A Call to Nursing

   With my last post you'd think, "how can an American team get anything done at that hospital?"  That's what we thought after the first day.  It took some brainstorming.  I can not say enough how impressed I am with our nurses.  They became doctors on this trip.  I watched them struggle to translate simple things like, "have you had a fever?"  (There are no thermometers.)  I've watched them sit down and do math problems (there are no calculators) to figure out the doses of medicines they had never heard of.  I watched them take notes at 11pm to learn new skills and ways to diagnose.  I watched them drive away in a car to transport a premature, malnourished baby to another hospital- a hospital who's only step up is they have an oxygen machine.  One nurse held the body and hand-pumped air into his lungs while another nurse held his head still on the CRAZY BUMPY african roads.  May I also mention that one of these nurses flipped her car only a couple weeks ago, so she has been extremely scared all week while driving?  None of these things mattered when it came to another human-being's life.
   We've learned that the people here have a very fatalistic way of thinking- they believe that all events are predetermined and therefore inevitable.  Their actions do not matter.  They are not responsible for anything.  As bad as the Ugandan nurses seem to me, the patients seem just as bad.  I remember my mom taking me to the doctor, the doctor prescribing something, and my mom telling the doctor, "No. That is not good enough. We are not leaving until you prescribe her [this]."  The patients will hear what their child was supposed to get, yet not ask for it when they don't see it.  The culture is so different.  People die all the time here.  You grow up watching people die.  They don't understand there are actions (many times simple) that can prevent these deaths, that they can fight for life.  
   Let me tell you the story of the baby that was transported to the hospital.  One of our nurses Alicia, discovered a premature baby whose twin had already died.  The mom was only 16.  I'm pretty sure she said the baby was fine (Another thing we learned is no one here wants to disappoint, so they tell you whatever they think you want to hear.) but Alicia opened the blanket to discover an extremely malnourished and jaundiced baby.  She could see his heart, his ribs, etc. He was only breathing 10x a minute opposed to the 60 something times he should have been.  Finally they got it out of the mom that he had not eaten since birth.  Our nurses said they wanted to cry when they discovered this baby was a full week old.  After much difficulty we learned the mom wasn't breastfeeding because of some kind of superstition.  She believed the baby would be cursed if she breastfed him before certain rituals were done.  The ugandan worker who translated for us was the only assertive ugandan woman I've met here.  She had us pray over the mom and baby (in their language) that the baby would not be cursed and would start sucking.  In Jesus' Name.  Amen.  Immediately another one of our nurses, Amanda, went to put the breast pump (a cut-up plastic water bottle with some kind of suction thing taped to it) to the mom's breast in hopes there was still some left for us to use in an eye dropper to drip milk into the baby's mouth, however our translator wouldn't let her!  She said, "we prayed he would suck so he will suck".  As frustrating as this was our nurses kept their cool the whole trip.  After the translator left they squeezed some milk out for the baby.  By this point he had an I.V. and seemed more alert.  He actually started sucking!  Understandably the nurses were still very worried about him.  The next day he got to the point where he was only breathing six times a minute.  This is when they took the car to the hospital in the city.  (The hospital does have an ambulance (a van with a light?) but it is unreliable.)  Alicia and Katie, our other amazing nurse who transported the baby, did say the mom was shaking and showing emotion.  The Chief Medical Officer of our hospital went and pulled the father out of the local drinking hole and gave the family money for food, expenses.  This morning Katie and Alicia went back to the new hospital to check on the baby.  At first they heard he had died.  Then they heard, no, his parents unplugged his oxygen and left at 5am.  Our Chief Medical Officer said he will go to the village and find the family.  He was not happy, and we're sure he will do it.  He is great, but I'm not sure he would have done all of this without the nurses' persistence.  I think now we understand though, that he knew something like this could happen.  Still, I'm glad our nurses have been fighting since they got here, while at the same time "being patient in affliction".  (Romans 12)
   I went to a surgery while here and started blacking out.  Nursing will never be my gift.  At least I have the privilege of mobilizing nurses.  Thank you all nurses for everything you do.  Nursing is a beautiful calling.  We need you here in Uganda.  We're setting up short and long-term trips.  But let me tell you, the bar has been set.  Thank you Alicia, Amanda, and Katie.


