay it on.  They spend hours and hours roasting it next to the fire adding spices and oil quite frequently. Then, when it is done, they wrap it in a paper bag and deliver it to the feast. It doesn't always look great, but I can assure you that it has the tenderness and flavors that everyone can love. 


After the meat was delivered, my friend took the meat off of the bones and onto a serving tray, and since there was so much meat that is best served hot, everyone here was invited to come and bring a side dish. It reminded me of a 4th of July barbeque, with kids running everywhere with food and sugary drinks. It was one of the better meals I have ever had in Niger, not just because of the meat, but also because of the community that was a part of it. 

Thursday, July 1, 2021

We arrived

After a week of quarantine and a one-day delay for the weather (wind/dust storms), we boarded the small plane for the last leg of our journey to Galmi. https://drive.google.com/uc?export=view&id=1fGerUtO5IGKLYLVn1q0XznIWZbmapgJX
https://drive.google.com/uc?export=view&id=16ldRqmfk-MBjGWn8VdL9Odns8KjltgI2
The four of us in the back row. 

https://drive.google.com/uc?export=view&id=1fF3keOeU6LnMYIEslsPaqRSMjcfjiQeUhttps://drive.google.com/uc?export=view&id=1D0bTUZdSI96IS1wB_w8M8XR-T6FsnNL0
The kids (especially Eo) were thrilled to discover that our friends had stocked our new home with plenty of children’s books to enjoy!

Sunday, June 20, 2021

“Quarantine “

COVID. Some things became more hectic, many things slowed down. And while the slow-down can drive us crazy, many of us have realized the benefits of a less hectic schedule and are choosing to continue to slow down and focus on the things that really matter. Right now, we are experiencing another “slow down” as we quarantine for a week before moving on to our final destination. 

In the era before planes, trains, and automobiles, traveling across the ocean to another continent required a journey of weeks to months.  Now it only takes hours to days. There are some advantages to having a longer transition time. For one, no jet lag! Also, time to process the leaving of friends and family and to prepare for arrival and new relationships. 


Now, I’m not saying that I want to go back to the days of packing all of your belongings into a coffin to travel for weeks to a foreign land. However, a week of imposed “down time” for COVID quarantine turns out to be not such a bad thing, and is even helpful in several ways such as:

  • Time as a family without places to be or the demands of work and school...even our grocery shopping is done for us. https://drive.google.com/uc?export=view&id=1Kl6qX6sb9u5KcRIcm9D2n-X6he_Ca193

J learns to mop the floor

 

https://drive.google.com/uc?export=view&id=1H-hLilFa3yb0KFVxjDJOjZxcAhKRXfd-

Wearing googles to go outside in a wind/dust storm.

  • Flexibility in adjusting to the 8 hour time shift. With little kids this is no easy matter. They say it usually takes a day to adjust for every hour time difference- so by the end of the week maybe we will be on a normal schedule?! One can hope.

  • Time to recall how to make yogurt, use cloth diapers and a gas stove, adapt to power outages, convert tablespoons to grams, etc.

https://drive.google.com/uc?export=view&id=1aB_r8c6mUqbPmi_EwD_uBOL21-N65F-a

Power outage fun
https://drive.google.com/uc?export=view&id=1TyUtO6cY5iW_nRr23gQ3FgfI1CY6OFgM
“Dad, you really do know how to make popcorn another way!” https://drive.google.com/uc?export=view&id=15YA-ZNtiKt7g8YoCD8GVWQN9F1r_CYrO

  • Beginning the process of adjusting to the heat- and to drinking lots of water.

  https://drive.google.com/uc?export=view&id=14PntPQ_SgRCzCOkprGIeDW-WhZzyNjAgBaby, it’s hot inside
So far it has been great to spend time as a family and prepare ourselves for the work that is ahead. Just a few more days, one more COVID test, and we should be on our way!

Friday, June 18, 2021

Can you eat lizard eggs?

The kids have enjoyed watching the various lizards run up and down the walls outside. They are intent on catching one for a pet, but as of yet have been unsuccessful.

