The Art of Reflection

I want you to stop loving on people.

noreply@blogger.com (lindsay) — Sun, 14 Jul 2013 22:24:00 +0000

Yep. I said it.

I think Christians need to stop using the phrase "love on."

I totally understand that many Christians think "loving on" people is a good thing, especially on missions trips... for example "we're just so excited to be able to go and love on orphans in Africa." I get that and I respect the heart behind it.

It's just that somehow we've decided that it sounds much more spiritual to "love on people" than to simply "love people."

My problem is this: "loving on" someone is doing something to them rather than with them and that sounds more like a project than a relationship.

If you tell me that you are going to walk on me, sit on me, or cry on me-- well, you can imagine that I might not feel those are very nice things. I might also wonder why you seem to have rather a lot of choice in what happens to me while I have very little say in the matter.

However, if you tell me that you would like to walk with me, sit with me, or cry with me, I would emphatically say yes please! Please walk with me through this mess called life. Sit with me as I wrestle with questions. Cry with me when I grieve.

Out of many names for God my personal favorite is Immanuel or God with us. Jesus took human form and walked with us, went fishing with us, and came over for dinner and a glass of wine. God chose to enter into relationship with us rather than imposing His will on us. Being made in His image we too are called to enter into relationship with and love each other.

You may think it's just a phrase and it's no big deal, and you may be right. I imagine that you're the kind of person who wants to love people well and not turn them into projects. But at least in the context of missions or service projects I think we ought to be very careful what we do to people and focus more on how to love people in a way that promotes their dignity and worth as image-bearing children of God. And if nothing else, let's use language that makes sense to those who don't speak Christianese.

With love and in love,
Lindsay

Children I met in Danja, Niger

sunrise, sunset (daily routines in Haiti)

noreply@blogger.com (lindsay) — Wed, 23 Jan 2013 02:34:00 +0000

I don't know that there's ever a really typical day in Cite Soleil clinic, but there is a daily routine. Since we couldn't go to clinic today due to some safety issues I have more free time than usual to do a little blogging and catching up with some emails. At the moment I'm listening to the crickets and geckos from the little front porch in front of Jill's room. I can smell smoke from the burn pile out back. I can't see too many stars tonight due to cloud cover but I can still see the moon in amazing detail behind the clouds. It's waxing just over half-full, and I wonder when was the last time I noticed the phases of the moon? I miss so many things when I'm not in Haiti (or Africa), and being able to see the moon and stars is certainly one of them.

Back to clinic routines.

Normally we leave for clinic at 0645, so I'm up before sunrise to make sure I can pull myself together and grab some breakfast. Today I had a few minutes to watch a glowing, muddled pink-orange sunrise over the hills behind the compound. After breakfast we ("we" being the other volunteers, several Haitian health educators, myself, and Jill, the clinic coordinator/ dear friend) pile into a van and begin the 30-minute drive to Cite Soleil slum. The first 15 minutes or so go smoothly as the road was repaved last year before the President visited this area. After 15 minutes things start to get a little rougher with potholes and increasing foot traffic-- kids on their way to school, men hauling construction materials in wheeled carts, women selling merchandise along the road, and various goats, pigs, and chickens. During the whole ride we are of course driving on whichever side of the road is the smoothest and passing all slower vehicles no matter how fast the oncoming traffic. With about 10 minutes' drive remaining we pull over to wait for our motorcycle escort-- one in front, one in back. These men help ensure that we're safe after we enter the Cite Soleil slum until we drive onto the clinic compound.

Me with some of our amazing clinic security team; the motorcycle escort men are in the yellow vests.

When we arrive at the clinic we unload the water jugs and any supplies we've brought, then head in to meet the rest of the staff for morning devotions. Currently the clinic employs about three doctors, three nurses, two pharmacist technicians, four triage staff, and several others to help run the clinic. Devotions involve singing several songs, either in French, Creole, or English. Afterwards one of the staff leads the devotional which is always graciously translated into English for the benefit of us volunteers. We pray to close then begin our various tasks for the day.

Since I'm a nurse practitioner this time around I've been both seeing patients and also working with David, one of the health educators. He teaches the patients about lifestyle and diet changes for diabetes and hypertension so we're working that content together. David also helps translate for me when I see patients.

David (in yellow) and I working together to teach a gentleman about his medications.

I'm seeing about 15-20 patients a day, mostly adults with diabetes and hypertension. I've also seen some STDs, asthma, various skin rashes aka "I-have-no-idea-what-that-is," and even a possible tuberculosis patient. Maybe you didn't know this, but chronic and lifestyle diseases (like diabetes, heart disease, high blood pressure, and obesity) are starting to outpace infectious disease in many developing countries as the biggest health issues. And of course, the effects are always disastrous-- if someone survives a stroke or a heart attack in Haiti, how will they earn money to support themselves and their family? Who will take care of them? So although it's not as exotic as dengue fever or malaria, I'm happy to treat the chronic diseases-- you never know if you might help someone avoid being disabled.

For lunch I usually do what the clinic staff does and order either rice & beans or rice with another kind of sauce. Either way it's always delicious, but I make sure to save some as there are several local kids who come by the clinic for help with homework and to eat a bit of lunch.

Me with one of the kids who comes by the clinic after school.

We wrap up seeing patients at about 1530 (3:30 PM) and drive back to the SP compound. We finish early at the clinic since several of the staff commute for hours and it's safer to do so during daylight.

In the evenings we ("we" being the volunteers) have been helping Jill with any miscellaneous projects she had saved up for our arrival. We also chat with the Haitian SP base staff who work in various departments such as logistics, the kitchen, or the WASH team (Water, Sanitation and Hygiene team, aka well-drilling and community education). It's amazing to hear stories from many staff who are taking care of children orphaned in the 2010 earthquake-- some take care of as many as 19 children and work multiple jobs to do so. It's humbling, really. What do I know of sacrifice or loving others? Volunteering a few weeks of my time is vastly different from raising orphaned children as my own.

Every evening the stars and the geckos come out while the night security guards begin their rounds of the compound perimeter. We all wind down for the evening by talking with family back home, reading, or simply getting to bed early so we can get up for the next sunrise.

The beautiful sunrises and sunsets in Haiti are due in large part to the ever-present smoke from burning trash, industrial factories, and vehicle exhaust. I'm reminded again that so much of life contains both beauty and brokenness in the same breath, and it seems especially that way here in Haiti. But God is here and is at work in ways I can't even begin to imagine. And at this moment that knowledge is enough for me.

oh by the way...

noreply@blogger.com (lindsay) — Fri, 18 Jan 2013 11:07:00 +0000

...I'm in Haiti for two weeks! I graduated in December, took (and passed!) my boards on January 12th, and flew to Haiti the 14th for two weeks with Samaritan's Purse.

Right now the internet is really spotty so my updates will be infrequent. This one in particular is not my usual coherent narrative but rather a list of random observations from the last few days.

We drive past the mass graves of the victims of the 2010 earthquake as we travel to the clinic each day. The ground is scorched due to a recent fire. I don’t know what to think exactly, but it’s sobering each time.
I can still do a navy shower; this is a handy trick to know.
Yesterday a large Vodou parade went by the clinic. People were carrying a tree in the front and singing. Many of our patients left to go watch (or join?) so we wrapped up an hour early. Brings back memories of Benin which is the birthplace of vodun, aka voodoo. Vodun came to the Caribbean on slave ships filled with West African slaves, the ripple effects of which are still felt to this day.
My ankles are super swollen for an unknown reason. Possibly an interaction with my antimalarial medication-- will have to look into this more. Not uncomfortable other than to look at!
Mangoes out of season are still amazing.
What is it about looking at the stars that makes me feel closer to God?
One of the clinic staff told me today that they found a baby in a pile of trash. The child has been raised as one of their children & is now three years old. This staff member works two full-time jobs to help support the family, sleeping only about three to four hours per night I would guess. This is love in action-- a reminder that love is not just an emotion but a choice.

The fabulously talented Cite Soleil Clinic staff, plus me.

Many other staff members also care for children that are not their own, some even setting up home orphanages to care for children left alone after the earthquake. I’m talking about 10+ kids. Also love in action.
I learned yesterday that many people don’t take their medicine (ie for blood pressure) they don’t have something to eat at the same time. I had to ask how common it was for people to not have anything to eat. I don’t know the numbers, but it’s common to only have one meal a day... or nothing at all. My usual recommendation to “not take medications on an empty stomach” now has a new connotation.

Finally, what is the right response to and for Haiti? I don’t know; it’s beyond me. All I know is that I am content to be here at this moment.

to Haiti with love

noreply@blogger.com (lindsay) — Fri, 25 May 2012 04:07:00 +0000

I'm still processing the two weeks I spent in Haiti with Samaritan's Purse. Like all of creation Haiti contains both beauty and brokenness. At first glance you notice green rolling mountains and tropical blue water. Look again and you notice the mountains are crumbling due to severe erosion. Dotted in the midst of the hills and valleys are tarp-over-sticks "houses," many covered with bright blue Samaritan's Purse tarp. Brown streams empty the waste of city inhabitants directly into the ocean and you realize this is no pristine tropical paradise after all.

