Avec Deux Mains

Pélé

noreply@blogger.com (Deborah) — Sat, 28 Jan 2012 07:51:00 +0000

I’ve had a really fantastic caseload this week. I’ve been busy, but my patients are challenging, and interesting, and I’ve really enjoyed them as people!

There’s K. with the TBI . . . his enthusiasm in each treatment session is contagious and his determination is inspiring.

And H. who comes for hand therapy . . . she expresses deep gratitude with each small step of progress which helps remind me that I love my job, not for the thank you’s, but for the small steps that help people live again.

There’s also Little H. who still cries and hides his face every time he sees me coming, but whose struggle to survive keeps present in my mind the reality that life is fragile and short, but worth the fight.

I have others too, but I really want to tell you about M. . . . who, after today, will be fondly referred to as ‘Pélé.’

A couple of years ago, M. was in a motorcycle accident which caused an incomplete spinal cord injury (SCI). That means, he some use of some muscles from mid-chest down, but not all. And even some of those are super weak.

M.’s doctor asked me to see him to give him a cushion for his wheelchair, as he has been admitted to the hospital for a pressure wound. But according to my French-to-Hausa translator, who talked to his Hausa-to-Tamajeq translator, he doesn’t have a wheelchair.

Instead, he pointed beneath his hospital bed.

Much to my surprise, there, under the mattress, I found the metal frame (and some wooden supports where the metal broke down) of a BEDSIDE COMMODE! You know, the toilet-chair that you find in medical supply stores, long-term-care facilities, and OT gyms. Except, the seat was missing.

I stared at it.

Then looked back at him.

‘Ban gani ba’ I said (I don’t understand).

‘Tafiya’ he answered (walking).

I blinked.

‘Ama, ban gani ba’ I repeated (but, I don’t understand).

‘TA-FI-YA’ he slowly said again, as if it was the actual words I was stumped on.

Eventually he understood my confusion and made his way to the edge of the bed to demonstrate.

His brother place the commode-turned-walker in front of him. He placed his hands then swung his body into a standing position.

CRASH!

I jumped.

With one swoop, he had lifted the commode and threw it slightly ahead of him, levered his body upward on the armrests and took a step. He turned toward me and flashed me a toothy smile. My eyes were as big as his upper arm muscles.

The problem with his current commode-setup is that it’s rather short, and therefore difficult to walk. I thought, at first, about reminding him of the other obstacles to the ambulation process that he was facing . . . but decided to play the optimist for once.

When I arrived a year ago, I was given half a dozen metal walkers that I was asked to use or get rid of. I figured one would be the perfect height for M.

I walked into the room and his eyes lit up as if he had seen The Tree in Rockefeller Center for the first time. He couldn’t get up fast enough.

But his arms aren’t used to the new position. And since we OT’s don’t actually work for a living, but play all day long, I decided M. needed a little football (that’s soccer for all you Americans) in his therapy session.

The problem with my master plan was that the new-to-him walker has a bar pretty low to the ground, so even if I bowled a strike, when he ‘kicked’ the ball it hit the bar and bounced right back at him.

The only way it was going to work was if the walker was behind him. I pulled out a stool.

‘Sit’ I commanded in Hausa. He looked at me, puzzled, but obeyed. I lifted the walker above him, turned it, and wedged it between him and his bed.

‘Okay, stand up.’

He placed his hands on the backwards handles, shot a concerned look that conveyed his doubt, and raised his body.

The father of the boy in the bed next to him gently rolled the ball toward M. as initiated his triceps and lifted his body.

With all his might he activated his weak hip flexors and whipped his right foot forward.

The ball sprang back toward his neighbor’s father.

We all cheered!

‘Akwai Pélé!’ (There’s Pélé!) I shouted.

M. beamed with satisfaction and pride.

The ball was rolled again, and this time his kick was a little more accurate.

‘Olé, olé, olé, olé, olé, olé!’ I started to sing.

And before I knew it, the three other patients in M.’s room joined in!

Oh Yeah, I'm Still Here

noreply@blogger.com (Deborah) — Wed, 25 Jan 2012 23:59:00 +0000

Sometimes I forget that I'm not working the US any more. One would think that my surroundings would remind me on a minute-by-minute basis . . . but no.

And normally I don't remember until I do something my patients find ridiculous!

Like, today, for example.

I rounded the corner to my office to find a man sitting on the floor, against the wall, facing my door. His crutches were sprawled out next to him. His companion was standing to his right.

He held his outpatient treatment card up to me . . . and I was relieved to find that he wasn't coming for crutches . . . since he obviously had his own pair.

He was, however, coming to learn a few basic exercises to keep his knee mobile.

Which, on the surface, sounds like a pretty easy task . . . but throw in a language barrier and a man who's clearly never won a round of charades and the stage is set for a really funny treatment session.

I had him start up on my treatment table . . . legs out straight . . . telling him to push his knee straight down into the table. Thankfully he was wearing shorts, which around these parts is rare on a grown man, especially in January, which is still considered 'cold season' (it's quarter to one in the morning, and my thermometer is reading 77F/25C). So I could see his quad contracting . . . or in his case, not contracting.

I tried explaining again.

He didn't get it.

I tried acting it out.

Nope, nothing.

His friend with him understood and tried talking him through it in Hausa. But he just couldn't motor-plan enough to figure it out.

I stuck my hand under his knee and told him to squish my hand.

Still didn't work.

I finally gave up that tactic and told him to scoot over.

Unaware of what I was going to do next, he moved. I hopped up on the table. His jaw dropped.

I grabbed his hand. His eyes bulged.

I shoved his hand under my knee and pushed down. He nearly had a heart attack.

'Ka gani?' ('Do you get it?') I asked.

He was speechless, but his friend roared with laughter.

It was at that moment, as my patient began to breathe again and his friend tried not to wet his pants, that I remembered I was in Niger.

Niger in the News

noreply@blogger.com (Deborah) — Sun, 22 Jan 2012 19:36:00 +0000

Interesting article on the food crisis in Niger and the ongoing conflict in the northern region of our southern neighbors.

Click here to read it straight from the BBC.

Flash. Mob.

noreply@blogger.com (Deborah) — Fri, 20 Jan 2012 13:51:00 +0000

We all have a Bucket List. Mine is decently long. But I confess, sometimes I add things after I've already done them, because I'm not actually creative enough to come up with interesting and adventurous Must-Do-Before-I-Kick-It's.

But one thing that has been on The List since I first discovered it, was to dance in FlashMob.

And so, that's just what I did.

Now, before your imagination goes too wild, for those of you spend no time on YouTube and who have no idea what a FlashMob is, let me explain.

A Flash Mob is when a large group (the 'mob') gathers in a public place and pretends to be just normally participating in the same thing as everyone else (like shoppers wandering a mall or tourists at the Eiffel Tower or commuters in Grand Central Station). When all of a sudden, something starts to happen (the 'flash'). Sometimes the mob simultaneously freezes . . . they stand in place as if time has stopped. With others FlashMobs, one person will 'spontaneously' begin to sing or dance as others 'randomly' join in.

