Super Size Me

We are on the edge of the second part of this big adventure. If the actual moving of our material things and ourselves - the realizing and accepting that we have left behind our friends, our comfort zones and cozy places- was Part I, then we are ready for Part II- meeting new people, starting new routines and trying to understand new systems.

Having a baby has certainly been a great boost to our popularity. Everyone loves a new baby. People in the neighborhood stop to congratulate us and wish her well. A woman down the road even stopped to offer me a ride home one day. Nothing increases a sense of belonging so much as seeing people from your neighborhood outside your neighborhood and being recognized. So now I know Ingrid, whose little boy was born in America, New York to be precise, and whose grin grew so wide and so bright when I suggested he was my little brother that you might have thought I was offering him a position as part of the royal family. There is the guy on the corner who sells phone minutes, soda and eggs (an interesting combination to be sure) who greets me every morning with a “bonne journee” and welcomes me home every evening with a “bonne arrivee.” And the woman at the little super marché who waves and calls out a cheery “Good morning” in her Ivorian accent. We’re beginning to find a fit in the neighborhood.  Now for the school.

School in French. I finally managed to land a real job with a real contract in a real school, even if it feels like another world. Although I haven’t begun teaching yet, I am sure that the French system is vastly different than the American system I have been teaching in for the last 12 years. I’m just not sure what different means. 

Nabih and I will be in the primary school in a bilingual class. I teach the English portion of the day and my co teacher will lead lessons in the afternoon in French. We’ll both be teaching our native language and math. In addition, I’ll teach science and technology in English and he’ll teach geography in French. Apparently we also plan PE, art and music (though the coordinator of the bilingual program has been recruited for singing, since she has some talent in this area.) When we are not teaching, we’ll each work with small groups of students who need extra language instruction.

It sounds as though I will be spending most of my day in English, though the manner and method of teaching is still unknown to me. I am working to get Nabih in this class and, if it works out, he is sure to be marked for help in French. A nice way for him to ease into the program. Mohamed, however, already at the lycee (secondary school) will be completely immersed in French, as well as trying to learn Spanish (we opted out of the choice to take Latin, 3 languages at once seemed like one language too many.)

It’s not just the teaching methodology that is sure to be different; the teachers themselves will probably mystify me for a bit. The French culture is one I haven’t spent a lot of time around, despite my years in Francophone Africa.

What I’ve seen so far, after just hours in the classroom, is that I want more.  I want more books and more space. I want more planning time, more teaching material, more information about how the day is run. Because the French system is an officially regulated system (meaning there is one-and only one- curriculum that every French school is mandated to follow) the teachers seem to have a lot less planning. My co teacher has been doing this for 26 years so that, coupled with the fact that he has a text for everything, means he is feeling pretty laid back about the beginning of the school year.  He has all his favorite teaching materials and has spent virtually no time in the classroom preparing.  It seems to be the norm as very few teachers have been around the few times I’ve visited the school. In this week before opening, the classrooms are quiet and dark; the doors are locked.  Most of the walls remain bare.

I wrote up a list of questions that I had about getting through the first week. We spent 3 hours going over philosophy and routines- enough time to give me a pretty good idea of what I’ve gotten into. Luckily we both have similar ideas about how to guide children through their learning. Making sure they understand why they are learning something and what the actual objective of the lesson is are common points we share. What I didn’t hear was any thoughts on differentiating, aside from allowing students to work at their own pace and recognizing quality over quantity. The way he accomplishes this is to have the students come to his desk every time they finish a problem. This also serves as a way to integrate some movement into the day. It sounds like a lot of lines and wasted time. And the thought of sitting at a desk is completely and utterly foreign to me. I’m not sure I can do that.  

Talk of assessment was equally dismal sounding. Most of the assessments are included in the text, though he mentioned creating a few of his own- multiple choice.  I realized that my expectations for student learning are probably slightly different than his- and than what the students are used to. It would be completely unfair of me to bring that into the testing or the evaluating. I am going to have to remember this.

