A trip to Losso (written two weeks ago)

Things I (may) have took for granted but for which now am SO thankful

Being as it’s Thanksgiving I thought I’d try to catch up with all those Facebookers who have posted one thing they are thankful for each day this month. I thought I’d add a little spin on it, writing 24 things I appreciate so much more after 8 months of living in Congo.

1. Running water-I have it here, but if the generator doesn’t work to pump the well water to my tank, I have to draw it from the cistern. And I have a garden, but to water it you have to pull water from the cistern-there is no hose, and no automatic timers. And I’m thankful the cistern is right next to my house, so I don’t have to go far for water. Some people walk at least half a mile or more with large containers for water. 
2. Electricity-this too is such a precious gift. Being a ‘rich missionary’, the house I live in has a solar panel and a battery to store the energy, and an inverter to change the DC current to AC current. So I have current pretty much all the time. The rest of the town gets 3-4 hours a day, alternating between afternoon/evening and late evening. And sometimes not at all. Many places do not have electricity. The hospital has electricity but it is tenuous. We have solar panels and generators, but there is often something going wrong with one thing or another, as well as lightening strikes taking out fuses and breakers. Without electricity, we cannot run our oxygen concentrators, surgery is more difficult (and we generally don’t like to do it without electricity), and patients care suffers. 
3. Hot water-the only way to get it here is to heat it yourself or wait till midday on a sunny day when at home-the pipes get hot and voila-hot water!
4. Refrigerator-for me, this one is a hard thing to live without. I didn’t realize how much I depended on the idea of a fridge until I was here and didn’t have one. It really changes how you think about preparing meals, and even more challenging when it’s just you eating it. You can keep left overs, you just can’t keep them cold. So making just the right amount takes some finesse. It also involves more frequent trips to the market to buy fresh produce.
5. House with brick walls, windows with screens and glass panes-keeps out the mosquitos, and many bugs, despite infestations of flying termites.
6. Bed on a frame, with mosquito net that has no holes. 
7. My bed is a water bed, so it keeps me nice and cool during hot nights. Or hot days. Sometimes I retreat there when it’s at it’s worst.
8. A bike, and the ability to ride it. I have a means of transport other than my feet.
9. More than one pair of shoes.
10. More than two or three outfits, and none of them have holes or tears.
11. Mobile phones-(when the network works)-I can reach the others here easily, I can call family back home, and I can live at the mission when I’m on call rather than living at the hospital.
12. A supportive family and friends-without them it would be so much more difficult to be here, even though I have good support here in Impfondo. 
13. I’m thankful I can afford toilet paper. Some people have to choose between soap and food. I can not only buy the soap and the food, but also the toilet paper, and buy all in bulk if I desire. 
14. Cheese. I miss it. Laughing Cow (or ‘La Vache qui Rit’) cheese is just not real cheese. And I cherish the cheese we can get in Brazzaville, though there is no cheddar.
15. ICE-you can only have this with a functioning freezer. And on a hot day, it is SO great in a drink!!!
16. I mentioned hot water, and running water, but I am also thankful for CLEAN water. 
17. Having a functioning oven (when we have gas). I can make my own bread (that has taste!) and other goodies. Makes me feel more at home with some home baked goods.
18. Internet-and at a sufficient speed to video skype with family in friends! Truly it is a different age for missionaries. I can communicate with way more than just two-way radio or letters taking months to arrive home. 
19. My computer
20. My iPhone
21. My Kindle-all these electronics are way more than almost any one has here. I have seen one or two laptops among patient caregivers here, and one iPad. But for most, the most advanced electronic they have is their cell phone-and they are not smart phones by any stretch of the imagination.
22. My education-my teachers were all there each day. Never had a day when the teachers just decided not to come, and then not come for days on end. I was taught a wealth of information, I had my own textbooks to use, and I was provided lunch during the day. I was able to finish high school without a war interrupting my education, and even continue on to higher education. 
23. Being raised in a Christian home, able to go to a Christian college, and continue to have Christian friends to encourage me and pray for me.
24. The ability to speak another language. I never thought I’d be able to speak another language fluently. While I’m not fluent, I can carry on a conversation well enough. And now I’m learning a third.
25. God’s mercy, grace, and love. Without it I am nothing. 

