Coming Back

As I once again gather my things, this time to go home, I am pondering only one question from my friends and colleagues here. “When are you coming back?” I’m grateful to be asked, but that’s a hard question to answer.

I am very ready to be done with the heat and the dust, my painfully swollen feet and my lack of ability to communicate as I wish. I’m weary of the bone-rattling, axle-breaking potholes that make driving nearly impossible in some areas of the country.

But I know I will dearly miss Sister Nadege’s bubbling laughter and the loving care with which Sister Pauline has prepared all my meals and listened to my stories of the day. I will miss morning Mass and evening prayers. I will miss the patients who approach me in the courtyard and say “Thank you for making me better”, or the ones who honor me by requesting that I be their doctor. I will miss the nurses who have begun asking me questions about patient care, with an obvious desire to expand their knowledge base. I will miss the enthusiastic “Doctor Carol!” greeting I receive so many times throughout the day.

I question whether I have really made much of a difference here. Perhaps in two very small ways; an important medicine that was being administered incorrectly is now being given as it should be, and a medical issue that was being overlooked is beginning to be managed more optimally. I am proud of these things, but I wish I could have done more.

I know I am the one who has benefited the most. I have been welcomed from the first moment and have felt unceasingly loved and cared for. Any missteps, inadequacies, or less than perfect outcomes have been viewed as only to be expected and not nearly as important as I think they are. I have been taught lessons in acceptance, love, humility and grace.

Am I coming back? I’m not sure. But as Sister Pauline so wisely told me, “The Lord will let you know.”

May God continue to bless the people of Cameroon and all of Africa. 

Je voudrais parler français!

I very much enjoy my “consultations”, which are what patient visits are called here. 

Many of the concerns with which the women and couples present are identical to the ones with which they presented in my US practice. The nurses have been good about trying to give me English speaking patients but there aren’t as many of those and, even with that, there are communication challenges. So many people here speak at least two languages, French and English, and often more than two, that I am embarrassed by my own limited abilities. But staff and patients are always gracious as I try my best and they thoroughly enjoy my inability to grasp what seem like very simply phrases to them! Smiles and warm touches usually bridge the gap.

patients waiting to be seen

Morning Mass in Douala

Let me try to describe for you what it is like here to go to morning Mass. When we go outside it is still dark, although not entirely quiet as we are in a city and there is always at least some traffic noise. But it is nonetheless peaceful as the courtyard is not yet filled with patients, the moon is shining down, and only a few people are about. The Sisters and I murmur some soft bonjours, but nothing more than that.  

One of the men who watch the front gate at night emerges to drive us and the drive is slightly less perilous then as the traffic is a bit lighter early in the morning. As we approach we see many people walking in the dark toward the church. Older women slightly bent with age, young men with a young man swagger, older men dressed for work, children in their colorful school uniforms, and mothers with little ones.

It is pleasant in the church as large fans are blowing and the heat of the day has not yet arrived in full force. The pews are a bit dusty and I always see the Sisters wipe them clean before they sit. The benches on which we kneel are hard wood. There are empty spaces in the pews, but not a great many.

The church itself is wooden with painted murals of the Stations of the Cross along the walls. A large bouquet of Bird of Paradise flowers fronts the altar and periodically flashing red and green lights surround the large gold tabernacle.

The Order of Mass does not differ, so I can follow along even though I cannot understand more than a few words of what is said. The accompanying peace and joy are the same. And the singing! I would go for the singing alone. It is jubilant and soaring, sometimes accompanied by clapping hands and swaying bodies.

As we leave the church we see Douala burst to life with people gathering everywhere, roadside food carts doing a brisk business, children running to school, and motorbikes weaving in and out. The trip home is a lively affair with the Sisters talking and laughing. I, on the other hand, grip the arm rest as the driver darts in and out of the terrifying traffic and only relax when the metal gate opens and we reenter the courtyard, nourished for the day ahead. 

waiting for Mass to begin with the sound of singing

More than one right way

When I perform a delivery, I employ certain ingrained maneuvers that result in the baby lying along my left arm cradled against my side. Similar to how a running back holds a football. It keeps my right hand free for other things and provides a stable platform for the newborn.

