Wednesday, March 28, 2012

First Full Day in Lambaréné

I ended up staying two nights at the hotel in order to wait for the director of nursing and ride with her to the hospital. The ride was a little over four hours. The road was well paved (it’s a national “highway” I believe called route 1) except for the occasional potholes and such. I tried my best to stay awake but I’m a notorious car sleeper so add that to jet lag and I’m a goner. What I did see was beautiful though! I don’t know what it’s like here in the dry season, but right now it’s “la grande saison de pluie” (the big rainy season—there’s also a small season) so everything is incredibly lush and green. It’s exactly what I imagined a jungle would look like. I’m half expecting to see Mogli and Baloo. I got to the hospital in time for dinner in the réfectoire (cabbage salad, spaghetti with meat sauce, baguette, pineapple for dessert) and to get all settled in my room. Thankfully I slept pretty well (the ceiling fan helps immensely).

Animals/creatures start making noise around 4:30 am. Most of the noises I can’t identify as anything remotely familiar, except of course the rooster(s). And you know what? Popular culture has it all wrong. I blame Disney (yes this is the second Disney reference in one post) and maybe Old McDonald. Roosters do NOT only crow once, they do NOT only crow at dawn, and there is NOT only one of them. This is actually something I discovered in Haiti, but evidently it’s not just Haitian roosters. So needless to say I really didn’t sleep past 4:30, but the thought of actually getting up then was not too appealing. So I stayed in bed until about 6:30 and then started my day.

I did a full tour of the grounds, which are just beautiful. The hospital is a compound of sorts that has schools, housing facilities, a little restaurant and store, the cafeteria, and all the hospital related buildings (pediatrics, internal medicine, surgery, maternal/infant services, dentistry, art therapy/counseling etc). I basically live in a cabin so it feels very much like summer camp, except instead of rock climbing and horseback riding I do literature reviews and plan health interventions (actually the only camp I ever attended was for ballet so I think that’s what occurs at camp, but if this is akin to the rooster situation, I have NO idea what occurs at regular camps). Overall though today was all about meeting people, getting an idea of what projects have been done in the past, making plans for potential projects, and understanding the population and hospital’s needs. It looks as though my first project will be something along the lines of a survey of the community’s knowledge of family planning. This is bound to change or at least morph into something very different, but that’s the goal for now and I’m prepared to be flexible along the way.

The Script

Despite the fact that I know the subject of marriage and children to be perfectly culturally appropriate topics, and I should expect to answer questions about them when traveling, it always throws me slightly off guard when I’m asked if I’m married/engaged or if I have kids.

The conversation usually goes something like this. After a few minutes of chit chat the guy inevitably asks:

“Are you already engaged? Married?”

“No, but I have a boyfriend.”

“Then why aren’t you married?”

“Because I’m too young. I’m not ready to be married.”

“How old are you?”

“How old do you think I am?”

“Hmm… 19?” (oh dear, and I thought 23 was too young).

And then later on in the conversation I’m asked if I have kids. Sometimes I venture a joke along the lines of “but I’m not married how could I possibly have children?” as if that were actually a prerequisite for procreation. But today when asked this I wasn’t really on my game, call it jet lag or whatever you want, and I apparently had a truly horrified look on my face and replied with an emphatic “NO.” The guy immediately starting laughing and said it sounded like kids would be a nightmare for me. In my head I’m going “well at this point in life they kind of would be.” I most likely would not be in Gabon if I had kids, or if I were here the decision would have certainly been more complicated than it was. I stumbled along saying something along the lines of “I’m working and traveling, it’s too hard to have kids now,” as if it were something I were actually considering.

And so this conversation happened today and it will happen a million times over for the next four months and for as long as I continue to work internationally and/or with other cultures or groups where marriage and family are milestones that occur much earlier than they typically do in the U.S. (speaking generally of course). It’s one of those many scenarios where I smile and nod and bit my tongue so as not to be offensive or push my ideas on someone. Sometimes I’m pretty good at playing this game, on saying my lines, and sometimes I slip up.

