One chapter comes to a close...

We've been back in the states for about 2 weeks now and continue to organize pictures, pass out souvenirs, and reflect on all that we experienced. It seemed appropriate to conclude our blog with some of our favorite quotes and experiences of the trip. We hope you find them as entertaining as we did.

While standing in line at security in Minneapolis, a very helpful airport employee approached Greg and asked, "Sir, would you like a wheel chair?"

How to tell if you are at a nice restaurant, according Eliza (5 y/o): "There is a toilet seat, toilet paper, and soap!"

Chako's favorite joke, told to us outside of Church following the service one Sunday:
"Three men die and go to Hell, an American, a Frenchman, and a Nigerien.  They ask the telephone operator if they can make a call home to warn their families about the terrible conditions and change their ways so at least they will go to Heaven.  The American places his call and tearfully tells his family to be good because Hell is horrible.  At the end of the call, the telephone operator says, "That will be $5 for the call." The American pays him and moves on.  Next the Frenchman calls home and gives his family a similar message. When the call is over, the telephone operator again says, "That will be $5 for the call." The Frenchman pays him and moves on. Lastly, the Nigerien makes the call and tearfully warns his family to change their ways so they can go to Heaven.  After he hangs up, the telephone operator says, "That will be 10 cents." The Nigerien man replies, "Do you think because I am Nigerien, I don't have enough money to pay the full price?" "No," the telephone operator replies, "I'm asking for 10 cents because you were placing a local call."

Upon meeting Gretchen, a resident from Iowa who was going to be working with Susan for the month of February, Chako asked, "So, how do you like...Hell?" Gretchen wasn't sure how to respond.  She didn't really get the joke. (Truth be told, she wasn't there at it's telling.)

Sometimes talking to a 15 month old/parrot of three languages is a great source of entertainment.  For example: "What's my name? (Michelle)" "Shell!" "What's my name? (Kristina)" "Butt!" and "Dursies?" (said while looking at Kristina's chest) roughly translated is "Lunch?" And then there was the random outburst of "Geez!" by Dr. Carey while driving and probably witnessing some type of traffic infraction or accident that was repeated over and over and over again followed by a chorus of giggles. :)

I know you have all been waiting with bated breath to discover what this large structure is that Greg is claiming for his own.  We have 3 winners: Tom, Jeanne, and my sister Allie!  Congratulations!  It's a termite hill.

While talking with one of our new friends and learning his life story he told us about going to school, playing soccer then learning about driving and taking care of cars.  After telling us about his first job as a mechanic he told us, "Then I wanted a wife, so I got one." Hmmmm, finding a spouse in Africa kind of sounds like shopping.  I wonder if they have catalogs ;)

At one of the dinners we had, Chako said to Kristina, "So, tell me about your shuga." "Shuga? (confused expression)" "You know shuga, dun da dun da dun dun, oh honey, honey." (In case you don't get the reference, he was asking about her husband Jason through the popular oldie.)

"I think we're stuck." ~Jeremy after we're loaded into the car ready to head back into the city after watching the sun set over the dunes.

Good thing we were being followed by a village of children, willing to give us a little push.

When Greg returned from his trip to Danja, he wanted to hear all about our experiences in the city while he was away. We talked about the clinics and hospitals and the people we met, and how everywhere we went it seemed we were on display in some way.  Dr. Carey made a comment about how some Tuareg men were oogling (roughly translated as staring inappropriately at) Kristina and I as we walked out of a government building. To which Greg replied, "Well did you put your arms around them and say, sorry boys these are my wives?!"

We truly had an amazing time, and while this chapter is coming to a close, I have a feeling there are many more African adventures in store for us in the years to come. We'll carry the experiences we had, the skills we learned, and the people we met with us what ever the future holds. I hope you've enjoyed reading our stories as much as we enjoyed sharing them.

Au revior and Sai wani lokoci!

Videos!

While perusing the capabilities of this blog site, we discovered there is an insert video button, so we decided to oblige and share a few videos with you, I hope they work:

The beginning of Kristina's camel ride. Current, future, and all other PTs, here is a prime example of the sternocleidomastoid (or SCM for those who prefer), in case you couldn't tell.

This is a video of Michelle (or Meesha as she is known by her African street name) getting schooled in the yard by an 8 year old (or he may be 15, everyone looks younger than they really are). In her defense, playing in a skirt is hard. And yes the trash talk of "schooling" someone is also used half way around the world.  We discovered this when one of the kids was taunting another and then started drawing ABC's and numbers into the sand. Though not demonstrated in this video, the finger is also apparently universal...

