25 March 2007

Home and Safe

I arrived Thursday and have been relaxing in Alexandria since then.

My mother emailed me to let me know that my cat is sick, but that they're taking very good care of him. He had an asthma flare-up, so they're giving him nebulizer treatments and created an oxygen tent for him. Next to the stove. See below.


Below this would be my cat's extremely unhappy face framed by his "oxygen tent":


According to my mother, his HMO gives us extra points for home treatment. Fantastic.

19 March 2007

Really fascinating article on HIV/AIDS in Afghanistan. I cannot imagine how much more dangerous and more difficult working in Afghanistan is, to say nothing of the sector of work. The strong religious aversion to homosexuality is very similar here.

A second interesting issue was that of the response to General Pace's comments on gays in the military. He called them immoral, so protesters responded with:


Pretty amusing. Sorry to miss that and the major anti-war protests.

16 March 2007

Art Gallery in Abuja

Today we went to an art gallery with A, our gracious host. There was an incredible array of absolutely stunning, authentically Nigerian art and things from South Africa and other parts of West Africa that were probably stocked as novelties for wealthy visitors -- there aren't any other kind here -- who don't know (or care) about the origin of African art. There were also a few sad obligatory "typical" African statues and items hidden among the treasures.

As was my intention, I picked out some gifts (from the non-South-African and non-stereotypical items) and helped G decide on some art for his house -- of course, by "help," I mean that I stood next to him supportively and nodded while he picked it. Quite contrary to my intention, I fell in love with a painting by a Nigerian artist, Jonathan Lessor.

The painting I love looks like the one below, which depicts the yellow buses and crowds in Lagos, but it has more reds -- it's so vibrant and bold, full of primary colors. The painting is strikingly unique, and it's completely Nigerian. It perfectly captures life in Lagos.



I also finalized my flight plans, as of yesterday, and I'm flying in Thursday afternoon. Still flying with the Dutch. Nats has offered to come pick me up, as has B. I'll be back at work Monday, but I hope to spend the weekend in North Carolina. Both B and S have claimed to have "a big bubble" waiting for me in Alexandria. Hopefully I won't need it. I feel so, so much better.

Buh-Bye Dukies

Three pieces of terrific news from home today.

  1. Duke bit the dust. B imed to warn me not to read SI.com because he knows Duke is in North Carolina, and he knows I love college basketball. Thankfully I'm a Carolina girl. The only emotional reaction I'll have to Duke's loss is delight. Oh, and, the loss made the front-page of the NY Times online.
  2. Almost as cool: NY and CA are movin' their primaries to February 5. Does this knock Edwards out? His main hope was Iowa -- and my main hope is that he's out.
  3. Thanks, K, for the tip: you can get a free New York Times Select subscription with a valid .edu email address.
I got to call my grandmother for her birthday yesterday, which was wonderful. Other than that call and a few medical-advice pleas, I've been Skype only. In other news, I'll be traveling to Lagos again tomorrow and to Port-Harcourt on Monday.

Congratulations to my friend Nat who will be going to Shanghai for a few weeks this summer to teach, and to Rachie, who printed and submitted an (absolutely) amazing thesis today!

15 March 2007

Much Better!

Wish I had more opportunities to go to the beautiful places in Nigeria (and to show them in my photos). There are many amazing parts of the country I'm only able to read about, not see or go to. The places I go for work are largely in industrial areas and some of the most crowded sectors of the cities.

Nothing new, just more research and writing for several hectic days. Today was my grandmother's birthday, and I was happy to be able to call her for a few moments.

Hopefully more photos and news soon. I finished the anti-malarials and the antibiotics and should be much better soon.

12 March 2007

Super-Supportive Family and Friends

My sister always shows her love and support with a maximum of dignity and decorum during our Skype conversations. Here she's...well, nevermind, I don't even know.


My kingdom for Starbucks. What we have in Abuja is Nescafe, powdered or condensed milk, and sugar. Lots of sugar. And here he is dangling a latte in front of me. So thoughtful. I appear to be comatose or perhaps seizing in response.


Thankfully I do have one loyal supporter:


It's impossible for me to catch one funny photo of someone I'm talking to that's also a good photo of me in that little left-hand corner box. It's like a law or something.

