Brave Woman

Adventures of a future nurse-midwife

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Even the Fruit Has Teeth

Posted by Lucille on June 4, 2011 at 12:55 AM Comments comments (0)

Meet the jaw fruit, which is the size of a soccer ball, covered in shark-tooth-like scales, and can kill you by dropping on your head. Evolution had fun with this place.

Space Bubble

Posted by Lucille on June 4, 2011 at 12:55 AM Comments comments (0)

We went back to Sanyang today. It was nice and deserted at first, but then several buses worth of boys, maybe 10-15 years old, showed up. Someone had brought a ball so we all got in the water and started playing keep away.

One boy grabbed me around the waist. I removed his arm and kept playing. He grabbed me again. (I assume. I had sunscreen in my eyes during half of this, so I'm not actually sure if it was one boy or several.) At that point a wave went over his head and he started freaking out, and I realized he couldn't swim. He was grabbing at everything around him, including my breasts (which I think was intentional), but seemed genuinely in distress so I let him grab my shoulder so I could guide him to shallower water. Which was fine until he tried to slide his hand between my legs.

So I drowned him. Since I could swim and he couldn’t, going under the water seemed like the logical thing to do, the only way that I might get an advantage. Except then he started panicking and climbed onto my back, and kept trying to get his hand where it shouldn't be. He wasn't messing around, either. He was strong and it was clear he'd done this kind of thing before. He put his finger in my butt by accident and pulled back for a moment, but then kept trying, reaching and reaching while I strained away from him, pushing helplessly against his arm while trying to stay afloat, and way-too-calmly trying to map routes to shore.

I think I thought about calling for help. There were other girls from my group around me, but there were more of the Gambian boys, and I was afraid of escalating things by getting anyone else involved. After that it didn’t occur to me again.

I thought I would go into fight-or-flight. That’s what people tell you happens when you’re actually in danger, that you get an adrenaline rush and temporary super strength. The opposite happened. Maybe it was because he was so much younger than me, but that aggression didn’t come. Instead I was calm to the point where it felt like I was watching myself struggle against him from above, mildly amused and just waiting to see what would happen next. It’s pretty hard to fight someone off while you’re in the water, but this was more than that. My body wasn’t obeying me properly, like in those dreams where you run like you’re going through quicksand. I had no power.

And still we struggled, him trying harder and harder to reach where he could hurt me, and me fighting through a mental shut-down so I could keep straining away, and trying to keep his head underwater because I knew I had more air.

And then our group leader was there, looking absolutely fierce. I couldn’t hear her words, but the boy let go of me, fast, and disappeared. I made my way out of the water and back to our table, where I met the rest of the group.

Someone asked me if I was okay. I said yes.

Some of the other women from our group were upset and telling the men from the lodge that the boys had grabbed their breasts.

“Oh ho, she is afraid of the boy children!” one of the men teased.

Don’t,” I said. I don’t know what my face looked like or my voice sounded like. I felt utterly calm. But he immediately apologized, offered us extra towels, and got up to get us some more water. Where had that fierceness been five minutes ago?

My brain slowly started going through what had happened, in a detached, numb sort of way. The boy didn't succeed in what he'd been trying to do. He didn't hurt me. He was really young, maybe 14, so I bet violation is something he's had to deal with as well. My mind and body were thawing, and I started to feel again. Instead of anger, or fear, what I felt was grief, and pity. My instinct was not to fight him, but to hold him, rock him the way you would calm a terrorized child. I wish I could undo whatever trauma led to that behavior, but that's not within my power. I can't heal the world.

I wasn't sure if I wanted to write about this part because I don't want you all to worry about me. But it was part of my experience here so I'm going to include it. More so than being bothered by what happened, I'm bothered that I'm not bothered. That's the kind of situation where you're fully justified to freak out. I would have expected myself to panic and start screaming. Instead I made my way to shore, went back to the table, and finished eating my trail mix. Part of it was energy. I don't have enough energy left. Part of it is comparison. I'm not giving birth on a table or watching my brother have a seizure so I don't think I have much to complain about. Part of it is also circumstance. In the US I probably would have freaked out. Here I've gotten used to meeting things as they come and moving on from anything that isn't an immediate threat. I don't want to do that, though. If you go into survival mode you can't learn, which is the whole reason I'm here.

On the bright side, I didn't get a sunburn this time.

Not Cool, Brain

Posted by Lucille on June 4, 2011 at 12:55 AM Comments comments (0)

I had a dream I got HIV. Very relieved to wake up from that one.

I'm Famous!

Posted by Lucille on June 4, 2011 at 12:55 AM Comments comments (0)

We were in a restaurant last night with a TV in the corner and saw me in a crowd shot. I was on the Gambian national news!

Outpatient

Posted by Lucille on June 4, 2011 at 12:45 AM Comments comments (0)

The head of the hospital was gone today, and everything went to hell.

