BOOK REVIEWS Toubab: An American Doctor in toubab, experienced in Africa. He was Africa Medicine and Education West Africa assigned to the emergency department (WAME), a nonprofit program to help of the major hospital in The Gambia. His support medical care and general edu - By David Levine, DO. 281 pp, $25.00. ISBN: text relates numerous insightful experi - cation for West African children. The 978-0-9821064-1-9. Self-published; 2010. ences of friendships, cultural collisions, book notes that all profits from the sale sickness, frustrations, heartbreak, anger, of Toubab will be donated to WAME. The Gambia is a poor, small country in happiness, and much more. A couple Buying this book will help these kids West Africa in which day-to-day life is a examples follow: survive a difficult life. challenge. Healthcare services available My recommendation is to buy there are only a fraction of the services [Stunning to me were] the depth and Toubab and read it, and then try to pic - available in even the smallest towns in breadth of the chasm of ignorance of ture yourself living in such poor condi - the United States. I imagine that condi - the average Gambian about illness. A tions. You will leave Dr Levine’s story tions in most of Central Africa are sim - friend will report to me, “My auntie with a greater appreciation for what we ilar to those in The Gambia. In 2006, is in the hospital.” have in the United States, despite all the “Oh,” I say, “what is wrong with David Levine, DO, a family physician distractions that we’re experiencing in her?” from Washington State, volunteered for medicine today. 1 year to provide medical care for the “She is sick.” people of this country. The life journeys “What is her sickness?” “I don’t know. She is just sick.” Gilbert E. D’Alonzo, Jr, DO that eventually led Dr Levine to Africa Editor in Chief, American Osteopathic Associa - Or, “My auntie died in the hos - tion, Chicago, Illinois help us understand why he did this. As pital.” is clear from reading his book Toubab: “What did she die of?” An American Doctor in West Africa (orig - “She was sick.” inally published in 2008 and republished The older people may or may not Editor’s Note: Toubab: An American with amendments in 2010), Dr Levine know the term malaria. It will be rare Doctor in West Africa is available by has a huge social consciousness. In the that they will be aware it is trans - contacting Dr Levine at toubabdoc book’s introduction, he writes of his early mitted by mosquitoes. They do know @gmail.com. Dr Levine notes that the experiences as a physician doing vol - it becomes more prevalent in the $25 price of the book includes ship - unteer work at the Hôpital de Luperón rainy season. ping costs, and all proceeds will go to his nonprofit charity, West Africa in the Dominican Republic in 1992: It is 9/11 and I am a Jew living in a Medicine and Education. Muslim country. Few people here I washed my hands in old-fashioned know that I’m Jewish. They will ask porcelain basins, sewed up lacera - if I am Muslim and when I tell them tions from motorcycle accidents, and I’m not they assume I am Christian. helped treat endemic typhoid fever. Here, you are one or the other. The I went into mountain villages with a idea of being secular is puzzling. If I “flying squad” of nurses, doctors and tell them I am Jewish there is no reac - dentists. It was in the villages that I tion. None of them have any experi - really began to see some of the diffi - ence of Jewishness; of Anti-Semitism. culties in getting health care to people ... Toward me, there is only kindness in poor and isolated conditions. How or, alternatively, a target from whom do you diagnose without lab and X- to gain advantage or cadge money. I ray? What good is a diagnosis when am a toubab, and a non-Muslim. That there’s no chance of follow-up? What is category enough. if there isn’t medicine? What good does it do to treat chronic problems on a hit-and-run basis or even for a Toubab is embellished with many month if there isn’t long-term inter - black-and-white photographs of people vention? and scenes from The Gambia. These pic - tures strongly connect the reader to the Toubab means white person in the story in Dr Levine’s journal. language of West Africans. Dr Levine’s Dr Levine continues to help the book is in the form of a diary that tells people he worked with during his year the fascinating story of what he, as a in The Gambia. He has established West Book Reviews JAOA • Vol 111 • No 8 • August 2011 • 513.