But I assure you, there's nothing spontaneous or random about it! These routines have been carefully organized and thoroughly rehearsed.

At least, the ones that make it to YouTube are!

But here at Galmi, we do things a little bit . . . um . . . what's the world . . . disorganized . . . no that's not it . . . not-well-thought-through . . . no, that's not it either . . . SPONTANEOUS!

Two weeks ago, when all of SIMNiger was in the capital for our annual conference, late one night (when most of the creative magic happens), my friend Cool-J asked me to show her some of my fab Bollywood dance moves.

Since it was dark and I didn't think anyone else would see, I let loose a little and wowed her and two of our other friends with my stellar moves . . . well, at least they would have been wowed had they not been laughing hysterically at me.

'Those would make AWESOME FlashMob moves!' Cool-J said.

'I've ALWAYS wanted to be in a FlashMob!' I said.

'Let's do it!' she insisted.

Most people make the wrong assumption that I enjoy being up in front of people . . . or that I like making a fool of myself before a large audience . . . I guess it's because it happens so frequently (at least the making-a-fool-of-myself part).

But I dug in my heels and refused.

No way was going to dance in front of two hundred and fifty-ish people.

Unfortunately, I was out numbered.

The plan was to organize a group of women to join us . . . we were hoping for 20 . . . run through a few simple moves and then in the midst of the Saturday evening program, execute and deliver . . . it was now 11 o'clock Friday night . . . we certainly did not have time on our hands.

As we talked through the list of women we would ask to join us in our a-last-minute spontaneous if-we-don't-pull-this-off-exactly-we'll-look-like-fools dance, I became discouraged and incredibly doubtful. But before I knew it, I had I swallowed my pride and found myself in front of a microphone explaining our 'genius' plan to a room full of skeptical women.

The plan was to meet in a secret location for half an hour to learn the (simple-only-if-you're-coordinatively-inclined) steps.

I prayed for a miracle and hoped for 20.

But missionary women never cease to shock and amaze me! We had over double what I was expecting!

Being an OT, and therefore the resident expert in giving oral instructions on movement and body positioning, I was assigned the task of teaching the routine. (Oh to have been a fly on the wall!)

And the ladies did great!

We practiced a few times without then with the music (Jai Ho, the theme song from Slumdog Millionarie) and then we were off . . . hoping they would all show up in the end.

When the time came, the music started. Cool-J and nôtre amie E. started us off . . . after 8 beats I joined in with the retired wife of our conference speaker. We were in the front row on the left side . . . so other than Cool-J and E., there was no way to know if anyone else was with us.

It wasn't until we reached the middle point when we all moved to the aisle, did I find we were not, in fact, alone.

No . . . all those who had practiced with us, danced with us . . . and even some who didn't! We were truly a mob!

We managed to get women dancing who would never have dreamed of participating. We had all demographics, all types. We would each forever be a part of the SIMNiger-Conference-FlashMob-Sisterhood.

What can I say?? That's how we roll in Galmi!

Promises . . . Galmi Style

noreply@blogger.com (Deborah) — Thu, 19 Jan 2012 22:26:00 +0000

One of the worst parts of living in Galmi is that our compound has a revolving door. In my first year here, we've had over 100 'short term' folks come, help, and leave. ONE HUNDRED! That's a lot of hellos and goodbyes.

Today, our friend, SwissA, left.

Saying goodbye is a way of life here . . . but it doesn't really get easier.

To ease our grief with the departure of yet another who shares our experiences in this crazy corner of the world, Cool-J and I ate chocolate.

I never thought anything could trump PeanutButter M&Ms . . . until I was given some DarkChocolate and Raspberry DovePromises. OH MY GOODNESS!! Stop what you're doing, right now and go out and hunt some down . . . oh wait, you're reading my blog post . . . never mind . . . FINISH READING, then go and buy some. You will never be the same.

So Cool-J and I sat, sipping coffee and savoring DovePromises.

'Enjoy the childhood joys of winter,' Cool-J read aloud.

'WHAT?!?!' she cried out. 'WINTER?!?! I HATE YOU DOVE!'

Just as she was starting to feel better about our friend leaving, the failed-greeting-card-writers at the DoveChocolate headquarters dashed her down to the pit of despair.

'I think they meant cold season' I offered, trying to console her. I grabbed a sharpie and crossed out 'winter' and wrote in 'cold season.'

Enjoy the childhood joys of ~~winter~~. cold season.

OOOH! That was fun! So we kept going:

Satisfy your sense of surprise . . . when there's a mouse in the house or a roach in your shoe.

Catch ~~snow~~ dust flakes on in your ~~tongue~~ lungs.

Feel free to be yourself . . . as long as your legs and head are covered.

Sleep in late tomorrow . . . but don't expect a shower because Ousman will be watering the plants.

Satisfy your sense of surprise . . . all night, on the toilet, after an evening of spicy Nigerien food and unfiltered water. (story here)

Chocolate won't let you down . . . it clings to your hips (until Hot Season at least).

The fastest way to my heart is chocolate . . . or diet coke, or care packages, or ice cream, or anything that says 'just add water and stir.'

Indulge your sense of enjoyment . . . with milk powder, onions, and nescafé.

Sleep late tomorrow . . . unless you're on call; or the birds dance on your roof; or it's just way too hot, even to sleep.

My Own Mango Princess

noreply@blogger.com (Deborah) — Wed, 18 Jan 2012 23:35:00 +0000

If you've never read Where is the Mango Princess by Cathy Crimmins , you should. It is the firsthand account of a wife's journey with her husband as he returns to life after a Traumatic Brain Injury (TBI). It's funny and sad all at the same time.

Kind of like my therapy session with L. today.

L. has a brain injury. He's only just woken up from a coma and has massive physical and cognitive deficits. And according to his brothers, he's demonstrating personality changes.

It is hard to sit in front of an early 20-something who presents like a cross between a three-year-old and an old man who's had a stroke. It is heartbreaking to know the long road ahead of him and the extremely limited resources his family. To know that his ability to walk safely is a high priority because he will never have access to a wheelchair.

But it's not all sad.

It's exciting to watch as patients with TBIs progress from one day to the next, especially at the beginning of their recovery. Every new movement or spoken word, each command followed or step taken is a major victory that is celebrated.

And sometimes, funny things happen . . . or are said . . . in the midst of the therapy session.

L. and I were working on visual tracking and acuity, accuracy with grasp/release, ability to follow simple one-step and two-step commands, sitting tolerance and balance, dynamic reach, and object recognition . . . which is all a fancy way to say, I had wooden blocks and he had to reach for them, take them, then give them back to me.

At one point, I held out a square block and asked him, in Hausa, 'What is this?'

He stared at the block for a few seconds. He leaned a little to check out the other side.

A smile crept across his face as he was sure he had found the word for 'wooden block' tucked away in the language cortex of his brain.

'MOOOOSSSSSQUITO!' he shouted.

Adventures in TBI

noreply@blogger.com (Deborah) — Wed, 18 Jan 2012 15:06:00 +0000

I like burn care. I'm good at it. I understand it. It makes sense. It's logical. The burn healing process is predictable.