The Arrival

I arrived in Gabon after roughly a day of travel, though it certainly felt like more than that. I flew from Detroit to NYC to Paris to Libreville (the capitol). I’ve flown to Europe several times, and normally I feel like jet lag wrecks me. I must have convinced myself that two 7-hour flights was just a normal thing to do because I was actually feeling pretty good upon arrival.

I stepped off the plane in Libreville to HOT and HUMID weather. Holy humidity. It’s the rainy season here so it’s to be expected. There was a “contrôle de la santé” (health control station) before immigration and thank goodness I had on a whim brought my vaccination record. You have to appreciate when your “just in case” moments become “thank goodness” moments. I had to get several vaccinations before traveling, but yellow fever is a specifically enforced requirement (offhand I’m not sure if this is a continent-wide or region-specific requirement). The contrôle and immigration were fine, and thankfully so was baggage claim.

(A side note about packing: I am a self-proclaimed super packer. I pride myself in my ability to bring only the necessities. And yet, I found packing for this trip very difficult! It’s a delicate balance between wanting to have enough socks and underwear to avoid frequent laundering, and just plain overdoing it. I also felt I was bringing an inordinate amount of toiletries, but something tells me I’ll give myself a pat on the back when I don’t have to run around Libreville looking for contact solution).

I wrangled my bags, exchanged some Euros to Central African Francs, and talked a taxi driver into a pretty reasonable fair to the hotel. I had planned on walking there (it’s only about 15 minutes), but it was starting to get dark and I didn’t want to chance anything. The guy who carried my bags asked for my number and a tip. He only got a tip.

I stayed at a motel that HAS arranged for me right on the water. I could hear the waves from my room and there was a delightful breeze J. There was some confusion as to how I was getting to HAS….first I was told I was being picked up on Monday, then it was Sunday, then a HAS rep found me at the hotel saying he had been at the airport waiting for me! We couldn’t have left that night anyway because driving that far at night is not advisable (HAS is four hours away) and his truck broke down anyway. I was very thankful HAS was looking out for me, but embarrassed I had missed him at the airport!

I’m writing this at roughly 4 am local time. I’ve woken up every couple of hours. Time changes are such a bizarre thing! One last thing: when I arrived in my room I found by the sink a bar of soap and a condom. There’s also an ashtray in the room, but I’ll take 2/3. Public health for the win!


“If I have seen further, it is only by standing on the shoulders of giants.” –Sir Isaac Newton

I’ve heard that quote many times over throughout the years, but it didn’t come to carry any specific weight until my last semester at BU. In the fall, I took an intro to global public health class (yes, as a “senior” of sorts I was taking an intro class, but I came upon global health a little late in my grad school career. Plus, the professor was awesome and the reading list not too shabby). The professor quoted it often as a way of impressing upon us the importance of knowing who came before you and using them, both their successes and missteps, as guides. Never has this resonated more with me than now.

For the next four months I will be working at the Hôpital Albert Schweitzer (henceforth referred to as “HAS”) as a public health fellow. The grounds of HAS are riddled with giants’ footsteps. Schweitzer founded the hospital almost 100 years ago, and it became his and his family’s life passion. His philosophy of “reverence for life” is still the guiding force behind the hospital’s functioning today. He is certainly the first giant to recognize. But there are also all the fellows that came before me, both medical and public health students, and the staff at HAS. People who know much more than I do about the hospital’s functioning and cultural nuances I am sure to discover. They have laid a foundation for me, the bottom rungs of the ladder. I have to know and recognize what came before me if I am to progress.

But sometimes giants, or ghosts if I can use Hochschild’s term, can be a messy business. Sometimes their intentions or legacy aren’t always as pure as we’d like them to be. Reading the history of the region, one encounters the utter terror and tyranny that occurred there. Schweitzer founded the hospital in the wake of this terror; the hospital was a piece of the road to recovery for the region. It’s that ugly part of history that we try to but cannot deny. And the fact that I am a foreigner, a white American, working in Africa is a potentially contentious fact that I cannot deny.

And so giants can be historical figures—the altruistic or the autocratic kind—but they can also be found much closer to home. I have my personal giants, my friends and family, who have shaped and supported me. No matter how old we get, I’m fairly certain we always learn through observation and imitation, and I’m grateful to have the best to work from.

Thanks for reading and following me throughout this journey! It’s sure to be a wild ride.