Go fly, kite!

I grew up amongst seagulls; a noisy, messy bunch, but not at all threatening, even when they came in large groups searching for treats. Once I left Texas, I was largely removed from groups of flying critters, except for occasional swooping pigeons, but living overseas has changed all that.

In Africa, swarms of fruit bats filled the sky at dusk, darting in and out of the trees and, sometimes, flying so close to me as I walked I could hear the “swoosh” of their giant wings.

In Islamabad, we had crows. To discourage them from roosting, we hung fake owls in the trees—owls are evidently a natural enemy of crows—along with shiny strips of twirling metal. It didn’t work. The crows would foul the ground below the trees and make a terrible racket at both dawn and dusk. The worst was when they became infected with H1N5 (avian influenza). Dead birds, scattered by the dozens around the grounds of the embassy, caused a minor panic.

Karachi has kites, black kites to be exact. These large, rather intimidating birds soar and swoop in groups all day long, not unlike vultures waiting for carrion to appear.

Black kite

My apartment has a very nice balcony with some lovely teak furniture. It might be a nice place to sit and read a book. I say might because I will never know. The kites like to land on the balcony rail and sit on the arm of the teak chair, and they are aggressive. I got a good look at a kite perched outside my window, and that thick, curved beak and the menacing talons were enough for me. My balcony belongs to the kites. I will never venture there.

For Reflections on Nursing Leadership (RNL), published by the Honor Society of Nursing, Sigma Theta Tau International.

Where does an 800-pound gorilla sit? Anywhere it wants to.

Four years ago, I experienced one of the most magical and meaningful experiences of my life. I was in Kigali, Rwanda for a three-month tour and was lucky enough to find a last-minute ticket to the Mountain Gorilla Reserve, a real triumph since these spaces are sold out a year in advance. I contacted a recommended guide, Danny, to drive me to the reserve the day before our 7 a.m. hike into the forest. I would spend the night before the trek at the Gorilla’s Nest Hotel.

You may remember something about Dian Fossey and her fight to save the mountain gorillas from poachers in the 1970s and ‘80s. Her death in 1985 brought the publicity needed to stop the near extinction of these remarkable creatures. Her work inspired the book and 1988 movie, Gorillas in the Mist. Today, the gorillas are out of danger, well protected, well funded and a fitting living memorial to Fossey’s life and work.

The current families of gorillas living in the mountains have grown up in the wild but, during their lifetimes, their forest has always included humans. While humans are not allowed to interact directly with the gorillas, they continue to study and track them. There are five gorilla families on the Rwanda side of the reserve and, every day of the year, eight humans are allowed to visit each family for a maximum of one hour.

When you arrive at the reserve, you are assigned one of the families. Wherever that family is foraging for the day is the goal of the hike. For me, it was approximately a two-hour hike up a very wet and muddy trail through the bamboo forest. It was miserable. More than once, I wondered if it was worth the effort. Then, unexpectedly, a small gorilla swung out of a tree, careened over the back of one of the guys in the group and ran off. That started the vocalizations and the rustling in the bamboo, and we realized we had arrived.

First, we came on the silverback. Wow, he was huge! Calmly chomping on bamboo, he barely even looked at us, but we knew he knew we were there, and we were acutely aware he was in total charge of his area. Standing in a straight line—eight visitors and two reserve workers—we watched and snapped pictures. We had been told not to talk, as that can agitate the gorillas. This was not a gorilla we wanted to agitate. Other than camera sounds, we were absolutely silent.

After about 10 minutes, he started through the forest. Before we ran into the silverback, one of the guides had to chop through the forest with a machete to make a way. Once we were following the silverback, there was no more need to cut a trail. As he moved through the forest, the bamboo was trampled under him and we just followed the cleared path.

Eventually, the silverback came to a small clearing and flopped down. Within a couple of minutes, three females—one with an infant—and three juniors came into the same clearing and settled around the big guy. For the next 40 minutes, we watched and took pictures. We could hear other gorillas in the bamboo, but no more came to join the group. The juniors played and tumbled, and the females groomed each other. Our group stood about 5 feet from the silverback, with the females behind him. The juniors were anywhere they wanted to be, including inches from us, as they played. It was remarkable.

Before setting off on this expedition, I had high expectations but it was more than I could ever have imagined. For half of the reward, I would have climbed twice as high and still been awe-struck.

These creatures, along with their few cousins that live across Rwandan border in Uganda or the Congo are the only mountain gorillas in the world. If you ever find yourself in this part of Africa, do not pass up the opportunity to make this incredible journey.

I like to classify my exceptional travel experiences in terms of being Top 10. The mountain gorillas are Top 5, no contest. Seeing them was magical. Next time, I’ll tell you about another meaningful part of this trip.

For Reflections on Nursing Leadership, published by the Honor Society of Nursing, Sigma Theta Tau International.

How do YOU spell relief?

The snow has been falling intermittently in Prague for two months. The streets and sidewalks are rife with patches of ice that threaten all who trod there. I’ve been doing quite a bit of slippin’ and slidin’ myself, and I’ve had a number of patients come to the medical unit that have been injured from falls. Some have been referred to our local emergency departments or orthopedists for treatment.

