Niger feels like a world away from my US home in more ways than one:
1 - Washington's skies in February are typically grey and cloud. Niger's are blue and hazy.
2 - Washington's landscape is green, with prominent topographical features like hills and mountains. Niger's landscape is orange and flat, flat, flat.
3 - Washington's roads and cities are full of pavement, concrete, differing building shapes, slanted roofs, florescent lights brightly illuminating vast areas of space, huge box stores, and transportation predominantly being accomplished by cars and truck. Niger's roads are dusty and sandy, with mud-and-straw structures being commonplace, or houses tucked behind 8-foot high walls with broken bottles or barbed wire at the top, flat roofs, tiny, open-fronted or tented shops, random long, florescent tubes sticking out in various locations, and streets crowded with some cars, but mostly scooters, motorcycles, donkeys, camels, carts, and lots and lots of people.
4 - In Washington I turn on the heat before I climb into a bed piled high with blankets, down comforters, quilts, afghans, and fleece throws. In Niger I make sure the fan is on, my 2nd sheet is pushed down to the foot of the bed, and my mosquito net is tucked in tightly under my mattress.
5 - In Washington I have a network of acquaintances that has been growing and expanding for 23 years. This includes, my family, our friends, various church bodies, my work peers, my students, and the loads of faces that I share this geographical community with that I've run across countless times over the years. In Niger, everyone I know was a stranger 3 weeks ago.
6 - In Washington my attention is divided in many ways - with work, responsibilities, priorities, desires, other people's wishes, and the ever-present possibilities of the future. Niger doesn't hold so many options for me: I have no cell phone, the internet doesn't work well, and watches don't matter because people think of time in generalities rather than specific minutes. I walk or ride with someone, rather than driving a car. My clothing options are limited due to both a limited amount of clothes with me, but also much more extreme ideas of propriety and modesty, and I don't even worry about how my hair is done, because it's tied under a head scarf anyhow.
7 - In Washington I find myself usually chilled, with cold fingers, a cold nose, and never leaving my house without a sweater and blanket and scarf. In Niger, being in the shade and maintaining all opportunities for a breeze to blow over my heated skin is an ever-present reality.
8 - In Washington I drink liquids in their hottest form, usually to try to avoid the chill. I'm not even sure I would have to drink anything if I didn't want to, because my epidermis would probably absorb enough moisture from the air to sufficiently maintain my body operations (OK, maybe that's an exaggeration, but you get the idea!). In Niger, I just drink liquids as much as possible, because if I don't, my skin dries out, my lips get chapped, I get a headache, dizzy, and could suffer other, much worse repercussions of dehydration.
9 - In Washington I really hate getting the bottom of my trousers wet from the pooled H2O that accumulates on the ground almost all the time. In Niger, I just try to avoid dragging my skirt through any kind of excrement, and make sure I wash my feet and ankles before going to bed.
10 - In Washington the common noises are ambiance jazz music, big-store announcements, car's driving, radios running, and machines running. In Niger, ambiance sounds are animals making noise, people talking, vehicles lacking mufflers, horns, the call to prayer, and music that I can only think to term "wailing" in nature coming from radios.
The differences are astounding. All of my senses support this fact.
As a result, sometimes it seems a little... shall I just say, "strange," to move from one of these worlds into another within a relatively short amount of time.
Granted, my trip home from Niger was pretty long. Thursday afternoon (after doing a final set of rounds with Dori, snapping photos, and watching a cleft palate surgery and uterine cyst surgery simultaneously in "Salle 1" (ie: one of the operating rooms), I hugged my new friends on the Galmi Hospital compound goodbye and hopped into a 5-passenger airplane for the 90 minute flight back to Niamey (ground previously covered in a 8+ hour drive). It was fun to see the Nigeran landscape from the sky - it looks like the Sahel, alright!
We spent the night in Niamey, then were able to explore a couple things in the city on Friday. Chris dropped us off at the airport about 10PM, and we swatted mosquitoes and visited with people that a member of our team had met in Niger 25 years ago that "just so happened" to be leaving Niger on the same flight we were on (yeah, a VERY cool little God-ordained intersection there, I think!), amid various security checks. Apparently Niger is going to strictly enforce the security of the people coming in going from their country's one (yes, ONE!) official airstrip!
other than my luggage deciding to exert a little independence and spend more time in Paris than the rest of our team, we were on the ground in Holland in plenty of time for a little sales shopping (on my part - it was 75 degrees COLDER in Amsterdam than in Niger, and my jacket, closed toed shoes, socks, and hat were all packed in the Paris-visiting backpack!), and some touring in the quaint little town of Haarlem outside of Amsterdam for a few hours.
I split from the group in the afternoon to head to the YWAM base in search of some friends that I'd stayed with in the past in Amsterdam. I had no problem finding it, even after 3+ years, but unfortunately my friends had moved on to Singapore during that time. However, once again, God did his God-things, and after buzzing the doorbell, I met some girls that had JUST seen my friends the week before when they were in Singapore (of all places!) at a little training thing, and they were able to give me the report on my friends, and then invited me to come have a cup of tea while they worked on dinner preparations for the 45 people currently at De Poort. I agreed to the tea, but didn't sit to enjoy it, rather I grabbed an apron from the stack, a knife from the knife rack, a cutting board from under the sink, and the garlic that was sitting on the counter, and THAT is how I found myself a part of the YWAM community for about an hour on my way home from Niger! I didn't visit with my friends, but I did make new ones (!!!), and felt so blessed to spend some time with other people my age who are passionate about the same things I'm passionate about!
A very long, hot shower and tasty panini dinner out of the way a few hours later, I crawled into bed and slept until it was time to do the final repack, grab some breakfast, and check into the Delta counter for the final flight home. It was a little sad to hug my teammates goodbye in the baggage claim of SeaTac, but it's fun to know that I'm a bit of an adopted member of a church community in Seattle.
My cousins and sister met me at the airport, and we headed to a Jamba Juice in the mall for a little bit of catch up time. I think walking out of Macy's into the mall center is when it really hit me - the vast difference between Niger and Washington. I grabbed my sister's arm as I stopped in the middle of the white tile floor, and said, "Hang on, I think I need to go through about 5 seconds of cultural readjustment shock here!" There were too many white people, and everyone was speaking my language! I don't recognize these things until I've been away and out of this environment, then it seems like such a glaringly obvious fact that I'm surprised by my lack of acknowledgement!
As long as this blog entry is, it still feels inadequate to articulate exactly the process of traveling 9 time zones and being on a different continent for a few weeks. In some ways, it feels like I'm two different people leading two different lives, but I can't be both people at the same time. So when I'm American Dani, I'm here, living here, but when I go overseas, it's like American Dani gets put on pause - and her life along with her - and the overseas Dani takes over and that life resumes. Then when I come back, I re-enter American Dani's person and life, someone hits the play button at some point during the flight, and I come back to my world here.
The difficulty is in reconciling these two lives - the constant struggle to let one life impact and permeate the other life, while still valuing both lives, and continually striving to find a way to dissolve the line that seems to be drawn between the two. I really don't know exactly how to do that! But I hope that the more I do this back and forth thing - or at least, the more I think and talk about this two worlds thing - the process and steps to take will become easier.
To all of you new readers - thanks for following along on this little adventure! To all of you who've been praying through my list 16 things, or praying of your own initiative, thank you. It's impossible to fully know how impacting those prayers of have been on this side of eternity, but I'm completely confident that they HAVE been heard and answered in more ways than you or I are aware. I appreciate them greatly!
Showing posts with label Niger. Show all posts
Showing posts with label Niger. Show all posts
Monday, February 21, 2011
Wednesday, February 16, 2011
Half of my Heart's Got a Grip
John Mayer - regardless of your personal feelings toward him - sings a great song called "Half of my Heart" (I think. I'm not always so good with song titles). I love some of the chorus's lines: "Half of my heart's got a grip on the situation, half of my heart takes time, half of my heart has a right mind to tell you that I can't keep loving you, with half of my heart." I have a weird tendency to find spiritual meaning in pop culture songs, and the lines in this song often convict me to consider whether I'm loving people - and God! - with only half of my heart (On the same topic of pop culture music, Norah Jone's song "Come Away with Me" always makes me want to grab my Bible, notebook, and a pen, and sneak away to some quiet, restful place to spend some quality time with my creator).
Tonight is our team's last night in Galmi. We're scheduled to take 3 different flights out in small planes tomorrow back to the capital. We'll spend Friday shopping, maybe hanging out with some chimpanzees, possibly seeing a giraffe reserve, and then catching the midnight flight back to Paris, then on to Amsterdam, where we'll spend about 24 hours, then finally back to SeaTac, arriving Sunday midday.
