"Wow, I really live here now."

February 16, 2013

Greetings from Nyankunde, DRC!  As I passed through the hospital tonight shaking the hands of elderly men and saying goodbye to one of my new teenage moms, I had a moment of realization that “wow, I really live here now.”  This feeling continued as I passed into the pediatric ward where one of our nurses was lighting his nighttime lantern and preparing evening medications.  I went to visit a little girl named Furaha (which means “joy” in Swahili) who I recently diagnosed with acute rheumatic fever.  This little girl had swelling from her head to her toes, a roaring heart murmur, severe arthritic pain, and a strong history of fevers.  She was sitting over her metal bowl of fish and plantains, as happy as could be.  She was much happier to be examined by me while eating her plantain and frankly ignored me.  I asked her mother how the day went.  She reported that she had been playing outside and had not been severely short of breath.  Her neighbor was surprisingly happy to see me, a little boy with congestive heart failure-also appearing to be due to acute rheumatic fever.  He happily reported that he had not been eating ANYTHING with salt in it (as advised)!  For the first time in many days, he appeared to be feeling better and have more energy…not needing his wheelchair anymore.  That was very rewarding from a kid who could barely walk across the room only 5 days ago!  There is a surprising amount of cardiac disease out here.  Cardiac problems are exaggerated by anemia caused by malaria.

My kids with various stages of rheumatic heart disease

My teenage mom with her baby Furaha

It is a bit like my eyes are being opened just a little bit more every day that I am here.  I see lots of malnutrition and am starting to understand the complicated cultural dynamics/food security issues behind this.  It seems that children are much less likely to be malnourished in homes where the father provides for the family.  A woman may be in better health if her husband is home and she is not the sole provider for the children.  It is really important to understand the social support network of families…what food is available, who cooks at home, etc.  Eggs seem like the perfect source of protein to me, but unfortunately men are ones who eat all the eggs around here.  I am hoping this is up for discussion.  On the whole, families seem to really want their children to thrive and welcome suggestions.  Food is a very common topic of conversation around here.

My patient with Pellagra (Vitamin B3 deficiency)

Another picture of her

This past month I was very thankful that one of my teenage moms finally accepted her premature baby and was able to see them home from the hospital.  I found myself very frustrated as the mother pulled out nasogastric tubes and didn’t follow our advice.  It is really hard to watch a baby lose weight, knowing exactly what needs to happen when it isn’t happening.  God began to show me that this was a young mom who really needed to be supported and didn’t have it.  The father of the baby was a soldier and had left the mother.  The mother was also probably shunned by her family.  We worked on building rapport and encouraging the things she was doing well, instead of focusing on immature behavior.  The core issue was that she had not really accepted this child as her own.  The hospital director’s wife sat down with her and reinforced that every child is a gift from God and needs to be embraced.  She also said that there is no guarantee that God will grant her the ability to have another child, and that she needs to be responsible with what she has been given.  This was very powerful coming from another Congolese woman.  This resonated with the mother and with me.  The BONUS is that she has come to see me for weight checks and encouragement for the past two weeks.

We have been blessed to have the Barton family (and friends) with us these past two weeks.  This is Dr. Barton and his daughter Anna’s second trip to DRC.  Anna has been taking French lessons with her friend Kristina who came along.  Ian is our representative Canadian who has become quite well known in town for his beard.  We have been trying lots of new recipes from the “More With Less” cookbook by our wonderful cook Sarah.  Yesterday we tried Moussaka and coconut rice, which has quickly become a favorite!  Today I drove to the market with them to do some shopping for material to take home..we blend in quite well as you can imagine.  Dr. Andrew Barton has been training the OR staff in regional and general anesthesia.  I have learned a lot and only hope I can get the ventilators functioning when they arrive!  We are thankful they could join us.  

