Bonjour

Good morning from Niger-- this is just a quick post before I leave Niamey because I wanted to take a picture of the Niger river which runs right outside the mission house. Leaving on a small plane for maradi soon, see you later!

Oú allez vous?

I am in Niamey!  I have really good internet access here so I wanted to take advantage of it.  The flight to Niamey from Paris was smooth and when we got on the ground we rode to a mission guest house where we are spending the night.  I am learning a little more of what to expect when we get on the ground in Danja tomorrow.  Jacqui is a RN from Australia but formally trained in the UK.  She is coordinating the nurses on the ground in Danja and claims that she is in need of some extra hands at night.  Once properly trained she says that she could use my help checking catheters, taking vital signs, etc.  Mark is coordinating all the shipments to the hospital and a big container full of medical supplies has just arrived so I expect to be doing inventory on it all tomorrow along with setting up some beds and shelves.

There is also need of a research assistant who will study the time limit for catheterization post-op for fistula patients.  Some hospitals keep the catheter for up to 6 weeks post op-- the longer you leave the catheter in the less the patient is able to control their bladder after the catheter is removed.  There is also a higher risk of urinary tract infection the longer you leave the catheter in.  I'm trying to do some research right now to see what has been studied on time limit for catheterization so that I can help with this once surgeries are in full swing.

In other news, I am loving hearing all the different accents and languages around me.  Here at the mission house I hear spanish, norwegian, french, and english.  It makes me want to study and learn ALL THE THINGS (shout out to Mary French).

Just to give you an idea of where I am and oú je partirai demain (pardon my french, I'm trying to learn more..)  The map below shows my trajectory for tomorrow:

Thanks for reading and I will let you know how my first day on the ground tomorrow goes!

Airports

Hello from Paris! Or from the airport at least. I'm on my way to Niamey now that I have met up with Mark, the director of the Worldwide Fistula Fund along with Jaqui, another nurse who is heading out to the new fistula center to help set it up with us. On the plane to Paris I met a 3rd year medical student from BU who is heading out to Africa to do her clinical rotations as part of the Schweitzer foundation. She went to Niger in undergrad also and was so excited that I am going over there to study maternal health. She went back the summer after college because she loved it so much. I still don't know exactly what to expect but I'm so excited to meet the people and learn about health in a hands on setting.

I wanted to read Cutting for Stone on the plane as many of you have recommended it to me but I didn't have time to pick it up before I left so I grabbed The Emperor of All Maladies: a Biography of Cancer that Professor Tannenhauser recommended to me over the summer when I was telling him about my interest in clinical research. I haven't had any life changing experiences yet (unless you count navigating the Charles de Gaulle airport) so I will start my first blog post with a review of my in flight entertainment:

I think what strikes me most about this book and similar ones like it ("The Immortal Life of Henrietta Lacks" and "Flu: a History of the 1918 Flu") is that they make research sound like results are made every day and it is the most exciting, fascinating career to be a physician scientist-- on par with that of a rockstar or a fireman. Even when I read it, I forget how tedious and frustrating research can be and how long it can take to get real results. I salute the writers who make seemingly mundane acts of running test after test sound like a scene straight out of CSI. It truly brings you back to the "glory" of research. If I weren't heading off to Niger right now I'd be ready to hit the lab and read the literature in the manner that
Siddhartha Mukherjee so eloquently describes. I haven't finished the book yet but I look forward to reading the rest.

Thanks for reading,next stop Niamey! I promise my next post will get down to business as Ive been assured by Mark and Jaqui that we will all be very busy on the ground in Maradi.

A New Adventure

Hello all!

As many of you may know, I am conducting an internship in Maradi, Niger this semester at the Danja Fistula Center with the Worldwide Fistula Fund.  I am incredibly excited to see women's healthcare at the grassroots NGO level and to understand many of the challenges involved with administration of adequate health services with limited resources.

For those of you who may be unfamiliar with obstetric fistula or vesicovaginal fistula, it is a hole that forms between the bladder wall and the vagina due to prolonged childbirth.  Women who are in need of a cesarean section yet are not in adequate facilities for the procedure often develop a fistula.  In childbirth the baby's body presses against the bladder wall cutting off blood supply thus causing tissue death and the formation of a hole.  This hole leaks urine through the vagina and leaves women incontinent due to their lack of bladder control.  Women with obstetric fistula are the most devalued in society and are often isolated due to their urine soaked clothing.  Surgical repair of fistulas is the only treatment and requires proper surgical resources which are often lacking in rural areas of Niger.

At the Danja Fistula Center I will be helping to set up a brand new fistula center that will accept its first surgical patients on February 6.  I will be living on the compound at the hospital viewing surgeries and assisting in community development of prevention methods in nearby villages.  I leave tomorrow for Niger and I look forward to posting about what I am learning and sharing it with everyone.  If you would like to send me a letter my address is below:

SIM NIGER

CSL Danja

 B.P. 10065
9 Rue de la Tarka
Niamey,  Republique du Niger