...for God's gifts and his call are irrevocable.
-Romans 11:29

The malnourished (really, not nourished at all) baby.

Getting fluids 

About to get air hand-pumped.

Alicia, Katie, baby on route to hospital in Mbale

What to [Not] Expect in a Third World Hospital

Today was our last day at the hospital.  I realize I have failed to communicate what I mean when calling this a "hospital".  People come here to be treated, even Kenyans because we are so far east.  However, there are some major differences from the healthcare facilities you're used to.  Before I tell any more stories I think I should paint this picture for you.  

1.  There is no running water.  If someone chooses to wash hands/equipment (and it is a choice), they pour water over their hands from one bucket to another.  They do not always use soap.
2.  There is no electricity.  There IS a generator used in the one Operating Room to power some sort of sterilizing machine that I believe is from the '70s.  Neither the generator or machine always work.
3.  Trash is thrown in an old cardboard box, totally open, if it is thrown away at all.  I know I saw bloody bandages on top of patient files in the children's ward.
4.  By "ward" I mean bitty room with 12 beds shoved right next to each other. 
5.  Food is not provided.  You must bring your own.  Many family members cook/do laundry right in the yard of the hospital.
6.  Linens are not provided.  You have to duck under clotheslines as you walk from ward to ward. 
7.  Clothes are not required.  Toddler's go around with their behinds flappin' in the breeze.  I definitely saw poop on the back of a child's leg today walking around in the children's ward.  I think he was there with a sibling who was admitted.  If you are a nurse and want to bring your toddler to work with you that is fine too.  
8.  You must bring your own toilet paper for the hole you squat over in the outhouse.  Let me tell you, you can't call yourself a World Traveler until you've gone "number two" in this place.  I am now a World Traveler squared.
9.  You wait in line ALL DAY.  You first see someone who gives you a consultation.  Then you wait in line for treatment.  That person may then tell you to wait in line for the doctor.  Hopefully you don't need surgery and you are then just in line for pharmacy.  There is a government pharmacy you go to first.  If they don't have what you need, you wait in line for the private pharmacy.  The line waiting is even MORE complicated than this believeitornot.
10.  The private pharmacy pretty much tells everyone, "out of stock", and turns people away.
11.  The drugs they DO have sit out with the tops off, barely organized.  Some are even in containers for different drugs, but at least they write over the containers in sharpie right?  
12.  Any writing is a miracle and deserves much praise.  If you are able to find a patient's records/treatment sheet, THAT is extraordinary.  If it actually has notes in it- THAT is a supernatural phenomenon.  
13.  If you get upset with a nurse for not writing anything, not giving medication, you are the biggest jerk in Uganda.
14.  She may even put a curse on you.  Some of the nurses are also witch doctors.
15.  There are zero consequences for any of these actions.      


I'm not always trying to be Negative Nancy, but I know people (Mom, Grandma) who were probably picturing something else when I said I was working in a hospital.  This hospital has actually improved a great deal from what I understand.  Hopefully more will come from my being here and witnessing these things.  (Of course not everything I mentioned needs to change necessarily.  It's a different place with different customs.)  A lot of good came from the amazing nurses/doctor who accompanied us.  I'll share more soon.  Thanks for praying :)

Bugobero Hospital

Lines. Hopefully we can figure out how to get these shorter.

Part of pharmacy...definitely needs organization.

Katie getting the J-O-B DONE!

No shoes, no britches, no problem.

