Tuesday, May 29, 2012

I Now Pronounce You Man and Wife….Part 2

Drum roll please.....the problem was....a broken fuel pump.  Now another problem is where the heck do you find a fuel pump in the bush?  Never fear, Johnny was all over it.  He took off on the motorbike again and Meredith and I went back to our movie.  45 minutes later he was back with a fuel pump.  He told me that these are VERY hard to find and he was surprised he could find one.  Thanks Jesus! (Also, sorry to the person who may have had their car at the mechanic and this pump was "borrowed" from their car.  I learned later that it's pretty common....)  Anyway, Johnny jimmy rigged the fuel pump with a bunch of wires connected to wires connected to wires....and Boris purred like a kitten!  I won't tell you how much I spent because I don't know how much these things are supposed to cost in real life, let alone in the middle of nowhere.  Let's just say I'll definitely use my "car maintenance" portion of my budget this month.  And next month. Seriously though, I'm very thankful it turned out so well. Johnny started telling us about the sketchy things that happen on that road and I was glad that neither we nor Boris had to spend the night out there.  

So after a delightful 4 hour breakdown, we were back on the road.  We drove for another hour or so and reached the city we were staying in. We were shown to our room.  Air conditioning and hot water.  H.E.A.V.E.N.  For dinner, we had the best pizza I've ever had.....maybe in my life. 

Before Johnny left us he told me that the next day I needed to take Boris to the mechanic and have them pull my old, broken fuel pump from the gas tank.  The next morning I woke up bright and early to take my car in....... but then I got tired.  I called my friend who works with me and asked if I REALLY need to take it in this morning. Isn't it ok to leave it until tomorrow? I'm tired! He gave me a hard time for being lazy about my car (might have had a point there) so I decided to take it in.  Car stuff is just so boring!!!  I took it to the mechanic that my friend knew but the mechanic was out of town so his apprentice helped me.  He said it would take a couple hours so I gave him my keys, hopped on a motor bike and headed back to the hotel. 
I’m not sure if this kid had ever driven before….but at least he was careful. He took my “please drive slowly” VERY seriously!

A couple hours later he came back with my car and Meredith and I headed to the engagement.  It was originally supposed to start at 4pm but right before we were getting ready to leave I got a call from my pastor friend that it was going to be delayed until 5.  Since we were all gussied up in our African dresses, we decided to head there anyway to hang out with people and see if we could help. 

We hopped into Boris and away we went.  For about 10 minutes.  Then the same thing happened again, and Boris just died.  Darnit!!!  I called the mechanic who had "fixed" it this morning and asked if he could please get his hiney out here and fix it for real.  While we were waiting, for some reason I decided to show Meredith the dance to "Joyful Joyful" (Sister Act 2...anyone?) that I learned when I was in middle school.  Several feet away a little girl started copying my sweet moves.  Please be impressed that at 30 years old I can still remember almost every move from that dance. And have now performed it in Africa.  How very international.
Meredith dressed up for our breakdown #2

Mechanic Man came and fixed us up again and we were off.  Since we'd been delayed by a mini breakdown when we got to the village we were right on time for the engagement.  Or so we thought. They weren't ready to start yet so they showed us to a little room where we could wait.  While we were waiting there I was chatting with the groom and the pastor.  Something came up about the grooms mother and since I knew the groom was actually from the Cameroon and not Sierra Leone, so I jokingly volunteered to be his mother.  They all started laughing but then suddenly it was part of the program.  He's a good 10 years older than I am, but I am his mother. 

This was our “waiting” face. We used it a lot, but don’t we look excited??
After about an hour of waiting we were moved down to the house where the engagement would take place.  All right! Things are starting to happen! We were shown inside the house and told to take a seat.  After sitting there for a while we heard some singing outside so we went out there.  It was family and friends singing, dancing, having a grand ole' time.  So we watied out there.  And waited.  At about 7:30 (getting dark by now) we were taken back inside the house...to wait some more.  When I asked what was going on, the pastor told me.  Although the bride's father had given his blessing the night before, some family had arrived in town who were concerned that since the groom was from the Cameroon, he was going to take his bride there to live and they would never see her again.  Wow!  The pastor ended up signing a paper that said HE would be held responsible if the groom took his wife back to his home country.  Interesting.......
I found someone to keep me busy while I waited

Now it was really getting late.  Meredith and I decided that we had to leave by 9:30. I usually try not to drive at night and that was my original plan....when it was going to start at 4pm!  Since now I was going to be driving at night, (the hotel is about an hour away from the village) I didn't want it to be so late that there would be no one on the road if I broke down.  Not that that would ever happen.

