When I have children… I am taking as many drugs as possible

I spent the day in the labor room today and got to help deliver a baby! So crazy! Tomorrow, they said I have to do it all by myself. I can’t believe the stuff they let me do here!

I also got to hang out with the Midwife students who are so amazing. They took a bunch of pictures with me. Here are some of them and some with the baby too!

From Demo Clinic
From Demo Clinic
From Demo Clinic
From Demo Clinic
From Demo Clinic
From Demo Clinic
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The day I went to Church… and kinda liked it

So we all know that I am not the most religious of people. However, when Mrs. Lolo (the principal of the School of Midwifery, and my new personal hero) invited me to a ceremony/celebration of the graduating Christian Medical Students, I couldn’t refuse the offer.

We arrived in Makarfi early in the morning but the church was almost already full. All the graduation students were seated in the middle wearing beautiful matching white and black attire. By the time the ceremony was to start, there was not a free seat in the house and there was a crowd of people sitting in chairs outside as well. The service began with the liberation choir. OK, I used to sing in a church choir for a while, but this is probably the exact opposite of my personal choir experience. The music was load and energetic and the whole crowd broke out in song and dance. And not the normal church song and dance; people were just going crazy and whooping and hollering (I am not sure how exactly to explain the kinda Indian warrior call that some of the girls were doing) and the dancing was amazing. This was one of those times though that being the only white girl in a crowd of a couple hundred Nigerian’s and not being able to dance, really sucked. This lasted for about 15 min and then the preacher came up to start the ceremony. We all sat down and I was kinda bummed, thinking that was going to be the end of the singing. Boy was I wrong! Every person that came up there was singing! Some were choirs, a few soloists, and some just kinda broke out into song during a speech they were giving. It was really entertaining. My only complaint of this whole experience is that they were using these mics that were just absolutely horrible! (Uncle Cliff- you would be horrified at the old ghetto mics that they had). The singers that sounded the best were the ones that just didn’t use the mics at all!

The service was going on forever so Genome (Mrs. Lolo’s son) and I went outside to join the others. There, I was surrounded by people who wanted to know where I was from and what I was doing here. I don’t think that I will ever go somewhere where the guys hit on me more! I make friends everywhere I go though so that is nice. I had a great time talking to a few guys named Alec, Jesse, and one that I can’t remember. They all want to come visit me in California. They say that it is their dream to come. Of course I told them all that if they can get a plane ticket, I will house them and show them around. I think I have told that to at least 20 people since I have been here. I hope some actually take me up on it, but maybe not all at the same time. Somehow, I got pulled into a picture….. and for the next 10 minutes, I had to take pictures with a ton of random people who I didn’t know because they wanted a picture of the them with the baturea. Finally, one of the guys told everyone that was enough and pulled me away. I have gotten used to the attention that I get here but in situations like that, it is kinda embarrassing.

After the ceremony, we went to one of Mrs. Lolo’s friend’s houses where she gave us rice and meat which is always really good. Then we drove home (and survived). I absolutely love Mrs. Lolo and her son is really fun to hang out with as well. I think that there is a difference between the Christians and the Muslims however, I like them both for different reasons. I am sure you are all surprised to hear me say it but, today, I had a great time at church!

Partying in Nigeria

Last night was definitely one of the funniest nights ever. It was so amazing that I am actually hesitant to put it in words for fear that I will not be able to convey the experience to its fullest. But, I am willing to try so here it goes. Adam, Ian and I were all starving after getting back to Kaduna from Abuja and decided to go to this great Lebanese restaurant down the street from my house. I am still not very good with directions here because the roads have a tendency to curve and twist in random areas that make me really confused. But, we knew the general direction to the restaurant so we hopped on ochadas and went for it. Turns out, we knew where the restaurant was, but the ochada driver refused to listen to us so we ended up making three U-turns before we finally made it there. Then, of course, the ochada driver insisted that we pay more for getting him lost. But, the food was worth the trouble! We had Shawurma chicken, hummus and chips (which are fries but they cook them in a ton of oil which I’m sure is horrible for you, but delicious at the same time).

