The one who speaks on his own authority seeks his own glory; but the one who seeks the glory of him who sent him is true, and in him there is no falsehood.

John 7:18

I leave the ship tomorrow. It’s so surreal that time has passed so quickly, yet it feels like I’ve been on the ship for a long time. We got temp-stranded on an island, I got to experience my first hospital emergency, ate some tasty treats, learned about obstructed labor, re-discovered Chick-fil-A sauce, died in a fire, started a ship-wide controversy, ate more tasty treats, worked my last shift, saw what 2 million GNF looks like in cash, and brought down the house during ship-wide karaoke.

🏝 🛶

Let me tell you our West African island adventure brought to you by boatman Camara.

Laura arranged a boat for another trip to Roume. I went there before and it was soOOOooo beautiful and it had been a while since I went, so I signed up to go with since I had the weekend off. We booked with Keita (a guide) who then arranges with a boatman to take us to the island. There’s a public ferry, but it only stops at (a different) island three times a day. It’s cheaper, but also it’s known for being West African crowded, so we opted to hire our own boat.

On the way to the fisherman’s port, I saw this group of chickens with two kittens running wild on the side of the road. The kittens I’d guess were barely a few weeks old from how small they were. So cute, though!

The fisherman’s port (more like a pier) has all sorts of really colorful boats. We got there at high tide. This will be important later in the story.

People set up shops and stalls in the port to sell all sorts of goods from clothes, hats, snacks, trinkets, and sunglasses. The port and water are saturated with rubbish. It’s everywhere to be seen, and garbage is disposed of casually on the ground and into the sea at people’s convenience because there’s no good public waste management program. Not just in the port, but all over the city and roads, garbage is thrown on the ground and then swept into piles before being set alight. Broken fishing nets tangle easily with all sorts of rubbish and wash in and out with the waves. It’s quite a heartbreaking sight to see, and it makes me wonder how much of the environmental burden in the world the single-use plastics and things in the ocean are from underdeveloped areas and how much are from developed countries like the States that have resources to implement and enforce laws and alternatives to reduce their impact.

We went to Roume, which is an island situated behind Kassa, the island closest to Conakry (noted off-map by the anchor in the northeast of the map below). Tamara (also known as Fotoba), is further out. This is also important to note for the story.

We met up with guideman Keita at the fisherman’s port, and met another guide that worked with him named Mustafah, with whom we exchanged the usual pleasantries. We paid Keita beforehand because this time he was going to be going to Kassa and not all the way to Roume with us because he had business on Kassa island. Keita assured that the boatman was hired to wait for us at the island and he was just tagging along to get to Kassa. He already arranged everything and Rachel and Laura had already done two excursions with Keita, so we knew he was a reliable guide.

In any case, we finally clamber into our boat after waiting in line for a few other groups to leave. While we’re loading our boat, another group (we don’t know them) is loading the boat next to ours, climbing through our boat to get to theirs. But we finished loading first, and our boatman Camara starts pulling out from the pier, with some late-20s dude from the other group still trying to jump into the other boat (which is going to Kassa). We yell at boatman Camara to slow down so the poor clumsy guy has a chance to jump into the next boat, but in typical African fashion, he just keeps moving as people are trying to get in and out. The dude finally gets in the boat at the very last moment and we go on our way.

We spent some extra time to drop Keita off at the Kassa port, which is about halfway down south the eastern shore (you can see a long pier sticking out). Since we weren’t going around the northern side of the Kassa directly to Roume, the boat ride was considerably longer distance than the last time I went.

The seas were choppy due to the tide, so it went a bit slowly so we wouldn’t destroy the boat or tip it over from going too fast over waves. Eventually we made it to the island after a pitstop at Kassa to drop off Keita. Boatman Camara asked us when we wanted to go back and we told him to meet us on the beach where he dropped us at 3:30pm to head back to Conakry.

The sun was really cooking on Sunday! I even got a little sunburned on the tips of my ears, cheeks, and tops of my shoulders. But the water was super cool and it was really nice. Good times.

We packed up and head back to the beach 3:20pm to go back to the beach, and boatman Camara is no where to be found. We wait a while, but by 3:45pm it’s clear that he’s not around. We call guideman Keita, who says that boatman Camara is on his way, and to wait a while.

