Count my blessings......

DISCLAIMER: Peter reads and approves all blogs before I post them.  Just so everyone knows. J

Peter and I went to a Portland Timbers game this weekend.  It’s been a dream of mine to surprise him with tickets to a Tottenham Hotspurs game (his favorite English team….don’t worry, I’d never heard of them either).  His birthday was last week and since I couldn’t give him Tottenham tickets, I did the next best thing.  Timbers tickets…..?  Not QUITE the same, but I was excited just the same.

The game was so fun! When I bought the seats I really had no idea where we were sitting but when we arrived and I heard all the chanting behind us I thought “Oh that’s fun! We’re sitting near the ‘crazy fan section.’”  Then I realized we were sitting right in front of the OPPOSING TEAM’S “crazy fan section.”  Oops.  The Timbers kept them pretty quiet though, with a final score of 3-0.  My job during the game was to google all the black players and see if any were from Sierra Leone.  No Sierra Leoneans, but a Liberian and Nigerian so…some good West African representation.  Peter was pretty vocal during the game and would occasionally yell things out in Krio.  I always love watching people around us watch us while trying not to look like they’re watching us. J  I always want to lean over to them and give them my stalking secret. Sunglasses.  You can look anywhere and nobody knows!!

After the game we stopped off at the hotel before heading to dinner.  We used a gift card we got for our wedding which is my FAVORITE because I love eating for free!! I love it so much that, even though we were heading to dinner, I begged Peter to let us stop off at the hotel restaurant where they were having a “managers reception” with free appetizers and free drinks!!  I just can’t pass up free Diet Coke!

It ended up being a good thing because our wait time at the restaurant was over an hour.  Thanks Free Pre-Dinner!!!  About 30 minutes into our wait, Peter looked at me and said, “I don’t know if it was the medicine I took or what, but I’m feeling really tired.”  I asked him what medicine he took and he told me he took the cold medicine….the nighttime one, since it’s evening time now.”  Ha! There’s 50mg of Benadryl in that medicine!!  He was wiped!!  I told him we could just go grab dinner and take it back to the room but he wanted to press on. J  Conversation during dinner was….not lively.  At one point I asked him a question and it took him 3 seconds to come up with “yyyyeeesss!”  You could almost see the neurons trying to connect through the fatigue.  We went back to the hotel where he walked straight from the door to the bed and was out in 2.7 seconds.  At 9:15.  I spent the evening watching HGTV….and am going to get to hold this one over him for a while! J 

The next morning at breakfast I commented how much more talkative he was when he wasn’t all drugged up and he kept shaking his head and saying he was never doing that again! J  Later we got to have lunch with some good friends who were actually in Sierra Leone soon after Peter and I started dating.  (Shout out Stephen and Pasha). Steven had had the mission while he was there to “scope this guy out” and get a guy’s perspective. 

What happened at the end of our weekend is really why I decided to write a blog.  This was just my really long way of getting there.  A friend of mine works with a Sierra Leonean woman and she called Peter to tell him about a special prayer time they were having for Sierra Leone in Portland. It was perfect timing because we were already up there.  We spent an incredible 2 hours worshipping the Lord together and praying about the Ebola crisis in Sierra Leone and the rest of West Africa.  There were probably 30-40 people there and they were from all over Africa.  At the beginning of the meeting the pastor called up several people who were NOT from West Africa and had them each pray in their own language.  He remarked that while they weren’t from West Africa, their hearts were still burdened for their friends and were calling out to God on their behalf.  It was beautiful.  These people understood. They too are far from their families and friends, watching the suffering from a distance.  I shed tears for Sierra Leone, for the people who are suffering, the people that are interceding, and for my husband. 

I got to watch Peter worship in his own language, sing songs from his own country and become instant friends with people he just met.   I am intimately acquainted with the loneliness that can come from being so far from home, but was always so blessed to have a community around me from the United States.  My home culture.  Peter hasn’t had that.  And his country is in crisis.  So although I thoroughly enjoyed spending time with Sierra Leoneans, speaking Krio (although I was ashamed of how bad it’s become) and sharing stories, my favorite part was watching my husband enjoy it. J  After the service we were invited to a woman’s house who had made a staple Sierra Leonean dish (cassava leaf or “green glop”) that I didn’t even know we could get in the States!  Peter was in heaven!! It was the perfect end to an incredible weekend and as I drove home I marveled at how much God had blessed us and how incredible the Body of Christ is.  Thank you so much Jesus!! Thank you for stretching us, and thank you for encouraging us!  

This virus!!

The other morning I walked into my house after a night of working in the ER and I had one of those moments of absolute bliss. You know those moments? They’re not common, but when they happen you think “There is no way my life could possibly get better.” My adorable daughter was snoozing away and I climbed into bed with my wonderful, happily sleeping new hubby.  I’d had a great night at work where I’d had plenty of supplies, tons of resources, and best of all a doctor who was WAY more knowledgeable than me.  It had just been fun! Blissful. 

Not only was my little fam sleeping, but I saw that Marie and my niece had put the.....toilet plunger to bed. Complete with blankie. 

I took a nap and woke up to the sounds of my hubby and daughter playing together.  I got on the computer and did what I do most every morning (or in this case afternoon) which is look for any update on the Ebola situation in West Africa.  The bliss was immediately gone.  The situation isn’t getting better. More new cases. More violence.  More pleas for help.   My heart was being torn in two.  Again.  I want to be there!! I’m not supposed to be here! I’m supposed to be there, in one of the space suits, fixing this whole situation!!  They need me!!!!  It’s an inner struggle that I deal with several times over the course of any day. 

