Finally Back Online!

My apologies for the long break between posts--after a very intense storm here the internet has been very sporadic in the whole town. But, it's finally back now and I can tell you what I've been up to.

The past week has been a very fun one, and one that has given me even more good memories of this country. In the health clinic, I've spent a lot of time in the wound care ward. I've seen patients with a variety of wounds caused by anything from cooking accidents to falling while using the toilet. Yesterday, I even helped one of the nurses give stitches to two patients, one who was assaulted by her brother (the police brought her in) and one who presented a large laceration on his right shin. Helping the nurse with these stitches reminded me of my own injury prone childhood, where I received stitches quite often.
I also have started to cover the outpatient ward for the nurses, who value midday naps due to the rigor of a midsummer Ramadan. If there is a unique case that I have not seen before, then I ask the nurse what steps to take. However, most of the patients nowadays are small children who present vomiting and fever. We test these kids for malaria and then prescribe medication according to the test results. Luckily, we have not seen too many cases of malaria.

This past Sunday, our group travelled to the Senegambia Beach Hotel to enjoy a nice day at the beach together. I enjoyed a sunburn-free beach excursion, and also enjoyed bodysurfing the large waves. I got out of the water after two Dutch fellows pointed to a large, dark, fast-moving shape in the water no more than five feet from where I was swimming. I do not know if it was a shark, a ray, or a barracuda, but I was not willing to find out. I sprinted out of the ocean.

After the sun set, we went to a pizza restaurant up the road. Having not consumed anything all day except a Guinness and a Fanta, I ordered a family-size pizza for myself. To my surprise (and probably the disgust of everyone else), I finished the entire pizza, along with half of Brenda's fries, a slice of Sam's pizza, and three beers. Luckily, I've been running and lifting every day to offset the potential harm of that day of the "Michael Phelps Diet."

Tomorrow marks our last day of work at the health center, and we are planning an 11:00am farewell party for all of our friends there. It will certainly be a bittersweet moment, as all goodbyes are. But a major positive of this party will be that it signals the beginning of travel week.

For travel week, we are planning to go to the town of Juffreh, where Kunta Kinte was from. This town has a rich, yet infamous, history in the slave trade. It will certainly be a worthwhile excursion to be an eyewitness to a large and important era in American history. We are also planning (if funds allow) a trip to the President's hometown of Kanilai, which boasts one of the most modern infrastructures of any Gambian city, as well as an impressive zoo. In addition, we would like to take a river cruise to see the untamed, untouched, and unbelievable portions of the River Gambia. Throughout travel week, I still plan on running and lifting every day, and buying gifts for family, friends, and myself.

Last, but not least, today is July 31st, which is of course the last obligatory day of "no-shave July." However, I'm strongly considering bringing the beard home with me to the states. If you feel strongly one way or the other, speak now or forever hold your peace.

I'll leave you all with a picture of a wooden lion I had made by a craftsman across the street. The price: $4.

A Blog Post With Pictures!

As I alluded to in my prior blog post, we had an exciting weekend planned. This mainly involved a trip to the Abuko Nature Reserve, a small but dense and diverse plot of land in the middle of the Serrekunda suburb of Abuko. This was a small taste of a real African rainforest, and I was absolutely fascinated by some of the things I saw. I have below a bunch of pictures to post both about our trip to Abuko and about our trip in general. I hope you enjoy them.

Above: Some hyenas lounging around. These were some big boys.

Above: A monkey (Nameus Unknownus)

 Above: Me and Nurse Jakka's son, Muhammad. I don't

think he very much enjoyed my company.

Above: A fisherman at dusk. My inability to shoot a clear photo actually

turned into a neat result: an impressionist photograph. 

Above: Independence Stadium, the largest stadium in The Gambia. 

Austin and I use the gym facility located inside. 

Above: A pond/swamp at the Abuko Nature Reserve. Our tour 

guide told us that about a dozen crocodiles inhabit this water, although

we didn't see any on our excursion.

Above: Me breaking the law.

Above: One of the most humorous political billboards I have ever seen. If

you cannot zoom in, it says: "From darkness to light with President Jammeh. You

cannot afford to continue hating yourself by not voting for him in 2011."

