Tuesday, March 31, 2009

Another Long Night

Warning: this is a sad blog. I know I post a lot of really discouraging and sad blogs, but I will also write some more uplifting and lighthearted ones. This actually happened almost 2 weeks ago. I've been really behind on writing blogs because I've been busy, traveling, and then sick. With that preface and my excuses out of the way, here's the story.

Another night shift in pediatrics. I had a feeling it was not going to be a good night. Ansley had told me that there was one baby with meningitis that had not been breathing well, and somehow I knew it was going to be trouble. Sure enough, around 2 AM, the family came to get me to tell me that the baby's breathing was getting worse. I came to look, and decided immediately to go get Dr. Jacques. The baby would breathe really quickly for a little bit, and completely stop for a while.

When Jacques came, he went to the OR to find the baby size ambu-bag. We both stayed by the bed and took turns pumping air into the baby boy's lungs. Every once in a while, we would stop to see if he was breathing better on his own, but we weren't seeing any improvement. After 10 minutes of bagging the baby, I said, "Jacques, what are we going to do? We can't keep breathing for the baby all night." He didn't answer me directly, and we continued. Then Jacques was called into the ER for an emergency. I stayed by the bed, pumping air, but my wrist started getting tired. All together, we ambu-bagged the baby for a little over an hour. Finally, Jacques was satisfied that the baby was breathing well enough, and he went back to sleep.

About 20 minutes later, the family came up to me again. "He's not breathing well, come see."

I looked and very quickly realized that he wasn't just not breathing well, he wasn't breathing at all. I started CPR and prayed hard. I didn't want to lose another one. I got him to breathe again and went back to my desk, but 20 minutes later, the family was back again to call for me. All through the night, from 3 AM until I got off shift at 8 AM, I went and did chest compressions on that little boy every 20-40 minutes. One time, he had stopped breathing and had no pulse as well.

By the time my shift had ended, I was exhausted, and as I passed off the patients to Salomon, I just knew in my heart that that little baby boy was not going to make it much longer. I went to the middle house to lay down and rest for a while. Then I went back to the hospital to find Salomon.

"Is the meningitis baby still here?" I asked, but I already knew the answer.

Worth the Trouble

There are some small experiences that I've had here that I've been so glad for. Every once in a while, I'll see an opportunity to do something small, something that probably won't make a life-changing impact, but that makes an impact nonetheless. I actually just finished reading a book called The Shack by William P. Young. It definitely challenged my view of God and gave me a lot of profound insights into the love and character of God. But there was one line at the end of the book that has really encouraged me.

Lately I had been feeling kind of like a failure. I came here to be a missionary, to touch people's lives for eternity, and I'm afraid that most of what I've done is just make some really good friends and help to heal people physically. There's nothing wrong with that, and I know it's good work. But I had really hoped to make some kind of lasting impact on someone's life. Anyone. Even just one.

Then I read this line, spoken from the perspective of God in The Shack: "...with every kindness and service, seen or unseen, my purposes are accomplished and nothing will ever be the same again."

Since then, I have had a new perspective on things, and when I see opportunities to do something for someone, I try to take advantage of it, to accomplish God's purposes. Which, by the way, I believe that quote is very true. Anytime we choose to show love in any way, we are witnessing to the universe that we believe that God's way is the best way.

The other day I had a unique opportunity to show love. Ansley, Caroline, and I were walking back from the market with Simeon, a 10 or 11 year old boy who only has one arm. It was super hot because it was the middle of the afternoon, and we were tired from having walked to the market and buying things. Along the way, we saw a girl, maybe 6 years old, with a baby strapped onto her back, and another young girl who looked to be about 18 months old following behind. We watched as the smallest girl stumbled and faltered in a zig-zag pattern behind her sister, falling and then standing up to walk forward again. It looked like her legs were somewhat crippled, possibly from Ricketts. Then Simeon told us, "You know, she's four years old." We were in shock. It didn't seem possible that she could be that old.

Ansley shook her head and said, "Malnutrition." She's probably right. So Caroline took one of the girl's arms, and Simeon took the other and helped her walk along the path. She was still having some trouble walking and continued to stumble despite their help, and she was breathing hard. I asked Simeon, "Do you know where she lives?" He said he did.

I then picked her up, and she looked at me with little to no expression on her face. I was glad that she didn't cry because some of the young children here are really afraid of white people. We walked all the way to her hut, which was only about 2 minutes out of the way, and I walked into her yard and set her down on the ground. She stared up into my eyes, and then unexpectedly, she laughed. Her eyes smiled with her mouth, and that laugh was the most beautiful sound I have heard in a long time. I smiled back at her and waved goodbye to her older sister and the baby, and we continued on our way.