It would be much easier, of course, if the lessons in English were as readily available as the ones in French. He opened the supply cabinet to show me how he’d organized it- one side for each of us, his row of shelves stocked with teaching guides and reference material, my side empty. Since this is the first year of CM1 (the American equivalent of grade 4) as a bilingual class, the math book will need to be translated. Luckily only the sections I will be teaching.  The science and technology are already in English, apparently some CD thing we will view on the SmartBoard.  I am not expecting any experiments but hope to be happily surprised. It’s the kind of thing that I wonder if it will be frowned upon if I bring it in. I don’t want to be that teacher that comes in and insists on doing everything different, but there are some things I may not be able to change, don’t want to change in fact. Learning by doing. Learning by seeing and trying. Learning by experimenting and drawing conclusions.

One of the biggest adjustments I may have to make is in the study of language. The guideline I was given breaks it down into 5 categories- grammar, conjugation, spelling, vocabulary and the last box a double title, reading/writing. In one box? This box only contains the titles of one story- in some of the periods only a genre is given. A period is about 2 months. When I inquired about a reading log or some other tracking system so students can see how much they read and what genres they are reading, it was translated as reading rally, as in a race to see who reads the most. Not exactly what I was thinking. I was trying to figure out how to create a culture of reading in a classroom devoid of books. There is nothing in the boxes that refers to types of writing or extended writing of any sort. As a lover of literature and a writer myself, this is going to be a huge change for me. I might be able to go ahead with a reading program that is slightly modified from the one I am used to, but writing?

When I asked about homework, I was told technically it is not allowed.  No homework until they get to college (middle school) when they get piles of it, without ever having had the experience of it before. I was told that realistically, homework is given out but very minimal. Reading, maybe a few exercises from a text or “learning a lesson” (further inquiry required to understand this means being able to recite back a rule of some sort- I understood it similar to spelling rules I grew up with as a child. “I before E except after C or when sounded as A as in neighbor and weigh.” ) Students are given a week to memorize it and share it in class. No writing. Writing is strictly forbidden as homework. Hmmmm.

In the end, I am left feeling as though I have been downsized (not necessarily a negative thing. It means adjusting, that’s all.) Other things I’ll need to get used to:

• Less technology- While we have a SmartBoard in our room, there is only one desktop computer available with the program for running it. Anything I’d like to create will need to be completed on this computer. There is no Wi-Fi, no teacher laptops and no school email. How am I going to create a class of bloggers, wiki users and Google searchers? There is a lab where I can take students- 12 computers for our class of 23. Lab partners will work out fine, but I am left to wonder where the acquisition of technology skills falls on the priority level.

• A shorter workday- School runs from 7:30-1:00. No lunch is served as the campus lacks the facilities for this. Once a week there are meetings for the bilingual class teachers and every other week a full faculty meeting. Otherwise, many teachers go home at 1:00 most days of the week.  I’ll probably stay a bit longer out of habit, and also because my program is new and will likely need more preparation and creation of materials.  But I have a theater idea in my mind and might consider offering that as an after school activity. I’m not sure if it’s the local contract or the French pay scale, but either way picking up a few extra francs during a fun after school activity is probably a necessity in my future.

• No sticky notes- what??!! Students are required to buy all of the materials they will need- and even some us teachers will need (like reams of copy paper.) The school provides very little (I am tempted to say nothing, but there is a small paper and supply room that the Cycle 3 teachers share.) There is no requesting office supply material- buy and bring your own. So long, sticky notes. You probably won’t make my budget. 

• Fewer emergency drills- In Kinshasa, we had drills for everything. Fire, intruder on campus, emergency information to be distributed, the ‘safe room.’ These drills were coded with colors, red, orange, blue, yellow, and each required retreating to a different space depending upon the nature of the emergency. Here, one drill, one meeting space. Keeping it simple.

In light of the recent addition to our family, keeping it simple is hugely important. After my months of restlessness and cabin fever, I am suddenly quite content to sit and stare at our little cutie. If that happened to pay well, I would never have ventured out into the world of work and structure.

I’m sure as this experimental year goes on, I will have plenty of opportunities to re-examine my current philosophy and methodology of teaching. I may find some opportunities for growth and adoption of new ideas as well as a confirmation to hold firm to current convictions. In between all those ideas, I’ll be busy staring at the baby- who is bound to be doing some growing of her own.

