Thursday, October 16, 2014

X-Rays: a la Cameroon Style!


Medical care in Cameroon can be a little different as it is delivered in a culturally unique manner. Getting an x-ray in a foreign country can push one out of their comfort zone and yield surprising results.

~o~

I hate doctors.
Yes, I know. I am a doctor. That doesn’t mean I like being sick, being a patient, being on the “other side” per se. When the roles are reversed, my stomach churns with anxiety and my palms sweat with fear. I make a very good doctor. I make a lousy patient.

But, pain is an unremitting taskmaster.  Funny how convincing she can be?!

The receptionist smiled at me as I approached the radiology suite along the main road in Buea. I often walked past with my dog for our afternoon walks. Most of our client-patients utilized their radiology services for x-rays. The staff knew me well.

“Good afternoon,” I greeted the receptionist. I looked around the front room of the office. Only a couple of other young men, I couldn’t tell if they were supposed to be working or potential clients, lounged against the wall in conversation.

“I want to make an x-ray,” I addressed the receptionist.

“For you?” Her eyes startled open a centimeter.

I nodded. “Yes.” (So much for an incognito entrance).

The receptionist turned and walked into the back. I had no idea why she’d left so abruptly but I wanted an x-ray, preferably now, so I stood at the counter, waiting, exchanging uneasy glances at the young men in the waiting area. Both of us probably wondering what the other was thinking.

“The doctor says it is ok,” the receptionist reappeared abruptly to my left.

I turned to face her. “Oh, good.”

Just then, a very enthusiastic French-speaking radiology technician appeared from the back hallway.

“Vien, vien,” she motioned with her hands to follow her.

“X-ray?” I hoped that the doctor had translated the instructions for which x-rays to obtain. I had serious doubts that she would otherwise know what to do.

“Please, God,” I breathed silently as I followed her to a small room in the back with an army-grade x-ray machine. It looked as if it had survived a few wars.

“Chest,” I pantomimed as my whirling dervish technician briefly paused in her swirling activity to contemplate her next move.

She nodded excitedly. A bit too enthusiastic for my comfort, I’m afraid. How could anyone be so enthused over a black and white photograph of someone’s insides? But, what else could I do. Hope for the best.

The technician’s face lighted up and suddenly she made up her mind. With rapid hand gestures she motioned for me to strip off my shirt and hang it on the hook on the door of the room.

“Now?” like right now in front of her with an open door and curious young black gentlemen just around the corner? I hesitated.

“Now,” she nodded impatiently with a look that said she couldn’t understand why in the world I’d dawdle to take off my shirt.

So, off came the shirt, and bra. I hung them on the door. She smiled happily and quickly scooted me over to the wall and the x-ray’s photo plate board. I turned one way. She frowned and turned me the other way.

We were like a mismatched dancing pair for a few awkward moments. She’d step one way and mumble French directions that I couldn’t understand. Perhaps they were French insults but I’ll never know. She was smiling the entire time so who could tell.

She tried to direct my inept steps toward the correct arrangement. Left, no right but not that much right. Shift forward but not quite so far. She pushed and prodded me inches one way and another way. Finally, she seemed satisfied that her subject matter, me, was properly posed.

“Stay,” she motioned with her palm with a big grin, clearly pleased at her success in posing me properly for her film. I swallowed and tried to be the compliant client in spite of my misgivings. I really didn’t want to repeat this tango again.

“Should I take a deep breath?” I figured somewhere in this process, lungs should be inflated for a proper film.

The technician nodded her head earnestly. I wondered if there was anything she’d not agree to by this time. All the time she chattered away in rapid fire French. Whatever I thought she might be saying was truly a guess.

Somewhere within my asking if I should take a deep breath and hold it and her enthusiastic chatting, she took the x-ray. I still cannot pinpoint the precise moment, but she effortlessly came round from the back of the machine and indicated that I could shift from my nose-to-wall position. Not that the wall was so bad to stare at but it was a little monotonous. All white and all. The wall was probably bored by staring at me too.

Another round of tango ensued in which the French technician tilted and bent my body to her tastes, cheerfully giving out instructions in French that could have been in Klingon for as much as I could understand. In spite of my foibles at anticipating her instructions, her smile never wavered. As I practiced being a human Gumby – remaining stationary after she shifted my limbs into the correct position – she clucked encouragingly. She was pleasant, at least. Our communication abilities were less than ideal but at least she was friendly.

For the second picture, I didn’t try to coordinate the whole breathing thing. I focused on the other wall and basically tried to not stir. She stepped behind her machine, fussed over the knobs a bit, and finally re-emerged, still smiling.

“Done?” I asked hopefully. She took the correct number of films. I decided that was a promising sign that she’d also taken the correct views.

“Yes, yes,” she answered. She walked briskly off to develop the films. I re-clothed myself, thankful the place didn’t have any other clients waiting. I’m not as modest as when I was a teenager, mind you. Still, I have noticed that white-man skin tends to attract an unwanted curiosity on the part of my darker skinned community. Not the kind of attention I crave.