It's easy to take for granted the things we have every day. But most of the things we have in the US are not found in the majority of the world. Most of the world's population still draws their own water, do not have electricity, and live in mud houses.  So when your water stops running, or your electricity is cut, or your computer dies-remember you still have WAY more than most people in the world today. It's a lesson I'm still working on learning.

While I'm away, the termites play...

While I was away on vacation, there was a little invasion. Unfortunately, it was alot less pleasant than the British Invasion. Here's a glimpse of what went down. Thanks to my lovely neighbors who cleaned it up before I got back!!

They even made the map of Congo...

See?

Here they are starting to rebuild...I've used lots of duct tape to try to limit their invasions...

Les Tresses

While in Cameroon, I finally had time to sit down and get my hair braided. I arrived shortly after lunch, about 1:30 pm. After negotiating the price, I sat down to start the process. Here are a few photos from the process...

A few minutes in...maybe 20?

2.5 hours later...still have to do all of the back of my hair...

2.5 hours later...finally done!! A total of five hours...

Having all that hair also allows you to do some funky things with it. Here's one...

Then there is the process of taking them out. I started with cutting them all shorter, so I could undo the braids...

Two days and a total of about 3-4 hours of time later, they were all out...

Don't worry, all my curls are still there, though my hair may a little bit thinner now....

You go girl!

Ants in my pants, but I didn’t dance all the way to France…

While traveling in Cameroon, I discovered that like in other African countries, the idea of a rest stop and public bathrooms remains somewhat an enigma. “So where do you go to the bathroom when traveling?” I ask. “On the side of the road.” My friend Trixy tells me. Huh. Well, this is not surprising, but as we were going through a town at the time, I said, “Really? Just along side the road here, with all these people about?” She tells me yes, that’s what you do. Huh. I don’t have a problem going to the bathroom in the woods, or tall grass, or in a privy. But when you’re surrounded by people who pick you out a mile away and shout “white man, white man!”, I think squatting over the ditch in town might draw a *little* more attention than I’d like. And for all you are wondering, yes, white people are really white ALL over. 

On our way from Douala to Buea, I was blessed with being able to use a gas station restroom that was clean, had a flushing toilet, a functioning sink, toilet paper, and soap!!! It was amazing. Then a few days later we traveled to Dchang, about a 4 hour drive from Buea. Normally, I can make a 4 hour drive without needing to stop with little problem. However, today we started soon after breakfast, during which I had a cup of coffee, and a glass or two of water. Still thirsty, I continued drinking water while en route. About halfway through, I needed a place to pull over. We searched and waited for a place that 1)Trixy could pull the car all the way off the road, 2)Didn’t have a ton of people around, and 3)had tall grass to hide behind. It took a little while to meet all these requirements. Finally, we found a nice place, I relieved myself, and we continued on. The next day, on the way home, Trixy says, “if you want to stop to go to the bathroom we should start looking soon, because soon we’ll be on a bigger road where it will be more difficult to find a place.” I was a little unsure of whether I really needed to stop or not, but going on my mother’s keen advice of, “you can always at least try.” I decide that if we can find a place, then stopping would be a good idea. We search and search, and finally she finds a place. There are two children on our side of the road, but the tall grass is opposite. I pray that the children don’t follow the “white man” into the grass, and cross the road. As I part the grass (which is several feet taller than me), I notice I could go a little further, but then realize there is a pineapple plantation there, and decide it would be rude to use such field for my business. So I part the grass around me, make a nice little space, and squat down. 

(waiting)

Can’t go. 

(Waiting)

Still can’t go. Can’t relax. Notice something crawling on my foot.

Look down-

It’s ants. I think, “ok, I can handle this. If I just go then I can get out of here. I can ignore the ants.”

(Waiting)

Still can’t go. 

OUCH! What was that? 

These are biting ants!!!

