Hepatitis B training

The hepatitis B immunization campaign continues out in Obulle. We are doing roughly 200 a week now. That means each Friday we register, screen and inject people. We are one of the few clinics in the district still offering to give it so people are coming from far to be tested and receive the vaccine.

 This is a very normal look for Friday mornings at our tiny clinic.
There has been so much confusion and false information surrounding Hepatitis that I offered to do a training. We had it scheduled on a Saturday afternoon at the local school but because of some miscommunication it was canceled. But it actually worked out alright because I've been asked to do the training for smaller groups in different locations. I've given it twice and have two more scheduled.

Both had good turnouts and people had tons of questions so I'm happy with them. 

Inservice

I preformed my first inservice in the clinic today. Overall it was well received. At few of our last deliveries the babies have given us some challenges so we discussed the first five steps of the newborn resuscitation logarithm.  (They don't have the resources to go beyond those first five steps). It was obvious that Tony and Barbara had never had this training before and John and Rose had been in discussions as students but had never seen or held an amb bag or done anything beyond some lecture of hypothetical situations with vague suggestions.  They thought it was great that I could give them "rules" to follow. I tried to explain that these aren't rules exactly, and that they still need to follow common sense and what each situation calls for, but they took it very seriously.  All four of them practiced and we had good discussion about intrapartum suctioning with meconium present, how to do apgars and several other things that I had just assumed they already knew. It was good for all of us. Now I pray we never need to use it again. 

Prayers please for this sweet little girl who got a nasty burn three days ago. Her family, unfortunately, neglected to care for it and then when they heard I was coming, they sprinkled flour on it to make me believe they were using antibiotic powder. It took the VHT and I nearly an hour this  morning to scrub it out, remove all the dead tissue and get her wounds covered. She got a pretty hefty dose of codine (can you use that on three year old?!) but it was still really painful. She didn't fight us at all. Just sat still and sobbed while we made her bleed. I'm worried about the scar tissue in her axilla inhibiting the use of her right arm however, we need to get through this high infection risk time before we can worry about anything else. Her family has already shown us they aren't really interested in taking care of her so, she needs your prayers. Have I mentioned recently how much I hate treating burns, especially in little kids. Yuck!!

Parents!!

Hey Mom and Dad! Don't forget, you need to head to Chicago in 6 days. We are busy getting ready for you here. I have some good news and bad news for you. First the good, it seems like the dry season heat wave has broken. This could be a false alarm but it seems like possibly our days of 100+ degrees might be over.  We had a great rain last night and today was much more tolerable.  I still don't have running water but that could possibly be resolved by the time you arrive. OK, more good news, We are doing easily 10 births a week at the clinic. Dad, this won't effect you so much but Mom, you may want to throw in some scrubs. I have every intention of making sure you go home with some stories.
OK, now the bad news, yesterday, I received a rooster from a patient as appreciation. He is way too skinny and stringy to eat so I'm keeping him as stud. Is that a thing for chickens?  Anyway, he is pretty loud and starts around 5am. Sorry about that.
See you in a week!!!

Pretty sure this should be only for nurses

Warning, this post might be a bit much for non-medical people. It was a bit much for me and I'm supposed to be trained in this sort of thing.
I was called yesterday evening from the clinic with a woman who had been pushing without progress for too long and the staff didn't feel comfortable. They called me to come assess and possibly transport into the hospital. So I headed out.

Well, I'm not sure crowning is the right word, but baby was presenting nose first as I entered the labor room. I've never seen anything quite like it. Eyes, nose mouth, I could see the whole face and nothing else.  There are more graphic pictures out there but lets just stick with this one. Thankfully after a quick episiotomy, which by the way I'd never done before with a scissors let alone with the scalpel blade I'd been handed, the baby slid right out. Baby girl struggled quite a bit for the first hour and the mother bled far more than I liked and sewing up tears should be rewarded with Olympic medals but we all survived.

It was also the first time I convinced a father to do skin to skin so the night was full of firsts. Baby was cold for a long time (which seems strange as I'm sure the delivery room was 110 degrees as I had sweated through my scrubs before I even got gloves on) but she looked really good when I checked in on them this morning.
This is the mother and her attendant recovering afterwards.

And this is the nurse cleaning up the war zone that is our delivery room. 

Clinic day

Another thing I'm thankful for, my day job. The clinic is challenging but I really do like what I do. And I like it even better now that Rachel does most of my paperwork and charting for me. :-)

Two full term moms, the nurse, Rachel and I all squeezed into the postpartum room. 

There is a surprising amount of paperwork for each mother. (Most of it from USAID)

Also thankful that my leg is almost completely healed already. Thanks everyone who was praying.