Ian selling beans in the market

Nyankunde market

This week I saw the Biblical account (Matthew 8: 1-4) of healing of the man with leprosy with new eyes.  There are many places in Scripture where Jesus asks those who have witnessed miracles, not to tell anyone, and the man with leprosy is no exception.  Jesus tells him specifically to present himself to the priest and offer the gift commanded by Moses as a testimony to them.  I love how Jesus means this to be a witness to God the Father to the Jewish people.  Jesus was also wanted this man to re-integrate back into society and tell others what Jesus had done for him.  I am amazed at the wisdom in this.  I am sure Jesus did not want to be known for the miracles themselves, but for changed lives.  As I think about applying this to my own life, I ask myself what do I say when I witness healing.  Do I think, “What a great decision I made to treat this or that…or “He was healed because of this or that antibiotic.”  My first response is to ascribe healing to science.  But I need to take these opportunities to give thanks and glory to God.  I know there is much commentary when I step away from a bedside…this might be related to what I am wearing, my mispronunciations of Swahili, dietary instructions given, or what a child’s weight was.  It is my hope that when I leave a bedside that people will say, “Look what God has done!”  Personally, I am learning how to give God the glory for healings and ask more about people’s needs.

Warren and I are doing well and taking one day at a time, to rely on God for our daily needs.  There are numerous challenges, but so many blessings.  We are becoming rich in relationships.

 Thanks for  your friendship and involvement in our lives!

Love,

Lindsey (for us)

Arrival in Nyankunde in Photos

 Here is a little photo journey of the month of January 2013 at Nyankunde

Traveling into DRC from Uganda across Lake Albert

Our first surgery in the new surgical building, a birth

A baby resuscitation

Our wonderful cook Sarah and Kristine making passion fruit juice

Local tie-dying for local sewing projects for the handicapped

Kristine conducting one of her teaching sessions with the upcoming ICU staff

Josh and Warren learning gold panning the local way

Kristine and I

Local gold mining

 

Kristine playing around

The ICU nursing class on the last day

A Sunday afternoon brunch with the boys

....a classic

Our teenage mother and her thriving preemie-a small victory

On Nyankunde mountain

Josh and his buddy

From Lindsey

January 27, 2013

…we are already one month in to our new life here at Nyankunde, Democratic Republic of Congo!  Thank you for your interest, prayers, and support as we get started here.  It is good to finally be here.  Since we have Congolese friends here, it has seemed very much like coming to a familiar place.  We are growing accustomed to the rhythm of life here.   I (Lindsey) have had my first Congolese dress made, am driving a Land Cruiser, and have begun shopping in the local markets.  Today we drove up to the top of Nyankunde mountain to see the mountain views.  It is unbelievably beautiful, rolling green hills spanning in all directions.  It would make a great place to camp and it is right outside our front door!

As many of you know, Samaritan’s Purse helped to re-build the OR/Intensive Care Unit here at Nyankunde Hospital.  We are proud to announce that the first surgeries and endoscopy procedures have commenced in the new building.  Word is spreading and slowly people are arriving for elective surgical care.  The move-in process will be a gradual one.  All of the sterilization and post-operative care still happens in another place, but eventually we will use the new building.  Our friend Kristine Foth has been here for the past month training the nursing staff in intensive care monitoring and bedside assessment/care.  Several of the nurses reflected on the old intensive care unit here “before the war.”  They seem optimistic about the future, realizing that the future of this place is in their hands.  Kristine’s last session with the nurses was on bed-making and bathing patients.  This is something that is currently the responsibility of the patient caretakers, but will change as we use the new building for on-going care.  One of the nurses remarked that she was looking forward to caring for the personal needs of patients again.  Many of the nurses view working in the new building as a new start.