At the counter, I paid the customary 5000 XAF ($10) for the x-ray. Turns out one of the young men lounging against the wall was supposed to be the cashier. X-rays in Cameroon are probably a bit cheaper than those in America. Granted, of course, there was no electronic data file available. And, although the radiology technician was happy with her work, the quality of the black and white film was a bit fuzzy in areas with some developing fluid drips staining the lower portion. The good news, the pictures were adequate. I didn’t have to repeat them.

And the other good news?

The electricity went off just AFTER my x-rays, not to return until the next day.

And the x-ray pictures results?

Well… the radiologist’s interpretation is at least unique. I doubt I’ll ever get another read on a chest x-ray that says, ‘…small heart!!!’. Not sure if the triple exclamation marks were necessary…

~0~

 “Suffering has been stronger than all other teaching, and has taught me to understand what your heart used to be. I have been bent and broken, but - I hope - into a better shape.”
― Charles Dickens, Great Expectations

Sunday, October 5, 2014

Eleven Differences I Notice Since Living Overseas

Author note:
It seems everyone is making up their “top ten” lists these days. I thought I’d join the foray with my own few observations. Those of you who’ve spent any length of time in a foreign culture may relate.
~o~

"The world is full of obvious things which nobody by any chance ever observes." 
- Sherlock Holmes in The Hound of the Baskervilles, ACD.
~o~

10 11 THINGS I’VE NOTICED SINCE LIVING IN CAMEROON 

(note the word “Cameroon” -- not “Africa)

1. Television Commercials Are Annoying


How many times do I need to be reminded how I must be unhappy until I buy items that I don’t really need? I have never been a fan of commercials but recently, when I watched the season premiere of a favorite television series I follow, I was seriously put out by the multitude of hyper commercials advertising for services and things I wasn’t even remotely interested in spending money upon. Those commercials for prescription medications were particularly inciting on so many levels.

2. People Are Multicultural



Americans are just that – Americans. The United States is a country of immigrants. I can’t define people as black or white or Hispanic or Asian anymore. Each person has their own unique heritage. The lovely Greek lady at the supermarket was a treat to meet. Her accent brought up sunny memories of Greek island beaches and delicious Feta cheeses.

3. American News Channels Are Terribly Biased


I have been privileged to live in different countries and talk with peoples from a vast array of cultural backgrounds. America is not the only country in the world. There’s so much more. The local news channels strike me as bordering on brainwashing. I want to shake the radio and yell, “Wake up, people! There’s more than three top stories happening in the world!” Ok. Deep breath. I’m thankful for the internet and the opportunity to glean from news agencies outside U.S. borders.

4. There Are A LOT of Choices/Options


OK. So much has already been said about the gigantic variety of choices that Americans are presented with wherever they go. I remember going to PetsMart and wondering to myself, “How many different kinds of flea product are really necessary?” The entire left-hand side of the isle was stocked with an overwhelming plethora of choices. I certainly didn’t have the time to read every label and do a statistical analysis of price versus quality versus reviewer rating before buying a product that would rid my dog of fleas.

 5. The U.S. Is Full of Emptiness


I take my dog for a stroll along the country roads. Each house I pass with manicured lawns and blooming flowerbeds is still and silent. The windows are dark. No dogs bark. No children bounce around the yard. My husband and I drive to the park. One other person with his son walks around the track with their two dogs. We drive along the freeways, only in the centre of Washington DC do the roads seem congested with traffic. Elsewhere the streets have plenty of space between vehicles. No motorcycles or pedestrians crisscross the lanes either. The neighborhoods seem eerie and empty.

6. Excessive Signage


In Cameroon, there are no street signs marking the names of streets/roads/paths/etc. This is generally not a problem since most roadways do not have official names; and, if they do, they’re not very descriptive or unique. Buea is full of streets termed ‘street one’, ‘street two’, street three’, ‘street four’, and such forth. Each different neighborhood/quarter has its own set of street numbers and unless someone specifies the neighborhood, one cannot differentiate which ‘street one’ is being mentioned. There are the basic traffic signs in Cameroon too. A few stately STOP signs grace the intersections suggesting to the taxi drivers that they might want to consider reducing their speed before crossing the thorough-way. I've never heard a foreigner complain about an overabundance of signage though. In contrast, take the intersection her in Virginia where I’m spending a few days. The Interstate 95 bisects Route 17 at the 4-way stoplight. There’s a digital WellsFargo Bank blinking the temperature of the moment. Another sign warns “Do Not Block Intersection”. The Sleep INN proudly boasts a ‘fresh look, complimentary hot breakfast, and wifi’. To my right there are signs directing traffic one direction, other signs announce, ‘End Work Zone’, ‘Over Height Do Not Pass Under Bridge’, “End Road Work’, ‘Left Lane Ends Merge Left’. To my left are more signs declaring, ‘Unmarked Pavement’, ‘One Way’, ‘Stay in Lane’, and ‘Exit’. Every empty patch of dirt appears taken with a signpost and the traffic signal poles are strapped with flyers and notices. There’s even a tiny white plastic spike with the writing ‘Caution Water Valve’ imbedded intoa scruffy tuft of remaining green grass. Signs, signs, and more signs. I’m feeling lost in the exuberant enthusiasm of the written posted verbosity.  Let’s not start on the cereal cartons!

