Sarah's Travels

Blood, Pus, & Speculums

2011-04-05T22:04:00.000-06:00

As we spend time in clinics and in our global health class, I find myself more and more interested and focused on children's and women's health. The biggest rates and statistics of death and disease in developing countries are from children under the age of 5 and from maternal complications during pregnancy and delivery. In Africa I received a lot of experience in delivering babies and some complications that arise from that. Here in Nicaragua there has been less of that and more a presence of STIs, pelvic inflammatory disease, and cervical cancer - which has a very high prevalence rate in this area.

Dr. Caldera really pushes women's health and has been trying to make it more of a norm. Despite that, many women are still very shy about mentioning any symptoms or letting us do an exam on them. It is a lot different from the hospital in Africa where there was no personal space or privacy. Whole wards of people together while we did all kinds of dressing changes and most of the nurses being male. Here, even with a personal enclosed area, a blanket covering most everything and only girls assisting Dr. Caldera, it can still be hard to convince the women to let us examine them.

Dr. Caldera is one of the kindest, most understanding doctors I've ever worked with. He takes so much extra time to teach us and to let us do procedures ourselves. Because of the wariness of the women, the few of us girls have gotten a lot of experience in gynecology this semester. Vaginal exams, pregnancy check-ups, speculums galore, and even an entire clinic of just Pap smears in one village. I know that this subject is not an interest for many, but the more I see how much the women suffer from these problems and diseases, the more I want to know more on how to help them.

Our group is set up to have 2 students on call with Dr. Caldera at all times for any medical emergencies that come up, or house calls. These trips vary a lot between actual emergencies, just visiting an old woman with a cough, and transporting maybe a kid with a broken arm to the hospital in Waspam. My most recent call, I call our gynecological emergency day. David and I are partners and were called late Sunday morning to go with Dr. Caldera to see a woman that had been bleeding excessively. We walked down to the clinic first to grab a pregnancy test, a speculum, and some other meds and vitamins that might prove useful. Then we walked our way through the village in the heat to the woman. She was visiting her mother who lived in the classic one room wooden house up on stilts. The animals hang out under the house and the family cooks on the porch. This woman was visiting from the city, Managua, which was great because she could speak Spanish well and wasn't shy about explaining everything to us.

She had been spotting blood for a couple weeks and then developed significant bleeding for the last 2 days, getting really weak and dizzy. After a lot of conversation we found out that she had had many irregularities in her menstruation before and had been on some hormone medications in past years. She had quit taking them a while back when she thought she was better, and had no menstruation at all for a while. We did a pregnancy test first to rule out any chance of a spontaneous abortion or other complication with pregnancy, and that turned up negative. So Dr. Caldera had me get out the speculum we had brought and find out if she was still actively bleeding or not. There was a lot of blood and big clots that made it difficult, but I finally found the cervix and could see constant blood leaking through. With that knowledge, Dr. Caldera was stuck in indecision on whether we should be sending her to Waspam yet from too much blood loss, or do something here in the village.

We headed back to the mission and he explained how he really didn't have much experience in this kind of case. He asked me if I knew anything about what to do from a fellow women's perspective. I told him that I had friends with irregular menstruation that had started early on with birth control pills to help regulate, but that's all I knew. So we split up at the mission and agreed to meet up in 30 minutes after consulting medical books. I checked the Where There is No Doctor book first, but in the "bleeding unrelated to pregnancy" section, all it said was to see a medical provider for help right away. So then I went to my Wilderness Medicine manual and found a great little section describing treatment of taking a months worth of contraceptive pills in one week to control bleeding. We met back up and Dr. Caldera said he had come to the same conclusion, but we had none in our clinic.

A long walk to the other side of the village took us to Janet, the MINSA nurse's house. MINSA are the government-run clinics that are in most of the villages, staffed by usually one health worker or nurse. Janet said she had some pills at her clinic, so we trekked over there to get some. In the process of all this, a man had approached us on the road, wanting us to look at his wife who supposedly had a tumor. Many times people tell us they have tumors or a "ball" somewhere in their abdomen or back that they are sure they can feel. But when we check and feel around, often we find nothing and wonder about these imaginary tumors infecting so many. This sounded similar to one of those cases so Dr. Caldera kept saying, "We have an emergency right now. We can't see her. Come to the clinic in another week when we open up again." The man was very insistent, though, and Dr. Caldera finally caved saying, "Go sit at the clinic and we will look at her next time we walk by."

That next time happened when we walked by with the contraceptive pills and saw the man with his wife sitting on the steps of our clinic. So we headed in for what we thought would be a quick exam. As the husband explained once again the problem, we realized he was actually pointing to her groin, not the abdomen. So I got some sheets and took the woman into a room to change out of her clothes and lie down on one of the beds. She was very shy so I did the exam once again and found a large abscess about the size of a softball protruding from one of the outer lips of her vagina. Ouch! It looked painful. We poked it with a catheter and drained out about half a liter of white, green smelly pus. David and Dr. Caldera could hardly stand the smell, trying to keep their heads turned away, but to me it just smelled like the hospital in Bere. We drained so much pus out of people there and so many nasty infections that you eventually just get used to the smell like it is normal.

After draining the abscess, Dr. Caldera took a while to get out some sterile instruments and cut open the skin a little more to pack it full of bandage, leaving a hole to drain out of. I gave her a shot of ceftriaxone, a pack of antibiotics, and then sent her home. We grabbed our medical bags again and hiked back over to our first patient's house to give her the contraceptive pills, explain everything, tell her to check up with a doctor in Managua when she got home, and to see the MINSA nurse if she got worse while we were gone on the river trip. Then back to the mission to continue packing for our week out in Krin Krin on the river.

Later in the evening as it was getting dark, Mrs. Brown, who cooks for our group, walked up the hill with her daughter asking for Dr. Caldera. It sounded like a very similar medical case with her complaining of bleeding over the last couple of days. As we talked more, she explained that she hadn't had her period for 3 months previous before this bleeding started. Dr. Caldera turned to me and asked, "Sarah, I am so busy right now trying to pack and prepare your tests for next week. Can you take her down and examine her on your own?" I jumped at the chance and a few minutes later after grabbing my headlamp and scrub pants, David and I were walking back down to the clinic in the dark with the girl.

First up was a pregnancy test once again. This time it was positive! Good news. Mrs. Brown would be excited about another grandkid. But now the worry about the chance of a spontaneous abortion with the bleeding. David got me a speculum and I checked again to see if she was still actively bleeding. This time she wasn't. There wasn't near as much blood as the first woman and I couldn't see any coming out of the cervix. Good news once again. So after giving her instructions to lie down and rest a lot, and a bag of prenatal vitamins, we headed back to the mission. On the way we stopped by Mrs. Brown's house to tell her the news and tell her to make sure her daughter followed the instructions on resting from work if she wanted to keep the baby.

One day, three patients, all gynecological. Fun times :)

Dear Sonya, Liz, and Hans,

2011-04-03T23:15:00.000-06:00

This is a letter to my 3 comrades from my time in Chad, Africa. I think of you often while down here in Nicaragua. My experiences with you in Bere have shaped so much of how I view things down here in Central America. I imagine how we would joke together at the many luxuries here that most see as hardships. Outhouses with real toilet seats on them! Rice and beans to eat every day (I know! Real beans! Not just some spit sauce). Real, large, metal-framed cots to sleep on at night that never collapse. Free email through the ham radio each week.

I am grateful for the examples the 3 of you gave in Africa and have incorporated a little bit from each of you into my life and work here. Every time I'm tempted to stand back and let someone translate to English for me, I think of Hans, and how despite his excellent French that he could already communicate with, he still spent time studying and learning Arabic and Nangjere to communicate even better with the level of the people. I remember his interest in the politics behind culture and understanding why people do what they do. So here I keep trying to engage myself in the culture with the Miskito people. Ask questions about why they do things. Repeat all the Miskito words that I can. Build relationships with the locals.

In clinics I am constantly reminded of Liz and all the medications and nursing procedures she took the time to teach me. Her commitment and love for patients was so apparent in the way she treated and cared for them. It has encouraged me to spend more time with my patients, touch them, talk to them, explain what I'm doing or giving them. Rushing babies to Waspam at night always makes me wish for Liz, my CPR buddy back in Africa.

And Sonya, I was always so amazed to watch her creative interactions with the people and especially the children. No matter the language barrier, she could always make them laugh. And such simple games with bottle caps, crayons, or rocks, she could make friends within minutes and entertain for hours. On the most recent clinic I suddenly found myself pushed out of my station with nothing to do for the rest of the day. Starting to get annoyed with the turn of events, I looked around and though, what would Sonya do?....Of course, she would entertain the children! So I grabbed the bag of balloons, made a crazy ridiculous balloon hat to wear that would have made Sonya proud, and proceeded to blow up millions of balloons for the kids. Remembering how she would get creative and find ways to include kids, soon James and I were blowing up balloons within balloons and adding little rocks to make them rattle. I tasked a group of boys with finding good smooth rocks and another group to be in charge of telling me whether a kid was being honest or not about receiving one already. Soon we had a real production and game going on that lasted all the way till dinner.

Oh my life is so much richer down here by remembering your examples! Thank you for that! With a bigger group down here, it is harder to have the same comraderie, deep love, and understanding that the 4 of us shared in Chad. But I get excited when the breakthrough does happen here and there. The last few days, our group has been hit by some kind of explosive diarrhea phase that makes me start singing about Giardia. A month or so ago, most looked at me with disgust or disdain as I would try to describe the fun moments of a true diarrheal episode. With the recent personal experiences had, however, we've had such great conversations already with no holding back. I know you guys would have no qualms about joining in on descriptions on what it is like to be peeing out of both holes, to have an "accident" when you thought it was just gas passing, and to be burping up yellow metronidazole. So good. It bonds in such a unique way :)

I hope you are all well. Sometime we will have to get together, don our scarves and turbans, and ride in the back of a truck on a bumpy dusty road, singing "Ka Kongdi."

Love, Esther

Chatting with Elisa

2011-03-26T13:33:00.000-06:00

Elisa is one of our translators that we take along on all our clinics. She is 41 years old and probably the least proficient in English compared to the other two. But I love her so much. The slightest joke or funny incident makes her erupt into endless giggles and laughter. Her English is getting better and better the more time she is with us. Usually she translates for the pediatric station and that is my favorite station to be at, so I think we have naturally been drawn to hanging out together as we both hold babies and laugh at the kids.

This week at clinic in Esperanza, we finished early at peds, so I asked Elisa if she wanted to walk with me to see the river. It is a beautiful flowing river that reminds me a lot of the Umpqua in Southern Oregon. So we walked out there and sat by the edge of the river chatting about life in our halted communication.

Me: Elisa, have you been to Esperanza before?
Elisa: Oh yes, yes. It is good like Santa Clara. Not too much people. Francia is too much.
M: Yeah the houses are so close together back in Francia. How is your son doing?
E: Son?
M: Your boy.
E: Oh! He lives in Waspam.
M: Do you get to see him very much?
E: Sometime I see. Sometime not so much.
M: Oh that is too bad. I'm sure you miss him. So on Tuesday and Thursday you come on clinic with us. What do you do on Monday, Wednesday, and Friday?
E: My plantation! I go work.
M: Oh you have a plantation! What do you grow?
E: I have beans, the papaya, cassava...
M: Everybody is harvesting beans right now, right?
E: Yes, but it is not so good this year.
M: From all the rain?
E: Yes too much rain.
M: So you go work each week. You know all the people that come to our clinic say that have back pain.
E: Yes everybody, everybody!
M: I think everybody in Nicaragua has back pain! They work too hard in the fields.
E: Yes, work too much. I only carry little bag back, but you know other women carry big big bag. Too much!
M: And then the women have so many babies!
E: (Laughing) Yes, yes. Sarah, how many sisters do you have?
M: I have one sister and two brothers. There are 4 of us.
E: Ah...I have 5 sisters and 3 brothers.
M: Oh! So many! There are 9 of you!
This river is so beautiful. Why doesn't Francia have one?!
E: (Laughing) Yes, Francia river is only little and brown. Not good for much people.
M: In the summer I work with kids.
E: Oh?
M: Yes, they are age 15, 16...And I take them to a river like this to have fun. We get a boat and go down the river and at night we stop to camp on the side. For one week!
E: Oh do they work?
M: The kids? No, no. It is just fun.
E: About one year before, maybe two, I don't remember well...3 boys were coming down this river in a boat. They work at plantation far away. There was rain. Lots of rain and the river here was full. Big. And the boat...how you say?
M: Oh the boat tipped?
E: Yes the boat tipped and one boy fall out. He try to swim, swim, swim but not make it and he died right down there.
M: He drowned? That is very sad.
E: Yes.

M: Elisa, I heard that the whole village of Francia had an election on Sunday?
E: Election?
M: A big meeting to decide leaders?
E: Oh yes!
M: So what did they decide? Was it all good people you like?
E: Yes good people. We vote a new judge and new leaders everywhere.
M: What does the judge do for work in the village?
E: Well, you know if a boy take something, that is not good.
M: You mean stealing?
E: Yes, yes. The people take the boy to judge and he give the boy a lot of work.
M: He makes the boy work for stealing? I like taht. It's productive! Does the judge do marriages too? Or do people here get married?
E: Some people get married. It is good to wait a while to know your husband is good before you get married.
M: Do you have a husband Elisa?
E: Yes I have husband.
M: For how long?
E: Ten months.
M: Oh, that isn't very long. Are you married?
E: No, but I would like to. I know now that he is good man.
M: Well then you should get married! And soon so I can come!
E: (Laughing) Yes, yes. Sometime.
M: Do you have a party when you get married?
E: No, not so much.
M: Oh, in the US it is a big ceremony with a pastor and many people come. They usually have lots of food and party.
So Elisa did you have a husband before this man?
E: Yes, but he bad and I not marry. He drink a lot, not good. But my boy is very good. Never ever drink and good worker.
M: Oh that is good that he didn't pick up bad habits from his dad.
E: Sarah are you married?
M: No not yet.
E: How old are you?
M: I am 23.
E: But no children?!
M: Haha! Nope, no children yet. I am still in school. It is hard in the US to have children when we go to school for many years.
E: Ah yes. It is good to wait. Do you have a boyfriend?
M: Yeah I do.
E: Yes?! But you are here! How do you have a boyfriend?
M: I actually just saw him 2 weeks ago. You know when we left to go to Corn Island? He flew on a plane from the US to Corn Island to see me.
E: Yes?! Oh that is far!
M: Yes it was very good to see him. We have been together for 2 years now.
E: Oh so long? But that is good. You need to make sure he is good man. Make sure he not drink alcohol a lot.
M: Yes, it is good to know those things.
E: And Sarah, if he is bad you come live with me.
M: (Laughing) Ok I will do that! But it is very unlikely.

As we walked back from the river together, one of the other translators came up to us and said something to Elisa in Miskito. I asked,
"Elisa, what did he say?"
"Oh he say you are my sister!"
"Yes, yes Elisa. You are my sister.

BOMB SCARE

2011-03-23T01:44:00.000-06:00

Finished with our survival and spring break on Little Corn Island, our group said our goodbyes to the island paradise and flew out of Big Corn to the town of Bluefields on the Atlantic coast of Nicaragua. I love flying into the little airport there in our small 12-passenger plane because it brings back memories from a mission trip I did to Bluefields in high school. When we fly in to the runway I can pick out and see the roofs of the building our group lived in and the church that we built. The airport has a long walkway out to the runway with a bright blue covering that I can remember walking down before.

We landed and hung out in the waiting room of the airport for 3 hours watching dramatic soap operas in Spanish. It is fun to make up our own commentary of what is happening on the shows. Finally our plane arrived to take us to Puerto Cabeza so we gathered our passports and belongings, and stood outside waiting to be allowed to board. We watched them gather all our big bags and start packing them into the back of the plane. Suddenly one of the airport attendants grabbed one of the large army bags, threw it onto a cart, and came booking it up the walkway towards the airport. He ran up to the security scanner and tried to fit it through in a bit of a panic. Wren recognized it as one of our bags and walked over to see what was wrong. She turned to the rest of us confused and said, "It's beeping?" We all gathered closer and could hear a definite "beep.....beep.....beep...."

A group of airport security had gathered by now and had some concerned, fearful looks as the beep started to speed up faster and faster. Beth turned to me and exclaimed, "Sarah! That's your Catchphrase game that Arthur left." We all laughed and tried to explain to the airport security men that it was just a game. They didn't understand and motioned for me to find it. So I opened the bag and dug down to the very bottom and pulled out the round little game that was beeping like crazy. They all looked relieved but then wanted me to turn it off. It turns off on it's own and has no switch to keep it off so we eventually had to get a screwdriver and take the whole back off so that I could pocket the batteries before they were satisfied that it was no longer a threat. We quickly boarded our plane and headed off into the sky, laughing to each other over the scare it gave that young attendant trying to get it to the scanner in time and being glad that it happened at this little airport in Nicaragua instead of a bomb crazy airport in the States.

Feeding the 5000...or maybe just entertaining a hundred

2011-02-20T20:31:00.000-06:00

On our 3-day clinic expedition, I packed my scrub pockets full of balloons and stickers for the kids as usual. As a last minute thought, I threw in a few extra handfuls of balloons into my bag. Usually I only give out to kids coming through as patients to avoid the mobs. On our last clinic, though, out in the furthest village of Polo, I felt more the remoteness and little chance the children have to see much out of their village.

About halfway through the clinic, my group was taking forever on a family. Since only one person can question at a time with only one translator in our group, James and I moved on to the other 2 kids in the family. We had fun playing with them while checking them out, listening to their lungs, making a big show of breathing deep so they would imitate, looking down their throats and in their ears. Really they were a healthy bunch, but since they never have access to medical care out there, every family in their entirety were coming in to be looked at with some rather bogus symptoms or just a couple family members actually sick. All of the kids definitely needed worm medicine. We got the funniest descriptions from moms of the different sizes and colors of worms coming out in their kids' diarrhea, mouths, and noses. One mom even said her boy had moths coming out! We exchanged some dubious looks at that one.

