I have been a nurse for many years, the majority of that has been working in an Emergency setting where triage is always a part of my job. The concept of triage, choosing who is sickest among the sick is one that is developed over time through practice and experience. Comparing triage from when I worked in Trauma in San Francisco to here in Mozambique brings much obscurity because of the blatant differences that I see. It is hard for me to fathom triage in the Africa hospitals, hard for me to imagine walking with those nurses every day through the grief that they see. I had the opportunity to visit a hospital again the other day, and both times that I was there, my heart was torn is so many ways, as a nurse and also as a person. The first triage challenge that I was met with was the previous day at a way in clinic out in the rural communities where I met a young woman and her daughter who was very ill. The white cold toes, the bulging little eyes, and the fragile hair caught my attention even before I started hearing the history of the child. She was almost 2 years old, and was under 6 kg, had been sick with Malaria many times and was just not growing. The mother explained that the she had been told that her child needed blood and I could see the evidence of that as I looked at her girls face. Instead of seeing the dark, brown skin that I have grown to love so much, I saw discolored patches across her face that told me that her blood levels must be really low. Anemia in Canada is a problem just like it is in Mozambique, but finding blood to transfuse in Africa becomes a problem for the family as they have to supply the blood. I sat there looking at this little girl going through the many reasons why she would be so low on her blood levels…malnutrition, liver damage from the malaria, underlying disease such as AIDS and I was challenged by my perspective of triage. Despite my first instinct of packing the child up and taking her immediately to the hospital, I relied more on my Africa triage knowledge, and made a plan to provide transport in the next day for her to go. With many other women looking on as I assessed the little girl, it was hard to believe, but so true that there were sicker children that this little one that needed blood. Despite the obvious problem, she was breastfeeding well, and wasn’t fighting any infection at this point. She was alert enough to voice her discontent for this white woman who was trying to touch her, and I could see that she had lots of fight left in her. As the team continued to work through weighing all of the children, it became even more clear that triage would be needed because more that 90 percent of the children present were underweight and fighting illness. Challenge just doesn’t seem enough of a word to describe what I felt.
Thankfully we were able to bring the mother and babe to the hospital the next morning and as we talked with the health director, I was quickly reminded why the hospitals of Mozambique have always raised the hair on the back of my neck. I heard the sound the minute I stepped into the hallway, the sound that has always made me instantly nauseous, the sound that brings goosebumps to my skin and tears to my eyes, it was the sound of a woman wailing. As we rounded the corner, I saw a woman sitting on the floor holding her face in her hands and wailing. At first, it was difficult to know what to do, and it was so hard for me not to just run to her and hold her as she cried. Eventually the story was explained that she had just been told that her daughter had died, and if that wasn’t enough to rock my emotions, one of the women pointed to a little baby and explained that the mother of the child had just died. As the baby looked curiously at me, and as I reached out and let his little hand grasp my fingers, the sound of the mother wailing for her daughter brought waves of despair. This precious baby didn’t know that his mother would no longer be holding him, would not longer be feeding him, would no longer be keeping him warm. But just when I thought the grief of it all would overtake my ability to cope, a woman came and gently lifted the baby onto her back and began binding him to her for the journey home. I don’t’ know who the woman was, I imagined it could have been the babies aunt, or other family member. It could have been a neighbor, or perhaps the woman’s friend, but it blessed my heart so much to see someone come and start loving that baby. There were no words from the grandmother, there was no formal process, it was just a silent way of ministry, a form of love like I have rarely seen. Even though that baby would never know his mother, he would know love, he would know care and he would know he was wanted. Again, just as many times previous, peace overcame my soul and enabled me to continue on with the other challenges of the day.
Later that day the triage aspect of my nursing was challenged again as we returned to the hospital. As I walked toward the entrance, there was a crowd or people and we heard that a young boy around 6 years had just been struck by a car. Given my previous experiences with the hospital, and know that they Emergency room didn’t even have basic supplies like oxygen, I felt the difficulty of the situation. I walked toward the ER and I heard his little voice as I stood outside in the hallway. I couldn’t understand what he was saying, but I did recognize the fear that I heard. As I stood and listened my heart sank as I heard the room go silent which never is a good sign when you have a pediatric trauma patient. When I am thinking about triage at home with children, a crying child is always better than a child that is difficult to rouse or is too weak to cry. As I was invited into the examining room I was met with a sight that broke me. This little boy, the size of my nephew, was being restrained on a plastic mattress with blood coming from his head and nose. He had obviously been struck on the back of his head and his forehead had been driven into the pavement. By the time that I started to assess him, he became agitated again, and was repeating words in his local dialect. I discovered that the boy at the end of the bed holding his legs down was his brother, and so we encouraged his brother to go and talk with him to try and lessen his fear. My heart sank again as I watched the little boy barely respond to his brother and continue to utter confused phrases. Even my placing a blanket on the little guys legs was terrifying for him, and I recognized that many of the things that we were seeing were evidence of a head injury. I then turned my energies to what the plan was and learned that the nurses wanted to transfer him to a bigger hospital. The only ambulance that was available was heading there way in an hour, and so my triage mind continued to deliberate what would be best. I thought about trying to pack up the child and drive him to the next hospital 40 minutes away, I thought about the pressure that could be building in his head, or the bleeding and injuries that I couldn’t see. I thought about the fact that this little man was alone without his parents and how scary that would be. As the cry changed, and they told me that the child was crying because of pain, my tears started to build, because I knew that the hospital didn’t have more than Tylenol to offer. What was the best plan? Was there such a thing as a best plan, or the most appropriate triage choice? What would I do at home? Well, at home, this child would have had an Ambulance present at the accident, he would have been assessed and most likely flown to Children’s hospital via helicopter, he would have been met by Emergency and Neurosurgeons, and most certainly, he would have had his mom or dad at his side. Here, he was afraid, confused, and without any parents to comfort him. The decisions fell to an older brother that was equally terrified of what was going on. I stood at the side of the bed and quietly told the little boy my name, that I was a nurse, and that I wanted to help, all the while trying to figure out what I was going to do. After thinking in an Africa triage mindset, I realized that even the next hospital wouldn’t have what the boy really needed, nor would any hospital for that matter. I realized that this little boy would lay on a bed and wait for hours by himself if we were to take him to the next city, and wouldn’t get any better care. I realized that in taking him, he would be without his family, and his parents wouldn’t be able to see him for an extended period of time. The decision that I made was one of the most difficult ones, as I chose to pray for the little boy, to leave a blanket on him and to walk away entrusting his care to the medical system that he was a part of. As the prayers of others went up from that place, my hand remained on his leg and I continued to whisper words of comfort to his little spirit. Although it felt like we were doing nothing, like we were just standing by and allowing this little boy to get worse, and even die, I knew in my spirit that wasn’t the case. Jesus was in that room, He was whispering to that little boy, His arms were holding him, and there was peace. As I walked out of the little Emergency room, I glanced back and saw the little boy close his eyes, his crying stopped, he stopped fighting, and one way or the other, I knew that his little spirit had found rest and peace.
