24 July 2014

Niger in the News

This post in the NewYork Times came through on my facebook feed this morning.

What struck me at first was the advertised headline was 'Niger is poor and located in the desert'.  My first reaction was: well, NYT, at least you've got your first facts straight.

One line I can't get away from in the body of the text:  The country’s women, held back by their husbands and by imams who inveigh against “Western” notions like birth control, don’t demand it.  

"The country's women . . . don't demand it." 

Well, Mr. Nossiter, it's interesting to me that all the way from Dakar you assume Niger's women are free to make such demands.

Read the article here.

23 July 2014

A Dose of the Best Medicine

I did my undergrad degree in Athletic Training . . . also known as Sports Medicine or Sports Physio in some places.  So when I moved to Galmi to start up the therapy department, I didn't feel too out of my element when I needed to see just as many (if not more) traditionally Physical Therapy cases as I do Occupational.

There are still PT patients that stump me or who require knowledge way beyond my bag-of-tricks . . . and when that happens, I call in the virtual-cavalry and get expert opinions via email from Physio colleagues around the world.  It's kind of like our own form of distance learning, just without the exams or tuition fees.

About a year ago I started getting consulted for dysphagia (swallowing difficulties) with stroke patients.  It pulled me out of my comfort zone a little bit, but going off the advice of a Speech and Language Pathologist from my Philly days, I got by.   But last week a visiting ENT (Ear-Nose-Throat doc) arrived and that's when it got really exciting challenging intimidating stimulating interesting.

18 July 2014

The Big 'C'

'Uh, D├ęborah, what is cancer?'

I looked up from my teaching notes and blinked at the five men circled around me in the wound care room of the OR.

'What did you ask?' I question, assuming I must have misunderstood.

'You're talking about dressings for patients with cancer, but we don't know what that is.'

I looked at each one, hoping I'd get an indication that they were joking . . . but they weren't.  Four OR Techs and a NurseAnesthetist-in-training, and they didn't know what cancer was.

15 July 2014

Where There Is No Hospice

**I wrote this post over a month ago, but couldn't bring myself to finish it, let alone publish it.  I have detailed heavier cases . . . shared events I find more devastating.  But for some reason, this was just too difficult at the time.  It's happened before, just doesn't usually take a month to process.**

Our Little Girl of Peace passed away early Thursday morning.  Her burns were just too severe for her little body.  And her battle was over.  We just don't have the resources here to change certain outcomes.

That afternoon I sat next next to a mom who was cradling her frail child.  Pressed against her mother's chest, this precious one looked to be four, maybe five years old.  Her skin hung from her boney frame, eyes hollow and deep.  AIDS had ravaged her little body . . . malnourished and weak, the doctor admitted her, hoping to do something to ease her suffering, but recognizing the prognosis wasn't good.

On Friday, our last patient of the day presented to the gym with an atypical concoction of symptoms.  'Stroke' had been listed, but it became quickly apparent that the history I was getting was not what had been given to the doctor.  And as I transferred M. from the wheelchair to the treatment mat, the back of my hand, which was sandwiched between her left arm and her chest, could feel the enormous mass in her breast.

What started off as a localized cancer, had spread to her brain causing her potpourris of symptoms.  A quick chat back with the doctor--there wasn't much we could do.

14 July 2014

Confessions of an Educated Woman

'He says he has 17 children--no, wait, 18.'  B. translated, and counted, as my new patient attempted to list off the names of his offspring.

Trying to do cognitive retraining with a 40-ish year old man who suffered from a traumatic brain injury (TBI) two weeks ago can be challenging . . . attempting to do it in Hausa without wasting anyone's time takes a lot of creativity.

Since I'm limited by language and he's limited by severe immediate recall deficits, we ended up limping along together and some how he made progress.  I'd say it's because of my education; my patient and his friends, however, wouldn't agree.

05 June 2014

Niger in the News

1 in 4 Nigerien girls are married before age 15 . . . 4 out of 5 by 18.  For some, it's just business.

04 June 2014

Refuge Gone Wrong

When over 200 Nigerian girls were kidnapped from their boarding school in April, the world was outraged.  Using hashtags and digital polaroids, the phenomenon that is social media took the story viral, making famous the militant fundamentalist group that has been terrorizing Nigeria and recruiting young men in Niger.

Across the border our Nigerian brothers and sisters live amongst the acute trauma of kidnappingsbombings and massacres.  And while on this side we don't face the same acute horrors, we do feel the secondary effects.

On Friday, I wrote about the Little Girl of Peace, who had been brought to our hospital with severe burns after a car accident.  Turns out, she is a refugee.

30 May 2014

The Peace Left With Us

"There are six new burn admissions upstairs," B. said as I walked into the gym this morning.  I knew it was pretty serious if he hadn't at least said good morning first.

When I got up to the surgical ward, I found them all, lined up on gurneys in the front atrium across the nurses's station.  Three adults, two teenage boys and a little girl.

