Act of Faith

For many of the women we serve, coming to the center is an act of faith. On Thursday we discharged an old woman who had her fistula repaired and she is dry. In the clinic as we were doing her final discharge screening and education she told us it was difficult for her to come in the first place. She didn't have the support of anyone in her family or village. They kept telling her that the problem she has is not treatable. There is no help for her. It is pointless for her to even try. She has this problem for a reason so she needs to learn to live with it.

She came anyway.

I laugh thinking about it because she told us there are four other women waiting for her return in her village. They all have the same problem she did but they waited for her to come back and report what happened here. This older woman came out as a guinea pig to see what would happen to her. I have heard this before. Patients coming out, knowing others in their villages who have fistula. There has to be one brave enough to make the first step to come. For this one woman, if she goes home dry, the others will follow.

No pressure here.

The hard part is when a patient comes and she leaves wet. There are many reasons a patient can leave wet: a failed surgery, a healed fistula but the woman has stress incontinence, some women need multiple surgeries to be completely dry... When she goes home this won't be translated well. You are either wet or dry. If you are dry, others will come. If you are wet, they don't see the point in coming.

This patient is dry and she will go home and report what she experienced here. I am looking forward to the day I look out the windows in the clinic and see the four patients from her village sitting there waiting...

Dentist

Me and my dentist

I have never been one to really be sick. Never broken a bone. Never been hospitalized.

Never, until a year ago. 

In the last year I have: broken my pelvis, been to the emergency room in Sierra Leone, had X-rays, a CT scan, ultrasound, mammogram, MRI and yesterday I was able to add Niger dentist to the list. All of those things listed, except the MRI, were all done in West Africa. Someone told me today I should write a book about my medical experiences here. I don't have enough to fill a book but I have come away with some good stories.

It's always a good day when the local grocery store has chocolate. Not just any chocolate, but good chocolate. The Toblerone, triangular goodness that melts in your mouth unless you forget to put it in the fridge, then it melts in your cupboard. On Sunday I was enjoying my piece of chocolaty goodness when it became a bit crunchier than normal. It wasn't the grit of added sand that accompanies many meals here, this was like a rock. This was a big part of my tooth. Luckily it was one of my back teeth so you couldn't see it, but I wanted to gag when I felt this gaping hole with my tongue. Being a nurse my mind started racing. I was going to get an infection, then abscess, then major tumor. Luckily I live with missionaries who have lived here for a long time and knew of a good dentist in the area. He was able to see me early yesterday morning and June, Leng and Ashley all accompanied me on this adventure.

We walked right in to this small room that had a desk, a dentist chair and supplies. I was quickly told to sit down so I did. All I knew was that I didn't want anyone drilling in my mouth or doing anything that was not necessary. I didn't want any shots or teeth pulled. I can't believe my lack of French or Hausa after living here for almost ten months. June and Leng did a great job keeping me informed about what was going on. Yes, a large part of my tooth broke off but luckily it was a clean break and all the dentist had to do was fill it back in. Only a small amount of drilling to make it possible to add more cement to fill in the hole. It was even white. I kept my eyes closed, knowing Ashley was right there taking pictures and making sure everything was ok. I had to. The needle, which was never used, was sitting right at eye level tempting my fears. It was better to just close my eyes and pray it was all over soon.

All in all it was a memorable experience. The hole is filled and even though it is temporary, June had the same thing happen to her a long time ago and went to the same dentist and her temporary fix lasted a long time. I pray that is the same in my case as well. It is still a bit rough. The dentist apologized for not having a buffer to smooth it but it's not bad. All this for about $4.

Visit the dentist in Niger... check.

Thankful

Last year when I was living in Sierra Leone my sister sent me a book called One Thousand Gifts. It was a great book that helped me changed my outlook on my situation there. It helped me find joy in everyday things I encountered. In the stressors I had, I was able to think about and notice the little things which caused me to see each situation differently. It helped me to persevere through some difficult times.

