Our last entry

The Mission Hospital at Ngaoundere has approximately 250 beds, meaning that it houses about the same number of patients as most metropolitan hospitals here in America.  Yet there are only 8 doctors and about 100 healthcare workers, half of which are nurse aides.  It is not one big building like hospitals here, but rather a composite of many smaller buildings spread over a large complex. There is even a tuberculosis ward that consists of 6 patient buildings each filled with 4 to 6 patients.  I think to myself, good at least I can avoid this area.  But in reality they come out of that ward and up to the Emergency Department to receive their daily medications.  So much for that thought.

                                                           

In this hospital, the nurses round on patients like doctors.  They write orders for medications, IV fluids, procedures and lab tests. In some specialty units, a doctor will round on patients daily, but in most other units perhaps once a week. In most cases it is the nurse who decides what the diagnosis is and how to best treat the patient. Now there is a lot of variability in each nurse’s level of training and experience.  Sometimes the diagnosis is incorrect and other times the wrong treatment is given. Tests ordered by the doctor or nurse, must be performed by the nurse or nurse aid. If a spinal tap or ultrasound is needed, the nurse must do it.  If blood work is ordered, the nurse must draw the specimen and take it to the lab.  Doctors complain that the nurses give no care, but the biggest reason for this is that it the nurses are too busy practicing medicine. 

In this country the family does most of the cares for their patient and also gives them their oral medications.  There is no standard of care and each family cares for their loved one as best they can, but often they do not have the knowledge to do it right.  There is no linens provided by the hospital, so if the family does not provide a sheet to lie on the mattress, then the patient will be placed on the bare plastic. The family is responsible for cooking for the patient and for cleaning them up.  Most rooms at the hospital have beds for 4 patients, and many family members stay in the room with them the whole time.  So in a typical ward in any given room there are usually 20 plus people staying in there.  On the hospital complex there are a couple of cooking houses where families prepare food and a water spigot and large rocks for them to wash dishes and do laundry.  Definitely not an American laundry mat!  Having the family provide the care has been the custom in this country for many decades and I don’t see that changing soon. Our mission there is to help them to better function within their own means. And rather than insisting that the nurse give all of the cares, much can be gained just by teaching families what to do and by telling them what is expected. 

There is no health insurance here and before any treatments or medications can be rendered, the family must first pay for it.  It does not matter if the patient is near death from a low blood pressure that can likely be fixed right away with IV fluid bolus’s, no treatment can be given prior to the family paying. Nothing is supplied for free or included in the room charge.  If it is an IV that is needed, they must buy not only the IV fluids, but also the needle and tubing to infuse it with. It is hard to stand by, waiting and wondering if the family will come up with the money.  Sometimes one is just compelled to reach into your own pocket to come up with the few dollars it costs to begin life saving treatment.

This trip although short was very busy and despite the time crunch we were able to accomplish many things.  Steph was able to train over 100 healthcare workers in basic life support, helped organize the store room and somehow managed to get them to type out an entire list of the supplies there, trained ambulance workers to be better prepared for emergencies and was even able to go on an actual ambulance run with the crew. She also spent some time working in the Pediatrics ward (can’t keep her away from the kids) and somehow also found the time to help out with the massive amount of burn care we had to perform every day.

I spent most of my time working with and training nurses in the Burn Unit and ICU.  In our time there we treated patients with burns, strokes, heart attacks, gastrointestinal bleeds, active hepatitis, malaria, tuberculosis and AIDS.  Many of these patients we would be caring for in full body armor at our hospital, but there is no such thing as isolation in this hospital. No negative air flow rooms, no gowns, masks or face shields. Gloves were our only protection.  Culturally medical illness is treated very differently in Cameroon.  My own practice of preparing families for the worst, yet hoping for the best is not in their mind set.  Even though you think it likely that their family member might die in the night, it is taboo to tell them so. Also if a family does not have the money to treat AIDS, then to diagnose the patient with this disease is to sentence the patient to death.  So a husband might die with a diagnosis of pneumonia and even his wife does not know that it was AIDS that killed him and that she likely has it too.  I haven’t checked lately but I think the average deaths from AIDS in this country are reported at around 17%.  That number is likely low due to the appropriate diagnose never being made. 

Much of my visit was planned to evaluate how departments we have helped them re-model or build in the past are functioning and to assess the overall operation of the hospital from the ground level.  It can sometimes be easy for them to prepare administrative reports that make things appear better than they are.  Some things are going well, but many problems continue to exist. Workers are not being paid on time, and sometimes not at all.  There are big disparities in how they are paid, and it has little to do with the job they perform at the hospital and more to do with what tribe they are from. Tribalism, like families delivering most of the care, seems likely that it will go on forever.  This holds them back in so many ways and I am discouraged because how can they progress if they refuse to move forward.

They lack basic equipment like stethoscopes, blood pressure cuffs and thermometers.  Supplies of gloves and dressings are very limited.  X-RAY and ultrasound equipment is in poor shape, much of it very used and too old to find replacement parts. More training is needed for nursing staff, managers and bio-medical technicians. Administration tends to deal with any and all problems by shuffling all workers around within the system and therefore it is hard for any of them to become truly good at any specialty. The needs remain great, and so now the next step is to make on going plans for how to best spend time and money and figure out what supplies will best help them in the future. 

 Plane schedules from the north to get us back to Douala did not work at all with our departure back to the USA, so we had to take a very long, overnight train ride to Yaoundé, then rush to the bus station with all of our luggage crammed into a taxi along with us and then wait for the next bus to take us to Douala.  We paid extra to get on one of the supposed nice buses only to find that the air conditioning stopped functioning as soon as it started moving.  Another 5 hours in sweltering humidity and heat on that bus and then another taxi ride with all of our luggage to get to the hotel.  We had pulled out of the train station at 620 PM the night before and did not arrive at the hotel until after 2 pm the next day, we were wringing wet with sweat and totally exhausted. 

After checking in, we celebrated brushing our teeth with actual running water and showered.  Despite that our feet were still black, so we decided to go soak in the pool awhile.  For sure this hotel looked at least ten times better on the way out than it had on the way in!  This was Saturday night and our plane did not leave until one AM on Tuesday.  We hired a taxi driver recommended by a former missionary and drove to Limbe to see the black beaches. Beaches created by the active volcano known as Mount Cameroon.  Today the mountain is obscured by clouds as it often is, so on the drive, we can’t see the mountain.  The sand was definitely black and a sight to see.  The amount of garbage being washed ashore was not so pleasant, but hey we found lots of sea shells because nobody seemed interested in picking them up there.

The humidity all along the coast is almost unbearable at least for me, but we made a day of it and saw a lot of the country that I had never seen before.  We saw banana plantations and others filled with rubber trees.  They are tapped for rubber much like trees around here are for maple syrup.  Pretty interesting because I never before realized that rubber actually came from trees.  Along the way we also saw sand extractors who took large canoes up the river and filled them with sand, and then brought it back by the boat load to near the highway so that trucks could easily pick it up,  Coming from such an industrialized nation it surprises me how much physical labor is required for such common products.

Without question, to perform this mission, we endured many hardships, totally left our comfort zone, faced miserable conditions, unbearable travel and at times dangerous situations, but for certain we grew stronger in our faith. We hold tight to our children, the dogs, and our families, somehow loving them all even more than you did before.  We are more appreciative of all that we have and are thankful for the talents and opportunities that we have been given.  

The only thing that I can compare it to really is child birth.  You somehow forget all that was so bad about it and are left mostly with what was good.  You remember the smiles of the people you were able to help, the friends you made, and the beauty of this land located in the midst of so much hopelessness.

