The Bush

I’m sorry for the long gap between my last post and this one. It’s been fairly nutty around here lately. Tomorrow is the last day of classes, so as you can imagine I have had a lot of work to do for both my African Lit class and at the Eye Clinic. For African Lit, I gave my last presentation today on the Somali writer Nuruddin Farah’s “My Father, The Englishman, and I,” and I just finished typing my take-home final exam, and I’ll hand it in tomorrow. If you’re looking for a good read, I would suggest looking up some Nuruddin Farah. He’s a good writer, and his books are shockingly progressive and sensitive to the trials of African women; his portrayal of Somali women is surprisingly touching and accurate for a male writer.

Anyway, moving on from complaining about my workload, I wanted to write this post about the time I have spent out in the bush in the last week. On Wednesday and Friday, I was lucky enough to be able to go out with Dr. Sumit Kar, who is Dr. Tulika’s husband, and who runs the Primary Healthcare Project (PHP). It, like the Eye Hospital, is funded and supported by the Tulsi Chanrai Foundation (TCF) along with some cooperation from the Adamawa state government (they seem to mostly provide the vaccines and some other small items). Anyway, PHP is a really interesting operation. They have created 24 “Health Posts” in the Yola area. These Health Posts are basically small mini-clinics staffed by one or two Health Attendants (the number depends on how large the community they serve is). These Health Attendants (HA) have been trained by PHP and TCF for about 5 months in primary healthcare. They keep tabs on everyone in their villages, and they check in on “Priority Families,” which are those with a child under 5 and/or a woman of childbearing age (15-45). As you may imagine, this is almost every household in their area. They also conduct ante-natal workshops with expectant mothers, administer Tetanus Toxoid I and II, test hemoglobin, take blood pressure, and screen for blood sugar and excess protein in the urine (which is a sign of pre-eclampsia), When the time comes to have the baby, the Health Attendants deliver the child either at the Health Post or at the woman’s home, depending on whether the woman comes to her or sends someone to fetch her to her home. If the delivery is too hard, there are complications, or the woman is in labor for more than 12 hours, they call for the PHP’s ambulance to take the woman to the Primary Health Center, which serves as a low-grade hospital for the PHP. It’s staffed by women and men with more medical training than the HA’s, so they are better able to handle difficult deliveries. If the woman needs a C-Section or the PHC can’t handle it, they will send the woman to the hospital. Unfortunately, she will have to pay if she goes to the hospital, but everything that PHP directly provides is free.

Dr. Sumit took me out to some of their more remote Health Posts out in the bush to check in the Health Attendants (which he does weekly), and to see how their operation works. It was amazing to meet these Health Attendants, and I was so happy to see all the women who had showed up for their antenatal visits on Wednesday (they do antenatal counseling, etc. every Wednesday). Adamawa state has the highest maternal mortality rate in the world. I believe Dr. Sumit said the rates is around 1,500, and Nigeria as a whole is roughly 1,000. If you look up other rates, you’ll see how high that really is. I am no expert, but it seems to me that this is largely because women (and everyone else) have no access to healthcare of any kind. These Health Posts and Attendants are the first and only facilities for these women. So, further out in the bush and outside of the project area, if a woman has complications or if she hemorrhages after giving birth, there are absolutely no resources to help her, and she will often die as a result. 1 in 5 Nigerian children don’t live past the age of 5, and I would suspect that the rate is much higher in Adamawa. If you look at the case sheets of the women at the health posts, you’ll see that many of then have had 5 or 6 pregnancies, but only have 1 or 2 living children still. The PHP also works on children under 5, providing treatment if the child is sick, and supplemental feeding if the he is malnourished.

Health Attendant Aisha with some of the people at her health post in Philinjirgi.