After dinner, we walked up the street to where there was a small market. Nigeria’s streets are lined with large gutters so that it doesn’t completely flood during the rainy season. Some of these gutters are really skinny but really deep also. Since there are no working street lights, walking in the dark can be a bit dangerous. I really didn’t want to fall into one of these gutters so I made sure to watch every step that I took. As we were crossing this grassy area, I saw that there was a large gutter so I made sure to step right on the really dark part of the ground. Next thing I know, half of my body is in the gutter and the other half is awkwardly hanging on for dear life. Turns out, that really dark spot was dark because it was a hole, not cement. On the bright side, the gutter was not wet so I didn’t get soaked. On the down side, I don’t think Adam or Ian will ever let me live that down, I banged up my knee pretty bad, and I have lived up to the stereotype of the stupid baturea falling into gutters. Oh well.

After we finished laughing, we went to the NAF club (National Air Force) because Shelly, a GIIP student who interned in Kaduna before, told us it was a fun place to hang out at night. We got there around 9:30 and it was still pretty dead so we sat and watched the live band and had a few drinks. As the night wore on, more and more people started showing up and we realized why Shelly had recommended the place to us. Their was a live band which was actually pretty decent but the best part was that at about 10:30, the girl dancers come out, turn their backs to the audience and then just shake their asses. Then a guy dressed up as an old man (died white eye brows and beard with a pillow stuffed in his shirt) joined the girls. He was absolutely hysterical and oddly enough, a pretty good dancer! A little while after that, another guy came out and basically just shook his ass too. As the crowd got more and more drunk, some of the guests would go up on stage and dance with them too. I have a video but it definitely does not give the whole thing justice.

When I went to the restroom later in the performance, there was a girl standing in front of the mirror practicing shaking her ass. I was joking around with her that I can’t dance like that and so she insisted on giving me some lessons on how to do it. Her name was Precious which just adds to the amazingness of this whole experience. Upon returning to the table, I saw that another woman had joined Adam and Ian. That woman just so happened to be a prostitute. But she was a very nice and interesting prostitute and we had a pretty entertaining conversation. The most entertaining part however was watching her hit on Ian and how incredibly uncomfortable he was the entire time.

Somehow, it ended up being 12:15 and the dance club had opened up. Precious came and found me and told us all that we had to go inside to see real Nigerian dancing. Of course, we were all down to go to a Nigerian night club! But, it cost N1500 to get in (which is a lot) so Precious somehow convinced me to try and get in without paying. After that failed miserably, we decided that we were going to wait till another weekend to go to the nightclub. Its crazy, the club opened at 11:45 and at the time we got there, it was only just beginning. I think I need to prepare the next time we go by taking a long nap during the day so that I can stay up that late and get the whole Nigerian party experience.

Oh how I love Nigeria…..

Enhancing Civil Society use of ICT’s in Nigeria

Enhancing Civil Society use of ICT’s in Nigeria
by the Berkman Center for Internet and Society at Havard University and Georgia Tech
at the Digital Bridge Institute in Abuja, Nigeria
June 14th – 16th

Enhancing Civil Society use of ICT’s in Nigeria was a conference put on by the MacArthur Foundation for their grantees. There were about 40 NGO’s from all over Nigeria and Africa who came to this two day training on ICT’s and how to use them.

Day one: The first day consisted mostly of talks regarding what ICT is, how it is being used in other countries, and how it could be used in Nigeria. The discussion was moderated by Colin Maclay from Harvard and other speakers included Ethan Zuckerman, who teaches at MIT and Harvard (Global Voices) and Juliana Rotich (Ushahidi). After each presentation, the crowd was very eager to ask questions (sometimes a bit too eager) and add comments . The whole conference is also an amazing way for NGO’s to learn about each other and to network and make connections. I was able to met Dr. Murtala Mai, one of the administrators of Pathfinder, a company based in Abuja with a smaller office in Kaduna. They are doing work in medical records systems as well so we are going to do a presentation for them on my project in Kaduna. Hopefully, we will be able to work together to make medical records systems a more common practice. That night, they provided us with a wonderful dinner of smoked fish, suya and goats head soup. All was very good, although it was a bit hard to swallow the soup. We had the opportunity to sit with Tunjo Lardner, CEO of WANGONET. He was absolutely hysterical and gave us some very wise and ridiculous advice.

