Just Another Day in the Life

It started out like most Thursdays.  I knew it was going to be a little crazy – Thursdays usually are.  It is market day, after all, and that draws a crowd to the village, and subsequently, my porch.  It was hard for me to think what it would be like – the past 2 weeks had already been crazy with sick people.  I was seeing 20 – 30 patients a day – much more than normal – and turning several away each day..

Thursday is also laundry day for me – so I knew I needed to get started early.  I was up by 6 am – had my quiet time, and got the laundry ready – loads separated, washer filled, everything dragged out of the laundry room, and also got the dishes ready to be washed.  I knew that Isatu and Kanko would be there early to get started on their work.

Jim was out for a run so I had not opened the front door yet – a sign to the village that we are not yet ready to face the world.  We try to wait until Jim is back and showered before he opens the door.  It is possible that, if people knock when the door is not open, I might get a little fussy – maybe.  

 So the knock on the door that I heard that morning was not welcomed.  I went out –prepared to tell whoever was there that I do not work in the morning and to please come back in the afternoon.  It was a man who is originally from the village – but who now lives somewhere else.  He was instrumental in helping us move into GKB.   

He was here because his wife was very sick – near death – according to him.  I was skeptical – I get that story a lot – and it is usually not true.  He said that she had woken up at around 3 am and started vomiting and having diarrhea and that is had not stopped since.  He was afraid she was going to die.  Now, it is not that I am not sympathetic, but I have been “lured” to many a hut under the pretense that someone is VERY sick, only to find them sitting up drinking tea or eating rice. 

 So I was not about to fall for it again.  I said, “Fine, bring her to me and I will see if she needs to be sent to the hospital.”  A short while later, there was a motorcycle beeping obnoxiously in the front yard.  I went out to find a middle-aged woman nearly unconscious on the bench.  I would ask her a question and she could barely open her eyes.  Her blood pressure was super low.  While I usually try to avoid it, I could not see any way around giving her a liter of IV fluids.  (I avoid it for several reasons -1. I am not really supposed to be treating adults. 2. It is very time consuming and could become a full time job. 3. Typically these are people who have been told to go somewhere else for treatment but have put it off until the person is half dead – something that makes me crazy.)  Anyway, I was not sure putting her in a taxi was a good plan – I was not sure she would arrive alive at the hospital 2 hours away.  

So I started her on IV fluids and got her settled on my porch.  There was a constant flow of people coming to see her.  She threw up all over the porch twice.  What to do!

Several hours later, a woman showed up to ask if I would come look at a girl in labor.  It was her first baby and they wanted me to check her.  Fine.  I gave Jim instructions on what to do with the IV and took off with my baby delivering bag and a 2 way radio.  I went to the house and found a young girl – maybe 16 years old – crawling around on all fours – in active labor.  I checked her and felt something – I couldn’t tell if it was the head and the umbilical cord, or what.  But I knew we were a long way off from delivery yet.  I ran home and treated the 5 -6 kids who were sitting waiting for me on the porch.  Then I headed off again.

The baby had moved a little down the birth canal – when I check her this time, I was very certain it was not the head but the butt I was feeling.  Not a good sign.  By this time, the town midwife was also there, but she was lying on the bed, complaining of a head ache.  I gave her some Ibuprofen and we waited.  The time dragged by.  I called Jim and asked him to read me (over the radio) what to do with a breech baby.  He did.  

 Baby was moving down the canal – but slowly.  I convinced the midwife that the baby was breech.  She got worried (I was already at that point.)  I was praying quietly that God would intervene.  The older women started chanting and praying to “allah”.  Nothing was happening.  The girl was pushing but to no avail.  Finally the midwife looked at me and said, “Gulun-nga, you need to pray to Jesus. If you do that, He will answer and help us.”  

 My prayer went something like this –Jesus, did you hear what she said?  PLEASE help us here!  Finally, I decided to try to reach into the birth canal and see what I could grab. I was finally able to get ahold of a foot and get the first leg out.  Then I grabbed the second leg.  There were 6 women in the tiny room at this point.  It was blazing hot!  Sweat was pouring off all of us.  The girl pushed and I gently pulled on the legs and more of the baby came out.  