Unlike that of traumatic brain injuries (TBI). Which is anything but predictable!

Right now, on my caseload, I have two guys in their early 20's that both have a severe TBI. And while at first I was a bit nervous about it, I'm having a ball!

Both were unconscious for five to six weeks . . . and are now slowly regaining speech and motor function. We work on simple command following, visual processing, coordination, balance, ambulation, attention, reaction time, activity tolerance, short term memory and recollection, impulsivity control, active movement, and functional capacity.

Needless to say, they've come A LONG way, and have even further to go.

It's challenging to treat a brain injured patient when we can only communicate partially. With one of the two, K., I can speak French . . . at least for the first 15 minutes . . . then as he starts to get tired, we move to Frausa, a mix of French and my sorry Hausa. After about another 15 minutes, he's had too much and all my commands must be in his mother-tongue . . . let's just say I'm happy his brother is there to translate Deb.Hausa to RealHausa!

Another challenge to the process is that both boys are illiterate. I tried, the other day, to do some cognitive retraining with K. by drawing shapes on a piece of paper. I asked him to copy them, one by one. With his typical three second response-time-delay, he picked up his pencil and began drawing circles all over the page. 'Look!' he started (three second pause) 'I'm writing in Arabic!' We didn't go too much further with that activity.

So, when resources are limited, we get creative.

A few months back we had a surgical resident from the US come to work with us. She left me all sorts of wonderful toys . . . uh . . . I mean . . . EQUIPMENT . . . therapeutic equipment . . . which included a bag of red balloons. Which is nice, because I love red.

I pulled out a balloon and blew it up.

POP!

His brothers and I jumped. Three seconds later, K. looked up to find the source of the noise.

I grabbed another balloon.

This time it held its shape.

I tapped the balloon in K.'s direction, not sure what the outcome would be.

He reached up, instantaneously, and hit it back in my direction.

We volleyed for about 10 seconds before the balloon hit the ground. He impulsively lunged from his wheelchair toward it, nearly spilling onto the floor himself.

Once safely back in the chair, we started again. I tapped the balloon, he swatted.

SMACK!

Our child's-party-favor-turned-therapeutic-tool hit me square on the nose. I thought it was funny, but no one else responded . . . so I didn't either.

Three seconds later, K. erupted into uncontrollable laughter!

I'll Be Ready

noreply@blogger.com (Deborah) — Fri, 13 Jan 2012 12:53:00 +0000

Yesterday I was working with a guy who shares a room with three other patients. Each of the four has a caregiver who sleeps on a mat on the floor at the base of the patient's bed. It makes for a crowded treatment session, but after a year, I'm getting used to it.

As I was helping my patient sit up in bed when suddenly there was some background music. It was a ringtone coming from the brother of the man staying in the bed across from my patient. It took him a few runs through to find where he had put his phone, so I had enough time to recognize the tune.

I knew the tune, but couldn't place it. I began humming it to myself. And that's when it hit me!

It was the theme song from Baywatch! HA!

The Cries We Like to Hear

noreply@blogger.com (Deborah) — Thu, 12 Jan 2012 12:39:00 +0000

For about six weeks now, I've been treating a little boy who is not quite two. Little H. has partial thickness burns over the entire right side of his body. He was burned by hot oil.

It has taken a significant effort to keep this little guy alive. There were several periods over the last month and half that I wasn't sure he would survive. At one point he refused to eat or drink anything and his surgeon ordered a nasogastric tube.

It took a few educational sessions, but we were able to teach his mom how to feed him via the tube in his nose and how to keep it clean. We had to put little mittens on his hands, yet he still managed to pull the tube out twice.

But it was working. He was thriving and starting to maintain a healthy weight. He began eating again from his mouth.

So they discharged the tube.

And I went to Niamey for the conference.

But within only a week, he had stopped eating again and had lost so much that he was nothing more than (burned) skin and bones.

When I did his wound care on Tuesday, I was certain I would break his leg simply by lifting it.

The doctor again ordered an NG tube and we taught the woman with him, his father's other wife, how to feed him and encouraged her to try to get him to eat orally as well. She was a quick learner and understood that if Little H. didn't eat he was going to die.

Little H. and I have a love/hate relationship. I love him and he hates me. Dysfunctional, I know, but we make it work. Hey, I can't hold it against him . . . I make him cry and hurt and scream. I make his pain worse. And he's too little to understand why.

Normally, he only has to look and me and he starts crying.

When I left work yesterday, this precious baby was too weak and limp to move on his own . . . too weak even to whimper when he saw me.

I wasn't sure he'd make it through the night.

When I came in this morning, I checked the stack of charts, first, before heading to his room. I admit I've reached my max capacity for lost babies . . . and I didn't think I could handle another one. Not today.

But his chart was there! He had survived!

I went into the room.

He was sleeping in the bed next to his father's other wife. She saw me and lit up.

'Look!' she said as she pulled Little H. into her arms.

He slowly turned his face toward mine, took a good look, and began to scream!

The momma and I both began to cheer!

He was strong enough to turn his head! Strong enough to scream!

Throughout his dressings this morning he was a natural little wiggle worm!

The road to recovery is still a very long one . . . but praise be to God, Little H. is back on it!!

Pipe Dreams

noreply@blogger.com (Deborah) — Wed, 11 Jan 2012 21:40:00 +0000

Today, I shared a fabulous bonding moment with the old plumber that works for our hospital. I love this old man . . . not as much as I love my own Soho from the OR, but almost. He's gentle and kind and always assumes I speak more Hausa than I actually do.

My shower has always had a bit of a drip . . . but while I was away for the conference, it turned into more of a stream.

I had been advised that when it comes to leaky faucets, it's best to try and fix it yourself. So that's what I did.

But that was a really dumb idea.

I know about as much about plumbing as I do brain surgery . . . which should have been my first hint not to touch anything.

I fiddled with a few knobs and before I knew it was holding the only movable part of my shower in my hand.

Oops!

At first I couldn't get it back on . . . but with a little elbow grease and prayer for a miracle, the nozzle slipped back in place.

My fear of not being able to shower greatly outweighed my desire to Mrs.FixIt (we all get to play the 'shallow' card once in a while). So, this morning, I called in the big guns.

I left Soho the Plumber alone in my bathroom to work his magic. After a little while, I stepped in to check on the progress.

He resembled the Little Dutch Boy . . . just old and African.

He was leaning over the side of the tub, left hand pressed flat over the hole where the water faucet was supposed to be. In his right hand was the biggest wrench I've ever seen.

He was soaking wet!

Suddenly the wrench slipped from his grasp and landed with a thud on the floor of my tub. I instinctively reached for it . . . just as he did.

Water came shooting from behind his hand . . . right into my face!

It was only for a split second, but it was enough!

And like the water spewing from my shower came our roars of laughters!

He got the spout covered again and we managed to communicate enough for a handoff of the pieces he needed to finish the job.

We laughed again and again as he recounted the story to me in Hausa, as if I hadn't been there!