Tuesday, July 6, 2010
Wednesday, June 30, 2010
To Feel or Not to Feel
Today my heart was challenged with a choice that is never easy, and as I have learned over my years of nursing, never is going to be easy. I had to make the choice of allowing my heart to feel pain or not.
Today, our team visited a young mother of a 17 month old little girl who has been suffering with hydrocephalus – a medical problem in which there is too much fluid within the cranial cavity. I met this mother and her child a couple weeks ago at the clinic and the instant that I saw her little girl, my heart began breaking. She shared with me that her girl had been born a bit early, but was healthy for the first 3 months and my mind thought about my little niece and how precious she was to those around her at that age. I thought about the relationship that must have been created between this mother and her child over the past 17 months.........
The mother shared that she noticed the childs’ head start to get bigger after an infection and despite taking the child to the hospital numerous times and asking for help, there was no help to be found. A mothers’ love is a marvel on so many levels and I saw an even deeper aspect of that in this mothers eyes as she gently showed me her girl. As I began to examine her little angel, I felt the weight of the child’s head that could no longer be supported by her neck. I was met with the harsh reality that the child was going blind in both eyes and that her hearing was failing. I noticed that her reflexes were very sensitive and as I felt her soft hair, my fingers found a large soft spot on her skull that should have been closed months ago. I could see that this child was scared, as she was limited in her ability to know what was happening, and I so wanted to reach out and hold that child tightly so that she didn’t feel the fear that her body was showing. As her little fingers gripped mine, I felt the life and the spirit that was still living in this failing body and my heart broke. Again, I thought about my little niece Hope calling out her mothers name and running to her, and I knew that this child would never do that. I thought about the joy we felt when Hope took her first step, spoke her first word, and I knew that this woman would never see her daughter do those things. I thought about when Hope has been scared, and how her mother goes to her quickly so that she doesn’t feel that…… As I glanced at the mother, I saw love, a deep love for her daughter despite the extra care that was required. Not one word came out of her mouth about how sore her back must be from carrying her daughter around, or how hard she has to work each day. She didn’t mention the many kilometer walk she had made to bring her daughter to the clinic, or how tired she must be, she just wanted help for her little girl. I sighed deeply and prayer for strength because I knew that there was nothing medically that we could offer to this family.
Today as we walked into the little community where this family lived I saw the mother quickly getting chairs and setting out mats for us the familiar challenge came to my heart. I had to choose whether or not I allowed myself to feel the emotions that would come with this visit. My first thought was to become numb, to not allow it to permeate to my heart, to not think about what I would be feeling if this was my daughter, or my family. That would be easy, it wouldn’t require much investment on my part, and I could be as sensitive as I could and then just leave and forget. But again, the motto of the mission here, and the challenge to all of us of loving God and loving His people resounded in my mind and I knew that I couldn’t do that.
Early in my nursing career I made a promise to myself that when it got to the point where death was no longer hard, when I could see dying children and it didn’t affect me, when I stopped feeling, that I would stop nursing. That is because for me, nursing has always involved my heart, had always involved trying to imagine the pain that the people I am caring for are feeling. So as I sat on the mat and looked at the mother holding her dying child, I allowed the waves of pain to come and it took my breath away. As I spoke the stabbing words of no treatment available, no medications that can make this better, I saw the mother accept the destiny of her child in her own way and I choked back the tears. It felt like poison coming out of my mouth. If the weight of a dying child wasn’t enough, I learned that this young mother was alone most of the week as her husband worked away, and I tried to imagine carrying for a dying child and doing it alone. Even though this mother didn’t show much outward emotion, I knew that she was feeling grief that I couldn’t fathom. I imagined her crying in her hut at night, or feeling the anger and the confusion that many of us would. I thought again to my little niece and I knew that if her little life were in danger, that I would do anything within my power to change that, and I saw the exhaustion in this mothers eyes knowing that she was struggling with that and many other things. As she continued to breast feed her child, I saw the connection between them despite the many barriers, and I encouraged her that she was doing a good job. She shared that the child had already started to have seizures, and as I heard the complications that were happening, I prayed for mercy. It is a difficult prayer for many reasons because part of my heart believes that God can do miracles and that this child could be healed. But the other part of my heart also knows that God’s sovereignty doesn’t always involve what our minds think is best, and so I prayed that this life of this child would not suffer endlessly. I prayed for strength for the mother, that again I couldn’t fathom, and I prayed that God would not allow this mother to feel alone or for her child to feel the fear that I saw.