Friends

My last few post have been so full of complaints that I can't even read them. I'm sorry. In an attempt to be in a better mood I'm going to try to focus on the positives.
This group of people right here is the best positive in my life. I'm so thankful for these guys. They keep me sane. And fed. And healthy. And challenge me spiritually.  I love doing ministry and life with them.

So, that being said Ronnie and Collin and kids head to the states in two days for a well deserved furlough. We hung out together for the last time tonight. This is possibly the hardest part of being a missionary. The constant goodbyes. They will be back in three months. But things will be different. They always are. And there I go again. I can't seem to keep anything positive.

So here are a few pictures of their kids being cute.

I need a padded room

Lets start with the good. First, sometime in the last 12 hours, the city water pressure has been high enough to fill my water tanks. So, I have running water in the house again which means, at least for a bit, I can stop carrying jerry cans and I can shower and flush my toilets and filter drinking water instead of boiling it.

Second good thing, my parents are arriving for a visit in two weeks!!!! I can't wait. I'm going to spend quite a bit of time hanging out in Jinja with Izaac and Ellie and I'll drag my mom along on clinic days and put her to work and we are going to spend a day canning salsa and for my Dad I have a list as long as my arm of odds and ends around the house that need fixing.

However..... I'm not there yet. Last night I got home rather late and was re-arranging dirty dishes in the kitchen (until the water came back on I spent a bit of time doing that) and a scorpion came out from under the cabinets and attacked me. I've since been told they are just looking for water because it is so dry, but I'm pretty sure it was a malicious, pre-planned attack. I swore for a second or two then decided I had to kill it before I could go deal with my foot. After dumping a half liter of insecticide on my kitchen floor, I went and quickly swallowed 100 mg of diphenhydramine then packed my foot in all of this week's meals that I had in the freezer. (my freezer is the size of a shoe box, there is no room for ice in there.) After about an hour of thinking this actually doesn't feel anything like a bee sting, but having no difficulty breathing or arrhythmias I added a norco to the mix and went to bed. This morning it was a bit swollen and I still definitely have pain but there didn't seem to be any reason not to have a normal day. So I headed out to the garden where

Daniel and Collin have agricultural and livestock projects. (here and here)  I was cutting elephant grass and due to sweat and sunscreen and possibly a little scorpion venom (?) the machete slipped out of my hand and embedded itself in my leg. Well, a little more swearing and a lot of pressure held on the wound while I packed up the hay I'd cut and I headed back into town. I'd been kind of happy that I didn't have any referred patients today so wasn't going to spend any time at the hospital. Well, two hours and a few stitches later I'd gotten in my requisite time at the hospital. I should probably admit here that I had decided that steri strips would probably be good enough but in cleaning the wound it was pretty obvious that it was stupidly deep and that I'd hit the bone.  So, wise nurse that I am I went in for stitches. Where there was no sterile gloves or drape and the needle, needle driver and suture material all touched my skirt, the wall and/or the bed before being use on my leg. Started myself on antibiotics immediately after getting home. So, there you have it. Nothing productive accomplished today and I'm probably a danger to myself and others.

Not comfortable right now

I'm warning you this post is going to be whiny. But I regularly remind myself that I don't want this blog to contribute to the unrealistic picture people can have of missionaries. So I'm going to be grouchy and petulant as I write today.

Desperate for a bit of water....

