Tuesday, April 15, 2008

A Restaurant Nightmare

April 15, 2008

Hans, Liz, and I are in the capital, N'djamena, right now. Dear Sonya was too sick to come. We are waiting to pick up some new volunteers this evening who are going to do a dental clinic for a couple of weeks. Planning to do a little shopping, we came a few days early. It has been strange enough being in such a big, noisy city (really nothing compared to U.S. cities), but nothing prepared me for our experience today.

Yesterday we went shopping at the Grande Marche (market), bartering for all sorts of things. It has been surprising to see so many white people (we are used to maybe seeing a new white person every couple of months), and we had trouble not staring at them or running up to ask them what they are doing here. Last night we went over to Rich & Anne's place (Evangelical missionaries who moved up to the capital for a while from Bere -- they are basically our adopted parents here) and Anne fed us some of her famous delicious pizza. It was great seeing them and as we were leaving, Anne gave us some extra money to go "fatten" ourselves up at a good restaurant for one meal. They recommended a place for breakfast, so this morning, Levi picked us up in the hospital truck and took us to a bakery/cafe.

It was a nice, small cafe with croissants, pizza, omelettes, etc. We took our seat at a small round table and tried not to stare at all the white people sitting around us. There was at least half the cafe filled with white people! And the rest were rich, African business men. The problems started with ordering. We were a bit confused with everything, asking all sorts of questions, because it has just been too long since we've been in a place where you order food. I felt like a backwoods country girl, awed by my surroundings. Our drinks were brought to us, and as we waited for our food to come...things started to feel very strange. Everything was too clean and polished, white people were coming in and out, the food was too different and perfect, the building felt enclosed and claustrophobic with lights on during the day?!, women wearing pants and shorts. I felt so uncomfortable and nervous, constantly shifting in my chair and darting my eyes around at everything.

Slowly my chest started tightening, my hands started shaking, and I started feeling light-headed. I'm having an anxiety attack?? This isn't even a real full-scale restaurant! Resting my head down on my hands, and trying to control my breathing, tears started coming out of my eyes. And there in the middle of the cafe, I started crying! I couldn't believe myself! I was finally able to control myself some as Liz and Hans agreed they were feeling really uncomfortable too and tried to distract me with other topics to talk about. I kept looking at Levi to focus my mind on Bere and what we are used to -- open space, no electricity, cooking outside, dirt floors -- everything I'm comfortable with. Our food came, and although my omelette tasted amazing, once it got to my throat, I thought I was going to choke on it. I couldn't get over my nervousness, and kept pushing my tears down over and over. Finally forcing everything down (there was no way I was going to waste any food when it was so expensive), I excused myself and practically ran outside. Walking down the sidewalk a ways, dodging motos, I calmed myself down while the others finished eating. We paid, left, and came straight back to our guest house, all feeling too spent from the experience to go shopping as planned.

Back at the guest house, I feel like things have even changed here for me. When we arrived on Sunday, this place seemed amazing -- real beds, fans, electricity, air-conditioning(!!!), refrigerator, microwave, bathroom with shower and toilet, just about everything you could think of. When the caretakers arrived and showed us everything, I was a bit overwhelmed when they turned on air-conditioning, fans, lights and plugged the computers in all at once. I thought for sure the fuse was going to blow! Now, however, after our experience at the restaurant, it all makes me feel uncomfortable too. Too big, too much. I have definitely changed. I can't even imagine what it will be like going to Europe and back to the States. So be prepared for me being a crying wreck for a couple weeks :) I know I will adjust again with time -- but definitely after TIME! Hopefully Europe will be a good buffer before going home to family and friends.

We all feel a bit better now after handwashing our clothes in buckets of water and hanging them up to dry outside, to the amused look of the housekeeper. They do have a washer and dryer here...but doing what we were used to was much more therapeutic :)

Thursday, April 10, 2008

Goat Attack

(A short story for Steph & Lisa)

Because of the heat, I almost always sleep outside now on my reed mat, just outside my hut. My family does too, but not quite as often as I. This particular night, it was a bit windy out, and I was the only one out under the stars. As a side note, here in Bere, animals run free. They are not confined by any sort of fence so it is normal, especially at night time, to have them all wander into our courtyard, scrounging for food. I don't mind too much except I particularly dislike awaking to a grunting slobbery monster black pig up by my head (happens a lot. The neighbors own him).

