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

Leavin.....on a jet plane!

October 13^th.  That’s the last day that I wrote a blog. Oops!  I have several of them mostly written in my head (the witch doctor that was dancing outside my house in an effort to find the thief who stole my neighbor’s things…..the day I had three deliveries in a day and may have finally overcome my reflexive urge to vomit from nervousness every time a laboring woman comes in, etc). But it’s old news now, so I’ll just have to leave those blogs to your imagination (and please imagine them to be the perfect balance of information, hilarity and emotion.

It’s 4am now and jet lag has me wide awake write a blog about the most recent exciting event in my life.  My trip home!! In order to tell it well, I have to go back a bit to explain my travelling buddies.  One of the reasons I was so frantic in my last blog to get everything legally squared away for Marie was because I knew I would need those documents to get a visa for her to go home at my usual time in November.  I figured that if I got legal custody, they would have to give me a visa for her right?  Um….wrong.  I spoke with a friend of mine who was in a similar situation.  She and her husband had obtained legal custody of a 10 year old Sierra Leonean boy who was sick. They had exhausted all the medical options in Sierra Leone so wanted to take him to the US for medical treatment. We all know that when trying to get a visa for someone, the object is to try and prove that they will come back to Sierra Leone when they’re supposed to.  Unfortunately, because such a high percentage of Sierra Leoneans DON’T come back when they’re supposed to, it’s VERY difficult to get an American visa.  My friend explained that even though they had legal custody of this little boy, the consulate was still VERY concerned that he would run away (he’d been living on the street in Salone) from them while he was in America and wouldn’t come back.  So they POURED over her documents and ended up saying something to the effect of “Ok, I’ll give you this visa, but don’t bring this boy back again and don’t bring me any more children!”  Yikes!!! 

For this reason, even after I got Marie’s legal custody papers, I was still nervous about getting her visa and was mentally preparing myself to spend my first Christmas in Salone.  Since Marie is only five and never lived on the street, I was hoping they wouldn’t think she’d run away. However my friend advised me that I had to prove I would come back with her.  I brought all the documents I could think of and just started praying!  The day of the visa interview we went in and I had a very pleasant interview experience.  There are two people that conduct the interviews (Americans) and the woman I got asked me quite a few questions, but they all seemed perfectly legitimate to me and in the end gave me a 2 year, multi-entry visa for Marie.  Woo hoo!!!  America here we come!!!

Ok, now about my second travel companion.  Oh boy.  Peter is a friend of mine and we’ve been…eh hem….talking? dating? Spending a lot of time together? for the last year or so.  My parents have met him, but we decided it would be fun for him to get to come to America with me over the holidays to spend some more time with my family and experience my culture.  To be honest, I was a little excited for him to experience what it’s like to be in a culture that’s so foreign from your own with different languages, different way of doing things, different way of thinking about things, etc.  He’s always so sympathetic when I’m feeling homesick or on the days that I “feel like I’m taking crazy pills” because everything is just SO different, but until you experience that kid of “fish out of water” experience, it’s hard to explain.  At one point he asked me how many black people there are in my town and I explained I live in a small town that isn’t very racially diverse.  However, I assured him, that I highly doubted the kids would yell “BLACK!! BLACK!!!” like they yell “WHITE WHITE” at me in Sierra Leone when I’m walking down the street.  So it wouldn’t be exactly the same……

We had a little trouble getting Marie’s application completed online so Peter’s interview was first. We took everything we could think of to prove that he would come back when he was supposed to.  It still didn't even take them five minutes to deny him a visa. Bummer. 

A friend of mine suggested that we call the American ambassador to see if he would have any sway.  As the day for the interview approached, my dad tried to call the ambassador a few times but could never get through. Then I found out that his term was over and the new one hadn’t arrived yet.  Bummer!!  Our ace in the hole plan was foiled!! 

To be honest, I was a little annoyed. Not at anyone in particular, but I was 100% sure that Peter would be denied and really didn’t want to make the 7 hour trip over a horrible road just to sit at the embassy for 4 hours and be told that once again, he couldn’t have a visa.  If we applied for a visa again, we were supposed to come with new information that would prove he was going to come back. But we'd given them everything we could think of the first time. Peter did end up getting a letter from a veterinarian telling them how many cows, sheep and goats he had……but somehow I didn’t think that would make a big difference. 

Miracle of all miracles happened though, on the interview day!  The woman that interviewed him was the same woman who had interviewed Marie and I and she recognized the name of our NGO.  She ended up calling me to the counter to ask about the nature of our relationship and the purpose of his visit. I just told her the truth.  And she gave us the visa.  We. Were. Shocked.  We both just stood there staring at her and she started laughing.  That was NOT what we were expecting!

