Saturday, March 29, 2008

Making any difference?

March 25, 2008

"I'm dreaming of a white Christmas...just like the ones I used to know..."

Strains of music come from the computer as Liz, Sonya, and I sit watching the classic movie that perhaps makes us feel a bit cooler. As we dream of cold snow while sweat drips down our faces, our rest period is suddenly shattered as one of the Tchadian nurse's face appears at our window. "There is a patient at the hospital that I need the doctor to see."

After already doing four surgeries this morning and doing consultations all afternoon with Dr. Bond, I don't really want to get up and go back to the hospital. "Go tell the doctor yourself. He's just next door."

My hope for peace, though, doesn't last as I hear Dr. Bond's voice booming a few minutes later, "Esther! Esther, come here! We have someone to go see at the hospital." Sighing, I get up, throw a scrub top back on, grab the keys, and head across the compound down the little path to the hospital with him.

As we walk in the consultation door, I immediately feel a little guilty for my unwillingness to come as we find a small Arabic girl lying flat on the exam bed. At closer inspection, she appears to be rigid as a board. Her legs are stretched out with her feet curled and pointed, almost like she's doing ballet. Her arms are both bent up close to her, and nearly impossible to extend. Her neck is stiff in one position and her jaw locked so that she can only talk by moving her lips.


After telling David to start an IV on her, I follow Dr. Bond into James' office to look up in books what we can give for tetanus of what we have in our limited pharmacy. Amazingly we find some tetanus antitoxin kept cold in the small kerosene fridge that the lab uses. The problem is that it won't work for a couple days and we have to keep her alive until then. She has already spent two weeks at the hospital in Moundou before being referred here. If the tetanus paralyzes her respiratory muscles, we're going to have a hard time keeping her breathing and we will have to bag air into her constantly.

When Dr. Bond decides on her meds, two of them are very strong drugs that she needs very small dosages of, or they will kill her with too much. Instead of turning her over to the nurses who change with every shift, don't look at dosages carefully, and may give it wrong, Dr. Bond tells me to sleep at the American house and come over to the hospital every six hours to give those two medications.

That evening I set out the two syringes I would need with the dosages already in them and set my alarm for midnight. Stretching out, I try to relax and fall asleep in the heat...

10:30 PM, I've barely fallen asleep as suddenly I hear David in my confused slumber, calling me at the window next to my bed. "There is a woman who came having trouble giving birth."

"Dr. Bond isn't here, he's next door," I answer, knowing, though, that I will probably still have to get up and help.

Sure enough, a little bit later after hearing Dr. Bond go over to the hospital to check her out, I hear him come over to my side and call, "Esther, we need to do a c-section. I called Abel and Simeon to come help so come over when you hear the generator come on."

I get up and change back into scrubs and then try to keep myself awake as I wait for the loud rumble signaling we have power to do a surgery. A whole HOUR later, I finally hear it and grab my OR cap and face mask that we reuse and walk over, still a bit dazed. It is almost midnight, so I quickly give the tetanus girl her meds, one IV and one IM and then walk into the OR. Simeon is preparing the patient with Enoch, a nursing student. Dr. Bond is barking orders and grumbling about Simeon coming so late and Abel not even showing up. "Quick Esther, scrub in!" he commands me. Soon I'm helping him drape the patient with sterile cloths, Simeon is giving anesthesia, and Enoch is getting things ready to resuscitate the baby.

We pray and then Dr. Bond takes the scalpel from me and starts cutting the skin. As I start to hand him clamps, he barks, "No! First we get the baby out, then we worry about the bleeding." He continues cutting quickly through the fat, muscle, and fascia until we are into the abdominal cavity. Quickly I pull the bladder out of the way of his knife and he cuts rapidly through the thick uterus. The baby's head pops out and as he pulls it completely out and clamps the cord, I start suctioning the baby's mouth. Once the cord is cut, we hand the baby over to Enoch and Simeon, and pull the placenta out. As blood splashes everywhere, I understand now why Bond offered for me to wear the rubber boots.

It took under 2 minutes to get the baby out and now we spend half an hour sewing up the uterus, stopping the bleeding, putting a drain in, and finishing up. Now back to bed.

Crawling out of my bed at 6, I stumble back over to the hospital to give the drugs again to the tetanus girl who doesn't look any better yet. The books say that even at the best hospitals, half the cases of tetanus die. What chance do we have at this little bush hospital in Africa? While feeling discouraged, I stop by to see the new mother and baby we delivered. As the little baby's hand clamps over my finger, my frustration dissipates as I am reminded that we are making a difference here at this hospital. Just take it one patient at a time and leave the worries behind.

Friday, March 28, 2008


March 23, 2008

I have been in Africa now for almost 7 months. Sonya and I are heading home very soon (43 days!). My thoughts have changed from, "Will I ever make it to the end?!" to "Will I be ready to leave?" Such conflicting emotions --- I am stuck between two worlds different like night and day. I love both and have gotten to the point of understanding Paul when he says in Philippians,

"I have learned the secret of being content in any and every situation, whether well fed or hungry, whether living in plenty or in want. I can do everything through him who gives me strength." (vs 4:12-13)

Both lives are enjoyable as long as I'm living for and with God. I am content...