Tonight is a beautiful night. I walked over to the cyber cafe under the light of the moon beaming through a thin layer of clouds. It's about 90 degrees outside - I think the daytime temperatures have been up to 105+ in the sun the last couple of days, and today was 94 in the shade at 4PM - and absolutely lovely. I love nights like this.
Last night most of the compound went on a picnic to a rocky hill outcropping a few miles out of town. It was perfectly comfortable to sit and watch the stars come out in our short-sleeve t-shirts. I made a new friend in the form of Norman, the resident Northern Irish representative. I was actually interviewing him for the "Personnel Profile" I was creating as part of the writing project I'm doing for the Hospital, but only about 1/10 of our conversation had anything to do with my questions for the article. I forgot how much I LOVE Northern Irish people! They're so delightful! We were talking about thinking and Norman - an astute fellow - made the claim, "Dani, you obviously think too much. Your brain's like a superhighway in there, you know. If you ever get married, you're going to have to marry an understanding chap. He'll need a lot of patience to filter through what's important and what's just... not." The evening was riddled with such good natured poking and jests, frequently interrupted by the questions and company of "my" students, particularly Nat, who loves to ask the most curious (and difficult to answer questions), and Dan, who decided that my lap was a more comfortable place to eat dinner than sitting on a rock. Elisha also showed up to show me the fossils he'd found. Precious!
Speaking of the students, the boys finished their essays today and I must admit, my teacher-heart just about burst a button (except I wasn't wearing any) as I listened to them read their essays aloud. They worked HARD on this little writing process unit project, and I'm proud of their accomplishments. I was blessed by Teacher Barb's expression of being encouraged by my work with the boys. It was such a little thing on my end in terms of work - I teach the writing process all the time - and it provided a huge feeling of investment and understanding of the behind-the-scenes work here, besides being a tremendous way to get to know these precious guys, but it provided her with a dose of encouragement, collaboration, and some specific tools to continue working on writing with the boys in the future. That's so neat. I love how God works like that!
I was also encouraged by a little conversation I had with one of the Mom's here on the compound this afternoon. Meredith, one of the beautiful girls who lives here, came to dinner Monday night with her family. Toward the end of dinner I noticed she'd kind of gotten trapped in the back corner of the dining room, and since I didn't want her to feel like she'd been abandoned to a room full of people talking doctor talk, I recruited her to help me wash the dishes. It's a pretty long job that requires standing within elbow-bumping vicinity of your neighbor while you tackle the dishes, so we had a great opportunity to visit and get to know each other a little. I thoroughly enjoyed hearing her perspective on life, her own progression and growth in her faith, her take on her siblings, life as an MK, and finding out about what's important to her. I was also impressed with her ability to ask good questions! We talked for several hours, before I finally had tell her, "Meredith, I'm sorry, but I'm fading rapidly. Can I kick you out without making you feel like you're getting kicked out?" When I chatted with Meredith's Mom today for awhile at Wednesday's Cinnamon Bun Social time, I was so blessed by her thankfulness for my conversation with Meredith. Again, it didn't seem like a huge thing for me - I got as much if not more out of it than Meredith probably did - but it was able to fill a specific need that Meredith had for socializing and having a real heart-to-heart talk. God's SO cool like that!
In addition to feeling like I've been receiving all kinds of affirmation in what I've done here (a total blessing to this words-of-affirmation girl here, folks!), I was ALSO able to crack down and get a good draft finished up for this journalism/writing project I've been working on. Around various power-outages (difficult to work on the computer), and discovering that the hospital director's wife keeps cold brewed coffee in her fridge (difficult to find motivation to leave their dining room table!), I am pleased to have wrapped it up. More than anything I wanted to get a template developed and a first draft typed up. Besides interviewing Norman last night on the picnic, I also spent some time talking to Dr. Chris, Stephen, his wife Barb (over her iced coffee!), and I even popped into the HIV/AIDS/TB clinic this afternoon to speak with one of the HIV counselors about the work that happens there. I was very touched by Sani - the counselor's - kind, compassion manner and humble response to my questions. If you think of it, keep him and the clinic's staff in your prayers. It's a hard, hard job to tell people that they've tested positive for HIV, particularly in a culture where lack of understanding about the disease prevails in contributing to a very negative stigma and fear of it. These staff members get to meet with people in one of their most tragic life moments. Pray for courage, strength, compassion, mercy, grace, and love to exude form them.
After I scrambled to finish up the typing and formatting of the update project this evening, I found myself walking across the quiet compound in the dark. Today was a holiday (Mohammad's birthday), so it's been quiet around here without the Outpatient Department and other clinics open. Everyone must either be partying indoors, or partied out, because I didn't notice any loud speakers going.
It's moments like this, when I look up at the moon and hear my feet crunch on the orange dusty road as I walk that I wonder what is possibly holding me back from coming back here for much, much longer. I'm not ready to leave tomorrow. I recognize there are hardships I haven't even come close to experiencing here at Galmi, but I somehow feel at home here. The combination of work is just so unique, and I find the whole atmosphere of it intriguing. There is definite need for at least one, possibly two teachers next year here at the Galmi day school. I cannot help but wonder if perhaps God has been orchestrating events in my life and in the lives here on the compound toward further interaction for much longer than I've anticipated.
I don't know. All I know is that half of my heart feels a little bit like it belongs here - like this IS where I've been looking for in terms of the "next step." But half of my heart still wonders if I've just been drawn into the romance of the warm weather, blue skies, moonlit nights, breathtaking displays of stars, orange dirt, and a community of people committed to serving the desperately needy here in West Africa.
But then again, maybe that's not such a bad romance to be caught up in. It sounds a little like a Divine Romance of sorts.
Tonight is our team's last night in Galmi. We're scheduled to take 3 different flights out in small planes tomorrow back to the capital. We'll spend Friday shopping, maybe hanging out with some chimpanzees, possibly seeing a giraffe reserve, and then catching the midnight flight back to Paris, then on to Amsterdam, where we'll spend about 24 hours, then finally back to SeaTac, arriving Sunday midday.
Tonight is a beautiful night. I walked over to the cyber cafe under the light of the moon beaming through a thin layer of clouds. It's about 90 degrees outside - I think the daytime temperatures have been up to 105+ in the sun the last couple of days, and today was 94 in the shade at 4PM - and absolutely lovely. I love nights like this.
Last night most of the compound went on a picnic to a rocky hill outcropping a few miles out of town. It was perfectly comfortable to sit and watch the stars come out in our short-sleeve t-shirts. I made a new friend in the form of Norman, the resident Northern Irish representative. I was actually interviewing him for the "Personnel Profile" I was creating as part of the writing project I'm doing for the Hospital, but only about 1/10 of our conversation had anything to do with my questions for the article. I forgot how much I LOVE Northern Irish people! They're so delightful! We were talking about thinking and Norman - an astute fellow - made the claim, "Dani, you obviously think too much. Your brain's like a superhighway in there, you know. If you ever get married, you're going to have to marry an understanding chap. He'll need a lot of patience to filter through what's important and what's just... not." The evening was riddled with such good natured poking and jests, frequently interrupted by the questions and company of "my" students, particularly Nat, who loves to ask the most curious (and difficult to answer questions), and Dan, who decided that my lap was a more comfortable place to eat dinner than sitting on a rock. Elisha also showed up to show me the fossils he'd found. Precious!
Speaking of the students, the boys finished their essays today and I must admit, my teacher-heart just about burst a button (except I wasn't wearing any) as I listened to them read their essays aloud. They worked HARD on this little writing process unit project, and I'm proud of their accomplishments. I was blessed by Teacher Barb's expression of being encouraged by my work with the boys. It was such a little thing on my end in terms of work - I teach the writing process all the time - and it provided a huge feeling of investment and understanding of the behind-the-scenes work here, besides being a tremendous way to get to know these precious guys, but it provided her with a dose of encouragement, collaboration, and some specific tools to continue working on writing with the boys in the future. That's so neat. I love how God works like that!
I was also encouraged by a little conversation I had with one of the Mom's here on the compound this afternoon. Meredith, one of the beautiful girls who lives here, came to dinner Monday night with her family. Toward the end of dinner I noticed she'd kind of gotten trapped in the back corner of the dining room, and since I didn't want her to feel like she'd been abandoned to a room full of people talking doctor talk, I recruited her to help me wash the dishes. It's a pretty long job that requires standing within elbow-bumping vicinity of your neighbor while you tackle the dishes, so we had a great opportunity to visit and get to know each other a little. I thoroughly enjoyed hearing her perspective on life, her own progression and growth in her faith, her take on her siblings, life as an MK, and finding out about what's important to her. I was also impressed with her ability to ask good questions! We talked for several hours, before I finally had tell her, "Meredith, I'm sorry, but I'm fading rapidly. Can I kick you out without making you feel like you're getting kicked out?" When I chatted with Meredith's Mom today for awhile at Wednesday's Cinnamon Bun Social time, I was so blessed by her thankfulness for my conversation with Meredith. Again, it didn't seem like a huge thing for me - I got as much if not more out of it than Meredith probably did - but it was able to fill a specific need that Meredith had for socializing and having a real heart-to-heart talk. God's SO cool like that!