Last Sunday I decided to start a list. I have been making a list of things I am thankful for. It has helped me change the way I have looked at some of the situations I encountered this week. As I started writing this list I kept having an overwhelming urge to write a list of challenges this week as well. I didn't. I needed to focus on the blessings of my days. Yes, there were days I just wanted to come home and crawl back into my bed, turn on my ac and sleep, but when you take the time to stop and look around, you notice blessings in the midst of challenges. Here are a glimpse of things I have been thankful for over the past six days:

• Having a flashlight on my phone
• I have not gotten malaria this year
• Packing nyquil/dayquil when I came
• Purple flowers growing among the corn stalks being harvested
• Patients being discharged to the village
• Dead earwigs
• Bananas erupting from their pods on the pigmy banana tree
• Moringa trees growing larger
• Women returning on time for their surgical appointments
• Ants marching creating veins in the sand
• A newly hired nurse
• Long walks home
• Skirts that make you walk a step slower
• Receiving two roosters as a thank you gift inside the hospital
• A finished malaria policy
• Kosai
• Old patients returning dry
• Watching people harvest their crops
• Women pounding their grains
• Listening to country music in the car
• With the windows down
• At night
• Turning down country music and rolling up the windows while passing through checkpoints
• Water filters that make brown water drinkable
• Friends who will protect me from bats
• Two hens purchased for the roosters so we can have eggs
• Air conditioning in my bedroom
• Watching patients doing rounds on each other--on the fresh post-op patients to make sure they are ok
• Losing patients but then finding them sitting under a tree in the dirt behind the OR
• Training nurses to take over my jobs
• Nurses who work hard
• Rice and beans for lunch
• Learning a new word in hausa and using it appropriately 
• Just standing in the pharmacy (the only room in the ward with air conditioning)
• Being told I can go to Niamey with Ashley to say goodbye
• The way the young patients wear their gowns
• Having my massive set of keys reduced by three
• Excitement by patients who are brought into the ward for surgery 
• Bottle of some sort of sugared nuts
• Chocolate in the grocery store
• Buying a purple shirt at Wrangler
• Witnessing an ultrasound of a patient who did not know she was pregnant
• Showing this woman her child inside her womb
• Seeing the tiny hands, feet, spine and all four chambers of this tiny heart beating inside her

Family

Yesterday we had one of the largest clinic we have seen. 30 women in four hours. Most were new women we have not seen before and the majority of them were scheduled for surgeries this month. We have a very busy month ahead but it's exciting to have so many women who will be able to come through our doors. For now they will be staying in the village where the village manager will be starting her literacy classes. 

Today there were two women who came to the hospital. One was here a few months ago and had surgery but she needed to return for a planned follow-up surgery. I walked her out to the village and when we were half way down the path, to the point where the women in the village could recognize the patient I was walking with, claps and yelling started coming from the huts. Many of the women recognized this patient from before and it was like a home coming. There was even one who jumped up and danced down the walkway to us so she could carry her baggage and give her a huge hug.

I love how the women become a family to one another. So many of them travel from one fistula center to the next hoping for a permanent cure and they get to know each other. The one who danced down the walkway to greet this patient I was admitting knew her from her previous surgery done here. Even on the ward it is incredible to watch the women and how they interact with one another. Not just with each other, but with the nurses. Last night one of the patients walked around to all the doors making sure they were closed tight and locked before the patients went to sleep. Another is sick with malaria and just feels awful. The other patients come, carrying their catheter bags, to help change the bed and pads of this women. They bring her water and talk with her. We are not short staffed with nurses and we don't expect this of our patients. We have never asked the women to do this. They do it because they know better than any of us what they are each going through. I watched as an older woman helped a girl about half her age use a pot to pee in because she had an IV running. When a woman returns from the operating theatre, there are patients on the ward who will make their own rounds. They will make sure the women have water or someone to talk to since they can not move in bed because of the anesthesia. They love each other and care for each other more than I ever could as a nurse. 

Food

I made a new friend. The boys who live next door lost their ball in a pile of bushes. The local boys they were playing with did not want to help them look for the ball because they saw two chameleons living in the bush. Most people here don't like chameleons because they think they bite. I don't know if Simon found his ball, but he did find this chameleon. I was in my house when he yelled for me to come out because he had caught one. It wouldn't be too hard to catch because they move so slow. 

I get a lot of questions about what I eat. This picture is bissap. I had it first when we went to Park W in April and I have been wanting it again ever since. Hauwa, my boss, picked me up some at the market. They are leaves that you boil and it makes a deep red, bitter tasting drink. Add some sugar and it's pretty amazing. 

