It Takes a Village

We have discovered in our time in Africa that family relationships have a whole new meaning here. I suppose it has something to do with the generally close proximity that families live to each other. Most kids grow up with numerous extended family members within a 5 minute walk. The villagers here don’t seem a bit confused by how everyone is connected, but frankly, it confounds me.

One problem is that we rarely see a father, mother, and all of their children together in one place. And who they call their children may not be someone who was born between a husband and wife. Namesakes can be called kids, as well as nieces and nephews. An aunt might be called a small mom and an uncle a small dad.

I can’t tell you how many times this has happened to me – someone will come to my porch asking for help with money. I will say to them, why don’t you go ask your father? He is dead, they will reply. Okay, what about your mother? She is dead too, is the answer. We go through the whole line – this person will appear to be an orphan. But the following week or month, they will come to me and say – did you hear that my dad (or mom) died? What??? I thought you didn’t have any parents left. Oh, they will say, this was my small dad, (or my small mom) that died! Um….okay.

Kids are often left in the care of grandparents. Many times it is grandpa or grandma who brings a sick child to me. Because women give birth in later years, I try to clarify – is this your child or your grandchild? Sometimes they think that is really funny – other times they act offended. Sometimes they seem really irritated that I can’t figure out who goes with whom. This week a woman said – Don’t you know that she is my grandkid? Sorry, not so much. I am trying so hard to figure out how everyone fits together….

Then you add to the mix wives and co-wives and it gets even more confusing. (On a sad note, the word for co-wife is, at least to my toddler ears, suspiciously close to the word for bucket, okra, and broom – so as a general rule I try to avoid saying it – in an effort to not embarrass someone – myself included! When referring to a co-wife, I say, you know, your husband’s other wife….)

Another interesting family dynamic is that children here belong to the husband. As it has been explained to me (here is your birds and bees lesson – Yalunka style), the man simply implants the entire baby into the woman and she is kind of just the incubator. Therefore, if a child is born out of wedlock – or a woman leaves her husband and returns to her family, the kids stay with dad – as long as they are weaned. They are his property.

Another issue we face is that many people have the same names here. So it is confusing to figure out who someone is referring to. They will be talking about someone and say – you know, Fanta. Since I know about 15 Fantas in town I need more to help me clarify it. So they will say something like – you know, Fanta, the one with the yellow husband who fell out of the tree the other week and broke his leg. Oh, that one……. We personally have names for people so we can tell them apart – we have Bread Foday, White Ali, Nice Teeth Kuta, Peanut Sana, etc. It is simply a way for us to clarify who is who. The villagers don’t have the same problem with us – since we are the only white people around.

I do love to see the interaction between people and it is so great for kids to grow up in close relationships with their families. Now if I could just plot everyone on a family tree……

BYOB

Now, before you report me to the powers that be, this does NOT stand for Bring your own Beer…. Lately I have been reflecting on the life we live here in Guinea. It is a crazy place, I have to say. And I am always amazed by the communal aspect of village living. Everything is shared. I guess, then, I should not be surprised when I am called on to give out of my supplies…..

When I go to baby deliveries, I now carry baby blankets (BYOB – Bring your own blanket). After the baby is born and washed, there rarely seems to be a clean cloth to wrap them in. I spent months being frustrated about this fact – it is NOT like a delivery sneaks up on you – typically there are many months to prepare and 8 -12 hours of labor to locate a clean cloth. But alas, it is a battle that I often lose, so instead of being frustrated, I just take my own.

At my own house, things are worse. I had a young boy arrive recently with a smashed foot. Sadly, he got injured out in the bush (a piece of wood fell on his foot, smashing the 2 smallest toes – completely exposing the bones) so he was forced to walk to town and then, because the injury looked so bad, everyone was afraid to wash it.

