24 Hour Fitness

I confess, I am a fan of the TV show The Biggest Loser, of which I have watched several seasons. When you watch the show, you see constant advertisements for 24 Hour Fitness. I live in Africa, so I admit that I don’t know if that means that it is open 24 hours a day... that is my assumption.

For those of you who know me, most know that I have been on a weight loss journey of my own. In the past 2 years, I have lost about 70 lbs. It has taken a lot of hard work and diligence – especially in a country where I can get few vegetables on a regular basis, and I can rarely count calories, since I make a lot of casseroles, and a lot of my ingredients are written in some language that I cannot read. . . .

As I fight to keep the weight off, and lose a little more, I have to be very consistent in my exercise. I need to exercise at least 5 days a week. Our closer friends in the village know that I exercise, because if they come in the morning, I often can’t answer the door because I am in the middle of it or, in an emergency, I answer the door all sweaty. I have seen a look of consternation on their faces – trying to figure out why I take the time to do that. It seems absurd to them.

The longer I live here, the more I understand their confusion. No one here in the village has to work to lose weight No one seems to have even a pound of fat on them. For the majority of them, their arms are toned, their stomachs are flat, and their muscles are well- defined. And it is easy to see why. Nearly everything they do requires physical labor. They wash their clothes by hand, pound their rice by hand, cut their rice by hand, plant their crops by hand – see a pattern…. Everything is done by hand. Most places they go are on foot or by bicycle.

My friend Isatu is on a quest to teach me how to be a Yalunka woman.

On my resume so far….

1. Removing beans from the pods by pounding and then fanning away the chaff.

2. Slicing okra to dry in the sun

3. Pounding rice

4. Twisting dead fish into circles…. Recently I learned this valuable skill that I am sure many people DON’T have. There is a certain kind of fish here – most of which are 5 – 9 inches long. Many people here smoke them over a fire and put them in their sauce for their rice. For reasons that no one can explain, when they dry them, they fold the whole, gutted bodies nearly in half, and then jam a side head fin bone thing (probably not the scientific name) into the tail, holding it in place in a semi circle, and then lay them on the grate to smoke. (Let me know if you want me to come to the US and do a seminar for you.)

5. Pounding whole fish into fish balls.

And last week, I went to the farm to learn how to dig up sweet potatoes. By sweet potatoes, I don’t mean the nice, deep yellow ones in the US. I mean the very white and very starchy ones here – of which I am not a big fan. But in the interest of learning something new, I went. The day was hot as the sun was beating down. I met Isatu at the farm where she was working with her 3 little kids. There were long heaps of very dry and very hard ground.

The lesson began.

You take your hoe and you start digging – looking for cracks in the ground to signify that there MIGHT be potatoes there. You might dig a 2 foot by 2 foot area and find nothing. Or you might hit the jackpot (is that possible with sweet potatoes?) and find many. Of course, many times, you end up chopping the potato right in half (at least I did). Isatu was so pleased with my progress that she said I could keep all the ones I dug up. That wasn’t exactly motivational, but I couldn’t stop when I saw how happy she was.

I kept digging and digging. Sweat was pouring off me. I realized again how VERY spoiled most of the world is in regard to food. We don’t give it a second thought and we certainly don’t have to work physically hard for it. My hands were getting sore and I could feel a blister starting to form. She asked how I was doing and was I tired. No – I hedged. I am fine. (Not technically a lie because I was still upright and my hands weren’t bleeding or anything).

At the end of our time, we needed to walk home – a short walk, compared to many who walk several miles home, lugging their goods with them. She gave some stuff to her kids, handed me a small, light plastic pan, and hefted a massive, heavy pan FILLED with sweet potatoes onto her head –at least I helped with that part. Of course, she was able to carry her load with no problem –balancing it perfectly as she walked down the uneven gravel road.

I also (sort of) balanced my pan, though, about every 3 steps, I had to stop and readjust. Not my fault, you see, since apparently my hair is SLIMY – at least that is the word they use for it. (I share that in case you were worried that I might be getting a big head here about my appearance.)