7. America is the ‘Land of Many Toilets’


I’m not claiming the U.S. has more bathrooms than other countries. Cameroon has plenty of unofficial potty spots. In reality, any dim alley can serve as an emergency bladder-relief spot if necessary. However, in general, bathrooms are not as readily accessible, available, and convenient as the States. The supermarkets here in America have multi-stalled bathrooms freely available to their customers. Every CafĂ© maintains at least one fresh-smelling toilet. Quaint city parks with mere acres of grass and a tiny walking path still have at least a men & women bathroom facility. There’s nowhere I can go where I’m terribly inconvenienced by my bladder’s demands. I’m not complaining about this, mind you. It’s nice not having to plan my oral intake levels based on future availability. I must admit that I’m still getting used to the new norm of flushing the toilet EVERY time. The old adage, ‘when it’s yellow, let it mellow….’ Is harder to contradict than one might imagine. I find myself still calling out, “Bill, do you need to use the toilet before I flush?” at bedtime. 

8. The Supermarket, A.K.A. Food Supply, Is Far Far Away


In Buea, at the end of my workday, Jordan (our dog) and I would stroll around the neighborhood. I’d get my exercise, Jordan would get her excise, and we’d both find supper. Living on the outskirts of town right now, I find it takes at least fifteen minutes, by car, to reach the nearest supermarket, or really any store for that matter. Shopping and sleeping are much farther apart in the States as compared to life in Cameroon. No wonder everyone owns a car.

9. Where Are All the Ants?!


Ok. Ok. I admit, I’m not the most nit-picky house keeper. Our house in Buea was generally swept and the dishes at least in various stages of being cleaned; but, no one would have pinned a blue ribbon on the place giving me a Martha Steward award. Still, I learned to put every open food packaging in the fridge immediately after use. Where’s the sugar for the tea? In the fridge. What about the bread? In the fridge. No matter how minuscule the food particle, if it laid out on the kitchen counter for more than five seconds, the ants would come. Tenacious, persistent, incredibly intelligent little scavengers that could burrow their way into almost every form of packaging…even occasionally the as-yet unopened ‘sealed’ cartons. 
And now? There are freshly baked muffins cooling on the counter top without a hint of an ant. A small amount of sugar from the sugar bowl in the cupboard spilled this morning. Nary an insect has come. The candy sits in the candy dish without disturbance. The biscuits sit in the pantry in an already opened wrapping without a bug. The lights above the dining table shimmer alluringly but no flying six-legged critters fly overhead or fall into our stew. Amazing!

10. Small Change Lasts Forever


Thanks to Visa and MasterCard, the coins and dollar bills sit around in my change purse forever. No more searching for change. No more waiting until the end of the day when the pharmacy might be able to break a 10,000 XAF bill into spendable 1000 and 2000 XAF paper bills. My quarters and nickels wait patiently until the next parking meter, which is the only time I use cold, hard coins these days. The convenience is handy. My math skills in addition and subtraction that I’d use to ensure my purchases added up to a suitable round number that the clerk had change for, and then double-check the leftover change, are dwindling. 

And...since I couldn't contain my list to ten...

11. Fuel Prices Are Variable


My father has an app on his iPhone to help him locate the pumps with the least expensive fuel prices. One doesn’t have to drive too far to pass fuel stations with all sorts of different prices advertised; and, they change daily! Even fuel stations adjacent to each other advertise different unit prices per gallon. In Cameroon, during my five years, due to government regulations, the fuel price changed once. Very standardized. The fuel prices were not cheap but they were consistent. 

Obviously, many other cultural nuances and differences assault my observations these days. I'd love to hear from you and see what differences you've noticed internationally speaking.





Tuesday, September 30, 2014

There and Back Again -- with a Hitchhiker! (part 2 of 2)

Jordan and Milo's Health Books from Cameroon




Part Two: And Back Again

So now you have the “There”… time for the “Back Again — with a Hitchhiker”.

“You want to take the cat back?” my husband inquired with undisguised hope that I’d answer to the negative.

Ignoring his unspoken plea, I answered, “Yes, I would like to Milo (our cat) back. We don’t know if there will be a replacement living in this house when we leave; someone might not come to replace me for months, it wouldn’t be very nice for Milo (our cat) to abandon her when it’s not that difficult to bring her with us. We brought the other volunteer’s cat back last summer and it wasn’t too bad, remember?”

Bill rubbed his temples and massaged his neck muscles at the memory. “Yes, I remember.” Grudgingly he admitted, “she was pretty easy to transport. However, I don’t mind if someone else wants to keep her here in Cameroon.” His voice lifted for a moment at the end, still hopeful the cat might find a friend to take her in Cameroon.

“Well, I think we should move forward with trying to bring her back in case no one else wants her,” I answered.

“I’ll call the vet and set up an appointment for her rabies vaccination then,” Bill caved to my wishes with a patient sigh. The rabies vaccine for international travel must be up to date within one year but also administered more than 30 days prior to the departure date. Both Jordan and Milo were appropriately vaccinated and boosted with rabies vaccine.