Today as Luke was digging in the sand looking for a shovel the kids buried, we found some lizard eggs! We’ve never done much digging in the Niger sand, so this was a new discovery for us.
https://drive.google.com/uc?export=view&id=1miVxVNj8ib3_g8Btl_skz3DbWkmJWVjf

The kids wanted to know if we could eat the eggs. Apparently it’s safe to eat lizard eggs (turtle and crocodile being the most commonly eaten), but we decided to put the eggs back instead so the baby lizards can grow.

https://drive.google.com/uc?export=view&id=1Z_q98J1YjMl-sgA-YdArHmLnVhmTqCDE

Thursday, June 17, 2021

We made it!

https://drive.google.com/uc?export=view&id=1oe5H27OLCYGlX2yOdtcPiBN53JZUbYgk

After a thirty+ hour journey, we have arrived in Niger! Overall, the kids did very well on all three flights. 
https://drive.google.com/uc?export=view&id=1ksOm6dwuZKS3kyFZS2TVQJCYSuLVdq6zhttps://drive.google.com/uc?export=view&id=1IxVgT4DCX7n3UQXAkAk6phyRyXquUQiehttps://drive.google.com/uc?export=view&id=1-pVnfvNRkhBAUIxwXeu3oPRn1cLSFD0L
Transiting through the Niamey airport turned out to be the most trying part of the journey. What often takes thirty minutes ended up taking almost three hours. And three hours seems like forever after thirty hours of travel with very little sleep.

Filling out ten entry forms (one each for the ministry of health, one each for customs) was harder than expected-trying to remember our French and keep all of the passport numbers, birth dates, etc. straight... while keeping the kids from wandering off down the enticing escalator. We were the last people to get our passports stamped.

At baggage claim our luggage was the only stuff left and our bins had already been loaded on to carts ... we counted and thankfully 14/15 checked bags had arrived with us in Niger. We sorted through fifteen airport luggage labels to find the one that matched the missing bag. Then, we reported the missing bag at the counter. 
https://drive.google.com/uc?export=view&id=1ER1aNtFCXHtY6pDkFfsRoZYXk9Dv1-sD
We moved on to the final step where they put all of the luggage through X-ray. They pulled Luke back in to a side room to ask some questions. Turns out the donated batteries for the Galmi X-ray machine looked suspicious.  They X-rayed all 14 bags again. They opened the bins.  By this time, Winnie had had enough and she  just cried/screamed. Even candy and Octonauts on the iPad couldn’t calm her.  It was miserable. We were the last travelers in the airport. They lights were shut off. Still we waited while Luke talked to the officials. After over an hour of inspection and explaining and showing our paperwork/letters, etc. we were able to go with all of our luggage. 

We were very relieved to be greeted outside by our friend who had wait waited patiently to pick us up. We loaded into the car and took the final short drive to our quarantine house.  

We are so very grateful that the airport was renovated a few years ago to include jet-ways, enclosing the baggage claim and adding air conditioning.  If we had had to do all of that in 100 degree heat- we all would have been crying with Winnie! 


Tuesday, May 18, 2021

LSC Presentation


You can watch us talk about our past experiences and upcoming trip to Niger in this video, skip to 27:10 to see us. 

Wednesday, March 9, 2016

Last Weekend in Nigeria

Our last weekend in Egbe, I was called at 4 am to see a man with abdominal swelling. I quickly threw on my scrubs, grabbed my headlight, and rode my bike down to the emergency department. There I met the victim, a middle-aged vigilante security guard hired by the townspeople for protection. A few hours prior  three young men had thrown a large rock at him, hitting his left side.


the rock

His vital signs were stable, but he didn't look good. He was sweating and his abdomen was tense and tender. I did a quick ultrasound showing copious free fluid in his abdomen. Blood. Lots of it. We didn't have much time. He needed an emergency exploration right away to stop the bleeding. 

While waiting for the OR team to arrive, I asked the team to prepare blood for the patient. Their reply, "There is no blood in the lab." To make matters worse, the patient had an uncommon blood type for the region.  Dr. J, the family medicine doctor on call and medical director, took charge and started looking for donors among the nursing students and staff.  

Meanwhile, I helped transport the patient up to the operating room in an effort to get him on the table as quickly as possible. It wasn't fast enough. As the anesthesia tech was preparing the patient, the man's blood pressure suddenly dropped to 70/40 and his pulse became rapid and weak. Time was running out. 

There was no time for intubation. His blood pressure at this point was barely detectable, he pulse was very weak, and he was no longer responding to us. He was dying and blood was still five minutes away. I quickly gowned, gloved, and prepped the abdomen. We quickly gave what anesthesia we could before I grabbed the knife and opened his abdomen. Blood rushed out. I rapidly explored the abdomen and found the source of bleeding- a ruptured spleen. I applied pressure to stop the bleeding while we worked to stabilize him.