Sweet Applause

noreply@blogger.com (Deborah) — Wed, 11 Jan 2012 07:02:00 +0000

No, I haven't been ignoring you . . . or holed up like a hermit. I've been away at our annual country-wide spiritual life conference in the capital. So not to worry, I've got a few pre-written saved-up posts coming your way. Thanks for your patience.

Yesterday, one of our short-termers, Cool-J, came to work with me. She shadowed me for the morning and then shared a bit on her own blog . . . which I HIGHLY recommend! So please skip on over to Cool-J's No Zebras Here and read her account of Sweet Applause.

How Not To Build Rapport

noreply@blogger.com (Deborah) — Thu, 29 Dec 2011 21:49:00 +0000

This morning a little girl from the Under 5 Clinic came to see me. She's nearing three and cannot walk. She was a little bit like a rag doll . . . really floppy . . . and absolutely adorable.

She came into my office hidden under her mom's flowing head covering. We all three sat on the floor, ready to play . . . well, at least I was ready to play. She was ready to scream.

And that's all she did for the next half an hour!

Despite all efforts to distract her with toys and bubbles, she sat and screamed at the top of her lungs.

Eventually, I gave up trying to play and started to show her mom some simply 'play'-like exercises she could do to work on trunk control and balance. They only live about 25 minutes from Galmi, so I had been hopeful that they would be able to come back for therapy on a more regular basis.

However, since Little L. didn't seem to be able to get calm, I gave up that dream pretty quickly.

Trying to teach mom a few things proved a bit difficult without a Hausa vocabulary large enough to include terms like 'sitting balance' and 'standing endurance' and 'gently pull her this way and push her that way' I decided to call in a translator.

My nurse-by-day-matchmaker-by-night friend came to my aid. She said what I couldn't say and explained what I wanted Little L.'s mom to do.

We were mid exercise-explaination, when all of a sudden my tiny patient stopped shrieking sounds and began yelling words. My friend turned to me:

'She said she will play if you leave the room.'

Unfortunately, they all seemed to miss my whole purpose in being there.

Curious to see what she would do, and hopeful for a better chance to evaluate her functional capacity, I went into the hallway.

'Woviaj iaj flkvja owij alkfv oaiwjrg vlkz vmlk ageoijv lk!' my patient shrieked. Her mom and my friend began to laugh.

'She said she doesn't want you to play peek-a-boo with her, so you need to leave and go where she cannot see you.'

Eventually I was allowed back in the room . . . but with my entrance came another round of shrieks. She admitted to being afraid of my skin . . . and there was no convincing her that I was there to help and play, not hurt.

Needing to fill out some paperwork, I decided to try one last resort.

From a pile of freshly cleaned linens, I pulled out a pink bed sheet and draped it over my head.

But . . . my sorry excuse for a Halloween costume worked!

For the first time in over 45 minutes, the child had stopped screaming!

I guess I've found the new Therapy Department uniform!

TED Gets It Right Again

noreply@blogger.com (Deborah) — Mon, 26 Dec 2011 18:34:00 +0000

Alberto Cairo is an Italian PT who works with the Red Cross in Afghanistan.

Lessons from the Tour

noreply@blogger.com (Deborah) — Tue, 20 Dec 2011 21:01:00 +0000

This morning the operating room staff went for a tour of the new Post-Surgical Building. Our current facility is the original (plus some simple extensions as we grew), dating back to the 1960's. The cement is crumbling, there is barely any airflow, it's dark, and it was time for a change. So we are nearing the end of Phase I, next up is OB, then medicine/peds, then . . . I forget.

It's been a long process (not sure how long, but I'm confident that someone from my team will read this and let me know just how long, so be sure to check back for details). And we're nearing the end!

But you don't want to read about buildings . . . okay, really, I don't want to write about buildings, I want to write about people. So, I arrived on the tail end of the OR staff's tour of the new facility. And experiencing it with them was a privilege.

At first, with all the Oooh's and Aaah's I heard as I approached the building, I half expected to see the Rockefeller Center Christmas Tree up in the foyer . . . instead it was the hospital logo painted on the wall.

'Déborah! Régarde! C'est trop modern!' the Chef d'équip (the boss) of the OR said to me.

The were impressed with everything . . . tile on the floor, strips painted in the hallway, the metal and glass doors, the high ceilings in the hallways . . . it was like nothing they'd ever seen.

They gaped, wide eyed; they gasped with glee.

It was the way I felt the first time I walked into the lobby of the Ritz.

Back home, this new building would be nothing spectacular . . . it wouldn't be prized, it wouldn't be impressive.

But it's all about perspective, isn't it?!?!

Here, on the south-side of the Sahara, when I see metal, cement, and floor tiles, my friends and coworkers see the Taj Mahal of hospitals.

Our Director was telling me that he took some staff through the other day, and one turned to him and asked 'So this building is for staff only right?' 'No, it's for our patients!' 'But it's too nice [for villagers]!!'

Like children around the Christmas tree, my coworkers were awed. It was spectacular to see their faces and enjoy their delight. To feel their glee and share their wonder. Not because I was impressed with a building I've entered many times through it's process . . . but because their joy gave me joy.

As I was following them back to the 'old' hospital, I had to wonder if I was feeling, on a very small scale, how God our Father feels when we find joy in His creation. When we are in awe of what He has done for us. When we are speechless at His gifts.

With Christmas only a few days away, it was a strong, tangible, example of the way I should walk into the stable . . . seeing The Baby in the manger as if for the first time. Hearing the wonder of His birth as if I was a child. Rejoicing that the story doesn't end with the wise men bringing gifts.

Knowing, that when I delight in the coming of the Son, the Father delights in having given Him.

Stupid Birds

noreply@blogger.com (Deborah) — Thu, 15 Dec 2011 21:45:00 +0000

While most of our local wild life doesn't span beyond the imagination of donkeys, camels, chameleons, snakes and the ugliest spiders on the face of the earth, we do have quite an array of birds. There are swallows that dive to drink out of our swimming pool . . . and these beautiful blue ones that don't do much of anything except fly away the moment they sense a camera within a 10meter radius.

And there are the pigeons.

Stupid pigeons.

Like everywhere else in the world, our Galmien pigeons leave a mess of poop and feathers, and generally contribute nothing to society.

Being a native NewYorker, pigeons have always just been a part of the scenery.

But it's one thing to see a legion of pigeons on your metal roof. It's another to hear them.

The first few days my mom was here, she waged war with the winged squatters . . . armed with a broom, she let them know who was boss. After a few banging tirades, they found another roof and filed a Change-of-Address form with the post office.

They were gone.

For good.

Or so I thought.

Two days ago I started to notice some soft scratches coming from above. I thought nothing of it. Then yesterday, just as I was falling asleep for a much-needed nap, I was startled awake by a thump which was followed by an array of clicking, clacking, and clattering.

In an angry tirade (HEY!! Those stupid birds woke me up from my nap!) I grabbed my broom and ran outside.

There they perched . . . scattered across my roof.

Forgetting I was already holding my broom, I bent down and picked up a rock.