I pull up my pants, and hop out of there before I get bitten where the sun doesn’t shine. Crossing the street, I stomp my feet and shake out my pant legs. I can feel them crawling on me! I stomp really hard before getting in the truck, but then as I sit down, I still feel several crawling on me. I hop back out of the truck and shake my pant legs out some more, looking under them to find the ants and exterminate them and stomping my feet. Soon, I get back into the truck and we take off.  I still found at least 3-4 more ants in my pants once in the car. They did not live long after being found. 

While it was a bit uncomfortable for me, Trixy tells me my little dances were quite amusing! Before I left to come to Africa, a friend of mine gave me a Go Girl. For those of you who don’t know what it is, it’s a little oblong silicone funnel that when placed correctly, allows a woman to pee standing up. I’ve never really had reason to use it until that fateful day in Cameroon! 

There are a few lessons I’ve learned:

1. Be careful where you squat
2. Aways bring your Go Girl! (But what will they think of a white woman standing up and peeing like a man, I wonder?)

Photo from www.go-girl.com

Take my yoke upon thee, for I am meek and humble in heart

Two weeks ago I left Congo for the first time in 6 months to go to Kenya for a retreat with Samaritan’s Purse. As some of you know, this came at an opportune time for me, as I was at a point of burnout. I was going through the motions, trying to get through each day, biding my time until I could get away, to be able to reflect, to spend time alone with God, with no distractions, to be able to hear Him. In the several days just before I left, it became harder and harder to speak french, and by the day before my departure, I could barely do it at all. Thanks be to God, I had an intern with me who speaks English, French, and Lingala, so he was of great assistance to me, especially that last day. 

         When I left, I was angry. Angry because of all the frustrations, angry because the insufficiencies of our hospital in equipment and staff to save lives,  angry at all the deaths that occur on such a regular basis. Angry. Angry. Angry. There is no better way to describe it. And yes, I was angry at God because of all this. Why does he allow it all? Why do we continually struggle just to keep power, let alone enough supplies and nursing staff to care for our patients? Why does it all have to be so frustrating? God knew how I felt, and let me be angry for a time. I didn’t want to let go of my anger. I was a bit proud, like I knew better than He what to do, and He just needed to do it. He just needed to fix the problems. He can heal the sick. He can provide us with consistent electricity. But He doesn’t always work that way, and He needed me to know and accept that.

To me, the main theme from the conference was rest. There were several sessions in which this was the theme, each using a different way of demonstrating rest. The first comes from Matthew 11:28-30

“Come to me, all you who are weary and burdened, and I will give you rest. Take my yoke on you and learn from me, because I am gentle and humble in heart, and you will find rest for your souls. For my yoke is easy to bear, and my load is not hard to carry.”

I must admit whenever I’ve thought of a yoke, I thought of it as something for just one animal, But I was reminded a yoke is often used to join two animals together to make pulling a heavy load easier on both. So when Jesus is saying to take his yoke upon us, he’s not giving us all the work-he’s sharing it with us, making our burdens lighter and easier. He can take care of all our worries, fears and frustrations. We can rest in him. If there is anything I’ve needed more at this time, it’s to rest, and most importantly, to rest in HIM. I’ve been a bit like a fussy child who knows they need a nap but resists it, even by throwing temper-tantrums. Fortunately, God does not give up on fussy children, but gently tries to calm them until they rest comfortably in His arms. And in this last two weeks, I’ve been able to quiet myself until I could rest in Him, almost feeling His arms around me, comforting me. It’s not all the time I feel that way, but it’s enough to start to bring some healing to my hurting, broken heart. 

The second was a session entitled “Even God Rested.” The speaker used several passages to show that Jesus often rested. Among these, Luke 5:15-16 sums it up best: 

“But the news about him spread even more, and large crowds were gathering together to hear him and to be healed of their illnesses. Yet Jesus himself frequently withdrew to the wilderness and prayed.”

