A World Class Physician Serving in Angola

The CEML Hospital Medical Director, Dr. Steve Foster, just received a distinguished award from the Royal College of Physicians and Surgeons of Canada.  This award, given in evaluation by a consortium of honored physician-peers in Canada, exemplifies one of the highest honors of  the North American medical field.

The Teasdale-Corti Humanitarian Award, acknowledges and celebrates Canadian physicians who, while providing health care or emergency medical services, go beyond the accepted norms of routine practice, which may include exposure to personal risk. The recipient's actions exemplify altruism and integrity, courage and perseverance in the alleviation of human suffering.

Below is the Award biography story of Dr. Foster:

Stephen Foster, MD, FRCSC, has devoted his life to improving health care in Angola.
Even when armoured plates had to be installed under his car, the 2010 Royal College Teasdale-Corti Humanitarian Award winner continued providing high-quality medical treatment in a country ravaged by more than 27 years of civil war.

“Despite the apparent dangers, I’ve had more fun here than I would have had anywhere else,” Dr. Foster said. “The average general surgeon in Canada does five or six different types of operations. I do more than 100 procedures, 1,400 times in any given year.”

Dr. Foster, 60, was born in Brantford, Ont., but spent most his childhood living in Zambia, where his father, Robert Foster, MD, worked as a missionary surgeon. In 1971, the young student had just completed his second year of medicine at McMaster University in Hamilton, Ont., when he decided to spend the summer working at a central Angola clinic.

“This is where I first fell in love with surgery,” Dr. Foster said. “It opened my eyes to the experiences and rewards that are possible in medicine.”

Dr. Foster later completed his general surgical training through the University of Toronto’s Gallie Course. But after entertaining offers from hospitals throughout southern Ontario, he returned to Angola, driven by the desire “to not turn my back on everything I’d seen and could do to help.” He has since founded surgical units
in numerous hospitals, mentored dozens of nurses and surgeons, and helped design a postgraduate medical education training program.

When there were no doctors available to run a hospital in Kalukembe, a rural town in southwest Angola, Dr. Foster trained nursing staff. The hospital, which serves a population of 500,000, now provides the only medical care for the region, handling all surgical emergencies, said Michael Bentley-Taylor, MD, FRCPC, senior cardiologist at the Toronto East General Hospital and a longtime volunteer with Dr. Foster in Angola.

“The nurses do everything, from 250 C-sections a year to putting you into traction, including putting the pin into your tibia,” said Dr. Bentley-Taylor, who travels to Angola twice each year. “It is a real paramedic hospital. This is a man of vision.”

Angola is roughly the size of Ontario and has a population of more than 18 million. All but one of the 12 mission hospitals in the southern region were destroyed during the prolonged civil war, which lasted from the country’s 1975 independence from Portugal until eight years ago. More than 500,000 Angolans died in the conflict.

Providing treatment in war and post-conflict environments has been difficult, Dr. Foster said. The health infrastructure, already inadequate in 1975, deteriorated rapidly during the civil war, while the education and family systems also struggled. This made it harder to deliver timely, effective treatment, as well as teach proper methods and techniques to residents. (From Royal College of Physicians and Surgeons Award site)

Rebuilding Angola's Roads

All African nations, Angola included, heavily rely on road transportation to move goods and people from one location to the other. Unfortunately the roads are limited in capacity, are poorly maintained, or in Angola's case been decimated by the war.

In 1994, Angola's usable road network totalled some 75,000 km (45,000 miles), but by the end of the civil war in 2002 little of the paved network remained outside the main cities. The war meant that much freight was transported by air, as road haulage was risky and limited, isolating most settlements in the interior. Since 2002 efforts to clear an estimated 7m landmines and rebuild roads and bridges have reopened most of the main arteries.

Considering that a large percentage of Angola's population live in rural areas, the resulting impact of no road travel means that in the remote areas infrastructures of every other kind scarcely exist and those that exist barely function. Until recently due to the war, there were few accessible roads in rural Angola and these few are poor, dirt and unpaved or hampered by the insecurity of land mines.

The role played by infrastructures in the economy of a rebuilding nation like Angola cannot be overemphasized especially its effect on sustainable development, foreign direct investment flow, GDP growth, inflation reduction, job creation, trade, agriculture, delivery of goods and services, lowering cost of business, improving health and standard of living and poverty reduction. Therefore, efficient and effective provision of infrastructure in a nation underlines all attempts to reduce poverty.

