It was a slow day in the hospital… I have been thinking about donating blood for a while but just hadn’t gotten around to it. It’s so important though… there is a serious shortage of blood in our hospital. Women have died because they could not get blood transfusions… I haven’t donated since I was working at my old job in Tacoma… so it was really time! I am thankfully not afraid of needles so we had a little fun… enjoy the pictures =)
Well, the Lord guides me every time to the woman I am to monitor… I introduce myself and find out her name. I find her case sheets and familiarize myself to her entire pregnancy notes, ANC visits, medical history, HIV status, doctor notes, and all of the exam findings since admittance. A partograph is a universal chart used to monitor the progress of labor and the condition of the mother and baby. I keep accurate records on this chart by taking pulse, temperature, blood pressure, fluid input/output, descent of the baby head, progress of dilatation, and intensity/frequency of contractions. If IV fluids are needed I can insert an IV canula and connect a fluid line, I can administer oxytocic drugs which are used to augment labor, I encourage the mother to stay hydrated and fed, I comfort her in any way; massaging her back and legs, sometimes I sing to her, pray with her, wipe sweat from her face, clear away feces, keep her clean, I also encourage her to move into different positions to aid in labor progression. I keep close watch for any signs of complications. I take into consideration any risk factors she may have from short stature to young age. I gather the supplies she has brought for the delivery and supplement anything she is missing from our teams supply. I get the clean khangas ready for baby and get the sterile delivery kit. I draw up 10 units of oxytocin and cap it for after the delivery to aid in good contraction of the uterus. As the head descends I call over one of my instructors to watch over my shoulder. At this point in my school these are strictly our deliveries, meaning we call the shots but our instructor is always there if needed to assist or guide or answer any question. It’s procedure to double glove so my second pair of gloves is now a clean pair of sterile size sevens. I keep watch for good stretching and will make the call if an episiotomy is needed or not (preferably not!). I use two hands to guard for safe delivery of the head checking that the chin has cleared the birth canal and that the umbilical cord is not around the neck. If the cord is around the neck I take precautions to manage as needed. Then the anterior shoulder, posterior shoulder, trunk, legs are born. Then baby is brought belly to belly with mama. Hopefully baby is doing well and resuscitation won’t be needed, but if that occurs my secondary (a person assisting me by caring for the newborn) would take the baby after I quickly cut the cord, to save the newborns life. The baby is welcomed in the name of Jesus with prayer and a knitted hat! Meanwhile I inject the oxytocin intramuscularly at the thigh and stay with the mama keeping a close eye on the height of her uterus, estimating blood loss and encouraging her to push through the third stage of labor as the afterbirth is finally delivered. The end is closer, now I must be sure her uterus is well contracted and blood loss is controlled- this could mean suturing any tears or repairing an episiotomy. The mama is then cleaned up and reunited with her baby on a recovery bed. Both baby and mama are carefully observed for any signs of dehydration, infection or other complications. Vitals are taken immediately after birth, then fifteen minutes after that, then 30 minutes from the last set, and the final records are taken 1 hour after the last set. As long as no problems were detected the mama is moved from her recovery bed to the Post Natal Ward, where she will likely share a bed with 1 to 3 other women and their babies. It’s also my job to do all the clean up after the delivery and to fill out the hospital forms and our school forms. The only thing I forgot to mention is the photo session =) I always make time to take photos with my baby and mama!
So now you might have a good idea of what it’s like for me to work in the labor ward at Temeke hospital… of course what I have described would be considered a normal delivery. But no two deliveries are alike and I am trained to manage complications as well… As of today I have conducted 26 deliveries! Praise the Lord!
10:39pm tonight, after my hour and half of balancing the team finance books, I realized sadly… tomorrow is my second to last day in the labor ward! Time is quickly passing here in Tanzania and I just have to give you guys a taste of my daily life in Africa… so similar to the post I wrote back in India ‘A in the life’, I’m going to make tomorrow another rendition! So I start this blog just moments before bedtime… I just indulged in 45 minutes of Glee with some of the girls (season two, the one with Gweneth Paltrow and they do Singin in the Rain, my favorite episode) I don’t know exactly what tomorrow will hold… Father, you know the path you have for me tomorrow, will you take my hand and lead the way? Goodnight.
