Category: From Peter

We got comfortable with our life here in Niger. The things we missed were kind of stored away somewhere to keep ourselves from craving and obsessing. And periodically, between net-grocer shipments, we think of something we should order but it often gets forgotten before the next order is placed.

Rome was kind of a tug back in the sense that there were all those stimulating visuals and tastes. Gelato twice a day! Candy stores and pasta shops. Is that bacon cooking that I smell? I couldn’t finish my pizza and salad and had to ask for a box to take it back to the hotel to savor later. “You’re not Italian,” remarked the waiter.

Coming back to Niamey was different. We still love it but oh how I miss that coffee! There certainly is a difference between a plate of Italian cookies vs a Nigerien wheel barrel mound full of green and red peppers. Both can be stimulating and overwhelm the senses. But I think you tend to miss the ones you can’t get.

So it pleased me to the bone when I received my birthday care package from my loving family on Wednesday. I thought perhaps I might get a book or a CD (they know me well). But this delighted us all like Christmas! There were chocolates, dried fruits, boullion, organic pastas, cookies, and easter candies. There were two CD’s and not just a book, but books; some for the kids and 6 for me! We hadn’t expected these suppressed stimulants for at least another 2-3 months.

The medical conference lasted 5 days. We were recertified as BLS instructors and ACLS. I met a lot of people from various posts that I hadn’t met before. We connected with our friends and wandered around Rome looking at all the sites, wandering with the Sunday hordes down Via del Corso and eating pizza, pasta al pomodoro, grilled eggplant salads. But the real bonus was that MED released our bid list for 2008. Check it out!

accra
addis
asmara
astana
bangkok
beijing
brasilia
bucharest
budapest
chisinau
havana
kiev
kigali
lilongwe
moscow
pretoria
quito
sarajevo
tirana
tokyo
yaounde
yerevan

Tomorrow we fly home to Niamey.

My week leading up to our departure for Rome was quite stressful. I don’t know if it was all the preparation with finishing up a lot of small projects, a conflict with a colleague, or a patient who had an unexpected outcome and I had to Medevac out to London that made it so sleepless. Plus our dear friends are leaving for Hawaii. He’s coming back but Sirianna and Eila won’t be so we had our last get together before we rushed home to pack and catch the flight. We all refused to cry because we know we’re friends for life and nothing could ever change that (but I did fight back a few tears except for one which fell into my wine glass when no one was looking ). Oh! And I had to go get my haircut as well.

The plane left at 12:35AM and I was exhausted. Still, I had trouble sleeping on the plane. I reach a point after about 3 hours where it feels like my neck muscles have given up after all those head jerks and there is no position for relief. At 2AM I was vaguely aware of Camille eating the dinner they brought. At 3:15AM my neck snapped and I opened my eyes, only to see her laughing with a set of head phones on watching old cartoons. We landed in Paris on schedule but they couldn’t get the catwalk to work so we sat and waited on the plane for over an hour before they finally got some stairs. People were standing in the isles and they kept announcing, “Ladies and gentlemen, we apologize but we have a broken finger.” You can imagine where my mind went and the joke I made with that a la Gene Garson style. We missed the connecting flight to Rome. They rescheduled us for a 9:40 flight but since it’s Paris, we really didn’t mind; a magazine stand, a croissant and coffee, a beer? Why not? Everyone else is having one!

Then we get onto the flight to Rome. There is a strange and menacing vibration and drilling sound heard from under the plane. The plane heads for the runway with frequent lurching stops (no relief to my poorly recovering neck). “Ladies and gentlemen, we unfortunately have a problem with our brakes and will have to return to the terminal. Thank you for your understanding.” Then, after a few more lurches, “We have reset our computer braking system and have rectified the problem so we will procede to take off.” Still a bronco ride while taxiing followed by an announcement that they are changing the braking system computer. “Thank you for understanding.” We sat just off the runway while they worked on the problem. Then, “Ladies and gentlemen, this is your captain speaking. I apologize for my premature optimism. We still have a braking problem and will have to return to the terminal. Thank you for your understanding.” Fine with me! After the first announcement, I had already written down “Problem with braking system! Pilot given the go ahead for take off anyway!” on the air sickness bag in case we were found and there was an investigation. At least the family back home could get a few mil.

