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.

Encore

As I was seeing another bunch of men with prostate problems today, this man came in. He had a foley, but he also had fevers so I checked him for malaria. No surprise...positive. What I found ironically hilarious was this:

That turban on his head is a mosquito net!! Well sir, I said, mosquito nets are more effective around your bed...not around your head.

Isn't it ironic?

I gotta admit, in clinic I get a little tired of seeing old men who have problems peeing because of an enlarged prostate. Another rectal exam...ugh. I think we could take out a prostate every day and still not cure all the BPH (benign prostatic hyperplasia) in the country. 

Last Thursday, I had a bit of a chuckle when I saw how this guy had his urinary catheter plugged- with a vial of furosemide, a medicine used to make people urinate. Ha. The irony.

a few pics from our weekend away

one of my favorite things we saw in the "big city" store

picnic lunch

the yellow tea submarine

seasons change

We have three "seasons" here: cold season, rainy season, and hot season.  They could more accurately described as: hot season, hot & humid season, and unimaginably hot season. Its never cold. Anyway, as we progress through our second year here we are starting to recognize other seasonal patterns of change like the boabab trees growing leaves, the swallows migrating, and the limes ripening on our tree.

Yesterday, I stopped by Luke's office on the way home from work and witnessed another seasonal event. On the way home, we saw swarms of lizards running and jumping about outside the administration building.  Luke told me that he saw this last year, then he led me to a hole in the ground that looked like this:

The lizards and birds were just running around eating as many flying termites as they could as the bugs emerged from their holes in the ground. The flying termites filled the air. It was kind of gross but fun to watch the lizards jumping and eating them...until the termites tried flying up my skirt. Yikes!

I'm BATMAN!!!

From time to time we get interesting animals appearing on our compound. Last week one evening a goat found it's way past the fence and into the lush gardens of our neighbor. All was well until one of the dogs noticed him in there. They managed to chase him around for about twenty minutes until he finally found an exit.

This is one of the goat chasers. He likes human food, sleeping on cool floors, and barking at strangers.

A couple months back now this guy landed on our power lines. A mistake he will not make twice. A consequence of being 30cm from head to toe. The smaller bats never have this problem. He ended up staying there a few weeks before he finally fell. No surprise, the young boys around loved it and the girls thought it was the grossest thing ever.

This is actually a fruit bat and not very common here since there isn't much fruit.

We actually have many bats here, they are small and live in our roof. They chirp all day then at night the pigeons come and coo on top of our roof. Always activity. 

bush meat

A few weeks ago I noticed our promising tomato plants were being eaten by something. I talked to our gardener and he said "Gafiya!  The gafiyoyi did it!"  Then he showed me where the gafiyoyi came from (two holes in the shed nearby).

What is a gafiya? It is a large possum-like rat that lives in the desert here and is considered to be good for eating. Gafiyoyi is the plural noun.

Later that night I heard some rustling near our compost pit and I thought it was a family of hedgehogs. I grabbed my camera and went to get some pictures of them for our family back home. Instead, I discovered two large gafiyoyi eating my compost. I took some pictures and called my wife out to see them.

Gafiya are grey and kinda cute in a large hamster sort of way. The second one is out of focus in the back.

The next day I told my friend the guard, S,  that we had a gafiyoyi problem. I showed him my tomatoes and I could see the wheels turning in his head. He noticed that they were living in a nearby shed so he blocked the holes that animals were coming and going from in an effort to trap them inside. The next night when he was on guard duty I noticed him outside my house looking for something. He had spotted one of the gafiyoyi (they are nocturnal so night time is the time to hunt for them). He had found a new hole they had been using to get in and out of the shed.

We talked about catching them. He told me he had an idea that he would bring tomorrow night. The next night, right as it was getting dark, I saw him walking towards my garden with  a large metal trap in his hand. He set it up in front of the shed and he removed some stones so that the gafiyoyi would have to get in and out through that one hole. About an hour later I was sitting in my house when I heard clanging and rattling. I went out to the garden and there was a gafiya stuck in the trap! I notified S and he freed it from the trap and carried it to the guard station where he used a knife to finish it off.