In the mornings as I walk to work there is a small market right outside the hospital. Many people will stop and buy this, fanke. There is another fried ball like thing called kosai which I prefer to this, but it's more difficult to make so that will be for another days lesson. Ashley and I had a fanke cooking lesson this past Sunday. Hannatou, our translator in the hospital, and Hawa, one of the nurses, came to Ashely's place for the lesson. It's basically flour, yeast, sugar and water, then you fry it in oil. The kosai that I really like is similar and looks the same but it is made from bean flour. Add some yagi pepper to it and it's fabulous!

Moringa

I have been wanting to write this post for a long time now. I love that we hired a gardener/landscaper. He has been working here for a couple months now. What I didn't realize until yesterday is that I have been calling him the female form of his name for the last two months but no one wanted to correct me. I feel so bad. He just laughs and says ba matsala, no problem. He has done a great job landscaping the area around the hospital. I was really excited to talk with him about planting moringa trees when he was hired.

I first heard about moringa trees about ten years ago when I took a Mercy Ships class about tropical medicine and they spoke on moringa trees. These trees are incredible. They were basically created to grow here. Everything I read about these amazing trees calls them nature's medicine cabinet. One ounce of moringa contains 7 time the vitamin C found in oranges, 4 times the vitamin A of carrots, 3 times the iron of spinach, 4 times as much calcium as milk and 3 times the potassium of bananas. What else is there to say? I get so excited when I think about these trees and what they can do for this area of the world if people would tap into them. I can't wait for ours to get big enough to have pods. I read they can produce 400-1000 new seeds a year. Plenty to send all the women here home with some seeds! I have a great vision for these trees and the ways they can first help our women, and then teach the women how to take them home and help their communities with them.

So, my first talk with our gardener was about planting these moringa trees. Two days later he brought in about 25 of these trees to line the walkway out to the village. Yesterday we had our first moringa harvest and ate of the abundant leaves. Another great thing about moringa is how quickly it grows. Our trees were planted about six weeks ago and we are already eating from them. I have a book on all that you can do with the leaves and plants and pods. Everything from antibiotics to skin infections to diabetes and low blood pressure, anemia, diarrhea, water purification... the list continues of all the ways it can be used.

Moringa

Crops and Painting

On my walk home from work today Ashley pointed out how tall the crops are getting. I am 5'8'' tall so you can see the height. These crops are huge! We have been getting a lot of rain which is fabulous for the crops but not so fabulous for Niamey. If you have not heard, Niamey is flooding. It has completely flooded the SIM school there and they are having to look for another place. Please pray for Niamey and the flooding. It has left many homeless and destroyed many crops with the rising river. Check out the BBC news on it here. http://www.bbc.co.uk/news/world-africa-19384377

Last week we painted again. Again, when I told the women to paint whatever they wanted they giggled and just looked at me before they painted random shapes. I painted the picture in the upper right then they all started copying mine. I think I will make some postcards as samples and see what they do with those as far as copying them. I really love what they came up with!

I don't eat a lot of meat here. When I go home, one of my major food cravings is for Red Robin. Here, we pulled over and got guinea fowl from this guy. It was pretty pretty good. There are some things I continue to struggle with food wise. Meat is one of them. I was excited that when I bought this because  he cut it up and cooked it longer on the fire. When I took it home and started pulling if off the bone I hit a vein and blood came spurting out. Overall it was good meat, but I don't know if I will buy meat again here.

Painting

Painting on the ward

The other day was painting afternoon on the ward. First, it was the painting of the fingernails. Then we pulled out the paints, paper and brushes that my parents and Anita and Cal donated. Thanks! When I told the women what we were doing, they looked very confused and asked what they should paint. We told them they could paint anything. It took some time for them to get into it but when they did they enjoyed it and painted some great things.

A bladder stone

This picture was taken on a short trip I made here to Niger in 2010. It is a picture of an X-ray of a bladder stone which was in one of our fistula patients. This woman was transported to another hospital where she had it removed. We had to send her in an ambulance because she was very sick and we wondered if she would survive. She returned to the center two weeks ago and on Tuesday she was discharged home. Dry. She has had multiple surgeries for this problem and she is finally leaving happy! I love it when patients from my first trips here come back so I can see how they are doing.

Nurse Picture

My ward nurses

It's difficult to get lined up. Smiling is even harder for some. It always makes me laugh because you can be talking with someone and tell them you will take their picture and they automatically put their arms to their sides and don't smile. For many of the patients, if I want them to smile I ask to see their teeth and you will at least get half a smile. 