In addition to feeling like I've been receiving all kinds of affirmation in what I've done here (a total blessing to this words-of-affirmation girl here, folks!), I was ALSO able to crack down and get a good draft finished up for this journalism/writing project I've been working on. Around various power-outages (difficult to work on the computer), and discovering that the hospital director's wife keeps cold brewed coffee in her fridge (difficult to find motivation to leave their dining room table!), I am pleased to have wrapped it up. More than anything I wanted to get a template developed and a first draft typed up. Besides interviewing Norman last night on the picnic, I also spent some time talking to Dr. Chris, Stephen, his wife Barb (over her iced coffee!), and I even popped into the HIV/AIDS/TB clinic this afternoon to speak with one of the HIV counselors about the work that happens there. I was very touched by Sani - the counselor's - kind, compassion manner and humble response to my questions. If you think of it, keep him and the clinic's staff in your prayers. It's a hard, hard job to tell people that they've tested positive for HIV, particularly in a culture where lack of understanding about the disease prevails in contributing to a very negative stigma and fear of it. These staff members get to meet with people in one of their most tragic life moments. Pray for courage, strength, compassion, mercy, grace, and love to exude form them.
After I scrambled to finish up the typing and formatting of the update project this evening, I found myself walking across the quiet compound in the dark. Today was a holiday (Mohammad's birthday), so it's been quiet around here without the Outpatient Department and other clinics open. Everyone must either be partying indoors, or partied out, because I didn't notice any loud speakers going.
It's moments like this, when I look up at the moon and hear my feet crunch on the orange dusty road as I walk that I wonder what is possibly holding me back from coming back here for much, much longer. I'm not ready to leave tomorrow. I recognize there are hardships I haven't even come close to experiencing here at Galmi, but I somehow feel at home here. The combination of work is just so unique, and I find the whole atmosphere of it intriguing. There is definite need for at least one, possibly two teachers next year here at the Galmi day school. I cannot help but wonder if perhaps God has been orchestrating events in my life and in the lives here on the compound toward further interaction for much longer than I've anticipated.
I don't know. All I know is that half of my heart feels a little bit like it belongs here - like this IS where I've been looking for in terms of the "next step." But half of my heart still wonders if I've just been drawn into the romance of the warm weather, blue skies, moonlit nights, breathtaking displays of stars, orange dirt, and a community of people committed to serving the desperately needy here in West Africa.
But then again, maybe that's not such a bad romance to be caught up in. It sounds a little like a Divine Romance of sorts.
Tuesday, February 15, 2011
TB, Malaria, and Malnutrition: Welcome to Galmi Hospital
Today I spent some time in the Outpatient Department, first observing Brett (our Pediatrician) as he worked with Dennis (the local Pediatrician), and then moseying down the hall to sit in on Mike and George's room (George arrived yesterday - he works with several of the doctor's on our team back home in Seattle).
This was the first time I'd really spent in Outpatient. I've tried to go a few different times, but I think every time I've gotten lost. Galmi isn't a huge hospital compound, and it's actually a lot more of a maze to get to the Maternity Ward or the Operating Room, which I've frequented fairly often, but the massive crush of the patients in the waiting room for Outpatient has intimidated me a little, so I haven't pursued it extremely hard. Today I remember that there's a back door to access, and once I thought I'd identified the correct location, I took the plunge and started pulling back curtains. One of the Nigerienne doctors noticed my tentative peeking through drapery and directed me toward Brett - our team's Pediatrician - for further references.
The process of the Outpatient Department is interesting. As patients come to the hospital, they either go to the Emergency Department or the Outpatient Department (or, if they're here for a specific service, they might go there directly. But usually it's one or the other). Before they even get access to a doctor, they see a Triage nurse. The Triage nurses are amazing here. They see, assess, diagnose, and treat the vast majority of patients - and they do it well. If they think a patient needs to see the doctor, they send them across the room to wait in the other half of the waiting room. Nobody seems to come to the hospital alone - they come with spouses or parents or children. The waiting room is usually crammed full, with more people sitting on the floor and outside in the shade or sidewalk. Just to get through the room, people have to pull their legs in and move aside. It's a hodge-podge of colors, smells, voices, printed fabrics, and facial expressions.
If the patient sees Nigerienne doctor, the process seems to run relatively quickly (as quickly as Africa Time operates...). It is a touch slower when patients see Western Doctors, because many of the Western docs depend on a translator to communicate. The translator's here definitely earn their keep and are worth their weight in gold!
Today Brett and Dennis were working in a room simultaneously, seeing two patients at a time (one each), while the translator translated for both. Since this is a malaria hot spot, many, many, many patients come into the hospital with malaria. Unfortunately quinine, which is what is typically used to treat malaria here, is in very short supply, so the doctors are having to get creative with the pharmacy to come up with alternatives.
Another leading cause of health issues and death among children in particular is malnutrition. The hospital even has a malnutrition center here on the grounds where they treat children with malnutrition by the twofold approach of treating the immediate problem, while also educating the Moms on how to better supply nutrition to their kiddos.
One patient came in today - carried by his beautiful, regal Mom - wearing a Chelsea Football Team jersey, and looking as sick as I've ever felt. The best word I can think of is "lethargic" to describe him. He was probably 3 or 4 years old, and he was almost limp, with every movement seeming to tax his system to the limits of its capacity. His eyes seemed wary in an exhausted way. I was impressed by his observation of all that happened around him, but the poor, painful, tired, ill expression on his face just kept hitting tender spots on my heart strings!
Brett took a moment to show me some of the signs he was noticing in the little guy. He was diagnosed with malnutrition and malaria. He'd actually been in to the hospital the week before and he'd received treatment to take home that they were hoping would be enough, so they wouldn't have to check him into the hospital. Unfortunately, it wasn't enough, so he was back today. His little feet were swollen, and around his eyes was puffy. Brett explained that the type of malnutrition this guy had wasn't caloric malnutrition (when he isn't receiving enough calories in general), but rather a malnutrition caused by a lack of protein. So much of the diet around here is comprised of relatively nutritionally poor grains that while it fills the stomach, it doesn't fulfill the body's needs. Apparently when this sort of case happens, there isn't enough protein in the blood to support the blood volume, which means that rather than the blood carrying the important nutrients it needs to transport throughout the body's system, the liquid in the blood tends to settle into "third space tissue" - the non-blood, non-lymph systems.
Our little patient was also showing signs of malnutrition in the thinning of his skin - the skin on his little legs looked almost like dried mud, and in the "cracks" of that "dried mud" the blood looked like it was just under the surface. In addition, this little guy had a positive malaria smear, which means he was suffering a high fever and generally miserable from those symptoms.
He's been admitted to the hospital this time and should be receiving treatment to boost his nutrition, and treatment for malaria.
When I see these little ones come in looking so absolutely miserable it makes me want to just cry for them! Fortunately, this isn't a case of cerebral malaria (which also happens frequently around here), so he has a much better chance of recovery.
After I left the pediatrics room I walked down the hall to find Mike and George. George was examining an extremely emaciated woman who was showing the most signs of being in pain that I think I've seen any woman show here. George was feeling her abdomen and she kept wincing. He was wondering about perforated typhoid, but her abdomen wasn't distended and he was hearing bowel sounds, which means her bowels were still operating in at least a semi-normal manner - probably not typhoid. He was going to run a number of tests, including the ever common malaria smear (it's almost just standard to run one here on any patient that is getting blood drawn - and did you know it only takes a little pin-prick here?! When I heard that I thought it completely unfair that I kept having to get units of blood taken out of me when they were trying to determine whether I had malaria last fall...).
I suggested tuberculosis, based on the fact that she looked a lot like several of the sick women I'd seen in Kolkata who had tuberculosis at Mother Teresa's Mission House. George thought that was also a strong possibility. After Mike and one of the Nigerienne doctors come and looked at her, they found symptoms of TB in her spine (which would explain why she crawled into the room on all fours - it would be painful to stand and put that much pressure on her spine), and even though our X-ray machine is currently off line, they're going to get her started on tuberculosis treatments.
When I left the OD a little later to find Dori in the OR, I saw the TB woman with what I presume is her husband and a sister or daughter. Her husband was dressed in the traditional robes of a Toureg nomad, complete with the long headscarf partially covering his face, and they were sitting on a little porch, with the sick woman laying on the concrete below them.
