Orange juice

Side note- oranges here never get orange. They are still green when they are ripe.

On a much lighter note- while I was writing this morning a man came to the gate selling oranges. Looking at the kids playing in the yard I figured it would be a good snack. I sent the boys back to the gate with a basin and 5,000 shillings (about $2.50). They came back with 100 oranges. Oops, a few more than I figured. Worse they bit into one and told me they were sour and hard. Ummmm, some quick thinking gave them an hour project and me some more quite time while they worked. I gave them my lemonade recipe and had them start juicing. They seemed to have a good time if the mess was any indication and now I have 3 liters of juice in the fridge plus the (at least!) two liters they drank. Best 3 dollars I spent all week. 

Adebo

So here is mid (ok, actually late) morning and I’m sitting at my computer staring off into space again.  I’m thinking how much I miss bedside nursing but actually that topic is for a different  post.  I’ve managed to put in something like 3 hours of work already today. I order to vent my full frustration I need to back up to yesterday or even further back. Several months ago I met a little girl, Adebo, who clearly had some problems. (http://atimeasthis.blogspot.com/2011/01/6-chronically-ill-mentally-and.html)  I had promised to follow up with them but was having a hard time locating them. No one seemed to know exactly where they had come from. Anyway, I was picking up another child yesterday and word had gotten to the Adebo’s mother that I was looking for her and she was waiting for me at the home of the other child. Her daughter looked terrible. She is about 6 months old now but weighs only about 6 kilos (13 pounds). Her breathing was appalling, well over 60 breaths per minute, she had sternal retractions deeper than I’ve possibly ever seen (maybe looked so bad due to the marasmus), was hot to the touch and in trying to console her, her mother put her to the breast but she just absolutely couldn’t drink. So I packed everybody up in the car and set off.  I needed to bring the first child to an “epilepsy clinic” (I use that term very loosely) though I wanted nothing more than to race back home for my neb machine. Figuring a few more pieces of the puzzle would be nice I stopped in the best doctor’s office in the city. Friday- no doctor there, only a medical officer. I considered leaving right then, but still wanted a chest x-ray and maybe a CBC. What a joke. I had to convince the MO that the baby had pretty serious pneumonia and not malaria (fever = malaria in EVERY situation don’t you know?!) and that a chest x-ray was really called for. The only labs that that lab could do was the malaria film and honestly I didn’t care about that anyway. Meanwhile, I can’t stop counting her respirations. On the way out the door I privately asked one of their nurses to put in an IV for me. (Cindy- I still HATE putting IVs in kids, especially malnourished, dehydrated ones!). She took one look at the baby and did it so I know she saw what I did.  I took them back to my house, sat them in the shade of my mango tree and started a little albuterol and atrovent, hung an IV with some ceftriaxone and pushed some hydrocortisone. The neb worked wonders and soon we were both breathing easier. At this point in the day I left them sitting under the tree and headed for the burial of Robert. When I got home, pt’s mother reported that Adebo drank some and she was now soundly asleep. Her little body was still burning up but resps were within normal. They have an uncle who lives in the military barracks and they said they could stay in town with him  tonight. That worked well for me as I could give a dose of abx at that time, bring them there and go back early in the am to give another instead of driving out to the village over and over. I had hoped at that time to switch her over to PO meds and get them back to their family in the village. But this morning didn’t look good. Retractions back, abd painful and distended (what is that about?!), fever higher than before. So I gave another neb with good results again and continued with the IV abx. I’ll head back in a few hours to see them again. This all just seems so silly. This kid belongs in a hospital! Instead I’m giving meds to a 6 month old baby in the army barracks! On top of all that I’m sure that there are some key medical pieces that I’m missing. Why the extreme wasting and failure to thrive? What if she’s got an empyema or effusion going on in there? There are so many things. I am not a doctor! Ugh. 

