Tuesday, May 31, 2011

Pictures From Chad

Pierre & Howa, my African mother and father, and little Bezo who always wants to be in all the pictures!



My Home the 1st 2 1/2 months I was here in Chad.



My Bed and Mosquito Tent in My Hut





My Laundry Drying on the Line.


Bezo & Fabian were members of my Africa family. . .


. . . as were Dorcas, Sidoni, Emma, & Bezo. Aren't they adorable!




Working "Night Guard" [The 3 p.m.-9 a.m. Night Shift]




Many big Mango Trees provide shade on the Bere Hospital grounds.




Patient's Families--and sometimes the patients--in the courtyard around the hospital. At night it can be a challenge to find the patients outside!




Here I'm holding the baby I saved from the prolapsed cord.(See "Trust Needed")

20 Hours

May 17, 12:30 pm - My phone rings. Its Danae saying there is a delivery in process. I drop everything, hastily change into scrubs and bolt for the hospital. These African women deliver quickly and I know every second counts. Breathlessly I arrive at the delivery room just to find out I have at least an hour to wait. Since I am working the night shift starting at 3 pm I figure I should take the opportunity to go back to get my things for work and eat lunch. Twenty minutes later, I’ve accomplished both and am walking back to the hospital. The delivery room is humid and the air is stagnant despite the ceiling fan. Though she has regular contractions the progress is slow. I settle in for the long haul. I'm determined not to miss this delivery. Sitting on the exam table my eyes start to lull and close. It isn't even 2 p.m. yet. I wonder how I will ever make it through the night.

As it gets closer to shift change I get nervous. What if she delivers when I am getting report? Reluctantly I leave the delivery room for report but instruct them to call me the minute something happens. Sure enough, not even halfway through report I hear my name. I dash down the hall, only to find it was a false alarm. I quickly finish report and return to find her close to delivery. She is having difficulty. The baby’s head is visible but she is worn out. We check the baby's heart rate and find it is too low. If she doesn't get this kid out it will die. I'm worried. The last kid I delivered was dead. I want so much to deliver a live baby. Finally with much encouragement the mother uses the last of her energy to deliver a healthy baby girl. My hands, guided by the experienced hands of the other nurse, bring her into the world. I cut the umbilical cord and am passed the baby. She cries lustily. I am glad!

Although I am glad to have experienced a healthy delivery, I am now faced with a big mess to clean up right at the beginning of my shift. Thankfully the other nurses stay over time to help get things back to normal and complete the paperwork. The Maternity ward has 8 beds and 9 patients on the registry. Before the night is out it will have 10. Two patients also have babies receiving treatment for infections or malaria. An IV needs to be replaced and medications haven't been started. I take a deep breath.

Surgery has 10 patients as well, but thankfully does not have complicated medications to give. One patient however is agitated. Three of his family members have to hold him in the bed to keep him from pulling out his catheter and IV. I try to ask my 2 other nurses on duty what to do, but both are too busy to give me an answer. After calling Danae, I write for Diazepam and attempt to answer all the family's questions. I am in the middle of trying to get an IV to work for 6 pm meds when 3 student nurses arrive from Moundou. Apparently they are here for a month to do a practicum. One of them, a smiley young lady, chooses to work with me. Praise God! I have help tonight! God has provided yet again! Although she doesn't feel comfortable working independent of me, it is good to have another person to talk to. I can't tell you how good it was just to have the company! God is good.

The women who delivered tells me she has a lot of blood and pain. Although i don't see any frank hemorrhaging I think her uterus isn't as hard as it should be. I call Danae who tells me to hook her up to fluids with a oxytocin drip. Later, Danae (bless her heart) comes to check on me. Thankfully the woman doesn't need oxytocin after all. Just then a woman comes in with broken water at roughly 8 months. Danae was right there to assess and proscribe a treatment plan. Since she's had 2 C-sections already it is impossible for her to deliver vaginally. I am instructed to keep her NPO and watch her for the night. One person is at the door asking me to come. Another behind them is anxious I know their family member’s IV fluid is finish. A patient without a bed is asking where to put her stuff. I try to focus on one task at a time. I feel like I'm saying "wait a little . . . wait a little please" every other sentence. I pray silently for grace and continue taking one thing at a time.

