Treatment of the Mentally Ill

While walking home in the evening, I came across a women lying in the middle of the road, screaming in agony at the top of her lungs. It looked like her arm was bloody, and my first thought was that she had been hit by a motorcycle. There was a small group of people standing back on the road observing everything, so I quickly approached them to see if they knew what had happened. They did not. They told me that she was mentally ill, however. They seemed unwilling to do more than watch, so I went to the woman. She had a large head wound and her shirt sleeve was soaked in blood. She was crying and moaning that her head and arm hurt. I tried to ask her what had happened, but she did not respond. One man came over and said he thought she had come from the hospital. We asked her again and she said that she had been at the hospital and they drove her away, she returned and they beat her. The man nodded and explained that she often disturbed patients there and that this was a likely story. It is no secret that people with mental problems are not treated very nicely here. In town, people often make fun of them, push them away, or even throw things at them. However, it was saddening to believe that a hospital would do this to anyone, let alone a mentally ill patient. The hospital, of all places, should understand how to treat and handle someone suffering mental health issues. This left us in a bit of a dilemma. In her condition, under normal circumstances, I would have recommended that she go to the health center to receive treatment. However, if it was the health center that did this to her in the first place, that was no longer an option. I doubted that the police would be very helpful, if any of them could even be contacted or found. We were able to extract a relative’s phone number from her, and immediately called him. He was in a different town, but said he would call another person to come and collect her. In the meantime, I decided to go to the hospital (only a short walk away) to find out what had actually happened. I arrived at the hospital and found a nurse. I began to ask her if the woman had come to the hospital. “Yes, she was just here.” I then mentioned that she had some wounds and might have been beaten… “Oh yes, it was me,” the nurse replied. “She came in and scattered my things and put on my sleeping cap, and so I beat her well and then the guard brought her to the road.” Mystery solved. It was so disappointing to hear the health care worker talk about how she had beaten a mentally ill patient to the point of bleeding, all because the lady had put on her sleeping cap. It’s times like this that I become discouraged or disappointed with this country. How could someone hurt another human being like that? Beatings are rather common here, but normally it is a small slap to the arm, or a hit with a stick to a school child—still things that I don’t approve of—but not to the point where you have done true physical harm to the person. To beat somebody until they are bleeding from their arm and head is incomprehensible to me. I tried to advise the nurse on how to treat the woman in the future, but it didn’t leave much room for hope. We went back out to the woman, who started to wander off despite our pleas for her to stay. We called her relative one last time to let him know where she could be picked up, but that was as much as we could do. 

Vaccination Campaign

This past week my village health staff underwent the challenge of providing free yellow fever vaccines to everyone in the community. The government provided free vaccines to all men, women, and children who were over 9 months old. It was a wonderful opportunity for the people in village, as this new vaccine protects them for life. It was a great initiative, but difficult for the health to actually carry out. They had about four days to vaccinate 14 villages. There are three health workers qualified to give shots. They were busy, to say the least. Each day we split up and travelled to two or three communities before returning home late in the evening. Most of the travel was done by trekking to the villages, often in the rain as it is currently rainy season, carrying a container of the vaccine, a box of disposable needles, and a cardboard box for the waste. On one day, I trekked in between 15 and 20 kilometers. When we arrived in a community, we would gather the population at some central point, like the chief’s palace. I would unwrap the needles, and the health worker would prepare the shots. Everyone would line up, and then the health worker would inject people one by one. The health staff did not have gloves, they did not have band-aids to cover the injection spot, they did not have alcohol swabs to wipe the arms. They simply took the syringe, gave the shot, and the person walked away. Then the used needle was dropped into the cardboard box.

