Sunday, May 24, 2015

Getting out alive!

5/24/2015-  Ok, it's Memorial Day weekend now and I'm not finished with this blog! Life gets busy in the 1st World I guess.... So, it's not done but here it is. I may post a couple of humorous stories later that I would like to share. On the other hand, I may not!

Special an sincere thanks to all of the financial supporters through GoFundMe and my generous, missions-minded family of Elk Creek Church in McCall. Over $5000 was raised and supplied everything from 1st aid supplies to training materials to usable knives and the very 1st microwave ever owned by the CBC training center kitchen staff! Thank you all so much. The program we started exploded with popularity and support. Per the CBCHS Director, it will now be standard for all drivers to get the 1st Aid training and an emergency kit for all vehicles!


Thursday & Friday, April 9-10th:
 
     Thursday and Friday went by in a blur. Students in the final class began arriving full of energy and excitement on Wednesday night. A barrage of introductions to wonderful, smiling faces with hard-to-remember names poured into the rest house where our rooms were. I did my level best to plug their names into my mental Rolladex. Over years of being terribly forgetful, particularly with names, I've gotten good at faking it. In addition to all of the students, 30 plus expected, 50-60 doctors and nurses arrived for a two day conference finalizing a distance learning class on treating patients with HIV/Aids. There is still a learning curve in treating that disease in Cameroonian hospitals and clinics, but, as I've mentioned, they've made incredible strides. What's remarkable is how dedicated these people are to bettering themselves through education so they can serve their country and people. They are so driven to make Cameroon better- it's inspiring.
 
     The only drawback to their inspiring behavior is that the training center is a very busy place. Rooms were quickly full to bursting, the kitchen staff became overwhelmed- feeding 100 people out of a tiny, inadequate kitchen, and Paul and I lost our spacious classroom. We were moved to the  "Welty Building," second floor above Central Pharmacy. We had a more average sized classroom to stuff close to 40 students into and try to break into areas for practical sessions. The single AC unit above the window couldn't keep up with the body heat. We did our best to stay focused and engaged as educators and students in the hot, body-odor laden room. We were able to secure a couple of offices for skills stations. I don't know how anyone working in these office spaces can be productive with the nearly constant activity in their buildings. As everyone has learned to do when they're accustomed to not having perfect circumstances, they bent with the challenge like elephant grass in the wind.
 
     Class three was markedly different from one and two. The primary reason was that Paul and I gave the majority of instructional duty to our freshly minted trainers. Each trainer had at least one section to teach with some pregame coaching from Paul and I. Subject matter comprehension was better by orders of magnitude with students being taught in native tongue. Their practices were more comprehensive and efficient and we accomplished as much or more with a larger class and limited space. Proof that the train-the-trainer concept is such a successful model especially when a language barrier exists. I was impressed by our selected trainers' comfort and eloquence in the teaching role. They all demonstrated an uncanny ability to take complex medical concepts and practices and boil them into a logical and comprehensive coalescence. In other words, they're good at making hard stuff seem simple. Paul and I learned a great deal from their teaching style and terminology. I've no doubt the program will be propagated successfully in their hands.

     Difference number two with the final class was that it was attended by Pius Tih, CBCHS Director and Cameroonian "Big Man." As I've written before, Pius is an inspirational, humble and revered public figure here. I'm admittedly nervous to have him learning the bulk of our program from instructors who are teaching it for their first time. Pius was an engaged participant that added wisdom and support to the rest of the class of drivers. His demonstration of buy-in showed the students that they won't be "stepping out" in their new found skills without the full backup of the CBCHS. It was an honor to have Pius sit in and just be a student and, as expected from a truly inspirational leader, he made Paul and I feel like honored guests and accomplished educators. Pius, being the Big Man that he is, also added an undercurrent of excitement to class by inviting the NATIONAL new media to cover the inception of the Good Samaritan Program, something he truly believes is an important development in Cameroon. The media arrived on day two and Pius instructed me to perform a practice scenario from start to finish for the camera. I did so with my best efforts to remember each step and skill that we're preaching and to narrate it in a clear and concise manner while trying to stay in character. I have no idea how it turned out except to see it on Tom Welty's phone later in raw form. It was going to air several days after Paul and I returned home. I'm waiting eagerly to speak with the Weltys to find out how the attention was received.

