interesting factoids about our watchman, chini…

16 Jul

We learned an interesting fact about Chini the other day from Pastor Rebecca, one of the chaplains at the hospital.  Apparently, Chini suffers from asthma and has an inhaler for relief.  His worst attacks occur when he is angry, which surprised us because Chini is never angry – always smiling and singing the wrong words to his favorite songs.  But Rebecca informed us that Chini likes to pray for Christians who he thinks are not living like Christians, especially, she said, women who wear short skirts and shorts.  And when he prays for these women in short skirts, he gets very angry and often has an asthma attack, requiring his inhaler.  Classic Chini (isn’t he the cutest thing?)!

Chini also likes to play the guitar… and we don’t mean a normal guitar.  He owns an African guitar, a four stringed instrument with no frets.  The boys were lucky enough to get a live performance and luckily captured the show on video for the girls to enjoy as well.  We will post the video once we have good enough internet to support video downloads.  It’s amazing.

– Rachel & Adam

happy birthday to mr. adams!

14 Jul

First of all, HAPPY BIRTHDAY TO ADAM!!!  He turns 19 again today.  Here he is ready to celebrate (haha)!

And he got a motorcycle for his present! (just kidding, but he may be getting one when we get home.)

The other very important thing that happened today was a volleyball tournament in support of the nursing school.  The BMC put together a team made up of Aaron, Rachel, two peds nurses (Bruno and Maxwell), and two other Ghanians.  Aaron and Rachel were determined to teach them how to run a 5-1 (for those of you not familiar with volleyball, this means that there is one person who is always the setter).  It took awhile, but they finally convinced them that it is better than the current Ghanian system where whoever is in the middle on the front row is the setter.  We played against a team of six Ghanian men, all part of the nursing school.  We won the first game, they won the second game.  There were two other people from the BMC (both Ghanian) who wanted to play and so they substituted in for Rachel in the third game as well as one of the Ghanians.  Because of the substitutions, we had to switch back to the old way of playing and lost in the final game.  Despite the loss, we had a great time and provided some entertainment for the many people who came out to watch the tournament (probably about 60-70 people lined the court boundaries).  Everyone loved it when Rachel dove for a ball and rolled in the dirt, and people go crazy when Aaron spikes the ball for a kill.

We don’t have a lot of medical stuff to talk about for today, but one very exciting thing happened that we wanted to share… our comatose patient that Rachel has been following for the last several weeks who starting eating yesterday got to go home today.  His mom was smiling ear to ear and gave Rachel a huge hug before they left.  It made our day to see him leave.  Another good day.

Tonight, we had dinner with all the volunteers and career missionaries here at station meeting, a weekly gathering on Thursday nights that involves dinner, dessert, prayer time, worship music, and a message delivered by one of the volunteers.  Evan, one of the missionary kids, played guitar and led worship for us – it was so wonderful to sing praise to God together, especially after having such hard times this last week where God was our only strength.  After singing, Adam gave us a message out of the book of Mark that encouraged us all to share our faith more openly (see the blog titled “keeping secrets” for details).  Many people came up to him after to tell him how much they appreciated the discussion, making his wife so proud of him.  We then had mango cobbler with ice cream to celebrate Adam’s birthday after singing to him – so amazingly delicious!

– Rachel

oh happy day!

13 Jul

We want to thank everyone for their prayers and words of encouragement in response to our blog yesterday.  It means everything to us to read your comments and keeps our spirits up every day.  And we hope you are as blessed as we are to know that God is hearing all your requests, because we had such a wonderful day today.  I think He knew we were getting close to our limit and needed a little happiness.

We went for a run this morning – a little farther than before down toward the river, which was refreshing.  We then went to the wards for rounds, which went surprisingly efficiently.  We got to send so many children home today, and we saw tons of smiles – a rare occasion with our patients.  One in particular made our day.  He is a little 2 year old with cerebral malaria who was super sick last week with seizures that were difficult to control followed by a coma that had persisted for about 5 days.  Today, however, he was sitting up on his mother’s lap taking food by mouth from a spoon with his eyes open.  His mother had a huge smile on her face when talking about how much better he is doing.  He will likely get to go home soon – praise the Lord for his healing power!  Rachel also took care of a new admission that came in unresponsive during rounds after suffering from a seizure this morning.  She examined her quickly and then thought to take her glucose, which read as “Lo” on the glucometer.  Rachel gave dextrose (essentially sugar water) through her IV using a syringe and about half way through, the girl opened her eyes and starting looking around.  It felt so good to fix someone!  So glad we went ahead and bought that glucometer to bring with us.