We had some difficulty loading the third video so I've included a link to it on facebook. It's of us singing a song in Hausa and English, dressed in our custom African attire. I hope you like it!

http://www.facebook.com/video/video.php?v=602321640782

Turns out loading videos to the blog is difficult/slow even in the states. Good times, good times.  Hope you enjoy!

The Culture of Niger

We thought we would share some of the interesting cultural differences we found while we were in Niger:

1. The men show physical signs of affection (such as holding hands, hugging, etc.) with each other while in public, but not with women.

Dr. Carey and Greg publicly displaying their true feeling for each other in true Nigerien style.

2. We saw many nude men (doing laundry, washing in the river, relieving their bladder) while in Niger and this appears completely normal.  We also saw a lot of women completely pull out their breast for their child and leave it out in case the child needs to breastfeed again.  Also, completely normal.  However, women showing their knees?  Unacceptable.

Michelle and Kristina being scandalous, showing their knees in Africa

3. For Muslims, the left hand is considered the dirty hand; therefore, they will not use it to eat or otherwise touch their mouth.  This made it somewhat difficult to do rehab with left-sided stroke patients and brachial plexus injuries because they will not use their left hand for these tasks, even if it will help them get better.

4. Formal hello's and long goodbyes are the norm.  A standard goodbye after a meeting can take almost as long as the meeting itself!  Nigeriens definitely put the Minnesota goodbye to shame.

The start of our goodbye to the med students...

...still saying goodbye...

...getting close to the end of the goodbye...

This goodbye session took at least 30 minutes and consisted of at least 50 pictures...we decided to spare you some of the details.

4a. In addition to taking a long time to greet you, Nigeriens also greet your family...present or not.

Chako saying hello to Jason from half way around the world.

5. When offered a drink, you have to accept.  A polite refusal, turns out, is actually rude there.

6. Niger is a very patriarchal society.  Women are referred to as Madame (insert husband's first name here).  Many men have multiple wives that are typically "bought" when they have the money.  Many girls marry at 13-14, while men wait until around age 20.  Many women are illiterate.

While we were in Niger, we did not see this quite as much since we were working with medical students and more educated people in Niger, but the people we saw, according to our hosts, are really the minority.

7. With poverty comes begging (we saw beggars everywhere, especially at intersections where they would come up to the car).  Handicapped children tend to get more money for the family, so often times, parents will not treat their kids' deformities because it help bring more money to the family.  We also saw a few cases of twins where one twin would get all the food and attention while the other one would be neglected because of lack of funds.

8. Disabilities may be viewed as deserved because of what someone or someone's family has done, so people will not get treated.  Disabilities may also be viewed as sorcery/curses and people feel they cannot be treated.

9. People use traditional healers, especially for extremity conditions.  An example, one guy in the med school class sprained his ankle and went to a traditional healer where, in order to be successfully treated, he had to get a massage from a women who had given birth to twins.  After class, he asked Michelle for an ankle massage.

10. Wana is widely thought of as a disease that cannot be treated with medicine.  It involves complaints of GI issues to jaundice to death.  The most serious type of wana means the person will die.  We learned about the belief fro Ishmael of the Medical English Club, who comes from the culture where this is believed.  He does not believe it exists.

11.  In Hausa, people commonly ask about one's sleep and one's tiredness.  Apparently, not the same because both questions are asked in one greeting.

12.  Traffic laws are suggestions.  Not to mention, there's a semi-lane for camels and donkey carts.  And there are goat/sheep crossings.  It is totally acceptable to drive the wrong way down a one way if that's where you need to go.  Traffic lights, also suggestions.  You more or less turn when you want to.  We did see one speed limits sign...but I'm thinking that, too, will be more of a suggestion.  Other road sings are written in paragraph format and are impossible to read while driving by.  The streets, we are told, have names, but they're not marked and different people call them different things based on sites on that road.

13. White people can only have 5 people per car (we were pulled over for having 7), but Nigeriens can cram as many people as possible in their "19 passenger vans" (roughly the size of an American mini van with one extra row)...they also put people on the roof and hanging off the back.

You can see the people crammed in the "19 passenger can" along with a ridiculous amount of things on top... loosely tied I might add.

