I have now been back in the states for a little over 48 hours and thought it would be appropriate to blog on my overall experience in Cameroon.
In some aspects, this trip was a lot easier to absorb in terms of culture shock than my previous excursions to Central America with David. This is due, in part, to the fact that David did a good job of describing what the airport experience would be like, the language differences, and general culture differences. It also helped that I have been to South Africa before (through Calvin College in 2001 for a 3 week study of post-apartheid challenges). Perhaps the biggest challenge was the subtle difference in language. Even though Pidgin English is all English words, it might be sequenced differently or a certain word might mean a different word. For example, the word “for” could mean any preposition (to, by, on, of, in, etc.). If you wanted to assess how well a patient is eating, you would ask “do you chop fine?” The language is a more simplified form of communication for the people native to the country, but more difficult for me!
Poverty is a way of life in Cameroon. I remember thinking on the drive from Bamenda to Douala that it would be nice if everything in Cameroon could be ripped out, dug up, and re-built to a higher standard. Then at least things would look better. But I suppose that wouldn’t achieve anything. I was amazed at how little people had, yet they were not focused on receiving or obtaining more. In fact, the opposite was true. During one of the church services at Mbingo 1 (the church that a majority of the Mbingo Baptist Hospital employees attend) the pastor focused on the faithful giving of a tithe. It was an excellent sermon and reminder that God will provide what you need in all circumstances.
On my way back to the US, I shared a few flights with a Cameroonian named Mary. While we were waiting to board our flight from Brussels to Newark, NJ, she shared with me why she could never live in the states (she has a daughter in the US, a son in Canada, and another daughter in Germany). “Everything is too far away from everything else,” she said. The neighbors are far away, you can’t walk to church, and you have to get in a car to go to buy groceries. In Cameroon, everyone knows everyone else. If someone is in need, you know about it and you help them. She gave an example of a group of neighbors that came to her house recently and said they heard crying and wanted to know how they could help. She replied that she wasn’t the one who had been crying, so they moved on to find out who it was. Just like poverty is a way of life, helping someone in a time of need seems to also be a part of Cameroonian culture. The sense of community is very strong in Africa, and we certainly lack that in America. In fact, I think it’s safe to say that Americans prefer to be left alone and not to meddle in others affairs. I am ashamed to say that I live in a big condo full of people whom I have no idea of their name, occupation, or religious affiliation. Perhaps we would all live more full lives if we took the time to get to know one another, to show that we care about each other.
One aspect of Cameroon that didn’t grow on me was the overall lack of urgency within the culture. Since I am a “get it done” kind of person, this was hard for me to stomach. Construction projects sit half-done, patients in need of surgery may sit on the ward for days before seen by a surgeon, people present to the hospital with such advanced disease that there is nothing to be done, and everyone walks very slowly. I’m sure there are reasons for construction not getting done (ie – lack of funds) and sick patients not presenting until they are near death (not enough money), but I can’t think of reasons to explain the lack of urgency once a patient is admitted to the hospital and the slow walking. Oh well.
For the most part, I felt like an adopted member of the Cameroonian family while in Cameroon. I obviously stood out since I am a particularly white person. A few of the younger children passing by on the road would exclaim “White man! White man!” when they saw me and come running up to greet me. That made me laugh every time.
In regards to my impact on Cameroonian pharmacy practice, I hope that what was discussed was helpful. Since I was there for a short 2.5 weeks, I focused on answering any questions the pharmacy technicians had and discussed some tough issues that they regularly encounter such as stock outs of medications. My visit was timely in that the four pharmacy technicians had recently been through a 3-year training program (’04-’07) that consisted of 2 years of classroom learning and 1 year of experiential training. The majority of course material was taught by a volunteer pharmacist from Britain. This training essentially equipped them to practice as pharmacists at their site. There are other pharmacy staff (pharmacy auxiliaries) that help with dispensing and patient counseling. I would have liked to tackle one major problem that they see over and over again (antibiotic management or the persistent problem of stock outs), but the scope of either of those projects goes beyond a few week stay. It looks like I will have to come back.
