She's back...

Yes Mariama is back and we’re having a ball!

After one week with the Kande household, Mariama ended up homeless yet again and back on our doorstep…skinnier and dirtier than ever! Turns out Fanta’s bratty teenage sister didn’t like Mariama and refused to let her stay at the house any longer…despite the rest of the family’s protests. Unfortunately, Annie and Samson didn’t want her at our house either. So we decided to make her the “Dispensaire kitty”.

Still very tiny (she hadn’t been fed adequately while away – our fault entirely for not having explained things better) we were concerned about leaving her alone at the Dispensaire during the night and enlisted the help Souleymane - the dispensaire’s night guard. A decision for which I’m sure Mariama would express her gratitude, could she speak. Souleymane was tickled to have been asked to help care for the little one and his compassionate soul insists she have a steady diet of freshly grilled fish in order to grow.

The result? One very chubby, spoiled kitty who refuses to eat anything but fish but who has also adjusted beautifully to life at the Dispensaire and is loving it!

"yes, yes I see...and when exactly did these problems start?"

It has been an interesting social experiment watching her win the hearts of people who typically don’t take the time to notice animals…maybe even helping the next generation to be a little more kind to God’s creatures.

But it’s not all play…Mariama has been receiving intensive training to become a great little hunter and guard kitty and JP (her trainer…since she was separated from her rightful trainer while still very tiny) tells me she’s doing nicely. I’m told the mice, bugs and geckos soon won’t stand a chance!

9 to 5... and then some...

We’ve often been asked “what do you do all day?” Here's the general gist…

5 to 6 am – wakened by one of several causes:

1. Arabic prayers blasting over loudspeakers from one of the two mosques that are located on each side of us (happens 5 times a day)
   
2. “The Boy” meowing pitifully because he’s bored and his sister wont play his rough-house games, or he wants to go outside
3. Restlessness apparently brought on in part by the anti-malarial medication (not to mention the vivid dreams it causes), and eating so late
4. Our night guard snoring :)
   

Samson high in our mango tree...with a playground like this, I'd be bored in the house too!

~6am – JP gives up on the possibility of sleeping any longer and gets out of bed to read. Tammy can’t sleep either but refuses to get out of bed…hoping/wishing/praying she’ll fall back asleep.

~7am – JP makes muesli with fresh fruit and brings it to the bedroom to share with Tammy (which is more the reason she stays in bed).

~7:30 – 8:30am – Dress, brush teeth,check email, change dirt in litter box, feed cats, gather our stuff, and head to work. About 150m away. Sweet.

9am to ~1:30pm – At least 90 percent of our patients visit the Dispensaire in the morning, so we usually know by the lineup (or absence thereof) when we arrive whether or not its going to be a busy day. A high number of people would be 15 or 20 consultations or bandages in a day, not including pre-natal consults, contraceptive consultations, vaccinations and deliveries. All told, we could see 30 + people on a busy day. A slow day would be maybe 5 people or less for the entire day, for all services. There are probably an even number of slow and busy days.

1:30-3pm – Lunch and rest break. Tammy usually makes rice and a Senegalese sauce like “Yassa” or “Maffe”, or just a sauce of whatever’s left in the fridge. Sometimes we’ll have cucumber and tomato sandwiches on locally baked bread, or leaf lettuce salad with corn chips and beans mixed in. The long rest means we get to relax a little bit over lunch as well, which is nice.

3-5pm – Return to work for the ‘home stretch’. There are usually no patient visits during this time (even 12-1pm is pretty dead), so we usually end up reading something or working on little projects around the Dispensaire, like organizing a cupboard or digging through archived documents. We also often wander out the back door into the garden to pick a few mangoes to eat on the spot, and to take home for supper and next morning’s breakfast. At 5, we lock the Dispensaire and head home.

5-7pm - We prepare something light for supper, like crackers or a piece of bread and fruit or nuts. We often eat in the backyard which is now closed in as a play-pen for the cats. Although we eat lunch on Senegal time, we find it hard to eat supper as late as the Senegalese (8-10pm), so we try to sneak in a small meal a bit earlier. We usually get visitors at this time, since they aren’t going to be eating supper for a while, and have sometimes been waiting all day for us to get home after 5pm.

Our little escape artist sharpening her 'tools' for the next window screen she plans on ripping open to escape (4 holes and counting)...we're still looking for rubber kitty booties on ebay!

Our night guard arrives at 7pm. It gets dark around 8pm.

7-9pm – Visitors continue to stop by and sometimes our neighbors come over and sit outside our door to braid each other’s hair by the outdoor light. Between visitors, we try to do a little bit of emailing and maybe Skype chats with family and friends. If we’re lucky, this is also when the after-hours patients show up at our door looking for treatment or medication.