She didn’t have an extra cloth that they twist into a donut to help balance the pans – so it REALLY wasn’t my fault. We marched through town like that. I felt like a toddler – people were clapping and cheering. When I passed Kanko’s hut (my friend who does my dishes), she was very pleased. I told her that the next day, I was going to try and balance a Big, metal open pan of red oil (like liquid gold around here) on my head and walk around. She didn’t seem to feel that was a good next step - not sure why!

It is my short forays into my friend's world that make me incredibly grateful for the relative ease of my life – even in a little village in Africa. It also makes me even more grateful when they share with me – as I realize the time and work that went into growing or making anything. And I am not yet ready to start my own farm. I guess I will have to stick with exercise DVDs at my house – no matter how strange that seems to people.

The Truth, the Whole Truth, and Nothing But the Truth

Recently I had an interesting experience where I had to balance telling the whole truth with being culturally sensitive.

It all started one evening……

Last Sunday Jim and I went to town like we normally do. When we got Isatu’s house, she was excited to see me. She was just getting ready to make fish balls, something she had been desperately wanting to teach me. So we got started.

She had already gutted the fish, which were all around 6 – 8 inches long, and had them piled deep in a wooden mortar. She handed me the long wood pestle and I started to pound. The fish made a kind of sloshing sound as the wood pounded into them – smashing apart their bodies. Over and over I slammed down the wood, smashing bones and heads and fins. Isatu surveyed my work. She had me stop and she added corn powder, bullion, onions, pepper, salt, and peanut butter. Then I pounded again.

The mixture began to get heavy and thick. It stuck to the pestle. It was a bit like trying to pull your tennis- shoed foot out of a deep mud bog. The longer I kept at it, more and more of the fish meshed into a think, brown paste. There were, however, heads and tail fins that kept surfacing. I asked about them. I understood her to say that they would be discarded. I was relieved.

Finally, Isatu looked at the goop and declared it done. Okaaaaay………. We sat down on stools and began to form the paste into balls. When I got to a big piece of head or tail fin, I set it aside. Soon, I discovered that Isatu was picking them up and working them into balls. Several thoughts were running through my head:

1. I am glad to don’t have to eat these.

2. I can’t imagine being hungry enough to eat them.

3. How am I going to get the smell of fish off my hands?

Meanwhile, Isatu started water mixed with peanut butter boiling over the fire – settling the pot on three stones over the wood. When it was hot enough, I plopped the balls in the water. She assured me that the bones would soften as they cooked.

When the fish balls were done cooking, she would remove them, finish the sauce with tomato paste and then put the balls back in. She would then serve it over rice. I was feeling rather relieved that we needed to head home and was also feeling thankful that I had leftover pizza in the fridge.

We went home and ate supper. Jim, Hannah and I were laying on the bed, playing cribbage, when I heard a voice calling out my name in the darkness. It was Isatu, who had come to the house, with a small pan of rice and fish balls and sauce. OH BOY! I thanked her profusely and said good night. When I returned to the game, I had a small bowl of rice, sauce. . . and one fish ball.

Hannah barely touched the rice and declared it too spicy. I gave Jim a small bite. I could see the bones in it as I cut into the ball apart. He bravely chewed it up. Then it was my turn. I tried, I really did. I took a small bite. . . and nearly threw up. The small bones were hitting my tongue, but more than that, I could still see and hear the fish bodies as I smashed them together. I am not a big fan of fish under the best of circumstances, which this was NOT. I couldn’t eat any more. That was enough for one night. I put it in the fridge.

I was dreading what came next. I had been incredibly touched that she was willing to share with me. There are a lot of kids in their family and I felt guilty that she shared so generously when I didn’t even want the gift. And I KNEW she was coming the next morning and would want to know what I thought. What could I say? The rice was good but the fish balls were disgusting. They made me gag. Somehow that answer seemed wrong. I did not, however, want to lie to her for several reasons.