On Friday, I went out with him again, and I got to see an immunization day at one of the health posts. They do them once a month, and they provide all the immunizations on the routine schedule from WHO. These include DPT, measles, polio, Hep B, yellow fever, etc. It had rained all night and all morning, which means that there weren’t as many mothers as usual. There were still about 90-100 women with infants and toddlers there, and it warmed my heart to see all them taking such good steps to safeguard their children against the many preventable diseases that cause the deaths of babies and children. I wanted to take a photo, so I asked a couple mothers if it would be okay, and they said yes. Little did I know what I had started. After I showed the women their photo on my camera, everyone in the room wanted me to snap them (that’s what people call it here “snapping” someone). That took some time, especially since you have to show them all the photo.

A C.H.E.W. doing an immunization day at one of the health posts

If I thought I got stared at and followed when I was in Yola and Jimeta, it was nothing compared to the stir I made out in the bush. There were people on the side of the road as we drove by (though “road” is really a generous term—dirt path is a more accurate term), and their eyes would absolutely bug out and their mouths literally dropped open as they say the Bature drive past. The little kids followed me everywhere, and, at one point, we went to visit a woman who had delivered the night before, about 20 kids and a goat followed me into their compound.

This was about half of the group following us around the village/health post. I am even more of a novelty in the bush

These are some of the traditional huts/homes that people live in out in the bush and away from the cities

Anyway, I really learned a lot on my two days with Dr. Sumit, and I enjoyed it out in the bush. I would love to share the photos with you, but, alas, the internet is still too slow. When I get back the US, I will go through and add the appropriate the photos to the right blog posts.

On Sunday, I found myself back out in the bush, again. We drove about 2 hours out of Yola on a dirt road to an area called Yadim, which is inside Fufore Local Government Area (LGA--states are divided into smaller administrative districts called LGA’s). We went out there because in the mountains near Yadim there is a waterfall. The drive to Yadim was fairly life threatening in a of itself, because after about 30-40 kilometers down a bumpy dirt road, we turned off the road, and drove through the grass, and over one terrifying rock passage that, if the car was off by 2 inches, would plummet you into a hole that would leave the car stick there for all eternity. Anyway, we miraculously made it through the drive, and then we parked under a couple of trees and started walking up. I think I should, at this point, explain that it was not made clear to me of exactly what "going to the waterfall" entails. I was told to wear long pants and tennis shoes and bring my swimsuit, and that was it. I was not told that we would be hiking straight uphill through what I would, generously, term a boulder-laden minefield completely covered by long grass that grabs your ankles and makes you fall. This was all, of course, happening between 10:30am and 2:30pm, which means that it was blazing sun and 95 degrees. I am usually a fairly good hiker, but I hadn't eaten breakfast (the caf doesn’t open until 7:30, by which time I had already been picked up), and I think I had heat stroke, making it a tad more difficult. However, since there is pretty much no option besides going up or walking back down alone, I made it to the waterfall. Upon arriving at the waterfall, it was clear that the hike was actually worth it (something I was questioning whilst stumbling up the mountainside). The waterfall was absolutely beautiful. We were down at the bottom of the fall (which is still at least more than halfway up the mountain), and apparently at the top, there’s a lake with a village next to it where the people live very traditionally, because they are so hard for the outside world to reach. I think some of the other people in the group who live in Yola permanently-ish might try to get to the top sometime in the future). The waterfall cascaded down into a pool at the bottom. Because the rainy season is really just beginning, there wasn’t too much water, so we could actually sit directly under the falls and get a nice shoulder massage from mother nature. We went swimming in the pool, which was about waist-deep at the most, and the water was actually quite cold, and, after the hellacious hike it felt really nice. After an hour or so of swimming and eating and laying out in the sun to dry off, we headed back down. Fortunately, the walk back down was much shorter, but I think the sand that was coating the pants and socks of everyone made it slightly less comfortable. If I thought the walk up was dangerous, the walk back down was absolutely treacherous, and as Rachel and I noted, it was an absolute miracle that we all made it down alive and no one went catapulting down the boulder-y mountain. We had some guys from a local village volunteer to bring us up and back down, which was incredibly nice, and they kept laughing at us a little because they can scamper up and down so easily and the Bature were huffing and puffing and slipping and asking them to hold our hands over tricky bits. I am fairly certain that they could have made it up and down three times in the amount of time it took us to get halfway up. An interesting example of how people adapt to their environments. They didn’t ask for it, but we paid them some money and gave them all out extra food and water and soda when we got back down to the cars. Also, we gave a small tribute to the Oga of the area, which is basically, the “big man” of the village. We actually passed through two Ogas’ land, and we refused to pay all of them on principle, but gave them a small tribute upon leaving as a thank you.

