Summary

Someone recently asked me “what is it like to live in West Africa?”

My initial response was...”I don't really know”.

This question is huge, there is no one answer. So here goes...

I have become accustomed to bleaching my veggies to kill parasites, sleeping under mosquito netting, thinking of malaria each time I get a headache, the call to prayer of the local mosque, the lizard that lives on my porch, the bats that occupy one corner of my ceiling and the rain that thunders on my metal roof.

I am used to seeing men wash their faces, ears and feet for prayer, watching them prostrate themselves and come back up, sand on their foreheads. I skirt around the edges of their mats instinctively understanding that it is bad manners to step on them with your shoes. I know that the metal pots women use for food preparation are made in Nigeria, and that they are often given as wedding presents. I can tell you the monetary exchange rates for three different currencies, I daily function in at least two and sometimes three different languages and can inform you of the time differences between Cameroon, Europe and home.

I enjoy the brightly colored cloth the women wear and how they wrap themselves from head to toe in matching patterns. I like how they strap their children on their backs so that the baby's cheek is smashed against his mama and his little bottom sticks out making a sweet silhouette of mother and child. I am consistently amazed at how they so elegantly glide around with huge loads of firewood or cooking pots on their heads. I enjoy their greetings and bright smiles as they casually sit around the hospital with their children.

I like how the men take off one shoe and put their foot up on the bench where they sit conversing. I like how visitors at the hospital all remove their shoes at the threshold of the patient's room, leaving a little pile of flip-flops, or how they greet you while holding their hands out toward you, as if to bless you or receive blessing. I enjoy watching them moving in and moving out of the hospital, like ants in a constant stream or ducks in a row, carrying large loads of belongings.

I especially like the little old ladies who look as if they are made of dark brown leather, stooped over and shuffling along, holding their wooden walking sticks.

I find this country beautiful and marvel at the homes made of mud. Their shape differs depending on location, some are square, some are round, some made of brown earth, others of red earth, others of stone. Flowering vines creep up and over their walls and children, goats and chickens run around the yards. Their roofs are often thatch, which on the round homes come to a point, secured by a tire, or a brightly colored pot. They sweep the dirt in their courtyards, giving their homes a clean, neat appearance.

I like how they never throw anything away, but fix or find new uses for everything, like the plastic chair in the market with only two front legs, a wooden crate has been fastened to the back and viola, a whole new chair! I enjoy the market, the constant movement, people coming and going on bikes and motorcycles, carrying what looks like impossible loads. Little old ladies sitting at the dried fish stands selling their wares, piles of ground spices and seasonings in colors of amber, dark green, brilliant white. The music plays and men drink tea and chat and women walk around with plates of cucumbers or eggs on their heads, just in case you would like a snack.

Since my arrival I have seen mountains, hills, valleys and bush. Cameroon contains them all. I have witnessed a group of elephants making their way to the watering hole at sunset, and giraffe running across the plains at full speed. In the hot season, everything is brown, and in the simmering heat, the Sahel opens up with a kind of savage beauty of thorn bushes and dry season millet. In the rainy season, cool breezes blow through, surprise thunderstorms come flashing in and everything is green and lush. Bushes and trees burst forth with flowers in orange, yellow, red and pink and birds in matching colors sing from every branch.

However...

It is so difficult watching people die of infectious illness that are so easily prevented in my home country, watching them struggle. I am frustrated when they choose to go to traditional healers in the village and seriously injure themselves, then come to us for help.

I don't understand how they can't accept chronic illness and death, but would often rather fight, even though they will not win, exhausting all their meager resources. To tell someone they will most likely die is a taboo, so I treat, knowing it will not help, knowing they don't have the money, wishing they could just go home in peace.

I am frustrated at the risks they take on the road, riding too many to a car or a motorcycle, driving too fast in bad conditions, then come in after their accidents in the middle of the night, bodies broken. I hate it when children die of malnutrition, wasting away as their faces tell stories of misery. I hate malaria, and the fevers and convulsions that accompany it. I hurt when a parent takes a seriously ill child home, stating they do not have enough money to stay at the hospital.

Trying to communicate has been a challenge. I do my best, I observe, try to use examples they will understand, I change my vocabulary, but there is often a disconnect and perhaps a deep-seated mistrust that blocks my attempts. So this ability has been stripped away and misunderstandings and conflicts have inevitably taken place.

I can't control death, this has been difficult for me to accept. I can't save them all, this too, has been difficult.

I often get tired of being conspicuous. Simply taking a walk in the village draws a crowd and cries of “nazara” and “bye bye”. People stare at me all the time and watch every move that I make. Teenagers mock me. My skin is too white. Moving through the market illicits attention from children forced to beg, the mentally ill, and vendors who assume you are rich. Coworkers ask you for loans, patients ask you for medications, people glance hungrily at your bag, skirt or shoes, coveting them.

I miss my family.

I am aware that no matter how hard I work to understand this culture or show love, I will never truly belong.

I realize that there is so much I don't yet know.

So, there are many things about my life here that I appreciate. There are also some difficulties that come with living and working in a culture and amongst a people so different from my own. Perhaps the best thing about my time here is what God has been teaching me. That I am powerless, that this is too big for me, and I need to rely on Him with complete dependence. This understanding is liberating, and it draws me closer to Him.

I also have a new, deeper understanding that God is good in all circumstances. In the midst of poverty and suffering, He is the only thing that makes any real difference, that brings any real hope or peace. I have witnessed this.

If given the option would I do it all over again? Yes. It has been worth it.

Trust

This morning during rounds, the doctor and I started ward 3 together.

I saw and greeted the husband of one of my previous patients. His wife was back in the hospital a 3rd time in 2 months for respiratory difficulty. In all of my dealings with this couple they have shown intelligence and understanding, patience and kindness.

However, this morning, the husband was obviously concerned and told me that his wife's status had worsened. But before I was able to see her, I was called away to another ward, and left the doctor to finish the rounds on her own.

Later that afternoon, an examinateur came and found me, stating that this patient was in severe respiratory distress and I was needed right away. Upon our arrival, we saw that she was unresponsive and breathing with great difficulty. As I entered the room, the husband looked at me and in a choked voice stated “I wanted you to see her this morning...”

God bless this sweet man. Desperate to save his wife, he believed that I could help him. He trusted me...not knowing that I am powerless.

I just coordinate care, it is God who saves lives.

I placed my hand on his shoulder and told him truthfully that his wife's case was serious, that we had done everything in our power to bring her back to health, and that he had done an excellent job caring for her. After taking all the emergency measures possible, the team left the room.

Shortly afterward, she died.

Her husband shook my hand and thanked me and the team for our help and kindness. He then sat outside in shock and grief as his family packed their belongings for the journey home.

God

There is so much pain here.

There are so many seriously ill people. Sometimes I wonder how much a body can take.

Just recently I escorted one of my patients into the operating room and stared in shock as he was placed on the table. Naked, feverish and emaciated, he was mumbling something that didn't make sense. He was a pitiful, wretched sight. It will be a miracle if he survives.

The only prayer I could manage was a strangled, “Father...”

In the face of all this pain, these eyes that plead with me to do something, the hopeful, desperate relatives that keep vigil by the bedside I cry out to God.

I am powerless, this is too big for me, I can't relieve their pain and I hurt for them.

God is good, He is faithful, and He hurts for them too.