Monday, January 30, 2012

Water, water everywhere!

On Friday I headed back towards Freetown because we have a medical team coming in March and in preparation for them coming I get to do a lot of visiting different government buildings, etc. Since it usually takes multiple visits to one office to get a document I need and since I need a bunch of different documents, the 7 hour trip from Freetown to where I live makes it a little tricky. That being said, for the few weeks leading up to a medical team I come hang out with my friends near Freetown.

This year, two of my friends, John and Kaysie, were finishing up a 2 week "camping trip" in the middle of nowhere, so I decided to join them for a couple of days at the tail end of their trip. Part of what WMT has begun to do is drill wells. They drill a bore hole using a completely manual method. John has about 7 or 8 guys that he's training in this method. They spent 2 weeks in the middle of nowhere drilling two wells in two different villages. Since I live so far away I don't get to be a part of this very much so I was excited to see it going on in person.

When I arrived I felt like I was camping back in the States! These guys know how to camp!! I almost expected there to be a little fire pit with the bars to put over it and a camp ranger to swing by and make sure we had the right permit.

Our excellent campsite!
When I arrived they were finishing one of the wells but were having trouble with the second one. Since all the drilling is done manually it's not 100% guaranteed that they'll be able to complete a well. The agreement is that they'll try 3 times and if they're unable to get it then they stop but the people who hired them only lose a deposit. They were on their 4th attempt when I got there (John really didn't want to give up). Apparently they kept hitting rock and just couldn't get through it. On their first attempt they hit this rock at about 25 feet and worked for 3 days with zero progress. That's a little disheartening. So they moved to a different spot but kept hitting rock at about the same depth. Finally, they moved a little farther away from the community. They still hit the rock at the same depth but hit water a lot earlier (about 8 feet) so there will be plenty to last all through the dry season. Yippee!!! The thing that is so cool about this well drilling is that they do both profit and not for profit wells so that the for profit wells can fund the not for profit ones. So sustainable!

In addition to drilling the wells, they were also there to share about *esus. They had some teaching every night and shared the *esus film in their native language. There was no church in that village so the people had a lot of questions. Some of my favorites were "can a man be a *hristian if he has more than on wife?" and "why do *uslims take their shoes off to enter their house of worship but *hristians don't?" There were quite a few people who got really really excited about it and are excited about starting a church in that village. Awesome blossom...extra awesome (name that TV show).

Getting ready to show the *esus film
John and Kaysie brought their 6 month old son Aden along on this adventure. One of my favorite parts was seeing all the villagers, both men and women, fawning all over him and yelling his name all the time (well, kind of his name....they couldn't really say it so they shouted "Idi, Idi, Idi." He ate it up. :)
"Idi" with one of the older ladies in the village
I got to experience some new things like a new kind of meat called Fritombo. It was actually pretty delicious. Kaysie convinced me to try some of the liver of the Fritombo which was NOT delicious.
Fritombo roasting on an open fire...
When I was little and we would go on road trips and one of us had to go to the bathroom, my dad would always give us the option to "go like the campers" which meant pull off on the side of the freeway and have at it. After the unfortunate event in which my dad thought it would be hilarious to move the car and turn the headlights on my brother while he was doing this (turns out it WAS hilarious!) I never voted for that option. However here, there was no other option so....go like the campers I did. I was a little nervous about how my shy bladder and I would do (is that an overshare?) but we did A-Ok. Of course I was glad to be back to my flushing toilet after a couple days. Kaysie is a rock star for doing it for 2 weeks! With a baby!!

On Sunday we had a church service and then packed up and headed out. It was a great time and I was so glad to get to see the awesome things that God's doing through this well drilling!

Wednesday, January 25, 2012

A couple of days ago I was nestled all snug in my bed when I heard the familiar "whoop, whoop, whoop" of the ambulance. It was in the wee hours of the morning but since I'm trying to learn everything I can about OB in about 10 days (that's possible right?), I hauled myself down to the hospital to see what was going on.