So they brought him many miles away to me. By the time he arrived, the mud/blood was ground in and caked on and dried. I tried and tried to scrub it clean, but to no avail. Finally I decided that I needed to soak it. I couldn’t find my normal soaking container so I took off my gloves, washed my hands, went inside, and started going through my Tupperware. I finally found one that would work. I was reluctant to sacrifice it, but what could I do. The whole time I was muttering under my breath – you know, doctors in America don’t have to give up their Tupperware (if you read my blog posting about containers, you will know that they are important to me).

That is not the only thing to go out of my house. I use my aluminum foil to wrap medicine and send home ointment for dressings. My vinegar is used to make a medicinal wash for women. My precious Karo syrup is used for cough syrup and constipation for babies. Vegetable oil is used to soften ear wax. When I run out of a particular medicine for the village, I usually dig into our family stash to fill the need. I have ripped up sheets to make splints and sacrificed pillows for transport of an accident victim.

When I have sick people who are not eating, I will give them oatmeal (this is NOT as much a sacrifice as I think that oatmeal as a cereal is disgusting – though it is NOT bad in monster cookies…..) and milk powder and sugar. For people with colds, I give them mint tea. Old socks are used to cover feet dressings and many times I have had to dig through my kid’s closets to get a shirt or pair of underwear or something for a patient. I also pass out Q-tips to apply medicine in the mouth.

Occasionally I feel crabby about this aspect of village life. But usually something happens to change my perspective. Someone will show up with a pan of rice, or peanuts, or a chicken to say thank you for helping them. They will bless me over and over and tell people how much we did for them. They come by to say thank you and somehow that makes it better. I think it really is more blessed to give than to receive.

Eavesdropping

Have you ever overheard someone talking about you? It happens to us all the time. People in general are intrigued by tubabus (white people) and discuss us at great length. If they talk about us in French, English, or Krio, we can often understand them –though many times they don’t realize that – especially if they are not used to being around us. They talk about our kids and they talk about what we eat and what we wear. When I am in town, learning how to cook like a Yalunka woman, they stop by and talk among themselves about what I am learning – usually very pleased that I am trying.

On the porch, with my medical work, I hear lots of things. Sometimes it makes me crazy. The rule (laid down by the health care worker who is over this area) is that I am not allowed to see adults unless they have been seen somewhere else first. The goal is to NOT hand out free medical treatment to EVERYONE– in an effort to encourage people to finish the clinic built here in the village that is almost done. This clinic will, in turn, benefit lots of people – whether we are here or away.

People seem to understand that I can’t treat adults – and are not offended by it, until it applies to their family. Then they think that I should make an exception – just this once. And they promise to not tell a soul that they received treatment with me. Shhhhh….. Of course, I say no, I am so sorry, I can’t help you. But if you go to a hospital and get treatment and are not better, then please feel free to come back with your papers and I will see what I can do.

That starts the talking…… She won’t help people, they say. Only kids, they mutter. We don’t understand why she won’t help…. they exclaim. Her medicine is good and she won’t give it to us… they complain. They are usually talking among themselves, but loud enough for me to hear. It is always hard for me. I spend so many hours treating patients, and yet, they fuss when I have to say no. I know that none of the hundreds of other people I have treated that month means anything to them when they have a desperately sick relative who needs help. So I do get it. But I still hate it when they talk like that.

Sometimes I don’t understand what they are saying. A while back, I heard them talking about me. They said, Gulunga’s hinnana is BIG. Everyone was agreeing – yes, they said, it is really big. Okay, I admit I was a little self-conscious. I had NO idea what a hinnana was – but I wasn’t sure it was a compliment. I finally got the courage to ask a more experienced missionary.