I launched it into the air.

It went up, then straight back down next to my feet. The birds silently mocked me.

I picked it back up and lobbed it again.

This time it landed a few feet in front of me, but still quite a ways from the roof.

The bored birds blinked at me and shifted their weight from one claw to the other resulting in that awful sound a metal shovel makes as it scrapes snow from an asphalt driveway.

That's when I remembered the broom.

I lunged toward the house and with a might CRASH-BOOM-BANG my enemies retreated. They fled for nearby branches or another corner of the roof. So I swung again.

When I returned from work (having never gotten my nap, mind you) I found them there again. This time, my rock throwing was a little more successful and the pigeons left without much fight.

Naïvely, I thought I had won. I went to sleep last night to the sound of silence above me, and I was satisfied with my victory.

Little did I know they were perched, waiting, ever so silently conniving their attack plan.

At six-thirty this morning my alarm went off as it always does. I hit snooze, as I always do.

And just as I rolled to doze back into my slumber, those stupid birds began practicing their tapdance routine!

The harder I tried to ignore them, the louder they tapped and the faster they danced.

'GO AWAY YOU STUPID BIRDS!' I screamed at them. I'm certain now that my outburst only encouraged their jig.

I jumped up, grabbed a sweatshirt and wrap around skirt to throw over my pajamas, ripped my broom from it's resting place and fumbled for my keys.

As I flung the front door open, those stupid birds froze mid-saché.

In the midst of my rage I had a lucid moment . . . 'Hey, those birds are sitting on the roof just off to the side of my window . . . EXACTLY ABOVE MY BED!!!!' And while I was impressed with the precision of their tactical positioning, that really boiled my blood!

That was the last straw!

Maybe it was my awesome death stare, or the fire shooting from my nostrils, but all it took was one quick step forward with my broom raised and they were out of there!

You better believe, this means war!

A Kettle, a Pot, a Log, and a Crocodile

noreply@blogger.com (Deborah) — Wed, 07 Dec 2011 13:53:00 +0000

I've been back from dropping my mom at the airport since Sunday. Today is Wednesday. And still hospital employees say good morning by first asking how she is . . . if she arrived safely . . . and when I'm getting married.

Today it was a man who works in the outpatient chart room.

The three employees that pass their days in an oversized walk-in-closet asked me how old I was. When I told them, they gasped. The younger man shot back, 'You need to hurry up!'

The older man in the room laughed at him and said 'And who are you to say that?' And continued to give him a hard time in Hausa about being 40 without a wife.

I chuckled.

'You know, we have a saying in English,' I started to say knowing I would have to explain it in the end . . . but it was only after I had started that I realized I only knew of one word I could use in my new Hausa context for which we have multiple synonyms in the US.

'The big pot says to the little pot, hey, you're black.'

They stared at me.

I blinked at them.

'Uh . . . it means that one points out that the other is covered with charcoal from the fire, but doesn't recognize that he too is covered with soot.'

They stared at me some more, then gave me a courteous little nod.

I was surprised because my Nigerien friends are often speaking to me with Hausa proverbs that they translate into French.

I guess the African saying is true: A log can float in a river, but it will never be a crocodile.

Maybe Close Is Good

noreply@blogger.com (Deborah) — Tue, 06 Dec 2011 11:03:00 +0000

I just had a brilliant conversation with my gardener's father in English.

It all started when he asked how my mom was doing . . . if she had arrived safely in the US . . . how she liked Niger . . . and so on. Then he asked how many sisters I had in the US who would take care of her since I was here. I told him I had no sisters.

'But, how many brothers?' he asked.

'One.'

'ONLY ONE!!!'

'But he has three children.'

'It is better than two. And brother, he has how many?'

'He's 33.'

'And you have 30?'

'Yes.'

'It is the time for marry.'

'I'm thinking about it.' I told him.

'It is not good to be very old without some children. Because, you will be very old when you marry and very old when you have some children and if you are young with some children it is very good to school [raise] the children but if you are very old it is difficult to school the children.'

I thanked him for his advice. But he wasn't finished.

'We have concern for you. You are too alone. It was good when Momma was here, but now you have no one. You find husband now. It is not good for a woman to have the house and the work but no husband.'

I wasn't in the mood for another counter-cultural women's-lib chat this week (and it's only Tuesday!), so I decided to oblige him. 'Okay, I'll think about it.'

'But not an old man.'

I chuckled at the thought . . . and reassured him. 'Well, then I will look for a young one.'

'Maybe 20?' he suggested.

I laughed.

'Oh no,' he said, reconsidering. 'You white people do not like that much. You want man and women [note the singular and plural there!] close. Maybe two three years. But no ten. That too many.'

I laughed again. He continued.

'We Hausa, we like it big difference.'

He paused and thought to himself.

'But then, many times, we have big big problem. Maybe close is good!'

This Is How We Roll

noreply@blogger.com (Deborah) — Sun, 04 Dec 2011 19:33:00 +0000

I write this blog to help you better understand what life is like for an outsider in this little corner of the world I'm currently calling home . . . okay, so really it's to help ME better understand my not-so-brand-new-anymore context . . . but you've been invited to be a 'fly on the wall'. So in the spirit of the holistic approach, I documented my trip from the capital back home via the Nigerien version of the BulletTrain: the bus.

Since most of you will never have the privilege of riding the bus in WestAfrica, here it is, chronicled as it was happening:

04:40

It's 4:40am. I've been on the bus half an hour and we are still sitting in the parking lot.

Outside the morning air is comfortably cool. In here, however, I've broken a sweat. And there's nothing quite like breathing the recycled air of 75 strangers.

I was supposed to get here earlier, but my cab driver showed up 40 minutes late. Which, from his point of view, was a courtesy, as I wouldn't have to wait as long for the bus to leave...since we westerners are impatient and don't like waiting.

What he doesn't realize is that this is a 7 hour trip and by showing up 'late' I've lost the advantage of getting a decent seat.

He's clearly never been forced to squeeze in next to the biggest Hajiya on the bus!

In addition to the lack of seating options, arriving late also means no overhead storage space. But I learned something on my last bus trip: it's culturally acceptable, in situations such as these, to push.

Not wanting to be buried alive under a few kgs of semiprecious carrots and cucumbers, I shoved my reusable walmart bag above me, forcing multiple plastic trash bins and various winter coats to yield to my arrival.

But I'm second guessing that decision all of a sudden as we've just now pulled out of the gate and already the bags of two passengers ahead of me have tumbled to the floor taking out an old Tuareg man in the process. I'm hoping the force of my wedged veggies will act upon the resistance of the parkas surrounding them, and stay put.

05:30
I've been trying to sleep, but there's just something about three clashing odors of incense that is keeping me awake. Or maybe it's Hajiya snoring in my right ear.

05:5o
We've just pulled off the road. 94% of the passengers have descended from the bus.

It's prayer time.

Carrying mats, beads and plastic kettles of water for washing hands, face and feet, my fellow travelers have filed onto the shoulder of Main Street (the sole paved road that runs east from Chad to Burkina Faso to the west), face where the sun has yet to rise, bow and pray.

