Thursday, June 18, 2009

The usual garbage

Picture:  Along the Somali Road

Do you remember the movie “Sex, Lies and Videotape”?  The first spoken line is by Andie MacDowell who says “Garbage. All I’ve been thinking about all week is garbage. I can’t stop thinking about It”. She should have seen Djibouti.  The first impression one has upon emerging from the lunar base camp environment of Camp Lemonnier, and turning onto the Somali Road into town is that, perhaps, a garbage truck has exploded flinging refuse in every possible direction.  Then you drive on, and the further you get the more apparent it becomes that, no, there is just a lot of garbage everywhere.  In the more urban areas it is often swept into heaps, or piled in alleys or vacant lots, but as the superheated air over the coastal plains starts to rise during the later morning, the onshore breezes waft the lighter bits of trash hither and thither around the city.  This explains the ubiquity of what the Americans call Djibouti flowers; blue, pink or yellow plastic shopping bags lodged in the rocks, shrubs, trees and fences and fluttering in the blast furnace breeze.


No one has explained to us what the story with the refuse might be, leaving room for speculation.  Nothing loathe to fill this niche, I have three theories (*)which I present for your reflection.


  1. Weather:  Perhaps it’s just too hot to bother with picking up trash, and perhaps even if it were picked up it would just be carried back to the streets and sidewalks by the winds (this last probably wouldn’t apply to the tires, abandoned machinery, etc).
  2. Sociology:  When we were in Sicily, which prior to Djibouti was the most casually garbage strewn place I had visited, at our “cultural indoctrination”, our instructor explained that i Siciliani had a “weak civic ethic”.  This was accounted for by the long history of exploitation, repression and abuse which the Sicilians had suffered at the hands of just about everybody since their cultural apogee in the 13th century.  Do Djiboutians have a weak civic ethic?  There is a good deal of tension between the Issas and the Afars (a civil war having concluded only a decade or so ago), and there is a large and destitute refugee population here who presumably feel little affection for the land of their exile. Certainly you don’t see any signs saying “This highway adopted by the Djibouti Rotary Club”.
  3. Khat:  If you’ve got to get most of the work done in the morning to make time for an afternoon chewing khat and an evening recovering, there might not be time for such low reward activities as the policing of trash. 


(*) I mentioned my theories to Alex our OR nurse.  He said maybe it’s because there are no trash cans.  Hmmph.


In any event, after you spend some time here, a strange thing happens.  The garbage becomes invisible.  Do you remember Hans Christian Andersen’s story The Snow Queen?   When Gerda rescues her friend Kai from the queen’s castle, a bit of ice (the troll mirror) falls from his eye and he no longer sees only the bad and the ugly.  Some similar phenomenon is at work here, in reverse though.  It happened in Sicily too the mind filters out the appalling accumulation of trash, and one sees the city and the countryside as normal.  It’s a fascinating phenomenon and one that I think explains our both our tenacity as a species, and our occasional distressing complacency…we can get used to anything.  Except sauerkraut in my case, so I guess there are limits.


Just returned from a 2 hour luncheon with our French colleagues from CHA Bouffard.  They have both a reservist general surgeon and orthopedic surgeon here in town for the next couple of months and they were anxious that we get acquainted, which was thoughtful of them.  We met at Bouffard, stopped for a spot of pastis at the residence of Pierre Emmanuel – the head anesthesiologist, and then they took us to a smallish Ethiopian/European place nearby, where my salad niçoise was fine, and Herman reports that the shrimp were good as well.  A glass or two of wine and I must admit that despite the dark Ethiopian coffee at the end, a nap seemed like a fine idea.  Being made of sterner stuff though, I settled down to my keyboard instead.  We’ve been invited over for a few pediatric tonsillectomies and a bowel reanastomosis this weekend, so our schmoozing was not without some beneficial effect.  I’ll admit that after a couple of days in the third world conditions at Peltier, the Djiboutian hospital, a chance to work in the relative luxury of Bouffard seems worth giving up a couple of weekend mornings.


Apropos of that, on my last visit to Peltier I spent the day with one of their anesthesiologists, Dr. Mustafa, who had just returned from a volunteer trip to Mogadishu in Somalia.  In a mix of French and English he told me that it had been a life changing experience for him, because although he thought he made do with next to nothing in Djibouti, in Somalia there was literally nothing  with which to treat the war shattered wounded while the sounds of explosions and gunfire echoed through the streets.  To him now Djibouti is luxury.  I guess we can get used to anything.  Although he did ask if could bring him a set of American scrubs next visit….


Anyway, I’ll sign off here lest I overstay my welcome…

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