Living a Life of Joy

Opening Ceremony

2012-02-11T05:17:00.000-08:00

Today was the second and final official opening of the hospital. The first ribbon cutting was last Monday with the minster of health and today was the official ribbon cutting with the rest of the world. We all got new clothes made for the event. I got this one and another made. They both have a few kinks which need working out but I think the tailor did a good job overall. The top picture is, from left to right, Nancy, me, Ashley and Jackie. Nancy will work in the ward with me. Ashley is the OR supervisor and Jackie is here for a few weeks to help get the OR set up and running. The bottom picture is me and Ashley. Lots of people came out for the celebration. It was a great morning full of wrong translations and the same band as last night. This week we will have two full days of surgery and fill more beds. I can't wait!

Pictures

2012-02-10T23:02:00.000-08:00

Morning walk to work.

The village.

Operating room.

The ward.

Last nights dance.

Life to the Full

2012-02-10T13:04:00.000-08:00

When I left the hospital tonight I thought about walking around the hospital to avoid ‘the band’. I was tired from working and was ready to just crawl into my bed. I had not heard any noise yet so I figured it was safe to walk the normal way. Nuhu is the anesthesiologist and we found out the other day that he is also the manager of a band in town. Of course he is. We hired him to bring his band and put on a show for us. When I arrived to the front of the hospital Ashley and Mark were sitting on the hospital step while the band was setting up. I knew I was going to have to stay to witness this… the bass was just getting warmed up playing Amazing Grace while some other people were watering the sand in front of where the rest of the band was setting up. I sat down next to Ashley and we looked at each other and reminded each other that this is just another day in Niger, watching someone water the sand while instruments are being brought in and people are arriving. It didn’t take long to realize why they were watering the sand. That would be the dance floor. When the music started there were four girls who shuffled along in a line and danced, or shuffled, in a large circle through the sand. We all jumped in and followed and before long the fistula women from the village started wandering in from behind the hospital. They came and sat along the step to the hospital but after one or two of them got up and danced I knew the best was yet to come. People from all over the hospital, compound, nearby towns started showing up. I think we emptied out the village and all the fistula women came, even the two patients from the ward who had surgery were there. There were people dancing on the walkway to the hospital, on the ground, and as the circle continued to shuffle its way around and around I kept thinking to myself: John 10:10. This is living life to the full. Not just for me, but for the fistula women. Looking at all the women there laughing, jumping as Dr Steve had a laser pen he kept scaring them with, dancing, chatting, going up to dance then running back and giggling, just sitting and watching, laughing more. This is living life to the full. Even the woman who brought me to tears just a couple days ago knowing the chance of her being dry was slim, she was out there dancing, singing and laughing. I don’t think I have seen such a large group of VVF women laughing so much and just living without fear or shame. They were women sharing their lives together. The teenagers danced together. The older women sat and laughed. Everyone in between lived. No fear. Just John 10:10, living life to the full.

Night Shift

2012-02-10T12:57:00.000-08:00

I wrote this last night when I was on the first of the night shifts. There is no internet at the hospital so I wrote it there and here you go...

Today was the first day of surgery! It was supposed to be on Tuesday but things can get a bit crazy when the minister of health decided to visit the day before you are supposed to open. We had to push the first surgical day back a couple days but it did give us more time to continue screening the mass of women we have staying out in the village.

I have enjoyed the clinic days. Two days a week we will have the clinic open so we can screen any women which have arrived and are waiting to see the doctor. We started by seeing any new women, those who have not had surgery here before, then moved on to those who have had surgery and need more help. I love seeing the women come back, those I have known from previous trips being here. One woman came in, basically to just say hello. She sat on the exam table and started talking and talking and talking and even though I couldn’t understand her verbal language, her body language said it all as she would get angry faces and pretend to spit and then smile. She was telling us that before the surgery, people would spit on her and avoid her and now she has found a new husband and people don’t spit on her anymore. She lives very close to here so I’m hoping to see her again. Another woman who I knew from before came in. She sat on the exam table and was completely wet. I knew what was coming, what the doctor was going to say, so I stood a bit behind her so she couldn’t see my face. I then had to leave the room because I couldn’t stop crying. The women who I know from before, I see them as my friends. I want the best for them, for all of them, but sometimes we are just about at the end of what we can do to heal them. I stood on the other side of the door and listened as the surgeon explained options to her, none of which are easy.

This morning we came to the hospital early to collect the three women from the village who would have surgery today. Today was a day of learning, to say the least. Everything from bathing to eating to handovers to making beds, everything was a first for here. To try and make this a place that will last and to do it well, you have to analyze every little thing. Why did it take over an hour for three women to bathe and have a sitz bath? Oh, the many reasons, but next week it will be easier. How do we get food from the kitchen to the patients? How can we change the beds so we aren’t constantly hitting our heads on the mosquito net frames? Ashley and I were sitting tonight talking about all the many things on our long lists of things to do and fix and review and none of them are bad. They are just things to have to work through and find answers to. All part of opening a 42 bed hospital.

I am sitting in the nurse’s station right now. It’s almost 10:30 at night and the three patients are tucked in, sleeping. Day shift. Night shift. How to make this work as well? The women were all asleep when I tucked their mosquito nets around them. I felt like a mother tucking in her kids. Before they fell asleep, two of the patients were laying in their beds facing each other, talking. Ashley and I were sitting in here wondering what they were talking about. I was mentioning things my friends and I would talk about when we would spend the night at each others houses and what we would say when we first turned the light off (Bridget). Ashley said they were talking about if they would be going back to their husbands now. Who knows what they were saying to each other, but they were super cute lying there in a stark white bed frame with a blue sheet on their bed. Each of them with their catheter so tonight they are dry.

Scorpion

2012-02-05T01:14:00.000-08:00

The front of the hospital

I am currently standing in my kitchen waiting for my tortilla dough to sit for fifteen minutes. I don’t know why it needs to sit for fifteen minutes but I am told it needs to before you roll it out so I will wait…

What made me jump this week? Not as many things as before. I am getting used to the spiders. We were moving the maintenance room out of the middle of the ward and behind a box I moved was a scorpion chilling on the wall. I thought it was dead. It wasn’t. Ashley was the brave one to kill it. Just a small one though. I hear they get pretty big here. The gecko still lives in my drain. We are becoming more understanding of one another’s space. I still laugh as he runs and squeezes his fat little body down my drain when I come in, but we are learning to live together and share the space in my sink.

In Maradi there is a ‘French Club’ which has a swimming pool and tennis court. It’s a good place to go on the weekend to relax. We went there last weekend and played tennis. It was fabulous! Ashely and I both brought our tennis rackets so we could play. I loved it! It was great way to relax. I’m wondering how we can make a court here… Put that on my list of things to do!

What a week this has been! The transformation of the hospital has been incredible, really. It’s been a ton of work but even through the early mornings and late nights putting shelving units together, unpacking boxes and scrubbing floors, I wake up thankful to be here and excited to head down to the hospital. It really still surprises me, although it shouldn’t by now, just how God gives you the strength and grace for wherever it is that He calls you to.

Dr. Steve and the rest of the team arrived this past week. Today was our first full staff meeting. Ready or not, Monday is almost here. Monday we will start screening the thirty something women already waiting to be seen. I wish I would have had more time to spend with them this past week but that time will come. On Tuesday we will start our first surgeries. We are starting slow and I’m grateful for that. Starting from the beginning means training everyone and working out all the kinks. Even things like this should go there or who was supposed to clean that and all the little details we may have overlooked. This will be a full week but I’m really excited! I do feel so privileged to be here for such a time as this. I couldn’t imagine being anywhere else right now.

Please continue to pray for my Hausa. I have been getting better but still a long way to go. It was helpful having cleaners in the ward this past week. Zo, come. Shigo, come in… I threw out any and all words I knew to practice on them. They laughed, knowing I was doing my best but then they helped to teach me as well. Please pray for this coming week that kinks will be worked out and policies will be written and women will start to be healed. Thanks!

Another Step Closer

2012-01-26T22:45:00.000-08:00

What a week this has been so far! Monday morning we started cleaning the hospital. It had not been touched in months so we knew a major job was ahead of us. We were able to hire ten workers to help us and overall they were great. We were able to bust that place out in two and a half days. When we finally started putting the beds into the ward the tears started. I cannot wait for that place to be filled with women. They have already started coming. If you build it, they will come, and they have. Two women from previous trips are already here. About six more and their children are waiting as well. They are staying in the huts. The huts are the cement dwellings behind the hospital where the women can stay pre or post operatively, especially if they need further follow up but they live too far to return every day. So the initial cleaning is done. 42 beds have been moved in with their mosquito net frames. All the windows have been cleaned. Hundreds upon hundreds of spiders killed. Every wall bleached. All floors mopped. All fans dusted. Laundry done, for the most part. The operating room looks great. More spiders killed. Now we are waiting on the container to arrive so we can have the supplies we need to begin.

I am still learning so much on a daily basis. Did you know that when you make popcorn on the stovetop you should make sure your pot has a lid so the popcorn doesn’t end up all over your kitchen? This is a fact. Did you know that home made yogurt is perhaps the only type of yogurt I will eat now? Absolutely amazing stuff! Did you know that Sarah actually translates into hausa to be Saratu but they drop the ‘h’ and this disappoints me a little. I have been proud of the ‘h’ on my name so I may be the only Saratu spelling her name Sarahtu. Did you know that in hausa the word for sing and the word for wash sound very similar so when the cute little girls from church came over to sing for me I thought they were telling me to go wash, not sing.

Maybe I’ll start having a section on here called: Things That Made Sarah Jump This Week. On Tuesday I had just returned to my home when I put my key in my door to lock it from the inside. As soon as I started turning the key a little head with big eyes shot out from the top of the lock where there was a small gap. I don’t know what type of animal, big game I think, these eyes belonged to but I do know that I yelled loud enough for Ashley to hear me and I kept jumping around my place thinking it was crawling all over me. I have gotten better though. I don’t live in fear anymore of a snake jumping out at me whenever I open a cupboard or door. I think this is a big improvement in a week.

An update on the current snake situation: just about everyone here knows of my fear of these rancid animals. Some still like to report on the daily snake sightings though. Two were found in my neighbors hut outside their home which they use for storage. I never saw them but I know they were quickly killed then burned. Oh, and get this. There is an area on the compound that we frequently walk down which one of the boys here called snake city yesterday. I think I will walk another way from now on.

From all this cleaning my back has gone crazy. Please pray for the pain to go away. We have a long journey ahead of us and I can’t be hurting. Please continue to pray too for our hausa lessons as well. We had our first one Tuesday and another tonight. Please pray that it will all sink in quickly for both Ashley and I. We have a great teacher, but languages have never been a strong area for me. I have learned that when people see you are trying they want to help you out and get excited for you when they know you learned another word or greeting. I look forward to the day when I can talk to the women without a translator! Thank you all for your prayers!

Foodies of the Desert

2012-01-22T10:48:00.000-08:00

Yesterday I came to this realization that I will survive. Don’t take this to mean I didn’t think I would but yesterday I saw and learned that cooking here is doable. I am not the greatest cook and even with my limited cooking ability there is usually some sort of processed something in there. There are four other houses here filled with missionaries who have been on the field for years. Nancy has lived in Niger for fourteen years and I guess you could say she is a foodie of the desert. She was just going to teach Ashley and I how to make yogurt but then she asked if we wanted to learn to make tortillas. No question there. I was tempted to even pack some when I came but no room was left in my luggage. We went back to her place later in the day for our tortilla class. Well tortilla class turned into bread class, which turned into sweet roll class, which turned into icing class, which turned into vinaigrette class. All this in under three hours even. I’ll admit, for some reason making your own yogurt kind of freaked me out a bit. Leaving my warm glass jar wrapped in a towel on my counter in the heat of the day kind of concerned me but this is what you do. Tonight I made myself finally try it. It was bitter but as soon as I added a bit of sugar, I am already hooked! No more buying yogurt in the store. Beyond easy too. All you need is powdered milk, water, and a small bit of yogurt starter. Done. I’m already thinking about how to make frozen yogurt and using the yogurt for baking and mango yogurt and vanilla yogurt and… We documented our entire cooking day, basically step by step but I can’t seem to get pictures on here, sorry. I am sure more cooking days and stories are to come!

Guess What Is In My Drain...

2012-01-20T13:53:00.000-08:00

Sanu! I have made it safely to Niger. I have been here almost five days. Wow. It seems like I have been here weeks already. My flight here was pretty uneventful. Nothing too exciting to report on that. I met up with Ashley, the OR supervisor, at the airport in Paris and we flew the last leg of the trip together. It was great to finally meet. We arrived in Niamey and stayed three nights at a guesthouse there before we could catch our final flight here. All my previous trips through Niamey were really short so it was great to look around a bit. Found an amazing Indian restaurant close to where we stayed.

On Wednesday we flew the last leg of our flight to Maradi. Had a rocky start to the flight but the rest of the two hour flight was smooth. I’m still in awe as we fly across Niger. With there being only one paved road across the country and tons of small villages converged upon by small walking paths, it’s no wonder why VVF exists.

I was thinking the other day how God changes our hearts. I never imagined I would be living in the desert. Not in a million years. I grew up on the beach and love the water. I definitely have sand, but no water. Take away all the times I have jumped or screamed the past two days from random things that have spooked me and I can almost say I love it here. Daily I have been getting more relaxed with where I am. I am not as afraid to open a cupboard and think that a snake will jump out at me. Tonight I was in my bathroom and jumped then laughed and stood in disbelief as I watched a gecko shove its fat little head down the drain in my sink. He is now down in my drain and I don’t know if he can get out. He’s chilling right under the drain. I’m afraid to use it. It was the most random thing to see. It’s little body was wriggling all around as it forced its head down the drain…

The last two days have been filled to overflowing with information overload. There are four other houses in the same compound where I am living that house four families with enough mission experience to last multiple lifetimes. They have all been great in teaching Ashley and I how to live. Tonight we got a good introduction on how to light our stove. Yesterday we did the market. In all the time I have lived in West Africa I have not had to do all my own cooking and cleaning and clothes washing, and I mean by hand. I saw the market yesterday in a whole new light. It was great to have people to translate for us and tell us how to find the best produce and what to do with it once we got home. I bought flour and sugar by the kilo from a nice man on the corner with a scale. I now have flour and sugar in my freezer to kill the weebles in it. I was told the stuff I bought was fresh so I didn’t have to do it but at this point if you tell me there is a chance I have bugs in my flour or sugar I will do anything I can to kill them. Things that back in the states would take minutes to do can and do take hours here. After the market your day is not over. Now you have to clean everything. By cleaning I mean first washing it with soap and water and then letting it soak in bleach then rinsing it again. Lettuce is the most annoying one. Every piece of lettuce is washed this way. You definitely learn how to appreciate what you eat. Something else I learned was that you need to know what you find in different seasons. Right now as you drive through Maradi you see sellers with plates of carrots on their heads. Carrots are everywhere. It’s carrot season. I’m told that in a few months you won’t find any so now is the time to freeze them so you will have some to eat later. After going through the long washing process now you cut them up to freeze them. I have carrots, bell peppers, onions, cilantro and flour and sugar in my freezer. I’m so thankful I went to the Brown’s for dinner tonight. I would have stuck with a granola bar if I hadn’t.

Yesterday evening we went to see the hospital. Once it is cleaned it will be so beautiful. I can’t wait to see it filled with women. The ward is huge. The operating room is amazing. The hospital has been locked up for months except for a construction team and it is FILTHY. It seems like an overwhelming project but starting Monday we will start cleaning, hopefully with a team of workers. The amount of spiders everywhere in there could possibly set a record though. We opening one door and in the door frame was a gross pregnant spider. What scared us even more was the egg sac next to her. This egg sac was cream colored and covered with spikes. I came home a googled it and I’m wondering if it is a brown widow spider??? I kind of don’t want to know. Either way it is still there and we are hoping the eggs don’t hatch anytime soon. SO GROSS! That is how I feel about that.

We met with our hausa teacher today. We’ll start lessons next week. That is really the biggest prayer request I have right now. I am awful at languages and not only do I need to learn hausa, I need to eventually learn French as well. Hausa is first since most of the women speak it since they don’t live in the cities. Everyone else speaks French though. Please pray that I will be able to pick them both up quickly.

Tomorrow is a new day. I think I will try and cook something on my gas stove now that I think I know how to fiddle with it to make it work. I can’t thank you all enough for your prayers. Please keep them coming and let me know how I can be praying for you too!

Now is the Time

2012-01-14T11:32:00.000-08:00

Two and a half months I have been back in the US. I have rested. Visited. Played with four adorable, growing nieces and nephews. Laughed. Ate some pretty nasty jelly beans. Recovered. Worked on policies and procedures. Prayed. Ate. Gained weight. Cleaned out my storage unit. Had a spaghetti dinner fundraiser. Watched 'A Walk to Beautiful'. Spoke about my heart. Wondered about a great many things. Been prayed for. Hoped...

Now I am back in the airport. I will land in Niger in 23 hours. That seems longer than I was thinking. I feel ready. Ready to get back to work. Ready to unpack a large container and organize the ward. Ready to meet the heat face on when I land. Ready to face the adventure that lay ahead. I don't know if I would say I am completely looking forward to all the challenges that lay ahead, but I am really looking forward to the expectation of God's hand moving and seeing what He does during the next few months, year, who knows how long I will be there.

I had wanted to write a post to catch you all up a long time ago but time just seems to always get away from me. It sounds like the internet has been working lately in Danja so when I get in I'll write to let you know I made it. I'll be in Niamey until Wednesday then will fly to Danja then.

Thank you to everyone who has prayed for me. Supported me financially, spiritually and emotionally. Come to listen to me speak. Offered words of encouragement. Given me a place to sleep and food to eat. Given me three closets and a basement to put everything from storage into so I can get rid of that finally! (Thanks Rebecca and Stephen!) I have really felt loved and supported. I know I am not going out alone. I know Christ goes before me but I also know I have a huge team back in the states praying for me and ready to help. Thank you.

Here we go...

VVF Fundraiser

2011-11-26T21:26:00.000-08:00

As I am preparing to leave for Danja, Niger I wanted to let you in on an opportunity to learn more about VVF and find out how you can support me and the operations in Danja.

On December 10 there will be a spaghetti fundraiser dinner and you are all invited. It will be at Waypoint Church in Gig Harbor, Washington (12719 134th Ave KPN Gig Harbor, WA 98329). There will be dinner, a presentation about what I will be doing in Niger, and a pie auction to help raise the support needed for me to work in Danja. Tickets are $7 and you can either purchase them from me before hand or at the door. Please RSVP to sarah_daphne@hotmail.com if you are planning to attend so we can have an idea of how many people to plan for.