Day two: The activities on the second day were much more interactive and was designed to teach some of the technologies we had talked about the day before. Some of the technology work shops focused on FrontlineSMS, Facebook, Twitter, Websites, and WordPress. I helped Ian run the WordPress section which had at least 20 people in it. After Ian’s talk, I was able to help show a few people how to set up a WordPress blog. It is amazing how excited people were to do it! I think that they felt very empowered to now have a space where they can write whatever they want and were proud of themselves for learning a new technology. I am excited to read what they have to say and I hope that they do use the blogs that we set up for them.

Day three: The third day was an extension of the program put on by Digital Bridge Institute for NGO’s all over Nigeria, not just MacArthur reps. There were about 80 NGO’s there and the day consisted mostly of presentations. Colin Maclay and Ethan Zukerman gave a great presentation in the morning explaining ICT’s for development. Other presentations included ICT for Citizen and Political Participation, ICT for Social Change, and How to Obtain International Donor Funding.

Abuja is actually really different then all of Nigeria that I have seen so far. It actually resembles a normal city! Most of the people there are much more liberal and wear western clothing. Also, they don’t all stare at you every where you go. (well, some do but at least its not everyone). We got to eat some amazing fish while we were there. I am going to learn how to cook it so that I can make it for everyone when I get back. Also, its kind of nice here because you eat with your hands which makes it much easier. Overall, I had a really fun trip to Abuja but I like the North better. Kaduna is much more lively and has a stronger culture which makes it more interesting.

General Hospital

Today I visited the government run general hospital next to the School of Midwifery. I have to admit that it was actually quite difficult to see the facility first hand. The hospital is set up to where each department has its own building with one long room. The buildings are connected by walkways, some of which have overhangs covering them and others do not. The conditions in the hospital are ridiculously substandard compared to what hospitals are like in the U.S. Most of the floors have dirt on them, the bathrooms are disgusting, there is no privacy for patients, and the operating room consists of a “clean” room with two beds in it.

When I arrived in the morning, one of the faculty took the time to show me around the whole facility. There are different wards set up including out-patient, woman’s general, woman’s critical, mens general, mens critical, child, infant, maternity, and surgical. As we entered each room, the doctor explained to the nurses that “She is a student from the US and she is here to see how beautiful our facility is!” Then, I had to agree with him and tell everyone how lovely the hospital was. It was really frustrating because I am not sure if they really believed that their hospital was at an acceptable standard or if they were just putting on a show for me. No matter the reason, it was incredibly uncomfortable and difficult to keep a straight face during those interactions.

Throughout the tour, I had the opportunity to meet some of the patients and the doctor would explain to me what was wrong with each patient. When we reached the mens ward, I saw a man sitting in a chair next to a bed with a little boy in it. His whole body was covered in white/green ointment or puss (I don’t really know what it was) and I actually could not tell what was wrong with him. When I asked the doctor, he told me that the child had been in a kerosene explosion but he was doing much better now. If that was doing much better, I can’t even imagine what he must have been like when he entered. He was visibly in a lot of pain but the doctors told me that he would survive. As we continued, I saw two more burn victims. One was a middle aged man who was burned by gasoline. The other was a young man and the doctor told me his story because the man was not able to speak. He is a taxi driver and had been driving his car at night when he pulled over to pick up a man from the side of the road. Instead of getting in the car, the man opened the drivers door and threw acid on him. The driver was taken to the hospital and he will survive, except it will take many months before he is able to leave the hospital, his body is permanently deformed, and he lost his left eye.

Those were the worst cases that I saw that day, however the combination of the patients and the conditions of the hospital were incredibly upsetting. I don’t understand how we let it get to this point. How can we let a whole country with 200 million people live with a health care system that is so ineffective and rudimentary? I am going to spend time in the hospital observing the practices in woman’s health care. I think it will be interesting to contrast the care given in a clinic to the care in a hospital. I am also going to look into their medical records system to see if we could work with them in the future to introduce a medical record system. I think that working in the hospital will be the most challenging part of this trip, emotionally at least. It still surprises me though that no matter how horrible the conditions are in the hospital, everyone that works there never loses hope and their spirit is unbreakable. I hope that is something I can learn from them as well.