Hanging out with my good friend Mamadou...

9-10pm – We get cleaned up. Since a couple of days after our “Water we gonna do!” posting, we’ve had running water - no bucket showers since then! After showering the day’s sweat and dirt off (it’s amazing how truly dirty sandalled feet get in dry, dusty places like this!), we retire to our bedroom and chat about the day and read together. Right now, we’re reading Scott Peck’s A Road Less Travelled. Then, we drift off into dream land, ready to start all over the next day…or to answer the late night raps at our bedroom window which are inevitably followed by the too familiar words “il y a un malade au Dispensaire!”

The best laid plans...

Like I said…travel with the Duchesne’s is never uneventful!

After many late nights working the clinic and the need to both renew our visitor’s visa and celebrate my birthday…a trip to Gambia was exactly what we needed.

Gambia is the tiniest nation in all of Africa and other than it’s Atlantic coastline to the west, it is wholly enclosed by Senegal. Since Gambia is a former British colony, English is spoken by most and our trip there afforded us an opportunity to ‘brush up’ on our English :)

4 hours, 2 ‘sept-places’ (7 passenger station wagons), and 2 taxis later (all in a North-Westerly direction), we arrived at the quiet beach town of Fajara on the west coast of Gambia.

The ride there was hot and a little uncomfortable but not nearly as uncomfortable as after I took a spill returning to the car from one of our many military checkpoints. In my clumsiness, I fell and sprained my right hand…pretty badly. One week later the swelling has gone down and I can now pull up my own pants (yipee) but I still can’t bare any weight in that hand…I’m enjoying being catered to though while it lasts! :)

In choosing our holiday destination, we had 2 very important criteria:
#1 – a quiet place with nice accommodations…we weren’t going to chintz this time
#2 – a lot of good restaurants to choose from…it was going to be all about the food!

With the promise of beautiful beaches, a quiet garden hotel with a classy ‘near vegetarian’ restaurant, a nearby Morrocan restaurant boasting a celebrated chef and a mean Sunday brunch, a restaurant offering a dinner buffet of Gambian fare (always fun to try new things), and a chic Indian restaurant (my favorite), Fajara seemed like the perfect pick. The clincher though was the nearby “Palais de Chocolat” ('Chocolate Palace'…need I say more?)…now we knew Fajara was the perfect place to spend a couple days.

Turns out we had to move hotels because we were kept up all night in our quiet garden hotel by bed bugs; the Sunday brunch consisted of a few cold leftovers from the day(s) before (apparently a reflection of being the end of tourist season); the Gambian buffet no longer served a buffet (also because end of season); the Indian restaurant was delicious but very expensive and we were too embarrassed to go back after not having brought enough money to pay our bill (the mandated 25% gratuity/tax…oops); and the Palais de Chocolat didn’t have anything chocolate!

Bottom line is our plan for weekend indulgence was a bust. But not all was lost…we moved to a great little place on the beach (at 2/3 the price of the Garden Hotel…go figure) where we enjoyed endless hours of strolling the beach, chatting, reading and snuggling in perfect solitude…heavenly!

We also walked to Kachikaly Crocodile Pool in Bakau village – a sacred site for locals. Apparently, crocodiles represent the power of fertility so many ‘infertile’ Gambians go there to pray and bathe in the crocodile’s water…

JP taming the crocodiles...

With some 80 adult crocs and countless little ones, this is the last water I would want to bathe in!

A 'taste' of village medicine

JP – “What?!? Forget it!”
Tammy - “What do you mean you won’t taste his pee?”

It’s no secret I’ve often been frustrated with our lack of diagnostic services at the clinic. Tests as basic as blood sugar would often be very helpful in properly diagnosing and treating my patients. After one patient I saw for a large slow healing ulcer to his ankle (see below) refused to see a doctor in Ziguinchor for some testing (because it cost too much), I was left searching for alternatives.

David Werner in his sometimes-overly-practical guide book “Where There Is No Doctor” suggests that “one way to test the urine is to taste it.” So I took it to ‘my boss’ who has expressed great interest in beefing up our lab services…but he wasn’t interested. Probably just as well…David also says that “If it tastes sweet to you, have 2 other persons taste it. Have them also taste the urine of 3 other people. If everyone agrees that the same person’s urine is sweeter, he is probably diabetic.” Looks like I would have been on the hook too!

No Hollywood make-up here...he's been dealing with this kind of 'sore' for years!

Other side of the same foot!

David mentions in the following paragraph that “another way of testing urine is to use special paper strips”. Why wouldn’t he have started with that option??