 Now the top part of the baby was stuck.  I reached in and pulled down first one arm, and then another.  I was thrilled with the progress we were making, until I realized that the uterus had clamped down on the head.  It was STUCK.  I was praying and begging the girl to push as I gently pulled on the baby. FINALLY, the baby was out –but NOT breathing.  I began to rub her vigorously.  I grabbed a face mask and began to give her slow breaths.  Finally, she took one breath and then another.  I kept rubbing and encouraging her and soon she was breathing on her own.  It was a total miracle.  

 We got the placenta delivered and got mom cleaned up.  I took baby outside and washed her up and dressed her.  The midwife came out and asked if I had remembered to check for the baby’s teeth.  O-kayyyyyy.  I rubbed my finger on her gums and declared that I was sure that the teeth were all there!  (I was going on faith at that point.)  We got mom and baby settled in bed and I instructed mom to start breastfeeding right away!  

 I left some Tylenol (nice, huh?) and some Gatorade for mom and asked someone to follow me home to get some antibiotics for mom. I figured that my hand had been inside her uterus enough to warrant some preventative antibiotics (guarding against a womb infection). In the heat of the whole event, I was more concerned about getting baby out alive than making sure that everything was sterile.

The whole event was insane.  In mu discussions since that day, I have come to discover that there are babies born breech here – but that they rarely survive.  God did a miracle with that baby!

Last night, I got a call (and by call I mean someone standing outside my window calling my name) at midnight to come and see another girl in labor. 

 I got dressed and headed out – a nervous feeling in the pit of my stomach. I reminded myself that most babies are born head first and without complications.  I asked the Lord for an easy one this time.  I stepped into the dark hut.  As my eyes adjusted, I saw a baby – JUST born – laying on the dirt floor on a dirty cloth.  I dried her off, suctioned her nose and mouth, and cut the cord.  We delivered the placenta, and I took baby outside to wash her up.  (I remembered to check for the teeth this time – they were all there- I think…..) I got her dressed, and settled in bed, gave mom instructions, and was back home in 45 minutes.    

There just really rarely is a dull moment around here!

Well Leave the Light on For You (if you pay for the generator fuel)

Traveling in Africa adds new meaning to the need to be prepared, flexible, and to maintain very low standards.  Being prepared is ALWAYS a necessity, as is being flexible – as things often don’t go as planned.  And even a moderate standard usually lowers with every hour that you travel.  This takes on more significance when you are searching for lodging on the road.  Take for instance our recent trip to Senegal to visit the boys at boarding school.

On our way to Dakar, we left at 5 am, traveling 13 ½ hours to reach the border of Guinea/Senegal, only to discover at 6:30pm that the border had closed at 6 pm because ??????  We had hoped to pass the border and reach a bigger town 2-3 hours into Senegal where there were decently clean motels.  What were we supposed to do?  We could not go any further on our journey and needed to find a place to sleep.  Since no one in the vehicle was voting that we sleep on the pavement like the taxis full of people who had also arrived too late to cross, we decided to look for a place to spend the night.

We had passed a “motel” a few miles back, one of the only ones we had seen since leaving Conakry over 13 hours earlier, so, by process of elimination, we decided to try it.  It was dark by this point.  Thankfully, they had rooms available – and even had AC – which would even have been better if the generator had been turned on.  They did have small, dim light bulbs that ran off of a 12 volt system, which provided a little light.  In the end, the dim light was a blessing as the condition of the rooms was not something that should be exposed at 60 watts. 

 There were 6 of us and they insisted on us renting 3 rooms as the beds only slept two.  There was lots of commotion in the shadowy courtyard and there were soldiers around making noise.  I was a little nervous about security, so we voted for Jim and Hannah to stay in one room, Arnie and Katie (another father/daughter team) to sleep in another, and Cheryl and I (both moms) to sleep in the third.  We unloaded, prayed over our vehicle with all the stuff tied on the top, and tried to get settled.  We were exhausted. 

 They had told us that the generator would come on around 9 pm and turn off at 3 am.  It was so hot – the night air was still.  We asked if we could pay for the fuel for the generator to stay on until 5 am, which was our intended departure time.  They agreed.