It was supposed to be my first day in outpatient. When I got there, people were moving chairs around, rearranging bottles, and stacking books. I sat down, and after a few minutes everyone had left. I waited an hour. Finally, a man came in and motioned for me to come into his office. Some nurses joined in and sat down. I waited another hour. Patients started opening the door, and the man waved them off. "We're not seeing anyone now." I finally asked what we were waiting for. "We're on strike."

Oh. Well, then.

They said that someone is supposed to clean the outpatient room every morning. Today, no one cleaned it, so they went on strike. "It's filthy in there," they said.

I looked over their shoulder, and it was filthy, but about the same as everywhere else. "It's dirty in the other wards," I said.

"Yes, it's filthy. We cannot work where it's filthy, it's not good."

Word must have gotten out about the strike because patients started banging on the door. One woman came in yelling, "I am a teacher, and when I get to school in the morning, even if the floor is not swept I start my work! You people are just sitting on your asses while there are patients out here who need you. This is not correct!" The man told her firmly to get out. I didn't like that the patients were grouping me in with the nurses, so I left and went to maternity for a while.

All of the women needed to be transferred, so we talked with the midwives. The head of the maternity ward was beaming and told us she's getting married later this month. Our whole group is invited.

Someone eventually mopped the floor in outpatient and work began. I was paired with a student from Senegal so most of the morning was in French. We had a man who had not spoken or moved in 3 months. They diagnosed him with depressive syndrome and said it was caused by thinking too much. I hope that's code for 'we don't have a clue', because otherwise I'm in serious danger.

The door burst open and a group of people came in carrying an 8-year-old boy who was having a seizure. They moved toward one of the tables, and I saw that there was a bloody needle on it (not attached to a syringe). I tried to point it out to a nurse, but she didn't do anything, so I grabbed the needle and put it in the sharps bin just as they set the boy down. The student from Senegal looked horrified. "That is very dangerous," he said, switching to English for emphasis, "You understand? Very dangerous!"

I know, that's why I didn't want them to put a seizing kid on it.

I only touched the plastic part. I didn't touch the blood and I definitely didn't get a needle stick, so I'm sure I'm fine. It was just a scary moment. I realized in a split second that someone was going to touch that needle, and it was either going to be me or a seizing kid. I'd do it again but I sure hope I don't have to.

They gave the boy a muscle relaxant to stop the seizure, and there were a few minutes of chaos while the Spanish-speaking doctor, the French-speaking student, the Mandinka-speaking nurse, and the Fula-speaking family all tried to figure out what had happened. He hadn't had a seizure before, so they concluded he was diabetic, but they didn't know if he had high or low blood sugar. No one knew when he had last eaten so they took a guess and put him on a dextrose drip (diluted glucose).

The boy must have bit his tongue because there was blood dripping from his mouth. His dad tried to wipe it away with his hand and I grabbed a tissue from my bag to help him. (No, I didn't touch it. There is to be no contact with other people's body fluids on this trip as far as I'm concerned. On Monday I'm insisting someone find me a pair of gloves.) Then the door burst open again and a boy came in. This case was already feeling close to home because the boy was around my brother's age, and then this boy who looked around my age came in saying, "My little brother...they called me, they said he just fell down. Is he okay?"

No one else answered him, so I told him he was doing better. "But I'm just a student," I said, "I don't really know. But the seizure's stopped, and that's good. I'm sure the nurses know what they're doing." I was careful not to promise anything, but I could tell that he didn't listen to my mumblings about not being sure, though he nodded fervently whenever I said something to the effect of his brother doing better. He was the only one in his family who spoke English, so we worked together to relay information to his parents.

After a few minutes, the boy still had not regained consciousness, so they transferred him to inpatient. Apparently there are no stretchers, so this was done by disconnecting the IV and telling his parents to carry him to the next building over.

Our next patient was an 8-year-old girl. She came in tied to her mother's back the way they usually carry babies, whimpering. Her stomach was bloated and her mom said she couldn't go to the bathroom. Just then the nurses decided it was time for lunch. One woman looked like she was staying, but then she walked to the door. "You'll be okay by yourself, won't you?" I told her I didn't know what to do, and she said, "That's okay," and left.

I was alone with a woman and he whimpering daughter, both of whom were looking at me like they expected me to know what to do. I stayed for a while, but the nurses didn't come back, and the silence broken only by the girl's cries was killing me. I left to check on the boy in inpatient.

I touched his brother's arm and he made room for me at the bedside and took my hand. I’ve avoided holding hands with anyone even though I know it’s not a romantic gesture here, but this time I didn’t hesitate. I identified more with this boy as we watched over his little brother than I have with almost anyone else here, and it felt important. The electricity cut out. The hospital doesn't have a generator, so everyone took out their cell phones and made a circle of light around the boy so the nurse could set up another IV.

I have no idea if, pragmatically speaking, well-wishers do any good. Medically I knew I could do nothing for him. But I felt a strong desire to be by him and thinking good thoughts, so that's what I did. Maybe it was a comfort to his family at least.

