Life Unparalleled

Loving Life as a Foreign Service Family – Current Parallel 6° 27' North- Lagos, Nigeria

The White Expert in the Room

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A baby under LED lights for treating jaundice

I have been busy with a new and amazing volunteer opportunity. I had been looking for a volunteer opportunity in my field since we arrived. It was difficult to break into though. We live in the affluent area. There are travel restrictions etc etc. You never know where you will end up unless you take the chance and just get out and meet people. Lots of people. The expat world in particular. Follow this people chain-fencing tournament for my son(at the French School)-random woman(who happens to be Romanian) I sit next to who happens to teach violin and after getting to know me a little bit better over a few months she feels like she can recommend me with good conscience-a person(French/Brit married to an American) who she happens to know through friends runs an amazing nonprofit organization that runs medical clinics all over Nigeria. 99% of these clinics are far out of the area in which I am allowed to travel. But….I found a solution. Once or twice a week myself, driver and a mopol(hire-able Nigerian policeman) go to a medical clinic and maternity home. Because of security and privacy I won’t be sharing the name of the facility or tremendous details. But I am so thankful to have found a place to volunteer in my field.

The first day I arrived the car tried to park on the crowded street in front of the facility. There were so many people, chickens, vendors, people eating, cooking,  doing laundry etc that we had to inch down the lane. When we finally did arrive the mopol jumped out of the car with his giant gun and ran around the vehicle to open my door. If no one noticed I was there they sure did now. This is just a simple example of what it feels like to almost always be the only white person in a room. When I originally  met with the director of the nonprofit organization she decided that after reading my resume she could best use my skills at observing and evaluating the nurses and midwives in the facility and helping to provide continuing education courses for them to help keep their skills up-to-date and improve their communication and patient care. A big task and project but one that I feel like I am up to. So I arrive at this facility and basically my job is to just sit there or stand or move out of the way and observe all of these medical professionals and the setting. I don’t have a direct job to do I don’t have any tasks I need to accomplish my whole role is to just sit and observe. It is a challenge trying to break down the behaviors and medical procedures that I am seeing through my own thinking and biases, by asking questions, or more than anything just getting to better know the culture in general. Even after 8 months I still really struggle to understand much of what people say which doesn’t help. Truthfully it is pretty emotionally and professionally stretching. By stretching I mean it is difficult but I can feel myself growing and improving so I do it anyways. I picked up some self confidence somewhere along the line in my life.

So back to my first day this is an incredibly uncomfortable place to be. I know no one.  They’ve been briefed with what my role will be and that I am arriving sometime this week but I literally walk in off the street.  I’m in and I am instantly able to just observe them and see their interactions with patients. I instantly feel uncomfortable in my own skin and can feel the growth of this experience oozing out of me.

Below I will share just a handful of experience that help illustrate my attempted suppression of my very white skin and privilege:

One of the first things that a nurse did was take me around to do rounds with her and the oncoming doctor. She introduced us to the patients that were in the care facility. We walk into a private room where a father is sitting on a bed holding his child who has some type of lung infection and as I walk in the father instantly stood, waking the child that’s laying on the bed. As the nurse starts the rundown he interrupts and says “This must be my new doctor.” There’s always an assumption that I am higher educated then everyone around me, which isn’t necessarily true. The facility staffs three doctors and multiple midwives and nurses.

The doctors do a prenatal lecture by PowerPoint at the beginning of each antenatal day. The room filled quickly with all the available chairs being filled.  I gave up my seat multiple times to expectant mothers as more arrived late. Ultimately I walked down the hallway to go to the waiting room to gather a few more chairs. I was followed by two pregnant women. The women gathered their chairs first and started walking down the hallway back to the lecture room when I picked up my chair instantly two men from the main waiting room jump to carry my chair. I was not the woman 9 months pregnant.

There is an assumption that I won’t be able to say, or remember, peoples Nigerian names. So they always give me their Christian name which is a Anglo style name of some sort. Alice, Blessing, Friday, Frank, Peter, are all examples. They essentially alter their names for us, to make our lives more comfortable. Unfortunately they are correct, even with writing down names I’m terrible at them and I definitely can’t remember them without a piece of paper and even with that can’t usually say them correctly. But I am really trying. The thing is, their names are really beautiful and they mean something. They are named with an intent and a blessing. This is the longest one I have heard lately. The baby goes by Bruno but his full first name is Ekwakwarakponabrunooghenebikosioemrano- 38 letters. It means” the burdens of this world is too much, God please remove some” For real. Awesome.

People have been shocked when they find out that I have four children as people think of Americans as “being selfish and only having one or two children”. They have also been surprised when they find out that I had all of my babies with midwives and three of them at home. Well really, to be honest most Americans are shocked to learn this as well. A father who was there supporting his laboring wife said that he assumed almost everyone in the United States had cesarean sections because they were afraid of pain.

Almost every person who talks to me in the waiting room asks one of a few questions:  what I think of Nigeria to how do I like the heat and three why do I want to live in Nigeria when all the Nigerians want to move to the US.