None of us that visited that family left the same; we were all impacted in one way or the other. But for me, the biggest impact came while we were leaving. If I had just been told that my child was going to die, and that there was nothing that could be done, I am sure that it would be so difficult to talk or to move or even breathe. I wouldn’t be thinking of anything except my child, and I certainly wouldn’t be thinking about the people who had just told me that news. But, as we left and I looked back, I saw the mother coming after us. She had strapped her child to her back, and she was walking us to our vehicle to thank us for the visit. She was honoring us and showing us her gratitude…….. I don’t know how to describe how that made me feel, but the tears came then and continue to as I think about it even now. What strength, what ability to continue with life despite the tidal wave of grief that had come, what endurance and ability to think about others instead of herself. It is hard for me to understand. I don’t know the time and date that the child will die, but I do know that as we left God stayed, that He will be present in that hut and beside that mother. I know that His arms are around her, and that He is calling that angel home where she will no longer be afraid, where she will run and sing, and feel joy. I know that God will continue to carry that family and many others here in Africa, and despite my struggle, the pain in my heart, the confusion in my thoughts, my spirit felt peace. To feel or not to feel continue to be a challenge, but for now, with the strength that I am being given each day, I am choosing to feel, to love those around me, to care, and to continue doing that. My prayers are with that family and will continue to be there for much time to come.
Suzanne
Today, our team visited a young mother of a 17 month old little girl who has been suffering with hydrocephalus – a medical problem in which there is too much fluid within the cranial cavity. I met this mother and her child a couple weeks ago at the clinic and the instant that I saw her little girl, my heart began breaking. She shared with me that her girl had been born a bit early, but was healthy for the first 3 months and my mind thought about my little niece and how precious she was to those around her at that age. I thought about the relationship that must have been created between this mother and her child over the past 17 months.........
The mother shared that she noticed the childs’ head start to get bigger after an infection and despite taking the child to the hospital numerous times and asking for help, there was no help to be found. A mothers’ love is a marvel on so many levels and I saw an even deeper aspect of that in this mothers eyes as she gently showed me her girl. As I began to examine her little angel, I felt the weight of the child’s head that could no longer be supported by her neck. I was met with the harsh reality that the child was going blind in both eyes and that her hearing was failing. I noticed that her reflexes were very sensitive and as I felt her soft hair, my fingers found a large soft spot on her skull that should have been closed months ago. I could see that this child was scared, as she was limited in her ability to know what was happening, and I so wanted to reach out and hold that child tightly so that she didn’t feel the fear that her body was showing. As her little fingers gripped mine, I felt the life and the spirit that was still living in this failing body and my heart broke. Again, I thought about my little niece Hope calling out her mothers name and running to her, and I knew that this child would never do that. I thought about the joy we felt when Hope took her first step, spoke her first word, and I knew that this woman would never see her daughter do those things. I thought about when Hope has been scared, and how her mother goes to her quickly so that she doesn’t feel that…… As I glanced at the mother, I saw love, a deep love for her daughter despite the extra care that was required. Not one word came out of her mouth about how sore her back must be from carrying her daughter around, or how hard she has to work each day. She didn’t mention the many kilometer walk she had made to bring her daughter to the clinic, or how tired she must be, she just wanted help for her little girl. I sighed deeply and prayer for strength because I knew that there was nothing medically that we could offer to this family.
Today as we walked into the little community where this family lived I saw the mother quickly getting chairs and setting out mats for us the familiar challenge came to my heart. I had to choose whether or not I allowed myself to feel the emotions that would come with this visit. My first thought was to become numb, to not allow it to permeate to my heart, to not think about what I would be feeling if this was my daughter, or my family. That would be easy, it wouldn’t require much investment on my part, and I could be as sensitive as I could and then just leave and forget. But again, the motto of the mission here, and the challenge to all of us of loving God and loving His people resounded in my mind and I knew that I couldn’t do that.
Early in my nursing career I made a promise to myself that when it got to the point where death was no longer hard, when I could see dying children and it didn’t affect me, when I stopped feeling, that I would stop nursing. That is because for me, nursing has always involved my heart, had always involved trying to imagine the pain that the people I am caring for are feeling. So as I sat on the mat and looked at the mother holding her dying child, I allowed the waves of pain to come and it took my breath away. As I spoke the stabbing words of no treatment available, no medications that can make this better, I saw the mother accept the destiny of her child in her own way and I choked back the tears. It felt like poison coming out of my mouth. If the weight of a dying child wasn’t enough, I learned that this young mother was alone most of the week as her husband worked away, and I tried to imagine carrying for a dying child and doing it alone. Even though this mother didn’t show much outward emotion, I knew that she was feeling grief that I couldn’t fathom. I imagined her crying in her hut at night, or feeling the anger and the confusion that many of us would. I thought again to my little niece and I knew that if her little life were in danger, that I would do anything within my power to change that, and I saw the exhaustion in this mothers eyes knowing that she was struggling with that and many other things. As she continued to breast feed her child, I saw the connection between them despite the many barriers, and I encouraged her that she was doing a good job. She shared that the child had already started to have seizures, and as I heard the complications that were happening, I prayed for mercy. It is a difficult prayer for many reasons because part of my heart believes that God can do miracles and that this child could be healed. But the other part of my heart also knows that God’s sovereignty doesn’t always involve what our minds think is best, and so I prayed that this life of this child would not suffer endlessly. I prayed for strength for the mother, that again I couldn’t fathom, and I prayed that God would not allow this mother to feel alone or for her child to feel the fear that I saw.
None of us that visited that family left the same; we were all impacted in one way or the other. But for me, the biggest impact came while we were leaving. If I had just been told that my child was going to die, and that there was nothing that could be done, I am sure that it would be so difficult to talk or to move or even breathe. I wouldn’t be thinking of anything except my child, and I certainly wouldn’t be thinking about the people who had just told me that news. But, as we left and I looked back, I saw the mother coming after us. She had strapped her child to her back, and she was walking us to our vehicle to thank us for the visit. She was honoring us and showing us her gratitude…….. I don’t know how to describe how that made me feel, but the tears came then and continue to as I think about it even now. What strength, what ability to continue with life despite the tidal wave of grief that had come, what endurance and ability to think about others instead of herself. It is hard for me to understand. I don’t know the time and date that the child will die, but I do know that as we left God stayed, that He will be present in that hut and beside that mother. I know that His arms are around her, and that He is calling that angel home where she will no longer be afraid, where she will run and sing, and feel joy. I know that God will continue to carry that family and many others here in Africa, and despite my struggle, the pain in my heart, the confusion in my thoughts, my spirit felt peace. To feel or not to feel continue to be a challenge, but for now, with the strength that I am being given each day, I am choosing to feel, to love those around me, to care, and to continue doing that. My prayers are with that family and will continue to be there for much time to come.