~o~
Rabies Vaccination Signed and Stamped in their Health Book

“How’d it go in Douala at the Brussel’s office?” I asked Bill after his trip to the international airport.

“Fine, fine. I have the tickets for the pets and us.” Bill slouched down into his chair and tried to forget the harrowing driving conditions that a trip to Douala entails these days. He showed me the pile of boarding pass sized airline tickets. The pet tickets specified one carry-on pet (that would be Milo, the cat) and one extra luggage of a pet as great or greater than 15 kilograms (that would be Jordan, the dog). The pet tickets were tied to our own passenger tickets, specifically, Bill actually. I found it a little ironic that in spite of my husband’s reluctance, he still ended up tying his airline ticket with the dog and the cat.

~o~

“I read the email from your husband,” the local veterinarian hopped off his motorbike and sat down next to me. Bill was still away in the U.S. while I remained to finish my last few months of mission service in Cameroon. “Bill seems to be quite anxious about the pets.”

I nodded. “Yes, he wants to make sure that the animals get their health certificates without any problems. He wanted me to ask about any blood tests that the dog might need too. He mentioned something about a test for screw worms…” my voice trailed off. I really didn’t know what to make of this last requirement Bill and I had read about on the custom’s website.

The veterinarian nodded. “The health certificates have to be obtained one or two days before the departure date. It’s still too early. We can have everything together though and be ready to take the documents for signature and stamps on Thursday.”

“And what about any blood tests?” I prompted again.

“To be honest, your dog hasn’t had any non-healing wounds, right?”

“Never,” I affirmed.

“Well, then, we don’t need to worry about screw worms. She doesn’t have any signs or symptoms suggestive for the worms.”

“So we don’t need any blood tests?” I wanted to be clear on this last point. I didn’t want to find myself in the situation of getting down to the day of departure and suddenly being informed that my dog couldn’t travel because she hadn’t had the required blood test for worms or whatever.

The veterinarian shook his head. “We’ll get the certificates for the dog and cat on Thursday. The signature and stamp will be from the government veterinarian so the paperwork will be what the airline officials in Douala are used to.”

“Oh?”

“Sometimes people have their private veterinarians sign the certificates but then you might get questioned at the airport. It’s better if I get the government signatories that they’re more used to in Douala,” the vet tried to reassure me.

“OK then,” I smiled, “but since our departure date is Thursday, how about we try to get the certificates on Wednesday?” I suggested. “I mean, what if the official is not on-seat on Thursday? Maybe it’s better to try the day before since the date can be two days before departure?”

The vet smiled. “Oh, ok. I get you. That’s ok then. I understand you. No problem.” He hesitated like he wanted to say some more but held back at the last minute.

“You have the health booklets with the pet’s rabies vaccination certificate inside, right?” I checked to make sure he hadn’t forgotten.

“Yes,” he answered, producing the booklets to show me.

“I have the photos for their books now too.” I produced a four by six inch photograph proudly. With the help of one of our volunteers, I had taken a photo of the dog and the cat and had them printed in such a manner as to come out the appropriate size for pasting in the health booklets — 2 inches by 3 inches. They were even in color!

Milo's Passport Photo
(2 inches x 3 inches to fit her health book)
Jordan's Passport Photo
Our veterinarian was duly impressed and proceeded to paste them into their respective booklets with great care. I’ve never seen anyone take so long to glue two photos down. At last he departed with the promise to get back with me next Wednesday. “I have to travel next week,” he informed me, “but, I’ll have someone get the documents next Wednesday.” He drove off in a puff of exhaust.

The next Wednesday our motorcycling, traveling veterinarian was still far away in Kumba. Thankfully, he kept his promise and sent his brother who collected the signed and stamped official health documents and delivered them to our doorstep. The check list was complete:

1. One dog; one cat - check
2. small health booklet with photo pasted inside and stamped, official rabies vaccination record — check and check
3. printed tickets from agent at Brussel’s airlines for cat and dog, including receipt of payment - check
4. dog crate - check (same as the one we used bringing her) - check
5. cat carrier - check (brought by Bill and borrowed from our friend who used it to transport her own cat the year before) - check
6. health certificates - check and check
7. Small bag of dry cat food and dog food - check (not that the animals actually ate on their trip)
8. attachable bowl for water/food for dog; small bowls for water and/or food for cat (again superfluous but psychologically comforting for owners)
9. extra towels and pad for cat carrier and dog crate (should have brought more disposable towels for cat carrier…)

The All-Important Vet Certificate of Good Health
(Must be dated within 2 days of departure date)
Thursday dawned. So many goodbyes were said. We fed the animals early. We gave them last chances to relieve themselves. The cat was a bit miffed that I locked her in the kitchen for the afternoon. The dog was happy to go for an extra walk. She could sense that we were traveling and she wanted to be as close as possible. She sat determinedly under Bill’s legs with an ‘I’m-not-letting-you-out-of-my-sight attitude. She at least was able to maintain her nearness to “her Bill” during the taxi ride to the airport since the vehicle was jammed pack with 4 suitcases, 2 backpacks, 1 large and disassembled dog carrier, 1 husband, 1 driver, 1 friend, 1 cat in her cat carrier, and me  — does the list remind you of a song?! …’two missionaries — and a kitty in a cat cage.’