We took showers and got ready for bed.  The floors were covered with bugs, a great feast for the toads that were hopping around outside (and who occasionally hopped in under the door.)  Cheryl and I had a room that had obviously been quickly vacated by someone else, evidenced by the dirty towel on the bathroom door and the used birth control device floating in the toilet. 

 Soon the generator, and then the AC, kicked on and we fell into an exhausted sleep.  Cheryl and I both woke up at some point, and started to giggle about the condition of the room and the circumstance that we found ourselves in.  The generator really did stay on until 5:15am, shutting off as we got ready to drive away.

The next night, we were able to reach some mission guesthouses where we had reservations in Dakar.  What an incredible blessing to stay in a clean, safe place!

Our return trip was even more interesting.  We made it across the border in good time, but knew that we would not be able to make the next mission guesthouse in time (you have to cross on a ferry that closes at night and if we reached that too late, it would necessitate sleeping in the vehicle until it opened again).  

 We passed our “motel” from the trip up, but decided to try the next bigger town to see if there were some hidden motels there.  We had heard from missionary friends who had once been stranded there that there was somewhere to stay.  Besides, we needed to buy diesel for the cruiser and there was a station there.  

 When we arrived in town, we called our missionary friends to ask about the place they had stayed.  It turns out it is just really a house with a few rooms and no power.  We knew that with the heat, we would not be able to sleep without at least a fan.  There were two other places in town, both described as glorified brothels.  So we were forced to return to the motel we had slept in on our way to Dakar.

We arrived and greeted everyone.  We asked if there were rooms available.  The courtyard was deserted, so we were pretty sure there would be.  Yes, they said, there were rooms.  There was a small glitch, though.  We were the only guests.  This was not a problem, except that, if we wanted to have the generator on, we would need to pay for 6 rooms – otherwise they could not make a profit.   

Jim and Arnie figured the cost of fuel for the generator and knew we were being fleeced.  We were at an obvious disadvantage, and they knew it.  They really were the only choice we had.  It was either there or the car.  And if we opted for sleeping without the AC, we knew, because of the heat, that we really wouldn’t sleep.  Arnie talked and talked but the guy wouldn’t budge.  

 Sadly, we arrived much earlier in the afternoon this time so we saw the rooms in full light.  The rooms seemed less than clean – especially our bathroom, which AGAIN, had used birth control, this time stuck to the tile wall.  The curtain rod was suspended with an electrical cord, which then ran up to power the lights.  The shower was 6 inches from the toilet and just drained onto the floor.  There was, however, TP – AMAZING –and the towels seemed clean.

There was a small café there on the property and they said food was available – 2 plates of spaghetti and 4 plates of chicken.  We agreed – since we didn’t have other food available.  Not long after that, the cook began chasing a rooster around the courtyard.  About an hour later, supper was ready!

We decided to allow the two girls to sleep in their own room this time. 

 However, earlier in the evening, I had accidently locked them out of their room and the manager had to come and open it.  As I lay down to sleep at 9 pm, the thought struck me that someone else had a key to their room.  I was not sure what to do, and didn’t want to scare them, so we prayed that God would post a very large angel with a sword outside their room.  

 I opened our window so I could hear if someone went in or out.  The generator shut off at 2:30am this time.  I woke up when the AC shut off.  The stillness of the night was LOUD and as the hours ticked by, the room got hotter.  I thought I heard the girls’ door open.  I lay there for a while, hoping that I was hearing things – but I could not sleep.  As quietly as I could, I snuck out our door and listened outside theirs.  I could not see or hear anything, so again prayed for their protection and went back to bed.  FINALLY 5 am came and we packed up and left.

That next day, we were again able to make it to a mission compound, and slept in a house with bucket showers, and little power – but it felt MUCH cleaner and safer- surrounded by friends and the cool night air. 

Staying in a friend’s house on a journey is always refreshing, but here in Africa, it can mean the difference of a good night’s sleep in clean, safe housing – a blessing that is NEVER taken for granted.

Subway, McDonald's and Taco Bell are all CLOSED? I guess we are on our own for lunch. . . .