     Our final class ended in an organized and jubilant graduation of a rather large class. Each student held their certificate up high and posed just a few seconds too long for photos, ensuring every camera had an opportunity to own an image of that glory. One of our students was uncharacteristically emotional to the point of tears during the ceremony. I was touched that it meant so much to him. Another student explained to us, however, that the man had found out just after lunch that his mother had died during the course of the day. He wanted to complete class before attending to his mother's remains and family business. The dedication when an educational opportunity is presented is remarkable. Penn Azamah, the Cameroonian native studying nursing in Maryland who I mentioned before, pointed out our casual American attitude towards education to me stating, "I can't believe that not everyone in America goes to all the school they can! My American friends just tell me that they don't really want to." As we chatted on the plane to Douala she expressed her genuine frustration at our flippant disregard of educational opportunities in the U.S. I understand now how cultural this belief is in Cameroon. An educational opportunity can make the difference between a nurse and a "free woman" here. It was humbling to teach such an eager group of learners and it made me want to do better for them all. We all parted satisfied with our efforts to make the roadways of Cameroon a safer place. Pictures were taken after class and email addresses exchanged. I extended heart-felt invitations to come visit McCall anytime to so many that if they actually all showed up at once my yard would like a refugee camp. I will truly miss them all though.

     Saturday and Sunday gave Paul and I a little time to explore without as tight of a schedule. We played another round of volleyball with the usual suspects. It was much warmer this time so we followed up with fresh picked mangoes from the super-security CDC tree and lots of water. After showers we jumped in a truck with Nurse John, new 1st Responder trainer, and a driver who could take us to the big market in Tiko. Paul and I wanted to buy a few more souvenirs for home including traditional African outfits for church the next day and more bottles of ground nuts to snack on. I also picked up a few knives for the kitchen staff in an effort to make their lives easier and their fingers stay attached longer.

     I retreated to my accommodations again to prep for the long 30+ hours of travel to start the following afternoon. Shower laundry in my trusty 50franc, thick plastic bag and preliminary packing. I hung my clothes in direct sun after chasing the colorful lizards out of the piles of dry leaves on the ground under the clothesline. I was acutely aware of the parasitic possibilities with line drying my "dress" (local vernacular for clothes that left me confused when someone told me I was wearing a "nice dress") outside, but with humidity hovering around 1000 percent I figured the sun was my only chance to avoid moldy clothes in my suitcase. These kind of afternoons are challenging when traveling in far-away places. I always try to milk every minute I have on foreign shores in order to become as close to local as possible. My family and I call it "checking off the map." It's nothing more than getting your money's worth out of the travel expenses. When I get home from trips and people ask the ubiquitous (and wise) question, "what was your favorite part of the trip," that mental goulash of memories proves that it's the small moments, the true moments with people, that resound. So on these final evenings when the last grains of sand slip the fastest through the waist of the hour glass, you feel that you don't have enough time to go explore and create those moments. If you're an OCD, 6-hours-for-one-bag packer like me, those last moments turn into folding your moldy, parasite-ridden clothes for the 4th time at around midnight. Again, that's when the malaria mosquitoes come out to play. Mom never told me that being an anal retentive night owl was bad for my health.

     Our last of Gladys' breakfasts and a quiet campus greeted us on our last morning. After two weeks enduring my zeal to learn about everything in Cameroon, I think Paul, Edie and Tom still liked me a little. We were all sad to end our trip and this rewarding project we've undertaken. I showed up in my traditional African dress (see, it immediately puts an image in your head) for breakfast, prompting "oooooooo, Freeeddieeeee. Thees ees very good, African dress." I was hoping to blend in with the local at the larger church service at the Baptist church in Mutengene. You know, the still pastey white guy that's eight inches taller than everyone dancing like Steve Martin in the jerk when he discovers "music" kind of blending in. I think the thought was too awful for my fellow travelers so we went for a walk instead.