Thanks again for all your support!

New Beginnings

2011-11-17T11:08:00.000-08:00

I feel like I am entering into a new chapter of my life. That isn't a huge surprise knowing I am home now and getting ready to leave again soon but knowing where I am headed next, I feel like the experiences I have had thus far have been preparing me for this. The challenges, the new experiences, the cultural issues I have encountered have all been preparing me for what is to come. I wait in eager expectation for this next adventure.

Being home has been good. I have already spent some time in Coeur d' Alene with my sister and family and played with my niece and nephew there. They are both three and I can see how they are learning more about what I am doing. Whenever I left the house my niece would look at me and ask multiple times if I was coming back.

After staying with them for a short bit I headed to Kentucky for an international medical missions conference. The week I was there was just what I needed. I reconnected with some great old friends and was encouraged beyond measure. The times of worship and speakers had the words I know so many of us there needed to hear. Throughout the day there were sessions you could go to to hear speakers on different topics dealing with medical missions. Everything from how to minister to the Muslim community to worms to dealing with ethical issues. So much was presented that I am still processing through it all. I was excited before but now I have a greater excitement boiling inside me for all that could possibly be accomplished next year.

I am back now in Western Washington staying with my brother and his family. My nephews here are great. It's been wonderful reconnecting with them. I will be here for a few weeks to rest and play with them.

Mid January I will be leaving again for Niger. Until then I will be reconnecting with friends and doing fund raising. There will be a small team of us going to open a VVF hospital in Danja where I have visited and worked twice before. I am having to raise my own support for this so if you feel called to give there is a red tab on the right under my picture that you can click to give. Any gifts given through there are tax deductible and you will receive a receipt. Thank you for your help in changing lives of VVF women in Niger.

I will be in Western Washington until mid December then I am headed back to Coeur d' Alene for a bit. If you would like meet up and chat about any of this or just meet up for some coffee, please leave a comment on here and I would love to catch up. Thank you all for your prayers and support during this time!

Goodbye Sweet Salone

2011-10-27T19:12:00.000-07:00

Yes, again it has been awhile since I last updated on here. Sorry-o. I am now home in the USA. I will say it is nice to be home but in all honesty, it was very hard to leave. Many tears were shed and my heart hurt as I got in the water taxi to go to the airport Wednesday night. I'm still not fully home. One more flight to take me to Spokane and to bed.

One of the reasons I haven’t written on here in so long is honestly because I didn’t have time. The last month in Sierra Leone was c-r-a-z-y! You could say it did not end how I had hoped it would or in the way I had imagined. When the thought came up of me coming home early, I should have come home in January, I knew it was right. I had trained up a national nurse to be the ward supervisor and I had full confidence she would do a great job. I knew I could leave knowing she would be fine and the other nurses looked up to her and respected her. I felt like I had accomplished what I went there to do.

About two weeks ago this all changed very quickly when it was found out that many drugs were missing from the pharmacy and she was the reason. To say I was devastated would be an understatement. After learning this, more lies just as horrible were brought to light as well. I felt like the last six months I had spent training her were all of a sudden a lie. Like the work I had been doing was a waste of time. I don’t believe that now but it was a huge struggle for me for a time. After this all came out I laid in bed and went through every conversation we had and wondered if all we talked about and all she shared with me was a lie as well. When we realized medications were missing I told people it wasn’t her. I couldn’t believe it could be. I felt completely let down but I know my nurses did as well. They all trusted her as much as I did and I know this all came as a shock to everyone who worked at the centre.

God really is so good though. As I was training this nurse, I was training up another nurse along side her as well. She did not have as much training with me as this first nurse but I really do believe that she will do a fabulous job. The areas she struggles in are areas where she will have much support from others at the centre. Computers, paperwork, those lovely things.

Many people have asked me in the last week what I will miss about Sierra Leone: the patients, the nurses, my friends, beautiful Sierra Leone beaches, Thursday and Friday lunches (groundnut and rice and beans and rice), the sense of community in the ward where the women take care of each other, VVF women who come back to have their babies at the centre-- just to name a few. I do find comfort in knowing that come January I will be headed back to Africa, Niger this time, to open the fistula centre at Danja. I am so thankful that my time working with VVF women has not come to an end although my time in Sierra Leone is done. I have learned so so so so much this year and I know I can take most of that with me next year.

My current plan is that I will be in the states now until mid January before I leave for Niger. I will write a post soon about what that is all about. I will be home visiting family and friends and doing fundraising. Back at it! Thank you all for your prayers and support during my time in Sierra Leone. In all honesty, I don’t know if I would have survived without all your prayers and support during the past ten months.

Oh, and my bruise is much better. It’s still there but now it just looks like a large birthmark on my back. Still tender to touch it but I know that will get better with time.

The Fall...

2011-09-30T15:40:00.000-07:00

I started writing this the day after I got injured. It is now three weeks later and I am ok...

Before I start this post, I want to say that I am ok.

Yesterday (as in three weeks ago when I started writing this) I went to my room to eat lunch. After lunch I grabbed my umbrella and headed back to work. It had just started raining. I opened my umbrella and started down my steps. Crocs on, umbrella open, carrying my water bottle and empty bowls. I made it down the first set of stairs then turned the landing and as I started down the second set of stairs my feet went out from under me and I proceeded to hit every step on my way down. Cement stairs covered with tile. My left flank and left elbow hit every step on the way down.

When I got to the bottom I could only swear. I could move and feel my legs but I knew I couldn’t get up. Luckily I had my phone in my pocket and I called Jude, my boss. I told her I was hurt and told her where I was. My umbrella landed right over the top of me so I was able to stay mostly dry. She came quickly. I couldn’t get up. Dr John and Maggie and Simon and everyone else showed up out of nowhere. I was told they were going to get the stretcher but I kept saying that if I just sit for a few minutes I would be ok. Deep down I knew that wasn’t true. Any movement and I started crying. The decision was made that Simon would pick me up from behind and someone else get my legs like a fireman hold and get me in a chair. From there they would carry me up the stairs to an empty room. The pain was unbearable and only got so much worse when they tried to put me in the chair. I couldn’t sit. The stretcher showed up and I was laid on it. When my tears came they couldn’t stop. The pain, the embarrassment, everything that started running through my head about being in Sierra Leone and what could go wrong.

They carried me on the stretcher to Orange Ward which was empty. I told them to just put me on the bed on the stretcher but they wanted to get me off it. Profanities ran like a river out of my mouth. I could only lay on my right side. Esther showed up and I realized that things that are said that annoy me so much, annoy so much more when I am hurt. I really dislike it when I am told not to cry when you know that crying helps so much to get the emotion and even pain out. To tell someone that you will be fine or that Jesus will heal me so I don’t need to cry or worry about anything. You don’t know if I will be fine. You don’t know if I will be ok, will need surgery, or if I broke something. You don’t know. Jesus does heal. Miracles happen. God can deliver you from your pain. Does He do it for everyone? No. That is His choice, not mine. I know I shouldn’t worry because God does have a plan, but don’t tell me that God will heal me and I won’t need surgery and I shouldn’t cry. I know she was trying to help and just doing her best to comfort me. A clash of cultures which wouldn’t be the only one of the day.

Jude and Dr John decided pretty quick that I needed X-rays. The ship has a machine but they wouldn’t be able to be read until a day later. I looked up and Dr Lewis came in and told me I was going to Emergency Hospital. I cracked a smile, thinking she was joking. Emergency Hospital is the hospital we send our VVF patients to if they have an RVF. A local hospital which is run by the Italians. When I heard I was headed to Emergency, I have to admit, I got scared. I would have preferred the comfort of the ship where I know people. Where I have friends. Dr Lewis’ husband works at Emergency as a surgeon. She was confident that this was the best place to be seen. There is an orthopedic surgeon there and she was certain this was the place for me to go.

Back onto the stretcher. More tears. More language. Out of the heart the mouth speaks. I was loaded into the back of an Aberdeen Women’s Centre car. All the long ones were out so when I was put in the shorter one, the doors wouldn’t close fully. The back doors were tied closed with wire.

The trip to Emergency was unbelievably painful. Every pothole and every bump was felt and received with tears. Dr John was sitting next to me and held my hand the way there. It was comforting. I felt like a little kid continually asking if we were there yet. I could tell where we were at times. I knew we were on the long stretch of road that passes right in front of the ocean when it felt like we were driving over a cheese grater. We were in Lumley when I saw the colorful umbrellas from the sellers in the market. Laying down in the back I could see full taxis and busses passing. Babies carried on backs and women with large baskets on their heads.

When we arrived at Emergency I was taken out of the AWC vehicle on the stretcher and I felt like I was dumped onto the Emergency stretcher. They wanted me to lie on my back and straighten my legs. Ow. No fun. It’s a very vulnerable position to be in when all you can see are the people pushing you into the emergency room and the white ceiling.

Although the pain in my back was excruciating, the pain from my full bladder was increasing. HR 106, BP 140/80. Yes, I do remember this. I don’t remember when I so aware of what was going on. Needing to know what was happening. I was laying against the wall with the air conditioning unit right above me, dripping water from the unit collected in a bucket below and every now and then I would get a drop on my face or arm.

The doctors were Italian and the nurses were from Sierra Leone. They were all so good to me. After the doctor examined me I was finally given diclofenac IM. That helped with some of the pain. The worst was yet to come though. X-rays were needed. I was wheeled into the hallway and parked there to wait my turn. The pain was already returning. I was crying as I pounded my hand against the wall. At this point I think it finally hit me that this wasn’t a good situation to be in. If something was broken, what were my options? Would I have surgery here or be evacuated? Why the heck did I fall? How ridiculous was this?! I knew it wasn’t good. Every small move brought forth a pain I couldn’t stand to bear. It was finally my turn in radiology. The men were very nice but to turn onto the hard boards was not something I enjoyed doing. This was the worst pain yet. After it was finished, about an hour later, more x-rays were needed to back in I went and more pain had. After the x-rays were done, I was taken back into the emergency room, the large open room, and my wet x-rays were brought and hung on the IV pole at the end of my bed with the chemicals dripping down onto me.

While I laid there waiting for the results, some interesting patients were brought in. Like I said, this was an open room. No curtains. Nothing to separate you from the patient next to you who broke his wrist. Three doctors surrounded this calm looking man and as two pulled traction and the other casted, the man screamed and screamed and screamed. I couldn’t help but watch. My stretcher was the table for the bandages. When that was done another man was wheeled in. His mud house fell in on him the day before. He was unable to move his arms or legs since. He was taken to a local healer who poured boiling water down his back in an attempt to heal him. This is not uncommon here. I looked over when he was rolled onto his side and the skin was all burned off his back. A woman came in who had fibroids which needed to be removed. I guess they can do them at Emergency. I wish I would have known that earlier. I was always told no where in Sierra Leone could this be done. We get so many women here in Aberdeen with this and no where to send them.

The docs finally came to look at my X-rays after giving me a shot of tramadol. That is great stuff! They finally said I had a broken iliac wing. Three Italian docs looking at my many films all decided this. Dr John and Jude were finally allowed back in to see me and we decided I would head to the Africa Mercy to recoup there.

When I got to the ship there was a good amount of people waiting for me. The tramadol stayed in my system for hours it felt so the ride there wasn’t bad. It took just over an hour or so to get there with the traffic. When I arrived, the side door opened and I saw Jane, a wonderful friend there who worked to get things situated for me to arrive. When the back door opened there were four big Ukrainian guys ready to carry me up the gangway on the stretcher. I will say this many times, but this was the most humbling experience of my life.

To speed up the story now...

When I got to the deck 3 hospital, I was taken to C ward where my friends had made me up a bed with a bright green apple comforter. I was taken first to get new x-rays of my pelvis and left elbow which had a great tunnel formed in it. My films from the ship were sent to the orthopedic doc who comes to do the ortho surgeries on the ship and to another radiologist in Canada. The ortho surgeon said I had broken my pelvis and I had a funny looking SI joint which I would need a CT scan to fully see if it was broken, and the radiologist in Canada said everything looked fine. All I knew was that any movement and I was in excruciating pain. The iliac wing fracture which was my diagnosis at Emergency Hospital turned out to be a smudge on the films. Kind of funny to look at now and see this smudge which brought me so much anxiety a few hours earlier...

For seven days I was on bed rest on board the Africa Mercy. If the ship was not here I would have been airlifted to Europe somewhere for scans and treatment. Finally on the seventh day I had a CT which showed nothing was broken. Seven days later it still hurt so much to bend or move certain ways but the pain was improving. Those seven days in the hospital I was shown such love. The friends I have here are incredible. I never ate a meal alone. We had picnics for lunch and dinner where friends would bring me food from the dining hall. We celebrated two friend’s birthdays while I was there with cake and watching Planet Earth. Documented my bruise which grew and changed to the prettiest blues and purples. They came and watched movies with me. Brought me a fake plant to brighten the room. Talked. We figured out how I could turn a bit so they could wash my hair. They listened to me and advocated for me and listened more to my frustration as I knew I was going to have to cancel my flight home for my brother’s wedding. All such amazing women.

On day seven, after the CT results, physical therapy came to get me out of bed. Jane helped as well as I first stood and walked with a walker then crutches. After I could do this, I moved to a guest cabin and saw rain and sunlight for the first time in seven days. I spent another week in that cabin sleeping mostly and moving more.

I’m now back in Aberdeen. It’s amazing to hear all that has happened in the last three weeks. The week before I fell I had to fire two nurses. Esther hired two more while I was away. I wasn’t expecting this at all. She told me the questions she asked and reasons for not hiring certain nurses who interviewed. I am very impressed with her and proud.

Now it is slowly getting back into work. On the 8th we will be launching a hotline for VVF throughout Sierra Leone. A toll free number where people can call if they think they know someone with VVF. It should be a wonderful day. Please pray for this opening that it goes smoothly and women hear about this centre who need to.

Blood

2011-08-18T13:28:00.000-07:00

I have talked about blood before. How if a patient needs blood, we are the walking blood bank. I know the blood type of my colleagues. You never know when you will need to call them up and ask when they last gave blood because you need theirs now. Usually people here will have to bring in their own blood donors if they go into a hospital knowing they will need a transfusion. Last week a VVF patient needed one so we asked her to call her family. She needed two units so we needed two people to come in. Even though she was from Guinea she still knew enough people in Freetown that her family was able to call around and find two people to come in. Even though they were not the type we needed, it still helped to give us blood in our bank and we were still able to get her the type she needed.

The blood drama of the day started yesterday. When a patient needs a blood transfusion, you know it is going to be a long day. Yesterday there was one patient and today another. We still had not finished with the blood drama of yesterday before today had started. Both the VVF patients who needed blood did not know anyone in Freetown. We did not have the correct type of blood in our bank. Next step, ask those who work at the centre. Ok. I still don't understand what it is, but giving blood is taboo here. Even the woman who is going into the community to advocate for blood donations would not give today even though she knew she was the right type. I asked probably thirty people today if they would donate. Only five people were willing to even be tested to see if they were the right match.

Here are some of my favorite excuses:

I'm fasting.

I have high blood pressure.

My menses stopped yesterday.

I don't have enough.

I am not the right type. (After hearing that we couldn't take someone with AB blood,

all of a sudden eveyone had AB blood)

I am not prepared to do it today...ask me tomorrow.

I gave a year ago and I'm still working on getting it back.

Yes. Some are legit excuses. Most just made me laugh. One man I found to be tested was a caregiver of a sick child in the outpatient pediatric clinic. He didn't work here. He was just willing to help. Too bad he wasn't a right match! Now we have him to call if we need him though. I'm sure some had health issues they didn't want known even to the lab guys and that is completely legit. It just surprises me that it was so difficult to find someone to help another person when there is so much suffering here to start with. With everyone I talked with I tried to teach them the fallacy in their thinking but there is something is so engrained in their thinking that donating blood is not something you do.

How do you change this?

Sisters. Sisters. There Were Never Such Devoted Sisters...

2011-08-17T10:54:00.000-07:00

I can't help but picture Bing Crosby and Danny Kaye singing this song as I sit down to write this... (if you have seen White Christmas you would know what I am talking about.)

Anyway, moving on.

We have a patient advocate who brings us many patients. The last group of women she brought were all from Guinea. Three beautiful women, all with the same last name. I didn't think anything of this since Barrie is a very common name especially if you come from Guinea. I quickly found out that these three women were related. Two of them sisters with the same mother and father and the other was the daughter-in-law of one of the women. They all came from Kaiyako, a samll village in Guinea. Fatmata Barrie was examined and it was seen that the extent of her injury was too much for Dr. Lewis so she had to return home. The other two, the sisters Mariama and Zainabu are still here and they even had their surgeries the same day. They both speak Fullah, the common dialect of Guinea. It is difficult to speak with them but we do have one woman who works in the office who can communicate with them. They both lived together in the same house before they got married. They never attended school.

Mariama met Bobakar, her husband, and became pregnant very soon after they got married. She stayed with her husband during her pregnancy and during the ninth month she went into labor. She was at home for six days in labor before it was decided to take her to the hospital. She did not make it to the hospital before her mother delivered a stillborn baby girl on the road. After arriving at the hospital the doctor told her to return home. At home she felt the urine starting to leak down her legs. When she told her husband, he sent message to Mariama's mother and told her to come. When the mother arrived she asked Mariama to explain the problem. After explaining to her mother, the mother and Bobakar discussed what they could do for her. Bobakar told her mother that he did not want her anymore and she would have to care for her. Mariama's mother took her in and cared for her.

Zainabu also became pregnant very soon after marrying Ibrahim, her husband. Again, she carried her child for nine months and during the ninth month she went into labor. For seven days she labored. On the seventh day she birthed a stillborn baby boy. If the child would have survived he would be twenty years old this year. Hew was delivered by Zainabu's mother in their home. The day after delivery she noticed she was leaking urine. She never went to the hospital to see a doctor about this. Her husband did not abandon her but they are not able to sleep in the same bed because she has this problem. Zainabu is one of three wives to Ibrahim. She is the only one not allowed to share a bed or even enter into his room.

Mariama and Zainabu were met by a woman who knew about this centre and she brought them down here from Guinea. They both had surgery on the ninth of August and they are doing well. They will be here for at least another week. All I can say to them is 'jarama', meaning hello. It always makes them laugh. Usually when I tell the women I want to take their picture they stand side by side with their arms to their side. When Mariama and Zainabu stood to get their picture taken they immediately put their arm around each other. It was really cute.

On a side note, the rain today was unreal. It has not stopped! Not just a drizzle. Torrential downpour. Even the locals say this is one of the worst rainy seasons.