At 9:20 things started happening.  And we were in the middle of the circle....no way to escape at 9:30.  I had no idea if this was going to last 1 hour or 5 hours.  Oh dear.  They called me into a room and gave me a bowl of stuff. As the groom's "mother" it was my job to hand this bowl to the man representing the groom's father when he asked for it. 

The man representing the groom's father (we'll call him Joseph) started off by telling everyone that he and his family have seen someone they want in this house.  He went on to describe her....beautiful, tall, etc. And her name is Finda.  That is why we've come.  And here is what we've brought to show that we're serious.  I gave him the bowl of stuff. 

This bowl is called the calabash.  It contains everything that the groom's family is giving to the bride's family, for their daughter.  Inside the bowl was some material for her mother and father (to make some clothes), a mat to lie down on, some money (this time it was about $125), some kola nuts...and I'm sure a few other things that I can't remember.  See what a bad mother I am?  They dispersed these items one by one to the family. 

At this point, an elderly genteman spoke up and said that no, HE wanted to marry Finda.  He brought out some money (a dollar or two) and gave it to the bride's father. They all chatted for awile and I guess he lost out. But then ANOTHER elderly man (think, toothless old) that said he wanted to marry Finda.  More money, more talk.  No go buddy. Looks like the groom is going to get her!!

So now where is she?  Joseph starts asking for her to come.  Come, come, bring Finda!!  There were some ladies in the next room who said, "She's coming. Wait! Her car has had a flat tire. Send some money to fix the tire!"  So Joseph sent some money.  A lady came in with a veil over her face and sat down in the middle of the circle.  Joseph went to lift the veil and, low and behold it wasn't Finda. It was an imposter!  He sent her back and asked for the real Finda.  A couple more veiled girls came after some more money was sent to them and finally, the real Finda arrived.  She sat down in the circle with her face uncovered but the veil still over her head.  Then they brought in the groom and he sat next to her.  The bride's father asked both of them some questions. The only one I caught was "You're not going to leave him/her?" to which they both responded "No!"  Then the food came out and the dancing started.  We ate some delicious food ("festive" food is different from the traditional spicy stuff....although this was still pretty spicy) and headed out.  We calculated that it was about 6 hours of waiting for one hour of ceremony.  But we were SO glad that we stayed.  It was a very fun experience!

Finda in her wedding wear
It was now about 11pm and we headed back to the hotel.  No clifhanger this time....we made it back in one piece.  Took our hot shower and went to sleep in our air conditioned room.  We have to rest up for the church wedding the next day!

Monday, May 28, 2012

I Now Pronounce You Man and Wife..... Part 1

This weekend I had an adventure.  Last month we had a team from Canada who came to do a medical clinic in a village about 7-8 hours away from where I live.  The pastor there told us that he was going to be getting married in May and I really wanted to go. I've never been to a Sierra Leonean wedding and here I knew the bride, the groom, lots of attendants and the officiant is one of my good (and a little bit crazy) friends.  I knew it would be fun.  Even though I wanted to go I hesitated because I didn't want to spend the money, I was reluctant to be away from the hospital for a few days, and the road is just....so, so long, and so, so bad.  I also didn't want to go that far by myself. I talked my roommate into going on an adventure with me so....let the adventure begin.

In a lot of ways, weddings in Sierra Leone are similar to the ones in the US.  In a lot of ways, they're very different.  If you end up having the BIG wedding  ( most Sierra Leoneans don't do this because it's too expensive )  then the ceremony lasts two days.  The first day they call "the engagement."  This is the traditional ceremony where they...do all the traditional stuff.  The second day is the fancy wedding where the bride wears the white dress, etc.  

We headed off on Thursday.  When I was home, I was in the dollar store and saw this white car paint.  I wasn't sure what I would ever use it for but...look how handy it was!!
I think she and I were the only ones that got this joke....
I mentioned before, that the road is awful.  I was not lying.  We drove for three hours on awful road and made it to Makeni, one of the bigger cities.  There we enjoyed luxurious pavement (as well as a delicious meal at a real restaurant )  for about twenty minutes and then it was back to crappy road.   ( Mom.  Please stop reading this blog now.  Join the rest of us for tomorrow's finale.)

We had been on said crappy road for about two and a half hours when all of the sudden my car  stopped running and all the little lights on the dashboard came on.  I tried to start it.  It would almost start, but then just die.  I tried again.  More of the same.

