Liberia 2017

Kwendin #18 | March 4, 2017

It's Kristie writing this letter. I feel like it is my opportunity to be protective of the team, and this will be a hard letter to write for many reasons.

I am very grateful for this experience, and i am in awe of the integrity displayed by each of my team mates. it is one thing to be kind and thoughtful on a Sunday morning or for 30 minutes, but it is another thing to be kind and considerate when it is consecutively 36 degrees or pouring rain, or wonder if it is a bug on you or another drop of sweat. That being said, today was the day where we decided to break open the starbucks microground coffee, tim horton's hot chocolate and have hashbrowns and eggs for breakie!

Being a nurse, one is often caring for many vulnerable situtions. I know am for certain that this is often   the same for a pastor. Up until my trip, missionaries were just people I saw on a postcard type paper for your fridge as a reminder to pray as they were in some far off place doing what ever the "Lord's work" is. I am now certain that the life of a pastor, a doctor, a nurse, and a teacher are similar: it is to come along someone's life in one of their most vulnerable times for reasons that can not be explained (and it is not at all influenced or persuaded by $). It is because of something within that calls us. Our God given purpose to flourish despite the feeling of knowing our own faults intimately.

Everyday we are crossing paths with people who need something, even though the question asked is not necessarily what is intended. Without a doubt we are seeing the results of prayer.

Now the hard part... Today is our day "off" to hang around our home and relax. To recharge and enjoy company when at 4:30pm I see a patient of ours come up on a motorbike. I was instantly frustrated as I have seen people come at the most inapproriate times to ask for something when they had been given time the previous day to come but didn't show up. I wanted to protect Pastor Bob and Dr. John as I have watched them give so much of their time, resources, and energy during their "on" times. Even Moses was told to appoint leaders from each tribe as he was getting overwhelmed.

It turns out this was an emergency. Our patient was here for his girlfriend and had been sent by the midwife. I discovered that his 17 year old girl friend who was 5 months pregnant was in pain with some bleeding. Kate, John and I got Uncle Sammy to drive us to the clinic (as our driver, DJ Mo, as I have given him the nickname, went to barter with some local hunters about deer they had killed earlier today).

When we arrive we see a woman flat out on her back and hot with a fever in distress. She is positive for Malaria. We start an iv with normal saline, add some sugar and give a dose of Quinine. This is the treatment for malaria when you are pregnant. We start to notice over the period of 25 minutes that there is a regular pattern to her distress... Is she in labour? She says "water" in broken English. We had just given her a drink, but there is another kind of water. we look, and I am grateful i had gloves on as under the calm guidance of Dr. Potts I deliver a tiny life that we know we will not attempt to resusitate. As I hold the baby in my hands, Kate kindly and graciously cares for the mom. To us in the West, kindness and compassion is assumed. In Africa, it is not that they are not kind. It is that in Africa, infant mortality (pre and post delivery) is common, so the coldness felt is more of a protective instinct. To say the liberian people have experienced much sadness is a gross understatement.

The saddest part is that this risk of death could have been reduced. For whatever reason, she did not have a mosquito net despite the fact I am told they are free. She was prescribed Malaria treatment a month earlier; however, I am told by Dr. Potts that taking the medication is not fun. She is only 17... what does she know? These statements not to cast blame, but to realize that the fact that we do not experience the same amount of infant death is not haphazard. In a period of sadness, I am reminded that God is truly good. And that while we are waiting for heaven, He is waiting for us to be his kindness, his generosity, his integrity, and common sense. We may think we have not much to give, but let us let those whom we share with decide.  

Grace and Peace,

Kristie  

ps. We are all doing well and there are many laughs to go around!  

*******  

This is John writing again. When Kristie asked to be able to write some of this letter I was very happy to have her version of the above patient-­‐-­‐always a tragedy when a mom loses a baby at 20 weeks and it always affects us, the caregivers. I know that it affects nurses more than it affects doctors-­‐-­‐partly that is the difference in the roles we play, and sometimes it is partly the male female difference in emotional attachment to our patients. We'll go down to the clinic in a few minutes to check on the mom before we go to church. And there is also a message that one of our hernia patients is there with some kind of   problem. Maybe a serious complication of surgery or maybe his dressing has fallen off. Or anything in between.

After church we go straight to Tappita for admissions again, so I will fiinish this letter this evening and let you know how the day has gone.  

