A lovely hike

Doug, Hannah, Mary and I went for a rather long hike this morning after breakfast.  We trekked up the mountain to the origin of one of the waterfalls, and then crept back into the bush to a lagoon where it starts.  It was really quite breath-taking. 

We then went further into the countryside, where we met several horses and cows.  Two of the cows demanded to see our passports, however after we explained that we were ignorant of that rule, they begrudgingly let us pass (I did overhear them exchanging rather patronizing "moos" after we left). 

A slightly uncomfortable interaction with some slightly angry guards

We had an interesting interaction with the Cameroonian army/police (I can never tell them apart).  We were riding to Bamenda, when our cab was stopped at a checkpoint about half way there.  We drive through this checkpoint every time we go.  Sometimes there are people there, sometimes not, but we never stop.  An excitable young man in an army uniform came up to the cab yelling something about ID.  We couldn't really hear him because the radio was so loud, and was stuck there, presumably for the life of the car. The Cameroonians were handing him their government IDs, but we tried to explain to him that we did not have such IDs, which should have been apparent from our glaring whiteness.  He wanted to see our passports.  Two of the three of us had them, but we didn't want to disclose who didn't, and we tried to explain that we were not in the habit of carrying them in case they got lost.  We offered to bring them the next day, however he simply laughed at this and ordered us out of the car.  At this point an interesting dual-natured good cop/bad cop, good suspect/bad suspect routine ensued.  As I have written earlier, in the marketplace the normal interaction involves a lot of angry yelling and accusation, after which a mutual agreement is met, and all parties are happy and smiling.  Mary attempted to use this model with the young guard, being confrontational about how we have never been asked for ID, and that this was highly unusual, and that the policy must have changed within the last two days as we had just been to Bamenda, and had no such requirement. The young guard (bad cop) was becoming increasingly irate, however only spoke Pidgin and French, and so we really could only tell that he was acutely-on-chronically unhappy.  Enters good cop: a slightly older police officer who was slightly calmer, however also holding a rather large machine gun.  He explained that because of the upcoming election, the police are checking the ID of every person traveling, every day, for the last three months.  Again, this is totally untrue, but who were we to argue.  We asked if we could go back to get the ID, or bring it tomorrow.  He wanted the one without ID to wait while the others went back.  We had no intention of disclosing which of us did not have ID, and certainly were not going to leave one person at the "military outpost" while we spent an hour getting the ID.  I asked him if I could pay him a 'fine' directly for our forgetfulness.  Either he didn't catch that this was an attempted bribe, or I wasn't subtle enough, or he actually was committed to his job, but he explained that this was not an issue of money, but rather that he had his job to do.  He then informed that until we produced papers, we were in the custody of the police, and were not able to leave (eek).  At least he was remaining calm, and never raised the machine gun to imply that, in fact, he was making the rules at the moment.  I apologized for our ignorance of the law, and insisted that we meant no disrespect to him or his country, but that we were not willing to leave one person here while the others went to get the ID.  I handed him my pocket medical-card (a copy of my US license that I carry with me) and explained that this is a very valuable card to me, and that I cannot practice medicine without it, and that if he would keep that it would guarantee that we would return with the IDs soon, as I had to get it back.  He told me that if I didn't return it wouldn't matter, as they would then have my name, and would call Yaunde airport to inform them that I was not allowed to leave the country (I resisted the temptation to tell him that was fine, as I was flying out of Douala).  He went to check with his boss, and returned a moment later, handing me the card, and saying that we could go about our business, but not to forget our ID again.  I gave him very flowery "thank you my friend" handshake, and apologized again.  The bad cop then ran up "Hey, Doctor, you di no tell me you speak French"  I informed him that I don't speak French.  He informed me that I do.  I again insisted that was not the case.  His contention was that if I worked in the hospital caring for French-speaking patients, then I must speak French.  I tried to discuss my use of interpreters, however he then began yelling at me in Pidgin that in "Dis country I am big man" and that not to allow disrespectful speech.  I placated his ego, which I can only assume was fragile due to the fact that he was a good six-inches shorter than the rest of the guards, and told him "yes, sir, you are the big man, and we di not mean no disrespect"  After that it was actually a fairly nice trip to Bamenda. 