With the current family, James and I gradually gained the kids' trust and they began to show us all their little cuts and bruises. After finding a fungal infection on the boy's foot and prescribing some Clotrimazole cream for him, I finally pulled out some stickers to keep the kids entertained while their parents were being checked. Before I knew it, the girl had run off and brought back friend after friend for stickers too. With a group of 6 girls gathered around me, I tried to talk a bit with them in limited Spanish and Miskito. Soon they were all shyly repeating "hello" and "how are you" in English as I taught them. Wanting to keep the learning going, I grabbed a balloon out of my pocket and tried to get them to say "balloon". It was fun and soon each of the girls wanted their own balloon with a face drawn on it.

You can't go very long handing out colorful balloons without kids noticing. Soon I had a crowd around me of kids, big & small, watching the production and hoping for one. It was crowding out the clinic so I grabbed my bag and sharpie and headed outside. The mob grew, and I began to wonder if this was a good idea or not. There was no way I would have enough balloons for them all. So I tried to make the best of the experience, making a show out of it by making exaggerated faces while blowing the balloons, taking the time to draw a specific face on each one, and making the older kids pronounce "balloon" before they could have one. All the parents began forming a ring behind to watch and caught on that I was drawing specific faces. So they all started guessing which kid I was drawing next from the hair style, etc. Great fun. Sometimes I'd get a dud balloon that just didn't want to expand. I'd blow and blow, until all the moms would start yelling Ai! No! She's going to blow all her air out and die!

I kept on, kid after kid, and really began to worry about running out with all the kids so eager to have one. I never looked into my bag, just stuck my hand in and rummaged around until feeling another balloon. Over and over I did that, praying each time, "Please God, give me another one." It went much longer than I expected until finally, the dreaded moment where all I could feel was my headlamp, knife, and other supplies at the bottom of the bag. No balloon. My spirits plummeted. Looking up, there were still 10 kids I could count who hadn't gotten anything. Reaching in my scrub pocket, I found half a sticker page and started handing those out. That was quickly gone and I was at a loss for a moment before I realized that the sticker page outline had little clouds printed on it. I started tearing those out like little stickers, feeling rather apologetic for giving such a measly gift compared to balloons, but the kids were grinning still, just happy to be included. Got down to the last cloud, looked around and spotted one last little boy, shyly standing back. I beckoned him forward and planted the last that I had on his sweaty hand. The perfect amount. There's nothing like perfection to tell you that God was a part of it in our non-perfect world.

NOT THE END OF THE STORY

2011-02-17T21:43:00.000-06:00

On one of our past project days, Becky, Jeff, and I volunteered to go search out all the wells in the village here in Francia. So after breakfast we headed out into the first quadrant of the village walking on little trails between stilted houses. When we found a well, we'd ask the villagers around about it, noting anything broken, possible new well heads to be built, quality and depth of water, etc. I'd mark it in the GPS and then we'd trek off in search of another one.

It was great to have the chance to see deep into the village. The people are rather shy, sitting back in their houses waiting for us to acknowledge or greet them. Very unlike the boldness in Africa where everyone runs up to shake your hand and kids crowd around to follow everywhere. We ended up covering over 3/4 of the village by lunchtime, much more than expected. And that includes all the visits with people Becky knew. She was a student missionary here the same year I was in Africa and was getting the chance to greet some long, lost friends. One of the first wells was with a man with heart problems who actually stayed a year in the states for extensive heart surgery. He was barely able to stand up and greet us as he is constantly weak from the blood pressure problems and siezures he has. Later on we ran into Armando, one of the head elders of the church. He has taught himself English very well, so is always our translator when we talk up front. He invited us up on his porch to chat for a bit, noting that he needed some bleach for his well too. Also ran into a man who was so excited to see Becky. She helped deliver his wife's baby 3 years ago, so they dragged the chubby little boy out to see her. He promptly screamed and went running for his mom at the sight of us.

Towards lunch time, we happened across the house of a newborn baby that we'd seen a couple days earlier. The parents had brought the baby to Dr. Caldera because she was sick with fever and not breast feeding at 10 days old. He check the baby out and was concerned that she was developing some lower lung pneumonia. So seeing the baby, Becky asked if we could check her out. We climbed up on the porch and were happy to see that she looked much more hydrated but still had a fairly high fever. She was taking the antibiotics ok, so after some suggestions on how to keep her fever down, we left.

The next day, we decided to go check on her again after talking to Dr. Caldera. He was still concerned because he'd asked the parents to bring her back to the clinic right away to get checked, but they never had. So at lunch time, Becky, Jeff, and I headed back out to the house. I came prepared this time with balloons after seeing all the kids the day before. So while Becky checked out the baby, I blew up balloon after balloon and drew faces on them for all the kids in the family. This visit we were surprised to find 3 young babies on the porch and it took a bit to sort out which was the sick one. The other two were twins that belonged to a sister. Becky said the baby was doing better, fever down and breastfeeding. So we headed home feeling good that she was improving.

The weekend came and on Sunday, Brittany and I got called out on a house call with Dr. Caldera to check on an older lady with bad heart and blood pressure problems who was having trouble sleeping. Dr. Caldera is such a great teacher, explaining everything step-by-step and letting us do every part of the assessment with him. The lady, Olga, had a very irregular heartbeat and through Dr. Caldera's careful teaching we narrowed it down to the exact heart valve that was causing it. She also had too high blood pressure so we decided to get some meds at the clinic for her. Noticing that we were close to the little baby's house, I asked Dr. Caldera if he wanted to check her and he readily agreed. So I led them over to the house, but we were disappointed to find the parents and baby gone for the day. Questioning the family, we heard that the baby was not doing well. Dr. Caldera said it was very bad that they hadn't come to the clinic again and that they should come immediately once they returned. The family brought out the twins to be checked instead because both seemed to be coming down sick as well. One of them especially could barely cry and both their lungs sounded like the beginning of bronchitis. With promises to return with meds, and instructions to send the newborn with us, we headed back to the clinic.

The rest of Sunday went rather smoothly until that evening when Dr. Caldera was called to go check on the newborn who had finally been brought to the clinic. The new on-call team, Justin and Rebecca, went down with him. I was studying on the porch in a hammock when the 4-wheeler suddenly roared up and Dr. Caldera went running into his house. Soon he ran out with the news that he was taking the baby to the hospital in Waspam, and took off on the 4-wheeler again. Justin appeared soon after since there was only room for Rebecca to go. He said the baby was barely breathing when they got to her. While trying to study, I kept thinking about her, wondering how she could have taken such a bad turn since we'd seen her just 3 days before. I was also trying to imagine them driving all the way to Waspam on the little 4-wheeler since the truck was gone. It might be faster going around all the potholes, but very exposed and difficult to fit them all on and keep the IV in that little 14-day old baby.

A couple hours later Rebecca walked in teary-eyed with the words, "she died halfway there" and then walked out. Justin and I took a few minutes to say "that's too bad" and "they should have brought her in earlier." Then we looked at each other and Justin said, "are we really un-feeling people?" After seeing Rebecca's anguish, our quick "wish it would have turned out better" seemed short and not enough. We've both already seen so much death, though, during our times in Africa that this just seemed like another one. Justin said that as soon as he saw the baby, he had no hope that it would make it to Waspam. We talked for awhile about how to balance expecting and being ok with death while also believing in the power of God to heal. We finally came to the simple conclusion that we would at least wish and pray to feel the same that God would feel over the death of that baby. I think God feels anguish over the suffering that happened and the loss the family will feel, but also joy and excitement over the knowledge that death isn't the end of this story.

THE WEEK I TURNED 23 YRS

2011-02-15T19:55:00.000-06:00

Celebrated with banana bread, a candle, & friends.

Saw over 100 patients in the village of Miguel Biken on Tuesday.

Worked Men's/General Pathology with Dr. Peterson & saw the results of lives full of hard labor and surgery cases to refer to Waspam.

Cut and popped some kind of parasite and larva out of Alex's foot.

Pitched tents around the clinic for the night.

Saw a huge scorpion on Jeremy's pack.

Got to call on the satellite phone for a few minutes for my birthday!

Woke up early on Wednesday to grab our backpacks & meds and hike 2 hours through the jungle to the village of Kapri.

Mud, mud, and more mud.

Set up clinic in Kapri in the little catholic church.

Worked Women's with Dr. Caldera and saw many pregnant women and STIs.

Made ramen noodles for dinner over a fire outside.

Pitched a tent for the night with a circle of curious onlookers.

Listened to crazy massive pig fights all night.

Rain.

Packed up in the morning, left personal stuff at the church and carried all the meds & clinic supplies to the village of Polo like porters in a line through the jungle.

More mud including some massive 3 ft deep holes with slick little logs to tiptoe across on.

Clinic all day in Polo, seeing practically every person in the villaage, family by family.

Thought we'd have to turn patients away to leave in time, but decided to just stick it out & chance hiking out in the dark.

Worked pediatrics with German med-student David, treating tons of worms, parasites, sinus infections, bronchitis, and UTIs.

Flew through tons of Albendazole, Mebendazole, Metronidazole, Amoxy, Doxy, and Cotrimoxazole.

Saw first case of intense Leishmaniasis, also known as Mtn. Leprosy, on a 14 yr-old girl.

Gave out every balloon & sticker I had with me to the crowds of kids.

Finally packed up to leave and hoofed it back to Kapri through all the mud pits again.

Grabbed our backpacks and after an intense pouring of rain, headed out on the long jungle trek back, slogging through the trails.

Darkness came and we got to hike by the light of the moon and stars, listening to the jungle come alive at night.

Arrived in Miguel Biken and finally met up with the truck for the long drive back to Francia Sirpi, our village.

Truck's headlights were fairly nonexistent so a couple guys had to ride on the hood, shining their headlamps on the road.

Listened to Tyler's farm stories and all the guys' battle wound stories all the way back.

Finally home with a big meal Mrs. Brown had prepared for us!

What an expedition!

EMERGENCY

2011-02-06T23:22:00.000-06:00

If you were told there was a major bus accident with many injuries and had 30 seconds to grab whatever you needed, what would you grab? And that includes not knowing how far away it is or how long you will be gone.

Today we went to the Adventist church here in Francia Sirpi. I think we tripled the amount of people there. Everything was spoken in Spanish and Miskito, so David sat behind us during the sermon to translate into English. After church we walked back up to the mission to eat lunch. Some were still down at the church when word came in that there was a large bus accident down the road a ways with many people hurt including some church members returning to Francia.

So I was sitting on the porch when Ryan ran up and asked if I wanted to go.

“Go where?” I asked, having not heard anything.

“There's an emergency. Go grab your water and jump in the truck.”

So I ran up to our cabin, pulled on some scrub pants, and quickly grabbed anything around me that looked helpful....my stethoscope, a few granola bars, sunscreen, headlamp, and jacket in case we stayed after dark. I ran out to fill up my water bottle but we ran out of water after only filling it halfway. I jumped into the back of the truck along with the 3 other students, the SM girl here, our leader Jeff, Dr. Peterson, and a German nurse doing a rotation for medical school out here. We took off and I heard the news that they thought a bus on its way to Francia had rolled. Everyone was speculating on how many injuries that could mean, how to respond, who to leave at the site while transporting patients, etc. I just sat down in the back and got comfortable for as possible for a long ride on the bumpy road, remembering all the miscommunication that usually happened with emergencies in Africa.

We drove through the village on our way out and stopped to talk to the church members about the accident. Within a few minutes, the German nurse, David, started mumbling excitedly in German and finally in English, “Why aren't we going?! Why are they wasting time talking!” As the trip continued, he was continually fidgeting and exclaiming, “How far is it? Are we ever going to get there?!

The SM girl, Brittany, and I kept responding with, “It's ok. There is no rushing it, and there's no reason to be worried so much about it until we get there and see the situation.” In my mind I was already wondering if maybe it was just a car or truck instead of a big bus coming all the way out to the village. Brittany started getting very concerned that there was only one other person along besides her that spoke Spanish well. I kept trying to reassure her too that we would be fine with our basic Spanish and hand gestures. Anyway, it turned into a long bumpy ride where I felt like I was constantly saying, “relax, we'll figure it out when we get there.” Looking back on it now, I wonder where I became so laid back. I can certainly have my times of wanting to have everything planned out and analyzed. And how can I say, “don't worry” when I'm a huge worrier at times. I think it's something to do with the “overseas mode” coming back to me. Letting things slide along as they come, not getting anxious about things we don't even know.

About a half hour down the road we stopped a moto driver heading the other direction. He surprisingly told us that he hadn't seen anything on the road on the way in. No accident, no large amounts of people, no bus. So we decided to head back to the village until hearing more. David immediately got anxious again, poor guy, so worried that we might just be leaving people out there to die. But we couldn't just drive out blindly, wandering around with not even a confirmed report. They had probably already all been transported to the hospital in Waspam if it had happened. As Brittany and I agreed on that and about waiting back at the village, he looked at us like we were ogres or something. I wonder if I'm too calloused already from past experiences. I returned to the mission without much of a later thought on what might have happened, knowing we might never know. All the students were sitting around in their scrubs, prepared for patients when we arrived and there was a bit of a collective disappointment when they heard the news. No, we aren't crazy EMTs always wanting people to be hurt, we just want to be there when it happens so that we can help!

Internet!

2011-02-05T15:54:00.000-06:00

This post is coming from my own hands on the internet. Exciting to be on for a little bit. We are at Clint & Marilyn's house a couple hours from our village. Clint is a pilot out here and they have quite the nice house and compound out here. Can't write much, but we are able to get some emails out through the ham radio now in Francia so I will keep trying to send a few blogs. Mobile clinics have been great and this next week we will be doing an epic 3-day trip doing clinics at 3 different villages. So driving to Miguel Beacon on Tuesday, walking to Kapri on Wednesday, walking to Polo on Thursday, and then walking/driving back to Francia that night if possible.

Hope you all are well and happy :) I've been sick with something for 2 weeks now which just lately has been diagnosed by the doctor as either strep throat, mono, or some other virus. Not fun. My tonsils are so covered in white right now, they look like 2 cotton balls in the back of my throat.

Love you all,
Sarah

The Tarantula/Cockroach Dance

2011-02-04T19:58:00.000-06:00

With the tropical weather, I've been pushing myself to drink massive amounts of water. But with that comes many trips to the outhouse...including at night. I have learned to be prepared for those nighttime jaunts both physically and mentally. As the air cools considerably in the evening, apparently all the tarantulas are attracted to the warm little outhouse sitting out there in the field.

So when the need is too great to ignore, I creak out of my cot, grab my trusty headlamp and slide my way precariously on the mud trail to the outhouse. First comes the outside inspection where I walk around the building and check for potential intrudors. Usually there's a big hairy tarantula or two hanging out on the walls. I mentally file away their locations and expected amount of time they would take to reach an entry point. Then I slowly open the door and start scanning from the top down because having a tarantula jump down on me is more disturbing than one along the ground in reach to step on if needed. Last time I arrived at the outhouse, I found 6 furry bodies with 12 beady eyes flashing back at me.The problem is that they don't conveniently congregate in one spot. While staking out their own private real estate, it makes four directions for me to monitor.

The other creature I keep an eye out for are the cockroaches. It might be disgusting to mention, but there are hundreds of cockroaches hanging out in all the glory down the hole. But when few humans are frequenting the building and nighttime arises, the bravest of the cockroaches come scurrying out of the hole to explore the surroundings.

Thus begins the dance. It is quite a workout to be squatting up over the hole, constantly turning my head to check on all the tarantulas who freeze in the light, and then be jumping my feet up and down to dodge the myriad of cockroaches going crazy as the light shines on them trying to run back to the hole. It's like practicing Capoiera, the Brazilian fight dance that Jeremy is teaching us. I guess the positive part of the experience is the extent to which it exhausts me to go back to bed.

DAY 4 - January 21, 2011

2011-01-31T20:20:00.000-06:00

In Nicaragua for the 4th day and it feels so great to be hearing the generator running in the background at the mission. My mind has been constantly comparing this place to the other places I've been, especially Haiti and Africa. Justin and I were just discussing today as we walked through the village, how the standard of living here seems much better than where we've seen in Africa despite being the lowest in Central America. Almost every house has a tin roof, they have pumps on the top of wells, and so many animals running around. All the houses are built up on stilts to keep away from bugs, although right now I'm sitting in the dark writing with my headlamp on, and there isn't a single bug flying in my eyes! Sonya, Liz, and Hans – you know what I'm talking about. Working night shifts at the hospital in Africa, and being attacked by all the bugs attracted to our lights as we gave out medications. And I mean bugs up the nose, in the ears, down the scrub shirt, and in the morning we'd clear an entire layer of dead bugs off the desks in the wards. Here in Nicaragua the air is so clear at night!

And everything else seems to compare that way with Africa looking more extreme in every aspect. We went to the market in Puerto Cabeza to buy food and hardly got a few side looks. No mobs of kids touching us or people laughing at every word. There is an abundance of all types of food here. The outhouses have a cement block with a toilet seat on it to sit on. I actually miss the holes in the ground in Africa because it seems more sanitary than sitting on the nasty seat. So I've been climbing up on top and squatting over the hole. Haha! I never thought I'd miss that from Africa.

But I do wonder about this desire I have for things to be hard like in Tchad. Maybe because that experience pushed me so much in every way, making me grow in ways I didn't even know I could. And now I'm wishing for that again. I want experiences to happen even if it's hard. I'm sure it will come and then I'll be wondering what I was wishing for! The first few days here have just been so lax and laid back. I should probably cherish them. And I'm sure I'll be finding experiences unique to Nicaragua like the 3 tarantulas we've chased out of the girl's cabin already!

TIME & EXPECTATIONS

2011-01-20T20:48:00.000-06:00

We have been riding the bus nonstop since 3:30 yesterday until around 5 this evening when we made it to Puerto Cabeza. Still have another 4-8 hrs to Francia tonight depending on how bad the roads are. It was a fairly nice ride on the bus in my opinion. We only had a flat tire once during the night and otherwise have just stopped for some food stops.