We started this week with a couple surgeries on Monday and that was all. By the end of the week we were all learning more about what it means that things happen best in God's time. Wednesday and Friday we had surgeries. The new moon is coming soon to signal the end of ramadan. Hopefully along with that we will have more women arriving for surgeries. Please pray for this.

If there is something specific you would like to hear more about, leave me a comment and I'll fill you in on what you would like to know more about.

Just Another Saturday

The pastor with baby Rebecca

My day started at seven this morning. I got up, put on a new outfit and met with some others from the compound to walk to a nearby fulani village for a baby naming ceremony. This 2kg baby was born a week ago. She is so tiny and so beautiful. After visiting the mother and holding the baby we went out and sat with the women under a covering. They wait about a week to announce the name of the child. All morning I was hoping the pastor would hold the baby above his head and say, Simba. Spoiler alert: that did not happen. There was buildup to the name being announced. It is a biblical name. From Genesis. The sister of... someone I can't remember. Rebecca. The child was named Rebecca. After the announcement the town crier yelled out and for the rest of our time there, at random intervals, he would cry out her name. After the pastor gave his sermon the baby was brought out by a friend since the mother stays in her house area for 40 days. Festivities go on all day but we only stayed for about an hour and a half.

My new outfit
On the walk home from the ceremony

From the ceremony we drove to Maradi for Saturday shopping. Today was the first day I bought what I call fly meat. Meat from the market. I will let you ponder why I call it fly meat:

Fly meat

From the market we went to the hospital. If you read my last blog post, you may remember that I talked about to do lists from January. The very first thing on my first to do list was to tile the patient sinks in their bathroom. It was really grossing me out that they were just cement. Today when we got to the hospital, there were two guys there tiling the sinks! Eight months later I can cross that off my to do list!

Patient sinks being tiled

After grocery shopping it was time for henna in the village. Hawa, Ashley and I spent the afternoon in the village with the ladies. Haoua, the nurse in the operating room, brought a girl out to do this for us. We had been talking about getting it done since we got here. It took all afternoon and into the evening but it was a really good afternoon. Ashley went first then Hawa so it gave me time to take a nap under a tree. There was a nice breeze all afternoon and the ladies were a blast to hang out with. It was the most relaxing afternoon I have had in a long time. I don't think I would ever want a tattoo, but this will wash off in a few weeks. I kind of feel like Madonna with her 80's style gloves although I love the design on my feet. I have been trying to get my Bible study homework done this evening but I am so distracted by my hands that I don't know if I can.

Henna

This week we have two surgeries on Monday. After Monday our surgical numbers are a bit low. Because we are in the season of ramadan, people do not travel. Many Muslims also do not like to go to the hospital for elective procedures because then they will not be able to participate in the fast. Because of this, we have a long slow month ahead of us. We know the women are out there so please pray that they will come. Coming right off of July where we did 40 surgeries and we were pretty busy, I am nervous about slowing down the pace because of my nurses. Being new, I'm afraid they will become lazy even though I have no reason to think that of them.

On a side note, I have been asked to post more pictures of the patients. Being here and working so closely with the women, I would love to post lots of pictures of them. The more time I spend with the women, the more protective of them I become. I can not post pictures of them on my blog though in an effort to protect them and their privacy. Sitting with them today in the village, all of us resting on the mats, I was thinking that if I was at home on a Saturday afternoon I would probably be hanging out with some friends. Yes, the women are our patients, but I do think of them as friends. We laugh together, cry together, rejoice and hug when they come back for three month follow-ups. Today I spent my Saturday afternoon with friends and I loved it.

My Office

I have an office. It's a good size at the end of a long hallway. It has two windows and a lot of light. It's the second office I have had since I got here. A few months after opening we decided to swap the clinic and administration. My most recent office has a sink in the corner. A little funny to me, but it wasn't until today that I really spent any time in my office and noticed it and noticed the two phones I have sitting on my desk. I have just been dumping things in the room. Beads and paints and other crafting supplies. Papers, a batik I got in Niamey, all just piling up on my desk until today. I finally had time to clean it and hang the batik. I was sitting at my desk going through things realizing that today was a big day. Having time to spend in my office to organize it and also get a lot of computer work done that I have been putting off, showed me how far this hospital has come. Can I tell you how much I appreciate my nurses? They are fabulous. Four new ones were hired just over a month ago and I don't know if I could have found better ones. They ask questions. I am having them read all the policies and they are asking questions. They are asking questions about patients when they don't know why they should be doing certain things. They are doing their job and not sitting down through work. They are critically thinking through things. It has almost brought me to tears sometimes. The first time I got a call from my nurse working on the ward and we were struggling through her French and my Hausa and she finally just said come, and I went, I knew they were going to be ok. She was not afraid to call for help when she needed it. I appreciated it beyond words. Now when she calls we don't even try to talk. She just says come and I get in the car and go down. I think because I worry about the patients, having these new women care for them and not knowing them, I didn't know if they would get it. Get how important the patients are. I think they do. Yes, we are all still growing here and learning every day, but knowing that they will call for help when they need it and not be afraid of calling, gives me peace knowing the patients are in the very capable and caring hands of my nurses.