We have been back at home for a couple of days now and we take pleasure in all the comforts that we have here. I think I am still brushing my teeth like every 2 hours, just because I can.  We have heaters for when we are cold, air conditioning for when we are too hot, fresh water to drink, reliable electricity and internet connections.  If we want to go someplace, we need only walk to our car and drive and can be pretty certain that we will get there. If we are ill we can get the best medical care regardless of our ability to pay for it.  The differences in our nations are pretty much the exact opposite.  They live in the land of too little and we live in the land of too much. 

For sure a journey such as this makes one much more appreciative of all that you have and all that you typically take for granted.  It opens your eyes to see a world that is so much bigger than just us and helps you to see that coming from this land of plenty that there is more that we as individuals and as a nation could be doing to help others.  Whether it be our neighbors that live right next door, or the homeless and hungry right here in our own country or those who are underserved in other parts of the world, we should all try to do something more than just talk about helping out.  By suffering very little, there is much that we can accomplish.  

 Trying the star fruit right off the trees at the botanical gardens in Limbe.

View of the palms at the botanical gardens in Limbe, Cameroon.

 A restaurant along the way in Douala

 Vegetables for sale in the market.

Washing laundry in the river near Garoua.

The end is here

Hello to all,

We are on our travel days again. We had our last couple days in Douala and it has been very hot and humid. Inland the temperatures have been about the same, but the difference is the dry heat inland vs the humidity closer to the Ocean. Still no sun, and it’s hard to take the humidity. It almost takes your breath away. We must have lost several pounds alone by just sweating. Our last day in Douala consisted of some souvenir shopping at the local flower market, which Llonda teased me thinking I was ready to go out on my own as far as bargaining. I was proud of how well I did, but I am still not as good as she is. They all tell her that when she comes back she should change her nationality to Cameroonian because she is so good at it. We made some really good purchases, but there will never be enough money to buy for all of the people we would like to bring things back for and we can never have enough stuff or room to pack it in. In actuality we had plenty of room to pack more, but as most of the stuff is wood, it’s heavy so our bags are all pushing the weight limit once again.

I had to laugh at the end with all of the marriage proposals I received and how many times I heard “But I love you!”. As I tried to explain to them in the little English they could understand that, they don’t even know me, but anyone is looking for a way to get to America. Most people in America don’t understand how wonderful of a Country we have until you spend some time somewhere else, myself included. I can complain about the gas prices, the high electrical bills, and not having my brand of peanut butter in stock. But in the big picture of it all, we all have an opportunity to work no matter what kind of job it may be, a cashier, a cook, to a lawyer or doctor. It’s very hard to imagine all of the people in the US who can get a job, but CHOOSE not to. Where here you have a country where there is virtually no opportunity for them, even if they do go to school. For example one of our interpreters who can speak many languages, is smart and has gone to school and has a certificate for it, and is such a hard worker. Yet, he cannot find a job, and the years and money that he has spent in school do nothing for him. Where in the US you can find a job with no schooling (maybe not a great job, but it IS a job), and with schooling you can find a good paying job. Benefits are unheard of there, and the life expectancy for a male there is 50yrs. Can you imagine having a life expectancy of only 50yrs. It’s sad all the way around and I only wish there was more we could do for them all.

After the flower market, we went back to change and then get something to eat at the Le Glacier Modern. It’s almost like a Dairy Queen. They have burgers, fries and some of the best ice cream I’ve ever had. Our waiter (who we had the other day) helped us get a taxi, and then it was off to the hotel to pack. We had to check out of our room at 7pm, but didn’t want to go the airport too early so sat down at the lounge with all of our luggage and making one final deal with the boys across the street to try to use up the rest of our CFA.

We finally boarded our plane and left at 1am Monday (which was 8pm at home) and rode the long hot smelly ride to Brussels. At Brussels it was rush rush to try to go through security again, and then make our way to the other side of the airport to get checked in. There was hardly enough time to go to the bathroom let alone anything else. Once again, we were nearly the last people to board the flight to Newark NJ. I can hardly wait to get back on American soil. I miss all the familiarities of home. My kids, my bed, my bathroom (mostly being able to actually sit down on a toilet!), my church, and work (yes I miss work even). Basically I miss it all! Most of all I miss being able to have a conversation with someone who I can actually understand

I am grateful for the time I had there, I would very much like to go back someday if the opportunity presents itself, but until then I will continue to pray for my new friends in Cameroon.  

Saying good-bye to N'Gaoundere

Bonjour from Africa!

It has been a long journey and one that is coming fast to an end.  I would like to say that I have learned some french but the truth is it's hard for an old brain like mine to catch on, plus when they are speaking so many languages, how can you focus on just one!  So I have learned a few words from a few different languages, none of which I'm sure I'll remember once I get back home.  But like I've said to everyone here, I'm trying:)  It has been a real eye opening experience and as my new friend Jim tells it: "they are very much living in the old testament here".  He is ABSOLUTELY right.  I will be honest is saying that I have not read the bible front to back, but I do know enough to know that he is right.  I wish that in America we took our religion our seriously and faithfully as they do here.  I cannot imagine going to Chapel everyday before work, but at this moment in life, I believe that it would help us ALL.  They are very close and would do anything for anyone in need no matter what the cost to them, and do it all so unselfishly.  We as American's can really learn a lot from them in that matter!

We left N'Gaoundere on Friday evening.  It was rush rush all day, trying to get to the market one last time to pick up any gifts we may see, and get to the hospital for a last round of good-byes and one final meeting which was suppose to start at 1pm and didn't actually start until 2pm.  Again, living on African time!  We had hoped to go get something to eat before leaving so raced to the house to get cleaned up and some money and before we knew it we had a house FULL of guests.  How can you kick your friends out to go eat when they have cared so much to come and say good-bye.  So I cooked all the left over macaroni noodles to eat with butter, Wesko (our German Dr in training friend) and Catherine (the German gal) cut up some fruit, and I cooked the last package of biscuits we had.  Really all the rest of the food in the house!  It needed to go anyways, but as Llonda said, I am totally crazy for cooking as she would have said lets go out and I'll pay!  But we had a good time and it was all worth it to spend our last time left with them.  We cleaned up and literally threw everything into bags and went on our way in the hospital truck with Samuel driving, Adda and Danielle, Eric, Ousman and both of us.  We definitely fit in as African's riding crunched in together:)  We got to the train station and said our good-byes and headed out to the train.  We had a sleeper car, which was hard to get but worth it in the end.  As we stood outside not wanting to get in yet, Jean Baptiste (the Chief supervisor) and Dr Danki (Chief medical Dr and surgeon) met us by the train to say good-byes.  It was very special and amazingly nice that they came to see us off! 

The train was an adventure in the least.  It stopped many times along the way, and rocked so hard I had to laugh thinking that it was surely our weight loss plan of our belly's jiggling so much:)  We left the station at promptly 6:20pm and arrived in Yaounde (the capital) at 7am.  All in all it wasn't that bad, but neither of us slept much, a half hour here or 15 min there.  It was hot, sticky and by morning we both smelled really bad and were in much need of sleep.  We headed straight from the train station to the bus station.  It was like from "Bad to Worse!".  At the bus station JB (who just got married) met us there to say good-bye and Eric, Llonda and I aboarded the bus for the 4hr bus ride to Douala.  The bus was hot and sticky and the air didn't work and for some reason we kept having water leak by our feet which got our bags all wet.  We had hoped to go straight to Kribi, but with our luggage thought it would be best to go to Douala first then a day trip if time allowed.  We go to the bus station in early afternoon around 1pm and loaded our bags and three of us in ONE car!!  The pictures don't do it justice and it is too long to upload, so while I have connection I will just write.  Because we hadn't planned to stay in Douala we didn't have reservations anywhere so where taken to a roach motel where Llonda, the driver and Eric went to check it out, while I stayed outside with the car and our luggage and was greeted by a man wearing a ratted old trench coat wide open and ONLY the trench coat.  Welcome back to Douala! I thought to myself.  Llonda and the others quickly came back and Llonda said we would head straight to the IBIS to try to get a room. 

