Heart Beginning's

"My daughter, give me thine heart, and let thine eyes observe my ways." Proverbs 23:26

"The plan of beginning outside and trying to work inward has always failed and always will fail. God's plan with you is to begin at the seat of all dificulties, the heart, and then from out of the heart will issue the principleso f righteousness; the reformation will be outward as well as inward." EGW

Wednesday, January 30, 2008

Mat Time

Date: 1-28-08

Have you ever taken the time to lay down under the vast expanse of sky above you just as the sun is going down and stay there long enough to watch the stars appear as the transformation from day to night occur. I realized that I never had as I took mat time tonight. I was feeling sick to my stomach so I curled up with my hoody and watched as God scattered his gift of twinkling glitter across the sky. It made me feel so very far apart from all of you but so close to God. As a satellite streaked its way across my expanse of African sky I whispered, "Take me with you." as I imagined it circling the earth and flying across the sky that covers Mom, Dad, Kev, Rae, Kyle, and all those I love so dearly. But then I thought of the time that is only 3 1/2 months away when I will sit under an American night sky and long for the beautiful simplicity of African life. Of time to watch my families faces as the sound of popping popcorn fills our courtyard, to laugh together as Dorcus attempts to do a Nangere dance little feet pounding, and arms flapping to the beat of the scratchy radio, for the family prayer said by the light of a lantern as drums beat somewhere in the night, yes someday I will miss this mat time!

Qualified, Licensed, Degree...what's that? Know what you're doing...hmmmm maybe :)

Date: 1-26-08

After delivering two newborns last night, prescribing Quinine perfusion drips, performing a cesarean, amputating a gangrene leg, suturing a head wound...okay so maybe the cesarean, amputation, and head wound part isn't true. But you never know the day when it might become true because you don't have a choice. All the deliveries I've ever done were as the baby was falling to the ground...but last night brought a new experience....a 22 yr. old woman in labor at 2:30 AM and with her previous delivery only made possible by a symphysitomy (cutting the pelvis bone). When I first checked her I could feel the hair on his head as he started the decent into what I hoped was now a big enough space for him to get through. It was just Sonya and I there to help her through her labor...good thing she didn't know I'd only caught falling babies...never helped deliver a difficult one. She never once screamed...just held onto her legs and moaned...as a headful of hair made a difficult entrance into a lantern lit room. Blood and meconium gushed out onto the table over the baby's head and off onto the floor. his shoulder's where stuck. I grabbed the bulb syringe to try and get as much poo as possible out of his mouth before he aspirated it and told Sonya to go get James. By the time he had arrived...I'd somehow figured out the way to turn him and out he popped screaming. That made for the 2nd birth of the night...aided by a social worker and a nurse who'd only caught falling babies.

"God does not call the equipped but equips the called."

Tuesday, January 22, 2008

God, Please help it not to kill her

It was almost midnight so I headed over to give midnight meds and that's when I found her. She was 22 year's old, a mother of a 4 day old baby, and she was now struggling for her life. As I approached her bed in the corner the light from my headlamp illuminated what I'd heard when I had entered the room. She sat upright leaning forward, breathing rapidly, exhausted, and with the look of panic in her eye. I couldn't find a blood pressure on her at all and couldn't feel her pulses in her extremities. Her jugular veins were pounding at 180/min and her respiration’s were 40. The confusing part was all the edema in her feet, abdomen, and the crackles in her lungs. Why all this fluid overload and zero blood pressure? And why were her conjunctiva completely white and her hemoglobin 12.9. I didn't understand! The family crowded around the bed as I finished examining her. I grabbed her papers and headed to wake up James.

He told me to run Ringers until I could find a Blood Pressure. I went back started a new catheter on her and ran 3 flacons of Ringer in. Her struggle for life pulled at my heart, she was the same age as me! I stood by her bedside watching the Ringers and rubbing her back. Before trying for a Blood Pressure again I asked her brother if I could pray with her. He nodded in agreement. The room became quiet and I pleaded with God. I know they didn't understand exactly what I said but I hope that they felt the peace and comfort that comes when the Holy Spirit fills a room. I checked her blood pressure, nothing, and her pulse was up to 200/min. Meanwhile the concerned husband pulls me to the side and shows me their 4-day-old baby. In the light of their lantern he peered up at me, his mouth smacking away searching for milk.