I was so exited to go, but was also nervous!  I'd never traveled with non-citizens before and was afraid I hadn't done something correct, or wouldn't have the right documents. I was especially concerned about Marie because I did NOT want to go to prison for child-trafficking!  

The first two officials we spoke with at the airport asked if we had documents for Marie and when I said yes, they said "ok" without asking to see them. Finally someone from immigration asked to see my documents and although I was nervous, he said it looked good.  Yeah!! Safe!!!!

We went through security and as they were checking our bags a police officer came up to us and asked about Marie. I knew that the police don’t really have much to do with immigration so I explained that I had just shown my papers to the immigration man. He told us he wanted to see us after we were done.  Oh great.   After we were done he came over to us and asked to see Marie's custody papers.  I pulled them out and he started pouring over them.  At one point he looked at the document that had Marie’s parents’ thumb prints as signatures and said, “Well these people aren’t educated. You could just tell them this says anything and they would sign it.”  Um….it’s true. But that’s not what I did!! See the magistrate’s stamp and signature!!?!?  Then he pointed out a word that said “recomendating” and said, “Um, I don’t think this is the right word is it? Shouldn’t it be recommending?”  I said, well yes, that’s not the right word, but I didn’t type it up.  AND SEE HOW THE MAGISTRATE SIGNED IT!?!??!!  (At this point I was getting a little frustrated).  He said, “If this was a real court document, I don’t think there would be these mistakes..........  Oh man. I started praying!!  I also pulled out the pictures I had of Marie when I first met her and she was near death with malnutrition.  I showed them to him and he immediately changed his tune.  “This was her? What happened? Was she in a fire?” (She has wounds all over her body in the picture). Peter jumped in and started explaining that she’d been in the hospital 3 times for malnutrition and was near death before she came to live with me.  The police officer said, “Well, God decided that she shouldn’t die. Thank you for taking care and helping her.”  Thank you Lord!!!

We made it out of the airport and were ready to go!! The trip was pretty uneventful….albeit long!  I had shown Peter where we had to fly on a map before we left, but you really can’t have a concept of how long it will take until you do it. Marie did awesome!!  I was SO thankful for the little personal TV’s because she was fascinated!  The hardest part was making sure she didn’t kick they guy next to her while she was sleeping. Peter and I learned after that to put her in between us! 

Food and TV on a plane. Could life get better?

First Starbucks!

Marie getting prepared to step off the moving sidewalk

My favorite moment was when we went on the moving sidewalk things and the escalator.  Marie LOVED them but every time we got close to the end she would start saying “oh! Oh! Oh! Oh!”  Our flight from Brussels to Chicago was delayed so we were cutting it pretty close to catch our flight to Portland. Unfortunately that was the time we had to go through customs and security and seemed to have our bags checked a million times.  As Peter took our laptops out of the bag AGAIN he said, “You really have to have patience if you want to travel to this country!!   So true! 

After about 30 hours of travelling we made it to Portland and were greeted by some familiar faces. I am SO excited to be home and get to share this with Marie and Peter!  :)

Wonderful reception at the airport

I'm Legal!!

Marie came to live with me in January.  I inquired about the custody process with the Child and Social Welfare office in Makeni, which is a 4-5 hour drive from my village.  It was quite the process as I had to first get her birth certificate, her passport, bring both her parents for an interview, etc.  I started in March because I know how slow the government can be here, and wanted to have PLENTY of time to get everything in place before I hoped to travel home with her in November.  In March I was granted custody for six months as a preliminary step before beginning the adoption process.  I was assured MANY times that this was all the documentation I needed in order to travel with her. I even went to the American embassy to make sure I had the right documents.

My six months custody was supposed to end mid-November so they told me I needed an extension so my custody wouldn’t finish while I was in the States. The two men at the office assured me that it was a simple matter of getting the magistrate to sign a form.  Simple. Ha. During the last month I’ve made three trips down to Makeni to try and get this precious signature. First, the magistrate was out of town. Then they had changed magistrates, so the new one hadn’t started coming to court yet.  Last week was the third time we’d went down. We tried to call the men to tell them we were coming, but neither were answering their phones. 

When we arrived, we found out why. One of the men was in jail, and the other was nowhere to be found.  Apparently some motorbikes were missing and they were locking up all the suspects.  I couldn't believe it!  The men’s boss, who we’d never met before was at the office. When we explained why we were there, he told us that he had to sign off on all such cases and had never heard of our case.  When I showed him our paperwork he looked at the signatures and said that the man who was locked up had signed his name, but had used the boss’s stamp. So it was a forgery.  He said that anyone who wants to take a kiddo out of the country has to be referred directly to Freetown.  No one had ever told us that. I was devastated.  My interview for Marie’s visa is next week.  And the last eight months of work for all the custody stuff had all been for nothing.  I broke down in the office. 

