Friday, September 20, 2013

Everyday life at Nyankunde

September 20. 2013

This month I thought I would post pictures from everyday life.  Sometimes I forget that even this can be interesting to people.  Where do we live?  What do we eat?  What do the streets look like?  What do we enjoy doing in the evenings? 

So….we got a second African grey parrot.  He kept repeating the word “chacu,” so we decided that this was his name.  He is quite young and scrappy.  He jumps off his perch and mimics lots of birds he hears.  He likes to try anything you might be eating (loves beans and passion fruit sorbet) and even nestles under Warren’s chin.  He even like his head scratched.  Who knew that birds could be so personable?  Our first parrot Bubu is socializing more now that she has a comrade.

I love colorful African fabric prints.  Someone told me that it is rare to see straight, symmetric designs and more common to see complex, natural themes.  Within the designs are often flowers, vines, trees, water, and fruit.  Some of the designs are rather abstract.  Here is a taste of some of the designs I have seen recently.

We live in a beautiful, renovated house up the hill from the hospital.  It’s about 1/4mile walk to the hospital which also means a 1/4mile home uphill.  So just making a couple of trips everyday is a workout.  As I walked to the hospital today I stopped to pet two baby goats born last night, sunning themselves on the road.  Our water comes from a fresh water source off the mountain in back of our house.  The water undergoes an underground purification process in a series of aquifers before it arrives to our tap (designed by Swiss engineers back in the old days).
Series of aquifers at the top of the hill behind our house

Do you see our TV?

Our 9-foot long dining table

Peterson trying to come in the house

Most people do not have running water in their homes.  Most carry it from water sources set up throughout the neighborhood surrounding the hospital.  The water has been tested and shown to be good to drink-we still filter especially after hard rains.  We have a solar water heater for showering and exist almost solely off solar power. 

Solar water heater and my favorite crazy Congolese flowerI (Lindsey) even have an outdoor bathtub Warren installed for me off the garden which is wonderful on warm evenings.

Farming is a way of life in Nyankunde, yet it is a lot of work.  For many Congolese this requires hiking long distances with heavy loads on their heads, hiking up steep inclines, and terrace farming.  It is not for the faint of heart.  We have a new appreciation for how people live off what they are able to grow.  This is actually really hard to do!  We have a large garden and we have not managed to come close to doing this! We have a gardener named Soborabo who helps us cultivate the basics to put vegetables on the table every night.

I cook entirely from scratch and am continually learning new twists on things.  Eggplant curry, coconut rice, chiapatis, chili with local beans, fried plantain…etc.  Now I realized how so much of the food I was accustomed to in the US was highly processed and maybe not the healthiest.  Eating out is really a rare occasion, but we try to organize ourselves to have pizza on Saturdays and do something special.  We really do live in a “petite village.”  I wouldn’t trade our village life for city life for anything (even if there was fast food)!  We have an outdoor charcoal oven (which Warren designed) that we are trying to use more and more for baking bread and pizza.  Most Congolese are not accustomed to baking, as they are more used to eating foo-foo (manioc) and rice.  The nurses at the hospital love my banana bread as it really is novel.

Many evenings Warren and I walk or run with our dog Peterson on the nearby airstrip.  It is really quite
pleasant.  We have a chance to catch up on the day’s events are process through things together.  I am very thankful for Warren and the opportunity to work together.  When Peterson comes running it is like the parting of the Red Sea, as people scatter in either direction.  People find it amusing to watch us running with our dog and are quite intimidated by her size.  We have the airstrip mostly to ourselves!

Life is full and exciting most days, also fairly routine.  Wow, did I manage to write an update without any talk of m*d*c*n*?  Speaking of this, Warren and I are headed to Uganda in the next couple of weeks for some necessary down time and acquisition of supplies.

Thank you for your interest in our lives.  We need your prayers and look forward to hearing from you!

Thursday, September 5, 2013

Already 8 months in DRC!

September 5, 2013
Warren and I dressed up for a wedding in front of our house.
(notice the upside-downlamp fixture in the background?) 

It is my turn to write a blog update of recent events.  It is hard to believe we have been here already 8 months!  It is amazing how a place so different than anything you have ever experienced becomes home.  I wake up to the sounds of the red-eyed dove and sights of ancient green volcanic hills.  I then sit down to drink a cup of home-roasted coffee and homemade bread covered hand-churned peanut-butter….maybe even some local passion fruit juice.  Wearing my qiquembe (wrap skirt), I walk to the hospital with a bag of our very own avocados in hand for the kids in the hospital.  I start the morning in the ICU and ER to see the new admissions and sick kids and then continue onto the pediatric wards to see the nutrition cases.  At any given time 25-50% of our hospital cases are in the supplemental re-feeding program.  My eyes are becoming skilled at picking out subtle signs of nutritional deficiencies.  One common theme is that the malnourished children take MUCH LONGER to recover from any illness and illness unmasks their deficiencies.  I continue to learn a lot.

On Doctoring
In memory of Sammy
I feel that I have become a better doctor since coming here…and hopefully grown in compassion.  I have seen so many conditions for the first-time.  I am the dermatologist who has learned to distinguish various bullous lesions.  I am the cardiologist who gets to diagnose atrial/ventricular septal defects for the first-time with cardiac echo.  I am the neurologist who tells a family their child has muscular dystrophy or has had a stroke.  I am the neonatologist baffled over how a newborn can be born with severe meningitis or tetanus.  I have been truly enriched to have the opportunity to see and manage these children’s medical conditions.  It really is fun (most of the time)!

