Daily life

Life has settled into somewhat of a rhythm here. Every morning at 7AM there are devotions in the chapel. This involves all the nursing students and a couple missionaries gathering together for about 15-20 minutes. First we sing in Shona (ok, ok, first they sing in Shona... I'm still learning). The sound is beautiful, but I can't help feeling sad that many of the faces are blank and appear to take no joy or even interest in these vocal exercises to praise the Creator. Then someone shares a short message. Topics have ranged from The Lord's Prayer, to grace, to a Canadian pastor's life, to gluttony. Ideally, I shower before devo's but I'll admit that some mornings the cold water chases me away. Then back home for a bite of breakfast and getting things together for rounds at the hospital.

Rounds start around 8am. I am still in the pediatrics ward and most mornings it is just me and the supervising nurse. She is amazing. She functions like a resident and gives me the low down on each patient as we come to them. Unfortunately a fair number of the presentations sound like this: Infant is feeding well, still having fevers, and oxygen level was 65% (should be over 90%) last night (after the power went out and the oxygen compressor stopped working).

Currently there is a 2 week old with jaundice who we have under blue lights to help the level go down. His mom is HIV positive which means that he needs to be breastfed only to reduce his chances of getting the disease. The other treatment for jaundice at this age is frequent feedings, so we are trying to get mom to feed him every 2 hours, but without being able to supplement feedings with formula, this is difficult. What also makes it fun is that right now we don't have the necessary reagents to check the baby's bilirubin level. So each day I look at baby's eyes to see if they are still yellow and then continue encouraging frequent feedings and blue lights.

So far I've done 3 c-sections. It is a very warm experience. There is an air conditioner in the room, but it usually doesn't work and under the operating lights in a surgical gown with a surgical cap and mask I feel like I'm in a sauna. At the end I am literally drenched with sweat, but the results of the blood, sweat and tears can be beautiful.

Yesterday I had an interesting experience, which started with a dead man. I was in the operating room (theatre) and when I stepped out into the hall, there was a man lying on the ground. He had been waiting for surgery and suddenly stopped breathing and they couldn't feel a pulse. So they started chest compressions and used a face mask and bag to breathe for him and then gave him some IV fluids and he actually came back. The surgeon asked what surgery he needed and then indicated that they should take him back to the OR. (I would usually avoid doing surgery on someone who was recently dead.) Turns out he had an abscess on his neck that needed to be opened up, so we did and it was really gross! I kept making "blech"sounds because I was so grossed out. Then as I am leaving the room, I hear the dead man behind me say "sorry." Guess you never know. Not only was he alive and with it, he spoke English!

My afternoons are spent in either the outpatient department (OPD) or in theatre. The patients I see in OPD are generally very sick, they are seen and treated by nurses first and only the serious cases make it through to me. I have seen at least 3 terminal cancer patients and wished there was some form of hospice training available for their families and some stronger pain medications.

I also have adopted a new sister. She is 6 and HIV positive. But she came in because one leg is shorter than the other. X-rays (yes, we have x-rays again!!!) showed that she has avascular necrosis of her hip, basically the top of the leg bone has died and is dissolving. But she is the sweetest, happiest little girl. I just wanted to take her home with me. I asked if she wanted to come home with me and her mom told her to say yes. I about cried.

My ultrasound skills are improving and I am so grateful for the learning I had in Wichita last fall. We do a lot off ultrasounds and they can be really helpful in deciding how to treat patients. I've seen liver cysts, bladder cancers, ovarian cysts, pancreatic cancers, pericardial effusions (fluid around the heart), empyemas (lung abscesses), and measured lots of babies to date the pregnancies. I even tried an echocardiogram (heart scan) yesterday. Not sure whether the bladder that had 3 liters inside (ouch!) or the galbladder that was probably nearly a liter in size was more impressive.

Most evenings, I get home between 5 and 6. There is an aerobics class that meets in our guesthouse conference room 3 days a week between 5 and 6. I've gone once and was very sore afterward, so usually I just sneak by as I return from work. The class is really a neat mix of Zimbabwean and missionary ladies.

Usually by then, the electricity is off, so I cook dinner on the gas stove (challenging!), and try not to open the fridge or freezer. Then maybe I'll chill with my housemates: watching a movie on a laptop or playing a game. I also attended a bible study with the midwifery students this week. And last night I actually read a book for a while. Generally, I go to bed between 8:30 (if power stays off) and 10:30 (if power comes on again).

Please keep praying! I believe it is making a difference here. The surviving twin is doing well. Generator fuel arrives just in time. The x-ray machine is resurrected. I find strength and hope to keep going. A Shona tutor appears. A little girl in a coma wakes up. Really, God is at work and I'm glad to be part of it and glad you are too!