     As it turns out, you can make those "moments" in small windows of time. And, they can be as ephemeral and permanent as a quick photo snapped at just the right moment. Beyond the back wall of our training center compound lies the recently developing CDC neighborhood where the expansive rubber tree plantations once were. Crude roads were worn into the grass and litter in whatever direction one of Cameroon's ailing vehicles needed to go. Surprisingly spacious and modern-looking homes with garages and security walls of their own were popping up along these roads like concrete-block-grey monuments to the peoples' wishes. Houses with arched doorways, columns, architectural window openings and shaded by colored tin roofs loomed empty on unmarked lots. Paul observed that the builders here must not use levels because window openings were often askew by enough degrees as to be noticeable. None of the new houses were complete and some were boarded or blocked shut permanently with ominous messages spray painted on them saying "project abandoned" or "not funded" or the like.
    
     The homes became more modest and long-standing as we closed in on the quarters closer to the highway in the East. Four small children ranging in age from about four to eight walked towards us, uphill on the road with their bare feet. They were carrying plastic buckets full of turbid water, the kind of bucket we might pick up at a gas station on the way to the beach because we forgot ours. They were fascinated by our white faces and friendly barrage of American-style greetings. They smiled, posed for our phone cameras then followed us with their eyes as far as a hundred meters while we walked away. They didn't stop waving and yelling goodbye to us until we were out of sight. They were the dirtiest, most beautiful little group of kids and I wanted to bring them all home and spoil them rotten. Who knows though, they may feel spoiled rotten already. We can't impose our standards on everyone right? The next walker we passed was a badly disfigured man with terrible traumatic scars to his head, face and neck. His hands were barely usable stumps. One of his eyes was large and bright while the other was forced to an ominous and uneven squint. He did his best to mumble his "good morning" and a few other inquiring words to us as we passed. Paul and I somberly speculated as to the nature of his trauma based on the more dangerous forms of labor we've learned of here. Could've just been a car wreck that an angry mob decided to light on fire instead of assist.

     We found the well that the kids had dipped their water from. It was a concrete block, barrel-shaped, open well to an inky-black wavy pool at the bottom.
 





One of the volleyball kids picking us mangoes from the top of the high security U.S. mango tree. Best mangoes ever.


My friend "Smiley" managing a quick cell phone chat while balancing five dozen eggs from the market.

A fancy Sanili motorcycle with only two men on it! The motoumbrellas were common and are shaped to accommodate multiple passengers. Dude wasn't happy with my entertainment in taking this picture.



The Baptist Hospital Mutengene Pharmacy. This is where Dr. John whipped up some medicinal cream for what turned out to be standard issue sun reaction rash catalyzed by malaria medication, confirmed by a P.A. at our clinic in McCall. No parasites thank you.

Not up to American pharmaceutical labeling standards, but, I trust my Nigerian Dermatologist- Thanks Dr. John!



Public Service Announcement Cameroon Style. They're still trying to educate everyone on the efficacy and availability of vaccinations in stopping epidemics that we haven't thought about for a hundred years in the U.S.

We treated ourselves to some "French" pastries at the boulangerie on our last Saturday night. They actually had cold Heinekens! Who knew it was a dessert beer?


One of our adept trainers who will take over stewardship of the 1st Responder Program, Nurse John, holding one of his twins. He has one older girl who is also adorable!


Gladys, Edie and Annette gettin' low. There was singing along with this dance.

Paul and I with our gracious hostesses. Great cooks, guides and mothers to us while we visited.


The long walk to the quarter 11 open well for a bucket of water. Toughest little feet around and the softest hearts. Cameroonians are the most genuine and gracious people I've ever encountered.

Well in Quarter 11. This is a new neighborhood and farming development seeded by the Cameroon Development Corporation (CDC). They cleared acres of rubber trees that had outlived their productivity and offered the ground to settlers for farming.