Anytime I walk around the hospital part of the compound during Outpatient Department hours there are people sitting in the shade, watching babies, nursing, taking care of personal functions, washing themselves, eating, or visiting. I don't really even have words to describe my reaction or how I feel about it, because I don't really know. I guess I notice more just based on the fact that it seems so different than a hospital waiting room in the US. But what's fascinating is that despite the differences, there reasons are still the same for people to be there: seeking help. Trying to find a way to solve their problems.
It's an incredible thing to be here - even in my very limited productivity capacity - and see needs being met, the sick being cared for, diagnoses being made, and treatment being given. Regardless of the case, whether it be TB, Malaria, Malnutrition, a labor that's been dragging on for days, a traumatic injury, or some other kind of problem, it's really, really cool to see how Galmi Hospital is helping to stand in the health-care-needs gap and offering at least some kind of services.
This was the first time I'd really spent in Outpatient. I've tried to go a few different times, but I think every time I've gotten lost. Galmi isn't a huge hospital compound, and it's actually a lot more of a maze to get to the Maternity Ward or the Operating Room, which I've frequented fairly often, but the massive crush of the patients in the waiting room for Outpatient has intimidated me a little, so I haven't pursued it extremely hard. Today I remember that there's a back door to access, and once I thought I'd identified the correct location, I took the plunge and started pulling back curtains. One of the Nigerienne doctors noticed my tentative peeking through drapery and directed me toward Brett - our team's Pediatrician - for further references.
The process of the Outpatient Department is interesting. As patients come to the hospital, they either go to the Emergency Department or the Outpatient Department (or, if they're here for a specific service, they might go there directly. But usually it's one or the other). Before they even get access to a doctor, they see a Triage nurse. The Triage nurses are amazing here. They see, assess, diagnose, and treat the vast majority of patients - and they do it well. If they think a patient needs to see the doctor, they send them across the room to wait in the other half of the waiting room. Nobody seems to come to the hospital alone - they come with spouses or parents or children. The waiting room is usually crammed full, with more people sitting on the floor and outside in the shade or sidewalk. Just to get through the room, people have to pull their legs in and move aside. It's a hodge-podge of colors, smells, voices, printed fabrics, and facial expressions.
If the patient sees Nigerienne doctor, the process seems to run relatively quickly (as quickly as Africa Time operates...). It is a touch slower when patients see Western Doctors, because many of the Western docs depend on a translator to communicate. The translator's here definitely earn their keep and are worth their weight in gold!
Today Brett and Dennis were working in a room simultaneously, seeing two patients at a time (one each), while the translator translated for both. Since this is a malaria hot spot, many, many, many patients come into the hospital with malaria. Unfortunately quinine, which is what is typically used to treat malaria here, is in very short supply, so the doctors are having to get creative with the pharmacy to come up with alternatives.
Another leading cause of health issues and death among children in particular is malnutrition. The hospital even has a malnutrition center here on the grounds where they treat children with malnutrition by the twofold approach of treating the immediate problem, while also educating the Moms on how to better supply nutrition to their kiddos.
One patient came in today - carried by his beautiful, regal Mom - wearing a Chelsea Football Team jersey, and looking as sick as I've ever felt. The best word I can think of is "lethargic" to describe him. He was probably 3 or 4 years old, and he was almost limp, with every movement seeming to tax his system to the limits of its capacity. His eyes seemed wary in an exhausted way. I was impressed by his observation of all that happened around him, but the poor, painful, tired, ill expression on his face just kept hitting tender spots on my heart strings!
Brett took a moment to show me some of the signs he was noticing in the little guy. He was diagnosed with malnutrition and malaria. He'd actually been in to the hospital the week before and he'd received treatment to take home that they were hoping would be enough, so they wouldn't have to check him into the hospital. Unfortunately, it wasn't enough, so he was back today. His little feet were swollen, and around his eyes was puffy. Brett explained that the type of malnutrition this guy had wasn't caloric malnutrition (when he isn't receiving enough calories in general), but rather a malnutrition caused by a lack of protein. So much of the diet around here is comprised of relatively nutritionally poor grains that while it fills the stomach, it doesn't fulfill the body's needs. Apparently when this sort of case happens, there isn't enough protein in the blood to support the blood volume, which means that rather than the blood carrying the important nutrients it needs to transport throughout the body's system, the liquid in the blood tends to settle into "third space tissue" - the non-blood, non-lymph systems.
Our little patient was also showing signs of malnutrition in the thinning of his skin - the skin on his little legs looked almost like dried mud, and in the "cracks" of that "dried mud" the blood looked like it was just under the surface. In addition, this little guy had a positive malaria smear, which means he was suffering a high fever and generally miserable from those symptoms.
He's been admitted to the hospital this time and should be receiving treatment to boost his nutrition, and treatment for malaria.
When I see these little ones come in looking so absolutely miserable it makes me want to just cry for them! Fortunately, this isn't a case of cerebral malaria (which also happens frequently around here), so he has a much better chance of recovery.
After I left the pediatrics room I walked down the hall to find Mike and George. George was examining an extremely emaciated woman who was showing the most signs of being in pain that I think I've seen any woman show here. George was feeling her abdomen and she kept wincing. He was wondering about perforated typhoid, but her abdomen wasn't distended and he was hearing bowel sounds, which means her bowels were still operating in at least a semi-normal manner - probably not typhoid. He was going to run a number of tests, including the ever common malaria smear (it's almost just standard to run one here on any patient that is getting blood drawn - and did you know it only takes a little pin-prick here?! When I heard that I thought it completely unfair that I kept having to get units of blood taken out of me when they were trying to determine whether I had malaria last fall...).
I suggested tuberculosis, based on the fact that she looked a lot like several of the sick women I'd seen in Kolkata who had tuberculosis at Mother Teresa's Mission House. George thought that was also a strong possibility. After Mike and one of the Nigerienne doctors come and looked at her, they found symptoms of TB in her spine (which would explain why she crawled into the room on all fours - it would be painful to stand and put that much pressure on her spine), and even though our X-ray machine is currently off line, they're going to get her started on tuberculosis treatments.
When I left the OD a little later to find Dori in the OR, I saw the TB woman with what I presume is her husband and a sister or daughter. Her husband was dressed in the traditional robes of a Toureg nomad, complete with the long headscarf partially covering his face, and they were sitting on a little porch, with the sick woman laying on the concrete below them.
Anytime I walk around the hospital part of the compound during Outpatient Department hours there are people sitting in the shade, watching babies, nursing, taking care of personal functions, washing themselves, eating, or visiting. I don't really even have words to describe my reaction or how I feel about it, because I don't really know. I guess I notice more just based on the fact that it seems so different than a hospital waiting room in the US. But what's fascinating is that despite the differences, there reasons are still the same for people to be there: seeking help. Trying to find a way to solve their problems.
It's an incredible thing to be here - even in my very limited productivity capacity - and see needs being met, the sick being cared for, diagnoses being made, and treatment being given. Regardless of the case, whether it be TB, Malaria, Malnutrition, a labor that's been dragging on for days, a traumatic injury, or some other kind of problem, it's really, really cool to see how Galmi Hospital is helping to stand in the health-care-needs gap and offering at least some kind of services.
Monday, February 14, 2011
Editor, Journalist, and Barber: My Workload Expands
I keep finding new ways to take little interests or skills I have and, like, microscopically blow them up so they serve a useful purpose around here!
Yesterday afternoon I spent staring at a computer screen reading a novel, scribbling notes on a notepad, and at the end of every chapter turning to the author to ask questions, make suggestions, get clarification, or express my enthusiasm. As a self-proclaimed Star Wars freak, it was very fun to step out of my world (as unreal as it's been seeming lately!) and step into an imaginary, fantasy-fiction alter-reality. I forgot how enjoyable reading a good storyline (that doesn't also make me think extensively about corn and corn syrup in the manner my current "for fun" read is doing) can be. It reminded me of why I like to read so much!
Today I have enjoyed the usual variety - I did rounds with Dori this morning, which involved a little oohing and ahhing over the pink, happy, healthy babies I saw born on Saturday. They're so cute! Rounds also offer a more serious or thought provoking side, which includes the inclassifiable stench of the hospital (kind of like rotting dead chicken), the corpse-like sight of several women suffering from extreme cases of malaria and other complications, and the tears from a teenage mom who was not going to be able to go home for her newborn's baby-naming ceremony because the baby was still on antibiotics. It was a lot for an hour and a half.
After a brief stop at the local version of "Safeway" with Dr. Chris (read: a woman comes to sell produce at the gate a few times a week and we haggled over carrots, tomatoes, pineapple, bananas, and the EXTREMELY novel appearance of sliced bread [WHOA!]), I raced off to my students to draw diagrams of windchimes on the black board and try to explain topic sentences and supporting detail.