Yet the beauty is overwhelming, even in the midst of the remaining rubble and the barbed wire and broken glass.

The sunrise over the hills at the SP compound each morning never failed to make me catch my breath. I cherished the moments spent holding hands, singing, and praying with the clinic staff each morning before beginning our day's work. The sandwiches made with hot-pepper infused Haitian peanut butter for lunch warmed both my mouth and my spirit. Mangos are simply divine, they really are. The evening breeze coming in from the ocean seemed to gently blow peace into my heart. And I fell really and truly in love with 68 adorable children at an orphanage outside Leogane.

In a million ways I was reminded that God is a God of healing, rebuilding, and restoration. He came to bring wholeness to a broken world. He promises to make all things new and all things right.

I spent my time in Haiti working in the Cite Soleil clinic, holding orphans, dispensing medications in the pharmacy, losing Scrabble games, discussing issues of faith and social justice with new friends, and laying in a hammock listening to the waves and watching the stars come out. But most of all I spent my time in Haiti being reminded that God is enough.

Sunset from Jax Beach, Haiti

welcome to Ayiti!

noreply@blogger.com (lindsay) — Sun, 13 May 2012 20:19:00 +0000

I arrived in Haiti (Ayiti in Creole) last Tuesday along with Sandy,the other volunteer nurse here at the moment. She's lovely and energetic and reminds me of a very grandmotherly Beth Moore.

Each weekday morning we get up around 5:30 as the sun is just coming up over the mountains. We leave for the clinic by 6:45. Along the way we stop to pick up some of the clinic staff including several doctors and some of the pharmacy personnel. We also pick up our motorcycle escort just before we head into Cite Soleil which one of the largest, poorest, and therefore most dangerous slums in the Northern Hemisphere.

Driving towards Cite Soleil.

The clinic has been operating since the earthquake in 2010, offering primary care for adults and children and some women's health services. SP employs two pediatricians, one OB/GYN, and one adult doctor that I know of for the clinic. Usually 2-3 different doctors work there depending on the day of the week, seeing anywhere from 150-200 patients a day. The patients line up in the courtyard, and Jasmine (the clinic coordinator) and Leo go through the line to try to sort out the sickest patients and the children to see the doctor. Leo fills out a health paper for each patient if they didn't bring their paper from a previous visit, and they are then admitted to the triage area.
Sandy and I work in the triage area alongside three Haitian translators named Eddy, Eddy, and Luko. This is where we ask each patient why they have come to the clinic and check their vital signs. The translators know what they're doing, but Sandy and I are here to help them think critically and help teach them so that they can in turn teach the patients. I love that aspect of this clinic; there's lots of time and opportunity to teach. There's even a health educator who talks to the patients waiting to be seen in triage, telling them about handwashing, diarrhea, and worms, among other things. In the triage area we often teach about foods to avoid if you have hypertension or acid reflux, how to keep a wound clean, etc. I am in the process of teaching Eddy how to calculate paracetamol (acetaminophen) doses for kids with fevers; the dose is based off their weight. It's a little complicated until you've done it a few times, but he's picking it up really quickly. I want to teach the other translators on Monday. I guess until now they've been going back to ask one of the doctors or Haitian nurses for the dose!

After the patient goes through triage they wait to see the doctor who writes prescriptions which are then filled at the SP pharmacy. It's a really organized process! Some patients also end up going to the treatment room which is run by Toussaint, a sweet Haitian nurse. In the treatment room they do breathing treatments, IV fluids, some dressings, and Toussaint is also training several Haitian nursing students.

We finish in triage about 2:30, which gives the doctors and pharmacy enough time to wrap everything up by 3:30 or 4:00. We finish early because some of the Haitian staff have 2-3 hour commutes, and they need to get out of Cite Soleil before it gets dark. By the time Sandy and I get back to the SP base it's usually around 4:30, and we have the rest of the evening free to read, nap, check email, and chat.

I really love seeing the work that's happening at the Cite Soleil clinic. I've had patients come through with health papers from 2010, meaning that they have been receiving some health care for the last two years! That's really exciting, especially considering that in West Africa I always felt that once the ship sailed away the people had no health care. Although there are hospitals in West Africa, most people cannot afford the price. So I really love that the SP clinic has been taking care of the people living in the Cite Soleil slum for years now.

During my evenings I've been reading a great book called "When Helping Hurts: How to Alleviate Poverty Without Hurting the Poor...And Yourself" by Steve Corbett and Brian Fikkert. I was really struck by one idea which I will quote for you:

"We are not bringing Christ to poor communities. He has been active in these communities since the creation of the world, sustaining them 'by his powerful word' (Heb. 1:3). Hence, a significant part of working in poor communities involves discovering and appreciating what God has been doing there for a long time!"

Oh this is so true. I am not bringing Jesus to the poor people of Cite Soleil. He is already here and has been working in a million ways both seen and unseen. During his time on earth Jesus loved children, tax collectors, lepers, prostitutes, and the least of these... at Cite Soleil we try to follow His example.

I can picture Jesus here, walking the dirt streets of Cite Soleil. I feel His pleasure each time I walk through the clinic doors to start a new day. I feel His presence when the clinic staff gathers to sing and pray before we start seeing patients. We pray for the clinic, Cite Soleil, the Haitian government, and the people of Haiti. We pray that God would bring not only physical healing, but that He would change people's hearts. And I feel His peace gently, quietly, patiently at work here in Haiti... and also in my heart.

it's that time again!

noreply@blogger.com (lindsay) — Tue, 10 Apr 2012 03:31:00 +0000

Time to think about anti-malarial medications, time to brush the dust off my passport, and time to buy traveler's insurance.

Yes, I'm still in school. In case you forgot-- after all I haven't blogged in forever-- I'm working on a master's degree in nursing. After I graduate in December and pass my certification exam, I'll be a Family Nurse Practitioner (FNP for short). If you're nice, I might even write you prescriptions.

In between semesters I have several weeks off so I looked at several different volunteer medical opportunities. I ended up being accepted to volunteer with Samaritan's Purse in Haiti for two weeks in May. I'll be working, most likely as a triage nurse, at a new medical clinic in Cite Soleil. A dear friend has been to this particular clinic with Samaritan's Purse and she gave me a glowing first-hand account.

I'm beyond thrilled for several reasons. First, I'm going a little stir-crazy here at home and I can't wait to go somewhere that my nursing skills are really and truly needed. Secondly, I think this trip will give me a better feel for how my FNP degree might be useful in a developing country clinic setting. By the time I get to Haiti I'll also technically have completed half an FNP degree and I'll be (hopefully) able to use some of my physical assessment and diagnostic skills. But most of all, I'm excited because it's a reminder that God continues to work in my life even though I'm not always aware of it.

As always, I would love to have you partner with me in prayer. At the moment, my biggest prayer request is for faithfulness in completing this semester! I love school but it's very challenging and by this point in the semester I'm ready to just be done. Regarding my trip to Haiti, the basics need prayer as always: safe travel, good health, and safety while in-country. I could also use wisdom as I collaborate with Haitian translators to see patients who may have illnesses uncommon here in the US. For example, the rainy season in Haiti starts soon which could mean increased cases of cholera.

Most of all, I want to "let my heart be broken with the things that break the heart of God," echoing a prayer written by Bob Pierce, the man who founded *both* Samaritan's Purse and World Vision.

In the meanwhile, I can't wait to get my feet on the ground in Haiti!

Photo taken the last time I volunteered as a nurse while in Niger, West Africa. It seems like a lifetime ago!

so it's been 10 months...

noreply@blogger.com (lindsay) — Fri, 08 Jul 2011 23:09:00 +0000

Have I lost my voice? Where are all the deep thoughts, the meaningful reflections, the heartfelt inquiries? I came home from West Africa 10 months ago and have not blogged since then. Not once. In fact, I left you, dear few and faithful blog readers, in Niger which is colossally unfair of me. Since then I returned to the ship in Togo, sailed to South Africa, traveled for two weeks in South Africa, flew home via Paris, and then spent two weeks in Seattle and another two in Rochester before settling in to a new life in Houston. I went to Hawaii for a family Thanksgiving, Mexico with my Minnesota girlfriends, and am currently in Minnesota about to embark on a canoeing adventure in the Boundary Waters. All of that to say, I can't possibly catch up on all that's happened between now and then, and I'm sorry about that. I'm sorry I left you hanging in Niger waiting for the conclusion of two intense weeks of VVF surgery.