"He hasn't eaten for a day, she's stopped giving milk, what do I do?"

The only thing I could think of was the Oral Re-hydration Salts we had, other nursing women here don't like to take other people babies in. We put the ORS in a little bowl with water and sucked up some with a syringe. He latched onto the syringe with force sucking and sucking, syringe after syringe full. I told him this would suffice for tonight, but tomorrow he had to find someone to nurse him.

After giving him a couple of syringe fulls I headed over to wake up James again it was 2:00 AM and I was dreading it. I walked to the gate by the light of a large half-moon praying that God would give James the wisdom to know what to do. I told him her vitals and what I had done He was quiet and then I heard him say, "Well it sounds like we've got a cardiac problem on our hands Unfortunately it's hard to know what kind without an EKG."

He'd already tried Furosemide when she came in thinking it was fluid overload and now we'd tried giving her fluids and nothing was working. No way to test Cardiac output, no way to have an EKG, and even if we could, we did not have the medication to treat whatever it might be.

"Well, looks like there's one last option that I can think of. There are 2 flacons of Beta Blockers (Propanolol) in the OR. Take my keys and go ahead and give her 1 ml. at a time slowly waiting 15 minutes in-between watching her pulse. Hopefully it'll slow her heart down enough to allow it to actually fill up and push blood out to her body."

I grimaced, if NCLEX got a hold of this I'd be fired! "What about not knowing her Blood Pressure?"

"Liz, it's the last option, it might help, it might not, but it's the last possibility that I can think of that might help her. Just push it slow!"

"I hope I don't kill her," I said, as he handed his keys over to me.

"You wouldn't be killing her, she's going to die and there's the small possibility that this might work, if not she'll just die sooner."

I closed my eyes, squeezed back the tears, took a deep breath and took the keys. As I walked back to the hospital beneath the flowering mango trees that scattered moonlight on the path, I lifted my hearts cry to God. "Please, she's my age, help it not to kill her."

Back at the hospital, I woke up Sonya and asked her if she'd come with me, I couldn't do it on my own. With medication in hand we walked toward the flickering light of the lantern at her bedside. Sonya touched her feet, found them cold, and began to rub them while I mixed and pushed her 1st dose. Within 15 minutes her pulse was at 124/min. I gave her another ml. (5mg.) and then had to leave to start on giving 5:00 AM Quinine perfusions. As light begin to push its way through the windows and illuminated the bed of a little boy with Meningitis, a family member arrived at his bedside where I was giving meds and motioned for me to come. I knew in my heart what had happened.

I arrived at her bedside. She sat leaning up against the cushion Sonya had paced behind her, head now bowed, the struggle over. I removed her IV and turned to her husband, put my hand on his shoulder and squeezed. He stood stoic, stunned by what we all knew was coming.

Sonya and I went back to the consultation room and I finally sat down. Looking out the window we saw him sitting on a brick bench under a Mango Tree head in his hands.

As I walked home I passed him holding a donkey and waiting at the crossroads for the 4 approaching women in the distance. As I passed them the moans that came from deep inside brought on the tears that had been held in al night. I turned to look back as he pointed them in the direction they had taken his wife. The sandy path blurred in front of me. I went immediately to my cot and finally fell asleep not waking up till 1:30. The sun was now high in the sky and one of the girls had placed a bowl of beuille on my mat while I was sleeping. Before eating I closed my eyes and thanked God for giving me the strength to make it through the night. I thanked Him for never leaving me. I thanked Him for the opportunity to pray with the family and laid all them in his hands.

As I ate my beuille, I was reminded of a thought from Medical Ministries that I hand underlined and had thought about during the night as I longed to be able to speak of Jesus to them.

"Living and working under the constant impression, "Lo, God is here," brings hallowed influence which the Spirit is ever impressing on heart and mind."

It's my prayer that through our touch and the presence of God she felt this. It's my prayer that someday we'll meet in heaven.

"We shall sing on that beautiful shore, the melodious song of the blest, and our Spirits shall sorrow no more not a sigh for the blessings of rest. In the sweet by and by, we shall meet on that beautiful shore. In the sweet by and by, we shall meet on that beautiful shore.

