Culture & Adjusting

Well, after about a month in Cameroon, we have come to "appreciate" some of the cultural differences we are exposed.

1. Today, there was a herd of cows eating our grass and pooping in the front yard.

* this is the same group of cows. Last week they stayed on the other side of the road out of people's yards.

2. Keys: we have a total of 6 doors in our house. We have a different key for each door in the house. We have only 1 front door key and 1 back door key. We have a key for the refrigerator. We have a key for the laundry room. We have a key for the safe. We have 9 keys to make our home functional, and no spares for any of them.

* our keys

3. Phrases:
     a) "Aasha." This roughly translates to "my condolences for your hard work," or "that is rough, keep your chin up," or "I'm sorry for your load." When in doubt, you can always respond with "aasha" and it seems to make sense.

     b) "You're Welcome." If "aasha" seems to fail you, "you're welcome" seems the next best phrase to use when unsure about what is appropriate. We are often greeted in the hallway with "you're welcome!" - much like: "you are welcome to work here, thank you for your time."

     c) "Purging." I finally discovered that "purging" was in reference to diarrhea and not vomit. Many of my patient's stories make a whole lot more sense now.

     d) Stool. Stool is at times called feces here in Cameroon. "Poop," however, has no meaning. More commonly, our friendly four-letter word beginning with an "sh" and ending with a "t" is the common vernacular. This is taking some getting used to. What wonderful things is Cathen going to be saying when we come back stateside?!?

4. Time: Time seems to have little bearing on how things operate... with the one exception of morning chapel, which starts promptly at 6:40 every morning. Otherwise meeting at 11:30 might mean 2:30, a STAT lab might come back the next day and as "O/S" (out of stock), and a chest radiograph might take a week to obtain. However, everything gets done, and everyone works on behalf of their neighbor; but our typical urgency simply does not translate.

5. Fire: two weeks ago, Mbingo mountain was set on fire. We thought it an interesting spectacle, but assumed it was a controlled burn. Apparently it was not. Many people fought the fire overnight to prevent property damage and injuries. Today, after a few days of rain, the entire mountain is green and lush.

* flames on Mbingo Mountain

We are adjusting and learning to live more comfortably in a new environment. Thank you for your thoughts and prayers. More later.

Week 2 Update

We are over two weeks in to real work on the pediatrics ward and the neonatal unit. It has been humbling to say the least. We often have a good idea as to what we would like to do, but sadly are unable to do it due to lack of resources. Other times, we are seeing diseases more common in developing countries and aren't as clear what to do. Thank you, for those of you who have fielded our internet consults! However, we are eager to learn and are excited about our time here at Mbingo.

Perhaps the most exciting thing about Mbingo is that it is a true teaching hospital. Our role here is not only to serve as pediatricians, but more importantly, to train the Cameroonian residents and nurse practitioners. We are also blessed to be neighbors with many of the training staff, and have the opportunity to become friends and not just co-workers. There are a number of small children that live across the road, so Cathen will have plenty of friends to play with as she gets a little older.

In addition to working, we've been trying to get outdoors and enjoy the hiking.

Pathology

Well, one week completed on the wards... and there has been much to see and do. Perhaps the greatest challenge has been learning how best to manage and care for these children with limited resources - to not get frustrated when I know what is theoretically possible, and yet so far removed from what I can currently offer. It is a struggle, but it emphasizes the role of compassion and empathy and reminds me that true healing does not necessarily come from medicines and studies.

What I have seen this week alone (or at least what it appears I have seen... I don't always have access to the true diagnostic study):
1. Necrotizing enterocolitis with bowel perforation
2. Septic arthritis
3. Sickle cell disease with osteomyelitis
4. Chronic inflammatory demyelinating polyneuropathy
5. Rheumatic heart disease
6. Neonatal sepsis
7. Neonatal jaundice with severe dehydration
8. Ambiguous genitalia (query androgen insensitivity)
9. Severe hypothyroidism/cretinism (adult height ~3 feet, myxedema, macroglossia, etc.)
10. Posterior fossa brain tumor (with diplopia, ataxia, proptosis)
11. Pierre Robin sequence
12. PCP pneumonia
13. Typhoid
14. Hydrocephalus
15. Pyomyositis

The list continues... almost everyone has true pathology and needs medical care. There is never a dull moment, never a visit without cause. As Cathen is settling into her new home, Lindsay will be starting up this coming week; and Angela (Chuck's wife) will be starting up on Monday. What a blessing to have partners to run things by. Thank you for your prayers and encouragement. More later.