Suzanne
Saturday, June 26, 2010
A Day To Remember
Sunday was a day I hope that I never forget. We had the opportunity to go out to a small community church that is associated with the mission that we are working with. We all piled in to the van that morning and It was about an hours drive from where we are staying. When we arrived into the community, we drove to the little church. It was a building that had a thatched roof and open on the edges with several supporting poles down the center of the building. The floor was the red African dirt that we are becoming so familiar with. When we walked in to the church there were about 12 wooden chairs set up and off to the side were bamboo and reed mats. To the other side were a couple of rows of log seating, typically seen in places for gatherings here in the rural areas of Mozambique. We were asked to come and sit as the chairs were pointed out to us. It became apparent that the North American style seating had been put out especially in honor of the visiting Canadian Mazoongos (white people). The women came in and sat on the mats that were placed on the ground on the right of the chairs and the men sat on the log seating on the left side of the church. The last time I was here in Mozambique I was very blown away by the way the Afircans do church. I believe if everyone did church like this, there would be way more people that would come. For that reason, I was looking forward to seeing if I these folks would do it the same as I had remembered. The service started out with singing. Amazing singing…. and let me tell you that there is no one here that is too afraid to belt it out. Let me remind you that there are no pianos or instruments other that a drum and the clapping of hands, and the only thing that can top off the singing is the dancing. Wow...these people know how to shake their “Bon Bon” and they have no problem doing it. My favorite was the 4 year old little girl that danced like I have never seen. The joy on their faces was so apparent with praise and worship. After the preaching was done the pastor stood up and said that they were going to do a “Love “offering. I wasn’t too sure what this meant, but it started out with more singing and dancing and that was ok for me. During the dancing all of our girls got to get into dance along with the Mozambican people and during the dancing, 2 tied-up chickens were brought to the front of the church and layed on the floor. Also a bag of fruit was brought and placed near the chickens. This was a gift from the church to our team in honor of our visit. After the service we were asked if we would please come and join the pastor and his wife for lunch. Now under most circumstances like these, it is best to thank them very much but give excuse. It is not always the wisest thing to eat the meals that the Mozambican’s prepare as often the result will mean many hours in the bathroom. This time we were told that the meal had already been prepared and refusing the meal would be not polite, so we accepted with a little hesitation. We were led to the pastor’s home and at the door of his little 10x10 house, stood the pastor and his wife with a jug of water and basin that they used to pour water over our hands so we could wash before the meal. Then the 16 of us entered the small home and sat in a circle. Due to the cramped space we were knee to knee. We were served and ate the meal of rice and beans that had prepared for us. We asked why we were all sitting in the small house when we could have been outside a little less cramped. We were told that it was a great honor for the pastor to have us all in his home and not outside. He was trying to give us all the greatest honor he could. In addition to this honor, we were told that this pastor had been able to grow only 8 cobs of corn due to drought this past year. He was hardly able to feed his own family but it was important for him to be able to feed our team in honor. . Our good friend and co-leader Jeff, told us that after 18 years in the army and after many occasions of honor that he was a part of due to the service that he had given, he has never experienced the honor that was given to the group that day in a little church in Mozambique. It was a moment that I hope we all never forget and will be able to hold close to our minds and hearts for a long time .
Wendy
Wendy
Friday, June 18, 2010
While being here in Africa I have seen so many people and learned so many things. One of the common threads that have been demonstrated over and over again is the amount of strength that the African people have. Mai Ania has been a prime example of that in many ways over the past two weeks. Throughout the week between the first and second team, I was so blessed to be able to spend time with this Grandma doing her exercises. There were times that she would smile and even chuckle despite her pain. Once the second team arrived, we began the next step of her physio and actually got her sitting in a chair to do her exercises. It is hard to describe the first time that she actually sat in the chair and enjoyed the sunshine. I have never seen her smile so big and as she practiced taking deep breaths and doing her stretches, she said to me that she was feeling happy. What a joy to hear that.
We were also blessed with the opportunity to give Ania an audio bible in her native language that had been donated from someone months prior. God continued to give us opportunites to share His love for Ania over and over, which makes sense now as we are ending this week. Although Mai Ania seemed to be getting better, and it really looked like we may be able to help her start moving again, things changed drastically. As we went for our usual visit, we found a decline in her overall health, although she was so determined to continue with the exercises, the team could just see her weaken. As we began searching for what was causing the illness, it was like God gently showed the team that her time was ending. There was no sign of infection, no fever, but the pain worsened by the day and her energy just seemed to leave her.
At first, we struggled with trying to treat what was happening, but then God again gently lead us through a conversation with Ania. We were sitting in her hut in the evening with Pastor Rick and were talking about God when Ania shared that she had been sick for so long and that she was tired of being sick. She looked at us and said that she wanted to rest, and in my heart I knew that it wasn’t only her body that needed to rest, but also her spirit. We told Ania about how to find peace in Jesus, and continued to support her as the days continued.
Watching a person suffer is never easy, and depending on how you look at it, it can be very horrifying. For Ania, the suffering has been going on for decades in her life and has continued up until this very day. Even though we tried to give all we could in the way of nursing care, Ania body has been through so much and in a country where the life expectancy is 34, she being over 60 is quite remarkable. It is a difficult call to know when to stop rehabilitation and start palliative care, but for Ania, the need for that change was very clear. Over the past few days, she has gone from being able to sit up and talk with us and working through her physio to now being semi-conscious.