Saturday, January 19, 2008

Toilet Paper....What's That?


So it's that early morning time...I grab a peice of kleenex and head to the place I have fondly come to call "the hole". After 5 months of doing the squat it has finally become a comfortable position...unfortunately this morning found me in a quandary. One peice of kleenex just wasn't going to do the trick. So it was time to learn to do things African style. The cardboard box that someone had thoughtfully paced next to the hole...had slowly been diminishing and now it was my turn to help in the tearing down process. Let's just say...a cardboard box wipe isn't the best thing for your skin...but it works. Hopefully somebody makes it to Kelo soon!!! (They've got toilet paper there!)

Tuesday, January 15, 2008

Home is Where Your Hut Is

As the sights along the road became familiar a feeling of excitement began to fill me. I wonder if my "family" was waiting for me. The Béré sign came into view my moto driver pointed at it and I nodded. We curved to the right and took off on the sandy path that leads to the hospital. We past Sonya's courtyard - her family coming out jumping up and down, waving, and shouting. We waved back. We were coming home! We pulled up to the hospital compound, drank a couple huge glasses of water and began with our second Christmas Celebration. Yes, each of us had a huge stack of packages to open. We sat there for a couple hours savoring each package and exclaiming over each other's discoveries of what was inside them. With Christmas over it was time to head home. Each of us packed up our bags and things from our packages to give to our families. When I opened the hospital door I found the 3 youngest girls in my family all smiles. I picked us Dorcus swung her around and gave the other two hugs. They each grabbed something I was carrying and the constant chatter began as we headed home. They told me about the New Years celebration and what each of them had gotten. They told me that Berthe was going to scream when she saw me. I told them we should try and surprise them. So we took off on a path that came out at the back of our courtyard. I told them to be quiet. They started shhhhinng all the neighbor kids as we approached the courtyard wall on our tiptoes. That's when Washike, and Howaa spotted me. Lee, lee, lee and heads began to pop up over the wall. Then Berthe came flying around the corner at the end of the path running at top speed with her arms out shouting lee, lee, lee. I wanted to cry but instead ran to her shouting "Berthe." She hugged me tightly for a long time. When we entered the courtyard greetings were being shouted everywhere. Howaa came running to me and hugged me in only a way that a mom can. Yep, I was Home, home to my hut. I immediately sat down on the mat and told them about my trip as I handed out dried fruit, lotion, lip gloss, flashlights, and other things from the packages. I've never seen people get so excited over such little things. They were absolutely radiate. That night I slept so well after drinking a cup of hot milk and eating beignets. How did I ever think I would be better off at the hospital house. God knew what He was doing all along. He was giving me a home and a family who loved me.

The Sacrifice

After sitting 8 hours in Maroua waiting for a bus to arrive to take us to the Cameroon border we finally arrived at our first police check before crossing the frontier. Hans sat in the front of the taxi that we had found with the driver and us three girls in the back. Military men surrounded the car talking to Hans, checking his passport, and peering in the window at us. One approached my side of the car and started talking to me. I played the dumb, I don't speak French part. We could tell that Hans was starting to do some bargaining. Finally we pulled away. Hans turned back to talk to us with a smirk on his face. "Do you know what they wanted?" He asked. We all just raised our eyebrows. We had our ideas but weren't sure. "They wanted me to leave one of you with them, but I told them it would be too much of a sacrifice." They argued saying that didn't make sense he had three of the white women. Our driver stated that everyone wants a white woman. And Sonya commenced to say that "It's not easy being this beautiful and white." We like to think it's as Sonya stated but really the hardcore reality truth is that it's not the beauty, its not the white skin, it's the pass to America that they want!

Friday, January 11, 2008

Don't wear chap-stick on a moto ride!!!!

