Tuesday, February 26, 2008

Podcast Duel....

So...there's not much do after work around here. The 8 movies we had on the laptop and old paperbacks are running out. Even for a med student, there's is only so much studying that can be done. The TV (sporadic at best) has been out for a couple weeks. The mileage on our evening runs is increasing. Often, we entertain ourselves with podcasts while we make dinner. God bless BBC Africa. You would be amazed at what's out there. Unfortunately, we don't always agree on what to listen to. So tonight Kevin and I have decided to hold the first ever Bratcher-Harvey Podcast Duel. Whoever can stand the other person's podcast the longest without falling asleep or talking wins. Kevin just downloaded 1 hour and 10 minutes of 2 English web developers talking about "HTML snippets, pros and cons of version typing, and a featurette on javascript techniques." Scary. However, I will unleash the New England Journal of Medicine February 21st. Highlights include: "Featured are articles on aprotinin during coronary-artery bypass grafting and risk of death, the effect of aprotinin on outcome after coronary-artery bypass grafting, surgical versus nonsurgical treatment for lumbar spinal stenosis, hepatitis E virus and chronic hepatitis in organ-transplant recipients, and scientific and legal viability of follow-on protein drugs; a review article on lumbar spinal stenosis; a case report of a woman with renal failure and stiffness of the joints and skin; and Perspective articles on quality-improvement research and informed consent. " If y'all are smart, you'll bet on me. Results to follow.

Thursday, February 21, 2008

Bringin' Home the Bacon....and melancia

This is some of the strange new fruit we're enjoying on regular basis, a purple olivey/grapey thing, yellow mangoes, tiny bananas, and a "melancia" which is like honeydew with red seeds. I'm getting very good at eating things first and asking questions after. Kevin brought all this home from travels to district sites. Every time the truck stopped, they'd be swarmed with people selling food from the roadside. One of the nice things about being married, I'm discovering, is help with bringing home the edibles (and if he brings them home in a cute new straw bag for me, all the better!)


There's a cholera outbreak in Quelimane right now, likely related to the amount of rain we've had lately. 75 people have been hospitalized and while the hospital is full, it seems they have a handle on the extra patient care. We'll be really careful with our water in the meantime. In other news, Hurricane Ivan has been in the Mozambique channel, but Quelimane has luckily not suffered any serious storm related problems. We'll update more later....

Tuesday, February 12, 2008

The Lab...

Frequently, we have to test little kids for HIV and malaria. It's a simple fingerstick rapid test, but I hate doing it. I get the kids to sit on their mom's laps. I smile and coo at them in Portuguese and English; most understand neither since they aren't taught Portuguese until they're in school. But they look at me with interest. Curiosity is the only emotion on their faces as I take a little hand and clean a finger with alcohol. They have so little experience with medical systems that they don't know to be scared when someone comes at them with a lancet. At this point, while the kid is still smiling at me in ignorance, I ask the mom to help me hold their hand still. “I'm going to pinch your finger a little,” I say in Portuguese, with a friendly look. I prick them with the lancet and see the inevitable, heartbreaking result. The first look is one of absolute surprise and betrayal. The nice lady who was talking and smiling just hurt their finger. Then they realize I've still got their finger and they can't get away. Panic sets in. They scream and cry, and try to twist into their mother's arms or stiffen their backs to slide off her lap and run away. Sometimes it takes me, the mom, and other lab guy to hold them still enough to get a drop of blood into a capillary tube. When it's over, I wipe the sweat off my brow and say to the lab guy, “Esse e porque eu nao sou pediatra.” I thought it was the worst...until the day I tested a child who lay limply in her mother's arms and never even blinked when I pricked her. I had been holding her hand tightly in anticipation of the battle to come, but she didn't move. Since then, when a child comes in who looks too thin or feverish, I find myself silently begging as I do the test. “Ok Mom, if you could hold her hand still please.” Kiddo please cry. Please react. Try to hide behind your mom. “Ok, if you'll hold this cotton on her finger until the bleeding stops.” Try to run away. Something. Anything. So many of them test positive for HIV.

