Literacy in the Jungle: a family affair

Who would guess that long ago, in a land far, far away, a remote jungle people (the U*) would be reached with the Word of God, and begin to desire a way to read it for themselves? Who would guess that my great-uncle had a divinely-inspired answer to that need (and to many like it around the world) which is still bearing fruit today?  And further, what are the chances that I would join a team in March 2013 and meet a family who has been working with this same remote jungle tribe (the U*) for almost 70 years, using the tools that my great-uncle created?

The story goes something like this:
My great uncle is Rev. Robert Rice, and he and his wife Alice started the organization called LEI (Literacy Evangelism International) in 1967, and led it for many years. After Uncle Bob's death, his son Sid Rice took over the leadership of this organization and continues to this day. see this link for the complete story: LEI history.  The mission is to teach literacy through basic "primers" which demonstrate common objects/nouns, verbs and also provide simplified Bible lessons, all as a means of learning to read and write in the person's native language.  These primers have been translated into over 220 languages now, with missionaries in >40 countries.

Kathy working with the U* women on some advanced lessons

Enter Jerry and Kathy Manus, and their wonderful kids Ethan and Emma. The Manus family's involvement in Amazonas-Peru dates back several decades, when Ron & Phyllis Manus (Jerry's parents) began work with Wycliffe Bible Translators to translate the U* language into written form, and had translated the New Testament.  I think (if I have the story right) he and his wife spent ~50 years with this people, and then they handed the baton to Jerry and Kathy to continue this work. Jerry and Kathy joined LEI 19 years ago and were in Iquitos, Peru when my Uncle Bob Rice went there to help write the first primer for the U* language.  Their work continues to this day, and has joined with the work of Renew Ministries, with whom I went for the U*'s yearly meeting at Aurora 2 weeks ago. It was wonderful to see in action this work I have heard about for years in our family! 
The story continues for the U*, who have now witnessed that women actually can read.  Two years ago the leaders of their community believed this was not possible, but were willing to see if they were wrong.  Turns out they were, and women are reading... now even reading from the U* Bible, and helping to lead their people in some worship songs.  This was an amazing story, where seeds planted long before I was even born, are now growing into a beautiful tree of gospel-fruit, transformation of lives, and fulfillment of my Uncle Bob's and Ron Manus' dreams and prayers. I am honored to have witnessed this legacy of my family and the Manus family, and I marvel at the LORD's wisdom and might as He determines the times set for us and the exact places we should live. 

me, Kathy and Ron at their home in Iquitos

Jerry teaching several women at the Aurora Camp

Two U* women leading their people in song!!

Lessons from El Paralítico and El Ciego

Looking from the foot bridge toward the Rio Marañon, which recently flooded

 