07:08

I was just dozing off again as we made our first drop-off/pick-up. It wasn't the passengers shoving by that startled me awake, no it was the roar of the jet propelled air conditioner that came on overhead.

I guess this is why I was advised to keep my sweatshirt handy.

07:47
We are back on the road. An employee of the bus company is heading down the aisle...I guess this would be the equivalent of a commercial airline's beverage service: a homemade bean cake in a baggie and a banana flavored yogurt-in-a-bag!

I thought about asking for a diet coke, but the guy didn't seem to have much French.

As he made his way down the aisle, he pulled the plastic trash cans from the overhead storage and spaced them evenly between rows. And while I am thankful that we have all been encouraged to dispose of our rubbish in a conscientious manner, something tells me these are going to get the way when the time comes for me to disembark.

10:30
I've spent the past five hours sliding off my seat. One would think that if the left illiac crest of the pelvis is wedged beneath the arm rest, the body would stay put.

Throughout my training, I've always been taught, if you want to control the movement of the entire body, the pelvis is the steering-wheel.

Well, I'm sorry to break the laws of anatomy and kinesiology, but truth is, when the bench seats of a bus are covered with a thick plastic tarp, no matter how jammed ones pelvic girdle maybe, the slip-n-slide is inevitable.

Maybe it wouldn't have been so bad if big Hajiya hadn't occupied her seat as well as half of mine.

11:48

We are just minutes away from Galmi! Wow that went much quicker (and quieter) than I was anticipating. The old lady across the aisle on my left saw I was gathering my things together. She smiled and welcomed me to Niger. She told me she was happy I was here and glad to have seen me today on the bus.

One of my favorite things about living in WestAfrica is how friendly the people are. Warm and welcoming . . . wherever you go. Even big Hajiya, when she was awake and out from under her blanket.

21:01

I have a special souvenir from my bus trip . . . a nice big black-and-blue bruise on my left hip where my illium was crushed beneath the seat's armrest for seven hours.

I tried applying the just-push-till-it-gives rule to my seat-mate, but Hajiya just wouldn't budge! Next time I'm getting there early so I can find the tiniest little granny and claim her for the trip!

Knock-Off Magic

noreply@blogger.com (Deborah) — Sat, 03 Dec 2011 07:10:00 +0000

Late Thursday night, I put my mom on a plane and she went back home. The month went quickly, and she had a wonderful experience being here.

And when in Niamey, for whatever reason, it's important to take an extra day or two and run as many errands as one possibly can. Like taking advantage of having a small grocery store. Or checking out prices on garden hoses. Or eating in a restaurant. Or . . . well, all the things you can't do when you live in a big village.

My friend B. is leaving for a bit and was in need of some jeans. I needed to find some fabric for a friend, and so, together, we grabbed a taxi and made our way to Le Grand Marché (The Big Market). It's called Le Grand Marché because it's a huge outdoor market and you can find nearly everything imaginable (if you just look hard enough) as opposed to Le Petit Marché (The Little Market) where loud vendors sell fruits and veggies and bullion cubes and frozen chicken and plastic buckets and brooms.

How's that for Pay-Less?

But as is true to the nature of Open Air African Markets, Le Grand Marché is really just a crowded shopping-mall of stalls (instead of shops) . . . and the food court is actually kids wandering the street out-front selling roasted meat, bags of sugared peanuts, and an assortment of tomatoes, guavas, and onions from a tray carried on his or her head.

We weaved our way to the Mostly-Women's-Clothing Section. Stall after stall was wallpapered with slim-fit skinny jeans and tops most appropriate for a night club . . . not what one would expect from such a modest and conservative culture . . . but I guess that's the bottom layer under all the coverings.

My friend wanted jeans she could wear without having to paint them on in the morning, so it was continual strike-outs for the first half an hour.

Eventually we found a place that had a pair of what seemed to be almost-boot-cut. She gave them a try.

The man stepped out of his booth and pulled a rolled-up sheet down over the door to make her an improvised little changing room.

While she was in there, the vendor next door offered me some name-brand shoes at 'A Veddy Good Pryce.' I assured him I was only looking today, and turned away.

'Well, then, you need to look.'

'CRAP!' I thought, 'I need a better line! Like: Oh, I can't wear shoes like those, I'll break my ankles, and then my neck . . . but that may be a bit too complicated for my current level of Hausa.'

My internal dialogue was interrupted when the vendor insisted that I check out his 'name-brand' shoes. Feeling a little trapped, I glanced over . . . and nearly wet my pants.

It's a pretty lousy shot, but not bad for being discrete
with a camera phone!

Hanging there was a pair of women's shoes claiming to be Sketchers. What first tipped me off was that these weren't exactly Sketchers style . . . but then again, I haven't lived in the US in nearly 2 and a half years, and fashion changes.

So I moved in for a closer look.

The label was a fake.

It looked like it had been cut out from an advertisement . . . or maybe even a photocopy of an advertisement . . . and glued onto the inside of the shoe!!

I wanted to laugh out loud . . . but there are just some things that don't translate.

Being a native of NewYorkCity, I'm quite familiar with Knock-Offs . . . you know, brands like Prado and Catch and Okey . . . I mean, in ChinaTown they get it that we can all overlook a swapped out or dropped letter . . . in fact, it's what we've come to love and appreciate in our Falls-Apart-After-10-Minutes Knock-Offs. It's what we want. It's what we expect.

But a decoupaged tag?? That brings us to a whole new level of magic!

His Brain Is Speaking English

noreply@blogger.com (Deborah) — Mon, 28 Nov 2011 20:58:00 +0000

This morning I was asked to see a patient who came in for an operation and had a stroke while he was recovering. The doctor told me that he had left hemiplegia, so I knew it was right side (of the brain) involvement. But since we live in a world of Where-There-Is-No-MRI, I had no idea what to expect.

It's been a while since I've had a patient with an acute stroke . . . but it's like riding a bike. One with a cool basket in the front and streamers in the handle bars!

I met with my patient in the morning and again in the afternoon. The second time around both his sons were bedside.

They watched as I helped their father sit at the side of the bed and tried to evaluate his functional capacity as well as his physical and cognitive limitations . . . which is quite difficult when my questions translate as:

Where is hand of you? There is hand of you!

and:

You give car me . . . no . . . you give cup me! Good! There is car . . . no, cup!

I'm sure his sons were evaluating my cognitive functional capacity throughout the whole session!!

Let just say there was plenty of 'babu Hausa' to go around. Unfortunately neither of my patient's sons spoke English or French. Although, I did give both languages a try. They just stared blankly at me.

I tried again.

Still nothing.

Words were coming out of my mouth . . . I was telling them what they needed to know and do . . . but they weren't understanding because I was not speaking their language.

Eventually the whole sight was painful enough for my patient's neighbor, and he offered up the service of his elementary English.

The sons and I went back and forth a bit through our new . . . translator. They expressed that they understood some of the things I was encouraging them to do, and I asked if they had any questions.

They did: What happened to our father?

