My Office

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

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

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

Video Night

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

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

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

Back At It

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

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

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

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

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

Hot Break

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

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

Baobab tree fruit

 Our cabin

Elephants

A man and his loom

A monkey in the zoo

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

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

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

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

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

Heat

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

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

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

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

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

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

Karin

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

http://larsonkb.blogspot.com/

Dance Party Danja

Teaching patients about taking pictures of your

feet to show where you have been.

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

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

Waiting for the dance to start.

Watering the dance floor, as you do.

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

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

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

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

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

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

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

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

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

we need to get a goat or chicken...