Here is the trap, you can barely see it. but the rocks form a tunnel so that the gafiya would have to walk over the trap to get out of the shed.

That wasn't the end of the evening! When we got to the guard station I was startled by a massive flapping and scraping sound. To my surprise it was a tattabara (pigeon) in the windows. Yes, he had caught a pigeon and as an impromptu cage he put it in the window between the glass and the screen. I was surprised and a little startled. So, S was doing pretty good that night. He had already caught two protein sources in one evening.

But we weren't done! While he was hanging one gafiya in a tree to keep the dogs from getting it, he spotted a second one off in the distance. This time he ran towards it chasing it towards a building. I followed and so did a second guard H that was sitting near the guard station. When the gafiya reached the wall it had no where to go but left and right along the wall. The three of us chased it back and forth along the wall. The two guards had their sticks. I just had my intimidating demeanor. After about ten seconds of it running back and forth along the wall trying to hit it, it disappeared. At first we thought it had run around the corner and we just didn't see it. So, we all walked that way to the side of the building. While we were rounding the building a pigeon randomly flew right at S. He batted it out of the air and to the ground like a tennis player at the net. He went over and picked it up and carried it off to his makeshift cage. 

Pigeon Prison?

Here you can see the wall that we chased the gafiya towards, the potted plants make for increased level of difficulty. It was like whack-a-mole but with potted plants in the way.

H and I continued to look for the missing gafiya. I became convinced that the gafiya had hidden in the plants out front of the building. Sure enough, upon further inspection a few of the pots had holes in the back sides of them. When S returned, I told them I would lift up the pot and they could smack anything that runs out.

I lifted the first pot, nothing. The second pot, nothing. The third and final pot. Gafiya! They swung their staffs, and missed and missed and missed. The gafiya ran back and forth, then tried to escape away from the wall but it soon discovered that was a terrible option because there were no pots to hide behind.  It wised up and went back to the wall. After about a minute it started to get tired. Finally it tried to hide in the pot again. But This time, they got him. Triumphantly they carried it back to the guard station.

The two guards are neighbors and between them they have ten kids and two wives. So, they split the bonanza of meat about 14 ways. They are also friends of mine and I've been to their home a few times. I can imagine their wives were excited to get such fine ingredients for their breakfast. Protein is something that lacks greatly in most people diets here. Considering that a kilogram of meat costs about a day's wages, you can see why meat is such a treat. I suspect they got about a kilogram of meat from two gafiyoyi and two pigeons

My friend with his gafiyoyi. He was the master of killing snakes, Now he is the master of killing gafiyoyi. We had so much fun.

There are plenty more gafiyoyi where those came from. That night we saw several more that we were not able to catch. And the pigeons are a plentiful too. One night I counted 60 on my roof. There were at least 30 more on my neighbor's roof. And if you did a census on the whole compound, I bet you would count several hundred. They are one of the more annoying birds I have ever encountered, always cooing and scratching on the roof and dive-bombing you without warning. Anyway, we had some of the most fun I've had since moving to Africa. We'll do it again some night. Only next time I am going to get some breakfast.

New Years Day

adventuring

New Year's Eve was kind of a bummer. After an emotionally exhausting weekend, I was looking forward to the evening prayer time with games and snacks to follow. But, by the time I got home from the OR, washed the hospital off and made dinner, prayer time was almost over and I was exhausted. Also, Luke was feeling anti-social. So, instead of having some fun, l collapsed into bed. Which, on the bright side, gave me some energy for a little New Year's Day adventure.

There isn't a whole lot to do for adventuring around here, but we had planned a fossil hunting trip a few weeks ago with our friend J, the school teacher and a few kids. It turned out to be an interesting little field trip.