Close to 9 pm meds, thunder rolls. I smile. I thank God for sending all my patients in to me. It’s very difficult to find them scattered around the hospital grounds in the dark. When they’re outside with their families, I try unsuccessfully to call out names like Kounmendgneu Dossuoum, and spend half my time simply hunting them down. Within minutes a torrential rainstorm hits. Calmly I lean in a doorway and enjoy watching the people stream inside past me. Things don't settle down until after 9 pm meds. Finally everyone has their medications and have asked their questions. The rain has stopped and the fresh air calls me outside. The moon is full and the clouds have broken up. I visit my other nurses. They have all finished as well. We stand together laughing and talking. I am reminded how much I love them all. One of them once again talks of getting me an African husband . . . like himself. This gave the other nurses much merriment. He promised to only have one wife and to become Adventist. I assure him it is good to be Adventist, but it should be for God not for me.

Close to midnight everyone is resting. I walk out into one of the open yards of the hospital compound. I stand there watching the clouds slowly blow by the full moon. I watch until there are no clouds left. The night sounds are comforting and all is peace. I talk with God. I marvel and am astonished before Him as I think of where He has brought me. I think of the 180 hours of night shift, learning French, feeling discouraged, having malaria . . . it all passes by my mind’s eye. My thoughts go back to the day when I first watched the mission DVD about Tchad. I remember the first time I felt the conviction to become a missionary nurse. Four years later - here I am . . . my stethoscope slung around my neck . . . in Tchad Africa. How strange, and yet wonderful. I wonder about the future and where God will lead next.

The need to give midnight meds tears me away from my peaceful ponderings. It doesn't take long. I go to my favorite sleeping spot: the concrete benches in front of Urgence. Stretching out, I breath deeply and soak in the night-sky’s beauty. I drift off for an hour, then get up to check the baby IV's. A man comes into Urgence with head trauma, and another for an infected stab wound. As is my habit I get up to see if i can help. The rest of the night passes with me checking the IV's and pre-term labor woman every 1 or 2 hours. The woman complains of some contractions so I check her every 30 minutes. Soon it is nearly time for 5 a.m. meds. The sky begins to lighten and the bats begin to fly and chatter excitedly.

Morning meds and vital signs are a juggling act for me as I work with my student nurse. It takes longer than I think they should. I cut my fingers when trying to open a Penta ampule and shake my head at my clumsiness. My fatigue is getting to me. I hear them singing hymns for morning worship as I take my last vital signs. One of my maternity ladies calls me over as I pass by. Her breast is one massive abscess and the dressing is already soaked in puss. The dressing change is the job of the day shift, but it needs to be changed now. I wheel in the treatment cart and proceed to milk out the puss. The smell gets to me a few times so I turn my head away for fresh air. She is so young. It hurts her terribly. She winces and sometimes reaches up to stop my hand. I don't know how to say "I'm so sorry it hurts" in Arabic. I wish I did.

May 18 8: 30 am - I've given report for both departments. I'm more than happy to turn over the patients to the capable hands of the 4 day-shift nurses. Walking home I look at my watch. It’s been 20 hours.

Sunday, May 22, 2011

Don’t Forget to Smile

Things that bring me joy:

During our ride to church, hearing big tall Jonathan boom out from the top of the land rover "BON JOUR" in his Texas-twanged French. His attempt at singing Nangere hymns is equally entertaining. All he has down is the "dummmm" that many of the words end in. It sounds like " ahhhhhh dummm ahh ahhhh ahhhhh dummmmm". It brings spontaneous smiles to my face.