First Days in Uganda

   Saturday we went to the hospital here by Mbale.  It's slow on Saturday, being Market Day, so we mostly just got a tour and met everyone.  Yesterday we went on the. best. hike. you. will. ever. take. in. your. life. oh. my. gosh.  It was in Sipi Falls.  We drove through the mountains, walked through the bush right by families hanging out by their thatched roofs, went under waterfalls, went through jungles, ran from gorillas, slid down cliffs, and saw the most amazing views.  A couple boys joined us on our hike.  A boy named Peter helped Alicia most of the way.  I think if he had a jacket he would have put it over the puddles for her.
   Today was our first real day in the hospital.  SafeWorld has been working in Luwero since 2008, but this is our first time in Mbale.  (Will share the cool reason for that eventually.)  Because of this however it was a big learning experience.  We're taking notes and will have an awesome prep packet for the next trip.  This team has been great.  They're excited to be the guinea pigs and help us design what we hope will be a long partnership with this hospital.  We struggled understanding the flow of the place at first.  There definitely needs to be more organization.  Most of the time at the hospital for me has consisted of getting records and inventory in order.  Dear Pharmacy Friends, the Ugandan nurse Annette quickly took over my job taking inventory of the drugs.  I was writing the pharmaceutical company's name instead of the drug's.  Really could have used y'all there.
   Some Stories:
   Our surgeon Jeremy went in the operating room to help with a hernia surgery.  What he thought would have been a small incision and quick operation was not.  He walked in to the man's intestines hanging out.  I'm not that familiar with hernias, but I think because the man had had it for so long a lot of other stuff got messed up.  They also had to remove his appendix and a testes.  Yeah.   
   One of our nurses, Alicia, helped deliver a baby.  THEN a mom who had delivered twins (boy/girl) asked Alicia what she would name them.  First she said, "Alicia".  The mom didn't seem to like that one, haha.  Then she said she likes the names "Jude" and "Joy".  When she walked by later she heard someone say, "yeah so the twins Jude and Joy..."  She got to name Ugandan babies! So jealous!  It's probably for the best.  I would have had too much fun with that.    "Do you like the name Gamecock?  It's really popular in the U.S."
   You know those adorable photos all your friends who've been to Africa have of them surrounded by dozens of black children hugging them with the biggest grins?  Yeah I won't have those.  Some school let out kids around 4 and they MOBBED us.  Alicia did a good job singing songs/running around with them.  Sarah and Rachel seemed to like it.  Not my thing.  In Haiti I could kind of communicate with the kids.  The language barrier here seems impassable.  The kids just stare at you expecting you to entertain them.  (Also I think they're perfectly entertained staring at us, but come on, that's weird.)  I feel so much pressure to perform!  I did sketch some portraits.  That was up my alley and theirs too it seemed.  
   I'm excited for tomorrow.  We had a team meeting and now know what to expect, where we can help,  what we need to ask.  
   What You Can Pray For:
-Better communication between our team and the staff.  Hopefully we can all learn from eachother.  Remember, there's not only a language barrier, but often times a culture barrier.
-It's my first rodeo.  Matt and Blake leave for meetings tomorrow.  We won't meet up with them until Friday.  Please pray that I don't mess anything up too bad leading the team.  I'm going to be watching everything at the hospital tomorrow.  I need to figure out how we can improve things for patients, the staff, and teams.  Seeing as I don't know common drugs vs. pharmaceutical companies, I'm worried my expertise in the medical sector could hinder this job.

CLICK FOR VIDEO OF DOCTOR USING EYEOLOGY TO EXAMINE ALICIA

CLICK FOR VIDEO OF KIDS LEARNING THE CHICKEN DANCE

CLICK FOR VIDEO OF KIDS SINGING HEAD, SHOULDERS, KNEES, AND TOES

CLICK FOR VIDEO OF KATIE TEACHING PATTY-CAKE

Group shot.  Sarah said she could photoshop sunglasses on me.

The Interns.  Obviously I missed the attire memo.

Peter helping Alicia.

Didn't know they were there.

I stopped and did this approximately every 17 seconds.

Alicia got to deliver a baby!!

Alicia playing Follow The Leader.