Pens in Cameroon are like cigarettes in prison

Mary and I had the pleasure of touring the wards this afternoon to distribute some pens left by Jeff Schlaudecker.  The response was rather amusing:  we have given away books, food, clothes and so on (things that are either more educational, necessary for life, or expensive), and the response is a polite “OK, great” without a ton of affect.  However when we gave ward nurses hand-fulls of pens, they were simply elated, smiling joyfully, and saying “God bless you”  I now know to stock up on pens, pencils, candy, and possibly clipboards before our next trip.  I will also try taking some to the market as a bargaining tool.  They may also prevent our being shived should we venture into more dangerous areas of Bamenda

Politics, religion, and Smurfs

Our trip to Bamenda today (yes, we’ve gone two days in a row) was highly enjoyable.  We started by going with Mr. Eta, a psychiatric nurse-practitioner (and therefore the only person in Bamenda capable of prescribing psychiatric medications) to the home of one of his patients, a 36 year old schizophrenic man.  We then had the pleasure of accompanying Eunice and her niece on a school-supply buying trip, which was much more fun than it might sound.  Unlike a Target excursion, we got to go throughout the market and little shops buying specialty goods at each one.  One of the shops sold a bag of 1 ounce shots of whiskey for 1000 francs (about $2).  I really wanted to get one for the novelty of it, however the hospital campus requests no alcohol on the grounds, and as we are guests I’ll respect that.  We also found popcorn, roasted bananas, and plantain chips.  Yummy.                  We had to wait about 30 minutes for our taxi home to fill up with people, but it was worth the wait.  The driver and the passenger next to me (there were four of us in the front seat) had a really interesting conversation about Catholicism vs Pentecostal, the process of dowry, marriage, polygamy, the importance of a good education, being charitable, being blessed by God for kind actions and so on.  I feel like I had more insight into some local culture in that forty minute car drive than I had thus far.  We shook hands when we got to Bamenda, which was unusual, but nice.

                We walked through the Bamenda market to get bananas, pears (which is what they call avocados), and a gift for Mary’s brother.  I then spotted the highlight of my daily purchases—a tarp covered with holiday hats, several of which being those worn by Mr.Smurf!  The price was only 300 francs (about 75 cents).  I couldn’t refuse.  As I tried it on the women in the market laughed, and appropriately so, as I looked like an idiot; nonetheless I love it, and intend to wear it around the grounds tomorrow, hoping to get a pose with Mr. Smurf.

                I continue to pray daily and thank God that He has blessed me to be here at all, and even more that I am here with Mary.  The peace of having my wife and best friend with me has kept my mind steady, and my spirit light.  Beyond this, I am here with more friends, and have made several in –country.  I pray that the Lord continues to guide and strengthen us, and that he would also open our hearts and minds, and temper our egos, in order to know and serve His will

A Toyota can fit many hogs

The taxi rides are some of the more interesting events that happen in this country.  I thought that the banana cab, and the crazy cabbie, were probably un-topable.  However, when Mary and I left for Bamenda yesterday afternoon, I don’t think we could have guessed our soon-to-be cab mates.  At first it was us, and a woman with a small baby.  Cute.  After about 10 minutes, though, we stopped next to a farm where there were three live, hog-tied hogs by the side of the road.  I would guess their weights at about 80 pounds  each, more or less.  We were in a compact Toyota hatchback at the time, and I was skeptical that our porcine friends could hitch a ride—oh naïve American.  I now know that three fully grown live hogs can be stacked in the trunk of a Toyota.  To make the ride more comfortable, you simply place a piece of carpet over the writhing pigs, and then cram luggage on top of that.  Yes, there was still the occasional angry snout that stuck out when we went over a speed bump.  And, yes, hogs have several opinions which they share loudly and often, but never again will I doubt the superior cargo space and smooth ride of a Toyota.