My heart has not been up to blogging, I guess.

I've been home in the states now for 10 months, and I am still grappling with all of the changes that have happened. I suppose I'm mostly over the reverse culture shock, except there's this part of me that misses being in West Africa. Each day that passes lessens the grief a little. I've thought about it-- a lot-- and I can find no other word but grief for this ache that I'm living with on a daily basis. I find myself wondering what's happening at the fistula clinic in Niger and what's going on at the fistula hospital in Freetown Sierra Leone that my friend Sarah helps run. I wonder how things are going on the ship, how the nurses are doing, how lives are being changed. I miss being in the thick of things. I keep thinking about what my role would have been had I returned to the ship this year.

I write this not because I feel the need for sympathy, but because some part of me simply needed to admit this publicly.

I don't imagine that my emotions would stand up to the light of scrutiny. Perhaps I miss feeling important, feeling needed, part of changing lives. It's heady stuff, doing the kind of work that Mercy Ships and the Worldwide Fistula Fund does. It could easily become addicting, feeling important, feeling useful to God as if he can't quite get things done without me. Which is of course laughable, but there you have it.

So here I am. I live with my parents in Houston and work full-time as a nurse at a community hospital a few minutes' drive away. I'm starting my master's degree in nursing this fall at the University of Texas in Houston. I commute 45 minutes each way to a wonderful church downtown although I have not yet made any friends or become connected there. I've fostered some really positive work relationships with coworkers. I've had cause to be thankful numerous times over for the blessing of being able to spend more time with my parents as they go through their own transitions in life.

And still, I ache.

I have no idea what the future holds, other than I'll be done with graduate school by next Christmas and be a family nurse practitioner (FNP). I keep hoping that I'll receive a clear call from God for whatever happens next, but so far he seems to give me only just enough grace for right now in this moment. It's so typical of me to want to run ahead of Him. I'm forever looking ahead to the next thing, all the while missing the very thing he has directly in front of me. I feel His whispering in my heart: slow down. Breathe deeply. Rest in me, in my presence, in my love for you, in the knowledge that all is well and all will be well.

Flower from a flame tree or tulip tree- I forget the name- in Hawaii.

fish lips

noreply@blogger.com (lindsay) — Wed, 06 Oct 2010 22:12:00 +0000

Continuing to blog about my time in Niger working with the Worldwide Fistula Fund.

Saturday (day 10): fish lips

After all the hullabaloo of riding camels yesterday, we had to say goodbye to part of our team as they left to fly back to the US. Our team is splitting up now, before our patients are fully healed, because we have to maximize space (and thus finances) on the small plane it takes to fly from Maradi back to Niamey, the capital of Niger. It also doesn't take as much manpower to care for our patients now that the surgeries are finished, so it makes sense to have a smaller team. Three nurses (including myself) remain, and Dr. Steve.

From L to R: Dr. Steve (surgeon), Alainie (RN), Sarah (RN), myself (RN), Ginger (RN), Dr. Lewis (surgeon), and Greg (anesthesiologist)

Although today is Saturday, those of us that are still here in Danja still have to work. After breakfast we head down to check on our ladies and do whatever nursing tasks need to be done for the day. But today is much more leisurely than last week and we spend more time playing with the kids than anything.

So without any further ado let me introduce you to the phenomenon known as "fish lips." This is Sarah's brainchild and a great way to make people laugh, regardless of culture or language.

Sarah (on the right) started it all!

Everyone in Niger that we've met loves having their picture taken, but all smiles disappear when you aim the camera (except Sharifa on the far left--I caught her off guard).

But little girls love to laugh, and when the crazy nurses start making fish lips of course they will join in!

Hauwa and Sharifa with varying levels of success... but trying really hard!

Me and Hauwa, two of the bestest fish-lippers you ever did see.

queen of the orient

noreply@blogger.com (lindsay) — Fri, 01 Oct 2010 23:54:00 +0000

Friends, I've been traveling with only intermittent internet access for the last several weeks, so I'm sorry for the long pause! Continuing to blog about my time in Niger...

Friday (day 9): queen of the orient

Today we did three surgeries on Abou, Marimouna, and sweetly timid Miriam from the Tuareg tribe (one of the nomadic desert people groups). We have arranged to ride camels after finishing work today, so we do two surgeries before lunch so that our afternoon workload will be lighter. It's only after our third surgery is over that we realize that we're done, not just with that particular surgery but with all of the surgeries for our trip! It's been so hectic that few of us have been really keeping track of the days, but we're now halfway done with our time here in Niger.

Since we front-loaded our work, we are able to leave our patients a little earlier in the evening in order to meet our camels. I have desperately wanted to ride a camel for, oh, about five days now since we first heard it was a possibility. As we're walking up the road towards the guesthouses we suddenly see camels, three of them! The camels have an eclectic group of men, teenaged boys, and even a school-aged boy caring for them. My particular favorite was this one sporting a snow-coat hood as his head covering. Only in Africa!

Gotta love the snow-coat hood. (Just in case it snows, you know.)

The camels themselves are ever so much bigger than any of us imagined and we each begin to have second thoughts. Then the camels notice us and start making the most un-animal braying, gargling, and even drowning noises we've ever heard. At this point I'm remembering all the stories I've ever heard about camels being bad-tempered, mean, and loving to bite.

I count the knobby joints in each sinewy leg and inspect the saddles, precariously secured with one lone leather strap around each camel's ribs. The saddle seats hardly look big enough for anyone's rear end, much less mine! But now that I see the camels in real life I imagine turbaned people riding these ungainly creatures through the vast expanses of the Sahara and Sahel deserts, trading spices, leather, and salt. My mind is made up: I can't wait to experience this!

Since there are only three camels, Sarah, Greg, and James (our Australian physical therapist missionary friend who lives on the compound) bravely volunteer to go first. Greg swings his leg over the absurdly high saddle, and before we know it he's miles high in the air but as relaxed as anything. Sarah's camel makes all sorts of dreadful sounds-- and Sarah makes all sorts of faces-- as she gamely tries to climb into the saddle in a skirt. The rest of us in are hysterics, including the men holding the camels. Finally all three are seated on their camels and the men lead the camels down the road for a quick jaunt while the rest of us take pictures in between bouts of hysterical laughter.

And now it's my turn, along with Ginger and Alainie. My camel is the tallest of the bunch and a beautiful off-white color with the longest eyelashes I've ever seen. I've learned from Sarah's experience and have on a pair of scrub pants underneath my skirt, a fact for which I am immensely thankful as I try throwing my leg over the insanely high saddle. The men place my feet on the neck of the camel, and as I hold on tightly the camel slowly begins to make its way to a standing position. It's rather like riding a seesaw and I tilt precariously backwards and then forwards as the camel unfolds its various knobby joints. Already I love this! I can picture myself riding across the desert, shielded from the sun by robes and a turban. Ginger, Alainie and I joke that "we three queens of orient are," and we set off down the road.

Holding on for dear life as the camel see-saws its way to a standing position.

Our ride on the camels is over much too quickly in my opinion. The camels saunter away with their owners, and our bellies are aching from having laughed so much. I imagine we have provided the camel owners with some stories to tell back home!

a queen of the Orient... or something like that!

What a gift this whole experience in Niger has been so far. I'm realizing that as I continue to explore the Nigerien culture and worldview, I keep falling more and more in love with it all. I love the Hausa language, I love the relaxed yet conservative nature of the Nigerien people, and I even love the head wraps. I hardly notice my own head wrap any more, and am quickly becoming proficient in various ways of tying it. It's amazing how much I've experienced in just nine short days, and I can't wait to see what next week holds.

Heading home after much laughter.

I think I want to go home

noreply@blogger.com (lindsay) — Thu, 02 Sep 2010 01:45:00 +0000

Continuing to blog day-by-day about my time in Niger...

Wednesday (day 7) and Thursday (day 8) : I think I want to go home

Wednesday went well--our first time doing three surgeries in one day. Two women had their surgeries after lunch, so for Sarah and I on the ward it meant most of our work was stacked at the end of the day. Everything went smoothly, but after twelve hours, I had nothing left to give. And still we had to come back in the evening after dinner to check on the women for the night and pass out meds.

I've begun to realize just how few resources we have here. There's no one to come and replace me when I have finished my shift. It would be easy in circumstances like these to feel like everything stands or falls on me and how much I pour myself out. Of course I don't have the resources or sheer will power to accomplish these things; only God does. But can I recognize that? Can I seek Him in the midst of need? That's always, always the rub.

Hard at work in the OR

Thursday promised to be similar to Wednesday's routine--three surgeries, one before lunch and two afterwards. But when Sarah received the first patient back from the OR, it became rapidly clear that this would not be a good day. VVF surgery is an art, and unlike some other surgeries you are never guaranteed a good outcome. Things started poorly in the OR with scarred tissue that wouldn't hold stitches. By the time she was with us on the ward, she was wet. And all we could do was start her on a medicine and hope against all hope that the surgery hadn't failed.