These last couple of months Warren has reminded me several times that I work in a developing world hospital and that it is not easy.  We have had some major problems with having essential medications and sometimes you have to wait for several days for the medication needed.  It is hard to see a boy that you have spent so much time managing his heart failure (over weeks) return to the hospital in a worsened state due to inability of the family to buy medications.  My response is, if I had only known we could have come up with a solution.  The reality is that this boy will live with his weak heart for the rest of his life and require these medications.  How do I maintain accessibility to medications?  Do I need to make home visits? How long should I keep another child with HIV before transferring to another facility where ARVs are available? 

There are a lot of things beyond my control.  Sometimes I see a child in clinic and see clearly that they have lymphoma/leukemia and have to tell them how serious this is.  I am not able to confirm the diagnosis, but I have a good idea what it is.  I refer them to Kampala, our closest specialty/advanced care facility.  Sometimes discouragement gets the best of me.  I diagnose a child with an advanced heart condition on echocardiogram with no means of surgery in the country.  I can give advice for her to live as long as she can, but I am limited.  There are a limited number of things that I can do something about.  Sometimes it is hard to practice medicine in a way that I feel good about when essential medications are lacking.  How do I deal with disappointment and discouragement in a healthy way?  Am I talking to Jesus about these things?  It is too much for me.  He has to help me in my weakness, assure me that He is sovereign over it all.  I am learning to accept that even giving someone a diagnosis is a gift and prevents them from searching everywhere for answers.  At times I can really relate to Paul yearning for something more, redemption of the body. 
“For the creation was subjected to frustration…in hope that the creation itself will be liberated from its bondage to decay and brought into the glorious freedom of the children of God.  We know that the whole creation has been groaning as in the pains of childbirth right up to the present time.  Not only so, but we ourselves, who have the firstfruits of the Spirit, groan inwardly as we wait eagerly for our adoption as sons, the redemption of our bodies. For in this hope we are saved.”  (Romans 8:23-24)

Free Time
Taming Bubu is not as easy as it looks!  

Warren and I are learning more about the balance between work and life, the importance of taking time off.  I am thankful that we live in such a pretty place and not behind tall walls and barbed wire of a city.  Hiking, watching the sunset, growing our own food, picking fresh guavas/avocados/mangoes from the trees surrounding us, and running anywhere with the dog are regular activities.  We go the market and cook up a storm on Saturdays and freeze homemade pizzas for the rest of the weekend.  We don’t have to cook on Sunday, so it really is a day to rest.  Then there is the occasional motorcycle ride.   My Swahili is improving slowly, such that I can say for example…”I’m amazed, so much rain is coming!”  People smile and wave.  I probably still say a lot of silly things. Ndege, ndizi, ndazi, ngazi all sound very alike to me.  As do many other words!

We are looking forward to exploring more the DRC.  About 35km from us are a series of famous caverns and waterfalls called Mt Hoyo.  We are waiting for more stability and accessibility in the area to visit this beautiful place.  Hopefully we will have a chance to see the gorillas soon too.  Pray for this country which has experienced so much war and instability…brokenness is even reflected in the natural world.  I know that God has a plan for the DRC-it must be one of the prettiest places on earth.  Have you ever thought about what the new creation will look like?  How will the world be redeemed?  I look forward to this as well.

Lindsey and Peterson on Nyankunde mountain
Warren continues his efforts to train our bird Bubu to stand on his arm.  She has been a tough bird to crack...and he is very persistent.  She is very beautiful.  We'll figure her out yet.  I am hoping to start some house plants she can climb.  Our dog Peterson continues to grow by leaps and bounds!  Most recently she has been jumping over the mop or an extended arm for fish.  She pretty much terrifies everyone who crosses paths with her, unless they know her and how she wants to befriend everyone.  We are hoping to take a short holiday to Uganda in early October to celebrate our birthdays...maybe watch some elephants.

Congolese Culture
Each day is an adventure.  Here are a few of my questions this past week.
-What does it mean when someone says they will go the market today and bring cabbage back for you?  Does this mean they will really bring it back today or tomorrow? 
-When someone says they will come over at 2pm, how long should you wait for them? 
-Does our friend Victor really want to sell us a crocodile? 
-When asked to be a witness in a wedding, what exactly does this mean?
-What is in traditional remedies?
-Why do women laugh when I seem baffled over the many types of bananas?

On Cooking
This Saturday I have invited the pediatric nurses over to our house to learn how to make banana bread in our traditional oven.  Outdoor ovens are a bit of a rarity here, as is baking bread.  Have you ever thought about why some cultures eat chiapatis or tortillas?  It is usually a bread substitute, made over a hot stone or skillet over a flame.  I will keep you updated on how the nurses enjoy bread-making.…I have a feeling this will become a bit of a tradition!

Thanks for your interest in our lives!  Drop a line.  Stay in touch.  Come out and visit!
May the Lord bless and keep you close to Him,

Our friend Lisa frothing milk "Warren style"