Rainy season

Last week the rainy season hit Cotonou with a vengeance. There were problems with flooding and the roads were a mess. I went on an off-ship site tour to visit a few of the projects Mercyships is running on land, such as an agricultural project and the dental clinic. On our way back the heavens opened up and it poured! Instantly the the many roadside stands were covered up with pieces of plastic and the streets were emptied of people as everyone ran to huddle in doorways or under trees. It made for some great driving though.

Hospitality Center

I have exactly one week left on the Africa Mercy today. This past week and a half I have had quite a few days off and have been seeing a lot more of Benin then in the weeks before, so I am running behind on my stories here. I'm just attaching a few of my favorite photos here of a morning and evening spent at the hospitality center (the place where patients who live quite a ways outside of Cotonou stay pre/post surgery). One rainy Saturday morning I wandered over there with some friends and we were happy to find that several of our previous VVF patients were still there, waiting to return to the North of Benin. We came back that evening for a manicure/pedicure session with all the ladies there.

Possotome - source de la vie

A lot of the water I have been drinking since arriving in Cotonou comes in a bottle labelled "Possotome - source of life". This past Friday I set out to explore this particular source first hand. It was a ship holiday, so a group of us set off on a day trip to Possotome, on the shores of Lake Aheme, a few hours out of Cotonou. We were hoping to go fishing. We arrived in Possotome with a vague idea of where we needed to be and eventually ran into a fellow who was connected with the company we were looking for. He walked us to the right location and then after reclining under some palm trees while a boat was prepared for us, we set off on our fishing excursion. Our guide explained the different methods of fishing used on the lake. He did some fishing himself, showing us how to properly throw the net, and catching a few fish and crabs while he demonstrated. Then we were all given a chance to have a couple of throws with the beginners/child's net. None of us caught a thing but it was a lot of fun. After several hours on the water in our rickety boat, we headed back to shore and happily ended the day drinking coconut juice from freshly picked coconuts.

Yovo!

Well the days are flying by and I only have 2 more weeks left on the Africa Mercy. In between work I have been puttering around the alternately dusty or muddy streets of Cotonou. The rainy season is definitely making itself evident these days. In the first weeks I was here I never went out into the city without feeling like it was an assault on the senses, but I am getting used to the chaos, darting across traffic and the frequent shouts of "Yovo", which the locals like to call us white people. It is used to get our attention in the markets, children like to shout it out and laugh or wave after us, and the occassional person will walk by and simply state "Yovo", just in case we hadn't noticed we didn't quite blend in.
On Canada Day all the Canadians on board got together for dinner and dessert. There are 22 of us on board at the moment! We reminisced about Tim Hortons and Stephen Harper and ate chicken, corn and fries. A few of us went to this tiny little pub right outside the port entrance for a drink, where the owner, a Sicilian, told us about his hernia and asked if there was any way we could slip him in for surgery...Well much more to write but my computer is about to die so bonsoir for now!

B ward

Over the last few weeks I have continued to mainly work in B ward, where our patients are all VVF ladies. I really enjoy working on this ward as these patients are here for much longer than many of the other patients, so I have a chance to get to know them. They are a fun group of ladies. There is Elise, who came several weeks ago and barely cracked a smile for the first week. Now, she is always smiling, and likes to have one sided conversations, where she will rattle off to you in her own language, and walks away content, having unburdened herself, somehow expecting that you have understood everything she said. She started to leak urine a few days after her surgery, and sadly the follow up tests showed that her surgery had failed. Then there was Bed 11, a one-armed, deaf and mute woman, who nevertheless managed to always be in the thick of things and who also did not let these considerable communication barriers stop her from getting her point across. What this woman could say through the use of her one arm, and an amazing array of facial contortions still amazes me. Once or twice a week a dress ceremony is held on the ward. The women who have been discharged and whose surgeries have been successful are given a dress, and some jewellery and then they come clapping and singing and dancing onto the ward, and after some singing and a message from one of the disciplers they each have a chance to tell their story. It is a joyful time, a time to celebrate, and a chance to say goodbye.