I was thinking about this last Christmas break when I went shopping with Arthur and my step-dad a few days before Christmas. We were leaving the mall and got stuck in the hoards of people also leaving. We sat for probably an hour hardly moving until we finally made it out of the mall parking lot. I can remember feeling frustrated, not believing that it could take so long just to get out of a parking lot. Thinking back on that now, I wonder how I can feel so differently on time. We spent 4 hours in Managua just waiting for our bus to arrive. When a friend came to me worried, asking if I'd heard anything on why it was so late, I just smiled and said, "We just wait. It's what we do here." Then we just spent the last 26 hours riding on a bus that hardly passed 20 mph because of the constant holes to bounce through with dust billowing inside like a Saharan dust storm. But despite the cruciatingly slow pace, I really didn't care. I guess it's the differences in expectations. Here I don't expect to go anywhere at a fast pace and there aren't really any deadlines to meet. In the States I expect to be places in the time I've allotted in my schedule. People are expecting me to be timely and punctual. Oh how great it would be to not have that time push back at home. To feel free to travel at whatever pace feels comfortable and even stop along the way to hang out and talk with friends. I wonder if it would make us more apt to help out that person on the side of the road or take more time in communication to actually understand the other person and their needs if we didn't feel pushed to just say what we need to say and get on with the day.

Right now most of the group is sitting by the bus just hanging out. We already ate dinner and bought dinner for the next week so I don't really know what we're waiting for instead of just leaving for Francia, but no one seems to care. We'll get there.....some time. And right now in the moment, it's great to just sit and laugh together.

Nous sommes arrives.....or llegado....

2011-01-19T07:39:00.000-06:00

We have arrived in Managua, Nicaragua! (and there is internet at the hotel!) Every time I open my mouth to speak, French comes out instead of Spanish. It's like being in a foreign country brings out the foreign language, but not necessarily the one that fits. I say "avec" instead of "con", "oui" instead of "si", "et" instead of "y", "ici" instead of "aqui"...and it's those little words that mess up my sentences. We stayed the night at a very nice hotel across the street from the airport and are planning to pack up the bus and leave at 11am after exchanging some money. Should be an epic 30 hour trip across the country. So long! But it will be great to see the entire stretch of the country from west to east, Managua to Puerto Cabeza and then north and inland into Francia Sirpi. Can't wait!

Off to Nicaragua

2011-01-16T12:38:00.000-06:00

Back to dirty water, poisonous snakes, and rice in abundance.

Back to smiling brown faces, stumbling through different languages, and stickers for the kids.

Back to sweaty scrubs, dirty wounds, and handing out medications.

Back to malaria, parasites, and fever.

Might sound a bit uncomfortable or intimidating, but it is like music to my ears. It is like going home. Tuesday evening I will step foot into Nicaragua for the next three months with my 16 other companions. It is my final semester before graduating in May with the classes Emergency Care II, Global/Public Health, Relief Infrastructure Practicum, Travel & Tropical Medicine, Jungle/Coastal/Ocean Survival, and International Relief & Mass Care. The fun is that these aren't the classic "sit in a desk and listen to a lecture" kind of classes. We get to get our hand's dirty building wellheads and other community projects around the villages. We get to don scrubs and hike out with supplies to do medical outreach clinics. We get to sit in a little boat for 24 hours anchored out in the ocean, enjoying the misery of surviving together.

As with any trip overseas, I don't know what is going to happen and if we will do what we've been planning on. But I do know that I will enjoy it immensely and be challenged immensely. And I hope that I will also grow immensely closer to God.

Updates on this blog will happen whenever possible when we travel through towns with internet. Otherwise, I will see you all the end of April!

So many trapped

2010-02-18T13:06:00.000-06:00

January 19

Imagine if you would...

Eight years old, waking up to a terrifying darkness, dust and grit mingle in your mouth and crunch against your teeth. You feel around and find your body wedged into a small space surrounded on all dimensions by heavy concrete. Sounds around you start to distinguish themselves, far off screaming and crying, closer moans wafting up through the same prison. As the situation clears in your mind, you remember the terrifying shake where your solid safe home crashed down around you, unlike anything you've known or understood in your young years. You start to scream for help, but it just adds and mingles with the rest of the cacophony. Times stretches out in endless dark moments, not knowing how your story will end.

The thoughts of what this young boy must have gone through were running through my mind today as we started our search and rescue mission. We were able to find transportation from the airport this morning in a dump trunk from the UN and traveled immediately out to the Adventist hospital in Port-au-Prince. On arrival, the doctors were rushed off to begin medical help immediately and our group was rushed into preparing right away to go out in the city and search for people still alive under rubble. There were reports that they could hear people calling for help and making noises still.

So we gathered our gear and led by a lady from the hospital, walked out with a large group of Haitian men, eager to be our manpower if needed, and a small surgical team, prepared to do onsite amputations if needed to extricate people. We very quickly created a large mass walking down the concrete strewn streets as more and more people added to our group out of curiosity or hope perhaps at the site of our rescue gear.

The first building was a school with a restaurant underneath. There was a dead body sticking half out of the ground level right in front of us, like a beacon forcing us to look. Some men told us that the lady had been alive after the quake, but while trying to extricate her by tying a rope around her legs and pulling, she died. After looking for openings under the collapsed sections, interviewing neighbors, and taking the dog around, it became clear that we couldn't find any sign of life or possible area to even enter to search. With time ticking away, there was an urgency to go to places where we knew there was life. The lady from the hospital leading us, pleaded for us to go to her own home just down the road where she had talked to her nephew under the rubble just the night before.

As we strode down the road to her house, she began telling the sad tale that has stuck in my mind. After the earthquake, she rushed home to find the entire multistory building collapsed with multiple family members crushed inside. She eventually heard her only son, trapped under big concrete slabs on one side of the house. She kept talking with him until a UN team came to help with heavy machinery. They were lifting one of the concrete slabs off of him when it fell, crushing him instantly beneath it. She buried him and then was able to also hear her little nephew on the other side of the house trapped as well.

Just 8 years old, as the days went by, he told them that there was an injured woman near him also trapped, and a dead body that he could smell. He was kept alive from a broken pipe near him that was dripping water that he drank to keep hydrated. People digging to get to him found the injured woman and she was alive in the hospital being treated. However, they never could get to the boy. When we arrived at the huge rubble pile, there was a Colombian SAR team at work trying to dig in the area the boy was heard. The woman said that her nephew had quit making any noise the day before, but she thought maybe he was just too weak or unconscious.

We sent Janey with her dog, Zeus, around the building. Zeus is trained to distinguish live people from dead. There were some bodies in the back out in the open that animals had been feeding on which threw him off a bit, but soon he was picking his way back over the rubble. In the area with the boy, he kept circling around and then finally laid down which is his signal that there is a dead body. It was sad, but the woman told us that she was so thankful to know that he was no longer suffering down there. It helped give her closure.

We continued throughout the day to trudge around the city and each time the outcome was much the same. No one alive. We got kind of lost for a bit and wherever we went, people would see us with our gear and start calling and pleading for us to come check their buildings where they thought people to be. We walked through little alleys, tried to jump over nasty puddles of water, kicked trash off our shoes...

Finally returned to the hospital well spent as the sun started to set. I think about all the people that maybe are so deeply trapped that we can't hear them or know they're alive down there. It has to be terrifying to consciously know that you are just stuck and going to die there. How would you even know the passing of days? In some sense, I'm almost relieved to not have found anyone alive today. It would have been near impossible in most of those buildings to try and extricate someone without some heavy machinery. And that would be awful to hear someone and not be able to do anything about it, especially with so many people looking on, expecting and hoping.

2010-01-26T12:12:00.000-06:00

Airport hanger in Miami with all our supplies

Zeus. The most amazing, trained search and rescue dog ever!

Our team from Union College working in conjunction with ACTS World Relief

In Haiti, sleeping on the airport tarmac, being blasted by hot jets every few minutes

One of the many military transport planes coming in and out of the country bringing supplies.

Arriving in Haiti

2010-01-25T22:42:00.000-06:00

January 18

We are in Haiti! But we haven't traveled more than 500 ft. from the plane... The entire day has been filled with change after change, but we just keep going with the flow and whatever is the plan for the next 5 minutes. After changes in planes, changes in airports, and not being sure we would even be allowed into Haiti, it was finally back to the original plan. We flew out around 6:30pm after spending the entire day in a big airport hanger at the Opa Loca airport. A cool Jewish guy funded all the trips to Haiti in his private leer jet ($30,000 a trip) that held 13 passengers at a time. We got to be the second team going out, but on the flight over, we heard that the airport was going to be shut down again the next day, so no more of our teams were going to make it.

After circling for over an hour above Port-au-Prince, we were finally allowed to land. There were tons of planes that our pilots were constantly dodging around in the sky, all trying to get clearance to land at the airport overfilled with huge military transport planes.

Walking off the plane, my skin felt sticky immediately although the temperature wasn't all that bad. After unloading the plane with all our supplies and gear, we found a spot just a ways down on the tarmac to set up camp. The recent news was that all the roads were closed due to curfew that was just started tonight. So we can't leave the airport till tomorrow morning. Even then, we have no transportation to take us to the hospital or anything.

Since the airport structure is declared unsafe (I can see huge cracks up the walls and broken ceiling at some levels) we are just sleeping right outside, next to all the planes that are rolling in and out. It is quite the experience! The military has some amazing huge planes that just about shatter my eardrums.

My voice is already going hoarse from yelling constantly over the plane engines...and now we are attempting some sleep with pieces of toilet paper stuffed in our ears.

Heading out to the latrines at the edge of the runways, we saw a huge line of mostly Haitians, waiting to leave the country. It looks chaotic to have everyone and everything out on the tarmac, but I still feel like it's at least controlled chaos.

Who knows what tomorrow will bring. There is a SAR firefighting team from California next to us and they said they found a live person today. So there are still people hanging on under the rubble. We have an amazing search and rescue trained dog with us, and I'm excited to see him at work.

Traveling Thoughts

2010-01-24T17:49:00.000-06:00

January 17, 2010

Haiti. My first time back overseas since I returned from Africa two years ago. Before leaving for Tchad, I had many months to prepare myself. Granted that was for a whole year and this is just for a week, but one day is just not enough time to be ready for what I can only imagine awaits us. And I don't mean being ready in the sense of having my bags all packed and saying quick goodbyes. I mean being ready emotionally for ugly devastation and very possibly entering the biggest disaster I will ever respond to in my life-time.

I know what poverty looks like, I know what horrific medical conditions look like, and I know what death looks like. My time in Africa included daily doses of it all. But all of that was cushioned by the people accepting and living with their lives that way. They knew how to enjoy their days despite the extreme hardships they faced, and taught me to do the same.

In Haiti, however, the people won't have that peace of mind to pass on. They've just had their meager belongings and homes ripped from their hands. They've seen their dear friends and family crushed under poorly constructed bricks. And they are alone in the grips of survival since everyone around them is grappling to deal with the same disaster. If Haiti is anything like Africa and how I've seen many 3rd-world countries to be, community is everything. Everyone's lives are interconnected and I can't imagine how that has been affected. Surely a disaster in the U.S. is devastating, but how much worse it would be if we actually knew every one of our neighbors personally and to then lose half of them instantly.

As these thoughts all whirl around in my head, we are in the air, flying towards Miami. During the quick half hour we speed-walked through the Houston airport, we received a call from the ACTS world relief director we will be working with. Before we left, the plan was that we would be working with some orphanages and hospital, so it was a surprise when he asked if we had packed any rescue equipment. Apparently the new plan is that we will be heading out in search and rescue among the debris.

I am not surprised that what we thought we would be doing has changed. As I was telling the reporter last night and TV crew this morning, if there is anything that I have learned from my trips overseas, it is that flexibility is a must. And that I almost never have actually done what my initial job description said.

It might even change again by the time we land in Port-au-Prince. When I think about search and rescue, it brings mixed feelings. Initially I'm excited about being out in the front of things, finding and rescuing people. It is what many of us heroically dream of doing. But honestly, when I think about it, how many live people are there going to be to rescue after 6 days. This more likely will be a task of locating and extricating bodies from the rubble. Even if we did find someone holding on, are there even trauma centers or good medical facilities to just whisk them off to? So it will certainly be a grim task. I also doubt more my skills in search and rescue. I haven't even done the SAR training in Colorado yet for my degree. There are so many other IRR students wanting to come who are so much more qualified than I am. I am very comfortable with the medical side of things, but setting up pulleys and systems to extricate people is different. At least I have some rope knowledge from rock-climbing...and despite my doubts and misgivings, I know God is sending me for a purpose, if none other than to remind me that it isn't by my power that people will be saved, but by His.

Well, we are landing in Florida now and must immediately head out to buy supplies that the commercial flight wouldn't allow us to carry. And it will be necessary to pick up as much rescue equipment as possible for our new job. The plan has been to fly out on a chartered jet sometime tomorrow morning to Haiti and I have heard that our team will be one of the first to be ferried over to get search and rescue in action immediately.

Haiti Blogs

2010-01-24T17:34:00.000-06:00

I just returned from a week down in Haiti helping with relief efforts after the January 7.0 earthquake that devastated the country. In many ways, I felt like I was going home, being the first time I've been back overseas in a third-world country since my year in Africa. Every night as I crashed on my pad for sleep, I did some journaling. There was so much to write about, although my exhaustion kept me from documenting all of it.

However, I now plan on typing up my journaling one day or so at a time to share our experiences. For those that don't know, a group of 4 students and a faculty member from my college were given the chance to travel down to Haiti for 5 days and start relief work with plans of more students to come later on. It was a great chance to use our skills that we have learned in the myriad of classes we've gone through for our degree in International Rescue and Relief. The college was amazing in so quickly approving our trip, excusing us from classes, and providing the financial means until we can raise the money to cover it. I found out last Friday evening I was part of the group leaving, and we were on the plane by Sunday morning! Bit of a hectic rush getting packed for the unknown, trying to get typhoid shots in the middle of a holiday weekend, and answering all the reporters' questions.

Anyway, the trip started with a day of traveling to Miami, and busy evening of gathering needed supplies...

MISSION: Pumpkin Pie

2009-10-22T19:10:00.000-06:00

I have always had a desire to make a pumpkin pie from scratch. From a really wonderful regular orange pumpkin. I don't think Arthur was as excited about it, but being as amazing as he is, he took on the challenge with me.

First lesson learned in the process...There is a difference between a regular pumpkin and a pie pumpkin. We got very acquainted with the local produce stand by the time we had finally acquired everything needed.

The initial excitement...

But that started to dwindle after
separating the seeds
cooking
scraping
burning the hands
pureeing
remembering that we needed a pie crust for a pie
lots of unhealthy ingredients added
getting sick of the color orange
it took hours...

But such fun hours! I'm glad we are both so optimistic. A comment starting with "Oh dear..." or "We forgot..." would just end with gales of laughter. Then the delightful end! Mature and complete, not lacking anything.

Makes me think about relationships.
The initial excitement and delight just knowing each other. Exuberantly happy, starry-eyed, little kid on tip-toes looking at a candy jar kind of excitement.

Then time continues and there are little changes. You forget the need to be courteous about everything, it feels just normal to be together, and perhaps even gets to challenges and disagreements.

But time continues still and you learn to appreciate the whole experience as your relationship becomes mature. And even laugh at the mistakes.

Beginning Again

2009-10-21T10:20:00.000-06:00

It is time to rebirth this blog, for multiple reasons.

1) I feel the urge to just write
2) Give my parents another way to know that I'm alive across the miles besides having to join facebook :)
3) To recognize the amazing little things that happen throughout my days that I don't take the time to notice
4) In writing, scattered, fragmented thoughts become whole
5) I am inspired and refreshed whenever I read Sonya or Emily's blogs or one of the multiple friends out as SMs. So perhaps that inspiration that I gain from them will pass on to someone else as I explore the fullness of life in and around me.

Malaria...AGAIN

2009-04-07T22:16:00.000-06:00

How did this happen?? I am quite perplexed. But the symptoms don't lie and the test was confirmed yesterday. I have malaria parasites running around in my blood again. God, you know I miss Africa...but maybe not this much! I think I could do without the fevers, nausea, headaches. I feel like I should be in Tchad, lying out on my mat, my African family all laughing about me living up to my name "La malade" (the sick one).

One thing I do miss is that when I had malaria in Africa, I still continued to work at the hospital as much as I was capable. Still helped people. It made the focus on them instead of me. Here, everyone is freaking out, trying to get me into the hospital. I appreciate the concern. It is so nice to know people care. But I really wish I could change the focus that is on me. It makes me feel so sorry for myself, thinking about how I'm getting so behind in classes, feeling awful,.... How do I explain that I really just want to go do a surgery on someone right now. I want to go hand out quinine to the other 20 people at the hospital that have malaria with me. There were those moments where I'd watch a kid take his last breath and realize that he just died from the same disease that was raging through my body at the same moment. But that made me realize how my life is totally God's. If he was still giving me life, than he has a purpose for me. Am I continuing to look for and follow that purpose? Maybe this malaria bout is a good reminder.

God, I am yours.

Frustrations, Africa, thoughts...

2009-03-04T17:23:00.000-06:00

This week has been one of the most frustrating...so much has seemed to go wrong...college is wearing me out, my car broke down, and I want more sleep!!! This morning, I was at the point of running in a hole to hide from any contact with the world (there are no mountains to run to in Nebraska, so I'm stuck with holes). I realized that I was desperately needing a mind shift -- so I took a class period today to talk with God and remember amazing things He has done. Automatically my thoughts turned to Africa as they often do, and it didn't take very long for me to get to the point of "God. You've done so much in my life. Why do I ever even doubt?" Everything that has happened this week seems so small now in comparison to the things I faced in Africa. I was just realizing that I haven't really been sick since before Christmas! Three months being healthy?! That was unheard of last year, when I counted myself blessed to go maybe two weeks without being ravaged by another bout of malaria or some other parasitic disease.