As my time here is coming to an end, I've begun to realize that it's the experiences like this that really make everything here worth the trouble.

Friday, March 27, 2009

House Call

I've had some really funny conversations with my family here because of our cultural differences, but I think last night beat all. I was sitting on the mat with my girls, and they were looking through my phone. Of course, all of the contacts on my phone are in English, so when Berthe got to "Home" in my contact list, she said, What's this number?"

Without pausing for thought, I said, "That's the number for my house."

Her eyes got wide with wonder. "If you call this number, your house will talk to you?!"

I laughed realizing that she had taken literally what I had said along with the fact that people only have cell phones here, not phones at their huts. I explained that no, my house cannot talk, but if I call that number my mother would pick up the phone and I could talk to her. Conversations like these have made me wonder just how much of a culture shock I'm going to have when I get home...

Friday, March 13, 2009

Life is Not Always so Kind

Today was a sad day in peds. It just kills me. When Ansley and I got report from Caroline, we found out that one of the really critical patients had died last night.

There was another baby who was really sick too. We had been treating him for malaria and a respiratory infection. He had been getting better-- his respirations were better, his lungs were clear, and he looked like he wasn't as tired as he had been. But then he went downhill again. This morning, he started having seizures, had a fever, and his respirations were not good again. Jacques decided that we would do a lumbar puncture to check for meningitis.

We moved on with rounds, but we hadn't even finished with the next patient when we heard crying and the grandmother of the really sick baby called us over. He wasn't breathing and there was no pulse. Jacques started compressions while I opened his airway, but it was all for nothing. Once again I had to watch another mother with tears rolling down her cheeks for the loss of her baby. Once again, everything we could do was not enough. I cried as Ansley took out the IV and Jacques covered the baby with a sheet.

There was another mother who kept trying to tell Ansley and me something, but we couldn't understand her. We asked another nurse to come translate, and that's when we found out she wasn't Nangjere, she was Gumbaye. We found a different nurse to translate, and what she said was just so awful. Her baby, only several days old, was on her second dose of IV Quinine and was doing pretty well. However, the mother had just received news that her older daughter back at home had died. When she left home, her older daughter was in perfect health; we don't know what happened, just that her daughter was no longer alive. This mother didn't know what to do because her baby wasn't finished with its treatment, and she couldn't just leave her baby at the hospital to go take care of things at home. So we had to talk to Dr. Jacques who prescribed other medicine so that she could go home. It wasn't ideal treatment for her newborn baby, but what else could we do? Throughout the day as we were preparing things for her to go home, I watched as she sat on the edge of her baby's bed, head in her hands, wiping solitary tears from her eyes when she just couldn't hold it in any longer.

Life here is hard. The longer I've been here, the more I've realized just how tough Chadians are. Their strength, both physically and emotionally, amazes me. Girls here learn how to cook for a full family at the age of 10. The 8 and 9 year old girls at my house almost daily haul up gallons of water to water both of the gardens. Women give birth to between nine and twelve children, and often have to watch up to half of them die before they reach adolescence.

I don't know what to do with all that I've seen here. I'm not sure that there's much I can do about the way life is here. It doesn't seem like anything I can do would make any difference at all. And yet, I try to remind myself of all the children that do go home, happy and healthy, because of the care that we've given at the hospital. I just wish I could do more.

Wednesday, March 11, 2009

Rats

This is a guest blog by Ansley Howe. She compiled a blog with a few of our favorite rat stories. Hope you enjoy. Just in case you don't already know how to access Ansley's blog, it's found at http://howeareyou.blogspot.com.

"Sarah," I say one hot February morning, "We must do something about the rats. Every time I work the nightshift I see rats, and last night there were five different times when I saw them. I'm pretty sure it wasn't the same one. They are in the ceiling, too!"

The hospital is very small. It is infested.

Sometimes we startle new volunteers with our various tales of rat encounters. The following are few of the memorable rodent experiences.

1.

One night Jason was giving an IV medication to an isolation patient who was waiting for tuberculosis test results. The man was a classic picture of tuberculosis and AIDS: small, wasted limbs, hollow face, clothing so big it looked like he was dressed in gowns for a Christmas pageant.

Suddenly, a rat ran down the windowsill and leapt onto the man's mattress. Startled, Jason jumped back. This sudden motion startled the rat, which dove for the nearest haven: the patient's pant leg.

As the patient began hollering, another isolation patient from the next bed jumped up, grabbed his IV bag, and ran to the rescue. He started grabbing for the rat shape that scurried frantically in the trousers of the unfortunate man.