10 March 2007

Health Care Part Deux

"Where are you? Are you in 'the bush' somewhere?"
I wrinkled my forehead. "Erm, I'm in the capital."
Dead silence, then "What? Well, then, there must be good medical care there."
"I had a sterile needle."
"Don't some Westerners live there? Don't they see physicians?"
"This is the best clinic in the city."
"Don't they speak English?"
"They do."
"Well surely they must be able to do these tests, then." Some other equally misplaced assumptions followed. I waited, idly itching at...a mosquito bite.
When I could get in a word, the only thing I could think of to say to try make it clearer to my doctor why it is that I am not going to be able to get more tests easily was a statistic.
"Life expectancy here is 44."

HIV prevalence here is only now a bit below 5 percent, and tens of millions of people are living well below the poverty line, which often means no clean water, vaccinations, or basic medical care. Throughout being sick, I've known that I'm very fortunate to get good medical care, and throughout I've also become ever-more aware of the challenges medical practitioners here face. Even in the best clinic, my Nigerian friends tell me, it's not rude to ask them to open the needle in front of you. No matter how many times I tried to explain to my US doctor the situation here, what limitations the clinic had for testing, she couldn't understand it.

This all came up when I went back to the clinic yesterday and was diagnosed with bronchitis, a souveneir of my trip to Lagos. So, now my total intake -- I'd qualify it by saying it's my total medicinal intake, but I'm really not yet eating much either -- is my original anti-malarial, fat lot of good it did me; Artesunate; curious-looking brown multi-vitamins; unnamed, powdery white pills for fever; and Avelox for whatever infections I've become host to in the meantime.

The pharmacy, from which I got the Artesunate, is actually the hotel gift shop and kids' store. The process of diagnosis and treatment consists of taking an elevator to the clinic, waiting for a while in a small waiting room, then stepping a few feet away behind the small divider to the nurse, who takes blood pressure and asks for your name and contact information only. No symptoms, known allergies, or family history information is given. Wait again in this chair for the physician on duty. Communication opens up somewhat at this point, but you still have to volunteer any and all information and complaints, and there's no physical exam. Maybe because they don't have time? My chart is two sheets of white paper stapled together with handwritten notes. There are no computers or electronics in the office.

The first time, I simply requested a test for malaria. The doctor called the nurse, who emerged from a back room -- rather, the back room -- with a metal pan that with two cotton balls in it. She set it down beside a wrapped syringe, a vial, and a length of clear plastic tubing. I stared apprehensively at the tubing, hoping it wasn't meant to transfer my blood from needle to vial. Not to worry. It was my tourniquet, and as it turns out, the entire syringe was to be inserted directly into the veins atop my left hand.

She tied off my arm and inserted the needle into my hand with some skill, but then proceeded to yank back the plunger so quickly that pain shot up my arm. I weighed my headache, fever, chills, and violent muscle aches against the pain of the blood draw and decided to wait it out. I waited for her to use the needle on the syringe to transfer the blood to a sealed vial. Instead she removed the needle from the syringe and carefully poured the blood to the vial. They didn't have sealed vials, I don't think.

I was charged N400 for taking the blood to the lab across town. I parted with my US$3.20 happily in exchange for not having to trek across town to what promised to be a bad neighborhood, given her reluctance to send me there, in my state. She said it would be an hour for the test, then an hour and a half. They were waiting on the lab. By the third time I called, three hours later, I was informed that, in fact, I did have malaria.

Five floors down, I got a prescription, a bag of vitamins -- I could swear they're the same ones I helped hand out in Honduras -- and some pills for fever. They directed me downstairs to the pharmacy. I went one floor down, thinking it would be on a floor with offices. No luck. I asked the guard -- every one of the guards always says hello, and they're always helpful -- and he directed me down another flight and a half. Surely not. That would be gift-shop territory.

A few minutes later I found myself standing next to some children's toys and some mysteriously transplanted Body Shop goods. I handed the prescription to a woman who might, in fact, have simply been shopping there. I was really disoriented. She handed it over to the pharmacist, who walked over a few feet to the metal shelving along one side and reached down to a small stack of boxes next to the Dove hand lotion. Artesunate. She plunked the box on the counter and asked for N600. That's US$4.89.