Thanks and Goodbye

2011-08-16T10:33:00.000-07:00

Five of the women sportin' their Lutherhaven gear

Some thanks are in order. Not just from me but from the patients as well.

First, thanks to Camp Lutherhaven for the t-shirt donation for the women. They are now nicely decked out in Cut, Crop and Quilt weekend and Great Escape t-shirts. Lovely! A bit of home for me to look at daily as well.

Also to my mother for the donation of crochet hooks. The women are loving them and making many chop covers,covers for their food. Thanks!

I have to share a story from today which brought me to tears. We have had a patient on the ward for two weeks now. She arrived from a screening trip completely wet and completely unable to walk. She could barely move her legs and had difficulty moving her hands as well. After being seen by the surgeon it was seen that she did not have a fistula but had completely lost all sensation to her bladder and the obstructed labor completely took away her ability to walk. We do have two physical therapists here at the centre who have been working with her and although she has a very long road ahead of her to recovery, in the last two weeks there has been such an improvement. Today when she left, she could sit in her wheelchair and use her legs to push or pull herself around the ward. She always smiled and thanked everyone for everything done for her. I have seen her cry more than any patient before. You could sense the frustration but she would never show it. She was just full of thanks. A few nights after she arrived I was visiting the ward in the evening. She waved at me and told me to come over. She took my hand and said she was going to call me her momma. Today her aunt and brother came to take her home. All the patients said and waved goodbye as she left. They have all been great with helping her with whatever she has needed. I cried as Haggar prayed for her. She has an appointment to come back in three months for follow up. Please join me in prayer that she will be walking through the door at that time.

Burqa

2011-08-15T11:22:00.000-07:00

This thought has been going through my head since I was on fabric row on Saturday.

As we walked past an outdoor shop selling fabric I noticed two women dressed as many Muslim women are, in their burqa. Completely covered from head to toe in black. You can not even see their eyes through the veil covering the thin slit for their eyes. It was a beautiful sight to see though as they were looking through a pile of bright, colorful fabrics. It seemed like such a clash of cultures. It completely caught me off guard to see this. It made me wonder what they wear under their black coverings. I picture colorful clothing that will liven their spirit when they are able to remove their burqa.

Today

2011-08-13T11:11:00.001-07:00

This is one of the babies of a mamma on the ward.

I love his Obama diaper!

What a great Saturday! It started with me walking to the roundabout to get a taxi to Bliss to meet Sandra for lunch. I somehow got a free ride from someone I didn't know. Olga, but there is the Sierra Leone hospitality for you.

I was on a mission today to find fabric. I need to get a skirt made for my trip to Niger in November. It's never a bad idea to plan ahead. In my six months here I have not been to the big market yet or to fabric row. I always heard crazy stories of this place and how crazy it is. It was fine. There weren't many people there today so that made it nice. This market is multiple stories. From what I saw of it, the main floor is crafts and upstairs is mostly fabric. I'll have to go back sometime when I have more time. The fabric row was great too. Found some fabric now I just need a tailor!

After shopping I took a bus back to Aberdeen. A bus. Another random mode of transportation in my day. It worked though. Cheap too.

The patients watching me get my hair done.

Everyday my patients say they want to braid my hair. Today I let them. I let Mariama. She did a fabulous job. Last year in Togo I was in tears when I let a patient braid my hair. When Mariama did it, I felt nothing. Loved it. It actually feels good having my hair braided. I was the source of amusement for the day. All the

other patients came out to watch and laugh. It was great. It was great talking with Mariama too. She spoke very good english. She is 32 and has only been pregnant once. Her baby was born alive but died two days after she was born. It was really interesting talking with her about relationships and boys and how she can't find a solid guy. She was saying that whenever a problem comes, the guys up and leave and find someone new on the streets. She was so frustrated with it. I was asking her where her worth comes from. I always hear how for women, their worth here is found in how many children they have so I found it intersting that she is 32 and has only been pregnant once. In her family they stressed education. She works for a mobile company and supports herself and her mother. She told me that if she lived in the villages, she would have many babies. Here, her family was able to give her an education and she only wants two children. She couldn't take care of more than that. It was really encouraging for me to hear. It's not like the stories I usually hear from the women here.

After she was done it was time for dinner. I don't usually eat dinner on the ward. Tonight I didn't recognize what it was. Yele I was told. Cassava, mango, fish, potato and palm oil. I was nervous to try it but it was good. Really spicy. Not all the women liked it so I bought them boiled groundnuts from outside the gate and we all ate those too.

Great end to a great day.

The Grace

2011-08-13T00:47:00.000-07:00

The grace of our Lord and saviour Jesus Christ

And the love of God

And the sweet fellowship of the holy spirit

Bless your name and abide with us all

Now and forever more

Amen

Rain on a Tin Roof

2011-08-12T11:06:00.000-07:00

When it rains here I think of the Julie Roberts song, Rain on a Tin Roof. I like the song and I've always liked the sound of rain on a tin roof.

I sleep under a tin roof.

It's rainy season.

I don't think my love for the sound of rain on a tin roof is the same as it used to be.

Pekins Post Fistula

2011-08-11T13:49:00.001-07:00

(Pekin is Krio for child)

I knew there was one more story I wanted to share yesterday...

I was sitting with the women yesterday evening right before dinner. When the dinner cart comes rolling out, all the women sit on benches on the opposite side of the wards and wait to be served. There was a maternity patient and her new pekin who was staying on the fistula side since maternity was full, and she came out and sat down with her child. Haggar, our main teacher for the patients, was there. She told us that this woman had a fistula, was healed at the centre, and returned to have her pekin here. Haggar went on to preach to the patients about how there is hope and possibility to have more children after having a fistula. Some women can't, but this woman did and now she has a beautiful child. Do not lose hope!

It's neat how having a maternity centre here brings it all full circle. After the women have their fistula surgeries they are given a card which will allow them to have a free c-section if they ever become pregnant. If they were to try and have a child again vaginally, the chances of getting another VVF or going into obstructed labor again are very high, putting the mother and child at great risk. If a previous VVF patient registers with us they are admitted at 38 weeks. They will wait until they start feeling labor pains and then they will have a caesarean. While the women are waiting they usually wait on the VVF side since we usually have extra beds. It's a great example to the patients waiting for their surgery and wondering if there is hope for another pregnancy since one of the major ways a woman has status in this country is by her ability to bear children.

Stories

2011-08-10T15:46:00.000-07:00

Yes. It has been a long while since I posted on here. So much has happened and so much has changed. My attitude being one, but more on that later.

I went home for four weeks from mid June to mid July. I actually had known since about two weeks before I arrived that I would be coming home. I wanted to make it a surprise though so no one knew. It was wonderful being back on familiar soil for a bit. It came at just the right time as well. To tell you the truth, when I left I didn’t know if I wanted to come back. So much was happening and I was struggling to keep my feet under me. Rest came at a perfect time.

Home was great. I spent four weeks with my sister and her family and was able to see all my nephews and niece. Many friends came to visit as well. I ate a lot and slept. Celebrated the 4th of July. Cooked on a campfire. Canoed. Hiked in the forest. Went fishing. Stocked up on some goodies for friends back here. It was great, to say the least.

I have been back a few weeks and honestly, it has been great being back. Having a time of rest, of real rest, renewed my strength. It helped too, that when I returned back here, nothing but good reports came from when I was gone. Bernadette and Esther, the two Sierra Leoneans I have been training to be the ward supervisors have been doing such an amazing job. Truly. It couldn’t have gone better. There was a visiting surgeon who came while I was away and he did 22 surgeries in a week. That is double what can be done on a good week, which we don’t see too much, but all my nurses pitched in and did a fabulous job. They told me that now that I am back, they can slack off. I told them absolutely not! And they haven’t. They are really showing me what they can do. It’s been great for me because I have been able to do more teaching and more detailed things to encourage and really try to get things right into place for when I leave in December. I pray this all continues.

Updates from the ward:

You wouldn’t believe it. So there was a woman who showed up with her sister and her daughter-in-law. All with VVF. The daughter-in-law has already gone home. Her injury was too extensive and there was nothing Dr. Lewis could do for her. The other two, sisters, both had their surgeries yesterday. Both are dry and doing great! More to come on them in the future...

Seibatu. The visiting surgeon attempted her again. Her third VVF. When I came back she still had her catheter in and was becoming wet. I decided to leave her catheter in longer than normal because she had said that her wetness was improving. The first thing I had noticed when I returned was that she still had her colostomy! She was soposed to get it reversed the day I returned home, four weeks before. Nope. They saw she still had a small hole so they left it longer. She was given another appointment at Emergency Hospital where she was going to get her reversal and last week she did!!! Two days ago I went to visit her so I could change her catheter but when I showed up they said she wasn’t having any urine from it so I just took it out. Her surgery failed, once again. Dr Lewis will examine her again this week and see if there is anything more she can try. Her colostomy reversal was a success though! Her RVF was closed!! The good news is that Seibatu has pooped! This is such a victory! For the last year it has all been coming out of her vagina and now, with the colostomy giving her bowels time to heal after her RVF surgery, she has pooped, three times! Every time is a victory for her! Chances are she will go home soon. After six months, she needs to go home and visit her children and husband and family. She told me she will not go if she is not dry. It will be hard to see her go but sometimes there is nothing more that can be done here.

It is Ramadan. In a country where you are either Muslim or Christian, this is a big thing. I have had old patients call me and ask if I am fasting. Nurses taking time in their day to pray. Breaking their fast in the evening. Having a VVF patient find out she is pregnant and the only question she has for us is if she can still fast. It’s a different world here sometimes...

This woman who found out she was pregnant, I was in tears. We do pregnancy tests on all our women. She came back positive. The obstetrician did an ultrasound but couldn’t see anything, so she did a vaginal one and yes, I got all choked up. So tiny on the screen. About six weeks along and you could see the tiniest little flutter of a heartbeat. It was incredible. She was given an appointment to return to have her baby here.

Oh, and last week we had such an overflow of patients that one night two beds were pushed together and three women shared and the next night an mattress had to be put on the floor! A full week this week and next week we already have a full OR schedule as well!

Last week Jane stayed with me for a bit for her vacation time. One night we were walking down the street and passed the side gate to the centre. There were five of my women there staring out and said they wanted groundnut. Jane bought them groundnut and we shared with all the patients. Now everyday they say, ‘Sarah, I want groundnut.’It makes me laugh whenever I hear this.

More stories to come. Off to bed for now though!

Seibatu

2011-06-17T12:54:00.000-07:00

It is hard to know Seibatu’s age. She has a very thin frame despite our attempts to fatten her up. She carries her perfect apple cheek bones without any trouble and she has had five pregnancies. I would put her into her mid to late twenties, although she could not confirm nor deny this. Here is Seibatu’s story…

Seibatu has been here at the centre for 153 days. Yes, you heard me right, 153 days. Her first surgery took place on January 19, 2011, but I am getting ahead of myself. Like I said, Seibatu has had five pregnancies. From those five, she has four daughters which I am sure are as beautiful as she. Zainab, Fatmata, Isata, and Jariatu. It was during her fifth pregnancy that she came into trouble. She went into labor at home. For three days she labored before she went to the nearest government hospital to her home. There she had her child without a caesarean section. The baby was born alive. A boy. Within one day he died. The next day Seibatu noticed she could not control her urine and one month later she realized she could not control her bowels either. She had both a VVF (vesico-vaginal fistula) and an RVF (recto-vaginal fistula). This happened ten months ago.

Soon after her problems started another woman in her village returned from Freetown where she became dry after having this same problem. Seibatu was taken to the Paramount Chief of her village by her in-laws to seek help. He told her to go to Aberdeen to get help like this other woman had done. She was brought by her husband, Umaru, a very thin man like Seibatu but with the same infectious smile. At home they work together as farmers: cassava and rice. Since Seibatu has been here they have not been able to farm. Umaru travels between home and Freetown to visit Seibatu and care for his family. He has been seen on the ground here cutting her toenails and taking care of her, a beautiful sight to behold.

January 19, 2011 Seibatu had her first VVF surgery. She came out of surgery with two stents and a foley. Quickly we noticed her surgery did not work as her bed was still wet. After she had time to recover from this first surgery, on March 1 she was sent to a nearby hospital to have a colostomy placed. When the colostomy was placed, her RVF was closed. To give her body time to heal she would need to keep this colostomy for three months. Three weeks ago she went back for a check up and it was noticed that the RVF was only the size of a pin point! This Sunday she will return to have the colostomy reversed. The first step to full healing. Her RVF is closed!

May 18 she went back in to have her VVF attempted once again. Again it failed. Seibatu does not have a lot of healthy tissue to use to close her VVF. The greater part of the VVF was healed though. That was great news. Next month another surgeon will be visiting the centre and hopefully he will be able to do the final part of her healing, to finally close her VVF once and for all.

I asked her how she feels about being here for so long. She said she is happy. She wants a ‘well body’ to take home. She desires healing so much. There have been many tears shed on behalf of Seibatu by her, by myself, by the nurses. Seibatu has come so far and we can only pray that she will leave here completely healed and she would go home dancing.

Rapunzel

2011-05-26T15:25:00.000-07:00

I have a hard time knowing how honest to be in my blogs. Honestly, the last week and a half has been great. I've been having a lot of fun with the patients. It seemed like my nurses were starting to get it. It has taken a long time, almost five months in, but I'm finally feeling like I can see a purpose and although it's not what I thought it was going to be, I'm here and I'm growing and learning and serving and it's not for myself. It's me, growing closer to God and learning to trust and rely and although I'm just starting to learn this, I'm learning to persevere...so I can be mature and complete... True, my time here is about the women as well. That is why I am here, and they are wonderful. It's about training up nurses as well, but there is so much more.

I am in a wonderful Bible study with amazing women. We met tonight. It's funny because one thing we talked about was how we once desired something and how we saw it come to pass. That's me here. I remember being young and desiring to "come to Africa". It's great to look back and see how it came to be... first turning my life over to Christ. Dropping out of college. Doing YWAM. Living and working at camp. Becoming a nurse. Doing Mercy Ships. Two trips to Niger... and here I am. Living with two feet on solid ground on a continent I once only dreamed of. Your desires can take a long time to be brought to fruition. When David was anointed to be king, it took him 22 years between the time he was called and actually being crowned. It all takes time. I'm digressing a bit.

So here I am in Sierra Leone. Not living on a ship. Living on land. Loving life on land, but struggling so much with my nurses and even more so today as I learned there is more dishonesty and lack of caring and concern and passion for the patients. How do you teach compassion? You can't. I've learned that. Most people here don't become nurses because they want to. They don't usually grow up thinking, I want to be a nurse. No. They have three options: lawyer, nurse or one other thing I can't remember right now. In Sierra Leone there are not many options. You go to nursing school because that's actually one of the three options. You either have compassion and a drive to work and do a good job, or you come to work and sit and talk on your phone and watch as your patient's surgery fails. The second someone isn't behind you telling you to get off your phone, fix the tape on the catheter, is the urine draining, maybe you should give your patient pain medication since they are obviously in pain, yes, constipation can ruin a surgery and maybe you should do something about it, and on and on and on.

Today I told myself over and over to persevere. Persevere not just for my sake, but for the sake of the VVF women. Persevere.

At Bible study tonight it was good to share and see how it's not just me not being able to handle it. Tonight there were five of us from four different organizations. We all deal with the same sort of issues. It's hard to see any sort of change even from those who have lived here for years. How do you change generations of corruption and bitterness? You don't. You can't. I can say with full confidence that only God can do that and I pray that a miracle will be done.

Constipation

2011-05-25T10:30:00.000-07:00

The best cure for constipation (for the patients) is water and a large dose of singing and dancing...

In case you were wondering...

Persevere

2011-05-24T13:15:00.000-07:00

Consider it PURE JOY, my brothers,

whenever you face trials of many kinds,

because you know that the testing of your faith develops

perseverance.

Perseverance MUST finish its work so that you may be mature

and complete,

not lacking ANYTHING.

James 1:2-4

Hawa

2011-05-24T10:29:00.000-07:00

I asked one of my nurses yesterday to write a patient story. I thought she did a great job especially since she wrote it as if it was the patient writing. Here is Hawa's story...

My name is Hawa Sheku. I am twenty five years old. I live in Gborbu Yawee chiefdom, Kailhaun district. I attended the Methodist primary school, Malayma Yawae. I stopped at class three when the war broke out in my village. That was the end of my schooling. I am a farmer and housewife but I want to learn a trade like hairdressing or dress maker, seamstress.

I am married to Sheku Ngebga. I was fourteen years of age when we got married. I became pregnant at fifteen and was happy. I have been pregnant twice and the second pregnancy gave me this VVF.

The start of the labor pains came for some time and bleeding followed. That was the time my family traveled with me to Kenema Government Hospital. I spent one night in labor pains and I was operated on for caesarean section by the doctor. I was in labor for two days overall. My husband did his best to bring me to the government hospital to save the life of my baby and myself but it was rather unfortunate that we lost the baby. He was alive for three days and on the forth post-operative day, I lost my baby. Also, that was the time I realized I had urine incontinence. At that moment I told my husband and we explained to the nurse who told the doctor. The doctor now explained to me what brought my problem, that during my prolonged labor the pressure of his head compressed my urethra and damaged it. He told me it was not his fault. He also told me about a hospital where they could fix it. It was only urine leaking from me, not feces.

My husband felt so bad because of the constraints, pain, finances and the loss of our son. My family members felt bad for me and since that day they have been having sympathy for me. My husband and my family supported me fully. I have had this problem for six years. The only problem now is that I don’t have a living child. I have never attempted VVF surgery before. This is my first time.

I heard about the Aberdeen Women’s Centre through the radio and a team from the centre picked me up and brought me here. I’ve been here for twelve days. When I came I was afraid I would not be healed. How was it going to work?

Now I know I am cured because since after my surgery I’m dry and observed no wetness. I am really cared for by the doctor, nurses, international staff, teacher and the other patients. My best friend here is Massah Saffa.

My husband will be very very happy. My relatives will also be happy. Some of my friends will be happy. Yes, they will welcome me.

I will be very happy to reach my home healed because I came sick.

