Last day at Chimala

I could not have put the last day at chimala in better words than my dear friend Allison. Below are the words that poured from her heart onto paper as the reality of our departure drew closer by the minute. Today was the last day at the mission, and I must say that I feel as though my heart has grown larger over the past month. I never knew I could have so much love for people that I never really even has a real conversation with. I woke up this morning to go to church, who have so much love and trust in us, but have I ever has a conversation with them? No. "kidogo Swahili." standing around in a giant circle after shaking over a hundred hands my heart just feels like it could burst. It is one of the best feelings ever, and to think that God loves each and every one of us!  We then sent the afternoon preparing fr goodbyes, writing out what we wanted to say on a card for each ears and a card for the patients we have grown to love. I the cards we expressed our love for them and God's love for them, each with a Bible verse, Phil 1:2-3 and Romans 15:13. Meghan and I then took the notes scribbled on notebook paper down to the hospital to get someone to translate it for us into Swahili so we could then transfer it onto nice cards. But before we went down to do that we stuffed my backpack with goodies that we wanted to give our friends. We walked into female ward first and went straight to Nazifa who had her mama at the bedside. We pulled out a five star notebook and a pack of fragile markers and her face lit up. Considering she hasnt smiled much since we took her for her past few dressing changes. This warmed my heart. Meghan then pulled out a kitenge and laid it on her, it was the green Tanzanian leaf one. Her and her mother repeatedly gave thanks. We then whipped out the peanut butter crackers, which I had a lot of. I gave some to Nazifa an then headed over to Bibi's bed to give her some, considering she was always asking for something to eat. She then, like every other day, patted the area of the bed next to her, encouraged me to sit there and then hug her. I wonder if this woman would be just as silly and goofy in English as she seems in Swahili. We said goodbye but knew we would be back later for our last goodbye. Meghan gave one more kite he for Malale's mama but we had no clue how to get it to her without the other mothers asking and wanting gifts. To our surprise and the Lord's will we ran into mama Malale outside of peds ward with no one else around. Meghan presented the "zawadi" (gift) to her and she was ever so thankful. We then continued on into male ward, where 2 of my favorite boys are. As jeremia heard our voices and knew that we were coming he covered his face to hide, just like he always does, and like I always do, I walked up to his bed, pulled the covers back, to reveal that sweet mischievous smile. Meghan and I got our daily high fives in and then dug into my backpack for some zawadis. I gave jeremia a moleskin notebook, just like the one I had given Odakis earlier. Then I took out my bag of pens and began dividing them up between the 2 boys and their smiles grew bigger with each pen of a different color. Odakis immediately began testing them out on his notepad. We gave the 2 boys some peanut butter crackers. I never knew you could make one peanut butter cracker last for 10 minutes, but somehow jeremia made it happen. We left the hospital knowing we would return later that evening for our last goodbyes. We spent the next couple of hours writing out cards as our list of patients we wanted to give them to kept growing. After evening church and dinner at the Stinsons, all 7 of us students went down to the hospital--headlamps on and notecards in hand. We went to OB first where we gave a card to the family of the most recent eclamptic patient. Their repeated thanks was very humbling. Next was female ward. We walked in to see all of the mosquito nets up, but through the nets we saw Nazifa's smile. We gave her the card and without even knowing what it was or what it said she clung it close to her heart and smiled. We gave Bibi a card and she had each one of us take a turn at sitting down on the bed next to her, giving her a hug, and then doing the snap handshake, where she then either gives you an approving or disapproving look based On how well your snap sounded. There is a lady in the back corner of female ward who has some second degree burns. She has always made a point to say hello to us so we gave her a note as well, along with a skirt from Meghan. She too gave repeated thanks. Meghan had a pair of white vans that she wanted to give to someone. She saw a barefoot lady and asked, "think she has size 7 feet?" with hopes of the shoe fitting Meghan gave them to her and a smile of thanks spread across her face. Meghan and I then gave our last hug to Bibi and then reached our heads into Nazifa's mosquito net to kiss her on the forehead . She said "kesho" which translates to "tomorrow" which is what we tell her ever day that we see her. To hear her say this just broke my heart and I left the ward hoping and praying that she lives a good life an knows God. After a quick stop in pediatrics we went to make ward where I knew I would have to say goodbye to the two sweetest boys. They were just getting tucked into their bed by their mothers and their nets were almost around them when we all came in for our high fives. We gave a note to jeremia, Odakis, and Ezekiel's mama and spent time getting our last goodbyes, photos, high fives, hugs, and twigas in. Odakis has become a very good balloon animal maker, with the help of Erin and her balloon pump. He had probably made about 7 giraffe (twiga) balloon animals. Meghan and I each got a hug from jeremia, which is a lot better than all the other times he has tried to bite or scratch us for fun because he thinks it is funny. With tears in our eyes we finally pulled ourselves away and walked out of male ward to find Nazifa's mom who had come to find us and thank us. She is a very beautiful woman and I love that I got to spend some time getting to know her and Nazifa. With last minute pictures and videos of the place we have put our blood, sweat, and tears into for the last month, we pulled ourselves away to make the last walk back to the house from the hospital. With Meghan and Ashli at my side we stopped at the bridge where the best view of the sky is. Looking up at the sky I felt so small, and could feel the greatness of God. The stars seemed to twinkle and all of the troubles of the world seemed to vanish and seem small when you look up to the big open sky and know that there is more to life. I want all of the people here to know that and feel that as well. That is why mission work is so important. You come to love the people, show God's love, let them know God loves them, and to let them know that If you give your life to God, true life awaits them past all life's heartache and trouble. 

New Heaven and a New Earth

^{Isaiah 65:17-24}

¹⁷ “See, I will create
    new heavens and a new earth.
The former things will not be remembered,
    nor will they come to mind.
¹⁸ But be glad and rejoice forever
    in what I will create,
for I will create Jerusalem to be a delight
    and its people a joy.
¹⁹ I will rejoice over Jerusalem
    and take delight in my people;
the sound of weeping and of crying
    will be heard in it no more.

