travelling adventures and misadventures...

So I arrived at the Zimbabwe airport very early last Thursday to catch my flight to Tanzania. No one at the airport seemed to know where the check-in for my airline was, but after about an hour someone arrived at one of the counters and began checking in the few of us who were waiting. My bags were checked, and praise the Lord the weight was ok. (Flying within the African continent involves a much lower weight allowance than flying to the US from Africa.) I was feeling very Zen at that time so the delay didn't phase me too much and I bought a Coke to help me wake up. I began to feel a bit nervous that my flight didn't appear on the departures monitor, but I was reassured by the fact that my boarding pass looked legit and there were at least a few other passengers waiting for the flight. A lady approached me and asked if I was waiting for the flight and I said yes. Then she asked, "are you Alexis?" Uh oh. "yes." "Your connecting flight to Tanzania doesn't fly today." In fact, there is never a flight on this airline to Tanzania on Thursday. Despite the fact that I have a confirmation number for the imaginary flight, I am escorted back out of the airport and my departure stamp in my passport is crossed out.

They did tell me there was a flight on Friday. I called the missionary who had dropped me off and asked to come back home with her for another night. Because of the delay, I was present for the arrival of a new missionary team which was headed by a doctor I apprenticed with in medical school. I had actually lived with his family for a month, so it was wonderful to catch up.

On Friday I headed out to the airport again. I briefly encountered the issue that I wasn't on the passenger list, but that got sorted and I arrived in Tanzania at 1Am on Saturday. Unfortunately the medical team I was meeting had already departed for our headquarters, 3 hours from the airport. The Tanzanian missionaries, however, had been able to change my reservation at the last minute so I had a place to stay. They also left me enough money to pay the cab driver and buy a bus ticket in the morning. I actually came up about three dollars short because I asked the taxi driver to help me find an ATM, and then I realized that I couldn't remember my PIN. Ooops! He forgave me the shortfall (maybe to get rid of the crazy American girl).

The next hurdle was that the bus I was on (with no money...again) had one of my suitcases underneath the bus in storage. The headquarters is on the road the bus takes, but they usually only drop you off if you have no luggage underneath. I spent some prayer on the issue because I couldn't afford another ride back to headquarters, and lo and behold, they let me off right where I needed to be! (maybe once again to get rid of the crazy American girl!) Oh, and on the bus, would you believe there was a vendor with a cold can of Mt Dew? I got him to accept an American dollar for it. :)

And so, despite all the craziness, I arrived and met up with the medical team on Saturday evening.

Final thoughts on my time in Zimbabwe...

The end of my 5 months in Zimbabwe caught me by surprise; it came so fast. Overall this experience has strengthened my faith in God. Some of you may know that I seriously considered not coming to Africa. After my last long stay in Africa, I made one of those rash statements that goes something like “God, I’m not coming back to Africa unless I’m married.” And last year, I dated someone who I could imagine sharing life with, except that life would have to be in the U.S. He loved Jesus and loved serving others, but didn't feel called to do that overseas. And this brought me to my Jonah moment. Choosing for myself, I thought that being married in the States sounded better than being single overseas. Then I got swallowed by a fish. Ok, well actually I just ended up in a situation where saying no to going to Zimbabwe seemed so catastrophic that I had to say yes. So I came to Zimbabwe more or less against my will.

But in Zimbabwe I found myself overwhelmed by the sense that I belonged. I was surprised by contentment even in the incredibly difficult and heart wrenching situations which arose daily. God graciously provided the right people at the right times so I never felt alone. He scattered flowers on my path every morning, sent me valentine’s candy, Mt Dew, and beautiful letters of encouragement from home. He restored my soul. And I am so grateful for his mercy that gives us not what we deserve, not what we want, but what we most desperately need.

I spent the last night before my flight out watching a total lunar eclipse from on top of a huge rock covered by ancient cave paintings. And I spent many nights as I walked between the my house and the hospital staring up at the stunning array of uncountable stars. I watched and experienced the tremendous power of Victoria Falls as an entire continent worth of water crashes over the edge. I saw the rainbows cast by sunlight through the mist. And I walked with lions. And I am blown away that the God who, with a word, created such things also knows me and loves me. He knows you and loves you even better than you are able to know and love yourself. I am honored that he has given me the great joy of proclaiming that truth to his children in Zimbabwe who may feel that he has forgotten them. And I am glad to share it with you too.

Some other things I hope to remember from my time in Zim include the

universal desire to be acknowleged, valued, and appreciated. It can be easy to do great damage in ministry by not acknowledging the importance of others contributions. And it is really easy to unintentionally overlook or simply fail to express appreciation and respect. We can drive away people who are vital to our mission and work, by not letting them know it and by treating them as less vital than ourselves. We truly are a body and the eye should not say to the hand, because you are not an eye, I don’t need you.