In lieu of church our final Sunday morning, we walked the dirt paths of quarter 11 behind Mutengene. People were getting out of services and walking home in their Sunday best. These four girls weren't sure about us following them but they liked to have their pictures taken in their outfits!


Banana and unknown, dried, sinewy meat product that no one could identify. It's for sale though.

Cameroonian Ice Cream Man?! From Alaska no less? This guy set up shop behind a church during service when all of the parents were inside and kids outside. Brilliant!

Church nursery. Send 'em outside.

The ice cream man spoke only French. My French wasn't good enough to ask what flavor these were.

A common sight on Cameroonian roadways. Edie emailed me a couple of days after I arrived back in the States to tell me about a young man on a motorcycle who had been hit by a car in Mutengene. The man was injured but a crowd gathered to beat up the car driver who they believed to be at fault. The next step, logically, is for the mob to set fire to the car of the party at fault. Happens frequently and was discussed as an impediment to patient care in all of the classes we taught. This car is one such victim.


 
 
Dr. Tom Welty warms up the third and final class. CBCHS Director Professor Pius Tih, seated in yellow at the front tables, honored us by attending our final class.

Lead instructor of our trainer group, Promise Yosimbe, a skilled and amazing nurse from the Baptist Hospital Bamenda many hours north of Mutengene. He is an impressive natural teacher.

Annette prepping okamobong leaves for lunch.

Chopped cow beef finds its way into many side dishes. They cook beef to very well done which is good since it sits in hot plastic bags for some time before it's prepped. Nothing on a cow is wasted. They eat the skin, nose, even the hooves.

I saw 80 y.o. women carrying more than this. How the heck? I'm certainly not going to use my cell phone with 50 pounds of plantains up there!

This Eveline. Another fantastic RN and gifted teacher. When she talked, we listened!

A common vantage that Paul and I had while offering ourselves up as practice patients.



Practical skills stations were crowded and rushed in all of the classes due to larger than expected numbers of students. They made up for the lack of practice repetition by being passionate and zealous during their turns. Great imaginations.


The honorable Prof Tih modeling the space blanket for trauma victims.



After Pius graduated and received his diploma, we presented him with the Idaho State flag that had been retired from service at the McCall Fire Station as a gift for hosting Paul and I and facilitating a CBC-wide training. Prof Tih brought in the national news media for us to demonstrate the system we were teaching to all of Cameroon. It aired after we left.

Our five instructors from left, Promise, Emmanuel, Eveline, John and Divine (all nurses) holding their Good Samaritan 1st Responder Trainer certifications. Certificates are a HUGE deal for students as it proves education and achievement. It is a source of pride and honor for their whole family. My friend and only non-nurse trainer, Denis, had to leave prior to the photo.

A gesture made by every student! Celebration of a certificate and education.

Prof Tih's personal driver and head driver for the CBC, Edwin. I spent some time with Edwin outside of class and campus in town one evening. He was one of our most engaged and bright students. A true asset of the CBC and 1st Responder program.

Prof Tih presented Paul and I with the custom-made, fine wax cloth of the CBCHS as a gift of gratitude. I plan to have scrubs made out of my fabric! Just getting to know the people there and learning about their culture was gift enough.


Some of the guys flossin' after graduation! The blue tarp roll on the right is the 1st Responder kit that will eventually be standard issue in all CBCHS vehicles. The tarp serves three purposes- bag for supplies, patient stretcher and vehicle protection from bodily fluids and contaminants.

Tomatoes covered in corn husk for freshness. About $5 for a large basket.

Mutengene tomato market. This space was on the road side on the way to our compound. You'd see a variety of produce and goods for sale here. Just happened to be tomato day.
 
777 to Paris. Such a huge, modern plane seemed like a glaring contrast to my experience over the two weeks of my stay.
 
 
 
Charles de Gaulle airport in Paris is fancy and oh so...Paris. The glamour of it was like a bucket of ice water to the face after Cameroon. This sculpture in the concourse reminded me that putting your feet on the ground to experience the corners of the world with your own senses makes the Earth seem so much smaller, and your mind much more open.