²⁰ “Never again will there be in it
    an infant who lives but a few days,
    or an old man who does not live out his years;
the one who dies at a hundred
    will be thought a mere child;
the one who fails to reach a hundred
    will be considered accursed.
²¹ They will build houses and dwell in them;
    they will plant vineyards and eat their fruit.
²² No longer will they build houses and others live in them,
    or plant and others eat.
For as the days of a tree,
    so will be the days of my people;
my chosen ones will long enjoy
    the work of their hands.
²³ They will not labor in vain,
    nor will they bear children doomed to misfortune;
for they will be a people blessed by the Lord,
    they and their descendants with them.
²⁴ Before they call I will answer;
    while they are still speaking I will hear.

Just for today

On Friday, I got to work on female ward, my favorite ward, with Allison. The morning went well with rounds, Allison and I both had successful IV starts, and Allison got her first urinary catheter successfully. Allison was a joy to work with. Sometimes there are people that you connect with immediately, and Allison is one of those people to me. As the morning progressed forward, we continued our nursing responsibilities—caring for the impoverished with compassion. After lunch, we were obligated to bring Nazifa to a dressing change for her burns. Every Monday, Wednesday, and Friday is burn dressing day. Our supplies are running short and my heart continues to break as I know her body will never heal to its previous state. As her screaming began to dissipate from the medication, we went about removing her dirty dressings. We removed the gauze that was soaked with her blood and pus, peeling skin away from her body. The gauze peels away, debriding her wounds and bringing fresh, raw skin to exposure of the afternoon air. Her wounds are healing. We know this because the edges are approximating, her wounds are bleeding, and she has no signs or symptoms of infection. As I was scrubbing her raw, bleeding skin, a wave of nausea met my stomach. I kept telling myself over and over again, Meghan you are fine, you have seen much worse than this before. In fact, you have been doing this three times a week for the last three or four weeks. But this feeling deep within my gut would not dissipate. I had to sit down, and Miss Bingham told me they had everything under control and that I could step out into the fresh air. I removed my blood stained gloves and walked outside. I took a deep breath and sat down on the bench outside of minor theatre. In my head I repeated the following words, “I will not get sick, I will not get sick, I will not get sick.” A few minutes later, I overcame my upset stomach and returned to minor theatre. We finished up with Nazifa and brought her back to her bed to rest. The nurses said there was nothing else Allison and I could do so we went to other wards to help as needed. In peds, a nurse asked me to help find a vein on a child needing fluid replacement therapy. After the first failed attempt, a wave of nausea hit again. I walked outside to embrace the breeze, but this time the nausea persisted. Miss Susan insisted I return to the house and she escorted me the entire way. She was very sweet and made sure to keep me steady as I weakly walked to the house. When I got to my room I embraced the coolness of the hard cement bathroom floor. I felt so awful I didn’t even care if the ants crawled over my feet or if the rats came out of the towel cubbord for a visit. All I desired was the coolness the cement floor offered. Unfortunately, the nausea overwhelmed my body and I gave in to the urge to vomit (tapika) the rest of the night. I slept in my top bunk, with my basin by my side. Miss Janice asked if I could stomach some pills, and there was no way I could keep anything down long enough to have therapeutic effects. I resorted to the injection. It’s not many times you can say your teacher has seen your bare bottom or given you an injection. But, this is Africa. The Phenergan burned and I felt a new sympathy for my patients. Soon enough, I was passed out on my bunk. At two am I woke up feeling weak, but better. I somehow managed to climb down my bunk and maneuver a path through the darkenss to the bathroom. I rinsed out my basin and cleaned myself up. Then I returned to the heights of my bunk. As morning dawn began to pour light through the window, I knew I needed to get out of my bed. Today was the day scheduled for us to teach the seventh graders down at the school about HIV/AIDS and sex. There was no way I was going to miss out on this opportunity to teach the young girls about saving themselves for marriage.

The advisors requested us to teach on the topic because many people in the villages have been trying to persuade young children to have sex with them. Many times they offer valuables in return for sex. This is a common problem in the surrounding village because there is a myth that having sex with a virgin will cure you from AIDS. We split the class up with us women teaching the girls, and the men teaching the boys. We emphasized that this is not true, and that you can run away from people who want such things. Kellum began discussing what your body does as your grow and reach puberty. She also described how AIDS can be transmitted from person to person. Then Allison and Erin discussed sex as a gift from God that is only to be opened after one is married, and only to be shared with your husband. Alaina followed with a story from the Bible in Genesis 39 about Joseph and Potiphars wife. She discussed how Joseph wanted to honor God, and remain pure. He denied Potiphar’s wife’s request to sleep with her, and he physically ran from her. She emphasized that they can physically run away from those who want them to have sex with them. Then Anna continued by having a girl read from the Swahili Bible some passages about how your body is the holy temple of God. She talked about keeping the house of God clean and pure. Ashli followed by telling a personal story about a commitment she made with her parents, when she was around their age, to save herself for her husband. I was blessed to end our topic of discussion with a prayer—asking for guidance and strength to remain pure. Our translator did not always understand our English, and we hope and pray that the message got across to the young girls. Our hearts reach out for these young souls to know the truth, and to know that they can remain pure, or start new today and be pure. Before we left, we decided to sing a song for the girls—

            Father God, just for today

            Help me walk your narrow way

            Help me stand, when I might fall

            Give me strength to hear your call

            May my steps be worship

            May my thoughts be praise

            May my words bring honor to your name

As we were gathering our possessions to return home, the girls asked us to teach them the song. We wrote the words on the chalkboard, as well as a paper copy for future reference, and sang the song a few more times, teaching them the words and the tune. Smiles spread across their faces. As we departed the school grounds, all of the girls escorted us. They reached for our hands, and shouted, “Asante, asante sana, asante!” Which means thank you, thank you very much, thank you. When we arrived back at the house, they sang us a song about the flowers and showed us a dance. We took a few last pictures and said our goodbyes. The love that these girls showed us is indescribable. I cannot fathom having so little and being so full of joy. These precious girls are an example to me, and I never want to forget what I have learned from them. You can find joy in the smallest things, and you can brighten someone’s day by a smile and holding their hand. I have learned that I need to be thankful for what I do have, and that I can do anything with Christ who strengthens me.

I overexerted myself this morning, and took a three hour nap. I still had not eaten any food, and attempted my first meal at lunctime. After I got a few crackers down, I could feel the strength returning to my body. It was a downhill battle from here!

