Acacia

For the past month I have been back in N’djamena, doing the work I am actually meant to be doing during my gap year! Work at the centre has changed quite a lot during my absence as a new group of women has started doing the rehabilitation course. To give you a better idea of what goes on, I have decided to take you through a week at the Acacia centre. Over the next few weeks I’ll also tell you about other things I do during the week.

In front of the centre

The week’s work at the Acacia centre starts at about 1:30 on Monday afternoon. All five women from the first rehabilitation course come to spend the afternoon making soap, bags and cards.

Soap in moulds and our buckets

The centre is actually in the same building as my flat (I really have to travel far to go to work- a 30 second walk!). On Mondays we generally start by cleaning the buckets and things which we used to make soap the Wednesday before. One lady is always there on time so I mostly help her as she sets things up and measures the oils and lye for the soap. We mix the lye with water and then have to leave it to cool all afternoon as it gets very hot. Naomi (a Northern Irish missionary who set up the vulnerable women’s ministry) and Annie (an American missionary who also works as a sports teacher at a local high school) and the other 4 ladies from the first group slowly arrive, some of them have work in the morning and finish late so they aren’t always on time.


Now that the first group have finished the initial course we mostly do practical things so they can support their families. Lately we have had quite a few orders for cards so we have been busy making sure we have enough of each type. Each order is slightly different, but thankfully Annie is there to sort everything out! We often sit and make cards all afternoon, each lady cutting out different animals from the scraps of African fabric and sticking them onto cards. I get to do mundane jobs like sticking stickers on the back of the cards or cutting out the “greetings from chad” messages.

Cards

It’s generally a nice “safe” place to be. We chat about everything and sometimes listen to music. At five we all get up and make the soap mixing the oils with the lye and pouring it into moulds. Then we tidy up, fold away the mat and everyone goes home.

Inside the centre

At 8 o’clock on Tuesday Naomi and I are back at the centre (Annie joins us later after school). We have a lesson with the second group. There were originally 3 ladies in the group; they started their three month rehabilitation course at the beginning of March. Since I have come back from Abeché the already small group has been reduced to 2 ladies. They generally arrive on time and we start with a Bible Story which I tell using big story books made by WEC, a missionary society. We have just finished going through the story of Moses and the Israelites going to the Promised Land and have started on the gospels and Jesus’ ministry. I read through the story then we go through it together and discuss what it teaches us about God. Then we have time to share prayer requests and pray before we have a short tea break.

Annie generally turns up about then and we do some “sport”: stretches to wake ourselves up before Naomi teaches the lesson of the day. Naomi is teaching the three month rehabilitation and counselling program which goes through varied and essential subjects to help the women gain life skills. We have talked about our value in God, limits, truth, forgiveness and many other subjects. Anne (an Australian missionary) has been helping her but has just gone on a break for a few weeks. I help where I can and read Bible passages. We go on until one o’clock in the afternoon.

Soap drying

On Wednesdays we meet again in the afternoon with the second group.

We tend to do pretty much the same things as on Mondays, cleaning the soap buckets, measuring oil… We also have to cut out labels and cloth to label the soaps after they have dried for 6 weeks so that they are ready to be sold.

We also make bags. The ladies are mostly able to make the bags at home now so all we do at the centre is cut up the cloth.

Using the new sewing machine

Lately they have also been making bags at the centre using our 2 new sewing machines. Rebecca (a lady from our old church who used to cook for our family at Guinebor) is also a seamstress and has been teaching the ladies how to use the machines. Some like it more than others but they all seem to be doing pretty well.  On Wednesday’s Naomi or Anne also do a short Bible study with the ladies. At the moment we are studying Ephesians. We hope that these ladies will share their experiences with those around them and that they one day may be able to run the centre by themselves. After the study we make soap again and finish at about 6.

Bracelet made with you-yous

On Thursday mornings we are at the centre with the second group again. I tell the Bible story then we do some crafts so that the ladies have time to go over and think through the things Naomi talks about during the lessons. So far we have made jewellery using homemade paper beads and small decorative flowers made from fabric which we call you-yous. We have also started making cards as the idea is that in the end this group will join the first one. In a few weeks’ time we are planning on making candles. We have our tea break and chat and listen to music.



Woman making cossey

On Fridays we are at the centre with the second group again. We tell a Bible story, have our tea break for which I go with one of the ladies to get cossey from across the street. Ccossey are deep fried doughnuts made with crushed beans which we eat with a sauce made from chili peppers. Often when we go the lady has only just started making them so we wait a while sat under a tree chatting and watching everyone walk by. When we get back we eat, drink tea and chat together. After the break and some sports or dancing we have a lesson like on Tuesdays. Around midday we finish, wish each other a “bon weekend” and lock the doors.

 

The centre is quiet for a couple of days.



You-yous

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?

Consulting

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!



Henna!

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.