Yesterday Peter and I got in an eh hem….discussion.  I was upset at his lack of……frustration.  I’m tormented about this. I’m constantly researching, talking, thinking, praying, trying to figure out what we can do. Should we go back?!? How would that be possible? We’d need new tickets, how would we pay for it?  What would that even look like? What about Marie? What about this? What about that? On and on and on. 

I see his crestfallen face when we read something new.  I see the e-mails that say they’ve added money to our Skype account yet again because he’s calling so much to check in.  Last week he stopped eating for a day and a half.  I know his heart is heavy.  So WHY ISN’T HE FREAKING OUT LIKE ME?!?!?!!? 

I realized that I wanted to see him stewing and fretting like I was.  I wanted him to be worried and constantly looking for a way for us to go “save the day.”  That’s just how ridiculous I am.  He gently reminded me that we didn’t plan for this.  We were planning on being in Sierra Leone by this time but as of now, they’ve cancelled our flights.  We don’t know why God allows these things to happen, but why fight against it?  He can see things that we can’t.  (I think I’ve heard that somewhere else before…..)  Oh this husband that God’s given me.  Such a quiet, calm and rational balance to my somewhat frantic, emotional exuberance. 

And he’s right.  This isn’t what either of us would have chosen and we’re both waiting for an opportunity to go back.  But for now we’re here.  And I’ve started counting the blessings I have in being here. There are a lot!! 

Peter and I have been brainstorming for a while about the best ways to serve and love the Sierra Leonean people from afar.  And we are getting excited!!  The details are being finalized for an operation that would involve supporting the churches in two of the districts hit hardest by the Ebola virus.  People in the church are dying and their family members are suffering.  They need food. They need water. They need cleaning supplies.  What an incredible opportunity we have as the body of Christ to stand with our Brothers and Sisters across the world and show them that they’re not alone!!  We haven’t forgotten them!!  Most of us will probably never meet them, but they are still our family!!  I get tears in my eyes just writing this!

But it doesn’t end with the Church!!  What if that was just the starting point?  We are going to help the local church reach out to its community by providing food, cleaning supplies, and other necessities to those people who need it most!  We can empower this church that is hurting and grieving to rise up and share Jesus with their community that is also suffering and grieving.  From thousands of miles away we can reach out to the Church and the communities that these churches serve.  It’s exciting stuff!! So excited to get to be the hands and feet of Jesus. 

If you’re interested in getting on board, you can make checks out to:

Willamette International

PO Box 772

Albany, OR 97321

*Just put “Ebola” in the memo line

If you’re looking for other ways to give, Doctors Without Borders is an awesome organization that’s been spearheading the Ebola epidemic in Sierra Leone. Their website says that they can’t earmark money for Sierra Leone, but they were able to even begin working there because people had donated before so I think that’s a good option.  Samaritan’s Purse is also working heavily in Liberia and I’m sure would love any support we could give them. 

Ebola II

It’s been a rough few days.  Yesterday afternoon Peter and I decided that we’ll be delaying our trip back to Sierra Leone. It was with heavy hearts that we made that decision.  Very heavy.  Several things happened within a couple days that just made us really unsure of what was going to happen. One airline stopped flying into Sierra Leone and Liberia started closing some borders with Sierra Leone.  Sierra Leone is surrounded by Guinea and Liberia and so we started getting concerned that if things continued to escalate, travel would be really difficult. 

Originally we were going to extend for a couple weeks just so we could see where things were headed, see if they settled down or escalated.  As of this morning, we’re not sure when we’re going to be able to go back.  The president has declared a “State of Emergency” for the country which we think is good! This should provide better control and will hopefully stop the spread!  We want to go back as soon as possible. 

The hardest part about not going back is feeling like we’re abandoning our friends and family back in Salone.  “Hey good luck with that Ebola thing! We’ll see you again after it’s nice and safe for our family to come back.”  Yuck.  During all the years that I was planning on becoming a missionary, I was going to be THAT girl.  The one that stayed after everyone else left.  I was single (and not looking to mingle) so I was going to be able to do things that people who had families just couldn’t do.   I was going to be one of the ones in the space suit.  And I loved that idea! 

To be honest, there’s a big part of me that still REALLY wants to be over there in one of the space suits, right in the thick of the chaos. Part of this is because yes, I love the adrenaline. That’s why I work in the ER and ICU.  But also…..they need help!!  SOMEBODY needs to be there taking care of these patients. Somebody needs to take the risk.  Sierra Leonean doctors, nurses and other medical personnel are taking incredible risks (as are missionaries) and I want to do our part!! And these are Peter’s people! He’s thousands of miles away from his family during all of this and I can’t imagine what that would feel like.  That doesn’t even take into consideration the fact that Peter is the brand new Country Director for our NGO…and what will happen to the NGO? We have a lone missionary there right now and we wanted to go back and support him as well as all the other people working for the NGO.  But I’m also concerned for my family!!  What could happen to Marie? What could happen to us if we couldn’t get out? So many unknowns and so much to think about.

Peter and I have are from different cultures and had very different experiences growing up.  For these reasons we often approach decisions with very different frames of reference. While we have been praying for wisdom and discernment, we have also been praying for unity in our decision. We are both really thankful that as difficult as the decision to stay has been, we both feel a peace about this. 

Please pray for the situation in Sierra Leone, Liberia and Guinea.  Pray for those who are still there!! Please, please please pray that this will be resolved quickly!!

Ebola

Peter and I are celebrating our one month anniversary today. 

Woo Hoo!!

We’ve celebrated our anniversary by having hours of conversation about whether or not we should re-enter a country that is in the middle of an unprecedented Ebola virus outbreak with a 60% mortality rate.  Wow, that sounds dramatic doesn’t it? (I’ve always had a flair for the dramatic....ask….well, anyone).

