Tuesday, September 9th

There was a huge cockroach on the other bed in my room this morning. I hit it with my flip-flop about 12 times, but a flimsy flip-flop on a bed matress doesn't pack too much of a blow against a hard exoskeleton. I am kind of glad that I will not be sleeping in there again tonight because I can just about guarantee I would be falling asleep to the thought of cockroaches crawling all over me during the night. Eww.

I began the morning in the chart room with Simon and Abel again and then helped draw blood on the HIV+ patients that returned for testing. I'm still not very skilled at poking people, but they were very patient with me.

I drove over to Ferke with a man whose name translates to "Adam." I'm not sure how to spell it in Jula, but it sounded like "AH-duh-muh." I learned that my name in Jula is "Aouha" (OW-ah). He thought it was pretty neat that we shared the names of the first man and the first woman. He told me he didn't speak much English and then we proceeded to talk about what he does at the dispensary, how long he has worked there, where he has traveled (Mali and Burkina Faso, wants to go to America), what kind of African food I liked, what kind of American food he liked (hamburgers and cheeseburgers), that he "wanted to be a doctor but God gave [him] electrician's hands," etc. So much for not speaking English!

I got to Ferke just in time for lunch with Diane (RN), Jen (MD), Deb (pharmacist), and Sarah (RN). It was a nice way to be introduced to them. Diane, Jen and Deb are all career missionaries. Sarah is a mid-termer who got here 3 weeks ago and will be staying for a year. I will be staying in her house during my week here. More on that later.

After lunch, I sat with Diane for a few consultations, saw a pelvic exam, found fetal heart tones, etc., and then she got word that they were having a difficult delivery and asked me if I wanted to go watch. Of course! I went to the OR (they were possibly going to have to do a C-section) with one of the African RNs (they receive the baby) who also told me that he didn't speak English and then went on to explain everything to me in great detail. : ) He was great!!

The birth was a little traumatic. At least it seemed like it to me. I haven't seen enough births to have a very good idea what the extremes of the spectrum are as far as birth trauma goes, but this one definitely didn't seem to be going well. They used the vacuum over and over and over. Again, I have never seen a vacuum-assisted birth and I have no idea how many times it is normal to use it, but it seemed like a lot to me!! I was standing at the head of the table pushing on the mother's shoulders, wiping her brow and desperately wishing I knew anything comforting to say that she would understand. She did end up having a vaginal delivery but the baby's APGARs were really low and it looked like they had sucked all of his brains out of his head. (Edit: I went to see him the next day in the nursery and his head looked MUCH better!!). We started an IV on him and took him to the hospital without ever showing him to his mother. That made me kind of sad.

Diane and the 4 African nurses rotate call at night for deliveries and emergencies. If a lady comes in to deliver, they get called to "catch the baby." When the baby was not doing well today, it got me wondering what happens if they go to receive a baby in the middle of the night who is not doing well. I asked Diane what their resources were. She said that sometimes you can call a doctor in to help out, but beyond that, there really aren't any other resources. They are it. They are the nurse catching the baby and you do what you can. Some babies die. That's just the ugly truth. She said that they see death as a part of life and it is not fought tooth and nail like it is in the States. Death is not necessarily failure. It is not the great enemy. It's just the way things go sometimes. People often come in so late into their illness that there isn't much they can do anyway. When a patient dies, the family often thanks them for the care that they were able to give and goes on their way.

I'm glad our baby lived.

By the time we were done with the delivery, clinic was over. I spent the rest of the afternoon with Diane and Sarah. They are GREAT!!! We ate dinner at Diane's house and watched a few episodes of Lost which just felt so normal. I mean, it was just life. Hanging out after work. Diane gave me a bit of a layout of what will happen in the next few days and I am really excited!!!

After we got home tonight, Sarah and I chatted for a little bit and she told me a bit of her story of how she got out here. She was working at a children's hospital in Phoenix with a different Diane who was a missionary here in Ferke for 10 years before she returned home to care for her ailing mother. Sarah was convicted about using this free, unattached time in her life to do something more selfless than just making money and then spending it on herself. She talked a lot with the Phoenix Diane and decided to come out for a year. She waited a year and half for her house to sell and there are some cool things about the timing of that which made her feel like God was confirming the perfection of his timing and his attention to details. It was really encouraging to hear her story and learn a little more about her passions. She has SO much energy and is just plain fun to be around. I think I am going to have a great week with her!!!

Well, it is already late and I have a big day tomorrow. Even after just half a day here, I am feeling better about this coming week. I think it will have a different feel than Torogo, less stressful and not quite so uncomfortable. I think part of it is that more people here speak English and part of it is that I am already becoming more comfortable in the culture. Diane and Sarah seem very attentive to things that may make me feel uncomfortable and they are really helping me feel integrated in the culture and the hospital. One nice thing about staying with Sarah is that she is new enough that she is experiencing some of the same cultural frustrations that I am, yet has been here just long enough that she knows her way around and is starting to get to know people. I am so thankful for her!!!