Deep in my slumber this night, I was slightly awoken by something brushing over top my head. Thinking I was dreaming, and too tired to completely pull myself awake, I ignored it. It continued, though, to run across my face and suddenly I awoke in a jerk, with thoughts of snakes at the top of my mind. When I realized it was just a rope, I sighed and laid back down. Wait a minute. Why would the rope be moving? Sitting back up, I squinted through the blackness and finally made out the form of a goat at the end of the rope. No problem. I threw the end of the rope away from me, scaring all the other goats, chickens, pigs, ducks, and dogs in the courtyard. As I laid back down again, it struck me as odd that the goat with the rope didn't shy away. Hmm...maybe he's just half blind....Zzzz....Zzzz...back to thoughts of going home soon to real showers...bread & cheese in abundance....cold drinks....mountains...Zzzz.....

Aaah!!! I was rudely awaken again with something ramming into the side of me. Jumping up, I looked down at the attacker to see that it was that goat again -- with a bucket covering his head! Sometime while he was scrounging around for food, he came across our bucket to draw water from the well and had pushed his head deep inside, getting stuck. At first I wanted to laugh, but then I realized that this was our bucket for our clean water. "You're contaminating it!" Also, if I was going to get any more sleep without being trampled on or attacked again, I would have to free this goat from his unknown prison. He seemed not in the least bit perturbed by it, probably just thinking it was a dark night.

Walking over to the rope, I picked it up and started pulling the goat towards me. He soon realized that something was going on and tried to run away. Which, since I was holding the end of the rope, he could only run in a circle, quickly wrapping the rope around me before I had a chance to turn (I was still a bit tired :) Struggling to keep my balance, I worked hard to get myself untangled with him jerking me here and there across the courtyard. (I'm glad no one was around to watch this. It was probably a bit amusing to see me in my pajamas, wrestling with a goat and a bucket)

Free once again, I set my feet and with a determined pull, began once again to bring the goat closer to me. Finally he was close enough for me to grab the bucket. His head was stuck in deep, though, starting a tug-of-war between the two of us. Back and forth, back and forth. I got knocked off my feet in one big jerk from him and ended up lying out on my stomach, still gripping the bucket as hard as I could. "You aren't getting away!" I said through my gritted teeth.

The goat started to bleat with all he had in him. With the bucket over his head, it echoed for the whole village to hear. "Maaa! Mmaaaa!" Suddenly I heard Anatole bumping around in his hut, probably looking for a light to see what was going on. Not wanting him to see me like this, I gave it one last heroic attempt. Still on the ground, I swung my body around and put my feet up on the goat's chest and pushed as hard as I could while pulling. Pop!! The bucket finally flew off and I went tumbling backwards with it. The goat went galloping off and I was left alone in the courtyard with the bucket in my hands.

Not sure how I could explain this to Anatole in French, I quickly threw the bucket towards the well, leaped over to my mat and threw myself down, shutting my eyes and trying to slow my breathing. The door to Anatole's hut flew open and he stood there, beaming his flashlight in every corner, stopping for a minute at the haphazardly thrown bucket with the rope....leading to me. His light moved to my still form for a long time until finally, unable to solve the mystery, he went back inside. Oh well, they already think I'm strange....crazy white girl.

Wednesday, April 9, 2008

Birthing 101

April 7

Monday, after work, my African mother, Julie and I headed out to the market. We picked up some soap and coal to cook on and then stopped by a tailor's small shop to pick up Julie's dress that she had made from the leftovers of my fabric. Everything took a while, it's not just a quick run to the store. This is Africa. So after stopping to talk to countless people we ambled along slowly down a dirt path between huts, passing women with pots on their heads.

Julie decided to spend the afternoon visiting, which I would have rather foregone, but it would have been very impolite to leave her,so I resigned myself to not getting home before dark.

An hour later, things got interesting as we walked into a courtyard to find a bunch of women gathered and a woman in labor! I was finally going to get a chance to see a home birth. Women here only come to the hospital to give birth if there is a problem or if it is their first baby.