Cleaning off my desk today I also came across the notebook I was using January through March when I first arrived. I took a few minutes and looked through it. Again, it showed me how much has been accomplished in just a short time. I had to do list after to do list after to do list in that book. Looking through and seeing the things I stressed about back then, just a few months ago, and now seeing them complete brought me joy. The walkway from the village to the ward is complete. Staff has been hired. Lights have been put in the bathrooms in the village. A flow of seeing village patients has been established. Policies have been written. The kitchen has been built and we are feeding our own patients from it. There are still some things left undone, even from my very first list: tile the patient sinks, finish health teachings for the patients, write more policies. It didn't bother me the things left undone and yet to be done. We will get there.

Two weeks ago I threw my back out from a sneeze. It put me in bed for two days in pain. It was during the week on surgical days. I was really anxious about it, knowing I should be at work. I learned a whole lot those two days. First, don't take the random German medication in the cupboard even if a doc says it's ok. He doesn't speak German and has no idea what it is. Thank you Ashley for sitting with me through that experience. Second, it's ok to slow down. It's so easy to get caught up in work, work, work. I came here to work. It's hard to stop sometimes, or to even slow down during the day to stop and just talk to my nurses or patients and to invest in their lives outside of work. Things did not fall apart during those two days. Nurses still treated the patients well. Surgeries and clinic still went on. As silly as it may sound, I learned that things will go on without me even if I am not there. It was a good and timely lesson for me to learn.

Video Night

I have been trying to get pictures to post for the past few days. These are the only two I can get to work. A few of us went to a village to visit a two day old baby and we passed this cute kid on our walk out.

Beading day on the ward. Now all the women want to do is make necklaces.

It's Tuesday night. My favorite night of the week. It's video night in the village. Last week I shared my skittles. Tonight I'm hoping the popcorn is ready. The cooks add sugar to it so it's a bit more like kettle corn. Last week at movie night I got to hold a 40 day old baby through most of it. It made me want one. She was ADORABLE. Really. Her mom was a patient on the ward with an RVF. I barely missed being soaked. When I gave the baby to my boss Hauwa, she got peed on. Not just peed on, but it went through the top of her skirt and all the way through the other side. Maybe that's too much information, but the baby was cute. The baby and her mom have been discharged so it's just the stars, a movie and the patients tonight. 

Back At It

I love finally feeling like we are in a routine here and things are moving forward. We did not reopen the hospital as quickly as we had hoped we would after hot break. When I arrived back in Niamey after visiting Togo, I had to return to the states before I even made it back to my home here in Niger. I had some issues I needed to take care of and as soon as everything was sorted and ok, I was back on a plane here as quick as I could. An hour after I walked into my house I was in a meeting to talk about interviews which were starting the next morning. Two completely full days of interviews for nurses, guards, gardeners, drivers, cleaners and cooks. After the nurses, my favorite interviews to do were the ones for the guards. To ask the question: what do you prefer to use while you are guarding, a sword or a sling shot, could not be done with a straight face! We hired some great people and my nurses have really impressed me. It has been a real blessing to have picked the ones we have!

July 2 we started surgeries. This month we have done close to 35 surgeries and have had a constant flow of women. It has been a lot of work opening and training the new nurses at the same time, but just about one month in and we have a good rhythm going. The nurses are learning, women are getting their surgeries, we have been able to do more intense surgeries this month than we have before, and the rains have brought greenery! Everything is turning from brown to green and I love it! We have also had another Danja dance party with a full on band where the patients come out to dance, the workers and patients from the leprosy hospital do as well, and we dance together in a large circle under the stars.

