Papaya

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...

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

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

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

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...

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

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!