One thing I've learned as an OT is the necessity to take complex concepts and simplify them for the non-medically-trained to understand. I make big words small . . . just don't ask me to make them big again . . . or spell them. But despite my efforts at simplifying the explanation of a Cerebral Vascular Accident, or 'Stroke', the terms were still too technical for our translator.

I tried again.

It wasn't working.

My gut reaction was to express frustration at our lack of a common language . . . and that's when it hit me . . . their father's body was experiencing our same frustration!

'Right now, your father's brian is speaking in English. But his body speaks Hausa. So, we have to teach his brain Hausa again so that his body can understand what his brain is telling it to do.'

That, they understood.

Sure it doesn't answer the physiological question of 'What happened to our father?' but they understood that there has been a change in the part of the body calling the shots . . . and that the brain and the rest of him could learn to communicate again.

All thanks to our earlier attempts of failed communication.

I guess 'babu Hausa' really does come in handy!

When the Cultural Tables Turn

noreply@blogger.com (Deborah) — Thu, 24 Nov 2011 12:40:00 +0000

Yesterday one of my burn patients asked if she could leave for a day or two and then come back. I thought it an odd request, but today her baby turns seven days old.

According to the local customs, turning seven days old entitles one to a name and a big party, the biki. I've been to a few, and yes, they are quite a big deal. Excessive quantities of pounded millet and sauce are prepared for the early morning meal . . . everyone you know, and maybe some you don't, comes to celebrate the birth and the giving of the name . . . everyone gives a gift to the mother and she in turn offers a little goodie bag . . . and then a sheep is slaughtered, bled, and skinned.

Yeah, it's a pretty big deal.

A big enough deal that a woman with third degree burns covering three quarters of her leg wants to leave the hospital and come back tomorrow.

As an Occupational Therapist I was intrigued by this request. Being a holistic profession, in our practice we take into consideration all the aspects of a person's life and how their current state of injury, illness or disability effects, hinders, and impairs her ability to participate in the life she wants to be living. We ask the question 'what is important to my patient' and we use her definition of 'purposeful and meaningful' to drive our treatment planning.

To my patient, this biki was more important than her own health and I wanted to know why.

I turned to two of my Nigerien colleagues and asked a whole series of questions like:

Q: Why does it have to be today? A: Because it's seven days after the birth.

Q: But why? A: Just because.

Q: Why does the mother have to be present when she spends the whole time inside the house and not actually enjoying the festivities? A: To accept gifts and hand out party favors.

Q: Why the granny can't go in her place? A: Because it has to be the mom.

Q: Why can't the family just accept the gifts for her? A: (I never got an answer, just two shocked expressions)

Q: What happens if the baby doesn't have a biki? Will he live his whole life being called Jariri (Baby Boy)? A: What kind of a question is that?

Q: I still don't understand, why can't the family just accept all the gifts and explain that the mother is in the hospital and can't make it? A: .......

My last question was met with a question, and suddenly the cultural tables turned. Without realizing it, I went from student to teacher, novice to expert.

'Well, then, in your country who slaughters the sheep?' my friend asked. I blinked at him, 'I'm sorry, the what?' 'The sheep. Who slaughters the sheep?' he replied as he drew his thumb across his throat.

I smiled. 'We don't do that.'

'WHAT?!?! You don't kill a sheep at your bikis?!?!?!'

'We don't have bikis.'

'WHAT?!?! NO WAY!!! Then when does the baby get a name??'

'Usually the parents decide together on a name before the baby is born.'

'WHAT?!?! BEFORE THE BABY IS BORN!!! THAT'S CRAZY!'

And considering how many still-births there are here and how many children do not survive their first weeks, giving a baby a name before he has even taken a breath is ludicrous.

'So if you don't have bikis when do people give gifts?'

'We do that before the baby is born too.'

My friends were dumb-founded and confirmed with one another in Hausa that they were, indeed, understanding me correctly.

'So then you take the baby and present him at the church?'

'Yes, but not for several months.'

'WHAT?!?!?! So when does the family come to visit??'

I explained that in my culture when a woman gives birth, the last thing she wants is a whole of company hanging around the house. And that it's really only the family that lives close by, except for the parents and maybe the closest siblings who come right away. But for the most part, we keep our distance to allow new-mamma to get some rest.

The pair were completely blown away by this bazaar culture I come from. So I thought I'd really lay it on thick and informed them that in my part of the world, when a person is sick they prefer not to have visitors.

That was the last straw . . . sick people who want to be left alone?!?!?! Without the whole village coming and sitting on your floor, saying nothing, just staring at you?!?!?!

My colleagues had heard enough. They didn't want another word about this foreign land where babies are named too soon and a man with the flu suffers isolated from all those that love him.

Black Wednesday

noreply@blogger.com (Deborah) — Wed, 23 Nov 2011 16:48:00 +0000

Tomorrow is my most favorite American holiday, Thanksgiving. I love it because we eat stuffing and apple pie . . . oh, and because we get to be thankful . . . maybe I should have put that part first.

And the day after tomorrow, when everyone is eating leftover stuffing and apple pie, is Black Friday. They call it 'Black Friday' because so many people start shopping for Christmas and the stores have BIG sales and . . . well, I don't really care, because I never shop on BlackFriday. My STA friend Cool-J, however, is a BIG BlackFriday shopper.

But we live in Galmi, Where-There-Is-No-BlackFriday and Where-There-Is-No-WalMart. So, we improvise . . . today is BlackWednesday.

I'm not going to lie, I've never been so excited to face the crowds and shop-till-I-drop . . . granted the crowds we faced included sheep transported on motorcycles and I was dropped from the heat of the sun and slight dehydration. But, hey, it's all part of the BlackWednesday experience.

With MyMomma in toe and our Swiss friend (who comes from another mysterious part of the Where-There-Is-No-BlackFriday world), Cool-J and I lead the charge to the middle of the village and hit the market.

As we weaved our way through the aisles of stalls piled high with flip flops or stacked with raw meat we came to a slight clearing where a man was selling rock salt, dried okra, and . . . wait . . . what's that?? LOCUST!

Now, Cool-J and I have been making jokes back and forth about eating grasshoppers, and last week, she left a little back of roasted crickets on my doorstep. We haven't yet gotten around to trying them out.

We saw the big pile of dried locusts and stopped dead in our tracks. I smiled at the vendor and pointed to the pile 'Wunin abinchi ko?' (Is that food?). His smile answered for him: Of course dummy, why else would I be selling dried locust?? I blinked back at him, 'Ama, akwai bubba!' (But, there is big!) He laughed.

We asked the price. He asked if we wanted one bowl or two. We tried to explain that we just wanted three, one for each us . . . NOT a whole bowlful.

At this point we had drawn quite the crowd.

The vendor showed us how to pull off the wings and legs. I informed him that he had left the head intact. He nodded. I said 'Ama, akwai idu!' (But, there are eyes!) The crowd laughed.

We snapped a few photos, and then each took a bite.

It was crispy at first . . . but then as my teeth and tongue reached the gritty inside, it seemed as if I was chewing on tree bark.