We see someone bailing water out of a green boat like the one we took, so we ask some locals if they know where the boatman is. A lot of yelling in local languages. No one knows. We call again, and we find out boatman Camara went to take some people to Fotoba island and then the tide went out so he was having trouble launching his boat again. We’re told to wait some more.

Then! Mustafah walks up to us and asks if there’s something wrong. We tell him that boatman Camara has left us and gone to another island and left us stranded on this island until he can come back. To make matters worse, we’ve already paid and so we don’t want to pay twice because our boatman didn’t honor the agreement to wait for us. He angrily asks for us to call Keita because “this boatman broke the contract and he needs to know we should not hire him again! I want to talk to Keita about this!” He takes the phone and passionately makes his case and then tells us the same thing: wait a bit longer.

In the typical warm African fashion, they bring us into the shade of the village and have us sit more comfortably while we wait. By this time it’s almost 5pm, and it’s obvious we won’t be back before dinner stops serving. TO MAKE MATTERS WORSE IT’S PIZZA NIGHT no one wants to miss pizza night (it’s been 8 more weeks). So luckily we have a phone that we can use to call reception to tell them to save us pizza plates. Bless reception.

Eventually boatman Camara walks up to where we’re sitting in the village and this middle-aged man in a Led Zeppelin t-shirt, swim trousers, and flip flops starts ripping into him (presumably about trying to earn even more money by taking a side job and not honoring the agreement to wait for us). It’s goes on for what seems like several minutes and we’re just sitting there awkwardly as this plays out. Eventually, Mustafah tells us to follow him because he’ll bring us to the boat and take us back. We find out Led Zeppelin guy was the village chief and he was really upset because of how hard he worked to make a partnership with the ship to get people to come visit the island and things like that.

Anyway, we walk over to a private beach (got yelled at but what can you do, boatman Camara parked his boat there) when Mustafah asks if we can take his sisters back to Conakry, so they get in our boat, too. We also ask to make sure that we aren’t going to stop by Kassa to pick up Keita, but going straight to Conakry, which he confirms. We leave the island a little past 5pm.

As we approach Kassa it’s a bit clear that our trajectory puts us close to Kassa and not in the direction of Conakry. We tell boatman Camara that we’re going to Conakry and not Kassa, but then he tells us he’s out of petrol for his boat motor! WELL YOU KNOW, IF MAYBE YOU HADN’T TAKEN A SIDE TRIP TO THE NEXT ISLAND OVER WE’D HAVE ENOUGH PETROL TO GET BACK TO THE PORT. But foresight is not boatman Camara’s strong suit as we have seen so far.

So we get to Kassa and as we approach, boatman Camara yells for “Essence! Essence!” at the top of his lungs over us and then his second mate hops out of the boat and basically swims ashore to grab three 1L glass bottles of clear yellow oil, pours it into the boat motor and then wades back to pay for the gas and then wades back so we can turn around and keep going. Meanwhile, there’s this really sick ship wreck right off the shore:

We pull into port and watch these fishing boats unloading nets and nets full of fish!! It’s super amazing and I don’t have a super great shot but there’s soOoOoO many people standing on two boats and there are just fish flopping from one to the other from the net. It was super awesome. And their boats are super colorful and have all these cute little flags and I love it.

We finally get closer to the pier, and a bit away from the pier there’s these four people taking photos on a rock that they’ve hopped out onto from the edge. They’re not dressed for water sport at all and the boys are holding their girl’s bags like the typical Instagram boyfriend. They’re surrounded by (shallow) water, maybe knee deep.

Why do I mention these people? Because our buddy boatman Camara just plows straight into the rock that they’re standing on and they all go down. Like we could hear and feel the rock scraping up the bottom of the boat. We’re yelling, second mate is yelling, the people are yelling, it’s nuts. Then they stand up and things are fine. Then boatman Camara backs it up and then plows into the middle of four boats to get to the pier. He does not aim very well and we are not even the boat closest to the pier. So we have to climb over another boat (which is also not up against the pier) and jump from the edge of the boat to the pier.

We’re finally on solid ground again and I notice that the local guy holding the mooring line for the first boat is wearing a UNC Chapel Hill shirt!!! I get all excited and snap a pic. He didn’t seem as excited as me to see UNC paraphernalia from across the pond, and may not have really recognized it, though when I asked if he went there he said, “oui” (yes). My guess is probably not, but who knows. Anyway, UNC is everywhere (hail hydra).