So, I said, I have this friend with a big hinnana – what do you think about that? Okay, actually, I didn’t. I said, So, I heard a new word the other day and I don’t know what it means. Then I confessed that people had been using it in reference to me. I waited in fear….. Turns out it is okay. Hinnana is compassion – so it is okay to have a big one. :^)

Yesterday, my eavesdropping netted me a huge smile. I was seeing a patient from another village – a girl who is around 10 years old and has been sick for several weeks. As I questioned the mom, I asked why she had waited so long to seek treatment. She informed me that she had bought medicine from the market but that it didn’t help. My friend was sitting beside her and looked at me as soon as the mom said that – knowing what was coming……. I took a deep breath and started in on my speech… here is the gist of it:

You know, those people who sell medicine in the market are SUCH nice people and they have good hearts, but they are NOT doctors (here I jump over the fact that I am also not a doctor – a fact that seems lost on everyone here….). Many of them can’t read and when you get medicine from them, you will probably just waste your money and your child won’t get better, or worse, your child could die because they gave the wrong medicine or too much of it. So, the next time your child is sick, please save your money and go to a clinic or come here to see me.

I finished my speech and continued assessing the little girl. I headed inside to get the medicine she needed. And I heard my friend on the porch start in on the mom. What Gulunga (me) said was true. You should never go to the market to get medicine for your child. It is a waste of money. All of the moms here in this village know that now. Even if you have an adult and you go and get medicine at the hospital, you should bring the medicine here to Gulunga to look at for you.

At this point, another lady jumped in – Yes, what Sayon (my friend) said about Gulunga is true. And we do bring our medicine here. Why, just last week the chief got sick and went to the hospital and got medicine and then he brought it here to Gulunga and she even took some of it away from him. (She was telling the truth about that. The chief had returned from the hospital with about 15 different medicines, most of which he was not taking properly. So I helped him sort it all out and took a few duplicate medicines away from him until he finished the first round. Apparently word was spreading about that.)

Later, at the end of my work day, I had already said I was done seeing patients when a family drove up from about an hour away. Sayon, one of our believers who often helps me on the porch, BEGGED me to see the kid. I was exhausted and on the verge of getting fussy (okay, perhaps I was a little past being on the verge). Finally I consented, though I was NOT happy about it. I saw the baby, asked all about symptoms, weighed him, and went inside to get medicine.

It sounded like a simple case of malaria – Fever at night with no other major symptoms. I could hear them talking on the porch, and Sayon didn’t seem happy. He was giving the dad a lecture about something he had said or done and I had the feeling I was about to get involved. I went back out to give dad the medicine and explain how to take it. I got finished and the dad spoke up. By the way, I forgot to tell you that the baby also has breasts coming out of his ears. (This is people’s way of explaining that the baby has an ear infection – because most kids are nursing when they get them, they have the idea that breast milk or some part of the breast has fallen into the baby’s ear – and then leaks out – because often there is pus draining from the ear.)

Sayon was looking at me. I was getting fussier. I asked why he didn’t say that at the beginning. He didn’t have an answer. Sayon said, I told him, when you go to the doctor, tell them everything all at once – don’t hide things. At least someone was listening to me. That happens to me all the time. I will dress a wound, and get all finished and then the patient will say Oh, I have another place where pus is coming out too. Or I will put a Band-Aid on a kid’s leg and then the mom will say, did I mentioned that he has been vomiting for 3 days? It makes me insane sometimes – something that the guys well know.

Some days, I tell Jim that I would like to be a fly on the wall and hear what people think about us. Actually, I probably wouldn’t. For now, I shall just content myself with being thankful when I hear my medical instructions being repeated over and over, knowing that those seeds have taken root. And try not to take it to heart when people say less than pleasant things – knowing that they are probably not trying to be mean, just trying to understand the confusing ways of the tubabus.

Day in My Life

This week has been insane – really, it has felt just out of control. My daily lists have fallen by the wayside as I have attempted to keep some semblance of control over my life. I am sure whatever semblance of control I had was a simple mirage, but it made me feel better. The week was filled with emergencies – both in the village and a late night trip to SLM to see a missionary kid who was sick – and complicated medical cases – all piled on top the daily routine and work of life here in the village.