Jesus could have taken up all his time caring for the sick and healing them, but he made a point to withdraw, to be alone before God. There was certainly no end to the number of people needing healing, be it physical or spiritual, yet he didn’t heal them all. His goal was to spread the kingdom of God, not to heal every sick person on earth. But to spread the Good News, the forgiveness of sins, sometimes this included miracles of physical healing. Sometimes it included casting out of demons. But despite these wondrous things, he still withdrew frequently to pray. He often rested in the arms of his Father. I am sure it gave him strength and guidance to continue on.

The speaker also shared three powerful truths that sum up his talk:

“The deadly scheme is this: keep them running and wear them out, that way they can never protect their hearts.”

“Peaceful and humble reliance on the Lord prepares us to minimize the frequency of stress in our lives.”

And most importantly:

“As a part of a well-balanced life of peacefulness, he slept. He left needs unmet. He took time away from busyness for reflection, solitude, and prayer.”

We will do well to follow His example!!

How am I now, one week following this conference? Better. No longer angry. Better able to accept His ways, and admit they are so much better than my ways. I am able to realize that my purpose in being here is not to be a physician, to heal every person who walks through the hospital doors, but to be a light for Christ. I cannot heal them all, nor should I kill myself trying. In fact, it is not me who heals them, I merely provide a means for them to be healed. Only God can heal. There will always be ill people waiting to be healed. I take comfort in two truths: 

1. It is ultimately not I who decides who will be healed and who will not. I can give the best care possible but God decides the outcome. 
2. I need to follow the example of Christ to frequently withdraw and pray.  I need to rest in Him.

Safu Pie

There are many types of fruit here I've never encountered before. So far, most of them are very tart. (When I eat them I make those faces like when one bites into a lemon). Some are much better with sugar, others are just still too tart for me. Right now, it's Safu season. 

Safu is a fruit that turns a purple color when ripe. You need to cook it first, as it's rather firm. Then you can eat it with salt or with sugar. I decided after the first time I tasted it, it was similar to rhubarb, and thus perhaps one could make a rhubarb pie with it. So I did. The result: Safu pie

My pie crust didn't really roll out too well, so I improvised.

The final verdict: A congolese liked and asked for the recipe. Success!

Lessons from Job

Why do the sickest patients always end up being the last to be seen in outpatient clinic? I had noticed the emaciated man earlier, waiting outside to be seen. I thought perhaps he was waiting to see our nurse who sees HIV and TB patients. But no, he was there to see me. I get the history: seven months of weight loss, night sweats, fevers. Appetite is good, he actually eats a lot of food, according to him. This belies his emaciated state-his temples are sunken in, as are his cheeks. The boney prominences of his face are clearly visible. His arms and legs are wasted, making the joints look unusually large in comparison. I can see each rib on his chest rise and fall as he breathes. If he’s truly eating well, then something is using up more calories than he can eat. There are three major things that will cause that here: HIV, TB, and cancer. Finally I moved to the abdominal exam. Rather than the concave shape I would expect to see given his malnourished state, I notice it is a bit distended. One touch of his abdomen, and I inwardly groan: his abdomen is firm, with a large mass in the middle. His ultrasound had revealed a pancreatic mass, and multiple metastatic looking lesions in the liver as well as in the abdomen. “Oh, papa,’” I think. “You’re so late in coming. Oh that I had a means of treating you, making you better.”  But I do not say this out loud.

Breaking bad news is difficult in English, in my own culture, let alone in French or Lingala, in a culture I do not fully understand. Do you tell the patient he is dying? Do you tell the family? Who is the head of the family? Are they present? Do you have to wait for them to be present to explain what is going on? Some of these are readily answered by the situation, others are less clear. I discussed it with a Congolese intern who was working with me. He recommends it best not to tell the patient at this time. I have asked for some tests, and we can wait until the results come back to discuss it further. 

He is admitted to the hospital because he is so weak. His HIV and TB test are negative. The metastases in his liver appear to be calcified, which is more consistent with a malignant (cancerous) process. He becomes weaker and weaker. Sunday the doctor on call talks with the family about taking him home to die. It’s must cheaper to transport a mostly-dead person than an already dead person, and these patients don’t have much money to begin with. There is nothing further we can do medically. The family searches for a ride, and asks the wife of one of the other physicians if they can put him in the back of the truck. She agrees.