To be perfectly honest though, we have spent HOURS in the last few days (many of them with me in tears….sorry Peter, can’t return me now) trying to figure out what to do.  We’re supposed to go back on Sunday.  When we left in May , the outbreak was present, but hadn’t escalated like it has now.  We’ve talked to so many different people, both here and in Sierra Leone and have received very different advice.  I think that's what we're struggling with the most.  People who we love and respect are telling us different things.  Last night  we were both utterly confused about what to do. So we holed ourselves up in our room and hashed everything out, all the while begging Jesus for wisdom and discernment. 

We’ve decided to go back.

We have precautions that we’re going to put into place.  Peter will be doing the administrative work that he can from home and will meet only with the people that he must.  I’d left my job at the hospital before we came to the States to get married, so I have no commitments at any health care facility right now.  I was planning on taking a couple months and help get our family established, help Peter in any way I can in his new role, and get homeschooling off to a good start. 

Now I’m a bit torn.  I won’t be going to the hospitals where the Ebola is, but as a health care worker, I find it difficult not to do anything when I’m sitting in the middle of an epidemic!!  But so far ALL the advice has been for me not to get involved in the health care aspect of things at this time.  Many of the Sierra Leonean people are confused about what is actually causing the outbreak and are angry with the health care workers. There have been some angry gatherings at hospitals and ambulances are being stoned.  There are lots of rumors and lots of distrust.  Any work that I would be looking at doing would be in seeking to educate the people.  I’m just not sure at this point what that would look like and what the risk versus benefit ratio would be. 

So we’ll get there and figure out what the best thing to do will be.  We’ll see. Please please pray for this outbreak in Sierra Leone, Guinea and Liberia.  Pray for the health care workers, the people risking their lives. Pray for the infected people and their families. That fear would not overwhelm truth and that trust will be built between the hospitals and the people.  Pray for the stability of the country. Unrest and violence will only make a dangerous problem exponentially worse. 

Parting is such sweet sorrow.....

I worked my last shift at the hospital a week ago.  I’m leaving to get married in a few days and when we come back to Sierra Leone Peter will be assuming the role of Country Director for our NGO and we’ll be living closer to the capital.  My feelings are mixed.  I love that I’ll get to be closer to my NGO team.  I’m excited for Peter and the new opportunity this will be for him. But I also loved living in the village. It was difficult, but I loved the work at the hospital and I loved living in a smaller community with no walls and will sorely miss the friendships I’ve made there over the last 3 ½ years.  But it's time. 

The time leading up to my last weekend of work was spent  packing up my house while continuing to try and homeschool and squeeze in some last visits with friends before we left.  To be honest, I was bone tired and hoping for a quiet, “lay on one of the patients beds and read a book” kind of shift.  Not quite. 

I was working a double shift and at about 9am a woman come in who I’d seen last weekend as well. Last weekend her complaint was pretty nonspecific generalized pain, and she wasn't sure if she was in labor or not.  When I checked her, she wasn’t in labor. When I looked at her card for her history, I noted that she was a previous c-section patient and had had FIVE pregnancies and had ZERO children alive. No wonder she was conscientious in coming quickly if she felt something.  I’ve lived here long enough to know that by now she’s been labeled a “witch” and everyone’s talking about what she’s done to her babies. 

The policy of our hospital is that once a woman has had a c-section, all future pregnancies should be c-sections. We don’t allow them to try to deliver vaginally. It’s too risky. (That’s not to say of course, that I haven’t had several patients come who had a c-section, then had five normal deliveries and are now coming back for some problems with the current pregnancy.  THEN what do I do?!?!?) 

So when the patient came in this time, I knew that she was a little nervous and needed a lot of reassurance that things looked fine.  I checked her, but couldn’t be sure if she was in labor or not.  She was dilated a little, but not any more than many women can be naturally are after multiple pregnancies.  I decided to admit her and give her some pain medicine to see if that calmed the pain down.  I also checked her blood, so we’d know that information if it turned out to be the real thing. 

Her blood work came back and she had a hemoglobin of 8 grams.  This is low.  In the ICU, we are talking about transfusing patients with hemoglobins this low.  I knew that if she was going to need surgery she was going to need more blood than that to begin with so I alerted the family that they needed to find a donor for her.  Several people volunteered to go get checked. 

When they came back a little while later they told me that one of them was a match but that the lab man told them there were no blood bags, so they couldn’t donate the blood. Wait. What?!! No blood bags?  I didn’t believe it.  I went down to the lab to talk it over with them and find out what “no blood bags” really meant. Surely it couldn’t mean NO blood bags.  85% of our pediatric patients are admitted to the hospital because they need blood!  Turns out, it really DID mean NO blood bags. I take that back. They had two pediatric bags left, but they’d reserved them for a patient they had who was actively bleeding.  Shoot.  I asked  when we could expect some more. They told me that they were supposed to come yesterday via public transport but hadn’t shown up so they weren’t sure when we’d get some more.  The town we needed to get them from was about 3 ½ hours away. 

I went back to the ward and for the next few hours just really hoped and prayed that she wasn’t in true labor.  I asked her about her pain several times that morning and she told me it was better. Awesome!  At around 2:30pm I was watching her and noticed she was shifting in her bed a lot and occasionally a little moan would escape.  Double shoot.  I asked her if she was having more pain and she said she was. Triple shoot.  I took her into the labor room to check her and sure enough, she’d was further dilated than she’d been earlier.  She was in labor.