We stopped halfway back to the terminal, waited 20 minutes for a bus which took half the passengers back while the rest of us waited another 20 minutes for the bus to return. Back in the terminal there was chaos since nobody knew where to go or when to expect the next plane. Finally, they got us back onto the bus and delivered us back to what could have been the very same aircraft we had just gotten off of.

We arrived in Rome at 4:30 PM. Our cab driver out raced all the other cabs for the hole shot and managed to write down some recommended “tipoco” Roman restaurantes that where not tourist traps while skillfully driving 100 miles an hour on a tight curvey highway. The drive in through the city was beautiful, right past the colloseum and all the antiquity. The hotel is beautiful. There was shocking news that it is against the law to have more than 3 people in a room (who passed that law I wonder?) and that we need to pay for an extra room but we negotiated and they compromized so we have to pay an obscene extra euros a night for an extra bed they brought to our room. Aren’t we lucky?

Things quickly became better after our doorman directed us to a very nice Pizzaria just a 5 minute walk from the hotel “Il Pomodorino.” A brick oven pizza was ready in 10 minutes! And what a pizza! Why does it take so long to get a pizza in Niamey? Dina had a salad where they walk with her and she points out from all the different salads what she wants and they put generous portions on the plate and serve it to her with a fine wine and San Peligrino water of course. My sausage gorgonzolla pizza was unbelievably delicious. A fine meal. Kids are happy. We’re all happy. Just a short walk in the cold night back to our room. Ahhhhh!

The kids are recooperating well. Someone asked Stefan where he was born and he replied, "Disneyland!." It had something to do with a NY Times review about a new family cruise Disney puts out. There was a large photo of a kid about to go swimming in a huge pool that had a screen with a dolphin in the foreground and the disney castle as a backdrop. When I asked him if that’s where he saw it, he said, "Yep! And I read the article too." Dina said, "How can that be? You were only there once when you were 7 months old." To which he replied, "How is that possible that I went when I was seven? I’m only 5!" Wise guy.

Last night was the silent auction to support the American’s Women’s Club. It was a beautiful spread at the Grand Hotel. There were a few nice items to bid on including one of Dina’s homemade dolls. We won a bid on a nice African painting a la Picasso. I won’t try to explain that.

We got home late and after I dropped Zuri off for babysitting, we watched a bit of the rerun of American Idol. Dina went to bed and I soon followed around 1AM, only to find Stefan in our bed. Sleeping with him is like sleeping with a breakdancer so I went to his bed and quickly fell asleep.

The phone rang at  3AM. It was a mother telling me her son was having an asthma attack. She had given him a dose of his inhaler without any relief. I instructed her to bring him to the Health Unit where I would meet them in 15 minutes (Don’t want to scare anyone).

The roads were surprisingly quiet. I put in a call to my nurse to find out where our nebulizer machine is. She has such bad laryngitis that I couldn’t hear her, especially since the roads are bumpy and the entire vehicle squeeks. The guard let me past the check point when I drove up with my flashers on (Peter is a flasher!).  The boy was sitting on the floor with his parents gasping for air like a fish out of water and his breaths were whistling. We got him settled down on the exam table and I gave him his first dose of Albuterol to open up his airway. It didn’t work so I gave him a second dose with little improvement.

I started to worry half way through the third dose. I had already loaded him up on steroids but that takes at least 6-12 hours to work. He wasn’t gasping as hard but he was still having inspiratory and expiratory wheezes. He was tired but able to speak in complete sentences.

He basically had near continuous inhalation of medication from 3:30 in the morning until 6AM. I decided to try my last resort of giving him an Epinephrine injection (adrenaline). Within 5 minutes his wheezing subsided. Everyone was exhausted and after watching him for another hour, I sent him home with specific instructions to continue his care.

