Off the Boat and Into the Past Century….Or Two.

I hope everyone is enjoying their weekend as much as we are happy for the break.  This past week proved to be almost as busy as last week and we are happy to be of use. I have to first issue a huge note of thanks to Peter’s mom who has thankfully waded through pounds and pounds of our mail every week!  She not only lets us know what’s important she makes sure any checks or bills that have arrived are appropriately taken care of.  Without Brigitte’s help we would certainly be at loose ends. 

Let me apologize in advance for the length of this posting.  Much has happened this week and I wanted to share it all with you.    

Peter at screening day

Monday, Tuesday and Wednesday were filled with many, many goiter patients that as you recall from last week means their thyroid glands have grown to enormous proportions and require surgery.  The criteria for surgery in this country under the limited circumstances we have are very different from what we are used to in the United States or any developed country for that matter.  As I mentioned in the entry regarding the mass screening day, the general surgery slots for hernia repair were filled on a first come, first served basis.  This was done to maintain order and avoid rioting by those that had waited the longest.  This, of course made most of us on the medical side unhappy when we would encounter someone late in the day with an enormous problem and all we could offer was prayer and the hope that we’d have enough surgical spots to get them off of the waiting list.

Fortunately, due to the need for lab and x-ray evaluations we had time to sort through the goiter patients and have more of an opportunity to determine who gets a surgical slot based upon medical need.  Sadly, during this week we heard that one and then later two general surgeons have cancelled their time with us in the near future so we have no knowledge at this point how many of our surgical candidates will now go without their badly needed surgeries. 

Probably every week will have a taste of roller coaster action and this week was no different.  We saw a few patients this week that sadly there is nothing we can do to help.  We thank God that He brought a wonderful Togolese woman to the ship – Clementine, who gently informs these people in their own language about their either malignant or equally untreatable medical condition.  She is also the person that informs the many, many people we discover to be HIV positive of their new found diagnosis.  I don’t know how she does it and still she is the most positive person I’ve met on the ship it seems.  Say some prayers for our dear Clementine. 

Each morning we three doctors go on rounds with our surgical colleagues and a gaggle of nurses to determine what each patients needs are.  Pretty routine stuff for a hospital.  What is not routine is that each small ward is packed with five beds on each side facing the narrow aisles in the middle.  There’s approximately a foot in between the beds.  The wards are completely mixed with men, women and little kids. Even more impressive, most patients bring a family member with them as their “care giver”.  This is always done in the local hospitals so we honor the practice here.  These loving folks literally sleep on a mat underneath the patient’s bed!  So, 10 patients in the ward, nearly that many care givers, translators, nurses, surgeons and we docs trying to sort out who needs what, when and why.  Yup – it’s a circus!  What is most impressive is how stoic the patients are and how happy they are as soon as they get out of surgery.  Big smiles and thumbs up from people mummy wrapped in gauze is commonplace.  It is very uplifting and that’s even before the band arrives for the singing and the dancing.  Part circus – part party.  

I spent part of this week digging in my brain archives for my pathology training.  Not only did I assist with a fine needle aspirate of an enormous lesion, I did the slide prep, stained and made multiple attempt to get cover slips on those slides without making too much of a mess.  It’s been over 15 years since my slide making days – so give me a bit of a break, here!  I spent much of the day screening and putting dots on the slides for review by the esteemed cytopathologist that was here in early Feb. for our screening day.  Yes – he’s no longer on the ship but via the magic of modern technology we have what is known as a “Coolscope”!  This amazing microscope transmits not only slide images via a website but Dr. Ed can completely control the microscope remotely from his computer in England after we put the slide in the machine!  Fabulous! 

