Old Habits Die Hard

It’s been 3 weeks now since I blundered out of that Ethiopian flight #0500, so happy to have fast mobile internet, burritos, and English. Now I can’t say that I had terribly bad reverse culture shock but none the less, there have been many times that I forget I am in the land of the free and home of the brave.

1) I don’t have to translate into another language for my day to day duties. I catch myself thinking about phrasing, gender, and conjugation when I’m looking for an item in Target.

2) Whenever I have to go pee, I look for the closest bush or door to outside before realizing I have a regular toilet in my house. Thanks to Nick, Allah, and Kim, I’ll now have that luxury when I arrive next week!

3) I start thinking what my friends and family would be doing 8hrs behind and then realize that we are in the same time zone.

It’s been really great being able to chill with Giada and Ina Garden with my cats everyday. Though everyday there seems to be something related back to Chad, I’m still getting a great vacation.

Feel free to give me a call on my cell here: (530) 927-7970! I’ve got exactly a week before I’m flying back!

Photo updates!

Caught in the rain in our makeshift umbrella.

This is what happens when the moto stops in the rain!

Our most of a group shot at the welcome to Béré sign.

Diana practicing her selfies at lunch time.

Post-rain view of Netteburgs’ house and awesome tree.

Zachary Gately
zchgtly@gmail.com
zgately.com
+235 91122492

L’Hopital Adventiste de Béré
ATTN: Zachary Gately
52 Boîte Postal
Kelo, Tchad
Africa

Half-way and Demonic Possession

Wow. We are over halfway through this journey of a year. The halfway point was actually March 14. It was a quite day. Nothing really out of the ordinary. A friend from undergrad is in Moundou now working with Scott and Bekki Gardner, Olen’s aunt and uncle. He came up to see Bere with Scott and it was good to catch up over the weekend.

I wish I could say that I had some great epiphany hitting this halfway point. I wish I could say the pieces have come together perfectly but between illness of mulitple people and political hang-ups and the general slowness of how everything often happens here, it has not been a smooth journey thus far.

But things are happening and progressing regarless. We have almost finished our lectures in all the quartiers and we are getting ready for our final meetings with our workers and the chiefs. The student missionaries are leaving three weeks today for good and Charis is leaving for a couple of weeks a week from Sunday. It will be different not having them around any more but I think the project will take some new turns that could be pretty interesting.

We have been having some interesting events happening recently. We have had over 20 girls come in for demon posession to the hospital over the last 3 weeks or so. Most are carried in by force and eventually they seem to come around. Its hard to know if it really is demonic possession or if they are faking it. There has been lots of controversy around this between the church, the schools, the government, and the hospital. The Chadian government shut down the entire school system for a week because of these happenings. It is interest because they are all girls around 15-18 years old, Christian, and the episodes don’t last very long.

I don’t know what to think because I see two sides. I have witnessed some very real spiritual things here but I have also seen how manipulative other people have been. I wish it was clear what to do but when people you know are biting other people in an attempt to run away, its pretty crazy. Some clearly are faking it where as others are either really good actors or there is something not right. Why would anyone want this kind of attention? Why would people think this benefical to their lives?

It will be nice to have these happenings finished so that school can go back to normal and parents don’t havae to worry about their daughters. Craziness is always ensuing here but that what happens when you sign-up to live here I guess.

Zachary Gately
zchgtly@gmail.com
zgately.com
+235 91122492

L’Hopital Adventiste de Béré
ATTN: Zachary Gately
52 Boîte Postal
Kelo, Tchad
Africa

I’d be Lai-ing if I said it wasn’t fun!

So as many of you know, we work very closely with our Traditional Birth Attendants and Community Health Workers. They are not paid by us. Either their hearts are open to aid their communities or they just enjoy having a title. Regardless, we make sure they work and we have enjoyed their enthusiasm. We completed the CHW trainings in December and the TBA trainings will be finished within the week.

One thing we do compensate them with is supplies for working. We give non-sterile gauze, tape, bleach (for bleach water solutions), and a few other tools. Each Friday is restock day for 25% of them. They come in and we look at what they have done that month. We determine what supplies they need based off of what work they have done and restock them.