The rat ran up the tunnel of the patient's pants. Soon both patients were swatting madly at the rat. The rat went up one leg and down the other. Other family members in the room came over to watch and add their vocal excitement to the scene. Jason could barely finish giving the medication for all the swatting, shouting, and din.

The rat finally escaped the pants trap and disappeared below the bed.

2.

Another time Sarah was working the night shift and assisting a patient to prepare for surgery the next day. She was in a small exam room with the patient and his two brothers, doing paperwork and telling the group how much the operation would cost.

Another nurse was working down the hall where he was finishing up vital signs.

A large rat ran out from the corner of the room.

"Shut the door!" yelled Sarah. She knew they would have a better chance of getting him if the space was enclosed.

The occupied nurse down the hall was surprised to hear the exam room door slam.

One of the patient's brothers took off his heavy shoe and began throwing it at the rat. There was a loud scraping of furniture as they tried to prevent the creature from hiding under desk and chairs. The shoe clonked against the wall, then was picked up and hurled again in the direction of the rat.

The other nurse heard all the commotion and was concerned for Sarah's safety. He had no idea what was going on, except for hearing yelling and banging and thumping coming out of the exam room.

He assumed Sarah had been telling the family members about paying for the surgery, and they had gotten upset and attacked her. He ran to the exam room and tried to pry open the door.

Sarah, not knowing who it was, yelled, "Don't open the door! Don't let the rat escape!"

The confused nurse was surprised as the door was slammed shut in his face.

The rat was finally captured and escorted off hospital property, and Sarah laughed with her coworker as they smoothed out the rumples of misunderstanding.

3.

One night, as Kristin prepared to give the midnight medications, she found the door to the nurse's station was closed. That door is never closed. Kristin heard some commotion inside. When she tried to open the door, Enoch, a fellow nurse, pulled it shut again, with some force.

Kristin was quite surprised.

"What do you need?" asked Enoch, "Do you want your bag?"

She replied, "No, I want the charts so I can give medications."

She heard a little shuffling around, and then Enoch opened the door a little bit. Kristin peered in to see Enoch bending over a limp furry object in the dark.

Then he said, "This rat, he's annoying me a lot!"

Kristin watched in horror as Enoch started beating the poor brown rat with some large hard object.

He beat the rat to death in front of her very eyes. She was mortified.

Then Enoch proceeded to flick it across the floor all the way down the hall and out the door.

4.

I cornered a huge guinea-pig sized rat behind the autoclave machine a few nights ago. Koumabas, one of the hospital pharmacists, came around the corner in the dark and asked me what I was doing, as I shooed the trapped rat from one side of the autoclave to the other.

"Koumabas!" I said, "The rat is cornered behind the autoclave, now what should I do?" I hated to just walk away after the chase, but I wasn't about to try and grab it.

"Well." said Koumabas. He always has something comical to say, and the funny thing is that he is usually actually being serious. "Maybe if we corner him here until the morning then Abel will arrive and we can turn on the autoclave and burn him."

Thank you, Koumabas. That's a practical idea. Let's stand here in the dark for eight hours until Abel arrives just so we can burn the rat.

As there were IV's to start and baby bottles to be washed, I ended up just leaving the rat to escape on its own. I released him from impending death in the autoclave at the hand of said Abel.

Pigeons

The other day as Ansley and I were sitting at the nurse's desk in pediatrics, we had an unexpected visitor. Mounden, one of Emily's brothers from Samedi's family, sauntered up to the desk. I started talking to him about random things, and then I asked him about his birds. Mounden, who's about 13 or 14 years old, loves to buy and keep these pigeons. When Emily was here, they made a little mud hut for all of Mounden's pigeons.

"How many birds do you have now, Mounden?" I asked, trying to make good conversation.

"Eight," he said as he smiled and kind of fiddled with something on the desk.

"Have you given them all names?"

He looked around, and thought for a second before he said, "Yes."

"Well, what did you name them?" curiosity got the better of me.

A huge smile came over his face, and he said, "Emily. And Alex." Then he tried to stifle some laughter.

Ansley and I burst out laughing, and then I said, "But Mounden, that's only two of them, what are the other ones' names?"

He thought for half a moment before he smiled again and said, "Caroline."

This was just too much. Ansley and I laughed again. Then Ansley said, "What about Ansley, is there an Ansley?"

"Yes, there is," he laughed some more.

"And a Kristin?" I asked.

More laughter. "Yes. There is one for everyone, Jackson, Sarah, James." We all laughed for quite a while over Mounden and his pigeon's names. Apparently there isn't one for Stefan. Later when Mounden was walking to the market with Ansley, Caroline, and me, we were telling Caroline about his pigeons. So she suggested that he name one of them Jackson Stefan. Mounden thought this was hilarious, and we all laughed some more too.

