i'm back in serrekunda to work on some nursery projects that involve computer work (contracts, schedules, guidelines, etc) and to pick up a bit more cash from the bank, though i've just remembered today is a holiday here, so i may not have any luck exchanging money. in any case, a few moments for the weekend update, mostly written in my journal, but transcribed here for your reading pleasure!

yesterday i was back on site for the nursery work and the familiar faces were there, shoveling, sitting, sweating, shouting - slowly slowly transforming the house into a nursery and the six foot pit into a toilet. i am thankful for the tetanus shot i had before i left for all the rusted iron corrugate and old nails laying around. i've not broken a sweat on this project - i sit with my pad of paper and use the time to think and plan - nodding and congratulating on their work accomplished. and every so often, they shout at me 'fatou sarr' (my gambian namesake) - to make sure i am ok on my own, they don't want me to be lonely. they know i've only five sundays left and i've told kebba, the man who (mostly) seems to be directing things on site (though he's not really broken a sweat yet either) that i'd like the work done in the next two sundays - so that i can commission the artist to work the week of april 7. if that happens, i'll be on track to finish this project. time will tell.

it's interesting to watch their interactions on this project. they look to me for the big decisions because i hold the purse strings - but otherwise, all decisions are made by committee. democratic, yes. efficient? not entirely. a project manager's nightmare. for example, they spent the morning digging around the toilets so that cement blocks could surround the pits for reinforcement - but half way through, after having mixed the cement with water which would soon harden, they realized that they needed to let the earth dry before they could proceed. so for 20 minutes, we sat under the tree, drinking attaya and shouting/talking at each other. it takes a village committee, i suppose. but things are happening. the windows are built and in place, and i think by next sunday we should be able to whitewash the inside and outside to prep for the real paint the following week. and i've got the carpenter working on the benches and tables. i'm very excited.

i spent the first weekend on the site attempting to manage things and hurry the process along. 'should we go get the cement so it's here when they need it?,' 'is the carpenter working on the doors right now?,' 'is there anything those men [standing around] could be doing right now?' ... but i've since relaxed because there are some times when the gambian way is really the only way. when my intentions, however well-meant, are just not the way to get things done. so meagan's hat comes off and fatou wraps her headscarf and sits patiently in the shade.

ebrima said to me last night that he wanted to name the nursery 'meagan's nursery' ... i am honored if slightly embarrassed at the thought, but told him that it really isn't mine, and emphasizing that the donations have really come from all of my friends and family around the world. so another THANK YOU ... but this time ... with another request. any creative souls out there who can think of a name for the nursery? let's hear them! i'll have to get mondo's name up there somewhere, but i think we might have room for a catchy name or a tag line. (though could certainly be happy with 'friends of makumbaya' nursery project) anyway, let me know!

in other weekend news ...

ebrima called me on saturday morning as i was heading to the beach to tell me that another mondo volunteer had worms and could i go with them to the doctor. he was coming my way in a truck, so it worked well for me to get a lift back, and i think emily was grateful for the fellowship. unfortunately, the african way of getting rid of worms is simply to wait till you see them and then pinch them out, and there was nothing the nurse could give her. i think i've seen too many alien movies to be comfortable with that answer, but emily didn't seem to mind too much. ebrima says the worms can come from not washing sheets regularly where they land and gather and lay eggs. so i went home and quickly washed my bed linens!

then on saturday evening, the grandmother asked me if i had any medicines for jainaba's stomach which has been paining her for nearly a month now. i went in to see jainaba and found her in tears, doubled over, clutching her stomach. this was really quite scary as i'd not seen her so vulnerable before - so i ran to get ebrima to see if he could get her to a doctor. in the meantime, i also consulted the manual that came with my hiker's first aid kit - but it REALLY isn't geared towards african life, and made no mention of things like appendicitis, kidney stones or an ectopic pregnancy - my three best (though with absolutely nil medical knowledge) guesses.

ebrima was in a meeting of the village elders and i pulled him out of this so he could get her to a doctor - and he asked if i would come too, so i grabbed my bag, some money and my phone and thankfully, a gellah gellah happened to be passing at that moment. who knows how long we would have had to wait if it hadn't. no ambulances out this way. so the three of us hopped in, and bounced along the sandy roads with jainaba's head on my lap and me trying desperately to control the jolts for her. i called her husband on the way and he met us in lamin. from there, we got a taxi to a small clinic in a neighboring village. (not far off the kind you see on ER when doctor carter goes to africa, only with electricity). and from this point in the story - my frustration begins.

the nurse saw jainaba for about 3 minutes and deduced malaria and a urinary tract infection - though she has signs of neither and scribbles a prescription on a piece of blank paper and hands us a pack of anti-malarial drugs. ebrima is quiet because he is really just the transporter here, not really involved in the intimacies of the issue. and jainaba's husband has not yet arrived in a taxi that was following ours. so i question the nurse about the anti-malarials. firstly to understand when she is meant to take them, but also to understand WHY she has been given these. i tried to play it off as my not entirely understanding because of the language barrier, but in actual fact, her english was perfect. then the nurse tells me the other prescriptions they do not have but we have to get at a pharmacy (yes, on a saturday night at 9pm in africa. right.) and that one of them is paracetamol. fine - but if this is appendicitis, i don't think 500mg of paracetamol is going to do the trick. anyway, i question her again to be sure i understand that she understands. when her husband arrives, he also questions the nurse because these are the same anti-malarial drugs jainaba was given when she came in earlier that week. the nurse finally raises her voice asking me how many times she has to repeat herself and then rushes off to prayer at the mosque next door, she is late. i assume, feeling somewhat guilty about her brusque treatment, she returns from prayer and asks us what more we need her to tell us, we are still sitting there. she doesn't look at me (i've upset her) - but instead speaks to ousmann. ebrima says the questions probably made her feel bad. but at this point, i'm not so bothered about that as long as we get the attention and answers for my friend who is doubled in pain and now vomitting. no one else seems willing to speak up and she and ousmann carry on an entirely unrelated conversation that goes something like this:

she: what more can i tell you.
he: oh, no problem. no problem.
she: no, you are not satisfied.
he: no, no, you are right.
he: do you know dr yahyah?
she: yes, yes he works here
he: yes, he is my best friend.
she: ah, right.
he: we are like sister and brother then?
she: no problem. no problem.
he: no problem.
she: you are welcome anytime, anytime.

clearly an african form of apology allowing her to safe face from our interrogation. and i'd like to feel apologetic - and perhaps from a cultural standpoint, i do - but it is incredibly difficult to sit back and watch this game of medicine unfold. especially when, as it turns out, had we given jainaba the anti-malarials she was given last time, we may have risked overdosing her. still, it is not the nurses fault - there are no records of previous visits, no database of patients, no charts. we should have brought the scratch paper the previous nurse had scribbled on so that she could have seen the previous diagnosis.

but that whole experience had me frustrated beyond belief and feeling quite possibly as helpless as i ever have done. how to even BEGIN to tackle healthcare systems in africa? i feel happy about what i am doing here with the nursery but it was all put into perspective on saturday night. there are FAR bigger issues here than i can ever hope to tackle - but who will? who is? i have no idea.

it certainly made me grateful for the healthcare systems of the west. however flawed and however much we complain with or without reason, they are nothing like this. i pray that is the last time i have to see the inside of an african medical clinic. and i hope my friend jainaba is OK, though i am suspicious of the nurses diagnosis. the meds seem to work for a day or so, and then she's groaning again. anyhow, she woke feeling fine on sunday, i guess we shall see.

and now i must work ... i believe a post from jason is coming shortly!
enjoy the pictures!