However, the women who are discharged whose surgeries have failed just quietly leave. We had one patient, Josephine who has been on the ward for weeks. I remember her always smiling and laughing and helping out in little ways. Our conversations mainly conisisted of Ca va? Ca va bien! and a smile. She had the habit of praying under her sheets in the wee hours of the morning. When I came to work for my last night shift this week she had been discharged. I will always wonder how her story ends. Will she have the chance for a repeat surgery? (the Africa Mercy is going to Togo next year, which is next to Benin, and some of the women whose surgeries have failed have been referred to come back next year, if they can make it to Togo). Even though I did not have the chance to say goodbye, my prayers go with Josephine.

where the streets have no name

Ok, if you look at a map the streets do have names, but when walking around Cotonou, I have yet to see a street name. I am slowly becoming familiar with the layout of the city near the port. I have two routes down pat, one route to an icecream shop, and the other to the Hotel Du Lac, which has a lovely pool and a restaurant on a terrace overlooking the river. I ventured off to the craft market the other day with 2 of my roommates, one who had a pretty good idea of where it could be located...we wandered through some nicer areas of the city on our way there. Here you can always tell when you are in a more prosperous area or passing a pricier shop by the guards posted outside. I also visited the main market in this city, Marche Dantokpa. This market is absolutely enormous and easy to get lost in. On the way there we wandered along the main fabric street in Cotonou where there are oodles of fabric shops, and as you walk along each store owner waves you to come in and see his goods. I was surprised to see that most of these shops were owned by Lebanese. Apparently,there is a very large Lebanese population in West Africa. We spent over an hour on the fabric street so by the time we arrived at Marche Dantokpa we had to head back to the ship as I was working that afternoon. I did barter for some fabric though (from 18000 CFA to 13000 CFA...pretty sure I still overpaid but I am still a fledgling at the bartering game). To get around on foot anywhere in this city you must become adept at darting through traffic. My trick is to attach myself to a group of locals crossing the road as they seem to have a better idea of when to safely cross the road. The odd thing is that you might be standing on a median thinking you are quite safe from the traffic when someone will decide to park where you are standing and come flying at you anyways. Ah, for the days of crosswalks and pedestrian lights.

Night Shift

I've just finished working 4 night shifts on the VVF ward and think I may have reached my quota on emptying catheter bags (8 patients with 8 catheters x 4 nights...alright I'll stop my whining). Work can be busy and often feels just like back at home but every once in awhile something hits you to remind you that oh yah, I'm in Africa. Like a set of bongo drums in the corner of the ward, or the fact that everytime the women get out of bed to go to the toilet they cover their hospital gowns with a wrap skirt. There are less translators around on the night shifts plus many of the women speak languages that the translators do not speak also, so I am rapidly expanding on assessing my patients using gestures rather than words...facial grimacing with lots of nodding and pointing. Some of the more unique habits some of these women have include a lot of spitting into paper towels or kidney basins they keep at their bedside...haven't quite figured out why they don't just swallow. I have found that flip flops are more comfortable on the night shift...but I may again have to reassess that as I managed to step into somebodies spit dish on the floor as well as dribble far too much urine upon my feet while emptying those catheters...but on the positive side feet are easier to clean than runners! But despite the little night to night hangups it has been a privilege to spend the past 4 nights caring for these women who have been through so much. I had a chance to sit down and read a little more in their charts about their histories, and it is quite incredible what many of them have had to cope with. I have already written before about how many of their husbands leave these women once they develop fistulas, but also a lot of the women were in labour for 5 to 7 days ending in a c-section and the death of the child. Yet still they smile and sing and pray and are a lot of fun to care for.