I am so grateful for the friends God has given me in Zimbabwe. It was very hard to say goodbye. Please pray for Rejoice, Anna, and Priscilla who I am already missing.

One of the hardest things about serving in Zimbabwe was realizing that some people hated me for my skin color, while others ascribed to me special status or knowledge because of it. There were people who viewed me as an invader, and those who looked to me to be a savior. And in some sense I am both and neither. I am so grateful for those who opened their homes and their lives and their hearts to me despite my different culture and skin.

Look out world! Alexis is behind the wheel in Africa!

So this last weekend in Zimbabwe was quite an adventure.  The original plan was actually for me to travel into the capital city on Friday and sit on my duff until my plane flew out this Thursday.  Which honestly sounded seriously boring, but beggars can't be choosers and in Zim, I am definitely in the beggar position with regards to transportation.  I was exceptionally grateful to be offered a couple extra days to say my goodbyes to the hospital  and my friends here.  Then on Thursday morning, I received a strange invitation.  One of the missionaries, Anna, had agreed to drive some of the local staff across Zim for a college graduation of one of their children.  But they needed 2 drivers and the second driver was now unavailable.  Would I like to drive a vehicle to the town of Mutare in the mountains of Zimbabwe leaving Friday mid morning?  To be honest the whole thing sounded crazy.  I have never driven in Africa.  They drive on the left side of the road which makes turning and passing confusing.  The speeds are in kilometers per hour.  To leave the hospital requires driving through the river.  And I have never met the person graduating.  So I was considering ways to say no to this absurd suggestion when I found myself considering that, originally, I had planned to be sitting around doing nothing.  It seemed like God had given me some extra time at the hospital and maybe I should pass along the gift.
  So Friday morning I rounded in the female ward, threw some warm clothes in a backpack (Zimbabwe winter is here) and agreed to the crazy scheme.  Thankfully the missionary had an automatic transmission in her car (I don't think I could learn to drive in Africa, while learning to drive a manual transmission, while transporting people across the country).  We were picking up the second car and the extra people halfway into the journey, so we began in the same car, with the missionary coaching me on how to drive, and the passengers warning me when we were coming up to sharp curves in the road or places where people they knew had been in car accidents.  Arriving in Harare, we split into 2 vehicles.
  So why did they need me?  Well having a drivers license is not a given in Zimbawbe.  Many people here never learn to drive at all.  Passing the driving test here is very difficult without paying a bribe, and many people can't even think of affording a vehicle to drive.  (We frequently have patients arrive at the hospital by ox-cart).
  So at this point, I am driving a borrowed car in a foreign city with passengers who have never driven a car.  I stuck to Anna's bumper as closely as I dared, because if we got lost I didn't know how to get found again.  Amazingly, in answer to many prayers we made it safely to Mutare by about 8p.m. (involving a fair bit of night driving which is also awkward).  The "highway" is actually very nicely paved, but only 2 lanes and passing requires pulling into the oncoming traffic lane on the right and it's super hard to judge speed and distance of oncoming vehicles based on the headlights.  Add to that the fact that I saw a lot of pedidles (not sure how to spell this, but cars with only 1 working headlight).  After driving back and forth across town we found our way to the relatives house that we were staying at.
  On arrival, all 14 of us poured out of cars to sit around the living room and exchange greetings.  This is not a mere hello, but a long involved discussion of the family relationships represented and recognition of each individual with a recitation of how they are connected.  This was followed by dinner.  I was shown out the back of the house to an attached small "bathroom."  This consisted of a toilet bowel set in the ground and a large bucket of water to pour into the hole to flush.  During the day they have running water, but at night no such luck.  After dinner we began to figure out sleeping arrangements.  Blankets were pulled out and laid on the cement living room floor so that 5 of us girls could sleep there.  Then 5 other women slept on the kitchen floor, while the 8 men piled into the single bedroom.  It was very cold overnight and there was no heat, but I did get a little sleep.

In the morning, people began waking up at 4:30 to start water boiling so we could all bathe.  One at a time we made our way out into the frigid morning and claimed a steaming bucket of hot water.  This we carried into the "bathroom" from last night.  In theory I was supposed to scrub down with the water, but it was so cold, I decided against it.  The graduation was at 9am outdoors on a beautiful, if chilly, campus.  Mahatmas Gandhi's grandson was the guest speaker.  Then  we headed back into town.
  The best part of the trip for me was getting to hear the people in my car discuss their thoughts on many issues in Zimbabwe and the hospital.  It really helped me to get an idea of what things look like to Zimbabweans.  I also had the opportunity to ask questions on their thoughts.  I think that travelling with local staff on long drives might just be a good strategy for building relationships and learning.
  Saturday night Anna and I escaped to a delicious Italian dinner in the capitol and the crawled between cold sheets at the guesthouse in search of sleep.