Back to the women... we have had some incredible cases come through this month. One young girl came in after having multiple surgeries at another hospital, and although she had a VVF she was also in a lot of pain because she had urine leaking from a hole in her thigh. She looked no older than twenty and would walk around in pain. She knew a few words in English and when I would walk into the ward in the morning I would hear her say good morning in a slow, intentional way. LOVED it. She has had her surgery and she no longer has urine leaking from her thigh. On Thursday about ten women left and I was honestly really sad to see them go. Another older woman, when she was seen in the clinic on the day she left, before she walked through the door she went over to Dr I, then to me and kept saying thank you over and over as she rubbed down our arms and legs. She was beautiful.

This afternoon Ashley and I had our first weekly craft time in the ward. When I was home my parents gave me a suitcase full of craft supplies, mostly beads. It was a great gift for the women. They all made necklaces and earrings. We have another young girl on the ward who is extremely hard of hearing. If you put your mouth right next to her ear and yell, she can hear you. During craft time today, she was sitting next to another patient who was having a hard time getting the beads on her string because she couldn’t see well. All the patients started laughing when they realized the patient who couldn’t see was talking to the one who couldn’t hear. The two of them stopped and looked at each other and laughed.

When I finally arrived back I had some friends here working. Cal and Anita who I know from Camp Lutherhaven. It was sad not being here when they arrived but we had a few weeks together anyway. Cal did an incredible amount of work during his time here. He built us a walkway from the village to the hospital so we can serve the patients food on the ward, started construction on the doctor’s house, was patient with us all as we daily have a growing list of maintenance issues…Anita had a gift for rolling cotton balls, coloring with the patients, and so much more. It was the first time friends from that side of the world merged on my life in Niger. They are already missed!

Hot Break

Again, I apologize for my long silence. I think I need to stop apologizing and just write more. I do not have much to say right now in the way of fistula or Danja or work because I have been away from Niger for the last month. We closed the hospital mid April due to the intense heat and I have been on holiday since. It was not until I got away that I realized how much I needed a break.

When I left, Ashley, the Browns and another couple from far east Niger went to Park W to see the animals. It was a twelve-hour drive from Danja to Niamey, then another two to the park. Who knew there was a place to see wild game in Niger?! It was great though. We hired a guide when we got there then climbed on top of our land rover and set off into the park. We stopped close to the entrance where there was a look out and we had lunch. The lookout was right by a river and because of the heat, this is where the animals come. We had lunch with a large herd of elephants, two crocodiles, some baboons which we watched move through our territory, a few warthogs, and some birds and deer. It was a great start to our three day trip. We drove all through the park and saw many more types of deer, buffalo and birds, but unless we were at a water source there were no big game to be seen. To get to where we would stay the night we had to catch a boat to take us to a small island. Ashley and I shared an adorable cabin sitting high up on some rocks surrounded by baobab trees. I could not have asked for a more relaxing place in Niger. It was right on the river and we watched elephants across the river as we played rummikub to the sound of frogs at night. Our plan was to stay there three days and explore. The second day we decided to just stay on the island and rest. Our guide took us on a walk through the island and we could see the damage made by the elephants to the trees as we walked. When we hit the other side of the island we watched as a few elephants were making their way across the river to our side. We climbed up onto some high rocks and followed them as they made their way through the trees and back into the river where they used their trunks as snorkels to swim back to the other side. The rest of the day we napped and read and played rummikub. I also learned that a great way to keep cool is if you get your wrap wet, lay it over you with a fan blowing directly onto you and it feels like air conditioning. I wish I would have known this earlier! Our final day in the park we drove around on top of the vehicle again and saw a few more deer before heading back to Niamey.

Baobab tree fruit

 Our cabin

Elephants

A man and his loom

A monkey in the zoo

(I don't have pictures of the rest of my time on my computer yet)

From Niamey I hopped on a plane to Togo. I spent about three weeks in Lome with friends who are still working on board the Africa Mercy. My first four days there I spent at Lake Togo with a friend and we swam, played scrabble, ate shrimps, watched football and talked. It was more than I could have asked for. It hit me right off how much I missed this. Being able to sit with someone who knows you and will just listen to you ramble and whatever you say or do is fine. You can sit in silence and there is no stress. It was a breath of fresh air.

From Lake Togo I boarded the Africa Mercy for ten days. I still have many friends who are working for Mercy Ships and I was invited on as a guest. It was a blessing to be somewhere with a hot shower and Dr Pepper and friends. I felt like God had set up my time being there. I was able to reunite with some great friends from years ago who just happened to be on board at the same time. Many of my friends are leaving when the ship leaves Togo next month so this may be the last time I see them for a long time. It’s funny though because I never thought I would get to see them right now either. You never know how or when you will be reunited with old friends.