Screen Time

The Simpsons. Family Guy. Big Bang Theory. Even getting the names of 3 TV shows for my opening hook was an exercise in heavy thinking- and most of those are old titles. We’ve never had TV before Abidjan. Of course, we’ve heard of the shows and watched them out at friends’ houses, but when I asked Nabih for the names of some of his favorite current TV shows, all the ones he gave me were in French (which I secretly love though probably couldn’t begin to spell.) Watching TV in French is something of a challenge for us all. But it’s good for our French.  It’s also been good for bringing up conversations about topics I might not have thought to bring up otherwise.

Nabih still prefers cartoons and is most likely to be found watching Camp Lake Bottom or Oggy et Les Kafars- a Tom and Jerry-ish cartoon that features a cat and three annoying bugs. (Honestly, he is a die-hard Big Bang Theory fan, which we have on USB for some reason. We have 6 seasons- in English. He is more likely to be found watching that if a computer is available.) Mohamed prefers the sports or music channels. When he is in control, we are watching a soccer game, music videos on Trace Africa or something athletic on Trace Sports Star (I’m not sure what the Trace connection is.) One of our favorites is the Top 20 lists that feature different topics about famous athletes: bad eaters, bizarre facts, cheaters, bad habits, most involved in a charity, stuff like that. 

Since we all pretty much believe Mohamed is going to be a famous soccer player one day (Insha’Allah) the lists have opened up the path for discussing how to handle stardom (sure to be good advice for becoming a decent, average person as well, in the event the whole famous thing doesn’t work out.) We’ve discussed bad habits like spitting (he’s promised not to be a spitter if he makes it to the big leagues,) how to deal with the paparazzi (patience, disguises and body guards over anger and violence) and wayward fans (I am still in shock over this story, Mohamed’s only strategies for dealing with this kind of behavior is to run and duck. I probably can’t offer any better advice.)   

Conversations like these have helped me to understand who his role models are and the influence they have on him. Happily I see that he is pretty good at mixing his personal values with characteristics he admires to create a fairly decent profile of the man he hopes to be.  I also like that he is aware of and has begun to consider the pressures people face- and how it intensifies the more popular you become.  Who knew the side effects of TV could be so deep reaching?

On the rare occasion when I am in control, I generally seek out news. On a lucky day I can find news in English. We have been so immersed in French that hearing news in English feels like a treat. Everything else about it is depressing. Ukraine, Palestine, Guinea.  Between war, illness and airline crashes there’s not much positive coming out of the news today. Taking it all in one afternoon, Nabih posed the question out loud that we all grapple with privately. Why is there so much war and fighting?

Mohamed’s analogy in response was simple and to the point. “Well, it’s about space. Everyone wants their own space. For example, you want your own room, right? So it’s like you have to fight to get it. And once you have it, you have to protect it so no one else will move into your room.”  The essence of war reduced to 9-year-old terms.

In addition to the new experience of raising a teenager, I am reliving the joy of late childhood albeit with the electronic twist of the 21^st century. Nabih is all about video games (though he somehow manages to maintain his love of reading.) While I remain a bit confused about what kind of skills he is developing and of what value they might be, we have found a place to meet and have fun together- electronic board games.

So far, he has Life and Monopoly- childhood classics. I enjoy the fact that all the pieces are intact- no one can borrow the Monopoly money for a game of Store or Gangster and then lose half of it under the couch or accidentally leave it in a pocket where it gets washed in the machine. The graphics in the Life game are especially fun for me as they resemble exactly the board game. As you drive around the board, the seasons change- I love the snowing area which makes me feel all cool and cozy and Christmassy without really being cold. No little people pegs get lost and the spinner never flies out of the holder (although one might argue that was one of the more interesting aspects of the game.)

Of course, the automatic banking system is both a positive and a negative. While things go much faster, no one has to calculate any math, which was, from a parent/teacher perspective, one of the benefits of playing the game.

There are a few other strategy games, a building game, and a virtual reality game that allows Nabih to construct imaginary worlds. I realized these games are similar to what we did as kids when we played with dolls or Matchboxes. The difference is he doesn’t have to scrounge for old boxes or cool pieces of hardware to serve as tables and chairs and couches.

As the summer winds down and we get ready to start new routines, one of which may very well include home schooling, I’ll be searching for the moral in the mundane, on the lookout for those teachable moments lurking just inside the ordinary experience.  And while I’ll be happy to see screen time reduced to a minimum, I’m going to try and remember that there might be a lesson to learn there as well.  