So now what in the heck do we do?????  She needs a c-section.  But her blood count is already dangerously low and this would mean literally cutting someone open with no way to give her blood if something went wrong and she started to bleed heavily. So that didn’t seem like a great option.  But if we let her try to deliver vaginally we risk her rupturing her uterus which would mean she definitely begins bleeding a lot….and in a much less controlled situation than an OR.  And still no way to give her blood. 

I started running scenarios through my head.  What would I want done?  If Peter was giving birth to my child (yes, he thought that reasoning was weird too, when I explained it to him)  I would want to take him to the town 3 ½ hours away where there was a bigger hospital that could give her blood if they needed to.  But I was afraid.  This woman had been pregnant quite a few times and the last thing I wanted was to deliver a baby in the middle of the bush….by myself….or even worse, have her rupture her uterus and begin bleeding uncontrollably….in the middle of the bush….by myself. 

I called one of the administrators of the hospital to ask his advice. He advised that we go ahead and do the surgery.  I called the surgeon to ask his advice as well.  He said he thought the best thing would be to do the surgery.  So we did. 

I was nervous and was fluttering around the patient in the OR like a nervous little chicken.  Or something else that flutters around nervously.  Do chickens nervously flutter?  But everything turned out fine.  The baby was a BIG beautiful boy and the patient and family were thrilled. 

So that was my last shift. Not as dramatic as some, but still a heavy reminder of the obstacles and challenges of health care in the rural areas.  It can be utterly frustrating…..but also such a blessing!! I’m really going to miss living and working here!

Baby Emily and I

Marie with the nurse that helped me take care of her after I met her for the first time at the hospital

My longtime neighbor Bethany and I

Saying goodbye to my house!

What a day!

I almost died. Ok, that’s a bit of an overreaction (which if you know me, you know that I almost NEVER overreact!)  As periodically happens over here, weird skin eruptions will occur on our bodies, causing us to ask ourselves (and usually consult others)….”is this a mango fly (a worm that imbeds in the skin) or a boil?”  Well, I woke up one morning with such an eruption and decided I’d start taking antibiotics sooner rather than later.  I had some Bactrim, so I decided to start it.  Last year I’d taken Bactrim and suspected I had some kind of allergic reaction. My mouth broke out in all these blisters and I couldn’t really eat for 2 or 3 days. A similar, milder thing had happened to me before but I couldn’t remember if I had been taking Bactrim at the time.  When I was home I talked to my doctor about it but he didn’t think it really sounded like an allergic reaction.  Awesome! ( I’ll admit I was always a little too proud about the fact that I could mark “no allergies” and “taking no medicines “ on any medical form I had to fill out).  Oh how the proud will fall.

I was working Sunday morning so took my first Bactrim before I headed down to work.  About 30 min after getting to work I was reading my book when I noticed that my gums started tingling.  Why in the world are my gums tingling? Then I remembered. I’d taken the Bactrim. Could that be it????  I decided to just wait and see what happened, and as I waited, my whole mouth started tingling.  Then I started feeling this ball in the back of my throat that kept getting bigger.  My tongue started swelling a little and I started having a little tightness in my chest with a little cough.  Shoot.  I didn’t know what else it could be except a stupid reaction to the Bactrim so I went home and took some Benadryl.  I was super antsy and couldn’t sit down.  I kept thinking of the patients I’d seen in the ER that came in with anaphylactic reactions.  I did NOT want to be one of those patients!!  I talked about it with a couple of my nurse friends who assured me they could give me a shot of epinephrine if I needed it and that I would probably be fine.  (There’s a chance I have a tendency to overreact….especially when I’m 3 hours away from a doctor, and thousands of miles away from someone who could intubate me). 

My symptoms slowly resolved and I left my visiting nurse friend down at the hospital to keep an eye on things while I went up to the house to make us some lunch.  A few minutes after getting there I got a call in whence my friend said…..”Umm….you should get back down here.” That's the kind of sentence that makes your stomach drop a little.

I got back down to the hospital and met a very pregnant, relatively unresponsive woman.  Her blood pressure was really high and the nurse that took her vitals said that she was “twitching” while he took her blood pressure.  I asked her family how many months along she was, and they said 9.  I asked if she was in labor and nobody said anything.  Ok?  I heard one of the women say that this “sickness” had been bothering her for about 3 days. 

Ok.  I had a couple different things going through my head.  Her blood pressure was really high. Was this eclampsia? Had she been seizing at home?  She also had a fever, so I was thinking it could be cerebral malaria.  She was COMPLETELY uncooperative.  I tried to start an IV and she freaked out.  Three of us had to basically sit on her to allow the lab to prick her finger. When I gave her the injection of anti-malarial medicine, I thought the needle was going to break off in her leg, she was moving around so much. Oh. And she fell off the bed. Off. The. Bed. I couldn’t tell if she was being overly dramatic or if there was something going on with her neurologically. 

Because she was so wild, I couldn’t tell if she was in labor or not. Initially I didn’t think she was….I just thought they’d brought her in because of another illness. But after we stopped torturing her, I began to notice that she seemed to freak out in a somewhat regular pattern.  When she said she wanted to have a bowel movement that sealed it. I needed to do a vaginal exam and see where we were. 

As I inserted my fingers, I immediately felt a head. Holy cow this woman was ready to push!!  Only she wouldn’t push. At all. She did a lot of yelling, but no pushing.  I found the vacuum and wrestled with her to get it attached to the baby’s head.  As the contractions came, so did the baby.  Just like that.  Crying and everything. But it was tiny! (Just over 3 pounds I found out later).  It took me about 2 seconds to look at the baby and her belly and realize that there was another one in there. That’s when I had my “Oh C.R.A.P.” moment  This was my first delivery since I’d gone home in November and my first time delivering twins……EVER!!!!!!!!!!