Rest, Relaxation, and Anticipation

Today was our first weekend. It is also a national holiday - Youth Day. We awoke early, had a wonderful breakfast of coffee (grown, roasted, and ground all within our hospital complex), yoghurt (made yesterday by Angela), honey (locally grown here at the hospital), and fresh pineapple and papaya. After breakfast we hiked down to Mbingo II, the next town down the road where all of the schools in the vicinity were gathered for Youth Day. The day celebrates the upcoming generations of Cameroonian children, and honors the hard work and dedication that they place into schooling and education. There were many people in attendance, and it was a wonderful display of pride in their younger generations.

Below are a few pictures from the event:

I have purposely not posted too many pictures of the landscape on the blog. We are currently experiencing the Harmattan - a strong, dry, and dusty West African trade wind that covers Sub-Sahran Africa with dust during the winter months. When the rainy season comes (about 1 month away now), the dust will settle and the surrounding valleys, plateaus, and vistas will become fully apparent. For the meantime, here is what we are seeing:

Overall it has been a lazy Saturday. We will attend church tomorrow with the local congregation, and then we will prepare for Monday: my (JR's) first day on the pediatrics ward! I am eager to interact with the residents, the staff, and the patients. I just hope that I have something to offer. Please keep us in mind as we learn how best to teach, treat, and care for the people here at Mbingo.

Firsts

This first week at Mbingo has been a week of many firsts for the Young family.

- The day before we left, Cathen first babbled: “dah, dah, dah.”

- Our arrival to Mbingo was an abrupt first introduction to Cameroonian culture and hospitality. The people are gregarious, kind, and genuinely welcoming

- On Sunday, we experienced our first Cameroonian church service

- Cathen’s first sleeping with a mosquito net

- Our first mouse kill

- Cathen’s first guitar lesson

- Cathen's first bath in Cameroon

- Our first introduction to local food: fufu and njama-njama

It has been a busy week, and a week of many new sights, smells, faces and words.  Parenting has been difficult. Cathen, although not yet crawling, still manages to get her hands into everything, and it is a challenge both to appropriately monitor what she gets into her mouth, and to relax and let her grow. We have had our first arguments in Cameroon, our first experiences of forgiveness, and our first time as a family to sit together and give praise for our blessed life here at Mbingo. Thank you again for your well wishes, prayers, and support.

Next week: our first days serving as Pediatricians at Mbingo Baptist Hospital!

The Trip and The Arrival

God is very good. 

We seemed to run into constant roadblocks and challenges leading up to our departure for Mbingo on February 2nd. First the sale of our house fell through in December; then we hit a deer and wrecked our car while in NC two weeks before leaving; then our visas threatened not to arrive; our malaria medicine did not arrive on schedule; and finally we found out that our air carrier would not allow me to hand carry my insulin. We began our journey excited, but also very apprehensive and a little frazzled given the circumstances. However, all things fell into place - our house is now rented, the car is fixed, the visas arrived 48hrs before take off, and I made it to Cameroon with my insulin in hand.  God is good!  

We are now here at Mbingo Baptist Hospital, having arrived at our new home on February 4th around 4pm. The trip itself was rather uneventful, our layover in Paris went smoothly, there were no problems with my insulin, and both Cathen and Isaac did very well with the long flights. We were fortunate enough to have a bassinet seat for Cathen on the plane (see below),

which made the flight a lot easier. We arrived unscathed, and only missing one checked bag per family, in addition to both car seats. We spent the first night in Douala at the Catholic Guest House and were able to purchase a used car seat at a random corner market the next morning before making the 6 hour drive to Mbingo - another miracle as car seats are seldom used. 

It has been non-stop action since our arrival at Mbingo - meeting hospital officials, the hospital tour, cultural orientation, unpacking, going to the market, buying house supplies etc - and we haven't even started to work yet! However, our welcome has been overwhelmingly gracious, and we are daily encouraged by the genuine hospitality of our new friends and neighbors. It is all new, but we feel very much welcomed and at home. Thank you for your support. Please pray for wisdom as parents and as physicians as we encounter new challenges daily. 

Here are a couple of photos from our arrival:

 - Our house - 

We are on the left side of the duplex; Chuck, Angela, & Isaac are on the right

- View from our front porch - Mbingo, Cameroon - 

- Taking it all in - 

- Making a house a home, our very own new toilet seat - 

New Horizons!

Well, we are finally heading off... today (2/2/12), at 2:00pm. Our bags are packed, and we're ready to move. Thank you for prayers and well wishes as we head off. We'll try to get a post up as soon as we're able.

Blessings,

JR, Lindsay, & Cathen