I can also see how living back in the States, being in college, has changed my thinking so much more inward instead of outward. Everything I'm worried about and frustrated with has to do with myself. I remember when all my worries were consumed with my patients, the people around me...when did that change?

My thoughts today have come to, "we are not of this world" therefore, why do I even worry about things in this world. They are nothing. This morning I listened to the song "I will lift my eyes" by Bebo Norman that we used to play over and over in Africa. Such good thoughts.

God, my God, I cry out
Your beloved needs You now
God, be near, calm my fear
And take my doubt

Your kindness is what pulls me up
Your love is all that draws me in

I will lift my eyes to the Maker
Of the mountains I can't climb
I will lift my eyes to the Calmer
Of the oceans raging wild
I will lift my eyes to the Healer
Of the hurt I hold inside
I will lift my eyes, lift my eyes to You

Just the thought I need to hold onto right now,

I will lift my eyes to my Maker...

O Christmas Tree...

2008-12-09T17:38:00.000-06:00

This Sabbath I got to go find a Christmas tree to cut down with my friends Keri and David. I couldn't help but think of when Liz and I decided we needed to find and cut one down in Africa last year. That "tree" had 3-inch thorns sticking out of it, but otherwise I would have to say that trees here in Nebraska look as Charlie Brownish as the bushes we found in Africa -- rather sparse. But it smells good! Everyone on our hall can smell our tree.

A week pursuing God...

2008-10-27T10:13:00.000-06:00

So yesterday ever since I woke up, I had this intense feeling that God was trying to get my attention. I spent a while praying, contemplating, listening...but felt like I wasn't every truly giving God all of my attention because of all the distractions on my mind. I also haven't had the time with God these last couple weeks that I wish to have each day. So this led me to my decision that I am going on a fast this week. I have never fasted before, but felt lead to do it, so I will be fasting until Sabbath - just liquids and some fruit to keep me from my propensity to pass out :-) I'm also going to cut my study time in half each day, and use the extra time to completely focus on God and my relationship with him. I think it is going to be difficult but also very rewarding. I don't expect necessarily that God is going to reveal some amazing thing to me...maybe all he wants is for me to see how such a daily focus on him can change my thoughts and keep me looking up more. I just ask that you keep me in your prayers this week. I just realized that God sure picked the right week to challenge me in making time for him as I just received my French course that adds 3 credits to my already full class load. AND I am starting my 2nd job tomorrow that will probably add about 20 hrs. of work to my week. But I'm determined to do this - this week.

Part of my goal...

"The place where we must always register God's presence is in our minds, our thoughts and feelings, our inner being. That means that my job in my spiritual life is to learn to continually focus my attention on God...the practice of spiritual life boils down to one single statement from Scripture: 'I have set the Lord always before me.' Psalm 16:8"
-Now What by John Ortberg (one of my favorite authors)

Romans 12

2008-10-19T20:34:00.000-06:00

So here's what I want you to do, God helping you:

Take your everyday, ordinary life—your sleeping, eating, going-to-work, and walking-around life—and place it before God as an offering.

Embracing what God does for you
is the best thing you can do for him.

Don't become so well-adjusted to your culture that you fit into it without even thinking.

Instead, fix your attention on God.
You'll be changed from the inside out.

Readily recognize what he wants from you, and
quickly respond to it.

Unlike the culture around you, always dragging you down to its level of immaturity, God brings the best out of you, develops well-formed maturity in you.

Memories

2008-10-17T10:57:00.001-06:00

Little things here and there send my mind whirling back to memories of last year. We just dissected pig lungs in my EMT II class and the clamps and scalpel in my hand felt strangely familiar. I can see a vision right now of Dr. Bond doing a gallbladder surgery and suddenly hitting a bleeder that shot out spurting blood all over both of us. He kept trying to clamp it, but the area was too small and deep to get his hand into. So while holding pressure on it, he gave me a quick 30 second lesson on what I should do, handed me the clamp and had me stick my small hand down into the hole and clamp it off.

Today I was washing my hands in the dorm bathroom. When finished I realized there was no more paper to dry my hands off with. As I walked back to my room with my hands held up dripping, I started having visions of scrubbing in to surgeries in the outer room of the OR in Bere and then learning to kick with my foot just the right way on the door handle to open it so that I could enter without contaminating my hands. (It didn't work on my dorm door)

Anguish

2008-09-22T21:59:00.000-06:00

So forget that last post. It doesn't matter what I do, my mind is completely caught up in Africa. I've tried so hard to focus on my studies, on my dorm pastor job, on making new friends, on ANYTHING!!! But my thoughts are consumed with Africa, the people in Bere, and mostly - Darfur. The fact that thousands are being killed while I'm listening to lectures is driving me crazy. I've done everything I can think of to be a part of what's happening over there, without actually dropping everything that I'm doing to focus on it. But calling representatives and senators feels like a lost cause. Telling the people around me has been frustrating as they don't care. I've been careful to conceal the battle going on inside me as I do the expected duties as a student, but I'm afraid of breaking apart soon.

This evening I felt so tormented by it, that I was pacing back and forth in my room,
not knowing what was happening to me or why I am so obsessed with this. My mind is a multitude of thoughts and pictures that keep reeling around and around and multiplying. If I sit around another week just going along with my little American life, I'm going to go insane! Why am I feeling so much anguish God? Are you trying to tell me something? Should I forget society's expectations and go follow my heart and get involved? Or is this just another phase I need to work through and get over? I am so confused! I cry almost every night now for people that I don't even know. Why? It takes me hours to fall asleep at night because of my thoughts. Why?

Why can't people ever see our world as just that - one whole world, one group of people. Everything is broken up and divided into our countries, jealous for our own prestige and success, only reaching out to others when it helps us. We are all humans! One people created by God. When will the horror over there stop?

I've tried to ask for advice from the people I usually do, and explain the anguish I feel, but this time it seems no one has understood. I get told to focus on the ministry around me, and I've tried! I get the feeling from others that they think I'm just in a transition phase still from last year...and maybe I am. One person I talked to and poured out all my feelings and frustrations and horror on the terror going on over in Darfur. After I finished, I heard a pause, and then they asked, "How is the weather over there in Nebraska right now?" I couldn't believe it! Did everything I just say just pass through deaf ears? Am I just a maniac with crazy thoughts that no one else thinks? Tonight as the tears came again, I searched my phone for someone to call who I could talk to about it, but finally gave up. So I'm writing in this blog again to at least maybe give me enough release from my thoughts so that I can sleep.

I could just go on with my life and ignore everything, or make a rash decision and quit school to be a part of something, but I'm not satisfied with either action until I feel God with me in it. So I guess I will just keep searching and asking God for answers.

Love God, Love People, Love Life

2008-09-17T12:55:00.000-06:00

I've felt the weeks of school dragging by as my mind is constantly on Africa. I constantly bemoan the fact that I can't be there and have seen no point to the endless lectures and classes.

Today, though, I realized that it is time wake up and enjoy the life God has given me! Close to a year ago, I should have died, but God showed that He still has plans for my life here on earth. So why am I living every moment in the past?! There will always be a part of me in Bere and maybe I'll even go back, but right now is the time to focus on what I'm doing here and now. And I'm not talking about focusing on myself, I'm talking about focusing on the people around me right now. God has called each of us, individually, to serve.

This new outlook is making my mood better, and has started to reveal areas that I've changed since I was in Africa. I was sitting in the cafeteria today listening to the people around me talk and I was amazed. The popular topic was the new chapel credits that everyone is "forced" to get each semester. Most students are upset that they are now required to go to some chapels and are even finding ways to protest. While I understand some of the frustration and feelings that we should be free to decide what we want to go to, why do we always just see the negative side of things? We are given such an opportunity to have a place to worship, to have such wonderful services planned for us! Last year I would have died to go to a vespers/worship/chapel service just once! I missed the fellowship and worshiping of God so much.

That thought led me to the next topic of how expensive the cafe food is, which I am guilty of complaining of almost daily :) Why do we complain so much?! I looked at my meal today and thought how blessed I've been to have so many different choices, and amazing tastes. No boule or spit sauce. And the water...we have clean clear water by the gallons! No worries of diseases or of our well going dry.

If you have $10 in your pocket, food in abundance, a friend to talk to, a comfy bed, and can smell the scent of flowers in the air...count yourself blessed!

Go out and enjoy this fantastic day!

Joy and Tragedy

2008-09-14T20:28:00.000-06:00

I am now well into school at Union College out in Nebraska and just recently received some news from Rich & Anne in Tchad. The wonderful news is that Steve has finally been released from the rebel group holding him since last October when I was there!!! Welcome home Steve!
However, that was followed by a horrible accident where 3 of the TEAM missionaries were killed in a car crash with a public bus. Please pray for the group in Tchad and the families involved. It has been quite a shock. I knew Kathrin, and met Rudi once up in the capital. Sandra had just arrived 2 days earlier to be a short-term missionary at a school. Although I didn't know her, her death is almost affecting the most, as I think about her being the same age as me when I arrived in Tchad last year.
I wish I could be there right now.

A God Moment

2008-07-06T14:08:00.000-06:00

Time is flying by while I'm at camp. I am finally on my first time off since camp has started. Our small RAD group has had a crazy fun time taking our campers rock-climbing at Smith, cliff-jumping and rafting on the Deschutes river, mtn. biking up Hoodoo, backpacking up into snow, canoeing around the lake, and anything else we could think of to wear them out!

There is still a lot of snow up here but not near as much as when we first arrived for training. The lake has unfrozen and the mosquitos have started coming in swarms. After a week of shoveling snow and preparing for camp, all of the staff were given a day off for solo time, the Sabbath before camp started. I almost went mtn. biking with some of the guys, but then decided to find somewhere to go alone. I looked around on some maps and picked out a trail to hike near here. I drove out to the trailhead and started hiking, hoping to make it to the top of Maxwell Butte. There was so much snow however, that I was having a hard, slow time trying to stay on track with the trail. Getting really frustrated in not making my goal, I finally just stopped in a snowy clearing on a log and decided to have my solo time there after becoming hopelessly far from any trail markings.

Reflecting on the past year and looking toward the summer, I was constantly bombarded with thoughts of how I would relate to the campers and just being back from Africa. I'm coming from living with kids who had nothing of their own and who ate the same thing every day -- to spoiled American campers who come to camp with their huge bags of "essentials" for one week, complaining about the vegetarian food, and 3-minute showers. I was so worried that I wouldn't be able to handle it all.

Flipping through my Bible, I couldn't find anything that encouraged me or anything that really spoke to me. Finally giving up on God leading me at all or giving any feeling of His presence, I threw my lunch back into my backpack, stuffed my Bible on top and headed back down the hill to try and find the trail again. A while later after having to climb a tree to eventually see the trail, I jogged back down to my car and jumped in, ready to head back to camp for the music practice I needed to be at.

My cd player happened to be on, so I reached over to turn it off and in the process, accidentally changed it to the radio. Being way out on forest service roads, it came as a bit of a surprise when the radio actually turned on. As I listened more, I was even more surprised to hear someone reading verses out of the Bible. By the time I focused in to what they were saying, they were reading from Philippians chapter 4:

...I am not saying this because I am in need, for I have learned to be content whatever the circumstances. I know what it is to be in need, and I know what it is to have plenty. 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...

After the end of the chapter, the radio just shut off and all I heard was static. I think I mentioned these verses before in a blog, but it was a great reminder to me that it's not about whether being poor is better than being rich, but about being content wherever God decides to put me, and learning other ways to serve Him. Right now he has put me at camp working with kids, and after getting through my first week, I'm really excited about the possibilities that we have to teach and influence campers spiritually. In Africa, I worked a lot more on the physical well-being of people, but here it is a lot more the spiritual, relational well-being of people. I think it is a harder challenge and I am excited!

Anyways, I don't know how that radio turned on and off at just the right time way out in the woods, except that it was a God moment. Keep looking up!

2008-06-17T01:25:00.000-06:00

It is time to write another blog. I don't know if people still read this now that I'm back, but I need to write.

I get lots of people asking me how I'm dealing with being back in the land of luxury. All I can say is that it is a whole different world. I feel like a completely different person, doing different things, thinking different thoughts. Adaptation has come a little quicker than I thought it would, but then that almost worries me, that I am too quickly being pulled back into not realizing what kind of life I am living.

This evening I was finishing up with my packing for camp and going through all the junk in my room. I came across all the cds that I'm getting ready to send out to people with pictures of me in Africa. Any little question from someone, a picture I happen to look at, or hint of something African makes me stop and just think for a while about what I just came back from. Did I really spend 9 months there, doing all those crazy things, or was it just a dream? Then I came across my ipod that I have hardly listened to since I've been back. There isn't as great a need when I have a computer that can be constantly plugged in to play music, a cd player, radio in my car, etc.

I started remembering how sometimes my ipod was my lifeline. Or I should say music was my lifeline. Turning it on, my fingers automatically scrolled through to that one song that kept me going. After work at the hospital, many days I would come home just completely exhausted. Not just physically, but in mind and spirit. I didn't want to interact with my African family or anyone so I would just walk into my hut, toss my bag onto the floor and collapse onto my squeaky cot. I could lay there for hours, doing nothing. Images of patients at the hospital would fly across my mind, hopelessness of their situations would overwhelm me, inadequateness of not knowing what I should do medically, knowing that I was completely uncapable, fighting with relatives to try to save patients lives so I wouldn't have to watch another kid struggle and die right before my eyes when he could be saved...

And that is when I would play this song. Not just once, but over and over and over. Tonight as I turned that same song on for the first time since being back and closed my eyes, I can't even describe the feelings. I instantly imagine myself on that cot listening to it, my feeling of helplessness ever so slowly ebbing away to a clearer vision that this too was all in God's hands. My life truly had never been this clear. I knew I was serving my God.

And I know that I can find you here
'Cause you've promised me you'll always be there.
In times like these, it's so hard to see
but somehow I have a peace you're near.

And I pray that you will use my life
In whatever way your name is glorified.
Even if surrendering means leaving everything behind.

And my life, has never been this clear
Now I know, the reason why I'm here
You never know why you're alive,
until you know what you would die for
and I would die for You

And I know I don't have much to give,
but I promise you I'll give you all there is
I cannot possibly do less,
when through your own death I live

And my life, has never been this clear
Now I know, the reason why I'm here
You never know why you're alive,
until you know what you would die for
and I would die for You

Europe Slideshow

2008-05-22T22:11:00.001-06:00

Back Home

2008-05-22T18:15:00.000-06:00

For those of you who don't know, I am back home in the States. Sonya and I spent a great 10 days in Europe with her mom, traveling to Spain, France, & Switzerland. Everything was so green and beautiful!

Now I am getting used to civilized living again and finding out what has happened in all my friends and family's lives while I've been gone. This summer I'll be working at Big Lake Youth Camp again as a counselor for the RAD camps. Then I'll be headed right away out to Nebraska to Union College. Life sure picks up quick when you live in the States!

A Restaurant Nightmare

2008-04-15T07:29:00.000-06:00

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 :)

Goat Attack

2008-04-10T07:15:00.000-06:00

(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.

Birthing 101

2008-04-08T19:10:00.000-06:00

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)

Piano Keys

2008-04-05T16:31:00.000-06:00

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.

Making any difference?

2008-03-28T22:27:00.000-06:00

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.

Tetanus.

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.

Home?

2008-03-27T19:39:00.000-06:00

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.

Taco Bell in Africa

2008-03-12T18:38:00.000-06:00

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

2008-03-12T18:29:00.000-06:00

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…

Sarah is Safe in Chad & God is in Control

2008-02-09T09:31:00.000-06:00

I talked to Sarah today. The phone lines (and internet) were shut down last weekend by the Chad government to keep the rebels from communicating with each other. The phone lines have been opened back up, but not internet. All your comments and emails are waiting for Sarah to log in once the internet is back on. Please continue to pray for the safety of the missionaries in Bere and for those still planning to travel in the near future (in & out of Chad). The rebels have been sent back to Sudan, but could return (last time they waited over a year to return).

Rich's radio is not an international ham radio, so they are not able to talk outside of Chad on it. I have received comforting news from the missionary group TEAM (that Rich & Anne belong to). They informed me that Gary (with his Cessna plane) is ready to evacuate the SM girls to Cameroon if the need arises. Lets all pray that it won't get to that.

Please post comments for Sarah to read your encouraging words once the internet is back on in Chad. There are still patients to help at the hospital and God's work must continue in Bere.
...posted by Sarah's dad (Terry).

Chad needs your Prayers

2008-02-02T10:57:00.000-06:00

Please pray for God to control the political situation in Chad. Some Rebels from Sudan (Darfur region) have taken over the capital of N'Djamena today and may overthrow the current government. Sarah is located far from the capital in a small village off the main roads, so should not see results from the fighting. They have a contact in N'Djamena to keep them informed by ham radio. Your prayers would be appreciated. See comment section for link to the latest news in Chad.

Kissed by the Devil

2008-01-26T10:34:00.000-06:00

Well, it was not as extreme as that title sounds, but I knew it would get your attention :)

The pilot, Gary, and his family decided to move from Cameroon, out here to Tchad and settle in our little village of Bere for a while. Some of us went to meet the plane as Gary brought part of their things to move in. Soon the plane had landed and we started helping him unload into the hospital truck. The crowd of kids and curious onlookers grew to a sea of black faces. As a couple men acted as guards with sticks to keep people away from the plane, Sonya and I had fun pretending to walk through the Red Sea (actually brown sea). We'd walk straight through the crowd that would part perfectly on both sides with everyone staring & avoiding touching us.

As we finished covering the plane, though, we noticed that we were no longer the main entertainment. A little ways away, the crowd had gathered around a woman who seemed to be acting quite strangely. Whatever she was doing was making everyone erupt into laughter, and though I was curious, we continued with the truck over to the house that Gary was moving into.