We then went to clinic and saw lots of malaria again, but more “well” children than earlier this week.  We handed out toys to many and actually got several smiles and laughs in return… what a sweet sound.  Courtney saw a seven month-old girl who was referred from Public Health for neck muscle weakness.  Sure enough, as she sat in her mother’s lap, it was apparent that she had very poor head control.  Her mom told us that she had never developed good strength, since birth; she cannot sit up, roll over, or lift her head.  Unfortunately, it was obvious that we were not going to be able to fix her problem, knowing that it was likely a permanent condition.  We consulted with Dr. Hewitt, who noticed that she had some subtle features suggesting Down Syndrome.  We are going to look into whether there is a place that she could go for physical therapy.  Yet, even with a diagnosis for which we have no treatment, she brought us so much joy today.  Among all the kids who are scared and crying, she had a huge smile and the sweetest giggles you’ve ever heard.  Every time we would look at her and smile, she’d grin right back and give a big laugh.  We gave her one of the plush flowers that Rachel’s mom sent along… could she be any cuter?!

– Courtney & Rachel

 

 

i am because we are

13 Jul

When we walk anywhere in Ghana, our feet, socks, and shoes turn an orange color from the clay / sand soil. The orange soil is everywhere and is impossible to remove. If we wash off the layer of dust in the shower or if we sweep and mop our rooms, we can find the orange dust there in what seems like a matter of minutes. The removal of this orange dirt is a constant task that will never be completed. This is how I look at the soil, as a nuisance, something that needs to be removed in order to feel clean. The Africans look at the soil as their means of survival. They plant their crops in the soil and hope that the rainy season will make for a plentiful harvest. The soil provides food for their animals and can be tied to much of the movements of life. In America, unless we are cultivators, we rarely think about the soil. Our food comes from the store, pre-packaged and washed, not from the ground laden with soil.

Adam and I have had several discussions about tradition. I have strongly considered what this term means while here in Africa. In many of our conversations with different African people they will inevitably bring up the word, tradition. Africans use this term as a way to identify who they are with their past and relate their future to their traditions from the past. They will tell us stories, proverbs, and parables that take into account their tradition. In Africa there is a not a sense of, ‘I think therefore I am’. They instead will say, ‘I am because we are’, a statement with deep roots in the tradition of those who came before them.

The connection here between Africans and tradition is like the connection between Africans and their soil. They are content with the soil being a part of their everyday movements. In fact, they are more than content, they understand the connection so deeply that no thought would cross their minds that soil was not an important part of living. The same can be said of tradition that no thought would cross their minds that tradition was not an important (if not the most important) part of living.

I should find it intolerable to think that, as an American, I rarely consider tradition. I should hate to fathom that I needed to remove or clean up my tradition in order to feel clean. I should detest thinking of tradition as a nuisance. I should recoil from the idea that my tradition needs to be prepackaged and washed. But this is how I think, I am because I have made myself to be something. But this is not how the Africans think, they continue to think, I am who I am because we are grown out of tradition.

Aaron

p.s. The internet has been pretty poor lately. We are trying our best and posting with pictures is getting more and more difficult. We will keep trying and thank you again for all of your encouraging comments. We love them!

the terrible, horrible, no good, very bad day (x2)…

12 Jul

to sum up our day, all we could talk about on our walk away from the peds ward at the end of today was how badly we wanted a pizza, a tub of blue bell ice cream, and a bottle of wine.  we keep thinking we might have one day while we’re here that could inspire a happy, up beat blog post… but unfortunately, we have yet another tear-jerker for you tonight.  however, even as we tell these sad stories, god has been faithful to remind us of his grace and power.  this morning, we went to devotional (held at 7 a.m. every morning at the front of the hospital and led by one of the chaplains) and the choir from first baptist church of nalerigu was singing.  they sang a few ghanian songs, and then began singing “because he lives.”