When I left the ship, my Irish friend Jane and I spent a week on the beach. This entailed more shrimps and much more scrabble. Lots of time to think and hunt for shells and just sit and watch the waves. One afternoon I was watching the water when it hit me, Danja is so quiet. I grew up on the water and love the ocean. I love watching the waves come in and listen to the sound of the water. Niger is so quiet. Cars and kids and the occasional donkey, but it’s so quiet. Good or bad? Neither. Just an observation.

It was a very relaxing few weeks break before we re-open the hospital again June 1^st. Lots to do before then as we are starting fresh in a way because we are hiring new staff and will have to retrain. I look forward to it and I can’t wait to have the hospital up and running full time! Again, these are all birthing pains! 

Heat

I wrote this post ten days ago. We were without internet for over a week so I wasn’t able to post it. Here it is…

I was told that one day the temperature would change and hot season would be here.

That day came yesterday, April 1. I wish I could say it was an April fools joke, but with a temperature of 106 degrees, it wasn’t a joke. I moved a table into my bedroom, turned on my fan and air conditioner and tried to stay cool. Many people move into their bedrooms for the hot season because the smaller rooms stay cooler if you have ac. My ac decides to blow hot air sometimes which makes it worse.

I have learned there are some things you shouldn’t do when the temperature is above 105:
*Don’t sit on your couch if it is covered in fabric. It will just make you sweat more.
*Don’t sit with your computer on your lap while it is on. I was afraid for my life and the life of my computer for a second when I realized the computer was sitting in a pool of sweat on my lap.
*Don’t stop drinking water. You should really drink ORS, oral rehydration, frequently. It’s impossible to keep up with your water intake.
*Don’t think a cold shower will cool you down. The pipes just heat up the water so your cold shower is now a warm shower. When you reach for your towel, don’t expect it to be cool. Wrapping yourself in your towel is like wrapping a towel around you which has just come from the dryer. Getting dressed, again, is like freshly pulling clothes from the dryer. Everything is warm.
*Getting into bed at night is like laying on warm sheets, again, from the dryer.
*Sleeping under a mosquito net, although a necessity, increases the temperature even more…
*Don’t cook or use your oven. All it will do is increase the temperature in your house.
*Don’t stand in the sun to talk if you run into someone on the road. Walk your conversation into the shade. There is a huge temperature difference between the sun and shade.
*Don’t make the wrong decision when you debate which is worse: not sleeping under a mosquito net because it increases the temperature you have to sleep in, or risk malaria.

Please don’t think I am complaining. I’m not. It’s just another thing I need to learn if I am going to be living in Niger.

Ten days since I wrote this post. Changes in the heat since… 114 degrees in the shade yesterday.

Karin

Take a look at my friend Karin's blog about her trip to Danja. It was great having her out here.

http://larsonkb.blogspot.com/

Dance Party Danja

Teaching patients about taking pictures of your

feet to show where you have been.

Ashley hired Nuhu's band to come play for us again last night. Again, the watering of the 'dance floor' was a sight to see. The band set up right outside the hospital and Ashley, Anna and I went and got the women ready. We tied their gowns tight and hung their catheter bags from the knot we made with their gowns. We hung their bag inside their gown so you couldn't see it and then the patients put their zenni, their fabric wrap, around the outside of their gown for added security and coverage. Add a head covering, or two, and we were ready to dance! Ai*, who has seemed sick and depressed since she arrived on the ward, would hardly let me sit. She would sit next to me and look at the circle of dancers, then at me, then nod to the circle and away we went again.

Anna is a friend who is living in a small village 3km away. She is working for a missionary family homeschooling their three kids. She is over today and we are going to have a Back to the Future marathon and make blueberry muffins. Thanks mom and dad for the dried blueberries! I think I will wear jeans today. Something I miss doing. It's just another day in Niger...

Waiting for the dance to start.

Watering the dance floor, as you do.

Anna's guard found a baby hedgehog and gave it to her. She has been feeding it and raising it. SUPER cute.

So Ashley and I were in a bit of a bind. We had some

spoiled food in our fridges and didn't know what to do with it.

