After many months of planning and preparation, we finally have a visible product of our work: the fence that will keep the hospital’s various sheep and goats from roaming through the wards will soon be finished. Stay tuned for pictures of us herding the animals in!
Modou working on the fence
Soon to be contained
On the last evening before Diana and Teresa left Bwiam, we made one more trip to see the women’s group in Kankuntu. We went to see them make tie dye fabric, which they make to sell locally. The village imam’s wife is the tie dye master, so we went to her compound to watch the process.
Measuring the fabric
We were unsure of how it would turn out when it was a puddle of dye and fabric on the ground...
...and we were shocked at how beautiful the fabric was in the end!
The hospital’s maternity ward has been adopted by the women’s group from the nearby village of Kankuntu. As a result, the women have volunteered to come by periodically and clean the maternity ward together. We joined in to help them this month:
Carrying water
More than 20 women worked together to clean the ward
Last week we ventured up-country with Diana and her friend Teresa to the Tendaba camp, a lodge on the River Gambia perfectly situated between two national parks: the Bao Bolon wetland reserve and Kiang West National Park. Our trips through the mangrove creeks were filled with sights of beautiful exotic birds and the occasional glimpse of a crocodile.
Sacred Ibis
On our land safari, we were lucky enough to see more gorgeous birds, a group of red collobus monkeys, and a huge group of hundreds of baboons. It was a great chance to see yet another facet of The Gambia.
Red billed hornbills
Tendaba at dawn
We hope that all of our friends and family at home enjoyed a wonderful Christmas. We were lucky enough to have some family here with us for the holiday: Jeff’s mom, Diana, is staying with us here in Bwiam for one month.
Alex and Diana have been enjoying shopping for Gambian clothes together!
We enjoyed a Christmas dinner of spaghetti and garlic bread with our friends Robert, Thomas, and Chief.
Our Christmas Dinner
We had a great time. We have been blogging infrequently as we have been so busy working, learning, and enjoying the friends that we have made here. We are looking forward to sharing more stories and pictures soon.
Happy Thanksgiving to all of our friends and family back home!
We celebrated our Gambian Thanksgiving today with our favorite meal, domoda- a delicious spicy peanut sauce served over rice. A cold pitcher of mango juice made the meal extra special. It’s not quite apple pie, but we’ll take what we can get!
Mabintu, our newest Gambian friend, joined us for Thanksgiving
One of the most troubling aspects of this hospital is the dismal state of its maternity ward. We are currently working on a plan to improve it- for more information, check out http://betterbeginning.wordpress.com
Sanitation is a major issue at the hospital, and yet they still found time (and soap!) to wash their sheep:
5 Dalasis to anyone who can explain how this works:
…or what the function of this key is:
Although The Gambia is best known for its birds, we have been most impressed by the insect population. Check out these crazy bugs we have seen on the hospital campus:
The Hospital has some serious sanitation problems. As you may have read, there are animals loose, toilets go uncleaned…the list goes on. The worst may be that cleaning is often done without soap. This means that at times, toilets, surgical areas and other patient facilities are only cleaned with water. By the end of the month the soap and bleach have usually run out.
Our solution to this problem is to buy cheaper, locally made soap. A women’s group from the village makes all-natural soap every week and sells it for less than the factory brands. Most importantly, the women know how to add natural anti-bacterial ingredients. They boil leaves from Neem Trees, skim the oil and add it to the soap. The tree is very common in our area and has a number of anti-bacterial, insect-repelling, and moisturizing properties which make it an ideal ingredient. We bought samples of the powdered soap this week. Here we are with the ladies. There are 45 of them in the group, so meetings (held mostly in Mandinka, not English) can get a little overwhelming. Fortunately we have made some friends in the group who are able and willing to translate for us until our Mandinka improves.