After what seemed like an eternity but was probably only a few minutes, the medical director arrived with two units of blood- one of which he had donated himself! We pumped the blood in as fast as possible while I removed the spleen (a difficult feat due to a stomach full of air and light anesthesia). After repairing an additional tear in the wall of his large intestine, I closed him up and we took him to recovery. After four units of blood and several warm blankets, his vital signs stabilized and we all breathed a sigh of relief. 
the spleen is out!
The rest of his recovery was uneventful and he was able to go home in less than a week. It was a great save, but it made it even harder to leave Egbe knowing there would be no surgeon coming to replace me for some time. If the man's injury had happened one week later when there was no surgeon at Egbe, he likely would have bled to death. The world needs more surgeons.
   

Sunday, December 13, 2015

There is no escape!!!

If you have been following along for the past couple of months, you must remember our summer was full of wild fires. Well, it seems even in Africa we cannot escape the flames.
We arrived here right at the end of rainy season. It has not rained here in about a month and a half. When it is in the nineties every day it does not take long for everything to dry up and become flammable. The past week or so has been very dusty and smokey. I guess the farmers burn their fields after harvest and the fires spread to everything else, it's not quite as dry around here as it was at home this summer, but things are still very  flammable.   Here are some pictures.

This is our normal view out our back door. 

It looks cloudy, but it is actually smoke. You can see tan roof there behind the trees. But the mountains behind are all obscured by the smoke. 
At night you can really see the fires light up the countryside.

One day last week the fires came right down to our compound. 

Guess who turned 8 months!


Tuesday, November 24, 2015

Money Matters I

Certainly the differences and similarities between American medicine and African medicine are many. One of the most striking differences is the way that medical care is paid for. In residency, we rarely discussed medical costs with patients and money rarely directly influenced our daily choices (that we were aware of). We just did what we thought was best for the patient usually having very little concept of how expensive the treatment was.

Then I moved to Africa to work in a mission hospital in one of poorest countries in the world. Not only is there no universal healthcare but there is almost no health insurance. For any planned operation, I would tell the patient how much the operation cost and they had to bring the money before we would schedule their operation. Often they would have to go back to their village and family to borrow the money. Sometimes they never came back because they couldn't afford to.

However, patients who were admitted in the hospital were not refused care even if they could not pay (this was not usually true in surrounding hospitals). All of their expenses were added to their bill, which they were expected to pay at the end of their hospital stay. If they didn't, they had to pay when they returned or else they would not be allowed to see the doctor.

I didn't know how different this was different than the way that many African hospitals function until we were in Burundi. How is it different? Almost everything is pay-as-you-go.  Patients have to buy supplies for each dressing, purchase every bottle of IV fluid before it is infused, and pay for labs before they are drawn. This really makes you think before ordering anything.

I learned the system the hard way with one particular patient. When I first met him he had been in the hospital for several weeks with burn wounds on his legs. He was waiting to find the money to pay for his skin graft operation. Until he found the money, we were doing dressing changes every day. The wounds looked pale. He looked pale...and so very thin. I asked if he was eating. He said he didn't have much of an appetite (and I don't think he had anyone to bring him food). Food had to be brought in by family members, it was not provided by the hospital (which is true for every hospital I have worked in in Africa).

I filled out a lab slip to have his blood level checked. The next day the lab was not done because he had not paid for it. I decided to write a prescription for iron anyway, since I was sure he was anemic. I brought him some avocados that had fallen from the tree in our front yard. A couple days later I asked him if he was taking his iron. It was then I learned that he never got the iron because he couldn't pay for that either. He was languishing before my eyes but I could do nothing because he had no money.

I decided to do something that I had never done before...I took his prescription to the pharmacy and paid for his medication myself. I know that my paying for his medication is not a long-term solution for the poverty and lack of health care in Burundi. But, I was only going to be there for three weeks and I really wanted to help this man. He smiled and took the medicine gratefully.

Two days later the long-term surgeon returned and I learned that, in special circumstances, the doctor can write a note on a lab slip so that, even if the patient cannot pay, that lab will be done. So, he re-ordered the blood level to be done without the patient paying first.

The next morning I learned that the patient had been transfused for a very low blood level but then, later that evening, he had unexpectedly died. They weren't sure what he had died from but it seemed his body just stopped functioning. I was stunned and troubled. Was it his low blood level? Severe malnutrition? A complication of the transfusion? I guess we'll never know. What I do know is that I am left wondering...would he still be alive if he had had the money to pay?

Sunday, November 8, 2015

the nightmare continues...

Well, we were quite happy that Luke was able to get his tooth filled. Until last night during dinner, a very soft taco/rice dinner,  Luke reached his tongue back and the brand-new filling was gone!  :(  It lasted less than 24 hours and we are back to where we started. We aren't sure what to do now. Does he go back to the same dentist? Do we leave the tooth as is and hope its ok for the next six weeks? Do we try a different Nigerian dentist? Or, do we rummage through the dental equipment here to try to find material to fix it ourselves?  Maybe.