Kaduna

Hello all,

Sorry for the delay in writing. I have had limited access to the internet. I am going to start going to the internet cafe most days so I will be more available via email or wordpress.

I have been in Kaduna for the past week and a half. Kaduna is a relatively modern city and is much smaller than Kano. It is also considered northern Nigeria’s political center and there are a number of training colleges and two universities (hence, why I am here).

I am staying at Dr. Mairo Mandara’s house with her niece, Khadija. Dr. Mandara is based in Abuja but she visits here some weekends. I actually finally got to meet her this weekend and she is a very intelligent and wonderful person. Khadija is 19 and a student here and also ridiculously nice.

I am working with the Shehu Idris College of Health Sciences and Technology Makarfi. They have a main campus in Makarfi (about 1.5 hours north of here) and a School of Midwifery here in Kaduna. The school has a demonstration clinic in the center of Kaduna for mothers and children. They provide free health care in the form of antenatal, labour, immunization, diagnosis, and pharmaceutical work. The clinic is run by some of the most amazing women I have ever met. They are all incredibly welcoming, willing to explain anything to me, and love to try and teach me Hausa. (I am getting better but they still all laugh at me whenever I say anything in Hausa).

I have just been observing since I arrived to see how the clinic works and to determine the best way to help out. My project was initially supposed to be about using cell phones in health care, but since I have been here, I have realized that it is not the best option here and probably would not work. One of the reason’s it wouldn’t work is that it is just too expensive. In order to use a cell phone, you have to buy prepaid cards which credit your account. It is a bit unclear as to how much it costs to text or call, although I know voice calls are very expensive (I spend about $15 a week for maybe 40 texts and 10 short calls). The other reason cell phones are not ideal is because not enough people have them. The clinic serves very poor people and most of them do not use cell phones. Also, the staff does not make much money either so they would not be able to afford using their cell phones in their work.

However, one of the other things I had done research on is an electronic medical records system called openMRS. It was developed by a bunch of NGO’s and the World Health Organization. We think that this would be much more useful for the students at the school in Makarfi (who study health information management), the clinic, and the community. Currently, the clinic keeps all of their data in paper log books and client health cards. They are not able to easily keep track of the amount of medication they give out, the diseases they encounter or the number of woman who use their services. Access to this information is absolutely crucial to improving the care given by this clinic and in understanding the health care in the country. Just to name a few things that could be done with this information; they would be able to show the government how much medication they need each week (now, they usually run out and have to tell the poor mothers to go buy medication, which they can’t afford), they could track disease patterns or locations of specific diseases, they could also track maternal and child mortality rates. We have spoken to both the provost of the school and the woman in charge of the clinic and both have been wanting something like this and are very excited to get started, and so am I!

Being in the clinic, I have done a lot of work….. but I also got to see some really amazing things. The first day I watched as about 100 babies got vaccinated for polio, Hep B, and yellow fever. It was great to see so many babies getting vaccinated considering only something ridiculous like 30% actually get vaccinated, but it was also heartbreaking to have to watch babies cry for two hours. Another day, I sat with the woman who does the antenatal care. It was amazing to see how many pregnancies woman have here. The highest number I saw that day was 12. She was a 36 year old woman who started having babies when she was only 15. Her first 4 babies all died during birth, her next 5 survived, then she had 2 abortions. She said that any more pregnancies were a gift from god and that she would keep them. Another woman told me (through translation) that the reason she wanted to have so many children (she had 6 and was on her 7th) was so that they could take care of her when she gets old and the more she has, the less of a burden she will be on them. Women who come in for their first time for antenatal care all have to be tested for HIV. If a mother is HIV positive, she is given free medication, counseling, and is encouraged to try and persuade her husband to come and get tested as well. Also, when she has her baby, she is given medicine to separate her from the baby and after the baby is born, he is given other medication which is usually successful in keeping the child from contracting the virus. While I was talking to the counselor, she showed me one of the HIV tests which was positive. She called for a woman who arrived with her small daughter and took her into the other room to give her the medication and counseling. Fortunately, her daughter was negative but it was interesting how the woman reacted to the news that she was positive. She did not cry or anything. They were speaking in Hausa so I could not understand exactly what was being said but it is pretty clear that she did not know the effects of HIV or the severity of it.