because he lives, i can face tomorrow

because he lives, all fear is gone

and i know, oh yes i know, he holds the future

and life is worth the living just because he lives

the words of this song, and the hope we have in god’s power to overcome death is so much more obvious and relevant to us here.  in the midst of suffering and hard times, it is so much easier to understand songs like this and to actually look forward to the day when he returns.

in the last two days, we have signed a total of 8 death certificates.  while each was difficult in its own way, we will tell the story of only one tonight.

he was an 18 month old boy who came in with malaria and seizures yesterday afternoon from clinic.  he continued to have seizures last night and so received valium and phenobarb (both seizure medications) and was then very sleepy.  rachel saw him and wrote in her orders not to give any more seizure medications overnight, as both could cause him to get sleepier and possibly stop breathing.  however, by the time we made it to the wards this morning, he had received two more doses of valium and a large dose of phenobarbital despite our orders.  he was difficult to wake up during courtney’s exam, but was breathing ok.  unfortunately, a few minutes later, one of the student volunteers noticed his breathing had changed.  courtney checked his oxygen saturations and found them to be decreasing quickly as he stopped breathing altogether.  he then lost a pulse.  courtney started compressions and called rachel over to start bagging (providing breaths with a bag-mask).  his pulse returned quickly and we got his saturations up to 95%.  but then we were in a bit of a pickle… he clearly had no respiratory drive due to the seizure medications, and we didn’t expect a speedy improvement, but yet we have no ventilator here to support him as we waited for the medicine to wear off.  so we kept bagging.  for 4 hours, taking shifts with the nursing staff and the student volunteers.  at that point, we enlisted the help of one of the anesthesiologists to find an intubation tube and blade to make the work a little easier for everyone, as the number of nurses had dropped to 2 after shift change and the ward was filling with new admissions already.  intubation was successful and we continued bagging via the tube for another 4 hours, again taking shifts.  all we had to monitor our patient was a pulse ox.  around 5:30 p.m., we checked his pupils and found them to be fixed and dilated, indicating a very poor prognosis and an unlikely recovery no matter how long we continued to bag.  we called the chaplain and made the decision to withdraw respiratory support.  the only request the mother had was to take a picture of her son, but unfortunately, there was no way to get it to her (no printer, no email address, etc).  it was heart breaking and defeating.

we were struck today by the fact that despite our ability to intervene here, there is no way of monitoring the intervention like we do at home.  in other words, there are no monitors, labs, blood gases, etc to help us adjust our interventions and ensure the patient remains safe.  it’s frustrating when we can’t do what we know needs to be done – we knew the patient needed to be intubated and ventilated this morning.  but there is no ventilator available (not even for patients under general anesthesia in the operating room), and even if there was, there are no blood gases to guide ventilator settings.  and truth be told, the patient would have been considered in “critical condition” even at home.  so it’s hard to know where to draw the line of what is helpful and what is only prolonging the suffering.

we were so thankful, though, for one of the peds nurses, who told us that we had done “such good work” today.  she said that even though we had lost a life, we had worked hard and that was appreciated.  it made us feel some peace knowing that even with a language barrier, the nurses and parents can see that we care.  and we can continue loving because he loves us and asked us to serve him in this way.

because he lives, i can face tomorrow.

– courtney & rachel

keeping secrets

12 Jul

On a couple of occasions Adam has given some of the local kids gifts. These gifts usually consist of crayons or a coloring book or simple black pens. Each gift is given in complete discretion. In fact, when Adam gives the gift to the children he lowers his voice, almost like a secret, and explains to them the importance of this gift being only for them. He stresses the importance of secrecy because if everyone knows about our stash then we will have requests all the time for gifts which can be overwhelming if not unfair. Two separate occasions have been particularly revealing.

The first time Adam gave a gift, the child promised that he would not tell anyone where he got his new supplies. He promised that, even if his brother asked about the origin, he would tell him that the people he received this gift from had already left and thus there is no chance of getting the materials. Adam made sure the child understood and asked one more time for confirmation and the child promised again assuring Adam he understood the importance of the secret. Literally the next day another different child came and asked us for new crayons because his friend had had new crayons at school and told him where he got those new crayons.