King Katwell Ngkitty

Greetings loyal subjects.  My name is King Katwell Ngkitty, and I am the ruler of Mbingo, a small city in the country of Cameroon, of which I am also king.  Bask in my glory!  I live in a palace built for me by my subjects.  During the days I inspect the different rooms, checking on the well-being of my loyal subjects.  If you visit, you will see that the palace is staffed by many priests and advisors—you will recognize them by their white coats, and spritely demeanor.  They attend to the needs of the peasants who come to pay homage to their king.  Note that as a peasant, you may not directly interact with me, unless it is to give me a fish (which you should do).  Otherwise you must consult one of my priests (you may also give them the fish, which they can then give to me).  In the mornings you will gather to sing me songs, however must then go to assist the peasants laying prostrate, awaiting my blessing.

Currently it is very dangerous around my palace, as the evil kitties have sent a curse of water from the sky to fall up us (kitties hate water, except of course to drink).  Fear not!  Upon arrival, all are given sanctuary under the protective roof of my palace, for I am a good and kind and jealous king.  I am cute, too. 

If you are truly blessed, you may get to rub my tummy for protection on future journeys (bringing me fish will greatly improve your odds)

Sincerely and purrrrrow,

King Katwell Ngkitty

PS: do not forget to bring me a fish

A vain attempt at a comfort from home

I can't honestly say that I've wanted for anything from home that I can't get here in Cameroon.  I rarely eat out, and I'm not a big fan of the cable tv that I inexplicably signed-up for earlier this Summer.  One thing that I do really miss, though, is ice cream.  The cold, creamy joy that I can purchase for a mere $3 a 1/2 gallon.  Mmmmm.  I decided to try making a facsimile of ice cream from powdered milk, eggs, and sweetener.  We do not have vanilla or chocolate, so I looked to the fruit in our kitchen for added flavor.  Bananas were the obvious choice, but not very adventurous.  A favorite of mine, that is very cheap here in Cameroon, was staring me in the face: avocado.  I have had sliced avocado on vanilla ice cream in the past, and the flavors really compliment each other quite nicely.  So what about avocado flavored ice cream?  They are easily mashed, and mix well with cream, so why not?  I cooked, cooled, and froze the concoction, and had my avocado-flavored frozen dairy treat.  Sounds disgusting, right?  Well it is!  Crap, why the hell did I think this was a good idea?  I wasn't drinking, or delirious, or even half-asleep.  The saddest part is, though, that I will probably try again on the premise that I just didn't have the ingredients in the correct proportions.  Perhaps tomorrow I will try to make Papaya-tuna casserole...

Harsh Reality

The wards are very sad.  Diagnoses and conditions that we view as extreme or rare are the norm.  At least half of our patients have HIV, several have TB, and cancer, when present, is rarely at an early stage.  I have never seen a case of Kaposi Sarcoma in the US, however have had four patient here with the disease in only four days.  When we admit critically ill patients in the US, we can be comfortably optimistic, though always guarded, about their recovery; here I have learned to expect death as the more likely outcome.  I do not want to imply that most, or even a majority of patients here die; rather patients who would have survived an ICU admission in the US often die here.  It is a harsh reminder of the reality of medicine in most of the world.  Ashiah. 

The Wonderful Mr. Smurf

As Mary and I were walking around the hospital grounds we noticed a tall, thin man who was sitting on one of the walkways wearing a white cap with a snowflake on one side, and that curled forward at the top, similar to those worn by the Smurfs.  He never had much affect, and stared off when people walked by.  We wondered if he might be schizophrenic, and stayed around the hospital grounds just for somewhere to be.  We decided to say hi one day, and he returned our greeting with a big smile, and said “good morning.”  We asked “how for you?” (Pidgin for ‘how are you’), and he replied something along the lines of ‘fine, yes, thank you.’  The next day he was walking around, and Mary politely asked why he was at the hospital (the family member’s of patients are responsible for feeding and  clothing their loved-ones, and so they are often outside the wards).  He lifted his pant leg, and revealed a mangled, but healed, shin.  He explained to us that he was in a car accident in Bamenda, and his leg was repaired at Mbingo.  You cannot leave the hospital grounds until you pay your bill, and so he was waiting for his brother to come from Yaounde (the capital) to pay his bill and take him home.  “When is he coming?” we asked. 