It currently climbs above 100 degrees in the daytime right now. The sun is unrelenting and the dust is downright dangerous at times.  And the nights just don't cool off.  I took a look at the 8 day forecast and 108 is the upcoming average. Without a drop of precipitation on it. My water tanks are all empty. City water pressure is so low that outside my house, my ground tap has a drizzle out of it but there isn't enough pressure to put any water in my storage tanks or into the house. So for the few hours a day that the water is on, the watchman and I monitor and fill jerry cans. It takes us a few hours to fill four. If the water stays on that whole time. Yesterday, as I was heading out to the hospital I reminded the guard to fill up again, once the water came on, and to remind the house girl that there wasn't enough for washing clothes. Well, the water never came on and something got lost in translation so when I got back yesterday the dishes had not been washed and there were three basins of soapy, clothes "soaking" in the bathroom. With no water left to rinse. So she left. And that also means no water for flushing toilets, dishes, or anything else. And I'd just had several frustrating hours at the hospital.  (Which is far from air-conditioned, btw). No water for showering.
I had several phone calls of people wanting things from me in the evening. But I ran out of airtime. This is significant because here people call you, letting the phone ring once or twice then hang up. That is your signal to call them back, using your minutes instead of theirs. But I didn't have minutes left. So people called and hung up over and over again. I just turned my phone off and went to bed. But it was too hot to sleep. And I have a head cold. I'm all stuffed up and can't breath. Over the course of the night I developed a full blown sinus headache and I laid awake all night. Finally at 6:45 when I decided I didn't want to toss and turn on my sweaty sheets anymore I got up and turned my phone on only to discover that my running partner had tried to call and couldn't get a hold of me. But I was out of airtime to call her back.  I did finally talk to her but discovered that she had panicked and called several other people who also needed to be reassured that I was fine.  I had just wanted a few hours with my phone off.
Today is pediatric immunizations
day at the clinic, so even thought I'd had so little sleep, I told myself to buck up and headed out to Obulle. Where the porch (also known as the waiting room) was overflowing with people and crying kids. After an hour of illegible records, screaming kids and working without help (translation or otherwise) from the clinic staff I realized I now had a migraine superimposed on my sinus headache. It was hot, dusty and we didn't have half the supplies we needed so they seemed to just decide they didn't want to work today. Then I stabbed myself with a dirty needle. That sounds slightly worse that it was, but only slightly. John, the other nurse, who was actually out in the village center, not working at all, came in with a friend and pushed through my mess of moms and kids and got his friend a Hep B vaccine. Then tossed the syringe into the trash can, right next to the sharps box. It got stuck in the lining and didn't fall down but I didn't see it until after I threw some stuff in the can and stabbed myself deeply in the side of my hand. I'm not proud of it but I kind of blew a gasket and pointed out to John that "The blasted sharps box is right there! and it would actually be really nice if you would work today as I'm a volunteer and you all are paid staff and there are still forty people waiting to be seen and could someone please translate for me?! And why does this entire blasted clinic not have a place where anyone can wash their hands?!"

Possibly the thing that is pushing me to write about all of this is that this morning during my quiet time I was reading something a fellow missionary had written. I had been sitting here feeling sorry for myself, telling God I just wanted things to be easier sometimes.  That it wasn't too much to ask for just a bit of a more comfortable life. For example running water.  And then I read this:

The more I grow in the Lord the more I think most Christians are not living for God's Kingdom and like Christ.  I am reading through the Gospels again and I am once again struck by Jesus - He and His ways are radical!  In other words crazy.  Christians today, are comfortable, not crazy.  We protect our comfort, safety, family, even things above the will of God.  Jesus said things like, "Do not store up for yourself treasures on earth, do not worry about your life, seek first my kingdom, in everything do to others what you would have them do to you, many will say my name but those who DO my will will enter my Kingdom, anyone who his parents/family more than me is not worthy of me, you have to loose your life to find true life, don't look good and be clean on the outside but inside/who you are needs to be good,  my loved ones are those who do God's will...  Yesterday I read Matt. 13:44-46 the parables of the Hidden Treasure and the Pearl Merchant.  This time it really struck me.  The words, "the Kingdom of God is like..." in each parable is very important.  Jesus said His kingdom is like a treasure hidden and when someone finds it he joyfully sells everything to get the treasure.  Jesus said His kingdom is like a person searching for a precious pearl.  He found it and gave everything to get it.  When we are in Jesus' Kingdom we will joyfully give up or give everything for it!  
I really don't see God's people willing to give everything - their comfort, safety, their home, things, family... - because Jesus is so worth it!  Anything He wants for His kingdom should be worth it - if He is the King of the Kingdom we should always say yes and obey. Christians are too comfortable.  Christ suffered and we are to continue His ministry – of suffering with and for others.  Jesus gave.  He gave up Heaven to come to earth, he gave His time, His heart, feelings, emotions, cried, He gave His love, His power, His wisdom, His blood, His life...  And He was glorified for it.  I think we are missing out on Jesus, His kingdom, and His glory when we want to be comfortable instead.  It is hard and painful, messy and scary when we have to enter someone else problem and pain.  Too many give money to help, say they are praying, care but stay away because it will interrupt our lives, it will cost, it will hurt.  We might not have the answers or what is needed, but we can love, we can be there.  If our goal is to become like Christ, then I want to do, think and feel like He did.  He would go and love at whatever the cost.  

So now, I'm still sitting here feeling sorry for myself, wishing life were more comfortable and also feeling guilty. I do want to be more Christ-like.  But today I'm having a really hard time joyfully giving up everything for it.

Turkey Committee Part 2

A few months back I wrote about a turkey program my church started. Post here.

Well, this week some of the recipients gave back two or three turkey chicks (depending on how many hatched) so that other vulnerable people could receive a pair. About half of the folks that received were already able to give back.  We will keep the chicks for a few months, until they are closer to mature then the committee will sit and select new vulnerable people to receive. Here are two of the widows proudly holding the chicks they are giving back.  Highlight of my week!

Daniel also wrote about it. His post here.