We carried boxes and bags full of rice and other essentials back and forth from the truck to the house. While waiting for Gary to finish checking everything out, Sonya, James, and I hung around outside. The crowd had continued on over to us and soon the lady that had entertained everyone at the plane, was again center of attention right in front of us. She was gesturing wildly while yelling out a constant stream of words, apparently funny, to the crowd. Soon she was throwing herself all over the place, on the ground, running at people and then very rudely dancing at the delight of everyone.

I watched her strange jerky movements, confused, until James mentioned that she was acting like the demon-possessed patients he's had come to the hospital. I disgustedly looked away as she singled out Tony, the guard, and half pulled her shirt off while dancing practically on top of the poor guy cornered against a wall. But then, almost returning to normal, she walked over to us and stuck her hand out to James. He took it and she shook hands with him quite vigorously. When she then stepped in front of me, I figured there was no harm in greeting her like James had.

As I grabbed hold of her outstretched hand, suddenly I felt myself being jerked towards her. With surprising strength, and quicker than a blink, she had grabbed the back of my head with her free hand and aimed for a straight-on kiss. Just in time, I moved my head enough to receive the loud smack on my cheek. She jerked my head around and tried again, but this time I got a hand up to block it and pushed her away with the help of James pulling her off. Bewildered and a bit shaken, I looked up to see the crowd laughing hysterically. So I shrugged my shoulders and smiled, figuring a little love never hurts anyone.

We tried to ignore the woman after that, as the crowd dispersed and she hung around the truck with us. As I rested my arms on the side of the truck and talked to Sonya, I noticed she was right across from me copying my movements. Only she moved at the exact same time as I did, staring straight at me.

As we finally left, I laughed with everyone else, although it was quite unnerving to me. These people are caught up in such a terrible, tangible battle between God and Satan. But, they don't see it when the master deceiver makes it funny to them, interesting to try, and pleasurable.

It is Well

2008-01-21T08:14:00.000-06:00

January 21

.... When peace like a river attendeth my way
.... When sorrow like sea billows roll
.... Whatever my lot, thou hast taught me to say
.... It is well, it is well, with my soul

The words of this old hymn really hit me hard last night. Whatever my lot, especially in Africa right now, God has taught me to say, "It is well, with my soul." It is my choice whether to believe in His faithfulness and say them. Even if my conflicting emotions say different, it is what I know to be true that matters...It is well.

I got home from Cameroon and headed to work to see all the patients that came in while we were gone. One was an old man who got too close to the fire to warm himself. Half his skin was severely burned along his back, chest, neck and one arm. It brought tears to my eyes to see everyone avoid him like the plague while his wife led him bent & stinking, rasping for air, covered in flies, inside for his dressing change. The nurses stood as far away from him as possible while gingerly picking his bandages off without touching a hair on his head.

I finally couldn't stand to see the poor man alone, naked for all to see as they passed, swaying back & forth with no support. So I sat down next to him and cradled the side of his body with the least burns against me. Immediately he leaned hard onto me, clasping my hand with his swollen one, and turning to muffle his agonizing cries into my chest. As the burn ointment, mingled with blood & pus ran down over both of us, I stroked his head with my free hand, whispering to him in English, and wishing I could bear just some of his pain. His rasping screams felt like they were coming straight from my own heart.

The injustice of the situation sprang open in my mind. All the special procedures for burn patients in the States...and this man in Africa, dealing with raw indescribable pain constantly, in a place reeking with infection, with barely a few ibuprophen pills to stem the pain a notch. "God, why such suffering to the undeserving?!"

As the man sobbed onto my scrubs, tears soaking in, I let my chin rest onto his head and glanced up. "No, God, You are faithful and holding this man closer than I am. It is all in Your hands...It is well.

Some of you have been asking how I'm doing and all I can say is, God has taught me to say, "It is well, it is well, with my soul."

Parasites!

2008-01-19T20:06:00.000-06:00

January 16

So Hans and I are suffering from a bad strain of Giardia. It is an awful parasite that I deem worse than malaria. Half of the problem is the medicine for it, my most hated: metronidazole. It is a nasty, despicable, incredibly awful yellow pill that I have to take 8 of at once for three days. I can be feeling fairly ok, despite the ongoing diarrhea, fever, and stomach cramps. Then I take my metronidazole dose...Aah!!! The nausea goes on and on so that I can't even sleep at night, sometimes ending in finally throwing up. It leaves a nasty bitter, yellow taste in my mouth constantly and drains me of all energy. Thankfully I took my last dose today, so I should be feeling better in a couple days. I just warn you to never, Never, NEVER!!!! get Giardia or any kind of bug that requires taking metronidazole to get rid of it!

Well, there aren't very many diseases left for me to get here. I've only had malaria twice, while poor Sonya has suffered from it every month. Never take for granted your health! It is a wonderful thing to be healthy; something we all enjoy here when we have it, since it gets taken from us so often.

The Travels of Hans and His 3 Wives

2008-01-11T06:40:00.000-06:00

December 28

There is nothing more certain to be unpredictable than traveling in Africa. Sonya, Liz, Hans, and I headed off for Cameroon the day after Christmas, in hopes of making it to the Koza Adventist Hospital that evening. Before we even left, troubles began. Well, I shouldn't call them troubles because changes and different circumstances tend to make life more exciting. We had hoped to leave by 6 o'clock in the hospital truck which would take us through Kelo, on to Bangor, a border town. However, Liz and Sonya had worked that night and their replacement did not show up on time. While we waited, the truck driver decided that the oil filter needed to be changed. While we waiting for him to finish, Andre, the hospital administrator, decided he needed to go to Moundou, the opposite direction from Bangor.

Eventually we got underway around 8 o'clock with the driver, Andre, the 4 of us, Gary (in case the truck broke down along the way), and George, who wanted to just ride along for fun and visit some markets. We had hardly passed the river when we came upon a whole group of hippos lounging around by some water! Being the first time we've seen some here in Tchad, we excitedly jumped out to take some pictures by the water's edge. A man tried to convince us to get closer in his canoe, but seeing it was half-filled with water and remembering the fates of some people that ended up at our hospital, we decided to continue to look from a distance. Gary acted as tour guide, informing us on many interesting facts about hippos (sometime, ask me how they poop), and then we were on our way once more.

Once we bumped and lurched into Kelo, we headed to the post office to pick up packages! Piling them into the back of the truck and telling George to guard them with his life, the 4 of us headed off to find public transportation while the hospital truck continued on to Moundou for Andre.

Lucky for us, a "bus" was almost filled for Bangor. We took the last 4 seats on a bench facing backward, squished behind the driver seats, expecting to leave any moment. Now I must describe this "bus" to you. It is about the size of a van with racks on top to carry luggage. They add a bench behind the driver where we sat and a long seat in the back where the trunk is. The goal is to fit as many people as possible in order to make the most money possible. Besides looking like a piece of junk patched together on the outside, everything is stripped off the inside leaving just the metal frame of the bus and seats. Pieces of molding foam were hanging off the ceiling, and windows were smashed out, leaving just tape covering them.

Eventually they were ready to go and attempted to shut the side door by Liz. While trying to jerk it closed, the top runner came out, the only part connecting the door to the bus. They put it back in, but could only get the door half closed, where they tied it with a rubber strap. Then came the problem of getting the bus started. We could hear the engine grunting and hissing, but not starting. A bunch of people outside started pushing us down the road, faster and faster, but still it wouldn't start. We rolled to a stop and the 4 of us were asked to get out so that they could get to the engine under us. The engine finally roared to life and we all scrambled back in quickly as they took off.

We got a good breeze from the open door for the 3-hr. trip. Sitting facing everyone, we felt like the travel entertainment. It wasn't very far into the trip that we realized how much we looked like Hans' three wives since it isn't uncommon in this culture to have many wives. This was confirmed many times when people asked us if he was our husband. I always just answered, "yes," figuring they'd mess with us less if they thought we "belonged" to him as the culture sees it.

Rumbling into Bangor, we made a quick jump onto some motos waiting and headed for the border. We stopped to register at a customs building, hoping we could actually go across the border. We assumed we'd have to buy visas for about a week, but who knows how much they would try to charge us, or if it was even possible. It ended up going very well. Elise, the lady we went to talk to, was very friendly. She was excited to hear we were from the Bere Adventist Hospital and gave us her address and number so that she could have a hospital built in her village. She stamped our passports and charged us only 1000 CFA each, about 2 dollars. Excited over how well it went, we were off again.

Our motos stopped again by a building saying we needed to check in there too. We could see Cameroon, just across a river. Going in to see the military men, we figured it would be a quick stop since we'd worked everything out at the last place. The man looked at our stamps, questioned us a little and waved us on, but as we walked out, an Arab man stopped us asking for our passports. We know not to just give them out to any military man, because the government is corrupt and many will make you pay to get them back. I only brought my passport and visa copies for the trip instead of my original since Gary had told me that was all that was needed. So we refused to give the man our passports and tried to leave. He was persistent, though, and kept asking, grabbing Hans' arm to get him to stay. Hans told him we had already been cleared, but the man became irate. He yelled at Hans and Hans yelled back for a while until I was tempted to just run across the border and leave the screaming man :)

He started telling us that he was with some anti-espionage group and that we were American spies. We wanted to laugh at that, but he was serious. (You know our favorite thing to do is go to Cameroon to set bombs and spy on their amazing military techniques to take back to the States!) Eventually the man we had checked-in with came out and told us that we couldn't leave and needed to be questioned by this man. Hans acted very mad, because usually if you push & bluff your way around, they lay off, but this man was very adamant that we were spies. They took Hans over to a grass shack with a bunch of men while Liz, Sonya, and I waited by the road.

We waited and waited, hearing a very heated conversation going on in the hut. We prayed constantly for Hans, hoping they wouldn't take any of his stuff or charge him an exorbitant amt. of money. After an hour, he came out, looking quite shaken and walked over to us quietly saying, "I don't want to get shot here. Give me your passports." We quickly handed them over and watched him walk back, realizing possible more was at stake than our money and belongings. Not too much later, he came striding out, telling us to quickly get our stuff together. We quickly hoofed it down to the river and crossed the border in a canoe before they changed their minds.

Hans relayed all that had happened. The Arab man kept screaming at him constantly that we were spies and Americans are horrible...on and on. Hans said he looked like he wanted to kill him. Hans explained what we were doing in Tchad & Cameroon and that he had #s for the doctors at both hospitals to confirm if needed. They argued continually and then eventually said they wanted to interrogate us girls one by one. Hans wisely played off of their Muslim beliefs and told them that he was responsible for us. It wouldn't be expected of their woman to appear in front of strange men alone. They could talk to him in regard to us. They agreed and that's when he came to get our passports.

Relieved to finally be across, we made it through the Cameroon registration points fairly easy. Amazing that we were allowed to travel in Cameroon with no visas, just a stamp saying we were leaving Tchad & entering Cameroon! Greg says most of the military men can't read well enough to tell. You could put any stamp on a paper and call it something without them knowing the difference.

We found a driver to take us into Yagoua to catch a bus to Maroua. We looked out, amazed at the difference from Tchad. So many nice houses and power lines! We had to wait 4 hrs. for a bus to finally come to take us to Maroua. We got there at 11 pm and proceeded to try and find a place to stay the night. Greg had arranged for us to stay at the Baptist Mission after hearing we'd be late, but there was some confusion and they wanted 15000 CFA! Thirty dollars for just 6 hours of sleep. So we ended up staying on the floor of a room in YaYa's house. A man Greg arranged to pick us up at the bus station.

It was a sleepless night with lots of mosquitoes. We were up early and on our way on another bus to Mokolo. It is so beautiful in Cameroon with mountains and agriculture. In Mokolo, we jumped on some motos for the last leg of our journey to Koza (after negotiating the price for a while). It was a fun trip up and over mtns. into the town of Koza. We arrived at the hospital by 9:30 that morning, seeing Audrey & Greg running out to meet us. Time for a vacation...

Christmas

2008-01-10T13:27:00.000-06:00

December 25

This year was lacking a bit in the cinnamon smells, colorful lights, cold snowy days, and family visiting that usually accompanies Christmas. Nevertheless, we did our best here in dry, hot Africa, to create a little of the Christmas spirit.

Liz and I, both coming from families that faithfully tromp out to find the best pine-smelling tree every year, were adamant that we needed a Christmas tree. So the two of us headed out one evening in December to find something that would suffice. Our rules were that it had to at least have the promise of being slightly green and had to be able to hold ornaments. Armed with a bucket, shovel, and saw, we marched out into the bush, carefully scanning anything that grew above the ground. After weaving our way around all the squatting people taking a dump out in the fields, we finally picked the lucky bush. From far away, it could almost be mistaken as holly. Soon we had sawed it off, collecting extra pieces for a wreath and headed home, triumphant.

Despite the skeptic looks of Hans, Sonya, & James, we set it upright in a basket filled with dirt and began decorating with colorful little ornaments sent by Liz's family, while Christmas music played in the background, hot chocolate was made, and candles lit.

In the weeks leading up to Christmas, we watched the classic, "It's a Wonderful life," and constantly played all the holiday music we had. Eventually our tree had to be replaced with a new one, since it died. So we cut down a bush that more resembled a pine tree, although it had 2-inch thorns sticking out everywhere.

On the 23rd, we held a Christmas party for the hospital staff. Sonya made a huge batch of delicious peanut butter cookies and juice, and we showed "The Nativity Story" after the generator came on.

On Christmas Eve, after work, we had a big dinner together with all the "white people" in Bere. It was a feast compared to what we usually eat and a great time to relax and enjoy each other's company. Everyone brought a white-elephant gift (I wrapped mine with mango leaves), and proceeded with exchanging gifts. The favorites were Sweet Pea lotion and chocolate!

Christmas Day wasn't very enjoyable for me. I worked and was sick with what I later found out was strep throat. After work, I ended up sleeping most of the evening and wishing I could be home.

The next morning, we headed off for Cameroon on vacation which is its own story...
Hope you all had a wonderful Christmas!

La Clase de Espanol de Milo

2008-01-10T13:23:00.000-06:00

December 14

Wow! You buys are amazing. I just received your letters last night and once I realized what they were, I felt like I held a treasure box in my hands. It is so easy to feel separated and like I'm just writing blindly. It's encouraging to know my blogs are somewhat of an inspiration when many times, here, I feel useless. Just a couple days ago we had a little kid come in with malaria, but the parents refused to pay for hospitalizing him. They took him to the traditional "healers" instead who made cuts all over his stomach and other rituals with promises to cure him. Today they returned, with the boy convulsing. I've spent all day pleading with them to buy meds. for him, and each time they finally do buy one dose, they act as if I'm cheating them out of their money. They don't believe that there is any other reason for me to be here except to make money off of them. Late this afternoon, the boy died, proving to them, that they paid for nothing. And I feel like I failed again.

I must say that any inspiration you get from my experiences are not from me, but are glimpses of God working in my life & in Tchad. Many times I feel weak, discouraged, and not trusting of Him, but He works through the least of us. Don't think (like I used to), that you have to reach a certain level spiritually with God to be used by Him in great ways. Just be willing to relinquish control of your life and say, "God, use me."

Nothing will be the same...imagine if you are tapping into the strength, love, & character of God, where is the limit??!
Then as He uses you, despite your limitations & shortcomings, to touch other people's lives & fulfill His purpose, the most incredible part happens ~ While working through you, He works in you.

Hmm...hope I'm not getting too carried away :) When I write, it kind of sorts out all my own thoughts. Well, I hope you all have a great Christmas and keep up with the Espanol! I was thinking I should write part of this in Spanish for you guys, but every time I tried to think of something, only French came up in my mind. Aah!! It's taking over. You all need to write me some Spanish quick!

Thank you again! I have your letters hanging up all over my hut walls.

Kitten-napped

2007-12-13T23:06:00.000-06:00

Rich & Anne have a kitten that I've fallen in love with while staying here. Her name is Bandit and she is quite a bundle of energy and curiosity. The other day she really showed that she's a kitten after my own heart...

Allison and I woke up one morning and couldn't find Bandit anywhere. Rich had taken the car to go visit someone and Anne was gone at the church. We searched everywhere inside and outside in the enclosed courtyard.

When Anne came home a few hours later, we mentioned that we hadn't seen Bandit all morning. She immediately became worried because Bandit had showed a curiosity for the car and liked to climb up under the engine. She called Rich to let him know and tell him to check along the road on the way back. He searched all the way home for a flattened kitty or one hiding in the bushes.

Finally he got back to the gate and told his guard to be on the lookout. A lady standing nearby called out, "Oh, the cat is already found."

Apparently Bandit had climbed up under the car, rode out to the gate, jumped down outside and began exploring. A Tchadian woman caught her and took her home to her hut.

Rich finally convinced the woman at the gate to show him which home. Nobody was around, but he saw a bucket overturned, and soon Bandit was found, crouched underneath. Her collar was gone, showing that the woman had hoped to keep her, but now she is home, none worse for the wear except for a hoarse voice from crying for hours and a big appetite. A few days later, someone dropped off her collar...it's amazing how everyone knows everyone else's business here. You can't do anything without somebody seeing you.

I have ambitions for Bandit becoming a great adventurer...

Picture: Bandit and I

Thanksgiving

2007-12-13T23:04:00.001-06:00

For Thanksgiving, we all gathered at Rich & Anne's house where I was staying while recovering. The 4 of us SMs, contributed with what we had received in packages. I made 2 pumpkin pies, yams, Jell-O, and donated a can of olives & cranberries. Liz & Sonya made a wonderful apple pie and Sarah made some special Danish gravy. Anne found 2 small chickens to bake in place of a turkey, made stuffing from whatever she could find, and ice cream! It was a feast complete with cold sodas with our dessert.

You can see everyone in the picture I'm sending (except for me since I took it). Rich & Anne are in front, James with the chicken in his mouth and blocking Sarah behind him, Allison at the back (a friend staying with Rich & Anne), and Liz, Sonya & Hans on the right. We also watched a tape of the Super Bowl from a few years ago that Rich had...have to have football on Thanksgiving! Hope you all had a great holiday as well.