I reached up in there and could feel the bulging membranes around the second baby.  I used my handy dandy fingernail to rupture them.  As I did, a MOUNTAIN of fluid rushed out and I was drenched!!! My first thought was “I can’t just jump away because I need to guide the head down so the cord doesn’t come down first.” My immediate second thought was “well, if this woman had Ebola (don’t know if you’ve heard about the outbreak over here) which is transmitted via body fluids……I’m in BIG trouble!” 

I reached up and felt a head.  Yea!!!  With a hand.  Not so “Yea.”  When I ruptured the membranes, there was a thick meconium stain. This means that the baby is in trouble.  I did a rapid thought process in my head.  The first baby was small. This one probably is too.  But there’s the hand. Can the baby’s head fit through with the hand? It’s not the woman’s first child which means there’s more space down there, but still. I’VE NEVER DONE THIS BEFORE!!!! And then there was the meconium stain. The baby was in trouble.  We didn't have a lot of time.  The woman wasn’t cooperating which meant she wasn’t pushing, which meant she wasn’t going to be much help. 

I asked my friend to grab my phone out of my pocket and dial one of the midwives who lived close-by.  I wanted her to at least be on the way in case I got into trouble. As soon as I hung up the phone my patient had a contraction and we pulled the second baby out.  He came out screaming.  He was a little bigger at about 3 ½ pounds.  Nothing like the screaming cries of two bouncing baby boys!  As I was delivering the placenta and cleaning her up, one of the relatives said, “Yes, someone mentioned that it was two babies.”  Huh. That might have been nice to know at the beginning. J Oh Salone.  

I was going in and out of the labor room, getting different medicines and I heard one woman telling another….”this woman  (meaning me) has done well! She really knows this work!”  I had to stop her right there and say…..NO!!! This was my FIRST time doing this. I don’t know anything! It was GOD that helped us today! J  And it was.  Just another day in Salone.......

Teams, teams and more teams.....

It's that time again....time for the medical team to come!!! I was super excited about this year's team because it had some really special people on it! My parents, 2 uncles, an aunt, a friend from college and another from high school....as well as some really other great people!  We went back to the village that we went to last year which meant.....camping again!  Woo hoo!!

Last year we had some teammates go ahead and get things set up at the campsite, which was a HUGE help. I didn’t know how much of a help it was, until we didn’t have it this year! We arrived at the campsite with about an hour and a half before the sun went down.  All I could think was “eat” and “sleep.”  We had to set up the tents so we could sleep, and find the stuff we were supposed to eat.  It was pretty chaotic.  Then in the middle of the mayhem, my dad pulled out this little number.  

It was a camping chair.  Converted into a toilet.  Crazy you might ask? Yes, that’s what we were all thinking too.  He bought them and then took them to the company that makes our canvas bags and had them reinforced.  Reinforced, camping chair toilets.  Complete with cup holders.  That’s right. We camp in style!  (Unfortunate mishap of the camping toilet occurred when I took my camera with me to take a picture of the toilet and put it in the cup holder while I was doing my business.  When I stood up my camera fell OUT of the cup holder, and down the 10 feet to the bottom of the disgusting pit.  After about an hour of weighing the pros and cons, we decided we’d just leave it down there.  Note to self: it may look handy and luxurious, but do NOT use the cup holders in toilets). 

She was all smiles until we all just kept taking pictures and not helping her out......

In addition to the awesome team we had, I think this trip will also stand out because of the patients we saw.  On Friday morning we were finishing up breakfast and getting ready to start the clinic when someone called me over to look at a kiddo who was probably about 2 years old.  He had the typical malaria symptoms, fever, not eating, diarrhea.   He didn’t strike me as super sick, but as I looked him over, he looked really really pale to me.  Now, I’m going to confess something.  I’ve been here for three years, but I’m still not super great at detecting the subtle nuances of paleness in my distinctly darker African population.  But in this case, even I could tell that this kiddo was pale!!  He needed blood.  At least I thought he did.  I called around to find the closest clinic or hospital that could check his hemoglobin and give him blood if he needed it.  It was about 3 1/2 hours away.  We decided to start giving him malaria treatment and see how he looked later that afternoon. A couple hours later we saw another little girl that didn’t look as pale, but looked clinically more unstable with a high respiratory and heart rate. 

At the end of the day they both looked about the same so we decided that we’d take them to the hospital early the next morning.  We brought the kids with their respective caregivers and explained what we wanted to do.  They were all in agreement that they would come to the camp as soon as the sun was up the next morning. 

I got up early the next morning to take the two kiddos in with their guardians. I waited around for an hour or so when a pastor we work with came and said that he had some good news and some bad news.  Apparently, one of the mothers ran away with her child in the middle of the night. Literally ran away into the jungle.  Guess she didn’t really want to take her kiddo to the hospital. She could have just said something!!  After some convincing, the pastor persuaded the other mother to take her child. So off to the hospital we went. 

We arrived at the hospital about 3 hours later….and I totally started second guessing myself. On the way, the kid had been talking, he’d asked for something to eat….all signs of an UNcritically ill child!  As we sat there waiting to see the provider I was preparing myself to be very humbled when the kid's blood was just fine and he was stable and we turned right around and took him home. I’m embarrassed to admit that when his hemoglobin came back at 4.3 (very low…needing blood) I was a little relieved.  It's just nice to know you're not an idiot sometimes......

