my throat is jumping up and down!

I apologize for my lack of posting – the internet here is still patchy. Apparently they just laid digital cable for internet and it’s making it’s way down the main street in Serenje, and will hopefully reach the Hope Center in the near future. This entry is gonna be long, so grab a cup of coffee and get comfortable.

I suppose I should tell you a bit more about our set up here. The hospital has 4 wards – male, female, pediatrics, and maternity. The maternity wing is new, and they’ve broken ground on an operating room. The operating room is greatly needed here for c-sections. Currently, you would have to travel about 100 bumpy kilometers to get to the OR, and obviously you don’t have that kind of time in an emergency situation. In addition to the drive, you need to bring the doctor with you to perform the c-section. The doctor here just started a few days before we got here, left for a week-long conference, was here for a week and is leaving today for another 2 weeks. Long story short, there is not usually a doctor to bring with you. The first week we were here, 3 women (along with their babies) died of uterine rupture during delivery.

Over the course of our two weeks here, the census at the hospital has been about 40-50 patients. There is usually one nurse, Geoffrey, and sometimes one other nurse. There is a midwife around most days too. Every day is different in the hospital – sometimes really busy, and sometimes pretty quiet. Due to the staffing issue, there is always something to do. Dr. Finley is working on his nursing skills and I’ve been working on my doctor skills. Last week I delivered my first baby! It was a 3.9kg boy, which is pretty big for babies around here. I also performed my first paracentesis, which is very different here than at home, as you may imagine. I had an empty bag of IV fluids and an IV catheter, so I threw the empty bag on the floor and stuck the catheter in the lady’s abdomen and took off about 3 liters of fluid. I could have taken about 4 more, but it wouldn’t have been safe. I also drained a very impressive abcess this week. I’m glad to report that all of my victims are still alive, and surprisingly grateful for my amateur surgical skills.

Our small successes have been accompanied by an ever increasing number of deaths. The worst one this past week was our little Amos. He was admitted to the hospital in the beginning of our stay here for malaria and protein-calorie malnutrition and was the skinniest little 18 month old I have ever seen. The day I delivered the baby, Dr. Finley called me back to the pediatric ward to help start an IV on him because he was lethargic and almost unresponsive. We tried for what felt like hours to find a vein and finally got one in his scalp. After a lot of running around, we got a unit of blood started and waited for the rest of the day to see how he’d do. As we were leaving the hospital that evening, we heard the familiar wailing of a woman in the female/pediatric ward. I was hoping it wasn’t, but it was Amos’ mother, and we all knew immediately that he had died. I didn’t want to walk into the ward but did anyway. Geoffrey helped the family to wrap him up, and one of the family members tied the baby on their back and headed home, with the wailing mother following behind. I honestly think this was preventable but I don’t know how to help here. My education and training relies so heavily on technology and equipment and protocols, so when all of it is taken away I feel totally helpless.

On a lighter note, we had quite an adventure yesterday. Steve, the guy that owns our hotel, took us to his friend’s coffee farm up north. Little did I know, the 40km drive takes over 1.5 hours. I would compare the ride in the back of the pick-up truck to being in a popcorn popper, or waterskiing over rocks. I realize that makes no sense, but whatever. Anyways, the coffee farm was beautiful and the people that live there have a beautiful house and garden. The weekend has been pretty uneventful because the guys went to Livingston to see Victoria Falls and bungee jump off the bridge. Right now my mom is thanking God that I didn’t go with them :)

The plan for this week is to continue to see our patients at the hospital and hopefully get some teaching done, now that we’ve established a pretty good relationship with the staff (I use the term “staff” loosely because it’s basically just Geoffrey). I want to talk with the lab guy and the pharmacist a bit more to see how we could best meet their needs in future trips. We’re also going to Kamena one day this week to meet some of the orphans. There are over 100 in the town, and I don’t see how I’m going to get out of there without adopting several of them. Geoffrey has threatened on several occasions to steal my passport. If he succeeds I’m going to become the “crazy orphan lady,” similar to the “crazy cat lady” in the states, but way less smelly.

I miss you all dearly, and can’t wait to share my experiences with you. God is doing wonderful things in my heart and I hope to return to you with a renewed spirit and purpose. I might also be returning to you with parasites, but that is another story altogether.

Peace!

Oh, I suppose I should explain the subject of this entry – I made apple crisp last night and gave some to Pastor Navice (church planter). After the first bite he said, “Ah! My throat is jumping up and down!” I took that as a, “it’s not half bad.”