This brings me to the topic of pain and, more precisely, pain control. Americans, probably more than any other society on earth, are interested in pain control. We don’t like to hurt, and we believe that unnecessary pain is a violation of our human rights. We have laws that govern pain control measures, and we have developed pain measurement scales to assist providers in properly assessing the level of pain or pain relief.

Many other societies accept pain as incidental to injury and, while they may offer measures of relief, they are not committed to pain eradication whenever possible. Of course, there are many areas of the world where pain medication just doesn’t exist, or it is reserved for the truly severe cases, so pain tolerance is expected.

I’m discovering that the philosophy in the Czech Republic, as in much of Europe, is that pain is to be dampened by using the most moderate means available. That usually means no narcotics. Europeans love NSAIDS (ibuprofen-type medications) and are really slow to suggest narcotics. They also rely on nonpharmacological methods such as ice, heat, breathing techniques, muscle relaxation, music, massage therapy, and the list continues. These important adjuvant measures are used in the United States, too, but usually not for short-term or immediate pain control.

In West Africa, I took a patient with an injured leg to the local emergency department. The X-ray showed a displaced fracture and the orthopedist was called to do a closed reduction. I asked the doc, “What are you going to give her for pain?” He looked puzzled for a moment, then turned to the nurse and said, “Please prepare some tea!”

A very quick and tense conversation followed regarding pain control in this patient, who was now terrified as well as hurting. It was finally decided that I would scurry to my clinic to bring an appropriate pain medication to the hospital for my patient, as all the doc could provide was an NSAID. My patient had pain medication prior to the closed reduction and casting and, while the procedure was still a bit uncomfortable, she did quite well. Oh, yes. She also had tea!

For Reflections on Nursing Leadership, published by the Honor Society of Nursing, Sigma Theta Tau International.

Unpacking history

Today is moving-in day for me. I arrived in Prague in October but my HHE (household effects) were just delivered. I had a much smaller shipment that arrived from Islamabad in October, so I’ve been perfectly content living with what I have, and I have dreaded this day for several months now. I need to give you the background on the problem.

Allow me to introduce you to one of the oddities of Foreign Service life. We move—a lot! Our standard tours are one to three years, depending on the difficulty of the location. While our housing is provided, and almost always furnished, personal items, household goods, kitchenware, books, etc. move with us. Some posts are in areas where standard goods are difficult, if not downright impossible, to buy. If we are moving to one of those “hardship” posts, we are also granted a consumables allowance, which is an additional weight to use for products we will need while we are at that post and are not likely to find locally.

In 2001, I transferred to Conakry, Guinea in West Africa. Conakry is one of those “hardship” posts where a consumables allowance is essential. Guinea is a country incredibly rich in resources with a long-standing corrupt government that has kept the people in abject poverty. Fortunately, people don’t usually starve there because food grows abundantly, but the people are starved for everything else. As a result, goods and services are largely unavailable.

I was supposed to be in Conakry until 2004 and I brought with me ample goods to see me through. I’ve learned that I do quite well on local food, so most of my consumables are things such as paper products and cleaning supplies. One can really tell a lot about a person’s preferences from seeing what is chosen for consumables. Let your imagination be your guide: disposable diapers, wine and beer, ethnic foods, various canned goods, etc. For me, it is American paper products. They can’t be beat! If you have ever used non-American toilet paper, you know what I mean.

Unexpectedly, I was offered a move to Kabul, Afghanistan for the spring of 2003, more than a year before I was supposed to leave Guinea. I jumped at the opportunity and began the preparation of moving. But there was a catch. Housing in Kabul consisted of a 17-foot by 8-foot metal shipping container, and I was only allowed to ship 500 pounds of goods and bring two suitcases. So everything I had in Guinea that was non-perishable was put into storage for me by the Department of State.

My plan was to do the one-year tour in Kabul and then go to another regular post, but again I was offered my dream job—worldwide rover. My things stayed in storage for the second and third year while I worked temporarily in nine different locations, filling in staffing gaps. In fact, the things I had shipped to Kabul were now in storage, too, as I was down to two suitcases—period!

As providence would have it, for my next posting I chose Islamabad, again one of those limited-household-effects posts, and all I was able to move was the stored goods from Kabul. I stayed in that one-year post for three years! This brings me to today. This morning the belongings that have been stored since 2003 were delivered to my apartment.

I have been opening boxes all day, discarding things I wondered why I packed at all, trying to find a place in my limited storage space for other things I know I don’t need. I’m even getting nostalgic over a few items. When I opened a box filled with dinnerware my son gave me years ago, I choked up. And when I came across a couple of items that had belonged to my daughter, I sat down for a good cry. Perhaps nearly seven years of not having my real life with me was too long. I need reminders of my history to reassure me and help me remember who I really am and where I came from, not just things that chronicle where I’ve been.

Some of the boxes have been real surprises with contents I actually don’t remember at all. Several times today I have said, to no one present, “Where did this come from?” Fortunately, I like most of what I’ve found.

And then I came upon the consumables. I won’t bore you with the details, but I will tell you this. For the rest of my life, I will never again have to buy paper towels.

For Reflections on Nursing Leadership, published by the Honor Society of Nursing, Sigma Theta Tau International.