Sunday, 2 April 2017

Hi tihajji waheda?

Est-ce qu’elle parle seule? Does she talk by herself?

You’re sitting on a mat in a small church building. It’s 43 degrees outside and the pastor’s son has just handed you a small glass of boiling hot, sugary tea. Opposite you a man nods an affirmative response which for once doesn’t need translating. Sat next to him a lady, probably his sister stares into space with wide eyes. Hmm…says the doctor, then the cycle starts again, is she ever violent? Est-ce qu’elle est violente? Hi tidawwis walla?
For the past three weeks I have been in Abeché, a city on the other side of Chad, not far from Sudan.  I’m here to help with translation for a conference on psychiatry. Two American psychiatrists, Mary and Bryan, who are working in Cameroon, were invited to Abeché to teach the MHGAP, a guide created by the World Health Organisation to help people treat psychiatric problems in areas with limited resources.

Patients waiting at the Health Centre
Since August last year, Ann Fursdon a British doctor working with AIM has been seeing mentally ill patients in Abeché. She has been doing one day a week at a health centre and one day at a local church, helped by Sarah, a surgeon from America. On the first day there were 9 patients. Last Thursday, we saw 60. As her reputation has grown, more and more people have been coming from all over Chad to receive care that isn’t really available in any other place in the country. There is just one trained psychiatrist working in Chad, at the central hospital in N’djamena and even he isn’t around a lot of the time.  So Ann, having always had an interest in psychiatry decided to start seeing patients, she has been getting more and more people over the past 6 months, people who have been in chains for the past 25 years, others who have been having untreated epileptic fits for 10 years, children with developmental delay which their parents just can’t understand… As more people have been coming Ann can’t cope with the numbers and wants to help other Chadian doctors and nurses to know how to provide this care. So she has organised this conference. 
Many patients are brought in in chains
The church where Ann also consults
My parents happened to hear about it while they were in N’djamena and mentioned it to me. I am particularly interested in psychiatry and never imagined I’d be able to see what providing psychiatric care is like in Chad. The conference was meant to take place last week but a few days before the flight to Abeché, Ann rang me to say that they had had to postpone it as the government had organised a vaccination campaign that week which meant that most of the health care workers that she had hoped would come would be busy. As our flights were booked we came to Abeché anyway and for the past few weeks we have been seeing patients at the two clinics, four days a week from 8 till 5. It’s been an amazing experience through which I have learnt a lot. I have been translating from English (the two American psychiatrists only speak English) into French and writing the medical notes and others have been translating the French into Chadian Arabic so that the patients can understand. Hence the three way conversations. My Arabic vocabulary has improved a lot; yesterday when the other translator was busy I was even able to translate a few consultations from English into Arabic. Though I still make lots of mistakes, I have now extended my skills of greeting and introducing myself to doing a short psychiatric consultation and telling people how to take tablets in Arabic. Useful skills!

Being in Abeché has also allowed me to spend more time with Arab women, which I have really enjoyed, it reminds me of Guinebor. I spent a couple of hours last Saturday visiting Mariam, a lady who has been helping with translation at one of the clinics. We drank sweet coffee, laughed at her three year old son and then I helped one of her friends set up a face book account. It’s an interesting paradox; she was so excited to eventually be “joining the world” that we had to entertain her baby! Today, after the Arabic service at the church where we have been running the clinics, Mariam invited Mary and I to have henna put on our hands (and feet for Mary as she is married!). I have also been able to see the amazing Chadian mountains and rocks again, I’m preparing for the next 3 and a half months in flat N’djamena!
With Mariam and Mary after a day at the clinic
It has been great to be able to be here for a 3 weeks, even though it seemed frustrating to miss even more time at the centre in N’djamena to start off with. I am very glad and thankful that Naomi and Anne were able to spare me at this busy time, I will write more about what’s happening when I get back. It has meant that Mary and Bryan have been able to get an idea of the culture and the care that can be provided before teaching and it has also meant we have been able to see and then follow-up patients and I have seen how they get better. There was one lady in particular who had been repeating the same phrase all day for 6 months. She was insulting people, calling them dogs and donkeys nonstop. We saw her in the first week and adjusted her medicine slightly, the second week she was no better and so we changed it again and then last week I saw her waiting outside, thought I recognised her and suddenly realised who she was. I hadn’t recognised her because she was silent! She shook my hand and greeted me normally. Even with limited resources it’s still possible to really help people!
A lady arriving at the church in a "rackshaw"
This experience had made me even surer about wanting to study medicine next year which is good as whilst I have been here I have also been hearing back from the different medical schools that I applied to! I am very excited to have received offers from Liverpool, Bristol and Edinburgh and am really hoping to hear from King’s soon!
Counting medicines at the church
Next week will be very different, translating the lessons at the conference from English into French. We did a practice run today, it is extremely tiring. We really hope that the nurses and doctors taking part will understand, be interested and inspired to start helping people with these problems themselves as Ann can’t do all the work by herself. The course will be from Monday to Friday and then we have a 10 hour coach trip back to N’djamena on Saturday, one day before Mary and Bryan’s visas run out! It has been a brilliant opportunity, I’m really glad to have been able to take part in this amazing work.