1. I prefer to tell the truth.

2. I didn’t want her to think I liked them and then bring me MORE.

Answers rolled over and over I my head. By the next morning, I was ready. She showed up, right on time. She praised my work the day before, saying that they had company that night and the people were very impressed when they heard that I had made the fish balls. I decided to take the offensive.

Isatu, Those fish balls have SOOOOO many vitamins in them. People who eat them will not soon be hungry! She was so happy. I did tell her that Hannah didn’t like the pepper and we left it at that.

I am still struggling with whether or not I should say more. If it comes up again, I think I will tell her that the bones were hard for me to eat because I am not used to them. It is an often encountered issue here – trying to be sensitive, and also to tell the truth. Step by step, I guess. . . .

Sure she can cure seizures, but can she cook?

Today, I again ran into a total dichotomy that I have noticed before in the village. Frankly, it astounds me. It all started like a normal day……

I don’t treat patients on Wednesdays. Never the less, I spent a great deal of time on the porch today, explaining that to people. These are not people from town – we are talking people from hours away. One man came from nearly 20 HOURS away – solely to be treated here. I was amazed. I kept saying, but did you come to greet your family or do SOMETHING else???? The answer was no – he had heard from a friend in Conakry (whom I had treated for the same illness he had) that I was here and could help. I spoke to someone else from another far away town – here with a kid who is having seizures. People who suffer from seizures are coming out of the woodwork, so to speak. I saw a girl from Conakry this week who suffers from them. Word is spreading like wildfire that I can help people who suffer from seizures – and they are coming on a weekly basis.

At first, I was reluctant to treat them. I am not a doctor, after all, and, though people here do not believe it, there are MANY things that I am not qualified to treat. (I do say that I can cure seizures tongue-in-cheek because I always give the big, long speech about how some illnesses can be cured (malaria) and some can just be controlled (diabetes, seizures) –they always say, Oh, I see. Well, I will bring this patient until they are ALL BETTER. And I say, Um, OK….) People have an amazing amount of trust in me – it is a little scary sometimes. I do a lot of praying and a lot of researching. And the Lord is blessing.

On the other hand, later today, I went to visit Isatu, who usually comes to learn about the Jesus road at my house on Wednesday afternoons – but who got caught at the farm today. She felt badly that she was late, and I said, no problem. Let’s just go and visit at your house. So we went and she brought out a bucket full of okra that she had picked and that needed to be sliced to be set it the sun to dry.

I offered to help, so she gave me a knife and we worked and chatted. Their backyard is a main path in the village and many people passed us, stopping in amazement as they watched me working. What is she doing? they wondered. Does she know what she is doing? Isatu said, She is learning how to cut okra. I am teaching her. People kept saying – Look at the work Gulun-nga (me) is doing. Others picked up the slices to inspect my work. Some have never seen me do that kind of work before today.

I loved the time I spent in town today. I love to prove that I am capable of manual labor and I love hanging out with women as they do the daily chores of life. When I got home, I was sharing what happened with Jim. I told him – you know, it amazes me that people have this incredible trust in my ability to treat sick people – undoubtedly much more than I deserve. It is humbling and scary. On the other hand, they have absolutely NO confidence in my ability to cook a meal or do other menial tasks – undoubtedly much LESS than I observe. That is also humbling.

Oh well, I guess I just need to keep proving myself. Tomorrow I get to learn how to cut sweet potato leaf to make sauce for my husband……….

Special Delivery

Caution: this may be a little graphic for some people – read at your own risk.


Recently, I have been contemplating childbirth. Not that I am wanting more children, mind you. N bata wasa – translation, I am satisfied – what I tell the villagers when they beg me to have more kids…. :^)

I think all of the contemplating came from a few sources – my sister-in-law was pregnant when we left the US, and also, right before I left the US, I got to spend the morning with a great OB-GYN who taught me how to use a Doppler to detect fetal heartbeats. I spent the morning in a beautiful office, with sinks and soap in every room, and access to lab work and ultrasound machines. It reminded me how very blessed we are in the US.

