C. goes Africa

Résumé

C. — Sun, 25 Nov 2007 00:04:09 +0000

6 weeks in Cameroon passed quickly, though not always smoothly but in any way enriching. I´m leaving with a lot of new impressions, memories and friends – so this is the time for some sentimental notes.

Being back home in the icy dull autumn weather my European reality has recaptured me appallingly quickly. Nether the less I realize how grateful I should be, being able to move in between so different worlds that freely.

To summarize 6 weeks in Cameroon, it´s not only

x Taxi rides 51 Tangui 1,5l H₂O bottles 11,3kg Bananas 0 times Diarrhoea 11.446km via air 1.538km via land l 6 Marriage proposals 64 new telephone entries 50h of hospitalisation 4l glucose perfusion 1.250mg Mefloquin 480mg Arthemeter + 2.880mg Lumefantrin 8.000mg Quinin 2.560mg Primaquin + 320mg Arthemisinin 3.600mg Proguanil + 1901,60mg Chloroquin 5.000mg Ciprofloxacin 3.000mg Roxithromycin 2.000mg Ofloxacin 7.000mg Paracetamol and 5,4kg Peanuts

but also the feeling of enrichment, the awareness of a whole continent being unknown to me, the certainty of a rough life in other parts of our world and a slight idea about the reality of Africa. I had the chance to see a little further now and the big dark spot in my mind called Africa starts to illuminate a bit. Expectations have been met, disappointed and raised. And I begin to long for more..

I hope I could give you a remote idea about my experience and let you participate in this journey. As mentioned: you need to see with your own eyes. There´s nothing to fear, just to experience.

And I´m really serious about this genuine offer: if one of you is interested and willing to take the effort, Dr. Martin Ndeutchoua, Fabrice Tiba and me, we´d be happy to help you organizing your stay/internship, in any professional field (though medicine the easiest) in Cameroon. Please feel free to contact me.

Thanks for joining.

Au revoir Cameroun!

C. — Fri, 23 Nov 2007 13:35:04 +0000

Time to say goodbye.

Though I´m very much looking forward to a clean kitchen and a lecker Burger at Udo´s I´m pretty sure I will miss this country. Meanwhile I got used to disorder and anarchy, fell in love with imperfectness and inventiveness, value directness and hospitality, move with 0.5km/h and start feeling comfortable in the streets of Yaoundé.

I could spend some more time around.

And even on my last days I turned wild and took a motorbike taxi home – which in fact is one of the life-sickest things one could do in Douala. (- which also stated the driver by commenting he´d never ever seen a white person climbing on a motorbike.) And still there are more things to discover and experience, but I guess all the other crazy things have to wait till next time.

If you don´t separate you can´t meet again..

Au revoir Cameroun et merci beaucoup!

botanical excursion

C. — Fri, 23 Nov 2007 13:02:14 +0000

Doing morning hikes through the forests of Medong at 5.30am had also an educational benefit. I´m happy to share my newly won knowledge with you. I might have been an ignorant, but about the origin of pineapples or palm oil I wasn´t really aware of.

Cameroon is one of the 10 ten countries providing over 90% of the worlds´ cacao production, about 125.000t/a. The sweet fluid of freshly harvested Theobroma cacao beans can be sucked. Otherwise the cacao is fermented and dried to get the

Also Coffee is cultivated to be exported.

The beans are white and hidden in a thin soft shell which changes colour from green to red when maturing.

Harvest is just once a year which is about the time right now. Unfortunately the price has fallen over the years and came down from an attractive 500CFA / kg in the 70ties to a 150-200CFA nowadays (650CFA = 1Euro). Hence less and less people take the effort.

Bananas and plantains are probably grown everywhere and everybody who has a tree around the house is likely to be owner of some bananas. Whereas the leafs of plantains show a slight red coloration and devoted for diverse plates, bananas are merely fruits to eat. But I needed to learn that there are even subtle differences within the plantain and banana family and none tastes like the other!?

Further carbohydrate providers are Manioc and Macabo, a yams variety.

Both fruits grow in the soil and the roots need to be digged out.

Gambos are some strange vegetables which are sliced and lend a unappetizingly slimy consistency when cooked in sauces.

In contrast Ananas comosus

and Carica papaya offer some nice fruits to eat.

These greens resembling the pest weeds in your backyard are called “ondolet”.

Their actual origin and purpose I don´t really know and eaten raw it´s awfully bitter. But cooked and pureed beyond recognition it can be quite tasty.