Monday, 6 March 2017

2 coach trips, 44 train tickets and 4 flights

Hi, I’m sorry for not writing for a while it’s been a busy few months. I had a great Christmas ( it seems a very long time ago now) in N’djamena celebrating with my church, choir and flat mates.

Boxing day dinner with friends
Over new year one of my flat mates brother’s came to visit and we all went to Am Timan to see my parents. We also got to go to Zakouma, Chad’s amazing safari park which is right next to Am Timan. It was brilliant, we got to see giraffes, lots of different deer, lions rather too close up, marabou storks, pelicans, the interesting secretary bird...


It was also a fun experience travelling as we took a Chadian coach. It was very nicely decorated on the inside with blue and white curtains on the way there and on the way back red, blue and yellow curtains to go with the Chadian flag. On board entertainment was a lot of Arab music videos and some Chadian films which were quite interesting though hard to follow as they were mostly in Arabic!

On the bus- curtains in the background
When we got back to N’djamena I just had 3 weeks left at the centre before I had to come back to the UK to do my medical school interviews. As you would expect the time flew by as I had to do some preparation, getting up to date on medical news and I wanted to finish going over the translation of the Acacia project’s course. It had been translated from English to French but Naomi asked me to take a look and try and make the French more natural. I managed to get through all 21 lessons which are now ready for the new course.  Whilst I was gone Naomi, Anne and Annie have been trying to find the right women to join Acacia and take part in the new course. They started this Thursday and I will be joining them tomorrow!

I was in the UK for about 6 weeks which is where the first two flights and the train tickets come in (unfortunately there are no trains in Chad). I had to do quite a bit of travelling as I had interviews at King’s College London, Liverpool and Bristol and also visited Edinburgh ( I have applied there but they don’t do interviews for medical school). On the whole I think they went well, it’s hard to tell but hopefully I will hear back from them soon.
So I travelled back to N’djamena on Friday, it was a 7 hour flight to Ethiopia then a further 3 hours to Chad. I’m glad to be back and happy that now my interviews are over I can really concentrate on work with Acacia.
So what will I be doing now that I’m back in Chad?
Hilton soap drying
Well I’m going to be helping as much as I can with the new course which is three mornings a week from 8 till 2.  Naomi has suggested that I may be able to help with telling Bible Stories. Also as Naomi and Anne will be busy preparing the teaching I will probably have more to do with Annie running the more practical side of the centre making soaps, cards and bags. The centre has been very busy recently as we have just got a contract with the Hilton hotel in N’djamena. They want to use our soaps in the hotel and would like us to make 2000 a month! We have got some special smaller moulds and more of their chosen essential oil- lemongrass and when I left we had made our first 3 batches. It’s hard work making sure they all look perfect and trying to get the soap into as many moulds as possible before it gets too thick- I’m sure they have worked out some new techniques while I’ve been gone. I’m also bringing back more lemongrass oil- it’s taking up 9 kilos of my luggage allowance. It’s a brilliant opportunity for the centre as it will mean the women have a regular income and publicity, we are very excited.
Our special Hilton moulds

Just before leaving for the UK I also got to visit some women in the community with Naomi and I spend some time playing with their children. Now that I have been introduced to them I will be able to go and play quite often.
I will also be back to choir practice and helping with the street children project.
I’m also going continue running a children’s club at an orphanage with a missionary friend and one of my French neighbours. We have been doing it for a couple of months and just before I left we worked on making it more structured, it’s good to be back so I can take part in all that we planned. Our theme for the month was you are precious.

Abeche is close to the border with Sudan
Finally in a few weeks’ time I will be flying again, but this time in Chad. There is going to be a course on psychiatry in Abeche a city on the other side of Chad. I am very interested in psychiatry especially in developing countries. A missionary doctor working in Abeche has invited 2 American psychiatrists who are living in Cameroon to come to Chad to do a two week course. She has kindly allowed me to take part and I will also be doing some translation work. It’s a shame it’s so soon after I come back but is an amazing opportunity for me to gain experience.
So I’m back in Chad, it’s nice to feel warm though today at 41 degrees it did feel like a bit too much! It’s really good to be back with my friends at the centre, at the choir and at home.
Camel riding with my neighbours Lucile and Estelle, my flat mate Ophelie
And Lucile's brother!