Saturday, 12 November 2016

Dry as a crisp and not just the weather

I think we’ll just become vegetarians was the line we were taking as we considered life in the North of Chad and the fact that meat was only available for parties when people decided to kill a camel.

Then we thought well maybe a tin of something meaty once a week. How-ever choices in Ndjamena seemed limited and expensive when we visited the supermarkets and then how much weight are you allowed to take in an aeroplane or how much space can we have in a pick-up. What about the fact that vegetables are not too readily available and don’t even mention cheese. So how to have a balanced diet- maybe just dried beans would be fine.

Finally one of our new team mates arrived in Ndjamena and we took her advice, followed her expert tuition and started drying meat. Boil mince meat for an hour or so then slow dry in the oven was her advice and its ready when it looks like light coloured coffee granules! So now we have several jam jars of meat ready to go with us. It’s amazing how much water there is in it.

Inspired we moved on to fruit and vegetables- we hope we may grow our own- but as we are not going as agriculturists we may be a little hungry at first and even later on. Some veg will be available but it all depends on trucks coming into the town with supplies and on us not being too busy and getting there before it’s all sold.

So we have dried green beans(chewy) and cabbage (not sure) and peppers (definitely nice like roasted ones). We have also dried pineapple and guavas (a bit seedy), apples and bananas soaked in lemon juice. Sadly it’s not mango season because as many of you know from the summer they are very tasty. We’ll have to get Rebecca trained when we’re away to do some for our next trip.

We’re still waiting for tomatoes and carrots to go down in price and then we will add them in. All these have been done in the solar cooker so no extra cost, not too difficult and finally no weight or space to transport them. It’s amazing what advice you can get on the internet when you’re not sure how to do things.

So now all we need is some recipes and we’ll be cooking on gas well not quite actually we will be using kerosene stoves and our solar oven!

The other good news is that we now know all the words for these things in Arabic and are even allowed to say them. So far we haven’t ended up with any of the wrong things at market but bargaining in Arabic money is not always easy but that’s another story…………





Wednesday, 5 October 2016

So you speak a new language


Well that’s the aim but not out loud just yet.

 We arrived back in Ndjamena 2 weeks ago – our first job was to collect all our belongings from Guinebor where they had somehow managed to get dusty even shut in a container. Then we unpacked a few necessities and set up in our new home in the middle of the town on the TEAM compound as it happens where we stayed the first ever night we spent in Chad although we have the big house so we can sort our things more easily. It’s been good to start to get to know the other TEAM missionaries and feel part of a new team (this could get confusing!)

 After asking for advice from one of the other missionaries as to how to find a language helper just a week later we had our first language lesson. This however is a lesson with a difference do you remember how you learnt to talk- well maybe not but do you remember how your children learnt. Well they didn’t write much down and they didn’t speak to start with and…… that’s what we are doing.

With the aid of pictures and objects and a nifty small MP3 recorder ( that we fortunately found on the market)  we are learning a new vocabulary but not actually speaking very much. So by tomorrow we will have 150 new words that we can recognise and we continue building on this for another 2 weeks with very little speaking till we get to 300.  We do know some words already and also we have obviously been doing the listening bit for a long while so we have spoken a little but are still following the method fairly closely. It’s fun but challenging too.

 The method is called GPA or Growing Participator Approach and the idea is that learning a new language means that, to quote the study guide.

‘You don't learn the language! Rather, discover a new world, as it is known and shared by the people among whom you are living.’

This gives us an excuse to go to market and practice our new words well actually so far rabbit, snake and the parts of the body have not been too useful. However Mark decided that if he looked the part perhaps it would help so we ventured into the clothes part of the market to buy a Jalabeer. He wanted a simple cotton one -not as easy as it sounds lots have a lot of embroidery and we were assured that the readymade one we were offered was 100% cotton until we found the label saying 100% yes but polyester!! Eventually the cloth was bought -at a price and the tailor paid and we picked it up last Friday. So far there hasn’t been any major change in the Arabic but perhaps it would help if he wore it!

 So we continue to learn a new language and to speak a little, one big advantage being no faux pas yet until we have to open our mouths.