And even though my heart is so sad for this Grandma who I have grown to love very much, it hurts me even more to see her lying on a hard mat, in a cold hut, alone, and in pain. I miss her greeting us as we enter the tent already, but her spirit is no longer in the body that has failed her. This afternoon, as we prayed with her and our hands felt her cold limbs, I knew that the end was very near, and despite the sadness, there was relief. I know that God is present in that hut; I knew that even though the pain continued, that God’s mercies were stronger. When I think of my friend, this Grandma who has lived her life in Africa, strength resonates through my mind so loudly. She has taught me so many things through her example, and I feel so honored for the time I have had to know her. I will grieve with her family when she passes, but I will also rejoice knowing that she will no longer be in pain, and will no longer be suffering. Our thoughts and prayers are with our dear Grandma tonight and with her family.
We were also blessed with the opportunity to give Ania an audio bible in her native language that had been donated from someone months prior. God continued to give us opportunites to share His love for Ania over and over, which makes sense now as we are ending this week. Although Mai Ania seemed to be getting better, and it really looked like we may be able to help her start moving again, things changed drastically. As we went for our usual visit, we found a decline in her overall health, although she was so determined to continue with the exercises, the team could just see her weaken. As we began searching for what was causing the illness, it was like God gently showed the team that her time was ending. There was no sign of infection, no fever, but the pain worsened by the day and her energy just seemed to leave her.
At first, we struggled with trying to treat what was happening, but then God again gently lead us through a conversation with Ania. We were sitting in her hut in the evening with Pastor Rick and were talking about God when Ania shared that she had been sick for so long and that she was tired of being sick. She looked at us and said that she wanted to rest, and in my heart I knew that it wasn’t only her body that needed to rest, but also her spirit. We told Ania about how to find peace in Jesus, and continued to support her as the days continued.
Watching a person suffer is never easy, and depending on how you look at it, it can be very horrifying. For Ania, the suffering has been going on for decades in her life and has continued up until this very day. Even though we tried to give all we could in the way of nursing care, Ania body has been through so much and in a country where the life expectancy is 34, she being over 60 is quite remarkable. It is a difficult call to know when to stop rehabilitation and start palliative care, but for Ania, the need for that change was very clear. Over the past few days, she has gone from being able to sit up and talk with us and working through her physio to now being semi-conscious.
And even though my heart is so sad for this Grandma who I have grown to love very much, it hurts me even more to see her lying on a hard mat, in a cold hut, alone, and in pain. I miss her greeting us as we enter the tent already, but her spirit is no longer in the body that has failed her. This afternoon, as we prayed with her and our hands felt her cold limbs, I knew that the end was very near, and despite the sadness, there was relief. I know that God is present in that hut; I knew that even though the pain continued, that God’s mercies were stronger. When I think of my friend, this Grandma who has lived her life in Africa, strength resonates through my mind so loudly. She has taught me so many things through her example, and I feel so honored for the time I have had to know her. I will grieve with her family when she passes, but I will also rejoice knowing that she will no longer be in pain, and will no longer be suffering. Our thoughts and prayers are with our dear Grandma tonight and with her family.
Thursday, June 17, 2010
The second time arrives
Well it has almost been a week since our departure and so much has happened. Our flights were incredibly long as we had 5 different flights to get here but when we did arrive, we got to stay our first night in Mozambique in a cute little beach house on the Indian ocean. In the morning when we got up the whole team got to go and see the sun come up. Such a beautiful start to our trip. We arrived on camp later that day and got settled into our new home, tents, for the next 3 weeks. For the past couple of days we have been making visits to a little 80 year old lady that is suffering from leprosy and a broken hip that was never set. She has been for the most part immobile and so the challenge set before us is to see if we might be able to get her mobilized before we leave. Such a sweet little lady that despite having so little, is still able to smile and is so thankful for a team from Canada that is trying to help. Yesterday we were able to go to the school that is associated with the mission that we are working with while here. That was such a neet day as I am sure all 260 children tried to hold everyones hand at sometime during the day. The kids here are so full of joy and smiles and have no fear of the Mazoonga. (white person). They want to sit on your lap and do your hair. Just normal children I guess. Tomorrow we will be able to participate in a immunization clinic. That should be interesting as there are sometimes 100's of children present needing vaccinations. Anyhow I guess that is it for now. I will try to post again soon.
Wendy
Wendy
Friday, June 11, 2010
Frustration leads to Motivation
This past week I have been on the farm with Keren and the workers finalizing the schedule for the next team to come. After returning from a visit at the coast which was so incredibly beautiful and refreshing and dropping the first team off, I was surprised at how tired I felt. Although I wasn’t able to make it to the clinic as often as I wanted, the times that I spent there were filled with many emotions. There are so many challenges here in the health sector, and so many limitations, it is very easy to get overwhelmed. Frustration set in even before the first year team left, and continued throughout the week. I was thankful that God has big enough shoulders to handle my anger as I prayed and sought after His wisdom.
One of the first situations that has challenged many of our emotions regarded Mai Ania, the grandma that we have been caring for with a broken hip. When we first arrived at camp, Mai Ania was living the home built for her by the mission and was being cared for by her neighbour Mai Lidia. It was a relationship that taught the entire team of true love and sacrifice. On one our visits, we were informed that Mai Ania husband and daughter wanted her to move back home to their community, which at first seemed like a really good idea. But after learning more about the situation, my heart sank as I realized that this had happened before and it resulted in poor treatment and neglect for Mai Ania as the other 4 wives of her husband were not willing to care for her. I couldn’t understand why Mai Ania would want to go back to such an unloving situation, knowing full well what would happen, but she was really excited. It hit me then, and continued to as the days went on that Mai Ania is like the rest of us, she wants to be loved, and regardless of how badly her family treats her, the invitation back was a reminder of their love for her in Mai Ania’s eyes. It saddened me, and I tried to not be too pessimistic about the situation, but my worry was deep as I thought about the many health problems that we were working with, and how the progress might drop significantly if Mai Ania was in that situation.