We arrived at the airport and our driver parked the vehicle in the parking lot area, allowing us to assemble the dog crate, bolting top and bottom together. Bill walked around with Jordan, giving her last chances to relieve her bladder. We joked nervously and munched on chin-chin snacks, feeding Jordan who happily snapped up the treats tossed her direction. The goal was to check in without feeling rushed but still not check-in so early that Jordan would be left on the tarmac for too long before boarding and plane departure.

“Let’s go in at 9 pm?” I suggested. “That way we’ll still have three hours before scheduled departure but if we’re hassled, we’ll still have some leeway to figure things out.” Bill agreed with me. Jordan wagged her tail. I rubbed my jeans and sniffed a damp corner of my shirt. “Uh! I think the cat peed already. The carrier is not pee-proof.”

“Sorry, dear,” Bill replied absently as he comforted his dog.

Our friend helped me change the absorbent pad in the cat carrier and replace it with a clean towel. I should have brought more old rags that would have served as disposable pads. I tossed the soiled pad in a sealed plastic and splashed on some instant hand sanitizer. “Perfume would have been nice,” I mused to myself. At least no one else seemed too bothered by my urine tinged travel clothes. *sigh*

We bid our good byes to our driver and friend and several luggage attendants came eagerly forward with their carts and hauled bags and dog carrier into the airport. With a few francs tip, it’s amazing how many willing hands and able backs are available to assist!

(Bill picks up the story here)  Health officials stopped us just before the Brussel’s check-in counter and inspected our pets’ documents (health certificates and vaccination records).  We paid 5,000 XAF (about $10 USD) per pet and received another two official-looking documents stating the animals had been inspected and were healthy. Tucking them safely into my bundle of travel documents, we continued to the check-in counter.

Health Certificates from Airport Inspector - One of the "chat" and one for the "chien"
The check-in agent weighed our luggage, inspected our documents, placed luggage tags on the four bags and dog crate DLA / IAD, indicating that we should not expect to see the dog or any of the luggage until Washington DC.  I took Jordan out of her crate and the check-in agent sent our bags and the crate down the belt.  Trixy was free to pass through the process of departure. I went with Jordan and a DLA (Douala Airport) security agent down to the baggage handling area where they inspected the crate and had me place Jordan back inside (note: I handed off my passport to another security agent in this process and retrieved it on my way back to the normal departure process line).  I said my good-byes to Jordan and wished her well, praying silently for her safety and special blessings for all who would handle her in process. Once back in the normal departure area, I handed in my white immigration card and processed through immigration to the departure gate.

Milo remained with us (Trixy’s possession mainly) as we traveled.  She was pretty quiet, like her daughter, Friday. I had traveled with Friday, Milo’s daughter cat, only the year prior, bringing her back to America for a friend and former volunteer in Cameroon.  Sad meows echoed pitifully from the interior of her carrier only during walking off the airplane in Brussels and again coming off the flight in Washington D.C. It appeared that the gravitational changes and alterations in environment gave the cat a false hope of escape from her cat prison at these times.

Brussels has two routes they fly to/from Douala, depending on the day of travel.  It might be BRU>>DLA>>NSI>>BRU or it might be BRU>>NSI>>DLA>>BRU.  We specifically booked the second for the shortest flying time to BRU.  We followed the advice of the airlines to book the full flight with them (they send checked dogs as excess baggage, United Airlines considers them as cargo. Apparently there can be problems when switching between the two. We didn’t care to find out).

In Brussels we mentioned we had a dog in the hold and enquired as to what should we do as we were transferring to a Washington DC bound flight.  The agent at the counter said the dog would transfer and we need do nothing special.  To verify we found the transfer desk and enquired about the process.  Same answer.  We settled into some very comfortable sofas in the airport waiting area for the next eight hours praying that our dog was also somehow comfortable wherever her crate was situated.  Since Trixy had the cat, we did not exit the airport and tour Brussels. Europe tends to have stricter import rules regarding animals than the U.S. We decided not to bother with attempting customs for just a few hours in the city.

We boarded our last airplane for the trip from Brussels to Washington DC. It was the last and longest leg of the journey. Milo settled down to a quiet sullen silence, curling up on another fresh towel, having refused food and water in spite of Trixy’s offers. We could only pray that we’d see Jordan when we reached America.

“So, we have to declare some things on the custom’s declaration form, right?” Trixy looked over for confirmation, pen poised.

“Yes, we have to go through the line at the custom’s counter for people with items to declare. Put down both the dog and the cat.”

In the end, it made little difference that we had pets to “declare”. The first official, the Immigration officer, welcomed us back without comment on the pets.  But a few questions on the “food” we were bringing.  Satisfied there was no risk or issues for America he passed us on to Baggage claim with a “Welcome home”.

“Over here,” I called to my surprised wife. “The luggage was tagged ‘priority’ so it’s already here.” I pointed to an exclusive pile of luggage at the head of the luggage turnstile.