Thursday was an example……

I woke up at 6:30 am with a kiss from my husband who was heading out for a jog. I dozed back to sleep and finally dragged myself out of bed at 7:30. In order to feel relaxed with my time with the Lord, I got a few jobs out of the way first. Thursday is laundry day, so I prepped the machine, pulling all the buckets and other things that get shoved in our outdoor laundry room, sorted the clothes, and got the first load ready in anticipation of Isatu’s arrival for work. I also carried out the dirty dishes and set up the tubs for Kanko to come and wash the dishes. I was then ready for some coffee (which Jim had graciously made) and some quiet time praying and reading the Bible- asking the Lord to give me love for people that day.

Jim arrived home shortly after that, and then Sayon came for coffee. I popped my head out the door to ask him about a patient I had seen the day before (on my supposed day off) and asked about his family. Isatu arrived and since Jim was out visiting with Sayon, I ran out to try and start the generator myself. Jim had done some work on the exhaust pipe the day before, and the generator didn’t sound quite right as I tried to start it, so I called Jim and asked him to do it.

I greeted Isatu and chatted with her for a few minutes and ran back into the house to get coffee for her. I also swept the house quickly and prepared Kanko and Isatu’s salary for the week. (Thursday is market day and the ladies LOVE that they can count on a weekly pay that provides for their families meals – and I LOVE that they help me so much with some house work!) I wiped down all of the counters and the table. The dry season dust is incredible. On a normal day, you can wipe everything down and come back by afternoon to write your name in the dust.

I sat down to write a few emails. I write a daily email to the boys in Senegal– usually a short but a quick reminder that we love them, miss them, and are praying for them. That day also included emails related to team stuff, a few to supporters and one to an OB-GYN in Fort Wayne who has been gracious to help with questions related to that field. I needed to discuss a delicate female issue that had been presented by a woman the day before.

In the middle of my email, I got called out to the porch by Jim to deal with a girl who had fallen and scraped up her leg during a bicycle accident. I try really hard not to work in the mornings as I am trying to get school done with Hannah and house work done, but when people are bleeding, it is a little hard to say come back in a few hours. I got her cleaned up and on her way. I was heading to finish emails and do the few subjects of school with Hannah that require my help when I got called out to the back porch where Isatu needed to talk with me.

I sat on the porch for a while as Isatu explained her desire to buy red oil, dried fish, bouillon cubes, and onions – all staples in daily cooking here – in bulk so that she could have them to sell to women on a daily basis. Those are usually only available on market day – and women purchase them for a day or two. But then they run out. So wise business women go to the bigger towns and purchase all of that for a slightly lower price and then come back and sell it through the week and make a small profit.

Of course, business ventures take capital. And since there is no bank here in town, she was coming to me. I often do give loans to my workers, knowing that 1. Some purchases need to be bigger than a one week salary in order to be profitable and 2. I can just pull it off their paycheck a little at a time – erasing the worry of not getting paid back. We negotiated a little and came to an agreement of how much she could borrow. I went to get her the money. The whole process took probably 30 minutes. I was trying to be patient.

Back inside the house, Hannah and I did school and then I stirred up a batch of muffins for breakfast the next day, got lunch ready to pop in the oven, and started supper preparations. My morning was nearly gone. I usually exercise for about 45 minutes in the morning, but had been having pain in my foot and I was fairly certain that jogging on it would be a bad idea. I have no idea how I would have fit it in anyway. I put water on for a shower and heard a motorcycle stop and then commotion on the porch. It was one of the former chiefs – who had been sick and had gone for treatment to the hospital.

Mordeka had come the day before (my day off), asking me to look at all of the medicine and the hospital record. I put him off until Thursday – making a concession to see him at noon instead of making him wait until evening for 2 reasons – 1. Because he was a former chief and the guys felt that I should give him a little deference since he was part of the reason we were allowed to move into the village and 2. Since it was a Thursday, I knew my porch would be filled to overflowing and that reviewing everything would take a big chunk of time that would put me behind with other patients. Isatu was finished with the laundry, so I went out to the back porch to look over her work and tell her thank you so much – something that she wants at the end of every work day.