Numb

To a medical professional, death can be seen as a failure in practice. Lately, I have come to realize that this is not true. Death is not something in our hands. God is the ultimate healer and he decides when it is time to cease breathing. This week has been overwhelmingly full of death. I am growing numb to the feeling when time of death is called. It is more a “guarding my heart” mechanism. The other night we got a phone call at the house to have someone find an ambu bag and run it down to male ward. Ashli, Amy and I volunteered and rushed to the hospital. When we arrived, Dr. Kent and Dr. Stephen were preforming CPR on the man with pneumocystis pneumonia (PCP). I pushed some epi as well as atropine as the doctors continued CPR. Despite our valiant efforts God chose to answer no to our plea’s. The man never took another breath. He moved on from this world. After he died, the family came in and began preparing his body. We helped remove all of the medical lines, and his mother closed his eyes and mouth. Then we all helped wrap up his body and position him correctly. The wife, now widower, came into the ward and laid on the ground clutching his lifeless body—wailing—grieving his death.

This is only one of the many accounts this week where I was faced with death. We had multiple cesarean sections with depressed babies that never came to. There was a little child, Fred, on peds ward who passed away, Rehema and 18 year old girl, the man with AIDS—and the list goes on and on. It seems like everyday there is at least one death.

One thing remains—the Lord gives, and the Lord takes away.

Grace

What is culturally acceptable? Many times culture varies from one location to another. Imagine there is a thief who has a stealing problem. What type of punishment would be appropriate? To what extreme can you justify vindication.

Today male ward was home to a thief. He was admitted with various injuries from being beaten. Ther was a ruckus outside the hospital and people were vigorously wanting to continue this mans punishment. Many times, thieves are barbequed—in better terms—taken by the community, doused with kerosene, and lit on fire. If the police had not gotten involved, or if it had been dark, the outcome would have surely been as previously stated. I thought someone was pulling my string, but confirmation was quickly established.

God wants us to love everyone—but I cannot honestly say that was my first instinct upon hearing this man’s situation. He was handcuffed to the bed, and I was full of mixed feelings. I wonder if this man had ever experienced unconditional love. What was his childhood like. Did he have a family? What motivated him to become a thief? How does he feel now? Any sense of remorse? But how could he steal, that is so wrong. He deserves punishment. He also is loved by God. And my mind ran in circles…and circles…and circles.

I decided that I would go over and introduce myself and say have a goodnight in Swahili and God be with you. I felt this strong urge to look him in the eyes and say hello. I wonder if anyone has done that yet.

I found out this morning that he had left the hospital without paying his bill. It appears that he has not learned his lesson, and I worry about his soul. The CEO of the Chimala Mission Hospital was talking about how we are a hospital that shows God’s love and we care for those even when others would not. He was not justifying this man’s actions, he was stating that God loves everyone and cares for everyone. We are to follow Christ’s example.

Purpose--the reason you are alive

I don't know where exactly this quote originated from, but it holds dear to my heart. 

Having a rough morning? Place your hand over your heart. Feel that? That's called purpose. You're alive for a reason. Don't give up.

I must remember the purpose behind my work—it is for the Lord. I had a rough morning. When I arrived in OB, there was a little one on the counter in the corner of the room. Anna and I went over to the little girl and did a physical assessment. She was freezing, had a weak heartbeat, had visible retractions, and her lungs sounds were not clear to auscultation. We sought medical attention. The small child was on oxygen via nasal cannula and I picked her up with her bundle of blankets and slid her into my zip up to acquire some of my body heat. Then I shared little one with Anna. The doctor came in and did an assessment on the woman in labor on the table, and determined the need for a cesarean section due to large fetus, increased fetal heart tones, and meconium. I started an IV on her and put in a foley and then Ashli came in to assist with surgery so that Anna could stay with the little one that wasn’t adapting to life outside of her mother. The doctors said it was only a matter of time until little one passed. Ashli and I wheeled mama over to major theatre and prepped her for surgery and then stood by waiting for baby to arrive. I got the opportunity to catch the baby, and I hurried over to place babycakes on the table. We had to perform manual resuscitation, and were successful in our efforts. Christ used our hands to help this baby breath. 

 

This is the OB ward where woman have their babies. The blue bundle on the right is where you place the baby after it is born and work on resuscitation. In this photo, that blue bundle is a bundle of joy that has gone to live with Jesus in heaven. 

When I arrived back in OB, there was a bundle in the corner of the room, and I knew immediately that this precious child had joined Jesus in heaven. Anna was not present, and I walked over to the bundle, just to double check. Sure enough, she had passed on from this world. Death is something that surrounds us on a daily basis, and no matter how many times I deal with death, it is something that you can never prepare for. I don’t even have words for how I felt then, or how I feel now. It’s just a fact of life that I have to accept, and move on with. The most comfort I get is that God is in control. He has blessed me with the ability to see new life come into this world, and he has shown me the sorrow of life passing on from this world. I know that everything works out for the good of those who love him.

The ward got quiet, Anna and I changed sheets, and enjoyed each other’s company. She informed me that she held little girl as she went to see Jesus. This brought a smile to my face, because this baby did not die alone, sitting in the corner of a room. It was in the arms of a wonderful young woman, enjoying the love of her fellow sister in Christ. We continued with our efforts to put fitted sheets in the shape of squares on rectangle beds. Then we folded gauze, which is considered bubblegum of the mind. I enjoy the relaxation of folding the gauze, maybe because I am in control of that situation and it keeps my mind focused on something other than the negative. Anna and I talked, and Miss Patty came in and joined us as well for a little bit. Soon enough it was time to head to lunch.

On the way back after lunch, I was already exhausted. OB, fortunately, was slow. I assisted as needed throughout the wards. After everything was done for the day, we went to enjoy some time with our burn patients. I must say—pop rocks are a big hit. The children, as well as the adults, LOVE the candy. Hands reach out for more and even Bibi wanted some pop rocks. Allison and I spent a good portion of time with Nazifa. She was in a good mood today, and would laugh at us frequently. Allison taught her how to mimic faces and voices. I have not seen a smile so large since I have been in Africa. This precious little girls face will be in my memories for years and years to come.