$4000?!?

Many things in Senegal are a few years behind North America. One such ‘thing’ is the average age of the vehicles on the road. The most beaten up, run down, falling apart hunks of metal are serving as taxis and transport vehicles all over the place, both here in the poorer Casamance, as well as in Dakar. As long as there’s a shred of mechanical or structural integrity left in a vehicle, it’s driven. When a vehicle gets abandoned, you’d better believe it was impossible to keep it running for even an hour longer. By North American standards, I'd estimate that at the very least, half of the vehicles driving here would get pulled over and taken off the road back in Canada. At least. Could be much higher if you consider the emissions testing program in the larger centres.

Nestled into its favourite resting spot, the Dispensaire 'steed' contentedly awaits its next call to service...

The Dispensaire vehicle is a Renault Type 18 diesel wagon from the late 80s. It had 64,000+ km on it when the speedometer/odometer stopped working (or was disconnected?) Though we’ve been using it almost daily from the start, we’ve poured in a fair bit of work to improve its condition. If we were in Canada, I’d also say we’d poured in a fair bit of money, but all told, I think the repairs we’ve done, parts and labour, have cost somewhere on the order of $200 to $300. Included are 9 or 10 brake repairs (the hand brake is thankfully quite reliable!), changing all 4 tires (to decent, used tires with tubes), repairs to many lights and other wiring problems, adding side mirrors which were missing, etc. The vehicle is banged up a bit and has many ‘quirks’ that older vehicles tend to get when not well-maintained. For instance, the rear-right door opens from the inside but not the outside. The rear left door didn’t open at all until just recently. It can now be opened from the outside, but not the inside, and even opening it from the outside requires a bit of training and experience! The hatch cylinders do not support it in the upright position (and it’s heavy!). There’s no radio and we took off the antenna since it was flopping around in its bracket, apparently no longer affixable to the vehicle. There are headlights, but the highbeams don’t function. Which is fine because most vehicle that go by us anywhere near dark flash their lights at us as though our lights are blinding them… we’ll be adjusting them soon.

A rare glimpse inside the cockpit of our T-18

For all of their faults, cars are like gold here. Our car, as is, would fetch as much as $4000 (Cdn) here... that's about 2million CFA!... anybody wanna buy a Renault?

Evil Incarnate

We had a rainy-season precursory visit the other day… while sitting in our backyard, a snake popped up onto the cement portion of our wall. We didn’t see it, but Samson did. As he shot over to the wall, I looked up to see it there – about 3 feet long, very slender and bright green. "The Boy" (Samson) whacked at it a couple of times as I shouted “No!” to get him away from it in case it was poisonous. But the snake realized it wasn’t interested in eating us (Tammy’s sure that’s what it was coming to do : ), and left quickly. Apparently, green snakes are non-poisonous here, it’s the brown and black ones that are of concern. Like the vipers and spitting cobras that apparently hang out around here! That’s what we’re being told, but we’re not buying the ‘green-means-go’ theory quite yet. We’ve heard a few over-generalizations already and this sure sounds like one to our snake-cautious ears.


That said, we just found out tonight that we’re neighbors with what the locals consider to be a fairly big black snake. Yup. He’s been seen coming and going from the termite mound that’s behind the house next to us, about 20 yards away.

Taken from the door to our yard, the offending termite hill is at the base of the tree...
a little close for comfort!

Here's a close-up of the mound, local children eagerly clamouring to get in the picture
The 'entry' hole is to the left of the little girl's head. See closer-up photo below, if you dare!

There seems to be no question that black means poisonous, anyway. I was busy pouring a bit of snake repellent (called "grezyl" - liquid that smells like moth-balls) on our wall when I was asked by a neighbor to pour some down this snake's alleged entry hole. Incredulous, I asked if this wouldn’t provoke the snake to leave it’s hole and then, finding me standing there like a not-so-smart guy with my bottle of grezyl… well, I tried to quell my imagination there.

“No”, I was bluntly told, “it won’t come out and eat you.” So I poured on the grezyl, my legs wound up like springs should the need-to-flee arise. I put about ¼ cup around the hole’s opening and thought that should be plenty. I walked back to our wall, keeping an eye over my shoulder… No sign of ‘im. We'll tell you if we ever see him, assuming we live to talk about it.

Evil lies within? I still don't like looking too hard at this picture in case my mind starts to see the serpentine outline of a head.

And the capper... this is a shot of the lane leading from our house to the Dispensaire... pleasantly lined with snake-infested termite hills. Who needs coffee for a morning jolt when you can walk down death alley? We're saving up to buy a whole case of grezyl!!!