Robert

I have 6 kids in my front yard asking me to play “kick the can” with them (which I’m sorely tempted to do), Betty is sitting here begging me to take her to Arapi market to get food for the month, I need to get out of my running clothes and get a skirt on and just plain get my day underway but yet I sit here at my computer needing to process but mostly staring into space.

A Ugandan friend of the team, Robert, died late last night or early this morning. He was a good man who did a good job raising his now adult children and currently he was caring for more kids that are not his own. I don’t have all of the facts but the things I do know seem to say that he died of an oral abscess- a tooth ache.

I’m so mad at the incompetent medical system here in Soroti. He was at the best doctor in Soroti and he still died of MODS (though he was never vasopressor dependent so maybe I can’t use this term… I’ve been out of IIU too long!). He had been under that doctor’s care for the whole day and when asked how the patient was doing in the evening he said that because he was unconscious he didn’t know what was wrong with him. When it was suggested by one of my (non-medical) team mates that could it be sepsis? the doctor began to ponder that. But Robert had un-measureable blood pressures since early yesterday morning and around 6 pm after having been on IV (glucose?!) drip all day he finally had a pressure around 70/40 but was unresponsive, vomiting brown fluids and not breathing well. Not surprisingly he died a few hours after that.  Talk about an un-necessary death.  I had offered a few weeks before to pull the rotten tooth for him but there are dentists in Soroti and Robert has a paying job and let’s face it I’m not terribly excited to remove teeth so I figured he would be OK. He delayed in going to see the dentist and by then needed to be on abx for a while before they would pull it. Then, apparently he was still undertreated and the abscess remained. Then yesterday morning on his way home from work he passed out on his bike and had been sliding down hill since.

I feel bad that I didn’t get involved- how preventable! But so many deaths here are. Kids in the states don’t die of diarrhea and they do here. Women don’t bleed to death after delivery there for lack of pitotocin and an educated midwife. I could go on and on but I’m only getting more discouraged.

Time to go play “kick the can”….

The making of fruit roll ups

Today's project? Fruit Roll ups. 

It's mango season here. Which means for the next few weeks kids (and adults) will eat almost nothing besides mangoes. There are so many they fall of the trees and just rot because people can't eat them fast enough.  Mangoes are loaded with good stuff. But the trees only produce once a year. So for the other 11 and a half months they don't get the benefits. So I'd been brain storming preservation ideas. Canning was out. Canning jars, rings, lids, seals- all way too hard to get here and way too expensive for the ugandans I would like to target.  So I thought about drying them. But they are so wet and mushy when ripe. Others have tried salting them but I've tried it that way and really didn't like it. 

So, with the help of the ever present neighbor kids, we gathered about 20 mangoes from my tree, peeled, pitted and mashed. Then I cooked the paste for a few minutes to make it all one consistency. Then spread it on well oiled cookie sheets and let it sit in the sun all day. About 10 hours this close to the equator seems like enough.

On chairs on black trash bags. Initially I had them flat on the ground but the chickens kept trying to walk through them. 

My oven thermometer reads nearly 150 degrees. 

Tastes like chewy, dried mango, which is what I was going for I think.

Happy Easter!

Least of these

Dad, you would have been so proud.
3 colors.
40 unique Easter eggs.

 As much as I like showing off my handiwork the point of this post is to let you know that the team (Mandy mostly) has arranged Easter parties for two groups of street kids.

You know how Jesus said he came for the lost and the hurting? (Luke 19:10) Well, these kids are it. Some have run away from terrible abuse and neglect. For them, living on the street, eating trash, sleeping in the dirt, is better than home. Some have been dumped in at the bus park with no way to find their way back. Some have wrecked their brains sniffing glue to try to cover up their hunger. Most have little hope. All need Easter. 

As I was thinking about writing this blog I was going to ask you to pray that we could be Jesus to these guys.  But as I think that through, please don't pray that. Jesus offered this. 

I don't offer anything that comes remotely close. We want to do the best we can for the least of these but at the end of the day we pack up and it is Jesus that remains. Will you pray for that? That these kids really understand and that Jesus meets their deepest needs in a way that we can't even begin to?