Guess I better share my addictions too… This is one of them; it’s a game on my ipod called Unblock Me. The goal is to move the pieces so the red block can exit the opening on the right wall. It’s what I play almost every night to make myself tired enough to fall asleep. Since Perth I have done a couple thousand of these puzzles- feel free to pray for me =)
Oh my goodness… it is so early!! To be honest I took this photo and then dozed off for another few minutes without really realizing it! Then I pulled my bible inside my mosquito net cocoon and did a little bible reading with the aid of my handy book light. Since beginning outreach I have been committing to reading the bible as much as time allows. I started at the end with Revelation and have worked my way backwards to Isaiah! I have a reading plan outline that will help me to finish reading the whole bible by the end of this school!
8:00 am Worship with the team. This is our meeting room. We have worship 2 days per week. Today the worship team took song requests and we took turns leading out whatever the Lord had shown us. It was a lovely time soaking in the presence of the One. At about 9 am we break for about 15 minutes to get our bags ready… I had to do a little last minute financial tasks (our accommodation rent money is due soon so I was getting our numbers straight in the books). Then we make the trek from our place out to the bus stop. We travel in groups according to which ward we are scheduled to work in… this is my group:
Sometimes there is no wait at all for our bus to come along.. other days it takes up to 30 minutes. Today our Temeke/Mwenge bus took only minutes to arrive and there was plenty of room for us to fit inside! Sometimes we really have to squish in… holding all our bags and hospital supplies- standing in a 2 foot square space with 3 other adults in the 95 degree weather with 100% humidity as the bus sways all around… well it can become quite sweaty.
Happy times on the bus. Today was a fun ride- about 8 of us caught the same bus and the ride become melodious as we sang worship songs and hymns. A few great conversations started up and people got to share about the hope we have in our loving God.
This is the scene as we enter the gates of the hospital.. our bus driver was so great to take us all the way to the enterance of the hospital- usually we walk a couple blocks. I love this place… there is so much life and death- I’m priviledged to be able to share in both with these beautiful Tanzanian people.
10:15am March 29, 2012 Labor room crew!! This is also Sarah’s last day in the hospital as our staff leader- she flies back to Perth, Australia on Saturday! So from far left working clockwise we have: Laura, me, Rosie, Sarah, Ingjierd, Meghann, Seini, and Caroline. We represent Austrailia, Peru, Norway, and the USA! After suiting up we come together and pray for the day- inviting the Kingdon of Heaven to invade the ward!
This was my first little man of the day… Laura delivered this wakiume (boy) within our first 20minutes and I got to be her secondary, meaning I got her supplies together, preped the oxytocin injection, and received the baby after delivery. I cleaned him up, weighed him (2.75kg), and took his first two wets of vitals. We had a lovely 45 minutes together! He is absolutely adorable! Man, I really love my job!
Next I began monitoring Siwema, a 30yr old mama. She has two kiddos at home and is in late labor now… I had a really beautiful delivery with her. We were able to try out a some different positions with her that worked really well for her body and she gave birth to a precious little boy, I have called Chad- it means God’s warrior. The highlight of my day was welcoming this little guys and then seeing the still large baby bump of her tummy! Yes! There is a second baby in there!! What!?! Her expression when I told her ‘Mbili Mototo’ (two babies). She was shocked and had this look of disbelief… she felt her tummy and almost started laughing! It was so funny and so exciting for both of us! Baby #B was taking some time so I continued monitoring Siwema, but got called away to be secondary for another delivery…
This little bundle of darlingness was my next ‘task’.. oh what a struggle it is to do this work, LOL. I was taken back by her bright eyes and look of knowing. She was so alert for a newborn! Amazing..