“Where should we look for our dog?” Bill tried to flag down one of the attendants hovering over the luggage claim area. Suddenly, I spotted Trixy waving from across the room.

“Over here,” she waved and pointed. A smiling airport employee rolled a familiar dog crate out into the luggage claim area. “She made it. Jordan made it.” My wife smiled.

“Jordan!” the furry canine inside wagged her tail furiously and whined in impatience — ready to break out of her 30-hour confinement.




On the way home from airport with furry friends

General notes:
While no one past Douala checked our documents, you are advised to keep with you at all times: health certificates, vaccine documents, tickets (i.e. everything related to your pet’s health and travel).

There are some good resources if you are traveling with pets and coming to the United States.  I am sure Europe has their own as well.  The CDC has these links:
A very good overview:  http://www.cdc.gov/features/travelwithpets/
Lots of details:  http://www.cdc.gov/animalimportation/travelingpets.html

We have two preferred airlines from Douala to Washington DC:  Brussels Airlines and Turkish.  Air France is also very good (we flew them to Cameroon).  But they tend to be more expensive.  We should also note that five years ago we were required to collect Jordan at the baggage claim in Paris and check her and my luggage back in before the next flight.  I don’t know if that is still how they work today.

We have heard stories that Turkish Airlines doesn’t always have a pressurized cargo area for pets.  I don’t know if this is true or not.  Our main reason for not choosing them was their longer flight pattern.  I flew Brussels Airlines with Milo’s youngest one year before we returned.  The Brussels personnel were helpful and never showed any sign of unpleasantness at me for having a cat on board.  In this first case I flew Brussels from DLA to BRU and then switched to United Airlines from BRU to IAD.  I would advise against this as you may have to pay twice, once for each airline. While not difficult, switching airlines, even partner airlines, adds a level of complexity. Both airlines counseled that it is best to fly one airline when possible.

We complicated our travel somewhat by booking our tickets and then changing our dates.  This caused some confusion within the airline.  I rebooked in the USA and should have just kept the rebooking with the agent in Douala.  That would have been the best thing.  In any case the agent in Douala made sure everything was set correctly and our rebooking secure including the pets.  The pet tickets are valid for one year from the date of purchase.  We paid for them in May and when we rebooked the confusion was what to do with the tickets, one person said we would have to pay a second time and we would be refunded the first amount, one person said there would be no refund, but the agent in Douala and the tickets themselves indicated no specific travel date and so were flexible to their human’s tickets, provided the pressurized cabin was not already fully booked.

Limits of our information:
Seriously, this is a review of our experience.  We normally travel DLA / IAD, we know the airports and the airlines we have used. Your experience may be very different.  We don’t know what it is like to have onward travel beyond the port of entry.

Here are the summary bullet points:
Choose your airline carefully (if you have options)
Fly the same one from your foreign home to the USA, if possible
Your foreign-based vet should be knowledgeable in securing Health Certificates a couple of days before your intended travel
Pets should be up to date on Rabies vaccine and proof in your pet’s health book/passport
Appropriate pet carriers should be secured well in advance
Food/Water for travel

Summary of Costs:  These will vary to your own circumstances, but be prepared.
Vaccines
Health Certificates
Airline tickets
Exit fees

I would also suggest you keep a photo record of your pet’s documents.  Be able to produce them on your smart phone, tablet, or laptop if anything should happen to the physical documents.
Airline tickets
Health Certificate(s)
Health book

Monday, September 29, 2014

There And Back Again -- with a Hitchhiker! (part one)

Jordan, our dog, prior to departure for Cameroon. 2009.
Photo compliments of our talented pet photographer friend, Linda Phillips.

Author’s note:
This blog posting is perhaps not as story-ish as other postings. Mainly it is to share what we’ve learned and to encourage our friends who’ve asked that it is possible to bring your pets to and from Africa and here’s how we did it. We encourage all our compatriots with furry friends to keep them.


~o~

Most readers are aware of J.R.R. Tolkien’s popular children’s book, The Hobbit, also titled “There and Back Again”. The title reminds me of our recent travel experience with our pets - our dog, Jordan, and our cat, Milo. Although, on second examination, it might be more appropriate to label our experience as “There and Back Again — with a Hitchhiker”.

Part One: There

The story begins back in 2009 when Bill and I were relocating to Buea, Cameroon, to begin our five-year mission term at the health institution. We sat around the table discussing things we would miss, good byes that would be difficult and fraught with potential tears and heartache.

“But why not bring Jordan (our dog)?” our experienced missionary friends inquired. “We took our dog over with the family when we lived in X country. It was one of the best decisions we made.”

“You took your dog with you to Africa?” Bill and I chorused in unison. “Really?! Wasn’t it difficult? The logistics complicated and tedious?” Both of us had assumed that giving up our pets was just one of the sacrifices we’d have to make in order to be missionaries in Cameroon.

“No, no, it wasn’t complicated at all,” our friends assured us. They then proceeded to outline the process. It sounded rather simple actually. The seed was planted. The idea took root and grew to fruition. 