This is the line we choose to walk in working with VVF. We exist moment by moment in the space between hope and despair, joy and sorrow, dancing and mourning. Most of the time we walk in light, rejoicing with the women as hope transforms them. It's easy to praise God in the light. But sometimes we seem to walk in darkness and pain. Only God can right some wrongs, and of course you have to wonder why He chooses not to do so. And when the answers are not clear (are they ever?) you have a choice. You can trust that He can and does work all things for good, despite appearances to the contrary. Or you can decide that because He allows pain and suffering in the world, He doesn't actually know what He's doing.

I choose to trust. But it doesn't make it any easier to sit and just be with a woman as her hopes shatter.

I choose to trust, but I also don't know how much of this I can take. It's all well and good when things run smoothly, surgeries succeed, women are dry. But on days like today, I think I want to go home.

next post (Friday) : queen of the orient

two surgeries and a stick shift

noreply@blogger.com (lindsay) — Thu, 26 Aug 2010 23:51:00 +0000

I'm working on blogging about my day-by-day experiences in Niger, but the sailing has been a little rough recently so it's been a couple of days since I last posted. I'm making up for the silence with an exceptionally long post. Enjoy!

Tuesday (day 6): two surgeries and a stick shift

Spirits are high as we head to the clinic area. We have our first two surgeries of the week today. The rest of the week we'll do three surgeries per day, but seeing as it's the first day we want to make sure that everything works well.

Foure, our first VVF patient of the week in Danja!

When we arrive, Mariama (one of the local midwives working with us on the ward) tells us that our first patient, Foure, is all showered and ready for surgery. The OR team quickly heads off to starting prepping the OR. On the ward, Mariama, Hannatou (one of our translators), and Sarah and I pray with Foure, then walk her across the courtyard to the OR. Before Foure enters we have her step in a bucket of water to rinse the sand and dirt off her feet. Everything in this part of Niger is so sandy that your feet are always filthy, and the water bucket was Sarah's brilliant solution to that.

So she's off. Now we settle down to wait the several hours before her surgery is finished. We have plenty to do--go chat with the ladies under the tree, play with the adorable kids, and even a little nursing work making a plan for when Foure comes back from the OR.

In a western hospital setting, after surgery the patient goes to a recovery room (aka post-anesthesia care unit or PACU) for about an hour to be closely watched (think blood pressure checks every 5 minutes!) while the anesthesia wears off. After the recovery room the patient arrives on the ward where we check blood pressure every 30 minutes for a while, then hourly, then every 4 hours, and so on. But this is Africa, and this is not a hospital--not yet anyway!) Hopefully the hospital will be completed in the summer of 2011.) So the patients will come straight from the OR to Sarah and I on the ward. We ARE the recovery room!

Dr. Steve previously instructed us that our whole time in Niger is meant to be laid back, and he's given us the freedom to do what we feel is right and appropriate on the wards. We both have a lot of experience with VVF patients, so he's also trusting our nursing judgment to guide our practice. In light of this, Sarah's and my sophisticated plan for our post-op patients is this: check her vitals signs when she comes to the recovery room, aka ward. If everything is fine, we'll check her again later. If there's trouble, we'll check her again sooner. We're both confident (arrogant?) enough in our assessment skills to be able to catch any trouble before it actually becomes trouble.

A VVF patient is transferred from the OR to the ward.

After a while we hear people outside the ward, so we investigate, hoping Foure is out of surgery, which she is. She's being wheeled across the sandy courtyard on the stretcher, Greg the anesthesiologist at her side. We settle her into bed, and I check her vital signs according to our plan. And she's fine! Our recovery room plan is working brilliantly so far.

Foure back from surgery and doing well! (And I'm nursing in a skirt and a cap... Florence Nightingale would approve!)

While I check on Foure, Sarah gets Zina off to the OR for her surgery. Then we sit back to chat with the ladies under the tree again. I check on Foure, but she's dry and doing well so I have nothing to worry about.

The recovery room peanut gallery.

The rest of the day goes smoothly and Zina also does well when she comes back from surgery. After Sarah and I get both Foure and Zina settled for the evening and tomorrow's three ladies are brought into the ward, we head back to the guesthouse for dinner.

After dinner, Sarah and I drive back down to the ward to check on the ladies once more before we go to bed. Everyone is doing well, and we tell everyone "se anjima" ("see you tomorrow") before we head back to the car. Again, this is a very non-western hospital occurrence, where nursing shifts are 24/7. I've never left a patient before and just gone home. But there are some local nurses on overnight, and our team has a cell phone so we'll each take nights on-call.

I climb into the driver's seat. I've never driven a stick shift, but I've always wanted to, and now's a good time to learn. One of the unofficial policies Dr. Steve has is that everyone has to be able to drive on the compound. So Sarah talks me through it, I let out the clutch while pushing in the gas, and...success! I manage to stall a few times, of course, but for the most part I love the challenge and it feels surprisingly natural.

So... as the stars start to come out in the inky black sky, I am in the middle of Niger learning how to drive a manual car. Who would ever have guessed?

Just another chapter in this wonderful, wild adventure that God is walking me through!

tomorrow (Wednesday): I think I want to go home

under the tree, into the ward (screening day)

noreply@blogger.com (lindsay) — Sat, 21 Aug 2010 22:33:00 +0000

Thanks for your patience with me friends! I arrived back on the ship from Niger last Friday and then we set sail for South Africa last Sunday... I'm writing to you from the middle of the ocean. But, with the comparatively-fast ship internet I can now post pictures! Enjoy!

Monday (day 5): under the tree, into the ward (screening day)

Today the rest of the team arrived: both surgeons and the anesthesiologist. After they'd settled in and eaten a quick lunch, we headed to the clinic area to start screening the women.

We found the women waiting under the tree as usual. Some women had previously been operated on in May and were returned for a check-up; some had been screened previously and were already on this week's surgical schedule; some had simply heard of the fistula center and came seeking hope.

The ladies brought their mothers, daughters, sisters...

Marouka and Aichatou

We set up our screening area in the maternity clinic, and one by one the women came through to be examined. I assisted the surgeons with the physical exam, handing them supplies and trying to anticipate their needs. We screened somewhere around 20 women, although I am not sure of the exact numbers. 10 will be operated on this week, and some of the others will return for surgery in November when the next VVF team comes.

Screening VVF ladies in the maternity clinic in Danja

At the end of the day we had a surgical schedule made up for the week, and we brought the first two women from under the tree into the ward that night. Similar to on the ship, we had to teach the women how to shower in preparation for surgery the next morning. One of the local nurses working with us explained that for many people in this region of Niger, you are considered clean if you have bathed your face, hands, and feet. This makes sense when you also consider the great distances that many people have to haul their water!

Tomorrow: the first two surgeries!

teaser

noreply@blogger.com (lindsay) — Sun, 15 Aug 2010 22:57:00 +0000

... more blogs about Danja are coming, I promise! Here's a few pictures of "the ladies" to hold you over until I have a chance to write more.

VVF ladies waiting patiently under a tree for the team to arrive

Some of the women who would have VVF surgery (and some other family members)

A caregiver (aka mom) for one of the VVF ladies--Tuareg tribe I believe.

Thanks to Sarah for taking amazing pictures of the women!

the blind and the broken

noreply@blogger.com (lindsay) — Sun, 08 Aug 2010 14:40:00 +0000

For a while I will have to blog day-by-day about Danja, Niger. So far my time here has been so rich and full that I think you might enjoy some details!

Sunday (Day 4): the blind and the broken (Hausa church)

There’s something incredibly rich about worshiping with believers in other cultures--each time I do, I see a picture of heaven where every tongue and tribe is represented.

Church today was in Hausa, the local language. June pointed me to the Bible verses that the pastor was speaking about, but other than that I had time to simply read, pray, and absorb what was going on.

Worship is more reserved and more laid back here in Niger than the churches I experienced in Benin. Each age group took a turn singing for the rest of the congregation, starting with the children, moving up to the adolescents, then the women, and then the men. But there was none of the booty-shaking, shoulder-pumping, exuberant dancing so prevalent in Benin and Togo. Instead, each group of singers stepped gently from right to left in time with the song.

"Reserved" does not by any stretch mean "boring" or "plain". I wish I could somehow portray to you the resonance of the drums the women played while they sang. As I leaned against the wall behind me I could feel every beat percussing through my heart and pulsing down my veins. One woman in particular had a beautifully haunting voice and I imagined the windswept desert underneath dark, starry skies while she sang.

