There is an old saying whereby "One bad apple spoils the entire bushel". Through a recent personal experience this profound wisdom was contrived: "One bad banana is enough to make a boy sick." Of everything that I've eaten so far (not that it has been anything extreme or bizarre by any means) I’m baffled as it was a simple banana that did me in. We're not talking anything severe, just simply starting with nausea, abdominal discomfort, eventually leading to mild loose stools. And in case you're keeping up to date with my blog, yes, these indeed were the bananas that I purchases after lying to the lad on Saturday about my financial standing. I guess Karma did get the best of me after all. I should have known better, especially after all the lectures provided by my much missed hostess during my 3rd affiliation - the lovely Ms. Becky Gibson. You'll make a Buddhist out of me eventually. :)
Let's entertain the earlier statement regarding consumed goods while in Tanzania thus far. Prior to my leaving my father and mother heard from a mother of a girl from MN who is in the Peace Corp here in Western Tanzania who I brought her laptop along with me on my voyage to Eastern Tanzania that she was forced to eat soup containing heads of fish, eyeballs and all, alongside some form of prepared rabbit ear. While I was much looking forward to such fine dining I have yet to encounter something so primitive. The first thing I actually consumed while in Tanzania, in case you're curious: beer. That's right, a nice tall lager. The brew: Castle. Not the best beer I've had, but then again I wasn't even expecting to find such goodness during my stay. It'll have to do for now. Where did I have this beer? At a night club. Another thing that I did not expect in Africa. When did all of this happen? Within an hour after leaving the airport. Fareena quickly made me change and "freshen up" after dropping my luggage off at her parent's place and carted me out the door to meet some of her friends at a club on the coast of the Indian Ocean at the outskirts of the city. It was also the first time I encountered the Maasai parking cars. The club was entirely outdoors as most things are here in Africa with some private VIP areas draped with white linens. People of all nationalities were in attendance, mingling and moving to the beats of modern American Hip Hop with occasional flavor of African music of the same genre mixed in for good measure. By far the neatest thing about the club? There was an empty swimming pool right in the middle of the establishment that allowed patrons the option to sit along the rim, dance down below, or purchase a beverage from a bar set up in the deep end. Creative use of space if you ask me.
Back to the topic at hand: food. Fareena introduced me to some of the highlights to Indian food while in her watch, including Samoas adorned with lemon juice, green chilies and coconut, spiced cassava chips, Tangaweze (My favorite soda! It's a strong ginger flavored beverage, sort of like our Ginger-ale on steroids), hot and spicy grilled chicken, chapatti bread, and chips (what we know as French fries). Fareena told me as we were eating out that night "Don't expect to lose weight while you're here because almost everything is deep fried". I've found that to be more the norm, but not the golden rule. Of course it was two days later that I actually really ate again. Luckily I had with me some candy (Twizzlers, whoppers, and Smarties) given to me by my dear friends Becky Gibson, Jeff and Mike at my going away party and my daily multivitamins to help tide me over. My, now departed mentor, Dr. Warren, came to my rescue by taking me out to an Indian restaurant. I had the Coconut Chicken Masala. Wonderful!!! Such a creamy combination of rich bold flavors. All was good in the world again. Once I discovered where an ATM was and could withdraw schillings and thereby allowing me to buy food of my own, it was off to find the nearest supermarket. Yes, I'm actually able to shop in a store for my groceries, not having to manage a chaotic market as you might expect. It is no Rainbow or Cubs by comparison, just the essentials, which is what I've been living off of. Some yoghurt, cashews, protein bars, fruit juice (mango, litchi, peach, and orange are some of my favorites), fruits and veggies, ramen noodles, soda, water, and the occasional splurge of a beer. Nothing profound, nothing unique thus far. I was remotely hoping and expecting that the produce here would be an out of this world experience with it being local and all. No such luck. Just bland and boring, even slightly sickly as noted above.
Besides the daily occurrence of finding a bit to eat I thought it might be behoove of me to enlighten you into the ins and outs of my daily routine. I must preface this by saying that 10 days in Africa is not enough to establish any means of routine, but here it goes. On nights that I've been able to sleep (3 thus far) and those that I just lie in bed wishing that I was sleeping I roll out of bed promptly at 6:45 A.M., just as the sun is starting to make its appearance in the eastern sky. From my floral printed queen-size slab of what feels like solid wood that is my bed I grab my faux wood rimmed glasses and walk off my plantar fasciitis through my U-shaped guest shack to the bathroom where I do my morning manly routine. I quickly grab a protein bar, wash it and my multivitamin down with some fruit juice, grab my necessary items for the day at the hospital, unlock my door with my long silver key from the inside, step out into the African heat where I begin to sweat at a greater rate than what I already had been since the moment I awoke 1/2 hour ago. From there I lock the door, now from the outside, turn to face my gatekeeper who is pulling back the 7' tall, red sheet metal gate that barricades the compound I reside in, greet him with the few words of Swahili that I know, and start off on the 10 minute walk down a pot hole ridden gravel road to the hospital. (Dad, Africa would be blessed to have you work your magic here).
As I'm walking locals pass by, staring the entire time. Each and every day I catch myself wondering if I'd forgotten to put a shirt on, if my fly is down, do I have something on my face, etc, but then I remember it's because I'm white. This is a regular occurrence during the day, the gawking and constant stares. My personal favorite is when the person, watching me walk towards them the entire way and then upon passing, turns their head, or sometimes entire body, to continue to stare at me in bewilderment. I feel like a walking car accident, train wreck, or natural wonder that one simply cannot take their eyes off. I have begun to stare back, thanks to the advice of Fareena. It doesn't faze them, though; they keep on staring. At first it almost bothered me, now it amuses me.