Relaxation

Relaxation—the return of a system to equilibrium after a displacement from this state. It is the abatement or relief from bodily or mental work, effort, and application. This should be the definition of a Saturday. As the day brought forth new beginnings, new choices, and new adventures, it was time for me to let the past go and embrace the present. The destination of choice for the day was in the eye of the beholder. There was one vehicle traveling past Mbeya to a coffee/tea plantation, and another trudging its way up the mountain the paints the landscape behind the Chimala Mission property we call our home. I braved the mountain with my peers and Miss Patty. We all hopped into the Defender, our land cruiser, and began our journey. Nyenye, our driver and guide, informed us of the 52 switchbacks we were about to face. At about the 3^rd switchback, with our wheels testing the edge of a very steep mountain, Miss Patty asked, “Is everyone here baptized?!” The car erupted with laughter, to lighten the air behind the truth of those words. We all responded with “yes” and knew that the rest was in God’s hands. At the halfway mark, Nyenye got out of the vehicle to check under the hood. He informed us that everything was okay, and we continued climbing the mountain. As we reached our destination, sighs of relief could be heard from Allison. Her eyes appeared out of the comfort of Alaina’s hands and we all exited the safe haven of Mr. Land cruiser. The fresh air filled our lungs, and the elevation gave way to a breathtaking view. Mountains set the landscape with various peaks and summits. The African jungle added a touch of greenery. The sky proudly portrayed its blue vastness, welcoming the sunlight that poured on our faces. As much as we wanted to capture the moment, a camera would not suffice. Justice to the beauty of God’s creation, the work of his fingerprints, is only something that can be preserved with a memory. After we embraced the moment, and yearned to stay longer, we knew that we must continue moving forward with the days events in order to return home before the dangers of darkness are upon us. We snapped a few more photos and piled back in our vehicle. Nyenye continued to maneuver on the “road” or better described as dirt path covered with large rocks and giving way to depths  and small hills. I attempted to take a video but it was so blurry and bumpy it makes one’s stomach feel as if they are on a rollercoaster. If the internet worked at a faster pace, I would attempt to upload it but it takes about 20 minutes to upload one still shot (photo). We began to question the faith we had in our driver when we were about five minutes down a “road” not visible to the American eye. The grass was taller than our vehicle, and honestly, we had no idea what our current position was. If the car broke down, or got a flat. We would have to face the dangers of the bush…spiders (poisonous) the size of my hand, snakes (pythons, deadly mambas) and who knows what else. Miss Patty asked the driver to stop and inform us where we were going. E said to the old Chimala Mission hospital. We hesitantly put ou faith and our lives into this man’s hands as we moved forward. All faith faded when he said are you ready to drop out? We were still in the middle of the bush, life to grass taller than my head. We thought he was kidding—for a second—but there was no humor behind his words. He was serious. We asked him if he could call and make sure this is where Mernard had told him to go. We could tell he was frustrated when he hopped out of the car and began to disappear in the bush, talking Swahili on his cell. And then the unthinkable happened—a man appeared through the grass, carrying a bundle on his head. As he passed our car I boldly snapped a picture, as seen below.

 

Maybe this was a road after all. I must remember that I am in Africa. On first thought, I see this man as crazy for traveling on foot through this grass, brave to face the dangers within its borders. But this is his home. The culture and tradition is the unknown to my life. I am continually introduced to new concepts daily.

I must say, God was watching over his children. A large tree had fallen on the road and we were forced to turn around and retrace our tracks. I’m not sure how we returned to the visible road, but we did. Nyenye took us to the next stop on our list—the river. A good 30 minutes or so later we arrived.

The water welcomed our presence. As we walked to the waters edge, Ashli introduced a new concept to my thoughts. She said, “Isn’t it amazing how the water makes noise. It flows over the rocks and creates such a peaceful sound but you would think it would flow silently.” Those words left an imprint. I have never thought of this before. God made that noise, he created the sound that brings peace and relaxation to the soul. He knew that today, we would hear that water and he placed us at its border.

I continued to journey down the rivers path and found a place to sit on the warm stones. I hung my feet over the edge and watched the water flow beneath me. I was propped slightly after a small waterfall and I couldn’t take my eyes off of the water—flowing over rocks, plummeting a couple feet, surfacing with bubbles, and creating its own course glimmering in the sunlight. The sound was music to my ears. I closed my eyes and laid down, cuddled up in a ball on the bed of stones that radiated its warmth to share with my body. The sun rays lit my face and danced across the waters surface, sparkling as if God brushed glitter into its stream. Each of us found our own place, and embraced the beautiful outdoors. My eyes remained closed and soon enough, I fell asleep. Typically when I wake up from a dream and return to reality  I am not surrounded by such a fairytale environment, in the middle of nature’s womb.

Once again, we needed to get on the road and continue our adventure. Nyenye said that his father was in a village nearby and we all decided to stop by and visit. A phone call and long drive later, we entered back into civilization. Fields of many crops, mostly rice and corn, enclosed either side of the road. There were patches of flowers, assorted between the crops. We inquired Nyenye what they were and he replied medicine for the crops. Sunflowers also peaked out of the corn stalks. We pulled onto a side road and Nyenye parked the car. His younger father (father’s brother) was there to greet us. This is his family member who sent him to school to learn to be a mechanic and learn English. Now, he can see the fruit from his money, the results of Nyenye’s schooling. They brought out benches for everyone to sit on and offered us fresh soda. I felt bad taking one but it would be rude not to receive what they offered their guests. Allison and I split a Fanta orange and thanked them for their hospitality. We stayed and talked for awhile and played Frisbee with some orphans before heading back home. We took a different route down, which took about an hour and a half. The road was extremely dusty, and we were covered upon arrival. When you patted your clothes, a cloud of dust filled the air. Our clothes had a brown tinge to them, and you could see the dust in the air for the last hour of the drive. When I blew my nose, it was brown. When I cleaned my ears—after I showered—the Qtips were still brown. My contacts took a dive and met the bottom of the trashcan. All in all, what a beautiful day we had been blessed with. As God’s children, we rejoice in the splendor of his creation.

The season for burns and Tabu's healing

As always, Allison and I were late making it to the hospital this morning. We have troubles getting out of bed. We made a pact to always wait for the other person, and we have never both been on time on the same day. Today… we were really late. I continued my shift in male ward, but didn’t spend much time in there for the morning shift. Unfortunately, it was burn dressing change day. I absolutely hate burns. We were only supposed to have three, but there was a new admit today of a pediatric with fresh burns. I seriously am so sick of burns. When we walk into the ward with the stretcher, and to the side of the child’s bed who needs a dressing change, screams fill the entire ward. As we wheel one child at a time to minor theatre, everyone’s heads turn to observe where the noise is coming from. Many times, we try to sing to the children and hold their hands as we bring them to surgery, and as they are being put under short acting general anesthesia. Slowly, their eyes start to close, and soon enough the grip of their hands in our own lose strength and we know that they are asleep. And then we begin to remove the pus filled, blood covered, potent smelling dressing on the child. Beneath the dressing is fresh skin, exposed to the air. Most of the burns are only second degree, but poor Ezekiel has some third degree areas. The worst burns are on the face, the hands, feet, and the genitals. I have seen all except the face. 