I was able to come back to Siwema and we did an exam and found baby B to be in a strange position with one foot way up by the head- wanting to come out together- which could get tricky… a doctor came to verify our findings and as she did she was able to hook her fingers around both feet and deliver the much smaller baby boy! I held her hand and encouraged her as her sweet little surprise baby came into the world just over 1 hour after the first baby. I named this little guy Chase, it means ‘a hunter’. I was so happy to hear his cries! His lungs were strong and he did very well with a little oxygen… Mama Siwema was so concerned and attentive to her tiny son- she didn’t want to leave his side when I brought her by the baby table before moving her to a recovery bed. But I brought the boys to her as soon as she was settled. Sometimes mamas will reject a sick or unhealthy child- especially when the other twin is so strong… but not Siwema she is a good mother, I can tell. She picked up Chase first and looked at him with wonder all the while keeping close watch on Chad too. Cute kids, beautiful mama.
Paper work… lots and lots of papers to fill out! We are responsible for the hospital records as well as our own school records.
It’s already 2:30pm… Late lunch time at the canteen! My rafiki’s (friends) Sele & Mwinye serve us everyday with these big smiles! And when we’re lucky we get to order chips myia (pictured below)!
That the end of my day at the hospital, it’s now about 3:30pm… back on the bus toward Msimbazi Centre. It’s a 30 minute bus ride home…
I took about 1 hour to work on the finance books for the team and then finished up my delivery notes to have them signed off by a leader. Now heading down our hallway of dorm rooms toward the main building for dinner! Tonight one of the German girls on our team made us a tasty German dish! Yum.
This is how we eat… all together family style at 3 tables.. We line up and serve ourselves. Every night there is one cooking eam and one clean up team, but I’m off tonight! Yay! At dinner we share stories from the day and take the days stats- to track many things like how many people received healthcare and how many babies were delivered and how many people heard the Gospel.
After dinner we spent a couple hours in “Small Groups” this is a very traditional YWAM activity! We have different themes every time, but tonight the focus was simply encouragement. We made space to be together and tell each other the things we admire about them, how we see God use them and so on. It was a really sweet time together! The photo shows my group from Left: Maj (from Denmark), me, Sarah (grew up in Peru), and Beck (from Australia).
It was 9pm by the time small groups finished… I was exhausted. I curled up on my bed and tucked in my mosquito net, read Jeremiah for a bit, played some more Unblock Me, and crashed by 10:30pm! Bring on Friday!
So this is a very typical day for me. You have seen a glimpse of my regular activities and schedule. Still the pictures and my blurbs of info can only convey the surface. There is so much more to everyday that I can’t begin to describe. It’s a depth that comes from working in life or death situations, praying moment by moment, rejoicing and sharing laughter, and being part of a group of people dedicated to serving the Lord with their whole lives! This life of mine is such a blessing… I pray that not one second would be taken for granted!
Today a mama was showing signs of progressed labor by screaming and panting and being generally very frantic and needy… laboring women in my opinion have a license to act however they please! In this case however the nurse decided to do an exam… it showed that she was still in very early labor and probably many hours away from the point of pushing. She was simply quite dramatic. This mama was unhappy to be asked to leave the labor room and return to antenatal care where all women labor until closer to pushing… so she picked up her bags of khongas and supplies and pouted the whole way until she got in front of the nurse station where I happened to be standing. In an elaborate show of defiance she dropped her bags and swooned to the floor directly at my feet… where she decided to pull off her skirt and open her legs to me and push as hard as she could. I knew the situation so I just stood there and calming expressed that I wouldn’t be catching her baby and she needed to get up. The moment was quite silly and so over the top, but now that I think back on it she was seeing that our team was getting ready to leave for the day and I think she just really wanted us to be the ones to deliver her baby and take good care of her, so she was trying to speed up a rather slow moving process for any first time mama. I smile remembering her!