One of the ladies here for VVF surgery sat in front of us, and I gained a firsthand knowledge of some of the shame they experience. Just a subtle hint of urine at first, but as the service progressed the smell became more and more noticeable. She strove to keep a little distance between herself and the people sitting next to her. When she stood to sing a damp stain of urine appeared below her right foot, and it broke my heart. But she held her head high and sang nonetheless, a beautiful picture of hope and strength.

Many of the people filling the church were patients; I saw many with bandages on arms or legs or eyes. I think the only difference at home is that many of our wounds are the hidden, internal kind... sins like pride, jealousy, anger. These wounds are easier to hide, perhaps, but potentially more damaging at the end of the day. I’m so thankful for a God who loves us despite our wounds, and who loves us enough to want to heal us, no matter how painful the treatment may be.

After church was over, I watched a woman let her children wander ahead of her on the path home as she led a blind man. He simply called out and lifted his stick, while she took hold of the end and began to lead him. A little thing, really, but completely beautiful to watch.

Lord, let me not forget: I too have wounds in need of Your healing, and I too am blind in many ways.

Come, restore my vision.

Come, heal my brokenness.

work, work, not dare to shirk!

noreply@blogger.com (lindsay) — Sat, 07 Aug 2010 16:35:00 +0000

For a while I will have to blog day-by-day about Danja, Niger. So far my time here has been so rich and full that I think you might enjoy some details!

Saturday (Day 3): work, work, not dare to shirk!

Walking down from our guesthouse to the Danja fistula hospital for the first time. Alainie managed to successfully carry our medical supplies on her head African-style.

Our objective today is to clean and set up both the operating room and the ward. The rest of the team is due to arrive on Monday, at which point we’ll screen the ladies and make up a surgical schedule. We are using temporary facilities here until the new hospital is built, so all our supplies are packed away in one closet in the OR. Turns out that the closet is also the local party palace for termites! Everything in the closet is covered with red dust, and there are substantial piles of termite leavings/poo. Not to mention that there are definitely bugs everywhere (in our house too, by the way)... spiders, mosquitos, beetles, ants, earwigs, and moths. We unfold the drapes for the surgical table, and insects fall out. We sweep them out from the cupboards. They are hiding between the catheters and the glove boxes... basically everywhere. We clean and bleach everything, and attempt to kill or shoo away as many bugs as possible.

Ginger, Sarah, and Alainie hard at work double-bleaching the OR.

Next we go to meet the ladies who are all sitting outside in the shade of a large tree. Some of them have been waiting for a week for our arrival, and all have brought mothers and children. They are thrilled to see us and warmly welcome us in Hausa. Of course none of us speak Hausa, but this is one of those times when words aren’t really necessary.

As a preface to the next little story, let me tell you about the bulls. We often see bulls grazing all over the compound, and we’ve been astounded by the fact that very small boys armed only with sticks are responsible for keeping them in line. Some of the boys look to be about 4 or 5, some perhaps 7 or 8. All are fearless as they boss around these massive horned bulls. So, now for the story. After cleaning everything in the OR and ward, we’re walking up to our house for lunch when one of the bulls starts to follow Sarah and I. Sarah peels off the the side and I walk faster, but the bull keeps following me. At this point I figure that if a small boy can keep a bull in line with a stick, then it’s really all about the attitude and about showing no fear. So I turn around to face the bull and put on my stern face and simply say “no!” The bull stopped, but he also didn’t seem inclined to wander away. At this point one of the boys came charging over, stick flailing madly, and shooed the bull away. Thank goodness for small boys with sticks!

Staring down the bull who by the way was not tethered. I appear to be smiling for some reason, but it was not amusing at the time.

My favorite part of today was going into town with James, the physical therapist from Australia. He took all of us girls to a local tea “shop” in Maradi which turns out to be a couple of benches under a pink and green umbrella with a tea kettle heating over a small wire basket of coals. Our tea, called “shiya,” comes in shot glasses and is sweet, a touch spicy, and wonderful. We sit on the benches, drinking our tea and watching the people passing by until the owner of the shop comes. He speaks small small (a favorite French-African phrase of mine) English, and proceeds to quiz us on which states we’re from (he’s stumped by Idaho). He tells us that he used to be in politics, but wanted a break so he quit and opened this little tea business. Now he wants to get back into politics, so he’s running to be the mayor of district two in Maradi. After two shot glasses of tea, we’re ready to leave, and we have to haggle with him to allow us to pay him--he insists that we should pay next time, not this time. He finally lets James pay for his tea, but he doesn’t accept money from us girls. I think the notoriety he gets around town for being the tea shop that the white women go to is perhaps payment enough, but I can’t exactly ask him, of course! It was just so wonderful to be able to sit and watch the world go by--something that I miss on the ship.

At the tea shop in Maradi with James and the girls. I wondered if the local Nigeriens thought we were his wives, especially with our matching headwraps!

We end the day by going to the French Club for dinner and a swim. Some of the other SIM missionaries are there with their families, so I chat with them for a long time about living in Niger. As the light fades, we are preparing to leave when someone notices that there are some small lemur-like monkeys in the trees. It’s just dark enough that we have a hard time seeing them, but we watch their silhouettes leap from tree to tree until the mosquitoes finally chase us to the car.

It’s just another normal day around here-- cleaning the OR, a showdown with a bull, tea with an aspiring mayor, and lemur monkeys in the trees. Oh, and let me not forget the sheep in the trunk of the car in front of us as we drove home... the passengers were all dressed up like they were headed to a party when all of a sudden a sheep sticks its head up in the back window of the car, then settles back down again. (Maybe you had to be there to understand it, but it really was hilarious.)

Like I said, it’s just another normal day in Danja. It's just that normal looks completely different here!

Tomorrow: the blind and the broken (Hausa church)

come fly with me

noreply@blogger.com (lindsay) — Thu, 05 Aug 2010 20:10:00 +0000

For a while I will have to blog day-by-day (internet access permitting) about Danja, Niger. So far my time here has been rich and full so I think you will enjoy some details! Warning: long post ahead!

Friday (Day Two): come fly with me

After a night filled with thunderstorms, we wake up early in preparation for flying to Danja. We don our ankle-length skirts and make sure to pack our head wraps in easily accessible locations, since these things are necessary for women in this part of Africa. Our pilot, Ed, shows up at 7am to pick us up and we head back to the airport again, only this time we pass up all the commercial planes and head for a back hangar. I’ve been anticipating this for months now--we get to fly in a six-seater Piper Saratoga from Niamey to Maradi (Maradi is only 15 kilometers--a quick car ride-- from Danja).

Ed opens the airplane hangar and proceeds to pull (yes, pull) the plane out onto the tarmac. We’re all a little giddy, seeing this tiny plane that will somehow manage to hold us and our luggage. It's a little hard to scramble into the plane in our long skirts, but we manage. I have the immense pleasure of sitting in the copilot's seat in the cockpit. At my feet are pedals, at my knees the steering console, and above that are numerous dials and knobs. I buckle in and put on the headphones, and suddenly I’m listening in on the chatter between the flight controller and Ed as they confirm preflight details. I am literally giddy with excitement!

Yours truly, "copiloting" the Piper Saratoga.

Ed starts the propeller, and we taxi to the runway. I can’t help but hold my breath as we smoothly lift off the ground, and the next thing I know I am watching the desert below, dotted with villages with footpaths to connect them. Sometimes the land below is green and lush looking, sometimes bare and sparse, but it’s always beautiful. I think I could watch the land scroll by below for hours. This Nigerien flying experience is such a beautiful gift from God!

An aerial view of Niger (brown part; less developed and irrigated) and Nigeria (green part; more developed).

After sitting with my eyes glued to the window for two hours, we land in Maradi, the second biggest town in Niger. As I step out of the plane I notice that we have an audience of farmers and their children, all watching us curiously. We’re met on the tarmac by Burt, the local SIM director, and a local airport official who informs us (Burt translating) that he would be happy to find us all good husbands. We laugh, and thank him for his offer, but politely decline. Although, on second thought, none of us have been able to find husbands yet on our own, so maybe we do need some help in that department!

After landing in Maradi, but before covering up our hair with headwraps.

We wrap up our hair in scarves and pile into Burt’s truck for the quick drive to Danja. Before we leave the runway, we meet yet another man who asks Burt in all seriousness “where are you going with all those brides?” Apparently all the single men have been living in Niger all this time... who knew?!?

Burt delivers us safely to the Danja hospital compound, and we get settled in the house of a family home for a year of furlough. We’ve met the other missionaries currently living on the Danja compound-- James from Australia is a physical therapist, and June from England is a nurse. Both are very warm and welcoming, and show us the ropes. In fact, we meet all the missionaries in this area because we're invited/requested to attend a monthly SIM prayer meeting. I'm amazed at the fortitude of these folks--these are the ones who live in the bush, so to speak, treating their own heart attacks (true story) and doing all sorts of other amazing things. It's interesting to meet people who have lived in Niger long enough that they call it home.