I found my way back to the Operating Room before lunch to see more of the human anatomy than most of you reading this blog will ever observe. One I won't bother to tell you about because it's a bit gruesome for some company (all male readers: you can thank me later), but I did see an awesome orthopedic surgery happening in the other operating room: a dude broke both his legs and at least one arm in a bad car accident. They were working on his right arm. When I saw the surgery, they'd cut the back of his arm open from just below his shoulder almost to his elbow, separated the muscled from the bone, and were putting in bone screws to support the bone. I've never seen human flesh so neatly filleted. It was really something!
After lunch I worked on a different project: developing an update newsletter for the hospital to send out to all it's supporters to share what's been happening over the past year or so. I jumped on this project last week after a long conversation with the Chicago-born director of the hospital. In addition to the fact that Stephen and his wife are from a pretty rad city, AND they speak French and live in Africa, Stephen also manages to do things on his computer that make me feel like I'm watching a real-live computer geek working to break into some secret government database in a spy movie. Massive cool points! Since I have this rather obscure enjoyment of collecting stories and publishing them in a newsletter-type format, I thought this project would be a very fun one to pursue.
My newsletter endeavors and development were interrupted long enough for me to run off to our host's home to do a quick hair-cutting workshop. Dr Chris's wife, Nancy, asked if I happened to have any hair cutting skills up my sleeve yesterday and I was able to respond in the affirmative. [Mom, I have to admit, it's a lot more fun to cut hair in a backporch in Africa than it is to do it in your dining room. There's better lighting.]
Now it's dinner time, and I need to go spend 10 minutes helping with the final prep, since I'm probably shirking my duties a bit by taking time to blog. The adventure continues over here - thanks for the comments, thoughts, and prayers.
PS: Stephen: Norman, the local Northern-Irish electrical engineer came by yesterday and fixed the fridge. No more shocking shocks!
Yesterday afternoon I spent staring at a computer screen reading a novel, scribbling notes on a notepad, and at the end of every chapter turning to the author to ask questions, make suggestions, get clarification, or express my enthusiasm. As a self-proclaimed Star Wars freak, it was very fun to step out of my world (as unreal as it's been seeming lately!) and step into an imaginary, fantasy-fiction alter-reality. I forgot how enjoyable reading a good storyline (that doesn't also make me think extensively about corn and corn syrup in the manner my current "for fun" read is doing) can be. It reminded me of why I like to read so much!
Today I have enjoyed the usual variety - I did rounds with Dori this morning, which involved a little oohing and ahhing over the pink, happy, healthy babies I saw born on Saturday. They're so cute! Rounds also offer a more serious or thought provoking side, which includes the inclassifiable stench of the hospital (kind of like rotting dead chicken), the corpse-like sight of several women suffering from extreme cases of malaria and other complications, and the tears from a teenage mom who was not going to be able to go home for her newborn's baby-naming ceremony because the baby was still on antibiotics. It was a lot for an hour and a half.
After a brief stop at the local version of "Safeway" with Dr. Chris (read: a woman comes to sell produce at the gate a few times a week and we haggled over carrots, tomatoes, pineapple, bananas, and the EXTREMELY novel appearance of sliced bread [WHOA!]), I raced off to my students to draw diagrams of windchimes on the black board and try to explain topic sentences and supporting detail.
I found my way back to the Operating Room before lunch to see more of the human anatomy than most of you reading this blog will ever observe. One I won't bother to tell you about because it's a bit gruesome for some company (all male readers: you can thank me later), but I did see an awesome orthopedic surgery happening in the other operating room: a dude broke both his legs and at least one arm in a bad car accident. They were working on his right arm. When I saw the surgery, they'd cut the back of his arm open from just below his shoulder almost to his elbow, separated the muscled from the bone, and were putting in bone screws to support the bone. I've never seen human flesh so neatly filleted. It was really something!
After lunch I worked on a different project: developing an update newsletter for the hospital to send out to all it's supporters to share what's been happening over the past year or so. I jumped on this project last week after a long conversation with the Chicago-born director of the hospital. In addition to the fact that Stephen and his wife are from a pretty rad city, AND they speak French and live in Africa, Stephen also manages to do things on his computer that make me feel like I'm watching a real-live computer geek working to break into some secret government database in a spy movie. Massive cool points! Since I have this rather obscure enjoyment of collecting stories and publishing them in a newsletter-type format, I thought this project would be a very fun one to pursue.
My newsletter endeavors and development were interrupted long enough for me to run off to our host's home to do a quick hair-cutting workshop. Dr Chris's wife, Nancy, asked if I happened to have any hair cutting skills up my sleeve yesterday and I was able to respond in the affirmative. [Mom, I have to admit, it's a lot more fun to cut hair in a backporch in Africa than it is to do it in your dining room. There's better lighting.]
Now it's dinner time, and I need to go spend 10 minutes helping with the final prep, since I'm probably shirking my duties a bit by taking time to blog. The adventure continues over here - thanks for the comments, thoughts, and prayers.
PS: Stephen: Norman, the local Northern-Irish electrical engineer came by yesterday and fixed the fridge. No more shocking shocks!
Saturday, February 12, 2011
From Camels to C-Sections: Why I Love My Life
Have you ever pinched yourself to see if you're awake or dreaming? I actually haven't - I usually have a pretty good handle on conscious reality, but the last day has been kind of one of those experiences where I maybe should have. As I sit here typing, I'm beginning to wonder if this whole trip isn't just some kind of dream that I'm going to wake up from at any second when my alarm goes off and I need to get ready to head out for my day.
While I might be what some people would refer to as an opportunist, I want to humbly state here on this blog that I really don't know why God blesses me the ways He does, He just DOES! And I love Him for it!
I crave adventure. It may be a sign of immaturity or discontentment, but I'm more prone to think it's just part of who God made me. I really like new, novel experiences. Ever since I first agreed to go on a short term trip to Mexico at the age of 13 after hearing that I'd probably need to thatch roofs with grass (really? Cool!!), I've craved going places and doing things differently than I do at home.
Today has been an abundant, overflowing blessing to satisfy that craving.
Leave it to God to make sure that this trip didn't just include sleeping under mosquitoe nets (WAY cool!) and every day being a predictibly sunny, 95+ degree day, and a star canopy to just take your breath away, AND the regular melodic cry of the call to prayer, AND bouncing around in the back of vehicles with no seatbelts and wearing all my funky Africa clothes, He also engineered today.
I wasn't planning to go camel riding today. I slept in until just before 6, so I was late getting outside to enjoy the pre-dawn (I think the mosquitoes were disappointed - less of a feast today). However, I was still up early enough to talk with Dori for awhile. I asked her if I could join her on rounds this morning, so when she left, I was her shadow. We spent a good hour or so in the Maternity ward, checking patients with Esther, the resident GYN, before we made the rendez-vous with the rest of the team for the photo op of seeing them all on camels.
However, I hadn't factored Dan into the picture.
Dan is the 6 year old student who has completely captivated my heart. He's got just the biggest, most adorable set of big brown eyes I've ever seen. We've been bonding over the past couple days. He showed up on his bicycle and started asking questions about the camels. We noticed together how the camels have big teeth, how some of the camels are muzzled, and how the camel owner is missing his right arm (it was amputated accidently by one of his camel's large teeth... ouch).
When they asked if I wanted to go, I looked down at Dan and he looked up at me, and I asked him if he'd like to go riding with me. At his eager nodding (he almost fell over), I was sold.
Away we went with our Toureg guide over the dusty, windy, orange-dirt path. I could almost hear Lawrence of Arabia in the background (actually, that was later, when I went over to the guys' house and poked my head into the man-cave that sports a 12-inch TV. They literally were playing Lawrence of Arabia).
As camel rides go, it really wasn't all that eventful. No kidnappings. No steep sand dunes. But I did have wonderful company, and I think my pillow actually worked to sort of cushion the jarring on my pelvic bone.
I don't normally think of pelvic bones very often, but today was a day where I thought about them a lot. When Dori and I made our rounds this morning, we checked on a 16-year-old-girl who was in labor with her first. She was tiny. All the women are thin here. She looked like she was about 12. Her hips were narrow, as Dori pointed out, and her pelvic bone was probably not going to be able to handle a vaginal delivery.
Sure enough, by 3 this afternoon Dori called from the hospital to ask if I wanted to come down and watch my first C-Section. Despite the 95 degrees, I practically RACED through the compound!
After donning sterile scrubs and a mask, I found myself holding the hand of the most stoic 16 year old I've ever met. I don't know her name, but she sincerely should have won a TV show for her ability to endure pain without showing one glimmer of it on her face. I witnessed the whole thing - the prep, the needle going into her spine, the slicing open through the skin, then the fat tissue, then the inner membrain, then the uterous, the retrieval of the baby, the cleaning out of the placenta et al, the stitching up through various layers, oxygen to the (blue) baby, the baby's first cry, the mother's slight hint of satisfaction as she briefly saw her daughter, and then the discarding of the sterile drapes and wheeling the mother out of the OR to her family in the maternity ward.