“Soon , I hope.” 

“How long have you been here?”

“Three months.  I am very hungry”  I’ll try to remember and post if he leaves before we do.  In the meantime, we’ll try to help him avoid Gargamel.

A trip to Bamenda

Yesterday we went to see a friend of Mary who lives in Bamenda, the biggest local city, about 45 minutes by cab.  Our trip there was quite fun—normally a taxi is split by about 7 people crammed into a model similar to a Volkswagen beetle, however we had the privilege of sharing the cab with a load of about 10,000 bananas on their way to the market.  Out driver was quite fun, and talked to us about his job as a cheufer for a ‘white man’ which enabled him to buy his own cab.  He also showed us his house, which was half-way between Mbingo and Bamenda.  We arrived at the central cab hub, which is quite a circus of little shops, meat stands, and of course, cabs.  Eunice, Mary’s friend, met us there, and immediately hugged us and welcomed us to Bamenda.  We took a cab to the main market, where she has a ‘friend’ who exchanges money at a good rate, and wouldn’t give us counterfeit bills (a common practice by ‘evil Nigerians’ in Cameroon).  The process of bartering was amusing to watch.  We sat next to an old Cameroonian nun in this 5x7 room at the market while Eunice bargained with the man in a rather fast and harsh tone.  This is how the market works, and Eunice is very good at bargaining.  We then walked around the market for a while.  One of Eunice’s friends sells pots and pans, but also has roast peanuts and this weird bready-cookie-deliciousness stuff.  The nuts had an odd texture at first, and Eunice explained that when peanuts became more expensive they started wrapping them in dough and frying them, expanding the volume at less cost.  We were, however, able buy two bottles of peanuts, sold in used peanut-oil containers.  They are quite good.

We then went to buy laundry detergent (yes, we washed our clothes in a giant tub in the bathroom, and hung them to dry outside during one of the rare dry-sunny periods), as well as fabric for mum.  I found one ‘rappa’ (about a yard) for 900 Francs.  Eunice told the vendor “800 Francs” to which he replied “900 Francs” to which she replied “yes, 800 Francs” to which he acquiesced.  We toured Bamenda on foot for a while, visiting some different shops, and stopping at what I am sure was a Department of Health authorized lunch stand which had various parts of a meat-based animal roasting over some open coals.  Eunice ordered “Soya” which is spiced roasted meat eaten with onions and hot sauce that would make the staunchest Mexican sweat.  This is eaten with toothpicks.  Most of the meat was fully cooked, though we might end up with trichinosis or cystecercosis, but so far so good.  The man next to us indulged in the roast intestines, and I think he was taking a greater risk.  It was delicious. 

We bought some souvenirs (can’t say what for the sake of surprise) and then went to Eunice’s home, where her family warmly greeted us.  I hadn’t realized how accustomed Westerners must be to the simple joy of candy, and the glowing eyes of kids as we gave them an assorted bag of fun-sized chocolates warmed my heart.  They made us a meal of smoked fish (I opted against the head, but could have had one), and ‘Gelaf rice’ which is best described as Spanish rice, though not as peppery.  It was very good.  Mary brought an NIV Bible for the family of 8, and Francis, Eunice’s brother, said it was wonderful as they had to fight over the Bible that they had (makes me want to buy them all one).