It was a bit strange driving home since I was tired and it was at a time when I’m usually driving to work. Kind of like watching a movie in reverse, backwards. The squatting lady by the roadside cooking benne’s hadn’t flipped one yet. My blind guy didn’t get to his corner. When I got home, the fire alarm was going off in the dining room but everyone seemed to be in bed without worry. It turned out to be a low battery. No cause for alarm!

I crashed in bed around 9:30AM and had that haphazard sleep when there are noises coming from electronic devises controlled only by your children. I touched base with my patient in the early afternoon and he is doing much better so I pray that we’re out of the woods. Yahoo steroids! He may not be wheezing but I bet he has hair on his chest and speaks in a basso profundo voice (just kidding).

Now I’m back in the clinic for a sprained foot. Nothing serious. It’s quitting time.

Driving – Camel crossings while driving over the Kennedy bridge over the Niger River. Herds of goats with kidlettes running out into the road. Pausing with hesitation once nearly across, then running back across as the car nears dangerously close! Shrinking water holes with naked bodies casting fishing nets, washing clothes, bathing babies, and watering livestock. Many species of trees Their large roots with sculpted trunks; some with leaves. Others without. Their silouetted bodies contrast against the bright daylight. One with green leaves turning lavendar. Small clusters of village grass huts with campfires. Hand  pumping water. Women walking along side the road with large pots and possessions on their heads. Scooters and bicyclists. Donkey carts pulling loads of firewood and hay. Children running with sticks and old bicycle tires.

Work at the Embassy – Teaching the Trauma Course all day. Burkinabes demonstrating treatment of mass casualties on each other: Triage. Stop the bleeding! Applying bandages. Perform the Heimlich maneuver (not Hindlick!). Demonstrate one and two-man carry. Waiting for a "no show". Talking to Paulina about morale and patients. Reading charts. Country team meeting with the Embassador and DCM. Seeing patients. Visiting with Dr. Riese. Hearing a babies heart rate for the first time and the pregnant mom getting so excited. She brought her husband later so that he could hear it too! Joy. Still a "no-show" on the recheduled "no-show."

Ouaga – Our driver loosing all his money (not stolen). La Palmeriae hotel like an oasis with one story buildings, clean white rooms with African art, and a swimming pool courtyard. Birds cooing in the night. Buffet breakfasts with fresh ginger juice, coffee, pastries, cheese plates, and mangos, mangos, mangos! Walking in the heat for an hour with winey children, looking for FESPACO information, then finding it just around the corner. Swimming and reading. Watching a short film clip on a young boy who lives at the dump. Eating out in fine restaurants. Discovering a French wine shop with temperature controlled storage. Then buying beautiful labels of wine to taste back home! Dinner at Paulina’s Hotel Richard. Good wine and fried fish with fresh steamed spinach! Live dogs and stuffed heads of big game on the walls. Feverish Stefan hallucinating with comical statements. Dreaming of Dyadya Oga. Last minute shopping at Marina Market (a real super market!) before leaving for home. Beefy chicken breasts at $28/pound!

Headed home – Late start. Crossing rocky hills with thick vegetation. Sub-Saharan desert. More village life. Camille getting Stefan’s illness. Niamey in lights as we drive home in the late evening. Home.

Saturday night, Dina and I got VIP tickets from Jennifer (our neighbor) to a sit down dinner and live African musical performance. We got dressed up and went with Jennifer, James, and another friend from the embassy. The event was outside and we were seated by a french couple that we have often seen dropping our kids off at La Fontaine. There was a lot of different dishes to try including smoked Capitan fish, cold cuts and salads, fish in tomato sauce, chicken in onions, and beef in a cream sauce, plus many deserts. The musician was from the Cameroon. He had a good voice and played guitar beautifully in African style but his music didn’t move me. It didn’t make you want to get up out of your seat and dance. He had a female vocalist backup singer, a percussionist, and a keyboard player which gave the band an electronic flute sound I found rather distracting. Another musician joined him for one song and they did a raggae number together which was by far the best one of the evening. But we were in good company and the wine was quite palatable!