Bits and Pieces

2011-05-19T15:35:00.000-07:00

I was so proud of one of my nurses today. She came to me and told me, calmly, that a patient had no urine output for two hours. I looked at her and said, do you realize this is an emergency. She said yes as I was getting irritated as I was almost running to the patient to see what was wrong. A blocked catheter, one that is not draining, can harm the patient and ruin an entire surgery if it is not fixed right away. I got to the patients bedside and I could tell she wasuncomfortable, another sign the catheter wasn't draining. I also noticed that on the end of the bed was a syringe with sterile water and a pair of gloves. I looked at Fatmata, the nurse and asked what that was. She said it was the sterile water and gloves so I could flush the catheter. For a second I felt like crying, then got over it, but I was so proud of her. Proud that she knew what needed to happen and had all the supplies there. I walked over to get another pair of gloves and she said she had some already for me. I told her those were hers since she was going to flush it. She looked surprised. I just don't get it. Fatmata knew what to do. She knew this was an emergency and to get help. I don't think her or the other nurses have been empowered to take the next step to follow through. She flushed the catheter just fine and the urine flowed and the problem was solved. Check. Now it's just taking her to the next level.

Massah, oh Massah. Massah is a patient who was here many months ago. She left dry but came

back after she had a small issue at home and her repair was reopened. Funny, funny woman. She speaks Mende, another language I have not and probably will not master. She likes to say words with funny sounds and I will copy her and we all laugh. Today I kept hearing a baby crying, no, screaming, so I went to see what was happening. Massah was sitting on a bench holding this screaming baby. The baby was just perched on her knee and the screams didn't seem to bother her in the slightest. I walked over to her with my fingers in my ears and said, "Massah, feed your baby!" I said this jokingly because I knew it wasn't her baby. She looked at me and smiled and said, "Not my baby. This my baby..." as she picked up the tube to her catheter and shook it a bit. Ok, fair enough.

Massah and Seibatu are friends. They both started their journey's out here together about three months ago. After Massah had her surgery, Seibatu would come and sit on the bed next to her and they would chat. Seibatu had her surgery yesterday. Things could be going better for her. Her catheter is bothering her quite a bit and today she started leaking. It's hard to tell at this point what it means but prayers for her would be great.

Birthday Babies

2011-05-17T10:56:00.000-07:00

I had mentioned in a previous post watching a birth on my birthday. Here they are. The baby on the right which the mother is touching is my namesake, Sarah. Although the mother is also named Sarah, this Sarah is named after me, according to the mother, Sarah. The other baby, guess the name... Rebecca. Sarah didn't know I had a sister named Rebecca and now there is another Sarah and Rebecca running around, or sleeping eating and pooping, in the far reaches of West Africa.

Yeama

2011-05-17T10:36:00.000-07:00

Meet Yeama. Yeama says she is 60, but I am willing to bet she is a little more than that. She no longer is a patient here but she always made me laugh. She spoke Mende so a few nurses could communicate with her. When she arrived here it looked as though she had scoliosis. She was very very hunched over. As time went on and Yeama spent more time here she stood straighter. She finally told us that she had her fistula for so long that she became hunched in a way to protect herself from humiliation. She left last week not yet completely healed. She says she will come back in three months and I hope she does. On rounds in the mornings you could tell what mood she was in by the glare in her eyes or the pursing of her lips. The day her catheter came out, even though we had explained what was going to happen, about five minutes after it came out you could see the fear in her eyes as she looked around for this tube and bag which had become her constant companion for twenty-one days. She had forgotten we had removed it after she had done such a great job taking care of it.

Touched

2011-05-17T10:25:00.000-07:00

On rounds today, Dr Lewis decided it was time for Seibatu to have her follow-up appointment from her first VVF surgery since it has been about three months. Her first surgery was big. The hole she had from her VVF was really, really large. There is still a hole but hopefully Dr Lewis will be able to close it. She decided she will take her back to surgery TOMORROW! She is so happy. I almost broke out in tears in the office. She has been here so long and we all desire so much for her to be dry! Please pray for her surgery tomorrow that she will have no problems. That Dr Lewis will be able to complete the repair which has been started and that Seibatu will be dry! In the photo, Seibatu is the one touching my back, second from the right.

Newbies

2011-05-16T12:35:00.000-07:00

Last Thursday ten new women came back from the screening trip to Pujehun, a province in the northeastern area of the country. I have to admit, when I heard there were ten, my first thought was, great, now they are bringing back women just to say they tried, but I'm sure they are not really actual VVF cases. I confess, I was wrong. All ten women have VVF. There are a few that are not ready for surgery since they are less than three months post-partem but they will stick around here until they are ready. One of them said she didn't mind staying here a month before her surgery since no one at home wanted her around anyway. That surprises me since this young woman has a smile that doesn't end. She is always smiling and on the verge of laughing it seems. I would love to know what she is thinking.

These ten women just make me laugh. There is something different about them all. Even the two frail looking young girls who speak only fullah are always smiling. The first two of the ten went to surgery today, the two who speak only fullah. It absolutely cracked me up when I was wheeling her back to her bed in the stretcher after surgery. We were on one side of the enclosed area which forms a rectangle with the open sky in the middle, if that makes any sense, and the rest of the women were eating lunch on the other side. When they saw her going back to her bed, they all stopped eating, stood and peered and stretched to see her. The patient got a large smile on her face and waved. It was like she was a princess or something. They were all smiles seeing her so well. The second patient went to surgery and came back without problems as well. There was a third who went to the OR for an exam with sedation but I was told that as she was going in, the other patient who was in recovery wanted to see her as she was walking by into the operating room to show her she would be ok.

This part of the day I would have paid to see, but I'm sure it happened... I was talking with one of the evening nurses tonight and she told me this story. She said one of the women who came back as one of the ten walked into blue ward after the two fullah speaking patients came back from surgery. She walked over and looked at one. She had a catheter and two stents, meaning there was a small tube going into each of her kidneys with a small bag attached. She walked over to the other. That patient just had a catheter. This women proceeded to walk out to the rest of the women and tell them, "Some of you will come out with only one tube coming out of you. Some of you may have one large one and two small ones. I don't know what this means but you will be ok." I can imagine this and it makes me smile. The women really take care of each other.

Quick Seibatu moment today...I was walking close to her and put my arm around her as we walked. I looked at her and said twelve days. She smiled and said, "Just tell me the day I have to go. Say today you will go and I will go. " That makes sense. No more countdown. Just enjoy each day without the stress of wondering what tomorrow will bring.

13 Days

2011-05-14T05:09:00.000-07:00

Yesterday Seibatu went to Emergency Hospital for a barium enema to see how well her RVF has closed. This past week I have found her numerous times sitting outside alone crying. I know she really wants to go home but she just can't right now. These tears weren't for loss of home though. When I would sit with her she would look up at me with her fragile frame and say, "No operation". She knows the time is coming for her to return to Emergency to have her colostomy reversed and be freed from her RVF, although her VVF is still terrible. She is so fearful of another operation. Yesterday when she went for her check up, it was found that her RVF is just a pinpoint hole now! That is wonderful news! They told her to come back in 14 days, 13 days now, and she will have her colostomy reversed. I went down to see her on the ward this morning and she was sitting outside alone, again. She wasn't crying this time, just looking sad. I looked at her and said 13 days and she just kind of smiled. Please pray for a peaceful heart for her, for comfort of mind, and for quick healing so she can go home soon. Her husband came to visit her a few times this week. I love seeing them together. After her colostomy is reversed, since she has been here so long, it's time for her check up from her first attempted VVF repair. PLEASE pray that Dr Lewis can attempt her VVF surgery again and that this time she will be completely healed! I will try and get some pics of her this week so you can see her beauty.

Birthday Weekend

2011-05-10T13:53:00.000-07:00

Yesterday was my birthday. I will admit, this was possibly one of my favorite birthdays. Not just the actual day but this past birthday weekend was amazing. I went with eight friends back to Samso's, a place at the far end of Lakka beach, and we rented a house for the weekend. This trip I also became an African driver. I have driven in Niger but only on the hospital compound. Here, I drove down the crazy streets honking my horn at every person, at every car. I am told that as long as you honk your horn, if there is an accident then it is their fault since you warned them. I love that logic. 34 km total and no accidents. Admittedly, I kind of enjoyed it even. I still don't have enough guts to drive through the city though and I'm ok with that.

I woke up Saturday morning to the sound of heavy rains on my tin roof. Bummer. The rainy season has started and I was worried about that for the weekend. By the time my friends arrived from the ship the rains had stopped. We went by the store for some drinks and snacks for the weekend and made our way to Samso's. This great house I have stayed at before. Three bathrooms, two bedrooms, and many mattresses. Just about a two minute walk to the beach. Not bad. When we arrived it rained a bit again so naps became the ticket for the afternoon. Even after everyone woke up and the rains continued, we still ventured to the beach for a swim. Warm water. Big rain drops. Lovely.

Later in the day we set ourselves up under a small hut to watch the sunset and have dinner. Right before dinner came a man came to the table and said rain is on its way and we must move now. Um, ok. Twenty seconds later as we were in the midst of moving, the sky opened up and the rains poured down! He was right. We still enjoyed our barracuda and fries on the deck of a cabin though. One thing I was really looking forward to was a bonfire and smores. That's becoming a birthday tradition for me since I have been spending my birthdays in warmer climates. With all the rain on Saturday this wasn't an option. Back at the house though, someone had brought big candles so we roasted marshmallows over candles and had smores that way.

After we went to bed and started struggling with the heat, again, the rains came. Not only did the rains come, the wind did as well this time. I had positioned my bed right in front of the open door to hopefully get a cool breeze through the night. Never did I imagine this. I laid there and watched at the trees blew around, mangos fell, branches broke, and fear of a mango tree falling on the car worried me. It wasn't safe to move it so I just hoped for the best and it all came out ok in the end. This storm lasted a long time and the winds were incredible. The next morning it was easy to see the damage. On the beach there were to covers which had been torn up and they were laying on their tops. Leaves everywhere. Debris everywhere. Joseph, the man who runs Samso's and wanted me as his wife, said storms like this only happen once a year and they usally happen over three days. This year it all happened on one.

A day of swimming and exploring rocks and playing scrabble on the beach ensued before we packed up and headed home. Lovely weekend with great friends.

Yesterday was May 9th, my actual birthday. Hettie had baked me four cakes. I couldn't believe it! Two for the weekend and two to bring back with me to the AWC for yesterday. I frosted them and shared them with the patients. They were excited to have cake but when I asked if they liked it they all just said it was so sweet. The did sing happy birthday to me twice and that was nice. Another patient called me to wish me a happy birthday as well. After work I decided to go stand in maternity. Sometimes I do that to think. The screams and "WHY, WHY, WHY" always help me to ponder life. As soon as I got in there I knew I wanted to see a birth on my birthday. I was told twins were on the way! Yes! The girl in labor was named Sarah as well. Go figure! She had been in labor since 3am though and it was 5 now. So yeah, any minute! Or so I thought... I stood there and watched for about an hour and heard major screaming down the hall so I ran down there just to see a little girl being born. I was excited to see the placenta as well but it was taking too long and I wanted to see babies. I went back to Sarah and her rocking and saying "what is wrong? what is wrong?" Nothing was wrong. Just your first babies taking forever to celebrate their birthdays with me! I left to eat dinner and came back and she was still there...By 7:30 and an episiotomy later, the first little girl emerged! Kate wrapped her up and put her on mama's chest then gave the baby to me so they could work on baby B. What a cute bundle of baby! I wasn't able to stick around for the send birth but I went and visited them today and they are all doing well. Twin girls. Super cute!

To wrap up the day we had oreo milkshakes at Katies. A-m-a-z-i-n-g! Great way to wrap up the birthday weekend followed by a great birthday!

Worms

2011-05-06T15:36:00.001-07:00

While I am waiting for the nyquil to kick in I thought I would share a story from last weekend...

Last weekend Katie, the head of the maternity side here, and I hosted seven friends from the ship. We barbecued a large barracuda and just talked all weekend. It was great.

On a side note, I have always had a small fear of creatures which may decide to crawl up my shower drain or even up my toilet. I have heard of stories of people going into their bathrooms and finding a snake which had crawled up their drains, or creatures crawling up shower drains. I don't hear of that in the states, but here it can happen, and it does and did.

So when my friends were here I was hoping to give a good impression of what life is like living off ship. I wanted to make it seem perfect so they would want to come back and visit me. Well late in the night on Saturday, before going to sleep, I went in to take a shower and the shower floor was covered in worms. Not cute little earthworms, not that I think earthworms are cute by the way, but small black wriggly nasty worms. Hundreds of them. It was absolutely disgusting. Even though it may have killed my chances of my friends returning, I had to show them. Ginger and Jane came in and together we tried to hose them back down the drain. Gross. All that happened was more came bubbling up. Gross again. Either the drain was clogged with hair or more of these gross worms. I didn't care to know either way so we left them and showered somewhere else.

Monday I told maintenance about them. They came to my rescue and told me the worms were coming up from the room below me. Gross. Gross. And gross. I haven't seen one since but I do keep looking down the drain when I shower to make sure no other living creatures are coming up...

Nope

2011-05-06T10:44:00.000-07:00

No beach day today. I feel like I have been hit by a truck. No, it's not some crazy African bug, I think I just have a cold that has hit me hard. Left work after lunch and have been in bed since. Sometimes this is a good place to be. It's hard to lay here and keep thinking about all I have to do down in the ward but it's hard to be on the ward when I don't have the strength to stand...

This past week was amusing. I hired three nurses and only one is still working here. On Tuesday two nurses started. One, the one still here, I'm very excited to see how she does. She has had a lot of experience in the OR and not much on the ward but she seems to be picking it up quick. The other nurse I hired who started on Tuesday was a sweet girl I interviewed two months ago. When she showed up to work I didn't recognize her. She had this big belly. I promise you, it was not there when I interviewed her. Within her first few minutes here she asked if we hire pregnant women. Oh, no. I asked when she is due and she told me next month. Oy. Small small thing which would have been nice to know a bit earlier. After the birth they get three months maternity leave. She promised me she would be back to work the day after her birth. This is her first child. Oy. I told her to come back three months after her birth. I had one other girl to hire who I had interviewed the same time as the pregnant nurse. When I called to offer her the job I asked if she was pregnant. She said no. I asked if there was anything stopping her from taking the job now. She said no. I explained to her it is a part time position but as soon as a full time one opens, which one will be soon hopefully, she can have it. She said great, she wanted the job. Lovely. She came in. We did a day of paperwork and she was to start the next day. Thirty minutes before she was to start she called me to clarify...yes, after this month of training, we could call you when we needed you to work. We had gone over that numerous times. She said great, that wasn't a problem. She would be in to work in thirty minutes. Ten minutes later she texted me and said I was too nice a person that she didn't want to tell me in person that she didn't want the job. She would only want a full time position. Thanks anyway.

It really surprised me, this second nurse who just would take a full time position. She is twenty four. Fresh out of nursing school and jobs are not easy to come by. She has been sitting at home doing nothing for the last two months waiting for a job to come to her. It did. Not a bad job at that. I can understand wanting a full time position but in a country where I have a huge pile of resumes sitting on my desk from nurses pleading for a job, it just really surprises me. Maybe she has other reasons she was too scared to tell me as well... Back to the drawing board...

Cold Drink

2011-05-05T09:58:00.000-07:00

I sat down next to Seibatu today. She was sitting outside in a chair alone. I just sat next to her, not talking, when she looked over at me and said,

"Sarah, buy me cold drink."

I had to laugh. Where in the world did she learn that? She is really picking up on English. Maybe tomorrow I will buy them all a cold drink. Maybe tomorrow we will go on a field trip to the beach. Maybe, maybe, maybe. I've been thinking and talking a lot about taking the women to the beach. It's a two minute drive, if that. Most of them have never seen the ocean. I can't wait to see their faces...

The Same in Any Language

2011-05-03T14:41:00.000-07:00

Yes, it has been a rough few months. It is my prayer that God would show me why I am here. What my purpose is and what the ultimate goal is. I feel like I have been spending so much time behind a computer screen and not enough with the patients and nurses. Late this afternoon I decided to just sit with a few patients at the tables they use for crafts and teaching. Seibatu was sitting there alone and although I know I should not have favorites, I really have a special place in my heart for her. Once I sat, a few more patients came up to sit as well. Seibatu has been here for months, it seems, and she has at least another month to go. Her VVF is too bad for Dr Lewis to fix but she also had an RVF where she was left leaking stool as well. She was sent to another hospital where she had a colostomy placed and her RVF fixed. She will have the colostomy for three months to give her body time to heal, then later this month she will have it reversed. She can't wait. She speaks Mende or Temene, I can't remember but I can't speak either anyway. My krio is still awful as well. Seibatu has been here long enough that she is turning into my translator for certain things. She has picked up on my sign language and I hear her yell across the ward sometimes when she knows I am struggling to speak to a patient. She is starting to learn English as well. It makes us both laugh. I have spoken of her a few times before but I laugh right now because I just realized she has been one of the constants in my life since I got here. I have no idea how old she is. I asked her today "how many years?" and she looks away shy and flips over her hand to let it fall on the table in a sign that she doesn't know. She is old enough to have four children. The oldest is maybe up to her shoulders in height so whatever that means in years... she only looks about fifteen or sixteen though. Her husband still comes to visit at least once a week when he can. In two weeks she will head back to get her colostomy reversed then come back to the centre for dressing changes, then home. She was telling me she would come back two weeks later for her VVF to be fixed. She kept telling me she is so ashamed. So ashamed. It is hard for her to understand and accept the truth. She is beautiful.

The longer I sat at the table, the more women appeared. Haua came and sat across from me. She took my hand and stretched out my arm. She pointed to my white skin and kept saying, "Fine, fine." I pointed to her black skin and said the same thing. We were bonding. She then opened my hand and looked confused as she looked at her hand then back at mine. She felt hers. Then felt mine. I could tell what she was getting at. Her hands are rough and calloused from years of work. Mine are not. She took my pen and pretended to write. She then put it down and pretended to be chopping things. She was telling me she works hard with her hands. I work hard with my pen. All the women laughed. How true was that comment? They all turned over their hands to reveal years and years of hard physical labor. I turned mine over to reveal a different world.

Another West African country. Another fish lips moment...The time had come. I looked at Seibatu and did fish lips. She looked at me confused until I said her name. She smiled and after a little struggle, hers too appeared. Haua... crooked, but there. Satta...Satta took a bit of time but eventually she too could speak the language of the fish. Everyone tried. Everyone laughed. This was good, especially for Haua who when she said down I asked, "Haua, you happy?" "No." She wouldn't tell me why and she had this concerned looked on her face but she wouldn't talk. She laughed though. Someone walked by and asked if I was teaching life skills. No. I wasn't, but the women laughed together today and I think that was big in itself.