Above is a graphic picture of a child’s hand, before the dressing change. The skin looks as if its peeled back, and there are visible blisters. The skin, peels away like paper. Then i had to peel the fingers apart, because if not they would fuse together. You must remove all the skin that comes off easily, and scrub the raw skin with normal saline to cleanse it. Then we cover the skin with silver sulfadine cream, cover it with petroleum gauze, sterile gauze, and then wrap it with more gauze. When we finished Nazifa’s dressing change, I got to help wheel her back to her bed. I picked her little body up off of the stretcher and placed her on her freshly made bed. Her mother was there by her side. As I placed her down and helped tuck her in, she was coming out of her anesthesia—she reached for my chin, and smiled. Normally, after a dressing change she doesn’t smile around me for a day, and then warms back up to me a day later. Her skin is also turning pink, and healing wonderfully. We didn’t even have to cover her chin today.

As the day progressed, things slowed down. Our dear friend Tabu showed up again. She was the one who had the Steven’s Johnson reaction to her medications. Here is a picture of her before and after.

 

This is a picture of when i first met our dear friend. The sores that you see on her lips and face are throughout her entire body. They do not just appear on her external surface--what you see on her lips continues inside her mouth and down her throat. These sores often are so inflamed that the eyelids are unable to be opened.

Tabu's skin has cleared up and she no longer has open sores on her lips. She did come in with a sore on her hand and had to get surgery again. Her feet used to be completely covered with one large blister, encompassing the entire surface of the bottom of each foot. These have completely healed and she is able to walk again. Praise be to the Lord! Continue to keep this woman in your prayers as her healing is still in progress.

Before we left for the day, Allison and I went over to play with Jeremiyah and Odakis, the two young boys in traction. We played ball with them, blew some bubbles, tickled them, and took videos with them. They love looking at pictures and videos of themselves. We heard them laugh today. I am very impressed with the children here. They are so patient, and sit in their traction for weeks without complaining.

Tomorrow we plan on hiking the mountain behind our house. Pray for no snakes!!

A new day

It’s as if yesterday was a dream. I have pushed the past events to the back of my mind and it is a constant battle to keep them there. But I must move on, I must overcome those voices that disturb my thoughts. I owe my patients a focused mind, not controlled by emotions. And that is what I did today.

My rotation shifted to the male ward, where I have many friends. Jeremiya and Odakis are two little boys who have been in traction since we arrived here in Chimala. Ezekiel is the little boy with burns who has been here for a little over a week. We have had time to build relationships and get to know these children.  Jeremiya and Odakis crack a smile everytime we wazungu (white people) walk into the room. They know that we will come over and give them attention and make them feel loved, whether it be cutting out snowflakes from paper and hanging them all over their corner of the ward, or playing ball and bouncing it back and forth, drawing, bubbles, balloons, wall crawlers, and today… pop rocks. I pulled them out of my pocket and they just stared at the package. I ripped open the top and put some in my mouth to show them. I think they understood, but I believe they had some once before with another person on the team. They reached out their hands and took some, placed it in their mouths and smiles lit up their faces. The little boy Ezekiel was next to Odakis and we have yet to get him to smile. I walked over to him and showed him what the candy (pepe) was, and he reached out his hand. He is the one with the worst burns I have ever seen, and he MOVED HIS ARM! That was a first. He could not angle his arm properly so I just placed some candy in his mouth. He did not smile but I know that he loved it, because he kept sticking his tongue out for more and after the package was empty we gave it to him and he was sucking on it.

The day was very busy. As soon as I arrived on shift, a man was dragged into the hospital by two other men. He was breathing heavily and unable to do anything. I got his IV started immediately and took his vital signs. His blood pressure was 260/130. I have NEVER heard a blood pressure so high. I retook it just to double check and sure enough it was accurate. The doctors came in and did an assessment, and I followed by giving the ordered medications, IV rocephin 1g and 500mg of azithromycin PO. I had to go to the pharmacy to get the meds, and then come back and reconstitute the rocephin. I love having the trust and responsibility to do nursing duties without supervision. I actually feel like a real nurse these days.

As the morning progressed and things slowed down, I got the opportunity to go to RCH and do venipuncture for prenatal checkups. The pregnant women sat in a line holding their labeled blood vials. I had all of my supplies on a little stand, and Kellum and I took turns with blood draws. There were only 8 patients, but all went well. After we collected all of the blood we took the samples behind the curtain and tested them for HIV and syphyllis. As I sat there staring at the tests waiting for the results, my mind was performing a blocking mechanism. I was staring at these strips, knowing that the results were not just strips, they were people. The odds of positive HIV testing was very likely, and I was preparing myself for the amount of positive results I was about to see. Typically, over half of the ward is normally HIV positive. But, after the allotted time, all of the tests were negative. NEGATIVE!! I was so excited! 100% of these women were free from HIV. What a blessing from God.