Sunday, 21 August 2016

Pictures at an exhibition?

Mother and Child- a present to Andrea
from the midwives at Guinebor II 
Half way through August and nearly at the end of our whirlwind tour of the UK up north to Lochgilhpead and down south  to Penzance and then across west to Penarth  and east to Eye too. Visits to BMS churches, friends, medical courses and holidays have all been squeezed in. Meanwhile we have been making plans for our return to Chad. We will return to Ndjamena on the 16th of September and be based there whilst we learn Arabic. Initially for 2 months and then afterwards in Amtiman practicing what we have learnt.

After that the next challenge begins getting ready to move up north and another language to learn. However as  we move on we thought we’d also look back one more time. On leaving our house in Guinebor II we emptied it and put all the contents in a container rather the reverse of our arrival where we had to empty the containers and sort out what had been eaten by termites or melted by the sun. Hopefully that will not be happening  this time.

Looking around at all the pictures we had collected over the last 5 years it gave us a chance to reflect and here are some of our thoughts.

The market scene just like the central market in Ndjamena where we or our house help do the weekly shop. This was a picture Mark bought on a roundabout of which there are rather a lot in Ndjamena he bought it soon after arriving in Chad when he spent a lot of time driving the girls to school and waiting around-before they could really speak French and we didn’t have our reliable driver Dago it seems a long time ago.

The second is a picture we bought
at Dougia a small hotel with a pool where we spent a quite few weekends relaxing. It is just south of Lake Chad on the river bank with Cameroon just 400m across the water. Sadly due to security advice we have been unable to go there for the past couple of years.
The artist sold us the picture, it shows a typical Chadian scene, a herd of animals in the desert reminiscent of cave paintings. The image glows as it did  in reality the day we drove to elephant rock and again not so long ago when we flew over the desert up to the North of Chad.


We keep this picture up of rice fields in Guinea as it reminds us of our time and friends there. All that we learnt in Guinea has been so helpful to us as we opened and ran the hospital from planning the pharmacy to knowing at least a little about the French employment code. It also gave us all a great love for rice with nearly every meal something readily available in Chad, although Chadians prefer boule and we are taking our time to fully adapt.

These women walking towards us remind me of the Arabic women in our hospital heads covered most wearing laffees (a long strip of material wrapped around over your clothes) and reaching for their headscarves immediately they awake from the anaesthetic or leave the consultation room.  I remember when we opened the hospital and wondered if anyone would come we have served so many patients since its becomes hard to remember them all. I also begin to wonder if I will ever get used to wearing a laffee as I hope I will in Amtiman and afterwards. I guess so as even at Guinebor it felt strange leaving the house without a headscarf.

Another group of women this time in relief the surface is hard and Chad can be a tough place to live heat and dust our constant companions not to mention flies they are incredible in Chad everywhere you go they follow you soon learn the value of a plastic fly swatter and mosquito netting.

Ruths picture from an old fort on the Isles of Scilly reminds us both of her and our holiday there a few years ago a magical place to relax and all our good times of rest in the UK away from the business of Guinebor.

A map of Chad made by women who have had fistula surgery  in Ndjamena and are looking to start afresh now cured. We look at this and think about our travels up to Bitkine over to Abeche and Goz Beida and down to Mondou. The quiet of a morning at Zakouma seeing a giraffe appear out of the trees. The sunset over the hills of Bitkine and the fun rickshaws in Abeche. The whole of Chad such a mixture of people with great needs for health, education and peace.

Women walking away from us-bought in a new craft shop in town this one was one of the artists old style pictures which made the price much better!! This is the last picture we bought and reminds us that we walk into a future that will still involve caring for women and children just as we have done at Guinebor and there is still work to be done.

Monday, 13 June 2016

Something new under the sun?

                                                                               International labour day  1st May 2016 spot the 2 Chadian flags

A time to arrive and a time to leave,

A time to work and a time to rest,

A time to teach and a time to learn,

A time to laugh and a time to weep,

A time for greetings and a time for goodbyes.