Friday

2011-04-29T13:52:00.000-07:00

It's Friday. I have to say that not only am I excited that today was the royal wedding and my dad's birthday, but it's Friday. I don't like 'living for the weekend'. I don't like living, hoping the weekend would come faster. I think that if you live like that then what are you doing in your life? I do believe you need to live each day, not just in anticipation for your days off from work. I will admit though, today I am really glad it's Friday even though I am sitting on my bed still thinking of all I have left to do in the ward or in my office. This week, oh, this week... Started off amazing. Spent all last weekend on the ship with friends and chocolate. Tuesday was going to be a big screening day here at the centre for VVF in the Western Province. One woman showed up, thanks for sending her Sandra. We did have seven women to screen which came from the screening trip the week before to Kambia. Three were suitable for surgery. Oh, Monday Ann Gloag arrived as well, the founder of the Freedom From Fistula Foundation, the founder of this centre. I honestly didn't feel much stress with her coming. I know I am here doing the best I can and that's all I can be doing. Wednesday was the 50th birthday of Sierra Leone. Music and celebrations galore. Wednesday, two nurses quit. Today, one more. When I found Sia's resignation letter taped to my computer I had to laugh. I laughed only because I knew that if I took too long to think about it, I would cry. Sia is the woman I have been training up to be the ward supervisor. She had been doing an amazing job in that position and I knew she was going to be the right person for the job. I was mistaken. Two more nurses as well... I had interviewed a few women not too long ago so I already had some in mind and at the top of my pile to hire. I found as I was calling them to offer them positions that hiring people is so much harder than firing. As it is anywhere, some people can interview really well but come to work and it's a different story. I really pray that the two nurses I hired today will fit well into the team and will be hard workers. Now I am on the prowl to find someone else to fill the position of ward supervisor. A national nurse. Please, please, please, join me in prayer for this.

On top of it all I am deworming. I know that probably sounds gross but I think it's time. I just hope this doesn't mean I am going to start gaining weight...

I have to share part of todays passage from My Utmost for His Highest:

To be certain of God means that we are uncertain in all our ways, we do not know what a day may bring forth. This is generally said with a sigh of sadness; it should be rather an expression of breathless expectation. We are uncertain of the next step, but we are certain of God. Immediately we abandon to God, and do the duty that lies nearest, He packs our life with surprises all the time.

So, so true...

A 50th Celebration

2011-04-27T07:43:00.000-07:00

Today marks the 50th anniversary of Sierra Leone's independence. You are not allowed to forget it. For the past weeks everything has been getting painted green white and blue. I walked to the beach last night to watch fireworks, which never happened, and the two roundabouts by the centre look like Christmas with lights and flags and freshly painted cement. Driving down the roads you are met by traders selling green, white and blue necklaces, buttons, t-shirts, pens, underwear... you name it. Ann Gloag, the founder of the AWC is here right now for the celebrations as well. I walked onto the ward yesterday to the sound of the patients standing in a circle waving their freshly painted flags and singing the national anthem. Monday night a group of us went to dinner at Alex's, a restaurant close to the centre. Stepping out onto the street was crazy. The amount of people walking up from the beach as we walked down was incredible. The mix of having it be Easter monday and celebrations for the 50th brought the entire country to Lumly beach, the beach just down the road from the centre. I felt like a fish swimming up stream with the amount of people I had to dodge. The funniest thing I saw was when I passed by the gate to the OPC, the children's centre here. All my VVF women were standing there just staring out the gate at the mass of people. They love to people watch as much as we do.

The women make their Sierra Leone flags.

Easter was great. I spent four nights in a guest cabin on the ship. It was such a great retreat. Friends, food, scrabble, movies... The past few weeks have been challenging and this weekend was a great getaway. As soon as I set foot on the ship I dropped my bags and headed to deck 7 for foot washing, then to a communion station and time in the garden of gethsemane to just sit in the quietness and presence of God.

Sandra, Mikey, Francis and I decorated Easter eggs.

Give the Gift of Blood

2011-04-20T11:59:00.000-07:00

Since I first worked on the Africa Mercy in 2007, I have dreamed of donating blood to a patient. That may sound funny but here we are the walking blood bank. There is a local hospital which has a large sign outside their doors that says if you need a blood transfusion you have to bring your own donors. On the ship and here at the centre the patient's don't have to bring their own donors, sometimes we ask if they have family or friends willing to donate, but we are it. I was never able to donate on the ship because my blood type is not common and here throughout Africa, it's even less common than back home. Last year in Togo a surgery had to be cancelled because there were not enough people with the same blood type that the patient needed on the ship. The day finally came today! I was sitting at my computer when Kate, the head of maternity, came in and said she could finally use me! There was a women who had a caesarean who needed blood and I matched. I was so excited. After a lunch of cassava leaves, rice and fish I headed over to the lab and gave a unit. Completely the highlight of my day and my week! Tomorrow I will go meet her.

Tokeh

2011-04-17T13:00:00.000-07:00

I just got back from an amazing weekend. Amazing in so many ways. First, this past week had many challenges and I really needed some time away. Second, I got to explore a new area I have not been to. Third, I met some new people and got to spend quality time with friends. And fourth, I got to sleep in a tent last night and I absolutely LOVED it!

I went camping at Tokeh beach. I borrowed a tent and we set up two tents in a field right off the beach and the others just slept under their mosquito nets. It was so relaxing. The taxi ride there and back was something that, to tell you the truth, doesn't really phase me anymore. We rode in a mini van taxi. Ok, not a problem, but the sliding door kept falling off. On the way back today a guy had to sit next to the door and hold it on while we drove. Yeah, no joke. There we so many holes and due to the lack of door not being fully secure, all the dust from the un-paved roads came right into the van. I showered when I got home but even afterwards I was still rubbing the red dirt off.

The taxi door fell off, again.

So Saturday afternoon we arrived at our campsite a few hours later than expected. Saturdays are cleaning days in Freetown. It's usually just once a month but on the 27th of April Sierra Leone is celebrating 50 years so cleaning days are every Saturday for now. On cleaning days no one is allowed to drive from 6am-12pm. If you are found driving you can get ticketed. Everyone should be outside cleaning the streets so we had to wait until this was finished to leave.

Campsite

When we got to our campsite it didn't take long to realize that right next door there was going to be an outing. An outing is a party which wouldn't be a party without large speakers, loud music, and lots and lots of people. It started about six and at 2am the music was still going. We walked down at about ten to see what was happening and there was dancing and people everywhere. At 11 the live music was going to start and at 12 the beauty pagent was going to begin. A couple of the guys with us stayed for the festivities but I was ready for bed. It was so refreshing to sleep in a tent! I didn't get much sleep at all with the music next door and the thin yoga mat I slept on didn't give me much comfort but honestly I didn't mind. Just sleeping in a tent was great for my soul.

Mechanic

2011-04-12T12:24:00.000-07:00

In the mornings we meet at 8:00 every day for a time of singing and devotion. The last couple weeks it's been a bit more exciting because the centre has hired a new mechanic. SHE is a woman and I LOVE it! I love seeing her at 8:00 every morning in her blue and orange jump suit, ready to climb under the cars and get to work. In a country where women are so oppressed and rarely given status, to have a woman in a role that is traditionally for men, it makes me smile every day when I see her.

Our numbers are up. I don't like playing the numbers game. I think that even if we just help one woman we are doing our job. The slight problem with that is that if we don't help more then our funding won't be there. For almost the last week we have had over 30 beds occupied. It's been great to see considering two weeks ago we were down to less than one ward. It's great to see so many women!

Sia has been gone for almost a month now. She was on leave then had to fly her father to Ghana for medical treatment. He is doing better and she should return soon. I'm really excited for her return for many reasons. First, I enjoy working with her and seeing her grow into a place of leadership as the ward supervisor. And second, I am tired. Trying to do her job and mine is a lot. Constantly trying to stay on top of things like restocking the meds and supplies and trying to keep things clean and organized in the ward where when you come in the next day and it's all a mess again, and no one seems to notice to trying to figure out where women are and how we can get to them... I like the work don't get me wrong, I'm just tired.

This past weekend Hettie and Ginger came to stay with me for two days. It was great. Scrabble and dutch blitz and chocolate and good friends to sit and chat with. Just what I needed...

Marijoula left today to return to Guinea. I love watching them leave. They leave as new people. Stronger and more sure of themselves.

Marijoula

2011-04-08T11:23:00.000-07:00

I was reminded today why I am here. The gladi gladi ceremony was a total of one patient. She was beautiful though. She also spoke Susu, a more common dialect in Guinea, not here in Freetown. During devotions she never sang because she didn't know the words. She never spoke because she didn't have anyone to speak with. During the singing today she just sat there and cried. At first I didn't know if they were sad or happy tears because I knew her catheter had just come out and I didn't know if she was still dry after that. At the end of a gladi gladi ceremony, the women usually start a song and others join in with them. When Marijoula sang, no one could sing along. It was just her. Her voice was beautiful. I cried along with her. The rest of the morning she couldn't stop smiling. It was a thing of beauty.

In the craziness and overwhelming frustration of this week and at times my wanting to just pack it up and go, standing there, seeing Marijoula sing and cry, I just thought, this is it. This is why I am here. To be a small part of this beauty.

Oh, and she is dry.

Unreal

2011-04-06T15:14:00.000-07:00

As I sit here to write this long overdue blog post, there are many things running through my head...

First, today is April 6th which means I have been here three months today.

Second, I can't believe how long it has been since I blogged. Time is really flying by! I was doing so well when I first arrived then life picked up and I stopped for a bit. Hopefully this means I am back and will try again to be more consistent.

It was funny to me when I saw what my last post was. Today as I was sitting in a class my phone kept vibrating and I kept turning it off. This person kept calling and since I didn't know who it was, I wasn't going to answer. They were persistent so I stepped outside and took the call. It was Fatmata, the patient I wrote about in my last post. The one who went on the radio and did the interview and the one I visited at her home. Another nurse gave her my number and she wanted to call. I asked if she was back in school and she is! I asked her why she wasn't in school today and she told me she is but it was lunch time. She will be back in a month for her followup appointment and I can't wait to see her. I am SO glad she is back in school!

So I'm going to go out on a limb here and be honest... I don't think I realized how hard it was going to be here. Yes, I knew it was going to be challenging. I knew there would be moments of craziness and trying to relate to national nurses was going to be hard, but oy. Today I feel like I have hit a wall. I'm tired. I'm tired of many things but I'm tired. Everything is a struggle. I can't get from one place to another in my day without some sort of issue. I have been working to get HIV trainers out here to train the nurses to be HIV counselors so we can start testing all our women. After going round about how much it would cost and finally getting the cost to something we could afford and settling on dates, they were finally able to come out. I thought my nurses would be excited for this opportunity. We are paying for and supporting them and offering them knowledge about something which I know affects each of them. After the first day of teaching they sat me down and proceeded to tell me everything I did wrong. It was one thing after another. My favorite was that the sodas weren't cold enough and they were pretty upset about this.

I am making friends though and that's been encouraging. Having the ship on the other side of the city has proven to be amazing. I have lots of returning friends from there and have spent the last few weekends with them and have loved it.

On the VVF side of things, the women are still lovely and amazing. Our numbers have been down a bit but I feel like things are going to be changing and I'm really excited to see that. We have some things in the works and this excites me. I'll keep you posted as I can.

Kambia and Then Some

2011-02-18T04:41:00.000-08:00

I got back yesterday from a four day trip to Kambia, a province north of here-ish. I thought it was a trip to Kambia but it turned out to be a trip to Kambia, Port Loko, Bombali, and Tonkolili. I knew there was going to be a lot of driving but what I had expected wasn't exactly what came to be. There was a bit more than expected.

Monday morning I left the centre with Francis, the driver for the four day screening trip. Along the way we picked up Bernadette, the screening nurse. Both Bernadette and I get car sick so the three of us crammed into the front. I tried throughout the trip to handle the back but with the bumpiness of the roads it was no good. So we got as comfortable as we could, the three of us in the front...

I was surprised how great the roads were once we got out of Freetown. The main roads at least.

I have to admit, the first two days were pretty frustrating. I have heard the statistics... Over 2 million women in Africa afflicted with VVF. I didn't know they would be this difficult to locate. I figured we would just have to walk into a hospital and they would come walking out. Not the case. The first clinic we went to in Kambia had one woman for us to see. She had a gynecological problem, but not VVF. At the clinic they were doing a class for mothers who had children at a young age and were not able to reintegrate back into the school system. They were teaching life skills and how to weave. We had an opportunity to share with them and asked if they knew of any women with VVF. A few people raised their hands. One woman said a prostitute nearby but she wouldn't tell us where because she was afraid of her. We found another girl who took us. This woman didn't have VVF but she said she knew someone else. We drove to this other woman's place, walked through some fields and found her. She came running out and kissed us all but again, not having VVF. It was valentines day and I got an offer of marriage from an old man living in the home. I had to sadly decline. Another girl from the school told us she knew of someone so off we went again. We drove up to a village and asked for this woman. She was out farming so someone had to go get her. We all sat to wait. Whenever we would show up anywhere, the second we step out of the car, benches get pulled out of huts and homes and from anywhere to offer us a seat. As soon as we sit, children come from everywhere. They always kept us entertained while we wait. Fatmata finally came from the fields. She walked into her hut and came out with a follow-up card from the centre. I figured the girl who brought us was confused and just brought us to see an old patient. Fatmata pulled out her card and her old operation report and we noticed that her first surgery for her RVF was back in September of 2007. She was told to come back for another surgery, for her VVF, three months later but due to unrest in the country she never came and never had enough transport money to return. Yeah! Our first woman!

By then it was starting to get late. Bernadette and Francis decided it was best to go back to Makeni to find somewhere to sleep. There were women they had wanted to visit there the next day anyway. More driving... We went to the hotel and it was fully booked. We had to go to the next village to find the next motel. We pulled up and I had such an erie feeling. There was one room left. This crazy room had a bedroom and two sitting rooms. It also had a balcony which the bathroom was built onto. I found out that I would be staying there alone. Oy. Francis and Bernadette didn't want me to stay where they were staying because when they see white skin the price immediately will double or triple or more. So they left and there I was, in my sketch motel room. Joseph, the nice man from reception said he could have someone sleep on my balcony if that would make me feel safer. Um, no thanks. Nothing like a little barricading of the doors to calm my nerves. It ended up being completely fine and I spent the next three nights there.

Tuesday we got up, screened two women who Bernadette found after they had dropped me off the night before and then went in search of a woman who lived in a village far, far away. This road was the worst of all. A whole two hours of it one way. When we finally got to her, it only took seconds of speaking with her to realize she did not have a VVF. Two hours back on the roller coaster ride of a road. After visiting another hospital and not finding anyone, my frustration was rising. We saw one other woman who again, did not have a VVF and by then had to call it a day. Oh, my highlight from Tuesday was getting to see Fatmata, the patient I wrote about in one of my last posts, the young girl who went on the radio with us. It was SO great to see her again! She was so excited to go home and see her family and we had the opportunity to meet them. She said she will have to wait until the start of the next term to return to school but she promised me she would.

Fatmata at her home.

Tuesday night I returned to my sketch room and prayed. With all my frustrations coming from so many different places I needed to be refreshed and even the passion I had for working with VVF women needed to be renewed.

Wednesday we returned to the hospital to follow up on some possible leads. I still don't know where Bernadette would come up with some of these women but we pulled up behind this bus and she said a VVF woman was going to be on the bus. I looked at her in disbelief. Somehow Bernadette had been talking with a woman who was going to bring us a fistula woman from the far north. There she was. Isatu is 17 or 18. She only speaks Fullah, a dialect not many people here can speak. She is very short and you could see the fear in her eyes. She wouldn't make eye contact and just went where she was directed. By the end of our trip, Fatmata, the first women we picked up, had taken her under her wing. She would point her in the right direction and even when we got back here to the center I saw her taking her by the hand leading her into the bathroom to show her how to shower.

At some point Wednesday morning we stopped by a home where we thought another woman was living. Nope. She lived in a village far far away but her sister would come with us to show us the way. Fatmata, the sister, piled into the back of the land rover and off we went. We drove and drove and drove some more. Such beautiful country! Eventually she told us to turn. Oy. This road looked awful. After we got up the first little hill it wasn't so bad. It was only a narrow road wide enough for one car and even then the bushes were still hitting the car. Eventually we reached a village. I thought we were there. Nope. We drove straight through the village and out the other side. I thought it was so random. How often do the people living there really see cars going through? Another village. And another. And another... and then as we left one, the road went from some resemblance of a road with tire tracks to a walking path. It looked like a car never had been that way before. We drove and drove down this small walking path, through more villages until we finally reached our destination. A small village in the interior. When we stepped out of the car, more benches came out of huts and I think there were more kids than adults living in this village. We quickly learned the woman we had come for was even further out at another village but there was no way the car would make it. A cute little boy, probably ten, took off running in jellie shoes, like the ones I had growing up, since no one else wanted to go. We were told it was far. Settling in for our long wait was fine. I was just amused at where I was and what I was in the midst of. Sierra Leone is really a beautiful country. Mountainous. Green. Lush. Three hours later...the jellie shoed boy came back with Isatu. Such a beautiful girl. We examined her and the excoriation from the urine made it impossible for her to wear any sort of pad anymore. She was positive and when we told her we could take her and do her surgery, she cried. She said she didn't have a mother and no way to pay. When we told her it was all free she was happy. Her grandmother was there as well which made for a great send off for her. Back down the long roads and after one flat tire we made it back to the motel. I felt like this was the answer to the prayers I had prayed the night before. True, we did come up with so many false leads, but it made all the difference to Isatu that we never turned back.

As we are coming up on the village.

Isatu in the blue striped shirt with the rest of her village.

Isatu in the middle with her grandmother and sister.

Yesterday we started back to the centre with seven women. Part way home we got a call that someone had thought we were already gone so they had sent a patient to Bernadette's home in Freetown...eight women then. It was a great trip overall. True, frustrating at times but it's a learning process and I'm excited to see where we can go from here and how we can improve our screening trips.

Growing Up

2011-02-12T06:30:00.001-08:00

For you did not receive a spirit that makes you a slave again to fear, but you received the Spirit of sonship. And by him we cry, "Abba, Father." Romans 8:15

As I was reading this morning I came across this verse. It turned out to be fitting for my day. Today I went out alone for the first time since I got here. I have been out many times before but always with other people. I had to go to the supermarket and everyone else went to the pool today. I needed some time alone today knowing this week I will be with people all week. I had to psych myself up to go. That may seem funny, and it is, but in all my traveling around West Africa I have never been allowed to venture out alone. With Mercy Ships you always had to go out in groups. In Niger we were so far away from anywhere that to get to town someone would have to drive you and honestly, I wouldn't want to go out alone there anyway. So today I took the poda poda, got stuck in traffic, surprise, walked the last bit there, made it to the supermarket, shopped, exchanged money, and got a taxi home knowing how much it was going to cost. When I sat down the driver said 2000 as I put my foot out the door to get out knowing he was charging me too much. I said no. He said 1500. I said no. He laughed and said ok as I said 1000, knowing that was the right price. He and his friend in the front seat said they were just trying to have a little fun. I told them they were trying to get more money out of me. They said yeah and laughed some more.