We made it to the IBIS and all was good.  We got a room, checked in showered and felt slightly better only still hungry and tired.  We hired a driver and went to find some food, then came back and went swimming.  It was Eric's first time swimming and I enjoyed very much teaching him some basic swimming skills and he was ecstatic about it.  We got back to the room, sent off a quick email and were in bed by 8pm.  We awoke early the next morning to get ready for a day long trip to Limbe, a town west of here.  There we went to the Atlantic Ocean where the sand in fine and BLACK.  It is black due to the volcano eruptions.  Mount Cameroon is still an active Volcano here, and we went up the mountain a little ways to see all it had to offer.  The last time it erupted was in 1999.  They are still selling rocks from when the volcano last erupted.  We went to the Botanical Garden which is full of beautiful age old trees of all kinds from around the world, which one was over 900 years old.  It was started in 1892 by a German man who wanted to perserve the land and the wildlife.  The pictures are wonderful and I only wish I could share some.  When we get home, we will post more.  We headed back to Douala and found a nice american burger place to eat, which was the first real full meal I had probably eaten so far.  Said good-bye to Eric who left on the bus back to Yaounde and then back to the hotel to swim a little and relax.

Heading home tomorrow, and I am very much looking forward to coming home, even though a part of me will miss this place.

In Llonda's Eyes

No internet for most of Sunday, but still It is hard to complain because it is the first time I have had it available here on the mission station.  Even when it is working well, it is about the equivalent of having one bar of service on your smart phone.  We are thankful for it when it does work, and it helps us to feel less isolated from home. 

The people we work with at the hospital are Christian and that is a requirement to be employed there. Each day of work starts with chapel.  Before going to your department to get report from the previous shift, you first go there. Some days it is packed in the chapel and on others only like 10% of employees show up.  It is a common way to start the day here.    Praying and singing together is not a bad way to start the day.  Some days we go, on others we don’t.

 The Muslim population is very high here in northern Cameroon.  Most of them, at least as far as I know belong to the Fulani tribe and speak Fulfulde.   All of the nurses speak French, but probably it is the second most common language spoken here.  Each day on rounds at the hospital, speaking with patients, 8-10 languages are spoken.  To be effective we must use interpreters.  Most everyone here is multi-lingual and our interpreters speak 10 languages, the only thing really different about them, is that they can also speak English.  A real problem with the multiple languages spoken is that for us, instead of just being wrapped up in and learning French we learn a few words from many languages.  How to say hello and how are you, how bad does it hurt…that is about it.

Even though I have met many Muslims and have been somewhat immersed in their culture, I do not fully understand their religion.  What I do know is that they are very dedicated to worship & prayer.  There are many mosques located everywhere and they have calls to prayer at least 5 times a day starting at 430 am.  These calls are played over loud speakers at all hours of the day and night,  and if one did not know better, you might think that at times it is a record playing that is stuck.  From those who can understand what is being said, they assure us that it is live and not a recording.  There is also a call to prayer at 1 pm every day and the whole town literally shuts down.  All the shops are closed, and there is no way to buy anything.  The mosques are so full that you see people all lined up in the court yards outside on their prayer mats praying.  If they have a family member in the hospital they do not leave there, but one can see them laying out their mats & praying wherever they are.  They use prayer beads and pray in a ritualistic style.  I do not know what it truly is that motivates them, be it fear or just love, but one cannot help but be astounded by their devotion.

Polygamous marriage is common among the Fulani and many men have at least 4 or more wives.  They typically have 20 children or more.  Their families of wives, from what I can tell all live in an enclosed compound, each with their own sleeping house, yet many common areas.  I’m not sure where the children sleep, but for sure the man sleeps where he chooses on what night.   The wife’s duty is to cook, clean, raise the children, pray and serve their man.  There is more to it than that, but that is more than enough for this story.  For certain not many of us American women could live this way, nor would we tolerate such a setting.

Work at the hospital is very challenging for us and we are expected to be experts on everything.  Of course we aren’t, but both of us have a lot more training than many working here.  Here it is reality that one must mostly learn from.  I guess the school of hard knocks.

Steph has been training workers in basic life support (CPR), and trying to get the store room full of goods sent from Global Health Missions & SMDC under control.  That alone is a job that one could spend a full year at and I do not even have the patience to attempt it. Her organizational skills go far there, and she is able to get the guys working there to at least do something,.  Global Health now sends containers twice a year to this hospital system, but there is a real tendency for them to hoard things as they never know when the next boat will arrive.  Those who run the store room do not work at the bedside and many valuable things lie there rotting. Many things are way past the expiration date, yet are very useful for patients in the hospital. Just knowing what is there will be a huge help to the nurse Majors in each department.

Tomorrow Steph will also begin special training for the ambulance workers.  The ambulance is only called when there is no other choice as it must be paid for out of pocket.  Many arrive at the Emergency department in a taxi as that is much less expensive.  So all I can really say about that is that when they are called, they are needed in a most desperate way, and the workers arrive on a bad scene with very little training or practice.  She has brought safety vests and other emergency equipment donated by the ambulance service she works for and it will all go far in helping them to do a better job at transporting patients.

I have mostly concentrated my efforts in the Burn/ICU department that I traveled here and helped them open back in 2006.  It is very interesting to see the transformation into an ICU specific for this area, but thus far certainly not what I envisioned it would become.  The burns they see are unimaginable and I wish I had refreshed my advanced burn life support and went to work some shifts in the burn unit before coming here.  Everyone cooks on open fires and use kerosene lanterns for light, so yes there are many burns.

We continue to care for the 2 small girls burned by tipping over the teapot.  They are our special cases.  Because of the wedding we did not work the weekend and so on Monday, we had to change their initial bandages.  The 4 year old with burns to legs, feet & bottom had gotten urine all over the dressings.   We wanted to insert a catheter to keep the burns from getting infected; Of course they have nothing of that size available even for sale at the hospital.  Luckily Steph finds one that is small enough in a box in the store room.  She brings it to the ICU when it is time for the dressing changes. We decide to put the catheter in first. Because the catheter is old and for sure not that sterile, we clean the area with lots of betadine first.  

We had many medications donated to us for the trip, and we gave this little girl a small dose of the narcotics before we begin.  We started to pull the dressings away and she is so brave.  The dressings are very dry and for sure they debride the wound as they come off. She barely cries and our interpreter says that he is surprised because even at her young age, she prays for strength for herself and for us.  Now any one of us would have been praying that we would just survive this and not really even think to pray for the nurse…  Another lesson learned, and this time from a 4 year old.  The skin on her legs, feet and perineum are badly burned.  What does not peel off with the dressings, must be cut away, with a tweezers and scissors.  Both of us are near tears, but again we do the best we can. With the next dressing changes, there will be little if any skin left.  For sure once the skin is peeled away we are all of the same color underneath.  The parents of these 2 little girls are Fulani and Muslim’s.  They are nothing but respectful of us and thankful to us.  They think that their girls are getting the best treatment because we are here. I don’t think that we know more but for sure we are more persistent at doing what we are capable of for them.

