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Snow capped mountain peaks poked up through the clouds as Kevin and I flew across the cascades. We were in route from Paris to Seattle, in route home. It was May 12; the day that I had dreamed about for 9 months. Was this day really happening to me?

The last three weeks had been filled with so many changes that I felt almost in recovery mode as I sat on the plush seats of the jet, using scented warm washcloth’s, and eating off my own plate. I found it hard not to stare at all the white people that surrounded me. After speaking to the stewardess on the Air France flight in French…I decided that I had not learned French I had learned African French. It was hard not to respond to their question’s that they ask in French because I understand what they are saying, but when I respond they grimace and look extremely confused. Oh well…I’ll just mark it down as another humbling experience 

Kevin and I had left Ndjamena on the evening of the 11th after returning from a 3 day trip to Zakouma National Park. We had flown up there with Wendy, Gary and their two children Kaleb and Cherice. We slept in little thatch bungalows, with hot water and flushing toilets. At night we could here the lions roaring in the distance, one night around midnight I heard noises outside our window. I got up and opened the door to find two dark forms of elephants on the lawn outside our bungalow…having a grassy midnight snack. We saw the Giraffes that I had always dreamed of seeing, many Elephants, different African deer, Warthogs, Ostrich’s, Lions, Water Buffalo, Storks, Monkeys and Baboons. Within the first couple hours of being at the park Kevin and Gary managed to get charged by a momma Lion, we’re thankful that they are still with us ;)

Leaving Béré was hard and filled with many tearful goodbyes, but I was at the point were I had to get away…I wasn’t sure how much more I could handle, especially since for the last week we had been without a doctor. Maybe it was because I could see the end in sight. Even though I was dying to get home, it was still hard to leave. Before leaving I had a party with my family. We all crowded in my empty hut, a couple evenings before I left, there I’d set up a slideshow of the year on my computer with the up-beat music that they love. Kevin had also made a treat of cherry and orange jello for them to try. They would get so excited when one of their faces would appear on the screen, laughing and pointing. Kevin and I got more laughs out of watching their faces as they tried the slippery jello that we spooned onto two big plates for them to eat. Then I handed out all the stuff from my hut and clothes for the girls.

A couple mornings later we ate our last breakfast of beullile in Africa. I hugged the girls goodbye as they left for school, they ran out the gate crying and Howaa ran behind the grass fence that surrounds the cooking area sobbing. I went back there with her and we held each other. I never thought that I would become so close to my family, and now here I am leaving a part of my heart in Africa. Dorcus did not understand what was happening as I hugged her goodbye and walked out the gate…Howaa says she will when I don’t come home. How blessed I am to be so loved by a family in Africa and in America…to be brought into their home, into their lives, to become one of them, to work, sleep, and eat along side them. It is an experience and a love that I shall never forget.

We boarded the little puddle jumper of a plane from Seattle to Spokane…I was getting giddy, unable to keep from smiling. This is it…Rachel, Mom and Dad were only 45 minutes away. The planes wheels touched Washington ground and we walked down the stairs and into the crisp 60˚air…from 115˚ it’s a big change. Once inside the airport, I ran through the gate into the arms of my family. Finally I was home! Mrs. Ekvall, Vanessa, and Kevin’s Grandpa and Grandma were also at the airport to welcome us home. Upon arriving home mom had set up a feast of Tamales, refried beans, chips, and salsa. It was beautiful…I wanted to take a picture.

Re-adjustment has not been too bad. I was slightly overwhelmed by the vast array of color’s in Target, a little nervous about driving for the first time in 9 months (especially merging on the high-way), and tried to find the matches to light our stove for cooking. I called Howaa and Pierre a couple days ago and hope to keep in contact with them.

I want to thank you all for you prayers, support, and encouraging e-mail’s/cards/packages, I can’t imagine what this year would’ve been like without knowing that you all were rooting for me. May God bless you abundantly for all that you have done.

Love and Prayers,
Liz

Sand, Urinary Stones and Babies

5-3-08

The wind whips up whirlwinds of sand that pelt your face and find you waking up in the morning covered in sand. Mmmm, gotta embrace the grit, mixed with sweat it makes for quite the natural skin exfoliate! That Friday morning found me in just that situation. It had been a windy night, the rooster crowed and I pulled my head from out of under the sheet shaking the sand from it and looked over to see Kevin still sound asleep under the eave of his hut. A few stars still twinkled in the sky, but in Africa as soon as 5:30 am hits, you have no choice but to awake with the goats and chickens or otherwise you take the risk of getting trampled. Sleeping outside on your grass mat has its positive and negative sides!

Kev and I joined Pierre, Brennon, and Washike for a beullile sharing session at breakfast. Kev's new favorite food is the beignets that Howaa makes every morning which we tear up in our beullile. She's determined to have him fattened up before he leaves!