Talk about a full day! Once again, I'm exhausted, so I fall into bed, after tucking in the mosquito net, of course. Tomorrow we plan to clean the ward and the OR, meet the women here for surgery, and try to relax a little before the week begins.

Tomorrow: work, work, not dare to shirk!

there is no 27B

noreply@blogger.com (lindsay) — Wed, 04 Aug 2010 21:11:00 +0000

The Danja team after a logistics meeting-- still on the ship in Togo at this point!

For a while I will have to blog day-by-day (internet access permitting) about Danja, Niger. So far my time here has been rich and full so I think you will enjoy some details! Unfortunately I can't currently upload pictures, but will keep trying. Let me try to bring you up to speed, starting with last Thursday, the day I left the ship for Niger.

Thursday (Day 1): there is no 27B

My time in Togo came to a bit of a whirlwind close as I worked my last few shifts and said goodbyes to lots of people, including my good friend Ben from home and my dear roommate Steph from Cambridge, England.

The Danja team--Alainie, Ginger, Sarah and I--all piled in the Land Rover and proceeded to sit in traffic for a while before finally reaching the airport. Once aboard the plane, I discovered that according to my ticket I was meant to sit in seat 27B... but there was no 27B. Fortunately it was a misprint, but still I had to laugh at such a TIA (this is Africa) moment.

Our flight from Lome to Niamey, Niger took just over an hour. Definitely not long enough for any of us to process all the goodbyes we’d said, the fact that we were finally going to Niger, or that our time in Togo was over. At the Niamey airport, we stood in lines called “police” and “health” which you might know as passport control and yellow fever card control. After we collected our bags, we had to once again put them through an xray scanner. The duffel bag packed with medical supplies sat in the xray machine for a while, but fortunately no one hassled us about it.

We were picked up at the airport by the director of the Niger branch of SIM, who took us to a SIM guesthouse for the night. We had dinner with a lovely missionary couple who run the guesthouse, and also with another couple who had spent the last two months out at Danja working on building the new fistula hospital.

As I settled in for the night I could hardly believe I was in Niger; everything seemed so surreal. It was so hot that I simply lay there sweating for a while, listening to the downpour on our corrugated roofing, before finally falling into a restless sleep.

Tomorrow: come fly with me (in a very small charter plane!)

I never dreamed of Africa

noreply@blogger.com (lindsay) — Wed, 28 Jul 2010 18:29:00 +0000

Over dinner with a friend this past week, I marveled at the journey that God has been leading me on over the last several years in particular. I never knew that following Him would be such an adventure, and I will be the first to remind anyone who asks that I certainly don’t deserve this kind of joy.

I never dreamed of Africa. I dreamed of traveling to Thailand with its rice paddies and elephants, and of India's tigers and kaleidoscope of colorful saris.

I never dreamed of being a nurse. Earlier dreams included bus driver, flight attendant, and dentist. In college I thought I would earn a biochemistry degree then launch into discovering cures for various diseases. After realizing biochem wasn't for me, I then proceeded to dream about becoming a doctor, a dietician, a physician's assistant... and finally, finally nursing.

Through all my 27 years I have struggled to place God at the center of my life. I’m no model Christian, not by a long shot. Yet somehow I always return to the fact that I am my Beloved’s and He is mine. Each time I wander away He comes to bring me back, sometimes gently whispering and sometimes using the megaphone known as Pain (my thanks to CS Lewis for a great metaphor).

I have no idea why He has chosen to be so gracious to me. Call me naive, call me rosy-eyed, call me idealistic, but I can’t help but think how stunning the grand adventure of life is with God! Most days are not page-turners, of course. There are chapters I wish I could have skipped. And I am holding my breath for some plot developments (romantic tension, anyone?). But I wouldn’t trade my journey for anything. God has written stories for each of us, and only as we walk through our own pages--and not those of others--are we truly content and truly alive.

I never dreamed of Africa or of nursing, yet tomorrow I fly to Niger to work as a nurse for two weeks at an up-and-coming fistula hospital in Danja. I have fallen in love with VVF ladies and with the transformation that happens in a woman when hope blossoms anew. I’ve fallen in love with the least and the lost. My heart beats for the outcast, the unloved, the lonely.

I never dreamed of Africa. And I certainly never dreamed that God had dreams ever so much grander, more satisfying, more everything than mine.

(Photo from Worldwide Fistula Fund)

VVF by the numbers

noreply@blogger.com (lindsay) — Tue, 20 Jul 2010 16:32:00 +0000

I don't tend to like numbers much; I prefer words. Words make sense to me, whereas numbers have any number of troublesome qualities like imaginary and irrational.

But I thought I might share with you some numbers now that all the VVF surgeries are over and done with and all of our ladies are journeying home.

Learning how to make soap while staying at the Hospitality Center either before or after surgery. The Hospitality Center is for patients who are from too far away to travel back and forth to the ship.

Why am I using numbers instead of words to talk about VVF? Good question. The truth is that I've had such a different role this year than I did last year when I was in the thick of things, so to speak. I pantomimed questions to my patients when no one spoke their language. I emptied catheters by the hundred. I learned to see things with new eyes through relationships with patients like Eugenie. I shared in the joys and sorrows of women I knew by name, simply because I was their nurse.

But this year was different. I've had two jobs, both of which were administrative. As a charge nurse, my main responsibility was to look after the nurses and to keep the shift running as smoothly as possible. As the Assistant VVF Coordinator (big fancy title, I know!) my job was to help handle paperwork, keep track of data, and be a clinical resource for the nurses.

So instead of stories, right now all I can offer you are numbers. But believe me, the numbers tell their own story!

We did VVF surgery on a total of 99 women (many of them had more than one operation, too--that brings the total up to 119 surgeries on those 99 women).
Of those surgeries, 90% were successful (the fistula was closed and the woman was dry). That is exceptional, because VVF surgery is highly specialized and is always, always difficult.
Thanks to a generous loan of a bladder scanner (a specialized ultrasound machine that measures how much urine is in the bladder), we were able to detect and treat urinary retention in our patients. (Urinary retention is a common post-op complication and can cause infection or failure of the repair. Without a scanner, the only way to check for retention is to insert a catheter into the bladder, which poses a risk of infection. And of course it's miserable for the patient!)
Using the bladder scanner meant that we caught and treated the 22% of our patients who developed retention after surgery. Look at it another way: we saved 78% of our patients from needing catheters inserted after their operation!

(Let me pause to offer a belated apology for talking about catheters and bladders and urinary retention. I should probably consider having a "medical disclaimer" on my blog somewhere.)

So although the numbers don't tell the whole story, they do show this: all of the surgeons, all of the nurses, and every one of you who prayed for these women-- you did well. God used each of us to pour love and life and hope into their lives. I wish you could have seen them, standing in front of a crowded room in a new dress to praise the Lord for being dry. I wish you could have heard the drums pound and seen shoulders lift in dance and smiles radiate joy.

The numbers just don't do it justice.

I first met Rosali (in green) last year in Benin... her surgeries that year failed. But she returned to the ship this year and is now dry! Also pictured is Clementine, a patient discipler & counselor on board who loves the ladies with every iota of her being.

the road to Danja

noreply@blogger.com (lindsay) — Mon, 05 Jul 2010 20:49:00 +0000

This is the road to Danja.

(picture from Worldwide Fistula Fund)

This is the fistula hospital under construction in Danja, and I'm going to work there for two weeks in August.

The fistula hospital is being built following the red outline. (Picture from Worldwide Fistula Fund)

Is your mouth hanging open like mine??

The VVF surgeon on board, Dr. Steve, is one of the surgeons behind the Worldwide Fistula Fund, and it's through this organization along with others that the hospital is being built.

Until the hospital is completed, surgeries will occur in other buildings on the compound. The compound also houses SIM missionaries and a leprosy clinic.

I'm so excited to see a different kind of Africa than I've experienced so far--the kind with sandstorms, camels, and turbaned nomadic peoples. But in researching it a little online, I've also found some tough news: Niger currently has the dubious distinction of being the least developed country in the world according to the Human Development Index.

A Nigerien VVF patient. (Picture from Worldwide Fistula Fund)

Please pray for me as I sort out the details of heading to Niger. I've booked a flight, but I also need a visa. Originally we thought that obtaining said visa required travel to Cotonou, Benin (where the ship was docked last year) because that is the closest Nigerien embassy. But we just found out there is a Nigerien Consulate here in Lomé (anyone know the difference between an embassy and a consulate?). So our passports are currently at the consulate, awaiting their official visas. I'm also praying that the return flight from Danja to Lomé goes smoothly, as I will arrive back on the ship just a few days before the ship is due to sail for South Africa.