 There are German medical students at the hospital, they are watching us & learning.  We are starting to work with them & hope they will continue with the burn care once we go.

The head nurse of the ICU yells at us because we use too much ointment and Silvadene and too many dressings to treat the wound. “You will use it all up for this one patient and we do not have more for the next patient. We do not know when more will come!”  In our country we really have no concept of what she is saying as we slather the dressings with special ointments and use as many dressings as we see fit.  Who cares if one too many? Seeing some of the amazing burn recoveries here, I start to think that perhaps less is more.    I need to try harder to wrap myself around this concept.  God knows I want the best of everything, ask for even more and accept nothing less.

We all say that we want to help, yet when it is time to dig into our pockets there is no money there.  Most of us are not that good at putting our money where our mouth is.  Seeing what we see here, I am certain that we can do better.  Steph and I, have spent tons of money, burned up our vacation time and traveled over 10,000 miles to get here & I think to myself, perhaps we should have just sent a crate of medicines,  Pain killers and burn ointments.  Now this sounds good in theory, but I know that without managing to where things will go and teaching and training, that none of it will ever get to the very people we have set out to help!

Corruption is a way of life here, not just among the common people, but also the police, Army, Government etc..  Anyone can see how things will benefit themselves or their own family, but there is really no one looking out for the good of all.  Much of what is sent here, just as it is to other 3^rd world countries somehow just gets lost in the bureaucracy.

We're still working:)

March 15^th, 2012

It is early this morning, and the Muslims are singing over the loud speaker like a broken record. Haven't had a whole lot going on the last couple of days. Wanted to update you all on the little girls with the burns, as many of you have asked and care so much, Thank you for that! Everyday we change their dressings, and everyday gets a little bit better. Llonda gives them a pain pill quartered up so it's not too bad. A special thank you to those who were able to send some with us, they have been a blessing!  The other day the 4yr old says “I'm flying”, while we were changing her dressings. At that moment we knew the pill was working:) We had brought with some little toys for the kids over here, and had given them each one and they both held onto them like it was the greatest gift they have ever gotten. Llonda has spoken with the German Dr in training (Wesko, pronounced Vesko), to keep up with the dressing changes after we leave to ensure that they get done. Otherwise who knows if they will get done or not, and they need to be done daily. He assured us yesterday that he will keep us posted by email, or facebook on how they are doing.

Llonda has been working on another burn patient, an adult male who was using kerosine and burned his hand all the way up his arm. He had went to the government hospital first then 3 days later came here. She also gives him a pain pill before dressing changes, but he is definitely not as strong as our two little girls, and yesterday when I popped in to see if she needed help, he was pulling the skin up himself while she cut it away.

   

I finished up in the storeroom and have been teaching CPR everyday.  They seem to enjoy it, and it seems a little strange to me training Dr's and Nurses in such a basic skill, but they are eager to learn it, and ask many questions (all that I've been able to answer so far knock on wood:).  I will finish up with my last two classes today, as tomorrow we leave and have to pack. 

I have been working with Ambulance crew, which right now consists of the driver, Samuel who they call all the time day or night, and two nurses from the ER.  We spent some time looking over the ambulance, going through their supplies, and I took them to the storeroom to replenish their stock and thanks to my boss Sue at home who let me take some supplies, they have a good start but need so much more!  Here we are below with a box full of goodies.  Samuel loved his vest so much he wore it all day long.  He felt so special and proud and loved bragging to everyone about it.

Yesterday we went to the hospital early to do rounds and change the burn dressings and then had to get our train tickets and then go see some sights.  Llonda and Eric went to go get the tickets, while I packed up the cooler of snacks for all of us, then Samuel came to pick us up.  There were no sleeper cars left on the train, so Llonda decided not to get the tickets.  So far nothing has been easy for us.  Samuel has a contact at the church that he thought could help us out, which he did.  It took a few hours to get it taken care of, but we had to pay for the tickets right away up front which ran us out of money (AGAIN) so had to borrow from Wesko.   We had to stop back at the hospital for Samuel to take care of something and while we were there, asked Wesko to come with us.  He was happy for the offer and came right over.  When Samuel came back he said there was an emergency and he needed to take a patient over to the government hospital by ambulance for an X-ray.  Not sure if I had said before but the hospital here their X-ray machine is currently broken.  I asked Samuel if I could go with to see how it worked and he was happy for the company.  The patient was man who lives out in the bush and was in a motor bike accident more than two weeks ago.  He stayed back at home and tried the witch doctor healing then finally decided it wasn't working and came in by bus.  He didn't want any help, so got in and out of the ambulance by himself.  We waited for the X-ray and when they put it up, I was shocked at how he didn't complain of any pain.  His wrist was fractured as well as his femur (right in half). 

We dropped him off at the hospital again, went back to pick up Llonda and Wesko, and we took off.  We were going to a water fall about an hour out of town.  The road was not good.  I was sitting in the back seat in the middle of Llonda and Wesko.  At one point I told him I was a ping pong ball and they were the paddles.  Every once in a while I'd let out a "Ping", when it got really bad.  Samuel did a great job driving, and at times hitting 65mph on this what seemed like a 4-wheeler trail.  It reminded Llonda and I very much of the time we were in Sedona, AZ and rented jeeps to drive out in the desert.  There you pay money to ride on roads/trails like that, here it is everyday living.  We made our way up there and had a picnic in a buckaroo, then walked the trail down.  One person had to stay with the car the whole time so it wouldn't get broken into.  I hadn't seen a sole for miles, but wasn't going to take a chance either.  They had just burned the grass so it was nice and clear.  I asked who burns it, and they told me either the village people or hunters, so they can chase the animals out.  They hunt porcupine and hedgehog mostly around here.  

The falls are called Chutes de Tello, and they were amazing!  Truly one of God's greatest natural wonders.  I could have stayed there all day.

We were lucky enough to be able to see it from every view.  Behind the falls, the bottom of the falls and the top of the falls. To see the top we had to cross a bridge that neither Llonda nor Wekso liked much at all.

It was a great day, and I'm thankful to have been able to see such a beautiful sight.  So off now to get ready for our last day at work here.

Update on our little girls with the burns

Just a quick update while I can't sleep again.  It's 12:30am here and the dogs are going crazy outside along with the sounds of many other things.  I spoke earlier of two little girls coming with bad burns.  Everyday they have to have their old bandages ripped off, yes literally ripped off of them and we have to cut off their dead skin then scrub the burned area and re-bandage them.  I did not help Llonda with this yesterday, but she waited until after I got done teaching my class so I could help.  We cathed her just before and gave her a bon bon then started what felt like torcher to her.  She cried and cried and said a prayer over and over with her mom "give me the strength to survive and make it through this."  It took every ounce in me to not cry and at one point I may have even shed a tear, and then the mother started praying louder and my translator told me she was now praying for us to give us strength.  She must have seen in my face that to hear her pain was unbearable to me.  It took what felt like hours and before we knew we had many hospital staff coming to watch us.  The German Dr in training came to our place later that night to thank us for allowing him to watch us, as he had learned more in that two hours of us taking care of those two little girls than he had in a week of working in the pediatric unit.  As bad as I had felt about it, I was glad that someone can learn something from it.  It took nearly and hour and half to do the older girl, she has mostly 2nd and 3rd degree burns, and only about a half hour on the 2yr old.  She is mostly burned on the one leg, and even though it is bad, it is not as bad as the other.  

The mother came up to Llonda while we were getting ready to leave to thank her, while we were sure that the two little girls will not like us anymore.  Tonight I prayed for strength all the way around.  