It took a couple hours to get everything settled but he got all set up with his meds and blood and we headed back to the village.  I arrived in the village at about 7pm.  When I arrived, I met a woman who had been there for a while and was clearly very sick.  The story those in the clinic had received was that she’d been sick for a week with a fever, nausea and vomiting but then that day had a mental status change and her abdomen became really distended. I talked with our doc and with the other nurses and we decided that really, she needed to go to the hospital.  We were suspecting typhoid with a probable ileus to her bowel, possible perforation.  She at least needed an ultrasound to know what was going on inside her belly.  She was a mother of four children and her husband had died last year.  Her mother and father-in-law were by her bedside all day. 

We decided that I would take her to the hospital that night. I didn’t want to wait for her condition to get worse.  So we told her family what we wanted to do, I got a different navigator for this trip and we all loaded inside the car.  It was another 3 hours on the road so I reached the hospital around 11pm. 

As soon as I turned off the car and heard the patient breathing, my heart sank.  My car is so loud that I hadn’t been able to hear the changes as they were occurring, but as I listened to her, I could tell that her condition had worsened considerably during the car ride.  If she’d looked like that when I’d seen her in the village, I probably wouldn’t have suggested we bring her, because there was really nothing I could think of that a hospital could do that we couldn’t do.  In her present condition, she was no longer a surgical candidate.  But what could I do? I couldn’t tell these poor people that their daughter was too far gone and pack them back up into the car to take them right back.  So I alerted the hospital that we were there and we went to get her checked in. 

It was a bit of a mess. The hospital was pretty full, so after giving her a diagnosis (without ever physically touching her) the doctor told me that I needed to take her to a hospital in Freetown. At 12:30 at night. After I’d been driving all day.  I basically said I wouldn’t go.  Oops.  I’m a nurse. I know all about full hospitals. I know all about having to transfer patients because there’s no beds.  But there WAS an empty bed, they didn’t want to use it because that’s where the nurses liked to sleep.  That’s when I put my foot down.   I know the nurses were aggravated with me for basically refusing to leave but I was really concerned that if I tried to drive another three hours I would die.  Literally. And probably kill everyone else in the car with me.  I helped the nurses to get her settled (trying to show that I wasn’t REALLY the beast that I knew they thought I was) and then set out to find a guesthouse for my navigator and myself. 

A few short hours later (I got a 6am wake- up call by the caretaker letting me know he’d warmed up some water for my shower. It was very thoughtful, but the thought of that happening at a hotel in America made me laugh out loud) we were back up and back at the hospital. 

It wasn’t time for visiting hours, but when I explained to the guard that I just wanted to go check inside to see if a patient was still alive, he let me in.  I went in and greeted her in-laws who had refused the guesthouse that night because they wanted to stay by her side.  There was no change in her condition. My heart broke for them.  At that point, I had a decision to make. I was fairly confident that this woman wasn’t going to make it.  But did I just leave them there? After working in a hospital over here, I’ve come to know that getting a dead body back to the village for burial can be much more difficult than getting a patient to the hospital. I decided that the best thing for me to do would be to settle in and do the vigil. The death vigil.  It’s something I’ve become all too accustomed to doing here.  It just means that I stay near the bedside to let the family know that I care about what’s happening to them.  They didn’t speak any Krio and I don’t speak Temne, so I couldn’t even talk to them to sympathize with them. But I believed my presence would say it in some small way. 

I called Peter to let him know what my plans were and he decided to come down to sit with me.  Twenty  minutes later I called to tell him not to come.  The doctor had seen the patient that morning and written for some labs.  The nurses gave me the paper to go pay for them but I decided to stop quickly to see the patient again.   As I stood looking at her with her mother-in-law, I noticed that she didn't appear to be breathing.  She’d passed away.  I went and called one of the nurses to verify and as I started crying while I was standing there, her mother-in-law understood my tears.  She started crying as well. 

As I sat there crying with this elderly woman, I started thinking about she and her family.  The patient had four children who were now orphans.  The burden of their care would now fall to this woman and her elderly husband.  Most likely, these kids won’t find adults who will be able to love and provide for them like their parents did.  It’s common here for children to be given to other people to be raised, but the majority are not treated like children, more like servants.  It was a devastating blow to this family.  And we wept.

When we got back to the village, the team and I cried again.  I was sad that this happened and that the team had to witness this tragedy.  But at the same time, this is the reality of working in Sierra Leone. Sometimes you do everything you possibly can, but it’s still not enough. Tragedy prevails.  So you cry and you mourn. And then you get up and do it again tomorrow because…….sometimes the outcomes are different. Sometimes we win.  And because we’re serving Jesus, we work hard, love well, and leave the results up to Him. 

Sweet Salone..........

Well, back “home”  (sorry Mom) in Sierra Leone.  To be honest, I was a little worried when I went home this year.  Every year when I go home I have the following conversation with Jesus.

Me: “Jesus…..I love being home! Are you SURE I should stay in Sierra Leone?”

Jesus: “Well Emily, you know you can glorify me anywhere, but it seems like Sierra Leone is a good place for you to be right now.”
Me: “Yeah, ok…..I get that.”

Every. Year. 

This year I put up more of a fight.  And I blame my family.  Completely.  I always have so much fun with them, but this year Marie got to spend time with her grandparents, cousins, etc. and it was so fun watching them all get to know each other.  Plus last year when I was in America I had Peter and Marie waiting for me back in Sierra Leone but this year they were WITH me in America.  So it was the perfect situation for me! J  As my time in America started creeping to a close, I got worried as there was a big part of me that still wanted to stay.  BUT!! Praise the Lord about a week and a half before I was supposed to go back I started getting excited and felt ready.  Thanks Jesus!!  Since coming back, I’ve only gotten more excited about the future ministry potential here.