It was a very interesting experience, as the entire town would watch as a particular person received a shot. Young kids in particular liked to watch to see what someone’s reaction would be, laughing hysterically if the person cried out or made a funny face. A funny pattern emerged, in which very young children were expected to cry, but almost all other people were expected to show no sign of pain. For the young kids, it was acceptable to cry and people understood their tears without trying to interfere. However, around the age of five or so, it became unacceptable to show pain. Little kids over five years had to suck it up, and did their best not to cry or make a funny face when they were injected. I was amazed by a tiny girl who stepped up alone, without any parent forcing her to do so, to get the shot. They put the needle into her arm and you could see a flash of discomfort come across her face, but then she locked it down. It must have taken her everything to stay impartial, but she did not break. She walked away in her flowery dress without a single tear falling. It was almost heartbreaking to see such a young child put on such a display of bravery. But it wasn’t only the little girl who had to put on an act. All children (both boys and girls) were not allowed to react in any way. Young men were especially not supposed to show any sign of pain. They had to receive the shot without any change in facial expression. All adults were also expected to remain calm, although old men and women seemed to be allowed to make a bit of a joke out of it. The older adults would often make faces of discomfort, which was acceptable, but still drew peels of laughter from the on looking children. However, the rules were bent for women from the ages of 15 to 25. They were actually expected to overreact and be incredibly dramatic. They would get a shot and would cry out or scream or shout and then rub their arms and run away from the doctors and then huddle with their others friends making faces.

In all, it was a very successful campaign, and hundreds of people are now immune to yellow fever. 

What I Love Most About Life in Cameroon

As I approach the one-year mark, I reflect on all the reasons I love Cameroon.

1. It is the closest I will ever come to being a celebrity. People know all about my life, while I don’t know their name. I can go to a different town and someone will come up to me and ask me how my puppy is. Children run up to me and poke me, just to say that they touched me. People show up at my door simply to say hi, and then trek back to their village. Kids come running out of their houses when I walk by. People stand out in the street shouting my name and waving to me whenever I’m around. Mothers will give me their babies to hold. Everyone wants to snap a picture with me. Random kids will come up to me and hold my hand until I am walking down the road with a trail of people touching random parts of my body. I will never again be surrounded by so many people who care so much about me while knowing me so little.

2. I am beyond prepared for the ice bucket challenge, should anyone nominate me. You think you’re so hardcore for doing the challenge? I get to do that every morning of my life here. Water comes out of my showerhead after sitting in a high-altitude mountain jungle all night. Yeah, it’s pretty cold. And guess what? It’s not hot here. Despite it being Africa and all that you may be imagining, I am living on a foggy mountain. My showers are not exactly enjoyable. But I’m also not screaming or running away every time the showerhead turns on (like many of you do in the videos I’ve seen). While we’re on this subject, most of my friends don’t even have running water. They have to go walk to a pump and haul their water back. They think you’re crazy for pouring a giant bucket of potable water—mixed with ice (a luxury I haven’t seen in 12 months)—onto the ground. And you film yourself doing it. A bucket of water here goes a lot farther than that. A single bucket can be a few baths, a hand washing station, used for cooking, poured into a filter to purify for drinking water, and then still used to wash your filthy stinky clothes. Don’t believe how dire it is? Ask the particular volunteer who put his dirty bath water into his water filter to drink later. But yeah, hey, a job well done to you for dumping that water on your body to get out of donating to a charity and having the internet capabilities to upload it so all your friends can see the struggle you went through. Ashia to you.

3. Where else can you hear, “I have prepared rat mole for you. Will you eat?” And under what other circumstances would you actually try it? And when else would rat mole actually turn out to be pretty good?

4. There is no focus on your appearance. There is nothing so humbling as not showering for a week, forgetting what makeup is, and wearing clothes that reek of mold. The thing is, it doesn’t matter. People are still happy to see you. They clap and give you giant hugs. They even tell you that you look beautiful. They compliment your dirty hair, they point out your strong feet, they say you have nice eyebrows, they tell you they love your dress. You also don’t have to worry about gaining weight, because everyone wants you to be fat! They are actually disappointed if you haven’t put on a few pounds. They say things like, “See your stomach is like your back! There are even no intestines in there! You must eat more!” And then when you do eat some more they say with pride, “You are really getting bulky!” And they cherish you even more.

5. Picking your nose in public is totally acceptable. I’ll admit, I haven’t exactly caught on to this one. It’s still a bit strange to me to be making eye contact with someone or be in the middle of a conversation with someone who is picking their nose. But I will say that I think the concept is kinda cool. No shame.

