Wednesday, September 9, 2015

CAMEROON TRIP

Since it is slower season now at the hospital, we finally have time to catch up. Even though our surgeon and our babysitter (also known as my in-laws) are gone, we still have more free time in rainy season. The drop off is sudden. We’re extremely overworked half the year and extremely overstaffed half the year. The respite is welcome. It also gives us time to catch you up with our news.


Way back in March, I had to chance to take a second trip to Cameroon. My first trip in January was very brief, and I only had the opportunity to visit Batouri, in southeast Cameroon. This time, I was able to see so much more and visit so many more people!


I left Bere on March 9 and caught a motorcycle taxi from out front of the hospital to Kelo, a little over an hour away. Through my sunglasses, I surveyed the familiar terrain of Tchad. Bone dry. Brown. Flat. I saw the Tchadians turn and yell, ‘Nasara!’ as they watched me go by, a bit surprised to see a white guy on the back of a motorcycle taxi. I saw mud hut after mud hut and thatched roof after thatched roof pass at 25 miles per hour. I felt strangely at home, exactly where I supposed to be. And I felt good. I felt like I was setting out on an adventure, fulfilling my calling and my destiny. And despite leaving my family at home, I felt happy and at peace. And I felt a bit of a sunburn starting on my forehead as well. I felt a lot of things. But after an hour and a half on a motorcycle by the time I gently dismounted, one thing I could no longer feel was my butt. I paid the driver and sat on some mud bricks drying in the sun while I awaited my next chariot. Normally, this would have been uncomfortable for me, but since my tushy was already numb, it was tolerable.


From Kelo, I hopped in a bush taxi (aka, a Corolla with seven adult men) to Moundou, also a little over an hour away. If you’ve never sat with three other large men in the back of a Corolla, you really should try it. It builds character, which is a cute way of saying, it’s survivable, but miserable, kind of like spending four days on a life raft in the middle of the ocean being surrounded by sharks and choosing which one of your dearest friends you throw overboard.


In this Corolla, you can’t sit flat, you sort of need to tilt your pelvis in order to make enough room for four sets of hips lined up in series. The shoulders are also an impossibility, so every other man will need to lean forward. The unwritten etiquette, which not all passengers will have read, perhaps due to its being unwritten, is that you do this in such a manner as to appear natural and comfortable, as if you would have chosen this semi-fetal position even if you had the entire back seat to yourself.


The great trick to master is shifting positions. Obviously, you cannot sit forever in this position or you could actually have an entire butt cheek fall off. I’ve seen this happen to fellow passengers and it’s not pretty. But you don’t want your seatmate/s to feel they are causing you discomfort when you’re shifting, particularly if they’re sleeping and drooling on your shoulder. So with the same extreme of care you would use to put down a colicky infant at 2am after spending the last 90 minutes rocking her to sleep, you slowly transfer the leg which has the knee in your chest, the same leg you are no longer certain is attached to you due to complete loss of sensation, down behind the foot you have resting on the floorboard, which is probably piping hot because the exhaust pipe has a hole in it. Then the lynchpin maneuver is transferring weight onto the numb foot while tilting your pelvis the other way. The whole process, from conception to completion is actually quite drawn out and takes about 15 minutes of deliberation and planning to decide yes in fact, I must change positions or else I will scream in delirium, and another 15 minutes to execute slowly without disturbing other passengers. Approximately 20 seconds after successful completion of this procedure, it is guaranteed that my seatmate will stir, snort, blow his nose into my shirt, and jam his hipbone into my kidney hard enough to make me pee blood for the next two days while flopping his head onto the passenger opposite me. I always get the one who didn’t read the unwritten etiquette.  Every.  Time.


Now, I know what you’re thinking. You’re thinking, Olen, what are you complaining about? That sounds absolutely delightful! Well, please recall it was about 110 degrees the entire time and there is no air-conditioning in any of these public transits.