However, the day came and we as a team went to support Mai Ania in her decision and transported her in the back of a truck to her new home. Upon arrival, we were told to put her on the floor in front of a small hut, and as I did, I felt like I was deserting her. It is difficult to create the picture in words for you to understand, but in a way it would be like someone going from the hospital, where you are getting nursing care to being placed in downtown Calgary on the street inside of a cardboard box. But, as I looked at Ania, the smile on her face told me that she wanted to be there. Unfortunately, her husband who can hardly move himself wasn’t very welcoming, but I was thankful that her daughter was there to care for her.
After the team left, I have continued to go and see Mai Ania, and each day is a different picture of how she is doing. The first day that I got there after the weekend, she was lying in the hut crying from pain and told me she was cold. As I sat her up, her tears were splashing on my arm and I knew that it wasn’t going to be a good day. We worked together to move her sore limbs, and I asked if she had eaten that day. She explained to me that she only eats what is brought to her, and I didn’t see any sign of food being brought on a regular basis. I spent time trying to encourage her, and despite her pain, she went through the exercises and then asked to rest. It was so sad to help her settle back on that lonely mat…… I left with a very heavy heart.
The next time I visited, my frustration continued as I found her lying on the matt with no clothes, and her legs were so cold from the nights drop in temperature. As a woman who struggles with Leprosy, her circulation is already compromised in many ways, and so to see swelling and lack of circulation in both of her legs worried me greatly. As I held her legs in my hands and began to massage some heat into them, her whimpers of pain broke me. I was having trouble controlling my tears as I slowly began moving her toes one by one, then her ankles, and so on. I was so frustrated knowing that if we were in a different place, this woman’s life would be so different. But God gently reminded me that I needed to be present in the realities of this situation and to trust Him, and so we continued.
As I was finishing the exercises, I recognized a smell that I would never forget….. rotting flesh and so I began my search. It didn’t take long to discover a raging yeast infection under Mai Ania breasts that was seeping green mucous. I wondered how long it had been there, and wondered how I had missed that in previous visits, but I was thankful to have found it. Again, as many treatments do, pain was a part of cleaning, and so we prayed together and I continued. All the while, Mai Ania uttered words of thanks. I accepted that, but wondered how it was possible that this woman wasn’t even getting help with basic tasks of washing every day…. Which would avoid this kind of infection. How could a woman be in a community, but be totally ignored and neglected………. It made me want to go out and scream, but I know that I am in a different culture, in a place where life is walked in a different way, and God again reminded me that He had brought our teams for a purpose, and for Mai Ania. I was again encouraged and motivated to continue to do all that I could, knowing that with every step I needed to continue to rely on God’s strength.
At the end of the week Keren and I were able to visit Mai Ania once again, and we were very encouraged to see the progress that had happened. The rash, although still painful, was healing well and we were able to continue treatment. But even more exciting and encouraging was achieving the goal of getting Mai Ania into a chair. I think it had been months since this women had been off of the cold ground…and her smile told me of her joy as we lifted her into the chair. It almost seemed that she felt some of her dignity return, I saw hope in her eyes that I hadn’t seen since coming, and I felt a wave of encouragement come over all of us. As we again worked through the exercises, we took it one step further as Keren and I helped Mai Ania stand on her good leg. It was a victory in her life, as she had said on my first visit that she didn’t think she would ever walk again, and despite the fear that she felt, I could feel a bit of spirit return into this Grandmas heart. It was another reminder again, that God’s hope is present in all situations, regardless of how negative or hopeless that is seems. I am excited to see how God is going to use the next 4 weeks of the nursing student’s care in Mai Ania’s life. What an honor for us to be part of what God is doing………
It is funny how there are waves of emotions and experiences that come while in Africa, life continues no matter where you are. This week there have been other situations that have tore my heart apart and I realized that it was possible to feel anger and deep sadness at the same time. One of the struggles that has been rearing its head this year is the fact that even though there is a medical clinic, the people in the community don’t come for help soon enough. The result of this was reality again, as we heard of a workers baby dying after being sick for a few days. The moment I heard that, the weight on my shoulders just was so heavy, how could we tell the people that maybe we could help. How can we make them trust us enough or encourage them that coming to the clinic to the thing to do when their little ones are sick. Despite that fact that death seems to reign in this place, each life lost is exactly that…. A life lost. I glanced at the antibiotics and other medications that are sitting in the clinic, and it just broke my heart. Most times the babies and people are dying from things that can be treated….. if they come early enough. How is it possible that precious babies are dying from basic chest infections that would require a few days of antibiotics and rest, how is that reality, but it is. At times, it seems like I am getting a hard heart, as I didn’t weep outwardly as I did in the first year that I visited here. But my heart is not hard, it breaks every time I hear of those lives that are lost, but I still have to be effective. If I allow myself to really think about a little girl dying just as her life is beginning, if I thought about the mothers wailing and the fathers grief, if I thought about my own dear family members and what it would be like to lose them, I wouldn’t be able to take a step. I would be wailing on the ground just as the African people do when they meet the grief of death…….. but we must continue to try and educated, to treat, and to care. We must walk up to the clinic and into the communities and do all that God gives us the strength to do, and then, we must rest in the warmth of His sovereignty.
The heaviness this week deepened even more as I heard from one of the health workers that his 3 month old baby had eye problems. What he explained to me sounded like cataracts, something that I knew would end in blindness here, and so I asked him to bring her to me. It was so precious to see this grown man as he introduced me to his little girl. She was so beautiful, full head of dark curly hair, perfect features, small little hands and feet, what joy she would bring. I listened again to the story and heard that the entire family had experienced an eye infection over the past week. I learned that she had been healthy since birth, that she was a bit fussy in the evening, and that she was growing well. I learned that both her father and mother were suffering from lack of sleep because their daughter seemed to like to cry at night…… it sounded like a very typical infant. I began examining her eyes, and quickly noticed the problem. Her right eye was totally fine and her discontent was very clear that she didn’t like me shining lights in her eye. As I carefully opened the left eye, I quickly saw the problem and I knew that it wasn’t cataracts. I saw a small white circle on the lower part of her cornea, which most likely started as a small scratch on her eye, but had developed into scar tissue, known as a corneal scar.
