Wednesday, November 21, 2012

Giving thanks

This thanksgiving I thought I’d write about how I’m thankful for the way in which God has orchestrated my life to prepare me for the mission field. I’ll try to put them in chronological order, but some are rather nebulous in time.

Second-born child, but first-born daughter-This took some of the pressures off being the oldest, but as the oldest daughter, I was often given responsibilities my sisters did not have until I left for college-much later than I started. This allowed me to develop some leadership skills (sitting on your sister when she doesn’t do her chores is appropriate leadership, right?). 
He put it in my heart from an early age. When I was little, adults used to ask what I wanted to do when I grew up. I often answered I wanted to be a doctor or a missionary. I don’t know exactly where this response came from, but it’s what I would say. 

Since my mom worked second shift, and my dad worked late in the winter months (tax season), I often had to make the meals for the family. It first started as ‘heat up the leftovers in the fridge’, and gradually developed to ‘make spaghetti and sauce’, etc. We often also baked together, especially around the holidays. This cooking knowledge has been helpful since most things I eat are made from scratch. Had I not learned to cook, I would struggle more.
We often traveled during the summers. I can remember camping, peeing in the woods, using pit-toilets (and that was at the rest area!), and other interesting places to relieve ourselves. Since most places I’ve visited in Africa have pit toilets, it wasn’t a big deal to me to use them, nor the ‘squatty potty’ so very common there. It may seem an odd thing to be thankful for, but I’ve seen some missionaries who had a hard time with this. For them, I’d suggest to invest in a ‘Go Girl’. Mom also taught me an important lesson when it comes to bathroom breaks: You can always at least try. You never know when your next chance is going to be, or if it will be among biting ants (been there, done that.)

Growing up, I enjoyed reading books based in the 18th and 19th centuries, pioneering, traveling and working in the old west. It may seem odd, but this has actually helped me, as living in Impfondo is like a strange mix of 19th and 21st century mixed together. Women still go to get water, most often from a pump well. Most things are made by hand, and from scratch-no Lean Cuisine dinners there. I had read about killing and plucking chickens, killing goats, farming (with a hoe, not a tractor), and many other things that have helped me be more aware of how things are done, and not be too surprised. There are sometimes certain words, or items that I know, only because I read those books. 
He also placed people in my life to influence my desires to be a missionary. My own family doctor used to take missions trips to haiti each year. In college I met other missions minded people, which expanded my horizons of possibilities in the mission field. College afforded me my first trip to Africa, where I fell in love with the continent. Medical school allowed me to return, and spend two months there. In residency I was able to make several short term trips to Kenya, Uganda, and Ecuador. Each of these gave me insights into different ways of doing missionary medicine, in different settings. 
The process which brought me to be a post-residency fellow with Samaritan’s Purse is quite a long and strange route. I met some people while on my medical school rotation in Kenya. A year after I returned, the wife of the couple died suddenly. I went to the funeral. At the meal afterwards, I met a resident at IU who did an internship at Kijabe Hospital in Kenya. He stated that there was a need for doctors, especially surgeons, at that hospital. Just a month or two prior, my attending for my surgery rotation mentioned he’d like to take a trip to Africa with his daughter in the summer of 2008. We had discussed combining forces to work in a hospital in Kenya. I contacted Kijabe hospital, who stated they could use both of us, but we needed to complete an application through World Medical Mission. This is the first I’d heard of them. The next fall, I went to the Medical Missions conference in Louisville, KY. There I met Scott Reichenbach, then the director of the Post-Residency Program. I wasn’t really planning on stopping at that booth, but I noticed the photo of a resident who had been at my program the year before I started residency.  I asked about her, and soon we were talking about the program. From my time in Kenya in medical school, I knew I wanted to do long term missions, but was a little hesitant/unsure how to go about it. This program seemed like a nice way to bridge the gap between residency and full-time missions. It’s a wonderful program!
There are myriad other ways in which He’s prepared me that are not listed here. Friendships, other events, professors, courses, familial encouragement have all played a part. 
Thank you, Lord, for how you have guided me, and how you will continue to guide me. Help me keep my ears and eyes open to your will for my life. 

