Evolution of an Adventure

Evolution of an Adventure....

10/23/11 Greetings! Welcome to my Nursing in Nepal blog! In May, 2012, I'll be graduating from San Jose State University's School of Nursing and in early June I'll be leaving for three weeks in Nepal along with SJSU faculty and other nursing students to provide nursing care to women and children in Nepal and I need your help to get there! Our team will be providing wellness exams, vaccination clinics, and health education in Kathmandu and other villages in the Kathmandu Valley. My goal is to raise $5,000, which will cover a significant portion of this trip. I realize that the current economy is making life difficult for all of us. Any amount contributed is appreciated as each dollar gets me closer to an opportunity to help disadvantaged families while building my skills as a nurse and caretaker.

I'll be updating this blog with amusing tales of adventures in preparing for international travel and, once there, I'll be documenting my experience with photos and stories as much as the available power supply will allow! Subscribe to my blog and please join me on my adventure in Nursing in Nepal! I welcome your comments, questions and insights through this amazing journey.

12/8/11 I have just received the uber disappointing news that the nursing trip to Nepal has been canceled as political unrest has put Nepal on the State Department's watchlist and the university won't let us go. While it will be incredibly difficult to quit dreaming Nepalese dreams, I am unshaken from my determination to take an equally awesome nursing trip after graduation. I just have to figure out where and how. So, I'll do some research in the hopes of finding another exciting opportunity off the beaten path and apply my passion and your generosity there. If I can't find anything within a few months, I will refund your donations. Thank you again for your support and stay tuned!

Next stop...

1/6/12 It's on like Donkey Kong! So, a bit of change... turns out I'll be going to the Edna Adan Hospital in Hargeisa, Somaliland. It is a midwife-led clinic and I'll be staying in a guestroom at the clinic (which I hope isn't code for hospital bed) and I will share more details as soon as I have them. When the trip to Nepal was canceled, I was heart broken, crestfallen and downright bummed. I had just long enough to think about it all that I had created an idea in my head of the adventure that I was going to have there. After a few hours of being sad girl, I said to myself "Self, you can still have an adventure somewhere. You'll just have to figure it out for yourself." According to ProWorld, their projects in Nepal are still on, so that was still a possibility, but a very expensive possibility. No different than when the school trip was on, but as long as my adventure options are open, why not find something equally mind blowing for a bit less money? I emailed a doctor who spoke to my nursing class about the Fistula Foundation (www.fistulafoundation.org) and asked if any of the clinics they support in Africa might be willing to take a new grad nurse for a few weeks this summer. An email turned into a conference call which turned into me going to Somaliland!

Side note to any nursing students who might be reading this: clinic placement is not the regular domain of the Fistula Foundation. I lucked into a formal introduction, but you can contact the Edna Adan University Hospital directly for service options.

Thursday, June 14, 2012

Today, I had an errand and oh what an exciting errand it was! Actually, it wasn't the errand that was so exciting, but, as is often the case, the journey surrounding the errand. Driving here is very nearly a contact sport.  Indeed, I think my driver missed his calling as a rally driver.  Travis Pastrana, if you're reading this, you may want to think about getting this guy on your team. Seriously.
Picture, if you will, a city not unlike Tijiuana. Mostly dirt roads, what paving there may be left on a road most certainly does not make it smoother than a dirt road.  Rubble and garbage is everywhere and, by everywhere, I mean everywhere. It lines the road side like a protective wall. Meanwhile, back on the road, it is like a video game come to life. Cars and trucks are backing out into the road randomly, pedestrians and goats and donkey carts wander back and forth.  The drivers just rip along as fast or a s slow as they dare (quite fast in my driver's case) and dodge and weave like Muhammed Ali.
The horn is used so prolifically here that after a while I began to wonder if the horns are perhaps used with more of a morse code-like purpose, communication amongst the bretheren.  At one point, my driver went to strike his horn and it did not sound off for him. I wondered how that wounded him: if it was akin to stripping an Arab trader of his haggling abilities, or cutting the hands off an Italian. Without his horn, he was rendered mute.
The neighborhoods have no obvious form of division.  Imagine a few Beverly Hills homes plopped down in the middle of Compton.  An Atherton mansion amongst the carports of East Palo Alto.  The few of Pacific Heights mixed in with the many of Hunter's Point. That's what Hargeisa is like.  There is simply no room for separation of economic class, not if you want an apartment that is convenient to downtown and shopping. The mansions are smashed in with the corrugated tin lean-tos and mud brick structures. The dividing factor being the broken glass-topped protective walls surrounding the nicer homes. And by "mansion," I don't mean a Shah's home. Rather, nicer cement brick houses with pretty windows. Outside of the broken glass walls is the same rubbish that covers this city as effectively as the ubiquitous dust.
Having safely arrived at my destination, I gazed out of the window at the breathtaking vista of a goat's ass, standing stop a pile of rubble, surveying his kingdom. Charming.
Back in the vehicle and racing back over the roads at top speeds, my driver nearly drifted through his corners, using the piles of rubbish and dirt (and probably a few goats) for berms. I suspect the goats didn't notice and my driver made it back just in time for noon prayers.