When I got down there I found the midwife with a woman who had been laboring for about 36 hours. The fetal heart tones were low but when we were contemplating whether or not to do a c-section we realized that she had progressed too far and by the time we called everyone in for the OR, it would be too late. So we gave her some medicines, got out the vacuum (which is of course a manual hand pump vacuum)and gave that a try. Side note about the vacuum: It's great, and I've seen it work really well however, whenever you gently pull but the suction comes off, you get a face full of vacuum....and other gooey stuff. Not cool vacuum, not cool.

Anyway, we were vacuuming, she was pushing...but that baby just did not want to come out! Finally, after what seemed like forever, the baby came out. But he wasn't breathing. The other nurse worked with mom and I did my best to resuscitate baby. Unfortunately our resuscitation options are pretty limited. We gave him some oxygen and bagged him....but just couldn't get him to breath on his own. The books say that you work on them for about 20 minutes and if you don't get anything then you call it. Well, we worked on this guy for probably about 40 minutes. Just as were were getting ready to call it, I touched him and he took a small breath on his own. Oh man! Now what do we do? So we started again. We worked on him some more but just could not get him to breath on his own. So we called it again. It was frustrating because I felt like if we could have intubated him (stuck a tube down his throat to help him breathe) for just a little while, he probably would have done great!

After it was done I was just looking at him...and he looked so perfect!! 9 months of carrying this baby and nothing to show for it. I've noticed something about working in the OB. When they lose their baby, they don't wail in their grief like they do when they lose other family members. In fact, they don't even give their baby a name for 2 weeks. This mom didn't even cry. She just turned her head and slept most of the day.

A couple hours later another woman came in who had been in labor for over 24 hours as well. Her pelvis was really small and she was only a couple centimeters dilated so we headed off to the OR for a c-section. Both mom and baby did great. I love bringing a baby out of the OR because there's always a crowd around (family members and other random visitors at the hospital) who all want to see the baby. They're just so excited! It's quite a little high.

I felt like that day kind of summarized living in Sierra Leone. Everyone was so excited about this baby that had been born, but just a couple beds down was a woman who had lost hers. It was hard to feel complete excitement because I knew this woman was in so much pain. Sierra Leone is absolutely beautiful, but all around you are signs of so much poverty. So many people are loving and great, yet the corruption here is horrible!

Well, I don't mean to get all philosophical...just some thoughts that I had during that day. Living here often feels like living on a roller coaster.

Thursday, January 19, 2012

Having a baby....Sierra Leonean Style!

Wow! Today was an adventure!! The other day I was talking with one of the doctors here and we were discussing the potential problems we’re going to have because several people from the OB ward are leaving. We are already short staffed and it will most likely only get worse in the near future. That being said, I volunteered to orient to the OB so I can figure out what the heck is going on in there. As an ER/ICU nurse, I have always run (very fast) in the opposite direction of the OB patients (no offense moms...but you're scary!!) So I was definitely getting out of my comfort zone…..but I was/am so excited to learn!!

I’d only been in the OB ward for about 30 minutes when they came and told us there was an ambulance call. I asked if I could go, so a nursing assistant and I jumped in the ambulance and off we went. During the very fast and very bumpy road, I was reviewing the possible things I might find there and how I could stabilize them until I got to the hospital. Bleeding patient? Septic patient? Seizing patient? Who knows? One of my old roommates had a really bad experience where a woman actually died in the ambulance on the way to the hospital, so I was trying to prepare myself for anything!

The patient was being referred from a health center so we rode with our siren on the whole way (keep in mind I think we passed exactly 2 cars the whole way). But the siren’s there so...might as well use it! However, we did turn the siren off about 5 minutes before we got to the health center because apparently the siren scares the nurse there. Alrighty.

After arriving at the health center, I walked into the labor room to see the patient walking around. Well that’s a good sign!! At least she’s not on death’s door! The nurse came in and told me that they were referring her to the hospital because she is just not cooperating. OK? I began to see what they meant when she refused to sit down, would yell if you even attempted to touch her and kept walking away from you. It took me forever to get her to settle down enough to just take a blood pressure! I wasn’t sure how we would make her cooperate more at the hospital but…ok, we can give you a lift.

