trip to jos on day 4

wow, i'm beat. so today was the trip to jos and they told me to be out in front of the hilton at 0600 for pick up which meant getting up at 0500 so i could do some calesthenics, shower, check emails and eat, first. so at 0630 i call godday and ask if he's coming for me. "o yeah, on my way." poop, i could have slept at least another 30 min! so i guess charles, who i'm going with, was late so that slowed down every thing else. on the road before 0700 and the traffic jam coming into abuja is fairly impressive; glad we're going the other way. except when the traffic gets really bad at rush hour people just drive the wrong way on the other side of the highway; smart. so we make a quick stop for cookies and soda (nigerian breakfast of champions?) and it's off to jos. and it's georgous! the whole drive out is all green; banana trees, papaya, palms, grasses and something that looks like (and might just be) corn. which is a beautiful contrast with the deep brick-red color of the earth. and then these rocks! there are these huge granite chuncks that just jut out of the ground at random places. it's absolutly breathtaking. then add in the random herd of cattle, wandering goats or motorbike strattled with 2-3 people. and then there are also these periodic "villages" (collections of shacks?) where people have tables of cassava root and yams, firewood and potable (maybe) water on sales display. the trip is long; 3+hrs and there are multiple police/vehicle inspectors along the way. luckily because of our red license plates that designate us as dod we get to breeze right thru the check points with the quintessential beep and a wave. the landscape changes to a more grassy and mountainous terrain and i find out we're getting close to jos. i didn't really need the heads up though because the road-side vegetable stands begin to exponentially increase so i'm pretty sure we're close to something populous. first stop, the hotel. we're not staying but the people partaking in today's training class (the reason for our visit) will be so we need to take care of the bill. funny thing is, unlike the abuja hilton in all it's high-class splendor, this hotel is on a rutted red-dirt road complete with stray goats and children shakily steering wheelbarrows. yeah, it's a slow trip even for the land cruiser. beautiful, though. so i finally get to empty my exploding bladder in the lobby bathroom (no door knob, lock, tp, soap or papertowels; typical which is why i carry tissues and hand gel) and we meet some other guy and he comes with us. so apparently our new arrival is an ex-lab guy from the local nigerian air force base and offers me a tour of their medical facilities. so we get on base with no id checks at all (but no shortage of big guns in the guards' defense) and park in front of the hospital which is a 1 story bright bule series of about 4-5 long buildings connected by open-air walkways. there are no pictures, of course, because of the military presence and their affinity for privacy. so i hook up with a nigerian infectious disease doc who walks me around the entire facility introducing me to other hospital employees and patients. we visit the labs, family planning, ob/gyn, isolation, and the men's and women's inpatient wards. even though it doesn't look anything like walter reed or bethesda it seems to be quite organized and well-functioning for the limitations of the facilities. for example; the pharmacy consisted of two rooms with only enough medications to fill, maybe, an icechest that would normally hold a 12 pack of longnecks. that's it. the lab and i.d. areas had non-functioning equipment as numerous as the stuff that worked and there was no refrigeration or special holding for growing cultures; they just sat on the desk with everything else in the id office. "isolation" was just a patient in a room but there was no protective equipment for the healthcare workers and the door was open to the walkway outside. the inpatient wards were just beds with colorful woven throws concealing mostly tiny, emaciated people curled up in the fetal position while recieveing fluids and antibiotics. yesterday 4 surgeries were preformed by a local orthopedist and ob/gyn who are on call here from the local academic hospital. i mean overall, i was impressed. but again, when i roll up and don't even recognize that this tiny facility is actually a fully-"functional" 60 bed hospital i realize that i just can't measure everything here by my own american standards. it was a fun tour. the people working there were incredibly proud of their military medical positions and were thrilled to meet and talk with me about their jobs here. smiles all around, really. even the patients were smiling at us! just a very friendly, welcoming place. and at mtf's in nigeria there is treatment of all locals as well as military and dependants, so it doesn't matter if they're not affiliated with the military; they'll still be treated here.