After lunch, we had another new admission. I had just missed the opportunity to drop an NG tube and place a foley, but the nurse said he still needed an IV, so I jumped right on top of that. Steven was finishing up his physical assessment and had me feel his abdomen. As soon as I pressed down, he tensed up, which is called guarding. Guarding is a natural defense mechanism. This man had an obstruction. We quickly wheeled  him to surgery, and I got the opportunity to scrub in. I stood right over the body as I observed the surgery. He was opened up, and his intestines started flowing out. There was one that jet black, and ten inches wide. Dr. Mahangy said, “Well that doesn’t look good.” I was thoroughly shocked at the site of this intestine. We discovered that it was his descending bowel, and Dr. Mahangy observed the site and made sure there were no perforations, and then Steven and him squeezed the bowel and dislodged the occlusion, which resulted in flatus from the patient… and lots of it. The smell in the operating room was horrible… worst smell I have ever had reached my nostrils. Even worse than having amniotic fluid fly in your nose. Erin said jamba (which means gas) and everyone laughed. After all the air and contents had passed, the doctors clamped off the intestine that was dead and cut it out. Dr Mahangy said, “Here girls, this is a gift for you to have as dinner tonight.” We just stared at him and were like, uh thanks but no. Lol. He was just kidding, but ew! That would be gross!! Lol. Then they connected to the two parts of the bowel together and began to close him up. Once they got to the last layer of skin Dr. Mahangy handed me the pickups and needle holder and said okay, you finish him up. I got to stitch this man’s abdomen back together. J I really do love being able to assist in surgery, because this is something that I would never be “qualified” to do in America. Who knows, maybe I will have the opportunity to go back to medical school someday. There is a desire burning within me to continue my education after nursing. Sometimes I wish I had enough time to get a handful of degrees because education is so interesting to me. I always want to learn more. After I stitched him up, we brought him back to male ward. His blood pressure was extremely low, so I started another IV on him to get double the amount of fluids flowing into his body. 

Everything slowed back down, and I visited the other wards before I headed home for the night. I went in to see my little girl, Nazifa, the one with the burns. As soon as I walked into the ward, she smiled. I kinda danced over to her bed, and then sat down. She was drawing and had a bunch of stickers next to her. I took some off and placed them on her dressings, then one on her nose. She giggled, and I put one on my nose. Then I shook my head and removed them and placed them back on her dressing. She’s such a little cutie, and has stolen my heart. I just want to bring her back to America with me and raise her as my own. She appears to be doing better, and I told her that I would see her tomorrow.

Today went well. Continue to keep the team in your prayers. Rehema passed away today, an 18 year old girl. Death is something that we see everyday. The morgue is right outside of the hospital and you can always here the wailing after a death. These are people that we know, people that we spend our time with everyday. We interact with their family and friends, we pray with the patients, and we try to bring a smile to their face while they are suffering. To hear the wailing…. I don’t even have words. I have never been surrounded by so much death.

A new addition to heaven

“Seek my face, and you will find fulfillment of your deepest longings. My world is filled with beautiful things; they are meant to be pointers to Me, reminders of My abiding Presence. The earth still declares My Glory to those who have eyes that see and ears that hear. You had a darkened mind before you sought Me wholeheartedly. I chose to pour My Light into you, so that you can be a beacon to others. There is no room for pride in this position. Your part is to reflect My Glory. I am the Lord!”

----------from an entry in Jesus Calling, a devotional book

Isaiah 60:2

“See, darkness covers the earth and thick darkness is over the peoples, but the Lord rises upon you and his glory appears over you.”

Today was an awful day… probably the worst day of my life. I have never had the shakes, the amount of tears, the sobs that come from so far deep within it feels like your stomach is being detached from your insides. I am still in shock, and I am still not sure I understand everything that happened because in the blink of an eye the moment was over and the damage was done. A sickening feeling compels your entire body, and in that moment, I relied on adrenaline. This is a very hard entry to write, and I understand that it may sound different on paper than it was in real life, but I had to get these thoughts out of my head.  

Rewind…. And here is what happened

I walked over to OB to get some lubricant for a pelvic exam in female ward. As I entered through the curtains there were three women on the beds. Provided. One mom had delivered a baby and Allison and Erin were with the baby as Steven was with the mom and we heard, “This doesn’t feel right. There are twins.” I walked in and immediately Kellum hollered, “Meghan, put some gloves on.” Allison and Erin put new gloves on as well. Allison went over to help Steven and Erin and I hurried over to the mother who had began pushing without any medical assistance at her bedside. It appeared as if the baby was in the breech position and we hollered over to Steven who poked his head in and informed us that the presenting part was the head, and that her membranes had not yet ruptured. The nurse handed a needle to Erin and told her to rupture the membranes. Erin offered to let me rupture her membranes because she had already done one earlier that morning. Of course I accepted her offer, I mean how often do you get to rupture a membrane?! Steven walked me through the process and then the nurse informed everyone to step back because it can spray a little. Steven said that at the next contraction while the membranes are protruding to just barely poke the tip of the needle on the sac. Sounds easy enough. Contraction…pushing…visible membranes. Poke… and membranes exploded… for the first time. Even though I had been standing to the side and back, I was covered in amniotic fluid. My hair was soaked and slopping over my face. Amniotic fluid had filled my mouth, gone up my nose, and soaked my right eye. My entire right side of my body was drenched. Then everything is kind of a blur from here on out. In the blink of an eye, there was another explosion of fluid, which also expelled the newborn, fully attached to the placenta via the cord, as it shot through the air and over the edge of the table out of my reach. I don’t even remember capping the needle and placing it to the side. I picked up the premature baby with one hand and the placenta with the other and placed them on the table. Everyone was still staring at the womans pelvic area because no one had seen the baby fly in the gush of fluid that sprayed across the room. Allison said that the next thing she knew, I had placed a baby on the table. I began to use the bulb suction on the baby when it finally clicked that Allison was poking my shoulder saying, “Meghan I got this, its okay, I got this.” I couldn’t open both of my eyes and the nurse guided me to the sink, sprayed something in my hands, turned on the facet and told me to wash my face. I scrubbed my face, and kept spitting the contents out of my mouth. I blew my nose into the sink and was eventually able to open my other eye. I hurried back over to the table sopping wet when Steven said to grab some epinephrine. The nurse said they didn’t have any, but I knew I had seen some in the female ward earlier this morning. I ran down the hall to female, grabbed the entire bottle and returned to OB. Steven said to draw up 0.02 ml, and the nurse handed me a 10 ml syringe. I motioned for a smaller one, and she shook her head and said pediatrics. So off I ran again, in the other direction, grabbed a handful of syringes with needles and ran back to the OB ward. I pulled up the medicine and went over to where Steven and Allison were resuscitating the baby. I managed to work around them and inject the medication, hoping and praying that this child would be alright. Kellum had one baby in her hands so that the area was clear for working on the second baby when the twins mama started pushing with the second child. I put gloves back on as Steven ordered me to go over and deliver the baby. I knew in my head he wanted me to “get back on the horse” so to speak, and so he talked me through delivering the twin. Baby came out and let out a scream. Praise the Lord. Suctioned, clamped, cut, passed baby on and I stayed with mama. I delivered the placenta, cleaned her out, rolled up her dirty garments… and had the nurse come over. My adrenaline rush had ended and I walked right into Kellum’s arms and balled my eyes out. Those deep heaves that do not suffice your oxygen demand. Tears were drowning my face, my nose was full of fluid, and I couldn’t breath. Ashli had appeared, so did Kent. Ashli came in and embraced me as well. All I wanted was to forget the last  hours events. WHY? WHY DO THINGS LIKE THIS HAPPEN?! I was a angry, devasted, embarrassed, exhausted, livid, unhappy, consumed with sadness, nauseous, light-headed, uncomfortable, all the while feeling guilty.