We recently traveled to the capital and I was once again faced with the decision of what to eat while on the road.  For many in the US, packing a picnic lunch is a fun experience – where they stop at a national park or picnic area, complete with benches and water fountains.  For us, packing lunch is a necessity – at least to have the basics.   

That is not because gas station snack prices are outrageous – though they are.  It is more because gas stations can be few and far between and break downs happen and food that is safe to eat can be a rare find.  Just last week, we had a team that left our house to travel to the capital.  I had offered to send lunch, but they planned on being in one of the bigger cities by lunch time so I just sent snacks.  Their car broke down an hour into the 11 hour trip– thankfully they were near a missionary friend’s house that was able to scrounge up something for them to eat.

Road trip breakfast is usually muffins of some variety and maybe apples if we have any left.  After our last trip – and because of many previous trips - I have decided to outlaw bananas in the car.  They never seem to travel well (and also I just do NOT like bananas!).  By the time we arrived in CKY this time, there was brown, sticky banana juice all over everything – a result of being accidently smashed in transit.  Jim, being the frugal person that he is and NOT wanting to waste food, was trying to eat the nasty brown little things as I was trying to pitch them out the window!

In the past, we have always packed a complete lunch – usually sandwiches – USUALLY TUNA (I get so Very tired of tuna – please don’t EVER feed it to me in the US…) and Pringles (about the only chip that is reliably not broken into bits and is usually still crisp).  I try to bake cookies or add some carefully doled out granola bars or candy that we get occasionally from the US.  

On a recent emergency trip to Conakry, I was focused on getting to the capital and very stressed about the trip, so I didn’t really plan on any food for the road.  I was traveling with Mr. Bah and felt kind of badly that he didn’t have anything to eat either.  In one town, we found “donuts” – a batter that has been deep fried in oil.  Mr. Bah went off looking for coffee – either served in a cup or put into a small plastic “to go” bag – but he couldn’t find any.   

When lunch time arrived, we stopped in a rather large town to find some food.  Mr. Bah went off looking for “sheep balls” - a meatball like food made from pounded sheep meat and peanut butter and salt and hot pepper.  I decided to pass and look for a sandwich.  I found meat kabobs in one little stand – which they put back onto the grill to warm up, day old bread at another stand (which, sadly, had ants in it, and more sadly, it was a fact that didn’t discover until the sandwich was nearly gone), and two little triangles of Laughing Cow cheese at another stand. 

 It was a fairly tasty sandwich – at least until I discovered the ants……  If I think about the meat kebobs too long, I have a hard time swallowing – because usually the little grills are set right next to the stand where they butcher the cows – complete with huge legs of meat hanging, chunks laying everywhere, lots of flies, and a herd (gaggle? flock? covey? ) of vultures.

Some people brave stopping at a roadside place to get rice and sauce (often also next to the butcher stand) – but that always makes me a little nervous; besides the fact that you cannot be sure you will be in the right place at the right time.  Little things like typhoid and amoebas have me running scared.

Water is another necessity that you must take with you.  You might not find safe drinking water on the road.  Occasionally, you can find cold pop or water at a gas station – always a treat.  As you reach the capital, they sometimes sell little bags of cold water – you just bite off the corner and drink.  (The nurse in me cringes to know how many hands have handled that bag – so I either avoid them or wash them with something.)

Last week, we returned from Dakar, where we visited the boys for about a week.  Often, on my return trips from vacation are a little iffy, since I haven’t taken the time to plan.  We pretty much scrounged the whole trip.  At the end of the first day, as we arrived at our kind of scary hotel (?) for the night, we asked if meals were served at the small café there on the property. 

 There were six of us – they said they had 4 chicken dinners and 2 spaghetti dinners.  We agreed – since we didn’t really have another option.  After a short while, as we were settling in, we heard and saw the white rooster, who had been minding his own business, being chased.  Suddenly it got quiet.  About an hour later, supper was served.  :^(

So, I confess, that when I am in America, it give me great pleasure to be able to pull into a gas station or stop at a restaurant or drive through for a meal. I enjoy NOT having to think hard about what we are going to eat or drink.  One of the small pleasures in life!