His dad called his name. The boy turned toward him, then went limp. His dad called his name again. After a while he stopped responding.

It suddenly hit me what I was seeing. "Oh my god I can't watch an 8 year old die." I made my excuses quickly and went to calm down.

When I came back to outpatient, a line had formed and the nurses were back. They were tending a man with anemia. I grabbed one of their hands and directed them to the whimpering girl, then left to check on the boy in inpatient.

When I came back the girl had stopped crying and was putting her shoes on. Her belly had returned to a normal size. "What did you do for her?" I asked.

"Nothing," he said, "I told her she might need surgery, and she went to the bathroom."

Whatever works.

It was almost time to go, but I went over to inpatient to check on the boy a last time. He was sitting up and drinking a glass of water.

Next I'll Be Writing My Name in Snow

Posted by Lucille on June 2, 2011 at 1:40 PM Comments comments (0)

I needed to go to the bathroom when I was on outreach, and when I got there, it was a tiny hole in the ground in a stone cell, the floor of which was covered in diarrhea. I knew the general idea was to squat over the hole, but I couldn't figure out how to do that without peeing on my pants. Then it hit me-- that's why the women wear skirts. I think I just solved a major piece of fashion history. So I'm standing there, wondering what to do, and I remember that I bought a 'feminine urinary director' at REI (mostly because I thought it was funny) and stashed it at the bottom of my bag. Hallelujah. I felt like I was in a sci-fi show, but it solved the problem. I think it needs a name.

4th of July

Posted by Lucille on June 2, 2011 at 1:40 PM Comments comments (0)

For 4th of July, we all walked to Gateway, the convenience store (not a store…the store) on the other side of the market, and our group leader bought everyone ice cream bars. The chocolate was amazing and the ice cream reminded me of when I was seven running around sticky at the fair. We should definitely do that again. Happy independence, everybody!


It's Official

Posted by Lucille on June 2, 2011 at 1:40 PM Comments comments (0)

This is the longest I've been away from home, ever. I told someone that I was homesick, and they said, "Man, already? How are you going to handle college?"

I have no idea. Hey Mom, Dad, what colleges are in Portland again?

You Are Here

Posted by Lucille on June 2, 2011 at 1:40 PM Comments comments (0)

We continue to delight in learning the intricacies of this culture. Whenever they don't know what to say, Gambians love saying each other's names in song-song voices, as a show of affection. "JAI-naba!" The proper response, we eventually learned, is to sing their name back to them. They also love stating the obvious. "You are taking breakfast." "You went to work." "You are back." I grew to love these exchanges; they felt welcoming.

"JAI-naba!"

"A-na!"

"You went to work."

"Yes."

"And now you are back."

"I am. You are cooking dinner?"

"Yes, come and see."

Because this was new to us, though, it was a constant (discreet) source of amusement. My personal favorite: as we ran into the lodge during a downpour, water spraying around our feet, our wet hair stuck to our faces, one of the men who was with the others sheltering in the common area looked up and said casually, "It is raining." We all burst out laughing.

Queue

Posted by Lucille on June 2, 2011 at 1:35 PM Comments comments (0)

Sorry I haven't posted in a while. The Internet's been terrible. I went to the Internet cafe and my computer wasn't working, so I found the person at a working computer with the least amount of time and waited behind them. When they got off, another person slipped in front of me and sat down. I tapped him on the shoulder and politely explained that I'd been waiting for that computer. "Oh," he said, "Well, I need to use it." I repeated myself more firmly, and told him that another computer would open up in a few minutes. "You see," he said, "I have to use this computer, because it has a program I need for work." I told him that was funny because I was pretty sure all the computers had the same program. "Actually, it's not a program, it's a download."

I looked pointedly at the 'no downloads' sign on the wall. "That's fine," I said, "Let me just check with the person at the desk." When I explained, the person at the desk threw his hands in the air with a, "Hey, I just work here" expression.

Now I'm usually a very patient person, but I was upset, especially because I had the distinct impression that would have gone differently if I were male. I sat in a corner waiting for a new computer to open up. Two minutes later the guy who 'needed that computer for work' had traded to a different computer and was on a gay dating website. Honestly I was a little impressed that he was brave enough to go on there in public, since homosexuality is punishable by death here, but mostly angry because I wanted to email my parents, for Pete's sake. A computer finally opened up, and I rushed over, logged on, opened gmail-- and the electricity cut out.

But, hey, I'm online now.


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HIPAA Disclaimer

Sometimes I have the privilege of being a part of intimate, powerful moments in other people’s lives. I cannot and would not share these stories, because they are not mine to tell. However, they touch my life and become part of my own story. When I share these moments here, you can trust that I have not broken anyone’s confidentiality. The characters are invented. They are not real, but could be. I take creative license to communicate the essence of my experience while respecting the privacy of others.