Having little, big bellied Vivian toddle over to me calling "Ro-chell, Ro-chell" in her high squeaky voice as she returns a purple bucket and water bottle I'd forgotten on the mat. She totters unsteadily as she holds them out. I thank her profusely and sweep her up into my lap. She throws back her head and gazes up at me with the biggest smile imaginable as her little hands pat my cheeks. "Do you know I love you" I say in English. She giggles. "I love you! I love you! I love you!" I say in a funny voice. She giggles each time. It sounds musical and like pure happiness. I plant a quick kiss on her forehead and she squeals with delight as she puts both hands over the spot. I clap my hands and hold them out. This is our favorite game. She claps her hands together several times and then lays them on mine. I like seeing her little hands against my big ones.

Watching the kids in my family play with their shadows, cast on the hut wall after dark by a lone flashlight. They strike heroic poses and call each time for me to see. I do my old stand-by charade of a rabbit with a dog who chases and eats the rabbit. Then I pretend my shadow dog is chasing their shadow. Emma calls for me to look at his shadow which spans the entire height of the hut. When he reaches up his hand the shadow disappears off the top of the hut into the night. "Look!" he says "I'm so big I'm touching the sky!"

The date bars Tammy Parker shares with me. So yummy! I go to get one out of the bag she gave me and just now notice it is a Village Market bag. For some inexplicable reason this gives me happiness.

When Adam, the brother of a pediatric patient, hurries up to tell me hello at the beginning of a new day of work. We do our special handshake where our fingers snap at the end. The first time we don't get a good enough snap. I back up and hold out my hand again. He smiles. We get a good loud snap this time. He's my buddy.

The time I was ask to retrieve the blood pressure cuff from another ward. When I walked through the door Salomon was waiting for me. He jumped out from around the corner. He chuckled at my jump and little scream. "Twa la" I said as I shook my finger (translates "hey you there!"). Undeterred I commenced my search for the BP cuff, but only found a pediatric one. "ohhh tro petite" I bemoaned. "oui, tro petite" he agreed, but looked far too pleased. Smiling broadly he brought the cuff out from behind his back. "Hey , how did you know!" I crowed as I grabbed it from him and ran back to maternity. He only smiled. Still can't figure out how he knew I was there for the BP cuff. I'm thankful for nursing friends and the smiles they bring.

I can't remember all the things that have given me joy here, but there are many.

Dear God, please never let me forget to smile.

Saturday, May 21, 2011

Trust Needed

Woke up with malaria this morning. Last time it was .05% (mild). This time it is .10% (moderate). Strange since I almost convinced myself it was my imagination. Thankfully I decided to get tested anyway.

Yesterday was one of those days that made me sit and think. I'll tell you about it.

It was a discouraging day at work. I was working Maternity. I'd helped mop the delivery room, sweep the whole ward, checked my charts, visited our four patients and aided in consultations. However when Danae rounded she caught a glaring nursing error I should have noticed. A post-op patient had not received any pain medication (Tylenol and Ibuprofen) since the surgery the previous day. I felt like kicking myself. There were a couple other minor things that made me feel like I didn't have both oars in the water. "What am I doing here?" I wondered. How can I try so hard and yet still miss the simplest things and make silly mistakes. Discouragement descended on me like a cloud. I began making excuses like : "If it wasn't for those illegible French orders . . ." or "If I could only understand 20 more languages maybe I'd know what was going on around here." But then I despised myself for making excuses. On the outside I maintained a cheerful, resilient exterior, but inside there was a struggle. I was tired of giving medicines, struggling with bad I.V's and not being able to communicate with my patients. All around me were good things. I learned how to greet people in 3 more languages and got some kids to smile. Every nurse I met in the halls greeted me affectionately with a hearty handshake or called out "Good work" as I hauled soapy cleaning water. Despite these good things I felt like leaving and not coming back. The hours seemed to creep and I constantly had to choose to focus on service, not self.