Here is a picture, which doesn't even come close to how much pain she is in.

Wedding Day!

March 12^th, 2012

It is early am and I had a hard time sleeping again last night. There are constant noises going on. The cockroaches sing, the Muslims chant and sing their prayers, and all the other bugs making noises. I swear people never sleep around here. No wonder why I feel exhausted all the time.

Have you ever heard of the expression your running on African Time. This is something that I have a very hard time with, but almost all of my family would fit in well with. They tell you that church starts at 7:30am. Which actually means 8 or 8:30am. Everything runs late. I can't stand it. So Saturday was the wedding, which is an all day affair here. The Council was at 9am. The phone rang at 6am that someone was going to drop off our dresses. I hung up and literally there was a knock at the door. They asked for a “document of just married”, I had no idea what they were talking about nor did Llonda so we took the dresses and they left. A few minutes later we received another call that they wanted us to print “JUST MARRIED” on paper to put on the car. I started to print it then let Llonda finish as I went with Eric to go watch him play football. (our soccer) He invited me to play and I politely declined thinking I would have probably been trampled on as most everyone here is in good shape. After all, they walk almost everywhere. Eric and I got back at almost 8am, so it was rush rush to get ready and be out the door and to the Council at 9am. We left at 8:55 thinking we would be late, and showed up and where the first ones there. Everyone else is running on African time. A few more trickled in, then we got the call that we were at the wrong place. So we piled into the couple of cars there and went up the street to the Hotel DEVILLE. It was a nice government building and I guess that one has to have a council ceremony before having the church wedding as it is the only legal wedding. Each the bride and groom have two witnesses. Llonda was one of Adda's, so she sat up front with them. Once the ceremony finally got started around 10am (again we are running on African time) it was over in about half hour. We went outside for pictures, then headed home for a break before the church wedding.

The wedding was at the Catholic church here in N'Gaoundere, and anyone who has been to a Catholic wedding knows they are long, and almost every wedding its always hot in there. The wedding started at 3pm and the priest Friday night at the rehearsal said we must not be late as there was mass Saturday night. So we made sure to be there promptly at 3pm as our prior engagement with the priest was not a good one, and of course we were one of the first ones there again. People trickled in up to an hour later. We stood there in the heat with our gowns on and had wished we left later. I begin to hate this “African time” more and more. The wedding starts at 4pm, and drags on and on. The priest went on for an hour about some speech who knows what he was saying as it was all in French which we couldn't understand. Between the heat and the smell of body odor I started to feel nauseous. I made it another half hour and when it was time for the offering, we took our chance and bolted outside for some much needed fresh air. We stood outside for awhile, with others as well, then went back inside and sat in the very back so we had an easy escape if needed. It was after 6pm, and finally over. We congratulated the bride and groom, took more pictures, then back to home to change clothes for the reception.

The reception started at 8pm at the hotel du lac, which is far away from town. We purposely didn't leave the house until almost 9pm not wanting to be the first to arrive. We were going to be officially running on “African time”. We arrived there to find that alas, we were again one of the first ones there. “Are you kidding me!”, I thought to myself. So we stood outside again, and it finally started around 10pm. We didn't eat dinner until 12:30am. We couldn't make it any longer and were the first to leave at 1:30am and they hadn't even cut the cake yet! Apparently weddings around here are nearly a 24hr ordeal. We found out the next day that most started to leave at 4am. Even getting home at 2am, we slept most of the day away.

Sunday, after getting up at around 12 -12:30pm, we tried to visit the neighbor man who moved to Cameroon with his family in 1960 as missionaries, but wasn't home, and I still was not feeling well from I think being a little dehydrated and overheated, so I laid down for a nap. We finally were able to meet up with Mr Nelson and he showed us a very nice presentation of N'Gaoundere from back in the 60's and how it has formed into what it is today.

After visiting with him, we went into the market to buy some groceries, as we had planned to make cookies and homemade pizza for dinner. We came back and were not home long before we had a visit from Adda, JB and Danielle. It was a short visit, but we had brought some medical supplies for JB for his schooling and had some toys for Danielle. We gave them their wedding present and then they had to leave. We cooked pizza for Eric and then had some more surprise guests show up. The Dr in training from Germany and another gal from Germany who is on a year long expedition traveling every week to a different town and hospital doing some sports medicine training. They were more than thrilled to have pizza and cookies. As was Eric. We stayed up late again even though we knew we would have a long day at the hospital.

Good night all!

 Llonda and I just before the Dowry.

At the Dowry going through the gifts.

 The Mayor with JB and Adda and each of their witnesses.

Llonda and Eric before the Council Ceremony

Settling In

Hooray… no water shut off for the past 2 days!  Still no ice or water readily available in the refrigerator door, and the hot water heater in our apartment has not been working well so mostly lukewarm showers,  It’s amazing the small conveniences that one can really take for granted.  The water is not suitable for our American stomachs, and it has to be filtered and boiled to be safe, and still it is only good enough for cooking.  We must buy water for drinking, which is very expensive here.  The soil is also contaminated and all fruits and vegetables have to be soaked for at least 20 minutes in filtered water with a special bleach solution for food.  The food prep alone can be exhausting and one can long to just run to McDonald’s.  Actually there are many cooked foods available on the street and some of it is not too bad as long as you don’t think too hard about where they got it or how it was prepared. Having tried much of it before and being fully armed with my Cipro, I readily jump in and will eat some of it, but Steph has not yet braved the street food.

Tomorrow two of my good friends from Cameroon, JB & Adda will marry.  I am to be a witness for the ceremony and this has consumed a good deal of time these first few days here.  Material to be bought, then off to the tailor for measurements, a copy of my passport to the consulate, & meeting with the priest.  Last night was the “buying of the bride” ritual, and then finally tomorrow the real deal.  At 9 am tomorrow we go before the council, and then the wedding at 3 pm.  Then in the evening the reception will be held.  One thing for certain it will be one very long hot day with me in an African dress and heels.  Anyone who really knows me will have a hard time envisioning that.  For the reception some other dress, but at least my flip flops.   Traditions run deep here, and they hold deep to their roots.  Whether it be the foods they eat, the style of dress, the type of place they live in, how they deal with pain or a wedding.  They fully embrace their culture, love their people, love their country, and they do not complain.  They are thankful for everything that they have, and we could all use a lesson in that.  For some, truly not knowing when they will get their next meal, when they sit down to dinner and thank God for the food provided, it clearly has a very different meaning for them than it does for us.

There is a constant parade of people at our door… selling fruits and vegetables, peanuts and home-made goods.  Some asking for money for school, others begging.  Today two brothers came selling something we were not interested in.  The youngest pleaded with us… it is so that his brother can get new sandals.  He removed his flip flop to reveal a large hole. Still we refused.  I sit here tonight feeling bad about it because for under $2 I should have just given them the money for the shoes.  We sometimes are in a tight spot.  Does he truly need shoes or does he just wear them to make the sale? One cannot know without further investigation.  So for now I just choose to feel bad about it.

We have started our work at the hospital.  There is so much work to be done there & so many jobs that are bigger than we could possibly accomplish in our time here.  You deal with many types of tropical diseases, and see many things such as deep wounds, horrific burns (both new and old) common medical problems that are quickly treated in America yet here are left to grow into unbelievable horrific medical cases.  The days are long and the nights are short. We just try and do the best that we can. 