A little bit about my car.  His name is Boris.  I've had him for several months now and am mocked my my NGO teammates about his rather "rough" condition on a regular basis.  However, while I admit that he has had his problems, I've always bragged that he has never let me down while I was traveling in the bush.  Way to go Boris.  You're proving everyone else right when they talk all that trash about you!!!!

So Boris broke down.  And it was just Meredith and I in the middle of the bush.  Darn.  I looked down at my phone and there was no coverage.  Double darn.  Now, I will admit that breaking down like this in the middle of nowhere has been one of my biggest concerns. It's always in the back of my mind when I'm travelling. I travel a lot. While I try to travel with Sierra Leoneans as much as possible, sometimes it just isn't feasible.  Like now.  What the heck am I going to do?

A taxi drove by and he slowed down a little bit so I flagged him down to ask him if he knew anything about cars.  He got out of the car, looked under my hood and asked if there was fuel in the car.
Me:  Yup, I filled up a couple hours ago.
Him: Hmmm Are you sure there's fuel in the car?
Me: Um, yes.  The needle is still almost to the F.  There's fuel in the car.
Him:  How much fuel did you put in the tank?
Me:  It.  Is. Full.  There. Is. Fuel. In. The. Tank.
Him:  (shrugs his shoulders and walks off) 
I decided to check under the car to see if it was something easily fixable.  Turns out...I still don't know anything about cars.

Fortunately while Mr. Helpful was asking about fuel a motorcycle driver stopped as well. He said he could go back the way we'd come, about thirty minutes, and get a mechanic and bring him to my car. Excellent!!!  He had a passenger on his bike and they offered to have him stay with us "so we wouldn't be lonely" but we said we were fine.  I'll take my chances.

I was heading towards the bushes to use the little girls room when all of the sudden I heard my cell phone ring. Jackpot!!!! There's service!!!  I talked with my friends in Freetown, who of course couldn't do anything but did offer excellent moral support!  At least someone knows where we were last seen.

As we were sitting there waiting for the mechanic, we discussed what a lovely day it was for a breakdown.  The sky was cloudy so it wasn't too hot.  We had some road trip snacks, we had water, we had the wilderness as our bathroom, and we had the movie "Never Been Kissed" on my fully charged laptop.  Could this breakdown get better? I submit that it could not!!

Our motorcycle rider returned about thirty minutes later with our mechanic.  Johnny.  I wish that I had taken a picture of Johnny, because my words will not do justice.  He was a small man with crazy eyes and a little ponytail.  If I had to pick an animal for him, it would be a spider monkey because he was so nimble and quick.  Before the motorcycle had come to a complete stop he was off and running to our car.  He asked what the problem was and then started doing a bunch of tests.  Under the hood, under the car, inside the car, hanging off the outside of the car.  Very nimble.  Very quick. He was pulling this, testing that, you know...car stuff.  I was impressed.  He seemed to know what he was doing.  He also took quite a fancy to Meredith, whom he called "my laughing friend."

I digress. After more testing and some cursing at the motorbike rider for being too lazy, he diagnosed my problem as......  and that's where I'll bid you adieu for the evening.  Did I make it out of the bush alive?  Am I writing this from the lair of.......I don't know, someone scary?  Was the actual marriage I went to the marriage of Meredith and Johnny?  Tune in.... later. When I have the internet again. 

Wednesday, May 23, 2012

Break A Leg

A couple days ago my roommate and I were invited to a play.  One of our friends who works at the hospital also teaches at a school and his kids were putting on “The Merchant of Venice.”  I know! So cultured!  He said the play would start at 2pm but Meredith (my roommate) and I told him we wouldn’t be able to get there until between 3 and 4pm.  He said “That’s ok, we will find something.”  Later at home we were talking about this and thought, “Wait. Did he mean he was going to find something to occupy them until we get there!??!!”  The next day I clarified that he wasn’t going to wait to start the play until we got there was he???  He looked at me like I was crazy.  Oops….guess not.  It sounds like I was being egocentric, but that kind of thing has happened to me before!!

The day of the play arrived.  We headed into town to pick up one of Meredith’s friends and go to the play.  They were charging 1000 leones to see the play (about $0.25).  I had a Le 5000 bill with me so I just paid for the three of us (I know, be amazed at my big spending!) and of course one guy standing nearby started yelling at me that I needed to pay for him too.  When I said no he looked completely put out.  Didn’t I know that it was my duty to pay for him??? Sheesh Emily. 

