simple things.

there is something so neat about a little letter getting across the country with a sticky thing saying 42 cents.

Health Care

with all this health care talk going on in the US, i thought i'd just point out some differences between health care in the US and Niger.

- health care is self-pay only in Niger. in Galmi, where i was, the most expensive surgery was around $140.

- HIPPA definitely doesn't exist. there are easily 2-3 patients being seen at a time in one room. they freely comment on each other's ailments.

-conversely, the physicians would ask other patient's family members if the patient in question has been going to the bathroom regularly. they did any of their business in front of each other anyhow...

- in the states, no one would come at 8 or 9 o'clock for an appointment that wouldn't happen until 3:00.

- very few patients ask for explainations about their ailments. i didn't have one patient come in with a list of questions that needed to be answered that visit.

- there definitely isn't any malpractice insurance. this is good and bad. do we end up valuing life less without a legal threat of retribution for malpractice? what if we truely don't have any medicine to offer?

- there is no palliative care treatment here...and yet there is a huge need because palliative care is regularly the only thing that can be offered. that was frustrating for me.

- you pay upfront....no back billing or coding issues. there is a flat fee for all visits which also includes 2 medicines. it is approximately $5. it is a lot less hastle for the providers!

- cleanliness standards aren't the same...we'll leave it at that!

Hopes and Dreams

there were many thoughts that went through my head while in Niger. one of the recurring themes was hopes and dreams. i headed to Niger for many reasons, but one of them was to learn more about my dreams and my future. after a day or two there, i started to think about the Nigerien kids....do they have hopes and dreams?

i volunteer at a free clinic in Houston. when i see kids, i always ask them what they want to be when they grow up. if they don't have an answer, i'll leave the room for a minute or two and then ask the question again. i won't let them leave until they have an answer. i just think that children need to use their imaginations and hope. it doesn't matter if they don't become a policeman or a jedi, but they need to "want to be something".

what happens to children that don't have people in society to look up to? what happens when you are malnourished? can you even hope for the future? is their hope to go to school? to have a lot of children? to become a good cook so that the family can survive? or is it to venture to the capital and break the cycle of poverty?

i wish i had answers for these things. i have noticed that malnourished children don't smile. education is a dream for most children. the cost of public education is 6 cFa (about $13 a year). if i were somewhere longer, i would probably interview a lot of children to get a better idea about how children think. i know that they are creative in their play, but do they dread getting older? do they know anything different? do all little girls desire to have large families?

Nigerien vs. American Churches

Here are the top 5 reasons that American churches would have smaller congregations if they followed the Nigerien practices:

1. All visitors are introduced during the service....whether you speak Hausa or not.

2. Multiple offerings are taken. I would count....the average was 6-7.

3. They would sing for 2 hours and then the sermon would last another 45 minutes or so.

4. You might have to touch the person next to you....you squeeze in tight...in 110+ degree heat.

5. Preachers at home get distracted with talking and sleeping in the congregation....try preaching while the women are openly breast feeding!

*Just a quick disclaimer....I'm not saying that either is right or wrong.

here is a picture of the pews...i don't have a lot of good pictures from church. i tried to upload a video and it isn't working with me!

Trip Updates

So sorry if you were looking at this blog for trip updates. I didn't have much access to e-mail and I didn't want to spend a lot of time on the computer either. I'll be updating with some stories intermittantly! All in all, it was a great trip!