March 8, and 9th 2012

March 9^th, 2012

I (Steph) haven't written in a couple of days, so starting with yesterday Thursday March 8^th, here is how the day began. We decided to skip Chapel this morning and start work at 8am. I went to work in the storeroom right away while Llonda hit the ICU. The storeroom is a dirty place that if filled with medical supplies that are not being utilized. It's frustrating and I don't think the hospital staff even know what their sitting on. So I am trying to take an inventory of all of the supplies there, and their expiration dates. Even though many supplies can be used after the expiration date, there are many that have been expired since 1996. The plan is once we have a complete inventory of whats in stock, we can provide all of the Majors with that list so they can see if there is anything there they can utilitze. The Majors here are equal to the head nurse at home, like a manager. Although they work harder. It is not an easy nor fun job and it seems it is a fight with the store room manager all the way. He does not like me at all and when I show up he comes up with some reason to leave and doesn't come back. There is another man who works there who is new, and does a WONDERFUL job. I wish I could make him the manager. I tell him what to do and with no hesitation or fight he does it and is eager to learn.

It was International Women's Day here on Thursday the 8^th. This is a day for of celebration just for women. They had a parade, which they call a March. Many of the hospital staff left to go to the parade, as well as many of the other festivities. We were invited by many to attend and they joked about us wearing our African Gowns in the parade, but we politely declined as there were just a few more things we wanted to finish before calling it a day.

The evening we spent relaxing in the apartment visiting with our neighbors here, a Dr. in training from Germany, the mission station managers father (who was taking care of things while his son was away) and Eric one of our translators. Late that evening about 7:30 we were going to the Dowry of Adda and JB with their families at JB's uncles house. A Dowry is where the Groom to be as well as his family offer goods to the bride and her family. This was between two different tribes here, which is a little harder. When one is marrying into the same tribe they know what to expect and there is less complication. But when two people from different tribes are wanting to marry it is a little harder. There was a room full of about 30-40 people crammed in a little room where JB's family sat on one side while Adda's family sat on the other. We sat on the floor. Eric our interpreter came with also. He translated everything for us which was very helpful. JB's family brought in two suitcases full of stuff. Anywhere from material, shoes, handbags, to dresses, personal care items and kolanuts (a type of nut). Adda's family sat in discussion as they looked in the bags, and said that in their tribe tradition is one suit case is for just the bride and the other includes items for the WHOLE family. These were not separated which upset them as well as their were no gifts for the Uncles. They did not like that, so JB's family went back out side to discuss what they could do. They came back and each family had a stern conversation, (which we could not keep up with) and after an hour they finally asked Adda is she would accept and she agreed. They clapped screamed and YaYa'd then said we need to talk money. We thought it was over and we could finally eat. No such luck. They requested 4.5million CFA. They ended up getting 150,000. Which goes to the brides family, and even the day after family members were still talking about how they were upset. We were just happy it was over and we could eat, but at this point we just wanted to go home and go to bed. I was wishing I was the little girl that fell asleep in my lap.

We ate a little so we would not be considered rude, and I was just happy Eric was with to eat all the stuff on my plate that I wouldn't eat, and then walked home to get ready for another day.

In the morning I couldn't hardly get outta bed. I thought that Jet leg was finally catching up on me, but I pushed myself out and got ready. First thing I went straight to the store room again, while Llonda headed back into the ICU. The guy I left the day before was still hard at work, while the useless manager of the storeroom was sitting playing on the computer. I immediately jumped on him that time was critical and I wanted that typed inventory done. He conveniently found some excuse to leave and we stayed for another 2hrs digging in the dusty boxes and counting everything before I finally got so upset and left on a man hunt. I finally found him playing in a secluded room on his laptop. I had words with the Chief of Supervisors and walked out of his office to have Eric (our interpreter who was with Llonda at the time) yelling at me that I was needed in the ICU stat.

Two little girls came in with bad burns. Their mom was heating up tea and walked away and they dumped it and got it all over their bottoms, legs and feet, part of their arms. Not knowing where the supplies were or anything I did all I could do to clean them up, and dress them. My heart ached as I could just imagine the pain they were having, and not a single way to ease the pain for them. No medications, nothing. Just the sound of my voice trying to comfort them. They are 4yrs and 2 yrs. The older girl at one moment asked me for a bon bon. Bon Bons are candy here. I usually carry a pocket full for the kids, but had not one on me, so after lunch I paid a visit to them with some bon bons. They could barley lift their arms to grab them as they lay their in pain.

I had a CPR class set up for 1pm and was nervous that no one would show. I was relieved when I had a room full and more trickle in. I had made CPR cards for them and laminated them. Then the laminater started on fire. Lovely! One of the things I thought may improve the morale of staff to have their own certificate with more to their title was on fire. So the rest will have a certificate that is NOT laminated, unless by some chance we can find one here.

Today was unbelievably hot. After spending a few hours in another small room teaching CPR and not drinking enough water, I got overheated and at that moment in time I would have paid a million dollars just to go swimming. So that's what I did. There is a pool on the mission station, but it is run by the Norwegian side of the complex. So we have to pay 3000 franks to swim. I didn't care, I knew I needed to cool my body down fast. I swam for only a little bit, and then took another cool shower (which I can't complain about because we have water!), but it was probably one of the first times that after the cool water hit my head it was warmer by the time it hit my back.

The kids have been coming everyday and Llonda jokes as they call us Mama bon bons. We have as many people coming to sell us stuff as we do kids! One little girl today while I was in the kitchen came right in the house. I gave her a bon bon and sent her on her way, but Llonda said I need to not be so nice cause they will all start coming in.

Tonight we had the rehearsal for the wedding at the Catholic church. Hopefully it will go by fast, because as hot as it was in there at 8pm, I can only imagine what it will be like with a church full in the middle of the day!

Hope all is well with everyone at home, “hi” to everyone, and we'll be back soon enough!

 These are some boys pushing one of the Norwegian Mission Managers kids around, with Flat Stanley.

 These two little girls (with among MANY others) walk everyday with their buckets and water bottles filling them up with water from the spigot by our house.  So they stop all the time for bon bon's.  I wish candy weighed less, we would have been able to take much more!

This is where the family members of patients come to cook their food.  3 rocks with wood under neath.  The place is swarming with flies, and everyone is excited to share their food with you.  

 A lizard outside our place.  There are lots of them around here.  My boys would have a blast.  Llonda say's when they get scared their tales fall off and the tale keeps moving around.  I try very careful not to scare them!

Here is a man outside the Hospital who makes beautiful woven grass into walls.  

So back to Africa it is!

 The travel was long and hard, either those plane seats are getting much smaller or else my butt a lot larger, probably both.  Weather delayed our departure from Minneapolis and made all of our connection flights there after tough to make.  I could not believe on our arrival in Douala that all of our luggage had arrived with us.

Prior to departing from the USA, I had not been able to connect with a porter I have used many times to help us thru and out of the airport; this is not a good thing when you land in Douala after dark.  Customs is a tricky place to get thru when you are white & there are swarms of people waiting just outside to get at your luggage or beg you for a few coins.  Even if you are inclined to help someone out in that place, the thought quickly passes as you realize that it will only bring them in larger numbers and increase the amount of danger you are already in the middle of.

 As we stood there waiting to see if our luggage had made it, a familiar voice called out my name.  A huge sense of relief overcame me when I seen that it was the man I had been unable to contact.  He no longer works at the airport, but was there to pick up someone else.  Truly a God send! We collected our luggage to find that the Hotel bus had either not came or left without us.  With our 5 suitcases and 4 large carry-on bags, taking only one taxi would be impossible and you should never separate in that situation.  With this wonderful mans help we are able to get 2 safe taxi drivers and he traveled with some of our bags in the second taxi to the hotel.  It costs money to have him help you, but in this case, we could not have paid him enough.

