Sunday, July 26, 2009

baby steps

This week with Cincinnati's Vineyard Community Church (VCC) has been amazing! They just got on their plane to head back home after the 7 days. But, we've gotten so much done in just a week. A couple of days were spent doing some construction for the new property to build outlines of where the buildings are planned to be built. One day was spent digging a water well with Self-Sustaining Enterprises (SSE).

The VCC team funded this dig. It was SSE's 50th water well dug and it will provide clean water for the Miango village, a village comprised of Christians that used to be Muslim. The conversion from Muslim to Christianity isn't seen as easy, as the families of the new converts are usually expected to shun them from the family permanently. So it was great to hear the testimonies of the people that comprise this newly formed village.

I spent a lot of time playing with the kids (surprise, surprise). All of the children in primary school (equivalent of our K-5th) haven't been in school for a month as the teachers have been on strike for a month. This isn't rare here at all. Many students don't graduate high school until their mid-20s because of all of the gaps in education due to unexpected strikes. I met a 15-year old girl named Christiana. I hung out with her and her little brother John pretty much all day. She told me that the teacher for her secondary school was running late... as it was 1:30 and school was supposed to start at 12:30. Walking by her classroom, or anywhere in any village here, REALLY made me understand and feel what it's like to be a minority. Conversations just stop and all eyes are on you. Children whisper to each other "Batore..." ("Look, a white person..."). She led me into her classroom where about 60 kids aged 12-20 were waiting for their teacher who was now an hour late. I asked her to show me some of the things that they were learning and she pulled out some small science and math books. As I flipped through her science book, she stopped at a page and asked me to teach something to her. It was a lesson about how flies can contaminate meat by landing, laying eggs, which produce more flies and disease. So I started to read and explain it and I couldn't help but stop and ask, "Are you SURE you do not know this?" as about 10 other children quickly gathered around to hear me read. She assured me that she had no idea and I continued to read. Shortly after, the teacher came in and proceeded to hand out exams, as they had their agricultural science exam today. The teacher welcomed me and gave me a copy. Christiana encouraged me to help her read the questions and answers aloud. I honestly had no idea about any of the answers. Everything on the test ranged from proper plowing techniques to definitions of different kinds of harvesting--no idea.

Outside, several hours later, the well digging machine had finally made it to a sufficient level and clean water was beginning to spew out of the top of the hole. Many Nigerians working for SSE were there dressed to impress--the men in suits and the women head-to-toe in the beautiful Nigerian prints. Later on, I received some Hausa lessons from Christiana in return for the science help. I now know how to say, "Where are you going?" "Are you tired?" "You are beautiful" and "What is your name?" in Hausa. The Nigerians crack up and think it is the funniest thing ever when I throw out my few memorized Hausa phrases. They respond in Hausa and ask me a question, but no matter what they say I usually end up replying with "Yowaaa" (meaning "Yeahhh... awesome") as I don't know how to say anything else... and the laughing continues.

But my favorite day this week, by far, was our medical outreach day on Friday at the Kisayhip village that Back2Back is closely ministering to. The need for medical attention was so great that we continued for half of the day on Saturday. Out of the 14-member Vineyard group, there was one nurse, one medical student, one nursing student, and one occupational therapy student. We had three Nigerian doctors there as well that volunteered their time for the outreach. The occupational therapy student was one of the three VCC group members that sat with translators and were at the "intake" station to understand and record the patients' information and medical needs. The nurse mainly directed the congested traffic going on inside our small little tents and also filled in the gaps whenever a lunch break was needed. The medical student also floated between the intake of patients and the pharmacy area. The nursing student spent about 10 minutes beforehand teaching me how to take vitals alongside her (temperature, blood pressure, pulse, and respiration). The nursing student and I saw about 80-90 patients each between the two days. My ears are still sore from having a stethoscope in them for 6 hours on Friday and 3 hours on Saturday. But honestly, the time spent doing vitals was so amazing and so worth it. That was my first time taking blood pressure outside of physiology class a year ago, and I was sooo nervous to start. But once I had a couple patients, I felt like I got the hang of it real quick.

