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programme

25 Jul

We all slept well last night thanks to continuous rain throughout the night (and the cool breeze that comes with it).  Missing our morning runs in Ghana, we decided to exercise this morning, using a yoga video and yoga mat (brought by Rachel).  It felt so good to move and stretch, but we also realized how far we have to go once we get home to get into half-marathon shape by December (we are running the Dallas White Rock Half with Rachel’s sister, Jen).  It also spurred conversations about how our home on the ocean is going to need a fitness room, as running during the rainy season would be a complete joke (it POURS here, and has pretty much all day today).  We had oatmeal again for breakfast with fresh mango on the side.  We weren’t sure what the “programme” for the day would be since we had not talked with anyone since church yesterday.  But this is Africa.  And of course, there were 6 African pastors on our doorstep around 11 a.m., asking us what our “programme” for the day should be.

At our request, they took us to see the largest of two government hospitals in Conakry – Hopital National Donka.

We were able to see the pediatric ward and met with two pediatricians (Dr. Moustapha and Dr. Emmanuel) that work at the hospital who were kind enough to stop seeing patients in the middle of their morning to answer our questions.  They explained how the healthcare system is set up in Guinea and how the educational system works, and then answered our questions until Pastor Elijah graciously recommended that we allow them to continue their work (none of the pastors were quite as excited to be there discussing medicine as we were).  We learned that there are three levels of care in Conakry: primary, or large hospitals with the highest level of care available, such as Hopital National Donka; secondary, which seems to include smaller hospitals and clinics that would be equivalent to small private hospitals in the U.S.; and tertiary, or community clinics that refer patients to secondary or primary centers if needed.  Patients are admitted through the emergency room typically, but can also be directly admitted if they accidentally skip the E.R. and show up on the wards.  There are 70 beds in the pediatric ward alone – the entire hospital is very large and composed of several buildings, each housing different wards, labs, and imaging rooms.  Within the pediatric ward, they have a nutrition center and have recently opened a room dedicated to diabetic patients.  Dr. Moustapha trained in endocrinology in France and heads up the diabetes room.  He explained to us that Novo-Nordisk (a company that produces insulin to treat diabetes) started a program in 7 countries in Africa, including Guinea, that donates free insulin, glucometers, and supplies to patients with diabetes.  It is supposed to continue for 5 years.  Dr. Moustapha has been treating cases through the hospital since April of this year with the help of this program, and travels to villages around Conakry to identify new patients who need treatment.  He has also started giving seminars to hospital staff to educate them on the diagnosis and treatment of diabetes, specifically coma due to DKA (a serious complication of type 1 diabetes).  They are also airing commercials on the radio to educate the public about signs and symptoms of diabetes.  It was so exciting to talk with him about what he is doing at the hospital and to see how motivated they are to improve the care provided to patients here.  Both pediatricians discussed how they recognize the flaws and limitations of Hopital Donka, but that they are working toward improvements as best they can.

the building that includes the pediatrics ward.

the pediatrics ward.

We learned that the education of physicians is quite different than in the U.S.  Students who pass the national exam after 12th grade (see previous post about school system) can apply for medical school.  Those accepted study for 6 years and have at least some clinical experience scattered throughout that time.  They then must pass an exam to be considered “general practitioners.”  Some then go on to specialize in one of several areas, including internal medicine, pediatrics, OB-Gyn, surgery – pediatric or general, urology, neurology, and others.  This process takes an additional 4 years.  For those who wish to sub-specialize, such as in pediatric cardiology or gastroenterology, it is rare to have the opportunity.  They must either snag a spot in a program in France, or find someone who has been trained in a particular field in France and returned to Guinea to work.  For example, Dr. Moustapha happened upon an opening for pediatric endocrinology in France and travelled there for his studies.  Now that he is back in Guinea, he is going to train Dr. Emmanuel in the same field.  When we asked how difficult it is to get a chance to go to France to train, they almost laughed and said it is “by chance or luck.”