The Promised Land

My French-English dictionary has a whole collection of what it terms “false friends.” These are words that may sound similar to one in the other language but have a different meaning than what you might be expecting. Librarie is one example of a French word that sounds similar to the English library.  While the English version refers to a place for borrowing books, free of charge, the French librarie refers to a bookstore.  Both terms have to do with books though the difference lies in the essence of what you do with them. Borrowing and buying have nearly opposite meanings. Décevoir is another example. Though it may sound similar to the English deceive, it actually means to disappoint. Both words pretty much sum up how my job search has been going. Disappointing and filled with deception of a sort. 

Quitting my job without having another one lined up is probably one of the most reckless things I have ever done. Or maybe it is just a side effect of turning 40. I got my first job when I was 14 and I have been steadily working ever since, most often juggling 2 jobs or some combination of work and school. The international teaching calendar, however, doesn’t really allow for grown ups to act like grown ups. It seems designed for the perpetually young and single, those with a fervor for travel and a lack of true responsibility. Though there seem to be more and more families in the circuit, the schedule remains unchanged- gets more intense every year in fact. The date to decide about whether you will stay or go gets earlier and earlier while the hiring season begins a month or so later. Essentially one is forced to decide if they will go or stay before receiving any offers of employment from another school.  

After much consideration (and a bunch of other pressure) I finally decided to just go for it. It’s the way things are done, I reasoned. Everyone else has gone through it and come out fine on the other end. So will I. And then of course, things changed a bit though by that time it was too late. Despite the challenges, I have always felt moving to Abidjan was the right decision. There is just the small matter of finding a job.

I spent the first month and half mostly waiting for the little one. I reasoned that job-hunting with a baby belly might be difficult. I did manage to have 2 interviews during that time however- both at the same place, both with promises of one sort or another that an offer was in the near future. It became clear soon enough, however, that despite all of the positive encouragement and reassurances, nothing was actually going to happen. Not soon anyway. Maybe not ever.

In the weeks just after birth I had another interview. I’d gone to drop off my CV and application at a local school that was newly reopening. I was met with a warm welcome and an interview on the spot. As our discussion came to a close, I asked for contact information in case I did not hear from them by the end of the week as promised.  The director said, and I quote, “You’ll hear from us. If you want to know, it was a good interview. And you being an American, a native speaker, that’s really a plus.” All signs pointed to yes.  Eerily similar to the positive response I’d received from the previous school. I was filled with a sense of déjà vu.

The promised day came and went without a word. Turns out that Friday was a holiday. I think Abidjan is probably the country with the most (obscure) holidays. Since the Muslim and Christian population (appear to be) equally split, holidays from both religions make the national list (and I definitely remember a host of random spiritual tribute days when I was a student in Catholic school.) It was easy to attribute the quiet phone to the holiday.   

As more days passed it became clear that perhaps this was another example of an unfulfilled promise. We pondered over why everyone seemed so free and easy with the positive words, gushing about how enamored they were with me only to disappear in silence at the last moment.

I did stop by the school to follow up and was told by a very friendly secretary that she’d heard the post was filled. She wasn’t sure by who or if that person had even been contacted yet. Things were busy with the reopening. She promised to remind the director to send out the emails and make the phone calls alerting potential applicants. Apparently I wasn’t the only one checking back in to see if a decision had been made. The vague answer left me still in hope. Still in wonder about how the initial greeting could have been so warm and the follow through so cold.

I finally received the call this evening at 6:30. Long after I’d given up. “I was supposed to call you,” the director said, as if we were old friends. There’s a reason why he is the director. I was charmed enough to overlook the fact that phone call was arriving a week late. He proceeded to offer me the position, details still murky but promised to be clarified in the form of a contract sent to my email inbox on Monday. Sounds as though it will be less than half time, which comes with both positive and negative aspects.

Luckily, I have another interview scheduled, also for Monday. This time I will not be swept away with hope and excitement at the mere prospect of an offer. A contract in hand is the only thing that can sway me. No vague promises. By Tuesday evening I should know without a doubt what my employment situation is. Of course, I’ve had that thought before and been completely wrong. No more false friends.