Although I'm not qualified at all, it was incredible to take the arms of the frailest, skinniest elderly women that I have ever seen and provide them with some sort of healthcare. But, I'd have to say that the time spent with the children and babies were my favorite. This was probably because I knew many of them from church and playing in the village for the last two months. So it was awesome to see the kids that I've been having fun with as my patients. And then I meet the adults, and can see their children and other family members in their faces--it's really cool to be able to mentally recognize the extended families by facial features.

I really admire the women that I see on Sunday at the village church in the choir that bang on the drums and sing at the top of their lungs all for the Lord. So that was great to be able to tell them that I enjoy seeing them at church and playing with their kids. They are so appreciative of the time that we spend here, however, are astonished that most of us will be leaving in a few weeks. "We appreciate and thank you so much for being here. Why you must return home??"

Many of my patients would have an infant on their lap and then 2 or 3 or 4 more kids all under the age of six at their sides; and all patiently waiting to be seen by me in my one small chair. I found that the easiest method for these situations was to just treat mom first so the kids could see that nothing hurts. Then, grab one of the kids and put them on my lap, give them a sucker, then proceed with everything I need to do. The babies were such a hit or miss for me though. Either they were passed out and bundled up so tightly in their clothes making it impossible to get a temperature in under 5 minutes; or, they are crying their eyes out terrified by our white skin or the idea that I'm wanting to hold their tiny wrist for 60 seconds. One baby made my day though when anyone so much as touched him, he let out a giant, hearty laugh. He was 6-mos. and would throw his head back and squeeze his eyes shut and would just crack up.

Over the course of 1.5 days we were able to see over 200 patients and provide medical treatment. The hardest part was cutting off the outreach. More and more people would come as they would hear about the treatment and would walk from their village all day just to be seen by a doctor. The number of individuals was unending and seemingly impossible. I'm praying that God allowed the people that needed the medicine and treatment to make it there. It's hard to see the fruit of the labor when the impact seems so minuscule, but I have to cling to the promise that serving the few is beneficial. It's so true that meeting the physical needs lays a foundation for meeting the spiritual needs. As God goes after the one (Luke 15:8-10; Matt. 18:12-14), I think He finds joy when we do too.

Saturday, July 18, 2009

Meet Maryann

This beautiful 8-year old girl has stolen my heart. Society would deem her circumstances worthy of a life filled with anger, bitterness, and sorrow, but none of these words come close to describing little Maryann. The picture below was taken on the first day we met.

Her mother died of HIV/AIDS when Maryann was just a baby. She had her father left, until a few months ago when he, too, passed. I see Christ in Maryann with every day I spend with her. She is like a giant ball of joy and energy. It's sooo easy for us to live without joy and thankfulness when we are daily experiencing the condemnation, trials, and brokenness found effortlessly in this world. I am learning that authentic, unshakable joy comes from these troubling times and situations.

From Andrew Murray's "Abide in Christ":
[Many Christians'] view of the Christian life is that it is a succession of changes, now joy and now sorrow. And they appeal to the experiences of a man like the Apostle Paul, as a proof of how much there may be of weeping, and sorrow, and suffering. They have not noticed how just Paul gives the strongest evidence as to this unceasing joy. He understood the paradox of the Christian life as the combination at one and the same moment of all the bitterness of earth and all the joy of heaven. "As sorrowful, yet always rejoicing": these precious golden words teach us how the joy of Christ can overrule the sorrow of the world, can make us sing while we weep, and can maintain in the heart, even when cast down by disappointment or difficulties, a deep consciousness of a joy that is unspeakable and full of glory. There is but one condition: "I will see you again, and your heart shall rejoice, and your joy shall no man take from you." The presence of Jesus, distinctly manifested, cannot but give joy.