Uh-huh. I didn't get light headed until the last few stitches were going in, then I just looked away, took a couple breathes, and felt fine.
45 minutes later, I was back in the OR witnessing the same thing. There was a second 16 year old, also with small hips, also in labor for hours dialated only to a 5 or 6, also with no further progress, and also in need of a C-section or both the baby and the mama would probably die.
Seriously?! This is life. This is THE life. This is MY life. I'm having a hard time just coming to grips with that. Things like this don't just HAPPEN every day - at least they don't to me! Camel rides, walking into any ward of a hospital that I want, photographing a C-section, conversations in 3 different languages simultaneously, getting a crash course on labor and delivery...
I'm in. Even the hard parts of today - most specifically, seeing a Toureg Dad interact with his 4-year-old daughter that was admitted today with possible perpherated typhoid, a positive malaria test, and a suspicious weakness in her legs pointed toward a polio case - are just incredible in their abnormality. I love that I get to be here. I love that I get to see this. I love that I can connect faces (and sometimes names... not always so good with that, though) to stories and suffering and pain, because it gives me such a strong motivation to sympathize, pray, hurt with these people, try to relieve or share the burden of their sufferin in some way.
It's hard, but it's good. Or maybe it's good, but it's hard. At any rate, I'm curious: what next, Lord?
While I might be what some people would refer to as an opportunist, I want to humbly state here on this blog that I really don't know why God blesses me the ways He does, He just DOES! And I love Him for it!
I crave adventure. It may be a sign of immaturity or discontentment, but I'm more prone to think it's just part of who God made me. I really like new, novel experiences. Ever since I first agreed to go on a short term trip to Mexico at the age of 13 after hearing that I'd probably need to thatch roofs with grass (really? Cool!!), I've craved going places and doing things differently than I do at home.
Today has been an abundant, overflowing blessing to satisfy that craving.
Leave it to God to make sure that this trip didn't just include sleeping under mosquitoe nets (WAY cool!) and every day being a predictibly sunny, 95+ degree day, and a star canopy to just take your breath away, AND the regular melodic cry of the call to prayer, AND bouncing around in the back of vehicles with no seatbelts and wearing all my funky Africa clothes, He also engineered today.
I wasn't planning to go camel riding today. I slept in until just before 6, so I was late getting outside to enjoy the pre-dawn (I think the mosquitoes were disappointed - less of a feast today). However, I was still up early enough to talk with Dori for awhile. I asked her if I could join her on rounds this morning, so when she left, I was her shadow. We spent a good hour or so in the Maternity ward, checking patients with Esther, the resident GYN, before we made the rendez-vous with the rest of the team for the photo op of seeing them all on camels.
However, I hadn't factored Dan into the picture.
Dan is the 6 year old student who has completely captivated my heart. He's got just the biggest, most adorable set of big brown eyes I've ever seen. We've been bonding over the past couple days. He showed up on his bicycle and started asking questions about the camels. We noticed together how the camels have big teeth, how some of the camels are muzzled, and how the camel owner is missing his right arm (it was amputated accidently by one of his camel's large teeth... ouch).
When they asked if I wanted to go, I looked down at Dan and he looked up at me, and I asked him if he'd like to go riding with me. At his eager nodding (he almost fell over), I was sold.
Away we went with our Toureg guide over the dusty, windy, orange-dirt path. I could almost hear Lawrence of Arabia in the background (actually, that was later, when I went over to the guys' house and poked my head into the man-cave that sports a 12-inch TV. They literally were playing Lawrence of Arabia).
As camel rides go, it really wasn't all that eventful. No kidnappings. No steep sand dunes. But I did have wonderful company, and I think my pillow actually worked to sort of cushion the jarring on my pelvic bone.
I don't normally think of pelvic bones very often, but today was a day where I thought about them a lot. When Dori and I made our rounds this morning, we checked on a 16-year-old-girl who was in labor with her first. She was tiny. All the women are thin here. She looked like she was about 12. Her hips were narrow, as Dori pointed out, and her pelvic bone was probably not going to be able to handle a vaginal delivery.
Sure enough, by 3 this afternoon Dori called from the hospital to ask if I wanted to come down and watch my first C-Section. Despite the 95 degrees, I practically RACED through the compound!
After donning sterile scrubs and a mask, I found myself holding the hand of the most stoic 16 year old I've ever met. I don't know her name, but she sincerely should have won a TV show for her ability to endure pain without showing one glimmer of it on her face. I witnessed the whole thing - the prep, the needle going into her spine, the slicing open through the skin, then the fat tissue, then the inner membrain, then the uterous, the retrieval of the baby, the cleaning out of the placenta et al, the stitching up through various layers, oxygen to the (blue) baby, the baby's first cry, the mother's slight hint of satisfaction as she briefly saw her daughter, and then the discarding of the sterile drapes and wheeling the mother out of the OR to her family in the maternity ward.
Uh-huh. I didn't get light headed until the last few stitches were going in, then I just looked away, took a couple breathes, and felt fine.
45 minutes later, I was back in the OR witnessing the same thing. There was a second 16 year old, also with small hips, also in labor for hours dialated only to a 5 or 6, also with no further progress, and also in need of a C-section or both the baby and the mama would probably die.
Seriously?! This is life. This is THE life. This is MY life. I'm having a hard time just coming to grips with that. Things like this don't just HAPPEN every day - at least they don't to me! Camel rides, walking into any ward of a hospital that I want, photographing a C-section, conversations in 3 different languages simultaneously, getting a crash course on labor and delivery...
I'm in. Even the hard parts of today - most specifically, seeing a Toureg Dad interact with his 4-year-old daughter that was admitted today with possible perpherated typhoid, a positive malaria test, and a suspicious weakness in her legs pointed toward a polio case - are just incredible in their abnormality. I love that I get to be here. I love that I get to see this. I love that I can connect faces (and sometimes names... not always so good with that, though) to stories and suffering and pain, because it gives me such a strong motivation to sympathize, pray, hurt with these people, try to relieve or share the burden of their sufferin in some way.
It's hard, but it's good. Or maybe it's good, but it's hard. At any rate, I'm curious: what next, Lord?
Thursday, February 10, 2011
Today I...
... walked the airstrip outside the compound (I climbed over the fence) under a pre-dawn canopy of brilliant African stars. The power went out just after I left the house, so my experience was authentically star lit. I didn't think about the possibility of lions until I'd reached the FAR end of the 1/2 mile long orange strip. Fortunately, they aren't around here (I don't think...).
... taught pre-writing strategies using a real blackboard and chalk.
... held our nurse and prayed for her to more fully recognize and understand God's love, compassion, and tenderness for us as she feels her heart strings being pulled while she sees and ministers to the patients here. One of the doctors described this place as less like a hospital and more like a war-zone front line medical unit. It can be pretty brutal emotionally.
... rode with 4 little (and not so little) guys in the back of a Land Rover (windows closed for dust, no AC) over dirt roads for 45 minutes to reach a village primary school. There were 7 adults in the front seats. There was much bouncing, wrestling, tickling, laughing, renditions of various verses of "99 bottles of beer on the wall," and rounds of 20 questions in the back.
... taught about 40 petit enfants how to say "good morning," and "high five!" and how to count to 10, using French (their second language) to communicate what the English phrases meant. As a result, I also gave at last 1,000 high fives.
... took photos and had 20 kids all try to crowd around my 2 inch camera screen to see themselves at once.
... found a (dead!) scorpion in the kitchen. I think I'll walk around with a flashlight when I'm in the dark house barefoot now.
... whipped through 3 different inventory projects in the pharmacy after siesta, including a lizard poop infested storage room to write a list of the inventory.
... serve as a French translator for the entrepreneurial young woman who runs a take-out food service for the compound.
... pondered how to eat carrot greens (recipes are welcome! Please let me know if they're posinous prior to going to bed tonight).
... got shocked repeatedly by the refrigerator. Why would that be happening?
... learned about eye pressure, bilateral breast cancer that has eaten through the skin, and typhoid's intestinal-destruction tendencies if left untreated over lunch.
... created grapefruit sweet tea.
... heard the following conversation at dinner:
Jan: "Today someone came into the clinic with a massive infection of the eye. David (the eye nurse) gave her an antibiotic, hoping to clear up some of the infection. Monday they're going to do an epiviseral (sp? proper name?)."
Jon: "What's that?"
Mike: "Will they take out the whole eye?"
Jan: "No, just the inside of it. They'll leave the shell."