Today I was posted in the post-natal ward. Upon arrival we found a tiny 2 day old baby sitting unattended next to a woman. The baby was trembling slightly, had an extreme temperature, and was severely dehydrated. Come to realize the woman beside the baby is the mother, Tobia, but she is mentally unstable and unable to care for even herself. First my frustration, over the fact that the situation went so long without anyone noticing or caring enough to help, really got the better of me. Then I had to just lay it down and focus on what could be dome now. We tried to help the mama breast feed but she wouldn’t even look at the child or anyone for that matter, Tobia just stared off and wined a little. Another mama had tried to give her a cup of porridge but she wouldn’t eat. I tried to hold the baby and her breast and do the feeding as she sat but it was not working and the baby would not latch. Critical time had passed and there was no bonding that happened, I believe babies can feel rejection and separation… We moved ahead and got 15mls of glucose saline into the baby asap using a syringe without the needle and the little girl sucked it down. Her tiny little body had dry skin, chapped lips, sunken fontanels and her umbilical cord was already almost completely dried out, after just 2 days. We then gave her an alcohol and cool water sponge bath. Her temperature came down from the danger levels and we had finally gotten the attention of the doctor on duty to make the decision to refer them both to a better hospital for special care. In past experience transfer that are not deemed critically urgent can take a very long time, so I got a can of formula from our team supply for this exact kind of moment and then went out to the pharmacy on the street and bought a bottle. I was able to make this babies first actual nourishing meal and hand over the supplies to a nurse who cared for the baby during the transfer. The mama was led into the waiting ambulance in tears saying that she didn’t want to go somewhere to die (her mind was telling her that she was not going to live if she left) I was broken for her and me and a friend quickly got permission to accompany them to the transfer hospital… we were on our way when the driver got called to pick up more transfer patients and so there wasn’t room for us, we had to go back but we calmed Tobia down and she was no longer upset when we had to leave her. I feel confident the baby will be cared for while in the hospital but from there… I worry that she will have no one. I prayed and got the name Lisel. My little Lisel is so gorgeous with a head of thick black curls and big knowing eyes… God, hold her and protect her and make a way where there seems none. Bring this baby girl a mother and help her to grow up happy, healthy, and knowing you Jesus. Amen
He is maybe 23 and he is a bajagi driver. We take these kind of autos all the time and I always make a point to ask the drivers name and see how their day is going… Tonight as five of us journeyed home from a really wonderful day at the beach, we hopped into a bajagi at a chaotic intersection in the dark and bargained our way from 10,500 to 7,000 shillings for a ride home. Peter was our driver. I asked his name and found out he spoke really good English. One of the girls asked him in a sorta silly manner if Peter knew her best friend Jesus… she persisted for a moment until he answered, “I think I have heard of him, but I don’t really know.” Woh! This was an honest answer and he stated it with curiosity. We proceeded to share the Gospel of Jesus Christ and Peter had many deep and thoughtful questions like “if God loves me then why has he given me this life- why not a better life?” “Why does God let bad things happen to innocent people?” “Is there a life after this one?” “God wants to talk to me?” “How do I become God’s child?”…. We talked about things like freewill, what sin is, who Jesus is and what he accomplished on the cross, what truth is and how God hurts when Peter hurts… It was a really amazing drive. In the end Peter received a bible in Swahili and a small gift from the Lord of some extra money. He was close to tears and tried to turn the money away. He said “why are you doing this for me sister?” I answered, “the money is not from me Peter, it is a gift from God, he must love you a lot.” We were able to get his phone number and he gave us permission to have our local Pastor friend call him and talk to him more about his questions. At our goodbye Peter said, “Wait you have my name but I do not have yours.” We had proper introductions and shook hands.. Peter said, “I have a feeling we will meet again.” I hope that we will see him again, if not here in Tanzania then in the presence of the Almighty! Thank you Lord for divine appointments!
Today I came across a mama that was having regular strong contractions… Sometimes I like to just go around the room and find out their name and pray for them to have great deliveries and healthy babies, especially at the end of the day when we are getting ready to leave. So with this mama I did the same, I got her name and put my hands on her belly and said soothing words to encourage her through a contraction, then I explained in broken Swahili that I want to pray for her in the name of Jesus. She didn’t say yes or no so I started in. I laid one hand on her head and the other on her belly. As I prayed the mama began to manifest- in my spirit I knew this was evil. I repeated over and over “in Jesus’ name” and I could feel she was not having a contraction but her head began to jerk at a strange angle and she began to growl in a deep voice and grunt. This manifestation was sudden and lasted about 20 seconds until I spoke out ‘in Jesus’ name be gone”. Then she just stopped- acted like nothing had happened… I continued to pray life over her and her baby and I rebuked the enemy and claimed freedom from any demonic spirit that would be near her… when I said Amen, I felt another contraction coming and she just breathed calming through it with me. This particular mama had interesting scars on her upper abdomen. I asked the doctor, a friend named Mary, what these markings were from. She explained that they are a from a tribal cutting ceremony where a razor blade is used to make several small cuts in a pattern and then local herbs are mixed and rubbed into the blood- it’s said to tie the person to good spirits and ward off bad things… a lot of witch doctor type of stuff. I knew instantly that I had definitely just experienced demonic activity and I claim victory over this woman and her child!