Reaching the hospital at 7:30 A.M., I change into my white scrubs, boot up the 8 year old computer that tries its best to run Windows XP, and eagerly await my email to come up, welcoming me to another morning with loving messages from my family in a familiar world from afar. It really is a great way to start the day. By time we start to see our first patient at 9:00 A.M. I've managed to read and respond to several of the emails; the others will have to wait until later in the day. Since Halima and the rest of the rehab staff really don't want to teach me anything, evident by not including me in patient treatment sessions or speaking entirely in Swahili without bothering to translate for me even when I ask what they're saying, I have already been seeking out other sources of learning in the hospital. This is where I've come to meet my mentor Dr. Warren. He has challenged my thinking and practice as a physio in an unprecedented manner in just 4 days by drilling me on my anatomy, scrutinizing rehab protocols to minute detail as one would expect from an excellent surgeon, telling me to interpret X-rays to him, pulling me into the ER to give me an firsthand look at viable tissue where he'll unexpectingly expect me to come up with the correct corrective outcomes for the patient on the table, almost as if he's waiting to perform the surgery depending on what comes out of my mouth. The whole time we're in surgery he continues to quiz me on anatomy, asking me what he'd damage if he were to be careless and cut this or go too deep there and what it would do to the patient - that is when he's not belligerently yelling at the incompetent surgical staff.
When I say my goodbyes from the morning surgery I make my way back to the physio department. On my way I pass through the waiting room/playground area where I am greeted by the children from the inpatient ward dressed in their blue hospital gowns adorned with white bleach blots, various combinations of casts on their legs, and all either on crutches or in wheelchairs far too big for them who call out my name in excitement as I make my way toward them. Greeting them with a gigantic smile, "Jambo mambo" ["Hello, how are you"] is all I can say to them as most of them know no English. It breaks my heart that I know nothing else at this point to say to them. But each of them gets a high five, an exploding fist pound (yes Rachel, I've taught the children here the exploding fist pound!!!), or a big ol’ hug. It is the highlight of my day when I hear one of those kids yell my name, knowing that they're excited to see me. It's for them that I go to the hospital every morning. It's for them that I came to Africa. It was worth it. Most of the rest of the afternoon I find ways to make it back to the ward or step outside and seem them again, to see their smiling faces. Generally it's not all that hard as I'm sitting around in the physio department by myself reviewing my pediatric notes and studying for my up and coming boards. That is when my notes are available and they haven't been stolen by one of the other staff there. [I caught my CI reading my book once when I stuck my head out of the patient treatment curtained-off area after she had disappeared on my in the middle of treating a patient. She came back a little bit later and began to give me a lecture/review of Down Syndrome, asking if I had ever heard or been taught that pt condition before, if I'd ever seen a kid with it, making herself seem like she was the expert of that condition, telling me that I could possibly try to find a book to give me more information on it, the whole time unknowing that I had just read the exact same information in that book, unaware that I saw her reading it. Who's teaching who on this affil exactly?]
Treating children here sometimes is painful. Kids are not encouraged to play, more so forced into positions, forced through motions. Every kid seems to get the same system of treatment: midline orientation, joint approximation, telescoping of limbs, quadruped positioning/four-point kneeling, two-point kneeling, squatting, forced into standing straight-leg flexion at the waist in which they're supposed to use their back extensors to pull themselves into upright standing, and then strapped into the standing frame for 15-60 minutes. There is a lot of crying in our department. Not many smiles. Except for when I am there treating them on my own. Maybe it's the fact that they're dumbfounded and speachless because I'm white but they seem to smile and laugh a lot more when I treat them. Maybe it's because I make things fun...
When our last patient leaves for the day around 2 in the afternoon, I sit and study some more, check some more emails, or track down Dr. Warren to have him push me a little more academically and teach me the intricacies of correcting club foot while the rest of the staff goofs off, chattering away in Swahili, and groom themselves in preparation of leaving for the day at 4:00 P.M. Even though they only see patients or are actually working from 9-2, they still remain at the hospital every day from 7:30-4:00 so they get paid the full day's wage. To me it's somewhat unethical, almost stealing from the hospital.
Once 4:00 comes about I'm off down the garbage lined, pothole ridden dirt road back to 1358 Mzinga Way. Once there I drop off my bag, grab my camera, and head down to the beach where I walk the remaining 2 1/2 hours of sunlight away. When the sun starts to set in the Western sky I make my way back to my house as it's not safe to be walking around when the sun goes down. Evenings are spent inside, alone. I listen to Matt Nathanson as I type up my evening blog, nostalgia sweeping over me as I think of my 'lil sis and how much I miss her. Sometimes I'll switch on the tube and catch the latest update on the ominous economic crisis, watch a terrible dubbed Spanish soap opera, or, maybe if I'm really lucky, catch an episode of Murder She Wrote or Walker: Texas Ranger. Then there is studying to be done, with sets of push-ups, sit-ups, and pull-ups interspersed. After working up both a mental sweat as well as a physical one above and beyond the baseline sweat from the African heat it's back to the bathroom to perform my evening manly routine. This generally includes a shower of cold, weak-pressured, ill-smelling water coming from a half rusted-over shower head that barely allows anything to escape its metallic confines. If only my pores were rusted over... At least the shower cools me to the point where I can finally stop sweating. Then, cool and clean, I walk off the pains from the day while wearing my faux wood framed glasses back to my sturdy wood bed and pray. Prayers of thanks for being able to come here, for the experience, for being fortunate for the things I have, to watch over my family and friends back home, for people's problems much bigger than my own, for safety, for patience, for strength, for peace in this point and time of my life, that I could possibly get some sleep tonight, that He would grace me with the ability to rise another day with the Eastern African sun, and that the banana I eat in the morning may be a good one.
More to Come. Stay posted.