It was almost time to go home. I was counting the minutes. There was a dump-truck load of laundry waiting for me at home and I was anxious to get started. Just then someone mentioned the word "delivery". I dropped everything and ran. As I stuck my head in the door my fellow nurse, Juliette, told me to call Danae. I saw an umbilical cord hanging out and was instantly running toward Netteburg’s house while reaching for my phone. I got Danae on the phone and she gave instructions, saying she was on her way. Back in the delivery room I quickly checked for a fetal heart rate and got 104 bpm. We rushed her to the Block and I called Danae to let her know the baby was still alive. I began holding the head off the cord and instructing the mother not to push. No matter how much I commanded and demonstrated panting, she still bore down with each contraction. My two fingers were no match for her muscular uterus. When Danae arrived she was wheeled into OR with me in-tow. They hurriedly prepped her and covered both her and me with the sterile drape. It was strange being down there, my face next to her urine soaked skirt, my fingers the only thing between the baby and death. My fingers were hurting and I felt I wasn't able to hold the baby up enough anymore. I asked to glove my other hand and switch out. Danae said "No, you're doing fine. Sorry, but we'll be done soon." It felt like forever. My toes curled up as they tried to dig into the cement in sympathy with my burning fingers. Just when I thought I couldn't last another minute, the baby’s head was suddenly gone. Only after I felt the prolapsed cord slither past my fingers did I hesitantly take them out. There was a flurry of activity as they resuscitated the baby and sought to suction out the profuse meconium. He came around eventually. I never lose the wonder of watching babies open their eyes for the first time and look around. It was amazing to look into the face of this little one I helped save.

Right on the heels of this excitement came another emergency. A girl with what appeared to be a placental abruption was brought into the Block while Danae was still closing up the first woman. I checked the fetal heart rate and got 140. Pretty good considering all the blood she was losing. We switched out patients and began prepping the new patient for a C-section, even though she was only 7 1/2 months. It didn’t look too promising for the baby. I looked over at the girl sitting naked on the table. Silent tears streamed down her cheeks. She looked so scared. I walked over and laid a comforting hand on her arm. Sometimes Tchadians pull away from being comforted but surprisingly she took my hand. I squeezed it and began lightly rubbing her shoulders. She put her other arm around me and before I knew it she had leaned her head on my chest. I held her as the tears continued to roll. When it was time for the spinal she leaned forward, wrapped both arms around me and hid her face in my neck like a little child. My heart went out to her and I held her with the tenderness I would want if I was in her place. Before scrubbing in, Danae ask me to place the Foley. As I was cleaning the area I saw something spurting blood like a little hose. "What's that?" I ask. Danae walked up and squinted. She'd never seen anything like it. A quick search revealed the source of all that blood was not the cervix, but rather the little bleeder thing which was simply sutured. "Way to save a baby's life Heather." Danae said." You get the Nurse of the Day Award today. If you hadn't asked about that thing I would have just gone ahead with the surgery and possibly lost a healthy baby." I shrugged. It was nothing heroic. I ruefully thought how just that morning I had been feeling like a complete failure.

I was reflective as I scrubbed my clothes that night. I had gone from the depths of despair to relieved happiness in one work day. I had gone from feeling utterly useless to feeling needed. God was trying to teach me something. I was serving Him just as much when mopping the floors as I was helping save a baby's life. I am too quick to lose heart and become frustrated at my own inabilities. God knows what He is doing. I need more trust.

"If you but trust in God to guide you and put your confidence in Him
You'll find Him always there beside to give you hope and peace within"

"I am still confident of this: I will see the goodness of the Lord in the land of the living.
Wait for the Lord; Be strong and take heart and wait for the Lord.”
Psalm 27: 14

Tuesday, May 17, 2011

Expired

It's official. I've "expired." I'm "past-date" material. My expiration date has come and gone. I'm apparently like that apricot jelly forgotten in the back of the cupboard that now looks more like grape jelly.

This was news to me, beings as I don't feel like I would expect expired apricot jelly would feel. However I was informed of this regretful fact by our respected and friendly shopkeeper, Abrahim. He said it with confidence and assurance as only an expert would. This is how I found out the awful truth.