Sisters of Charity

This morning I went with a group off the ship, once again braving the Cotonou traffic, to visit an orphanage run by the Sisters of Charity (if I remember the name correctly). There were about 20 toddlers and 2 four week old babies here. Many of the children are abandoned children and also a few handicapped children that the parents were no longer able to care for. On the positive side about 60% of these children are adopted by people within Benin! When we arrived a lot of the kids come running up with their arms in the air waiting to be picked up. The challenge is they don't want to put down again. Some of these children are HIV+. I think I found that the hardest part of this visit. I have cared for HIV+ adults before but there is something so sad about seeing a tiny child bearing the same burden. We spent a few hours playing with the kids and helping to feed them lunch before, dripping with sweat from the lovely temperatures here, we called it a day and returned to the ship. It is supposed to be the rainy season here now, but so far we have not had much rain at all. The air conditioning on the ship wasn't working for part of the day yesterday, and boy am I ever glad we have air conditioning, as it is stifling on the ship without it! Ship life definitely is a unique way of life, but I love just sitting by a window relaxing and watching the ships all around. There is always a group of ships on the horizon. Apparently these are ships waiting to dock in Nigeria, but as Nigerian waters are not as safe and do have some incidents of piracy, these ships prefer to wait in the waters off of Benin!

Off ship

So I almost met a king....It all began with a day off and a trip to Abomey, a town a couple hours drive north of Cotonou. Early this Saturday morning 7 nurses (one who is 79 I might add and still working in the OR here!!!) and one dental hygienist hopped into a Mercy Ship landrover with our driver Karl and set off on a bone rattling journey. About an hour into our trip we had a flat tire....the main roads here are paved but full of pot holes...Karl quickly changed that tire with the help of a local boy, and once more we set off, fingers crossed that we wouldn't get another flat because we were out of spares...About 3 hours later we arrived at our destination, Abomey, once the center of the Dahomey kingdom before the French got in the way. We had to ask for directions a few times, and the people here were very helpful: the first time we asked the guy hopped into his vehicle and escorted us to a historical site he thought we might be interested in seeing. We weren't, so we carried on, and had to ask for directions again. This time the guy offered to come with us and hopped into the back of the landrover. Along with proposing to me he also did some negotiating for us when we arrived at a palace we were hoping to visit, so we didn't end up paying the foreigner's rate (many places have rates for the locals, and then a much higher rate for anyone else). The first palace we stopped at was a private palace where a tribal king and his extended family lived...kind of a compound of sorts. I have no idea what sort of power this king holds...Have to look into that. Well, we all had to take our shoes off before we could enter and walk barefoot through the mud and gravel. First we were shown somes tiles set in the wall portraying the history of the Abomey kings and then our guide told us he could help us meet the king. Well, as we were being shown around there was also some sort of meeting going on in the grounds, and we could hear voices droning on and on, occassional shouts, and clapping and laughing, and well...we said we didn't want to interupt whatever meeting was going on to meet the king, and so, well that's my story of how I almost met a king:). And yes, I did say no to our helpful guides proposal...actually he first asked our driver if I was his sister and then offered to swap his sister for me...

After visiting this private palace we set off for the official palace of the Dahomey kings, which is the central tourist attraction in Abomey. Whenever there was a new king a new palace was built so the grounds are made up of 12 palaces and we were allowed to see 2 of them. One of these 12 kings had a harem of 4000 women, and when he died 41 of his wives volunteered to be buried alive with him to keep his spirit company! Taking loyalty a little too far, I'd say.

It was really nice to get off the ship and see a bit of Benin! There is so much contrast here: poverty and prosperity...mostly a lot of poverty with the occassional BMW; different religions, with many gorgeous Roman Catholic churches, mosques, and some voodoo sites; western and african dress...the odd thing is we could be driving through what looks like an extremely poor area with nothing but dirt and ramshackle huts, that pass as stores and people would be walking around very nicely dressed in button-up shirts and suits and talking on cellphones.