Getting out of the Corolla in the midst of the hustle and bustle of big-city Moundou, I couldn’t feel the right half of body or either leg from thigh down. I bravely opened the door and grabbed my leg, picking it up and swinging it outside the car. Steadying myself on the doorframe, I hoisted myself into a standing position, leaning ever so slightly and ever so casually on the car. I spent the next few minutes gazing about and taking in the scenery, looking natural. Unfortunately, the car was parked between two empty busses blocking anything else from sight. But no worries, I just made those busses the most interesting-appearing busses in Africa, staring with such wonder that others came to see what was so fascinating. Once the pins and needles left my feet, I hopped onto another motorcycle taxi across town to the car park for Cameroon. (Actually, I didn’t hop. I eased my heiny onto the seat. If you’ve ever ridden 100 miles on a bicycle after not riding for years… Then get on the bicycle again the very next day… Then you know what it felt like.)


In Moundou, I picked up Vadym, a Ukrainian surgeon I was fortunate enough to have along as a travel buddy. Waiting for Vadym, I passed the time watching a ragamuffin of probably ten or twelves years of age selling tea. He would fan a charcoal burner, pour a glass of hot water into a cup with a tea bag and give it to a customer. When the customer finished, he would take the ten cent fee, deposit the tea bag into the next glass and rinse out the used one in a pan of muddy water he had used to rinse out the last 100 glasses of tea. I wondered what his life would be like. Would he sell tea for $0.10/glass for the rest of his life? Would he move up in the food chain and start selling sandals or other things? It was the middle of a weekday, so he clearly wasn’t banking on an education getting him far. It made me sad, but why? He seemed perfectly content going mindlessly about his tea-service rituals in his torn and filthy rags. And his customers seemed all too content to have a minion to chide about his lack of tea-serving skills. Vadym showed up and stirred me from my stupor.


From Moundou was another couple hours to the Cameroonian border, through the border, and a little bit more to the next bus stop. Again, it was a Corolla. But this time, Vadym and I got the front passenger seat. Well, technically, Vadym got the passenger seat and I got the shaft. No, really. The shaft on the stick shift. That was my seat. I positioned myself as any self-respecting macho man would, leaning over on my side with my chest on Vadym’s shoulder, my nose in his neck and my leg up on his lap. We really could have made a very cute, if not uncomfortable, couple. It wasn’t too bad, except for fourth gear. It didn’t help that the driver was always very aggressive going into fourth. Fortunately, we only used reverse four times for a total of 78 seconds. I remember each of those 78 seconds extremely well. I wish I didn’t.


As soon as we hit the Cameroonian border, literally, that very mile, the terrain starts to vary. There are hills! And after that, mountains! It was a very neat experience to share with Vadym, who was excited about the scenery after being in Tchad for a bit. And nope, I still can’t feel my tuckus.


The next minibus took us to Ngaoundere. This minibus had the potential to be alright; however, Vadym and I unwisely accepted the front row, right behind the driver. There is a ledge about 12 inches high right in front of the seat. So your feet are tucked nicely in under your bum. It’s actually not too bad for the first hour or two. But eventually, you will be forced to abandon your bottom forever or adopt a new position. Essentially, all other available positions resemble an in-utero contortionist. We mercifully arrived in Ngaoundere around 10pm.




Debarking in Ngaoundere, everybody told us to spend the night in Ngaoundere and take the train the next evening to Yaounde and on to Douala. Forget that! We got places to go! You can’t slow down and drive the speed limit when you’re on about the Lord’s business!




Shorty after midnight, our big bus (our one exception with air conditioning!!!) left for Yaounde. Vadym and I were so excited to have rows to ourselves to stretch out! This section was absolutely delightful. It rained a bit, something I hadn’t seen since October. And in addition to the variation in terrain, there were other changes from Tchad. As we drove along, more and more thatched roofs were replaced with tin roofs. More and more mud huts were stuccoed and even built from wood. There was greenery, vegetation, jungle!!! Vadym was so excited to see the jungle and everything else, and I was very contented to be sharing the experience with him.


In Yaounde by early afternoon, we switched to another cramped minibus for a slow ride to Douala. Once again, I drew the short stick. I had the window seat, but also the seat over the wheel well. So once again, knees in chin. Arriving in Douala, I was ready to amputate my own gluteus maximus and minimus. I was 65% certain I had peed in my pants, but I couldn’t be sure. I simply couldn’t feel a thing anywhere near that particular zone of my anatomy anymore, besides the extreme burning sensation as the pressure came off my blood supply and I could feel the circulation start flowing through my nether-regions. And I really didn’t care by that point anyway.