Mango Season

It's mango season. I love it. I've only found a few things that seem bad about mango season, the main one being that sometimes kids climb mango trees to pick the fruit and end up falling out of them. Then we get to clean them up at the hospital. Another thing that's not so cool about mango season is actually kind of humorous.

I used to think that it was awesome that we have worship every morning at the hospital under the mango trees. I mean, really, how many people can say that they do that? However, I do not have these same sentiments any longer. My former sentiments have now been replaced with feelings of anxiety. Why?

The mango trees are home to many very large fruit bats. Every morning when I come to the hospital for worship, I have to look very carefully before sitting down because our cement benches are absolutely covered in bat droppings. Once I find a place that is clean enough to sit down, I spend a good deal of worship time praying that the bats won't make any fresh marks. I have been very fortunate in escaping the bat droppings thus far.

Unfortunately, good grace ran out this morning. There is generally a great sound of flapping wings and rustling leaves to signal the oncoming bombing, and this morning as I heard the warning, I cringed. Moments later, there was a small shower from above- just about the only moisture during this dry, hot season.

As I sat there feeling rather gross, I had to comfort myself with the thought that at least it's mango season and that's all the bats have been eating.

_________________________________________________

Just another short mango season story. Mango season can actually be kind of dangerous. As I said before, sometimes kids will fall out of mango trees because the branches aren't all that strong. Once, we had a woman come into the ER because a mango branch had fallen on her head. The other thing that you have to watch out for is falling mangoes. Mangoes will randomly just fall from the sky without warning.

Tonight I had to laugh because as Jason and I were standing outside the hospital gate talking to a local high school teacher, random mangoes were falling from the trees above us. There were a bunch of kids gathered around because Jason had brought out his guitar, and so every time a mango would fall from the tree, there would be this mad dash as the kids scrambled in the dark to find the mango first.

Friday, March 6, 2009

Oh Dear

I was just reading through some of my old blogs when I came across "Lai Revisited." All I can say is, please excuse my horrible grammar! As I read I saw some split infinitives, abused pronouns, and a lot of disagreement in number. My English teachers would be horrified I'm sure :)

I guess it's just been a little too long since I've been speaking civilized English. My vocabulary is dwindling and my grammar is suffering horrible cruelties. My specific apologies to Little Christen; it must pain you to read my blogs :P

Thursday, March 5, 2009

Fishing?

I used to go fishing sometimes with my Dad when I was little. I don't remember going a lot of times, but I do remember going once or twice with him. I really enjoyed going with him and my older brother, but I don't think I actually liked fishing very much. At least, not from what I remember. I didn't like to touch the fish. And I very specifically remember one fishing trip where my younger brother, Stephen, caught a little sunfish, but when we went to get it off the hook to throw it back, it was bleeding. Not something that little girls like to see, no matter how much of a tomboy they might be.

In any case, I got to go fishing here yesterday. You might be surprised to hear that there's fishing here in Chad, but believe it or not, fish is actually one of the favorite foods. Of course, there aren't really any salmon, trout, or bass. But there are fish. Sometimes you can see kids going out with their little poles to try to catch what they can in big puddles during the rainy season. Amazingly enough, they do sometimes catch things in the puddles. How the fish get into the puddles, I have never been able to figure out. The other mode of fishing is to stake two poles in the river with a net attached.

What kind of fishing might I have done, you wonder? Well, a very special kind of fishing, domestic fishing. Yesterday I was at home with Hawaa and Bezalel, the two year old. Hawaa was washing clothes, so naturally, she needed water drawn up from the well. Bezalel is ever so helpful, or at least wanting to be as helpful as any two year old can be. Hawaa would draw up the water with our water bag, and then let Bezalel hold the end of the rope after she had dropped the bag back into the well. He thought this was great fun, and he would pull on the end of the rope like he's seen everyone else in the family do, but inevitably it was too heavy for him, and he couldn't hold it long.

As he was playing with the rope, I thought to myself, "I hope that he doesn't let go of the rope." No sooner had this thought crossed my mind than Bezalel did just that. Hawaa turned around at the sound of the plunk in the water. She quickly went to find our grappling hook, but the rope attached to it was way too short. So I went and found the long cord I had bought as a jump rope for the kids. We attached the two together, and I began to fish. It was actually kind of fun, though short-lived. Hawaa was funny though, because as soon as I had hooked the water bag (which was conveniently still floating near the surface of the water) and began pulling it up, she started saying, "Quick, it's going to fall again!!" So I pulled faster, hoping that nothing would rip or fall again. Thankfully, we were able to recover our water pouch without any problems, and I think it may be a little while before Bezalel will be allowed to help in that way again.