We could not catch a plane north until Monday and Douala is a place where you have the chance to do a little bit of gradual dealing with the way of life here, the reality of where you are and the culture shock.  When we first arrived there at the IBIS hotel late in the evening, we were both severely dehydrated, tired and hungry, me I was suffering from acute nicotine withdrawal as well.  After getting our suitcases crammed into our small hotel room, I told Steph that I was going outside for a smoke.  While standing out there and realizing the time, I remembered a store just down the street and since it was near closing time, I decided to run there and get enough water for the night. We Americans cannot drink the tap water, even in this pretty decent hotel. After getting the water, I had another quick smoke and then headed back up to the room.  I had taken our only room key and by then Steph was terrified.  Wondering what could have happened to me, plus she had brushed her teeth & then wondered if that might kill her.  All things big and small can be scary in Africa!  By this time we are about 30 hours into the travel, not to mention having  gotten up many hours before leaving to try and finish up everything before we left, and then  very little rest on the trip here.  We quickly showered and went to the hotel restaurant to get a bite to eat before they closed.  Navigating the French menu in a delirious state was interesting. 

While in Douala we had a look at the local goods hand-crafted here in Cameroon, to get some idea of what we might bring our family and friends back home.  A former missionary from here had connected us with a taxi driver to chauffer us around.  There could be nothing like driving the streets and an African buffet to prove to us that we have really arrived.  Even I could not believe it when Steph ate some of the things from that buffet.  Amazing what starvation can do to a person!

We flew to Garoua late Monday afternoon, arriving there well after dark.   An old friend picked us up at the airport, which is no small feat given how much luggage we have and then he hauled us to the hotel.  I cannot think of one good thing to say about that place except for we survived the night and we were more than ready when he picked us up before daylight to take us to the bus station the next morning.

The bus trip at best was suffocating and hot, with a Muslim man standing in the aisle preaching in a foreign language for the first 2 hours of the trip.  We quietly celebrated when he got off at one of the stops.  No one on this bus wanted the windows open and many of them sat there with sweaters and hats on.  All I can say is that if I would have had one of those coats on me, it would have been soaking wet and weighed 100 pounds.  I cannot complain about the smell, because I really don’t think we smelled too good ourselves.  “A skunk smells their own odor first.”  Even though we were really thirsty, we did not dare to drink more than we had to have because we knew there would be no bathroom stops.

While traveling you see many villages along the roadside, most with similar yet distinctive building styles based on which tribe lives there.  It seems heavily populated and I assume that it is because most of them must walk everywhere they go, so the natural building spot is along the roadway.  Also I remind myself that we are in a land with little or no birth control, and that, along with traveling early in the morning when many are headed off to school this explains the large number of children we seen.  In America we would not dream of letting our kids walk this roadside.  I would not even want to drive let alone walk this route with all the buses, cars, motorcycles, bicycles, pedestrians and large trucks, let alone send my kids out there.  Yet somehow they survive. It is the way of life and they adapt.

We got off the bus in Ngaoundere and I thought, oh great no one is here to receive us.  Certainly no red carpet rolled out and no bands touting our arrival.  Hippolyte a hospital worker that I have known for many years now spots us and I am so happy that he is there.  He summons the hospital truck and driver, and finally we are headed for the mission station. 

We first must make a trip thru town to pick up Hippolyte’s wife who is shopping in the market. Now this is not a Super one or a Wal-Mart, but streets and back alleys lined with stands that sell most anything.  You can see fruits, vegetables, clothing, shoes, cigarettes, medications, even a whole cow lying on a table in the mid day sun.  Those selling goods there are trying to make a living on what they are able to sell.  Other than food to be eaten, most of it is unwanted, unused or rejected goods from other parts of the world.  Everything is useful here. They would truly build houses or insulate them with things we throw away every day.  The streets are crowded and this village has really grown up into a rural city since my last visit. 

Finally we arrive at the mission station.  The station is a 15-20 acre complex with many small houses inside of a 10 foot high fence.  On my first visit, I thought that fence might be to keep the lions out, but I later learned that it was to keep the locals out.  The gates are open during the day, and anyone can come inside.  But when darkness falls they are all locked protecting those who live inside a little.  This is not at all to say that the people are bad, but rather just that those who live inside these walls tend to have more than those who live outside.  It keeps the honest people honest; I guess is how to best describe it.

We have been assigned a former missionaries place, so this apartment comes with a few more accommodations than some places here at the station.  Besides a floor and a door, small kitchen and a bathroom it has a few more extras.  Most notably a washing machine, which it seems a sin to use, but we are glad for it.  It is the dry season here and water is scarce.  The local water company has been shutting off the water most every day at various times.  You have no idea when it will go off, for how long or when it will come back on. Don’t put off showering until morning because you may well regret that choice.

One cannot help but see God’s hand in our travels. So many places where things could have went wrong or where situations could have gone bad.  Somehow one feels closer to God in Africa.  You have no control over anything and there are many times when one cannot do anything but pray.  Whether it is for patience or to overcome an obstacle or survive a life and death situation… all you can do is keep faith that you will get through it.  I am reminded of the Pastors Ash Wednesday sermon, where the message was to, “shape up, and exercise those spiritual muscles.”  At the very least, I can report that we are most certainly doing that!

Some views to enjoy

March 6th

March 6^th, 2012

It has been an adventuresome couple of days! We left Douala on Monday the 5^th. We were allowed a late check out as we didn't need to be at the Airport until 3pm. We checked out promptly at 2pm, and asked about the 2:30pm shuttle bus to the airport that we had signed up for, and wouldn't you know, so he could take us immediately! Yeahhhhh, right? Not really; we were meeting the porter Abdouleye at 3pm. Of course we got there early and no he wasn't there, so Llonda made the bus driver stay with us to protect our luggage from the sharks. We had to pay him extra to stay, as well as a young kid who we had use his phone to call our porter and tell him we were there. Our previous morning trip to the Cam Air office was a bust, as they do NOT take credit cards so we used nearly all the rest of our CFA to pay for the extra luggage fees, and found that nearly everyone had a roll on carry on with them, which is what we were told we could not have. So our gifts we left behind in Douala, could have come with, but didn't.

The Cam Air flight flew from Douala, to Yaounde (the capital) to drop off and pick up passengers, only being a 40 min flight it wasn't all that bad, and they even gave out full cans of beer, as well as pop/or water. Brussels Air being an international flight didn't even offer that! After leaving Yaounde, en-route to Garoua, they offered another drink. Again the flight was fast, at about 1hr 10 min. Despite the smell of body odor it was not all that bad.