6. Witchcraft.

7. I will never in my life get more marriage proposals.  I won’t. It’s the sad truth. I have already hit my peak. But the good news is that my peak is going to last for a solid two years. I literally don’t think a week has gone by where I haven’t had at least one proposal. The man sitting next to you on the bus, your moto driver, some stranger walking by on the street, your friend who you’ve already said no to fifty times, a gendarme officer, a guy who claims to be president, the village chief, that bartender you once bought a drink from… all perfect candidates to propose to you! Declarations of love are made in all forms, from poems to general shouts to kissing the soles of your feet (see previous post). You’ll receive texts like, “Good evening beautiful, since the first and last time that I saw you I thought that you pleased me and want to see you again. Make me a sign that you accept.” And, “Dier my name is frank, pliers I will call u latar, I nerd to see u. I am mad becurs of u, pliers I will u good bye kiss frank?” Who wants to miss out on gems like those?

8. Outfits here are incredible. Style takes on a whole different meaning. I believe I have alluded to some of the androgyny that occurs with clothing here (like guys wearing shirts with extra fabric clearly meant to be filled by breasts, or grown men in pink sandals with sparkley flowers), but I want to reiterate it. People have some really great outfits. When else in my life will I get to see an 18-year-old boy wearing a shirt that says, “Do you have enough footballs for a girl like me?” Or a tough moto driver with a pink silk jacket with the word “Pretty” in silver rhinestones on the back? Or people wearing santa hats seriously? The answer is, I won’t. So I’m going to enjoy it while I can. One of my favorite pastimes is simply observing what people are wearing. You might be having the worst day in your life, but then some man is going to walk by in a denim suit with “Mishel Obama” written on the front pocket while also sporting a zebra-striped pimp hat and wearing pink sketcher shape-ups, and the world is good again.

9. People have a true enthusiasm for life here. Even the smallest of things can bring massive enjoyment. For example, my carpenter noticed a glade air freshener cone that I had originally brought from the US. He asked if I had an extra. I didn’t, but I told him I’d have my parents include one in the next care package. They did. I went to his house and delivered it. You would have thought I had told him he had won the lottery. He went batshit. I don’t think I have ever been blessed so many times at once before.

10. I will never complain about potholes again. I have a new appreciation for any type of pavement, no matter its condition. The roads in my village have gotten so bad that people are using snow chains because of the mud. Snow chains. No joke.

I am incredibly grateful for my year in the one and only C-roon. My life will never be this exciting again. 

Stray Ends

Today, while sitting on a bus, a strand of my hair fell onto my lap. I tried to brush it off to the side a bit, which attracted the attention of my neighbor and her young daughter. The mother picked up my hair and pulled it taught in front of her eyes. She and her daughter began to inspect it. They pulled it and twisted it and examined it a few inches from their noses. “This is yours?!” she asked me. They were absolutely fascinated. They began talking in their local dialect with each other and took turns holding it, passing it back and forth. Ultimately, they tied it around their umbrella handle for safekeeping. It was still there when we got off the bus and parted ways.

Epilepsy Expansion

This past week I went to Wum, in the North West region, for epilepsy work. It was our first time in the town, and we weren’t sure how things would turn out. There are currently three PCVs living in Wum who did all of the announcements and sensitizations, but they were still a bit worried about how many people would attend. A representative from CODEF also came to handle the consultations and to distribute medicine. Together, we all showed up at the hospital and met with the head doctors to introduce ourselves. The doctors then led us to a separate building where we would be holding our event. We walked through the doors and couldn’t believe it. There was a giant lecture hall packed with people! We had to bring in more benches and chairs, and still there were people who had to sit outside. It was entirely overwhelming. By the end of it, we had met 96 new patients. We began by giving lessons on epilepsy and talking about how to take care of someone when they have a seizure. We then began taking statistics and surveys, and one by one the patients went in to meet the CODEF representative for their consultation. Half way through the day we realized we would not be able to see every patient before dark. We ended up extending our consultations to the next day. We worked from 8:00am until after 6:00pm on the first day, and from 8:00am until 2:00pm the next day. By the second day we had seen everyone. It was exhausting! It was incredible that so many people were affected by epilepsy. This has been our highest turnout yet. We have been talking to the hospital about the possibility of starting an epilepsy clinic, and at the very least, Wum will be added to the list of places CODEF visits each month. We were told that even more people have epilepsy in the area and would have attended had it not been for poor roads and expensive transport costs. We are thinking of expanding in the area and traveling to some of the more remote villages near Wum. As always, everyone was very appreciative. As for myself, I could not be more thankful for the team of volunteers who helped out and made it all possible!

