Fourth of July in Guyana

I am having difficulty describing it here in Guyana. It is not any easy place to pin down- although I guess nowhere really is. I am feeling, when I walk around in the streets, that it reminds me more of rural, coastal Mississippi, if you could take out the cotton fields and rural, farms part and squish all the little towns and the buildings together & somehow have it be urban. To ,many of you this may make no sense, but to some it may?... I am living in what is considered a relatively nice ward, the city of Georgetown is divided into 'wards'- each with their own name. My ward is Queenstown, and I feel very pleased with it, but I must say when you walk down the street, an American would most likely not necessarily consider it "nice." This is just an observation or an assumption though. I am finding it very nice for me, all the same. The mention of ward does of course make me think of New Orleans. Taylor mentioned a few nights ago that he thinks of New Orleans when I write/speak of it here. I am sure it looks like parts of the Big Easy, but my recollection of New Orleans is childish and consists of a cathedral and a riverside hotel, so I am inept to compare. Georgetown is a coastal city and is a part of, or on a delta (not sure how you say this). We are at sea level here, if not below, and the ocean which I have yet to see, is apparently brown with runoff from the interior rain forests due to the rivers emptying there.

I visited two clinics where I will be conducting my study yesterday. Step 1 accomplished! Very exciting. One is called the Dorothy Bailey Center and it is one of four municipal clinics in Georgetown. I met with the nurse who heads the 4 sites. I am not exaggerating when I relay that she said there are 7 nurses for all four of the sites. The nurses divide up their time between them. Have I mentioned that there is a not surprising nursing shortage here, where isn't there I guess, except perhaps the Bay Area. But here where nurses get a free education, government compensated, there is a problem with them leaving Guyana for better jobs, pay, lives, elsewhere. Barbados, St. Lucia, the United States. The head nurse, Joan, reviewed the questions of my study (I did not show her the embarassingly long form of informed consent (other Downs's recipients will appreciate this comment), and afterwards I observed a prenatal clinic, which was I was not surprised, nurse run. This was of course, very fun for me. I watched 5 patients be seen by a sweet and jolly nurse named Jean. I was strangely amazed to see the fundal height being measured in just the same way as I had done for so many months this spring, the familiar pregnancy dating wheel turned to position just so, as to determine an estimated date of birth, the inspection of a paper describing numerically, iron levels in the blood and education offered about iron-rich foods, then the charting of what was done & discussed. Why would it be different. I guess just the recent familiarity of my own hands performing such tasks, feeling the abdomen with my eyes lifted toward the ceiling so as to better see with my hands, identifying the butt, and the back of a babe, estimating where we might hear the heartbeat best, all this is universal of course, and I know this seems silly & obvious, but in this distance from my "normal" life- it feels amazing & reassuring somehow, to be so similar, so universal.

Later in the day I headed to the second clinic, the Guyana Responsible Parenting Association, which is in some way connected (or once was) with the International Planned Parenthood Federation. It was an air-conditioned building and I think I will be there approximately 3 days per week, not for this reason, but how nice. Did I mention that at the previous clinic the windows were wide open during patient visits for a nice breeze and my nurse had her radio blaring funky Caribbean sounding music- so funny. I had to ask to turn it down to better hear her speak. All in all it was a reassuring day, seeing the 2 clinics where I will spend most of my time. I will periodically visit other clinics as well- but I believe these 2 will be the consistent sites. Everyone has been so friendly. I should mention everyone does have beautiful English here, although there is an accent that is difficult for me to interpret at times. I have to ask for a lot of repetition, which I feel bad about. I am trying to think of all the most polite ways to ask for the statement a second time. Pardon me, could you repeat that, excuse me, what was that, and so on and so forth... What's that you say? No that doesn't sound right. Happy 4th of July from me.