Monday, April 17, 2017

I need your help!

I'm trying to create very simple handouts so my patients can remember their exercises. I may only see my patients once, and I would like to give them something to take home. Most of my patients do not speak English and/or are illiterate, so I need to use icons and pictures. I want to make sure that the message is clear--that's where you come in.
Would you please take a minute and fill out BOTH of these surveys? All you have to do is look at the icon and tell me what you think it means. You don't have to be a medical person or know anything about PT; it's actually better if you don't have any background in therapy!

Saturday, April 15, 2017

"Yaya keke?"

There are really two things you need to know in Hausa.

1) You always greet someone. And ask how their evening/day was. And ask how their work is. And ask how their family is. And ask how their wife/husband is. And ask how their children are. And then maybe ask again how their work is. All this takes 5 minutes or so, and that is OK. Unless you're passing someone on the street randomly, you don't just say "sannu" (hi) and walk on.

2)The answer to every question in Hausa is "lafiyah (lah fee yuh)," which means "fine." Even if you're not fine, the correct answer is "lafiyah." It just is!

Now that you know these two rules, let me tell you how a normal greeting goes between me and the guard that is at the compound gate:

"Sannu. Ina kwana?"                                           "Hello, how was your night?"
              "Lafiyah sannu. Yaya gajiya?"                            "Fine. Hello. How is the tiredness?"
"Ba gajiya."                                                         "There is no tiredness."
              "Yaya karatu?"                                                     "How is school?"
"Lafiya. Yaya aiki?                                              "Fine. How is work?"
              "Mun gode Allah. Yaya gida?"                             "We thank God. How is your 
                                                                                            family (literally, home)?"
"Lafiyah."                                                            "Fine."
              "Yaya 'weekend?'"                                                 "How was your weekend?"
"Lafiya kalau. Yaya Lahadi?"                              "Very good. How was your Sunday?"
              "Lafiya. Za ki makaranta?"                                    "Fine. Are you going to school?"
"Ee, ni ce."                                                          "Yes, I am."
              "To, sa an jima."                                                     "Ok. Goodbye."
"Sai an jima."                                                      "Goodbye."
Now imagine that the same conversation and standard greetings happens EVERY morning with EVERY person that you stop and talk to. I'm learning to embrace it... and leave a few minutes earlier than I would otherwise so that I have time for greetings.

So after I greeted A___ at the gate, I saw I___'s keke waiting for me. He had come a few minutes before and was just around the corner at a little roadside shop buying some kosai (fried cakes made from bean flour, a typical breakfast food). I exchanged greetings with him and with the young girl dipping kosai batter into the large wok of oil sitting over the charcoal fire, then I___ and I went back to the keke.

As we drove to my Hausa class this morning, I asked him something I'd never heard asked before: "Yaya keke?" He half-turned around on the driver's bench with a curious expression on his face and repeated my question back to me: "Ki ce 'yaya keke?'" "Ee," I replied with a bit of a smile. "The keke is lafiyah!" he answered.

Last week the keke's engine was not lafiyah. Actually, it hadn't had an oil change in the three years since he'd purchased it used. (It's quite normal to do that; I don't think scheduled vehicle maintenance is a thing here, and even if it were, many could not afford the maintenance and repair costs.) But after he took me home from school one day last week, I___ took the keke to a friend of his' repair shop. And for N30,000 (paid for in installments because of their friendship and I___'s character as a trustworthy man), the keke was repaired. It now purrs instead of clunk-clunking, and its top speed has been restored to the normal 35mph.

Yes indeed, the keke is lafiyah!

Tuesday, April 11, 2017

It's just that kind of day...

Some days you just need pie. (Not that I would turn down a polka dot elephant bringing me pie, but I'd be OK with just pie.)

I had that kind of day last week. 

I just needed a homemade pie.

It was just the kind of day that needed apple pie. 

My mother had foreseen that this day might come, so she made sure I packed a pastry cutter in among the various kitchen utensils I brought.

The various people who've lived in this same apartment over the years have been so kind as to accumulate a collection of dishes and kitchen tools--including a pie dish and a rolling pin.

The provision shop around the corner sells Simas, a margarine-like product made in Indonesia that's sold in 250g packets. It's not Crisco, but it works.
The produce lady at the corner sells apples. There are only two varieties here in Nigeria; gala and golden delicious. Neither one of them is a great apple for pie, nor are they cheap at N200 ($0.50) each, but they work.

I may not understand Nigerian culture and customs, but I understand baking. I may not be able to read in Hausa yet, but I can follow a recipe. And when my brain is fried from culture adjustment, there's something comforting about knowing that the recipe for "double-crust pastry" from Better Homes & Gardens red and white plaid cookbook is going to work.

It was a good day for pie crust. Maybe it had to do with it being hot season and being 93* in my house, even with the fan going. Maybe it had to do with the Nigerian flour that always seems to need an extra 1/4c of liquid in any baking recipe. Maybe it was the Simas. Maybe God just knew I needed something to come out correctly.

It was delicious.