The Clinic and the Craft Market

This past Friday, I travelled with the mobile clinic to the town of Mandinary, located just North of Lamin, a village that borders Banjulunding. This clinic resembled the same rural and agrarian landscape as the clinic in Jambur, except this clinic hosted about four times as many patients. It was quite hectic, and the fact that there was no water provided for us at this clinic (Ramadan began that day) exacerbated the anxiety that comes with disarray. One of the bright moments, however, was that I was able to administer vaccines via syringe to a handful of babies and toddlers. It was not pleasant to hear them cry once the needle entered their leg or arm, but it was thrilling to give shots. I administered the Penta, pneumonia, and yellow fever vaccinations. The yellow fever vaccination was by far the most difficult to give because it required injection into the deltoid muscle (shoulder muscle), which in young children is quite small and underdeveloped. Plus, the children were much better at moving their arm than their leg during the vaccination. After the clinic finished and the last patients were attended to, we waited three hours for the ambulance to come pick us up. The delay was caused by the president, who requires the road to himself whenever he travels, thus causing traffic nightmares.

Friday evening I did some sprints on the beach along with some ladder agilities. On my final 40-yard sprint (which of course was run in record time), I ripped open a blister on my left big toe. The sand was simply too abrasive for my baby-soft skin. I suppose I will have to run in sneakers on the beach from now on.

Today I slept in and woke up at about 9:30am. After some breakfast and chocolate milk, I went to the craft market with Austin and Michelle. Austin bought an ornate mask that is quite scary and fascinatingly tribal. I set my sights on less expensive wooden things, and picked out perfect gifts for my friends and family. One of the shopkeepers wants to trade something for my old Nike trainers when I leave. I told him he was crazy to want these old pieces of crap, but I'd be happy to trade him for something small.

I took a nice run today back from the stadium, and felt really fast. It's a beautiful route along the coast, and the colorful scenery and ocean air certainly contributed to my willingness to run fast. When I got back I did the p90x ab ripper and hopped in the pool. Does life get any better than this?

I'll leave you all with a picture of a mask I bought myself at the craft market. It's a Monday mask, and I bought it over all the other days of the week because everyone needs some humor on Monday, right?

Three Weeks Remaining

Today marks the point at which we have three weeks remaining in The Gambia. The past month has flown by (as everyone told me it would), and although I am anxious to ultimately return home, I hope that these next three weeks pass by as meaningful and memorable ones.

Yesterday I ventured back to the hospital to resume my volunteer duties there. I sat in the outpatient ward, which is quickly becoming my favorite part of the health center. The nurses there are more than willing to provide me with first-hand experience, and they make the day fun as well. As soon as I arrived, one of the nurses handed me the sheets of paper and said, "you screen today." With her translational aid, I took patient information, documented the symptoms, diagnosed the patient, and wrote prescriptions to treat symptomatically (the medical philosophy of the health center). Of course, I had the nurse looking over my shoulder the entire time if I made an error or needed assistance. Still, this sense of independence was exhilarating and reassuring. It was another great day at the hospital.

This morning, Austin and I did some agility work and sprints on the beach right outside our hotel. There's something nearly effortless about training on the beach. There's no need for motivation because you want to be out there all day long. I plan on running on the beach most mornings here.

We have an eventful weekend planned. Hopefully it all turns into a great story to post on the blog!

Our New Home: Bakau

I should preface this post by stating that I am writing it from my mobile phone, since we do have Wi-Fi (slow, but existent) at our new location. Also I should say that our new home is called the Cape Point Hotel. I think I gave some of you the wrong name by accident.

Our new home is fantastic. We all have our own beds and we have a nice balcony overlooking the hotel grounds. We also have a small kitchen so we can still cook traditional Gambian dishes and some of our own creations, thus saving a lot of money by not eating out every night. We are very happy in our new location, and still can easily fulfill our main obligation to the health center via two short van rides to Banjulunding. It is truly the best of both worlds--we have a comfortable place to stay all our own, and we can still perform our volunteer duties at the hospital where we are needed.