This kind of problem is very commonly seen, and can be easily treated. The health worker had begun treatment of the eye, but despite the treatment, the scar had formed. Often, by putting a patch over the eye, and using antibiotic cream, the formation of the scar tissue can be avoided, but the health worker hadn’t brought the child to the clinic because he thought it would get better like the rest of his family. He looked at me, asking if I knew how to fix this problem, and having worked with him for the past 4 years, and considering him a friend, it was very difficult to explain to him that this might not be able to be fixed. He asked me if his girl would be blind, and again, as my heart sank, I tried to explain that I didn’t know for sure. We started some treatment, patched the eye, and prayed for his little girl. In Canada, there are corneal transplants and other surgical treatments available for this kind of problem, but in Mozambique, that would be very difficult to get done because of limited options of medical care and the high costs.
As I had felt many times throughout the week, I was frustrated that I hadn’t heard about the little girl earlier, although there is no guarantee that I could have helped, we might have been able to avoid some of the complications that I was seeing. I was again saddened at the thought of this perfect little girl possibly losing her sight and thought about how that would impact her life. But, I also felt motivated to do whatever I could to teach the people how to care for themselves, motivated to search and use all the resources that I can to try and help this little baby, motivated to help the people know to come to the clinic.
It is people like Mai Ania, and this little baby, and the many others that I see in the community and in the clinic that motivate me to continue trying our best to serve and love how Jesus would. The nursing teams that come don’t implement life saving measures, we don’t cure, we don’t make obvious changes in the lives of the people that we see, but we do try to love. God is always working, I reminded some of my students of that when discouragement came, and this week, I needed that reminder myself. We may not always see what God is doing but we can rest knowing that He is always working through us, or even despite us. And what He asks of us is a willing spirit to do what He needs, which may not be what we think should happen or even what we came to do. But with a willing spirit and total surrender to God’s plan, I have seen over and over the victories that come. Despite the sadness, frustration, anger, and many other emotions, I know at the depth of my heart that one day all of the suffering and the pain will end, and again I am so thankful for that promise. Until that day, we will continue to do what God has called all of us to…. Love Him and love those around us with all of our strength.
Much love from Africa.
Suzanne
One of the first situations that has challenged many of our emotions regarded Mai Ania, the grandma that we have been caring for with a broken hip. When we first arrived at camp, Mai Ania was living the home built for her by the mission and was being cared for by her neighbour Mai Lidia. It was a relationship that taught the entire team of true love and sacrifice. On one our visits, we were informed that Mai Ania husband and daughter wanted her to move back home to their community, which at first seemed like a really good idea. But after learning more about the situation, my heart sank as I realized that this had happened before and it resulted in poor treatment and neglect for Mai Ania as the other 4 wives of her husband were not willing to care for her. I couldn’t understand why Mai Ania would want to go back to such an unloving situation, knowing full well what would happen, but she was really excited. It hit me then, and continued to as the days went on that Mai Ania is like the rest of us, she wants to be loved, and regardless of how badly her family treats her, the invitation back was a reminder of their love for her in Mai Ania’s eyes. It saddened me, and I tried to not be too pessimistic about the situation, but my worry was deep as I thought about the many health problems that we were working with, and how the progress might drop significantly if Mai Ania was in that situation.
However, the day came and we as a team went to support Mai Ania in her decision and transported her in the back of a truck to her new home. Upon arrival, we were told to put her on the floor in front of a small hut, and as I did, I felt like I was deserting her. It is difficult to create the picture in words for you to understand, but in a way it would be like someone going from the hospital, where you are getting nursing care to being placed in downtown Calgary on the street inside of a cardboard box. But, as I looked at Ania, the smile on her face told me that she wanted to be there. Unfortunately, her husband who can hardly move himself wasn’t very welcoming, but I was thankful that her daughter was there to care for her.
After the team left, I have continued to go and see Mai Ania, and each day is a different picture of how she is doing. The first day that I got there after the weekend, she was lying in the hut crying from pain and told me she was cold. As I sat her up, her tears were splashing on my arm and I knew that it wasn’t going to be a good day. We worked together to move her sore limbs, and I asked if she had eaten that day. She explained to me that she only eats what is brought to her, and I didn’t see any sign of food being brought on a regular basis. I spent time trying to encourage her, and despite her pain, she went through the exercises and then asked to rest. It was so sad to help her settle back on that lonely mat…… I left with a very heavy heart.
The next time I visited, my frustration continued as I found her lying on the matt with no clothes, and her legs were so cold from the nights drop in temperature. As a woman who struggles with Leprosy, her circulation is already compromised in many ways, and so to see swelling and lack of circulation in both of her legs worried me greatly. As I held her legs in my hands and began to massage some heat into them, her whimpers of pain broke me. I was having trouble controlling my tears as I slowly began moving her toes one by one, then her ankles, and so on. I was so frustrated knowing that if we were in a different place, this woman’s life would be so different. But God gently reminded me that I needed to be present in the realities of this situation and to trust Him, and so we continued.
As I was finishing the exercises, I recognized a smell that I would never forget….. rotting flesh and so I began my search. It didn’t take long to discover a raging yeast infection under Mai Ania breasts that was seeping green mucous. I wondered how long it had been there, and wondered how I had missed that in previous visits, but I was thankful to have found it. Again, as many treatments do, pain was a part of cleaning, and so we prayed together and I continued. All the while, Mai Ania uttered words of thanks. I accepted that, but wondered how it was possible that this woman wasn’t even getting help with basic tasks of washing every day…. Which would avoid this kind of infection. How could a woman be in a community, but be totally ignored and neglected………. It made me want to go out and scream, but I know that I am in a different culture, in a place where life is walked in a different way, and God again reminded me that He had brought our teams for a purpose, and for Mai Ania. I was again encouraged and motivated to continue to do all that I could, knowing that with every step I needed to continue to rely on God’s strength.