  Sunday I attended a wonderful church with Anna.  The congregation is truly a blended multicultural group and it was enjoyable to hear some testimonies of God at work from Zimbabweans.

  And in answer to many prayers, I arrived safely back at the hospital on Sunday afternoon.

A Final Project

  As my time at Karanda is finishing up, I was thinking about what I might be able to do to leave things here a little better than when I found them.  First I decided to clean the drain in my shower, which had never drained well since I moved in.  One very large slimy hairball later, that problem was solved, and I felt empowered to take on another project.

  During my time here, one of the things that has caught my attention is the difficulty encountered in resuscitating newborns.  There are many times that despite attempts being made, the newborn resuscitation fails.  Sometimes this seems to be related to baby being born far too early or having severe problems during the delivery or even having severe birth defects.  Other times infants who could survive seem to die because the attempted resuscitation is incomplete, haphazard, or completely neglected.  So as a last minute attempt to make things better, I asked permission to try and address this issue.

  With the help of a girl here who is an artist, I created a large (~3ft x 2ft) poster designed to take the guesswork out of resuscitation and give those attempting it a easy and visible algorithm to follow.  There were already a couple papers on the wall with neonatal resuscitation information, but they were too small and complex to be referenced during a resuscitation.

  Here was the result of our attempts...

 
In case you are wondering about Step 9, Chiremba is the Shona word for doctor, which is to say that steps 1-8 don't require a doctor and can be done by the midwives, nurses, and even nursing students.

  I was really proud of the aforementioned poster, but the sad truth is that after I handed the poster to one of the midwives to put up on the wall last Thursday afternoon, the poster hasn't been seen since.  Not quite sure what happened.  Several people have searched for the poster to no avail.  Now I don't know whether to spend a couple hours making another poster, or not.  The culture here is such that perhaps someone thought the poster was wrong or inappropriate or even offensive in some way, but since it would be too confrontational to tell me, they instead "lost" it.  Hmmm... I wonder.

  With the help of one of our anaesthetists and my friend, Rejoice, who is a midwife, I also made a chart of commonly used supplies and medicines for newborns with their sizes and doses, so that there will be an easy quick reference for treating these babies.  This I will print out and put up on the wall in the hopes that even if my other poster is never found or recreated, it will help some anyway.

  I also sorted through the resuscitation supplies to determine what items were missing.  In the process I fixed the pediatric pulse oximeter (checks oxygen levels) which hadn't worked for a long time.  I also found a small IV pump that would allow us to accurately give the fluids needed by our newborns (currently a real challenge).

 I would love to see more results like the ones below...

The other stuff...

Since I've written alot about my work in the hospital, I thought I'd better tell you that's not all I do in Zimbabwe...

  I spend my evenings and weekends off cooking, surfing the internet, watching movies, and reading.  I think I've read about 15 books since coming to Zimbabwe.  All for fun (with the exception of scanning our surgery textbooks.)

  One of the long-term missionaries taught us to play a card game,"Nines," which has entertained us many an evening.  I've also enjoyed several movies here, most recently "The King's Speech," "The Adjustment Bureau," and "I am Number Four."  Sadly our movie projector bulb died a couple weeks ago, so our movie parties are a bit less exciting these days.  We watch in clusters of 2 or 3 people instead of all together.

Cooking is a necessity here, but I also find that it is cathartic for me.  Especially when I get to share it.  So I have to share a couple more cooking pictures.  (I also shared the actual food!)

This pizza was delicious and huge about 18 inches in diameter.  I made the crust from scratch and Alice made the sauce.  If medicine doesn't work our, I think we may open a Zimbabwe pizza parlor. :)

   In my entire life, I've baked 2 apple pies, both in Africa, so I suppose for me the saying goes: "As African as apple pie."

This gentleman had no idea how thirsty his shirt made me.

 This is one of our wall spiders who became confused and thought this egg was a new kind of rounded wall.  I buy eggs from one of the nurses at the hospital.  He raises chickens and apparently they are very healthy, because they lay super big eggs.

I went out and sat among the plumeria blossoms that I enjoy so much.  I'm going to really miss the plumeria when I leave Zimbabwe.

  I will be returning to Wichita when I come back to the U.S.A.  Looking forward to being roommates with one of the residents who I knew from med school.  I have applied for a job, but no official word yet.  So please be praying for those details.