The family gathered all their belongings, putting them on top of the cab of the truck. They placed a straw mat on the truck bed, and gently placed their loved one on it, his mother sitting at the front, so she could hold his head on her lap. He’s still alive, but barely. I can see his slow respirations through the thin jacket covering him. “Any time now,” I think. You can’t survive long breathing 4-6 times per minute. The rest of the family gathered round him-about 8 people all together-for the ride home. I’ll never forget the mother’s solemn face, the silent tears falling down her cheeks as she held her son one last time. We arrive at their home. Before taking him out of the truck, they prepare a ‘bed’ of sorts for him-a low frame with several sticks across it for support. One man takes the front door (which was not attached to the house) and places it on the sticks to provide a flat surface. He is then gently transported to this ‘bed’, no doubt his death bed, the very place he will lay while they mourn him. He’s still alive at this time, but barely. The tears fall more freely from the mothers face. Soon, no doubt, the cries and wailing will start. They will mourn him loudly, crying out in their sadness and grief.

I have heard the sound of wailing many times at the hospital. Sometimes, I wish to join in. I wish to cry out to God “Why are you letting this happen? Why are these children dying? What did they do to you? Have you no mercy?” My heart breaks for these people. Through my sadness I can see that God loves these people even more than I can ever dream. His mercy is far more than I can imagine. When my heart breaks, His breaks more. His heart breaks for the sadness of the parents as they lose their child. His heart breaks for the sin that so encompasses the people-idolatry, infidelity, stealing, lying, sorcery. Oh that they could know Him, and He would set them free! 

God, to Job:

“Would you discredit my justice? Would you condemn me to justify yourself? Do you have an arm like God’s, and can your voice thunder like his? Then adorn yourself with glory and splendor, and clothe yourself in honor and majesty. Unleash the fury of your wrath, look at every proud man and bring him low, look at every proud man and humble him, crush the wicked where they stand. Bury them all in the dust together; shroud their faces in the grave. Then I myself will admit to you that your own right hand can save you.”  

Job’s response:

“My ears had heard of you but now my eyes have seen you. Therefore I despise myself and repent in dust and ashes. “

Job 40:8-14

Job 42:5-6

nestor

three days after admission

He came in at the end of a long, hot day. Nestor sat in his mother’s lap, eyes distant, vacant. At 22 months, he should have been around 20 lbs. However, he weighed a measly 14 lbs. His mother states she weaned him from the breast at 18 months, and he refused to eat after that. He lost a significant amount of weight in that time. Now, likely after trying multiple ‘traditional’ treatments, including sorcery, she brought him to the hospital. I admitted him and started him on treatment for severe malnutrition. 

Three days later I saw him-or at least I thought I saw him. This kid looked a little different-he had fat cheeks! 

Three more days went by. I saw him on rounds. I had to double check the chart to be sure it was the same child. Avimbi! He’s grown!! Now not only did he have cheeks, but a found face, and his belly was starting to fill out. His eyes were still a little distant, but more attentive than before. 

10 days after admission

A week later he is a different child. He’s a normal child! He laughs, plays, smiles, talks, and walks. Now just catch-up growth until he can be discharged. 

2.5 weeks after admission

He’s not the only child to come in like that. We have had others, and seemingly more lately than usual. Some struggle to gain weight, others fatten up quite quickly. For me the most amazing part is when they lose that vacant stare for a healthy, attentive and curious look. It gives me hope, and I pray that once they go home, they will continue to grow happy and healthy.  

Day of discharge, 4 weeks after admission

Nestor and his mother, day of discharge.
Yes, he has an umbilical hernia.  It does not need repaired yet.

My first birthday!

That is, my first birthday in Congo. Tuesday, (July 12th, go mark your calendars) I celebrated my 31st birthday. It's not the first time I've been away from my family for my birthday, nor the farthest I've been away, but definitely the first time won't see them within a few weeks of my birthday.

My flowers-the hibiscus were
open at the time I received
them.