‘’I know that there is nothing better for people to do than to be happy and to do good while they live. That each of them may eat and drink, and find satisfaction in all their toil - this is the gift of God’      Ecclesiastes 3 (12-13)

Farid meowed at the door on  Saturday morning, it must have seemed a normal day to him, a good night out  hunting and now he could now look forward to his day job of lying around the house and being fed some delicious left overs. This is all he has ever known, but things were about to change. Firstly he was enticed into a box, then put into a car (did that really bring back unpleasant memories of a trip to the vet?) and off we set to a new home on the far side of town, a small walled compound in the middle of nowhere.  With our departure he can no longer stay at GII, so we are very happy to have found a place for him with Dia, our head midwife. She needs a new cat to keep the mice under control and to replace their much loved cat Princess who died recently. So long as he can adapt he has fallen on his feet, as cats tend to do. We will miss him.

Monday morning 7am and here I am in bed writing a blog, Andrea is making a cup of tea and Rebecca is still fast asleep on the veranda. Something new? This time last week the usual rhythm of the last 6 years was still there but change was in the air. Rebecca had already set off in the car with Dogo  for her last week at school to write her first exam paper, Philosophy, and Andrea and I were getting ready for our final few days and nights of work at Guinebor II.

The Friday before that (3/6/2016) a bit in advance so that it was before the first day of Ramadan, we had officially thanked the hospital staff and shared a meal together. Speeches were made and we received some fine gifts, amongst them a new leather briefcase for me and a mother and child statue sculpted in wood for Andrea. Really thoughtful and generous. The mayor came thanked us for our hard work, wished that we could stay and jokingly asked what we had done that we might be sent to Bardai (not a sought after posting by most Chadians)

By the following Friday, 10/6/2016 all was said and done. Bert Oubre, (CEF President and new Medical Director), his wife Debbie (Obstetric nurse) and  Kalbassou Dabassou ( Surgical technician/nurse) had arrived on Tuesday, handovers had been made and then by 5pm on Friday our time here was finished, only the packing up  of the house left to do. The day will always be remembered, Ruth got very good results from her first year at university and emailed them from her holiday travelling around Eastern Europe with friends. Rebecca sat her final paper for her Bac, and is now waiting upon results. It was Andrea’s birthday and also 33 years since we got engaged to be married. A life changing day for our family.

I did say goodbye at the Friday morning staff meeting from Andrea and me, and being the last day did make it seem a bit more real than the week before. We thanked them again for working with us as a team to serve our patients, each of them had played their role, nurses, midwives, doctors, cleaners, guards, pharmacy laboratory administration, health care assistants and sterilisation. Everyone depended on each other and will continue to do so, but we will miss the pleasure of serving with them.

And then I said goodbye, and  yes I said it in English. Au revoir just isn’t the same, although till we meet again is a fine sentiment, I preferred my mother tongue to really express my feelings. Goodbye a contraction of the old English ‘God bless you’

Good bye Guinebor.

Our last management team meeting May 2016

Saturday, 21 May 2016

The sun began to rain

A gentle patter of rain on the roof wakes us and we wonder what is happening .More confusion as I realise I am in my bedroom and not on my camp bed on the veranda the normal place to wake up to the bird song and the sun in the hot season. Yes it is raining not, I concede, a rare event in England in May but here we are having our second good rain in 3 days .Temperatures have plummeted to 23 degrees and humidity shot up to 90% and more. Little shoots start coming up out of the ground and butterflies have been seen flying around. Soon the frogs will join us singing in the rain as we did on Thursday when it arrived.

It made me wonder how it would be when it rains in Bardai (meaning cold) in the North of Chad. There it rains but a couple of times a year and sometimes not at all. It is a very small town surrounded by mountains in the middle of the Sahara desert not so far from Libya.

Thanks to Dave Forney MAF for flying us there and this photo of Emi Kosi
We flew there a few weeks ago to have a look at the hospital, meet the missionaries and see if we might feel called to work there. Flying over the desert in a small aeroplane was an experience never to forget with miles of sand dunes and then rocky mountains. We even got to fly over the highest mountain in Chad an extinct volcano.

