Senegal 1: First impressions

Tuesday

Arrived in Dakar late, almost midnight. First impressions of Senegal: Humid. Disorganised. Dirty. Everyone seemed to speak rapid, thickly-accented French. Interesting contrast of friendliness (airport staff helping us locate lost luggage) with dodginess (man at airport claiming to be the son of our driver, a common bag-snatching scam). There appeared to be only one sealed road during our hour-long drive to Thies, second-largest city in Senegal and our home for the next 9 weeks.

To minimise culture shock, we were to stay our first couple of nights with Dr Ted, a US surgeon of Japanese origin, and his wife Colleen, before moving into our own place. They helped us get used to the Thies way of life. Boil the water, then filter it. Bleach the vegetables. Flame the bread. Tuck the mosquito net under the mattress. We had our first bucket shower of the year.

Wednesday

We toured the hospital, our eventual workplace. First impressions of the hospital: Humid. Disorganised. Dirty. Everyone seemed to speak rapid, thickly-accented French. We met nurses, students, the cleaner, the lab guy, the pharmacist, all of whom looked the same. Ben, a British medical student, took us on a tour, the key points of which were the timing of lunch and the location of the good toilet and the drinks. This was followed by a vehicular tour of Thies, which was a disorienting maze of identical streets lined with ramshackle concrete houses, muddy puddles, and dusty Africans. Bucket shower number 2.

Streets of Thies.

Thursday

Moved into our designated house, recently vacated by a missionary family from Brazil. 3 bedrooms (A/C in the master), 2 bathrooms, front-loading washer, gigantic living room, intermittent cable TV. 20 year old security guard living in granny flat outside. Pros: Normal shower. Cons: House located in area of extremely high mosquito density. Killed 20 mosquitoes from 1 am to 3 am prior to sleeping under a somewhat hole-y mosquito net.

Spacious living area.

Friday

To reduce mosquito intrusion, spent morning using a spoon to push toilet paper into crevices around bedroom windows, prior to our orientation day at hospital. Got lost walking in and arrived 20 minutes late drenched in sweat. Introduced to the staff as les deux medicins honoraires d'Australie. I was designated as un specialist de medicin internale. Vicky was to shadow Dr Adamson, the Zambian anaesthetist/paediatrician, while I followed Ted, who saw a handful of consults before heading to theatre.

En route to work.

It had been 4 years since I had last been in theatre, so I was no longer sure if doing a circumcision under local anaesthetic was the done thing outside of Jewish circles. My job was to pass instruments and hold the 3 year old down. He was initially quite calm. Initially. Once the scissors made their first snip he became a screaming demon. He began to wriggle frantically and managed to escape his restraints (he was tied to the table). I recaptured his limbs and applied the bonds tighter but his writhing made aiming difficult for Ted. Difficult but not impossible. I fetched a third person to immobilise the pelvis. More local. More snipping. More howling. It seemed like hours. It probably was. At one point the child tearfully whimpered in Wolof: "They're destroying me ..." Finally, several tactfully-aimed sutures later, the destruction was complete.

Next, three gastroscopies. No sedation (the norm here). My role: to hold the mouthpiece in place, to ensure that the patient did not bite down on, and therefore destroy, the endoscope. Consequently I was also best-placed to wipe up the drool. Admirably each candidate managed to endure their procedure without asking Ted to stop more than thrice. Afterwards, was chuffed to discover Vicky and Ben had saved me some of the communal fishandrice, which was consumed rapidly despite the prior roosting of several flies.

Evening was considerably better. Invited to a friend's house for lasagne and ice-cream. Later at home, managed to somehow fix the cable TV, and discovered that the toilet paper had kept all the mosquitoes out.

Saturday

Woke up at 2 am. Chills, sweats. Vomited 5 times, breaking a 9 year streak. Spent the entire day resting and dealing with gastro. Luckily had cable TV. The wonderful therapeutic effect of Inspecteur Gadget in French cannot be underestimated. First home-cooked meal: instant noodles and "luncheon meat".

Sunday

Church. All in French, which made the sermon quite difficult to understand. May have been the dehydration. Lots of smiley faces and hand-shaking. Boiled our first pot of water for the filter, and discovered white calcific sediment on top, which explained the white calcific sediment in yesterday's noodles. I thought it was egg.

Just like a bath ring.