A Birth Story - Parts 2 & 3

PART II- La Gaaz and les sage femmes 

I spent most of the next hours comparing everything to my previous c-section experience. Technically speaking, it was comforting to be able to have a reference. Getting prepped, the anesthesia and even the ‘table’ were all the same. There was that sensation of pulling, similar to having a tooth pulled times one thousand- mostly the same.  The doctor here in Abidjan seemed to be a bit more brusque, but perhaps that is just due to the experience being more recent and fresh in my mind.

I recall complaining during both procedures, though, again, the doctors here seemed slightly more annoyed by it. Finally the anesthesiologist asked me to bend my knee- a test I assumed, and one I thankfully failed. Nothing really hurt, more of an intense pressure that was just extremely uncomfortable.  Both operations included that blank moment- just after the peak of my complaints. I’m not sure if all women experience this but in both cases I missed the moment of birth that is such a prominent mark in a regular birth. The release from the birth canal, the moment of accomplishment. The cry. I assume it is what woke me seconds later. I immediately asked about the baby, fearful I had missed more than mere seconds. A nurse carried a tiny bundle over to me and held her up for a kiss. She was sweet and small and wrapped in a warm green blanket. Quite the opposing scene from little Nabih, who appeared to be 3 months old at birth and all arms and legs exploding from his blanket. “Where is my baby?” I remember thinking as I caught a glimpse of him in the nurse’s arms. “That can’t be my newborn.”

Mbalia, on the other hand, was nearly lost in her wraps. She was still covered in fuzz, a light blond fur making her appear golden and fragile. She was whisked away to be warmed under the light, and I was left to recover from the anesthesia. Suspended time is the only way to describe those after moments alone in the recovery room. Everyone has cleared out, washed up, gone off to other duties and I am lying on the bed feeling my pupils struggle to adjust to the light.

Lost in her wraps

In both cases I was left with a tremendous desire to see my new baby, which conflicted, of course, with the nurses’ desire for me to rest and adjust to my new stomach.

I can’t recall how long it took me to recover when Nabih was born. Nature kindly wipes out most of the details of pain and leaves us with more of the sense of joy. I remember the first time I tried to sit up and the deadly sharp pain that shot through me. And then I remember sitting on the edge of the bed, waiting for my ride, all too anxious to get out of there. Nothing in between.

This time around? I definitely felt like I’d just come from battle. I was exhausted, beaten up and had the bruises to show for it (further proof that the Ivory Coast team really was more brusque- my IV’s and tried-to-be IV’s were bruised for weeks afterward.) The worst part of the whole deal? The beds in the Clinique were not adjustable. If I wanted to raise my head then I needed to sit up or reach around and fluff the pillow myself, both impossibilities.

Feeling like I just came from battle 

The best part? The sage femmes, the nurses and CNA’s assigned to care for me. They were all sweet and gentle and present. Having been in a variety of hospitals and clinics in Kinshasa, I can attest to this last quality as being the most important. While the bed may have lacked nifty electronic switches, there was a call button by the headboard and the nurses were constantly on hand.

At 5:30 every morning, someone came in to give me a sponge bath, surprisingly a warm and comforting routine. Shortly after, my medicines were checked and adjusted (I was being treated for malaria as well as given some pain medication.) The baby was brought in and the sage femmes continued to check on us throughout the day.

What I don’t remember from my first experience was talk about la gaz. I was given Lipton tea with sugar cubes on the side for breakfast. No milk. No food. Not until I had la gaz. The nurses were checking in with me every hour, which got Christian asking the magical (and previously very private) question. I thought maybe I was missing something and so asked Christian what the gaz was, just to be sure. Not only did he confirm my thoughts, but when he mentioned my possible confusion to a nurse she gave an impression that would make a 10 year old boy proud.

Considering that I had thrown up several times before arriving at the hospital I wondered what in my stomach was supposed to contribute to passing wind. Air pockets? Had they sewn me up with air pockets? Wasn’t that dangerous? I began to doubt the abilities of the Ivorian doctors as I wondered how many days I could go without eating. I wasn’t especially hungry, but caffeine and sugar on an empty stomach were slightly nauseating. Christian was convinced it was medicine and spent a good portion of the evening and next morning encouraging me to drink it all down. I wondered how much gas counted as la gaz and whether anyone would know if I lied? It was my only road to freedom. Not only couldn’t I eat, but I wouldn’t be allowed to go home either.