"You married?" He asked casually. He was the picture of stately repose as he reclined comfortably in his plastic chair, dressed in a handsomely embroidered robe as is commonly worn by Muslim men.

"No" I replied.

He took this news fairly calmly with a quick jerk of his head as he wisely surveyed the busy market street.

"How old are you?" He ask with distant interest, still surveying the street before him.

When I answered, the ox cart he'd been watching lost his interest. His gaze swung around so that his eyes met mine in a brief but intense moment.

"How old?" He demanded. "23?! Not married?” He paused as one does before pronouncing a devastating sentence.

"You've missed your chance. You're too old now."

Immediately I smirked at what I found to be an amusing comment. A quick look showed he did not share my feelings. Instead his face wore a grave look that said "tough luck pal, but you missed the boat."

I tried to explain how it is common in the U.S. for girls to wait until their education is finished before getting married, but he was unconvinced. He shook his head slowly from side to side.

"No, no, the Chadian way is better. I think 15 is a good age."

Now it was my turn to shake my head and sigh.

After surveying me briefly with critical eyes he revised his first sentence.
"You might still have hope if you get married right away . . . while you're still decently young."

I graciously accepted the kindness he showed me in making this concession, but explained to him that immediate marriage was impossible.

I think that’s when he decided this apricot jelly could not be salvaged, and abandoned it to the compost bin.

Sunday, May 15, 2011

I'm Not Tough

The heat is tremendous. I don't feel like moving. The sweat crinkles the page I'm writing on, glistens on my skin, and trickles into my eye. The salt burns my eyes. I need to forget about the heat and go work. It crosses my mind to complain. I need to be tough.
I'm not tough.

My hand shakes as I pick up the IV. The tiny hand seems swallowed up by mine. I grip it for dear life and squint at the faint trace of a vein. The baby whimpers and tries to pull away. I look at the IV catheter and then at the thread of a vein. It’s impossible. I don't want to miss again. I don't want to make the baby cry again. I miss again and give it over to another nurse. I should have been tough and tried again.
I'm not tough.

I somehow I think I should always work overtime, be cooking native food, be fluent in all languages and an expert at IV's. Instead, I don't want to go back to the hospital, don't feel like eating bouille again, don't particularly enjoy IV's, and just want to speak English. A missionary is supposed to be tough.
I'm not tough.
I'm weak.

To admit weakness is thought by some to be strong and admirable. But then there are weaknesses that are embarrassing. They don't boost the pride. They are the weaknesses you'd rather others not know—weaknesses that show your imperfections and fears. They are painful to admit, but they are God's workmen to make you strong in the strength of the Lord.

In the strength of the Lord I often forget about the temperature. In the strength of the Lord I hit veins, miss veins, and keep trying. In the strength of the Lord I keep going back to work every day and find blessing in service. In the strength of the Lord I actually enjoy bouille and do a little more language learning every day. It’s all in the strength of the Lord.

Without that strength I am yet another complaining, pansy volunteer who couldn't cut it. With that strength I am more than a conqueror through Christ who loves me.

A Sabbath

By 8:15 I am dressed in my new African outfit, have my hair braided, and my backpack packed. Jonathan and Fredrick pull up on a motorcycle. After brief Sabbath greetings, all three of us pile on and zip away through the village. During these Sabbath morning rides my heart is very happy. I sing as we bounce along, wave to children, and just take in the beauty of huts guarded by towering palm trees. At Bendalay* we all pile into the LandRover and head for Dobgay. Seeing a boy who has fallen from a mango tree, we stop to help. Melody and I assess him and decide it’s just a sprained or dislocated knee--nothing life threatening.

Once at Dobgay we gather under the mango tree. There are about 6 benches set up with a small, knee-high table in front that serves as a pulpit. There are songs, children stories and a sermon. Afterwards, the Bendalay missionaries and I gather for a Bible Study about prayer. We enjoy a wonderful lunch. They kindly provide me transportation back to the hospital compound, saving me a 45-minute walk.