It started off in the morning with Sarah (a missionary who lives in the apartment adjoining mine) brought me in a card and some fresh picked flowers-some local wildflowers and some hibiscus. They were beautiful. Then I joined Anna at the market for some much needed shopping. I hadn't been to the market in several weeks, which means I was low on canned goods and fresh produce. (Fortunately sometimes the store comes to me-people come selling fruit on my doorstep.)  We also took a little detour through the fabric area...I may have bought several more pagnes (6 ft bolts of material), and a pre-made outfit for myself that I saw on the way out of the market. Anna had told a few of the shopkeepers it was my birthday, and so I received felicitations from them as we went through the market. One even gave me a pineapple as a gift!

Me, my new 'birthday suit', and cake from Claire 

Mmmm...chocolate

The afternoon kicked off with lunch with the Harvey's, and a beautifully decorated cake that Claire made for me. It was DELICIOUS! I opened a few gifts there, and showed off my cards I received from my family (they were sent with some visitors who came from the US). Then, it was off to the hospital for some planned Skype time. I spoke with my parents, sisters, and my brother's family.

Demonstrating my new Kindle from my
parents. 

A painting I received from the Harvey's

Candid photo...it's what happens when
you give your camera to someone else...

   Then I headed over to the Wegners for dinner, visiting with the Wegner family and a family of newly arrived missionaries, and more cake. It was a wonderful day I was able to spend with friends and family.

Random pictures

These are some photos I've collected over the few months I've been here. They give a bit more of an idea of what things are like here...

Cardboard and a pagne make a great sugar tong splint!

The pangolin someone brought to church (to sell).
It eats ants.

You can buy all sorts of 'Obama' paraphernalia here.
Including Barak Obama underwear for children.  

This is our own version of a 'tractor pull'. It's how we would get
the old tractor working so that we could start the generators.

I think my favorite thing about this is that it's "recyclable".
The worrisome thing is that these get put in the trash, which is burned.

Bikes of hospital workers outside the hospital. The jerry cans
are for filling up with water before they go home.

If you have to bring your child, you can put a
chair on the back for him to sit in on the way.

Not sure what I like better...the old, dirty looking commode,
or the black bag of dried fish sitting right next to it.
Lunch, anybody?

Each morning when I leave, I see something like this. The people
are waiting to fill their jerry cans with water from the tank on the left.

Another one of the market...this is the area with the produce.
Don't step in the 'mud'. 

This is Samy, a little boy who had a leg amputation due to gangrene.
He was at our hospital for a long time, and had rides on the donkey
to help with balance. This is his drawing of Donkey.

Mama Marie just before she goes home. She was badly
burned on the boat fire that happened in April. She was cooking
on a kerosene cooker, which blew up on her. She had burns on 45%
of her body. Now she has healed, and almost all her skin is now black.

We see some interesting shirts here. Most people
don't know what they say. Some are inappropriate.
This one just made me laugh.
She lost weight rapidly, but not on a diet. ;-)

The cat who lives at my house, Tuxedo.
(I do like that he has a little 'bow-tie' on his mouth)

Not all of our beds sit evenly on the floor. Patients are very
creative in adapting. This is not the only bed that wears a sandal.

"Natural candle" It's sap from a tree. It lets out litte
puffs of white smoke every now and then.

The meat market. Mostly fish, and beef, sometimes crocodile, chicken, or monkey.

Me after a full day of shopping at the market. Usually I don't buy this many groceries.

A little boy who was burned by falling in a fire
on his way to get his dressings changed. He wasn't
wearing anything besides his dressings.

Me with my "new" 1956 Schwinn Tornado, with all original parts.
Also sports a nifty saddle bag basket I purchased with it.

We get scrubs of all colors and sizes. Stephen
is sporting "baby pink", showing off his slim figure,
with a pediatric stethoscope to emphasize his petite frame.
;-)

A lizard that came into the Administration building
right before we have our weekly team meeting. He caused
alot of excitement. After running around the room while all
the women stood on chairs and took pictures, he was captured.
I think he was dinner for one of the nurses.