I have been talking with some of the girls about how weird it will be to go home after all of this… Our eyes have been opened to so much. Our daily conversation here is about life and death and the deep things of our God…. How hard it will be to come home and discuss traffic and the like…. Not that people are always shallow conversationalists. I’m lucky to have such amazing friends and family because I know they really care, but in general that’s just the way people talk to each other, ya know? It’s our culture, it’s our American comfy lives (that I certainly miss at times)… So this is just a little warning, I hope you will be okay at times when it might look messy to hang out with me. I am really going to need to share things, the hurts and the frustration and the hope and the need. I might need to cry with you and pray with you. I will need time to process this year of my life. I have changed in a lot of ways, but I am also the same me. I know you understand.
Today I was working in the Intensive Care Unit of Temeke hospital. In this ward are all the Eclampsia patients and all the recovering C-section mamas. Just minutes after pulling on our uniforms and praying to start the day we came around the corner to find a newborn baby sitting on the rescusitation table.. not breathing… alone… Two of my teammates jumped to action, and we all gathered to pray for a miracle. We were all holding our breath waiting for the baby to take a breath! The babies heart rate was okay but she just wouldn’t breath. Minutes passed as we called on the name of the Lord and continued to bag and mask the baby. Suddenly she started to breath! Praise God.. her breaths were normal but she was non responsive and never did cry. In the next half an hour the baby began to have better reflexes but she was still unconscious when she was transferred to a hospital with a higher level of neonatal care. My heart breaks for this little girl, I named her Dashka (means God’s Gift). She was left alone for critical minutes after her birth which now may have left her with brain damage. However we prayed our hearts out on her behalf and it’s very possible the Lord has even now healed her completely! Please pray for Dashka.
A friend needed me to go with her across the street to a vendor who sells medical supplies, because we needed some for the labor room. As we walked out I saw a woman, about 45… she was crying alone on the walkway. I felt the Lord prompt me to go to her. I just knew I was supposed to hold her. So I silently just sat down and put my arm around her… she sobbed onto my shoulder. Racking sobs from the gut… I didn’t yet know what had happened but I cried with her. I prayed out loud and held her tight. I asked her if someone has died. She said yes and cried more. Then I realized a young man sitting nearby was silently crying too. His tears were streaming down his face. I stood up and came beside him with one hand on a shoulder and I prayed for him. This all happened over about 15minutes. I was hurting with this family for their loss and I felt like I had lost someone too… and I think in a way I was grieving for the people I have lost since being away from home- because I was feeling what they felt. Full-on. Soon a group of 5 other people about my age came up to mama (as I call her) and fell at her feet wrecked with tears. These were obviously her children. I believe the Lord sent me to be there until they arrived because I felt absolutely at peace now, like it was okay for me to go and leave this family now to grieve together because mama wasn’t alone anymore. That’s my God… he sends his people to do his work and sometimes it looks like crying with a stranger.
As Dashka was being transferred a man walked into the ICU dragging his wife from her underarms… Swahili words were exchanged and the doctors allowed him to bring her inside, I helped him lift her to a bed. I could tell he wanted to stay by her side but only patients are allowed inside no matter the circumstance. I followed him to the door, put my hand on his shoulder and prayed a quick blessing, then I told him in my most encouraging voice that I would take care of her- he didn’t understand but nodded and gave a sad half smile. Zainabu is only 17 years old and about 2 minutes after lying on the bed she has a severe seizure. Her tummy is small… according to paperwork she only about 6 months pregnant. Seventeen, married, pregnant, and now unconscious after the fit. We work fast to set up an IV line and give anticonvulsant medication. Her vitals are taken and a catheter is inserted. We test her urine and find she does not have the disease we first assumed called Eclampsia. I stayed by her bed side, administering IV drugs, holding her body to the left lateral position, and making sure to keep her airway clear…. She proceeded to have 14 fits in less than 4 hours. And only just before leaving a family member was questioned further about her history… in fact she had experienced fits before her pregnancy infrequently… she has epilepsy which has been triggered and further exacerbated by her pregnancy. Every time she had a fit she quit breathing and it was taking longer and longer for her to begin breathing again after the seizing ended…. Her tongue and gums would turn purple and I would clear her throat and pray for her to take a breath! Zainabu never regained consciousness and the next day she was still there… still having fits however less often. I don’t know if her baby was still alive.