Another essential plant of Cameroon is the peanut.

Eaten either freshly harvested, dried, roasted or caramalized, as snacks everywhere sold in the streets for 100CFA. (the nuts are found in the soil – as the German expression might indicate “Erdnuss”).

Also palm trees can offer much more than a nice tropical appearance.

Beside the famous Cocos nucifera, the Elaeis guineensis, the Oilpalm, is mainly cultivated all across Cameroon. To gather the fruits one need to climb high up in the trees.

Afterwards they´re pressed and the collected oil is boiled and purified to be sold in used Tangui water bottles.

That Persea americana thrives high up in these trees was barely known to me.

The first one to find a fruit gets an avocado for free.

Nothing eatable but important for export reasons is the caoutchouc cultivation. Like all things in Cameroon the rubber liquid takes its time to drip down the tree..

Everything what´s left behind by the collectors is gathered by the children of the surrounding villages to fabricate some balloons for their own.

All in all this is just a small extraction of the rich variety of what nature can offer around the equator. Everything else you need to discover for yourself..

Discovering a country

C. — Thu, 22 Nov 2007 23:28:02 +0000

Though my little trip through the Western part of Cameroon actually revealed only a small part of this country, I´m anyway quite happy I had the chance to discover something else than the taxis of Yaoundé.

A 4 days journey lead us, Dr. Martin Ndeutchoua and me, over the river Sanaga from which sand is won for constructions of houses and the like, through Makenene which offers with its market the possibility for travellers to gather some energy, via Bafia and up into the mountains to Bagangté and Bafang where we were hosted for one night by the “father” of Martin. He´s 80y old but goes each morning for a 5km run and shared his philosophical point of view over a rice-crevettes dinner in the open air kitchen with us. Living in this region is simple and poor but people don´t complain.

Up in the highlands the weather is refreshing and the air is clean. For Cameroonian standard this is cold whereas one have to mentioned that permanent residency in average temperatures of 30°C implies the lack of reasonable judgement on the coldness of 15-20°C.

In Mbouo we visited a hospital and the orphanage. Over 100 children in the supervision of a handful women who voluntarily work to feed, educate and entertain them.

After Bafoussam and Dschang we came down the mountain slopes to the “Plain de Nbo” where our search for elephants was unsuccessful and apparently in vain, as we were told. We stopped for a night in Medong, the village of birth of Martin. His mother (this time the real one) welcomed us warmly and steady laughed – maybe at me for unknown reasons. With a fully packed car loaded with bananas, peanuts, yams, manioc, .. we left for a quick visit of our colleague at the hospital of Medong where we met a pregnant woman in labour but no doctor.

Our route to Douala led us through vast fields of banana, palm and caoutchouc trees. Bananas fields for export are well guarded and the fruits are considered to be worse in taste than otherwise cultivated bananas. Cameroonians themselves don´t eat those cultivated ones.

All along the road you can buy wood, manioc, yams, potatoes, oranges, bananas, plantains, Petrol, palm oil, .. and farmers spread their fruits along the street side to dry cacao, coffee and manioc.

On our way back to Yaoundé we crossed the proudest piece and relict of German colonisation and a proof for durable construction technique. The bridge of Edea over the river Nyong meanwhile counting a hundred years, is still a symbol of the proper and profound work of the German people.

Speed and skin – Die Entdeckung der Langsamkeit

C. — Thu, 22 Nov 2007 18:09:17 +0000

In spite of everybody reassuring me there are a lot of Foreigners (French, German, Chinese,..) living in Yaoundé I most of the time felt quite lonely in my “whiteness” (not counting the numerous albino people). Still gathering some curious looks on me in the streets, people in the neighbourhood had already accepted my presence and probably assumed me being the wife of one of the Yimga sons´. Anyway still I´m often spontaneously addressed to “Bonjour la blanche”, and more than once I had the discussion about European women marrying Cameroonian men – leading to more or less obvious marriage proposals (none of which I have accepted so far!)Most of the times I encounter curiosity and friendliness and though German colonisation didn´t seem to be one of the funniest times ever, people are still rather thankful towards the ´goods´ the ´Germans´ brought – to the very contrary to what´s the general mood towards France. But colour of skin is not the only characteristic by which I differ to the Cameroonian. I´m probably the person moving the fastest in whole Cameroon. Never met anybody being able to go a distance that amazingly slowly. Every step seems like an effort, every distance invincible. As mentioned definition of time is different. Therefore you´re never really under pressure. If I don´t come today, I´ll be there tomorrow. Things happen when they happen. Work and people can wait. A delay of some hours should always be taken into account. Actually I think I did a very good job in assimilating to this characteristic of society. Anyway this understanding and mentality makes things so extremely difficult to organize. I rewind whatever I might have said earlier about the political situation in this country. Stable still (already for 25y with the very same president – who´s right now trying to install the law for “vote for lifetime” – and passing on of the title to his son after death). Anyway no dictator regime, but far off from democracy anyway. Anarchy rules this country. Pure anarchy. Everybody does what he wants and tries to get a piece of the cake. Corruption is prosperous. Actually a quite sad situation. Which maintains itself in a vitous circle. The government doesn´t show any interest in changing anything or developing the country and unfortunately the intelligent force of the society is leaving for better opportunities abroad. Brain drain is reality.