The second time Adam gave a gift, he gave it to the child who asked for new crayons after finding out from his friend at school that we were gifting new materials. So, once again Adam sat down and had a talk with the child about the importance of secrecy. The child left and met some of the volunteers right outside our house. He asked them if they could also give him new crayons but not to tell Adam because he made him promise that he would not tell anyone where he obtained his new exciting gift. The child lasted maybe two minutes with his secret.

And as Jesus passed on from there, two blind men followed him, crying aloud, “Have mercy on us, Son of David.” When he entered the house, the blind men came to him, and Jesus said to them, “Do you believe that I am able to do this?” They said to him, “Yes, Lord.” Then he touched their eyes, saying, “According to your faith be it done to you.” And their eyes were opened. And Jesus sternly warned them, “See that no one knows about it.” But they went away and spread his fame through all that district. Matthew 9: 27-31

As Christians, we carry an important secret with us all the time. We hope that this secret is revealed to everyone. We hope that others will understand the importance of the secret once they hear. But how quick are we to reveal our secret? Are we so excited about our secret that we can hardly walk out the door without telling others about the information we know? Does the excitement of this love just spill out of mouths?

Aaron & Adam

 

 

 

seminga (white girl)

11 Jul

i was in the maternity ward the other day, examining a baby, when a young man (who is a nurse) greeted me.  i smiled, and replied to his greeting, then continued to examine the little one.

a couple minutes later, he looked over to me again, as he prepared a bath for one of the newborns.

“how do you bathe?” he asked.

“you mean, how do i bathe the babies?” i responded.

“no, i mean, how do you bathe yourself?”

“well, i shower usually.”

“with soap? with a big fluffy sponge?” he questioned.

“yes, with soap.  i just rub it on,” i replied, quite confused at where this conversation was going.

“well, then… how do you get your skin so white?”

priceless.

-courtney

things we miss…

11 Jul

things we miss…

  • our families.
  • turkey sandwiches.
  • cold milk (or any milk other than powdered, for that matter).
  • cereal with cold milk.
  • normal bowel patterns.
  • reliable plumbing.
  • clean feet.
  • mexican food and guacamole.
  • cuddling with our husbands (it’s usually too hot for that here).
  • fresh strawberries, peaches, salad, bell peppers, corn on the cob, tomatoes, and all those other delicious fruits and veggies in season (hello, canned peas and mushrooms).
  • ice cream (blue bell, if you want specifics).
  • looking (and smelling) nice.
  • whole foods pizza.
  • a clean shower (i.e. one not filled with red dirt).
  • paved roads.
  • our own comfy beds (queen-size with soft sheets and fluffy pillows — instead of two twin-size beds pushed together).

 

don’t worry, we don’t miss candy… we brought it all with us.

al-la-fia bene (“i am feeling strong” – a common response to how are you)

9 Jul

Yesterday was an especially trying day.  The peds ward was completely full and many of the kids were very sick or had confusing/unknown diagnoses, so it took a long time to see everyone and get orders written (not to mention it was the first day that no other physicians came by to see peds patients).  Clinic starts at 10 a.m., but we didn’t make it there until 1 p.m., just to give you an idea of how far behind we were.  In the midst of rounding, two medical student volunteers came to tell us that there was a premature baby in the maternity ward that was having trouble breathing.  Rachel went with them and arrived to find a blue, floppy baby in the incubator next to our other premie; the nurse was trying to resuscitate the baby using a bag-mask and she was told the heart rate was “good.”  The Ob-Gyn doctor, Lynn, told her that the mom had delivered the baby (estimated to be around 28 weeks) in a village around 6 a.m. that morning and had just arrived with the baby at 10 a.m.  She took the baby’s heart rate and found it to be 50 (not good) and so started compressions.  The baby died about 15 minutes into our resuscitation efforts.  The mother had lost her first pregnancy the exact same way.  We called the chaplain to come pray with the mother.

After such a tiring morning, we decided to have lunch before clinic.  We then saw patients with rashes (again, not sure what all of them were), lots of malaria, viral URI’s, etc.  The translators in the clinic teased Courtney about her catarrh (their word for a cold, but actually just a horrible all-day allergy attack, which only made a long day longer).  Before heading to dinner, we rounded on 12-15 new admissions in the peds ward – there were people standing, sitting, and laying EVERYWHERE.  We ended up having 46 patients total (with only 36 beds to put them in).