I then stuck my head out the front door, greeted the chief, and told him that I needed to wash and would be right out. He was happy with that. I ran in and took a quick shower. Lunch was ready but I wanted to get the chief finished up first. I was heading out the front door, when Isatu called me from the back porch. She had been out to purchase some items, but the price was higher than she thought, so could I add to her debt? I was getting a little fussy, but since I had already advanced her several weeks pay, what were 2 more? I went in to get the money, and then listened to her blessings. By the way, she said, there is a boy on the front porch whose foot is so injured she was afraid. Great - I thought.

I went out to the front porch to find the chief dutifully waiting, and a boy, about 10 years old, who had been injured when a tree limb fell on his foot. The problem was that it had happened out in the bush – and in the process of walking back into town, the blood has mixed with the dirt, which turned into mud. The injury scared everyone so badly, that they refused to wash the foot. So, by the time they drove on the moto to see me, several miles away, the dry air had caked the mud on.

I couldn’t tell what was flesh and what was mud. I tried and tried to wash it but was having little success removing the mud. Finally I went inside, looking for something to soak the foot in. I found an old Tupperware and put water, soap, and Betadine in it and soaked and scrubbed as much of the mud away as possible. What I discovered under the mud was that the 2 smallest toes had been crushed, exposing the bones, and that a layer covering most of the ball of his foot had been sheared off. (No matter how many times they explained what happened, I couldn’t figure out how both of those things occurred in the same accident.)

I wanted to send them to the hospital, figuring that at least one of the toes would need to be amputated, but Sayon said that they don’t really do that, and could I try to take care of it here. Why not? I said, but if it looks like it will not get better, he has to go anyway. (I suppose that exposes my lack of faith in the medical system!) I finished scrubbing out as much mud as I could, bandaged him up, gave him a tetanus shot, started him on pain meds and antibiotics, and sent them on their way – with instructions to come back the next evening. I was exhausted. But there sat the chief, looking at me expectantly. OYE!

I called in the house and told Jim and Hannah to go ahead and eat. It was after 1 pm and I knew it was going to be a while. So I grabbed his medical record and unpacked the 2 plastic bags of medicine that he had with him and started to sort through it all. He had about 15 different medicines – some of which I had never heard of. I got out my drug book and tried to figure out what they were. There were partial treatments which he had started but stopped several days before because he was afraid to take them.

There were STRONG antibiotics, cough meds, pain killers of all varieties, and some lidocaine (a topical anesthetic). Since he had not had any surgery, I asked where he had gotten it. He said the doctor had given it to him as a gift – in case someone in the village needed it. Yikes. I told him to please NOT use it. I sorted through the rest of it, taking some away since they weren’t ever finished anyway. I encouraged him to take them all well, and to rest and eat well, and to come and see me if he wasn’t totally better when he got done. He thanked me and left. I went back inside and ate a quick lunch and chatted with Jim for a while. It was after 2 pm when I was done.

I called Dawn Cluckie (our teammate) by radio to check on her since her husband was in CKY. We chatted for a few minutes about their family and then discussed a few medical cases that she had questions about. I told her to call if she and Adam needed anything while Bruce was gone. Then I went outside to send emails by satellite modem and then take down the laundry which was now dry.

Isatu showed back up and helped me take down the clothes. She wanted to let me know she had purchased the red oil that she needed and to thank me for helping her. By the time I got back inside to read the emails, it was after 3 pm, when I usually start work on Thursdays. Considering how much time I had already spent on the porch, I knew I needed to be a little late. I explained that to the group on the porch and quickly read emails and finished preparing supper.

When I finally got outside, there was a big crowd waiting. Over the following few hours, I saw 22 patients. As the last one left, Jim and Hannah set the table and we starting eating around 7 pm. Afterwards, we watched a show together and I fell into bed – exhausted. Sadly, that was how most of my week went. I would never have survived without Jim and Hannah’s help! Here is hoping that this week is NOT so crazy!