23 February 2009

The video

Apologies to those of you who receive this blog by e-mail and weren't able to view the video. It's also available here.

22 February 2009


Seventy years ago, when Benin was still Abomey, a Q-tip-shaped parcel of land wedged within French West Africa; when the memory of Portuguese slave ships was fresh and the mention of Dahomey warriors still struck fear; when Mohandas Gandhi was fasting, Adolf Hitler was attacking, Judy Garland was following yellow bricks, and John Steinbeck was writing about angry grapes—seventy years ago, when the world was declaring war on itself for the first time, Gbayi* got sick.

It may have been measles—it often is. The thing is, unlike others who got what he got, he survived, but the victory was unfortunately Pyrrhic: not long after, his lips fell off.

No, seriously. I've written about noma before, but it never ceases to amaze me. See, we all carry around in our mouths somewhere on the order of 800 species of bacteria, but, besides feeding on the detritus you leave behind when you don't brush your teeth (and lining the pockets of Procter & Gamble executives), these bugs do very little of dramatic import.

Except in noma.

In noma, an immune system weakened by a recently-fought-off infection becomes unable to contain the bacteria, and they're left alone, free to devour more than food.

Why they attack some patients and remain docile in others, I don't know. But seventy years ago, when the French were still guillotining people and Clark Gable was going with the wind, they ate Gbayi's upper lip. And part of his nose.

Gbayi is now 77 years old. Age has rendered him unable to walk—he was carried to the stadium on his son's back—and, seven decades later, his hands perpetually hover around his mouth, as if by doing so they can prevent the shame that has shadowed him since Einstein was researching atomic bombs.

And Gbayi was only one of over 2000 stories we saw in two days at the Hall des Arts, Loisir, et Sports this week (loisir, for sure: half the chairs in the stadium were brown—sometimes garish red—leather armchairs, incongruously defying the remaining wood-and-metal seats; they, I assume, are where the important people sit). Over the course of two days, patients who had begun lining up in the middle of the week wended their way through the sports stadium toward the surgical schedulers, who would give them a date for their surgery. Not everyone made it there, but we said yes far more often than we said no.

Massive tumors and goiters the size of watermelons, clubbed feet and contracted arms, burned faces and bowed legs, hernias, hydroceles, and fistulas—each accompanied by a story like Gbayi's.

Physical deformity, a lawyer once wrote, calls forth our charity. The need, as always, is greater than any group of humans can help. But that is perpetually a good reminder.

The first patients arrive on Monday. Pictures will be forthcoming, but, in the meantime, here's a six-minute video from the day (Gbayi shows up near the end):

*Not his real name

17 February 2009

They do things a little differently here.

All it took was a nun.

The flight from New York City to Paris and on to Benin was about as uneventful as flights go; maybe half an hour of turbulence and two complimentary glasses of cognac rocked the entire sixteen hours of travel. Until I landed in Benin, the only thing eventful that had happened to me was that, despite my best efforts, I thoroughly and completely lost an armrest war to my left-hand neighbor, who seemed to consider that his window-seat ticket also bought him a controlling share in the adjacent aisle seat.

Given that he was approximately double my size (you will see...this promises to be a recurring theme), I'm surprised I lasted as long as I did—which, to be fair, was only about 27 minutes. I had little choice but to become intimately familiar with the contralateral armrest, and each passing, just-wide-enough-to-make-you-rue-elbows, duty-free-stocked beverage cart propelled by plastic smiles.

All this changed, though, on arrival at Cotonou's Cadjehoun airport. Miles more developed than Monrovia's airport, Cadjehoun has regimented lines with regimented passport agents sitting at actual, regimented desks behind actual, regimented plastic, with actual stamps, making actual, official, stamp-like sounds.

It's a thin veneer.

Evidently passport confiscations are de rigeur here; my kindly, smiling, official-sounding passport agent conveniently "couldn't find" my passport after she sent me aside to fill out an arrivals form (the first attempt being deemed subpar). She was sure she'd given it back to me. I must have just misplaced it.

My refusal to believe her led to a swift surrounding by three other very kindly and official-sounding passport agents, reminding me that—don't you know?—they were police officers and would be sure to deal with me as police officers do, merci beaucoup. Thankfully, the bluster didn't last long, and some well-placed obstreporousness aided the magical reappearance of my passport.

A little shaken, I got my hands on one of a number of freely-roaming luggage carts and settled into the throng of people waiting for suitcases. Apparently, I chose poorly, because, of all the passengers, with all their luggage carts, I was singled out.

"That's my cart," someone behind me said.

I saw no reason to believe him, and, admittedly, told him so.

"You use my cart, you pay me," he protested.

This went on for a few parries, just long enough to settle the matter peaceably, without the exchange of either money or fisticuffs.  But, unfortunately, also long enough to infuriate a thrice-as-large-as-me passenger from my flight (who, incidentally, happened to be friends with my armrest mate). He turned around, sheer anger on his face, took my two bags and proceeded to hurl them to the floor with as much force as he could muster (which was a lot).

As if this wasn't dramatic enough, he then began screaming at me, his words mostly drowned out in the shower of spittle I found myself under. When he started pushing—hard—a small British nun in a grey habit stepped between us.  For this, I'll one day get to thank her.  

After my erstwhile attacker had returned to his conversation with my erstwhile armrest antagonist, she turned to me, said, "They do things a little differently here," and quickly disappeared into the throng.



Meanwhile:  It is spectacular to be back on the ship, back among friends.  Our screening day is tomorrow, and surgeries start on the 24th.  Updates will be forthcoming.