Precious Maryann is full of so much spunk and life. Her giggles are unending and are absolutely contagious. I rarely see her without her huge grin plastered across her face.

One of the few times that I have seen Maryann serious and intense was when we were hiking one afternoon. And she says to me with a solemn and worried expression, "Auntie, let me carry your bag." This isn't uncommon as the kids are constantly trying to help us out by carrying our stuff even though they realize our bags are half the weight of themselves. My bag was pretty heavy as it was filled with food for lunch, camera, and two full water bottles. So I said to her, "Thank you, but I will carry it, it is very heavy today." She wasn't going to accept that as she looked very stern and said, "Auntie please give me your bag, I want to carry it for you." Knowing I couldn't change her mind, I handed her my backpack. As she added the weight onto her tiny, little frame, her trademark grin was across her face again.

Tuesday, July 14, 2009

first half

I was able to get a good amount of pictures on facebook.
Go here to view them if you don't have facebook:

Saturday, July 11, 2009

"I am the vine, you are the branches"

Yesterday was my day at Evangel hospital. I guess I should give some background about why I went. Another intern here, Mark, has been interning with me at Back2Back but has been spending the last couple weeks in Evangel watching and occasionally helping as he is in his second year of medical school. For half of my undergrad, I pursued nursing and was close to having all my prerequisites done when my heart tugged for social work (short version of the story). After I finish my social work degree next May, I'm still interested in possibly doing the accelerated nursing program at community college mainly for the ability to take that into any city or country. So Mark asked if I would be able to tag along too for the day, and next thing I know I'm leaving at 7am for a full day at the hospital.

I had toured Evangel a week or so ago very briefly, so I was already slightly familiar with Evangel. We began in the doctor/resident meeting (as they start with every single morning). There are a couple actual doctors but most of them are all residents and chief residents (residents that opted for an extra year, very respectable position). It’s basically an update on the new patients that came in since the last day as well as any mortalities that happened overnight. A good portion of the patients are drawn from RTA’s or road transportation accidents. Since everyone pretty much rides motorcycles everywhere (they are taxis), there are TONS of motorcycle accidents. Lots of broken leg bones from RTA's. Other new patients included those with ovarian problems, cerebral malaria… to mention a few. A couple babies died last night--one of heart failure and another resulting in poorly developed lungs. Today I learned that Nigeria has the highest infant mortality rate (1 in 7 die) and highest maternal mortality (1 in 10 pregnant women die) rate in the world. That’s incredible for me to fathom, as I flashback to my Intro to Soc. class where we were handed packets with information on every single country in the world and their mortality rates, economic status, industrialization, etc. So in the meeting I listened to all 20 or so in the room talk about each case. One woman in particular they spent about 20 minutes brainstorming how in the world she has an ovary in the wrong place in her body. It was really neat for me to see the teamwork and deep patient interest in the hospital.

The first part of the day we went into the neonatal intensive care unit (NICU) where four teeny, tiny 3-lb. babies were—each in their own little fish tank-sized incubator with oxygen and IVs. I’ve never seen babies that small before up close, it left me awestruck seeing their short, quick little breaths. It truly is amazing that God is able to sustain such tiny and intricate babies. And it’s equally incredible that they have the ability to be our size one day.

Next we followed a few doctors/residents on their rounds. We went into the maternity ward, where most of the five women who had just been in labor the day before, now had five very healthy babies. "You are welcome" is the resounding phrase heard in the room, encouraging us to enter. One of the residents handed me a bundle just under a day old—sooo precious and amazing. I told all of the women that their babies were very beautiful and it was apparent they were very proud of their babies. The mother to baby bond is so beautiful. I think I’m much more appreciative of the victory that both mother and child are living and healthy. I'm left in awe of the fact that women here go through so much pain in birthing, the aftermath of birthing, and knowingly chance the alarming mortality rate for the sake of life.