The woman was laying out on a reed mat, obviously having close contractions, with a bunch of people fanning her. Julie and I were given chairs to sit on (a luxury since I'm white), and brought water to drink. It's like a show! Everyone sat around just watching her. It was explained to me that this was her sixth pregnancy with 4 living children right now. So we settled in to watch and wait, expecting the baby to pop out easily since she had birthed so many already.

When another hour passed with no progress, I started to watch her more closely. She started to actually yell some which usually means that they are having a harder time then usual because these women hardly make a peep when giving birth. If they do yell out, they usually get scolded by family members.

Some blood started to come out of her and as the worry started to circulate among the women, I glanced at Julie who gave me a little nod. We both stood up and went over to the woman, Julie explaining that I worked as a nurse at the hospital. I started rapidly asking questions, Julie translating my French into Nangjere. It soon came out that she hadn't felt the baby move for over a day and had now been in labor for 6 hours. I checked her pulse and conjunctiva color which was very pale. O God, she's already anemic!

Immediately I turned to the relatives and started explaining that she needed to go to the hospital. She was going to need blood right away and there we could check her out better to determine if the baby was still alive or not, if she would need a c-section, etc. I realized soon that I was talking to deaf ears. They ignored me, only answering with excuses and the usual, "We don't have money."

"What do you mean you don't have money?!" I cried out, easily seeing they were well off. "You can take your bike as collateral and pay for it later." The husband countered that he needed his bike to get to work with a smile on his face. How can he smile about this? "Don't you need your wife to cook for you and give you babies? She is going to die if you don't take her to get blood!" Anemia is one of the biggest reasons for death here among pregnant women.

A loud cry from the woman moved my attention back to her as a gush of blood came out. Kneeling down next to her, I looked into her panicked, sweaty face and knew I couldn't just leave her. Sending up a quick prayer for guidance, I started preparing to help as much as I could. I knew I needed to examine her and see if I could feel how the baby was positioned or if there was a problem, but...no gloves? I've gotten used to some blood on me from IVs or other random little things, but we always use gloves for pelvic exams.

Letting out a sigh of decision, I asked the family for water and soap to wash my hands. Maybe at least I can keep from giving her an infection. Then with a quick mutter under my breath, "I hope she isn't HIV+, God protect me!" I pushed my two fingers up her. She was fully dilated and I could feel the baby's head, but for some reason, she was having a hard time pushing the baby out.

After rinsing off my hand, I went up to her head and started trying to coach her breathing and pushing to coincide with her contractions. Minutes passed and it still wasn't progressing, with her getting weaker. So I ordered a couple women to help her get up and squat.

There was way too much blood coming out of her for my liking but my constant pleas to take her to the hospital were still ignored. In the squatting position, she was able to push better and I started running my fingers inside the edge of the cervix trying to open it up more fore the head that was now showing. Finally, getting desperate, knowing this baby hadn't been moving for over a day, I reached in and put my fingers in the baby's mouth like James has taught us, and started pulling with her contractions.

Suddenly in a rush of blood and fluid, the baby slipped out almost easily. The cord was wrapped tightly around his neck and he was blue and still. After slipping the cord off, I thought, "What do I do now?!" I don't have the instruments to suction its mouth or clamp and cut the cord or bag air into him.

Sweeping mucous out of his mouth with my fingers, I quickly put my lips down on his little blue ones and started sucking and then spitting onto the ground next to me. The family brought string and a knife to cut the cord and I stopped long enough to tell them to wash it and pass it through a match flame in front of me before using it. Then I continued rubbing the baby vigorously, starting chest compressions, hoping it would stimulate the lungs too, and breathing into his little mouth, watching for his chest to rise.

Liz! I wish you were here to help me right now!

Some of the women started their mournful wailing, so I turned to them frustratingly, "He isn't dead yet! I can feel a weak pulse." I was determined not to stop for at least a half hour, remembering a time earlier this year when Liz and I were able to resuscitate a baby in almost the same situation as this one.