Some of the things they regularly see are cuts, pregnancies, and malaria cases. For malaria, the best predictor seems to be flu like symptoms plus a temperature of 101F or more (38.3C). So we have given them all thermometers to use. These are the traditional glass armpit ones. They have had a rough time reading those small blue lines because 1) many of them have no higher than an 8th grade education and 2) many of them need glasses badly.

Needless to say, I had to jet over to Lai (17 KM east) to the hospital supply store for more tape, gauze, and thermometers. Our moto doesn’t have the proper papers to leave the district so I had to take a taxi moto. That was an adventure but it was a much needed distraction. Tensions are high at the hospital as big decisions are being made about leadership and as many of the Nasara’s are looking forward to their annual leave (in April, it will be me and and the Netteburgs).

As the wind is blowing through my hair that needs a haircut we see one moto go down as he hit a sand pit. We see huge trucks fixing the road. We see the nomadic Fulani people traveling. Adventure only a few minutes from home!

We arrive and I can’t quite communicate that I need the hospital supply store. I have never been there but after a few questions to locals we find it. The guy inside is nice and quickly processes my order and I’m out in a flash. I run over to the Alimentation Oaisis to buy things like olive oil, cheese, and a new melange of green and mint tea. Then over to the “hardware” store for varnish, rope, and paper. These are all things I cannot buy in my little outpost of Bere. The hardware man like us in Bere so he throws in a brush for free! I’ll take it!

The ride back was about as eventful as coming with the exception of no accidents. It was just so nice to get away for an hour and enjoy the freedom of the road! It is necessary to have these little breaks (even work related!) to stay sane.

Like I said, I bought thermometers. We have a joke with our CHW/TBA’s about how to tell the difference between rectal and oral thermometers (its taste!). But some how I still bought rectal ones! I have no use for these but at these times, all you can do is laugh and make another trip to Lai. haha!

I am pumped for next week as a couple of us will be headed up to N’Djamena for a little pleasure and a little work. We can’t do much research due to internet speed here but up there we can! So look forward to some more pictures! I was actually able to get some posted last weekend (timing is everything, i.e. 4 am) on the blog at zgately.com. Go check them out and have a good week!

Zachary Gately
zchgtly
+235-9112-2492
zgately.com

L’Hopital Adventiste de Béré
ATTN: Zachary Gately
52 Boite Postal
Kelo, Tchad
AFRICA

Olympic Lectures

For the past five weeks, we have been going to every neighborhood or quartier to deliver health lectures to the community. While there, we meet with the delegate (chief) of the village and his assistants. We then deliver nine lessons over two days followed by questions and demonstrations for the members of the quartier. If we are lucky, the chief will feed us tea and gateaux after the lecture or even a full meal of rice and sauce.

At all these lectures, we are blown back at how many people come out to listen and are ready to participate. We have nursing mothers, children, and high school students mainly but there are also many men and older people too.

Our lectures were developed by some previous volunteers here at the hospital and we have tweaked them as we see fit for the community. For answering questions, we reward them by handing out toothbrushes and toothpaste. We have lectures from Maternal Health to Malaria to Family Planning. Our Student Missionaries have done a great job thus far of assisting in the delivery of these lessons.

We have had several community members say how impressed they were with the lectures, giving sincere gratitude for the little lessons. Most wish they knew these principles when growing up so they could have taught their children. This is not me tooting my own horn here. It is to show that even though we may see these princples as simple and common sense, many people have never been exposed to the radical idea of prevention.

Honestly though, this is not much different than in western countries. Instead of not knowing what to do, we know what to do but refuse to do it. We eat that extra side of fries at night and skip the early morning run the next morning. We stress out and freak out without any type of release.

Jamie is an awesome handyman and actually rigged the satalite for the Olympics! Sunday, I was able to watch a few events and was in awe at their dedication, skill, and even enjoyment! That is how I want to be: I want to love what I do, be healthy, and enjoy the balance of eustress, rest, fun, and food.

So here’s to the new year (well, whatever…)! Here’s to working hard but also playing hard. Here’s to giving back to the community you live in and participating in it. Here’s to just being you! Who knows, we may just end up in Brazil or South Korea for the Olympic Games!

*if anyone can tell me how to become a biathalete, I would be more than greatful. Researching here is a bit tricky.

**if someone wants to help with my taxes too, that would be awesome.

Johnny and Naomi talking about Maternal Health in Tcha-Asse.