Brett: "So how's that soup, Jon?"
Jon: "Uh, want my jello? It's reminding me of eye-insides."
... felt like I contributed to the day.
... witnessed more countless, brilliant smiles than I've probably ever seen in one time, at one place. They were all to the backdrop of grass-thatched roofs, shimmery, dusty panoramas, and wandering camels.
... taught pre-writing strategies using a real blackboard and chalk.
... held our nurse and prayed for her to more fully recognize and understand God's love, compassion, and tenderness for us as she feels her heart strings being pulled while she sees and ministers to the patients here. One of the doctors described this place as less like a hospital and more like a war-zone front line medical unit. It can be pretty brutal emotionally.
... rode with 4 little (and not so little) guys in the back of a Land Rover (windows closed for dust, no AC) over dirt roads for 45 minutes to reach a village primary school. There were 7 adults in the front seats. There was much bouncing, wrestling, tickling, laughing, renditions of various verses of "99 bottles of beer on the wall," and rounds of 20 questions in the back.
... taught about 40 petit enfants how to say "good morning," and "high five!" and how to count to 10, using French (their second language) to communicate what the English phrases meant. As a result, I also gave at last 1,000 high fives.
... took photos and had 20 kids all try to crowd around my 2 inch camera screen to see themselves at once.
... found a (dead!) scorpion in the kitchen. I think I'll walk around with a flashlight when I'm in the dark house barefoot now.
... whipped through 3 different inventory projects in the pharmacy after siesta, including a lizard poop infested storage room to write a list of the inventory.
... serve as a French translator for the entrepreneurial young woman who runs a take-out food service for the compound.
... pondered how to eat carrot greens (recipes are welcome! Please let me know if they're posinous prior to going to bed tonight).
... got shocked repeatedly by the refrigerator. Why would that be happening?
... learned about eye pressure, bilateral breast cancer that has eaten through the skin, and typhoid's intestinal-destruction tendencies if left untreated over lunch.
... created grapefruit sweet tea.
... heard the following conversation at dinner:
Jan: "Today someone came into the clinic with a massive infection of the eye. David (the eye nurse) gave her an antibiotic, hoping to clear up some of the infection. Monday they're going to do an epiviseral (sp? proper name?)."
Jon: "What's that?"
Mike: "Will they take out the whole eye?"
Jan: "No, just the inside of it. They'll leave the shell."
Brett: "So how's that soup, Jon?"
Jon: "Uh, want my jello? It's reminding me of eye-insides."
... felt like I contributed to the day.
... witnessed more countless, brilliant smiles than I've probably ever seen in one time, at one place. They were all to the backdrop of grass-thatched roofs, shimmery, dusty panoramas, and wandering camels.
Wednesday, February 09, 2011
African Kids
Obviously, as I travel to various locations, I get to observe people in plentiful quantities. It's always fascinating to me to see how children, in particular, are treated.
I've made some observations here that I'd like to share:
On the hospital compound where I'm working there is a malnutrition center where moms and babies come and stay for 4 to 6 weeks. The goal is to get undernourished babies (the entrance requirement is that they're at the 40th percentile or lower, I think, in terms of weight for their age) plumped up, and their moms educated in some basic nutrition and food knowledge. This country is extremely poor, and their main subsistence is "millet." Go buy birdfeed and look at the small grain for a visual of the grain. There is practically no nutitrional value in millet. The people who eat millet all the time are malnurished, and their babies are too.
I went to the malnutrition center yesterday with Dr Chris, our host, and Dori, the OB-GYN, Jon, "Monsieur Construcion," and Jan, our eye nurse. As I'm realizing is relatively normal, the ladies greeted us with beautiful smiles and cheerful calls of "bonjour." Their children are equally gorgeous. Babies are tied to the backs of their mothers and carted around - just little bobbing heads and the occassional tiny foot sticking out from a lump hidden by a flowing cloth. Usually the babies are minimally dressed. The women go about their normal work - chatting, grinding food, laundry, etc - with their children tied to them. One of the little guys started spitting up while we were talking to them (well, Dr. Chris was talking - I was smiling), and the mom just calmly stepped back, untied the baby so she could help him spit up on the dirt ground, then she mopped him and herself up.
The sheer simplicity of the interaction between mother and child is fascinating. In America we have swings and carseats and bassinets and cribs and playpens and mobiles and jonny jump ups and all kinds of thing. While those things certainly are useful and fit into our culture well, the contrast between home and here is striking.
Today I worked in the day school on the compound. There are 4 students. One is a North American who has grown up here and reminds me a little of my brother. He rides his bike with abandon, observes and asks insightful questions, and is quick to step up and help younger students with homework. He's a sweetheart.
I worked with the 1st grader on reading word families. Dan is the youngest of three brothers. Their father is from SubSaharan Africa and one of the few national doctors here at the hospital. After we'd practice pronouncing the new vocabulary, we read a pirate story together and Dan looked for the "magic E" words while I kept getting distracted by the plotline. He was sharp! Later, he read to me the story of Brer Rabbit and the Tar Baby (one of my favorites!), and as he sat on my lap in the electricity-less schoolhouse (the power went out for awhile today) on the cement floor (it was coolest down there - today hit somewhere around 100 I think), I couldn't help feeling like my heart was escaping my body to attach itself to this little guy.
His older brothers are also precious. They came looking for me this afternoon during siesta time. I was napping. Apparently they looked for me all over the compound as I had multiple people tell me they saw I'd made some friends. :-)
Tomorrow we'll head to a different school in town - the kids and their teacher and Dr Chris and myself. We counted pencils by groups of 6, and bundled tootsie rolls and tootsie pops into groups of 5 and 10 to count. We'll be taking them as gifts to give away. I'm also going to be teaching a short writing unit to "my" boys during their language arts time. Their teacher, "Aunti Barb" asked if I'd be willing to do that. I accepted, of course, and I'm thinking about how we'll get through the writing process with a 1st grader, 3rd grader, 4th grader, and 5th grader in a week, writing very short autobiographies. It should be fun!
The kids are fantastic here, and I'm looking forward to hanging with 120 adorable little ones tomorrow! It's incredible how these kids are able to survive. Dori, who has already delivered several babies by C-section and seen countless women in the 2 days she's been at the hospital, was mentioning tonight that she's never seen such thin women. "It's incredible their bodies are even able to support and sustain a baby," she mentioned. Then she said something about how thin their abdomenal walls are compared to the women she's worked with in America, using what the non-medical persons on the team call "Doctor-talk" (you wouldn't believe some of the conversations we have around our house!). Apparently malaria is also very bad here - the malaria season this year seems to be starting early, as several pregnant women have already come in with malaria episodes - and is particularly dangerous to babies in utero.
Every time I look into the dark eyes of the kids here I'm reminded of the miracle that their life is. It's particularly difficult to see glimpses of the small little guy in the tetnus room I pass to get to the pharmacy. Little kids with strange growths and malformed bodies are part of the package here on the compound, and it's such a bittersweet experience to have them on my radar.
I've made some observations here that I'd like to share:
On the hospital compound where I'm working there is a malnutrition center where moms and babies come and stay for 4 to 6 weeks. The goal is to get undernourished babies (the entrance requirement is that they're at the 40th percentile or lower, I think, in terms of weight for their age) plumped up, and their moms educated in some basic nutrition and food knowledge. This country is extremely poor, and their main subsistence is "millet." Go buy birdfeed and look at the small grain for a visual of the grain. There is practically no nutitrional value in millet. The people who eat millet all the time are malnurished, and their babies are too.
I went to the malnutrition center yesterday with Dr Chris, our host, and Dori, the OB-GYN, Jon, "Monsieur Construcion," and Jan, our eye nurse. As I'm realizing is relatively normal, the ladies greeted us with beautiful smiles and cheerful calls of "bonjour." Their children are equally gorgeous. Babies are tied to the backs of their mothers and carted around - just little bobbing heads and the occassional tiny foot sticking out from a lump hidden by a flowing cloth. Usually the babies are minimally dressed. The women go about their normal work - chatting, grinding food, laundry, etc - with their children tied to them. One of the little guys started spitting up while we were talking to them (well, Dr. Chris was talking - I was smiling), and the mom just calmly stepped back, untied the baby so she could help him spit up on the dirt ground, then she mopped him and herself up.
The sheer simplicity of the interaction between mother and child is fascinating. In America we have swings and carseats and bassinets and cribs and playpens and mobiles and jonny jump ups and all kinds of thing. While those things certainly are useful and fit into our culture well, the contrast between home and here is striking.
Today I worked in the day school on the compound. There are 4 students. One is a North American who has grown up here and reminds me a little of my brother. He rides his bike with abandon, observes and asks insightful questions, and is quick to step up and help younger students with homework. He's a sweetheart.
