Whats Lifetime Fitness Membership

Six months later

I have just in the blog probed by friends who lived in the past few months in Nairobi, Kenya - and came to the idea of making an entry about how I've been living in Switzerland again, as I look back now and what this Gabon stay still lives on.
few days after my return I started my next internship in the medical emergency of the Inselspital in Bern. The trip home proved to be surprisingly smoothly after some confusion, finally, the night before I realized that I no longer had the return ticket - it was like another has already been stolen from my room? Despite a long search measures, including the rubbish it did not come to light. Sun went I hold off in the company of Owen with a driver of the hospital without a ticket. Owen still owed me money, which he intended as already collect in Port Gentil from his relatives in Libreville, which in turn owed him money. In Port Gentil then all debtors were straight away or by phone "not easy to achieve." This time we were sitting by yourself. The driver had us dropped off at the Tropicana Hotel, where Leah and Theo had already arrived two days earlier. I sat completely out of water, had just about 500 CFA on my phone card (about 1.25 francs), which would last for about half a Call Stuff, had not even money for a taxi, and Leah and Theo were not there. It was so absurd, that Owen and I could only laugh. We finally went without much hope to walk towards the airport, to find a working ATM machines - but the airport was out of service. In addition, we found a close and - surprise, surprise - he spit out money, freeing us for the second time from a slightly awkward position. Lea had then managed somehow without any evidence, my e-ticket into a ticket to convert, so that the problems were solved and drinlag even a short trip to a market where I could still buy a few rocaillesbesetzte Strappy ballerinas, it unfortunately for the substance, I still wanted to buy was not enough.
Well, to return to training on the island. I, who used to tell me I always used when colleagues were trailing by patients who appeared due to any small Bobos on the emergency, I had to get used again until at Swiss yardsticks. Getting used to was really for me is that people appear because of an ongoing 2 days ago colds with possibly some fever at the University of emergency - where they then wait for 6 hours, are widely Estens clarified, and finally released with a prescription for Dafalgan again, they are for 3.50 Fri and even in the pharmacy could have purchased. The cost of the emergency Intermezzo will amount to well against the 500 francs; Dafalgan an expensive ... It was also good. Due to the existing Baseline (time structures) can deal much better here with mental health problems that are left in Africa, given the (seemingly?) Prominent physical disorders largely ignored - if you applied in Switzerland as a doctor because even want to. So I had myself been involved with a senior physician trouble when I began looking for a patient, the acute under a clear and escalating psychosocial stress situation and suffered like a few days had been added to the crisis intervention center of the island. The doctor she wanted to send her home, although the third time within the last 5 days hyperventilierend appeared on the emergency. Looking back, I also had
just the limited diagnostics and the limited financial resources of the African patients learned a lot, I had to think carefully about why I needed a particular inquiry and what a result they would have, too often I had to opt for the more important of two important studies, as the money just was not enough. I first learned to pick out the truly relevant laboratory parameters and to assess learning. In Switzerland, I was first overwhelmed with the plethora of mostly been clarified, laboratory parameters. In most cases, I could also Asssistenzärzte not explain why now the confident parameters in the "Admission laboratory serve really," just the way we do it here, " "Yes, this value is outside the norm, but that is not relevant "...??!
Internships in Africa also gave me structure, so that I automatically re-introduced to the Swiss pace and the Swiss mentality. After the emergency practices followed by an internship and anesthesiology to a very short-organized training in a walk-in emergency clinic. With all the internships I was very lucky, I was able to work very independently, was also taught, and had great team around me.
beginning of May, then began the lectures on the closing price and I am now definitely decided to hang after one more elective year before I next summer at the final exams would go. After the end of last year I really was not very good, I wanted to or had to up a gear lower. I am also not so sad, I had already considered before long to make a second choice academic year and there are so many things that I see still want this additional year is even too short again.