Monday I am leaving bright and early to head to Kenema, a province north of here. I am going with Bernadette the screening nurse and Francis, our driver. We are going from Monday to Thursday for a screening trip. I'm excited to go and see more of the country and to see how these trips work. Lately not many fistula women have been coming back with these trips so I'm excited to see why and learn what we can to do improve that. Please pray for me this week. Pray for safety for the trip. Pray we will find women who need help. Pray my eyes will be open to how these trips can be improved. I'm sure I'll have stories to share when I return.

Live

2011-02-11T11:58:00.000-08:00

This week we did two live radio shows to get the word out about VVF in this country and to tell about the AWC. On Tuesday we went to the first station. I went with Bernadette, one of the screening nurses, and Fatmata, one of the patients. We arrived at about ten to four. Our on-air time was 4-5pm. I had money in hand and we were ready to go...until we got there and they looked at us and asked what were we doing there. The actual station was an hour away. It would have been nice to have been told that when we set up our date last week in this office. They said they could put us on at 6 instead. Fine. We went to that station and walked up some stairs and down this sketchy hallway. It was dark except for light coming from under the doors we were passing. Another moment where I just think...what am I doing here. At the end of the hallway was the production room. A table with two microphones coming up out of the middle of a padded table and some radio gear. Fatmata is only a girl. Still in school and I was afraid she would be too afraid to talk. I never really saw her talk much on the ward. Put her in front of a microphone...she did great! I was proud of her. Bernadette talked for awhile about VVF and the clinic and all that stuff but Fatmata told her story and she wasn’t afraid. She was even able to talk a bit in Temene, the dialect she speaks at home. It was a call in radio broadcast. Flashing. Flashing is something done a lot here in Sierra Leone. If you want to call someone but not use your minutes, you will flash them. You will call them. Let it ring once and hang up. The person you are calling will see you called and hopefully call you back. The only call-ins we got were flashes. The radio station isn’t going to call you back! So no call-ins that night. That was fine though. The program still lasted an hour and I was so proud for Fatmata!

Yesterday we went to another station. One that reaches the entire country and even a bit into Guinea and Liberia. The frustration with this one came when we went to pay. It was more expensive but I was expecting that. So we paid. We were about to start when the person who was going to run the interview wanted to know how much we were going to pay her. Huh? We already paid. By now we were running late and they were trying to force us on but I know that unless you get money issues sorted before you start something then it just gets messy. Finally the producer came in and said whatever money we give is fine and we need to get on with it. I think that is one of my biggest frustrations here. Money. There is always more and more and more that is expected. There is never an end. If you rent a taxi for a day and take it to the beach, the driver expects you to buy them lunch and after he drops you off to pay more for him to get home and on and on and on...But back to my story... So we gave her a small small amount, and moved on. OY. The show went better than expected. I figured that since we had made our moderator angry that we would have a bad show. It went well though. Again, Fatmata was incredible. Bernadette didn’t come this time. The other screening nurse, Fatmata-a popular name here, came. The callers that called in called from all over the country. From Kenema to Bo to the far reaches of Sierra Leone. It was really encouraging. There was one man who called in after Fatmata, the nurse, had made a comment that after surgery a women can’t have sex for six months. This man called and said that the woman would do whatever the man said. OY, again. For real? After comments like that I look at Fatmata, the patient, and I am so thankful for her. She is headed home tomorrow. I asked her today if she is going back to school and she said yes in a way that made me feel small. I have gotten that feeling from a few of the younger patients here. After this they really know what’s important. Fatmata is headed back to school next week. She is so happy. I don’t know how many times she thanked me today and hugged me. I wish I could see her five, ten, twenty years from now. I have a feeling she will do something big with her life. Driving home from the radio station Fatmata, the patient, got a phone call from home. They had heard her on the radio! She is going home dry, but also a celebrity.

Becoming

2011-02-10T13:44:00.000-08:00

I have stood on the top of mountains and gazed at the majestic work of your hands.

Lord, how I desire to to sit in your presence which could only by your grace and mercy be any more beautiful.

Finally

2011-02-06T00:47:00.000-08:00

Three of the women after their gladi gladi.

Mama Finnah

During the gladi gladi the women dance twice around the wards.

The wards are set up in a square. To the right is the green ward. To the left is blue ward. Across the way is orange ward. My office door is the one right in the center of the picture.

River #2

Sandra, Me and Bernie

George and Mikey

Every time we pass this hospital I try to get a picture of the sign. You can't read it well at all, but it says: Notice No Money Transaction For Blood Transfusion Please Bring Donors.

A great deal of the population are afraid to donate blood which causes the blood banks to run low. If you need surgery you need to bring people to replenish their stock in case you need some. They won't do many surgeries unless you bring blood donors before you are cut.

HAPPY BIRTHDAY!

2011-02-05T13:35:00.000-08:00

Happy Birthday Mom!

Love you!

Susu

2011-02-04T09:49:00.000-08:00

I have to admit that I am glad it is Friday. This has been a busy, draining week for me. I wouldn't say that is a bad thing though. I learned a lot and got a lot accomplished and now I'm just tired. Nothing River #2 tomorrow can't help with. I was getting pretty down on myself this week. Patients seem to be being discharged but only a small few are being admitted. We are sending nine home tomorrow and that will give us only a handful of patients left. I was actually taking it personally at the beginning of the week, as random as that sounds. I see part of my job as being bringing the women in. Making sure they hear about us and know how to find help. Only being here a month I am still learning, yes, but I still felt like the low numbers were my fault. As the week went on and I spent one afternoon going around to the different radio stations and getting us slots for next week to go on air, I was starting to relax a bit. I felt like God was really starting to show me that: A. I am not here to do this alone and B. women will come, I just need to be patient. Another reason I was getting frustrated was because we had to cancel the screening trip that was going to go out this week because the screening car needed to be worked on...if anyone out there would like to donate a new vehicle for screening, please get in touch with me. :) There's my plug. The reason I say new is because the roads here are so bad and the places the screening trips need to go are even worse. You don't find many women in the cities. You need to go out into the small villages where the roads are, well...I'm going out on a trip in a week so I'll show you pictures when I get back. Anyway, canceling screening trips slows down the progress we make. I wrote about the advocacy program last week on here and as the women go home I truly believe they are going back and sharing their experiences here in hope of helping their friends. Even today I walked into the ward and there was a cluster of women talking with one of the nurses about a woman back in her village who is wet but she is so scared to come forward. They were all trying to tell this patient who knows the woman how she can go back and encouraging her to come out. The fistula women are the only ones who get one another. No one else can truly understand them.

Today we said goodbye to mama Finnah. This woman was so funny. She has been with us for a few weeks for surgery. She had her day of gladi gladi today and her 'pikin', daughter, came to pick her up today. I wish I had a picture of her hair but she always wrapped it up when a camera came out. She kept it braided in five neat rows. The top of the braids were black but between the braids it was silver. She is well along in her years. The longer she was here, the more silver came out. I finally asked her and yes, she dyes her hair.Her catheter came out a few days ago and she is dry! Whenever I see her she throws her hands up and says, "Tell God tenki!", and we do. Then she looks at me and says, "Shake yo body!", and we do. When she left today I cried. I cried, not because she was leaving, but I cried because of Mariama. Mariama is a seventeen year old patient. Finnah and Mariama both speak susu. Susu is not a dialect spoken by many in the Western Area of Sierra Leone. Finnah spoke susu, krio, and a few other dialects. Mariama only spoke susu. She was crying because the only person she could communicate with was leaving. Finnah went over to where she was sitting and wiped the tears off her face and put her arms around her. It was a great picture of the two of them and the bond they created in the short period of time they spent together.

Radio

2011-02-03T09:20:00.000-08:00

Today I took a trip to Freetown. I always enjoy getting out especially when I can take a driver and not have to fight for a taxi or poda poda. Francis drove and Fatmata, one of the screening nurses, came with me. We were on a mission to get on the radio. First stop: SLBC. I have no idea what that stands for. Fatmata seemed to know everyone we met. One woman I was told was famous on the television in Freetown. I thought for a second if I should ask for her autograph but I held back. We found our way up three flights of stair to an office. We were talking with a man about doing a radio show to talk about fistula and get the word out about the AWC. We are scheduled for next Thursday for an "interactive show". I think that means people can call in and ask questions.

Next we hit Star Radio. I'm glad Fatmata was with me because there was no way I would go up to that place alone. We walked through a door which opened up into a small garbage dump then through another sketchy door and up some narrow stairs...good thing I trust my nurses. Star Radio already had a jingle done from before so we just paid for it to continue then got out of there.

Democracy Radio was our final stop. We will do another interactive session with them on Tuesday. I will go along as moral support but due to my lack of Krio I will not be speaking.

I hope the radio will bring in patients. Usually if you just walk outside you hear a radio blasting from somewhere. Sitting in a taxi, you can't get away from it. We are discharging our patients and not as many are coming in. I don't pray for more VVF patients but I pray that those who are wet and need help can find their way here.

Month One in Sierra Leone

2011-02-02T12:33:00.000-08:00

Let me take a moment and reflect on the happenings of my first month in Sierra Leone...

January 3rd I arrived. It’s not hard enough to just land and find your baggage in the midst of hundreds of people, but then having to get on a water taxi to get to the mainland. The adventure had only just begun...
Was welcomed into an amazing group of people.
Visited some of the most beautiful beaches around!
Ate some of the greatest seafood!
Was crammed and pushed and folded into poda podas and taxis.
Sat in traffic...
Sat in traffic...
Sat in traffic...
Met some amazing women with fistulas.
Cried in front of my boss.
Laughed.
Stressed.
Prayed.
Sent away women in tears knowing where I was sending them was not where they wanted to go but knew there were no other options.
Led my first staff meeting.
Wanted a dog.
Taught my first lecture on hyponatremia.
Ate African food for lunch five days a week.
Shook my tumba.
Danced, and not just at gladi gladi.
Watched season 1 of Bones.
Got a job title.
Questioned what I am doing here.
Questioned why I ever questioned what I am doing here.
Saw patients wet.
Saw patients dry.
Saw patients somewhere in between.
Learned about #2 and #3 plugs.
Slept under a mosquito net every night.
Woke up at 0230 covered in mosquito bites.
Breathed.
Forgot to take my doxi for three days.
Went to my first management meeting.
E-mailed the girl in this job before me with tons of questions.
Made some great friends.
Took a shower for longer than two minutes in Africa.
Ate haggis...twice.
Learned to play carcassonne.
Saw one monkey.
Made my first roster.
Fixed my first roster.
Still fixing my first roster.
Witnessed pure joy.
Witnessed pure heartbrokenness.
Ate my first lobster.
Was woken up at 5am to be told there were no more diapers.
Learning more and more what it really means to trust God.
Walked into the ward and saw a patient standing directly in front of a large fan holding her shirt above her head.
Watched an ultrasound.
Saw brand new babies.
Bonded with a nurse over scrubbing cabinets.
Sweat.
Got filthy from just siting in a car.
Reunited with friends I had met on a ship last year.
Joined two Bible studies.
I think I may have quit one Bible study.
Sat and talked with patients without using words.
Heard awful screaming from the labor ward.
Floated down a river into the ocean.
Learned very small small krio.

And tomorrow I may be on the radio.

Two More...

2011-01-30T14:31:00.000-08:00

The team house where most of us live. The bottom floor is where we eat together and the kitchen and laundry room. Soon we will have couches in there for a lounge as well.

I live on the second floor but I will be moving north in a couple weeks. There is a better view and a brighter room.

On the other side of the cement wall to the right, which you can't really see, is the maternity ward.

This would be why it takes so long to get anywhere. There is so much road construction and crazy drivers and unreliable cars which break down everywhere that to get anywhere is an all day ordeal.

One Photo

2011-01-30T01:21:00.000-08:00

I've been trying to get pictures uploaded on her for the last few days. It took about ten minutes for this one. It's a start and I will try and do more later.

Here is a picture of a girl on the day of her gladi gladi surrounded by eight other patients awaiting their turn.

Burns Night

2011-01-27T13:30:00.000-08:00

Who or what in the world is Burns night/Burns supper? I had never heard of this guy until a few days ago and tonight I had haggis for the first time, possibly the last. It's not that I didn't like it. It honestly didn't taste that bad but with every bite I had to consciously tell myself not to think about what I could possibly be eating. Jude, the manager of the clinic, is Scottish and she brought it back with her from her last trip home. It looked like a massive, massive sausage. When it was brought out it had to be walked around the table and we all stood in silence. Then Jude stabbed it with a dagger. Quite possibly the most random thing I have seen since arriving in Sierra Leone. After dinner Mikey read his poetry. Mikey isn't Scottish but I guess this is what you do at a Burns supper.

As random as this all was, this is something I really love about living in this sort of community. We all come from different places from around the globe and yet we all bring something so unique...and sometimes so strange. The funny thing is too, is that I was invited to another Burns supper/poetry reading tomorrow night. I'll have to let you know how that one goes...

Get Belly

2011-01-26T09:55:00.001-08:00

There are two women on staff here who are trained to do advocacy teaching with the VVF women. I sat in on the first half of the day with them. Fourteen VVF women sitting in a circle talking, I felt like it was a support group, which it is in many ways. One thing I have noticed about Freetown is the large number of NGOs in the area. When you go out you can't help but pass numerous white land rovers will a different charity scribbled on the side. One of those charities is Health Poverty Action. To be honest I really don't know much about them but what I do know is that they have put together this great advocacy training program for the fistula women for when they return home. The women are taught how to advocate for other women they may find in the same situation they are in, leaking urine and alone. Not only are they taught what to do if they meet one of these women and where to send them, but they are taught what to do if they meet a woman who "get belly", is pregnant. If the woman is in labor and if they see the sun two times, one-night-two, and they still have not delivered, they must get them to a clinic or hospital where they have trained doctors.

While they were sitting in the circle, Florence had the women go around and say how long their labors lasted. I have heard these numbers before and see them daily as I enter them into the database in the computer, but to go around a circle and hear each woman say: two days, one day, three days, seven days, two days, four days, six days, ten days, three days, one day, seven days, four days, three days, two days... makes it so real. When she asked one woman how far it is from her home to the nearest health clinic of any sort, thirty miles was the answer. For most of us thirty miles isn't anything. That's a drive into Tacoma from Vaughn. Into Spokane from Coeur d' Alene. Imagine not having a car though. There is no way. And if you are in active labor...

After the training the women are given a book about Fata. It is written in simple language so some of the women can read it if they have had any schooling. Fata becomes pregnant and gets a fistula. It tells her story and it tells what needs to happen next and what could be done about it. The women can use it as a tool when they get back to their villages to help prevent fistulas.

This evening I was walking through the ward and I heard someone reading, slowly, but trying, and it was Mariama. Mariama is sixteen and only got her fistula two months ago so it is too early for her to have surgery yet. She will be with us until it is time though. She needs to be "built up" so she will be better physically for surgery. Vitamins, ensure and three meals a day will help with that. I sat with her outside for a bit this evening. I was trying to hear her story but the nurses who were translating for me got busy. I had her open her book on Fata and read instead. She speaks Mende and small small Krio but she knows her alphabet. She is slow reading but not bad. If she got to a word she didn't know she would spell it without any problem and usually figure it out from there. Such a beautiful girl. I'm sure I'll share more about her later.

Esther left today, the girl I wrote about two posts back. She wasn't able to sit in on the advocacy training so before she left I pleaded with her that if she heard of anyone with piss problems from obstructed labor to send them in. She said she would and I know she will. That girl is a strong one. So funny too. She was helping me with my Krio which is still non-existent. She is still wet but will be back in two weeks for a checkup. For now, it's back to school for her.

Tell God Tenki

2011-01-20T10:02:00.001-08:00

One of my favorite things that happens in the morning during rounds is when the patient is asked how she is feeling. Her response, more often than not, is:

"Tell God tenki."

Tenki means thank you in krio, the local language. Tell God thank you. Even through all these women have been through, their daily response is:

"Tell God tenki."

Their response isn't:

"Why did God allow this to happen to me?"

or:

"Can you PLEASE take this catheter out!"

or:

"When can I get out of here and go home?"

or:

"When can we eat?"

it's:

"Tell God tenki."

On another note, there is a woman who had surgery yesterday and now she has three drains coming out of her. A catheter and two stents which come out from the kidneys. Those will be removed in seven days. When she gets out of bed she carries the stents around in a bed pan. Don't worry, it's super clean. But that's not what I want to share about. So today was visiting day and her husband came! That in itself is always a beautiful sight to see. So many of these women are abandoned by their husbands. But I looked over and he was bending over cutting her toenails with a razor blade. That was a tremendous picture of love! She was sitting there with a foley bag and a bed pan full of two other bags and tubes and he was lovingly cutting her toenails. I walked over to them and they both looked up at me and laughed, as did I.

Esther

2011-01-18T10:27:00.000-08:00

This weekend when we were driving home from the beach we passed and man and his daughter selling beautiful fruit on the side of the dusty road. We stopped and for Le 3,000 I was able to get half a dozen perfect sweet star fruit then on top of that he piled that many more sour ones so I could try them. That was less than a dollar. I just ate one and it was delicious!

I walked past a patient today who was leaning over her bed digging around inside the plastic bin all the patients are given for their personal belongings. I noticed she had a stack of those composition notebooks. When I asked her if she was in school she said yes. She told me she was studying agriculture. Instead of being in school she is laying in a hospital bed trying to not leak urine. We got to talking for many reasons but it was also nice being able to talk to a patient in english. She learned english in school and spoke it very well. I opened her agriculture book and quizzed her on the difference between substance agriculture and commercial agriculture. Pretty smart cookie she was. She told me that she didn’t want to be a farmer but someday she hoped to become a nurse. At seventeen she has her life in front of her.

Here’s a bit of Esther’s story: She became pregnant about a year and a half ago and was in the midst of taking her exams when she found out she was pregnant. She decided to continue with school though. The “young man” who got her pregnant continued to help her with her school fees. When she started feeling a little pain she told someone but she told me that because she is only a child, she didn’t know what to expect from labor. She thought that when her labor started her whole belly would start moving around and everything would hurt. When this small small pain started the woman took her to the TBA, traditional birth attendant. For three days she labored. She asked them to take her to the hospital but they said they could not afford an ambulance. It would cost Le 20,000, about $4. She gave the TBA a small amount of money to call her boyfriend but they took the money and never called him. She told me the baby tried to come out but it got stuck. “It wouldn’t go up and it wouldn’t go down.” Eventually they gave in and took her to the hospital. The surgeon there said he would only do the operation for Le 200,000, money she did not have. Another day went by and that night she passed her dead child on its own.