At this point there is a huge crowd around, all yelling at the patient and her mother. Then the mother started to cry because she didn’t want to go to the hospital because she doesn’t have any money. She wants her daughter to deliver at the health center. I’m not sure ethical guidelines were exactly followed as the crowd pretty much bullied them both into the ambulance. We turned on the siren (guess it only scares the nurse on the way in) and away we went. For about 5 minutes. Then the ambulance driver remembered he didn’t get the ambulance fee paid yet so he stopped in the middle of the road and went to the back to ask for the money. They didn’t have it. But the nursing assistant who was with me convinced him to go ahead. So we did.

We got to the hospital and went to check the patient. Wow. That was difficult!! The midwife and I tried first, but we couldn’t keep her down. Every time we went near her she would scoot all over the table, throw her legs together and try to turn over. She was really strong! We called her family in to see if they could talk to her and convince her to let us check her. They tried and tried and ended up slapping her on the legs and arms. Multiple times. As hard as they could. They kept asking her if she wanted to kill her baby and making slightly inappropriate innuendos about her not being this afraid 9 months ago. Yikes! I could understand their frustration because she literally did not want us to do anything but……I tried to picture any of this going on in the States and I had to chuckle a little. Could. Not. Happen.

Anyway, it didn’t take long to decide that unfortunately, she would not be able to deliver vaginally. She just wasn’t cooperating. So they went to do a c-section. I wish that they could have waited, but I could see their point. Might as well take the baby now when he’s nice and strong instead of waiting until she’s been laboring for hours, the baby starts to decompensate and she still refuses to push. But I always think it's a bummer to have to go the c-section route (although of course better than the alternative).

So I was down in the OR waiting for the anesthesiologist when I got a call from the midwife. There was another lady who was laboring and was ready to start pushing. I ran down to the OB ward and sure enough…there was the head! The midwife tried to let me deliver it and I started to…but I got so scared! I was afraid I was going to pull the head off! I watched really closely and the midwife gave me some pointers for next time. I want to deliver one SO bad!!! The miracle of life and all that.

Anyway, it was my first day back…and what a day it was!! I love my job. 

Friday, January 13, 2012

Back again, back again, jiggity jig

Well, 30+ hours later I am back in my sweet Sierra Leone....with weird, mixed emotions. On the way over I had a sense of fear that I hadn't felt in a long time. I know it's because I was leaving everything that was comfortable and familiar and even though I've lived in Sierra Leone for a while's just so different! And kind of scary sometimes. :)However, when I felt that old fear coming I started thinking of how incredibly faithful God has been to me and that even though I felt like I was alone, I definitely WAS NOT! Deep breath, ok, all better. :)

I was expecting to get blown away by the heat when I got off the plane, but it was actually pleasant! I had to turn the AC off on the way home because it was too cold. Now that's just crazy talk!

I finally fell asleep around 1am and slept until 11am (I'd missed 2 nights of sleep while flying, so cut me some slack) when I was awakened by a gaggle of kids jumping on me. Apparently Aden (John and Kaysie's 6 month old and the future husband of my niece) couldn't wait to see me. :)

Today I relaxed a little, made some phone calls to some people to let them know I'm back and pretty much just tried to stay awake so I can sleep tonight (ALMOST made it!)

When I went to greet our day guard I got the comment I knew would come. "Oh Emily, you body fin-o" said while flexing his muscles. What this means is, "Emily! You got chubby while you were gone!!" I know they mean it as a compliment but...well, yeah. But what could he expect? The combination of Thanksgiving, Christmas, New Years, my birthday the knowledge that I have a brief window to eat everything delicious, and cable television well...the pounds just come on easily that way!! Fortunately Jillian Michaels could hardly prescribe a better diet plan than living in Sierra Leone so...I'll just chuckle away at the comments and thank God for keeping me humble. :)

It's good to be back!!!!!!! :)