I have a few to still have contact Gabonese few friends, some by telephone, sometimes by e-mail. The telephone lines can usually be set up only after several attempts and are usually so bad that it is hard to understand - I am indeed still communicate in French, does not make things any easier. The e-mail contact eingie weeks was not possible because not all Internet connections in Lambaréné worked. Sorry, but they are also working with very little lines disappear - they seem to be rather lazy about writing. In fairness, one must also say that it is not really motivating to travel first to the city to an Internet cafe to send e-mails at all can.
for Guillaume I had in March this year, like an exhibition space at the Youth Art in Olten organized to him to provide a platform for his paintings. My brother had done this very successfully for a friendly young Costa Rican artist who within a few hours all his could sell paintings and could not afford a plane ticket to Switzerland in order to paint here for three months and to establish networks. And after a second successful exhibition at the Youth-Art is a year he was even a kind of scholarship and went a second time to Switzerland. Well, unfortunately I was too late and all the exhibition spaces were already taken.
During my time in Gabon had I measure a lot of discussions with Owen on training and the associated independence it boot company as "employees" in his uncle. During this time he lived, was very irregular and at the discretion of his uncle's wage and it also happened that with his uncle the Money that Owen gave him set for a shopping, shopped for things to Owen and the money is not back him. It was so typical for Africa Abghängigkeit ... in which Owen does not feel particularly comfortable, but it is not looked after, that would change in the near future something about it. Owen had broken off like so many other young people to school and then seemed containing your failed attempt to have had to open a bar with friends about what he really never wanted to talk. I motivated him to take his own life in hand to get an education that he was interested in trying to be dreams from which he had a massive scale to put into practice. I was glad that he mancmal was very enthusiastic and Schmeider plans began to go back to school and still make up for the Bac. As one of the few he had a family in the back, he can finance the school and would, he should seize this opportunity. The more I was shocked when I heard shortly after my return that he had moved at the same time with his uncle, a rented apartment and had signed up at a night school. In the morning he went to work somewhere. So I had my course, not presented, I would have advised him to stop first step to school, maybe then take off with his uncle - and if all this would have really worked to take the step to Ghana to make the computer school, of which he dreamed. I was shocked and had the feeling to be responsible that I had pulled into something with which he was completely overwhelmed and that could bring him life in serious trouble.
In the wake repeatedly short phone calls from him somewhere in the jungle, where he earned with the impact of tropical timber money. Whether he actually goes to school this morning when he was so often away from home - I have his statements up to now not completely understood.
with friends who traveled from Switzerland to Lambaréné, I sent each of photos and small gifts to various people. An apparently true Solh program sparked arguments among my have that they did not get everything what had sent me and the others would have diverted his part;; friends like, I then found out slowly walked it but above all, a toothpaste that I left behind when I leave and around which one felt cheated by the other. This for the people there so typical jealousy and suspicion that you notice when otherwise only partially came here fully to light. Re: I can to all that want to understand those dynamics a little bit only recommend the book by the Swiss anthropologist "The Economics of witchcraft in Africa, or why there are no skyscrapers.
In July I heard that Lynn, her sister passed Owens Bac would have. She, who with her 20 years already has 2 children - that I find a really great performance. To be rewarded, I would like to give her a Swiss Swatch Clock at the end - with the hope that it might also spur the younger of the family something to close the school.
From Africa came with several returning again and again stone sculptures and African clothes to me to Switzerland, which I am always very. Meanwhile, I have half African wardrobe together. I wear them though hardly, but it would take a whole lot of courage, but they only occasionally to look at or to take home evokes good memories for me every time - along with many enlarged photos from Gabon, I've hung in my apartment.