after a pleasant goodbye from the hospital commander we're off to the local public hospital's lab to meet the trainees. there are a few stragglers and charles is getting frustrated that the most local of the attendees on the roster are the late ones. nevermind though, and i get a tour of the lab here with it's new pcr facilities. again, quite impressive; they do viral loads, western blots, elisa and sequencing here, and training for other nigerian facilities as well. so then we leave. yup, leave. huh? so apparently the only reason we came all this way was to get people to sign the roster and give them their travel costs in cash. we leave as soon as the training starts! i mean, i don't care about being trained on some specific piece of equipment that i'll never see again, but we haven't even been here 2 hrs yet! so we stop for lunch and i get rice, plantains and a spicey chicken leg with a bottle of coke. it's weird because i rarely drink soda or juice but no one here drinks water since it has to be paid for and they'd rather have something sweet. at this rate i'll get fat on beverage alone! but after the quick bite we're back on the road home. charles wants to get some produce since we're here (jos is know for their fresh fruits and veggies) and we stop at a long row of vegetables on display. and then the mob! there are people with various foods atop their heads totally storming the cruiser and i'm amazed he even makes it out the door. after what i assume is a lot of haggling, charles is finally ready to go. i've managed to get godday's help with trying and buying some weird food (sweet pear? it's hard to understand the sub-par pidgeon english) which looks like an olive but tastes somewhere between a grape and an avacado. not necessarily good but totally snackable. in fact i had a bunch for dinner before deciding i should wait til tomorrow to finish them in case i have some adverse reaction (uh-oh). and we go back down the road to stop at a fruit stand. i want bananas and roasted nuts and jeeze what an ordeal! ok, i'm not good at bargaining at home where we all pretty much understand each other and i know what i'm spending and when it's too much or a steal but here i am really at a total loss. people mob my open car window; like 7 kids selling the same thing that i just bought!, and they lean in and try to give more and ask questions and say things and giggle and i don't understand any of it. i mean, none. and apparently they don't understand me either. after i buy some snacks i ask "can i take your picture?" and hold up my camera. they say yes and then when i go to take it they back out of my view finder shaking their heads and pointing up. i have no idea, and after we go back and forth with some attempts at communication and fail miserably, they proceed to just lean on the truck and i leave the camera in my lap. whatever; i have no idea what just happened. but at least now i have snacks; tons! i've got roasted and boiled peanuts, a huge bunch of bananas, about a dozen oranges (i think anyway, they're certainly not orange-colored though) and those weird sweet pears or whatever. i would have bought more but it was just to confusing, uncomfortable and frustrating (any tips would be helpful...). i'll try again soon. and then it's time to really go home. or at least back to the office. once there, the doc tells me that this is what i make of it, he'll just give me a few meniel tasks that will actually be helpful for them and the rest is up to me; just be enthusiastic, have fun and volunteer to do the stuff i want to do. sounds great, right? i go back and forth all the time about it being too short and too long of a trip all at the same time. and should i try to scam the usuhs system and tag this as a "clinical" experience? i don't really think it qualifies but if i could get it touted as such i'd easily be able to justify another "research" rotation for the child soldier program in liberia (i'm still working on the logistics). it's nice that everyone's cool and laid back but that also means i don't have any "real" work to do or a schedule to keep and that can be tireing and slack-inducing. but it's not that long and i've already got other trips planned (lagos and kaduna) so it should be fairly smooth as far as getting stuff palnned and done. one of the funniest things is the fact that i have nothing to wear! doc said bring 3-4 sets of AF blues and gym clothes so that's what i did. thankfully i included a little more because he's since said i should only wear my uniform when on official military business at a nigerian base. well, usually i'm at the dod office so i have to wear business casual! so, luckily, i have a skirt and a few tops i can make work and then i wear my super-sweet air force uniform pants (as in the pics from today). it's not pretty but it works, sort of. at least no one's called me on it yet!

so i got dropped off at the hilton and came upstairs to another glass of that free bottle of wine (the same bottle) and a dinner of boiled peanuts, a few sweet pears, 2 bananas and a cup of instant decaf. o yeah, and a mini butterfingers ( i brought a bag of assorted minis from home for the office. it'll get there, eventually). so i just spoke with the florida professor, george, whose offered to show me a good local seafood restaurant sometime this weekend if i'd like. sounds good to me! that's it for now; i'm beat.
by the way, i'm posting more pix online at snapfish. i'm not sure if it works if i send a link but if not it'll be in your email. http://www1.snapfish.com/thumbnailshare/AlbumID=173486504/a=38006894_38006894/t_=38006894