I locked up my hut and lived my dream of walking down the sandy path to the hospital with Kev. It was the start of a beautiful day which was just about ready to get insane. You see we are once again without a doctor. The hospital administrator was gone, and the African surgeon who sometimes does surgeries here at the hospital (Dr. Ongram) was in Kelo. I had just finished doing all the dressing changes on patients, starting a urinary catheter on a lady with a vagina fistula who'd pulled her last one out during the night, and doing rounds with the head nurse Jacob, when the chaos began.

We called Samedi (the janitor turned surgeon) in for a hernia on an old Arab lady. He approached me on the floor and asked if I could assist. I told him I could, but the other nurse would be leaving at 1:00PM so I needed to be back on the floor before that. So in we went. Hans was circulating and giving IV meds, I did the spinal anesthesia, scrubbed and soon we had one patient done. With another lined up, a Dilation and Curettage (D & C), on a mother who had her baby 1 month ago and had been bleeding ever since. After doing the spinal on her, we found that her uterus was full of fluid. Samedi called an end to this D & C and said we'd have to wait for a Doctor. By this time sweat had soaked all of our scrubs. It was running from under our hats and down into our eyes and filling our mouths with its salty taste. We thought we were done, but that's when a nurse popped his head in the door and told us he thought there was a possible C-section sitting outside. A quick examination showed almost 48 hours of labor and presentation of the baby mouth first, yep she was headed into the OR. In between starting a catheter on her along with antibiotics a little boy arrived who a week ago had an operation performed on him to remove a urinary calculi (stone) and now he lay here on the stretcher pee squirting out of his incision right above his pelvis bone. I started a catheter on him. We were all out of pediatric urinary catheters so I had to use a 12fr on him. We then transferred him to a mat outside to wait until after the C-section for further evaluation.

We were running low on help, so Kev came in to take the baby. I did the 3rd spinal for the day (thanks to the teaching of Dr. Bond) and soon we had out the baby with the biggest head and lips I'd ever seen. After having his head compressed on the pelvic bone for such a long time his whole head had become edematous. I did a quick suction, Samedi cut the cord and I handed him to Kev. Shouting out instruction's for resuscitation. Kev was doing compressions with the help of Hans bagging and suctioning, but still no cry. I un-scrubbed and joined in the efforts. Soon he took a gasping breath and a faint heart rate could be heard. I began suctioning with the mouth suction piece removing a couple ml. of phlegm from his throat. After about 10 minutes we finally had a cry. I re-scrubbed and rejoined Samedi who had already sewed up the uterus. I finished by sewing up the skin and soon we had her transferred to the floor. Yes to the floor, it was 3:00 PM time for change of shift and the nurse who had been working with me had left early and left all the 1:00 PM meds un-done. Frustration central. I finally headed home with Kev at 4:00 PM and upon arrival at my courtyard collapsed on one of the mats. We lay there talking about Africa, its frustration's and its beauty and starring up at the vast clear blue sky above us.

That evening found us at the hospital house singing to bring in the Sabbath. We headed to bed at 9:00 PM laying our grass mats once again out on the sand. At 3:00 AM pounding awoke me on the locked tin door of our courtyard and to the question, "Is Liz here". It was the guard from the hospital. The nurse at the hospital wanted me to come, there was a four year old boy with urinary retention and he was at a lost of what to do. I donned by scrubs and walked down the dark path to the hospital. Half-way there I could here the scream's of the little boy. A urinary stone had made it's way all the way to the tip of his penis where it was stuck. I tired pushing it out with tweezers, and pushing it back in hoping to be able to relieve his urinary retention with a Pediatric Naso-gastric tube (the smallest size of urinary catheters left was 18fr). Nothing budged. I worked for about a half an hour with him and that's when a very large momma arrived in labor, making for two momma's in labor. I joined the night nurse in the delivery room just as baby #1 made its entrance into the world. He wasn't breathing so I began resuscitation as the other nurse changed gloves and delivered the next baby whose head was already cresting. Finally the baby I was working on let out a loud cry as baby #2 also let out a cry to let the world know she'd arrived. Two new lives squawked out their protest as we stood on the cement floor covered in fluid and blood. Now back to the little boy!

I was looking over books on anatomy in James office trying to see if the urethra narrows and if it was possible for the stone to come out, when a sleepy Kev arrived at the hospital. We agreed that if it had made it that far it had to be able to come out the rest of the way. After another ½ hour of screaming and kicking I sent the guard to get Samedi. Samedi arrived we immediately gave an IM dose of Ketamine and he began to work with the tweezers. Soon a little piece of the stone broke off allowing us to pull it out with a sigh of relief. I inserted the pediatric NG tube into his bladder and taped it to his leg since there's no balloon to blow up in the bladder.

Kev and I walked back to the hospital house it was an early 5:00 AM Sabbath morning. The sky was beginning to brighten as we fell asleep on cots at the hospital house.