Upon seeing them, I knew this was no ordinary house fire.

29 May 2014

Niger in the News

This happened just up the road from us . . . pretty interesting article from the BBC about slavery in Niger.  Makes me wonder how many of these 'fifth wives' pass through our hospital doors on a regular basis.

Niger Sees First Slavery Conviction Over 'Fifth Wife'



And then there's this one, just for fun, which gives me one more reason to try to get up to Agadez some day.

25 May 2014

Tomorrow I'll Say Goodbye

This morning I found out that a very important little friend of mine took her last breath yesterday.  For those of you who have been reading my ramblings since my arrival in Niger, you might remember R.'s story.  For those of you that are new, you can check out bits of our time together here, here, here, here and here.

R. was the patient that convinced my Nigerien colleagues that I was a worthwhile part of the team.  Suddenly I was so much more than another single white girl that showed up on the bush plane one day.  R. was one of their's, and by providing her with a make-shift wheelchair that would meet her unique needs, I cared for their whole community.

Suspicion dissolved into understanding . . . invisible barriers came crumbling down.  They got it: I wasn't here to give life, I was here to give living.  Because of her, others came . . . because of her, others trusted me with their loved ones.

R. was the breakthrough . . . and now she's gone.

14 May 2014

A Handful of Miracles

In the three years I've been in Galmi, we've had some amazing therapists and therapy students come to visit.  Whether they've come for two week or two months, our OTs and PTs have all left their mark.

While I was away, we've had an OT-extraordinaire here covering.  M. has been a breath of fresh Canadian air for our little department . . . and has definitely made an impression.

Yesterday she was telling me about an unusual case she saw while I was gone . . . and today I got the rest of the story from B.

12 May 2014

The Night I was Almost Stabbed in the Shower

You know that scene in Psycho . . . when the woman's in the shower . . . and then the knife comes hacking down . . . and the blood circles the drain . . . and the freaky screeching music is playing in the background.

Yeah, that was reenacted tonight in my bathroom.

Kind of.

You see, the shower part was the same . . . but instead of a knife or blood, it was the most gigantic scorpion I've ever seen!  And I knew one of us wasn't going to make it out of the tub alive.

09 May 2014

The Comfort and Sorrow of Ikea

Getting out of Niger . . . away from the dust and the heat, out of the fishbowl . . . seems to always come with mixed emotions. 

Feeling stress physically leave me body . . . it’s kind of like a slow leak, a little bit at a time until I notice that I’m breathing differently, almost normal, but not quite.

Overwhelmed with gratitude for every blade of grass or evergreen needle . . . capturing each lapping wave in my mind’s eye to save for later.

Cherishing single-customer taxis and fixed prices at the market . . . savoring fresh cheese and enormous strawberries and everlasting cucumbers.  

And then there’s Ikea.  

30 April 2014

April is OT Month

April ends today.  So does Occupational Therapy Month.

I had big ideas and grand intentions to spend this month publishing wonderful posts about the worlds greatest profession, opening your eyes to the wealth of understanding that is summed in two little letters: O and T.

But I didn’t write them . . . not even one.  And now the month is over.

Sorry, OT, I dropped the ball.  

Maybe next year.

Next year I will explain to the world what it is that we do . . . and why it is an essential portion of the healing process . . .  and why we are an integral part of healthcare teams . . . and why the whole world needs our services.

Next year.

Yeah, next year I will offer links to valuable OT resources around the web, like so many other OT bloggers have done . . . and I will promote this life changing profession that builds and restores quality of life, meaningful participation, purposeful existence and functional independence.  Because that is what we are about: quality, meaning, purpose and function.  

Next year I will tell you about how we who practice Occupational Therapy believe that all humans have value, regardless of capabilities . . . and that physical, cognitive, psychological or socioeconomic limitations do not nullify the right to human worth.  


But it will have to wait until next year.  Because April is over . . . but then again, for our patients whose lives are changed by Occupational Therapy, every day is OT Day.

22 March 2014

The Cost of a Check Up

Lately my mind has been occupied by the reality of the great cost of seemingly small decisions pertaining to life in these parts.  A patient who runs into a burning house in order to salvage her life savings.  Or the son who decided to hold his father upright while walking because he can't spare the extra money on a walker.  Or the grandmother who hasn't eaten for two days because her kiddo has a therapy appointment.

My Favorite F. came to see me on Wednesday.  She was supposed to come last week, but they didn't have enough money for the bushtaxi fare to get to the NGO clinic that would drive them the rest of the way to the hospital. 

When they arrived, Granny greeted me and immediately helped herself to a floor mat that was rolled up in the corner.  She spread the mat in the middle of the gym, laid down and fell asleep.  When she awoke about half an hour later, I asked if she was unwell and needed to see the doctor.

'I'm fine,' she said.  'Just hungry.'