So. We get to the play.  It’s being held in the community center, which is a big open building with a stage at the front. Perfect for a play.  We find some seats on the second to last bench in the back.  It is now 4:45.  We were told the play started at 2.  It still hasn’t started.  But they’re doing some short skits as a prelude to the play. My Krio is to the point where I can understand a fair amount of what I hear……unless it’s being shouted into a microphone that’s turned up all the way.  Unfortunately this was the case for the play, so I wasn’t understanding very much.  Fortunately one of my friends showed up and she translated for me. 
The skit that we saw went like this. A woman was cheating on her husband with a blind man.  When the husband returned, the son told him what was going on and they set a trap to catch the blind guy/boyfriend of the wife.  When the guy showed up to meet the woman, the husband pretended to be her.  Through a number of awkward gropes, the blind man came to realize that the person he was groping was not in fact the woman he was expecting.  The crowd thought it was hilarious. I felt a little bit violated.

Now it’s time for the real show.  I know that I read “The Merchant of Venice” when I was in high school, but I didn’t remember the play at all.  The only part I remembered was when the guy Shylock (was that is name?) wanted a pound of flesh.  Since my friend got wrapped up in the show and stopped translating for me, I kept watching to see if I could pick up the “Pound of flesh” part.  While watching for that part, here are some of other highlights that I noticed.

  1. Kids.  They’re the same everywhere.  During the marriage scene, when the couple fed each other the marriage supper the audience started ooooohing and aaawwwwing while the actors looked like they wanted to die on the spot.  Loved it!

  1. The curtain.  Like most theatres, there was a curtain at the front of the stage.  There were two guys who were in charge of opening and closing the curtain.  And they really liked their job.  They opened and closed the curtain every 30 seconds or so.  Unfortunately the rope that held the curtain had a lot of knots in it, so the curtain was always getting stuck while they tried to open it. At one point one of the guys got extra rambunctious about opening the curtain and literally fell off the stage.  Ha! Thankfully he was unhurt and eagerly reassumed his position as operator of the curtain.  I don’t think I’m exaggerating too much if I say I think about 25% of the play was spent opening and closing the curtain.

The infamous curtain.  Open close, open close.  Repeat 35OO times.
  1. Photographers.  Also, as with most plays, it was videoed and pictures were taken. This one was unique however, because the photographer would call the actors away from their scene to move to the side and pose for a picture.  The bride was in the middle of her marriage feast when she stood up, moved to the side, posed like a model for her picture, and then resumed her seat. I was impressed though that none of the other actors broke character when it happened and just kept on with the show! J Very professional.  

When we arrived for the show we were in the back of the seating area.  There weren’t any more seats, so everyone in the back stood up behind us.  And they kept pressing in farther and farther.  After about an hour and a half there were so many people and so little air circulation that I wanted to throw up.  Meredith and I decided we’d give it about 10 more minutes and then call it.  At that minute something happened…I have no idea what, but everyone started standing up and moving forward.  We took that as our opportunity and high tailed it out of there. 
I tried to capture just how many people were crowding in, but I couldn't do it justice on film

All in all it was a great experience and I’m glad I got to go.  It took me back to the days of my church “Psalty” plays.  Next time I will bring a fan and try to last through the whole show.

Tuesday, May 22, 2012

Oh. My. Gosh.

The last week or so has been slow in the OB ward.  Our ambulance was broken which I think contributed to the slowness, but this hospital is no different than others with the ebb and flow of patients.  Anyway, I was bored.  I complained about how slow it was to someone, which any person working in a hospital will tell you that is a big no no.  But I did it. Oh dear.

Yesterday I was working an evening shift, so I arrived to the ward at 3pm.  I was informed by the nurse that we had a woman laboring who was a previous c-section so would need another one for this baby.  The c/s was scheduled for 4pm.  Yeah!! Something to do.  I bustled around getting everything ready for the surgery and by 5pm we were in the OR.  I’m in a race with some guys from the OR to see who can guess the sex of the baby more frequently and was in high spirits when I took the lead by correctly guessing the sex of the bouncing baby boy that was born.  The last c-section this woman had had, produced a baby that was already dead so we were all excited about this beautiful healthy baby. 

Two hours later at 7pm I was sitting at the nurses station when I heard the ambulance siren.  Wait, I thought the ambulance was broken.  I couldn’t tell if the siren was coming or going so I went out to investigate.  When I got outside the driver told me he had brought two women in labor.  Yikes, 2! And one of me.  Ok, show time!

One of them was able to walk and one wasn’t. I took the one that could walk and guided her into the labor ward.  The thing about the ambulance, and the thing about giving birth here in general, is that they usually will not come to the hospital for a normal delivery.  So you know, especially when they come by ambulance, that something is wrong.  I started talking to the woman in Krio but she wasn’t understanding me so I went and grabbed one of the nursing students to help me translate (something for which I would be extremely grateful for later!) 