Once landing in Garoua, we were meeting up with Thomas, a connection made prior by a friend of Llonda's. We walked through the airport and waited for the sign being held with her name on it. He was a terrific man, who spoke English well. A man of God who travels all over Africa spreading the gospel to Muslim's trying to teach them about Christianity. On the way to our Motel we learned a lot about what he does, and I was impressed with his faith in God, and the confidence he has with his beliefs. Our Motel was not far, which we loved as it was already nearing 9pm. Thomas got us all set up with our room and agreed to pick us up again in the morning and take us to the bus station to get on the bus to N'Gaoundere. He left and we went to our room. After opening the door I hesitated & wanted to start running after the truck and begging for him to come back and take us anywhere else. The Motel, which at one point must have been a fabulous place had been run down, with walls covered in mold and peeling paint. There was no toilet seat with the toilet in one bathroom and a baud-ea with the sink and tub, in the other. In a matter of 5 minutes we managed to break the toilet and the lamp. Our only light. Llonda went up to ask them to come fix them and no one spoke any English. It was like a game of charades trying to explain to them about the toilet and lamp. Finally he said he would come and look. I think it was mostly just to shut us up. He got them all fixed. The toilet handles are a plastic pole sticking up out of the middle of the toilet lid that you pull UP. Not down, in case you ever need to know:) Since we were too late for dinner, we decided to try to have a drink at the bar. Llonda asked where it was, and we started to follow the man. I walked in and turned around and Llonda was gone. Lovely, I tried to ask the women if she was open and showed her my watch. She told me 10pm, I looked again at my watch and saw it was already 10:20. “Oh so your closed,” I said. She looked at me again and said 10 or maybe 10:30pm. The best she could say it to me. So again I said, Ok so your closed. Llonda walked in at that moment and in pure frustration I said “THEIR CLOSED!” We walked out and she said she wanted to jump in the pool; we had been sweating all day, and neither of us had showered. Sounded like a good idea, but we had only one towel in our room. Again to the front desk for a game of Charades, which was not understood so after this I reached my breaking point and figured I was best just going in that awful room and try to go to bed. Scared to even undress I laid on top of the sheet in a bed that I was jack knifed in from the mattress sinking to the boards in the middle and I just wanted to cry. Pure stubbornness kept me from totally breaking down. I set my alarm on my phone which was all we had, and tried to figure out if he was going to be there at 5:45am, we had to be up by 5:10, knowing neither of us would touch a thing in that bathroom, and hadn't even unzipped any of our luggage just hoping and praying for morning to get there. I had to set it for 10pm as the time never changed from local time at home, and so I was hoping it was right. Thomas came with another nice young man who spoke no English who was also traveling by bus to N'Gaoundere and he would watch out for us. Thomas got our tickets and waited for us to get loaded and we couldn't be more thankful for him, and Jim N., who connected us up with him. He did all of this for us with asking nothing in return! Which is not common around here, when it seems everyone expects a tip. And they expect an even bigger tip if your white. (especially a fat white, that means your rich). The bus ride was very long. We departed at 7:10am and I sat in the middle seat between Llonda and an African gal. It was not a fun ride. Both of them leaning on me, sweating, and no one would have the window open. African's like it hot! I felt like a was suffocating a slow a painful death. The road was paved the whole way which was nice and along the way there were many villages that we saw with women fetching water out of the well by buckets and rope and their small stands by the side of the road and the little kids running around naked or at a minimum a shirt that was too big for them. Most of the school aged kids were in school, and their schools are nearby their village. Electricity is not seen for many many miles on the road and the radio signal is weak for most of the ride. The closer we get to N'Gaoundere more life starts to appear. You can see electrical towers on the side, and certainly more markets. We went up a Mountain before getting into N'Gaoundere, and it is nothing for these buses to pass other vehicles going up the hill. Lots of broken down Semi trucks hauling goods, surely due to overheating. At the bottom of the mountain Security gets on the bus to check our passports and we are all cleared to continue on. We arrived at the bus station where one of the hospital workers met us there and waited for another vehicle to come and pick up our luggage. He drove us around to see the markets and there must have been markets on every street. Covered with people we could barely drive through. Honking left and right he finally gets through and we safely make it to the Mission Station. We arrived here (the Mission Station) around 12:30pm and couldn't wait to take a shower. It had been since Saturday night that either of us had showered and we were soaked in sweat with the same clothes we had had on for days, and my white shirt was now brown. They showed us to our apartment and informed us there was no water. Ummmm WHAT! They are shutting the water off daily from 7-5pm. Really? So here we were with no water and nearly no money left and filthy dirty. The mission house we are in is big, with two bedrooms, a living room, dining room table, kitchen, bathroom and even a laundry area with a washing machine. All of which we are grateful to have and look forward to being able to have water. It took all of an hour for Jean Baptiste (the chief supervisor at the Hospital) to come right over and take us over to the hospital and show us around. Llonda is clearly well loved over here and many recognized her right away and were very happy to see her. It only goes to show that the work she has done over here before has been welcomed and appreciated. She is happy to be back on her old stomping grounds and didn't take long to figure out where we both will be working and needed. The hospital is a large facility, spread out over a 10 acre complex. (I'm guessing) There are people every where waiting to be seen, and the Muslims are praying on their prayer mats in the hallways, outside, and inside. It smells of urine and the heat only makes it worse. The staff are clearly busy with patients and much like many hospitals in the states, they are under staffed and under paid (if they even get paid). They work long hours 7-5:30pm and 5-7am, with 3-4 per unit/department. We were well greeted, and most of it I'm guessing to due to Llonda's prior visits. Eric, on of our translators comes and joins us in our walk. He is a young kid with great enthusiasm and speaks English well. We meet in JB's (Chief) office and discuss the goals he and his staff have for us. I wasn't sure what exactly my role would be here, but they were very excited to have heard of my ambulance/trauma skills and have a whole list besides the CPR training of things they would like me train on. Llonda will be focusing most of her time in the ICU's which she is much of an expert at.

We walk back to our place with Eric and visit, and ask him to take us to the market to buy some groceries. He is more than happy to spend the time with us. We hop on the Moto Taxi's, they are motor bikes, Eric, I and a driver ride on one, and Llonda with the driver on the other. They cruise in and out of cars and around pot holes at great speeds. Truly one would be very injured if they ever crashed. We go to the market with the little money we have left in CFA and choose our items wisely and get only the bare essentials. The International day of Womens festival is going on in town, and Eric suggests we go. We hop on another moto taxi and head over there. We meet Eric's mom, who Llonda has met before, and she is a nice woman who is happy to us. We walk around the festival seeing all of the different types of food and they way the prepare it in the various areas of the country of Cameroon. From porcupine, fish, chicken, steak to Boa (snake). Many vegetables being sold so we jump at the chance to pick up some potatoes and lettuce. They were cheap and plentiful in amounts given. We left the festival and went to a local pub, enjoyed a cool drink and then headed back home. Eric came with to visit, and good thing he did as we forgot our water. Beings you cannot drink the water here, it was much needed, so Eric took off with the last 3000cfa we had to buy us some water. As we stood outside with a man trying to sell us some silver, Adda, JB and another translator showed up. It was a great surprise as we had no way to communicate with them that we were here. Word got around fast and they knew. We talked about the wedding and the plans for the next couple of days, showed them the dress Llonda had picked up for Danielle (JB's daughter almost 4yrs). They loved the dress and shoes that she had picked out. We had a good visit and then they left and we had dinner plans with Jim and still no water at 7:15pm so we went as stinky and dirty as we were. Jim picked us up (he is only staying across the road) and we headed off to Le Plaza; a nice place downtown. The food was good and the company was excellent. We had wanted to pay for Jim's meal, but were broke so he had to pay with all intentions of us paying him back. We chatted for nearly 3 hours. It was hard to imagine we had been up since 5am and it was going on 10:30pm. Jim has truly been a god send for us and we could never repay him for all the contacts and set ups that he has made for us, and the security of knowing everything will be OK. He is a great man with many gifts and I am grateful God has brought us into our life. We finished dinner and came back home and started going over our list from JB (the chief) of all they would like to have done and where we should start. We pulled out all of the supplies we had brought with and sorted what goes where. Finally the water was back on, and it was more than due time to take care of the S's (s*!t shower and shave). All three of which I hadn't done in days! We knew it would be a short morning at the hospital but had to be to Chapel by 7:30am. Good night all, we love and miss you!