~o~

Veterinarian Certificate for International Travel
Certificate of Good Health and Microchip Confirmation Paperwork
“Now which country in Africa are you traveling to again?” The vet technician smiled sympathetically as she checked Jordan’s heart, teeth, and drew a blood sample to confirm the absence of heartworms. She scanned Jordan’s fur and wrote down the Avid microchip number on her paperwork certifying our dog’s general healthy status and identification.

Vaccination Record including the all important Rabies Vaccine
“Good luck,” the veterinarian and her assistant waved to us as we left their office, dog pulling ahead with her leash, and owners clutching the paperwork and a prescription of some kind of doggy Valium termed ACE. “Give it to her just before you put her in her crate and on the plane,” the vet had instructed.

Our check list was complete:
Air France ticket for dog - booked at the same time as our own tickets
Paperwork certifying the dog was in good health
Vaccination Record
Airline approved dog crate

Bill and I filled Jordan’s plastic dishes that attached to the crate’s wire bars with food and water. We walked her around the dog park at the airport complete with its faux green grass and plastic fire hydrants one last time — finally we administered her doggy sedative and headed for Air France’s check in counter. “I think that medicine is affecting her already,” I observed as Bill walked ahead with Jordan on her lead and myself trailing behind with the crate on a push kart.

Jordan gave a lopsided wag of her tail and staggered with a pronouncedly wide gait, swaying slightly with her happy panting. “She’s walking like she’s drunk.”

“At least she’s a happy drunk dog,” my husband remarked. She entered her crate and was wheeled away by the Air France attendant without any resistance. “You have a well behaved dog,” the check-in personnel commented. “Now remember, you will need to collect your luggage and the dog in Paris. You can walk her around in the pet area at Charles de Gaul before re-checking everything again for the flight from Paris to Douala.”


~o~

“Where’s the dog?” I asked Bill with a frown and worried whine. “We have our two suit cases that were checked but where is the dog’s crate?” Both of us scanned up and down the luggage collection area. Distracted passengers bustled around all around laden with their own luggage or pushing karts overflowing with suitcases. Push and shove. The typical airport chaos. Lugging around our carry-on bags and now two large suitcases, one of which had a very bad habit of tipping over at the slightest provocation, did not make for an ideal situation to search for where our pet might have been deposited.

“You stay with the luggage, I’ll look around,” I rushed off with just my shoulder bag leaving Bill to manage the suitcases. He wasn’t thrilled.

At last, in a corner of the large arena designated for luggage claims, I found a cluster of plastic pet crates — Two crates containing German shepherd puppies, another crate with a large canine of nondescript lineage and finally a familiar cage with a very familiar furry face inside. The last carrier went thump - thump and shook a little as I approached. The inhabitant, a relieved Jordan, recognized me. I snapped on her dog lead and waved to Bill to join.

It’s not exactly convenient to collect one’s luggage mid-way through a long journey from one continent to another. One has to haul their 20-kilogram suitcases and large dog carrier all the way across the airport to the airline check-in counter again. Since we only had four hours until our next leg of the journey, we immediately began the trek. As we struggled forward through the hustle and bustle of the busy international airport in France, searching for the appropriate signage that might indicate we were headed in the proper direction, I also scanned for a “pet rest area”, some designated spot for owners to let their pets relieve themselves and get a drink. While Bill waited at the check in counter, I strolled with Jordan on her leash outside. Concrete. Asphalt. More concrete. Not the faintest hint of a green blade of grass. Nothing organic to be seen in all directions. Poor Jordan. “Sorry, dog,” I shrugged to a very disappointed dog at my side. “I don’t see any grass anywhere for you to pee. If you really have to go, you’ll have to water the pavement.” Jordan was too much of a lady to condescend to such antics. She bravely lapped some water that I fetched her from the sink at a nearby loo but turned up her nose when I tried to feed her some treats and dog food.

Jordan was much more un-willing to enter her crate the second time around. We prayed we’d see her when we arrived in Douala as the airline attendant whisked crated canine away.

~o~

“Bill? Trixy?” our church Union officials approached us and inquired hesitantly.

“Yes, yes,” Bill and I shook hands with the officers who’d come to welcome us to Cameroon and assist with our luggage, translating the French of the airport personnel when necessary.

“We have a dog with us too,” Bill informed the church welcome committee.

“A dog?” they exchanged glances and bravely nodded their understanding. Dogs are generally feared in Cameroon. Appropriately so since almost all dogs are raised as guard dogs. Many a Cameroonian can testify to an accident with an escaped guard dog.

One by one our luggage appeared on the suitcase turnstile. “Yes, that’s all the bags,” we answered. “Now we just need to look for our dog.” Both Bill and I scanned the small luggage-collection room anxiously. Did Jordan make it to Africa? Was she ok? Did she survive the trip?

Suddenly, one of the church officers pointed to the far left corner of the room. “Look, over there, is that your dog?”

Glancing in the direction of his outstretched hand, we noticed a small cluster of dark-skinned, orange vested airport luggage personnel huddled in an animated discussion around a familiar large kennel. “It’s our dog!”