Now the biggest challenge is integrating the soap for general hospital use. There is a general feeling among the staff that all local products are inferior to those that are imported from abroad. We hope that once the soap is in use, they will change their mind, but until then the administration has advised us to distribute the soap while keeping its origin to ourselves.
Congratulations to Justin Zorn for making it to the Rhodes Scholarship Finals. Dequan Rhodes – below – is rooting for him.
Saturday, October 25
After a day of meetings, Jeff ate Barracuda and Ladyfish that had been grilled over an open flame by these people: (left, angry/rude Lebanese man who doesn’t speak English and his daughter, right, SuperBob).
Then Carol called us with an unexpected dinner invitation. Through friends she had connected with a Gambian construction magnet, Famara Shams. The party was almost entirely Baha’I Iranians who have sought asylum in The Gambia, as the Ayatollah has systematically persecuted them since taking power. The place was amazing –there wasn’t a single bug in the entire house. This may not seem like a big deal, but in this country it is an almost unattainable feat.
Monday
In the morning, we had breakfast with Carol at her hotel, Safari Garden. We met quite an interesting bunch, including the woman who writes the Gambia and Senegal travel guides for Lonely Planet and a very successful financial manager who had been kidnapped for two days in Dakar.
In the afternoon, we had an appointment with the Secretary of State for Health for the entire country. They use British titles, so his position is Cabinet level and equivalent to something like the Surgeon General in the US (that’s if the Surgeon General was in charge of a massive state run health care system in a tiny, poor country). We were introduced to him as “grant-writing experts” – a very polite embellishment. The meeting and the trip to the main building of government offices were fascinating.
After taking advantage of our last few hours in the capitol by buying some cooking and cleaning supplies, it was time to head back to Bwiam.
Tuesday-Thursday
The rest of our week was spend running around the hospital updating Carol on the situation and brainstorming with her as to the best way to approach the multitude of problems which they are facing. Her expertise as a cultural consultant really helped us to think about our approach in a new light, and her help has made our work here easier ever since.
A highlight of the week was our trip to the Somita clinic, located in a village about 25 minutes away from the hospital. The clinic was built by members of the community and is maintained daily by volunteers. The remarkably clean and welcoming facility spoke to the community’s pride in their clinic. We were extremely impressed by what they had managed to do with so few resources (very limited electricity, water, and medical supplies). It’s amazing what a sense of community and ownership can create.
Somita Maternity Ward
Somita Clinic Bathroom
Incidentally, the clinic is located next to a kindergarten. Here’s what happened when the kids saw Alex walk by.
Friday
After an exciting and exhausting week, we returned to the capitol for the last set of meetings, this time with the local Rotary clubs. While Carol and Mr. Badgie held their first meeting, we went to MacFadi’s (the Gambian take on American fast food) with our friend Pete, a Peace Corps Volunteer.
Inside Macfadi
In the afternoon, we visited the African Living Art Centre, an incredible combination of a salon, art gallery, and café. The entire building and much of the artwork was designed by the owner, Suelle, who is a captivating and talented individual as well as the former Minister of Arts for The Gambia. We are hoping to spend much more time with him at the Art Centre during our future trips to the area.
The African Living Art Centre
Last week, our friend Carol Cunningham traveled to The Gambia to check on the progress of Power Up Gambia’s solar panel project-their goal is to provide 24-hour solar power to the hospital within the next few months. Carol was kind enough to invite us to join her for her whirlwind week. We will post about it in segments, as there is so much to write. For more information about the project, check out www.powerupgambia.org.
Friday, October 24
On Friday, we woke early to a wonderful surprise- our toilet flushed (thanks Kathryn & Carol!). The adjustments that had been made to the water pumping system the day before had made it possible for water to reach our second-floor room.
The GamSolar team and Tamba, Head of Maintenance
The hospital staff was signed up to participate in a day of work in President Jammeh’s fields in Kanilai, a village just 15 km from Bwiam. Everyone in the country is expected to spend time harvesting in the field as a contribution to the president’s foundation for peace. We waited for the bus for about an hour, but (somewhat to our relief) it never showed up.