We are having trouble keeping our devices charged. We found out last night that the connection on our generator that recharges 12v batteries is not working, so our batteries are both flat. Bob and I took the generator apart far enough to find a fusable line with a fuse that is blown. So we will get our driver to look for a replacement in Tappita this afternoon while we are in the hospital. And if it can't be found we will hot wire it with a different fuse option. It will work somehow. TIA. This Is Africa.

*************  

Here we are just before 5, home again. The story of this afternoon unfolded in unpredictable ways as usual.  

First, just to say that our driver succeeded in finding a replacement fuse, which has no writing on it so it is not rated but we think it is about right judging by the diameter of the wire that runs down the centre part. Bob and I have already installed it and tested it. Should be able to recharge our batteries with the generator tonight.  

The driver is an interesting guy. I told you a few nights ago that he brought the car over to the neighbour's and turned up the music so they could dance outside. he has a little music plug with his preferred music, which was perfect for dancing. His name is Mohammed so he was christened DJ Mo by the girls that night, and that is how he is now known. He is happy with it. He is obviously Muslim (you can tell by his name) but he is married to a Christian and they are completely fine together. He is perfectly comfortable around Christians and enjoys our worship music.  

Before church this morning we had someone show up at the door saying that one of our hernia surgery patients was having trouble. We already were planning to go to the clinic before church to see our lady from last night, so we agreed to see this guy as well.  

When we got there, our lady from last night was sitting up doing well. Ready to go home with her treatment for malaria. And the fellow from hernia surgery had developed some bleeding inside his scrotum. It had swelled up much bigger than a grapefruit. It needed to go back to the OR to clear out the blood and ccontrol the bleeding. So we told him to wait there so we could pick him up after church and take him to Tappita with us.  

Church was good. Bob preached on praying instead of worrying-­‐-­‐always a good message. We sang "Days of Elijah" for them and that was appreciated. Then we set off for Tappita-­‐-­‐Kate and Kristie and I, leaving Bob and Spencer to walk   home.  

There were 6 patients booked for surgery today. Usually we only book 5 but the last one was added out of compassion for a little kid with a huge hernia that needed to be done. And when we got to Tappita, there were 4 patients already waiting for us. Plus the one in our car. That makes 5-­‐-­‐a good number for a list.  

We got started on the process of admitting them. I think the admitting officer was the same one as we had earlier so he was completely familiar with how we operate. I paid him for so many different things that he ran out of receipts and told me to pay the rest tomorrow!  

While I was writing up the history and physical notes for the patients on the ward, a fellow came up to me with his son who had a large hernia, said he was from Kwendin and had come for admission for surgery. I was baffled. It wasn't either of the remaining 2 patients on my list. We also searched through our list of patients that we have seen, and he is not on any of those lists. I told them to wait for me at the main waiting room of the hospital. Whereupon he walked further into the ward to visit with his relative who was already admitted there.  

It was back at the main waiting room that I went over our lists carefully. This was a boy who we have never seen, and the man was simply trying to get him onto the surgical list by showing up at the right time. Kate and Kristie were completely in agreement with saying no to him. The fact that he was smelling of alcohol did not help his case. He begged in a few different ways, including going privately to Kate to beg. Maybe he thought she would be a soft touch compared to the hard hearted doctor. Wrong girl, my friend. She made the decision nice and plain to him. Good work, Kate.  

So we were waiting for our car to come pick us up when a fellow walked up to us and introduced himself-­‐-­‐ patient #5 from our booked list!  

We admitted him-­‐-­‐did not take long.  

Am I ever glad we said no to the other fellow! As it is, we have 6 patients to do tomorrow, which will be a long list.  

We stopped at our usual shop on the way through the town of Tappita. Kristie has found a shop that sells peanut brittle, which they call ground pea candy. And we each got a cold pop. And headed for home.  

So here we are. Kate and Kristie and I have had only bananas and peanut brittle for lunch so supper will be welcome.  

We are kind of swamped wit fruit just now. The plantain is getting ripe enough to eat without cooking so I have cut up 4 of them. There are 2 stalks of bananas getting ripe and another 4 clusters ready to eat. I have cut up a pawpaw and there are 3 more ready. And we have had 2 pineapples brought to us in the past hour. Sometimes the right approach is to select suitable fruit to carry outsde to the workers there so it gets eaten before it goes bad. Nice problem to have.  

Better send this before the battery goes flat. One more week here in Kwendin!

Dr. John Potts