Anyway that encompasses possibly the most African experience I’ve had. What a great day.

☕️ 🍪

Esther made me a cuppa cocoa and drew a cat with chocolate syrup. It’s easier to see if you ignore the third eye on its forehead.

Also we had another Asian party with the updated Asian crew and Niña made this awesome egg custard cake and more of those awesome plantain spring roll things.

April just happened to call while I was at the party, and so she got included in the selfie! She was packing after finishing her stint at Tenwek hospital in Kenya, and she’s off to her big next adventure!

For my last week of work we had the usual party with treats with the HSS department + biomed (classic) + infection control (Lizzie). Kathy made these AMAZING cookie + dark chocolate + raspberry cheesecake bars. They were soooooo good. I should get the recipe she used for them.

🚨‼️🚨

I got to experience my first somewhat crazy hospital emergency! We had an emergency admission from the dental clinic for lady who (presumably) had a bad tooth that just abscessed really severely. To the point where the abscess (infected tissue, filled with pus) spread down her jaw, across her neck and was swelling and threatening her airway. So even though she wasn’t a patient that was being evaluated for surgery, the dentist saw how close this lady was to dying from it and sent her to the ship for surgery.

They operated and the operation went alright, but the patient crashed later that night, needing fast labs to isolate the problem and see what was going on. Kathy got paged and then she called me in to help. We had to issue blood because her hemoglobin dropped drastically (luckily we did her blood banking when she had surgery), but then we weren’t sure how much blood she might need so we had to pull people out of bed and off the ward to donate in case she would need more.

They were all such good sports about it. It happened to be right at the time of shift change (10pm); both Mary and Anna were coming off their evening shift and came in to donate. We pulled Tam (most Aussie of Aussies) out of bed, too.

We didn’t go to bed until 1am and still had to wake up for work the next day, but it was super exciting and I’m actually kind of happy I got to be involved in it. The patient is doing much better now. :)

🔥🔥🔥

Last week here, last fire drill! Coltan let me be a victim again for one last hurrah. We also shook it up with having two real-people victims (as opposed to the dummy), the other being CLAPDOG!! We finally got a second hospital physician so she did the super nice thing of removing her own experience from the emergency medical team so that the hospital physician can get her feet wet all by herself. How considerate.

Coltan did some really hardcore special effects makeup to give us some sick burns. Food coloring, cocoa powder, Elmer’s glue, sugar, water, and toilet paper.

It looked super gross and realistic when we put it on at first, but then as it dried and stuff, the sugar in the mixture started crystallizing and giving us a weird tan crusty layer. Eugh.

The situation was a container fire. Laura had a broken leg from falling from above after smoke inhalation, and I was inside the container with altered mental status after failing to put out the fire and .

Unfortunately… I died. They found Laura immediately because she was situated outside of the container, but after the team put out the fire inside the container, they didn’t check a second time after the smoke cleared and so I wasn’t discovered. Eventually Coltan said, “hey, is there anything else inside the container?” and then they opened up the door more and looked inside and someone went, “Oh my gosh!! There’s another person in here!!!” then we continued our simulation as if I had been found immediately.

It also was my last day (cookie raspberry cheesecake bar day), so I had to go take a shower after the drill and clean up so I wouldn’t have this nasty glue-sugar skin peeling off all over the tables.

💵

Ever wonder what 2,000,000GNF looks like?

🤰

We had a really good talk on neonate and maternal mortality due to obstructed labor for our medical in-service this week. It was hosted by UK physician Dr. Liz Goodall, one of our women’s health doctors, with more specific surgery questions answered by Dr. Itengre Ouedraogo, a surgeon from Burkina Faso, a West African country about two country hops east from Guinea.

Our women’s health “season” started this week. The surgical treatment aims to repair obstetric fistulas, which is a condition that rarely happens in the developed world.

The medical in-service shed a lot of light on the disparity of prenatal and postpartum care in the developing world. It is estimated that in 2015, 303,000 women died due to pregnancy and childbirth, about one every 2 minutes. In a low-income nation, maternal mortality is about 239 out of every 100,000 live births. In high income nations, that number is closer to 12.