We went to the man’s house who wasn’t in jail to see if we could talk to him,  but he was MIA.  So what the heck do we do now?  After talking with the bossman for a couple of hours he finally agreed to write a letter for us to the Freetown office.  I wanted to go down to Freetown on Monday, but wouldn’t you know malaria struck again and I didn’t think I’d be able to drive that far.  So Tuesday morning I woke up bright and early to head to Freetown. 

Several months ago Marie’s mom and dad started having some marital problems so she went to stay in Freetown with her brother. Her father decided it was time to reconcile, so I picked him up on the way down so he could go see her family in Freetown. (Dropping him off is worth a whole blog in itself as I found myself in one of the most uncomfortable positions I've ever been in.  And that's saying something!)

Wednesday morning I headed to the office. My dad is coming early Tuesday morning and Marie’s visa interview is for the day after he leaves. This meant that I had four days to get this paper done. Four days. Dealing with the government.  Impossible.

I went to the office and they told me that sure enough, the paperwork I had wouldn’t get me anywhere. Except maybe Pademba Road (the prison) for child trafficking.  NOT where I wanted to go.  They told me what I needed and praise Jesus I had everything I needed INCLUDING both of her parents in Freetown. What are the odds???????

After two VERY long days of waiting at the office, I emerged last night at about 6pm with my official, court mandated custody paper and a letter from social services saying that I was permitted to travel with Marie.  And the only money I had to give was the “fee” for the magistrates signature. I wasn’t sure if it was a bribe or not.  I’ve always had a strict no bribing policy so I wasn’t sure what to do.  I talked with some other people who had gone through the same thing and hadn’t paid any money either, except this magistrate “fee.” Apparently there’s not a way to get around it.  So I paid it. For better or worse…..God judge me as You will.  All in all I couldn’t BELIEVE that everything had gone that well….that fast, without greasing the palms of everyone involved.  They really really really tried hard for me!!

My precious document!!

As I was driving home last night, I started thinking about the last week. When I arrived in Makeni and found the man I’d been dealing with in jail, I was devastated. Surely this meant I wouldn’t be going home!  As I thought about it though, I realized that if they hadn’t gone to jail, their boss probably wouldn’t have shown up.  (Their boss is the regional supervisor so travels a lot and has never been there when I’ve been there).  If their boss hadn’t shown up, I never would have known that I had the wrong paperwork. I would have gone to the interview and been told to go take a hike. I had this mental image of me sitting in the office crying, thinking all was lost when God was there saying, “Emily….this is for the best! I know it doesn’t seem like it right now, but wait and see!” I don’t like to get all philosophical….because I’m just not that good at it. But it really made me think about all the other times in my life that things seemed lost, doomed, destroyed.  And I cry and fuss and grumble (sometimes the things really are HARD!!)  But Emily (sometimes if I use my name when I talk to myself it makes me pay better attention to myself)….don’t you think that God is still saying, “Emily…this is for the best! I know it doesn’t seem like it right now, but wait and see!” 

Things worked out really well this time.  And by “really well” I mean that they ended how I wanted them too. And I’m SO SO SO thankful for that.  There are other things in my life that I’m still “waiting to see” how they’re going to end up for my good.  But I’m thankful for this little reminder that THEY WILL!!  Even if I don’t see how until I’m in heaven.  Thank you, Lord Jesus, SO much for your faithfulness! 

Final Musa Update

Musa died early Sunday morning. For the last two weeks, he hasn’t been doing well. He got another kidney infection, was in a lot of pain (suspected a sickle cell crisis which is often precipitated by infection) and wasn’t peeing, no matter how much medicine I gave him. I kept offering to have him admitted to the hospital because they would be able to manage his pain easier and he would be closely monitored. But he kept putting me off and settled for my daily visits to give him pain medicine injections and IV Lasix (to try  and make him urinate).

I had to go to Makeni on Tuesday for some custody stuff for Marie and ended up being delayed there until Friday. I called to check on him on Wed. and he didn’t sound great. I encouraged him to go to the hospital but when I called the next morning his mom told me that he was afraid to go if I wasn’t there. I pushed it and he started feeling badly enough that he finally agreed.

