Ouaga was very very interesting and had many different contrasts to Niamey. It is more “city,” more developed, and more western in terms of shops and restaurants and clothing attire. The health care standards are higher with newer clinics and greater application of modern resources.

I felt I had accomplished a lot for just a 5 day visit. I had seen quite a number of patients, visited multiple clinics including a radiology center, two clinics which provide full services including basic surgeries (I observed part of a hip replacement), and an AIDS infirmary that not only gives care to patients and their families but also is working on an experimental HIV vaccine. I had also met with many of the Embassy community as well as the local health community. I gave a 30 minute lecture “Health and Well Being.” 53 embassy employees attended.

On Friday night after we had eaten out at a fine restaurant, I awoke in the night and vomited. I was assuming the worst and wasn’t going to be fooled by the instant relief and momentary good feeling one gets right after. But the blahs never returned. I guess I was just lucky. The following day we went to the artisan festival. It was hot but I mostly viewed the art work of venders inside air conditioned buildings. We had a very nice evening at the Ambassador’s residence. Early the next morning I was half awake because of the booming music coming from the discoteque across the street when all of a sudden, “Bang!” I developed an acute onset of pain on my left lower side. Such a sensation I’ve never felt before. The usual medical possibilities ran through my brain; bad food or water, parasites, bladder infections, gunshot wounds, ovarian cysts (not likely)… The pain stayed localized and intense but no nausea or diarrhea. Unable to find a position of comfort or use the bathroom, I got up and paced. Dina heard me and I told her what was going on. We called Paulina, the embassy nurse, who came and took me to the clinic. I didn’t have to tell her what tests to run, she skillfully took the initiative. All of my lab work was normal except for my urine which was concentrated and revealed 3+ blood. I drank lots of water and got a liter of IV fluid. The pain subsided and then went away. My suspicion is that I probably passed a miniscual kidney stone complicated by some dehydration. Now, a week later, I’m recovered (deep sigh).

The drive home to Niamey was uneventful and I came back to a very busy week of work. I had several meetings to attend and had to write several reports including a travel report on Ouaga. Too many phone calls. Most of the patients presented complicated issues including some psychosocial problems that can go way beyond my scope of practice. I’m not a therapist. “Don’t go selling crazy here. I’m all booked up” says Jack Nickelson. I have some limitations but I’m always willing to listen and try to help. I spent a few hours, after work on Friday afternoon, catching up.

Now it’s Saturday morning. Stefan is playing with his cars, making all those engine noises. Camille is rubbing her sleepy eyes and Dina is waiting for the computer.

We are in Ouagadoughou (pronounced – O-waga-doo-goo), the capitol city of Burkina Fosa. This is my regional medical travel post. There are only about 30 Americans here but it has so much more of a city feel to it. Niamey seems like a small village in Mexico in comparison. There is a far less Muslim influence and it is noticeable. For example, we see many more women running and conducting businesses and they are uncovered! More are driving cars and motorcycles independently. There are less visible mosques and call to prayer. There is definitely more pollution as well. But the people are just as friendly and sincere.

The car ride here took 6 hours but was surprisingly beautiful. Lots of greenery. We did not expct to see so many watering holes and springs. We often would see a group of men or women (always separately) wade in up to their necks and playfully splash each other. The road is well paved and safe with the exception of goat and cow crossings. The landscape changed dramatically with plateaues, shrub covered dunes, and bolderous hills.

My first day at work, I had a briefing with the Ambassador. She was very warm and receptive. She is now inviting us to come to her residence for drinks and a viewing of her art collection on Saturday.

The clinic here is in many ways is better than the one in Niamey. It seems more inviting and less cluttered. The nurse here, from Chile, is very well organized as is my nurse in Niamey. But the building is it’s own edifice where in Niamey it’s part of a building which doesn’t seem like it was intended to be used for medical examinations. I feel as though I’m seeing a lot more patients here in Ouaga but I think that is because I’m new (they’re checking me out!) and I only come here every 12 weeks so they schedule more appointments when I’m here. A lot of interesting cases; from a new foreign national hire as a security guard, a pregnant women about to take medical leave, and a poorly controlled hypertensive. I must say, I’m not missing the stress of the ER and I love the new patient-provider relationships I’m building. It really is rewarding.

Ouaga hosts an artisan festival once every two years. It so happens that it starts tomorrow. It should be interesting. It will be fun to see the local art and possibly buy some jewelry, crafts, and art work. When I come back in February, they will have their annual film festival as well.

Tonight is a reception for me at the hotel (Ricardo – her husband runs it) where they are having a Chilean dinner with French wines! There will be many local health practitioners there. My friend Cliff says, “first impressions are lasting.” Let’s hope I’m a good one!

Dina’s big idea to join the FS has proven to be exciting. I never dreamed I’d be living and working a job in Africa where there are so many interesting people, cultures, and things to see.

Oh! A patient! Gotta go play doorman!

Mental cruelty for sure regarding the home internet. "Here you go! Now give us back that router!" It does depict how business usually operates here in Niger. Everything is doable. It usually requires more time and patience than you anticipate. Sometimes more money than you expect. But eventually, you are successful with a long story to go along with the experience and some good people along the way.

For instance, our neighbors here on a Fulbright, moved into the house next door to us and the AC didn’t work in most of the rooms and suboptimally blew wisps of cool air in others. They refused to pay their second months’ rent until it was repaired (all in their contract). A whole band of contractors and plumbers showed up with their hammers to do the list of repairs. They removed the air conditioners and took them outside and sprayed them with a water hose, "to clean the dust filters," they said. Most of us are taught at a very early age not to put water on electrical appliances! One of the units already gave a small electrical shock when they turned it on! When Jennifer told them that cleaning the filters wouldn’t fix the problem, they patronized her. And of course, that didn’t fix the problem. The unit that was shocking users, he claimed to have fixed and when she touched it and didn’t get shocked, she enthusiastically asked how he fixed it. He responded by sternly saying, "What?! Are you trying to take my job now?!" And sure enough, that evening, their housekeeper got an electrical shock when she turned on the AC.

We know we can get internet (even on an Apple) here in Niamey. It could be better but it works. I’m hoping that once we get a good router, most of our problems regarding the internet will be over.

I’m looking forward to our trip to Ouagadougou scheduled in two weeks. They can’t take that away from me! – or can they?