Wednesday, June 6, 2012

The Berbera road to Hargeisa.  This picture does not adequately illustrate how cram packed we were in that bus. The landscape went on like that for miles and miles... our bus got stuck in the sand at one point and the men had to get out and push. 

Here are a few shots from my canal tour and one of the giant tea cups at Schipol airport in Amstedam.  At Schipol, they like to get all of the vomit out of the passengers before they ever set food on a plane. Just kidding.  They are cafe tables at the airport.

Add caption

Cold showers suck.  It's just not hot enough here for cold to be ok. Imagine, if you will, an old timey commode, with the tank that is way high up with a pull chain flush.  That is what appears to be in my (luckily en suite) bathroom, except the tank is a water heater for the shower.  There is a hot tap which goes to a shower head and a cold tap which goes to a hand sprayer like what lots of kitchen sinks have. Yesterday, after my second cold shower, I fiddled with the heater and got it to turn on.  Better late than never.  Cut to: this morning. The end of the taps coming out of the tank were both quite warm.  Promising.  Turned on the shower and? Cold.  Sprayer? Cold.  Bugger.  Clean up, get on getting ready for my day.  Fiddle with the heater again before heading out, still couldn't get a positive response from it. Later in the afternoon, I realize my Camelback is running out, so I bust out my bucket and proceed to fill it from the cold sprayer to get on with filtering.  Hot water.

I've been trying to load pictures here and on facebook, but the internet connection just will not cooperate. I'll keep trying.

As usual, forgive the typos.  This mini keyboard is a pain.

So, my average day so far... hard to say after just 2 days in which I'm really just shadowing Matron to learn what an average day is, but I'll do my best.  The day begins with a wake up call from the neighborhood mussein over the super duper loud speaker at 4am precall and 5am call to prayer in case you didn't hear it the first time.  Funny how quickly one gets used to neighborhood noises.  The first day, it was appallingly loud, but this morning I nearly slept through it.  But I was still up before 6.  Cold shower, clean up, hope for internet connection (my lifeline to home), breakfast at 7am. Yesterday morning, I had Somali bacon, which is camel meat jerky.  It's laid out to dry in the sun, then fried. It pretty much just tastes like beef jerky, with an ever so slightly gamey flavor like mutton.  The hospital cooks lay out a table for breakfast, lunch, and dinner for the volunteers and employees who live here at the hospital. It's pretty repetitive, but it's good.
7:30, rounds begin with the resident midwife through the ante/L&D/maternity wards. 8:30, rounds with the doctors through the medical wards and any OB patients which need more attention.
I am working with Matron, who is not a nun. She is a Latvian nurse who is more or less charge nurse for the whole hospital, hospital administrator, supply manager, facilities manager, and general whip cracker.  She is probably about my age, married, and quite impressive for the job she has taken on here.  Matron is terribly excited to have me here as they only ever get visiting doctors, never nurses.  She is thrilled to have some back up to keep an eye on the troops and, hopefully, improve their performance.  She isn't someone I would want to defy, so I'm not sure how the troops will listen to me any better than they listen to her.  We shall see.  This trip may well end up being an exercise in learning how to beat my head on the opposite side of the world instead of at home for free.  I will make an effort to learn a bit of Somali and hope that greases some wheels.
Speaking  of which, the nurses are all taught in English in their nursing classes, but few of them speak English with any real proficiency.  Herein lies the problem.  Their incompetence is lamented by senior staff, but they've been started unfairly.  Because they are being taught complex ideas in a language they don't really understand, they rely on memorization to pass exams, but have little real understanding of what they're being expected to know.  Then, later, management endeavors to get better work out of them when they are entirely ill equipped to perform.  We'll see how far I get with that issue...
Holy moly! The craziest rain storm just exploded out of nowhere! Windy and insane! I better wrap this up while I still have a connection. Cheers!