The history for the first woman is this.  This was her fourth pregnancy and she has been in labor since the night before.  She started bleeding but the bleeding has stopped.  The TBA (traditional birth attendant) who was attending her birth became nervous when she started bleeding so decided to refer.  **** A million gold stars to this woman for recognizing a danger sign and referring her somewhere else!!!****  I checked to see if she was bleeding and she wasn’t. I called the lab to come check her hemoglobin to make sure it hadn’t dropped too much.  Then I called one of the doctors to see if she could come down and do an ultrasound to check for placenta previa.  (Placenta previa is when the placenta gets too low and can go over the cervix.  When the woman tries to push the baby out she puts too much pressure on the placenta and she will start to bleed.  She can hemorrhage and die from this, so it’s pretty serious.  The treatment option is to do a c-section).  The woman’s vital signs were fine and the baby’s heart rate was fine.  Since the woman wasn’t bleeding and it wasn’t an immediate emergency, the doctor said she’d finish her dinner and be right down. Perfect!

By this time they had brought in the woman who was unable to walk by herself.  This was this woman’s 8th (yes 8th!) pregnancy.  She has four living children.  She too had been in labor since last night and although she was fully dilated, stated she didn’t have the strength to push.  Vitals signs?  Good.  Baby’s heart rate?  Good.  Ok, I did a vaginal exam and sure enough, she was fully dilated and the baby was right there.  I tried to pass a foley catheter to see if I drained her bladder if it would help the baby come, but I couldn’t get it in.  Next, I decided to give her a medicine that would help strengthen her contractions.  I’ve been told here that women who have given birth a lot have uterus’ that are just tired and need a little help.  I started the IV and sure enough, about 15 min. later her contractions were stronger and she really started to push.  

At this point the people in the room were myself, the nursing student I’d called for translating, and the TBA who came with the patient.  Although I’ve been working in OB for awhile, up to this point, for one reason or another, I’ve always had someone else with me when it was time to push the baby out.  This time, I was the most experienced in the room. Oh dear.

Push Push Push Push Push Push Push.  Little by little, the head came down.  Finally, out it came.  I reached up a little and felt the cord wrapped around the neck.  I yelled for the hemostats and clamped the cord and then cut it.  I expected the body to come out with one more push (as had happened with every delivery I’ve seen) but it didn’t come.  Crap.  I gently pulled, but nothing.  I started getting a little panicky at this point.  I tried to call the doctor but the call didn’t go through.  I know that even if help comes, it will be too late, as I just have a couple minutes to get this baby out. Now I’d been praying ever since the woman came in, but at this point it was more a guttural cry of desperation to my God! I’d listened to the heart tones of this baby just a few minutes before and it had been strong. Now, if I don’t get this baby out quickly, the last 9 months will be wasted in the last five minutes. 

The only case of shoulder dystocia (when the shoulder gets stuck on the way out) I’d seen  was when one of the doctors delivered a baby that was just about 30 weeks.  The baby had died inside the uterus.  He had had to really tug and pull hard, dislocating the arm etc., but it didn’t matter because the baby was already gone. I was really afraid of doing something to harm the baby.  Finally (and I’m still not sure how I knew to do this) I reached up and grabbed one of the shoulders and pulled it down.  When I did that, it came out. Then I lifted up and the second shoulder came out. 

The baby was not crying, not breathing, and very floppy.  I glanced down at the woman and saw that she wasn’t hemorrhaging then literally scooped the baby up and took off running.  Because Jesus loves me, the generator had randomly been turned on about 5 minutes before so I knew there was oxygen and suction in the OR.  As I glanced down the hall to the OR doors, I saw they were locked so yelled to the nursing assistant to grab the keys.  She flew past me and had the OR unlocked by the time I got down there. I ran to the main OR doors and saw that they too were locked. These doors don’t have a padlock and the lock that locks them is pretty flimsy. I knew I couldn’t waste time going to find the hidden key so I literally used my shoulder as a battering ram and opened one of the doors. 

Now we were in the OR but I didn’t know where the lights were.  Fortunately though, because we’d done a c-section earlier that night I knew the oxygen and suction were still set up.  I yelled for light and the nursing student and one of the other OB patient’s mothers (who had followed us down) brought out their cell phones that have flashlights on them.  I started giving the baby oxygen, bagging him, sucking out all the goop and slapping him around a bit trying to wake him up.  It was so dark that I couldn’t see if his color was getting any better. 

I yelled, “I need Marie!!”
”That other white woman.  Someone go get the other white girl!”  Somebody took off running.