By the 3rd day it was becoming comical, in that horrifying way. I couldn’t face another cup of Lipton. I was ready to go home. I’d mostly mastered walking if not sitting up and lying down on my own. I finally felt something that seemed good enough. We signaled the nurses and began planning for our departure. That evening, the cafeteria sent up a bow of oatmeal. “Quaker” as it’s called here. “They let us know you had la gaz.” He smiled (did I imagine the wink?) as he set the tray down. I envisioned the cafeteria workers breaking out in a musical, dancing around the kitchen and singing about my gas as they prepared the next round of torture. Quaker showed up again for breakfast. I was happy to be going home before lunch.

PART III- A million medicines and a mom

If you’ve been reading for awhile, then you are aware of my on-again-off-again relationship with doctors. I fluctuate wildly between trusting them and preferring my own version of seeking health and wellness. In general, I feel exactly the same way about medicine. I have a collection of essential oils that I tend to rely on, a few teas and herbs and a strong belief in suffering through whatever other aches and pains they won’t take care of. I believe in garlic and cinnamon. In ginger and lemon, in yogurt and pumpkin seeds. For whatever ails me, there is usually an herb or spice or food that has a history of curing it.

So I was completely appalled at the list of medicines the doctor prescribed for me. Anti- inflammatory, pain medicine, iron, antibiotic, antiseptic.  There were compresses and gauze pads, even a sterile razor- for taking out the stitches a few days later. The baby didn’t get off any easier. I’d already noticed a bottle of something to soothe the stomach that was bigger than she was. They’d been giving her formula in the nursery, waiting for my milk to come in. I imagined she had spit up a few times, resulting in an immediate prescription. In addition, she had vitamins- folic acid pills (pills? for an infant?) and liquid drops, eye drops, alcohol and an antiseptic (yes, 2 different medicines for cleaning her cord- a cord that was an inch long and going to fall off in 5-7 days, 3 of which had already passed at the hospital.) There was another medicine for after the cord fell off and it actually stated on the box “for the healing of umbilical cords.”

I now had enough medicine to open a small pharmacy. While Christian was busy encouraging me to take them all and follow doctor orders to a tee, I was busy looking for any excuse to lighten the load. I read all of the inserts. Several included the notice “not to be used during pregnancy or breastfeeding,” which was enough for me. The doctor had previously given me a prescription for carbonated calcium, in which was explicitly written “not to be used during the last months of pregnancy.” I’d ignored that and was prepared to ignore most of these as well. The baby vitamin insert stated they were “not formulated for children under 1.” It was enough to shake my confidence in doctorhood once again.

But for the tot’hema, a combination of magnesium, copper and iron which promised to cure my anemia once and for all, and the house calls I might have been resigned to permanent disillusion. Christian, ever popular with the nurses and a seeming favorite of the doctor despite their initial haggling over my admission and hospital fees, had arranged for several home visits. At first, I’d cringed and resisted, but upon reflection I realized that even in the States a home visit wasn’t so unusual. If it made him happy, then I could suffer through a few more rounds with the medical team.

The nurse came the day after we’d arrived home. I thought she was there simply to check the baby and offer a few tips on cord care. It wasn’t until she offered to bathe me that I realized the full extent of the visit. A warm sponge bath in the days after surgery had been welcoming, but the prospect of one in my own home struck me as downright weird. I politely declined. 

The doctor came a few days later. She showed up with her 97-year-old mother who took a seat outside by the door. I would have loved a photo of this woman, dressed to the nines, resting on a plastic chair on our porch but couldn’t manage to do that without appearing to be a tourist in my own house. The doctor, rather stylishly dressed herself, attended to my stitches in the comfort of my bedroom. And why not? I had a rather complete pharmacy at my disposal.  She came back the following week just to remove the final bandage and clean the area where the adhesive had left a sticky residue. One of my prescriptions had been for this very medicine, which also doubled as an anesthetic she informed us- for bandits. She mimed the way chloroform is used in the movies, soaked on a rag and used to knock someone out before a kidnapping. Christian and I both looked at each other and laughed. “Don’t get any ideas,” we said at the same time. After all, what fun is having your own pharmacy if you can’t knock someone out at will?

