The Mostly Unvarnished Truth

Again, it has been some time since I updated this blog.  I have been hesitant to share my experiences here; they are not always, or even often, fun, enlightening, “Out Of Africa”-style adventures.  It’s more like “The Constant Gardener.”  Facing poverty, disease, dirt, bugs the size of toddlers, laziness, intransience, ignorance, corruption and greed every day is exhausting and depressing.

I find I don’t want to be comforted, or reassured.  I don’t want to be told it will get better, or that I’m doing amazing work and it’ll all  be worth it in the end.  I just want to complain about my day with the people here who’ve gone through it too, and then go to bed and try to sleep through the constant cacophony of prayer call so I can get up and do it all again the next day.  I guess one might say that I’m not entirely happy here.

There, I’ve said it.  That’s what I haven’t wanted to tell all the wonderful people back home who have been so supportive.  I haven’t wanted to say that I am tired and angry and depressed and frustrated.  I haven’t wanted to complain about how expensive life is here, and how I’m going broke way ahead of schedule because the cost of things like fresh milk and toilet paper is so high.  I’ve hesitated to voice my frustrations with the way things are run here: the hospital, the store room, the OR…the list goes on.  I don’t want to disappoint all the people who’ve helped to send me here.

But the truth is the truth, and I can’t pretend everything here is leaping gazelles and pulling children back from the brink of death with will power and an IV.  There are bright spots, yes.  I don’t mean to imply that this journey as been a waste, or that I am never, ever satisfied with the work I am doing.  I am learning more here than I could ever hope to learn back home—suturing, EKG’s, burn care.  I see diseases and conditions I would never encounter back in the States.  Tuberculin abscesses in the brain, cleft lips on 17 year-old girls, fistulas, unbelievable burn contractures that turn human limbs into alien flippers.  All of this and more is now a part of my knowledge.  That is valuable, and I am proud to be able to say I’ve cared for so many diverse and exotic conditions, as well as the more mundane V+D, fractures, gastritis, stroke and heart attack patients.

Life is not confined to the wards, however.  I also teach over one hundred students across several specialties.  This has been a 50/50 mix of rewarding and so upsetting that I am in fact planning to resign from one of the classes at the end of the semester.  Some students want to learn, and they are a joy to teach.  But others couldn’t care less, and I refuse to continue beating my head against a brick wall if the wall thinks she already speaks English just fine, thank you very much, and doesn’t need me (I hate to burst your bubble dear, but if you respond to the question “how are you doing today” with a blank stare of total incomprehension, you really don’t speak English “just fine.”).  I want to reserve my energies for the students who listen and answer questions (sometimes with the right answer!) and have questions of their own.  I want to give my time to the students who request extra study sessions in anatomy and physiology, to strengthen the weak spots in their education.  These are the students I love to teach.

As for life outside the walls of the compound…I don’t see it much.  We drive anywhere we need to go, and I only get out 1 or maybe 2 times in a week if I am lucky.  I chafe under the constant house arrest.  Before I came here I never appreciated the freedom to take my dog for a walk or hop in the car and run to the corner store.  To go outside is to invite constant scrutiny.  Even behind my enormous sunglasses and enveloping head coverings, with only a few square inches of my face visible, I feel the burden of being “other.”  To be white here is to invite higher prices, long, unabashed stares and intrusive questions about my origins (“Canadian” I say, if the mood feels off.  No one hates Canadians.  I figure this is a small enough lie that it’s OK.  Besides, no one here knows what Canadians do or do not sound like.).  Walking through the market, redolent with the reek of goats, assorted goat waste products, dust and burning frankincense, I am either loudly courted by obnoxious peddlers hoping to sell the rich (ha!) white women something, or given wide berth by suspicious-looking people who mutter unfriendly-sounding things in Somali.  It’s one of the few times I am glad my Somali is so poor, and limited mainly to medical terminology; I feel I’m better off not knowing what they’re saying.  My patients seem to like me when I’m not giving them shots, and that’s what really matters.

Perhaps I will regret telling you all of this.  Maybe it was better when I kept it to myself, sharing this part of my experience only with my fellow expats, who live it and understand it completely.  But people have been asking for updates, and I found I couldn’t bear to sit down at my computer and type a cheery update about all the fabulous awesomeness.  It just didn’t ring true.  And that, in the end, is why I wrote this, and why I will post it once the internet comes back up.  Because I need to tell the truth, and you deserve to hear it.

An old man naps in the shadow of the hospital's mosque.