Along with a flat tire our day held a few more challenges. We tried to fill up with gas when we first got to Abomey but 3 of the gas stations we went to had no power so we weren't able to fill up until later in the day when the power came back on. On our way home we were stuck in a traffic jam and Karl did not want to wait so we were introduced to the back roads of Cotonou. At one point we took a narrow road across a swamp...I think we were driving on sandbags with some dirt on top. At the end of the road some guys had a rope strung across the road and were charging people 200CFA (about 40cents US), to go through. Karl refused to pay and a nice shouting match ensued with 4 guys and Karl...I was getting a little nervous here...would have just paid...in the end though they did let us through without paying. Because of the traffic jam we missed dinner on the ship, so we went out to a restaurant.. The power did go out briefly during dinner...but if you ever find yourself in Cotonou, I highly recommend the lasagna at Livingstones:). All in all quite a day!

Nursing Notes

I must confess...I took the flip flops off right before heading out the door to work. It just went against every nursing fibre in my body...
So if you're not a nurse this following bit may bore you. Just finished my 2 orientation shifts back to back (ie. evening shift ends at 10 pm, sleep for 6 hrs, then day shift starting at 7am). My patients on my first shift were all VVF ladies (women having surgery to repair a hole in their bladder caused from prolonged labour, that causes them to dribble urine constantly. Often these women are abandoned by their husbands because of this and become social outcasts). Many of these women are the ones I wrote about earlier who have come from the north of Benin and do not speak French or Fon. Many of them have never been in Cotonou, have never seen the ocean and have never been in the hold of a ship, awaiting surgery, surrounded by white people. All a little scary for them. And it's a little sad to see them walking in with a big wet patch on the back of their dress! But.....help is at hand:)
The wards will definitely take some getting used to. I know I will appreciate so many things when I get back to work in Canada...simple things like blood pressure machines on wheels, overhead bed tables, space...., beds with buttons, space...did I mention that already. Most of the wards have 2 rooms with 5 beds against each wall, with about 1.5 feet between the beds. The beds are very simple beds, with ancient railings I have not yet tried to move..pretty much cots with railings. Some of the beds have mattresses underneath where a family member sleeps. I believe many of our supplies are donated from around the world, so so far I have seen medication boxes in German, and some script I could not decipher (?Arabic). And there is a sad lack of pens...if anyone has worked with me you will know, I am always losing my pens. Please send me pens:)
Today was a far more challenging day though. I had my second day of orientation with a pediatric nurse and had a crash course in peds! We had a young patient who had major maxillofacial surgery the previous day, to remove a massive!! tumour! The poor little guy just had one swollen eye peeping through all his bandages (extra bits: nasal trumpet, NG tube, foley, penrose drain in his mouth, packing in his mouth, JP drain from his head, IV, SL,...bandages...q 1 urine output, q2 IV meds, q3 NG feeds, glucoscans, q4 vital signs...and 6 other patients!!! eeh...thankfully I was orientating. We also had one tiny little patient 2. 6 ish kg, with a cleft palate, who was part of the refeeding program on the ship. So cute:) and slowly gaining weight.
Well tomorrow will be the first day on my own. Say a little prayer for me!

Scrubs and flipflops

20 minutes till my first shift...wearing my first pair of Mercy ship scrubs, which I most conveniently don't have to wash meself, and my flip flops...yup, flip flops...no WBC here:)!

Ship Life

So, I'm gradually getting used to life on a ship...bow, stern, starboard, portside...the slight rolling back and forth of the ship. This morning the clouds rolled in and the rain came and the ship has been rocking back and forth a lot more than the previous 2 days. I had orientation today and was introduced to a job risk that comes with nursing on a ship: needlestick injury related to unexpected movement of the ship! Hopefully I don't poke any patients in the eye! I am getting used to picking up my feet through every door way so as to avoid flipping over the ledges which are everywhere. Almost flipped down some stairs from the top deck yesterday. Our bathroom has a few issues...occassionally the toilet won't flush or the shower won't drain...makes things a little messy! I'm attempting to perfect the 2 minute shower...must admit that I have some work to do on that one, but that is what they ask us to do....well those are just a few of the little things that have become part of day-to-day life. It certainly is convenient being so close to work. My cabin is about 20 steps or so from the hospital. Tomorrow I start my first shift! Til later...