And now for a quick topic change. One of the things I love most about blogging is the fact that I can give whoever reads my blog a small glimpse into another corner of the world. I can tell stories of God's faithfulness, of what He is teaching me, and of the work He is always, always doing. So I just want to say a quick thank you to you all who take the time to read what I write and who pray faithfully for me and who encourage me in a million little ways.

We are all part of the grand redemptive work that God is scripting, whether or not you realize it. May you live your life Soli Deo Gloria-- for God's glory alone--wherever He has placed you, whether it be in Seattle or Rochester or Houston or Togo. Or Niger.

the short version

noreply@blogger.com (lindsay) — Wed, 23 Jun 2010 19:15:00 +0000

Last year I was so good at this blogging thing. Of course, last year I also only had one job, and I still had a job waiting for me back home too. This time around I have two jobs on board and I am unemployed and rootless back home. All of my belongings are boxed up and hopefully surviving the Houston summer heat and humidity in my parent's garage.

I've had on my closet door for months now an ever-expanding list of the things I need to blog about.

I am so hopelessly behind on my blogging that I'm reduced to catching you up on the last several months of big events in one fell swoop.

Meeting Ben at the airport

My good friend Ben from Minnesota came to work in the lab on the ship. He came bearing cards and even chocolate and music from our mutual Minnesota friends. It has been such a blessing to have someone on board who has known me for more than 6 months.

My blood is worthy of an A+

I was finally able to donate blood to a patient--one of my goals on board this year, since when I get home my blood will be blacklisted for a year or so due to my having been in a malaria-prone part of the world.

Upper Wli Falls, Ghana

I spent a glorious weekend in Ghana with some great girlfriends, hiking in one of the most beautiful places I've ever been. And by "hiking" I mean "rappelling down a steep hillside holding onto vines in a very Indiana Jones-esque way." It was glorious! And the waterfalls were amazing and totally worth all 6 hours, especially since I have a "thing" for waterfalls since an experience in Benin last year.

A tasty barracuda, teeth still intact!

I returned to Benin for a weekend of laying poolside, playing frisbee on the beach with headlamps at night, and wading in the ocean while watching the stars and digging my fingers and toes into the sand looking for bioluminescent bacteria (which, by the way, are amazing little sparks!).

Our first VVF screening (see previous post) went so much better than I could ever have dreamed. We screened 66 women and scheduled exactly enough for the first four weeks of surgery--exactly what we needed. It's amazing how God provides!

Since then, we've finished those four weeks of surgery and are in the final two weeks. We've been able to bring on a second VVF surgeon due to a maxillo-facial surgeon being unable to come. This past Monday we had our third and final screening, screening 51 women and scheduling 42 for surgery, once again filling perfectly our remaining surgical slots. God has wildly exceeded my expectations regarding screening, and He continues to do so each day that passes.

So there it is--the short version, minus the details. I can't promise that I'll have more time or emotional energy in the following weeks to do better at blogging, but know that I think of you all often.

and so it begins

noreply@blogger.com (lindsay) — Sun, 23 May 2010 12:13:00 +0000

My online silence has been due in large part to an overwhelming lack of energy. The day-to-day routine of living on the ship has been so draining for me recently that I have just barely managed to half-heartedly start one or two blog posts. I have so much to tell you: a good friend came to the ship (and will stay to the end of the outreach!); I finally gave blood to a patient; I traveled to Ghana with some girlfriends and had a fabulous time; we had another little baby die on the ship. So many stories to tell, yet right now I must tell a story about the very reason I came back to the ship: the VVF ladies.

Tomorrow is our first VVF screening day, the day where about 75 women (that we know of) will come to the ship to see if they are surgical candidates. Women will come from all corners of Togo, some speaking languages that we have no translators for. Some will have walked for days to get to a bus, then endured 10 hours' drive while urine slowly dampened their skirts and tracked paths down their legs. They come from brokenness, shame, isolation, and unspeakable pain. They arrive at the ship looking for a miracle because what we offer is so much more than mere surgery. If by God's grace we are able to operate successfully the woman may have her very life back, returning to her home, community, family, husband, and occupation: all things lost due to the fistula. This is why we are all here: to be a part of the transformative work that God does here in West Africa.

Pre-screening a woman with probable VVF at a general screening

So today Maggie and I will head to the Hospitality Center (where the women from northern Togo are staying at the moment) to begin the long process of gathering histories from these women. Do you leak urine all the time, both day and night? Did it start after a difficult labor? How many years have you had this trouble? All of our questions help us to know if a surgery will help.

Maggie prays with a woman with VVF at general screening

Please be praying for Maggie and I and the entire team who will be screening tomorrow. We'll start at about 6 in the morning and work well into the evening. Pray that the women would be truthful with us; sometimes they are so desperate for help that they tell us what they think we want to hear rather than the truth. And sometimes they genuinely don't know the truth; we often hear "I fell asleep and when I woke up the baby was gone." Did they pass out from exhaustion? Did they have anesthesia for a cesarean section? It's hard to say. Many don't even know their age, because it's hard to mark the passage of time in a land with no seasons, only perpetual summer.

Pray for wisdom as the surgeon decides who he wants to operate on, and pray for compassionate words as we have to tell many women that we cannot help them. May each woman see in our love a reflection of God's immense love and compassion for them.

the least and the lost

noreply@blogger.com (lindsay) — Sat, 10 Apr 2010 15:41:00 +0000

It's one thing to sail a hospital ship to a country in West Africa; it's another thing to find patients. It's a different matter altogether to find the right patients because we have such a small range of very specialized surgeries that we can do on board. Usually Mercy Ships solves this problem by having one or two large screening days, seeing 4,000-5,000 people in one day. This kind of large screening wasn't possible due to the elections in Togo, so we've tried a new process this year--screening multiple times a week, each time seeing only a couple hundred people.

I tried several times to go to one of the screenings, but each time something would come up to prevent my going. I finally had my chance two weeks ago (yes, I know, I'm behind on blogging!).

I am glad I wasn't the one actually screening the patients as I would not have known how to keep saying no to people. I did watch the screening nurses as they interacted with each person coming through the line, gently touching lumps and bumps, slowly moving burn-scarred arms and legs, peering inside mouths. Living on this continent with any kind of deformity or disability condemns you to a life of ridicule, scorn, and isolation. I couldn't help but wonder when some of the people coming through the line had last been asked to tell their story, last been touched, or last been truly seen as a person made in the image of a loving God rather than a shameful outcast.

People come with every thing imaginable: hernias, fungus over their whole body, goiters, neurological disorders, paralysis due to improperly done injections, burns, erectile dysfunction (yes, really), diabetes. Sometimes I'm pretty sure we can help, like the little boy who'd already had a surgery to have the tumor slowly creeping out of his mouth removed. Although the tumor was gone, somehow he was left with a slack jaw and floppy lips, unable to speak, eat solid foods, or even hold his mouth closed for very long. He got a card to come to the ship. So did the mama whose baby, mere days old, was born with a big gash in her lip, the cleft causing her to be unable to breastfeed properly. We can stitch that lip back together so she can eat and speak properly... so she can smile.

Sometimes we should be able to help but can't, like in the case of the little boy with severely bowed legs. This is the worst: we could straighten those legs out, but there's not any more room on the surgical schedule.

Sometimes we refer people to local doctors because we don't have the resources on the ship to treat cancer, or medical issues like fungus or diabetes.

And sometimes we can't help at all, which believe it or not isn't always a bad thing. It's a bad thing when you "only" have a little goiter no bigger than a walnut or a plum: we only have room for the watermelon-sized ones, the ones grown big enough to actually start compressing your windpipe and slowly strangulating you. Not being able to help is a good thing, though, in the case of a little girl who'd been badly burned. Her arm was covered in thick, scarred tissue... but her mother had worked hard to keep that arm flexible, so the little girl had full range of motion and therefore didn't even need surgery.

I watched people as they came through the line, the least and the lost, reduced to living lives of hiddenness, shame, and isolation. God knows each name, each tear cried, each insult flung their direction, each whisper about being cursed. God knew the exact moment the tumor began to push out the healthy tissue of the cheek, finally protruding out the mouth. God saw the baby forming in the womb and knew the baby's feet were clubbed. God saw the injection needle hit the sciatic nerve in the back of the leg, causing life-long paralysis.

I do not pretend to understand why God knows and sees all this and yet allows it to continue. I know deep in the innermost places of my heart that He grieves over His children's sufferings. I choose, although it is not easy, to trust in His promises: that He is always at work, that He will wipe away every tear, that He makes all things new.

Some people leave the screening area clutching a yellow card, their golden ticket to come to the ship and be assessed by the surgeon. Some leave with less than they came, their hopes laying broken at our feet.

Yet all leave having been touched, acknowledged, seen, sometimes for the first time in years. Those we turn away we pray with, cry with, hold. It doesn't seem enough.

We try to rest in the knowledge that God is sovereign, that somehow, some way, He has good purposes at work in all this despite what seems like insurmountable evidence to the contrary.