Zachary Gately
zchgtly@gmail.com
zgately.com
+235 91122492

L’Hopital Adventiste de Béré
ATTN: Zachary Gately
52 Boîte Postal
Kelo, Tchad
Africa

Trying to Pack a Pachyderm

Packing has always hit me hard. It’s the one area that I am ever so slightly OCD about. Packing for a weekend requires at least a basic list and one repack. If I am packing for a week, the list is a bit more refined and requires probably one to two repacks. And when I am packing for trip requiring special equipment like a suit or cold weather layers, I have been know to repack upwards of five times. So, as I am preparing to pack for two years, should we take bets on how many time I will rewrite and repack? Hmmmm…

So I’ve been able to find most things on my (current) list: hammock, insect repellant clothes, tooth paste, multivitamins, toilet paper, biodegradable soap, iPad, and maybe a few pens. But the other essentials like underwear or socks or sheets or meal replacement haven’t shown up in my shopping cart yet. These items are needed before I leave this current home as there are no Targets or Whole Foods Markets in Béré, Tchad. Four weeks should be enough to find it all, right?

Moving to another continent for a new job in a different culture without online shopping is going to be a life changing experience. Not necessarily in the iconic “I-live-in-a-developing-country-so-I-have-an-even-stronger-savior-complex” experience that people share up front at church about. I hope to develop my skills of a communicator and program planner. Throw in French and basic Arabic along with a smattering of local languages and I’ll truly never stop talking. Writing, planning, administering, and evaluating a grant funded project will most like cause a few mental break downs followed by amazing data that can hopefully change the way public health is viewed in this region.

I’ve never been to this region of the world but I can tell you that I am ready to see what happens! I may not be packed yet, but as I walk on to that plane as it departs Reno International Airport and try to get some rest on the following four flight, I know I’ll be ready for that adventure!

Public Health is Important too!

*DISCLAIMER* I have lots of medical students as friends, I respect their ambitions, I see the importance of the career, and I know they work very hard to earn their medical degree. With that being said, please read with understanding.

I am not new to the notion of spending holidays away from my immediate family. I have spent every holiday away from family at least once, due to both choice (ie, I wanted to go travel) and to distance. Regardless, I can say that I am extremely thankful for my family, as they have supported me throughout the myriad of locals I have lived in and career choices I have brought up.

This Thanksgiving was one of those distance holidays. I had school on Wednesday so there was no way I was going to drive the 10 hours home for only 3 days. I am lucky to have my aunt, uncle, and cousin living just down the road but they weren’t doing a traditional meal this year since 1) my uncle is British, 2) who wants to cook all those dishes for only four people, and 3) we are all vegetarian. Our new family tradition is to make gourmet pizza, drink Martinelli’s, and eat apple pie. There’s much less clean up and we can move afterwards.

Still wanting some yams, dinner roast, and hot apple cider, I ventured over to the second annual “Orphan’s Thanksgiving,” reserved for those whom do not have immediate family within traveling distance over this short break. There we dived into a traditional dinner, complete with a deep-fried turkey, green bean casserole, and so much more food. The highlight had to be a dessert combination of cookie dough, double-stuffed Oreos, and brownie mix baked together.

Since Loma Linda University is a world recognized instituted (and SDA’s have lovingly called it the Adventist equivalent to Mecca), we had students represented from every school who could not go home for this holiday at this Thanksgiving feast. Among them, there were two medical students who caught my attention as they were saying their good-byes. They found out I was in public health and did the whole, “Oh. That’s nice,” with a sympathetic smile.The first medical student proceeded to name the one person in the SPH and I happen to have all my classes with him. He is also in medical school, taking a year to do his MPH in preparation for a career in infectious disease. As the conversation continues, the first medical student mentions that, “it is a nice certificate. A really good add on.” Now, I have worked both with doctors who love public health or don’t see any point in it and I can see where they come from.

But let me tell you: I am working hard for my master’s level degree. I have taken all the same science classes as the medical students as well as the MCAT but found that public health is where I want to be. I plan to continue to work hard in my field, taking care of what doctors do not have time to do.
The other medical student also shot himself in the foot as he continued to agree with the first medical student on how they don’t have time to really learn how evidence based medicine really works. He literally said that it was a good thing they had a recent MPH graduate on their research team or else they could not have found out if any of their research was even significant without her expert knowledge. If he did not have the time know learn how this works (mind you, this was during the summer which means no classes) then I am worried for when these student start practicing medicine. I want to know that my doctor has a solid understanding of why and how and if a medication or procedure will work, not just a hunch that it will work.