Last Saturday, October 1st, my sister-in-law was in labor and gave birth to a beautiful little girl named Maren. She was about a month early and spent some time in the NICU. I can imagine the scene from when I had my kids at the hospital – squeaky clean floors, lots of medical personnel, all kinds of equipment and excitement. Thankfully, we hear she is doing well. I am so thankful for medical technology and for the wisdom that God has given to doctors.

About 6 hours later, I also had an experience with a birth – but it was slightly different. You see, I have a friend, the daughter of one of our believers here in town. Her name is Gnouma. She had a little boy- about 3 years old – and showed up on my doorstep when we returned from the US – looking very pregnant.

She visited me several times over the past few weeks and I began to tease her that I thought there might be 2 or 3 babies in there. She was never overly amused and said that if she had more than one, she was giving one to me. As her due date grew closer, my thoughts turned to her throughout the day and I spent most nights expecting to be called out to her hut for a delivery. I asked her dad about her often.

Finally on Saturday, I told her dad to have her come that evening and let me check her out. She showed up an hour later, complaining that she had been having contractions and back pain and pressure. I offered to check her then for the placement of the baby, or to meet her at her house. She opted for my front porch, and the next thing I knew, she whipped off her skirt and lay down behind a short wall.

Okay then. I got my gloves on and checked her – and could feel the baby’s head. I told her to walk back to her house and that I would meet her there. A few minutes later, someone called me from the front porch as I was bustling about, grabbing my bag and letting my family know what was going on. It was the girl’s aunt –who had met her walking on the road and told her to come to her hut to deliver the baby, since most of the village had gone to the farm. No problem, I said. I am on my way.

I grabbed some leftovers for a quick lunch and headed out the door. The hut was just a short walk from my house. I had on some cotton Capri’s and a comfortable shirt, but was wrapped up with a cloth as a skirt so I would not be indecent in the village. We got her settled and I checked her again. Baby was definitely coming but I had no idea how long it would take. Gnouma was exhausted, having been up much of the night with contractions. She lay on the floor, on top of a plastic covering and I sat on the wooden bed. It was dark in the hut, but fairly cool, considering that is was blazing hot outside.

As she rested, I looked down at my bare feet on the cow dung floor and contemplated what my new OB-GYN friend did during her deliveries at the hospital. I watched chickens and a cat and some goats wander by outside – stopping to peer in the open door, intrigued, no doubt, to find a white woman there. After she rested for a while, I asked Gnouma to get up and walk – hoping to stimulate the contractions again. She was amazing- did everything I told her to without complaint.

After a while, I checked her again and her bag of water broke. I could see the baby’s hair. She pushed and I encouraged and out came the baby’s head. I suctioned its nose and mouth and she pushed again – out came baby. A beautiful little girl. I was pumped since she already had a boy. I got her dried off and the cord clamped and cut and wrapped her up.

Now it was time for the placenta to come – the baby’s friend, as they call it here. She pushed and pushed – we tried everything. No luck. She tried jamming a stick down her throat – a common practice here in the village, I have come to discover – one which I am anxious to put a stop to. No luck. I was starting to get a little concerned. Only one time in my village nursing career have I had to manually remove a placenta –it scared me to death, and I did not want to repeat that.

I told her to lie down and try to push once more. She did, and what I felt was not a placenta, it was another head. It’s another baby, I said loudly. Sure enough, one big push and out popped a little boy. I suctioned him out and dried him off and cut the cord. I couldn’t stop smiling. This time, the placenta was easy to deliver. I was still smiling. Gnouma looked at me – why are you laughing? she asked. You called these twins – this is your fault. I just smiled.

We went out front and washed up the babies – scrubbing their heads and faces and bodies with a rough plastic scrubber. I stopped short of suspending them from each limb and giving them a good shake like my African midwives do. We dressed them in donated shirts and hats and wrapping them in little blankets. I helped Gnouma wash up and get settled on the bed. I put ointment in their eyes and tucked them in beside mom, telling her to rest a little and then try to nurse them. I needed to run home, I said, but I would be right back. The whole time I was saying, I can’t believe she had twins.