On arrival after being fed a delicious meal made by one of the very versatile missionaries with dried meat (no meat available in town except occasionally camel) we visited the governor. He was extremely welcoming, then to our delight we were taken to see some prehistoric carvings in the rocks just on the edge of the town no entry fee or queues just there for all to see. Strange to imagine that elephants roamed the area at one time.

The next day we visited the hospital a surreal experience it was an exact copy of Goz Beida but empty .It has been open since 2011 and as yet no operation has ever been performed despite having 2 fully equipped operating theatres. Most of the very good equipment was still in its original packing. The doctors there have about 10 outpatients a day 7 deliveries a month and anything complicated is referred to Libya a 12 hour drive across desert or Faya in Chad a 24 hour drive through the mountains. Many staff who are transferred there are not keen to stay because it is so isolated and the doctor in charge of the area has no surgical experience and has only been qualified 3 years not an easy situation.

The need is obvious but the population small and life there would certainly be different, houses are very simple and we slept outside under mosquito nets to avoid the scorpions,(they are such a problem that the hospital stocks anti-venom). It was a welcome respite from the heat of Ndjamena as we huddled together under a sheet, Bardai living up to its name even in the hot season.

The next day as we left looking down over the town surrounded by the date palms it was hard to imagine the wadi filled with water but apparently just  2m  down there was water available and last year the centre where the missionaries work was flooded. Meanwhile we continue to ask where God is leading us and enjoy the water all around us here in Ndjamena as we finish our time here.

Monday, 7 March 2016

Happy Mother’s Day!

Last night was the celebration for baby touristic at one of the smart hotels in town .The plan was to meet two of the midwives wearing our best clothes and join in the celebration for the first babies born this year at various hospitals around the city. This year we managed to have one born in the slot between midnight and five am and they were going to receive along with many others gifts and money funded in part by the tourism office and with the aim of encouraging safer delivery.

Unfortunately it was not to be for me and I ended up getting involved in the practical part of safer delivery instead. As deliveries do nothing but increase here since we opened the new maternity I had failed to appreciate that I might not be able to leave the hospital and go to the party. The night was extremely busy with 2 caesareans and 2 miscarriages and a normal delivery and a difficult delivery of a baby already dead when the 17 year old young girl arrived. Every time I thought I could leave something else occurred.

It was a happy day for 2 ladies but although not happy at least a safe end to the complications the others suffered. We were struck by the privilege we have here as more women come and we are able to help them .One of the ladies with a miscarriage initially refused a curettage as she had heard they were not a good idea. When we explained that it was also not a good idea to bleed excessively she agreed and was surprised to find how easy it was- hopefully she will tell others now.

It contrasts greatly to the situation we found in Goz Beida in the East of the country  near the border with Sudan.  We visited recently to see if God is calling us to work there, in a small border town with a Darfur refuge camp next door. Amongst the deliveries of which there were about a third as many as we have here 25 % were by Caesarean and the same number were stillbirths although the percentage of caesareans is normal for England here it represents women coming in in labour late on with complications and the high maternal death rate of   3% showed this.
Many women live far from the hospitals and the  180 km journey from Abeche on the main road took 6 hours6 hours and had to be done in a four by four vehicle because of the sand and is impassable for 2 months of the year due to flooded wadis.  We were welcomed by the hospital staff and it is clear there is a great need so we are wondering whether God is calling us there. 

In the meantime after getting to bed at 5 am I was woken by a cup of tea and a paper daffodil from Rebecca (no flower shops here) and am glad to say all patient are doing well and today is calmer so far. I hope to find out tomorrow how the celebrations went and as for Goz Beida we continue to seek Gods guidance for the future.



Sunday, 24 January 2016

Félicitations et Encouragement

So it’s a New Year, and  the  first thing to do as a doctor in the UK  is drink a cup of  tea in bed, leaf through the BMJ and  the Times and check that your obituary has not been published. Provided that’s OK, it’s time to get out of bed and start the New Year with one or two resolutions.  You might, if you are particularly eminent, check that you haven’t been named in the New Year’s Honours list, but I guess you get asked about that in advance.