Ann on first boat

So, on to this weekend’s adventure story.  Yesterday we had the privilege of travelling to the quaint village of Togoville on the beautiful Lake Togo, about 40 km away.   With a friend we met at the Partners reception here onboard a few weeks back.  She is an ophthalmologist with an NGO from Germany and Peter stuck up a conversation in German with her and they hit it off immediately.  She and her driver (!) picked us up and he drove us to a boat launch that one could take a ferry of sorts across the lake.  One can drive to the village but our friend, Irmela thought this a more picturesque method of travel.  We gladly hopped in the boat with about 10 other Africans.  As her driver was negotiating the price things got a bit heated.  It’s not uncommon for whites to get charged more for things and we accept that as we do have the means to pay.  Apparently it became clear that price wasn’t the issue-  they did not want us IN THAT BOAT!  If we wanted to go across the lake we’d have to hire our own private boat.  We thought it interesting and sort of part of the day’s adventure but her driver, a local guy, was incensed.  

We did not hire a private boat from them but went to a lovely resort a short distance away and hired a different boat and had a lovely ride, gondola style.  We felt transported almost back to biblical times when the sailor unfurled two long bamboo poles with a scrap of cloth attached with two strings.  Voila!  Our sail!   

The ride across the large lake was very peaceful with a gorgeous, cooling breeze.  As we neared the shore we saw a dozen young men run down the long dock toward the shore and I thought, hmmm a welcoming committee.  We figured they saw us as easy marks needing a tour guide and thought a simple “no” would suffice.  You can imagine our shock when they ran into the water and offered to carry us to shore!  We, of course, said “No, no, no!!”.  When I glanced over my shoulder and saw two men had hoisted Peter out of the boat and were hauling him to shore I knew I didn’t have a chance.  Next thing I knew I was suspended above the water hoping this young man hadn’t over estimated his strength since I’m significantly above my “bride going over the threshold” weight.  Suffice it to say the man had to work for his few francs that Peter reluctantly doled out.  So, that was weird.  Africa – land of the entrepreneur. 

We then went for a peaceful walk to a school for the blind that Irmela wanted to visit since her organization partners with many clinics and other agencies that work with vision needs throughout the world.  We met with the nun that runs the school; saw about 40 kids that live at the school who then broke into an amazing song for us, complete with gorgeous harmony.  The school struggles with funding and rarely has anyone with her experience to see to the vision needs of these kids so she offered to come back next week and do eye exams.  We’re hoping to see if there’s any way the eye team on the ship assist her. 

Main altar in Notre Dame du Lac

We continued our visit of Togoville with the beautiful Notre Dame du Lac church that sits overlooking the lake.  Apparently John Paul II visited this church on one of his visits to Africa.  There were many, many pictures of him around as you can well imagine. 

On the trip back across the lake we managed to convince our previous hi-jackers that we would walk the 10 paces thru the water to the boat and we managed to return to the other side of the lake with as much pocket change as we did when we entered the boat.  Whew! 

We then visited a most disturbing museum that apparently housed slaves from the region prior to hauling them in the holds of the slave ships travelling to the Americas.  The house itself appeared quite nice however we soon learned that the captured men and women were made to crawl thru a three foot hole on the side of the foundation to their new quarters under the house where 100s of them would stay for a week or two until the next ship arrived.  The height of the space was about 4 feet!  The slave traders lived in luxury in the rooms above.  Apparently it was a couple of Americans that came researching their roots in the slavery that actually discovered this house was still there and how it was used as the locals had no knowledge of its significance!  This area was, during those awful times known as “The Slave Coast”.  Words fail me here. 

Slave holding quarters.  Small slave entrance

We finished the day at a lakeside retreat with some drinks and water before heading back to the ship. 

Today we’re sort of hanging out, resting up for the week to come.  Peter is on call next weekend so we’ll be ship bound and our adventures will be curtailed.  So – I’ll try to find something interesting to write about next week but it will probably not be the lengthy missive you’ve been given to wade through this time! 

We hope you’re all well, happy and keeping warm.  It is hard for us to remember that it is winter there but we think of all of you often and would love to hear from you.  Particularly our elusive sons…hint, hint.  Until next time….