Bill and I strolled over to the huddle of confused and anxious personnel. “Our dog,” we smiled happily. The African airport baggage handlers seemed relieved. The church officials spoke in rapid French. Eventually, both luggage and dog crate were hauled out to the airport parking area and deposited next to the church’s SUV. I opened the barred front door of the crate, which by now was shaking dangerously with a very happy dog inside who recognized her owners. I placed her on her leash and led her out to a patch of grass while others figured out how to fit cage, luggage, and humans into one SUV. Jordan relieved her bladder for a very, very, very long time. I had no idea a dog could contain herself that much. Poor dog.

No one asked to see any paperwork on Jordan. No vet inspected her in the cage or looked at her certificates and vaccination records. The last officials to glance at her papers had been the Air France employees in Washington D.C. Bill, Trixy, and Jordan… we were a happy and thankful trio to exit the airport and complete our journey to Buea in the vehicle. Jordan quickly adapted to chasing lizards with long blue or orange tails instead of squirrels. She adapted to beans with rice and a complement of egg, meat, and vegetables/fruits instead of commercial variety dog food. Her yard was bigger than ever before. She was with her beloved humans. She guarded her new home faithfully. She trotted around Buea and introduced the concept of “pet dog” to many. She growled and snapped at the little children who dared throw rocks at her during her strolls with her humans. She pretended to be mean and vicious with her gentle-leader halter snug around her snout while everyone else thought it was a muzzle because she was such a wild dog. She didn’t even care when others joked, “Dash me your dog. I want to eat your dog. Your dog would make good pepper soup.”

Jordan hunting Lizard
In general, perhaps Jordan adapted to life in Africa even better than her humans. Certainly both she and them were glad she came along to share in the adventure. The only glitch came a few months into her life in Buea. One February her female human, Trixy, came home from the bakery with a box that went ‘meow’. “I didn’t find any peanut butter but I found this…” she called out cheerfully.

“Oh no, a cat,” Bill replied as he peered inside the box with a tiny fluffy grey kitten inside.

“Isn’t she cute!” I answered with joy. “Come, Jordan, come and meet your new friend.” 
Jordan checking out Milo as a kitten

Jordan tiptoed over to the box cautiously. “Hiss!” the fur ball inside suddenly fluffed and arched its back in a menacing stance. Ok, it wasn’t the best of first impressions but eventually the dog/cat duo came to a truce of sorts. Cat teases dog but dog remains champion over the food bowl.

~o~

“Petting, scratching, and cuddling a dog could be as soothing to the mind and heart as deep meditation and almost as good for the soul as prayer.”
― Dean Koontz, False Memory






Wednesday, September 10, 2014

Reflections

Two months ago I left Cameroon. I was exhausted and could rarely see the good and positive - though I knew it was there.  

Today - here and now - I am on the eve of my flight to return to Cameroon for the last time as a resident.  I am seeing snapshots in my mind - scenes of Cameroon’s lush countryside, of steep and rugged mountains, of sweeping vistas, of the black sand beaches of Limbe and the white sand beaches of Kribi.  I see the winding roads through the jungle.

I smell the scent of the wet jungle, I feel the sand and water between my toes, I hear laughter floating across the breeze.

Memories - times shared - conversations engaged - laughter, insights, dreams, trials, struggles, failures, successes.  Each image a story rich in culture, context, and sub-text.

Life is what happens when you aren't looking - or so they say.  But living and working in Cameroon for nearly five years I have been constantly aware of life in the making - here - and now.

I think of the people with whom we have shared this time: Cameroonians and non-Cameroonians.  People of similar faith and those with very different belief systems.

Images of my favorite places to hangout float through my mind: Arne’s; Capitol Hotel; A1-Complex; Gideon, the Shawarma guy; Bonga Juice; Clerks Quarters; and the Mediterranean.

I see Thanksgivings and Christmases and parties at our home and with friends at theirs.  I see quiet evenings and game nights.  I see failed game nights that turned into beautiful quiet evenings and spontaneous quiet evenings that became game nights.

I see church: fellowship meals, sermons, and energetic discussions.  I see the friends and colleagues who traveled far and near to visit.

I taste the many cooking experiments of our own making and that of our volunteers.  I can taste the oil and pepper in the black beans; the succulent chicken and tomato sauce; 

I remember the very day the first time I smelled the grass, February 14, 2010 after the first rain of the season.  I smell delicious food and the burnt aromas of forgotten popcorn or rice.

I feel the cold dampness of the rains; I feel the warmth of the sun and rejoice in the gentle breeze.  I feel the cool of each evening; 

My thoughts drift to the Health Centre, what was, what it has become, and thinking what it can yet be.  Much of this I am still processing.

Some speak of legacy - this time in Africa.  But it is only a drop in the bucket during a rainstorm in Buea.  The entirety of our life is our legacy: the good, the bad, and the ugly.

Each of us is a gift to humanity - a gift of our talents, our time, and our skills.  We gift our interests and efforts.  Sometimes it is appreciated - sometimes not.  The quality of the reception of our gift need not change the gift.  The quality of the gift of ourself is our choice, not the choice of someone external to ourself.  

Let us encourage one another.  Because there are many days of struggle.  

Be courageous! Love with genuine affection.  Love the lovely and the unlovely.  Bless all with the gift of a life lived in and through Love.