Tuesday, June 5, 2012

A shot of my flat and flatmate in Amstedam.
Amsterdam was lovely and interesting for the short time I was there. I'll try to post the couple of pictures I took there soon.  My flight to Dubai left late and we were held up with traffic on arrival, so we were deposited some distance from a terminal and got bused in.  That's when things got a little crazy. I was afraid that I was late for my connection and had to get my bag transferred over still since it was a different airline that I couldn't check in to until getting to Dubai. Thanks to a very helpful information agent who personally delivered me to the hidden ticketing desk for my  airline, I was able to get everything taken care of in time. As it turns out, things in Africa run on a much looser schedule since vehicles and conditions cannot always be counted on.  My confirmed itinerary had me scheduled to depart at 2am, but the flight wasn't actually scheduled to leave until 4am.  My relief for not missing my flight, combined with a heavy realization of the miles between me and home, on top of the hours I'd been awake (probably ~30at that point) all combined to create the perfect storm and I had a bit of a melt down.  I felt so alone and so far away from anything I know and I had a bit of a cry.  I was doing a mediocre job of keeping a lid on it as it was, but then I got to chatting with a couple of friendly folks in the queue to go to Somalia and they asked where my husband was and, consequently, some very nice men talked me down from the real melt down. I was so exhausted and so overwhelmed by the enormity of what I was doing and was starting to w   onder what I'd gotten myself into. Thanks to one of these men (sadly, I'm bad enough at remembering names and all of these foreign names are a near lost cause for me), my trip to Africa was made much easier.  His helpful and friendly nature, always finding something to laugh at, helped me to shake off my freak out and get down with the experience.  The experience started with us being herded out to a couple of buses, driven out to a distant corner of the airport, where we were loaded onto a plane, the likes of which I haven't been on since maybe 1980 and the plane would have been old then. By this point, I've forgotten that I ever had a space bubble, the aroma I smelled most likely came from me, and my butt was so sore from the 2 previous flights that all I could think of was finishing the last leg of the trip without an ice pack (though, honestly, the seats on the antique 737 were more comfortable than the 2 modern KLM crafts).

Little did I know... we flew into Berbera because the Hargeisa airport is closed for renovations.  I stepped off of the plane and immediately thought "this just looks like Mexico". Ha.  Right.  Mexico would be close to home. The "international airport" (the banner said "Welcome to Berbera International Airport") was one small stucco building, where secured my visa and changed my 40 American dollars for 6,500 shillings (or the equivilent of $1.  Not a very fair trade in my opinion, but I think they need the money more than I do), and joined the fracas going on in the baggage area.  Yes, my bag was there, but it had to be loaded on top of the "bus" with the rest of the bags. And the wind, oh the wind! While I waited for my bag to be loaded, I enjoyed looking out on a landscape as barren as one can imagine.  In the near distance, there lay a cargo plane which apparently didn't make the run way and was on its belly becoming a part of the landscape. The friend I'd made in Dubai was busy keeping an eye out for me and making sure I was ok. If I hadn't met him, I don't know if I would have made it this far on my own. I may well have chickened out and gotten my bag and myself right back on the antique and gone home.

The bus ride to Hargeisa to several hours over trecherous roads. I doubt that we got much over 25mph most of the way, got stuck in the sand once where recent rains had washed riverbed over the short bridge, and my already sore butt was crying  out in agony over the rock polisher of a ride. At this point, I'd been awake for nearly 40 hours. When we finally arrived in Hargeisa, I found that I was the spectacle du jour, despite my modest clothes and head scarf. Small children and beggars approached me with their hand out looking for money, not a handshake. My airport friend came here to visit family.  His uncle just happens to be the former Vice President of Somaliland. The former VP was kind enough to drive me to the hospital - another blessing.

Once arrived, I was shown to my room - a perfectly nice small room with a wardrobe to put my things in and a private bathroom with a western toilet. I had lunch and then retired back to my room where I promptly fell asleep.

Sleep.  Yet another thing  I've taken for granted that I thought I had so appreciated.  You asolutely canNOT possible truly appreciate sleep until you visit a Muslim region and find that the call to prayer begins 5, unless of course there is a pre-call to wake everyone up in time for  the 5am prayer.  The precall is at 4.  That didn't much matter this morning though because I was awake at 3am.

Saturday, June 2, 2012

1:30pm: Here I am, parked in my window seat, next to a guy who can't stay on his side of the invisible space bubble.  This guy could barely mutter politely when he got up to let me in my seat, but he could IMMEDIATELY start chatting up the woman who showed up to claim the aisle seat in our row. Not that I was hoping for a seatmate with a bottomless pit of scintillating conversation to pour out on me. I'm just wondering if he can't take up more of her personal space instead of encroaching on mine while simultaneously ignoring me. I mean, if you want to snuggle, that's fine, but I insist you introduce youself first. And now he's tucked his foot unde his leg, the bette to face Ms. Aisle Seat, so his foot is also not in my space.  I expect he'll want to share my fold-down table as well.  10 1/2 more hours...

Less than an hour later, I have staked my claim on my half of the arm rest and have just cued up 21 Jump Street. Cops in shorts, on bicycles, arm rest, snacks... this flight is looking up.

30 minutes later: Ms. Aisle Seat gets up to take a tinkle and Mr. Chatty Pants takes the opportunity to sniff his arm pits. Awesome!  Let me help you out, buddy.  It's your breath that stinks, not your pits.

3 hours in: Ms. Aisle Seat has busted out the ear buds and Kindle. Chatty Pants is looking like he just got shut down. Arm rest score: me 3, Chatty Pants 2. 21 Jump Street is pretty great. Dinner is a little weird, but ok.

3 1/2 hours: Someone just farted.  Not me.