PSA: Attention all nocturnal yard dwelling creatures....

While I love your presence, I would appreciate it if you would wake me a little less at night.

Mother and baby hedgehog rolling up with spines out because I'm big and scary.  

Seriously! How long can you stay mad at that?
I'm sorry little buddy- you can wake me up at 1 am whenever you want. 

Housekeeping

I've been a bit "under the weather" lately which is code for "I've been sick with who-knows-what but it isn't malaria, typhoid or cholera." (Schistosomiasis has not yet been ruled out but don't worry, its most likely the flu.) Anyway, that being said, I've been doing a bit of sitting around because I can't seem to drum up enough energy to do much else. I have had plans to work critically on the blog because I feel like it is so egocentric lately. Well, I guess that is stupid as it is a blog about my life, how can it not be egocentric? But I want it to be about life here, not just MY life here. So, I'm striving for some new perspective. (Hopefully) Over the next few weeks you'll get some new stuff on here. I have 35 posts that I've started since arriving in Uganda but are still in the draft phase and need work but you'll see (some of) them. Also, and here is where I need your help, please let me know what you want to read about!!! Stuff here has become just life for me and I've forgotten a bit of what is unusual and what you'd like to hear about. (Because I've been sick I tossed a movie in last night. I haven't done that in a really long time. But the movie showed the freezer aisle of  a grocery story and I was amazed that I'd kind of forgotten about those. And highways with overpasses, signs, exit ramps and crazy stuff like that. And white people, so many really white people.) Wow, on that note, thats enough rambling for today. 

*** Funny addendum: So school kids are on holiday for the next month. That means there are a multitude of kids here right now. As I typed grocery store aisle I actually first wrote isle. I knew that was wrong but couldn't figure out the right word- I blame it on my currently unidentified illness- so I typed it in on another page to figure it out. Well, for some reason I was on google images. I found the word I wanted, finished the blog and hit post. Then the google page popped up. 4 kids looking over my shoulder quickly yelled to the others to come look at the pictures. (They LOVE ANY pictures.) Go try it. Type in grocery store aisles (or isles) and see the images you get. Now pretend you have to explain to 20+ children under the age of 15 what those pictures are.  And for them this :

 is the biggest market they have ever seen.

Palm Sunday

I planned to go to a church in Onyaki village this morning. Betty and Abella both asked if they could come and without thinking it through I said yes. Three of us on two bikes (the girls took turns riding on the back of mine), we headed out. A ride that generally takes me around 45 minutes turned into an hour and a half. But a great hour and a half.  There are three BIG hills between here and there and after climbing the first Betty was tired so we stopped to switch. While stopped, we saw some women, dressed for church, cutting branches. It’s Palm Sunday. As we set off again we got to talking about why the palms. Betty’s answer: Because it is Palm Sunday. Abella, always the more contemplative of the two, knew what I was asking but didn’t know the answer. So, as we labored up the next hill I talked about Jesus’ entry into Jerusalem. As we traveled down the hot, dusty road I got to tell them of how the Jews were expecting a Messiah and they KNEW Jesus was it. They had seen His miracles and heard His words. Now he was making his way to the capital. It seemed like now was the time! Hosanna! Here comes the King! They were excited. He was going to overthrow the Romans and take power! Right? Well, that is what they thought. Jesus rode into the city like a King. Their cloaks spread out, I understand now, as I have traveled on dusty roads. Their branches waving.  The breeze and shade was probably nice. Betty and Abella could picture it, I think, and me too. In a way I had never before. 

We reached the top of the next hill and they needed to switch again. And there were some palm trees off the side of the road. So we walked and climbed and cut some good branches. Just like they would have as Jesus passed through.  As we got back on our bikes, tying the branches on the back of Abella’s, we started to talk about why the disciples were all on their way to the city with so many other people. Betty said it was because Jesus was going to die for their sins and they wanted to watch. I would have chuckled if I wasn’t trying to breath up the last hill with her on the back of my bike. I explained Passover, why they would be celebrating it, why it was such a big deal to them.  How because their houses were covered in the blood of the lamb they were spared the punishment of the rest. How Jesus was going to be that Passover sacrifice this time. I’m not sure they got it but it was pretty profound to me as I watched goats cross the road in front of us and REALLY SAW parts of the story for the first time.