There are mostly wards containing 15 or so patients per room at Evangel, and there are a few private and semi-private rooms but are more costly. One patient in a private room we visited was an older woman who had been having chronic diarrhea. Nigeria also has a super low life expectancy, so the fact that she looked well over 80 was in itself amazing. She evidently has cancer in multiple places (can’t remember which) and her family has chosen not to tell her so that she may die in less fear and worry. I hear that it's a common and respectable thing to do to protect the emotional wellness of the elder.

The woman in the next private room I heard had a hysterectomy (I did not go in) and had her uterus was lying in a bedpan beside her—yep, serious. Unfortunately, it is not uncommon for “phantom surgeries” to occur where a woman goes to a hospital and is told that she has received a surgery, but instead the doctors just make an incision and stitch it back up and tell them that it’s taken care of. So the uterus in the bedpan is pretty much proof that the operation happened. The woman is also HIV+ so it’s strange to me that her bloody uterus would be just lying next to her in her room.

In one larger room, we visited a couple women whose C-sections were stitched up a day prior. Both women lost their babies during labor but still needed to stay for rountine check-up on the healing. Keep in mind that all wound cleaning, wiping, etc. is done without any anesthetic so a lot of screams and mourns are heard all the while.

An OB/GYN doctor that is here from Fort Collins, Colorado, super sweet guy… walked Mark and I to a ministry called Faith Alive a few blocks over. Faith Alive is a hospital, laboratory, school, and counseling center for HIV+/AIDS victims. Once we arrived we met a few others from their group (all from Colorado) then followed a Nigerian counselor, Simon, to his office for an opportunity to sit-in on any HIV therapy sessions. I was super excited about potential counseling and therapy for the sake of great social work experience, especially because I have been interested in HIV/AIDS awareness since I was a kid.

Simon's open hours are from 9am-4pm and yesterday he had 3 patients… all day. So the odds were stacked up against us at the start. A husband and wife came briefly, they had been both living with HIV for three years and had to come in for a routine CD4 count (amount of T-cells your body still has). Another man also came in for a CD4 count a bit later. He is a first year medical student and just found out that he is HIV+. He comes from a reputable family and travelled 8 hours to Faith Alive just to avoid anyone finding out about it. In order for patients to start counseling at Faith Alive, they have to confide in someone, either a close friend or family, that they are HIV+. So he won’t start until he decides to tell someone. He is afraid that because of his family’s status and the stigma of HIV/AIDS that he will be shunned from his family. Simon said that they have seen over 5,000 patients living with HIV since the start of Faith Alive. The time spent there mainly included Simon answering my million questions about the entire counseling process and their resources provided. He also let me read through the educational information they use to train their staff on HIV/AIDS. The myths about HIV/AIDS are absolutely crazy--it’s not uncommon for many villages to believe that the way to cure the disease is to sleep with a virgin.

Faith Alive’s primary mission is to promote healthy and productive living while having the disease. They discourage finding the source of the disease as all it usually accomplishes is blame shifting, many times blaming the wrong individuals or circumstances. Instead, they promote healthy diets, counseling for coming to terms with the disease, and a variety of vocational training to allow them to be productive members of society (cosmetology, computers, seamstressing, etc.). So after Mark and I had been sitting with Simon for over an hour we decided to head back to Evangel as no patients were coming in for therapy.

We changed into scrubs and went right into surgery. (The operation room is about three feet to the right after walking in the front door, it is literally possible for anyone to enter.) I think my “picture of the day” was probably the first thing that my eyes saw after entering the OR. A 14-year old girl was lying on a table, wide awake, and looking around while a resident and nurse held up her stub of a left leg and were in the middle of suturing the amputated leg—she was under an epidural anesthesia. They were suturing her up and all I wanted to do was hold her hand, but I wasn’t sure if I could touch her, so I instead pulled off my mask and shot her a smile. She returned with a slight grin.