13a.  In addition to a ridiculous number of people, Nigeriens also pack vehicles with excessive cargo...and interesting cargo...

Though not clear because it was taken out of our back window, this is a motorcycle with a goat.  And hay on the front in case the goat got hungry I guess...

14. Bargaining is always appropriate.

15. People move their TVs outside at night to watch them.

16. Men gather at designated areas to drink tea and socialize.  No women allowed.

17. All medical supplies are over the counter.  Included lumbar puncture supplies.

Betsy getting her IV after her lumbar puncture, which we bought all the supplies for at a variety of pharmacies

18.  Africans saw backwards.

Kristina and Michelle learning to saw the African way.  It works really well...I think they're on to something!

19.  Placing your hand to our left axilla (armpit) after shaking someone's hand is a sign of respect.

I am sure there are tons of things we are missing, but this is a good chuck of what we noticed while we were there!

Machoui

We arrived at Panera Bread in true Nigerien style, 15-30 minutes after the agreed upon arrival time, to begin work on the next series of blog posts. Although, walking out the door into the -11/-25 degree windchill was a pretty good reminder that we're not in Niger anymore. However, drinking hot coffee in front the fireplace, looking through pictures of our trip is a good way to cut through cold outside.

The next series of pictures comes from our thank you dinner for the medical students, interpreters, and physical therapists we worked with during our stay.  We called a caterer to have food prepared and delivered to our compound for the occasion. The finished product was a sheep stuffed with couscous and it was delicious! Susan and Mariyama worked hard to get the side dishes and dessert ready with a little help from Kristina and Michelle.  Turns out, when people glanced in the kitchen and saw us wearing our traditional dresses and cutting up vegetables, they thought we were Nigerien. We were told the roasting of a sheep was called a machoui, which sounds kind of like you are sneezing.  We truly enjoyed the time of food and fellowship with everyone that so graciously made us feel at home away from home.

Here is Greg and Dr. Carey proudly displaying the sheep. Notice Dr. Carey's traditional boubou (not to be confused with mu-mu).

Yacouba and Dismas, our sheep surgeons

The US PT group with the Nigerien PT group

Dismas, our med school interpreter with Dr. Carey...Smile!

Us with all the medical students that also served as translators in the clinics and hospitals.  They took time away from studying and everything else they have going on, to work with us and make sure language wasn't a barrier to the work we wanted to do.

Same group plus Susan and Abi (future translator)! We are so grateful to Susan and her husband Jeremy (not pictured) for playing chaffeur, translator, liason, and cruise director during our stay in Niger. They are an amazing family and we were so blessed to work with them.

Kristina and Michelle with the president of the medical english club Ishmael. He not only served as a translator during our National Hospital visits, but also gave us a tour of the Musee (the local zoo) and help us negotiate with vendors to purchase souvenirs at the market.

Kristina and Michelle with Dismas, who put up with us even though we never gave him our lectures until the morning he was supposed to translate them.

A picture of the whole party.  No that's not snow, it's the flash reflecting off the dust in the air.

A better picture of the party on the patio of the place where we stayed.  You can almost see everyone...

Our friends riding their motos off into the night.  Motos are the vehicle of choice for most students.  We never did get a moto experience but I have a feeling it would have been more terrifying than the camel ride considering rules of the road are more like suggestions in Niger.

We ended the night with a repeat performance of the song we sang in church the day before.  Vincent brought his piano and we sang songs in French, English, and Hausa. It was the perfect ending to the celebration. We are so blessed to worked with such incredible people.

A Day in the African Operating Bloc

In honor of our surgical post we thought we'd show a picture of us in scrubs with one of the translators we've been working with at CURE.  This picture was not taken today but at CURE last week when we observed a cleft lip surgery there. The hospital was beautiful and the surgery was completed without any problems...it was a completely different experience than our later adventures in the OR...

Today we had our first experience at the National Hospital.  Everyone was very gracious and we were able to spend time in both the physical therapy "gym" and observe a couple surgeries.  In this particular post we would like to account for you our experience during the surgeries.  Be forewarned, some of the descriptions will be too graphic for the weak of stomach.