We reached church. They were dancing and worshiping and waving their palm fronds. We joined right in. And the celebration hit me stronger than ever before. I was asked to share “a small word” with the congregation and it just came out. The wonder of our worship this morning.   I explained that I was so excited to worship with them and how we could REALLY celebrate. Unlike those who worshiped with palm fronds on the first palm Sunday we knew the rest of the story. The Jews back then celebrated Jesus as he entered the city. Then 5 short days later it was all over.  He had been arrested, tried and hung up to die. What was there to celebrate? This dead man isn’t going to overthrow the Roman empire. He couldn’t be the king they were waiting for. Their hoped dashed. Their celebration for nothing. But as I joined our celebration this morning we know! He was not just king over Jerusalem, not just overthrowing the Romans, not just for the Jews. We are celebrating a King who is eternal! Who is overthrowing all sin, all wickedness, all despair! Because of that death that was devastation to those who were hoping for an earthly kingdom we have an eternal, heavenly kingdom! Hosanna! Now is the time! Here comes the King! We shouldn’t be able to contain our excitement! 

Rafael

Here is another sad story from Amecet: Rafael came back the other day. He came the first time in July 2010, when he was 2 weeks old. His mother is mentally ill and even his grandmother is a mental case. His uncle brought him that time and took him back after 3 months of stay. Later we heard that the great grandmother now looked after Rafael. Two weeks ago we met Rafael and the great grandmother in the feeding center in the hospital. I hardly recognized him. I was shocked, where was the little cute baby Amecet had sent home?!?

Amecet asked if the grandmother could ask the uncle to come for a meeting. And today he came, together with another clan member. There are a lot of problems in the family. And nobody wants to care for Rafael. They found his father, he was put in jail, but got out, now they want to sue him and let him pay for all their expenses had for Rafael. Clearly they didn't spend much though! Amecet called the Probation officer (child protection) and had a long talk with them. Next week they will go to Katakwi where the family is from, and have a talk with the father. The family of the mother can not use him to make money and the father needs to take on his responsibility. Rafael will stay in Amecet till everything is settled and also until he is healthy again. His weight is only 4.7 kg. They have to put a sock on his hand, because he was biting himself there all the time. So sad!

Cathrine, on the right is one week older than Rafael but weighs 2 kg more and can sit up by herself. 

Dorothy

Dorthy is 5 years old, HIV positive, chronically sick and the size of a child two years younger. She is the sister of Dorcus. They, and two other brothers, live with their elderly grandmother in an abandoned mud home that is crumbling around them. Their mother is alive but lives in the village and is also HIV positive.  I know that I've written about them and her in various different posts but power is out and I only have a few more minutes of computer time so I'm trying to be quick. You will have to find the past posts yourself this time.
My good friend Kathy (from MI) works with kids around Dorothy's age and when I mentioned her a while back Kathy began praying, with her little charges, for  Dorothy. In the past few months Dorothy has been much less sick. She is still petite but her skin looks better, she has fewer fevers and is eating better. There is nothing here I can attribute to her improvement. This is a God thing! She absolutely would not look at the camera this morning but you can tell she is looking well. Thank you Kathy for being willing to let God use you in this way! It was a good reminder (again!) to me that I should not be so quick to rely on medicine and treatment. There was so little I could do for this girl.  I have been encouraging her grandmother to get her started on ARV's but they have not done it yet (which makes me really mad but that is all for a different post) and I only had her on a multivitamin but God is so much more powerful than anything medicine can do.   Thank you  to all of you others who also pray regularly for the work being done here. It isn't about us! It is all about God!

People stress me out.