Velveeta Rotelchicken Pasta

party in the Bouka

After our three months spent in the Bouka we wanted already proposed by Anne-Laure Fête in the Bouka implement our farewell still in action. As Leah and I both CFA moderately slow rather sat on dry land, we had to look around for a more favorable opportunity. We bought pineapple, a régime de banana drinks, chocolate, rice and vegetables, and Yoghourt, milk, flour and yeast (which was probably baking soda). From this, we conjured up after all soaked in chocolate banana and pineapple pieces, a king cake, braid, banana cream, Rice salad, and guacamole. The visitor was not huge parade and Leah spent half the night in bed after his head had struck a double bed and again found unconscious on the floor, probably with a slight concussion - tropical wood is hard. But Gabonese our friends drove somewhere to a fanfare and sang and drummed with and for us. All in all a successful evening, but beforehand I had also complicated. As always when one is rather short on time, I had rather a lot of work in the afternoon in the clinic and the hospital and was then invited by the friends of Major Kopp to the tailor because they wanted to give me an African Tenue. As containing correct Gabonese, we met first time the ladies, that we drank a beer and after a visit to the tailor, they drove me to the taxi or in a bar where there was drinking again and I was still with Palm wine was bottled. As they knew well that I still had a lot to prepare, but then we said goodbye to "prematurely" from the others. Regrettably, just then, of course, no more taxi and we went the distance to the nearest Carrefour on foot, in order to finally find a taxi that drove us to the Schweitzer Hospital. Lea was understandably quite annoyed because I stayed away so long and only about half an hour was left to prepare everything before The guests began to arrive. With a little improvisation and the confidence that in Gabon seem all too late anyway, but hats then executed hit very well.

Rockstar Grllchevy 2500

two days with the PMI way

Gabon All over the various hospitals try Betreuug the fullest possible use of young children, pregnant mothers and guaranteed. That is, from a hospital runs a mission in each cycle to its allotted dispensaries. A dispensary may include a blechumzäunten garden shed to the stone house, everything. In the 4x4 of their principal drugs are taken, vaccines, and the main study material.
Every Wednesday and Thursday driving the PMI of the Schweitzer Hospital off, on the other days, the PMI is working on the hospital itself is usually with each of the student of Pediatrics, since this seat for Anne-Laure's departure in late December has become free, we now share Lea and I are the exits with PMI.
I drove on Wednesday and Thursday Ebel-abanga Bifoun, from both towns on the road to Libreville, about 1 1 / 2 hours drive from Lambaréné.
As always, we come to about 10 clock in the morning at the dispensary, where most have many women waiting with their babies. If you are lucky, they even help a bear, the whole truckload of material in the dispensary. Then all the babies and small children are weighed and the weight with age in the PMI-book mentioned when asked for the diet, the weight entered into the growth curves. Described such a follow-up book costs 1,000 CFA, or about 2.50 sFr. And then the women pay for the regular weighing no more. For weighing the babies are taken off, in substance-Culottes pinned with a hanging straps and hung to the scales, which in turn is either aufgehägt from a hook or out of a tree. The older children are placed on a floor scale. Those children whose weight has fallen out of the growth curve, heraugepickt to discuss with the mostly young mothers to child nutrition and to provide tips and tricks. Not infrequently, listen to young mothers on breastfeeding, go, go because they hold still at school or work and then en brousse the babies feed only 3 times per day. The pint is not cleaned properly, in the heat of course a haven for germs, or the child has diarrhea for weeks.
then be called the mothers who want a consultation for a sick child - usually fever, runny nose, cough, diarrhea, not so much different than in Switzerland. Only prescribed that any fever without infection-find focus for a few days Quinine and Fansidar is, malaria is always present. And although recommended sleep, not all babies and pregnant women under a mosquito net.
will last, if any, called pregnant women. It often succeeds, the PMI as to reach women who do not go to the hospital check-ups. In Bifoun us a woman was presented by a neighbor who was apparently with her 26 years, about 10 times the pregnant, according to the information provided about the 5th Month. She appeared slightly mentally retarded, smiled constantly and did not seem to understand most of our questions properly. With the help of translation by the neighbor, we developed questions among pregnancies appear to be two abortions and two child deaths (according to the mother they have been eaten), the woman apparently lived nearby with an older man. For pregnancy tests, a plastic table cloth down on the stone floor, lying down on the pregnant woman. The fundus is palpated to go along with the "date of dernières règles" determined to estimate the approximate week of pregnancy. With a stethoscope the heart sounds of the child tries to listen, complemented by a digital-vaginal examination. Discharge, indicating a vaginal infection, approximately in the 26th SSW and about to give birth, there's a precautionary dose of Fansidar against the Palu. In the case of the above-described woman we could ever feel any fundus and the woman was ordered to the hospital for a consultation to first time to take a pregnancy test. During the consultations are underway to vaccinate the nurses the children. Unfortunately, when I were riding just gone out again once some vaccines, so that the mothers had to be told to go buy the vaccine itself in a pharmacy, cooled in ice to the hospital to get to him there to be inoculated to the child. Last
, usually by 2-3 Clock in the afternoon, after work, are also brought along an African lunch. Salad with baguettes, manioc leaves, "spinach" with dried fish, plantains or rice for example. On the return trip, the whole crew then covers mostly still on the road along the metal cans offered banana regime, pineapple, peanuts, a etc., because they are cheaper here than in Lambarene itself. In the evening we then drops dead tired to bed and hoped that the whole stampelnden, crowing, a baby in the culottes pissing not follow in his sleep. All in all a very good experience.