I got back Friday afternoon and immediately went to see him. He didn’t look well.  The next day was Saturday and I had to work. It was initially slow so I got to spend some time with him.  He wanted to go outside so we spread a mat for him and he and I went to sit outside so he could feel the sun on his face.  He was having a lot of trouble breathing but he started talking about Job (from the Bible).  We’d done a study about Job and his suffering and the following Sunday he’d gone to church with my friend Peter and they also preached about Job. I guess it stuck.  He said that Job suffered a lot but didn’t understand why.  He said he also didn’t understand why he had to suffer so much, but that he was trusting that God had a reason.  Somehow.  He then started quoting the twenty-third psalm.  As I write this I’m realizing that this was the last conversation I had with him.

Shortly after this I got a critical patient and was busy doing an emergency c-section.  Musa started seizing. He would seize and then go into his post ictal state (kind of unconscious---like a deep sleep). He would then wake up for a few hours but would seize again. His seizures were violent and at one point he broke off two of his teeth.  His faithful brother held the guard in his mouth for hours so he wouldn’t chomp down on his tongue.

After he seized he would wake up enough to make eye contact and I knew he saw me because he would do this little eyebrow raise that we always did to each other.  That night I went home for a couple hours but went back around 10pm. I wasn’t sure if he would die that night, but I knew I had to be there if he was going to.  At around 11:30 I laid down on one of the extra beds and dozed on and off until 1am. I heard his breathing change and sure enough, he’d started seizing again. After this one he never regained consciousness. 

It was painful to watch.  I honestly don’t know how his mother did it.  I was begging God to be merciful and take him home quickly.  His mother would leave periodically and his brother sent me out to encourage her if she was crying. At 1:30 I told her that he was sleeping. It was hard to watch him struggle for each breath like he was, but he wasn’t feeling pain. He wasn’t suffering. Shortly after that she took some of her things and went back to the house. I think she knew he was going soon. Sure enough, at 1:45am his breathing started to ease and he died.

At 2:30am I went back to my house to try and sleep. Musa’s family called me at 5am just to check on me and see if I’d stopped crying. I couldn’t believe that in the midst of their grief they were calling to see if I was ok.  Later that morning, around 8 I was getting ready to go down and check in at the hospital (I was supposed to work that day) when the family called to tell me they were waiting for me to do the burial preparations. Wait. What?!?! I have no idea what the appropriate stuff to do for a burial is. Why do they need me? I called my friend Peter and we went down to see the family.

I’d only been part of one burial here before.  This was a lot different because, as I came to realize after spending about 10 minutes in the house, instead of being the one to sympathize with the loss of the family, everyone was treating me as if I was one of the family that lost a child as well.  After the greeting formalities we all gathered in a circle and the Imam (who was also Musa’s grandfather) explained that they didn’t want to proceed in the burial plans without my approval and wanted to know if there were any special prayers or anything that I would want to do.  It was sweet that they wanted to show me that kind of respect, but I was quick to assure them that whatever they wanted to do, I was fine with.  I explained that I believed that because Musa had trusted Christ for his salvation, he was already in heaven and that my prayers were for those of us left behind who were in pain because of his absence. 

We stayed at the house for a few hours while they built a little house outside to wash the body. As they took his body out of the room to wash it, everyone stood up. I assumed it was out of respect, which it was. But Peter also explained that some people believe that if you don’t stand up when the body passes by, that you’ll be the next one to die.  Yikes.  

Periodically a new woman would come to the house and would start wailing.  People would allow her to cry for awhile and then would say “That’s enough. That’s enough.”  As we were all sitting around we started talking about Musa and sharing things about him that were nice, or made us laugh.  Some things are the same in any culture.

The burial was scheduled for 12 noon. We all met back at their house and they had a little service where they talked about Musa and his family. Then we headed for the burial site. Peter and I went ahead on his motorbike and watched as they carried the body towards us.  As they were coming, I realized that there were no women among them.  Islamic funerals don’t allow women to go to the burial site, so I stayed put and Peter joined the men to go to bury him. 

Afterwards we went back to the house where they women had been cooking up a storm and all sat around and ate rice.  We hung out for awhile and then I went back to my house to take a nice, long nap.  I’ve been spending a lot of time with Musa’s family this week. His father arrived the day after they buried him and they’re planning to do another memorial service in November. Yesterday the entire family came up to my house to “greet” me.  They just wanted to tell me that even though Musa’s gone now, they don’t want the relationship to end. At first, I thought they were talking about money, but Peter clarified and Musa’s mom said, “No, no! We’re not talking about money. I just want to be coming to greet you and I want you to be coming to greet me.”  It’s amazing to me how grief can bring people together.  My prayer is that I’ll continue to be able to love this family and that they will see Jesus!!