In the hospital they inserted a catheter. She was having a small amount of urine coming out but the rest just fell out of her. By the third day nothing was coming from the catheter. It was all just pouring out. She went home.

There was a car that came to her village. It was the screening team from AWC, where I work. The nurses met her and although there were other women in the same condition, they all ran away but she stayed. Others told her to run because these nurses would eat her. She knew she needed help though. She came and had her surgery but was still wet and had to come again for another one. She had her second surgery yesterday.

Esther told me that when she went home after her first surgery, although she was still wet, she didn’t tell anyone. She dressed fine and made herself look happy because she wanted to help the other women in her village. She wanted them to see that she went and was healed. She wanted them to come as well. Even if after this surgery she is still wet, she will do the same thing. She knows she is the one who can help her friends find healing.

The Power Won't Stop Flicking Off While I Am Trying To Post This

2011-01-17T12:25:00.000-08:00

Throughout my days I always think, I should blog about that, then I never remember what it was I was going to share.

I am settling into the routine here. Figuring out more day by day what my role is and how things work. I am training up Sia, a national nurse, to be the ward supervisor which I thought would be more challenging that it is turning out to be. She is fabulous. From day one she has been taking initiative and making sure things are getting done. I have been rearranging the wards to make things easier to get to and to have less clutter around and she has been giving ideas and jumping in to help. Last week I was teaching her how to enter patients into the database. She told me she took a computer class not too long ago but after we got past how to use the mouse, things picked up a little. She is a fast learner and I think this will be a great position for her to be in.

I am awful at learning names. I was asking someone the other day if they knew where a certain nurse was and she said she was the black woman sitting outside. I could only laugh and walk away considering the long row of patients sitting outside and I was the only white person around.

The patients are beautiful. They will stay here for close to twenty days so the opportunity to get to know them on a deeper level is something I am really looking forward to. Dr Lewis is the VVF surgeon here and she is wonderful. We have enough bed space that if a woman comes and and is malnourished, even if she is not a candidate for surgery, we will keep them on the ward to “build them up”. We will work on getting their nutrition in line and get some meat on their bones before sending them home.

This past weekend I went to another beach. It was amazing. Not only was the beach absolutely beautiful, I had my first full lobster. This beach was incredible. The restaurant we were at was inside this small bay. There was a sandbar that came out which left a small area for the ocean to come in. We would swim out to this bar and jump in the ocean and let it push us in. I felt like I was floating down the Clark Fork after being dumped in my canoe, without the fear of hitting rocks.

So far through this experience I have really been learning so much about God’s grace and goodness. At times I still wonder if this is the right place for me, if I have enough talent and leadership ability to not only do this job, but to do it well. True, I had a slight breakdown last week but who hasn’t when they start a new job. The people that are here at this clinic couldn’t be more supportive though. There is a substantial expat community in Aberdeen and Freetown. It’s been great meeting people from different NGOs and getting to know people outside of this place as well. And there are people living here from all over the spectrum but somehow it all works. Somehow in the almost two weeks of me living here I am feeling a part of this. I can’t wait to see what happens and what comes of this year here.

Papaya

2011-01-13T11:31:00.000-08:00

A patient gave me a papaya as a gift today! It's big and smells good and I can't wait to cut into it!

A little makeup...A little screaming...

2011-01-10T14:15:00.000-08:00

I walked onto the ward tonight at about 8pm and I could only laugh. There were two women sitting on the first bed as I walked in. One had just finished putting makeup on the other one. Her eyes were blue and her lips...outlined in thick black and colored in with a silver-type of color. She looked at me as I walked in, tilted her head back and rolled her eyes in a look-at-me type way. When she stood up she grabbed her catheter bag in one hand and held her other hand up in a sophisticated type manner. As she walked, she strutted her stuff, laughing at the same time as she paraded through all the wards. I needed that tonight.

The slight complaining I did yesterday about the house next to my window that plays the loud music, I take it back. I take it all back. About an hour ago I went to take a shower. The bathroom is on the other side of the hallway, facing the maternity clinic. As soon as I opened my door to cross the hall I could hear the screaming. It wasn't just screaming though. It was gut wrenching, horror filled agony. There is a momma in labor. Every once in a while someone will ask if I can hear the mothers from my room. No, because my room faces the other direction. I have to admit, that is something I am thankful for at the moment.

First Sunny Weekend

2011-01-09T11:13:00.000-08:00

Outside my window, on the other side of the cement wall, is a home. I don’t know who lives there but I know they like to listen to music loud all through the night and right now they are watching a horror movie. The suspense music part is playing right now. I’m just waiting for the scream...there it is.

This weekend I have been able to get out and see a bit more of my new home and surroundings. Yesterday I went to Lakka, a beach about a thirty minute drive away, with Pete and Sonia who work in finance, and Mikey, the pediatric physician who works in the outpatient clinic. Things here aren’t very far away but with the roads in the condition they are in it takes much longer to get places. If a truck or car breaks down, it stays there until it’s fixed. The road is also being widened so a great part of the hassle comes from the construction. It’s impossible not to notice the shops along the road. It looked as though the front of the shops had all been torn off and that is exactly what happened. When they had come through to widen the road any shop which was in the way was bulldozed and for many shops that just meant the front wall of the shop was torn off, keeping the inside exposed. I was told though, that the owners were compensated for this.

One thing Sierra Leone does well are their white sandy beaches. Lakka is a large crescent cove where the beach is lined with many small places to get chop, food, and they all have wooden lounge chairs and huts to lay under. The water is pretty clean and the swimming is perfect. The shrimps I had for lunch were massive and the chips, fries, weren’t too bad either. I laid on a chair and read most of the day and watched the fishing boats come and go. It was a perfect day to breathe and take in the new sights and sounds of Sierra Leone.

The main modes of transportation here are the poda podas, large vans which you shove as many people into that you can, taxis and motorcycles. Poda podas are pretty standard throughout most places I have been in West Africa, every place just has a different name for them. The nice thing about here though, is that the rates are pretty standard and easy to figure out so you don’t have to haggle for a better price. I had thought of getting a drivers license since I’ll be here for a bit but I think I’ll be able to figure out public transport just fine. I found the supermarket but we were in a hurry to get back so I’ll save that excitement for another day.

We all just said goodbye to Anna, who I am taking over from. It was bittersweet for everyone here. I have only worked with her for the last few days but she has done a fabulous job bringing the VVF part of this clinic up to where it is. Saying goodbye to her also means here I am. The adventure of this next year is just beginning.

Sierra Leone or Bust

2011-01-07T10:16:00.000-08:00

I’m back...to the land of VVF, heat and humidity, being tsk-ed at as I walk down the street, cockroaches, long hand shakes, sweat, urine, the unknown, dust, bars on my windows, barbed wire, ants, white sandy beaches, crowded taxis, dirty feet...I am back to the continent of Africa but to Sierra Leone for the first time. I arrived three days ago without much hassle. My luggage was underweight and it all made it! The pastor who was to meet me in the airport met me. He just walked up and said my name and we found each other easily. He helped me exchange money and get me on to the water taxi. When you land in Sierra Leone, the airport is on the other side of a bay so you have a few options: drive the five or six hours down a dangerous road to get to the city, take a helicopter, or take a water taxi. I opted for the water taxi. I had to laugh when I got in it. It was a pimped out water taxi. It was lighted on the inside with christmas lights and in the corner was a hispanic soap opera playing. There were many other expats on the taxi and we were all laughing by the time we go to the other side...a very amusing experience.

I’m here for a year. This is the longest I have been anywhere longer than seven months in the past seven years. I have my own room and if I look out to the left I can see the city of Freetown otherwise I just see rooftops. There is a beach about a ten minute walk away. That’s as far as I’ve made it beyond these walls so far. I don’t think I would swim there but it’s a nice place to walk to. The clinic is separated from the team house by a wall so I have a really short commute.

My first three days I have spent with Anna getting handover. I will be taking over her job and she leaves this weekend so Monday will be a big day. It has been, to say the least, very overwhelming, as any job seems to be when you first start. The Aberdeen Women’s Center (AWC) is where I am working. There are basically three areas to this clinic. There is the VVF side, which I will be working in, the maternity clinic where babies are delivered daily, and the outpatient pediatric clinic. Everyone I have met here has been extremely welcoming and supportive. The past three days have been trying to fill my head with every part of this place. I’m tired now. I'll have the weekend off and start fresh on Monday!

Danja 2.0 Pictures

2010-11-28T16:01:00.001-08:00

Me, Ginger, Jolene and Jacqui prepare to leave Maradi for Danja.

This is the incense they burn and swing around the ward for the smell.

Lots of bugs!

Meet Madje. Madje is a sock monkey made by my grandma.

Madje had many adventures in Danja.

The women loved her.

I told you that stone was big!

Jolene tames the donkey.

Hindou on the day of the dress ceremony.

Group shot.

The new hospital in progress.

Me standing inside the soon to be finished 40 bed ward.

(Check out that scaffolding!)

Two Weeks After Danja...

2010-11-28T15:59:00.000-08:00

I have been home from Danja now for a little over two weeks. Internet was touch and go while I was there so I’ll try and touch on the exciting points I haven’t written about yet.

Early in the week of surgeries we came across a slight issue. A woman who had surgery was bleeding more than expected. Even though we quickly took her back to the OR and stopped the bleeding and she was doing ok, her blood level was still too low. She was going to need a blood transfusion. Two units of blood. When we found out her blood type we realized there were three people in our group with the same blood. Like blood transfusions on the ship, we were again, the walking blood bank. There were many differences between the lab on the ship and the lab at the hospital. They don’t do many blood transfusions in Danja and we quickly learned that. Someone had to go to Maradi first to get the blood bags. The lab then drew a unit of blood from two people in our group who matched the patient’s blood type. Then I drew blood from the patient so it could be tested against the donors blood for compatibility. The whole experience of obtaining the blood and checking it for compatibility all seemed a little backward to me. Drawing a whole unit of blood from the donor before even knowing if it was ok to be used. Here in the states if I give a blood transfusion there are so many checks and double checks to go through. Jolene and I were a little cautious, to say the least, about giving this transfusion. When I went to pick up the blood in the blood bank the people in the lab just pointed to the fridge. I walked over and opened it and there were two bags of blood sitting on the top shelf with A+ written on them. There was our blood. When I took it back to the ward, Jolene and I did our double checks… We checked the A+ on the blood bag against the A+ scribbled on a scratch of paper clipped on the clipboard on the patient’s bed. Jolene and I looked at each other, spiked the blood with tubing we weren’t quite sure of, but knowing it was all we had and knowing she needed this blood, looked at each other again and I’m sure she was saying a prayer along with me in her heart, we started the transfusion. The patient became a little itchy at the end of the first unit, but besides that there were not any problems! Phew! She went on to have a great recovery!

One of my favorite things about these trips to Danja is the tree. The women sleep in small cement type huts at night but during the day they all congregate under “the tree”. They sit there all day and talk, do each others hair, eat... Although on the previous trip we told the women who were coming back just for a check up to come a week later, many were already there. I think they come so early because they are so excited. Abou was a woman we did surgery on during the previous trip. She came early as well. The first few days there we were discussing how to teach the women about what they would be experiencing. It would be scary for anyone having these foreign people who can’t even speak their language want to cut them and touch them and put tubes in them. We decided the best way to teach would be to have a woman who has gone through this before tell them. Abou was our woman. She has this attitude about her. Not in a bad way, but just a confidence you don’t see too often in VVF women. I knew she would be great. I sat down with her and Houa and Hannatou to translate and when we asked her to tell us what she would tell the women I knew we had picked the right woman. We didn’t have to remind her about too many things. She talked about the sitz baths, the shower (and how to shower), not eating or drinking before surgery, about the IV and how they “give you water in your skin”, the surgery and how even though you can’t feel your legs, they will come back to you. She went on about the catheter, pain, bedrest… When she presented this to the women under the tree she did a fabulous job! She put on a gown. Put on a blood pressure cuff. Demonstrated a sitz bath. There is nothing better for teaching than having someone who has been there before teach. After her teaching she went on to sing. Abou was the one on the previous trip who sang the “Urine in the Oppressor” song. She sang that song but then continued on. She kept singing and then sang some song that had all our names in it. It was beautiful.

On Sunday night we joined the other missionaries from SIM for their time of worship. We were asked to do the speaking that night. We brought Abou and asked her questions and she spoke to the group. Again, she did a wonderful job. Dr Steve spoke then I was asked to share a bit. I shared about Aicha and the story I wrote about on the previous post then spoke about how the women care so much for each other. I think this is one thing I’m really going to take away from this trip. When a woman would leave the ward to go to the operating room, a woman who had gone through this before would come in, get her dirty, wet clothes and wash them. They would be clean and brought back before she was out of the OR. As I spoke, tears filled my eyes. These women show such love and compassion for one another. Only they can fully understand the extent of the pain and rejection each of them feels.

There was one event that happened that completely blew my mind. The day we examined the women from the previous trip there were also some other women there who we had not met before who needed to be seen. Dr Steve was examining a woman who had been leaking for 30 years. During the exam he looked at us and asked if we wanted to feel something. I put on a pair of gloves and felt it. It felt like a rock not too far inside. Dr Steve looked at us and he went to work to get it out. It was like birthing this rock. By the time he got it out I had to check my facial expression. I was cringing at this stone coming out. It ended up being an 8x5cm stone! It was huge. I know there have been larger ones in the history of VVF but this was gigantic in my eyes! We gave her antibiotics and a date to come back for her fistula surgery.

On Tuesday morning we had the dress ceremony. Eleven women danced. All left dry and I pray that continues.

Pray for Pee

2010-11-06T09:08:00.000-07:00

The final two surgeries happened yesterday and today we started removing catheters. Eleven women had surgeries, one twice, and they are all doing well! The ward only has ten beds so on Thursday another one was brought in. It was something great to see because it means that in all these short trips, growth has begun. On the first trip out here only five surgeries were done and this is the forth trip and now eleven were done. It's great to see the growth even though the VVF hospital isn't complete yet.

On Monday we will do followup exams on the women who have had surgery at previous visits. It has been wonderful seeing them all again. They have all returned from the previous trip. Another thing that has been great to see is how the women help each other out. When a woman leaves the ward for surgery, another woman, usually one from a previous trip who is dry, will come in and wash the wet clothes of the one in surgery. When the women is on bed rest for twenty four hours after surgery, the other woman will bring her food and water and empty her bedpan if they have no family to do it for them. When it comes to these women they are never alone.

I was standing in the ward a few days ago and Aicha, a girl from the previous trip came running into the ward and yelled Sarahtou! Then she started looking all around for Linsay...sorry Lindsay. :) She is a girl who is 18 we helped on the previous trip. Later in the day I went to the tree to see her. She brought a girl up to me, probably about the same age and through hand motions and body language I realized she too had a fistula. Aicha had brought her. To me, Aicha isn't like the other VVF women. Maybe it's her age, but Aicha has this sort of attitude that an 18 year old in the states would have. I could just picture her passing this girl and smelling the urine from her then grabbing her and saying you have a fistula, come with me! I'm sure that's not how it happened, but I wouldn't be surprised. Aicha brought her fistual friend! One of the highlights of my week!

The small picture of me on this page on the upper right is from the previous trip. It's me with Hindou. Hindou was in the ward, showered and ready to go for surgery last August when we had to tell her we couldn't do her surgery this time. An emergency had come up on anther patient and we had to take her back so Hindou couldn't have surgery then. I remember sitting with her while she cried and cried, thinking we were going to leave her even though we had told her she would still have her surgery in November. She was the first to go this time. Her catheter came out today and she is dry! She has no problems voiding and is happy!

There are so many other exciting things I would love to share right now but we are headed to dinner. We have a little less than a week here. Now it's removing catheters and making sure the women can pee and empty their bladders before we leave. Please join me in prayer for this. You may think it funny to pray for someone to pee, but for some of these women their bodies don't know how. They haven't had to for so long. Their bodies are used to just leaking it out or their bladders don't empty completely which can lead to other problems too. Thanks!

Back in Danja!

2010-10-31T12:26:00.000-07:00

We arrived here in Danja Saturday morning. The trip here was pretty uneventful. Spokane to Seattle. Seattle to Paris. Paris to Niemey. Then early Saturday morning on a small six seater Piper plane, Niemey to Maradi. It was exciting to run into Jolene, Ginger and Jacqui in Paris. I hadn’t met Jacqui before but Jolene and Ginger and I worked together in Togo on the Africa Mercy. It’s great to be here with some good friends.

Harmitan is here so there is a constant haze. This is when the winds blow in the dust from the Sahara. Because of this we didn’t have great visibility flying here from Niemey. I’m hoping for a dust storm but I’m told it won’t happen this time of year. Bummer. From the pictures I’ve seen they look incredible!

The women are here! They were sitting under the tree when we arrived! Many of the women from the previous trip are here for check ups and many more are here to be seen. The rest of the team arrives tomorrow and screening will happen tomorrow afternoon to see who are surgical candidates. Surgeries will then begin on Tuesday. The four of us have been working to set up the operating room and ward. It’s been great reconnecting with the group here who help us. They translate for us, cook for us, laugh with us and at us, help us out more than we could ask for, and care a lot for these women as well. It’s a good team to be a part of.

More to come soon!

And I'm off...

2010-10-24T15:28:00.000-07:00

Yes, I haven't written on here in awhile. I got home from Togo and Danja mid August and here I am, again getting ready to go back to Niger in just a few days! I'm headed back to Danja for another two week trip with the Worldwide Fistula Fund. I can't wait! Not only will we be doing another ten surgeries, we will also be doing check up exams on the women who had surgeries last time! This means I will hopefully be able to see the women again who I met on the last trip! I'm really excited as well to see how the new hospital there is coming along.

My time here at home has been great. I spent time with my brother and his family first for a bit then came over to Idaho. I've been working and living here at camp for the last month and it has been great spending time with my sister and her family. When I'm gone I really miss my niece and nephews a lot so I really cherish the time I get to spend with them.

When I get back from Niger I will have about a month back stateside. Starting in January I will be moving to Sierra Leone for a year, working as the ward supervisor for the VVF clinic there that was started by Mercy Ships. I'm super excited for this experience and to see what this year brings. I'm also REALLY excited to be living on land! That in itself will be a whole new experience!

I'll be posting more on here now that I'm off on another adventure soon!

