Friday, October 16, 2009

A busy week

Or that's the way it feels!

The week started off on a pleasant note, as on Monday (the Columbus day holiday), I joined a group from the EMF for the long drive out to the little beach at the west end of the Ghoubbet El Karab - the enclosed bay at the extreme end of the Gulf of Tadjoura. I'd stopped there before, on the way back from a trip to Lac Assal, for a quick swim. At that point my companions and I had noted that the breakwater that separates the pebbled beach from the bay itself teemed with fish and corals. Unfortunately at that time we had only a single pair of swimming goggles to share between three of us. I'd been curious to head back with a proper set of snorkel gear to really explore, so the opportunity was too good to pass up.

We piled our gear in the Mystery Machine, and headed out about 1000. It's about a 2 hour drive, with passable roads much of the way (otherwise the venerable van probably wouldn't have made it), and we went in convoy with some other intrepid souls from camp lest either one of us develop automotive trouble en route. The weather was pleasant - the sky was full of dark rain clouds and even occasional warm sprinkles over Camp Lemonnier, but as we drove west the skies lightened and cleared eventually. The temperature was very pleasant - warm, but warm like a tropical island not like a blast furnace. Life in shorts, a tee shirt and sandals is actually quite comfortable. And the constant breeze is startlingly close to refreshing sometimes!

Anyway the trip out was uneventful. The diving proved to be quite as rewarding as hoped, despite a bit of surge on the bay side of the breakwater. Sightings included copious corals, anemones, clown fishes, sea turtles and three enormous red lionfish, lurking ominously in a rock and coral crevice - along with countless wrasse, parrotfish and other reef dwellers. The water was a perfect temperature - one could bob for hours without getting hot or cold, and we passed a very pleasant time indeed.

We had to speed back, in order to make a 6 pm appointment with our friends from the German medical detachment. They had switched teams again (they switch out every 8 weeks or so), and the newest group was coming by for a visit. The newest physician, Achim, and the EMT, Nicole, proved to be delightful. Friendly, funny and eager to continue to foster warm relations between the various medical detachments here in Djibouti. They stayed for dinner, and then joined us at "The Old Cantina" - the quieter of the camp's two watering holes - for a beer before heading out.

On Wednesday back to Peltier to try to help an unfortunate Somali refugee boy. This kid is an adorable 3 year old, who somehow contrived to aspirate a screw - sucking it deep into his right lung. The x-ray is astonishing as the vividly visible flat head screw appears to take up most of the main air passage on that side. Anyway, as there is no pediatric surgeon, ENT or Thoracic surgeon in the country, not mention no pediatric equipment we had to improvise a plan to try to extract the screw. I won't bore you with the details, but suffice to say that with the challenges imposed by having to get some form of 'scope, and a some grasping instrument down the same slender passage that the kid must breath through defeated even our most original and creative efforts - both on Wednesday and Saturday. We're still scratching our heads over what to do - referral options are essentially non-existent for Somali refugees. There is some possibility of bringing in some skilled help, but we're continuing to explore options. The child continues to do well, and to be as cute a bug's ear. Although he's not too thrilled with the sight of us at the moment...

Mid week we were presented with the case of a SeaBee who had been holding a couple of boards while a colleague nail-gunned them together. He missed, and the lumber nail shot straight through his coworker's hand from thumb side to pinky side. She was lucky enough to miss nerves, tendons, joints and bones, but we reckoned a trip to the Orthopedic surgeon at CHA Bouffard was in order. We got her to the OR there where Franck, their orthopedist removed the nail (she has it as souvenir), and an hour later the wound was washed out, drains placed and a splint applied. While she recovered from the anesthesia, we went for lunch with Franck. En route we stopped to admire the new CT scanner, now functional in the parking lot of Bouffard, which will be an incalculable aid to diagnosis here in the 'Bouti. Franck then dropped this bombshell: the Chinese have built an MRI, open to anyone who can pay the very modest fees, for a quantum leap in diagnostic capability. I swear, with all this and the lovely weather, I may have to reconsider buying a time share here!

Anyway, all this led to an invitation to our French colleagues to visit us at Camp Lemonnier - and this past Sunday, along they came - six doctors and nurses - to politely tour the the EMF with every appearance of interest. They showed considerably more enthusiasm when visiting the Bob Hope Galley (we can't match French food, of course, but the ice cream bar is the great equalizer), and the little Navy Exchange. I can't be sure of course, but it think it was a banner day for Franco-American relations.

That Sunday evening, clad in my whites, I joined Bill and, for a visit to the French base. We had been invited for a reception in honor of the feast of St. Luke, attended by all the officers, spouses and dignitaries of the local French military medical establishment. It was quite an event! The festtivities were held at the French naval base on Islet de Heron - the very tip of the peninsula on which the city of Djibouti sits. We were ushered into an open pavilion, overlooking the bay, across which the lights of city reflected on the water. It was a lovely setting, and with the breeze from offshore, even the polyester white uniform wasn't uncomfortable. So we listened to a speech by one of the French medical generals, and then mingled with the crowd, savoring cocktails and hors d'oeuvres. The French officers were tres charming, and their spouses tres chic, and we passed a delightful evening mutually assuring each other of our good will and amity. Probably the last time I'll get to wear the whites this tour - which can only mean it's time to at least start thinking about boxing things up and sending them home!

I think I'll end there - as I'm almost at the end of the next week, which has been full of international meetings, Chinese intrigue and dog surgery...until next time then.

Pictures are of our dive site.

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