And then I heard a sweet voice as Ashli spoke, “Meghan, I know theres a lot of different voices in your head right now, but do not listen to them. Only listen to the one voice, the voice of Jesus. Do not believe any of the things that your mind is telling you, because Jesus loves you. Listen to Him. This was not your fault. No one here blames you, because there was nothing anyone could have done.”

This made the tears come harder and stronger. The floor was soaked with my salty tears. And then I saw Allison’s feet appear. And at that moment, I knew the baby was dead. I could hear sobbing from everyone as the moment had its impact. Everyone just stood together in silence.

Steven informed me that this child was not well equipped to survive even before the incident. The doctors had planned on doing a cesarean section around lunchtime but the patient refused the procedure, so they let her labor instead. The ultrasound revealed an abnormality with the child, and they believed that there was an esophageal/tracheal fistula, which is hard enough to operate on in America. Once the child was born, Steven made sure to point out all the visible problems that the child had as well as inform me that the child had a genetic anomaly. It was also premature at 33 weeks. This tremendously assisted with my ability to cope despite the feeling inside that somehow this was still all my fault. Everyone kept reassuring me that there was nothing else I could have done, and that I did all that I could.  I don’t remember who said it, but they told me that this child flew into the arms of Jesus.

I would appreciate prayers for comfort for the mother, as well as myself and the others on the mission team who were present during this traumatic event. We need God’s assistance and guidance as we face the many different problems that arise at the hospital.

Early morning wake up call

Isaiah 58:9a

“Then you will call, and the Lord will answer; you will cry for help, and he will say: Here I am.”

God I am calling out to you right now. It’s been a rough night. At 117 am we got a knock on our door and a request to assist in surgery down at the hospital. Mama was eclampic and we needed to assist with an emergency c/s. Allison, Erin, and I gathered all of our equipment and briskly walked down to the hospital, meanwhile avoiding an branch that had a similar appearance as a snake. Upon arrival, we scrubbed in and made ourselves useful. Update from the surgeons revealed mama as eclamptic, BP in the 240’s and she also had a seizure. The seizure caused her to bite her tongue and she was having difficulty breathing because we have no artificial airways at our fingertips Surgery had already began, and Allison and Erin were on baby duty. I was there to do as requested and to have an extra pair of hands. Soon after, a hand poked out, followed by meconium fluid. The surgeons quickly removed the baby from the mother’s uterus, clamped and cut the cord, and passed over the baby to the girls.

I lost my breath as I saw the newborn. The room was silent except for clinking of surgical tools. … No breath of life….. but silence. The baby’s lungs were not working. There were no screaming gasps of fresh air. The girls had already began rescusitation, suction… meconium…moer suction… more meconium…. Suction…suction…suction. Erin reached for the suction machine instead of the bulb syringe, but there was no cord. Yet again, we are in a resource limited environment. They continued working at a quick pace, compressions and breaths, use of the oxygen mask. Only a matter of about 15 seconds had passed. I returned my mind to the operating table and Miss Pattie had me assisting her as scrub tech. I had suction in one hand, then a hemostat, surgical scissors… and so forth. I was getting a lesson in tech instruments while assisting in surgery. Miss Pattie is a great teacher and she always has the right equipment prepared before the surgeon requests it. Dr. Black and Dr. Brantley worked on the woman and closed her up. And time was clicking away…

Tick….

Tock…

Tick…

Tock…

Clink….

Tick…

Tock…

Still no screaming baby. And time continued on. Heartrate dropping…. Breathing on its own only once every 20-30 seconds.  They continued assisting the baby with resuscitation. Its hands and legs lay limp on the table…extremities purplish/blue… still not pink even with stimulation.

--------------------45 minutes later----------------------

Mama is closed up and being wheeled back to OB. Dr. Snell, Allison, and Erin are still being troopers and working on little one, switching off jobs to maintain optimum strength. Still….baby is not doing good. And then you hear a voice, sometimes you have to stop, I think its time.

The oxygen machine was turned off, little one was wrapped up tighter, placed in the basinet and wheeled to OB. We all shed our OR clothes and continued the work in OB. Oxygen was put back on little one, he was wrapped up in two more blankets, and we continued to monitor him.

All the while, another woman goes into labor.

As the night progressed, little one did not make it. His heart ceased to beat and he died in the four o clock hour. He went to heaven to be with his Daddy, to be free from pain and suffering, to be free from the cares of this world, and to be free from the grasp of Satan.

As I lay in bed, wide awake, I feel numb. I don’t know what to feel right now. Reality has not sunk in. One thing I do know is that Jesus is my light in the darkness, and I am not alone.

My God turns my darkness into light

Psalm 18:28
“You, O Lord, keep my  lamp burning; my God turns my darkness into light.”

Many times, when we find ourselves in situations that are undesirable, we feel as if we are in the darkness. Hospital stays. Sickness. Vomiting. Headaches. Pain. Needles. Death. Do any of those words bring light to your eyes or a smile to your face? Of course not. But many people are in this very situation as you read this. What can I do to help them? Sometimes the pain is something that cannot be treated. Sometimes the outcome is not what we want. Where do you find the light in that?

Throughout all things, Christ tells us to seek him. He is our stronghold. He will keep us going. He will hold our hand and lead the way home. He listens to our needs, our concerns, our prayers. He hears our voice as we come to Him in prayer. But as we are frail human beings, sometime we cannot always visualize the light. We need tangible objects—something to touch and to feel, to see, to hear.

Matthew 25:35-40

“For I was hungry and you gave me something to eat, I was thirsty and you gave me something to drink, I was a stranger and you invited me in, I needed clothes and you clothed me, I was sick and you looked after me, I was in prison and you came to visit me. Then the righteous will answer him, ‘Lord, when did we see you hungry or feed you, or thirsty and give you something to drink? When did we see you a stranger and invite you in, or needing clothes and clothe you? When did we see you sick or in prison and go to visit you?’ The King will reply, “I tell you the truth, whatever you did for one of the least of these brothers of mine, you did for me.’”