At the lab yesterday, I was talking with the lab guy about a tray of sputum samples and I caught some motion out of the corner of my eye. One of the samples moved. I looked closer and realized it was full of worms crawling around. Someone coughed up a load of live maggot-looking worms. I'm proud I didn't faint into a sweaty heap in the dirt. I need to refresh my differential of COUGHING UP LIVE WORMS!! Some nasty parasite. Ascariasis? Between brushing tse tse flies off my face and out of my ears while I try to use the microscope and spiders leaping out from behind the sharps box, sometimes the bugs are just too much.

Saturday, February 2, 2008

The Prey and the Bandito

Last night we went to eat at Nauticos, the restaurant at the end of the marginal. Since Christmas they’d put in a patio that connects the main dining room with the riverbank. It’s the first place in Quelimane that takes full and unashamed advantage of the beauty of the city’s waterfront. There were maybe 20 of us in our group so we effectively took over the entire staff and facility.

But I’m not writing about what we did last night. Today, I’m writing about a crime. A shocking trespass against humanity that will change the way you look at southern Africa. It involves deception, intrigue, violence, ransom, and just enough sex to ask that parents read it in its entirety before deciding whether allowing the kids a peek. Also, it’s hysterical.

Truth be told, this is all hearsay. Troy told us this story as his guard told it to him. It all happened late one night on Troy’s street when he was asleep. Long-time readers will remember that Troy’s street used to be our street.

Jacinto, Troy’s guard, had been noticing some peculiar activity as of late. Apparently, a young woman was luring men down the dark alley at the wee hours of the morning with the chance of taking part in the oldest economic activity in the world. Her victims would saunter down the end of the alley and find a nice comfortable spot. What he didn’t know was that his companion’s bandito accomplice was hiding in the shadows near the site of the illicit transaction.

At the moment at which her victim was most vulnerable (usually with his pants around his ankles) the accomplice would jump out of the shadows. In mock fear, the young lady runs off. Flashing a knife, the bandito shakes down the victim for all the money on his trembling body. Later the pair split the booty at a separate location.

Remember, the source of this story is a security guard. Why didn’t he help the poor fellows? Didn’t he feel bad for them? As it turns out, he is only responsible for malfeasance within the boundaries of the property he protects. Luckily (for the purposes of this story), he is required to thoroughly observe any crimes committed nearby in case he has to report anything to the police.

On one particular night, Jacinto saw our antagonist up to her same tricks. But this time she had picked out a prey that was larger than your average Mozambican. One can only imagine the sinking feeling in the bandito’s heart as he saw a lion caught in his rabbit snare.

At the appointed time, the bandito sprang the trap. However, much to the evil-doer’s dismay, the prey did not frighten, and instead decided to stand his ground. In the ensuing scuffle, the prey quickly gained the upper hand, our lady friend long gone.

According to Jacinto, the prey had wrestled the bandito to the ground near a mud puddle. With one arm around his neck and the other on the back of his head, he forced the bandito’s face into the mud. He held him there for a moment, and when he allowed him a breath the bandito’s first utterance was a call to his gang.

His face was back in the mud when his gang finally appeared. Seeing that he was larger than any two of the gang combined, the prey immediately recognized his continued advantage.

“If you want your friend back,” said the prey, “bring me 500 meticais.” An ambush had been parleyed into a hostage situation.

500 meticais is a lot of money in Mozambique, and the gang didn’t have nearly that much on them even after rifling the bandito’s pockets. The prey callously insisted that they go find it while he waited by the bubbling puddle of muck and the bandito’s face. After what must have been an agonizing wait, the gang returned with the ransom for their comrade.

This, I feel, is good news and bad news. Yes, there is petty crime in Mozambique, but most of it is perpetrated by small-minded, small-bodied idiots. I guess that’s the same anywhere. And, as in this example, maybe every once in a while the criminals get what’s coming to them. But I know that I’ll never look at a Quelimane mud puddle the same way.