Doctors for Africa

C. — Wed, 21 Nov 2007 22:20:56 +0000

One of these idealistic Cameroonian doctors is Dr. Martin Ndeutchoua whom I met 3 weeks ago and who became a very good friend. I had the joy to work and travel with him. He has his little hospital in Yaoundé, Mimboman which allows him to work independently and when possible for free for those in need. Thanks to him I had the chance to see some more of medicine in Cameroon except the cite verte HDCV and on our journey through the Western part of the country we visited a couple of hospitals in the country side and far off from functional medical infrastructure. He´s motivated to work for a better Cameroon and he wants to make a difference. One of his interests is also to open his country to the “Western world” and have people being interested in Africa. Detailed information about Africa is hard to obtain even nowadays which leaves a big black spot in the map in most of our minds. Therefore people need to come and see with their own eyes and work with their own hands under given situations. And he can offer doctors an profound medical experience and together we can organise an “internship” in any hospital or medical centre in Cameroon. So does Fabrice due to whom I ended up in this country.

So if ever anybody is interested dare to speak out loud and contact me. it´s definately worth trying.

(Julka, I know where we´ll be working together soon!)

medical cases

C. — Wed, 21 Nov 2007 22:07:35 +0000

I´ve seen some sad things so far. 6year old boy with Lyell´s syndrome probably due to Lumefantrin therapy (part of malaria treatment) showing exfoliation of about 36% of the body surface.Saddest of all HIV patients and AIDS/SIDA in all its variations. E.g. 23year old boy with Kaposi-Sarcoma and liver dysfunction who was absolutely unaware of his disease. Pneumocystis carinii pneumonia and cerebral toxoplasmosis are probably not uncommon but rarely diagnosed due to the lack of financial possibilities. At HDCV around 70 HIV test are performed each week of which about 10 are positive. The majority is female. As mentioned the government is supporting the medical treatment of HIV patients as well as it´s promotion. Anyway there´s still the idea of being HIV positive as a synonym for death sentence and people fear to do the test. The lack of information and the ignorance are major problems in the fight against this disease.

The biggest health problem and daily business in each medical centre is Malaria. Out of 70 Goute epaisse / thick smear done each day about 35 are positive for malaria /“palu/ paludisme”. Most common in this region is P.falciparum – the worst of all 4 – causing Malaria Tropicana. Again the lack of information and missing sensibility for prevention make the management of this disease nearly impossible. Mosquito nets are rarely used, each fever is treated with any kind of malaria medication, seldom in its correct dose and protocol and low financial status keep the patients away from medical aid and diagnostic features.

My first experience in Dr. Martin Ndeutchoua´s hospital was an urgency operation of an extra uterine pregnancy which ruptured in a patient whose Hb was anyway just around 9mg/dl. Anesthesia was maintained by Diazepam, painkillers where only applied postoperatively. Another disease rarely seen in our regions but quite common in Africa is the “Drepanocytose” / Sichelzellanemie (anemia due to malformation of the erythrocytes in homo- or heterocygote genetics whose English term I don´t know). 8y old boy with hepatosplenomegalia and recurrent pulmonary infections who has to be hospitalised regularly for the treatment of all this complications.

Last hospital I am working in on my journey to Cameroon is again a small private one, run by a very nice and calm doctor, supported by her husband and opened a month ago. Unfortunately the first delivery performed in her clinic yesterday ended in a dead born baby. Labor was unremarkable but the child must have been in distress because the amniotic fluid was contaminated with meconium apparently already for a couple of hours prenatal. The cause is unknown so far.