I spent the first week or so down in Freetown getting readjusted to everything “Salone.”  I was planning on staying in Freetown until both my teams from home come and leave, but I had a break in my schedule so decided to make a quick trip up to my village to see my friends. 

Coming back was awesome!! Last year when I was gone I had a little break-in occur at my house so this year I asked a teenager that I really trusted if he wanted to stay at my house while I was gone.  What a great idea!!! Instead of coming home to a house that hadn’t been lived in for a couple months, I came home to a house that was cleaner than I’d ever seen it!! My neighbor said it was a little embarrassing how much dirt he got out of my house.  I might be embarrassed…..if I wasn’t so thankful!!  He even decorated my living room with snowflakes and a white paper chain. J

I decided to work a few days while I am here. Nicole is a teenager from my hometown who came to hang out with me for a couple months so I took advantage of the free babysitting (and amazing cooking and cleaning……..please Nicole, can you stay forever?) and headed back to my stomping grounds of the OB ward.

As I walked into the ward I noticed that the oxygen cord was running across the walkway, which is never a good sign. It wasn’t for a laboring woman though, but for a little 3 week old baby that had been admitted the evening before. The initial diagnosis was an acute respiratory infection but earlier in the day the nurse had noticed that the baby’s abdomen was also really distended and firm.  The baby’s work of breathing had also worsened and the history included 3 days of no bowel movement.  A tube was inserted into the baby’s bottom and lots of gas came out, along with a little bit of liquid. (Sorry for the graphic details. I’m a nurse. It can’t be helped.) The belly looked better and the baby started breathing easier.  This had happened a couple times during the day, but the last time the nurse tried it, nothing came out and the baby continued to breathe with difficulty.  That’s when she’d started the oxygen.

When I went to look at the baby, I remembered a medicine that we could try to see if we could get his belly to start working better.  We don’t have a working ultrasound here at the moment, so we had no way to know exactly what was going on inside his abdomen.  I discussed the need for a transfer to a bigger hospital to his family, but they opted to wait and see if this medicine worked first.

He was very dehydrated so we wanted to start an IV.  Unfortunately several of us tried many times, but just couldn’t get a vein. He was too dehydrated.  If only I had a doctor here who could start an inter-osseous IV.  Ugh!  We kept giving him breast milk by spoon, but it just seemed too little too late.

More of the history started emerging and it seems that when the baby initially started getting sick, the family decided to give him some “country medicine.”  I’m not sure what exactly is in this country medicine, and although I’m all for natural remedies to diseases, I’ve unfortunately seen this given many times with fatal consequences.  Throughout my shift the baby’s temperature continued to rise, despite the Tylenol that we were giving him. I knew that a temperature of 104 was not going to help his hydration status.  I started him on the strongest antibiotic we have, hoping that would give him a chance to fight whatever infection was making him so sick.  As I left that night, I was fairly certain I knew what the outcome would be.  The next morning when I went down to check on him, my suspicions were confirmed. He’d died at 5am that morning.

I was sad. I was sad for his family that had watched him grow inside his mommy’s belly for 9 months and then only had a few short weeks with him. I was sad for the lack of education that can make a dangerous situation deadly. I was sad that we’d done everything we could possibly do…..but it was just so little, and it just wasn’t enough.  I’m embarking on my fourth year in Sierra Leone.  My prayer this year is to not allow myself to become jaded.  We’re surrounded by death so much that it can become easier to deal with. Lord, please don’t let it become so easy that I become complacent or lose my compassion. Please! Please give me Your unceasingly compassionate heart!

Going to the chapel and we're.....going to get.......

So…..there’s this boy, Peter. We started talking last September, and although I often seem to OVERshare about my personal life on this blog, I’ve been pretty mum about this fella.  At least online.  Part of the reason I’ve been quiet is because I wasn’t really sure what to call him. I HATE the word “boyfriend” as it just conjures up memories of 15 year old girls draped over these prepubescent boys who just KNEW they were going to be together forever……or at least until the homecoming dance was over.  I know it’s ridiculous. Plenty of people….just as old as myself, have boyfriends. But seriously, even as I write this, I give a little involuntary shudder.  Just can’t help it. So I have had this….”Friend” Peter, for a while now.

The other reason I’ve been quiet is because as much as I’ve liked this guy from the beginning…..the odds just seemed against us.  Different cultures, different upbringings, different way we’ve always viewed the world. How could this possibly work?!?!  For that reason, while a lot of my friends and family knew I was talking to someone, I decided to keep Facebook out of the loop, as I didn’t need the ole’ “Oh…sorry.” “Don’t worry, there’s someone out there for you” kind of comments, if by chance the status changed back to single. No. Thank. You.  (One of my friends eventually did hack into my Facebook account and change my relationship status….after it had become more an issue of me digging my heels in and refusing to change it simply because I’m ridiculously stubborn). 

I come back to America every year for 2 months. This trip home was a pretty big deal because not only was I bringing my new daughter, but my new…..friend….as well.  Time to spend some time with the fam!!  Peter met my parents last March when they came over for a medical team.  Boy was that awkward!  During that week, my parents, Peter and I sat down for the big “talk.”  At the end of the discussion, my parents gave the go ahead, but asked that we wait for 2 years before getting married. (Yes, I know I was 31 years old at the time, had lived overseas by myself for years, and was a mother….but I still wanted my parents’ approval. They have loved me longer than anyone else and I trusted that they had my best interests at heart. I really wanted them on board with the second biggest decision I’d ever make!)  