We didn't want to just throw it away because we didn't want to seem

wasteful so we had it just sitting in our fridges for a while. Someone

told us to bury it. Ashley put on her rain boots to

protect her from snakes and she dug a hole when no one was around to see

what we were doing. The neighbor's gardener came by and he

watched in confusion for a bit then went away and we finished. I think

we need to get a goat or chicken...

Iska

This has by far been the busiest week yet since I have gotten here, and my favorite as well. I am privileged beyond words. I wish you could all witness what I am watching unfold as I type this. Hannatou* is laying in bed singing. Nana* is stading up clapping. Saratou* is smiling ear to ear clapping while laying in bed and the other nine women I am watching are trying to sleep while these three won’t stop. I can only laugh. They are the true picture of beauty.

Last Thursday an anesthesia provider arrived from the states to be here for a week. A huge answer to pray. He could only be here just under a week so we pushed through and did twelve surgeries during his time here. Long days. A few cases of malaria. Two women returning back to the operating room because of bleeding... in the same day. Lots of singing. Knitting. Coloring. Laughing. We made it through. Out of the twelve women, twelve are dry so far. It’s incredible. In all my previous trips here and stents of surgeries, never have I seen all the women dry for this long together. I am filled with such joy!

I was not scheduled to be at work right now. It’s 10:15pm and at 7:30 I got a text saying the nurse who was on brought her sick baby to work with her so it could sleep next to her here. I am here now. She is at home. I don’t mind it. It just makes me laugh that she would think that was an ok thing to do, to bring her sick baby to work with her. She speaks hausa and French. I don’t. Let’s just say handing over the patients was interesting with me and a French language book. Night time here is one of my favorite times with the women. They are relaxed and chatty. They lay in bed and talk to each other and try to talk to me and laugh and say babu hausa, no hausa. Aque hausa, there is a little hausa, I tell them. Kadunk a dunk, small small, I say. They laugh. They sing. I shake, they laugh more.

During this process of opening this hospital I keep referring to it as the birthing process. This past week was a big push. The times up until here have been contractions. Some big and some small. The water breaking was the first surgery. Contractions started building with the grand opening. Surgeries continued. We realized we were going to have to change our course of action with anesthesia and things paused. An epidural was put in so we could rest. Anesthesia showed up last week and we pushed through. By the middle of April we will close for a few weeks due to the intense heat and then I feel like the birthing process will be over and we will start the growing process.

Some things that have happened since my last blog… the weather has been interesting. I feel like I haven’t seen a blue sky in weeks. The dust has been so thick and the wind, iska, has been pretty constant. No major dust storms yet. I had been looking forward to one. I think I have changed my mind. Yes, I would like to experience one, but even with this constant blowing of the wind off the desert, I never feel clean. The children look like the have put powder on their faces because of the dust turning them white. Men with once black hair now have grey. One of our cleaners shaved his head yesterday and when asked why, he said the dust was turning it white, and it was. My house is in a constant state of dirtiness. I had it cleaned today and had my mosquito net washed. It was turning brown. Coming home to a dusted, clean place made my day. It wasn’t the easiest thing for me when I hired someone to come clean my place once a week. I figured I could do it and be fine. With the long hours and constant need for dusting, it’s been a huge help. Also, it helps the community and families to hire someone so I don’t mind anymore.

I feel like there has been a plague of crickets. When I say crickets, I don’t mean the cute, tiny Jiminy Cricket types. I guess these could dress in a suite and top hat and carry a cane because they are so big! They are everywhere and fly around right outside my door under my light. At night it sounds like someone is knocking because they run into the metal door.

Another answer to prayer is that the container with supplies arrived yesterday. It’s like Christmas when a container arrives. I was helping sort out what belonged to us and what belonged to the leprosy hospital we share a compound with. I was excited for our supplies but almost even more so for them. The guy unloading for their side spoke English so we chatted and when the magnesium sulfate was pulled out he got so excited. This is used for pre-eclampsia in pregnant women and he said they had been out of it for so long. This and other drugs made him so excited. It was great to share in his joy. It’s not an easy place to be when you can only get so much in the country. They really do the best with what they have and they do it well.

Before Dr. Steve left here he shared a story with us a few times. It has stuck with me since. It’s from 2 Samuel chapter 24. I won’t type it all here because it’s too long but I encourage you to read it.

…I will not sacrifice to the Lord my God burnt offerings that cost me nothing.

2 Samuel 24:24

A thought to leave you with…

(*Names have been changed to protect the privacy of the patients.)