Causes of death can be direct (such as postpartum hemorrhage or eclampsia), or indirect (underlying medical conditions are worsened or reveled by pregnancy). In high-income areas, most (~70% in the UK) maternal deaths are due to indirect causes. This is because things like prenatal care, access to pre/during/post labor care, access to clean equipment and facilities all help prevent direct causes of maternal mortality. In low income areas, the lack of these things are compounded by other factors, such as women’s lower status in the family means they eat last during meals, leading to less access to nutrition during fetal development and pregnancy. They continue to work physically demanding jobs while pregnant. Oftentimes women are married off earlier and have children before they themselves are fully developed which leads to increased complications. Transportation is difficult, unreliable, or incredibly far.

Simply put, obstructed labor happens when baby gets stuck. Could be because baby’s head is too big, mom’s pelvis is too small, baby sits at a weird angle or is turned improperly, and so on. When obstruction continues, it’s a major cause of maternal and newborn morbidity and mortality. Risks include asphyxiation of the baby, cerebral palsy, birth trauma, stillbirth or neonatal death. The mother becomes exhausted and dehydrated from continued labor for days, and the continued pressure of the baby on the uterine wall can lead to uterine rupture. Mom can also have postpartum hemorrhage, develop an obstetric fistula, sepsis, psychological morbidity, or death.

An obstetric fistula is a hole develops in the birth canal which connects to bladder, rectum, or ureter. It develops due to prolonged compression of tissue between the baby and the pelvis, leading to tissue death of the birth canal. It is preventable by having a C-section and ending prolonged obstructed labor, which is not easily accessible or affordable to women in low-income countries. Women who have obstetric fistulas develop chronic urinary or fecal incontinence, and are shamed and rejected by their husbands and community because of the constant dripping of urine, feces, and/or blood results in a foul smell. They are unable to bear children, which is devastating for women who live in a society where a lot of their worth is determined by their ability to have and raise children. 

The surgical aims to achieve closure of the fistula. For women who have suffered for a while, it’s likely that they’ve had previous surgeries, with each subsequent one decreases the chances of success. From the comments from Dr. Itengre, the surgery itself seems a lot more complicated than sewing a hole shut. In addition to the surgical intervention, there is an incredible amount of emotional and mental healing that also needs to take place for the women that come through the women’s health surgical program. An interesting talk overall, and another insightful look into something that I didn’t know existed, as it’s nearly unheard of it in the developed world.

👥 🍽

The last week was full of just chill hangouts with friends, old and new.

YOU SEE THIS BAG???

THIS WHAT WAS INSIDE BLESSSSSSSSSSSSSS. Esther made chicken fingers and it was amaaaaazing. I had forgotten the delicious taste of liquid gold on my tongue. Thanks to Diana’s secret stash that apparently got mailed to her. <3 <3 <3 <3 <3

And of course, more Asian outings :) The Sanchez family rallied some of the Asians to a dinner the day before I fly out at Le Special.

👕👚

So I designed a shirt for the Senegal field service shirt design contest.

It is currently in the lead by… a lot. (It’s design #1.)

But then it started a fiery comment chain about what color people wanted the shirt to be. It started with general preferences of “I like this design, but can we get it in black?” to getting reaaaaaal deep about the possible negative connotation (death, danger, mourning) of red in West African cultures, and then pushback from people saying that it has no connotation, if not a positive one (courage, triumph over oppression, sacrifice for liberation). Anyway, people got real passionate about their opinions, to the point where they’re bleeding out into day-to-day casual conversation. Especially from people who know that I designed the “controversial” design. I can’t tell you how many people have mentioned it to me in the last two days since the poll went live. Yikes. I’ll not get to see how it pans out in person, but I’m sure I’ll hear more about it. And probably free shirt!

🎤🎵

So each Thursday one department is in charge of serving ice cream, and when Communications does it, they host ship-wide karaoke. So of course, though we were one person down with April gone, Rach and I smashed “Where is the Love?” by the Black Eyed Peas in front of everybody. All that Filipino karaoke throughout the field service prepared me to take the stage for one last night. Esther wonderfully captured the entire performance on video and I uploaded it to YouTube so everyone can watch us bring down the house.

I’ve gotten a lot of comments since then (though not as many comments as those related to the shirt controversy).

🔜

It’s strange to feel that this is my new normal and going home will be adjusting to a new normal again living with my parents. At the same time, it feels like this time has flown so quickly. We’ll see where the next chapter leads.

—Jasmin