It's been two weeks since our premier Sunshine Band and I am determined to keep it going, even though no one chooses to join me. Jaime Parker kindly loans me a guitar and I take off for the hospital. Starting in Pediatrics, I sing a lot of the same songs as last time. They smile and laugh. After "If You're Happy and You Know It," a lady asks excitedly, "What does it mean? What does it mean?" I give her the best translation I can and she smiles with satisfaction. After that I try to give a three or four word explanation in French for each song I sing. Even if they can't understand, I’m just happy to bring them some music. In each ward I always sing "God Is So Good" in English, French, and Nangere, hoping they will understand at least this one song.

I had just finished my singing rounds and was headed back to the Parker house when I noticed activity in Urgence[the ER]. Apparently there had been a car accident with 5 people injured. Olen** was already there assessing the patients. With the guitar still slung over my shoulder and still dressed in my Sabbath best, I stood back to observe. Turning to me he asked abruptly, "Want to do some suturing?" Would I!?! Always on the lookout for learning opportunities, this seemed too good to pass up. "Sure!" I answered, and headed for the Block [the surgery suite]with Olen. I laid the guitar on a hospital gurney and put on a surgical gown to protect my clothes. The patient’s shoulder was badly dislocated, his ear was almost torn off, and he had gapping wounds on his arm.

"You ready?" Olen handed me the needle driver and gestured toward the floppy ear. With a fair share of jitters, I commenced the tricky process of trying to suture in the small space behind the ear. After 4 pain-staking stitches I gratefully hand it over to Olen to finish. I restrain the now-combative patient while Olen sutures the anterior arm wound. At this point he takes a look at the posterior wound and groans. It’s messy, with missing skin, ragged edges and muscle poking out. "Is it possible to suture that?” I ask. "Oh sure," is his confident reply, but he continues to stand there looking at it and making faces.

About this time a nurse comes to tell him there is a patient with a busted eyebrow in Urgence.
"Yeah, I think I'll go take care of that . . . and Heather will suture this one."
My eye brows shot up and I managed an incredulous "Are You Serious?!" But he was already halfway out the door. He called back "You know how," a reassurance which sounded hollow to me. I starred at the gaping wound for a moment, picked up the needle driver and breathed an audible prayer.

"Dear God guide my hands."

Trying to remember all the pointers Olen had given me and the techniques I learned a year ago on an electrician-taped-lemon, I started in on the intimidating task. The wound was wide and I had to loop it three times to even make it stick. It was slow, hard, pain-staking work for my inexperienced hands. I was pouring sweat. In the end the arm was stitched and I was very, very happy.

That evening I walk home in the dark. Just as I get to my compound a kid jumps out of the foliage and gives me quite a start. Suddenly children appear from everywhere, shrieking in laughter at my fright. I smile and playfully scold them. This is the second time this has happened. I pretend my heart is beating wildly and say jokingly that next time they might scare me to death. They all crowd around to shake my hand and I wish them a good night. After giving my African mother a dramatic and laughter-filled report of my day, I retire to my mosquito tent.

Thank you, Lord, for another Sabbath.

Editor’s Notes:
*Heather is working as a nurse at Bere Adventist Hospital. Bendalay, about two miles away, is the African headquarters of Adventist Medical Aviation, directed by Gary and Wendy Roberts.
**Olen & Danae, a husband/wife doctor team, are the new co-medical directors of Bere Adventist Hospital. Olen’s specialty is ER; Danae’s specialty is OB/GYN.

Thursday, May 12, 2011

When All Alone

Another day of work is done. I fill my water bottle at the hospital spigot. Straightening up slowly, I pause to smile and lift my hands in greeting to an Arab woman watching me. With my eyes I try to communicate all my mouth cannot. She smiles broadly in return and then turns back to her close family circle lounging on a crimson carpet. I walk toward the hospital gate with the day’s activities replaying in my mind. The baby who died . . . how I'd been surprised . . . wondering what had happened . . . how it felt to care for the girl with aids . . . and those bats who peed on me in morning worship. My thoughts don't stay on the level of events, but leap into the realm of questions, wondering's and contemplation. After greeting the guard man and the half a dozen people lingering outside the gate I commence my solo walk home. People smile and greet me all along the way. Children run to their family gate to shake my hand then scamper back to their family's mat. I continue down the road. At home my family greets me happily. Longing for companionship I join them on the mat. We have simple conversation about the weather and the day’s events, then I sit back to observe their lively family activities. They tell funny stories, discuss politics and who knows what else, in Mun-dong. I can smile and observe, but not comprehend.