Two days left of work here at Béré Adventist hospital, is it possible? Is it possible that next week I will be sitting down on a plane next to Kev, and then set foot on American soil, hug my parents, eat homemade tamales, sleep in a bed with lots of blankets, and to talk to my sister till late in the night. But as these next days go by I ask that you will remember the hospital in prayer. Satan has quite a battle-field set up here. Without a doctor and a hospital administrator he even takes more advantage of those who come here for help. Pray for wisdom; pray that we will remember to depend on Him, the great physician, and not ourselves.

Pastries and Sensory Overload

Date: 4-15-08

Today I realized for the first time to what extent I've forgotten about the civilized culture. Esther, Hans, and I are up here in Ndjamena, waiting for Kevin's plane to land. Last night we went to Anne and Richards because they are up here too and they gave us a gift to go to a pastry restaurant this morning for breakfast. The truck driver picked us up at 9:30 and we bumped along the back roads littered with trash and Arab women selling vegetables. Soon we reached the paved street. Vendor's lined the sides, little girls trying to sell you peanuts, moto's whizzing by you, open sewer, and men sticking watches and cards in front of you. All of these things now so normal to me. Then we opened the door to the pastry shop none of us were prepared for the effect it would have on us.

It was like stepping into a little America. It was clean with air-conditioning, little black tables and chair's, glass show cases with an array of pastries displayed, and more white people all in one place than I've seen combined in the last 8 months. We were seated at a table and a waiter came to take our orders. We had invited the driver Levi to come in with us. For some reason his presence was very reassuring. As the waiter brought us fresh pressed juice on a tray with straws and ice, Esther's eyes started to look on the verge of tears. Finally I understood why the African's stared at us so much. I was having a hard time not staring myself. We sat in silence overwhelmed by absolutely everything. I suppose that I've never really stopped to think about how living in a hut has changed me until I'm in a situation that brings out everything that Africa has changed. Can it really even be put into words? I haven't forgotten what it's like to live at home in the USA, in fact many a day I've daydreamed about it. But why now,when given the opportunity to experience a little bit of those dreams all we wanted to do was leave. Was it sensory overload, or was it the fact that I couldn't stop thinking about how Howaa would react in being in a place like this?

"Hallas Fame, Hallas"

Date: 4-1-08

She lay as stiff as a board, toes pointed straight, jaw locked, and stomach muscles tightened. Her eyes blinked with fear as Tetanus took over her little 4 year old body. Her Arab father lifted her from their mat outside and carried her into the pediatric ward where I could start her IV perfusion. As he picked her up not a single limb moved on her body, he could've held her only at her stomach and she would have stayed completely stiff.

Esther and I were giving round the clock medication to her because Dr. Bond didn't trust the nurses to give the correct dosages of the medication he was prescribing. Tonight was my shift on the midnight dose. I pushed the diazepam, Peni. G and gave her an IM injection. "Hallas, Fame, Hallas". I whispered in the darkness of the ward "It's finished, Fame, it's finished". Her whimpers quieted and I patted her rock hard stomach and smoothed her little Arab dress. After 5 days of treatment her feet had started to relax a little bit and this evening her mother had stuck a little pair of Arab shoes on her feet.

The next morning at 6 O'clock I arrived for the next dose but this time armed with just more than medication. Her little brother stood by her bed and a smile broke across his face as I pulled out two balloon's one for him and one for his sister. Soon shouts of gleeful laughter echoed through the ward as he chased the bouncing balloon. Fame held onto her balloon with a little fist that had finally loosened up and looked up at me with wide eyes. Would she ever be able to walk again? Would she ever live a normal life? I suppose that's why I yearn for God to come more than I ever have before.

Ketchup Craving

Tonight the Ketchup craving hit the SMs. Esther walked in and sat down next to me, looking at the little bottles of Ketchup that someone had sent Hans. "Those look so good. If I opened a can of hot dogs would you eat them with me?" I looked at her and smiled that's all she needed and she was up to find the recently sent can of Big Franks. Yes, there was rejoicing at the SM house tonight as Esther, Hans, and I sat around of bowl of ketchup and a can of Big Franks.

The funny thing is that this isn't the first time. I wonder if there is some ingredient in Ketchup that we don't get here in Africa. A month ago I came in from work and upon seeing the bottle of Ketchup sitting on the table I just knew I had to have some or else I might go crazy. I searched the house for anything I could have it with. Nothing. That's when it hit me. The chicken coup. I headed out there still in scrubs and with my stethoscope around my neck praying that an egg, just one egg would be there. Nope. Just my luck,just chicken's..and fried chicken wasn't an option. Coming back I almost gave up and then it hit me. Patties. So just for ketchup I made up a whole batch of patties. Mmmmm boy was that ketchup amazing!