Saturday, January 29, 2011

The Mighty Hunter

This is a story about mankind's base instinct.  Long before we developed into civilized societies, we were tribes of hunters and gatherers.  While gathering may have played an important role, hieroglyphics and cave paintings rarely glorify the rituals of picking blueberries and daisies.  No, this is a story about hunting.

Certain people are offended by hunting; their attitude is that some creatures are far superior beings and have a responsibility to help others.  They believe hunters today are using technology that is inappropriate to stalk helpless creatures.  Some people would even go so far as to say we should arm the prey with weapons to kill their hunters to "make things even."  Those people might even enjoy this story...

The great and mighty hunt begins long before dusk most evenings.  I close my window to shut out the fresh air and I try to become one with my surroundings.  I will need to be focused if I'm going to succeed.  I will not have a battle plan, for tonight is as much about base instinct as it is about planning.  But, I have found that some advance field work will increase my chances for success.

My room is cell-like: sparsely decorated white walls, a tightly shut armoire, a desk with laptop computer another desk with several books covering its surface.  Two chairs, a nightstand, my floor-standing fan and my bed complete the interior decoration. 

The bed.  A place of rest or a place of action?  The bed will likely be the battleground once again this evening.  I am, of course, referring to the great evening battle of Man vs. Mosquito.

Let me set the stage:  Thursday night.  Power was off.  The generator was not working.  It was just me. And the mosquito.  Buzzzzzzzzz.  And a flashlight.  Tonight, I am the prey.  Have you ever tried locating a mosquito using only a flashlight?  Buzzzzzzzz.  At 4:00 a.m., with four welt marks and a decidedly uncheerful attitude, I decided to leave my residence and go to work.  Thursday night, victory went to the mosquito.

Friday night would be different.  The power was on.  The generator was working.  I decided on my plan of attack.  I would fasten duct tape around the doors and windows so there would be no escape.  I would go to bed before I was tired and wait - playing opossum to draw the mosquito toward me. Buzzzzzzzzz. S-l-o-w-l-y, I get out of bed, turn the light on and locate the mosquito.  Armed with the rigid annual report of the Neogen Corporation (who, ironically, manufactures a wide variety of products related to animal health care), I swat the mosquito.  I am then reminded of the slogan used by a famous manufacturer of a different kind of product: 

RAID: Kills Bugs Dead. 

I like that phrase. When it comes to mosquitoes, I don't consider it the least bit redundant.  Friday night will be a good night for sleep.

A post script:  I don't sleep with a mosquito net because it does not prevent this sound: Buzzzzzzz.  Instead, I prefer to kill the bastards and take preventative courses of action (namely, keep my door and window shut at night).  Saturday night was an especially vicious battle.  Somehow, five mosquitoes found their way into my room during the day, but I was unaware of their number until after I killed them all (three at night using the above "pretend I'm asleep" method and two this morning after I realized I was still being bit).  My previously white walls now have several marks on them...  

Sunday, January 23, 2011


These are observations that - taken individually - would never fill up an entire blog entry, but that certainly deserve a space.  In many instances, a picture would have been worth a thousand words, but walking around all the time with a camera would make me look like a tourist...

* Freedom is walking to work without a wallet, keys or a cell phone in your pocket. 

* The divide between rich and poor was never more apparent than the day I saw a deep blue, new Bentley Continental GT (MSRP: $182,800 or $207,700 nicely equipped) with the most luxurious, buff colored leather interior parked at a bakery directly next to a horse drawn wagon.  The horse had a roan exterior.

* I think McDonald's hasn't opened a restaurant here because the Senegalese like their hamburgers cooked so well done that the "Quarter Pounder" would end up looking like the "Quarter Ouncer."

* Buildings here are concrete.  I watched workers constructing the third floor of a building wherein 5 guys at ground level rhythmically shoveled sand up to 4 guys on a scaffold, who in turn kept beat and shoveled the same sand up to 3 guys on the 2nd floor, who in turn shoveled the sand toward several other workers who mixed the concrete using a manual machine.  I watched in amazement for several minutes, silently counting four seconds between shovels, and the workers never once lost beat although not one of them said a thing.

* African girls have bigger boobs

* Do you remember the last time you saw a child sitting on their parent's lap driving a car?  Do you remember how big the smile was on that child's face?  It's the parent's responsibility, so screw the National Transportation Safety Bureau.  If the parent gets in a wreck and hurts their child... well, here, they'll probably just have two more children.  And get off your mighty pedestal:  Malaria kills more children in Senegal simply because they don't have access to treatment than any form of parental irresponsibility.

* Where do stray dogs sleep at night?

* I have to cross one busy street to get from my residence to my place of work, but there is no crosswalk.  In fact, the rules of the road here are, "Biggest wins."  So, I stand on the side of the road and wait to cross the street.  But, you'll remember that I look a bit different than the average person in Senegal.  So, every taxicab that sees me must think I'm wearing a sign that says, "Early Retirement: White Guy Needs Ride Back to United States and Wants to Take a Taxi To Get There" and stops abruptly in front of me.  This, of course, impedes my progress across the street by up to five minutes per day.