And we try to hold on to the names and faces of the ones that we say yes to, the ones that will come to the ship and become part of our lives for a time as we try to piece broken bodies back together.

We trust that God has indeed seen the plight of his people: the name that Hagar called God when He met her in the wilderness was the God who sees me. (See Genesis 16: 13-14)

walking to Ghana

noreply@blogger.com (lindsay) — Fri, 26 Mar 2010 13:42:00 +0000

Up until recently, we've been fairly restricted regarding when and where we could get off ship (if we could get off at all) due to the potential for civil unrest after the elections.

So when I run into my Danish friend Jens last Saturday and he asks if I want to come with him and his "friend" James (Jens met James on a street corner in Lomé the other day), I don't hesitate. I throw on some walking shoes, fill up my water bottle, and we're off.

Jens is the kind of person that loves to interact with people-- all people, all the time. So it wasn't surprising that he'd made friends with James while out wandering in Lomé, or that he'd agreed to meet James for another day of exploring in town. Being from Ghana, James speaks English (helpful for Jens and I) but he also speaks Ewe, the most common local language (also very helpful, seeing as I speak a little French but no Ewe).

I shake hands with James, who promptly goes into raptures, unaccountably pleased that Jens has "finally" found a good woman to settle down with. It's no good trying to explain friendship and singleness to a West African; these are almost as strange to them as my white skin. So I simply wink at Jens while James eloquently wishes us long life and prosperity.

We start off by taking a taxi into town (last year in Benin we were close enough to walk to town; this year it would take a good 45 minutes to walk to town). I am so thankful that taxis are the norm here rather than the zemidjans of Benin. To own a taxi you must pass a driver's test (I think) and you must be registered. To own a zemi in Benin you need... nothing at all. In fact, you can have cataracts in both eyes and still offer yourself as transportation for hire (true story-- one of my friends last year took a ride with a partially-blind zemi driver).

Jens, James and I pile out of the taxi somewhere in town and start walking. I'm not sure what exactly James has in mind. We pass a large, modern building with multiple signs proclaiming "Musée National" and decide to go see this National Museum of Togo. As it turns out, the national museum consists of a small, hot room filled with various clay pots, smoking pipes, statues, and farming implements. Go down several steps into the basement and you can see pictures of all the various governors of Togo, which was ruled at various times by the Germans, the English, and most recently the French before someone finally decided the Togolese could run their own country. Needless to say, I hadn't exactly expected a Louvre-caliber museum, but it was still a little... well, African (not that I mind).

After our quick tour of the museum, James decides that we should see the border (Lomé is less than 30 minutes from the Ghanaian border, I believe). After another short taxi ride we again start walking, enjoying the sights and tolerating the smells. In between chatting with James, Jens and I practice my Norwegian. Danish is similar enough that he understands me perfectly, although I struggle to pick out his words sometimes as they are full of long, drawled vowels. As we're walking we notice that the street ahead of us abruptly ends, barbed wire fencing draped as far as the eye can see. On the other side of that fence is Ghana, which looks remarkably similar to Togo as far as I can tell. Every now and then there's large gaps cut in the fence and we watch as people carry fuel and other goods across the border (easier than going through the checkpoint, James tells us). There are weapons-toting guards lounging around on the Togolese side but they don't interfere with the border crossings happening in broad daylight.

(Togo on the left side of the fence, Ghana on the right, with an illegal gate cut into the wire fencing.)

The kids here in Togo are a little shy, and I find that I miss the wildly exuberant shouts and antics of the kids in Benin. The few kids who do venture a shy wave and softly call out "yovo, yovo" ("white person, white person"), Jens gently teases by calling back "ameyibo" which according to James means "black person" in Ewe. We get shouts of laughter and good-natured chatter from the mamas at this, and James interprets for us that the mamas are pleased that "this yovo, he speaks our language!"

We follow the fence south, towards the beach, until we come to a traffic jam of people and vehicles headed to and from Ghana. James tells us that once you pass under the black star you are in Ghana; I think I could have deduced that much from the "welcome to Ghana" sign just underneath the black star. I think about waving at Ghana, but decide that I would rather not attract any additional attention to myself. I get enough attention as it is being a white woman in an African country.

Now that we've seen the border, James suggests that we go to the big market. We flag down another taxi which deposits us at one of the entrances of the big market where you can buy nearly anything you want-- hair pieces, half a butchered chicken (or a whole live one), vegetables, antibiotics, TV's, fabric, "official" soccer jerseys, and "Dolce & Gabbana" sunglasses. Shopping in the market is very nearly the opposite of shopping at home. Here in West Africa, the tedious burden of actually having to look for what you need has been eradicated; instead, vendors clamor to show you their wares. Surely you are in need of a belt, my sister! You already have one? But surely two are better than one! And these are very good quality belts, my dear. I give you good price, ok?

We wander the market, occasionally running into other yovos from the ship. Not at all subtly, vendors admire Jens' beard (his beard would make an Amish man proud). Several men good-naturedly call him Osama. Jens laughs and somehow makes more friends even as he explains through pantomime that he is not Muslim; he just likes to have a beard. James explains that only Muslim men grow long beards here in Togo, but Jens isn't bothered by that one bit. Just a way to start a conversation, he tells me. And I can't help but agree because oddly enough he's managed to have several conversations about faith with the people we've met.

At this point James suggests that we head back into town to check out a "program" of some sort. In West Africa, "program" is a vague way of saying "something will be happening." I have had just the right amount of wandering and randomness for today, so I say my goodbyes to James and Jens in order to join up with some other Mercy Shippers out shopping at the market. A little womanly bartering and fabric-shopping seems perfect for the rest of the afternoon.

All in all I spend 6 hours of the day walking, letting the dust of the roads slowly sink into my pores and thinking that I can't quite account for the way things are so familiarly unfamiliar. I'm not necessarily at home here, but I've spent enough time in West Africa now to be able to really enjoy it.

I think I enjoy most of all the strange incongruities that arise here: I've just spent the day wandering around a town in Togo with a Danish carpenter and a Ghanaian fisherman.

language deeper than words

noreply@blogger.com (lindsay) — Wed, 17 Mar 2010 21:41:00 +0000

Thank you for your patience with me, friends! There's so much to write about at the beginning of the outreach here in Togo that I've not known where to start.

The first weekend that the wards opened I worked as a charge nurse, a slightly different role here on the ship than being a charge nurse at home. But I love being back on the wards with patients; things happen routinely here that would never in a million years happen in a hospital at home.

Just one example of "only in Africa."

Photo taken last year in Benin.

Any of the nurses here could write a book on the myriad ways that nursing on board is different than nursing at home. I have just one small example for you... nothing spectacular, but it's just one of the reasons I love being here.

The first weekend that the wards were open I worked as a charge nurse in our orthopedic ward. As usual, the orthopedic surgeons came for their morning rounds to see each patient and discuss the plan for the day. We ended by seeing two little boys that were scheduled for surgery the next day. One boy was severely bow-legged, rather like this: < > . The other boy had the opposite problem, and his knees met each other in the middle, rather like this: )( . Interestingly enough, both problems are corrected by the same surgery where an angular wedge of bone is removed allowing the bones to be straightened out.

The surgeons proceeded to talk to the boys' mothers, trying to make sure that everyone understood the surgery. After some confusion over drawings and pictures, finally one of the surgeons sat down next to the patient in the bed and hitched his scrubs up to bare his knees. The other surgeon whipped out a pen and began to draw on the first surgeon's leg and knees, much to the amusement of the boys and their mothers. This is where we'll cut the bone; this is how the bones will be reset to straighten the legs; this is where we'll place the pins: all a flurry of penstrokes on the knee and shin of a surgeon. I had to bite my lip to keep from laughing the entire time, for despite the best efforts of the surgeons the mothers looked increasingly confused. And when all was said and done, one surgeon walked out of the wards with his leg covered in geometrical blue designs showing bones, incisions, and wedges.

It almost didn't matter that the mothers didn't understand the surgery, because what matters most around here is relationship and simply being present in the lives of others. There is a language deeper than words, and in that language, the mamas heard we are here, and we are with you. We will take care of your boys. And when we bring them back to you after surgery and they have time to heal, your boys will be able to walk normally, without turning sideways to go through doors and without kneecaps rubbing together. We are here, and we are with you.

I need your suggestions at the moment to help me know what to blog about! Anything you're just unbearably curious about? Let me know in the comments or via email and I may use your question(s) as a jumping-off point for future blog posts.

(In other news, please continue to pray for the Togolese people. As I understand it, the election results preliminarily pointed to the re-election of the current president. The people of Lome have held some rallies and marches over the last weeks, and as a precaution we are avoiding certain parts of town where the opposition support is prevalent. But in the hospital, surgeries continue and ship life continues relatively unchanged.)