Little by little, the blue started to dissipate from his small body and he gave a few weak gasps every few seconds. Picking him up in my arms, I went next to the woman and reached down to show the grandma that she should be massaging the stomach harder. I figured they could deliver the placenta since they've been through so many births. I continued with the vigil of breaths & compressions and slapping his feet and hands. I saw his eyelids flutter a little and kept praying constantly. Finally he let out a weak, but throaty cry that gave me hope that he was going to make it. After letting him cry a few more times, I laid him down next to his mom and tried to get him nursing a little to help the uterus contract to deliver the placenta.

Just as I let go of him, I saw the women pulling the cord, jerk rather harshly, pulling the placenta out...but only part of it. God, could anything else go wrong right now?! What is the matter with these people! Don't they do this all the time?

Knowing we couldn't keep the pieces of placenta in there, I washed my hands and reached up her again, sweeping the inside of her uterus carefully with my hands, pulling out large bloody pieces. Deciding I'd done as much as I could, I rinsed off and stepped back, trying one last time to convince the family to take her in to get blood and antibiotics. I wished I was strong enough to just throw the woman on my back and carry her to the hospital! They responded the same as before, so after sticking a piece of fabric partway up her to hopefully stem any more bleeding, I turned dejectedly away and left. As Jesus says to his disciples, "If anyone will not welcome you or listen to your words, shake the dust off your feet when you leave that home."

Back at home, I changed out of my soiled skirt and repeatedly rinsed out my mouth to get all remnants of bloody mucous gone from my taste. For hours after lying down to sleep under the stars, I lay awake, unable to keep the days events from my mind. Did I do everything I could have? Should I not have helped at all? I am not a doctor or a midwife! I'm not even a nurse like they think I am.....but I work under the guidance of the Great Physician. By his wisdom and power, that baby is alive.

(The woman died this afternoon and now the family is spending tons of money, giving the proper funeral and entertaining guests with tea)

Sunday, April 6, 2008

Piano Keys

April 3, 2008

At the missionary's house down at Bengdale, I eagerly pull up a chair, flip the "on" switch, and slowly place my fingers on the familiar black and white keys. They have a keyboard that can be run on their solar power, and even though it is small, after 7 months, I would play anything.

Piano playing has always been my release and going through the hardest, most exhausting and trying year without being able to escape to a piano has been difficult. As my fingers automatically move across the keys, I can already feel tears forming in my eyes. God, take me away from this place for a little while.

The minutes fly by as I play and play and play....forgotten for the moment are all our problems at the hospital, people dying, people coming and then refusing to pay for treatment. Forgotten are all the hours spent standing at the operating table. Forgotten for now, that I am still struggling to get over malaria again, wondering if the nausea and headaches will ever stop.

"O Lord my God, when I in awesome wonder, consider all the worlds thy hands have made"
God, all these different cultures, languages, and worlds, Tchad, the States, India, Australia...

"I see the stars, I hear the rolling thunder, thy power throughout the universe displayed"
The millions of stars I see as I lay out on my reed mat at night, the magnificent storms that fly through here in a heartbeat, all a small show of Your power

"Then sings my soul, my Savior God to thee, how great thou art, how great thou art"
Nothing more to say there, God. A midst everything, that is one thing I can say and know to be true with no questions.

As I continue to play, my mind wanders to what it will be like to go home and play on a real piano. A piano where when you push the keys, you can feel the vibration through your fingertips and resonate throughout the whole piano. Where the keyboard doesn't suddenly stop one octave lower.

I think about my piano at home that I've grown up learning to play on with its squeaky pedal.

Or the piano at Milo in the church that I played for hours on, slipping over between classes, praying it was unlocked so I could play by myself in the quiet of the sanctuary with the sun pouring in through the tall windows. Or accompanying the school choir, following Dr. Barnhart's cues, or planning praise music for a worship service with a group of friends, trying to coordinate the piano with guitars and drums.

Then there is my favorite practice piano in the PUC music hall, 4th door on the left that I'd open with my key and pound on for hours before finals. Or the piano in Mrs. Rasmussen's office that I'd go to for my lessons and end up having to reschedule because we'd talk throughout my entire lesson :)

Time's up. Flip the switch again, unplug it, cover the keys with a sheet and head back out into Africa.