Our day began with an unexpected tour as we searched throughout the hospital for exactly where we were supposed to be. Our tour guide was one of the medical students who has been translating and helping us out while we were here, but apparently he hadn't completed his surgical rotation yet he so wasn't exactly sure where we were supposed to go. We ended up running into a surigcal intern who also spoke some English and offered to show us around, so we were handed off.  We continued to wander a bit, but part of me thinks he just wanted to practice his English for awhile. Apparently he thought Kristina needed to practice her French because she was forbidden from answering questions in English. After 45 minutes of our "tour" we met up with the medical students on the surgical rotation, and our surgical translator. They instructed us to change into scrubs and led us to a what looked like a break room because there were people hanging out and studying with both doors wide open. Apprently the modesty we've been exposed to since we arrived in Niger, doesn't extend to the hospital.

Fully dressed in scrubs and all our belongings in tow, we made our way across campus through the 107 degree heat. We arrived at the operating bloc and were instructed to put on our surgical masks and hats then bring all of bags and water bottles with us into the operating room. I think somethings got lost in translation because when we arrived we discovered that it was a thyroid surgery, not the orthopedic surgery we had been expecting.  But we were polite and watched the surgeon's work for a little while.  The surgical intern was very helpful and tried to position us so we could see what was going on in the surgical field but still be out of the way.  We were reminded to steer clear of the sterile field.  However, sterile field is kind of a loose term.  First of all, the sheet that made up the floor of the sterile field, was stained.  It may have been clean, but some how the gigantic stain didn't instill a whole lot of confidence in that fact.  Second of all, while the surgeons used gloves, their dirty glove bags were discarded into the sterile field. Third, a cell phone rang during the surgery.  Turns out, it  belonged to the nurse who was retracting something, so our intern brought the phone to ear so she could chat. He was leaning over the sterile field but kept his balance by holding onto the IV pole. One thing I noticed during this surgery was the heart monitor.  I have a general idea of what the heart rate should be kept at from watching other surgeries.  I also know that when there is a flat line that's bad.  Well, the entire surgery, the patient was flat lining complete with the alarm that goes off with this phenomenon.  Granted, no one seemed to think this was a big deal, which meant that they had probably removed the leads, but then how would they know what her vital signs were and why wouldn't they turn off the monitors and the annoying beeeeeeeeeeeeep!?!

After awhile, we decided to ask if there was an orthopedic surgery we could observe.  The response was, "No problem!  It is next door.  Go ahead and go in." So we walk into this surgery, unannounced, and stand in the corner, which actually isn't a bad viewing spot.  All of a sudden, all eyes turn to us and ask, who are you, what do you want, how can I help you, including the patient!!  Turns out the patient was awake, although obviously feeling no pain as the gaping hole in his leg and the broken bone within it lay exposed on the table and he didn't so much as look up to see who the strange white girls were that just entered the room.  We tried to explain in our best franglais who we were, what we wanted and why we were there.  Although I'm afraid it came out more like, "We are from America, therefore we can do whatever we want!" It was established that we could stay in the room to watch the end of the surgery.  However, turns out we were wearing the wrong shoes. We had been told that closed toed shoes would be just fine to observe in, but while standing in the room we discovered that crocs were the only shoes allowed.  I was a little confused because as I looked around the room, there was one man without shoes on and I know our translator had walked around the whole campus with his crocs on, how were they more clean than what we were wearing? But again, they let it slide and allowed us to stay. We watched as they closed the leg up but were both a little confused.  His x-ray was up on the light board and the tibia was in 3 distinct pieces.  The hole in his leg revealed the same thing, 3 distinct pieces of bone,  held together by skin which was now being stitched shut in about six places to cover the whole length of his shin. There was no fixator, no pins or anything to align the bones so they would heal.  The surgeon said something about infection as he finished his last stitch and proceeded to wrap the leg in gauze. There was no cast or splint that was added for support. Our translator asked if we would like to watch another surgery.  We politely declined and found our way back to the safety of the PT "gym" (we'll recount this experience at a different time because this is already a really long post).

In conclusion, I now understand when asked if we were taking Betsy to National for her lumbar puncture there was a chorus of emphatic NO's!!! That's all for now! We'll try to get a couple more posts in (complete with pictures) before returning to the states in a couple days.  There is just so much more to tell (our sheep roasting party, PT adventures at National, getting stuck at the sand dunes after dark, plus all the corresponding pictures) and so little time/internet connections/power to do it!  Sai an gema!