I apologize for not keeping up this blog more frequently, but of course the last week has been quite hectic. Now, a little more about the past few days:

We moved out yesterday at noon. A few members of the village stopped by to bid us a temporary farewell, but I think overall their emotion was apathy. This disappointed me slightly, as I thought we had made enough strong friendships with our neighbors to warrant a bigger and more emotional departure from our house. But we left anyways, Austin and I riding in the bed of a pickup truck piled high with all of our belongings. We spent the rest of the day getting to know our new surroundings, giving much appreciation to the hot water and internet access. We dined out that night, and shared a little joy amongst ourselves to make up for the bittersweet occasion earlier.

This morning, since it was not our shift for the health center, Austin and I ventured into town to buy supplies for the group, including food for cooking, cleaning supplies, and some green tea to make ataya. After this, we went looking for the nearest gym facility. We walked a probable distance of five miles, even though the gym was only about 1.5 miles away (we like to think we received poor directions). One of the positives of this extra walk, however, was that we got to pass the US Embassy. Since there were no signs telling me otherwise, I snapped a photo of the flag and the building in front. Of course, right when I took the picture, three Gambian security guards employed by the Embassy came out to talk to us. They made me delete my photo, and took my information and photo. They explained, extremely cordially, that the renovations to the embassy have caused the "no photographs" sign to be removed, and that they are simply following protocol by taking our information. Actually, it made Austin and I proud that America takes its security so seriously, even in a country as small as The Gambia. The guards let us go right after that, and we were on our way to the gym.

The gym is located in a big stadium in Bakau, and resembles a shoddy middle-school gym. However, it had everything to meet our needs, and so we bought a one-month membership for 100 Dalasis (3 dollars). We got a great lift in, and are extremely excited to return tomorrow.

I'm very much looking forward to the beach at sunset tonight, and to eating the dinner of pasta and vegetables that the girls are cooking for us tonight. Tomorrow I return to the health center to work, and I am anxious to see all of my friends and help to the fullest extent of my capabilities.

The attached picture is the view from our hotel balcony following an intense rainfall earlier today.

God Bless!

We're Moving!

Due to the inherent uncomfortable situation that has come about by sharing our house with another unpleasant and quite off-putting man, we have decided as a group to move out. Our group leader has arranged for us to stay at a hotel on the beach (poor us, right?) for the remainder of the trip. We will, however, still be working at the health center during the week and we will certainly be maintaining contact with the rest of our friends in Banjulunding, of whom there are many. We are still extremely fond of Banjulunding village, the health center, and our friends throughout the Gambia, but feel this is a necessary step to making our time here as pleasant and meaningful as possible.

Once we get settled in the new place, I'll post a much more detailed and photographic post!

And since all of you probable share Matt's inquiries, I'll address them now:

1. Yes, it is really hot and humid here.
2. I haven't seen any lions
3. I haven't seen any patients with HIV/AIDS
4. I mostly eat rice, fish, some chicken, bread, hard-boiled eggs, and peanut butter. 

Ataya Lessons

I've learned many good skills this past week, both at the hospital and lounging around at the house. First, I will boast of my success bargaining. After paying too much for most of the things I have bought so far (they run largely on a bargained price system), I was determined to improve my haggling skills. I am told that when I bargain, I am too nice. Thus, I focused my intelligence and harnessed my inner jerk. I went to Serrekunda (the biggest city) and successfully bargained a lot of fabric as gifts for family and friends at the market. I took to bargaining with the same tenacity that I bring to football or academia, and it paid off. I got 14 meters of very high quality fabric (of various designs) for a mere 630 Dalasi (about twenty dollars).

At the hospital, my skill set grew as well. I have worked in the outpatient ward the past two days, and learned how to prick fingers to draw blood, and use this blood to run an assay that tests for the P. Falciparum strain of malaria. No patients really enjoy receiving this test as much as I enjoy giving it. There was one six-year old in particular who cried bloody murder when he saw the finger prick emerge from behind my back. After a few minutes of struggle and the help of his father, we forced a finger into position and successfully drew blood. The kid gave the loudest shriek I have ever heard emerge from a human being. All of the nurses laughed, I think. I still can't hear a thing. I held out my fist for the child to "pound" my fist as a gesture of goodwill. He wound up and punched my fist as hard as he could, and instinctively I moved my fist to avoid the blow. His fist wound up meeting the side of the desk with a loud "whap!" and he shrieked again. I fear that this child now hates my guts.