In Chad it is more or less the same, except that the BMJ arrives about a month late and the Guardian Weekly doesn’t post obituaries, and the honours list?

 Last Thursday morning at 9:15 am  I was doing some admin in the office when Mbai gave me a letter that had arrived the day before, it was from the mayor’s office inviting me to a ceremony to mark the New Year, seating of guests was between 8 and 9:30 with the ceremony scheduled to begin at 10 am. Should I go? It wasn’t very convenient, was it just a circular and I didn’t need to be there?  I had a ward round to do followed by a busy clinic which I was hoping to finish early so that the staff could take part in the annual hospital union elections. I rapidly decided that I should go, we are here to be part of things and get involved in Chadian life and that is what is needed so be it. 

After a quick dash to the pharmacy and wards to explain my absence I was back in the office when Mbai said, the mayors secretary had just rung, ‘are you coming, the mayor  has something to give you.’ Great I’d made the right decision.  Straight into the car and a 10 minute drive along the dusty tracks until I arrived at Farcha and the Commune of the Premiere Arrondissement at 2 minutes past 10. It looked busy,lots of people, lots of police and other official 4X4 vehicles. After a quick emptying of pockets and once over with a metal detector I was shown through to the yard beside the offices to where couple of hundred invited guests were waiting for the Mayor to arrive They were seated on plastic garden chairs under a brightly coloured temporary cloth covered shelter  listening to arab style music from  a large PA system. I was ushered to a place of honour, with various police officers, gendarmes etc. We were sat  in rows,facing the main crowd, behind an enormous vacant sofa where the mayor would be seated. About 10 minutes later the mayor arrived and in front of the assembled TV cameras and press  the ceremony began. After a short introduction by the General Secretary it was the turn of the Mayor to speak. He thanked everyone for finding the time to come to his modest ceremony and wished everyone a peaceful, prosperous and healthy New Year. Then he outlined the improvements to the Premiere Arrondissement over the past year, new roads,  improved electricity supply etc. and then the difficulties due to reduced budgets with the falling price of oil, and the  new problem  of combatting terrorism and the need for all citizens to be united in their efforts to be united against it. He then announced that the ceremony would continue with the presentation of certificates to thank and encourage people who have made a particular contribution to the arrondissement in the past year.

First a number of police chiefs and gendarmes were honoured, as it was noted without them where would we be in these troubled times. Then the Mayors body guard, and other members of his staff, local  chiefs, school teachers, religious leaders and members of the local business community including David, a Chadian who with his Swedish wife Sarah  owns the farm where Ruth and Rebecca used to go horse riding. They have an expanding cheese making business. And finally as it was said, ‘’la santé avant tout’’, Dr Soloukna, the District Medical Officer and Dr Mark, the medical director of L’hôpital de Guinebor II.

As is normal there followed a ‘petit cocktail’, and an announcement was made to say who was to go to which area to eat.  I didn’t quite know where I was to go, but the secretary general picked me out in the crowd and took me in the mayor’s office a large room with all the chiefs, minus its usual sofas and in their place on a large table were two whole roast stuffed goats. Each person cut off their own portion, absolutely delicious as was the cous-cous and vegetable stuffing. The Chief from Alllaye was sat next to me and put what I took to be a delicacy on my plate. Rounded at one end and concave at the other, yellowy brown, I couldn’t tell what organ it was ,an eyeball a testicle?  It felt rubbery and I bit in to it with a certain trepidation only to find out that it was simply an egg white changed in colour by the stuffing!

On the way out there was lots of handshaking and congratulations, a few photos (sorry I didn’t take a camera)  and then it was back to the hospital to see some patients. I reflected in the car on the way back that although I am not a big fan of honours in the name of an anachronistic colonial institution but there does seem to me to be a place for civic recognition of the work of organisations and individuals for the good of society.
The next morning I showed the certificate to the staff and thanked them all, cleaners, doctors, grounds staff, guards, laboratory technicians, midwives nurses and pharmacy staff from the part of the Mayor for all their hard work in serving the hospital and the local community. It is after all the hospital team ,composed of many parts that functions together that represents the body of Jesus that should be thanked and encouraged.