Today I was helping a woman and her newborn who had been readmitted for jaundice complications. The woman was really surprised when I told her that there was no way for me to get her a job that the only way she could get a job at the US consulate was to apply herself. There is an assumption that things in the United States are run similar to things here in Nigeria meaning that a big portion of your luck in employment options and the amount of money you have is tied to one of two things: your sphere of influence or who you know, and corruption.  They believe that you can bribe your way into any circumstance and in most instances in this country they are correct.  Truthfully this happens in the states as well but the State Department and other agencies have gone through great measures to prevent it in the countries in which we serve. When I told this woman that I couldn’t help her get a job and I couldn’t help her move to the United States because I couldn’t even help my Stewart, who I trust so much,get a visa and she works in my home every day and she has worked for Foreign Service families for over 17 years before us. She just seemed so skeptical that this could possibly be true.

Today was a fun day, it was postpartum clinic where mothers would bring babies to be examined three days after delivery, a week after delivery, and onward for immunizations. That meant babies. Lots of babies and you all know how I feel about babies. I got the opportunity to hold and cuddle and care for quite a few. Nigerian women dress their babies very warmly. Even though it was 95° in the clinic which had no air conditioning running today, these babies are wearing long sleeves and long pants outfits, wool hats tied under their chins and wrapped in thick fleece blankets that have sown in caps, kind of like those special baby towels that have hats built in. I’m just noting this is has nothing to do with my story. Anyways, up until about the age of nine months if I pick up a baby they are as likely to pay attention to the ceiling fan above my head as they are to the shape and color of my face but right about 9 or 10 months, when baby starts to get object permanence and understand a lot more about the world, I’m a shocking site to behold. A number of babies who were crying from illness or from the reaction to an immunization stopped instantly once they saw my face. Toddlers were a different story they found me interesting but if I was helping to hold them down when they were getting an immunization, even though I wasn’t the one administering the shot, you had better believe that I was the one who was blamed. The pain would come and their eyes would jerk open and they would look right at me and scream. Why not? I was the only thing that was different, they only thing potentially untrustworthy.

I came out to the waiting room today and a little boy probably about 18 months old stood and froze and stared at me wide-eyed. He was so funny and completely shocked that people around the room started giggling after a little while. I finally asked where his mother was everybody shrugged their shoulders and one man finally said that he had walked through the front door unaccompanied.  At this point I picked him up and walked out to the street. I ended up walking a few modest houses down before I finally found the boy’s mother. When I sat him down at her feet he looked at me with that same shocked look and she and all of her family members burst out laughing. They love to see children’s reactions to our visible differences.

Toward the end of the day my legs are getting tired from standing. First let me describe the nurses room. The nurses room is about the size of a king size bed. In this room there’s an exam table a small sink, a table that holds vials of medication, a small refrigerator, another desk that the nurse writes notes in the charts on, an infant scale and a chair for the patient to sit on. In this room all vitals are tracked for patients as well as infant growth charts and immunization records filled out(in huge government funded books about the size of two large pizza boxes), prescriptions filled including injections drawn up and then given, and all paperwork to refill charts are kept in drawers under the exam table. In this room it’s not uncommon to have a main nurse taking a patients vitals, a nurse assistant behind her weighing a baby on a scale, a second nurse filling out records of immunization, a third nurse pulling out IV fluids and filling bags with the appropriate dissolution of medication, and an additional patient in the room talking to one of the nurses about some concern or question. Then there is me. Standing, trying to stay out of the way, help when I can, and asking questions along the way trying to muddle through what is cultural, variance in education or just plain personal technique. But mostly I just try to avoid getting my toes stepped on. It is quite a lot going on in one space, so anyways I had pushed some record books aside and had taken a seat on the exam table after spending about seven hours on my feet. Things had calmed down a little bit after seeing more than 16 children with malaria and 5 adults with malaria——Take your antimalrial drugs State Department People. Seriously—- 2 sets of stitches, 1 broken bone, half a dozen other digestion and lung related issues and about 30 immunizations. As I was sitting on the exam table I looked down and noticed that some gauze and some vials/ampules  from immunizations had fallen on the floor instead of into the trash can underneath the desk. So I stood and put on a glove and reached to pick up the items off of the floor to throw them away. One of the nursing assistants, actually it’s called a community health worker which is a program I will discuss in a different blog post, started to get up off of her seat to pick up the items that I was reaching for but she didn’t even have a chance to try before the mother started shrieking at her that she should be picking that up and I shouldn’t be on the floor. It was so disconcerting. It startled me and I dropped the glass ampule I was holding in my hand onto the floor and it shattered everywhere. So then the poor community health worker not only had to clean up the mess that was already there but then about 1000 pieces of broken glass that had spread everywhere. Class system is alive and thriving here for sure.

Several times every day at the end of an appointment, even if I do nothing other than sit there the entire time, a patient has looked at me and said “I hope to see more of you here”. It’s a very unreal feeling knowing that you are welcome completely into someone’s personal space, welcome into their country, and welcome into their community purely because of the color of your skin and nationaliy. I also hope to see more of them.

Really I walk around this country aware of how much space I take up. My money, my housing, the amount of water and electricity I use, myself alone being driven by a driver in my car with a minivan next to me packed with 20 men, how much I spend on food( per week is what an average housekeeper, driver or bank teller is paid for a month of work), my overstuffed house and need to purchase even more of it online. I sometimes feel like I am this white oppressive giant that everyone stares at aware that I am using far more than my share of space.

PS The lab tech, after my inquiring, is teaching me how to identify the malaria parasite under the microscope. Not only that, but also all of the stages of its life cycle PLUS how they look as they break down through various stages of treatment. I’m totally geeking out over it.

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