I looked down at the remains of the body. It was gross.

Suddenly it hit me that I was chomping a great big BUG.

I wanted to vomit.

But I swallowed instead. Figured we already had drawn enough attention to ourselves.

I couldn't take a second bite. So, being the kind, generous, thoughtful daughter that I am, I gave the rest to MyMomma . . . considering I had saved the best part for her. Hey, I hear in some places locust eyeballs are a delicacy . . . and I left them BOTH for her!

The rest of our BlackWednesday adventure wasn't nearly as exciting as the start . . . except for when I bought an Obama holigrammed belt buckle for my brother for Christmas.

America, you can keep your Death-By-Shopping BlackFriday . . . cause this is how we do it, every Wednesday, Galmi style.

Why I am Not an Expert

noreply@blogger.com (Deborah) — Tue, 22 Nov 2011 21:30:00 +0000

Most of the moments I share here in this space are the unique misadventures that color my new life in Niger. The thing is, like everywhere else in the world, there are even more 'everyday' type events that have become mundane and even, dare I say it, normal.

I had a great normal-moment today . . . I made two men laugh while doing crutch training with a patient.

My patient was wearing a full-leg cast, and that much plaster makes for a heavy lever-arm for even the strongest of hip-flexors. In other words, it was near impossible for him to use the crutches without putting weight on his leg.

We started out alone, but within minutes four men from the hallway stepped in to 'help out'. Which really means they all loudly barked orders . . . uh, I mean . . . generously offered advice to my patient on how he should be walking.

The Last-Man-In forcefully insisted my patient do the exact opposite of what I had advised. I tried explaining why his suggestion wouldn't work. But, considering my massive lack of Hausa, my charaded discourse ended with a simple shrug of Babu Hausa (no Hausa).

I turned back to my patient.

He had stopped attempting to walk.

All four Nigerien voices were simultaneously rapidly firing.

I understood nothing.

As the four began arguing, my patient grew exasperated. They got louder and louder and he began to grow angry. I tried the diplomatic approach of ba komi (no problem), but I got quickly shot down by Last-Man-In.

Suddenly the quartet became a duo as Last-Man-In bickered with his new nemesis. I decided to take advantage of the moment and I quietly whispered to my patient, 'Toh, chigiba' (litterally: okay, continue; Deb.'s translation: QUICK! Hurry back to your bed while they're too distracted to interfere again!).

The true meaning of my words was not lost! The two men who had been excluded from the debate flashed me a knowing smile and began to laugh.

But you know, for me, this scenario has become a daily event. I have very similar interactions all the time as the older, male family members attempt to 'assist' me with my work.

At first it drove me CRAZY! But I have come to accept that the louder a parent is during my therapy sessions, the more he is trying to prove that he is concerned for and involved with my patient.

One day, I found myself wedged away from the side of a patient by an older relative. The first thoughts that ran through my head were 'WHAT IS WRONG WITH THESE MEN!?!?! DO THEY HAVE NO RESPECT FOR EXPERTISE!?!?!?!?'

But then it occurred to me that here, in the culture of my new surroundings, expertise is not determined by education, degrees, credentials, or the alphabet soup we string behind our names. Nope. In the village context, expertise is determined by a Y-Chromosome and a gray beard.

Guess that rules me out.

The View from Here

noreply@blogger.com (Deborah) — Fri, 18 Nov 2011 21:18:00 +0000

Nurses from the hospital giving babies vaccinations.

We spent the morning with the vaccination team in a local village. My Momma handed out Vitamin A to moms and babies. I wandered and took photos. We both made many children cry . . . simply by saying hello. Guess they don't get too many ghost-like faces in their neighborhood.

I went mainly to get a better idea of what daily life is like for my patients, since, for most of them, Galmi is considered a pretty big town. Thought you might enjoy the little village of Gidan Miko 1 & 2 from the other side of my camera. Enjoy.

Women pounding millet kernels off of dried stalks.

Women and girls pounding millet kernels into
powder to be cooked and then covered in sauce.

We drew quite the crowd.

But not everyone was happy to see us.

Many of the little ones are not used to white
faces, so having 3 of us there was quite scary!

Most didn't want to come too close and cried
when we smiled and said hello.

Others didn't seem to even notice we were there.

Todays inoculations included polio, tetanus, and hepatitis B.

Mommies of all ages brought their little ones for shots.

Dust-covered older siblings made for a captive audience.

The local greasy-spoon.

Fisher-Price, village style.

Everyone was incredibly friendly.

And curious.

My Momma and her newest African grandbaby.

The kids were surprisingly cautious at first, but then warmed to us in no
time.

They begged to have their photos taken.

And still some pretended to hide from the camera.

Last shot as we were leaving the village: a
little girl loads up her donkey with water
from the well.

Ride, Camel, Ride

noreply@blogger.com (Deborah) — Thu, 17 Nov 2011 20:03:00 +0000

There are two things I really hate: heights and riding on animals.

The way see it, if God had wanted us to be up high, on Day 8 He would have created skyscrapers. And if He intended for humans to ride on animals, He would have created them with saddles on their backs.

But He didn't.

Early Sunday morning, my mom and I took our pillows (no, not the ones we sleep on!!) and made our way to the airstrip where we we joined five friends to wait for the camels to show.

In Niger, the camel is a normal part of life. No matter where you go, you will find people transporting heavy loads on the back of their camel . . . even the middle of traffic in the capital city! And word on the street is that up in the desert they race them like horses.

I've been here nine months now, and had managed to avoid the only tourist-trap activity we can offer, the camel ride.

I think I've been offered at least once every six weeks to go, and always had the easy excuse of 'I'm going to wait until my mom comes' . . . but, like going to the top of the Eiffel Tower, when Momma actually shows up, I've got no more easy out!

We were seven, and the one-armed herder only brought five camels . . . one girl backed out immediately, and I quickly offered to go 'another' time . . . but the one-armed herder wasn't about to lose another paying customer. Momma and I could ride tandem.

Now, let me emphasize again . . . I HATE HEIGHTS!! And I HATE RIDING ON ANIMALS!! What the heck was I thinking climbing on the top of a camel's hump??

Getting our lean-back-lean-forward-cause-the-camel's-got-eight-knees
lesson.

The camel was laying peacefully on the ground as we climbed aboard. With my mom in the front, I felt like an African baby tied to her back. It could just be that I was bear-hugging her like a seatbelt as white-knucked-hands were gripping the harness . . . and the camel wasn't even standing yet!

The one-armed herder (he's only got one arm now because one of his camels bit him . . . yeah, and you're laughing at me for not wanting to go for a ride!!) gave us instructions: When the camel first stands, you will need to lean back, then when he stands all the way up, you will lean forward. We practiced.

What the one-armed herder didn't tell us, was that as soon as we had practiced once, the camel would stand.

Needless to say, we were caught a little off guard!

Priceless.

The last time I smiled before it was all over.

I spent the next hour trying not to fall off, laughing in sheer terror, and being told by my mother that I'm a complete pansy.

Best part of the whole thing: I had a good excuse to wear jeans.