Singing

Witch Doctors

So after a day of flying we finally made it to Kampala.  We stayed in a gorgeous hotel with an amazing breakfast.  This morning we started driving to Mbale.  On our way we stopped somewhere to meet up with one of Matt's friends.  He told us to wait for him in this conference that was going on.  We found a bunch of Ugandan men in their dress shirts sitting at fancy tables.  There was no room for us so we went to a side room and ordered lunch.  After awhile Matt's friend came by to say, "hi".  His friend was Bob Goff.  I had never heard of him until working for SafeWorld, but have found out he is awesome.  That's his thing though.  He says you should be awesome, but secretly.  Goff is a lawyer who found a loophole in the Ugandan constitution so that he could get on Uganda's Supreme Court.  He's an American on Uganda's Supreme Court.  It's crazy!!!  He brings over his team and expedites all these cases that have been in limbo for years.  He told us if a dad doesn't like the young man his daughter has been hanging out with then he will accuse the man of assaulting her.  This is a common thing and these young men will just sit in jail for years!  I don't know why he's making things go so much faster, but whatever he's doing is working.  
   Unfortunately child sacrifice has been on the rise in Uganda.  He doesn't know why but people will see witch doctors and ask them for a child's body/blood thinking it will help them grow crops or something.  Before Goff came over no one would try a witch doctor.  They were too scared of them.  Goff said he finally found a scrappy judge to try them.  There was a little boy named Rodrick we saw on the compound today.  He looked about eight.  Evidently a witch doctor cut off his penis.  Rodrick miraculously escaped.  He was found collapsed on the side of the road.  Goff has been given temporary custody of him.  Roderick didn't know it, but Goff is flying him out to the US tonight for surgery.  A plastic surgeon said he could fix Rodrick!
   Goff was able to have the witch doctor tried and sent to jail for life.  This is the first time this has happened.  Oh, and so the conference we were at- those were all witch doctors.  Goff held this nice conference for all the witch doctors in the area to let them know what the laws are.  Once he got them there he made sure they understood that all he needed to know was "when" and "where" and he would put them in jail for life.  Hopefully now the witch doctors know he's the real deal, or if not, other judges start to see that this can be done.
   The most beautiful thing Goff told us today was how he wants to see redemption for people through this.  He visited the witch doctor who mutilated Roderick today in prison.  I mean, how many lawyers do that?  He wanted to see how he was doing (at this 3,000 man prison that was built for 600).  At the end of the conversation they got to talking about Jesus.  Goff said the witch said he wanted what Goff had.  He wanted Jesus to forgive his sins.  Wow.  Let's pray that child sacrifice/mutilation ends in Uganda and that the love of Jesus would change hearts.
   Tonight we are sleeping in Mbale- not Luwero like I said before.  I don't have time to explain all the new stuff going on, exciting as it is, but I will soon.  Because of this "new stuff" we will be in Mbale for the most part, traveling to Luwero some.  Tomorrow we go to a hospital here.  There will be some tough stuff to see.  Blake and Matt visited a hospital back by Luwero the other day. You can read about that on Blake's blog: http://beyondblake.wordpress.com/  and then Matt's blog: http://ethoshift.wordpress.com/ .  Follow along with them too.


Do not be overcome by evil, but overcome evil with good.
-Romans 12:21

Matt, Bob, Blake

Leaving for Uganda

   Tomorrow we fly out of Dulles Airport to UGANDA!  I would have never dreamed I would be doing this a year ago.  The cool thing is that it doesn't seem that weird to be going now though.  I've heard about our Ugandan staff Henry and Grace for a year.  I'm dying to finally meet these people who are my coworkers.  For a year I've read up on Ugandan news, looked at Ugandan maps, read bunches of blogs.  It's not THAT foreign of a place to me as it is for the stranger who asks what I do for a living.  It's just another piece of God's creation that happens to be a little farther from the piece I grew up on. 

   I wish the language barrier wasn't there!  We will have translators though.  We meet our team of doctors, nurses, and laypeople in the morning.  In Uganda we will set up medical clinics, distribute mosquito nets, check on hygiene/sanitation, and more.  I will try to blog while we are there, but only God knows if there's enough time/internet for that.  Our director Matt has been doing the tweet thing.  I can't always tell who's talking to who, but if you like Twitter you can follow Matt at @chambers_matt.  

   Finally I just ask you pray God's will would be done.  There's some BIG changes for SafeWorld I haven't shared on here yet.  I can tell you a lot more coming back from this trip.  Can't wait!

 Then Moses said to him, “If your Presence does not go with us, do not send us up from here.  How will anyone know that you are pleased with me and with your people unless you go with us? What else will distinguish me and your people from all the other people on the face of the earth?”
  And the LORD said to Moses, “I will do the very thing you have asked, because I am pleased with you and I know you by name.”
-Exodus 33:15-17