Still not feeling much better on the second morning, and now experiencing more problems breathing, I stumbled back down to the clinic at 2:30 pm. They promised they'd call when the doctor got in, but offered that she'd be back shortly. I waited. And waited. On the couch perpendicular to me was a little boy sweating out his own case of malaria really bravely. I can't imagine being that sick so young -- it's worse in young kids, too.

Finally I went back to my room and decided just to call every 30 minutes. Getting no response, I went back down after another hour. No doctor. Went back up. Tried calling again, and finally got an affirmative. I went back down to talk to her.

I asked for blood count and liver enzymes, per my doctor's (and mother's) instructions. She told me to come back the next day. Without examining me, listening to a few complaints about respiratory symptoms, she concluded that I probably also had an infection. She asked no questions, but when I asked if Avelox would work she said she'd prefer Augmentin. Okay, sounds good. Except that the hotel pharmacy charges exorbitant rates. I would shortly be grateful for it.

The doctor checked the price at another pharmacy, N2000 or US$16.27. The nurse offered to pick up the Augmentin so I wouldn't have to go out for it, deciding that I didn't look like a good candidate for forays into the city. I emailed my mother to update her.

I got her reply that night. Turns out I'm allergic to Augmentin. It's in the penicillin family. Don't want to know what capacity for handling allergic reactions the clinic has. Prefer not to think about it and take my Avelox quietly and gratefully.

This morning when I showed up for blood tests, the second time I had my blood taken, it was the nurse and not the doctor who attempted it and after two sticks, and collapsing two separate veins, she managed only a few ccs of blood. For some reason, she refused to try the veins in my elbows. I tried not to be insulted. They're good veins, after all.

After these two abortive tries, having noticed her tendency to push back on the syringe when she was drawing blood, I begged out of a third attempt and asked her to try to have the lab do the tests with that blood. I know just enough about drawing blood to know that it's dangerous to push back on a syringe, especially when it might have air in it. She poured the small quantity of blood from syringe to vial, spilling some of it on her ungloved hand (!).

Given that I do feel better now, by day's end, both re: malaria and bronchitis, I'm staying for another week. I canceled my ticket for tomorrow and have significant flexibility for rescheduling.

Thank you to everyone who wrote me to get well soon. I do appreciate it.

08 March 2007

On the Bandwagon

I have malaria, too.


Terrific. Here's to hoping it's not drug-resistant.

G accused me of being a copycat, but I maintain that we've had it for the same length of time and men are simply inherently worse at tolerating pain and sickness.

Day 1 -- 6:00 pm: First dose of anti-malarials. Hot diggity dog.

Lagos








Consultant Down

It's official: G has malaria. Despite every precaution and a full course of Malarone, we've got a consultant down. He'll be taking it easy for a few days, but he's insistent that he's not going home or even staying at the hotel entirely. One of the hardest working men I've ever met.

Sorry for the dearth of posts, but in addition to a hectic time, I've been in Lagos for the past two days. Our schedule was:

Tuesday

8 am: Rush to the airport after a last-minute call. I ask that my laundry be rerouted to G's room.
9 am: Arrive at the airport. Drag luggage onto tarmack and stand in hot, hot sun in heels.
10 am: Continue standing.
11 am: Assist with tossing of luggage into hold of very small plane piloted by crew of surly South Africans.
11:30 am: Embark on the plane, carefully discerning seating hierarchy. Sit with eyes lowered. Remember that my laundry is primarily undergarments. Blush violently.
11:34 am: Disembark from plane due to refusal of some official to properly lower eyes to another official.
11:35 am: Political jockeying begins in earnest. Four party planes are pawns in larger power struggle. Kicking random staff off trip is sign of might.
12:00 pm: Pair of blisters formed on left heel finally erupt. Call G to give strict instructions not to open laundry bag.
12:30 pm: We attempt to break and move inside to the air conditioned lounge but are "shushed" out of the VIP lounge to the humbler but still cool regular lounge.
12:40 pm: We discover we will be charged N1000 for sitting in the lounge. We don't care.
3:00 pm: We are adopted by a high-level official, who places us with him on a small but lovely plane. Everything is great.
3:30 pm: We take off. Fifteen minutes of violent turbulence ensue. My life flashes before my eyes.
3:45 pm: Plane stabilizes. Snacks are served. Life is good until Maid in Manhattan, starring Jennifer Lopez, begins.
4:30 pm: Arrive in Lagos. Hop into SUV for ride into Lagos proper.
5:30 pm: Arrive at not-so-proper hotel in Lagos proper. Pass out in "suite" consisting of three pieces of mismatched furniture, cranky AC, iron-barred windows, and a much-abused bar of soap. Check in with G. No laundry.
8:00 pm: Three calls and two minutes of door banging finally disturb me from my nap. Quickly dress and depart for event.
10:00 pm: Realize event will not take place.
11:00 pm: Arrive back at hotel.
11:03 pm: Big news breaks. Memo-writing commences.
Wednesday
2:30 am: Bed-time. Room is now freezing, possibly the coldest room in Africa.
7:30 am: Wake up for series of meetings.
7:50 am: "Breakfast" consisting of lumpy eggs of indeterminate origin and color -- texture unmentionable -- and excellent toast with terrific pineapple jam.
10:00 am: Meeting #1. One hour lost in Lagos and 42 sets of directions later, we arrive. Thankfully, instant coffee is available.
12:00 pm: Meeting #2. Incredible air conditioning. Intimidating iron gates and the heaviest security door you've ever seen. G informs us he has malaria.
1:00 pm: Meeting #3. Very productive. Glass of water I'm praying was bottled. Great AC.
3:00 pm: Lunch. I debate the cowleg stew but ultimately go with salad and chicken curry. G informs me that he has yet to find my laundry.
4:00 pm: Leave for airport. Call from G. "No skivvies," he informs me.
7:25 pm: E decides to stay in Lagos. We launch a valiant effort to free his baggage and emerge victorious.
7:30 pm: I board.
10:00 pm: Home sweet Abuja. I realize I repacked my laundry.

What killed me in Lagos were the billboards. One of the advertisements, one for paint, showed an interracial couple looking dubiously at the camera and had the slogan: "We know what colors go together." Another was for some household appliance and said, "The smart wife's 1st affair!" very cheerfully. A series of ads for Virgin Nigeria were borderline scandalous, especially for a religiously conservative country. An entire line of political ads for a gubernatorial candidate read "do you want more of the more" instead of "more of the same" while the largest advertisement for a presidential candidate bore a laundry list of adjectives I can only presume were intended to compel voters beginning with "clean."

There were also the fleets of boats and buses. Beninese live in houses perched on stilts above the water below bridges and along the coast, and if you're there early enough, you'll see the fleets of boats from the houses with people fishing and doing other water-related tasks right from the bridge. The buses are ancient yellow schoolbuses -- not much bigger then the VW from Little Miss Sunshine -- filled, filled, filled with people commuting or doing errands. They often whing by with the doors wide open and several people hanging from them to catch the air -- the interiors are so crowded, you can't blame them. I wish I remembered the Nigerian name for these buses. They're widely enough known that they've got their own slang and terms associated.

The city as a whole is very crowded and pungent. People sell everything imaginable by the side of the road: blenders, car mats, Brookstone grooming kits, magazines, and newspapers, etc. The most memorable part, however, is the smell. The smells are non-stop. The interesting thing about the smell, however, is that it's exclusively industrial. In so many developing cities, you encounter a lot of human smells -- I'll stop there -- but in Lagos it's gas and smoke and the strong cleaner used in cars, but not so much waste or rot. (That isn't to say there's not some of that -- people throw trash everywhere, and no one picks it up -- but it's primarily pollution and industry you encounter.)

04 March 2007

Dinner by the Pool

Very peculiar scaffolding -- it's actually just a bunch of curved 2x4s:


The boys at dinner:


On the way to work:


By the roadside:


Clipping-time:

03 March 2007

Skype Chat with my Sister

Chuchi was very curious to learn all about my time in Abuja:


She calmed down a bit after a while though and got bored with my stories, so she started playing NASA and paging me from Houston.


Pelusa also said hello briefly, and she brought my father along to show him how to use Skype.

01 March 2007

A series of largely unconnected thoughts and experiences for family and friends to follow as they see fit.