This morning all the new crew members went for a ship tour at 9 am. As we where finishing the tour we ran into Bill, who works in the hospital department. He invited us to join him heading off the ship into Cotonou, so 8 of use piled into a vehicle and first he took us to the Hospitality center for Mercyships, where many people come before going for surgery, and then stay there afterwards for some time after their surgeries. They do not receive treatment there but they are fed and if they run into complications they are sent back to the Africa Mercy, at any time of the night. A lot of the women staying there come from the north of Benin, and do not speak French or Fon, but one of the other 52!! tribal languages, so they require up to 3-4 translators (from English to French to Fon to ?other tribal dialect they speak). There were also a few kids there who have had their surgeries and are still not ready to go home yet. A few of the kids had received surgeries to release contractures from burns. Another little guy with neurological problems had received surgeries on both legs and was walking around with a little walker and both his legs in casts. Just having this glimpse of some of the work that is done here makes me eager to get to work!

After visiting the hospitality center, Bill took us for a drive around Cotonou, through some of the markets, and past some of the government buildings, embassies and resorts. So much to take in! Interesting to see what people are trying to sell at the stoplights (radios, wineglasses, phonecards, irons,....pretty much a portable hardware store). Traffic remains insane, as I noticed on our drive from the airport. After our mini-tour Bill took us to a hotel for some pizza and coke. Apparently the beaches here are not safe to swim along, because the currents are so strong, so a lot of the crew go to different hotels and pay a few dollars to use their pool for the day. The ship also has an above ground pool on the top deck (nothing really fancy but it's wet and in this heat anything will do!). Did I mention it is hot here yet!

je suis en Afrique

I am here in Cotonou, Benin now. I arrived about 4 hrs ago. I spent one night in a hostel in Paris (St. Christopher's...definitely recommend it, thanks Dave for that one, I loved the location along the canal). French men are a little, um, to be watched, as I had been warned, regardless of age. Some of them just stop and start following you, asking if you are alone, and what are you going to do tonight etc. etc....but so far my brief impression of Paris is great, with its boulangeries (bakeries) and outdoor cafes and restaurants on every corner! And I was able to zip down to see the Arc de Triomphe and the Champ de lysses before I had to catch my plane. My french speaking skills are atrocious but it's kind of fun trying them out. Ok, the first french words I spoke were sticking my head out of the bathroom stall at the airport to ask the bathroom attendant 'est-ce que j'ai besoin de l'argent?' (do I need money), to use the toilet...well in some places you do! and I didn't have any money at the time, so it was an important question...!

But now for Benin. We arrived in the evening, and walking off the plane was like walking into a comfortable sauna! 10 crew members arrived tonight and 5 of us were Canadian! We were all picked up in three Mercyship vehicles and had a quick trip through Cotonou to the Port. Lots of motorbikes zipping around everywhere with no one wearing helmets! Didn't see much else since it was dark. I am in a six bed dorm, with 4 others at the moment, all nurses, from Canada, New Zealand, Holland and Sweden. And really, right now it feels like I am sitting on a BC ferry with the engines humming and the ship rocking just a little bit from side to side. Well that is all for now. It's really neat sitting here and looking out the window and seeing the water and the other ships in the Port! Really I can't believe I am here. We shall see what the next 2 months bring.

28 hrs and counting

Less than 28 hrs until I leave for Benin. Not sure how scared I should be at this time. Every once in awhile my stomach drops when I think about it but then regular life carries on and I forget about it. I'm working my last night shift here in Chilliwack...and still fiddling around with this blog...new template today. The organization I am volunteering with is Mercyships. You can check it out at www.mercyships.org .

So I've created a blogspot:) Why one may ask. Well the plan is for me to head out to Benin in 2 weeks time, where I will be working on board the Africa Mercy.