My thoughts are still there. They are pressing and I long to talk to someone about them. God has blessed, but my feeble French only holds a teaspoon of my ocean of thoughts. Even if I was able to make myself understood I don't think I would find comprehension in my beloved African family. I long to share experiences and process thoughts with another missionary.

My fellow missionaries all offer wonderful encouragement in the time I spend with them, but after the visit is over, they stay with their family and I go home to my hut. Everyone else has somebody with whom they work, eat, sleep or rely on for care when sick. My work, living conditions, and location all set me apart, alone. I'm the only missionary nurse, the only one in the village, the only one with a vastly different diet and way of life. All my life I have had someone I relied on for comfort, protection, hugs, or an encouraging word. This isolation is something new.

At times the simile of being thirsty in the middle of the ocean has come to mind. All day I am surrounded with people to talk with, patients to minister to and children to play with, but despite this there is loneliness. My days are chalk full of amazing experiences, spiritual lessons or beautiful sights. It is hard not to have someone to share them with. I store them up in my heart, write pages, and learn more of what it is to talk with God as a friend.

Alone-ness is not my enemy, but here it has been flames in the furnace of God for me. When all human and earthy supports are removed, I am unable to replace God. He is the only one on whom I can rely. Despite its positive spiritual lessons, this experience has given me a new prayer for every missionary in the field . . . that every worker for God has a fellow worker who can lift up their hands when they are weak.

Through prayers and messages, many of you have been my "fellow workers." You have encouraged me more than you'll ever know.

Thank you my friends.

Tuesday, May 10, 2011

Smell of Rain

A sudden gust of cool air startles me. Pausing, I tilt my head up and breath in through my nose. There it is. It’s nothing I can see, feel or hear, but it promises so much. It promises of coming things. Cooler temperatures, shade, playing in puddles . . . a bath for the earth. It's the smell of rain. Rain gets its smell from the things it touches. It is the smell of coolness, earth, vegetation and many other wondrous things of nature. The smell has been there all the time. It was just waiting for the moisture of rain to release it.

Rain has finally come to Tchad. The unbearable dryness and heat is being tempered with fairly regular storms that sweep across the savanna plains. I love seeing the clouds billow and tumble in the sky. You can see them miles away with their dark curtain of rain connecting them to earth. After the first gust of wind you often have less than a minute to run for shelter. There are seldom gentle showers, only storms. You get a few warning drops and then a big swimming pool in the sky bottoms out with a big "whoosh" of pelting rain! Many times I do not run for shelter but run out the door. To turn your face to the sky and have rivulets of rain running all over is a joy difficult to explain. The rain is my friend and the smell it sends ahead and leaves behind reminds me of my friend.

The Holy Spirit is likened to a rain shower. The Latter Rain is soon to fall. The wind is beginning to gust and I think I detect the smell of rain. Prepare to be refreshed.

"Showers of blessing
Showers of blessing we need
Mercy drops round us are falling
But for the showers we plead."

Sunday, May 8, 2011

Hearts That Stop

I had just helped hold her head down during her spinal tap and listened to her raspy lungs. She was sick, very sick. Not long after we finished rounds, a family member appears at the door and waves us in. Before I comprehend what is happening they have taken out her I.V. Her lovely face is peaceful as if in a restful sleep, cradled in her mother’s arms. The raspy breaths have stopped. Squatting down in front of her I put my stethoscope to her chest. I had to know for sure for myself. I heard a flutter and then nothing. She had just slipped away, and what was left was a beautiful shell of a little girl. I took note of her bright blue bead necklace and slightly orange tinted curly hair. She was chubby and looked healthy, but life had escaped her too soon. A terrible disease had destroyed her red blood cells, starved her body of oxygen, taxed her heart, and filled her lungs. They wrap her in a pretty African cloth and silently walk away. I stand watching them leave, at a loss for words.