Surgery - November 3

2007-12-11T20:02:00.000-06:00

Sabbath morning...I was still feeling awful. Greg started me on antibiotics for the Typhoid fever. I threw up during the night and was still taking morphine as often as I was allowed.

Greg called James and Sarah over at the Koza Hospital in Cameroun to ask them to come with Gary in the plane, in case I needed to be evacuated. It was a long day. Liz stayed at the house with me during church while everyone went to listen to Hans preach.

James, Sarah, & Gary, the pilot, arrived in the evening in the plane. We could hear the whole village running to see the plane again. James came right in to assess me with Greg...lots of pressing and prodding. They left to discuss among themselves and soon reappeared to talk to me. They told me that if I was a local they would have already operated on me with the symptoms I was having. Clearly, the only thing holding them back was that I wasn't a local, the conditions at the hospital, and the possibility that I didn't even need to be operated on, since they can't do any tests hardly except an ultrasound.

They gave me 2 choices, stay in Bere and be operated on by them, or be flown out to Europe. I had one hour to decide to make the flight in time in N'djamena. Gary informed us that medivac would take a whole day to arrange with all the paperwork, so they told me that the plan would be for Cristina and I to fly to N'djamena, the capital, with Gary in his little plane. We would hopefully arrive in time for the one flight out to France at midnight. Cristina would load me up on antibiotics and pain meds. and somehow hide my IV under my shirt for the flight and then she'd help me to a hospital since she lives in France.

It sounded a bit iffy to me. Travel always seems to end in disaster in Africa. If I couldn't get on the flight to France, I'd be stuck in N'djamena. James told me that he wouldn't trust any of the other hospitals in Tchad.

I called my parents, talked it over, and still didn't know what to do. They, obviously, were more comfortable with me being in better conditions in France. But if I had a serious condition, it could be dangerous to try and go so far. My ultrasound didn't show much, just possibly something down in the pelvic area. My thoughts at the time were, "It's just stomach pain! Why do I have to be cut open?" James & Greg mentioned appendicitis a couple times which would mean I should be operated on immediately, but it didn't seem to match the pain I was having across my entire abdomen.

After praying a lot by myself and with the others and thinking through both choices, I made the more unlikely decision to stay here in Bere. One of my fears was just the likelihood that I would have to go home if I went to France instead of coming back to Tchad. I'd only been here 2 months so far. And I decided that I'd feel more comfortable around people I knew here than in some foreign country, especially if something went wrong.

Right away, everything started moving quickly towards preparing for the surgery. I talked to both of my parents briefly, informing them of my decision. Then I got online and quickly sent a short message out asking people to pray. Liz, Hans, and Cristina went over to prep the OR, dousing everything in bleach over and over. Audrey, Sarah, and Sonya helped me get ready. Right before we went over to the hospital, Greg asked to check me over one more time. The pain was worse and as I looked up into his eyes, he nodded to me and quietly said that he felt that this was right. The fear started to ebb away and I smiled back at him and told him I felt the same.

They had brought a stretcher to carry me over, but I begged to be allowed to walk. It hurt a lot as I shuffled along with Paul and Gary supporting me on both sides, but I felt a strange calmness around me as I glanced up at the stars and moon filtering through the mango trees.

I got to the OR and put on an old hospital gown. We gathered in one last circle for prayer, an all Caucasian staff for once, except for Anatole, my African father, who was faithfully waiting outside in case he needed to find blood for me.

Audrey, Liz, and Sarah went in with me and helped me climb up on the operating table. James & Greg came in to give me the spinal anesthesia (big needle!) and then left while I was covered with betadine and draped with blue sterile cloths. As I lay there, my arms getting tied down with the old ratty pieces of rope, I glanced up at the ceiling covered with nasty blotches and peeling, and thought, " O God, what am I getting myself into!" This is the room I've worked in, watching other people get cut open and now it's me! We had always just teased about how funny it would be if one of us had to be operated on...not so funny anymore. And have you ever been completely exposed and operated on by all your coworkers?!

James and Greg scrubbed in and got ready with the scalpel. They had planned on keeping me awake with just the spinal anesthesia, but it wasn't working fast enough, so Sarah gave me Ketamine and soon I was out cold.

The next thing I know, I'm awaking out of some weird dream trying to figure out where I am. Soon the blue haze clears and I can see that it's actually a mosquito net. Then the pain comes...as I mumble unintelligent words, Sonya and Liz's heads appear above me. I don't remember much except that I could only get one-word questions out at a time. They told me that I kept asking about one of the Tchadian patients I'd been taking care of before. I don't think I even remembered I'd had surgery in the beginning.

Sonya & Liz assured me that the surgery had gone well with no complications and that they had found a very angry, big appendix about to rupture. It had moved down under my uterus, causing the confusion of pain all over when they pressed my abdomen. I am so thankful that I stayed here since James is sure it would have ruptured mid-flight to N'djamena or France which could have caused worse problems.

As Liz went to get Greg while I woke up. Sonya told me later that she kept telling me, "you're so brave, so brave..." She says I looked back at her in my drugged state and mumbled out, "No, God's brave." So true!

I am now quite healed, over a month later, and am working again at the hospital. I stayed for a month with an Evangelical missionary couple down by the airstrip. They took great care of me and fed me wonderful food! I was amazed with the luxuries of butter & cheese, which I haven't had since I left the States. They have solar power set up allowing for fans, light, & a refrigerator!
I officially became the first white person to be operated on at the Bere Adventist Hospital! One Tchadian told me that he was amazed to hear I could be operated on here, he thought white people's insides were different than black people's, so they had to have surgery in Europe or the US. James says it has raised people's view of the hospital to know a white person lived through a surgery here. "God works all things for the good..."
Another thank you, a day later, the generator broke in the middle of a surgery, thankfully during the day. If it had happened during my surgery, at night....a bit of a disaster.
If you want to read a Drs. account of the surgery, James has written an account of it in his blog (Bere Hospital link on my blog). That way you can get a true picture of what my insides are like from his view :)

Continued (Fri - Nov 2)

2007-11-20T19:32:00.000-06:00

1440 - Finally made it to the post office! All my attempts to say post office in French didn't work...post, postal, etc. My driver took me to the Kelo hospital thinking that I wanted to go there since I'm from a hospital...finally got the point across and learned that it is pronounced something like postAY. Liz and Sonya were there. We were all very relieved to see one another.

1500 - We now have all the mail and packages. Liz and Sonya made friends with the postman that we now call Papa Jacob so that he would be willing to come back when I arrived since the post office usually closes at noon. Liz gave him hydrocortisone cream for his itchy skin problem and a U.S. granola bar. He is happy and knows all of our faces now after seeing all our names on packages coming in.

1520 - We're on our way back home. All of us were too exhausted to do anything else in Kelo...so Sonya found two new moto drivers while we watched the stuff. They look like much better drivers with motos that look like new! I'm with Sonya on one moto. The driver (Jeremy) is sitting on my lap so that there is enough room. At least he's a nice older man, Liz's young driver keeps proposing to her.

1600 - I think I'm going to pass out from pain. I am straining my eyes to see the river so that I can get off and stretch for a few minutes while we cross. Besides the discomfort of not being able to move because of Jeremy on me, my stomach is killing me. Every bump on the road is torture. Sonya helps me try to forget about it, though, as she pretends to fly on the back, flapping her arms and cawing like a bird :) I don't think Jeremy has had this much entertainment from passengers before.

1700 - We are home! I'm so glad to be back in our small village of Bere. We took pictures with our wonderful moto drivers and got Jeremy's number for when we decide to go again. Now it's package time! We all opened them one at a time in front of everyone. I got a package from my school with peanut butter m&ms! Everyone is enjoying a handful of the luxury. I'm still feeling sick though.

1900 - I'm kind of confused, lying on the couch at the American house with an IV in me. I guess I passed out for 20 min. in which time they put an IV in, gave me a shot for pain, and put sugar in my mouth. There's no better place to pass out than in front of 2 doctors and 2 nurses. Greg and Audrey think I'm just worn out from the day and a little hypoglycemic from not eating hardly all day. Well, I'm not too worried...I've passed out before :) They're keeping me on IV fluids all night, so I'm staying at the American house tonight. Liz and Sonya are staying on the floor next to me.

2400 - Woke up with a fever and more pain. Greg came over and increased my dosage of morphine.

The Whole Story

2007-11-15T14:28:00.000-06:00

November ??? (I don't know the date anymore)

I'm finally feeling well enough to write again...and what the stories to tell! I guess I'll just start from the beginning. Here is my missionaries log:

Friday, November 2

0530 - Rise and shine for....a day off from work! Plans underway for a trip to Kelo with Liz and Sonya to pick up mail, do some shopping, explore, etc. Moderate stomach cramps noted, nothing unusual, pain meds. taken.

0700 - Met up with Liz and Sonya at the house after picking up my beautiful reed mat made by one of the TB patients. Sunscreen applied and bags packed...we're on our way.

0800 - Found 2 motos near the market willing to take us to Kelo. One is in pieces on the ground, but the driver is adamant that it is safe after he puts it back together. Negotiations are underway as to price.

0830 - With the wind flying into my face, I'm plastered against my driver and the box strapped on behind me that we brought to put mail in. We just left Bere, with me yelling back at Liz and Sonya that I can't remember the name for post office in French. They didn't have time to answer. I'm on the broken moto...oh well, I always like a little excitement.

0900 - We've arrived at the river. Instead of taking the ferry, my driver headed for the little dugout canoes. I sat on the end of the canoe and watched the muddy water swirl up to within an inch of the top as we slowly were paddled across, the moto barely fitting in the center. I see Liz and Sonya arrive on the other side with the other driver and wave quickly as we speed off again.

0930 - The back wheel of the moto broke. Thankfully we were going slow through a herd of cows, horns brushing my shoulders as we passed. We've walked half a mile to a small village with some men who think they can fix it. I've been given a chair in the shade with 30 kids in a circle staring at me.

0945 - The moto was fixed for about 10 ft. until the wheel started fishtailing again and we realized that the brake wasn't working now. I clutched the moto tightly as we started to increase speed down the dirt road at a bumpy rate until the driver turned the key and we gradually coasted to a stop. I am back to sitting on my chair under a mango tree as they take the wheel back off.

1000 - I'm stranded alone now with the broken moto. The driver handed me his keys, told me "Tu attente asi!" and jumped on a truck going back towards Bere with the wheel under his arm for repair. Liz and Sonya still haven't shown up...I wonder what happened to them.

1040 - Liz and Sonya just passed on two different motos? I don't know what happened to make them an hour behind me. I waved wildly at them. Sonya saw me, smiled, waved back...and continued on.

1130 - Still stranded, I'm conserving water, little sips at a time. Stomach pains are getting worse so I took more meds. I think all my experiences earlier in life have been preparing me for Africa. All the times I've gotten lost hiking, stranded with my car in the middle of the night, etc. It is all a battle of the mind. I could go into a panic over the fact that I'm in a 3rd-world country all alone on a road, barely able to communicate in French (which 3/4 of the country can't speak), running out of water with just a couple granola bars for who knows how long...Or I can just say, as I've learned with all my other experiences, "What an adventure!" and make the best of it.

1230 - Sweat is dripping down my back. Men are trying to hit birds out of the tree with a slingshot. A man across the street is pumping a sewing machine with his foot as he creates a Tchadian dress. School just got out in the village. I now have 74 kids in a circle around me, watching every move I make...I've been here long enough to count them. The two teachers have come to practice their limited English with me. It will help pass the time.

1330 - Hallelujah! My driver has returned with the repaired wheel! They have put it on and we are back on our way to Kelo! Thank you God! Now I'm just praying with every bump that it stays together. I won't even complain about the close quarters, my nose in the drivers ear, and my chin getting bruised from hitting his shoulder with each pothole...and these stomach cramps that just don't seem to be going away.

1400 - Almost to Kelo, we just played chicken with another moto. I felt the woman's skirt whip my legs as we passed.

1420 - We're in Kelo! ....except now my driver doesn't understand that I need to go to the post office.

Stay tuned for the rest of the story....

Thank You!!!

2007-11-11T08:09:00.000-06:00

November 9

This is just a short note out to everyone to let you all know that I'm doing ok. I want to write a blog about everything that happened because it is all quite the story and your prayers I believe really helped work things out. I can't describe the support and love I've felt from everyone, it has just amazed me how many people have been praying...pretty much all around the world. I am recovering, slower than I'd like, but that could be because of the fact that I found out I have malaria again. I can't even try to distinguish between all the symptoms now, but I am starting to eat a little, and it is staying down for now. And I can sit up for about 20 minutes before the awful spinal headache comes. I'll write more when I can, right now it is still hard to focus that much and I keep falling asleep or feeling too nauseated to try to type. I love you all and thank you deeply for your prayers! Every day I read through all the comments sent to me to help me feel like I can make it through everything.

Please continue to Pray for Sarah

2007-11-08T20:42:00.000-06:00

Sorry you have to wait longer to get a personal message from Sarah. Thankyou all for the prayers and notes of encouragement, we all know the power of the Great Physician. I talked to her on the phone and she is still very tired and in recovery. Sarah is on antibiotics for the Typhoid Fever and has a hurendous headache from the anesthesia during the apendicites surgery last Saturday night. She also was informed Wednesday that she has Malaria again (a triple wammy).

Satin is trying hard to knock her down, but with all the support she is receiving from all of you with prayers and emails from all over the world, she wil get through this. She has been staying in the American house since last Friday, but has just moved in with the Evangelical Missionaries. The older couple (wife a nurse) will be able to watch over her and provide great meals to strengthen her. Sarah was looking forward to the cooling fans provided by the solar power at their house. With temperatures currently in the upper 90's and all the sicknesses in her body, it will be a little relief.

Pray, Pray Pray... Continue to post comments (she receives all of them almost daily)...Thanks, Terry (dad)

Sarah is very sick: Pray

2007-11-02T21:53:00.000-06:00

Please pray for Sarah. She has an unknown sickness or disease which is causing a lot of abdominal pain. Pray for her doctors (Greg & Audrey Shank from Koza Adventist Hospital) that they will have the wisdom from God to cure her. Your prayers and notes of encouragement mean a lot to Sarah. She will receive your comments posted here by automatic email (almost daily now).

Palu

2007-10-29T23:46:00.000-06:00

October 26

Another 17 hr. night shift at pediatrics with Liz...

We finish giving all the meds by the light of our headlamps, bugs crawling down our shirts. All the kids are doing well, no worries. We each open our dinners provided by our families. Liz has a bowl of pasta with tomato powder seasoning, and I have a bowl of the thick rice drink. Liz takes a bite, hands me the spoon, I take a bite, and hand it back. Back and forth we eat, occasionally stopping to pick out bugs.

Babies are quiet, families are sleeping on mats between the rusty hospital beds. Liz and I prepare our twin-sized bed, tucking the mosquito netting around. Soon we're both laying side by side, sharing a pillow and hoping to get an hours sleep before 12 o'clock meds.

At 11:30, a dad wakes us up. Liz tells me to go back to sleep while she checks on the baby. A few minutes later I hear her calling for me. Stumbling out of bed, I start looking for my headlamp and shoes.

"Esther!" I hear the urgency behind her voice this time, and hurry over to bed 3 where I see her light.

It's a little baby with palu (malaria) that we'd been treating for a few days already. He had been doing well, and we'd started him on pills the day before. Now his eyes were rolled back into his head and Liz was doing chest compressions on his tiny body.

"Go get the bag!" Liz cried.

I ran over the maternity ward and frantically scanned the room for the bag. Not seeing it anywhere, I ran through the wards looking for Simeon, the other nurse on duty. Finally I gave up and ran back, determined to just start mouth-to-mouth on the baby without the bag. When I got there, I saw Liz closing the baby's eyes, and the mom silently crying.

"He's gone," she whispered to me. I stared at the baby, so confused. He had been so alive just an hour ago, yelling loudly at us, when we gave him medicine. There was no warning.

People crowded around the bed and Liz and I stood there not knowing what to do. We couldn't explain what had happened even if there was no language barrier. We didn't know how to comfort the mom - what is acceptable in their culture? What do they do when someone dies? The dad left to find a moto to take them home and Liz & I finally left, feeling helpless.

We walked out away from the buildings and sat under the stars, each silent in our own thought. Eventually we talked, cried, prayed and held each other, and then went back to finish our shift.

That baby's death has bothered me a lot the last couple of days. I wish that I would have checked his pulse and airway myself after Liz told me he was dead, just to give myself some closure. I wonder what else we should have done. I've asked the Drs. for explanations, and even they are perplexed by the suddenness of it.

The only explanation I give is that it's malaria. A vicious disease that comes & goes, tricking people into thinking they're ok, and then striking them down. Everyone gets different symptoms, making it hard to recognize at times, and half the kids in Chad have it at one time. When you ask women here how many children they have, they always answer..."I birthed , and have living."

I ask God how these experiences have anything good come out of them. Well, I have an awareness now, what am I going to do with it? When I go back to the States, will I just remember the sad effects of malaria, a disease so common here, that it is easy to forget the seriousness of it. Or will I get involved and do something to change? I feel driven now to study everything about it.

Another thought, I've just made you aware of it. Will you brush it off as another sad missionary story, pleading for the usual, or will you allow yourself to feel for people you've never seen or met, and do something? It's your choice.

Languages

2007-10-29T23:41:00.000-06:00

So my French is coming along -- slower than I'd like -- but it's coming. I can understand a lot more than I can speak, and most of my vocabulary is from working at the hospital. I'm sure it sounds awful, but most of the time, patients can still understand me.

Sometimes I can hardly wait to study and learn more so I can communicate. But other times it just seems useless. French is their second language also, so only those who are educated speak it. Most of the women speak just their tribal language. So far I can greet people in Arabic, Nangere, & Gumbi, and ask if their baby has been vomiting :) But there are a multitude of more languages that I can't even recognize when they speak, like Lai Lai, Mafa, and Sara.

Then we get short-term missionaries and people visiting from countries all over the world that add to it all, Danish, Portuguese, Australian English (it's a lang. of its own), and my personal favorite, Spanish. I still find myself answering in Spanish when I mean for French to come out. Sometimes they actually understand, though, because of the similarity. So my motto is --- when in doubt, speak Spanish!