And so our birth story, which began with a furious fever and ridiculous negotiations at the most in opportune time, ends with house calls, health and good cheer. I've let go of all the things I couldn't control and managed to hang onto the things that I found especially dear. 

We're both exhausted- no glamourous photo for us

A Birth Story - in 3 parts

I’m finally back. Computer charging issues, internet connection issues and labor and birth issues all kept me isolated and unaware in my little house at the edge of the village. I have noticed in my time away, with only the briefest stolen moments visiting the cyber cafe, that already my fingers have learned a new keyboard and it is with some effort that I now revert to my original settings (happily, magically the j,k,l keys have been restored and are in working order.)

I am back with stories, they’ve been building up over the weeks and I guess the best place to begin is with the primary reason I was away. My birth story, or rather, the little princess’ birth story is, of course, not like others. Nothing I do is ever easy or straightforward it seems and giving birth is no exception. The little sweetie arrived in true African style- lots of drama and fanfare to bring her into the world.

We don’t have a new age story of a water birth or a contemporary account including a midwife or a doula. There is no amazing home birth tale and happily no tragedy to report. But there is a story- our story of one birth in Abidjan and it begins somewhere in the middle, as I am fond of stories that get right down to the essence of things.

PART I- Fevered Negotiations

Christian reached over to pick up the white sheet of paper lying on the tray, a sheet of paper I would have left behind, blank and untouched. He gave it his careful consideration, reading each question, checking off boxes and nodding his head in satisfaction. “What do you think? It’s good not to discourage anyone.”  He handed the paper to me for review.  He’d marked a variety of “satisfied” and “very satisfied” on the hospital survey sheet. I looked at him incredulously, smiled faintly and wondered if we’d spent the last 3 days in the same place.

We’d arrived at the Polyclinique on a Saturday afternoon.  The Thursday just before I had shown up with a slight fever and some contractions. I received a fever reducer, monitored the baby’s heartbeat and elected to go home once I began feeling better. The next day I felt so completely returned to normal that I was happy we had evaded the hospitalization and  c-section that had been talked about on Thursday. We had gotten the happy news that the baby had turned herself around and was in good position for a natural birth. We were determined to stick to that happy path.

On Saturday morning I headed out to see the boys' soccer game at the camp by the lagoon. An hour into the game, the cool breeze coming off the water had me shaking visibly and uncontrollably.  A pile of covers and my cozy bed was calling me.   I moved, not quickly, but with focus and managed to grab a taxi home. 

My temperature had plummeted to 34° and my fingers were blue. I breezed past Christian’s alarmed face and dove beneath the blankets.  Within 15 minutes my temperature rose to 37° and by the time we arrived at the hospital I was near 40°, sweat pouring out of me like a cartoon character and contractions coming strong enough to make my eyes water.  The doctor had agreed to meet us this time and so we sat in the waiting area hoping for her quick arrival.

She called us into an available office where she confirmed my temperature. She wanted a malaria test. I’d already had 2 malaria tests in the past 3 days- all negative. She began to speak again of admission to the hospital and a c-section. We’d been trying to avoid this. My main issue was not really being able to determine if I was in an emergency situation or not.  And whether or not I actually had malaria (remembering, of course, that it’s always malaria, even when it’s not.) The doctor had appeared to be pro-caesarean in the short time we’d known her and that was essentially the problem. We just hadn’t been here long enough to make a real connection, to develop the necessary trust and to really delve into her philosophy of childbirth.  Christian was really pushing to avoid the surgery and the doctor hadn’t convinced me yet.  But I was dehydrated and feverish and wanted attention. I admit to yelling a bit at this point. Yelling about the malaria test, yelling that I wish I could just trust the doctor's decision and not have to try and make it myself. I reflected- loudly- that perhaps going to the US would have been a better decision, even though I knew I didn't really mean it. Not for the months and months. But for just this one moment, this one health care moment, the US would have been a bit more comforting. 

Meanwhile, Christian began the negotiations on price. Because the hospital did not take my insurance, I’d had to complete a bunch of paper work and pre-authorization forms in order to be sure I would get reimbursed. This included the cost of the hospital, doctor and medicines. Often, hospitals in Africa require the patient buy all the medicines separately (usually, conveniently, at a pharmacy located within the hospital) in order to be treated. The doctor or nurse needs to receive the receipt of payment before issuing any medicine. We’d had numerous conversations trying to determine total cost and had been assured the fee sheet they’d given us was all- inclusive (doctor, medicine, room, even meals.) Now that we were being faced with possible admittance to the hospital, the game was changing. We worried that if the fees were suddenly higher than those we submitted, we wouldn’t get reimbursed.