I thought Marie might know how to turn the lights on.  When she got to the OR she didn’t know how to turn the lights on, but I dispatched her to go check on the woman I’d just left when I took off running with her baby. 

All this time I’m continuing to bag, give oxygen and suction.  Finally, our little man opens his eyes and gives us a cry.  We all started cheering.  His color started getting better and he started crying more and more.  I was pretty close to crying myself. 

We left the oxygen on for a little while until I felt we were out of the woods and then got him weighed and dressed.  He was 8 ½ pounds.  In a country where the average weight is about 6 pounds, this was a BIG baby!

I took him back to the OB ward to check on his mom.  Marie had delivered the placenta for me started to help get her cleaned up.  A few minutes later the doctor arrived and I told her about my adventure. She went to check the baby and said everything looked ok.  Thank you Jesus!!!!  The night OB nurse also showed up at this time (she’d heard the ambulance and thought I might need some help). 

Now that the chaos was controlled, we turned our attention to patient number two.  The ultrasound showed that there was marginal placenta previa so we could try a vaginal delivery but it would be risky. Since she’d been laboring for so long but had very little cervical dilation, we decided to just go for the c/s.  I got everything ready and helped bring in the third baby for that day.  Three live babies for three deliveries!!

I’m so thankful for all the help that I had that night. If that nursing student and patient’s mom hadn’t been there, I would have been scre…in big trouble.  I’m also thankful that my God breathed life back into that baby when there was none.  He doesn’t always do that, and I am confident that He is still good when things don’t happen the way I wish they would.  But I’m very thankful for the happy ending in this case!

Tuesday, May 15, 2012

Evolution of a Plant

There's a common phenomenon among the Apotos (white girls) that come here, and it usually occurs about a week or two after their arrival, or right before they're getting ready to leave.  They decide that they should "plant" their hair like the Sierra Leonean girls do.  The women here can do some awesome things with their hair and it looks.....well, awesome.  However, when the white girls do it?  Not so awesome.  Since I have a rather large head and therefore lots of room for a blazing white scalp to show through, I have put off jumping on the plant your hair bandwagon.

I have enjoyed however, standing by and watching lots of Apoto's get their hair planted while here. A lot of them are really cool!  Some of them are....different.  My all time favorite was a plant one of my friends got called the "snake."  Imagine a spiral braid that starts on the top of the head and and spirals inward until the remaining end of the hair sticks straight out of the middle of the circle.  Then imagine that you have one of these spirals on the top of your head, one on each side, and one in the back.  All with that piece of hair sticking out of the middle of the circle.  I still literally laugh out loud when I think about it.  But the girl was a trooper and left it in for 2 days!! I called her Cindy Loo Hoo.

People (my Sierra Leonean friends) have been telling me to do it for over a year.  Every time someone does it it's "Emily, do it. Do it. DO IT!!!"  But I stood strong and my scalp remained covered.  Well, last week I hurled caution to the wind and said, "Sun! Prepare to meet and burn my scalp!"  

I had a friend that was getting ready to leave and wanted to get her hair planted before she left.  I went to keep her company.  Now this girl has GORGEOUS hair....and a TON of it!  I asked how long it would take to plant and they said about 4 hours.  Yikes.  I sat there for about an hour watching them work on my friend and listening to them all tell me I should get mine done. And I caved.  They went and bought some extensions for me (red and black....why not?) and three girls started working on me.  And it hurt.  A lot.  At times I would have all three of them pulling as hard as they could on my head in different directions.  But alas, 3 hours later I was finished.  

This was what my face looked like for the majority of the time.  

I looked like I should have been part of a reggae band. Or at least a roadie.  The toughest part was that every time I moved my head, a bunch of little hairs would get pulled out.  My sister had this done when she was in Nigeria and she lasted 5 days.  So of course my goal was to keep it in for 6. I wasn't sure I was going to make it.  It was so heavy.   And so hot!!!

The girls and I after they finished.  They were proud!

After 2 days though, it started feeling better! I figured that all of the little hairs that were getting pulled have all just come out now so there's no more hair to pull. I didn't care. I was pain free. 
My favorite part of the whole experience was when I got back to the hospital. People freaked out.  I have never had so many people get so excited about one of my hair-do's before!  It was hilarious. When I complained about how much it hurt they just laughed and said "You have to bear. You have to bear" (which means suck it up).  
Since I got such a great response, I decided to make my goal 2 weeks.  Then on Saturday night I had a dream that I took it out and when I woke up on Sunday morning and it was still there....I was sad.  So I quit.  A couple girls came over and the three of us plus my roommate went to task taking out all of the tiny braids. After two hours I had air circulation to my head once again, and a giant pile of fake hair.  As Mr. Gibson would say....Freeeeeeeeeeeeeeeeeeeeeeeedoooooooooommmmmm!   