Toiletry Containers Checked Bag

drugs of the German military in pharmacy

As in a previous blog reported, received the Schweitzer Hospital mid-December, three drug charges by the German military, as this retired after the elections in the Congo. The whole load again due to Germany was obviously more difficult than having them sent a hospital. And as containing all leaflets are written in German, was offered to the Schweitzer Hospital. Overall, some
tons, was stowed the whole freight at first once in the side rooms of Pharmacy and since then heap on the floor as distributed before the drug frames (each course in the wrong place). Occasionally, they would reach quite interesting and important medicines. Because it is the pharmacist (which is actually a nurse) at least as organizing skills in German as well as to Elan on drug-missing (by drug name could indeed they look up what goes where), the drugs were holding after a month still quite chaotic around on the floor . Meanwhile, new patients arrived with candidiasis, toxoplasmosis, etc. in the coupling, for which often lacked the appropriate drugs. So I set to work and began to hold themselves all the beige boxes convert to arrange to label. The person or that patients could indeed be helped by a drug may be excavated.
After many many in the pharmaceutical and probably hundreds of kilometers traveled around towed drug kilos is the roughest times now sorted by subject. In the next few days, I will classify the drugs even after impact areas and label. For the translation afterwards has Eric, offered to the other Swiss. Initially, the Organisiererei was quite fun, but now stands with me to the neck. But at least there is now some order.

Yamaha Nytro Turbo Or Supercharger

C'est le Gabon ...