Witchcraft

In Mahole, a town so small, the children had never seen a white person before,* there are over 17 people living with epilepsy. Earlier this month a woman gave a child some peanuts, and the child had a seizure. That woman was immediately accused of witchcraft. She was beaten almost until death and was charged for her crime. Her case is being dealt with by the regional counsel. They consulted with a doctor who, through our initiatives, has worked with CODEF. He was able to advise the counsel that witchcraft is not a scientifically proven cause of epilepsy, and directed them to speak with CODEF further. When I met with the village, I gave lessons about the causes of epilepsy and how to react to a seizure. Over 20 people attended, all of them fervently asking questions and taking notes. One man raised his hand. He was the father of a teenage boy living with epilepsy. He stated, “We always thought it was witchcraft. We thought he had been cursed. Now I am realizing that a head injury can cause epilepsy. When my son was younger, he was working under a coconut tree, and one fell on his head. He got very hurt, and shortly after that he started falling [the term used for epileptic seizures in village].”

Witchcraft has been a very hard obstacle to overcome. It is ingrained in the culture and is part of most people’s belief system. Their belief in its role in epilepsy is the leading barrier to the reduction of stigma. Peace Corps Volunteers in conjunction with CODEF have been trying to educate communities on the proven causes of epilepsy (of which witchcraft is not one) in order to reduce stigma and promote proper care. In fact, one of our strongest arguments is that America does not have witchcraft (a fact Cameroonians strictly believe), but that America still has epilepsy.

After giving one such lecture, the hosts served us a meal and drinks. The hosts began talking about the witchcraft subject. “Africans are always using witchcraft for evil. They spend all this time only to create bad things, like epilepsy. But whiteman witchcraft is used for good! Look at the whitemen, they sit around thinking about how to create good witchcraft! Like…look at this bottle! [Holds up her soda bottle] This is whiteman witchcraft! This is good witchcraft! The whiteman has also made airplanes…record players…and…the telephone! Those are good witchcrafts! But here in Africa, we only have evil witchcraft. Africans can be just as smart, it is only that they are concerned with evil things. They need to create good witchcraft.”

* I know the children of Mahole had never seen a white person before because after my lecture a father told his daughter, “Now, when they ask you in school, ‘Who has ever seen a white lady before?’ You can raise your hand and say, ‘I have seen a white lady!!’” Then he turned to me and said, “They have never seen someone like you before!” Peace Corps: improving lives. 

The Sad Reality of Epilepsy

In one remote village, an old Pa shared his experience. His first born daughter had epilepsy. She was a mother of twin girls. One afternoon she went to the stream behind their house to wash clothes. It was during the dry season, so the stream was very low with only a few inches of water. She had finished the laundry and had it folded in a basket on the rocks when she had a seizure. She fell into the water in such a way that both her mouth and nose were covered. 

Her daughters began crying. Eventualy their cries drew a villager to investigate, but it was too late. She had already drowned. Her two young girls are now motherless. They are about to enter nursery school. They are shy, and sat on a bench quietly playing with each other during my meeting with the Pa. Their mother was my age. If she were alive today, she would be 23 years old.

Later that same year, the Pa’s second daughter had an epileptic seizure while cooking. In Cameroon, woman cook in outdoor kitchens over open fires. She was alone. She fell into the fire and suffered terrible burns. The Pa showed us the tattered rags that were left of the dress his daughter had been wearing that day. She was transported to the hospital, but died the next morning. She also left behind a young child.

The Pa additionally has one son living with epilepsy. He prays every day that his son will not be taken from him the way his daughters were.

The hardest part about confronting these deaths is that they are so unnecessary and senseless. If these women had had access to medicine, it is likely they would not have had seizures those days. If there had been basic education, if the women knew the safety precautions they could have taken, if the community knew how to react to a seizure, if villagers had accompanied them—countless ifs—those children would likely still have mothers today. Epilepsy is having dramatic consequences in Cameroon which can be prevented. CODEF and Peace Corps Volunteers are working hard to create awareness, distribute medication, and bring basic education to rural communities to fight against results like these.