 

 

It's the little things...

This afternoon I was asked to talk with a young woman who had come to the hospital looking for help with an abortion.  She was unmarried and had recently found out that the father of the baby actually had 3 wives and wasn't interested in a fourth or in supporting another child.  The young woman is unemployed and takes care of her mother who is disabled from a stroke.  She wanted the baby inside her taken away so she would be able to continue to care for her mother.  I spoke with her and prayed with her at length about her difficult situation.  I told her that God knew all these things she is facing and still decided to put that baby inside her.  I remembered that Mary was also unmarried when God placed Jesus inside of her.  I don't know how God will provide for this young woman and her baby and her mother, but I believe that he can and will, if she will trust him.  Please pray for Marie.
  After talking with Marie, I went by maternity ward to drop something off, only to stumble in on a delivery of a 24 week premature baby.  The smallest baby that has survived here was 800g (about 1.75 lbs) and around 30 weeks and this baby was a mere 620g (1.3lb).  Baby didn't ever breathe, but her little heart was going right along.  I asked to hold baby and cradled her in my hands until her little heart slowed to a stop.  (culturally people do not want to touch a dead body, so parents here prefer not to hold their children when they are dying - which makes me feel very sad!)  Not even 20 minutes later, another mother delivered her 20 week baby.
  I don't know if Marie is still hoping to find someone to remove her baby, but I know that life here is very hard and it is the little children who fall prey first.  But I am also reminded that to enter God's kingdom we must become like little children.  And in his measurement, any service to the smallest child is a service to Christ himself.
  So even as tears threaten to fall, I am thankful for these little reminders of what God values, and I ask that He will help me to trust Him and become like one of these little ones to whom His Kingdom belongs.

life on the pediatric ward...

For the month of May, I am rounding on the pediatric ward.  It can be very difficult to see so many sick kids.  The first day I rounded in peds, the ward was full and overflowing.  Thankfully things have calmed down and now the ward is only half full.  Some of the kids I really feel bad for are kids with femur fractures.  They have to lay in bed in the hospital for weeks with traction on their broken leg.  And unlike hospitals at home, there are no toys and no "child life specialists" to distract them.  Currently I have 2 children in traction and when the second one arrived, I hatched a plot.  They were in different areas of the ward, but I convinced the nurses to put their beds next to each other.  So the 9 and 10 year old boys at least have each other to talk to and commiserate with.  

  The weather here is beginning to get cold, especially at night.  Several weeks ago, I admitted a 3 year old girl with about 25-30% of her body burned.  Kids with burns are so hard to keep warm but it is very important for them.  I was able to get one of the American nurses here to let me use her space heater to warm the small isolation room at the from of the ward.  The little girl with the burns did miraculously well and was able to go home after a couple weeks. Currently we have several babies with malnutrition and a couple of them are only weeks old, so I've tucked the littlest ones into the warm room, in hopes they will do better there.

  On Wednesday night, Alice got called down to the hospital for a child who came in with fever and trouble breathing.  The poor 15-month old looked terribly ill.  His lungs sounded full of junk and he was working exceptionally hard to breathe.  The mother told us this all began at 1 o'clock that afternoon, but clearly the kid was too sick for that to have been the beginning.  We started him on antibiotics and oxygen and breathing treatments, and counselled mom that he was very sick and might not survive.  At that news, she began cutting off the strings tied around baby's neck and wrists and ankles.  The strings are blessed by "prophets" and are purported to prevent evil from entering the body.  The "prophets" often tell people not to go to the hospital.  (we recently lost a breech baby of a first time mom during delivery because the prophet told her she would deliver fine without a c-section, so she didn't come for her surgery).  As we got more of the story, it became apparent that mom was quite definite about this all starting at 1 o'clock while the baby had been playing outside.  We now realized that it was very likely the child had put something in his mouth and then gotten it stuck in the airway.  Unfortunately our scope for looking down into the lungs and fetching small objects out of them, was too large for this child.  We began considering other options and were able to contact an ENT who works near a government hospital.  He spoke with the doctor at the hospital who could do the procedure.  (understand this is a huge miracle.  Hospitals in Zimbabwe often don't have phone numbers, doctors are frequently unreachable, and coordination of care is mostly impossible)  Our hospital driver was gone, so one of the missionaries volunteered to drive the child 3 hours to the other hospital,  We loaded a huge oxygen tank into the truck bed and ran the tubing through a window.  The child arrived after hours and a doctor actually came in and did the procedure that night (also never happens here).  They found a small seed stuck in the airway and removed it and the child is recovering very well.  The long term missionaries say that they have never seen something like this happen so smoothly.  So we are thanking God for enabling us to save this little one's life.