Pictures of Danja

2010-08-14T11:46:00.001-07:00

The plane we flew in from Niamey to Maradi.

Alainie, Me, Lindsay and Ginger wearing our matching free bird head wraps.

The women waiting under the tree.

Camels are not as fun to ride as you would think!

Preparing for the dress ceremony.

Group hug!

Group picture.

The women in their taxi home.

The empty tree... until next time...

The new fistula center under construction!

Home

2010-08-14T11:38:00.000-07:00

I arrived home yesterday after being gone for seven months. Thank you Esther for picking me up! It was wonderful to be picked up by someone I had met in Togo on the ship.

The last few days in Niger our internet connection wasn't the greatest so I couldn't keep you all updated but everything wrapped up really well there. Ten amazing women had surgery and almost all went home dry! The final day we had a dress ceremony and the women looked amazing! Their smiles were infectious and it was bittersweet to walk them out to the end of the road for their ride home. It was amazing to see their lives transformed in such a short time. Women who showed up scared and frightened left laughing and smiling. One of the girls I had tried to reach all week came up behind me as we were walking out and held my hand out to the road. It was a beautiful sight to see them all pile into the back of a truck and drive away. It is my prayer that as they return home, they will continue on this path of joy. That they will be welcomed and accepted back with open arms and that the joy I saw radiating out of them will continue.

Yo Yo Yo

2010-08-06T15:13:00.000-07:00

In hausa the word for leaking, dripping is yo yo. I wondered why when I walked up to the group of women and just said yo, they all laughed. I found this fun fact out yesterday and today I was reminded of a camp song in which the chorus is "Yo, yo, yo..." over and over. I sung it to a patient today and she just laughed. It's an easy word to remember when I ask the patients if they are wet or leaking.

The final patients had surgery today. Ten women in four days. When I took one of the young girls to the OR I could tell she was petrified. Her mother was there but they speak Twarg, a language not many people here speak so we had difficulty communicating. We walked across the sandy ground and when we got to the door she stopped. She started crying. The fear that must go through these women and girls. To be in this state where they are outcasts and then brought to a hospital where white nurses are telling you how to prepare and how to wash and how to sleep in a bed off the ground and then being led to an operating room which is freezing to your standards and we will put you in stirrups and make you vulnerable and a male doctor is going to do your surgery after we stick something into your vein and another man is going to poke you in your back so you can't move your legs...I took care of her after the surgery and it took a bit to get her to smile, but she did. Her and her mother have been here for over a week waiting for this day. She is dry and has so much to smile about. Please keep praying for her and her recovery.

After the final surgery of the day we heard they were here. They are the camels. We had all been wanting to ride a camel on this trip and the time had come. They were waiting outside our house. When we drove down the road and I spotted them I got really excited! They were so tall and had seats on them and I couldn't wait... until we got out of the car. Camels are not the most graceful of animals. The way they stand up and get down to the ground scares me. One of them was yelling and was hating life. There were three camels and six of us. I knew that if I waited until the second round I would chicken out so I got on one. Here in Niger we need to wear skirts down to the ground. I showed more leg today than I have in months. There was no way around it. When the camel stood I screamed. I don't know how this seat didn't slide off. It felt so awkward. As long as the camel was walking I felt ok but if it was stopped I just wanted to get off. I will fully admit this was not one of my highlights for the week. After our short walk, when it was time to get off, the camel did his same awkward movements to lay down and again, not a good moment in my life as a volunteer. I was thankful only my friends could understand what came out of my mouth. Would I ride a camel again? No, but I am glad I did it today. The men who brought them got the biggest laugh from us all.

It is raining like crazy outside right now! It's actually a good thing for the tadpoles. The day we got here, the four of us girls walked by a puddle full of frog eggs. Every day we check on them and a day or so after we found it they had hatched into tadpoles! It rains almost every night so the puddle fills up. Once we had to fill up the puddle because it was almost dry and many of the tadpoles lay dead on the sand. We drug an old wheelbarrow full of old water and dumped it in. They were happy. Last night it didn't rain and we all got busy and the puddle dried up and the tadpoles died. We hung onto hope that they found refuge in the mud and with the rain now they will come back out. We can hope... This is our nightly entertainment.

................................................

I wrote this post last night but because of the storm the internet cut out. Here's an update on the tadpoles...they all died BUT the puddle filled back up to overflowing and it is full again of frog eggs! We will try to be more on the ball this time around.

The Urine Song

2010-08-05T11:35:00.000-07:00

I finally found out the gist to the song the women sing:

I became wet.

My husband left me.

He took me to live with my parents.

No one wanted me.

I heard about this VVF hospital so I came.

There are nice nurses and doctors here.

Now I can be healed.

Only one day of surgeries left tomorrow. I had to fight back tears today more than once. Tears of happiness and tears of sorrow and tears of joy. Women and girls finding healing and others finding a longer road ahead. One needing to wait a little longer but in daya, biyu, uku (one, two, three) months she can come back for surgery.

How do these women and girls survive? I say girls because we have one here who is 14 who had her surgery the last time the clinic was running. 14! Wild. The youngest here now is 18 but looks younger. Only one more day then a week more of recovery and other things.

I can't post pictures on here because the connection is too slow. When I get home I'll post lots!

Urine is the Oppressor

2010-08-03T14:36:00.000-07:00

The first two VVF surgeries were done today and the women are doing well and are dry! The day started of rough, which you will read about later, but it is impossible to not laugh and smile when you are with these ladies. Oh, how I love them!

I told you in my previous post about “the tree”, the place the women congregate. They lay their mats out and eat there and talk there and spend their days at this tree until it is time to be seen or have surgery. After the first woman left for surgery this morning I went over to that tree, my small book in hand which I am scribbling down the hausa I am trying to learn and attempted to talk with the ladies. My name in hausa is Sarahtou. I love hearing them say my name. Inakwana was all I said when I walked up and they started laughing and claping. I learned to say goodmorning, a change from yesterday when all I could say was sanu, hello. I have already learned more hausa in the few days I have been here than all the ewe I learned in my six months in Togo. Ina sunauki, what is your name. I am really bad at remembering names, but as they started telling me theirs I realized I would only have a few names to remember: Aicha, Howa, Mariama...if I say one of those three I will have a good chance of getting the name right.

Singing. I needed to hear them sing. After church last sunday, I needed more. The singing isn’t like what I have heard in Liberia or Togo. It’s not accompanied by the chicken dance or any other form of wild dancing. It’s slow and almost monotone. It’s really beautiful. I started moving my feet and clapping and they got the hint. I’m still trying to find someone to translate the words to the song they sang for me, but it was glorious. I could sit and listen to them sing forever. If they aren’t singing or telling me their names, we just smile and laugh at each other.

I feel like I have so much more to share but don’t know where to start.

For those of you who follow my blog, I wanted to let you know too that I received an e-mail today from Michael, Lovelace’s father. She went home to be with the Lord last week. I don’t know any details or how they are coping, but the last time Jane and I went to visit we had talked a bit about this time. He told us that he was never angry at God but that he trusted Him and knew that if Lovelace was going to be healed it would be and if she wasn’t going to be healed, then that would be. He trusted fully in the hand of the Lord and never spoke of anger or bitterness. She was loved so dearly here on this earth and I picture her now, asleep in the hands of God, no pain, no more dressing changes, she was a small girl who knew nothing but Love.

Under a Different Sky

2010-07-31T14:30:00.000-07:00

I arrived in Danja yesterday and it feels like I have already been here for weeks. So much has happened and so many new experiences in such a short time. Niger is like no other African nation I have visited. The red dirt gives it a sort of pueblo feel. The red brick changes the color of the houses and the ground. I hear this July has almost set a record rainfall. I'm not surprised as it has poured the last two nights. Tonight I have only seen lightning but no rain yet. I'm sure it will come. The heavy rains are making the fields green which I hear is uncommon. Great for the crops though which this country is in need of.

We flew into Niamey, the capitol of Niger on thursday afternoon and stayed at an SIM guesthouse for the night. Yesterday morning we got up early and got on a small six seater plane. Dr Steve once asked what we were most afraid while planning for this trip. I said this plane ride. I was not looking forward to it but it turned out to be amazing. The takeoff was so smooth and to see Niger from the air was beautiful. Dry land, many small villages, small lakes, different types of irrigation for the fields, dirt roads and more dirt roads...

As we landed on the small airstrip in Maradi we passed many farmers tilling their land right next to the runway. When we stopped, people came to watch us. Going into this trip I knew modesty was a must, but almost immediately I felt like I needed to cover my head. I was wearing a long skirt to the ground but I needed to cover my head. I had made us all head coverings from fabric I saw at a VVF dress ceremony on the ship. It's of birds flying out of a cage, symbolic of the freedom these women receive with the new lives they get after they are dry. Long skirts and head wraps will be my clothing for the next two weeks. Within a few moment of landing, a man said he would have no problem finding us all husbands and yet a different man, as we were driving out, asked our driver were he was going with all these brides. We had to laugh.

Driving through Maradi and out to Danja took about fifteen minutes. On that drive we saw real cowboys. Small boys, maybe ten, shepherding their sheep and goats, but also sitting on large, very skinny cows, driving them. The real cowboys of Niger! We drove quickly around the hospital grounds and took a look at the VVF center being built. The walls are going up and it is amazing. I couldn't help but think of the women who will soon be using that center. It's a great gift to the country and such a need. During the flight into Maradi, seeing one, maybe two paved roads that whole time and seeing villages out in the middle of nowhere, it hit me again why VVF occurs and why we are here. The women in these villages, even if they wanted to go to a hospital for delivery, can't. There is no way to get to one. They would be walking for days, weeks. By then the baby would die and they would still end up with fistulas.

Today we got to work. We were told there were already some women here waiting for us by "the tree". They had been screened the last time Dr Steve had a team here and they are ready! My eyes teared up as we walked over to them. About fifteen women sitting on their mats waving as we walked up and smiling. I only know how to say hello in housa and that amused them as we shook their hands. I can not wait to get started! These women are sleeping on their mats under "the tree" just waiting. ..

Lindsay and I set up the ward with Mariama, one of the head nurses here working at the leper mission. We made their beds, cut black plastic garbage bags to use as pads on their beds and hung mosquito nets. Hanging the mosquito nets made me laugh. I never thought I would be here, hanging mosquito nets on beds to do VVF surgeries in Niger. At this moment, I would not want to be anywhere else though.

When we were done in the ward we helped Alainie and Ginger finish setting up the operating room. A few more things to do tomorrow and we will be set and ready for Dr Steve to arrive monday for exams and start surgeries on tuesday!

Here are a few more random stories of the last two days:

Today one of the guys working here took us to town to a "tea house". The tea house turned out to be a tea tent on the corner of a busy street. Maybe the best tea I have had. Spicy, had a good kick to it. The owner came and told us all the states he knew in the US and all the presidents he knew. A TIA moment at its finest (This Is Africa). Great place to sit and watch the city. Cows pulling carts, a man and a boy on a motorcycle carrying hands full of ginny hens? Women in their burkas. Men at prayer in a mosque. Trucks with too many people to count hanging on. Trucks loaded down and overflowing with goods. A gas station where you get gas poured into your gas tank from old glass or plastic bottles via a funnel. Sometime in the next two weeks I hope I make it back there.

After an afternoon out, it was dark as we drove back to the hospital. We were stuck behind a taxi coming up on a checkpoint. The taxi was full of women dressed in their finest. One woman was pretty glittery with all her sequins. We were stopped on the road talking about her sequins when a sheep slowly pops its head up in the back window from behind the back seat, looks around and slowly goes back down. We wondered if the people knew it was even there. It looked like a puppet. We all had a good laugh with that.

I'm trying to upload pictures on here but it's not working. Check back tomorrow and I will keep trying!

Danja

2010-07-15T05:47:00.000-07:00

I thought I would take a moment to fill you in on my life after Togo. It's only the first two weeks after Togo, but that's a start. More to come later on my life after two weeks after Togo...

My time here on the ship is starting to wrap up and I can't believe how quickly the past six months have flown by! I leave two weeks from today and I feel like there is so much I haven't done or seen but those feelings are always swept over by the memories of the things I have seen and experienced and tasted and seen and touched.

In two weeks I head to Danja, a small town in Niger. I am flying there with three other amazing nurses I have met here on the ship. We will meet up with Dr Steve, the surgeon we had here on the ship for the season of VVF. He works with The Worldwide Fistula Fund and they are building a VVF clinic in Danja. When this clinic is complete they will have a 42 bed fistula ward! That is so exciting for Niger which is one of the worlds poorest countries and has so many women suffering with fistulas. Click here to see some pictures of the site and where it will be. Here is a picture I took from The Worldwide Fistula Fund website which shows the current SIM hospital and the outline on the left is where the fistula hospital will be.

Because the clinic is not yet complete, WFF partners with SIM, another NGO, which has a leper hospital on the same grounds where the VVF clinic is being built. They give WFF use of their operating theater a few times a year for two weeks at a time so Dr Steve can bring a team in to do surgeries. I will be working with Lindsay as a ward nurse while Ginger and Alainie will be working in the operating room.

Please keep us all in your prayers during this time. Pray for safety and health for us all. For protection from dehydration and the heat and anything man might throw in our paths. Please pray for the ten women who will be having surgery. For physical and emotional healing. That we all can meet the women where they are at.

Yovo Chicken

2010-06-23T08:46:00.000-07:00

Last weekend I went back to Ghana with some friends. We went back to Wli Falls and this time climbed to the upper falls. It took about an hour and a half to get up. Scrambling up rocks and using roots to pull ourselves up. It was wonderful! A great weekend with wonderful friends.

After the waterfall we went and visited Lovelace and her family again. We decided to bring them some food so off to the market we went. It's nice to be out of the big city and in a smaller town market. People don't yell at you and you can just look around. You still get the occasional "Yovo!" but it doesn't seem to bother me as much. Fish, eggs, spices, rice, bread, fruit, roasted corn, palm oil... we were ready to surprise them with our purchases. We started down the road and came across a man selling live chickens... Yes! We walked away carrying a plump yovo chicken! There are many sad, scary looking chickens, but this was going to be a good meal, I could tell! We were all so full of excitement and laughter and we carried the yovo chicken to meet its new family.

When we arrived at their house, they were not there. Finding out from the neighbor boy that they were still at church, we waited for an hour and a half before they returned. We had been followed to their house by a small mob of children so we had plenty of kids to keep us occupied until their return.

They all pulled up in a taxi looking their finest from church, then my heart dropped. Lovelace looked lovely, but you could tell she's not doing well. She is now unable to walk because of the pains in her legs and hips. She is getting thinner as the tumors are growing. Michael, her father, has told us she is not eating much either. Esther, her mother, went and bought her a fan ice, ice cream in a sachet, and squeezed it into the corner of her mouth. She is so uncomfortable. We can offer ways to help her be more comfortable, but please pray her pain will go away.

Mighty Ships

2010-06-22T11:38:00.000-07:00

On the sail here from Tenerife to Togo we were joined on board by a video team from the discovery channel in Canada. They were filming Mercy Ships for their show Mighty Ships. Tomorrow night, June 23, you can finally watch the show! For those of my friends not from Canada I am pretty sure you can watch it online. If any of you watch it, let me know how it is! We can't watch anything online from the ship. They were everywhere here...waxing the floors and setting up the wards, screening day and eating, we had video cameras filming us. I would love to see it but I will have to wait until I get home. Check it out!

http://www.discoverychannel.ca/Showpage.aspx?sid=13057

Knitting

2010-06-14T11:16:00.000-07:00

I get asked what I do when I'm not working. Well, Tuesday evenings I go with a small group to the hospitality center to knit. The hospitality center is a place where patients go after their surgeries, if they are from far away, so they can come back to the ship daily or a few days a week for post-op appointments. It's a wonderful place for them. The wards don't have windows because they are below the water line. They get to go outside once a day to deck 7 for an hour. At the hospitality center they spend the majority of their time outside. They have room to run and play. It's a great place to go to hang out with the patients. I love going on Tuesday nights. I am never able to speak with the patients because there are very few translators there, but that's ok. Somehow you don't need verbal language to teach knitting.

Every week I think of Grandma Daphne, my grandmother who taught me how to knit. I know it would make her smile to know what I am doing with a skill she taught me. She was a wonderful knitter!

Faces of VVF

2010-06-13T12:01:00.000-07:00

Before posting pictures, I want to share a couple stories of the VVF ladies.

First, Rosali. Rosali had her surgery and although she was dry, she was retaining urine. She wasn't able to fully empty her bladder after she went pee. She was taught how to catheterize herself as she was going to have to do this at home. The longer she was on the ship though, the more she was able to empty her bladder and the day she left she didn't have to catheterize herself anymore. Rosali went home dry and healed! The day she left I went to give her a hug and to celebrate with her. She gave me a hug then grabbed my hand and rubbed it on her bottom and exploded with a huge smile and loud laugh. She had wanted me to feel how dry she was and this brought her so much joy!

Then there is Adjovi. What to say about Adjovi... She occupies a corner bed and I can't help but smile and laugh when I look at her. She has had two surgeries already in the short time she has been here and although she is finally dry, she too is retaining urine like Rosali. Please pray this changes and she will be able to empty her bladder and not have to go home with catheters. She just makes me laugh though. Whenever I look over at her bed she is always sitting up talking. Talking to who? Maybe she's praying, but this woman likes to talk. She speaks Tchicossi, a dialect from the north of Togo that only one translator on the ship speaks. When I walk past her bed or she comes over to where I am, she will talk and I will nod my head and smile. She knows I can't understand her and I'll talk to her knowing she can't understand me. I love these moments of speaking but not having a clue what the other person is saying. It happens so often here with patients, with friends from other countries, with taxi drivers or people in the market. I think Adjovi just needs someone to talk to.

Here are some pictures of the ladies. Some are from the screening day and some are from the first dress ceremony on the ship when the women are dry and get a new dress and we celebrate!

Raven

2010-06-12T15:46:00.000-07:00

My mom reads my blog to her fourth grade class and one of her students wrote this poem. I thought it was great so I wanted to share:

The Africa Mercy

Where lives are saved

Where saving the world

Is what you want

To do and making our

World the best it can

Be, To where you have

Joy to help others and

To see others as best

As can be

By Raven

Thanks Raven!

Aissa Update

2010-06-10T10:50:00.000-07:00

After I just posted about Lovelace, I was reading up on friends blogs and came across this update on Aissa. Aissa and Lovelace were on the ward at the same time. Two small girls with two very different problems. Sarah is the PA who met Aissa in Cameroon and came with her to the ship.

http://sarahmcwa.blogspot.com/2010/06/please-pray.html

Here is a picture of Aissa the day she left the ship...