Kristina and Michelle

P.S. Since no one tried to guess what we were standing next to on the last post, there are still five prizes left to claim!  We won't reveal the answer until all the prizes have been given away ;)

Weekend #2 (in pictures)

With the elections going on yesterday, it seemed that the internet was moving a lot slower than normal all weekend and all day yesterday.  Hopefully that means people were excited and researching who they were going to vote for to lead their country. In any case, it meant we were unable to update you all (or y'all for all our southern friends out there) as we would like until today!  Here is our amazing weekend in pictures...

Jumping/falling fown the san dunes with the kids in the background.  These kids followed us around most of the time we were there and so we gave them a soccer ball, which about half of them started a game with.   The kids also came in handy when our car got stuck in the sand, so they pushed it out for us (we'll load that picture in our next installment, it's classic)!

Picnic at the beach, I mean desert...

This is outside of church of Sunday.  We recieved many compliments on our Nigerien attire as well as our beautiful singing, yes we did perform a song in Hausa sometime during the 3 and a half hour church service. And yes we have video...that will also (hopefully) be in our next installment.

Giraffes! (No zoom needed)

This is Kristina, Michelle, and our new friend Jimmy.  He's hiding in the trees/getting himself a snack. Probably both...

We got to ride on the top of the jeep.  Thankfully, Jeremey was good at navigating around the thorn trees.  No blood this year! This is Kristina, Michelle, our new friend Gretchen, and our guide (he's too cool for a name).

Anyone know what we are standing next too?  Prize for the first 5 people to guess right...(answer on post #11).

Even though it's out of order, a sunset just seems an appropriate picture to end on.  It was so beautiful to watch from the top of the dunes as the sun slowly disappeared beyond the sand.

Reflections with one week to go...

Bon soir,

We've come to the end of our second week in Niger.  We had pizza cooked with veggies we purchased from the market and in the other room I can hear Toy Story 3 playing to make our pizza and a movie night complete. At times, life here feels so real and normal.  We have a morning routine, spend some time in the clinic working with patients or teaching and then can usually count on soccer in the afternoons in the yard. I sometimes forget than I am half way across the world in a country and culture very different from what I am used to. I am learning to read pepole and communicate without words, because my french and hausa are minimal at best. Even though I don't speak the same language as the kids in the yard (or pronouce half of their names correctly), I feel like I know them, who is most competitve and likely to get upset when a goal is scored against us, who has the tricky feet and will school their opponent every time, who will pass to the younger kids to make sure everyone feels included in the game, and who will take time to patiently correct my poor pronounciation after five failed attempts. The people here are so welcoming and sincere and fun to be around, depsite the environment in which they live.

There are other times when I am keenly aware of the disparities between what I am experiencing here and the life I am used to at home.  The conditions in which people live, the trash that lines the roads, and the beggars that roam the streets are heart breaking.  The whole picture can be overwhelming, what can I do to make difference? Is it worth traveling half way around the world and not even make a dent in the problems the face this country? We've had a few conversations as a team about this very idea. What's the point of a trip like this? What it comes down to for me is I know that we am not going to change the world, but we can make a difference in someone's world.  As Greg told us before we left, we are bringing the people not only physical therapy skills and education, but also hope. It's about the individuals we encounter, the difference we make in their lives, and the difference they make in ours. God has created us to be dependent on each other, learning and growing from the fellowship we share with one another, whether it is our neighbors down the street or a kid with a soccer ball half way across the world.  

I truly believe that God has orchastrated every aspect of this trip so that we are able to meet the people and visit the places that are instrumental for impacting the health care environment of Niger. It is obvious that physical therapy can make a huge impact on the lives of the people living here.  Many people live with pain or disability because they don't know what physical therapy is or where to go to find one.  The physical therapists here are desparate for continuing education, promotion of the profession among the people, and a school for locally trained therapists because they recognize the needs of those around them and how they could make a difference with the right training and resources.  Their passion for learning and desire to create a better life for the hurting and disabled in this country is inspiring to me and makes me excited to begin my career and use the skills I've been taught to make a difference in people's lives.

I've not only been inspired in my professional life, but in my personal life as well. God continues to reveal different aspects of his character throughout the duration of our trip.  I've realized that I try to fit God in a neat little box, small enough for me to understand who he is and what he is capable of doing.  A box that isn't too scary or intimidating, but comfortable.  The more I see how he is working in the lives of pepole here and even some of the events of our trip, I'm beginning to understand that God is beyond my comprehension and bigger than any box I can imagine.  It's both exciting and terrifying to see what he has in store for us next. Whatever it is, I know it will be better than anything I could plan or even imagine.

Au revior!

Michelle