We are certainly trying very hard to not damage any more teeth...and thus I was a bit dismayed to find this as I was eating some delicious Nigerian ground nuts today:
one of these things is not like the other

yep, that's a peanut-shaped rock- didn't get me this time. 
Needless to say, we are now chewing things very carefully in this household!

This is my nightmare...

 It all started at dinner two nights ago. We were eating a delicious baked spaghetti with extra ground beef. So good. Then crunch. Not an unusual thing, there's often a little sand or stones or bone or something hard in the food here. I started fishing out little pieces of bone with my tongue. Satisfied that there was nothing hard left in my food I swallowed it. That's when I realized that something was wrong. Where once I had an intact wisdom tooth, I now had a sharp cavity on the one corner.
I got quite a sinking feeling. I don't think that I would feel quite that bad if were we in America, But here, in rural Africa, I was sort of panicking inside.

Tab had a look at it. She didn't think it looked so bad, but who knows. It looked like some pink was showing? It didn't hurt, but that didn't mean that it wouldn't start. Based on a quick internet search, I should see a dentist right away. We went to the neighbor's house to see what they thought. Those doctors concluded I should see a dentist. But where? There is no dentist here. Well, it turns out that there is a dentist in a town about a three hour drive from here.  And, there just happened to be someone going to there in the morning so we arranged for me to ride with them. We left at six a.m. well before the sun was up. The road was rough but I slept no problem.

We arrived in the big city about 9. First stop was the dentist. The dentist office was in the middle of the city. The driver stopped and told me the dentist was down an alley and around a corner. I exited the vehicle and off they went to run their errands, they would pick me up when I was done.

Walking past open sewer and trash heaps in a dark and muddy alley way made me nervous. But there it was, I entered the gate and walked past a guard half asleep until he saw me.  I asked him "where is the dentist?" he pointed up to the second floor.

It was a decent looking place,  with a sleeping receptionist/assistant inside. I woke her up, she was surprised to see a white man, I am sure. I filled out the card and paid the consult fee and then she called the dentist to let him know that he had a patient waiting. In america, dentists are always busy, but here they seem to be quite free and see patients and do the work all on the same day.



I sat in the waiting room with no electricity and read a book I brought. 45 minutes later, the dentist arrived. He came in and started preparing things. One of the first things he did was yell for the guard down by the entrance to turn the generator on. After a few minutes the assistant/receptionist invited me into the procedure room. I told him I broke a tooth. he looked in my mouth and told me I broke the cusp off my tooth and he could fix it with a filling. He could do it immediately and it cost 7000 ~30 dollars. I agreed and he went and got the supplies, he also had the guard turn on an air compressor. Most dentist chairs are run on compressed air.

The room was okay, clean by west African standards. the dental chair and equipment seemed to be from the eighties. The dental tools were kinda stained but they came out of a sterilizer box. I could plainly see the sterilizer out on the balcony. I just hope it worked and they followed proper sterile techniques and this wasn't just for show.

Before you know it he had the drill in my face ready to go. He said he had to prepare the area and that "this will be sensitive." From the moment I realized my tooth was broken I suspected I would have a guy drilling and scraping in my mouth without pain killers.  It wasn't too bad. A few minutes later he was done. We talked for a bit about where I was from, and what I was doing in Africa. I asked him about his practice and where he learned dentistry.

This is the shelves of supplies that the dentists "sells" you to use during your procedure. It includes things like gloves and masks and composite filling etc. Anyways, the assistant was nice enough to pick out all the things that I would need.
I paid and waited for my ride to come back and pick me up. They came by and picked me up about 11. Enough time for my Ibuprofen to kick in. We ran errands that day all over town and finally got home about 6 p.m.

On our way home the driver kept stopping to buy things on the side of the road. Bread, water, and then this!


   The driver was very excited to have the opportunity to buy this guy for a mere 300~ a dollar and a half. I have posted about these before. In hausa they are called gufiya. One night two years ago a friend and I caught two of these things. I guess they are a prized meal here too.   hh

Wednesday, October 21, 2015

Nigeria Nigeria Nigeria

 So, we have been in Nigeria for just over a week. Everything has been fairly uneventful. All of our luggage arrived, traveling with a six month old went as well as possible, and the hospital and staff here has been great.


You can see the hospital just to the left of the hill. It is the small group of buildings, partially visible through the trees.