... if each of the trunk lid of the taxi on and slam if over the threshold on a bridge moves (because the trunk-lid broken)
... a taxi without cobwebs windshield (broken) is at least as rare as the cleaning lady to clean our Bouka on Monday of the bath appears
... if a car is made at least 5 different other cars: this is all taken apart and reassembled (shops, "vente of Spare Parts"
... if you notice after weeks time, that the dispensers for surgical hand disinfection ordinary dish-washing agents
comes out ... if it smells like vomit, it may well be that someone cooked cassava
... if it stinks in one evening in the Bouka of dead animal (because ate the cat is poisoned with rat poison rat from the Réfectoire has) and next evening penetrating of gasoline (because they have not poured over the spot where the dead cat, was further away by the smell lured animals)
... If patients declare that dizzying blood pressure values in the consultation, their blood pressure Medis had stopped because they went to church every morning to ask for lowering blood pressure
... if you instead change may well also get Maggi cube
... when you either permanently antriffst your patients in the city or get you there slowly all know when you return to Switzerland return back or what size shoe do you have worn the last time, when you first enter the store or just a woman (former patient?) anhaut shopping before the cooler, if she can feed her baby already Joghourt
... often in the hospital when nothing is running when it's not either own or makes all like children every day to their same duties always reminds
... if ever have any soeurs frères and be introduced to your consultations, occasionally if possible so that they do not pay the consultation must
... when you are constantly asked by patients to your phone number (preferably from those that appear conspicuously in uniform)
... when patients often times simply run away from the hospital to pay to not have to - and when they appear the next time because of illness their patients' records "lost" and still have "never were there" - because you would otherwise noted, yes, that they still owe money. This, however, the whole medical history somewhere in the archives and you will repeat all the tests have ever made - which are most likely then also do not pay back (unfortunately not very rare for patients to pay could actually)
... if all always want to change (especially the taxi drivers), but it is a constant shortage of small change
... when in the liner Lambarene Port Gentil at least twice as many passengers transported are as actually intended for the ship - the people are almost stacked on each other because one simply loads into it from above into the belly of the ship
... when children everywhere teeming
... as contraception is a foreign word rather
... when trying to drive many young women with all possible: any herbal bleach, ... - Lea and then in surgery to remove the remains must
... and was approved several years ago did not prevent, the government promoted children's wealth, although in every corner of infrastructure for such an abundance of children lack
... if anything frère and soeur calls. If there are indeed times "real" siblings, which is also said explicitly: "nous sommes frères - même mère, père même" - which is indeed a rarity but
... when the age of 38 may well be Grandmother
... and also as a man can have 26 children
... whenever everyone is ready for a chat and have an open house
... when children wear school uniforms colors depending on the school
... every few days when the hair is changed
... if the butter is melted or almost rock hard either, but certainly nothing in between
... if you like the air conditioning in the consultation room are all drowned auscultation
.. if you to "bonjour" someone "oui" to the answer is
... when the river is not to go swimming, because an otherwise Krokis in the A. .. Biting
... if in addition to student soon to become a secretary, pharmacist, ...
is ... the drinking water often times the color and taste changes
... if you can order in a restaurant Đino
... if à tout à l'heure up in 2 minutes 2 hours, possibly even can warm up in 2 days
... if you can buy roasted peanuts instead of almonds
... the tailor an offering of himself to come along on fabric buying trip, so I will not get ripped off
... senn you in a speedboat when passing a Pirogue kindly on the brake pedal must
... if it is almost normal for a student railed about the nasty teacher, whilst she is holding her 1-2 year old child in her arms
... if not a bit mosquitoes care about European anti-insect repellent or long dress, but blithely stand - especially me

... I pretty much give me skill to bring this all down here because it has become so normal that it no longer strikes me.