From Douala, we took a taxi to Buea, arriving 2am March 11. Well, scheduled to arrive earlier. But at one of the frequent checkpoints, a police officer (it was a one-man checkpoint) asked for my yellow fever vaccination. He lectured me about terrorists, since apparently they also don’t care their yellow fever vaccination cards. He also warned me that I might be bringing scary American viruses into Cameroon, which is equivalent to espionage. Lastly, he berated me that I may be harboring EBOLA, but I had no proof since I didn’t have my YELLOW FEVER vaccination card. He asked for a bribe to pass. I told him if I was really so dangerous, he should either imprison me or vaccinate me. He didn’t feel either of those were as beneficial as a bribe. By then we had been on public transit or waiting at a bus station for 41 hours straight. I regretted not having taken that train from Ngaoundere to Douala. My smile had worn off. Somehow Vadym still had his. Miraculously, we still had two butt cheeks each. And zero blood clots in our legs. Or lungs.


Despite our 2am arrival, Dr and Mrs Bellosillo greeted us warmly at their front door. Mrs Bellosillo had even prepared a meal for us!!! A real meal! Thus far, we had been sustained on soda and crackers. Now we had real food! Unfortunately, I was having trouble being sufficiently coordinated to lift the spoon to my mouth to eat it, I was so tired.


We spent the next five days at the Adventist medical center in Buea, Cameroon, a town in the tiny Anglophone part of Cameroon. It was delightful! In addition to the delights that Mrs Bellosillo fed us nonstop and Dr Bellosillo lack of interest in us seeing patients (reports of my clinical acumen precede me), Buea is in a perfect climate situated on the side of Mount Cameroon, the highest mountain in Central Africa. It’s elevation and proximity to the ocean kept it comfortable. We slept under a sheet and without a fan. It was perfect. In fact, all throughout Cameroon, we discovered fast and cheap internet and amazing (and amazingly cheap!) food. And the roads… oh my. I mean, the vehicles may leave something to be desired, but the pavement… after Tchad… it felt smooth enough to race an Indy car. Well, except the frequent speed bumps.


Dr and Mrs Bellosillo are real missionaries. I’m just a pretend missionary. These guys have been at it for over two decades on a couple different continents and in several different countries. They are the real deal. And with all that experience, they know what’s what. Vadym and I were enthralled listening to their stories from Zambia, Botswana, Nepal, Philippines, etc. We were impressed watching them navigate the administrative challenges like it was nothing. And we were humbled by the long hours they put in without complaint. I will never be Bellosillo-cool. I’m just not that hardcore.


Vadym and I spoiled ourselves rotten (and Mrs Bellosillo spoiled us too!) and went to the beach a couple days. Both of us, however, missed our honeys. Just not as romantic with a Ukrainian dude as with Danae. All in all, Buea was simply awesome. But we certainly saw both the need and the potential at Buea Adventist Medical Center. Dr Trixy Franke and her husband Bill really brought the center from death to life and it is quite busy (from three patient visits per day to now 20 patients/day in addition to the hospitalized patients, which are several). Now the Bellosillos are keeping that momentum going and the center will soon be upgraded to a full-blown hospital from a health center. And administrative measures are being advanced as well. And they even have real, sit-down toilets!!!


But there are so many needs still. They don’t even have a working microscope. They lack most lab supplies. They don’t have an x-ray. They don’t have an incinerator. Their generator is broken. They need paint. But what’s exciting is how they’re improving all the time and have such great potential to computerize and could someday become some sort of surgical subspecialty center. They have two operating rooms way nicer than anything in Bere!


From Buea, we left in a car to Douala, then fancy bus back to Yaounde. And I mean fancy. Stewardess pushing a trolley of croissants and pain au chocolat along with tea and soda. Oh my. And a toilet! From Yaounde to Nanga, the home of Cosendai University. All tolled, we awoke at 4am to leave Buea and arrived in Nanga around 8pm, well after dark. Then we sat at Cosendai guest houses for an hour or so while they searched for the guy who was supposed to have our rooms ready, but didn’t. Oh well, we went and got a hotel in town, which had a generator until we got there and ran out of water in the tank. That’s ok, though, there was a nice foam mattress.