While I was on the phone with insurance company getting the ok to be admitted and possibly receive an emergency c-section, Christian was busy negotiating the fees for the hospital stay. It sounded like he wanted even less than had been written on the fee sheet. Or maybe that's just the way negotiations begin- much lower than the final price you hope to end up at. And me? I was still dehydrated, fevered, drenched in sweat and contracting.  I’d like to think the part when Christian began suggesting we go hospital shopping for a different place that would accept my insurance outright (not possible I tried to assure him) or one that was less expensive  - yes, I like to think that whole conversation was part of a fever induced hallucination. Go out into the world, searching for clinics? In my state of half labor and half delirium?  Had he any idea how much scanning and emailing I had done just to get the clearance to deliver here, in this hospital?? Or was this just harmless threatening, all part of the bargaining process? Like, these apples aren’t that good for the high price you’re demanding so I am going to buy from that guy over there……and then hoping the response is No, no, no of course I will reduce my price for you.

Except we weren’t buying apples.  And I didn’t really want to negotiate. What I really wanted was some of that saline or glucose drip they give to people who are dehydrated. Every sip of water I had tried to drink came back up almost immediately and I’d been reduced to sucking on ice. We had been at the hospital for what felt like an hour – without ice- and all I wanted was a drink. I tried asking for that thing- yes, my French failed me miserably in the hospital, not having any of the needed vocabulary- you know, that thing, I said, you give to people who are full of thirst? Can’t I get some of that?

What I finally managed to get was moved upstairs. Christian and the doctor had agreed to begin treating the fever. We’d also discussed a c-section. I was trying to be convinced it was an emergency. It was feeling that way as more and more time went by with no one actually doing anything. The doctor kept saying,".....and you can check the internet on that." The 21st century version of 'trust me' I guess. The problem was I couldn't search the internet on that. Not easily anyway. I had tried looking for 'fever' and '37 weeks' but nothing helpful came up. And the site I really wanted was nowhere to be found. The one that said, "Yes, it's an emergency Soumah, you need the surgery. Go ahead and trust your doctor. Yes, you." In the end, what else could I do?  

In the maternity section, I was greeted by several of the nurses from the previous visit.  But still no one really took action. Somehow it appeared that the negotiations weren’t really over. Christian began talking about treating the fever and going home again. The nurses wouldn’t begin any treatment until he went down to admissions and paid something. It was the amount of the ‘something’ that was up for debate.

I had tried to work with him in the months before this moment, prepping him on how to support me during childbirth. I hadn’t run across any Lamaze classes or other childbirth prep and so tried to give him some pointers on how to best be my coach. He’d already succeeded in staying with me long past the moment when the nurses tried to kick him out. That part was good.  But at this moment, still arguing over costs and procedures- and it was getting heated- I kicked him out. Just go, I’d said while using my pagne to clear the rivers of sweat streaming down my face. I was ready to start throwing cash at the nurses in order to get some attention. “Don’t you even take the blood pressure?” I asked, feeling hopelessly lost and nearly invisible. Hello, it’s me the patient. I have money and I want help.

This was enough to get things rolling- or perhaps the negotiations finally finished. I was completely out of the loop on how those things were progressing. The raised voices quieted, laughter actually ensued as Christian went off somewhere to pay some agreed upon advance and the nurse finally took my blood pressure.  The fetal heart monitor was put in place and I saw my little girl was racing at just over 200 beats per minute.  Christian soon returned, began fanning me and reminding me to breathe, all those coaching lessons finally coming out. After an internal exam, the doctor began muttering about how ‘sensitive’ I was. “Just a touch and you start bleeding. There is no blood in Abidjan.” She repeated this last line several times, shaking her head to emphasize her worry over my likelihood of hemorrhaging. It was both exactly the kind of thing I didn’t want to hear and the kind of thing to convince me. The nurses began prepping me for surgery and from that point, most things returned to the normal world of doctors and patients, sick people healing and babies being born.

PART II- La Gaaz and les sage femmes