We then toured the laboratories and were impressed by the wide variety of tests available.  They have all basic labs in addition to cultures (identification and susceptibilities), viral serology, and even viral load for HIV patients.  The facilities are dirty and run down, but the lab appeared professional and organized, and the staff were clearly well trained.

our tour guide, the lab director (on the left).

the biochemistry lab.

rachel scoping out the microbiology lab.

Overall, the hospital appears to be “worse than a condemned project” (in Adam’s words), but we are excited by the opportunities that exist here.  In Ghana, we were often frustrated by the fact that the hospital was so limited and we were left guessing about many of our patients.  Here, because we are in a big city, it seems that we would have access to many of the same labs we use in the U.S. (even at the government hospitals – we haven’t seen the private hospital yet), which would allow us to practice good medicine and have the satisfaction of knowing what was happening in most of our patients.  Of course, there is A LOT of room for improvements, but that’s the whole reason to come.  And it is refreshing to see that the Guinean doctors are as excited about change as we are.

This trip has really been perfect.  We got to see a functioning hospital in Ghana and see what it would be like to work in that type of setting.  We felt rewarded by our work, and yet were not completely fulfilled.  We enjoy learning and teaching so much that we want to be in a setting with more opportunity for advancement.  Today, God reminded us that He has a plan for us, and likely in a larger city such as Conakry.  It’s exciting.

Thank you again for all of your prayers for us – God is clearly listening and working.

– Courtney & Rachel

welcome to paradise

24 Jul

The past couple days have been a wonderful blend of fellowship and rest.  On Saturday, while the boys visited the school at Mission Perazim and met with leaders from Prison Fellowship, we ventured off to the market with Surata.  On a mission to find African sandals, fabric, and produce, we rode through winding, bumpy roads to reach the largest market in Conakry.  We’ve realized how crucial it is to have a driver in Conakry (as Surata does), as we have yet to understand even a vague layout of the city, with all of its alleys and winding roads (all nameless), not to mention we are not the aggressive drivers one must be to make it two blocks without a wreck!

The drive took a little over thirty minutes, which gave us time to hear Surata’s story.  She shared their family’s testimony, of how difficult it was when they became Christians in America, then chose to return home to Guinea.  Not only did they sacrifice the luxuries of life in the U.S., but they found themselves estranged from their Muslim families, without close support in the transition.  She told us stories of how their business struggled, how they were down to one car (with Ishmael traveling to work and a growing family), and how their families asked them why they would choose the life they had chosen.  Then she described the deep trust that they found in Christ, as he brought them through that valley.  How it was worth it all, and how their families saw them stand strong in His grace.  She described the peace she has found, being where God wants her to be, and that nothing could be more valuable — no lifestyle, no money, no amount of luxury.  We learned that they did reconcile with their families after two years, and that although they are still different, their families now get to see God working through Ishmael and Surata.

Our time at the market was both productive and entertaining.  We found most of what we were looking for (including huge avocados and fragrant pineapples), and got it all at a fair price, thanks to Surata’s bargaining techniques.  Her genuine pout when they gave her a ridiculous price, her “game” of walking away to a new booth until they followed with a reduced price… it was both impressive and hilarious.  We will probably always need Surata at the market, if we are to pay “African” prices here.

After the market, we reunited with the boys, and moved our luggage to a new guesthouse, where we will stay for the rest of our time in Guinea.  The new place is one that was previously unknown to the Jamison family, but turned up this trip when all the other guesthouses were booked.  We’ve decided it was God’s blessing in disguise for all familiar places to be unavailable, as the new place has been a haven of rest and refreshment.  It is a condominium owned by the CAMA (a mission organization), and used to be inhabited by a career missionary from the U.S.  It has two bedrooms, two bathrooms, a fully-stocked kitchen (stove, microwave, dishes, refrigerator, coffee pot, spices, cooking utensils, etc), a large common area, and a huge balcony with an ocean view.  Who knew that it could feel like vacationing in Guinea?  Our place stays cool from the breeze off the water, and we enjoy sitting on our patio every evening.  We’ve been able to make oatmeal each morning (not over open fire), and have been enjoying avocado-tomato sandwiches for lunch.  The tile floor throughout the apartment is so clean, as are the bathrooms.  And we have internet — wireless and fast!  We even have access to electricity 22 hours per day (via generator when the city power is off, which is basically all the time during the rainy season); we have been judicious in using it, opting for candles and flashlights in the evenings but occasionally watching a DVD or charging our computers.  Being here has made us realize that you can be comfortable and feel at home even while serving in Guinea.  We’ve already started looking for beachfront property on which to build our home (and conference center, guest house, garden, etc).  All joking aside, we really do feel like this part of our trip was God’s gift.  It has given us peace about the future, to know that we could make Guinea home.