Saturday, April 8, 2017

Ni Zan Je

"Ni zan je.
Ni zan je da Yesu ko'ina.
Ba damu da gargara hanya ba.
Ni zan je.

I will go.
I will go with Jesus anywhere
No matter the roughness of the road.
I will go."

I first sang this song two weeks ago at an SIM prayer morning. Then last week as we were learning the future tense in Hausa, our teacher wrote this up on the board during our morning devotional time. It's a bit of a tongue twister to say "da gargara hanya ba" quickly to keep up with the song, but it's a fun chorus none the less!

I'm not sure who originally wrote the song (there are several covers of it and even another song that uses "Ni Zan Je" as its chorus), but I like it!

Give it a listen:

Saturday, April 1, 2017

My first yam

Yams are a big deal here. Like really big. If you ask a Nigerian what his/her favorite food is, they're likely to say pounded yam. In the market, there are men pushing carts or wheelbarrows of yams for sale.
Photo Credit
When Americans think of yams, we usually think of the sweet potato with the orange flesh inside that is often used for sweet potato casserole around Thanksgiving time. Here, yams are these oblong, almost hairy things with a white inside. The women will peel it, cut it into chunks and boil it, then pound it until it's a slightly-sticky ball that looks similar to bread dough. The pounded yam is usually served with some sort of soup or stew and it's all eaten with the hands. I've had yam and several of the Nigerian soups in the month I've been here. It's nice, but I wouldn't say it's my favorite food...yet!

Photo Credit
I have a yam sitting on my kitchen table.

There's a story behind the yam.

Well, to tell it properly, I have to go back to this past Tuesday at Evangel VVF Center. A woman came to the clinic thinking she had fistula, as she had urinary leakage following her last pregnancy and delivery. We were able to confirm in the clinic that she did not have fistula, but instead had symptoms of stress urinary incontinence--exactly what I specialize in. How glad we were that we could now offer her treatment! The physician running the clinic asked her to return on Thursday morning as I would be running my clinic that afternoon. I'm finding that it's common to tell patients to arrive two days before their surgery to ensure that they actually show up in time to be admitted and prepped, and like this woman, they may be told to come in the morning when they won't actually be seen until the afternoon.

One of the staff members is a young lady with an equivalent of CNA/Patient Care Tech training, and she plans to attend nursing school in the future. She's agreed to delay her training for a year to help me with my medical Hausa and assist me in my physio clinic (here, as in most formerly-British countries, PTs are called "physiotherapists" or simply "physios.") Praise the Lord! She and I planned to see this patient on Thursday afternoon after the surgical cases were over and she was finished with her patient care responsibilities.

So on Thursday, I spent the morning observing in the operating room (or "operating theatre" as it's called here). My assistant/translator was supposed to be free at 4pm, but because of some long cases in the operating room, it wasn't until about 4:45 that we were both free and I'd found some exam gloves! I was starting to have a migraine, probably from dehydration, skipping lunch, and the incinerator burning about 100ft from the VVF center, and I was really looking forward to going home for the day. But this lady had been patiently waiting.

I walked up to her and said, "Sannu, ki yi hakuri na yi latti." (I'll make you translate that here: Forty-five minutes later, after I'd finished the exam and had given her some recommendations and exercises to do at home, all three of us were smiling. The lady was relieved to know that she didn't need surgery or medicine, that she wasn't going to make it worse, and she could have sex/a baby. She allowed me to pray for her (in English, but hopefully in Hausa soon!), and she went on her way.

I called my keke driver to come pick me up as soon as he was back on this side of the city, changed out of scrubs, grabbed my bag, and walked down the steps of the VVF Center. There are always a few women sitting on the front steps waiting to be seen in clinic, doing laundry or cooking for their family members who might be VVF patients, or post-op patients waiting to be discharged. Many would rather sit outside than in the ward. I greeted a group of three older women who were at the bottom of the steps, and they answered with a string of Hausa that I couldn't decipher. But I did manage to catch "Mun gode likita" (We thank you doctor.) Then one of the ladies reached into the bag at her feet, pulled out the yam and handed it to me. I replied "Na gode mama," and reached for some Naira bills to hand her. She shook her head and waved goodbye.

All care at Evangel VVF Center is provided free of charge. The women who come here may have spent quite a lot of money at other fistula centers for prior surgeries, or they may come from tiny villages where they farm small subsistence plots and never have enough money to go around. Here, they're fed and cared for as long as they're here, and all nursing care, surgical expenses, and medications are provided completely free. Occasionally, a woman will bring a small gift with her, maybe a chicken or some produce, but many women have spent their last dime trying to get to the hospital. This center survives on generous donations from individuals and on grants from organizations dedicated to treating fistula.

I don't know who this older lady was. Maybe we'd seen her in clinic that Tuesday. Maybe she'd seen me around the VVF center. Maybe she was accompanying someone who'd had surgery that day. Maybe she didn't know that I was only a PT and not a surgeon or a financial donor. Maybe she was just grateful and wanted to share what little she had.

So I walked out of the hospital complex with a full heart, my bag containing dirty scrubs and an uneaten lunch in one hand, and this precious gift of a yam in the other hand.