I was afraid it was going to take as long to pull it out as it did to put it in

Apparently you can use it again, but I don't see it in my near future. So I gave it to the girls as a "thank you."  I would have been there for 3 days without them!

Tonight I was down at the hospital and an adorable 3 year old asked if she could plant my hair.  How could I say no?  Fortunately her idea of planting was twisting my hair around for about 15 minutes until she got bored.  My kind of plant!

Saturday, May 12, 2012

When I grow up

Working at the hospital means that I am around people all day, every day. I'm constantly meeting new patients, families of patients, friends of patients, etc.  Every once in a while, someone will stick out of the crowd and really just "get to me."  It happened this week.

I spent the last couple weeks in Freetown and up country doing the medical clinic, so when I arrived back in the OB ward on Tuesday, I didn't know any of the patients.  I started reading through some charts and saw that one of the patients blood pressure was really high.  Like 260/140 high.  The patient had eclampsia, and as we learned in nursing school, the treatment for eclampsia is delivering of the baby within 24 hours.  I asked one of the nurses if the plan was to go ahead and section her, but she told me that she was only about 26-28 weeks.  In the US, with all the advanced technology, babies at this age rarely make it. Here, where our resuscitation efforts include bagging and using oxygen if the generator happens to be on or until all our battery packs die....there's just no way baby would survive. Since we couldn't deliver, the plan was to try and keep her blood pressure down for as long as we could, ideally until at least 32 weeks.  

The next day the doctor called me to the patients bedside while she was doing rounds.  She couldn't find a fetal heartbeat with the doppler or the ultrasound and wanted someone else to check.  I looked and looked, but didn't hear anything.  Mom said that she had felt the baby move earlier that morning, but we weren't finding any heartbeat now.  We told mom, and she started to cry.  This was her first baby.  

We decided to wait one more day, and readdress things in the morning.  The next day I got to the hospital at 3pm for my evening shift.  They had given her some medicine to help start her labor so she could deliver the baby (although it had been confirmed once again that it wasn't alive), but she wasn't progressing very fast.  A couple hours later I started her on an oxytocin drip to help speed things along.  This made her contractions start coming faster and stronger.  It was so hard because the labor was so painful....just like when you're delivering a live baby, but we all already knew what the outcome would be.  She kept repeating "I'm done, I can't do this.  I can't do this. Jesus, please help me.  Help me, help me."  I tried to encourage her as much as I could.  I prayed with her, told her to get in whatever position was most comfortable for her, held her hand.  It was hard to watch.

About 8 hours after the initial medicine was given to start labor, the baby started crowning and she was pushing hard. The head came partially out, but then it was just stuck.  Because Jesus loves me, the doctor just happened to be down in the OB ward, so he came in to help.  Her pelvis was very small and he had to pull hard to get that baby out.  When it was over, she just kept saying "thank you, thank you, thank you."  Her family came in and one of them started crying.  In her very soft way, the patient said, "Don't cry.  You're supposed to be encouraging me...don't cry. It's ok."  She was an absolute pillar of strength.  I was blown away.

She asked if it was a boy or girl and I told her it was a little boy.  I asked if she wanted to see him and she hesitated for a second and then said yes.  I washed him off and covered up the signs of the difficult delivery and showed her to mom.  She said he looked like his dad.  

I've been a part of two deliveries now, in which we knew that the little baby wasn't alive.  It's not fun for anyone.  This woman, a young girl probably around 18 or 19 years old exemplified such calm acceptance and determination in such a hard situation....I want to be like her when I grow up. 

One positive outcome was that we discovered that she does have a really small pelvis, so we told her that she really needs to make sure to come to the hospital for her next delivery, just in case she needs the help of a vacuum or a c-section.  Hopefully now she'll come early and will give birth to a healthy baby boy....or girl.

Monday, May 7, 2012

Oh, Caaaannnaadaaaaa....my home and native land.......

Long time no chat!!  I've been "up country" (which is code for anywhere outside of Freetown) for the last week and a half with a medical team from Canada.  We had a team of nurses and docs and boy...can those Canadians see some patients!! We kicked butt and took names (and by that of course I mean compassionately treated more than a thousand patients who came to see us).  Since the week was packed full, I'll give you the low down bullet point style.