This post may be mostly for myself. One of those ones where I ramble on for a while about stuff I’m processing that no one really cares about. Sorry, but it is about life here so here it is:

As a team over the past week or so we’ve been working with Meyer’s Briggs results, how we as a team work and function together, personality stuff and other things. One of the issues we talked about was what stresses us out. The first thing that came to mind for me was “people”. People here stress me out?! Yeah, I guess they do. But this is KIND OF a “people person” job I’m doing. This could be a problem. I’ve been mulling it over for a few days now and trying to figure out what exactly is generating this stress. When I’m home, my stomach drops when someone comes through the gate. (But not quite everyone, just most people. If it’s a teammate it’s fine.) Why is it by the end of the afternoon I feel like I have to chase the kids out, lock the gate behind them then close the door of the house and pretend I’m not home?  

One thing I’ve come up with is this- 90% of people who pound on my gate want something from me.  On Saturday I was thinking about this so made a mental note of it. Here is how the day looked. 6:45am kids pounding on the gate. Can they come in to play? I’m not really even dressed yet so I sent them away. 7:15 again, different group of kids, same request. REALLY?! 7:45, now it is Betty and Abella pounding on the gate. The day hasn’t even started and I’m already sick of it. I let them in but I’m not really happy about it. Betty heads straight into the kitchen and grabs an egg. Woah! I don’t want that mess to clean up and she didn’t ask. “I’m hungry.” She says. I just wanted a quiet morning. She just wants breakfast. I let them make toast and have juice while I get dressed. Then I clean up the peanut butter and spills.  8:15am. Again with the pounding at the gate. I guess I should just unlock it. I send the girls to go see who it is.  It’s a nun and several others. Have I entered the twilight zone?! At least I’m dressed and have brushed my teeth. She is looking for Father Pius (our landlord) but to the best of my knowledge he isn’t even in Uganda. But by now the girls have let them in and they are making themselves comfortable in the shade of my front porch. Ummmm…. I awarkdly tell them I have to leave soon and pause and they assure me it’s fine, the will just stay and talk with Okello (the guard). I grab my bike and flee. Too many people too early in the day! I’m about an hour early for bible study but I head to the place we are going to meet, thinking it will be a quiet place I can sit and read until the others arrive.  As I ride I hear the customary “MAZUNGO!” as I go past. I reply with a good morning and then hear “YOU SPONSOR ME!” Excuse me? You just asked a strange white person on the road for money?! I think maybe not. Shortly after bible study I headed out to the village to check on the twins. Minutes after I arrive I’m asked to bring them out to see their grandfather. Initially I say no but then I’m told he is sick and she hasn’t seen him in a long time. I don’t have anything else planned so off we go. Once there I’m asked to treat all three of his wives and many others around. That is what I’m here for I guess but everyone that I see is over the age of 60 and life here is hard. There is really nothing I can do for their swollen spleens, aches, pains and cataracts. I gave out all of the Tlenol arthritis , vitamins, malaria meds and iron supplements I have. I told them I had nothing left in my bag that I could give but they pointed at antibiotics and childrens meds and asked for those. I’ve been home about 5 minutes and again with the pounding on the gate. It is a gentleman that I go to church with and he makes small talk then it is mentioned in passing that I didn’t make it to the overnight last night so maybe I could speak at the next one? I don’t see the connection there at all and I want to preach at one of their outreaches like I’d like to have my wisdom teeth removed again. I try to politely say no.  I wonder why he has come to my house and what he really wants. I guess culture says I have to invite him in but instead I just stand in the gate until he seems to get the hint and says he’ll see me at church tomorrow. (Beckie- if you are reading this the visitor was Fred. Are they expecting us to donate shillings to their next outreach?) I decide to leave the gate open because I’m sick of walking back and forth to it and within an hour I have 15+ kids in the yard. They ask me for a ball, for paper and markers, for books, for food. They ask me if they can bathe, can I give them soap and basins and if they can pick mangos and oranges, if they can ride the bikes. Finally it is 5:30. I send them all home and lock the gate again. Quiet. For a second. Then I hear someone at the gate again. I’m tempted to pretend I’m not here but I figure I’ve already been spotted. It is a teenage neighbor girl that we know who is pregnant and …. Anyway her story is sad. But she asks to charge her phone and charge the little light she uses at night. Fine. As I’m plugging her stuff in and telling her she can’t stay and wait but can come back in an hour for them, Betty comes back. She tells me she hasn’t eaten all day ( I remind her of breakfast) and can her and her brothers have some money for cabbage and tomatoes? Agnes is still standing there and she says her too. Cabbage is 800 shillings (40 cents) and tomatoes a little more. So I give them the shillings try to not feel…what? Resentful I guess. Annoyed.