On Sunday morning, we had breakfast with Ishmael before heading to Mission Perazim for church.  Pastor Karim is out of town at a pastor’s conference in Ghana, and so asked Adam to preach in his place.  We were all warmly welcomed by the church congregation – although we felt a little silly as they had us sit in the very front and served us bottled water and cokes on a platter during the service.  Adam discussed passages from Isaiah and the New Testament to portray a picture of the gospel in which God’s infinite holiness and infinite love become apparent in the person of Jesus Christ.  It was a beautiful message of being both humbled and exalted as Christians, and a challenge to be united as the body of Christ despite our differences so that we might be an image of God’s love for the world.  He even got applause and “amens” from the congregation at the end as he encouraged the church to be visible examples of reconciliation to the rest of the nation.  It was powerful, and we all enjoyed hearing him speak.

After church, Ishmael treated us to pizza, which was delicious.  We then took naps and rested the remainder of the day.  We had dinner and watched a movie at our place before calling it a night.  It was nice to have time to relax together.

– Courtney & Rachel

bienvenue en guinea!

23 Jul

It’s a whole different world here…  We are realizing how spoiled we were at the BMC guest house in Nalerigu with our cooks, easy coffee, microwave, 24-hour electricity, hot water, and wireless internet, even if it was sporadic.  While we are enjoying the relative down-time and quiet, we are definitely missing the “luxuries” of Ghana.  We were talking with a man named Mathias yesterday who is from Liberia and has been living in Guineafor 8 years.  He lived in Ivory Coast for a short time prior to coming to Guinea and has been to Ghana twice in his lifetime for conferences.  He said that he likes Guinea better than Ivory Coast because the people here are more hospitable to foreigners, but that Ghana, well Ghana is “excellent.”  While we are enjoying our time in Guinea, we would have to agree.

Upon our arrival, we were met by 4 people who greeted us and welcomed us to Guinea.  They took us to the OCPH (Catholic Organization for Human Promotion) guest house and helped us settle into our rooms.  We were thankful that Surata (Ishmael’s wife) was with us, as she thought of many things we would need overnight – toilet paper, water, towels, and cleansing cloths that she had her driver bring us after they went home.  Our first night was tough – the generator turns off at midnight and so that means the fan does too.  It was pretty close to stifling in our rooms, so we all slept poorly.  In the morning, we had planned to make our oatmeal, but then found out there was no stove here – only an open fire pit.  So we had peanut butter sandwiches instead.

We then went with several pastors (Elijah, Marcel, Desire) to visit Pastor Elijah’s school called Emmaus.  We were impressed by their organization and the success the school has had with their students.  Their exam pass rates are higher than any other school in Guinea and there is a waiting list of students who want to enroll – they are hoping to expand soon.  The tuition is $70-100 per year, depending on grade level.  The Guinean education system is set up differently than in the U.S.  The students start in nursery school and then progress to primary school which lasts through 6th grade.  They then have to pass a national exam to move on to “college” which is equivalent to 7th through 10th grade.  The students then take another national exam, and those who pass move on to secondary school, or 11th-12th grade.  During this time, they pick a track to purse – math, science, or arts.  If they pass the national exam after secondary school, they can then apply for the university.  On average, about 50-75% of Emmaus students pass the exams at each stage.  We met several of the professors and the accountant of the school, and then took a brief tour of the building.  Everyone was very pleasant and they answered all of questions with fervor.  We were excited to see what good work they are doing through the school – all the teachers are Christian and they say morning prayers before class daily and teach theology to the students who are predominantly Muslim.