I worked with the 1st grader on reading word families. Dan is the youngest of three brothers. Their father is from SubSaharan Africa and one of the few national doctors here at the hospital. After we'd practice pronouncing the new vocabulary, we read a pirate story together and Dan looked for the "magic E" words while I kept getting distracted by the plotline. He was sharp! Later, he read to me the story of Brer Rabbit and the Tar Baby (one of my favorites!), and as he sat on my lap in the electricity-less schoolhouse (the power went out for awhile today) on the cement floor (it was coolest down there - today hit somewhere around 100 I think), I couldn't help feeling like my heart was escaping my body to attach itself to this little guy.
His older brothers are also precious. They came looking for me this afternoon during siesta time. I was napping. Apparently they looked for me all over the compound as I had multiple people tell me they saw I'd made some friends. :-)
Tomorrow we'll head to a different school in town - the kids and their teacher and Dr Chris and myself. We counted pencils by groups of 6, and bundled tootsie rolls and tootsie pops into groups of 5 and 10 to count. We'll be taking them as gifts to give away. I'm also going to be teaching a short writing unit to "my" boys during their language arts time. Their teacher, "Aunti Barb" asked if I'd be willing to do that. I accepted, of course, and I'm thinking about how we'll get through the writing process with a 1st grader, 3rd grader, 4th grader, and 5th grader in a week, writing very short autobiographies. It should be fun!
The kids are fantastic here, and I'm looking forward to hanging with 120 adorable little ones tomorrow! It's incredible how these kids are able to survive. Dori, who has already delivered several babies by C-section and seen countless women in the 2 days she's been at the hospital, was mentioning tonight that she's never seen such thin women. "It's incredible their bodies are even able to support and sustain a baby," she mentioned. Then she said something about how thin their abdomenal walls are compared to the women she's worked with in America, using what the non-medical persons on the team call "Doctor-talk" (you wouldn't believe some of the conversations we have around our house!). Apparently malaria is also very bad here - the malaria season this year seems to be starting early, as several pregnant women have already come in with malaria episodes - and is particularly dangerous to babies in utero.
Every time I look into the dark eyes of the kids here I'm reminded of the miracle that their life is. It's particularly difficult to see glimpses of the small little guy in the tetnus room I pass to get to the pharmacy. Little kids with strange growths and malformed bodies are part of the package here on the compound, and it's such a bittersweet experience to have them on my radar.
Tuesday, February 08, 2011
TIA:Watches vs Time
There's two phrases that keep coming to my mind; the first is, "TIA: This is Africa." I first heard this in Morocco many moons ago when the custom somehow conflicted with my intuitive methodology for performing some menial task. I'd mention how "strange" or "weird" or "inefficient" it was to do it "that way," when I thought my usual way was superior in some sense. It was a common phrase in that community at that time to simply smile sympathetically, nod your head in understanding, and say, "TIA. This is Africa! We do things differently here."
After a few weeks, some not-so-tasty humble pie, and realizing that other ways CAN actually be just as beneficial as MY way, I began not only telling myself "TIA" when I had moments of frustration, but also joking with my friends - and enjoying! - the TIA way of doing things.
The second phrase I've been thinking lately is a new one to me. I heard it just a few weeks ago, in fact, at the orientation meeting for this trip with my teammates. Ken, our fearless leader, commented that there's a popular saying here in West Africa that states, "Americans have watches, Africans have time."
Both phrases have applied to my trip thus far.
I'm currently sitting in the rinky-dink "cyber cafe" here on the hospital compound, typing away at a rather ancient computer. This is my second attempt to get on the internet today, and I've been attempting to get the password and combo code to get into the cyber cafe for the past 24 hours. TIA. Things don't go according to preference or plans all the time.
But I actually enjoy it quite thoroughly. Mealtimes are fluid. Job times are fluid. Conversations are prevelent, and there's always time to stop, greet, speak, smile, and be gracious to people. My hosts have modeled this countless times today as I've toured the compound and started to find ways to put myself to work.
The plan this week was for me to work at a local school, helping reinforce the English lessons they're learning. I went to the school at 11 today with various members of my team, only to find the school abandoned. Apparently the students are protesting an unfortunate development in their education capacity, which has led to the students refusing to show up. The director thought it would last all week.
TIA. Things don't go according to preference or plans all the time (Don't worry, I'm sure I'll repeat that some more!)
So instead I found myself in the pharmacy, entering inventory into the computer, using my very, very, very basic Excel knowledge to account for all kinds of drugs I cannot even begin to pronounce, much less remember.
I haven't had to kill any chickens yet, but I there's plenty to do with food prep, clean up, and generally making myself available around our temporary home-away-from-home.
My ear for french is slowly picking up - I can find myself following the gist of many conversations, although my confidence in my ability to pronounce words or recall vocabulary of my own initiation is zero to negative numbers! It's a beautiful language, however, and my presence here makes me want to work on it more.
Generally, so far West Africa is captivating me. I've never seen a landscape so orange. There's no grass - anywhere - and this country only has 2 paved roads, I think - one highway going north/south, another going east/west. The further from the capital you get, the worse the road conditions.
There are camels aplenty, goats and sheep, and even a few donkeys. The people are beautiful, beautiful people. Even in the crowded, rather shockingly basic, spartan, and outdated hospital, they carry an air of dignity and beauty that I've come to expect of people who live a hard life, and can proudly state that they've survived.
The stars are brilliant tonight, and the temperature is mild and pleasant. I've been getting to fulfill one of my life to-do list goals by sleeping under bug nets, but the lure of pre-dawn and post-sunset are keeping the mosquitoes adequately supplied with fresh, American blood. Yes, I'm taking my malaria meds regularly, but some things seem to be ALMOST worth the risk.
My 5:30AM alarm will come all too soon if I don't get some good rest. Thanks for you thoughts and prayers - keep 'em coming!
After a few weeks, some not-so-tasty humble pie, and realizing that other ways CAN actually be just as beneficial as MY way, I began not only telling myself "TIA" when I had moments of frustration, but also joking with my friends - and enjoying! - the TIA way of doing things.
The second phrase I've been thinking lately is a new one to me. I heard it just a few weeks ago, in fact, at the orientation meeting for this trip with my teammates. Ken, our fearless leader, commented that there's a popular saying here in West Africa that states, "Americans have watches, Africans have time."
Both phrases have applied to my trip thus far.
I'm currently sitting in the rinky-dink "cyber cafe" here on the hospital compound, typing away at a rather ancient computer. This is my second attempt to get on the internet today, and I've been attempting to get the password and combo code to get into the cyber cafe for the past 24 hours. TIA. Things don't go according to preference or plans all the time.
But I actually enjoy it quite thoroughly. Mealtimes are fluid. Job times are fluid. Conversations are prevelent, and there's always time to stop, greet, speak, smile, and be gracious to people. My hosts have modeled this countless times today as I've toured the compound and started to find ways to put myself to work.
The plan this week was for me to work at a local school, helping reinforce the English lessons they're learning. I went to the school at 11 today with various members of my team, only to find the school abandoned. Apparently the students are protesting an unfortunate development in their education capacity, which has led to the students refusing to show up. The director thought it would last all week.
TIA. Things don't go according to preference or plans all the time (Don't worry, I'm sure I'll repeat that some more!)
So instead I found myself in the pharmacy, entering inventory into the computer, using my very, very, very basic Excel knowledge to account for all kinds of drugs I cannot even begin to pronounce, much less remember.
I haven't had to kill any chickens yet, but I there's plenty to do with food prep, clean up, and generally making myself available around our temporary home-away-from-home.
My ear for french is slowly picking up - I can find myself following the gist of many conversations, although my confidence in my ability to pronounce words or recall vocabulary of my own initiation is zero to negative numbers! It's a beautiful language, however, and my presence here makes me want to work on it more.
Generally, so far West Africa is captivating me. I've never seen a landscape so orange. There's no grass - anywhere - and this country only has 2 paved roads, I think - one highway going north/south, another going east/west. The further from the capital you get, the worse the road conditions.
There are camels aplenty, goats and sheep, and even a few donkeys. The people are beautiful, beautiful people. Even in the crowded, rather shockingly basic, spartan, and outdated hospital, they carry an air of dignity and beauty that I've come to expect of people who live a hard life, and can proudly state that they've survived.
The stars are brilliant tonight, and the temperature is mild and pleasant. I've been getting to fulfill one of my life to-do list goals by sleeping under bug nets, but the lure of pre-dawn and post-sunset are keeping the mosquitoes adequately supplied with fresh, American blood. Yes, I'm taking my malaria meds regularly, but some things seem to be ALMOST worth the risk.
My 5:30AM alarm will come all too soon if I don't get some good rest. Thanks for you thoughts and prayers - keep 'em coming!
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