In the end, there's nothing better than just speaking good old English. I've never appreciated my native language more.

Obsession with Guavas

2007-10-25T19:24:00.000-06:00

October 21

My toes grip the smooth brown bark as I shrewdly scan each branch of the tree. Eyes widening and mouth watering, I see the first one...a plump, juicy guava! Within moments, I've climbed within arms reach and snatch it. Guava after guava I pick with the delight of finding a treasure behind each leafy branch.

From the ground I hear Liz call that we have enough, and I yell back, "Just one more"...which turns into 2...and 3...4...5,6,7...

"Esther! We have plenty for a fruit salad. Come down!"

Sighing, I start to reach for the branch below, when I suddenly see it. The most beautiful guava I've seen yet, hanging perfectly in all its glory, sun reflecting off the sheen of its yellowish-green skin. Liz's voice becomes faint as I climb higher and higher, trying to get closer. I pull my skirt up to just below my knees so I can spread my legs apart enough to climb.

It is hanging at the very end of the branch and I try jiggling it off. After practically jumping up and down on the branch, the stubborn guava is still hanging strong. I walk out a few inches and try to reach out, quickly realizing that it is much too far for my arms. Grabbing a stick I try to poke it. Each poke sends it swinging back and forth, but not down.

Ignoring Liz's pleas to leave it, I grab the rake. Nothing is going to stop me from getting that guava. Being hard to get makes me want it all the more. Again and again I reach out with the rake trying to catch it on the stem, until my wrist is swelling from the weight. I sit on the branch for a minute, resting as sweat runs down my face and neck. I'm just not close enough! I study my scratched arms and the small skinny branch...thinking...Physics class. I imagine Mr. Byers standing at the black board drawing an elephant's foot and showing how the heel of a woman's shoe has more pressure than an elephant's foot. So I could be as heavy as an elephant and still stand at the smallest part of the branch as long as my weight is distributed over a large enough area...Never underestimate the importance of school! You never know when you might need it, like when trying to pick a guava.

Gathering my courage, I slowly lay my whole body down flat on the branch and start scooting out farther and farther, inch by inch, my eyes riveted on the guava, imagining the first juicy bite. Every muscle taut, holding my balance, I am close enough to reach out. Carefully, with my legs wound tightly around the bending branch, I let go with one hand and go for it. I feel a rush of exhilaration as my fingers close around the smooth round fruit and yank it off, almost falling from the movement. Looking at the guava, I feel a grin spread across my sweaty face, eyes sparkling with excitement. There's nothing better than a guava....

In the OR with Dr. James Bond…

2007-10-22T18:23:00.000-06:00

October 19

We had a visiting doctor here for a couple weeks, Dr. Bond. He is from Deer Park, CA, right next to PUC, and has been to Bere a few times before. It amazes me that he is able to survive visiting places like Africa with such an obsessive-compulsive attitude towards germs and parasites…but within a couple days, we were all very used to his demands for cleanliness.

James had a whole line of surgeries for Dr. Bond to do, and within a few days, we all found ourselves in the OR helping. I think he could easily have done surgeries with the usual 2 nurses that helped James, but he made us feel needed. So without having set foot in the OR, I was suddenly in there for hours every day, circulating and watching the surgeries. Even Sonja, a social work major, was pulled into handing out compresses and sutures with the rest of us. Liz & Christina got to try being the anesthesiologist a couple times, but whenever I’d venture their way to listen in and learn the anesthetics, Dr. Bond’s booming voice would exclaim, “No Esther! Leave all that to the nurses; you’re the EMT. Come look at what I’m doing…Closer, closer!”

So I’d watch over his & Abel’s shoulders as they worked miracles, taking out spleens, appendixes, prostates, hysterectomies, and Dr. Bond would gladly explain it all. It made me more tired, working all night sometimes, and then only sleeping an hour before going to the OR all day, but it was worth it.

One day, Dr. Bond strode up to me and proclaimed, “Esther, today you are going to scrub in and assist me.” I looked at him in surprise. “You would like that, wouldn’t you?” he said, watching me in amusement as I quickly nodded my head up and down.

A little bit later, Abel was teaching me the scrub in procedure and before I knew it, I was standing over a patient, across from Dr. Bond, handing him scalpels and clamps for a bilateral hernia. I was so hot, covered in all the scrub clothes, sweat trickling down my neck and back, and I held forceps pulling the skin apart until my arms were shaking from exertion. But whenever he would ask me if I was tired, I’d quickly deny it, wanting so bad to stay there and help him.

He let me help with 2 more hernias the next couple of days, since they were simple operations…but after he left to go back to the States this week, I haven’t been back into the OR. The good news is, though, that he’s coming back for a longer time in February!

The doctors from the Koza hospital in Cameroon are here now and James & Sarah flew over to their hospital for a month. There isn’t an airport here in Bere, but there’s an old airstrip in a field that they used. Greg, a pilot associated with Gospel Outreach, flew the drs. here and James & Sarah out in a small 5-person plane. I was taking my bath early in the morning when I heard a big commotion. I realized that it was the plane taking off, the whole village was watching it, as Greg circled a couple times before heading off. I was hoping they couldn’t see me bathing, since it’s entirely open on top. And white skin kind of stands out! It was amazing, though, to think that most of these people never see airplanes. The kids in my family were telling me it was such a big plane, so I was trying to explain that I came in a plane that held a few hundred people! They didn’t believe me…

My Life Has Never Been this Clear

2007-10-22T18:06:00.000-06:00

October 7 (here are 2 posts lost in ciberspace & re sent)

Squinting at the patient report in front of me, I try to make out the horrible handwriting as a new entrant walks in. The mother folds back cloths to reveal her baby, and I stare in horror at a child so malnourished that its skin is peeling and falling off all over. Its head is so big compared to its skeleton body that I almost feel like I'm looking at something other than a human...

A little girl is rushed in on a cart after falling in a water hole. I look into her frightened eyes as another nurse checks her over. After consulting a couple others, the nurse turns to me and tells me that the girl appears to be fine, just a little in shock. I'm not convinced, however, and do my own exam. She has a little water in her lungs and a swollen stomach, but that is not unusual since half the kids here have swollen bellies from malnutrition, malaria, TB, etc. Some of my EMT instructor's advice starts ringing in my head, "Trust your instincts. Don't just rely on outward appearance and test results. If the patient doesn't look good, watch him a little longer." As I look at the girl, she doesn't appear to be just under the weather, whimpering in her mother's arms. I can see Avery in my mind again, pounding on the table and saying over and over, "Mechanism of injury plus index of suspicion always equals internal bleeding!" Quickly I ask the parents if they're willing to pay for an ultrasound and 10 min. later, the girl is being prepped for surgery after finding out she has a ruptured spleen...

An 18-yr.-old girl is giving birth to her first baby. No painkiller, and no privacy. Her pelvis is too small. The baby comes out deformed and is put into my arms to resuscitate. Within 10 minutes, the baby is dead. Her 50-yr.-old husband comes in, yelling that she'd better give him children soon or he'll have to marry a 3rd wife...

I peer around the corner of the isolation ward and see little Ramadan asleep on his reed mat. His stomach is swollen huge from TB, and his clothes are like rags on him with his little behind hanging out a big hole. Quietly I creep closer and when I'm right above him, I yell, "Ramadan!" and squirt him with a syringe full of water. In a flash, he is up and chasing me across the hospital compound with his own homemade watergun, chubby cheeks grinning wide...

I go to give medicine to an acute malaria patient, only to find out that she hasn't had it for 2 days because her family says they don't have money to buy it. A few hours later, I see the hospital chaplain, an interesting man who used to be a trained terrorist/killer for Russia, heading over to her bed. She died and he tries to comfort the mother. I go to tell James, only to hear him say, "Why are you telling me? I can't do anything for her once she's dead. Go take care of the people that actually need you!"....

Smiling wide and holding out my hand, I greet one of the HIV patients, a skinny man with no strength left even to walk or sit up on his own. Although we can only say "hello" to each other in Nangere, our eyes and sign language speak a lot more. After holding his hand for a few minutes, I start a new dose of metronadizole into his IV and try to find a way to tie it above him on a tree with a piece of string I picked up off the ground...

Liz, Sonja, and I like to say, we can't help feeling alive in Africa with so much going on around us. It is constant ups and downs, and when I lay on my cot at night, overwhelmed by it all, I have a song I like to listen to. I hadn't heard this song before I came, but it encompasses my feelings and experiences so well. After some of these days, all I do is go to my hut, lay on my cot, and listen to it over and over, until I fall asleep.

"I Would Die for You"
by Mercyme

And I know that I can find you here
'Cause you've promised me you'll always be there.
In times like these, it's so hard to see
but somehow I have a peace you're near.

And I pray that you will use my life
In whatever way your name is glorified.
Even if surrendering means leaving everything behind.

And my life, has never been this clear
Now I know, the reason why I'm here
You never know why you're alive,
until you know what you would die for
and I would die for You

And I know I don't have much to give,
but I promise you I'll give you all there is
I cannot possibly do less,
when through your own death I live

And my life, has never been this clear
Now I know, the reason why I'm here
You never know why you're alive,
until you know what you would die for
and I would die for You

A Day of Nursing

2007-10-22T17:57:00.000-06:00

October 5

James has moved me to work in the Adult ward all week so that I will learn more French with the Chadian nurses. I don't know if I actually learned more French yet, but I've moved to doing more and more nursing as I learn from observing. It has probably been the most challenging week so far and today was crazy!

As I arrived at work this morning, I spent forever organizing all the paperwork that is always a complete mess. They don't see the value in writing things down, but anybody who knows me, knows that I have to have everything just right and organized. So after entering in all the new patients and getting the #s to add up right in all the wards, I headed off to take vitals on all the patients.

My coworker for the day was David, a nurse that I'd never worked with before. He grabbed all the patients' papers from me and started walking around randomly, snapping his fingers at me to take blood pressures of certain patients. By the time James arrived to do rounds, we hadn't even done half of the vitals and all the papers were in a jumbled mess again in David's hands. I used the distraction of James yelling at a patient who didn't buy meds. to take the papers and put them in order again. As we went around, I tried to work on my humbleness as David kept grabbing my pen, stethoscope, clipboard... snapping his fingers in my face and yelling, "Come!" "This patient needs this...!" I already wanted to say that I already knew since I'd been taking care of these patients for 5 days now and probably knew more than he did about them! But thankfully, sometimes the language barrier is a blessing so my anger doesn't pour out. It is teaching me to bite my tongue and calm down before speaking since it'll take me 10 min. to figure out a sentence to say.

After I finished with all the discharges and set out all the papers for 12:00 meds, I went over to the American house to try & send/receive my email. It hadn't been working for a week, so when it actually went through, I decided to wait for it to finish even though it was 12. I'm still just, supposedly in training, helping wherever James puts me. So I figured it wouldn't be a problem to let David do the meds by himself, which he would be doing anyway if I wasn't there.

I went back over to the hospital a little after 12. David was nowhere to by found with nothing done. I ran around crazily trying to find patients to give them their meds. Many of them go outside to lay around with their family. I tried to do everything like I'd watched others do it.
The last med. I went to give was for a TB patient in the isolation ward. Just as I walked up, I heard the wailing start. She had just died a minute ago.

Four new surgery patients poured in one after another. I finally found each of them an empty bed and started their paperwork. Lab reports came in for many patients, diagnosing them with malaria so I was prescribing Quinine and Doxy, left and right, trying to explain the importance of buying meds, otherwise they won't buy it. I just tell them they'll die without treatment and it usually works with adult patients. With pediatrics, it's harder because the parents have to decide if their kid's life is worth more than the meds cost, which half the time it isn't, according to them. We don't treat or give anything until they pay, which may seem harsh, but it is really possible for most anybody to pay. The hospital allows donations so they just have to give a bike or even just a cooking pot to be put in the garage until they pay their debt.

Anyways, I finally started 1:00 meds a little late, but Dr. Bond came in interrupting me. Dr. James Bond is a volunteer surgeon here for a while...a very interesting, eccentric man. I don't know how anyone so obsessive-compulsive could end up in Africa! :) He checked on all his surgery patients and barked out orders for me, handing me meds to give them and special instructions. I was so overwhelmed and nervous giving meds I'd never heard of before. Somehow I finished everything by the time work ended at 3. David came around ever once in a while. He'd see me giving an injection and run over to grab it from me, yelling "What are you doing?" I'd explain and show him what was supposed to be given. He'd grudgingly say ok and then leave again.

At least, after today, I have much more confidence in being able to take over and do things instead of just sitting back and watching. And patience is a virtue...to keep working on...
I can't help still wondering about the woman that died. If I had been there to give her meds an hour earlier when it was supposed to be given, would it had made a difference? Or if I had been around to attempt resuscitation?...She probably still would have died, but I can't help wondering...

What you all have been waiting to hear...

2007-10-18T20:27:00.000-06:00

October 17

Sonja, Liz, and Christina walked into the American house today and started singing to me, "Happy malaria to you..." Yes, I have the dreaded disease, although I am quite perplexed by the fact that I haven't been sick. I've been really tired, but that could easily be explained by all the work and stress at the hospital. Anyways, I decided to just get tested and found out that I have 0.10%! Liz, Sonja, and Hans have all had half that, .05%, and were throwing up, having fevers, headaches...And all I've had is a little fatigue. I'm not complaining, but I'm a little worried that it is suddenly going to hit me hard; I'm just holding my breath and waiting. When I go to work this evening, I'll prescribe myself some medicine. Until then, I've been reading the wonderful National Geographic "Malaria" article that Sonja brought. I don't think it does much more than scare us. :) Now I'm worried that I have the strain that suddenly hits, goes cerebral, and can kill you in a day...but hopefully I can just treat it and get rid of it before I ever get even a headache. Blessings to you all and don't worry...everyone shudders at the word malaria in the States, but here it's as common as rice.

I'm in Africa

2007-10-17T18:31:00.000-06:00

October 13

The excuse for everything around here is just, "I'm in Africa." So whenever bizarre things happen and I look at myself in disbelief, I just repeat it over and over.

I'm on a walk and find that I need a bathroom. No worries, I'm in Africa, and just go squat in the middle of a field.

I see 2 goats, 5 chickens, and 3 people on a moto going by, and I just shrug my shoulders and say, "I'm in Africa."

The nurse I'm working with takes the syringe he just used to give a medication and uses it to put a Foley in a different patient...I'm in Africa.

While getting a blood transfusion started, I get blood all over my bare hands. I go to wash at a dirty sink with brown homemade soap that has grits of dirt cooked into it...I'm in Africa.

I'm sitting outside at morning worship under a tree and feel cool droplets rain down on my head and shoulders. Regretfully I know that it's not rain, but pee from a lizard...I'm in Africa.

Liz receives some packages from the States and we all scream as if we've won a million dollars, as we eat cherished Wheat thins and a piece of gum...I'm in Africa.

I walk home at night in a thunderstorm and feel my sandaled feet splash in puddles that I know are filled with human & animal waste and trash from the streets. Oh well...I'm in Africa.

I share my shower with a little brown goat on the mud wall, the neighbors big black pig, and a hen with 5 chicks...I'm in Africa.

In surgery, the doctor and his assistant have boots on. Everyone else is barefoot to be the most sanitary...I'm in Africa.

Christina and I go to the market, and by the end, we have a crowd of 50 people following us and laughing at everything we do & say. I feel like a movie star...I'm in Africa.

The kids in my family bring me a guava that they all have taken a bite off of with their teeth that have never seen a toothbrush. I smile and eat it...I'm in Africa.

Just from one bad tooth, a woman's entire face is swollen from infection. I try to just breathe through my mouth as I give my opinion on how to do some dentist work on her, since none of us are dentists. Smelly pus is pouring out her ear all over my hands as I hold her airway open...I'm in Africa.

I figure out how to make a loaf of bread over open coals and feel like I've just conquered the world as I delightfully eat a slice...I'm in Africa.

Hans, another SM, moves in with a new Chadian family. He has to go to the bathroom in the middle of the night and does the classic squat on a mound out by the edge of the courtyard away from everything. The next morning, his new host approaches him to inform him, "You defecated on my mother's grave." Who would guess...I'm in Africa

No one can get an IV into a 4-day-old baby, so I watch, perplexed, as Liz follows James instructions and sticks the needle under the skin on the back of the baby. A few minutes later, the fluid dripping in, is a big bubble on the baby's back that will supposedly soak in...I'm in Africa.

Working at the hospital in the early morning hours, there is a woman in a diabetic coma. All I can do is instruct the family to keep putting cubes of sugar in her mouth to dissolve, until someone with a key comes later to get some dextrose soln. for her. And it works...I'm in Africa.

At the hottest time of day, everyone sits around and drinks steaming hot tea as sweat drips down our faces...I'm in Africa.

Coming back from a walk in the fields, I come across a couple young boys herding a few cows home. I ask for a ride and soon I'm perched on the back of one of the lumbering beasts, grinning at the boys and wearing a skirt...I'm in Africa.

It is so hot, I long to wear a pair of shorts, but that would be completely scandalous, letting people see my knees. So then I'm almost tempted to go topless like the local women...I'm in Africa.

Walking back from the market, I pass a group of boys playing soccer. They ask me my name and then excitedly try to pull me in to play with them. Apparently this whole side of the village knows that a white girl named Esther likes to play soccer...I'm in Africa. (By the way, Esther is my new name given by my African father so that there isn't so much confusion with 2 Sarahs)

As I write this, I'm perched in a tree out in a field. Before climbing, I carefully checked for snakes and the huge tree spiders I despise. I can tell it's time for church to start, not because of church bells ringing or an organ playing, but from the drumming starting, because of course, I'm in Africa!

Communication

2007-10-11T08:28:00.000-06:00

October 11
I just wanted to thank all of you who have been commenting on my blogs. I've just received them all, and it means more than I can say to hear from you all. Even the smallest note makes my day! It is nice also, to know that my blogs are being read. Sometimes it seems like I'm just blindly writing...If any of you want me to write directly back to you, you can send me your email address.
Thank you again. I love and miss you all!