We then went into the room over—there are three connected operating rooms total—where we observed a VVF (vaginal vasicular fistula). The VVF procedure is super common here for one reason or another. The vagina is torn, so the woman had no control of when she urinates as the tear was right before the sphincter (muscle to regulate urine control). It’s just a random drip of urine that comes out through the vagina. (As you can imagine that can cause a lot of problems, in addition to the cultural stigma of always smelling like urine.) I watched with a few other nursing students, as two doctors cut and prodded with many sharp tools—I’ll spare details. Just know that neither I nor Mark, who is in his 2nd year of medical school, could really identify much because it was such a mess. That operation took probably about 3 hours. All the while, the woman was completely awake but under an epidural anesthesia.

I learned that Friday at Evangel is the day for swapping out bandages from wounds/surgeries. Patients grit their teeth and let out agonizing screams as the residents wipe away at their healing sores. The craziest wound I saw was of a man that was robbed and his assailants had shot him with a shotgun through his thigh. It barely missed the fibula bone so he pretty much has a giant hole going through the lower of the thigh. The body is absolutely amazing in regards to how quickly it begins healing itself. The middle part of his leg was already healing quite rapidly and the hole had turned into two potholes instead.

Another surgery we watched was the removal of a lipoma (fatty tumor) just bigger than a half dollar above the patient’s eyebrow. He was given a local anesthetic, but was of course awake during the entire thing. The entire time I was praying that the man did not understand English because of the conversation that the residents were having among us and each other. “Do it how?” “Like that?” “Oops, sorry” At one point they asked Mark if he wanted to try suturing his wound closed after the lipoma was removed. “Do you want to try?” “Uh, no, I’d rather not.” “You’re right, you should probably practice on an arm or leg or something before practicing on the head.” At first glance it would appear that the surgery was reckless and archaic, but I am understanding that trial and error is moreso the approach to medicinal learning in a third-world country rather the luxury of extensive training with cadavers in the States. The guy took the entire operation like a champ, though you could definitely tell when the anesthesia was wearing off.

One thing that really took me by surprise was the fact that many of the patients that were going to have surgery next were wheeled into the big surgery room and could witness all of the surgeries from wherever they were sitting or lying. I don't know about you, but I think I would start wheeling myself out of there just out of the anxiety of the anticipation. All of the operations are super cheap though compared to the States… I asked a doctor how much a leg amputation would be and he pulled out his materials and procedure cost list and told me 3,000 Naira which is equal to about $20 right now. Keep in mind they have no social security, insurance, etc. A colonoscopy was about $15/$20. When I told the doctor how much it would be in the States without health insurance he said, “Well, you Americans can afford that price.”

We spent most of the day in surgery, then saw about a dozen women in labor rooms. Unfortunately, I didn’t get to see any births. But I did get to see a few sonograms in action: one of a healthy baby, one of a not-so-healthy baby, and one of an empty uterus. I think that covers most of the day. I wanted this to be a thorough update so you could somewhat have an idea of what this day was for me. But unfortunately this has been a very surface levely type of blog entry.

What I realized from the day and what I hope you can realize from reading this is that amidst the tough and seemingly unfair circumstances endured for medical treatment in most parts of the country, God has not lost control and still receives glory in every outcome, whether successful or unsuccessful. It is our job to be good stewards of the time, money, gifts, and relationships that He has given us--that's where the good is found, in our infinite opportunities to be vessels for God's glory.

Saturday, July 4, 2009

free time

What we do in our free time...

  • HIKE!
We spend a lot of time hiking since we are surrounded by so much beauty wherever we go in Nigeria! Pictures below are from a day where we went to a high, flat point in the boulder climbing to do some worship and check out the giant new Back2Back property. First one is of Sarah Guckenberger and I, then an intern Amanda and I, and then Amanda, Tina, and I... sadly the two of them are returning home tomorrow );

  • SWIM!
We've actually only gone swimming all of two times during the last five weeks that we've been here. Because there's really not many pools and the cultural need for modesty, we're all pretty pale as opposed to what you think we would look like after living here. Well, our arms are nice and brown--but that's about it. Pictures below are from a day we spent at a very nice hotel we found in Jos. The first one is of the pool patio, then staff kids Sami Guckenberger and Noah Ramos, and then me with some Guckenbergers, Noah, and Amanda.