1. I love getting to meet new people and see Sierra Leone through the eyes of first timers.  This was no exception.  Team Canada was great and I loved getting to know them and introduce them to the country I love.  Also, I learned the Canadian anthem while they were here so...I'm practically Canadian.  Just call me Amersalonian.  Definitely.

2. I love spending time with the Sierra Leoneans that always help me on these trips.  One of my favorite pastors here is...a little bit crazy...but awesome! I couldn't do these teams without him and I love hanging out with he and his wife!  He spends about 30% of the week going around snapping photos with his camera or ipod.  I spend 30% of the time trying to ruin whatever picture he's attempting to take.  It's a beautiful partnership....really.

3.  This year we had a doctor from Peru come join us.  Now, my dad has been building up this lady for....years.  "Emily, you need to meet this girl."  "Emily, you're really going to love this girl."  "Emily, she's like you....(which I interpreted to mean a little bit crazy).  Well, I spent the week with her and....well played Dad, well played.  She was great!!  We shared a room for a week and may or may not have literally spent hours giggling in the middle of the night.  Sorry third roommate!!  You didn't realize you were rooming with 2  ten year olds!

4.  There is a large population of Lebanese people living and working in Sierra Leone.  The hotel that we stayed at was run by a Lebanese woman and her son.  She and I hit it off and one day I was looking at pictures of her family and she was showing me pictures of hers in Lebanon.  It started to rain so I grabbed all my stuff from the table and took it to my room. A little while later she was looking all around and told me that she lost her key, and that her other key was locked in her room. I helped them look around some and then the maintenance man came to talk about breaking into her room.  All of the sudden I though, "Hmmm Emily, you wouldn't have taken her key would you?" Now, the only reason this even popped into my head is because....I'd already taken someone else's key earlier in the week.  I went to check in my room on the VERY unlikely chance that I'd taken it and...sure enough. There it was sitting on my bed with my camera, phone, etc.  Oops!! I tried to blame it on my roommate but....couldn't do it. It was my fault.  Fortunately she forgave me. :)  And REALLY fortunately, they didn't break into the room to get it.  Thank you Jesus!!

(Note: This is my Lebanese friend and I.  Apparently I took zero pictures this week, and the few pictures I did take wouldn't load....darn internet. So sorry for the essentially pictureless blog!!)

5.  I am constantly learning and re-learning things here.  One of the things that I've learned, is that the last day of the clinic is just....not easy.  All week when we see people outside and they beg to be seen, we can say "come tomorrow, come tomorrow, come tomorrow."  But the last day...no more tomorrow.  And since I am the keeper of the cards (the ticket into the clinic), the buck essentially stops with me.  I hate being the bad guy that says no.  Yuck.  I was sensing that I was a little emotional as soon as we pulled up to the clinic, but I started off the day doing pretty good!!  One of my biggest fears was that I would get frustrated by not being able to see everyone and by everyone asking for their mother/sister/uncle/great, great, grandmother to be seen that I would get irritated and snap at someone.  I needed to balance firmness with gentleness.  Not my forte.   But I was doing ok.  We knew approximately how many patients we'd be able to see that day so we handed out a certain number of cards and then just kept handing them out 5 at a time, so we would keep good control on how many we could see.  Then I was brought a list of 16 elders in the community who hadn't been around all week, but wanted to be seen now.  Ugggghhhh.  I lost it a little bit and started crying.
One thing that I have a hard time with here are the power plays.  I've grown up in a culture that teaches that the best kinds of leaders are servants....placing those they're leading ahead of themselves.  But that is traditionally not the way it is here.  If you're a leader or have power, it means you get the best seat, you are served first, etc.  So the fact that the people who had been waiting outside in the hot sun all day, every day, for the last five days were going to be pushed aside so these men could waltz in and be seen....frustrating.  I expressed my frustration to my Sierra Leonean friend who I trust to help me navigate through the political things that I don't understand here, and he was empathetic.  He told me that he understood my frustration, but the fact is, we are leaving tomorrow and there is a church and a school that will remain behind and these leaders have the ability to make things very difficult for them if we disrespect them right now.  
I could see some of the community members standing around me, wondering if I was about to make their lives a lot harder, so I swallowed my indignation and gave them the cards.  I still don't like it. I don't think it's right.  But when I get frustrated by things like that, I remind myself that I CHOOSE to live here.  So suck it up Emily.  Suck it up.

6.  Beach day.  Of course beach day was awesome. It always it.  What a beautiful display of God's creation and creativity!  I love going to the beach! :)

The season of medical teams is done now, and I'm planning on heading back up to the hospital tomorrow (providing Boris (my car) is done getting his face lift by tonight).  Bring on the baby borning!