In April 2007 the Angolan government announced plans to rehabilitate and expand Angola's road network with loans from China and the European financial institutions. An initial US$2bn phase of works will build 5,300 km of roads by the end of 2008, rising to 14,000 km, and with 120 new bridges, by the end of 2011.

China itself has granted Angola a US$211 million loan to finance the first stage of a project to rebuild roads destroyed in the civil war; starting with a 300km stretch between the capital Luanda and the northern agricultural and mining province of Uige. The project will be carried out by the private Chinese company Roads and Bridges Corporation (CRBC) over the next two years. (Info adapted from Economist Intelligence Unit: Angola)

African Folklore: Why the Giraffe and the Oxpecker are Good Friends

After God created the earth, when all the animals lived together peacefully, a huge bushfire swept through the land, started by a bolt of lightning. The tinder dry grass burst into flames and the strong winds that are common before the rainy season, quickly spread a wall of flames from horizon to horizon. Unable to do anything to put it out, the animals fled in panic before the deadly flames.

A pair of oxpeckers had made their nest in a hole in a tree trunk and had just hatched out their chicks, but the tree stood in the path of the advancing flames. The oxpeckers pleaded with the passing animals to help them rescue their little chicks, but they took no notice as they ran from the deadly flames.

Just when the desperate oxpeckers were about to give up hope, the kind giraffe came along and seeing the
birds so distressed asked what was wrong. "Oh Giraffe;' the oxpeckers wailed, "Our nest will soon be burned and our chicks with it. Please carry it away from the fire for us:'

Giraffe took pity on the oxpeckers in their dreadful plight and rushed to the tree through the dense smoke and the flying sparks. Because of his long legs and neck, Giraffe was able to reach to the top of the tree and pluck the nest and the young fledglings from the hole and carry them to safety.

"Oh, thank you, thank you, kind Giraffe;' said the much relieved oxpeckers, "How can we ever repay you for your kindness?"

"That will be quite easy;' replied the Giraffe, "I am always troubled by ticks. If you like you can ride on my back and pick the ticks off for me.'  "We will gladly do this service for you for ever and ever,' replied the
overjoyed oxpeckers.

Today, if you go into the African bush you will nearly always see oxpeckers and giraffes living together. (From: When the Hippo was Hairy and Other tales from Africa; Nick Greaves.)

Overland travel to West Africa - the possibilities are endless

Since the recent news touching on the chaos that the Icelandic Eyjafjallajokull volcano caused for tens of thousands of air travellers, I decided to look at the possibility of travelling overland to West Africa. It may take much longer, however it also could cost about the same as a flight, be much more rewarding, allow you to explore different elements of African culture along the way and be more environmentally friendly when it comes to your carbon footprint. After all, according to a Chinese proverb, “The journey is the reward.” Overland travel veteran, David Hatter, explains:

"Overlanding through West Africa will allow you to meet many people unaccustomed to seeing travellers, and it is in their nature to offer you their hospitality. You will witness a way of life that has unchanged for centuries, yet one that is rapidly changing as the world around them is developing fast. Local markets scenes, village festivals, and marriage ceremonies will help you understand the cultures of West Africa in a way that the media can only hint at."

Let’s take an example of Sierra Leone as a destination. The Itinerary is simple, and believe it or not, it is not dangerous either. A few people have even cycled the same trail that I will suggest.

Starting from the UK, you would most likely go through France and Spain, then head over the Gibraltar Straight to Morocco for a pit stop. In Morocco, you could relax in a Kasbah in one of the four Imperial cities of Rabat, Meknes, Fez, or Marrakesh. The hustle and bustle of Djemma-El Fna or the tanning pits in Fez will offer a great introduction to the “assault on the senses” that is North Africa, and experience the first signs of African hospitality over a cup of traditional tea and a Narguilé (traditional bubbly pipe with aromatic tobacco).

Continuing on, you will then head in-land to the Atlas Mountains, where the climate changes considerably as the altitudes get higher, with fantastic opportunites for hiking in the famous Todra, Ziz, and Dades Gorge, and have you first glimpse of the majestic Sahara desert.

"The Erg’s around Merzouga and Zagora are not to be missed. Picture postcard sand dune ranges roll for as far as the eye can see and suggest but a small hint as to the vastness of the Sahara desert which stretches out to the east as far as Sudan, with ample opportunity for camel trekking and 4x4 exploration." notes David.

