Iska

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

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

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

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

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

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

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

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

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

2 Samuel 24:24

A thought to leave you with…

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

Jikka Ukku

I apologize for the long delay in blogging. A lot has happened since I last posted and I honestly didn’t know exactly how to write about what was happening since there was so much uncertainty going on. Since the last update we have had to stop with surgeries all together. The decision was made to slow things down after realizing we needed more anesthesia help. For the safety of the women, the best thing to do was to pause until we found more help. Last Sunday we discharged the last woman out of the ward until we could find more anesthesia help. It was an extremely hard decision to make to close the ward for now. I haven’t slowed down though. The past week was spent training the new nurses we had recently hired and I have been busy working on writing policies and translating them into French. Google translate has been my close friend. Close when the internet is working which has not been very constant recently. A good friend from the Mercy Ship has been here for the last two weeks to help out. She came to help on the ward but since we don’t have any patients she has been busy working on the training of the nurses. It’s been great having her here for the nurses, but also to have another friend around. She brought lots of chocolate and letters from friends on the ship. It’s been a great encouragement having her here. Thanks Karin!

This Thursday we have an anesthesia provider coming for a week! I can’t wait. I’m excited to finally be nursing again and to see these new nurses in action. Most importantly though, I’m excited to finally be doing surgeries once again. Our surgical list is getting longer by the week.

Other things which have been happening… yesterday I killed two scorpions. Snakes have been a frequent topic of conversation lately. I have yet to see one which I thank God for daily. My neighbor killed one outside my place last week. A puff adder was found in another neighbors home, and the viper I blogged about in the past have been enough snake stories for me. I’m sure more are to come but I still pray I won’t see one.

I am continuing my hausa lessons. Sannu sannu. Yesterday we were learning about money. Wow. I am ok with up to about 50f but beyond that I am completely lost. I am getting better at counting numbers, but counting money is completely different. Everything is in multiples of five. For example, the number 6 is shidda. The number 30 is talatin. If you want to say something is 30f, you would say it costs dala shidda. 5 times six is 30. Ok, that is doable. Lets say something costs 3750f though. That would be jikka ukku da rabi da hamsin. Jikka ukku is 3000 since jikka means thousand and ukku is three. Da rabi means half of 1000 (500) and da hamsin means 250. So you have jikka ukku (3000) da rabi (500) da hamsin (250). So you add the 500+250 to=750. I failed pre-cal in college. After class yesterday I was thinking how Grandma Daphne would have loved this. Math is not my strong suite. 9750f is jikka goma ba hamsin. Ba means minus. Jikka goma is 10,000f-hamsin (250)=9750f. Oy. Please continue to pray for my hausa skills.

Sannu, Sannu

There are still certain words that I find funny that I have to talk about in my daily life. Today that word was viper. Snakes get talked about quite a bit but even less since most people know my fear of them, but today the word viper can not stop going around and around. There is a pretty good reason for this.

Nancy worked the night shift last night. I ran into her this morning and she told me that at about 2am she opened the door to let a woman out to use the toilet. Right outside was a snake lying across the walkway. She thought it might be dead because it wasn’t moving. She called for the guard but no one came so she got a broom. I still can’t believe she did this, but she flung it off the walkway and threw a cinderblock on it. It was alive as it started flailing around. The guard showed up and beat the life out of it. No one here likes snakes. A lot of people have been affected by them, knowing someone who has died from a bite so when a snake is found, it is quickly killed. This snake, Nancy told me, had the triangular head as vipers do. Ugh. It wasn’t just a snake. It was a viper.

On another note, I drove to a nearby village today, Madarumpha. I’m sure I butchered the spelling of that. We went in search of nurses to hire. It was a fabulous trip! I drove and it was the first time I drove off the compound. I miss driving. Basically I drove to the main road and kept going across the street. I didn’t know anything was out that direction but before I knew it I was driving through the desert. Thick sand for the whole 30 minute or so drive. It was like driving on snow. I haven’t really been anywhere besides Maradi and here so this was a good adventure. We drove through a Fulani village where I saw some storehouses I had never seen before. They looked like very large water pots, like the size of a hut which came to a narrow opening at the top. They put them up on large rocks to get them off the ground. I was told the only way in was from the top so I wonder how they get the grain out. I will have to stop sometime and see. The same village had probably ten camels just chillin’. Tied to their camel poles. Past the village was a wooded area. Massive trees! Camels just walking through, eating from the trees. I was in awe today. Eventually we came to a dry river. During rainy season there is water but it’s so dry now that this river is completely dry. It’s a pretty wide river too. Lots of reeds were put down to make the road so cars can drive across it. You can see the reed road in the picture. The most random thing though, was the bridge. There is a large steel bridge, looks like good construction too, that is the bridge to nowhere. It just stops in the middle of the river. I only got stuck in the sand once. I thought I was going to go through a big sand pile so I drove off the track made by previous cars because it looked like the ground was more solid. Nope. It wasn’t. I learned how to put the car in four wheel drive though, and get it out of four wheel drive.

The bridge to nowhere

We now have three women in the ward. We have a full surgical schedule but we are having to start slow, which is great. We are finding that even though we would love to have full days of surgery, there are so many things to figure out that we just need to take it day by day. Lately my phrase has been: sannu, sannu. Little by little.

Sannu, sannu…

Opening Ceremony

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

Morning walk to work.

The village.

Operating room.

The ward.

Last nights dance.

Life to the Full

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

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.