Setting out across the rocky landscape

interesting rock designs

a local shepherd boy and his cattle

some of the fossils...t top left is a fossilized vertebra, top right is a spiral seashell, and bottom left is a clam. Guess there once was  an ocean to go along with all the sand!

On our walk back we stopped by the local "butcher shop." Today was market day, so it was a pretty busy place as animals were slaughtered for market.

posing

being carried to the slaughter

up close and personal

photo op

not sure about this

bucket full of goat heads (not sure what they do to them...eat them?)

I got an impromptu "name that internal organ" Hausa lesson

On the walk home we walked through an area with rocks arranged to mark what we found out were gravesites

This was the only grave with a grave marker

As you can see...it was a pretty interesting 3 hour adventure all within a 20 minute walk of our compound. :)

Introducing Baby Nawal

Nope...its not  what you think. Baby Nawal is not a baby...its our current brand of laundry detergent. We like it- not because our clothes are nice and clean (although they are), but because whenever we need a good laugh we just have to go into our storage/laundry room and read the detergent label. For your enjoyment and entertainment... read on:

Nawal is an indirect Quranic name for girls that means “gift”, “blessing”, “bestowal”...not sure why they picked it for detergent. Maybe there is a famous baby named Nawal?  We have also seen "Welcome Obama" brand laundry detergent.

the auxiliaries and international-standard spicery...LOL

inon-hydronium exterior active agent. cool. whatever that is.

beware of the children and the bespattering of you eyes

adhibition? rigidulous? .I have no idea what any of this paragraph is trying to say.

funny thing is...this English is probably better than my Hausa

comic relief

It was a routine Saturday afternoon laparotomy for probable typhoid perforation. He had the typical story... a week of fevers, a few days of severe abdominal pain, diffuse peritonitis, and abdominal distension.  So, we opened him up and found a liter or so of foul-smelling pus and mucus-like stuff in his abdomen and a 1/2 inch hole in his small intestine.  We got to work cleaning the pus and junk out of his belly. Here is where it got weird.  As I was blindly reaching up into the dark recess behind his spleen to scoop out the pus, I felt a tube. What?! I was confused. Did this guy have an old drain tube floating around in his belly? He said he had never had an operation before. Then, I saw the tube, grabbed it with my glove, and as I brought it into the light I saw it for what it truly was. A long, live, squiggly worm. GROSS!!! I gasped, jumped back a bit and quickly dropped it on the drapes. 

Gross, right?!

Of course, the rest of the OR staff found my reaction to be HILARIOUS.  The chuckled and laughed and teased me saying stuff like,  "You're a doctor, why are you afraid?"   To which I replied,  "I'm not afraid...but that was unexpected, gross, and, well, downright, disgusting."  I mean, he had a big worm free-floating around in his belly. I wasn't expecting it to be there.  It was the first time I've pulled a worm out of a human's belly. I'm allowed to be a little surprised and grossed out.

the worm- Ascaris

  
Just goes to show...there are no boring days at this hospital!  After a few rough days, everyone needed a good laugh and the story of the worm that escaped out of the hole in this man's intestine and then hid under the spleen until it could give the white lady doctor a fright...perhaps it was just what God intended to give us a bit of comic relief! 

 

A few fun facts about the Ascaris worm from Wikipedia:

• Ascaris lumbricoides is the largest and most common parasitic worm in humans
• One study indicated that the prevalence of ascariasis in the United States at about 4 million (but I've never seen it in the US...not sure that it is that common nowadays)
• Perhaps as many as one quarter of the world's population are infected, with a prevalence of 45% in Latin America and 95% in parts of Africa.

 Check out more from the National History Museum website. 

one more day

Its almost over...five days of being the only surgeon. It has been busy. I wouldn't have gotten any sleep if I didn't have residents to take care of the inevitable middle-of-the-night lacerations, fractures, and ER admissions.  Thankful for that.  

I have lots of stories and pictures, but they'll have to wait until I have more time. I already have three exploratory laparotomies scheduled for today so I can't write now. Instead, here are a couple of pictures from last week.