This situation is one of many I have recently had of how others with (or in this case pursing) higher degrees, neglect to recognize the importance of public health in the medical task force. It brought to mind several thoughts that I am personal having trouble dealing with. The largest one is what am I doing after I finish? I love public health. I also am very interested in the clinical aspect of health. I also love research, organization, traveling, history, etc., etc. The list could go on but I am still heavily considering a career in medicine, politics, or straight public health. The lack of awareness about public health in medicine both attracts me to and detours me from it.

The Thanksgiving medical students were just the example how both fields need to be better educated of the others’ world and how they need to work better together rather than so far apart. Public health needs medicine and medicine needs public health. So regardless what career I end up in, I will always have the respect to acknowledge and respect someone’s career/educations choices rather than saying it’s a nice addition.

“Now you are the body of Christ, and each one of you is a part of it. And God has placed in the church first of all apostles, second prophets, third teachers, then miracles, then gifts of healing, of helping, of guidance, and of different kinds of tongues. Are all apostles? Are all prophets? Are all teachers? Do all work miracles? Do all have gifts of healing? Do all speak in tongues? Do all interpret? Now eagerly desire the greater gifts.” 1 Corithians 12:27-31

 

High schoolers and Global Health

It’s been a busy two weeks! I finally made it to the beach this year and it will not be the last! A group of the new Global Health cohort wanted to visit the golden coast and we could not have picked a better day. Clear skies with a slight nip in the air provided the proper person-to-beach proportion. There were a few naked Europeans wading and inner city kids who didn’t know what to do with the water but over all it was simply a calm in the midst of a busy quarter.

 

With midterms last week and finishing up my telemarker job for the School of Allied Health (I hate calling and asking for money!), I was ready for that extra hour that daylight savings provided. Even then, Sunday was crazy busy with our quarterly My Campus event. This event focuses on minority youth in the local inland empire, exposing them to the health science professions, and mentoring them. This quarter was uniquely great due to the fact that the School of Public Health was featured. Since I am a Student Association Representative and I work for our Community-Academic Partners in Service (CAPS), I was recruited to lead out in our Global Health Booth.

 

As the high school students rotated around to the different booths, we had many of them very interested in Global health. The students’ aspirations varied from those who didn’t want to graduate from high school to others who were dead set on becoming neurosurgeons. Thankfully, most students seemed very interested in global health and what it could do for them. They were thrilled to know how Global Health could be added on to their current dreams of physical therapy, nursing, medicine, dentistry, or business. Later in the program, there was a “speed networking” time and most of the students had a great deal more questions on how they could incorporate Global Health into their lives.

 

It is encouraging to see that so many people are interested in Global Health. The most important thing that I wanted these students to realize is that that Global Health is not so much a degree as it is a life choice. A Global Health Professional is simply someone who works with a variety of cultures in some aspect of the health field. Research based or clinical practice, it all comes down to a life of service and a drive to work in a culturally aware environment. 

Adventure Starts Now!

Well, that may be a lie. Its already week 5 and there have been plenty of adventures causing lack of sleep, great smiles and memories, along with a few “moments,” challenges, and cramming. I can’t believe that time has flown with this velocity. Somewhere along the way I should have hit my stride of Fall Quarter 2012, but I completely missed it.

Like you’ve seen in my past blogs (or you can read them here), I thrive on routines, lists, and time management allowing me to play all the more in between these set items. I just ordered something like 3000 sticky notes, I put up my white board, I have linked my iCal, Google calendar, and Microsoft Exchange calendar all to my phone and to each other but somehow I still can’t drag myself to run or even get to class on time.

Its really just a mind set. Though I have not taken HPRO 509, our health behavior class, I have glanced through the text book and see what I need to do to get myself going: I need a goal. A marathon to train for, a test to study for, a job to work hard for, anything to get me to keep something consistant to wake up and keep a daily routine. It seems easy to do but I’m just not feeling it quite yet.

There is a little bit of that feeling. I’ll do it for a couple of days but then I’ll miss a day and then I am thrown off. But here’s to change. Here’s to keeping that feeling going. To get in that grove and get on that adventure!