Shakedown

I try to drive into town as little as possible because you never know when a police officer is going to stop you at one of the many checkpoints and shake you down for some spending money. After several of these episodes (didn’t give any $), I finally agreed to paint the word “Ambulance” across the side of our Renault 18 station wagon since health workers are usually left alone. We weren’t asked to stop at a checkpoint for quite a while but were once accosted by a police officer driving around the city with his moped who tried to get us to cough up a few $. He threatened to take the vehicle, which I resignedly agreed to let him do. I guess I called his bluff because after repeatedly yelling and screaming that he was going to take our car with no change in my answer, he suddenly drove off on his moped. We waited several minutes in case he was coming back, but I could see him a little ways down the road stopping another vehicle, so we just drove off. I guess someone else was going to pay for his groceries…
Funny after the fact, but stressful and unpleasant in the moment!

It was my 31st birthday on the 25th of May and on my way back from town, I decided to take someone’s advice (can’t remember who… Luc?) and bring a cold soft-drink to each of the four police officers on the road back to Niaguis. Omar, our plumber and buddy, was driving and I was busy congratulating myself on such a genius plan. I was just thinking to myself “We may never get stopped again” when the cop waved us over. I couldn’t believe it! Omar got out and shmoozed with the guy as he ‘angrily’ demanded our papers and his license. Omar said “C’mon, I’ll give you a cold beverage to enjoy.” The cop immediately said, “Yes, give it to me”. I handed Omar a Sprite, which he then handed to the officer, who opened it and began drinking as he walked away. Omar took a Fanta (think orange pop... a Senegalese favourite) to the other cop and we were on our way. What a bummer! The one time I had something to give, the cop stopped us and it ended up being a bribe! At least the two officers at the next checkpoint didn’t stop us and were grateful for the drink and the gesture.

Maybe we need to try painting “Police” on the vehicle…

A sampling of Senegalese currency... the object of the officers' affections. I'm told the typical bribe is around 2000CFA. A sprite costs 500CFA, so we still came out ahead. $1Cdn is worth about 450CFA.

Not so Heavenly...

Before arriving in Senegal, we had heard that, at least in some parts of Senegal, it was necessary to iron all clothing before wearing them as a result of ‘mango worms’.

We did a little digging and learned that mango flies (or myiatic flies) are common in areas with hot and humid weather. When clothes are hung outside to dry, the female fly will lay eggs on them and the larvae then burrow under the skin when the clothes are worn.

1st sign - usually general itchiness
Within 3 days – painful, boil-like lesions develop
Over the next three days - pus emerges from each sore as it gets ‘ripe’ – as in ripe to express the worm (I’m told a fairly painful process).

Luckily, the problem can be easily avoided by simply ironing ALL clothing (as well as towels, sheets, etc) with a very hot iron to kill any eggs or by not wearing the clothes for 2-3 days after they have dried since the eggs don’t live that long.

Given how much I detest ironing, it was very important to my emotional wellbeing to find out whether or not such a thing was found in Niaguis. With any luck, no one had ever heard of such a thing and I wouldn’t have to take up ironing (it was bad enough that I had to wash everything by hand with water I drew from the well!).

Three different sources were consulted upon arrival and all reports came back favourable…"no such thing here in Niaguis”. In otherwords, NO IRONING NECESSARY! I had just finished washing all of our clothing the day Fanta, our “Bonne” (aka. Housekeeper - we’ll tell you about her another time), started with us (it was a Friday). She asked if we would like her to come back in the evening to iron all of our things and I of course said ‘no’. I knew I didn’t have to worry about mango worms and I’m not that particular with my clothes, so I was happy to tell her that anything that needed ironing could wait until Monday.

Saturday night, JP and I were awakened by the feeling of something crawling on us. Reaching for the light quickly, we were horrified to find our bed crawling with little worm like creatures with tiny wings! Mango worms? Could it be? Tried as we might to kill them all, we just couldn’t get to the end of them! For every one we killed, 10 more appeared out of nowhere. So up we were at midnight ironing our bed (mattress and all) and all of our clothing! Needless to say we didn’t sleep so well afterwards thinking we might have missed one!

I mentioned our experience to Fanta the next time I saw her - she didn’t seem at all surprised and indicated that was precisely why everyone ironed their wash! Did I mention that the 3 different sources we consulted were all men…they didn’t even know their wives ironed or why! Thankfully, Fanta enjoys ironing, especially with our electric, non-stick iron!

We still don’t know if we were actually woken by mango worms or not, but believe me when I tell you that unpleasant as they may have been, they aren’t nearly the worst/most repulsive thing Niaguis has to offer!

Just a few of the kids that hang out at our place everyday!