I like to meet needs. It is in the very fiber of my being- why I’m a nurse and who I am as a person. I am most satisfied when I can identify a very concrete need and meet it. But here it just isn’t that easy.  Am I creating dependency? And if I am, so what? These girls are hungry. But worse than that, at the end of the day I’m not thinking about a long term solutions. I’m just thinking “Please stop asking me for stuff!” But I’m rich! I have a fridge of food and am not worried about malaria or any physical needs. Why can’t I give joyously in every situation? There is something else too. I always question people’s motives, their honesty and their thinking.  I’ve learned this is just the way it has to be. They don't trust each other either.   Are they asking for money for food really or do they know if they tell me it’s for food I’ll say yes but if it’s for something else then I won’t give? 

O.K. I’m done rambling on. Have I reached any conclusions? Have people stopped stressing me out? Not yet….

I was “practicing” making Easter eggs today for a project we are going to do with the street the kids to celebrate.  Eggs here are brown, I don’t have any normal food coloring and this was more challenging than I though. But I’m pretty proud of the results so I thought I would share.  

One side note: 2 hours ago there were 4 eggs and now the cat’s whiskers are green. I think I know who my hen house thief is….

A real blog post to follow soon I promise!

Nothing much going on

Besides a few posts about animals I feel like I haven’t posted anything legit lately. So here is a partial attempt to bring anyone who cares up to speed.

It feels really strange in Soroti right now. Beckie is in the states, Bobby and Rachel are too. So are Tim and Angie and their kids. Heidi finished her time here in Uganda so she is back in New York and Jillian isn’t in Soroti for the next few weeks.

So what am I up to these days? I’m in Soroti and have no big projects going on. The rainy season has started and like everyone else around here I spend a few hours a day in my garden. I’ve planted all sorts of stuff like pumpkin, tomato, lettuce and herbs and can’t wait until they produce so that my vegetable selection is wider. I love working in the garden and getting muddy. I’m spending quite a bit of time with the neighbor kids and find myself adding “after-school-snacks” to my grocery list.  I like that my yard is a safe, fun place for them to be in the evenings. I’m not running, which I never handle well, but I suspect I damaged both IT bands in the tri so am trying to rest and let the knees and hips recover. I’ve gone to check on the twins and am hanging out a bit at Amecet with the nurses and babies there. (They are at capacity right now! Lots of babies and One more)  I guess that’s about it. There are other things that are just part of life- going out to the village with Helen, cleaning up ostrich poop, harvesting and preserving mangoes, reading, studying, praying, making bread. I realize as I write this I’m a little lonely but still filled with contentment. I like life here and am just enjoying the quiet while waiting for the next adventure to begin. 

More noctural hunting

I was awakened last night to the sound of something loudly dying in my kitchen. Power was off so investigation via flashlight exposed two hyped up cats and something else. I wished for at least the third time in not so many months that I kept my leather gloves in the house instead of out in the shed. Control was restored eventually, after a few pictures and a trip out for said gloves. Post mortum reveled a bat with a wing span only two inches shy of a foot. Even the bats around here are huge! And this bat fought back more than the rats. 
I will NOT be eating this one. I let the cats have that pleasure this time for their job well done.