The next morning at 7am, we met with the president and administrators of Cosendai University who were gracious enough to postpone their trip to Yaounde a couple hours so they could meet with us. Their dedication is impressive. I spent the rest of the day with Abemyil Marie, the head of the nursing school at Cosendai University. She’s something else. Just amazing. She has started the first four-year nursing degree in the country in conjunction with Loma Linda University. Her students love her and so do I. But the poor students need to go far away to Yaounde for decent clinical experience. Locally, the only options are a run-down government hospital or a teensy little dispensary at the university.


But there’s hope! Cosendai University has 554 hectares given by the village. That’s 1400 acres. That’s two square miles!!! And the government is ⅓ done building a new paved road from Yaounde to Bertoua which will be the main access for all parts north and east in Cameroon. Nanga is halfway between the two big cities of Yaounde and Bertoua. The potential is huge. And they already have a building ready to be turned into a 30-bed hospital. Just needs a little elbow grease! (And man-power and supplies, like a big-ol’ generator.) It would immediately be the hospital of choice for an hour in each direction. And as for the nursing school, with some teacher exchange programs and simulation labs and possibly distance-education lectures, this place could be world-class.


Later that same day, it was back on a bus for another six hours back to Yaounde, arriving after dark and settling into a hotel room bed. One hotel room bed. Vadym. And me. One bed. He was a complete gentleman the whole night, I’m happy to report.


The next morning we met with the Cameroon Union Conference officers and heard their vision for the future of the church’s health work in Cameroon. They have some big plans! We also went and saw a health center in Yaounde, which is doing well on the same campus as the big church and the big school and the federation headquarters. Run-down, but busy and passionately staffed and run by a great guy named Timothé.


Later that same day again, it was onto another bus to Bertoua! Once in Bertoua, we got on a motorcycle taxi (me, Vadym, a motorcycle driver and our luggage!) and headed off to find a car going toward Batouri. On the motorcycle, Vadym got his camera and iPhone stolen when a second motorcycle drove by and the passenger on the back slashed the camera bag strap and sped off. That was a serious bummer. After lots of head-scratching, we kept looking for a car headed to Batouri. We were told they were all gone and it was too late at night. But finally, we found a vintage 1870s-era pickup truck lorry headed in exactly that direction with two only moderately-devious-appearing guys in the cab. They offered us two seats for a frighteningly-low price and we set off, past the police checkpoint that had given me grief on the way in. The truck intermittently broke down. We came to various rain gates, which were bolted shut and honked and honked until we woke up the entire village and found people to unlock the gates. I kept the GPS on my phone and tracked us so I’d know how far we were from Batouri just in case the other two guys in the truck got creepy and Vadym and I had to bolt into the thick jungle. Always prepared I am. We finally arrived to Batouri Adventist Hospital at 2 am, were graciously given beds (two, in fact) and sacked out into a stupor.


I had been to Batouri just two months prior and still loved it. On top of a hill in partial jungle. This is a place with character, attitude and spirit. Dr Andre Ndaa had the hospital thriving, then it went through a tough few years before Dr Bellosillo arrived. Now the place is thriving once again under the leadership of the administrator Philemon and the physician Dr Roger. These guys are amazing, as are all the staff, who worked faithfully for a long time without being paid, although they are now being repaid all that overdue salary as the hospital is once again making money and paying off debts. The jungle which had taken over the hospital has now been hacked back and buildings which were swallowed whole in bush have been repopulated with patients instead of spiders and snakes. There are a faithful number of patients as Batouri Adventist Hospital has become the hospital of choice for the region, both inpatient and outpatient and surgical and ultrasound… You name it, Dr Roger does it! The patients and staff absolutely love this guy. A missionary from DRC to Cameroon via Chad.


The hospital still has some massive needs, however, including a new generator and garage and a water tower, as they’re completely at the mercy of city utilities, which are sketchy to none. They also need simple things like an incinerator, etc. But man I love this place! I do fear for what will happen once Philemon retires. He’s such a cool guy.


Anyway, the trip back involved a private car to Bertoua, a bus Ngaoundere, arriving very late. Staying in the pastor’s house. Very early bus to the border. Corolla to Moundou. Lengthy discussion with the police as I refused to pay the $4 bribe. They threatened to put me in jail. I pretended to call the US embassy. They let me pass. Near heat stroke. Then finally arrived to find my beautiful wife and kids and spend a weekend at a fancy hotel after a couple weeks apart and roughly 90 hours on public transit. And hear my wife tell me she’s pregnant with number four. And it’s mine!




I love my life.