That is not how it’s done here! Here there are no gowns to cover ones arms and clothes. And yes, those babies are messy and slippery when they’re born. Gowns are not really an option. Paper ones would be too expensive, and disposing of them would be a problem. Cloth gowns aren’t feasible as nearly everything is washed by hand. Here the midwife wears a standard pair of gloves and a long rubber apron over her pristine white dress. The maneuvers she uses result in the newborn hanging upside down by its feet, clear of her body and the apron. When the cord is clamped and cut a second nurse takes the baby to a nearby sink to wash and dress it. No one gets messy and no one gets dropped! Just another example of adapting to the circumstances and getting by with less.

Unanswerable Questions and Motorbike Marvels

We have just returned from a three day trip to Shisong where the Sisters have their motherhouse and St. Elizabeth’s Hospital. It was an adventure complete with a truck breakdown in the middle of the bush, delicious French pastry, a loving gift of sandals for my heat swollen feet, and encounters with the federal police!

I was honored to meet everyone from the novices to the Provincial Superior and to tour this amazing place with its own water purification system; large gardens and animals to provide food for everyone; schools for training young people entering nursing, midwifery and laboratory technology; and, of course, the hospital. St. Elizabeth’s is not only a general hospital, but is also a cardiac center where they perform complex cardiac surgery for the people of Cameroon and those from many other African countries. It is hard to believe this was all started by five brave women only 80 years ago. What a legacy and gift!

This long trip also offered me a glimpse into the lives and living conditions of much of the Cameroonian populace and it has left me struggling in mind and heart. How does one possibly reconcile such inequity in our world?

On a much lighter note, I have included a list of some of the things I saw on the backs of motorbikes during this trip!

·       Another motorbike.

·       A family of 5.

·       A complete chest of drawers.

·       Long lengths of 6 inch metal pipe balanced on the head of the passenger.

·       Five animal cages—with animals.

·       Innumerable water/palm oil jugs.

·       My boss, Sister Nadege!

May God bless the people of Cameroon and all of Africa. 

picture of Sister Nadege

picture of houses

Bonjour d’Afrique!

Let me begin by reassuring those who doubted my traveling skills (myself included!) that I did just fine. I’m thinking of it as a “self-affirming growth experience”; i.e., a few bumps in the road but I handled them and arrived in one piece. And, as promised, the Sisters were at the airport waiting for me and soon had me home, fed, and sent to bed. I had been told to expect them to be hospitable and they certainly are. Everyone has been very welcoming and if they keep feeding me as they have been, I will undoubtedly return 10 pounds heavier.

The day begins early here with prayers at 5:30, Mass at 6:00, a quick breakfast, and then to work. And work everyone does! One of many things I have found impressive is the way so many of the personnel competently perform more than one function. There is also a real sense of teamwork in Labor and Delivery that I witnessed firsthand today when a patient presented from clinic in the midst of a placental abruption, a devastating condition in which the placenta separates while the baby is still in the uterus. Unfortunately, the baby did not survive, but the mother is stable despite losing a great deal of blood. It turns out that there is a list of Sisters and employees available to donate blood in dire situations, and even some people in the community that will donate if the Sisters ask. Just one example of many apparently insurmountable hurdles they have somehow managed to overcome.

Labor and delivery is much different from what I have experienced in the past. Everyone labors together in one very small, very hot room, often with family members for support, and are periodically brought across the hall to be examined. When they are ready to deliver they are moved to the one delivery room or the one operating room. I have participated in several cesarean sections since I arrived and am learning how much can be done with very little.

Thank you all for the prayers and loving support. I feel very blessed to be here. 

view of Douala from my window

the delivery room

Calling

As I collect what I need and pack my suitcase, I am pondering all the questions and comments from my friends and colleagues. “You retired last month. Don’t you want a break?” “You’re a homebody. You don’t like to travel.” “You hate flying.” “You don’t speak French.” “Couldn’t you have found some place closer?” “What will you do without McDonald’s Coca Cola?” All well-meaning and valid concerns except, perhaps, the last one. No, actually the last one is legitimate, too!

But as it says in Luke, “Much will be required of the person entrusted with much.” And having been an obstetrician for so many years, I have been entrusted with the wisdom and knowledge of my teachers, the new knowledge and enthusiasm of my younger colleagues, and especially the gift of experience from all the women and families for whom I have cared. It is time to go. It is time to serve. As it says in one of my favorite hymns, “I have heard You calling in the night.”