Date: 1-3-08

As the trees whipped by and my head wrap flapped in the wind behind me I licked my lips and got a mouth full of dirt. Ohhh, that was nice. Yep, we were on our way to Nigeria from Cameroon and I just learned a very important lesson: don't ever put on chap-stick before a moto ride especially in the dry season. It's a recipe for how to get a gritty mouth for the rest of the day. Over mounds of dirt we flew, through herds of cows, by groups of waving children, and through 3 inch deep sand causing us to almost wreck a couple times. Finally we arrived at the Nigerian border and entered the market without any problems. The market was huge, we pushed back sheets and sheets of brightly colored fabrics, stopped to admire all the brightly colored peppers, and eggplant, bought some avocadoes for guacamole, held our breath as we walked through the meat market trying to keep the flies from flying up our noses, bargained for pink, green, and purple scarves that we hoped would disguise our whiteness, and paused to smell the pink and red Arab perfumes put into old medicine bottles. Our senses were on overload as we headed back to the border, one more country in Africa down and a very long moto ride ahead of us; a very long moto ride that would leave us all with very sore backsides, and raccoon eyes from the dust and sun glasses.

Wednesday, January 9, 2008

A Nalgene Smile

Date: 12-25-08

The morning sun filtered through the crack in my tin door. I opened my eyes to my first Christmas Day away from home. I bundled up in my sweatshirt and pants and opened the door to let in the first rays of morning light. Curled up with a fleece blanket on my mat and I opened up my bible for a Christmas morning time with God. Soon I heard the familiar, "Lee, lee, lee" letting me know that breakfast was served. "Je viene" I called out, as I slipped on my Chaco's. I sat down for a meal of white rice and tomato sauce. It didn't sit quite right on my stomach so I headed back to my hut after eating a little bit. There on my mat sat the gifts for my family. Now would be a good time to give them their gifts I thought and headed outside with the pile. As soon as Pierre caught sight of the new purple Nalgene (Vanessa had sent in her package) that I was holding towards him his hands shot out to grasp it and his face lit up like a Christmas tree. "Como, como, como" he kept repeating over and over again as he turned the Nalgene over and over again in his hands. He said thank you over and over again so many times. You see beside us Americans, only one other person has a Nalgene at the hospital and he's basically American (at least wants to be). Usually they drink out of old oil cans, or medicine containers. Next I handed out scarves to all the girls who immediately put them on their heads and wore them all day very proudly!! The picture book of landscapes in America that mom found at a second-hand store kept not only the attention of my whole family but also all the neighborhood kids for quite some time! It was a great Christmas. Couldn't be better after all those SMILES!!!

Monday, January 7, 2008

Making Peanut Butter

Friday, January 4, 2008

Does it take 9 months for a white person too???

Date: 12-22-07

Friday found us heading to the market. Us being Sonya, Esther, Wendy, Cherice (1 yr. old), Caleb (2 yr. old), and myself. As soon as we stepped foot outside of the Toyota we were mobbed!!! Fifty kids surrounded us, touching Caleb, and shouting until he started to ball. We walked the 1/8th of a mile to the market barely being able to move because the kids pressed in so close, bumping us in all the places we might have money hidden. It's never been like this going to the market - what makes it so different today?? Yep, it was defiantly Wendy carrying Cherice on her front and a crying Caleb in the other hand. It's like they'd never realized that white babies exist. We surrounded Caleb and tried to keep them from touching him but somehow a hand would always manage to squeeze its way through trying to find out if the this little white moving creature was real or not. Finally we arrived at the Arab market where we get phone minutes. The Arab owner decided to take things into his own hands. He soon had out a rope swinging it widely and the group dispersed for a couple minutes and then regrouped again surrounding the shops in even larger numbers. Finally we finished with the phones and decided to take the back path to place where the lady sells tomatoes. We didn't lose any of them. As we walked back to the Toyota another man appeared with a green stick, walking in circles around us, whipping it at the kids. It kept them at about 5 feet away, creating us as the nucleus of some strange happening in the little village of Béré.

Last night Hans enlightened us as to maybe one of the reasons the white babies are such an attraction. Upon arriving at his hut one of the boys in his family asked him if it took 9 months for a white person too?? They also where amazed when Esther was able to have her surgery here. They thought white people always had to go to Europe because they were different than black people on the inside and couldn't be operated on here. And yes the reason all the babies cry when they see us is because the Arabs have spread the news for the past couple centuries that we white people (Nasarahs) like to eat little black kids. I don't ever think we will become a normal sight. Sonya and I are considering trying the Charcoal trick someday and seeing how that goes over but I'll save that for another blog!!!