This day was memorable for me. It could have felt very heavy and depressing and disheartening… but it didn’t. I know without any doubt that I was exactly where I was needed today… and the things I took part in were needed and I made a small difference. That is a satisfying feeling.
I bet I will have some funny stories to tell about this upcoming adventure. I will cross 2 borders and see all of Kenya from my seat next to an open window (there is no AC on African buses)( There are also no toilets) We leave at 4:30am on April 10th! I’m excited for everything Uganda holds for our team. There are a lot of unknowns, but that just means the Lord wants to surprise us, right?! The possibilities for ministry include: 2 different hospitals, village tours for mobile clinics, island hopping to give immunizations and antenatal care in very remote areas in the middle of Lake Victoria (the source of the Nile River), Healthcare seminars educating local women, and partnering with several other ministries. All these possibilities and only 6 weeks in the country… means that our team will be breaking up in about 4 small rotating groups a few days at a time. And yours truly will be leading one of the teams! Pray for me- no joke… every day I will need your prayers. I’m really excited to have some- once in a lifetime- crazy beautiful- challenging and growing- memory making experiences! Thank you Jesus!!
As you may know my Birth Attendant School has 18 students, the largest school they’ve had yet. Sadly we are lacking in staff (soon to change because almost half of my school is returning to staff the next school), and we have been working most of outreach with only 2 leaders at a time. As of next week we’ll be saying farewell to several staff volunteers and our school leader, Sara. This means that the incredibly awesome Rachel will be our lone leader for the remainder of outreach. All the leaders have prayed and decided to ask 2 students to step into the role of “student-staff” and I am one of the chosen. This means I will still be a student just with a few added responsibilities. I will be responsible for our team finances, help lead groups on expeditions into the unknown (all very safe I assure you), attend staff meetings, wake up early (yes, early- I’m trusting the Lord on this one) weekdays to spend an hour covering our team with prayer, and oversee a couple student word duties. So I’m just really honored to be asked to do this and I’m also praying God will give me a refreshed heart for my team, humility to lead well and by example, and grace to do a good job. Thank you all for sticking by me and keeping me lifted in prayer- makes such a difference! Blessings!
There is nothing like stepping into an open air church- as the breeze flows past my face and I’m surrounded by beautiful smiling Africans! The African church is welcoming. The worship time is intoxicating. The Africans can sing and they can dance! Worship in the African church is not still but always moving. The rhythm boils in your heart and you can’t help but groove. The people here shake their booties and wave their arms and jump around and step back and forth. They pray with intensity and reverence and genuine humility before God. They don’t rush or brush by anyone who needs prayer. There is so much respect. The messages are real, honest and raw. They take hard looks at what God has to say about the life all around them. I am so inspired… and so challenged. There is so much freedom and bubbling joy! My cup runs over… I want to see this happen at home in the American church!
Swahili is a really cool language! Especially because this culture is so expressive! I enjoy using the little bits I have learned. The locals always get a laugh hearing my broken Swahili and encourage me to learn more. Everywhere I go I can find a Swahili teacher: on the Dalla Dalla, at the canteen, at church, in the shopping centers, at the fruit stand, in the hospital. Everyone loves to teach, so I thought I would post a few phrases and words. Someday when I come back to read this I’ll remember and smile.
Mambo How are you
Poa I’m good
Habari Are you well?
Nzuri Doing fine
Jina Laku nani what is your name?
Jina langu ni… my name is…
Asante Sana Thank you so much