It has been a long talked about aspiration here to kill and cook our own chickens for dinner. The kids had a lot of fun chasing them around the yard before the deed was done the other day. We ended up donating the chickens after the slaughter, but it was definitely a first. I'm really not as adventurous as it may seem... I watched long enough to take a "before" picture with the knife and the chicken, but then hid in my room until it was all over. I tell myself if I really needed to do it to provide, I would have done it.

Wednesday, July 1, 2009

Shelter Day 1--A First Look

I'm going to start posting the "Shelter" study that all of the groups in Mexico and Nigeria are going through. I'd love to dialogue or hear your thoughts on Psalm 91 as we continue to understand the idea of "dwelling in the shelter of the Most High." Enjoy!

The theme that we are exploring together this year is that of “Shelter.” Now immediately upon reading that word “Shelter,” chances are ideas come to you mind. Let’s start with some questions:
• How would you define the word “Shelter”?
• In what ways do you think God provides you shelter?
• In what ways do you think you provide shelter for others?

Did you know?
• ½ of the world’s population lives on less than $2 a day;
• 26,500-30,000 children die everyday due to poverty;
• Nearly a billion people entered the 21st century unable to read a book or sign their names;
• In 2005, approximately 1 billion people were living in slum conditions.

Their upcoming week, you are going to have the opportunity to serve in several children’s homes and impoverished neighborhoods around the city of Monterrey or Jos that reflect the reality of these statistics.
Imagine if your family, and everyone you loved, woke up one morning in one of these slums around the world. How would that affect your above definition of God’s shelter?
Oftentimes, we associate God’s shelter with the material provisions He gives us. Yet, all men are created equal, and God provides shelter to all human beings regardless of race, class, or country of origin.
Therefore, how would God define His shelter to us? How does God want us to experience His shelter? Where do we find God’s shelter?
Read Job chapters 1 and 2 (Old Testament, 18th book of the Bible). What was Job’s response when the Lord allowed everything in his life to come crashing down (Job 2:9-10)?
Job understood that true shelter in God is not found in family, possessions, or wealth, and he refused to curse Him when his fortune was reversed. Are we to praise God when things go well and curse Him when they do not? Job found his shelter in the Lord, not in what the Lord provided him.
We oftentimes think that the Lord provides shelter through our families, the houses we live in, and the comfort we are fortunate enough to have. But as Job shows us, true shelter is found by resting in the promises of the Lord.

“Find rest, O my soul, in God alone; my hope comes from Him. He alone is my rock and my salvation, He is my fortress, I will not be shaken.” Psalm 62:5-6

“Come to me, all you who are weary and burdened, and I will give you rest.” Matthew 28:11

God gives His promises to all people, that if we find shelter in Him, He will give us rest. God provides the same shelter to the 1 billion people living in slum villages as he does to you and me. Christ came to earth to sacrifice for all people. Everyone, regardless of wealth, race, or country of residence can find comfort and rest in His promises.

Reflection Questions:
How can you show this kind of Shelter as you serve those financially less fortunate than you?

How have we been called to provide shelter to others (Matthew 25:31-46)?

How does the Bible describe pure religion (James 1:27)?

When you visit the children’s homes and impoverished neighborhoods this week, how can you provide shelter and fulfill the verses above?

How can you allow God to provide more shelter in your own life?

Rethink the first three questions asked at the top of the beginning of today’s study. How have your answers changed?

Read through the rest of Job throughout the week and reflect on the idea of God’s shelter.

Remember, you are not here to save, but to serve. Reflect and journal on the promises of God, knowing that as you serve, you will in fact gain a better understanding of what it means to rest in the shelter of the Lord.