Mischievous Girls

2007-10-05T18:40:00.000-06:00

September 28

After having a vespers this evening with the other Americans, I headed to my hut, hoping the gate to the courtyard was open. As I approached, I realized there was no reason to worry, as it sounded like my family was having a party. The huge crowd of people, however, was standing around my hut. I slowly walked closer and noticed a girl stuck trying to crawl out of my window. Everybody was yelling and it just got worse as I arrived. I got the picture of what was happening as Anatorle told me to go inseide and check all of my things. My bags were in a mess, but I wasn't too concerned because I knew what the kids had been looking for. When I first arrived I gave a piece of candy to the kids in my family as a gift. I've been saving the rest for kids at the hospital as we give shots and such, but Kristel, Anatole's oldest daughter constantly asks me for more even though I tell her I have no more. Tonight, Kristel and 2 of her friends tried to crawl in and find some candy while I was gone, after her parents went to bed.

Poor Anatole was scandalized by what his daughter had done even though I tried to tell him it wasn't that important. The perpetrators were just three 10-yr.-old girls and as I looked at the 3 of them kneeling on the ground, tears streaming down their faces and a crowd of adults surrounding them, it immediately made me think of me and my 2 friends in academy, Lisa and Steph. These girls had to have been pretty daring to try and get into the "white girl's" hut, through the window bars about 8 in. wide and a foot tall, standing on each others shoulders. It gave me flashbacks of trying to sneak out of the dorm at night with Steph & Lisa. Getting stuck in a window sounds just like something that would have happened to us.

We got off a little easier on the punishment, though. These poor girls got quite the thrashing in front of everyone and Kristel is still being lectured by Anatole almost an hour later. The whole neighborhood is still in an uproar, and by morning, I wouldn't be surprised if the whold village knew.

I've finished cleaning up the mess and I think I'll just stay up now until I need to go to the hospital to help give meds at midnight. In just a day, the hospital is overflowing and we've started putting 2 kids to a bed for more room and patients in with the TB isolation patients. I'm so happy it's Sabbath, though, even if it's not always much of a rest. Maybe we'll ride the horses to the river tomorrow...

My God is More Powerful than Your God

2007-10-05T18:36:00.000-06:00

September 27

Most nights here are hot & clear. I usualy try to fall asleep listening to music, but when my ipod needs charging, I end up awake a lot laer because of all the noise outside. There are always a lot of drums being played loudly along with singing and kids running around wildly until late. I never minded the drums too much until james told us that most of the time, they are worshipping spirits & such at that time. The people here still hold on to their traditional beliefs and periodically I come across special ground roots and cuts on patients at the hospital to purge them of their sickness. James even had a demon-possessed woman come in one night last week.
So now when I hear the drums and singing, it gives me kind of an ominous feeling, especially since some people say they can actually see demons walking around.

Tonight as I was finishing up emailing at the American house, and dreading going to bed and listening to the drumming, it started to rain lightly. It got windier and windier, and I began to wonder if I should wait it out before going home. Usually the rain only lasts a few minutes. I decided to just run through it and soon realized that this wasn't just a regular rainstorm.
It was pure black outside as I dodged puddles, winding around the path to my hut. Usually i don't need light because the moon is so bright. The only way I could see tonight was from the lightning flashing, making it seem like daytime for a few moments. I cringed every time the thunder came...it was so deafening i thought my eardrums might pop and I could feel the power of it coursing through my whole body. In between the thundering, it was quiet enough to whisper and I thought the wind was going to knock me into a guava tree.

I made it to my hut right before the drenching rain hit. I kept trying to lock my window, but the wind was so strong, it was like watching an invisible hand that kept pulling the lock up out of the hole. I finally found a way to wedge it shut. Sitting on my cot listening,, I am just in total awe. I have never seen or heard such a storm before. (I hope Liz and Sonja are doing ok with their thatch roofs!) i could yell at the top of my lungs and never be heard over this roar. I was a little nervous at first as cockroaches and bugs seeked refuge with me, water seeped under my door, and my hut groaned so much i was sure it would collapse, but then I thought of who's in control of this storm.

God is powerful and I think every once in a while, he enjoys unleashing it in wondrous acts like this that just make me gasp in amazement.

There will be no drums tonight...and I can't help feeling like God is saying, "Do you really want to see some power? Just watch this!"

A Struggle for Life

2007-09-26T18:36:00.000-06:00

Sept. 22, 2007

Friday, the little girl who had the truck fall on her became my personal responsibility. I haven't really been working in a certain area since I'm still learning everything and watching other nurses.

So when James did his rounds and checked on her, he told me it would be my job to watch her for the day. Already earlier that morning she's had trouble breathing through the trach tube. Every time she started to come out of unconsciousness, she'd start to panic, breathing shallowly and bringing up mucous that would get caught and hinder her breathing. I sat next to her, checking vitals every 10 min. and helping her when she needed to get mucous out by suctioning until I had no breath left.

We had a couple close calls throughout the day, and when I got off work, she was too tired to breathe adequately by herself, so Sarah & Liz taught the family how to bag her through the night. She was constantly on my mind that evening & today at church. I had watched her for so long that her little face was imprinted on my mind and I could hear her labored breathing. She was doing well earlier today, and I think we were all thinking optimistically that if she just would wake up, it would be ok. The surgery had gone well and we kept telling the other little boy in the ward that soon he would have a new playmate.

Later today, Liz, Sonja, and I went on a walk and decided to stop by to see how she was doing. James was there and told us that her Oxygen sat. was still fine with the family bagging air into her, but he had noticed that her pupils were now fixed and dilated...meaning she was brain dead. I watched silently as he approached the family at her bedside and explained with someone translating in Nangere. He detached the bag and I quickly left, not wanting to see the life ebb out of her. I tried to control myself as I still had to smile at people and choke out greetings as we left the hospital.

The three of us walked out into the fields and rice paddies to watch the sunset and I cried for the young life that was so quickly gone. Some people say that I will become used to it and not be so emotionally attached, but I hope that never happens. Tears are cleansing and I will cry all year for these people because I love them. I will feel for them and just pray that God helps me to still give them the best care that I can with my limited abilities.

I stayed out with Sonja and Liz until it was dark, singing, praying, and talking. I had been praying and hoping before I came to Chad that I would get along well with them and I found out that they had been praying much the same about me. God answered our prayers even more than I had hoped. They are both filled with the same adventurous spirit as me and have an openness to God that is refreshing. We are going to have an amazing year together.

I am sitting on my cot right now, writing this as crickets chirp loudly and mosquitoes buzz on the other side of my netting. The drums and singing nearby has started to die down so that I can finally fall asleep...

Soccer

2007-09-22T09:25:00.000-06:00

September 20, 2007

It has been a long day. I worked in the pediatrics ward today with Liz and we got to discharge 2 boys this morning, leaving a lot better than they came. They were very excited, especially the one that had been there over a month, but I will miss their smiles, laughter, and playing tic-tac-toe with bottlecaps.

Our main concern to watch over today was an 8 yr.-old girl who had just gotten out of surgery the day before. A truck had fallen on her breaking her right femur and left tibia. She looked so tiny with the huge cast splinted with a brook handle and big sandbag providing traction on her femur. The best part of my day was when she opened and blinked her eyes for a few moments. I hope she makes it; last night she stopped breathing and James had to do an emergency tracheotomy on her.

Right before I left the hospital, I got to watch James drain a huge abscess on the eye of a 4-wk.-old baby. I am learning and seeing so much here!

After work, I found out that the locals were going to play soccer behind the hospital. I was so excited, I practically ran home to change. My mere made me eat first like any good mother, and smiled as I ran off yelling “Je vair football!” I wasn’t sure if they would mind having girls play, but they just seemed a little surprised and motioned for Liz and I to join a team. It wasn’t much different than playing at Milo with all guys, and the kids thought it was hilarious to watch us run. I guess they don’t see women in their culture run, with the long skirts they wear. There were big cows with horns in the field that made me a little nervous, but everyone just ran around them with the ball. It was so wonderful being able to do something without having to speak French and we played until the sun set beautifully across the fields…

In Bere

2007-09-22T09:22:00.000-06:00

September 18, 2007

I arrived at the hospital yesterday morning with Andre. We rode with the same moto drivers as the night before. Sonja, another student missionary here doing social work projects, welcomed me warmly and helped me move my bags to my hut. My African family lives very close to the hospital and they gave me a big hut to live in by myself! They have 5 kids who are very cute and Anatole, my African dad, works as a lab tech at the hospital. He is going next June to a medical equip. tech. program in western Africa and says that God sent me to him so that he can learn English well before he goes. It will be difficult for him because all his training and books will be in English.

Sonja took me to see the hospital after that and meet everyone. Soon I was running back to put on scrubs, grab my stethoscope, and start taking vitals as they admitted patients. The hospital is very primitive and they were very glad to see the supplies I brought, especially the casting and diabetic lancets to take blood tests. They had run out and were poking people with the same needles! James is the only doctor and he has to constantly operate even though he never studied to be a surgeon.

This morning I shadowed the nurses in the med-surg ward and maternity ward. I helped them change bandages, drain infections, and record medications. I wish I knew more French so I could talk to the patients more. Many of them are in a lot of pain and all I can do is somehow communicate that I am there to help them. When the babies see any of us with white skin, they cry! I guess we scare them. Liz, another SM who is doing nursing like me, came to get me this morning to see and help with a delivery. The mother was younger than me, about 15, and her pelvis was too small for the baby to fit through. James had to cut her to make a bigger opening. As I watched, I was doing my best to just keep thinking medically…giving James things as he asked for them and watching everything to learn as much as I could, but finally the other thoughts broke through. James kept suctioning the head to pull the baby out, but it still couldn’t fit, so he started cutting more where he hadn’t put anesthesia, trying to get the baby out quickly because it’s heartbeat had stopped. All I could think about was the mother yelling in pain as he cut, she was so young, and the baby that was probably already dead. I felt a tingly feeling creeping over me and knew that I had to get out of there fast. I excused myself and practically ran out to the little nurses room where there was a little bed to lay down on. As I tried to keep myself from passing out, tears ran down my face at the injustice of it all. Most of the people I had attended to all morning had serious problems, yet hardly adequate supplies to treat them. In the US, when people just have a simple sore throat, they go to see the doctor in an amazing clean facility where the doctors and nurses all have gloves and uniforms with nice music playing in the background. In Bere, the old beds have sticks tied to the corners to hold up mosquito netting, patients have to pay for each step of their care, including the bandages that the nurses put on them. Their families have to live outside the hospital to take care of them and feed them. When we change a dressing, someone has to stand over the wound and fan it to keep the dirty flies off of it. We use the same equipment for everyone and only wear gloves when we are in direct contact with a lot of blood…something my fellow EMTs would probably shudder at. I’ve forgotten all about BSI precautions J.

I had better get back to my hut for the night. I feel so incredibly blessed for where I’m staying. My hut has concrete instead of mud and a tin roof instead of thatching and it is big! My African mother warms water in a bucket for me to wash with every day even though I try to explain that I am fine with cold water…especially in this heat! This evening I ate a delicious meal of rice with mashed cassava leaves and I drink good water from a well. Life is good. And I must remember my blessings every night or I fear that I will become quickly overwhelmed by the poverty here.

What I’ve Learned from One Week in Africa

The art of tucking my mosquito netting in properly so that I don’t get the surprise of a cockroach stuck inside it…kind of an unpleasant night experience.
Saying “Lapia” and “Ce va” covers everything.
Everyone has malaria
Be careful around roosters
Check shoes before putting feet in them
There is no such thing as personal space…especially on a moto or bus
Chew carefully when eating to avoid breaking your jaw when you come across a few rocks
Guavas are the best thing created on God’s green earth!
The greatest honor you can bestow on someone is just to sit with or eat with them.

Please post comments

2007-09-18T19:00:00.000-06:00

For those that don't know how to send messages to Sarah. Please select the comment button at the end of a posted message and write a note of ecouragement to Sarah. Thanks.

In Chad…on a crazy moto ride

2007-09-18T17:56:00.000-06:00

September 16, 2007
I have finally arrived in Chad! It has been a long and interesting trip. After almost missing my flight to Paris and getting near to lost in the airports, I arrived in the capital, Ndjamena, on Thursday. Job, a pastor of one of the Adventist churches, picked me up and took me to his home to stay until I left for Beré. My bags never made it from France, so I had to wait for them. I was nervous at first, after being warned about a few things having to do with Pastor Job, but I am glad now that I had the chance to rest up in Ndjamena and see the city. I learned a lot in those few days about the people and culture that helped me be a lot more comfortable when traveling to Beré. I went to the markets and even got to visit Cameroon one day!

On Sunday, André, the administrator at the hospital, picked me up early to start our trip to the hospital. We went to catch a bus out of Ndjamena, and ended up waiting a couple hours because the bus drivers won’t leave until the bus is completely full. It was funny to watch all the bus drivers practically fight over each passenger as they came. They try to trick people into paying for their bus by stuffing a bunch of fake bags and strapping them on top to look like the bus is almost full. I felt very lucky, getting to sit in the front squished between the driver and André because the back was crammed with people. It was a 7-hr. trip to Kelo with a few stops along the way including government road blocks where they would try to get me to give them my passport. André was very stubborn about only giving them my copies to look at in his verrrrry slow methodical way. He said that they would make me pay them to get my passport back if I gave it to them.

When we finally made it to Kelo, it was too late to find a car to take us to Beré. André spent a whole hour negotiating and arguing with some moto (motorcycle taxis) drivers about taking us. They wanted more than the usual fare because it was late and the roads were really bad from all the rain. He kept refusing and I picked up a little bit of the French where he was trying to tell them I was a nurse for the hospital and had to get there that night to help people J A crowd gathered all around us to listen and stare at the white girl and interject their own advice. I kept trying to tell him that it didn’t matter, I would just pay it or we could go find a place to stay the night, but I’ve been learning that you can’t rush Africans. They take everything in their own time and will negotiate prices and such for ever! Finally he decided we would find a place to stay in Kelo because the roads were too bad and before I knew it, he jumped on one of the motos and motioned for me to do the same on a different one. I didn’t have time to say I’d never ridden on a motorcycle before and a few moments later I was crazily trying to keep my balance seated behind the driver holding onto my laptop, camera, and water bottle with one of my bags jammed on behind me.

It was dark by now and I started getting nervous about the thought that I was on this moto with some stranger who could easily take off in whatever direction he wanted. Just as I was telling myself that this was just another adventure, the headlight quit and the moto started puttering to a stop. André and his driver never noticed because they were ahead of us and soon they were out of sight. I guess the moto was running out of gas and my driver started walking it down the road looking for gas. We stopped next to a bunch of men smoking and he made me get off while he turned his moto upside down and shook it. I don’t know how that worked, but when he got back on it started again. We took off again, this time barely seeing people and goats in time to swerve around them since the headlight still didn’t work. He was going slower and looking down all the streets which gave me the feeling he didn’t know where we were supposed to go. I was getting more nervous and wishing I could speak French just for a minute to communicate with him since I might be lost in the town with him for awhile. Feeling very helpless, I happened to look up and was greeted by a sky brimming with stars and the moon. It was beautiful and somehow comforted me. I continued to look at them while we weaved through the dark town and thought of the verse in Psalms where David writes, “When I consider the heavens, the work of your fingers, the moon and the stars, which you have set in place, what is man that you are mindful of him, the son of man that you care for him?”

Before I knew it, the other moto miraculously found us and we found our way to a room for the night. I’m sitting there right now writing this, feeling incredibly cared for and loved by God…and all because of a few stars!

Tomorrow morning I will be in Beré (I hope) and I can post this as soon as I figure out how the internet works. Thank you for all the prayers while I traveled!

The date is set

2007-09-06T11:08:00.000-06:00

My plane ticket is bought ~ I leave next Wednesday, the 12th at 1:20 PM! I can hardly wait, but I also have so much to do in just a few days...I have to pack, take 20 min. hot showers to make up for a whole year without them, cram some more French into my brain, take my EMT national registry test on Tuesday, hang out with a few more friends who I won't see for a long time, finish writing back to a bunch of my campers from this summer, and stock up on important foods like chocolate and dried cranberries :) Hopefully everything will fall together. Today I'm visiting all my grandparents one last time and saying for the millionth time, "No Grandma, I'm not going to get lost over there...yes, I'll eat a lot of good food..."

No electricity for 10 months!!!

2007-08-22T19:46:00.000-06:00

I've started communicating with James and Sarah Appel, the doctor of the Bere Hospital and his wife. The 60-bed hospital is run by James, the only doctor, and 2 nurses, one being Sarah. There are no paved roads which makes for lots of mud to get stuck in this time of year and no electricity except for running an occasional generator during a surgery. They are looking for a Chadian family for me to live with so that I will learn French quickly and learn more about the culture. I've started the visa process finally! Hopefully it won't take long since I'm just applying for a 1 month tourist visa until I get into the country. Sarah is happily answering all the questions I've been throwing at her. I can hardly wait!

I've been accepted!

2007-08-15T23:15:00.000-06:00

After planning for a long time to go to Cameroon, I found out while working at Big Lake this summer, that those plans fell through and I was no longer able to go. Just a few weeks later, though, I got an e-mail saying that I was voted and approved to go to the Bere Adventist Hospital in Tchad! God works in great ways, I'll be right next door to Cameroon, but I'll get to do medical the whole time which is what I've been hoping for a chance to do. I am in the process of waiting for my visa and insurance info. to go through, and then I'll be headed off shortly. It sounds like the doctor has already been expecting me. This call doesn't support me with any stipend to live off of, so I am supposed to raise an extra $100 per month I'm there. I need about $300 more to stay a total of 10 months. Thank you to all of you who have supported me already, and if you would like to help, there will soon be info. at the bottom of my blog on how to do so. Now I need to pack to go camping!

Late Summer blessings to you all!!!