The child had been struggling along all day, but now the family calls us over. He has taken a turn for the worst. No longer conscious, his head is lulled backwards as he gasps for every breath. The mother has silent tears rolling down her strong face. I can sense her fear and anticipatory grief. I know what that is like. They have given him every possible medicine and started a transfusion. They have wrapped his hot body in a wet cloth and now I fan him in hopes of providing some comfort. I pray silently for God to bring comfort and healing. There is nothing more I can do. My shift ends, and few hours later so does his life.

I see the parents carry her, swaddled in a cloth, out of the hot Pediatrics building to the shade of a nearby tree. She is yet another case of lungs filling with fluid. A few minutes later they call us over. Once again there is an eerie silence, in place of the gurgling of her struggling breaths. I place my hand on the mother’s shoulder in wordless sympathy. Reaching down I stroke child’s head and marvel at how soft it is under my hand. Gently I pull the IV from her still warm hand. I straighten up and stand starring. Realizing there is nothing more I can do I begin stepping backwards, cast one more sympathetic look to the family, and walk away. "Rochelle, come here and start this baby's IV" my fellow nurse calls. I toss the dead baby’s IV in the trash and simultaneously reach for the new one. The new baby’s struggling breaths, sound just like the little one who just died. When will this cycle end?

A mother comes to us holding a gasping baby. We drop everything and all work together until an IV is started and a bag of blood hung. We sit there and watch the baby. I watch each breath and wonder if he'll have strength for another one. It makes me feel short of breath. My shift is about to end. What more can I do? I noticed a crucifix around the mother’s neck. In broken Nangere, I attempt to explain I want to pray for her. She nods her head gratefully. I place my hand on the baby's head and pray in English, scattered with French phrases. I pray for healing, comfort and strength. I pat the mother’s arm and give her a look that hopeful translates as " I'm so sorry. I wish things were different." Afterwards I hear the baby died 4 hours later.

I wake up to hear a baby's father calling me to come. It’s 4:30 in the morning. I had admitted this baby the evening before with a Hemoglobin of 2.3. He needed a transfusion. We tried for 2 hours to get an IV in the baby. I pray the whole time pleading for God to help us. Finally we get one in his neck. I breath a sigh of relief. I take care of all the other patients, assess everyone who seems a little unstable and then lay down for a rest. Now I walk quickly to the bedside and find the baby breathing with effort. The family wants me to pull the IV. I don't want to. There is no way this baby is going to survive without the blood, but they are insistent. Frustrated, I grab gloves, bend down and begin pulling at the tape. Just as I pull it out, there is one more gurgle, then nothing. I stop breathing too. I look at the other nurse who has come to talk to the family. "Is the baby dead?" He gives a quick nod. Shocked, I glance back at the baby in front of me. No! It can't be! I grab the nurse’s stethoscope from around his neck and press it to the baby’s chest. There is a slow, dying heartbeat. I push at the baby's chest, willing it to breath. I have wild thoughts of trying resuscitation, but the other nurse just stands there. I realize there is nothing to be done. I have just watched a baby drown before my eyes . . . just like all the other ones. What more could I have done? Surely something. I should have been watching. I should have caught it earlier. God forgive me if I could have done even one more thing to save this baby.

Each time I see a heart stop, something happens to mine. Sometimes I cry, sometimes I don't. Sometimes I know I did everything I could. Sometimes I question. I don't have time to stop and process all my thoughts right then, there are other children to take care of. I press forward and keep working, but later the thoughts come. When I look at the stars at night or see a happy healthy child, I think of these hearts that stopped.

I can hardly wait for the day when death itself will die. That Day is coming soon.