This is a long weekend due to President’s Day. Last night, our regional security officer and his family invited us out to a Japanese restaurant. I didn’t even know one existed here. Some other friends joined us as well. It has an inner courtyard and tables around a large pagoda, a waterwheel and fountain which currently have no water flowing. The food was surprisingly good but the service was terrible. A courteous and attentive African dressed waitress served us but the dishes came out one at a time (as ordered) as though the chef was cooking them one by one from scratch, including the double orders. We arrived at 7PM and by 9, we still hadn’t gotten our complete meal. The kids were tired and they have school today. It was a rough morning getting them up early. We had a nice evening out in good company but maybe lunch there would be better.

Last Friday I took the day off because I’ve accumulated some comp time and if I don’t use it, I lose it. But I came in to cash a check and send a draft of the school board minutes I had forgotten to do the day before. Sure enough! In come the patients. I kept trying to deflect but they had issues that required my attention. My co-worker was great in seeing most of them but I still became involved. So the day off turned out to be a working day and the jokes been on me ever since.

I caught a strange illness. Nothing specific. A lot od vague symptoms which bring patients into the clinic but drive health practitioners crazy. "Feeling blazay" is the only way to describe it. Sunday was a low energy day. I forced myself to go into work on Monday since my symptoms were "nothing." Then, during a meeting, I suddenly felt I might throw up. A few beltches produced a few surprises but I managed to keep it all down until the meeting was out.

My illness resolved itself but the kids got sick. First Stefan got a bad cold with a cough. He burned up with fever and stayed home 3 days. Half way into it, Camille came down with the same thing. Dina had to stay at home and play nurse (I love that image) while I dealt with work, patients, insurance companies (would you believe a Foreign Service plan that won’t ship overseas), and meetings.

Yesterday it got busy with patients. My co-worker ordered some take out from a local Nigerien restaurant. We split some rice with spicy chicken and were sitting outside in the shade of a mango tree. I was about to eat my food when a pigeon dropped it’s poop right onto my food! We salvaged most of it but somehow I lost my appetite.

Today is only a half day here at the embassy. We were trying to tidy things up in preparation for an inspection coming up and a visit from my mentor. We finally completed eliminating all expired pharmaceutical medications and had to flush the old meds and narcotics down the toilet. The first flush eliminated the over-the-counter meds without any problems (leave the best for last). But when we filled the bowl with the narcotics, the toilet wouldn’t flush. The water to the embassy was turned off by the water company. No one knows why or for how long. It’s not that I think for one second that someone is going to take those meds floating in the toilet of the womens bathroom to get high. It just looks funny when you see all those colored pills. I signed the waste since I witnessed it (sort of).

I had a few scheduled patients. A new family coming in that needed briefing on the common Montezuma’s revenge, malaria, and and don’t eat that yellow – oops! Wrong country. Of course there were a few walk-ins. That’s usual. But why on a day that I have to go to a luncheon? Here in Niamey, a lunch out can take over 2 hours. It got really busy. I even had to cancel an appointment with a well-child check.

A guy who works for the Department of Energy has been here for 2 years and is leaving with his wife back to Australia. I was invited on short notice to Le Pilier, a very nice French-Italian restaurant. Ironically, Dina had been invited there for lunch by her friend as a Birthday present and was making good on her word. It took some planning so that Zuri could pick up the kids from school.

I was seated at a large table with about 30 people there to see the man off. My back was turned to the the other diners but when I would turn around (often), I could see Dina looking beautiful in a cute dress. She would occasionally glance over and flash that stunning smile! I must have been looking too much because all of a sudden, the waiter came up and pulled a curtain just enough to obstruct my view of them. “That’s my wife,” I exclaimed, blushing! “Well I’m glad to hear that,” replied a TDY’er.

Our weather has been mild (60 – 80 degrees) but the air quality is really bad. The sand and dust is blown off the Sahara desert, called Harmatan. I’m seeing a lot of upper respiratory illnesses. Everyone is complaining about their sinuses. People with allergies are also having a time of it. I even see people riding on their mopeds and motorcycles with surgical masks on. But fortunately, our family seems to have a healthy immune system.