After dinner, we were called by a nurse in the pediatrics ward to tell us that a child who swallowed kerosene had just been admitted to the ward and was in respiratory distress.  Rachel went back up the hill to the wards to find a 2 year old girl lethargic and breathing very hard.  The nurse had already suctioned out her stomach and placed her on oxygen (the only respiratory support we have here).  She got two boluses and was placed on IV fluids, and we all hoped for the best, though had a bad feeling about her outcome as she was spitting up blood.  Overnight, Courtney was called to the delivery of a premature baby, who is doing okay, but has a long way to go.

Our new preemie.  We are using diapers to keep her dry (and thus warm), but unfortunately, we only have one size… obviously, it’s a little big on her.

Courtney then got called again early this morning because our 30-week preemie (the one we delivered last Monday) was having trouble breathing.  In the short time it took for Courtney to make it to the hospital, the baby no longer had a pulse.  Again, resuscitation was too late, and the chaplain was called to come pray with her mother.

So needless to say, we were a little down this morning.  But the patients were doing surprisingly well today on the peds ward.  Many went home, including the one who swallowed kerosene – she was sitting up eating porridge when we arrived.  Our little boy with the distended belly and meningitis is doing so much better and will likely go home within the next couple of days – Dr. Hewitt even complimented our management of the child this afternoon.  And we somehow made it down to around 30 patients by the end of the day.  The only one we are worried about today is a little boy that had two abscesses to drain and is very malnourished.  His HIV test is negative, and we’re treating for parasites just to be sure.  But we also got a CBC today that showed significant pancytopenia (aka, his cells that fight infection are low, his hemoglobin is low, and his platelets are low), which makes you worried about cancer or something else scary.  Unfortunately, there’s nobody that can do a good blood smear and certainly not a bone marrow biopsy.  Even if they could, there is no chemotherapy here.  We’re hoping it could be temporary marrow suppression due to some kind of infection…

After rounds, we had lunch and then went on a walk down to the river with the boys.  It takes only about 10-15 minutes to get there and is a beautiful walk – open fields and trees on either side of the dirt path with rolling hills ahead.  The river itself was nothing spectacular, but it was still fun.  There were women and kids washing clothes in it, and some tried to take our picture with their phones while we were looking away – they thought it was hysterical.  On our way back, it started raining, so we had to run back home.  But praise the Lord for the rain!  The temperature dropped from the 90’s to the 60’s in about 2 minutes, and it has stayed cool the rest of the day.  We all took long naps in our seemingly air-conditioned rooms.  It was wonderfully needed!

Keep praying for our kids and their families.  Pray that they would see God’s love in us and that we would be able to hold onto the hope we have that one day, there will be no more suffering.  What an awesome and powerful God we serve, that He could overcome death to save us.

“Christ Jesus, who died – more than that, who was raised to life – is at the right hand of God and is also interceding for us.  Who shall separate us from the love of Christ?  Shall trouble or hardship or persecution or famine or nakedness or danger or sword?… No, in all these things we are more than conquerors through him who loved us.  For I am convinced that neither death nor life, neither angels nor demons, neither present nor future, nor any powers, neither height nor depth, nor anything else in all creation, will be able to separate us from the love of God that is in Christ Jesus our Lord.” (Romans 8:34-35, 37-39)

– Courtney & Rachel

project #2

8 Jul

Once word got out that we were handier than a pocket on a shirt, we were asked to help with a second project. Chini is a former TB patient from the hospital that lives in Alafia Tinga (http://www.baptistmedicalcenter.org/projects/alafia-tinga/) and has four sons: Joseph, Abraham, Mordecai, and Timothy. We know of Chini because he sits on our front porch all day and greets us as we enter and leave the house. He is our protector, guardian, and watchman but sometimes we catch him taking a nap and he weighs about 90 pounds with clothes on soaking wet. The story of Chini is intriguing and I am sure deeply moving but we are only picking up snippets of his life gradually, so that will have to be a story we tell later and is probably best told with video.

One of the current volunteers, Mark, brought to our attention the need at Chini’s house for new windows, so we said we could take a look. Our second project was a little less complicated than the first and here are the results:

Before: notice the plastic stuffed on the lower right

Before: notice my hand sticking through the window

getttin’ after it

puttin’ new windows together


installin’ new windows

After: new windows with no holes, installed!