Note: Cutlasses = Machetes
In the early evening, we jumped into Mr. Badgie’s SUV to make the drive in to Banjul. We spend the next two hours whizzing by picturesque scenes of village life at dusk on a Friday night- groups of women fetching water and pounding beans in huge mortars, children playing in the dust, and men chatting in their compounds- as ndagga music blared from Mr. Badgie’s speakers. It was amazing how beautiful and romantic the landscape was-when viewed at a distance and with the West African soundtrack, the countryside gained a cinematic quality
After reaching the greater Banjul region and checking in at Fajara Guest House (where we were greeted by Super Bob), we reveled in some fried food. Soon after, Mr. Badgie picked us up to greet Carol at the airport.
To be continued!
On Sunday afternoon we took our first gelee gelee (bush taxi) ride from Banjul back to Bwiam. The gelee gelee is a family-size van that has been converted with tightly spaced benches that seats 18 people, the driver, and several babies (picture the classic clown car). We hunkered down for the 3 hour ride, which was just fine on the paved part of the road. Things got messier when we hit the dirt and an elderly woman hitching a ride on the highway sat on Jeff for about 35 minutes.
That morning, we had taken our first shower in a week and were feeling very clean and pleased with ourselves. This is what we looked like after getting off the “bus”:
Landing wearing his aunt's head scarf
This is Landing. We have decided that he might be the cutest baby in The Gambia.
Landing eating his book
Tumani and Musa were kind enough to take us on a walk to visit Bintang Bolon, a nearby tributary of the River Gambia. Below is a picture from our outing:
Looking for Crabs
Our work at the hospital will fall into three categories: computerizing the medical record system, working with senior staff to improve continuing education and writing a comprehensive report of hospital services.
At the moment, the hospital relies mainly on a paper record keeping system to track patients admitted to the hospital. There is virtually no data kept – paper or otherwise – for outpatient services. Some inpatient data is kept (surname, age, diagnosis, etc), but the records are minimal and represent a fraction of the individuals seen at the hospital. Alex and I have been teaching ourselves to use Microsoft Access – a database management program – to drastically expand record keeping. Next month solar panels will be installed, brining 24-hour power to the hospital. Once this happens, the hospital will allocate an additional computer to the Medical Records department, allowing us to quadruple the amount of time spent on data entry. We are designing the database so SJGH will finally be able to gather accurate data about the services delivered and track patient treatment.
In an effort to make the hospital a more attractive workplace and improve patient care, senior staff members have set out to design and implement a comprehensive continuing education framework. Alex and I will assist by introducing and training employees in the use of HINARI – a World Health Organization program which provides free medical journal subscriptions. The database is available to NGOs, hospitals and medical schools in poor countries which have very low medical journal circulation. Our hospital meets the requirements, so staff will be able to access over 5500 medical journals in dozens of languages for free. This will allow all staff to read the journals online, the department heads to print and circulate articles of interest, and institute mandatory research projects for staff.
To improve continuing education we will also help coordinate the activities of American doctors who will provide educational curriculum and training to staff. This January, eleven doctors from Christiana Hospital in Delaware will spend three weeks at SJGH, providing an excellent opportunity for lectures, workshops and hands-on training.
Our final and largest project is a comprehensive report which for the first time will chronicle everything which is happening here at the hospital, as well as the challenges being faced. It will resemble an annual report and serve as a basis for future grant writing, as well as a hospital website. To gather information for this sprawling report, we have begun interviewing all of the department heads.
Our co-workers love Alex’s camera and are always asking her to take pictures of them. Then they immediately load the photos on to their computers and print them in black and white on sheets of printer paper. In this picture Alex is posing with Edrissa, who works in the Medical Records department. After looking at the photo he exclaimed, “Now THAT is black and white!’