Our first view of the waterfall

Sumit, Rachel, and Me standing under the waterfall. Nature's answer to the neck massage.

The view from underneath the falls

We finally (and somewhat miraculously) made it back to the bottom on one piece. Please note my sunburn.

Unfortunately, I also sustained my first Nigerian sunburn on this trip. I had made it more than 5 weeks without burning, and I was hoping for a real victory in the form of a sunburn-free time in Africa, but, alas, it is not to be. It would appear that SPF-50 sunscreen, no matter how sweat-proof, is no match for the Yola sun, which was so intense. I applied it 3 or 4 separate times, but still got a little burned on my shoulders and arms. My face, however, isn't really burned. My back is scorched, though, because I completely forgot that I hadn't put sunscreen on it after I had changed into my swimsuit. It was only exposed for about 30 minutes, but there you are. It's not as bad as some of the ones I got when I was younger, and I don’t think it will blister or peel (which is a good sign skin-cancer-wise), but it was quite red for 2 or 3 days. When I went to get my shots and meds before I came to Nigeria, the nurse said that a side effect of the anti-malarial, doxycycline, that I am taking is an increased sensitivity to the sun, so she said I might sunburn more easily, but that a strange side effect is that it wouldn’t hurt. I don't know what the nurse was talking about, because it did hurt quite a bit, and my anti-malarials seem not to be removing the pain.

This post, in particular, is really making me wish I could post photos, because I don’t think my descriptions can do the waterfall justice. I will post good photos when I get back (in only 1 week!) so you can really appreciate the place.

It’s strange to think that I will be leaving for the US in only one week. It feels like its gone so fast, but I simultaneously feel like I have been here forever. I’m really going to miss my Nigerian friends at the Eye Clinic, and also at AUN. People here have been so great to me, and I am continuously struck by the generosity, kindness, and warmth of the Nigerians I have interacted with. As I keep saying to people when they ask me if I’ll come back, I don’t know when I will be able to come back, but I will most definitely back in Nigeria again!

I’ll be leaving Yola on Monday morning to go to Abuja. While I am there, I will be able to see and help out at the Pediatric Eye Camp, which I am so excited to see. I’ve seen most the children that the Yola Hospital is bringing because they’ve come in to be examined by the Doctor and then they have been at the hospital for a few days getting tests to determine if they are physically fit enough to undergo general anesthesia.

I am not sure if I’ll be able to get on the internet to post about the Eye Camp while I am in Abuja, but I will post one more time before I leave Yola to tell you all about my African Lit class, the Fulani Market, my work at the Eye Clinic, and the other things I have been up to these last few weeks.

On a side note, the phone network, Glo, which is what my cell phone uses, has been out for more than a week, so I am unable to make or receive calls. About 75% of the time I can get and send texts, but, when the internet here goes out too (which is does a lot), I feel completely cut off from the world, and I find it really frustrating not to be able to let people know if I am coming or if I will be late or anything. Also, the internet has stopped allowing me onto facebook, so those of you who are accustomed to communicating with me that way, I would recommend sending an e mail if you want me to respond to you.

I’m looking forward to seeing those of you in Minnesota in just a week and those of you in DC in only two months. I hope you’re all well, and, as always, shoot me an e mail or leave me a comment to let me know how you’re doing!