The trip back to Mbingo was a little strange.  We found a cab going that had a woman and three little kids in the back.  The man gave us the rate and we got in the cab.  He then proceeded to scream in Pigin English at the woman “You ???????? pay Sistah’, sure!”  He would then walk around, laugh with friends, and return to scream at her again holding up a 1000 Franc note.  In the meantime a rather large woman in bright clothes got in the back next to the woman and her kids.  She argued with the driver as well, however it was not as tense.  I had given the driver 2000 Francs and was waiting on my 400 Francs change.   I asked what the woman owed, and he explained that he wanted 1800 for her and the kids, and she would only pay 1600.  200 Francs is about $0.50, and so I gave him the difference and then some.   I had hoped we could then leave, but he wanted to cram two more people into the already-full cab.  I was about to give him another 1600 just to go, but didn’t want to flash a bunch of money and call attention to ourselves,  but about then he pulled off in a pseudo-huff.  He would aim his taxi at people on the side of the road, lay on the horn, and then turn away at the last moment laughing.  He seemed like either an antisocial jerk, or a fun-loving jokester--an experience to remember.

Here at last

After a seven hour layover in the Paris airport we boarded our plan for Douala.  I was surprised by how nice the plane was.  If I’d been asked to guess whether the plan from the US to France or from France to Cameroon would be nicer, I would have guessed the former every time—not so.  We had our own private movie screen with optional videogames, as well as a gourmet meal and all of the wine or beer you can drink (amazingly I abstained, however I don’t recommend it).  By the time we landed in Douala we were all very tired.  The customs line was very confusing, and we were called as a group to move up because the Schlaudeckers had little-ones with them; however when we got to the processing point, we then had to wait while Jeff, Liz and the kids went through.  This young Cameroonian guy then started yelling at us that we cannot just cut in the line, and had to wait like everyone else.  We tried to explain why we were standing there, but eventually decided that there was no convincing him.  We did end up cutting through rather fast, but this made no difference as the baggage claim area was a bit of a nightmare.  I had never acutely desired to speak French before, but did then.  It would have been nice to have a more effective way of communicating “No, I really don’t want help with my bags, or a taxi, or a prostitute, or life advice” than just waving my hand and saying “Merci no.”  Oh well.   Hannah, the Pediatrics resident, did not get any of her luggage, which was sad, but everything else came through.   I waited with the carts of luggage while Vincent and Silas, the Cameroonians who greeted us, went to get the car.  I was promptly surrounded by a group of young men who tried to explain to me that I needed to give them 20 euros, and some ‘dollas’ to them so that they could provide me with “airport security”  I tried to explain that I did not have any cash, and all of our financial issues were being handled by Vincent.  This was, of course, a complete lie, which the youth no doubt realized, however it was not really a refutable lie, short of him mugging me directly for the money I claimed to not have, which was a challenge I’m fairly sure he was willing to accept.  I wanted to explain to the youth the apparent contradiction of threatening to protect me, but Vincent returned at that time, and I merely pointed and said “talk to him” and then walked down the stairs with our bags.  We went to the “Guest House” which is a mission Hostel in Duouala.  It was very nice, had hot water, electricity, and an air conditioner.  I slept very well.  We breakfasted with Doug, a Urologist from Connecticut who is going to Mbingo with us.  Mary and I took a quick walk around Douala before leaving for Mbingo.  Douala is very crowded, and there are many street vendors.  We went to a bookshop, and I pointed at a French-English dictionary, and said “Pigin-Anglais?”  The kindly book owner responded “No, we don’t have Pigin dictionaries—I thought about letting you torture yourself, but I speak English” 

The trip to Mbingo took about six hours.  It is a beautiful countryside.  At every village a group of people run up to the car sticking various wares into the windows for you to buy.  We couldn’t buy anything because we were poor due to being very rich (only had 5 and 10 thousand Frank notes, which no one could change). 

The hospital in Mbingo is very nice.  There is in the constant smell of body odor and urine, however that is to be expected when in rooms with several very sick people.  Our homes are quite luxurious—our own bathroom, shower, kitchen, internet.  Kinda’ makes me feel guilty, but not enough to move into a tent.

Mbingo has its own residency programs in Internal Medicine and Surgery.  They do all of the outpatient work, and we help out with in hospitalized patients.  So far it is fun. 

Leaving soon

What may possibly be the least interesting of a series of moderately interesting posts, Mary and I are sitting in her condo waiting to leave for Cameroon.