Back to the coast, you will follow the Atlantic Ocean to the Western Sahara, considered as one of the most sparsely populated areas in the World, and in majority composed of desert flatlands. You will no-doubt encounter Tuareg herders on their way to a hidden Oasis or even one or two of the friendly folk that Michael Palin met on his way to Senegal in his ‘Sahara’ series. The true remoteness of the Western Sahara is really appreciated as you bushcamp on the coastline with unspoilt views of the night sky above as the moon shimmers off the hulks of abandoned ships lost long ago to the Atlantic ocean.

Next stop, Mauritania, a transition country between Arabic North Africa and Black Sub-Saharan Africa, largely populated by Berbers and Moors, this country is where you will come face-to-face with ‘true Islam’ and learn about the hospitality of those who practice this misunderstood religion.

David describes some of the wonders of Mauritania: "Witness what many people say is the longest train in the world as it carries iron ore from the mines at Zouarat to the coastal town of Nouadibou, explore the ancient and seventh holiest Islamic city of Chinguetti whose libraries reveal all kinds of clues as to its famous and glorious past, while the beautiful Oasis’ at Terjit and Ouadane allow for some well earned R&R from desert travel."

After staying in a Berber camp overnight, you will head over the Senegalo-Mauritanian border to a busy ‘market town’ called Diama, a hub for all trade coming from North Africa to West Africa. In Senegal, there are loads to do and see. Stop off at the ‘Lac de Guier’ where the desert meets the Savannah, visit St. Louis, the Jazz Capital of West Africa and a wonderful opportunity to watch the fishermen bring in their catch in their elaborately painted boats, go bird-watching in ‘le Parc du Djoudj’ (migratory pit-stop for thousands of birds), get lost in the vibrant sounds and colours of Dakar, explore the natural waterways on a Pirogue (traditional canoe) in the Siné-Saloum Delta, and much more.

From Sénégal, head over the border to The Gambia, home of the Kora instrument, first choice for the traditional musician caste of the region, the ‘Griots’. After a night or two in an eco-retreat on the Atlantic coast, head up the Gambia River for some fishing and experience nature at its best, untouched.

Leaving the ‘Smiling Coast’ behind, cross the border to southern Sénégal, also known as Casamance, where you will notice a huge difference from its northern counterpart. Tropical climate, animistic belief systems and road-sides dotted with Mango trees are some of them. From here, head east along less travelled roads to South-Eastern Sénégal home to the Bedick and Bassari tribes who practice Animism.

A new day, a new border! This time it’s the turn of Guinea-Bissau to welcome you. Once a Portuguese colony, this country is dotted with remnants of old-style colonial towns such as Boloma, former capital of Portuguese Guinea before the capital was moved to Bissau in the 40's. The Atlantic Ocean, which you have followed but not always seen, re-appears like a long lost friend, and this time welcoming you into a paradise like environment known as the Bijagos Islands, beautiful and untouched tropical Islands surrounded by turquoise seas, inhabited by friendly and hospitable tribes. Here you will have the chance to participate in the Bijagos masked carnival, a little known yet colourful and awe-inspiring cultural festival.

Here you will be able to relax for a few days on a Hammock, only disturbed by the sound of birds singing and waves lapping against the beach. After a well deserved rest, you will be back on the adventure trail to cross the last country before arriving at your destination.

Guinea is a tropical, French-speaking country, famous for its Jazz and Latino style music. It is also home to the Fouta Djalon, a beautiful area of waterfalls, mountains, and small villages… many say this area is the highlight of Guinea. After witnessing such beautiful natural scenery, you will arrive in Sierra Leone, and your final destination, Freetown.

Freetown is a coastal town which is surrounded by beautiful scenery. To the East you will find lush tropical hills rolling down to meet you, and to the West beautiful beaches made famous by the 80’s bounty commercial ‘a taste of paradise’. The coast is dotted with Islands, some of which have shacks where you can spend a few relaxing days snorkelling, sun-bathing, swimming and indulging in some of the best fish and seafood in the world.

For this particular journey of a life-time, you would obviously need an adapted vehicle. There are some companies that already do this kind of trip, and we are currently in the process of talking to them. For those of you who do not like flying, are worried about getting stranded at an airport due to unforeseen natural occurrences, or just plainly think that the journey is more important than the destination, then this could be the answer to your prayers.

West Africa is perfectly placed with respects to Europe in order to experience a multitude of different cultures, historical sites and natural habitats of Africa when journeying to your destination.

For more information on West Africa, Sustainable and Responsible Tourism or just if you would like to chat about your experiences in West Africa, don’t hesitate to contact us at info@westafricadiscovery.co.uk.

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