Medical Musings & Amusing Medicine: A month in Equatorial Guinea

In 2004 I had the amazing opportunity of working in Malabo, the island capital of Equatorial Guinea. I found some photographs of my trip recently and decided to post some of my experiences and memories. I've pre-dated the post back to 2004 to maintain a timeline even though I'm actually writing this January 2012.

This was to be my first locum contract with International SOS who had only contacted me 2 weeks previously (May 2004) with the plan that I'd work in Nigeria in August sometime. It just so happened that there was an attempted coup-de-tat in Equatorial Guinea and the hired mercenaries included some South African ex-soldiers. So I was asked to urgently fly in to provide medical cover for the Marathon LNG plant there since most of the South African doctors needed to return home to get a police clearance, which can take months.

I arrived in Malabo via Zurich (I had to fly from Windhoek to Johannesburg, then to Zurich, and then back down to Malabo! Windhoek is geographically closer to Malabo than Johannesburg or Zurich). I was greeted by the immigration security and ushered to a back room, which was probably the only back room in the tiny airport. A security officer in military attire sat at a table with his back to me while I stood in the doorway surrounded by a few other guards. He proceeded to question me about why I was there, why I had visited South Africa so many times, why I had my visa granted in Paris instead of South Africa among a few other questions. He then opened up my computer and found a directory with photographs I'd taken from home and recent travels to Istanbul and Israel and then asked me who each and every person was. I approached to try point out people and had taken no more than a couple steps when he abruptly put his hand up and said I need to stay back. He never turned to me so I never saw his face through this entire interrogation. The paranoid and aggressive state of the immigration personnel was to reflected by the military and police throughout my stay.

The clinic I worked in was in the camp across the bay from the "city" of Malabo, which is at the foot of an apparently extinct volcano. The clinic was staffed by another South African doctor (who managed to get a police clearance quickly), a Mauritian paramedic, a Filipino nurse, and several Equatoguinean nurses. It was a small clinic that was to be superseded in about 6 months by a much larger clinic for the next phase of construction. The camp itself was amazing with a typical Texan style built-environment consisting of large suburban like streets and 3 bedroom villas, a beautiful fitness centre and pool overlooking the bay. I spent my working hours each day seeing a few patients with cuts and bumps and coughs and sniffles. Thankfully nothing major happened.

One morning I needed to perform a safety and hygiene inspection of one of the offshore drilling rigs. I had to get up at 4am to drive to the port to leave at 5am. I hadn't had any breakfast and became the sickest I've ever been due to the bumpy boat ride through the choppy early morning ocean. I was so relieved to get onto the rig which felt like solid ground. After a light breakfast and probably the first cup of coffee I've ever had in my life, I felt semi-functional and was able to conduct the inspection.

I spent almost my entire time on that camp, as I was on call most of the time. I did venture out on one occasion to Malabo with a friend of a friend, Nabil, who I managed to track down after 3 weeks of trying. He is an American Baha'i who grew up in Ecuador and after working in Israel for a time, heard about the only former Spanish colony in Africa, Equatorial Guinea. He decided to explore the country and in fact he eventually found his wife there. I believe he is no longer living there though. He picked me up at the camp and we proceeded to drive around the bay to Malabo. I tried to take some photographs along the way but was quickly warned that since we were driving past the presidential compound, should any of the military see my camera it would be surely confiscated and I might be in worse trouble. Even in the "city" itself, I managed to take only a couple photos before being aggressively harassed by some small kids who were demanding money or they'd call the police. After a great evening with Nabil and his then-fiancée, we went to a small restaurant and had pizza, while he described all the difficulties he had had in trying to work there.

This was my first foray into West Africa but I was markedly taken aback by the dilapidation of Malabo, particularly considering the documented wealth of the country. One could see some older colonial structures, but everything was covered in a layer of black soot like dirt. The vast majority of the cars were all in pretty bad shape and were all imported from Spain apparently, decades ago. I do regret not spending more time in Malabo and among Equatoguineans as my stay there felt quite superficial in the compound across the bay.

(click on images for larger view)