Thursday was the most amazing and horrible day. I spent the day in the labour room with a 14 year old and a 21 year old who had both already been in labour for a few hours when I arrived. I have never seen anybody in so much pain before. They were in the “1st stage” room, which consisted of 2 beds with no sheets or pillows. For two hours I watched them cry, walk around the room, bend over, and do anything they could think of to lessen the pain. Their family members waited outside and came in every so often to give them tea or food. I don’t think I have ever been so uncomfortable in my life. All I wanted to do was go and try and do something, anything to make them feel better, but none of the other nurses paid any attention to them and they could only speak Hausa. I ended up just walking back and forth between them kinda putting my hand on a shoulder or rubbing their back. I was desperately trying not to cry with them and I really don’t know if I made them feel better by being there or if I just made them feel uncomfortable. After about two hours, another woman came in who was literally giving birth. They rushed her to the “2nd stage “ room, which has 3 metal tables with small plastic cushions on them. The doctor sprayed antibacterial on the floor around the bed and put a bit on the bed as well. The girl was very tired and very skinny. After only about 10 minutes, the baby’s head was already out of her and the doctor just grabbed its neck and pulled it the rest of the way out. It was a healthy 3.4 kg baby boy. One of the nurses took the baby, cleaned it off, and clothed it. The doctor cleaned the mother and cleaned the bed and instruments that she used (and I use the word “clean” very hesitantly because it was only a processes of soaking instruments in antibacterial soap for 20 min, rinsing them off, and then doing it again). Then the director came in to talk to the mother because she was HIV positive. The director offered her anti viral medication and the woman took them with the stipulation that she removed the label (there is still a huge stigma against HIV). She also explained that it is best to not breast feed her baby because it increases the chances of the baby getting the virus. The woman said that she was still going to breast feed because she was too poor to buy formula and because if she didn’t, people would question her on why she wasn’t. The director accepted this answer and told the mother it was OK, but that she needed to stop after 3 months, 6 months tops. The director and myself were the only two left in the room with the mother and baby, and when we left, the director left the baby on a table across the room from the mother. The mother had yet to hold her child or to feed him. She was only 18 and she was left in the labour room, all alone, 5 minutes after giving birth, watching her baby boy lay on a table. I know that it is a different culture and that they have different practices, but this is one that I don’t think I will ever understand.

On a lighter note, I have started to get my bearings in Kaduna. Adam came down for a few days and we were able to explore the city and find some good places to eat. One thing that I am still getting used to are the storms. To say it is pouring outside is such an understatement. Not only is the rain coming down in buckets (I finally understand that saying) but lightening is lighting up the whole sky every minute and the thunder is so loud! I have woken up multiple nights because the rain on the tin roof is deafeningly loud in my room. I know I am 20 years old, but I would be lieing if I said I wasn’t scared at times. When I told some of the woman that I work with how the storms were scary, they just laughed and told me that they are going to get even worse as the rainy season continues.

Mairo’s husband has two wives and his second wife lives next door with her two girls who are 8 and 11. They are pretty fun to hang out with and the little one has more energy than any kid I have ever met. They also like to use Adam as a jungle gym which is pretty entertaining to watch.

I realize this note is ridiculously long, but a lot has happened in the past week. I think it would be impossible to explain everything that I have done or experienced. I am really enjoying working here and I think that I will really be able to make a difference in the clinic. I am also thinking of a million other projects that I want to do here in the future.

Tomorrow I am going to visit the general hospital which is next to the School of Midwifery. My visits there are mostly just to observe and learn but I am really excited to see how a government hospital is run. I am going to Abuja on Tuesday for a conference with Adam and Ian which is for a bunch of NGO’s in Nigeria that use technology. I am really excited to visit Abuja and hopefully I will meet some very interesting people at the conference.

That’s it for now. Thanks for all the comments. I really appreciate all your support and I miss you all so much!!!

Check out my pics on Google

Hey,

The Internet connection is just too slow here and doesn’t have a consistent connection so it is just too hard to upload my pictures here. You can see all my pictures at: http://picasaweb.google.com/evelynlcastle

I also have video’s but I haven’t found a way to upload them yet. Those might not be able to go online until I get home.

Hope you enjoy them!