So while Peter had met them before, this trip would take it to another level, as they’d get a chance to really know him.  It didn’t take him long to win my family over, and with this final piece of the puzzle in place, I finally felt ready to say…ok.  Let’s get married. (He was pretty confident from the beginning that this would be the outcome. I needed some time!) 

My dad wanted to start the 2 years ticking in March of 2013, the first time they met.  Since Peter and I had been talking since the previous September (2012) (or beginning of October if you want to be a stickler and don’t count the phone conversations that consisted of “I’m not interested….please stop calling me” as dating) I pointed out that he was adding on quite a few months. Like six!  Since neither Peter or I are spring chickens, I channeled my inner Sierra Leonean and bartered until we compromised on  January of 2013.  Plenty of time to figure this whole thing out.    

So we came home this year and have been having a great time. It’s been so nice because I knew that we worked really well, together in Sierra Leone, but had some lingering questions of what our relationship would look like in America.  (Although we plan on living in Sierra Leone, you never know what will happen).  A few weeks ago, I had a lightbulb moment where it just hit me.  This guy is incredible.  He loves Jesus so much, is so kind, so patient…… and just…so great!  I love being around him….and want to be around him forever! J So that was it.  I was ready to marry him. 

Up until that point, all of our discussions of the future had been “IF we get married…….” Now it changed to “When…..”  But we still had a long time.  I’d managed to finagle the potential wedding date from January to November (thanks to the million holidays around that time) but we were still looking at a long time. Since we didn’t want to be engaged for more than six months, we were thinking of getting engaged in the spring or summer.   I’m marrying a Sierra Leonean. They don’t do big proposals in Sierra Leone like they do here.  Since I’m kind of a no frills girl, I told Peter (and probably even more importantly, my sister) that I didn’t need a big proposal when the time came.  It would just be weird.

My birthday was on Tuesday.  A few weeks ago, my sister started talking about wanting to give me a birthday surprise.  She wasn’t sure what we’d do but when I started getting excited about it, she’d caution me that it was NOT a big deal.  Birthday surprise turned into “Birthday Day Long Surprise.”  I pumped Peter constantly for information but he was a fortress and I couldn’t get anything out of him! 

My day started out with an 8:30am massage.  Massages aren’t something I get regularly (only when someone else buys it for me) but I LOVE them.  All the hours on that horrible road to my village are washed away in an hour of good massaging. After the massage I opened up my first envelope that sent me to a spa where I met my sister and we had manicures and pedicures.  I love pedicures but had never had a manicure because I can’t stand the feel of the nail file. However, since they’d put all this work into the surprise, I decided to bite the bullet. ( My self-consciousness made me feel the the need to explain to the manicurist why one of my middle fingers was slanted---crafting accident last year---and why she couldn’t really touch the tip of my thumb because it might start bleeding again –cooking accident the day before). 

After our pampering, Peter met me at the salon….and he looked hot!! J  All dressed up in the suit we’d bought him a couple weeks ago.  But I was confused. Why in the world was he in a suit?  I always tease him for being way more fancy than me and would only let him bring 3 pairs of “fancy pants” to America because we’re just more casual here.  Although I was surprised, when I thought about it, I just chalked it up to him “being Sierra Leonean” and thought my birthday was a good excuse to try out his new suit.

The next envelope I opened said that one of Elisabeth’s favorite things to do with Aaron is take a nice drive with some warm drinks. She enclosed a giftcard for Starbucks and directions to a location I’d never been to before.   I started driving north on I5 and kept asking Peter where we were going. He looked genuinely confused as well. He asked if we were going to my church in Jefferson, but I told him we were headed in the opposite direction.  We kept driving and after Peter kept mentioning a church that I liked, I finally figured out that she was probably sending us to one of these old, historic churches I’d seen online.

We got lost, turned around a few times but eventually found where we were supposed to go.  The directions on the card said to look around, so we did. I was really into the history of the church so started reading all the little placards.  After we had read everything at the church I suggested we move to the historic little cabin nearby.  He said, “maybe in a bit” which I remember thinking was odd because there was really nothing else to do at the church. He was talking a LOT (he’s usually not much of a talker), saying all sorts of sweet things about why he loves me.  He seemed kind of nervous.  He mentioned seeing a sign in my sister’s house talking about a family turning a house into a home and said that he wanted to make a home with me.  At this point we were in front of the doors of the church and he took my hands and told me that he wanted to marry me. I said, “I know. I already told you that I’m ready to marry you…..” Then he got down on his knees …..which confused me…. so I got down on my knees too.  He pulled out a ring and asked me to marry him.  Now that part shocked me.  It wasn’t time for this yet!

Sidenote: When my grandma passed away, her sons gave me her engagement ring at the funeral. My mom had been keeping it for me and when Peter and I started discussing marriage, I pulled it out to show him.  I went to look for it later that week and couldn’t find it. I SWORE I had put it back right after I showed Peter, but couldn’t find it anywhere. I searched high and low, asked my mom and sister…but none of us could find it.  I was sure I’d lost it ….somehow, because why would anyone else be looking at it?  When Peter showed me the ring, I was shocked, super excited, but also SUPER relieved that I hadn’t lost my grandma’s ring!! How could they have let me suffer like that!?!?!? 

After the niceties that I assume are pretty typical after someone gives you a ring and says they want to spend the rest of their life with you, I made the comment that we’d be engaged for a long time!! That’s when Peter dropped the next surprise that my parents had agreed to move it up a couple months.  We could get married in the summer (which in my eyes is still only cheating the 2 years by a couple months J)!!!! 

So that’s it.  That’s the story. J My life has not turned out like I’d planned at all!!  But I’m so thankful that God has sent me this beautiful little girl to be my daughter and now a man who will be an incredible husband and father.  And that’s that. J