* The official unemployment rate in Senegal is 49%

* I frequently run down a sidewalk that is frequently occupied by a very old woman and a very young child.  The old woman has lines all across her face that speak to experience, hardship and an ability to survive.  The young child is preschool age, dirty and better behaved than my children were at that age.  The lady has a parasol to protect her and the child from the sun and they sit on a mat.  I wonder who they are, why they   picked that place on the sidewalk, how long do they stay there and what they do to pass the time.  But, I don't speak Wolof and I'll probably never find out.  They have never asked me for money, but on my last week here I'm know where I'm going to leave all my spare change.

* We're directly on the west coast facing the Atlantic but the sunsets in Senegal are nowhere near as attractive as California, Hawaii or even Maine.

* I withdrew 50,000 CFA (about $100) from the ATM machine to attend a charity dinner with a friend.  Walking away from the ATM, I realized that I had two week's wages of the average employee and I was going to spend it on one meal for two.  A moment later, I realized that if I divided up the $100 amongst three guards, two housekeepers, three groundskeepers, a cook and two maintenance staff... that the charity needed the proceeds even more.  One person may be able to help change the world, but not even Bill Gates and Warren Buffet can just hand money to people and make everyone better off.  By strategically raising funds for organizations that can help change the infrastructure (teach a man to fish vs. give a man a fish), it might not take as much money as people think.

Saturday, January 15, 2011

Is There a Doctor in the House?

So-called health care experts often point to developing nations and say, "See? Even (insert povery stricken country here) provides (insert random medical treatment here) to its poorest citizens while the United States spends its money on advertising, bloated administrative salaries and Viagra."

The so-called health care experts often ignore the actual, day-to-day medical care systems and whether or not features of these systems might be adopted in the U.S.  Dakar is fortunate in some respects.  As an urban center, the best care facilities in the country are located here, health insurance is available here and most of the medical professionals in the country live here.  But to truly get a flavor of Dakar health care, I thought I might share stories from three different health care incidents.

One of my students complained, "The doctor didn't show up yesterday."  After further inquiry, I learned that in Senegal, you dial a number and a fully equipped vehicle and trained professional arrives - AT YOUR HOME OR OFFICE - to treat you.
If it is an emergency, they will transport you to a health care facility.  I need to do a bit more research on this, but from what I understand the doctors affiliated with this practice are essentially moonlighting!  Doctors earn relatively little compared to their U.S. counterparts when paid for their government work, so to earn additional money they need to be entrepreneurial.  Entrepreneurial does not mean, "figure out ways to bilk the insurance companies", so score points for Senegal's health care system for its ability to provide government-sponsored care to the poor while allowing its medical experts the ability to earn additional money using market-based techniques.

How is the quality of health care?  The next anecdote is from personal experience (and BEFORE I learned about the above SOS home health care visits).  I'll save the gory details, but I was severely dehydrated and absolutely could not drink enough fluids to replace what I was losing; I was unable to pinch even a bit of skin on my arm.  I rarely use the U.S. health care system, so to ask to see a doctor in Senegal was a big leap of faith for me.  I desperately needed an I.V. to get some fluids in my system and was willing to take a chance...

As a member of the upper crust here in Senegal, my driver took me to a very nicely appointed clinic - complete with tropical fish tank - on a Sunday morning.  After providing my health insurance card, I was told the total fee was $60 of which I was responsible for 20% with my co-pay.  I waited in a nicely appointed patient room and a guy entered about twenty minutes later with a large briefcase filled with medical stuff.  He was not "African", unless it was Algeria or some other area where the Whitest Guy in West Africa might even be able to camoflage himself.  In fact, he kind of looked Mexican.  He never introduced himself and could have been the janitor for all I knew (with apologies due to all Mexican janitors who may have completed medical school).

He listened to me recite my symptoms and my request.  I thought about trying to explain myself in French, but with my accent and under-achievements in mastering this tribal language, I was afraid my version of  "I do not feel well" might somehow be translated as "I have swallowed an entire goat." 

The guy (who might have been a doctor) performed a couple of routine tests on me.  By routine, I mean he pressed my stomach with his hands, took my blood pressure, listened to my pulse and used a stethoscope to check my breathing. 
Then, he pulled out a notepad and wrote me a prescription for an antibiotic, pain medicine and the prescription strength equivalent of Imodium.  He never drew any blood, so there was no way he could have known if I had a bacterial or viral disease.  When I said again that my reason for coming was because I was severely dehydrated and asked again about getting a fluid IV, he looked at me reassuringly and responded, "You should drink some water."  So, there you have it: $60 for expert medical advice to drink some water.  My six year old daughter performs a similar routine on me with her doctor kit back home, but doesn't charge me $60. 
I left the clinic to get my prescription filled and went back to sprawl out on a couch completely unsatisfied with the health care experience.  That's when one of my colleagues/housemates entered.  He, too, was not feeling well.  The difference is that he went directly to the pharmacy.

He explained his symptoms to the pharmacist and asked for an antibiotic and a pain reliever.  The pharmacist asked if he had a prescription.  He, in turn, asked the pharmacist for a notepad and wrote down, "Antibiotics and pain reliever" and signed it "Dr. Haider."  Now, in all fairness, my colleague has an earned doctoral degree. In mathematics.

The pharmacist looked at the fresh prescription signed by the good doctor and dispensed one box of antibiotics and a pain reliever...