I updated Jim and Hannah, grabbed a few supplies –including Gatorade – and headed back. I was still smiling. I gave her some Tylenol, started her on vitamins, and encouraged her to nurse the babies. When I went back a few hours later, I saw those two little ones again and marveled at the miracle of birth. Here I was, in a small crowded grass roofed African hut, listening to lots of women chatting and admiring the babies. Little kids with snotty noses ran around, chickens clucked outside, several of us were piled on the bed beside Gnouma and the babies – including a dozing 6 month old.

I couldn’t help thinking of the differences between the medical care in the first world and what we deal with in the third world. I am thankful for every opportunity I have to teach hygiene and good after care instructions. Some days I feel like I am making progress.

And then we have days like yesterday. Jim is gone and I had gone into the village to say hi to people. I was sitting outside the hut of my friend Kanko when the village midwife happened to wander by and mentioned that she had someone I might want to see – if I had time. She had delivered a baby the night before but they were never able to deliver the placenta. What do you mean? I asked. Well, the mom had delivered the baby at midnight, and here is was after 6 pm the next day. Where is the mom? I asked. In her hut, was the answer.

I got scared, and then I got mad.

SERIOUSLY – this woman had been lying in her hut for 18 hours without delivering the placenta and NO ONE came to get me. Well, it is Sunday and you don’t work on Sundays – was the reply. I guess MAYBE the plan was to come on Monday to have me check her. I was so frustrated that I could barely speak. They took me to her hut. As I ducked in under the grass, a terrible smell hit me – the smell of rotting flesh – never a good sign.

Sure enough, there she was, with the umbilical cord tied neatly with cloth in two places to the inside of her leg. I ran back to my house to get my supplies, and to call my teammate to talk through my options. I could manually remove the placenta with my hand – but was very afraid to do that after 18 hours. The only other option, though, was to put her on the back of a motorcycle and bounce her down the road for 3 hours in the dark to the hospital. That didn’t seem like a great option either.

I grabbed my bag and some antibiotics and my trusty Gatorade (good for rehydrating even the nearly dead!). The midwife met me on the road. I tried to keep my voice calm…. I started in with the thoughts swirling through my head -You realized that she can die from this, right. And if she doesn’t die, she might not be able to have more kids. Her child-lying –down place might be permanently ruined. Of course, she said, as if it was completely obvious. I decided it was best no to say anything else, going with the "if you can’t say anything nice" principle.

We got back to the hut and I had mom start drinking the Gatorade and started her on 2 different antibiotics. I was so afraid – what if the placenta falls apart in my hand? What if the mom goes into shock? What if she starts to hemorrhage? I am 3 hours from a hospital and Jim was gone so I had no vehicle. There are also no vehicles anywhere in town. I got her prepped, knelt down beside her, put my hands on her, and started to pray.

I prayed that Jesus, who is stronger than anything and who had created this woman, would help us to get the placenta out. I prayed that He would protect her and her baby. I prayed that, through this event, that the whole village, and this girl in particular, would know that Jesus was powerful and that His was the only road that led to heaven.

Then I started. I reached in with my triple gloved hands and began to peel the placenta away from the uterus. I didn’t have to do much. I could feel it loosening. I could see it. I told her to push. The midwife told her to push. And out it came – intact, as far as I could tell. I praised the Lord. It was amazing. We got baby nursing –which had not been done yet in the 18 hours since his birth. He is beautiful and was very hungry. I told them what warning signs to watch for in case of infection and went home hugely relieved. Today, several times, I have talked with people about it – using it as an opportunity to tell how great God is and to teach about the dangers of what could have happened.


All in all, given my choices, between shiny floors and cow dung floors, between comfortable hospital beds and mud huts, between lots of medical personnel and just one person trying to make a difference, I wouldn’t trade this life for anything. It feels great to know that you are making a difference – no matter how small. Even on those – 2 steps forward, 3 steps back kind of days…..