I (Lindsey) am getting into the routine of pediatric practice in a village.  It is fun to be seen as the baby doctor and to be taking care of infants again.  I am learning and observing a lot and teaching pediatrics to anyone who will listen.  I think there is a lot we can do in the area of nutrition, such as routinely doing growth curves on all kids and talking about good sources of iron and protein.  I am feeling the challenges of caring for preemies in this setting.  I am starting to dabble in diagnostic echocardiograms and will be working on this skill in February.  We have already had some difficult pediatric cases out here.  Most diagnostic tests are simply not available here.  The practice of medicine here requires careful observation, a bit of conjecture (!), thinking of the worst-case scenario, and close treatment and follow-up.  Disease follows a typical course and with a bit of observance, it really is possible to know what is going on.  I am learning a lot from my Congolese colleagues and will need to learn local patterns of disease.

The fields are green all around us.  We are able to grow many fresh vegetables for ourselves and buy much of what we need locally.  A woman brings us fresh milk everyday which we then pasteurize on the stove.  All of our electricity at the house is from solar power, as is our water heater.  A wonderful woman named Sara cooks for us everyday and we are trying out some new recipes together using what is available locally.  She has been introducing us to local Congolese food.  Tomorrow we will try eggplant soup…my recipe.  We have a passion fruit tree right outside our front door which makes great juice!  We have an indoor fireplace-this has been nice on cooler nights.  Some things have become simpler (like walking to work) and other things have become more complicated and require more planning.  It is still hard to believe that we actually live here with such beauty around us. 

Warren and I plan to start taking Swahili lessons very soon.  It is a rhythmic language…and I am picking up phrases and words here and there.  To really become proficient we will need to be intentional though.  We are both thankful that we can communicate in French with the staff without much difficulty.  French is a second language here, so greetings and personal conversations happen in Swahili.  Greetings and goodbyes seem to have more of an importance here, such that you really go out of your way to say goodbye at the end of the day.  It is refreshing.  I am sure that we are making cultural faux-pas, but hopefully not too many. 

We are awaiting the arrival of a couple of shipping containers with equipment for the OR and ICU as well as some of our household items.  I am looking forward to the foodstuffs that we have packed, books, new bedding and towels, rugs, and bicycles to go exploring around on.  Work has begun to renovate the guesthouse next door-hopefully this can be completed in the next few months.

Thank you for your friendship.  We are thankful for the many friends and family who have encouraged us along this journey to Nyankunde.  We love to receive your news!

Blessings,

Lindsey and Warren

We're here at Nyankunde

Greetings from Nyankunde in the Democratic Republic of Congo.

We made it! It has been a long journey. Lindsey and I spent Christmas with my folks in Switzerland. This was a blessed time. From there we traveled to Entebbe, Uganda, where we met up with Kristine Foth, a nurse who has joined us here for a few weeks. We got a ride to the border, then took a boat across Lake Albert. It was another long and frustrating endeavor. We arrived considerably later than we had hoped. From there we had another arduous journey to Nyankunde, arriving well after dark. The road beat us up pretty good. Travel in Africa is always an adventure, but we always seem to end up on the extreme end of that gamut. Still we feel very blessed to have arrived with all of our luggage and without any major mishaps.

We have started the work at the hospital. Today we did our very first surgical operations in the new building. We did a suprapubic tube on a man with a urethral stricture, a cesarian section (a beautiful little girl), a drainage of a horrendous abscess on a baby and a man with an hernia/bowel obstruction. The new building has lost a little of its shine as it has now been baptized with various unsavory bodily fluids. Still it is amazing to see everything work! We have light, we have electricity, we have oxygen, we have cautery, we have supplies. It almost seems too good to be true!

There is much that remains to be done and much need for prayer in the days to come. There have been plenty of frustrations along the way, but God has been so good to us and we rejoice to see the work go forward.

Please pray for us as we struggle to pick up some swahili and make friends here. There are many issues involving paperwork, administrative concerns, hiring of new staff, etc.

In spite of all the challenges, it is a joy to be here and to begin the work that God has given us to do. Thanks to everyone for their prayers and support.

Sincerely,
Warren and Lindsey

P.S. No pictures... Our internet connection is miserable. Still we are fortunate to receive email if you are so led.