At the end of the week Keren and I were able to visit Mai Ania once again, and we were very encouraged to see the progress that had happened. The rash, although still painful, was healing well and we were able to continue treatment. But even more exciting and encouraging was achieving the goal of getting Mai Ania into a chair. I think it had been months since this women had been off of the cold ground…and her smile told me of her joy as we lifted her into the chair. It almost seemed that she felt some of her dignity return, I saw hope in her eyes that I hadn’t seen since coming, and I felt a wave of encouragement come over all of us. As we again worked through the exercises, we took it one step further as Keren and I helped Mai Ania stand on her good leg. It was a victory in her life, as she had said on my first visit that she didn’t think she would ever walk again, and despite the fear that she felt, I could feel a bit of spirit return into this Grandmas heart. It was another reminder again, that God’s hope is present in all situations, regardless of how negative or hopeless that is seems. I am excited to see how God is going to use the next 4 weeks of the nursing student’s care in Mai Ania’s life. What an honor for us to be part of what God is doing………
It is funny how there are waves of emotions and experiences that come while in Africa, life continues no matter where you are. This week there have been other situations that have tore my heart apart and I realized that it was possible to feel anger and deep sadness at the same time. One of the struggles that has been rearing its head this year is the fact that even though there is a medical clinic, the people in the community don’t come for help soon enough. The result of this was reality again, as we heard of a workers baby dying after being sick for a few days. The moment I heard that, the weight on my shoulders just was so heavy, how could we tell the people that maybe we could help. How can we make them trust us enough or encourage them that coming to the clinic to the thing to do when their little ones are sick. Despite that fact that death seems to reign in this place, each life lost is exactly that…. A life lost. I glanced at the antibiotics and other medications that are sitting in the clinic, and it just broke my heart. Most times the babies and people are dying from things that can be treated….. if they come early enough. How is it possible that precious babies are dying from basic chest infections that would require a few days of antibiotics and rest, how is that reality, but it is. At times, it seems like I am getting a hard heart, as I didn’t weep outwardly as I did in the first year that I visited here. But my heart is not hard, it breaks every time I hear of those lives that are lost, but I still have to be effective. If I allow myself to really think about a little girl dying just as her life is beginning, if I thought about the mothers wailing and the fathers grief, if I thought about my own dear family members and what it would be like to lose them, I wouldn’t be able to take a step. I would be wailing on the ground just as the African people do when they meet the grief of death…….. but we must continue to try and educated, to treat, and to care. We must walk up to the clinic and into the communities and do all that God gives us the strength to do, and then, we must rest in the warmth of His sovereignty.
The heaviness this week deepened even more as I heard from one of the health workers that his 3 month old baby had eye problems. What he explained to me sounded like cataracts, something that I knew would end in blindness here, and so I asked him to bring her to me. It was so precious to see this grown man as he introduced me to his little girl. She was so beautiful, full head of dark curly hair, perfect features, small little hands and feet, what joy she would bring. I listened again to the story and heard that the entire family had experienced an eye infection over the past week. I learned that she had been healthy since birth, that she was a bit fussy in the evening, and that she was growing well. I learned that both her father and mother were suffering from lack of sleep because their daughter seemed to like to cry at night…… it sounded like a very typical infant. I began examining her eyes, and quickly noticed the problem. Her right eye was totally fine and her discontent was very clear that she didn’t like me shining lights in her eye. As I carefully opened the left eye, I quickly saw the problem and I knew that it wasn’t cataracts. I saw a small white circle on the lower part of her cornea, which most likely started as a small scratch on her eye, but had developed into scar tissue, known as a corneal scar.
This kind of problem is very commonly seen, and can be easily treated. The health worker had begun treatment of the eye, but despite the treatment, the scar had formed. Often, by putting a patch over the eye, and using antibiotic cream, the formation of the scar tissue can be avoided, but the health worker hadn’t brought the child to the clinic because he thought it would get better like the rest of his family. He looked at me, asking if I knew how to fix this problem, and having worked with him for the past 4 years, and considering him a friend, it was very difficult to explain to him that this might not be able to be fixed. He asked me if his girl would be blind, and again, as my heart sank, I tried to explain that I didn’t know for sure. We started some treatment, patched the eye, and prayed for his little girl. In Canada, there are corneal transplants and other surgical treatments available for this kind of problem, but in Mozambique, that would be very difficult to get done because of limited options of medical care and the high costs.
As I had felt many times throughout the week, I was frustrated that I hadn’t heard about the little girl earlier, although there is no guarantee that I could have helped, we might have been able to avoid some of the complications that I was seeing. I was again saddened at the thought of this perfect little girl possibly losing her sight and thought about how that would impact her life. But, I also felt motivated to do whatever I could to teach the people how to care for themselves, motivated to search and use all the resources that I can to try and help this little baby, motivated to help the people know to come to the clinic.
It is people like Mai Ania, and this little baby, and the many others that I see in the community and in the clinic that motivate me to continue trying our best to serve and love how Jesus would. The nursing teams that come don’t implement life saving measures, we don’t cure, we don’t make obvious changes in the lives of the people that we see, but we do try to love. God is always working, I reminded some of my students of that when discouragement came, and this week, I needed that reminder myself. We may not always see what God is doing but we can rest knowing that He is always working through us, or even despite us. And what He asks of us is a willing spirit to do what He needs, which may not be what we think should happen or even what we came to do. But with a willing spirit and total surrender to God’s plan, I have seen over and over the victories that come. Despite the sadness, frustration, anger, and many other emotions, I know at the depth of my heart that one day all of the suffering and the pain will end, and again I am so thankful for that promise. Until that day, we will continue to do what God has called all of us to…. Love Him and love those around us with all of our strength.
Much love from Africa.
Suzanne
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