Liters of peanuts...necessary for survival on long OR days

The compound dogs, Martin and Buddy, taking naps during church last week. At least they come. :)

Big post

As usual there is a lot that has happened here the past week or so. I shall share some photographic highlights. Click on them to make them bigger.
First is the animal highlights. There are all sorts of animals here. One night I was given a toad as payment for a glass of water. Kids do strange things.

This here is a bonafide hedgehog. They have fleas and pokey spikes. But my friend is not afraid to pick them up. We often see them scurry around at night. When frightened they roll into a ball.

This is my good friend Martin. He likes chicken skin and laying on cool cement floors. He comes over and does this  as often as he can.

 One of the biggest events lately is the arrival of rain. This is the first rainfall we have seen since we have been  in Africa. Coming from Seattle that is a big change for us. When the storm came it was amazing how much it felt like a midwestern summer thunderstorm. The wind picked up and was cool. The sky darkened water poured down. There was so much water so fast that there were rivers of mud and flooding hospital wards. No one was hurt but it created a lot of extra work. It has actually rained three or four more times since then.

This is our laundry getting an extra good rinse. As you can see the dirt has all turned to mud.

I really like this picture. It is big. Click on it to make it bigger.

 More Great news! We got  a  package from our friends in Seattle. It had some awesome stuff in it. I wouldn't have believed that I could get so excited about peanut butter. We  have peanut butter here but it is not the same. This week I realized one thing that I took for granted while living in america, Tortilla chips. They are amazing, cheap, and plentiful. tortilla chips are so hard to make by hand. Lucky for us. A team came here a few weeks ago and brought a tortilla press. They didn't want to take it home with them when they left, so they gave it to us! SCORE!

Ice cream recipe book will come in handy. I miss molly moon's. Tab is excited to have a stethoscope. I am excited to have BBQ lighters for lighting our oven. It is very difficult to light with a match. 

I took this picture from the water tower. It is of our town at night. Many of the lights are cars or motorcycles. Some are  televisions. 

Just some random Africa stuff

There haven't been any major events going on in our day to days here recently. However here are some pictures that capture some interesting moments. The first is of the night sky. After having spent my entire life in North America I am not used to the moon being in a northern direction from me at times. I had the opportunity the other night to take some cool pictures while the moon was full.

This is the moon low in the sky, notice the orange color?

This is the moon later in the night. Looks the same where you are too, right? Let me know if it doesn't.

One of the things that I looked forward to seeing on our trip to Africa is a chameleon. And today, I finally got to see one! They are so cool. At first I thought that it was a leaf blowing across the driveway then I realized it was a lizard walking very slowly. Then I noticed that it was a CHAMELEON! Our Friend got it to  walk onto a stick so we could pick it up and look at it. The thing was so cool. Too bad we had to go back to work so soon. We put it on a tree, he walked around slowly for a while and then we went inside. When we came back out it was gone. Hopefully he was not eaten by the cat. The cat loves to eat lizards. I hope to see more of these one day. 

Here is my lovely holding the Chameleon on a stick. I love how the tail coils up 

Here is the Chameleon playing dead on the stick. You can tell he recently shed his skin from the white patches on his head and back.

Apparently some Africans are quite scared of Chameleons and will kill them whenever they see them. They believe that they are evil or cursed or something. They will not touch them and they don't understand our fascination with them. When I told my African friend about us finding a chameleon today he asked me if I wanted him to kill it. I told him no. No thank you. 

things that made me smile today

Fresh homemade peanut butter, a gift from my patient for treating her abscess.  So sweet! Made my day.

Now selling in a store near us...Liquid Chlorophyll. Plant juice?

Did you know that petroleum jelly comes in barrels? 

 It is scooped out with a hoe. Perhaps one requires that much to keep heels from cracking open during dry season. We just might have to invest in some.

Luke playing Sodoku in front of the air cooler