“For I know the plans I have for you,” declares the Lord. “Plans to prosper you and not to harm you, plans for a hope and a future.”
Jeremiah 29:11

Tuesday, November 20, 2012

Doing it all in high heels and backwards

As I’ve been discussing some of my frustrations and stresses of work in Congo with fellow missionaries, I’ve gained some perspective. One asked “Would you have the same sort of responsibilities if you practiced in the US?” Let’s make a comparison:

US physician responsibilities:
See patients-inpatient and outpatient
Fill out miles of paperwork for insurance companies 
Complete Gigabytes of electronic medical records
Collaborate with others within the practice (business stuff)
Take call-medicine and obstetrics
Other things I’m sure I’ve forgotten

My responsibilities as a physician here:
See patients-inpatients and outpatients
Fill out small booklets as the patients medical record, which they usually carry with them
Fill out the minimalistic chart we use on inpatients
Perform cesarian sections
Perform exploratory laparotomies
Perform other random surgeries ranging from urological procedures (repaired a man’s ruptured bladder last week), to orthopedics (I have amputated fingers, toes, done larger amputations), neurosurgery (assisted to elevate a depressed skull fracture), general surgery (bowel resection, repair of gastric ulcers), to plastics (repair of lip which was bitten off in a fight).
Assist with ordering medications, keeping stock in pharmacy
Be the social worker, discharge planner, nutritionist, physical therapist, occupational therapist, and perform patient education
Know how the electrical system at the hospital works, know how to turn on the generator, and trouble shoot minor electrical problems
Over see ‘wound clinic’
Manage financial issues such as encouraging people to pay their bill, and sometimes reducing the bill so they can go home.
Assist with deliveries
Perform and interpret ultrasounds
Deal with the preoccupations of medical and non-medical staff
Read x-rays

Now, do all these things in French and/or Lingala

So why am I stressed?

Thursday, November 1, 2012

You know you've lived in rural Africa when...

You know you’ve lived in rural Africa when:
  1. You know how to knock ants out of bread.
  2. The 10 second rule becomes the 30 second rule, which quickly becomes, ‘if it’s not growing something on it and no cockroach is standing on it, you can eat it.’
  3. You can’t throw any bottle or container away because:
    1. You can use it to store food.
    2. You can use it to provide containers for nutritional milk to feed malnourished children
    3. You can use them to give away food to people who might not bring back your plastic containers.
  4. Chocolate is priceless, even if it’s been melted and cooled several times. 
  5. You’re willing to pay $16/gallon ($2 per ½ liter) for liquid, irradiated milk because 
    1. It’s not powdered
    2. It tastes closer to real milk than anything else you can get
  6. Instead of throwing out food the cat or dog got into, you either 
    1. Eat it anyway
    2. Scoop out where the animal ate from it, and eat the rest
  7. All your clothes are either 
    1. Faded (from drying in the sun)
    2. Stretched (from being stretched on the clothes line)
    3. Stained 
    4. All of the above
  8. “I’m traveling on such and such a day” really means you may be traveling the day before, the day of, the day after, or not at all. That's just you-your luggage may or may not come with you.
  9. You know what sounds termites make, especially before the flying ones are about to leave the mound.  (Shiver!)
  10. Lizards and geckos in the house don’t really bother you, because they eat flies, termites and mosquitos.
  11. You have two types of seasons:
    1. By weather
      1. Rainy
      2. Dry
    2. By produce
      1. Mango
      2. Avacado
      3. Papaya
      4. Caterpillars
  12. You know how to make pizza from Laughing Cow cheese.
  13. Having granola and yogurt for breakfast means:
    1. making your own yogurt
    2. buying honey from a local pygmy
    3. making your own granola, which involves
      1. Buying, opening, and grating fresh coconut (if desired)
      2. Buying and roasting peanuts (if desired)
      3. Buying oatmeal 
  14. You know how to 'candle' eggs to tell if they are good or not.