There have been a few hiccups though. The first day at work for Tab, her iphone broke, for unknown reasons. When she got home I informed her that the computer we brought wasn't functioning so well. The track pad doesn't work right and the delete key, space bar, and tab key all stick from time to time. which makes editing any text impossible. I am using the touch screen to write this and it is a pain.
To top that, baby J would not drink from a bottle while Tab was at work. She has always been pretty good at drinking from a bottle, so I thought it would be easy to feed her some milk a few times a day
while Tab is working. We made the mistake of using milk and a bottle to feed her her first dose of mefloquine (antimalarial). She hated the milk with mefloquine and refused to finish her dose. I don't blame her. It is gross. Well, she remembered her last meal from the bottle when I tried to feed her her regular milk and she refused to even taste it. She has mostly decided that she would rather not eat all day than risk getting medicine milk ever again. We'll see what we can do about that.

We had a welcome committee come by and drop off a load of gifts for us. You [We] are welcome, as they say here in Nigeria. It was rather impressive. There was a case of Coke, two cases of water, some plantains, a flat of eggs, and a chicken. That haul was brought to us by the reverend and pastor and retired reverend of a local church. Luckily our neighbor raises chickens and has a coup. Now we need someone who knows what to do with plantains.


Sunday, October 11, 2015

where have all the motorcycles gone?

Anyone who travels in West Africa knows that motorcycles, or "machines" are ubiquitous. After years of traveling by road around here and always dealing with motorcyclists weaving in and out of  traffic and getting in the way, we were surprised to find that in the big cities here, there are no motorcycles. Instead we saw green taxis and a bunch of these trendy three-wheelers:


I asked our driver why there weren't any motorcycles in the city and he said its because motorcycles aren't safe-they cause too many accidents. Also, its a law to help prevent terrorists from bombing and or shooting up the place. Motorcycles can get away from police and security forces very easily in a busy city. But, its easy to catch these three-wheel vehicles!  I felt a little less safe in the city after talking about terrorism prevention strategies. However, it is good to know they have taken some drastic measures to improve safety and security.

Friday, October 9, 2015

And we're off

We have boarded the plane on our way to Nigeria. Here's to a good long flight with a baby. :) and J already has a new toy...a baby bird Lu rattle from our friendly Lufthansa flight attendants. '

Saturday, October 3, 2015

lightning started the fire..and summer ended

As we rolled into August, we were excited to have a few weeks of fun summer time. You know, time to swim in the lake, visit with friends, and relax a bit. Alas, it was not to be. First, the Wolverine fire flared up and started getting uncomfortably close. Despite the fire, we went ahead with a planned trip up the lake with some friends. It was a fun (albeit smoky) time.

Babies 

nope, not a morning mist...just a smoky haze
When we got back home Tuesday, the fire had calmed down and the smoke seemed to be clearing up. We moved to live over at my Grandpa's house. In the midst of moving, we took an internet break on Friday. While I was being distracted by facebook I saw this:
"It's happening in Chelan right now."
I thought it was a joke. I read some more and  figured out that there was a big fire...Luke said in his somewhat pessimistic tone "The power is going to go out."  I rolled my eyes...then the fan stopped turning.  And the internet stopped. And the phone didn't have a dial tone. Cut off from the world. And so it began...two weeks of wildfires, power outages, smoke, and red sun!
keeping the freezers going by driving the generator between houses
firefighters marching through the field
As the fire got closer and closer, it sort of felt like an army was approaching and you didn't know when or how. It could round the bend at any moment, day or night. And finally, after a couple weeks of preparing and worrying the fire arrived.
smoke rolling over the mountain...this is when baby J and I evacuated

the view at night from the front porch as the fire came over the mountain

a tree goes up in flames




There were a couple of tense moments when the fire arrived. The fire was slowly creeping downhill towards the pasture that makes a nice buffer around the house. Our biggest concern was having the fire get on the down hill side of the house. There was a fire line that was supposed to prevent that from happening, however, fire lines do fail from time to time.
At one point the fire flared up, with shooting flames hundreds of feet in the air. There was so much smoke and flame that it looked like the line had failed and we were going to be fighting the fire in all directions. To know for sure, I ran down the road and looked at the fire line myself. By the time I got there, the flames and smoke had died down quite a bit and I could see a few brush trucks keeping the edge of the fire line wet. It looked like it was going to hold. The large flare up so close to the edge of the fire line must have worried the hotshot crews as well because over the next hour there were probably a dozen  water drops right in that area. Then they brought in another bulldozer to cut yet another fire line. After that, it was kind of like watching a giant camp fire.
the cows don't seem to mind

and then the fire died...


My brother, F, one tired firefighter after 15 days straight of fighting fire.
Well, there went August...and there was only five more weeks until we leave for Nigeria. Also, factor in a two week trip to North Carolina and Illinois. And preparing for our return in January. And we're feeling very busy.