All over the Cameroonian health system is suffering from non-existence, patients from poverty and lack of information and doctors from non-compliance and lacking facilities – and unpaid salaries for months. Specialists are rare in the country, e.g. there are 2 rheumatologists as well as 2 orthopaedics in whole Cameroon (17Mio people). One needs to be generalist to meet the demand and I pay my respect to all the doctors fighting idealistically against these problems under this unimaginable circumstances day by day.

Douala and the West

C. — Fri, 16 Nov 2007 11:45:34 +0000

After having the chance to get to know the capital city of Cameroon extensively I thought I could also go for a bigger one. A few days before departure I ended up in a 1.8 – 2.6 Mio inhabitant city ( numbers not exactly known. census attempts have been difficult). anyway I don’t think I will really succeed in getting an overview – it took me 5 weeks to orientate myself in Yaoundé.

Douala is rather the commercial and economic capital of the country, in contrary to Yaoundé which inherrits the administrative organs. Also, due to the harbour and biggest airport of the country the city seems to be home for a greater variety of ethnic groups and foreigners.

Unfortunately my plans going into the nowheres of Africa and learn about medicine ‘where there is no doctor’ didn’t really work out in the end. anyway I had the chance to do a little tour around the Western part of the country which opened my eyes for the wealth and beauty of this country.

I met people who really have not much more than what they carry but who received me as friend and family member. I experienced life which is hard but people who never surrender and welcoming every day gratefully. I saw a lands which are rich in all variety of nutritive and productive plants..

There are many things to tell but even more to experience. It’s definately worth an effort to see with your own eyes. Africa welcomes you!

rough society

C. — Tue, 13 Nov 2007 19:00:25 +0000

It´s hard to give a picture of my impressions on the Cameroonian society.

First thing which stroke me – and I´m still struggling to understand – is the engaged way of discussing. No matter how unimportant the issue is the dialogue can quickly reach a point of surprising intensity and discussions can easily be misunderstood as arguments or quarrels.
Intonation is usually loud and expressive, mostly accompanied by strong gestures and lively mimics and to make things clear sentences might be repeated not only once.

In any way the society seems pretty rough to me and very hierarchic. It´s a society of service for which you are paid or simply obliged to offer because of your social status (in family, ..). “Donne-moi!” (give to/hand me..), “attends!” (wait),.. do this do that and who´s in a position of power takes advantage of this. You try to take profit. You need to survive. Money is a steady concern. Prices are always discussed. And if there´s something you don´t consider as correct you make your point clear.
On the very contrary in front of persons of respect (militaries, also doctors, intellectuals, ..) the loudest and proudest Cameroonian falls silent and appears nearly shy. To get a clear answer one sometimes need to ask quite explicitly and if people do understand you can never guess from their facial expressions. It´s amazing how much indifference people carry on their faces. Nothing really seems to touch them and eye contact is rarely held while talking to people. Impoliteness is hard to define under this circumstances. Sadness, fear or even anger might be interpreted in this indifference but maybe people simply really don´t care.

C´est un petit peu comme ca.

On the other hand as soon as you find out you might know the same person or even the “grande soeur” of your neighbour´s “bel fille” is the “petites soeur” of the others working colleague you won a new friend. My friend´s friend is also my friend.
And here we enter the whole world of hospitality and friendliness.

I was carried along already into a couple of private houses of divers patients, friends or family members and it seems nothing special that people just step by no matter if alone or in a whole group, known or unknown. Without explicitly invited you make yourself comfortable, talk, watch TV (which is practically running all day long) and leave after an appropriate time – which might range from min to hours. If within the possibilities of your host you´re always offered something to drink and eat. Sitting facilities are usually numerous and partly occupied by some of the countless family members who are not part of the working world. It should be taken care that the carpet is respected which means you always undress your feet as soon as you are approaching a carpet – which again is easily done because the overall popular footwear consists in slippers.

Tu vois un peu, non?!

Overall I have to state that everywhere I went to, and was went to respectively, I was welcomed warmly. People were interested getting to know me and happy about the respect and interest I payed to their country by the pure fact of having taken the effort and coming to Cameroun. I shared already a thousand times my telephone number and email adresses occasionally and was given bracelets and other things by mere strangers to bring back home some souvenirs from Africa to friends and family. preoccupation or suspicion seem unknown. Amazing hospitality.

for protocol: tuesday, 13.11.07, 11.54 test Widal & Felix pos.

african feeling

C. — Tue, 13 Nov 2007 18:58:50 +0000