We can care for Jesus. We can help bring light to those who cannot see it; a simple touch, a caring spirit, that extra moment when you just sit with someone and hold their hand, or you pull their covers up over their shoulders and tuck them in, with each prayer, each song, and each smile. Each patient is a precious soul that belongs to the Lord, and we need to treat them as we would our Savior. I want Christ to be seen in my actions. I want him to guide my hands, guide my words, guide my thoughts, and to lead my heart in His ways. He has shown me suffering, death, sickness, and those who are most vulnerable. But amid all of the sadness, he has shown me light. I have seen Jesus in my companions, my instructors, and many patients. I have seen the way that he shines through the lives of those that I am with on this trip and it brings a smile to my face. He has shown me that even with death and dying, there is still goodness to be seen. For example, my young friend (rafiki) that passed away, is in heaven right now. When the child on pediatrics passed away yesterday as I was on that ward, the grandmother came up to Miss Bingham and said, “Asante sana.” (thank you very much). The culture here has the concept of “to try is to succeed.” This grandmother was so thankful for all of the help that had been given, and even though the baby passed away, she was grateful for the efforts put forth. She saw light in the darkness.

Last night during debriefing, Ashli introduced us all to a new song by Christy Nockels called Sing Along. Below are the lyrics.

From babies hidden in the shadows
To the cities shining bright
There are captives weeping
Far from sight
For every doorway has a story
And some are holding back the cries
But there is One who hears at the night

Great God
Wrap Your arms around this world tonight
Around the world tonight
And when You hear our cries
Sing through the night
So we can join in Your song
And sing along
We'll sing along

From the farthest corners of the earth
Still His mercy reaches
Even to the pain we cannot see
And even through the darkness
There's a promise that will keep us
There is One who came to set us free

Great God
Wrap Your arms around this world tonight
Around the world tonight
And when You hear our cries
Sing through the night
So we can join in Your song
And sing along
We'll sing along

So let Your song rise
And fill up the earth
Let Your hope ring out
Let Your heart be heard

This song touches my heart. I am in love with it, and if I had faster internet access and my itunes account I would buy it in a heartbeat. It reminds me that yes, God can wrap his arms around me, yes he hears me when I cry out, He will set us free, and He will sing with us.

I stumbled upon this verse today:

Romans 12:9-13

“Love must be sincere. Hate what is evil; cling to what is good. Be devoted to one another in brotherly love. Honor one another above yourselves. Never be lacking in zeal, but keep your spiritual fervor, serving the Lord. Be joyful in hope, patient in affliction, faithful in prayer. Share with God’s people who are in need. Practice hospitality.”

This verse motivates me to love unconditionally. It’s a simple reminder to be persistent with love, and to share in suffering when our brothers or sisters are suffering. We can face the pain together.

I needed words from Christ and His Word after a long hard day. I am currently on female ward, which I have come to find as my favorite ward. There is one child that I feel very called to, but I know that I must be very aware of my actions and spread my time out equally among all of my patients. This little girl is 6 or 7 years old, and is covered in burns all over her body. I believe I have blogged about her before. Today was the day for her dressing change, which terrifies her. As soon as we walked over to her bed with the stretcher to transport her to minor theatre, she began screaming and crying. I went over there and scooped her up in my arms to transport her to the stretcher. She cannot weigh more than 35 or 40 pounds at the most—her skin stretching taut over her bones. As Ashli and I rolled her down the concrete hallway, we each held one hand and sang Jesus Loves Me over and over again. She seemed to calm down some, but as soon as we entered the surgery room, she started screaming again. I picked up her fragile body and placed her on the operating table. Ashli and I held her hands and continued to sing to her as we waited for Dr. Black to come in with the ketamine which would sedate her for the procedure. She screamed out many Swahili words as she was receiving the medication through IV and we asked Dr. Black what the translation was. He informed us that she was saying she was going to die. My heart sunk even further because those words stung just as bad as her screams. With assistance from Anna and Alaina we were able to get her all cleaned up and coated with new treatment creams and all patched up with fresh gauze. Her burns were healing, and her wounds were approximating, as we had hoped. She is such a fighter and traveling on the road to recovery. Yet again, I picked her up to transfer her back to the stretcher to return to her bed in female ward. We got her situated and comfortable in order for her to rest. The ketamine wore off throughout the early morning and when she woke up, she was frightened. Her mother had left to get lunch and she was terrified. Ashli and I couldn’t understand what she wanted, but eventually realized we think she wanted to be held. I asked if I could stay with her, and Ashli helped get her on my lap, being very cautious of her wounds and trying not to cause any unnecessary pain. She cuddled right up and and placed her head on my shoulder. Almost immediately, her tears ceased and she calmed down. Then my tears started to trickle down my face. I rocked her in my arms for awhile, and then she started tearing up again. I layed her back down on the bed and tucked her in with all of her blankets brought from home. She loved this various brown assorted checkered fleece blanket. I made sure to have that one on top where she could see it and hold it. Then I layed down next to her, found her tiny hand and placed it in mine. With my other hand I began gently running my hand over her head, and wiped her tears off of her eyes. Her crying and whimpering slowly ceased and she closed her eyes as she drifted off to sleep. The tension left her face and she began to look so peaceful. I just stared for a few minutes, thanking God for her rest, and then got up to help out with other patients.

Sometimes I find myself wondering how God could let this happen to such a young girl. Why her? Why here, as a victim of this culture where resources are limited? It’s not fair. I want to be able to take her pain away. I want to question God. And then on the other hand I feel guilty for thinking such thoughts. I know that God is in control and that he is comforting her. It’s a round-about that continues to circle through my thoughts. I know that God is the light in the darkness, and I know his fingerprints are on her healing. My prayer is that he blesses this child with healing, with comfort, and an ease from the fear and pain that she is surrounded by. 

Matthew 5:14-16

"You are the light of the world. A city on a hill cannot be hidden. Neither do people light a lamp and put it under a bowl. Instead they put it on its stand, and it gives light to everyone in the house. In the same way, let your light shine before men, that they may see your good deeds and praise your Father in heaven."