Congrat Phrases New Job

HIV and AIDS

HIV and AIDS, here such a common problem that I did not have written much about ... which must be completed.
On the day of my arrival in Libreville fell me the many posters that to make aware and educate on the disease. The PNL (National lutte contre le sida program) is working here with a 3-point slogan: 1 abstinence, 2 fidélité mutuelle, 3 préservatif. Since the first two points of access for the majority of Gabonese ere not, must be in practice probably begin before the same point in three.
In our HIV-positive patients for the prize en charge each open a special file, which is usually my job. In addition to the hard data such as laboratory values, personal data, and disease-indexing diseases and the risk factors discussed in each case - very few of these patients have ever used in her life Präservatif.
As an HIV-positive patient with Justin in the consultation did not know what a Präservatif, had never seen one and we demonstrated it to her, was with me exceeded the limit.
the Internet I found a fairly explicit Series, which explains the use of condoms for men. In large format prints I hung them up in the clinic, which initially provoked a small minor scandals at the Department's employees - I think it was rather out of duty, at least I was then asked by some to Flyers to them her "children" to show (resp. to read himself). As already hinted, the image series, I also reproduced as flyers, which has since rest in my office. The other two internal medicine although they are not, but at least are within reach in order to make risk patients. I do not care: I have been distributed to the 80 list - and thus perhaps prevent some infections. Also on the latent lack of condoms for selling and dispensing has not changed much. The few hundred that I brought from Switzerland, were shortly after my arrival to leave. As an educational center for sexually transmitted diseases, it is actually quite embarrassing and negligent, if not even more condoms is available here for the few responsible ones, they are now. Well, it is unfortunately not the only thing missing in here. We have just two example toxoplasmosis patients for whom there is simply no more medication. Even worse, the replacement drug is considered.
Despite the educational posters exist here in Gabon as everywhere in Africa a lot of stories and attitudes to AIDS. Many claim to traditional Practices (traditional medicine practitioners) can cure AIDS and consequently many HIV-positive patients are simply not in the controls because they receive treatment instead of somewhere in the boonies of a healer. They usually appear shortly before dying in a hospital setting but again - some with CD4 counts of 4 .. (500 above normal). Justin was of course on - both because it makes helpless and partly because it the reputation of the hospital course, not just better if people come here just to die, and then blame the hospital to their death.
more frequent, however, that a positive result, patients simply do not believe, do not accept it, it negligieren, and therefore also refuse any further treatment and disappear en brousse - probably further to infect an entire series. "A whole range of other" less because of the mostly elderly couples occurring polygamy, because more loyalty with many Gabonese is more of a foreign word. As Guillaume had said "comme chaqu'un a plusieures chaqu'unes et plusieurs chaqu'une a chaqu'uns ...". But there are also quite good patient when, unfortunately, more likely in the minority. Just today I had a pretty hefty conversation, in the morning hours I had a patient with herpes zoster (shingles) of the left upper side of the face. Because such a common occurrence in patients Immunkomprimitierten, I suggested him to take an HIV test (unfortunately a rather expensive test: 8,500 CFA, almost 15 CHF): the result was positive. I told him the result and the disease, and he seemed to understand well, even asking questions - a good sign. And he also asked me for his wife, perhaps even a positive one. I tried to encourage him to make it to tell her, offered him, they hereinzubitten and the whole thing both to explain again. He was afraid she was too fragile to prästieren to the result. And in my experience such people accepted it is usually the result anyway, affecting even the partner so that this treatment breaks off - at first very insightful patients, I have unfortunately already experienced this. After much hesitation, the patient came in, his wife and I explained the whole thing again. They barely reacted, but was willing to get tested. Was hurt, disappointed. Although I viewed the people, not the when, why, by whom look to the infection, as it currently does not have much, I can imagine what the result to the personal relationship between the two states. The result will be there on Monday, unfortunately I already almost certain to be read as it is.
few days ago, I compiled the statistics of the seropositive patients hospitalized in 2006. There were just 100 in the seropositive patients hospitalized Kopp - with many that you forgot to write some more secure. A few weeks ago I presented a statistic from 2004 - 2006 all together positive and negative tests of the entire hospital - Justin she needed to get the anti-retroviral drugs, for which he regularly has to personally go to Libreville.
are now all the drugs for free, already a significant achievement. However, all the tests in advance, which are necessary for treatment, paid for by the patient / patient (approximately 20,000 - 60,000 CFA) - an impossibility for many. The therapy would indeed be free, but the beginning of such a fail at the hurdle of the necessary investigations.
Next Wednesday is my turn to give a talk related I would like to introduce the statistics of the coupling, with a Rappel on HIV / AIDS - not a few of hospital employees are seropositive. On this occasion I would also like to take a new HIV information leaflets in the round, the old one of the many "copies of a copy of" barely legible. Guillaume, the young Gabonese of the studio des Arts et d'expression leads me to provide the illustrations, let's see obs works. Because, unfortunately, the stage will soon come to an end, time is always far too brief and be prepared with the presentation even more scarce, so I also apologize right here for my more rare items in the blog. And incidentally, the wife of my zoster patients was seronegative. Although in the first 3 months after a second test, a certain result, I was pleased the extraordinary.