The pastors then took us to visit Pastor Sanyo, who leads Bethel Church where we have had clinics on previous trips.  He was surprised to see us (not sure that anyone told him we were coming by) and unfortunately has been sick and in the hospital for 3 days recently.  However, despite his fatigue, he was more than hospitable and greeted all of us warmly.

We then visited a clinic associated with one of the local churches.  It was very well organized, though had very limited resources due to lack of funding.  They had a small laboratory with an incubator, centrifuge and microscopes.  There were several consultation rooms with exam rooms connected.  A dental room had a single exam chair in it, and they said they rarely have the supplies to do much dental work on the patients as it is very expensive.  They are able to deliver babies for mothers with less than 3 risk factors (short stature – less than 150 cm, age less than 16, age over 35, previous C-section, etc) and has supplies for neonatal resuscitation (aka a bag-mask), which we were happy to see.  A unique aspect and our favorite part was that they had an observation room where they can give boluses or short infusions and observe patients for up to 24 hours before sending them to the hospital if needed.  There were so many times at the BMC that we wished we had something like this connected to the clinic there as many patients only needed a bolus or a transfusion.  It’s fun to get see a need in one place and then see a solution somewhere else – we’re taking notes for our own adventures in the future.

We then took a nap while the boys went to exchange money into Guinea francs and get minutes to add to our phone (which by the way was the best purchase we have made on this trip, as it has allowed us to have flexibility since we can always reach our contacts here or each other).  Surata then came to get us and took us to an internet café so we could let everyone know we made it safely – it will be difficult to post any pictures for sure, but we should be able to post a couple of blogs while we’re here (we think, seeing that the electricity went out in the internet café in the midst of checking emails…).  She then took us to their home and prepared dinner for us.  We sat on the back porch and watched her make our meal from all fresh ingredients – onions, garlic, parsley, peppers, tomatoes, and freshly slaughtered and plucked chicken – over a charcoal flame.  It was a treat, and she taught us some of her tricks.  She can tell when the fried potatoes are done by the sound the grease makes, which she apparently has to do at times when they have no light (crazy!).

We were all very hungry by the time dinner was prepared (around 9 p.m.) because none of us had really eaten lunch, but it was worth the wait.  The chicken was boiled with spices, then grilled over charcoal with extra sauce and seasonings – to die for!  We also had fried potatoes and plantains, and rice with peanut sauce.  It was by far the best meal we have had in the last month, maybe since we all went to Capital Grill.  And she is planning on cooking for us most nights we are here, a treat we are all looking forward to.  We also enjoyed spending time with Surata – she is so fun and because she has spent time in theU.S., she is so easy to relate to.  Her 7 kids are adorable, and they loved the toys we brought them – the boys immediately started kicking the soccer ball around the Adam and Aaron while we were waiting on dinner to be ready.  We also gave Surata chocolates, since we decided that’s what we would want if we were here.  It rained while we were at Ishmael’s house, which helped cool our rooms down, so we all slept better last night.

This morning, we were true Africans – we cooked oatmeal over that open fire pit using a pot Surata loaned us.  It tasted so good to have a normal breakfast!

The boys left after eating to have a meeting with administration from the Prison Fellowship to discuss plans for future endeavors.  We are waiting on Surata to pick us up.  She is taking us to look at another guest house in the area (one with 24 hour generator power and a stove apparently) – if it’s nice, we will likely move there for the next 3 nights.  We are then going to the market for avocados (apparently they ARE in season now, at least inGuinea) and salt to make avocado sandwiches for lunches, sandals, and maybe more fabric if we find something fabulous.  The rest of the day is pretty open, which sounds great to us – time to relax and sit around while the boys stick to their “program” (aka their plan for the day).

We will continue to write blogs while we’re here and hope to post them as often as possible to keep everyone in the loop.