At home, I have learned a skill that I think my father will enjoy tremendously. I can now brew ataya. Ataya is a tea that the Gambians love to make, very strong and very sweet. There is a certain way you must add the ingredients, boil the water, and mix the tea to make a nice froth on top. It is quite difficult to master, but I am getting much better. I look forward to bringing home my ataya pot and brewing some for the folks.

I hope to upload some pictures soon. I've been taking a bunch and hope to share the good ones with you all.

Abarraka (thank you in Mandinka)

-Yusupha (my given Gambian name)

"Nobody Has a Monopoly on Knowledge"

It was a great weekend here in The Gambia, and Sunday was no exception. After a great lunch at the house of Mr. Salifu Kujabi, we listened to him talk about the miracle papaya, traditional healing, and Gambia's history. I learned a lot about the country, but in particular I remember him saying that nobody has a monopoly on knowledge. This stuck with me, and I think it is a very important thing to remember as a visitor to a foreign country.

After lunch we walked to the crocodile pool, and I got to touch a six-foot crocodile. I tried to hide it, but I think the camera captured my petrified state. The photos are unfortunately not on my camera, so I will try to locate them later.

Sorry for the short post, but I have only a few minutes left of internet for today. Hope all of your Mondays were enjoyable!

A Birthday, A Wound, and Continued Humidity

It was a really hot day today, but one that was of the utmost pleasure and fun. I first want to wish a warm Happy 25th Birthday to Ashleigh Woodfield, who has touched my life posthumously in a plethora of positivity. In memory of her birthday, and since they don't sell Sour Patch in Gambia, I bought the local kids an orange soccer ball to play with. They have been begging us for soccer balls ever since we arrived, and usually play with mangoes or rocks. I thought it would be a nice reward for them to enjoy some fun and laughter on Ashleigh's birthday, and I think she would have enjoyed the sound of children laughing and enjoying a simple but rare game of soccer with a real soccer ball.

Work at the clinic today was extremely interesting. I worked in outpatient services with a nurse by the name of Therese for about an hour, after which time we moved to wound dressing due to the absence of the normal nurse in that area. I watched her clean and dress about ten wounds of varying complexity. This usually involved washing the wound with a saline solution and cotton swab, applying hand sanitizer or hydrogen peroxide to the wound (the former was quite a shock to me), putting some form of antibacterial ointment on the wound, and dressing the wound with a bandage, usually a gauze wrap. Therese began to get hungry (as they take breakfast around 10:00am), and so Michelle and I volunteered to take over for her in the interim. Of course, the first patient we saw was by far the worst of the day. He had massive open sores on his left hand, which was immensely swollen and severely infected. He said that these wounds were not the result of an injury, that they had more or less spontaneously formed a few days earlier. I'm not sure what could have possibly caused these injuries (one could clearly see the bone on his ring finger, and could nearly see through the hand in other parts). One thought of mine was that he had an infected form of Leishmaniasis, but of course this diagnosis is given without real medical knowledge. Michelle and I treated the wound as per the protocol of the medical center, and I think we did a pretty good job. Using scissors and forceps, I removed the infected portions of skin (which essentially fell off) with as close to surgical precision as is possible for and untrained twenty-one year old. The man writhed in pain throughout the cleaning and dressing (as all of you know who have ever been administered hydrogen peroxide), but insisted that we continue. He was very pleased with the dressing at the end, and was given some oral antibiotics to hopefully stop the infection. We treated about four more wounds of far lesser magnitude in the same manner, and stopped when there were no more patients to be seen. It may be strange to say, but this was the most fun part of the trip so far. I felt as if I was actually making a difference, a big difference, by performing a medical service. I hope days like this are many in the future.

It looks like it is about to thunderstorm here, so I must cut the blog short and hustle home before I get stuck in the mud. Best wishes to Michaela as she flies off to Europe today. Also very excited to hear of the great advances in Uncle Rob's health! I can't wait to see everyone when I get home, and eat a few McDonald's McDoubles with you all. Unfortunately I have no pictures today, as I didn't bring my camera to the internet cafe, but expect more in future posts.