...whether lying on a cushioned bed with clean sheets at night with a fluffy pillow or lying on a reed mat outside under the stars with Kristel's dark arm slung over me.

...whether cooling off with a flick of the air-conditioning unit or by pouring cold water from the well over me.

...whether throwing my clothes in a washing machine or scrubbing my clothes in a bucket outside and letting the sun dry them.

...whether starting IVs with the protection of gloves or starting them with the freedom of no gloves so I can feel the veins better.

...whether sick at home with the flu or sick in my hut with malaria.

...whether scrubbing the shower with a sponge and cleaner or sweeping out the leaves in the shower with a handful of grass tied together.

...whether eating every food imaginable at anytime of year or eating rice and mangos every day.

...whether dressing up nice and fixing my hair or not even seeing myself in a mirror for days.

...whether wearing comfortable jeans or skirts and scrubs every day.

...whether eating salad with a fork or with my fingers (Sonya and I agree it's much easier with our hands --- we want to walk into an Olive Garden when we get back and eat African style)

...whether jumping into a clear blue cold mountain lake after hiking all day or jumping into a muddy brown river, watching out for hippos, after riding the horses there.

...whether eating at a table with chairs and separate place settings, or squatting on the ground around a communal plate of rice bowl and a communal bowl of water being passed around.

...whether riding in an ambulance with the excitement of going on a call as an EMT or wheeling a patient into the African OR with the excitement of scrubbing in and assisting the surgeon.

...whether reading with a big light, illuminating the whole room at night or reading under the dim light of an oil lamp.

...whether driving around in a car or walking everywhere.

It's not about what is right or better than the other. It's about being content wherever God sends me. I am very excited about being home soon, and seeing everybody, but I also wouldn't mind staying here longer, being able to tangibly see the need.

Thursday, March 13, 2008

Taco Bell in Africa

February 24, 2008

Have you ever gone without a Taco Bell burrito for a year? If you have then you would understand why our eyes widened in disbelief and wonder as Stan, our newest volunteer, pulled out four burritos that he had brought all the way from the States for us. No worries about mold, he ingeniously put them in dry ice! We fried them a little and slowly savored each bite with real Taco Bell sauce that he brought along. Amazing! Stan is a mechanic from Tennessee and is going to be a big help hopefully getting our generators working well again and working with Gary on the plane. It is always great to get new people over here. James and Sarah have sadly taken off already on furlough and are at this moment eating wonderful foods in Denmark and planning ski trips up in Norway. But I’m not jealous….because we have Taco Bell!!!

Rats & Snakes

February 23, 2008

We have gotten a wonderful chance through the last couple weeks to really experience Chadian creatures to the fullest.

Gary (pilot) and Wendy arrived home one evening with their two little kids and waited patiently while Caleb attempted to unlock the screen door. Finally Wendy pushed past him as he finally opened it, preparing to walk in…until she suddenly saw a big black snake curled between the screen and door. Gary and her each grabbed one of Caleb’s arms and jerked him back. Gary then proceeded to pin it down with a shovel and kill it. They say it was trying to bite itself which is characteristic of poisonous snakes as a defense mechanism if they think they’re going to be killed anyway. Afterwards, Gary identified it as a Black Mamba, neurotoxic…not the kind of snake I ever want to come across!

All the excitement is happening at Gary’s and Wendy’s house. A week ago, while Gary was gone taking James and Sarah to the capital, we went to hang out with Wendy one evening and while getting ready to leave, we thought we saw a cat run around the side of the house. Hans went to check it out and suddenly exclaimed, “Wow! That’s the biggest rat I’ve ever seen!” We all hurried over to check it out and immediately backed away as we saw a big fat rat about a foot long with a 2 foot long tail. From our position of safety (we thought), all of us girls yelled, “Kill it! Kill it!” Hans picked up a large rock and threw it at the nasty rodent. Before we realized it, the rat ran around the corner right into the alleyway that all of us were huddled into. I’m sure the whole village of Bere heard our screams as the confused rat scampered around our dancing feet. Wendy and I have battle wounds from throwing our bodies against the wall to get away. Hans cornered it and proceeded to throw rock after rock until it was dead, belly up. He, of course wanted to save it as a trophy to show the other guys when they returned, but our protests led to launching it over the wall into their neighbor’s courtyard.

Tonight we met the rat’s younger brother while leaving their house again after a great Sabbath. Gary and Hans eagerly took off on the chase to kill it. It tried to crawl up over their fence, but Gary knocked it down with a rock and they beat it to death. After gathering around to ooh and aah over their handiwork, we ended up giving it to the guard who was excited about having a delicious rat dinner that night. He already had the fire going by the time we finally headed home.

Who knows what we’ll find next. I hear scorpion season has started…