Love,

Jon

Independence Day

Happy 4th of July everyone! We celebrated by doing the most American thing we could think of: we went to the beach. The beach we went to is located in a part of Gambia called Senegambia, and fairly close to the monkey park I discussed in my earlier post. We arrived at around noon at the beach bar called Poco Loco, and enjoyed some hamburgers, spaghetti bolognese, Gambian beer, and of course a nice glass of Johnny Walker Black Label Scotch. All of this cost only around $20, which made it even better.

The ocean was extremely warm, the warmest I've ever felt it, and the water was fairly clear. The waves weren't too high, but succeeded in removing my sunglasses and hat on my final walk out of the water. Fortunately, we found my hat. Unfortunately, my sunglasses were never found again (sorry, Michaela, you're always right). I survived the day with only a small major sunburn on the part of my back I couldn't reach with sunblock, but this is a really bad place to be burned when you're doing bench press at the gym the following day.

In the evening, we tried to go to the casino near the beach, but were really disappointed when they didn't have a craps table and when there was a minimum D1000 buy-in to any table games (there were only three total, as the casino was perhaps 100 square feet). Thus, we left without ever placing a bet. I suppose that is never a bad thing to break even after leaving the casino...

Today is Thursday, which is always the busiest day at the health center. I assisted in distributing mosquito nets to the pregnant women and women with infants. When I worked a travel clinic on Tuesday, I vaccinated about fifty babies against polio and administered vitamin A supplements orally. I'm hoping that I can move on so syringe injections by the next clinic.

I'm looking forward to a cooler, less humid weekend here, one that allows me to sleep soundly and not in a puddle of my own sweat. I think the luxury I miss most of all at this point is air conditioning.

Here are a few  pictures of the beach day and other things. Now that I figured out how to post pictures I hope to include them more often:

 Above: The health center in Jambur where we held one of our field clinics

Above: Some of the public health students and I crammed into the ambulance. There were 17 of us in this vehicle.

Above: Fourth of July with the flag at Poco Loco. Notice it is "No Shave July."

Above: Sunset at the beach

Sunday is for Football

This past Sunday (yesterday), I played in a village friendly soccer match with some of my fellow Crossroaders and young people from Banjulunding. It was tough to keep up with the fast-paced game, not only because we were playing with a few players from the Gambian professional league, but because the soccer field was more of a beach. Running on sand is much more difficult than running on grass. Nevertheless, the Gambians were very generous with the ball and made sure that we had our chances to kick the ball and be a part of it. We started off slowly and by the end of the first half we were behind, 1-0. In the second half, one of our pro players took over and scored (rather easily) a goal from outside the box. Later on in the half, I received a cross from the right side and somehow managed to put my left foot on the ball, sending it past the keeper on the far post for a goal. I blame luck, not skill, for that one. Regardless, it put me in a great mood. We ended up winning 3-1 (with the help of a few calls our way at the end), and were exhausted afterwards. After a brief three-hour nap, we went to our friend Sambou's house and watched the final of the UEFA Euro cup. I was rooting for Italy (because Spain always wins), but of course Spain annihilated Italy and that was the end of it.


Today was another day of firsts for me at the health center, as I was put to work in the "pharmacy" section. In reality, this was just a table with a bunch of pill bottles on it, but it was fun to decipher the prescription in terrible handwriting (as always), count the pills, and put them in a little paper cone for the patient to take home with him. I even learned a few now-forgotten commands in Mandinka that tell the patient to take two pills in the morning, afternooon, and at night.

In the evening, I visited the monkey park and the beach in Senegambia, one of the "touristy" areas of the country. This was amazing, and we got to see many monkeys in the trees. Unfortunately, I am inept at making the camera function properly in low light, so many pictures came out blurry. The beach was incredibly beautiful, and it was quite remarkable to be on the other side of the Atlantic. Connecticut, home, is just across the way...


I realize I've been lacking in uploading pictures to the blog, so here are a few choice photos to let you get an idea of the country in which I've spent the last week and a half:

 Above: Our house with a few people out front. We occupy only the left side of the house.

 Above: Two youngsters, Kaybah and Dadi, play with a hoop after some rainfall.

 Above: Some front squats at the local gym. The weights are all old car parts and are quite heavy. 

Above: Lamin and I before the second day of work at the health center. In my defense, this was really early in the morning.

Above: The labor ward at the health center.

Above: A few blurry monkeys at the monkey park