(translation = The Paralytic and the Blind)
In any of the experiences I've had overseas, there are always people suffering from conditions which began way before I met them, and will (unless the LORD brings about healing) for years to come.  My least favorite conditions in this category are ones involving the eyes.
First of all, eyes are amazingly complex, intricate, and powerful. They are the lamp of the body, a window to the soul, our means of taking in our world, the tools with which you can see to read this text, powerful communicators, and often tell a story we may not even know ourselves.  Secondly, eye problems were never my forte in medical training, and thankfully (or not...) I refer people to eye specialists when there's an eye problem.  Thirdly, I recognize the finality of conditions like blindness and have nothing in my "medical bag" to treat it.
The first day we arrived to Fundo Aurora (the Aurora Camp), we were approached about Rosa, a woman suffering from blindness for several years. We were asked to go see her, no doubt in hopes that we would be able to affect her condition.  We found her in one of the Cabinas, in the back room where people slept, laying on the plank floor on her sleeping mat. She was likely in her 40s and with her mother, who appeared to be easily 60 or older, now again caring for the needs of her daughter.  Rosa's husband had led us to see her.  We used a translator from Spanish to U*, trying to obtain some details about her condition, though knowing well that there was little we could do.  One of the lovely parts of understanding Spanish, is hearing directly from the person what they have said and often knowing what they mean.  I asked how long she had been suffering from this problem with her eyes.  "Tiempo" was the answer (translated to me from U*). "Time".... she's been dealing with this for ... time.   Still curious, I pressed for more of a sense - was this 6 months time or 6 years time?  After a few words of exchange, they picked the latter.  That is Time.
Upon examining her, she had an opacified (opaque, white, cloudy) lens in the Right eye, but a different appearing cloudiness to her cornea (covering the surface of the eyes) on her Left eye.  Kathy and I had little to offer except prayer and the recommendation for her to go to Iquitos for a visit with an Ophthalmologist. This is not a simple endeavor, but likely her only chance short of a miracle to have even some restoration of her sight.  We collectively prayed for her that Monday afternoon - in English, Spanish and U* - and went on our way, meeting people and making introductions.
Thursday afternoon, I was approached again by Rosa's husband. He wanted me to see Rosa again, and was concerned about her eyes, and headaches as well this time.  Admittedly, I was initially bothered, since I had already made my diagnosis & treatment plan: blindness, unclear etiology, not something I can treat, refer to Optho.  I felt I had nothing further to offer.  However, for her headaches, we had some tylenol, knowing full well that it is but a temporary measure; so with that in mind I returned to her quiet, dark dwelling.  This time accompanying me were Jacinto, a U* leader and believer, helping with translation, and Rafael a young man from the DR team who had expressed interest in being part of our medical work, and joined me to pray for people that day. I was so glad he did.
Rosa's husband brought her out from the back sleeping quarters into the front living space of their community's Cabina, and we sat together on the simple wooden bench, rain starting to fall on the tin roof overhead. We talked about her headache, I offered some tylenol, and again explained that I had nothing to treat her eye condition.  My bothered attitude softened and tears came as I felt the hopelessness of being blind in the jungle. They nodded as Jacinto translated, but then we offered again to pray for her, for them as a family.  They agreed.  Rafael and I prayed in Spanish, as did Jacinto, and we heard him praying for them to have faith, like the Paralytic, and his friends, reminding us as well as the LORD that Jesus healed such hopeless conditions... like paralysis, like blindness. 
As we finished praying, Jacinto began encouraging this family in the U* language to have faith, to ask Jesus for healing, and to remember the Paralytic and the Blind Men who Jesus healed in response to their faith, and His mercy.  (We knew he was telling them these stories because there are words that don't translate in to U* and so we heard "paralitico" and "ciegos" break through the otherwise unintelligible words to our ears.)

Rafael and I sat, humbled, watching this U* brother exhort his neighbors to believe... Even in the face of such a 'hopeless' situation.  We learned later that Jacinto had, just that morning, heard the story of the Paralytic and his friends who brought their hopeless situation before Jesus, in faith. 
Some of these lessons become much more plain in the Jungle, when faced with someone who has been blind for Time.  

Life on the Amazon

a community along the Rio Marañon

We spent our days with the U* on the Rio Marañon, which is one of 3 main tributaries to the Amazon River. The other two are the Rio Ucayali (which is where I went with Amazon Hope in 2006) and the Rio Itaya, which meet at Iquitos and become the Amazon.
It is an amazing part of the world, and a number of people groups have lived there for ages, still today retaining their cultures and lifestyles much like in centuries past.

In this part of the world, transportation is largely by canoe, houses have to endure significant rain and change in water level each year, and life revolves around the River.  These rivers are teeming with life - fish, reptile, plants and animals of all kind. These photos give a sense of what I saw every day, and are strikingly similar to the views I saw in 2006 on the Rio Ucayali, so it was quite familiar in many ways.

The vast expanse of the Rio Marañon

The Aurora Property which sits on the Rio Marañon and extends back to include many other buildings, 200+ acres total.

Our boat (called a lancha) which took us back and forth from the lodge, and served as a classroom for Health Promoters. Some of our team also slept on the boat in tents or hammocks.

The sunsets are spectacular and different every day. This was evening settling over the Rio Marañon from the banks of Aurora.

Wilma

This woman deserves far more than her own post. She is one of the quiet heros of the faith here on earth... a warrior for justice and peace, spreading the love of Christ in some of the most difficult places on the planet. I am different from the brief time I spent in her presence.

me, Wilma, Clay, Josiah in her school

Wilma grew up in Lima, with her 10 million neighbors, and at some point was orphaned or abandoned, and ended up living on the streets as a teenager. She was truly one of the least, likely not sure if she would even survive to see age 20.  At 17, a family (I think missionaries living in Lima) adopted her, and she was given hope, and in every way a new life. She was transformed by the love of this family, eventually finding faith in Jesus and was further transformed by the gift of forgiveness, eternal life, and a sense of purpose and hope. She married and had 3 beautiful children, each of whom are now professionals -a doctor, dentist and lawyer.

an example of the ¨Cerros¨in the outskirts of Lima

She was walking by some street children one day years later (when she was in her 40s), and was siezed with conviction as they begged her for coins, knowing that they were who she used to be. Wilma decided from that moment on that she would devote her life to *seeing* these children who are invisible to much of society, hoping to do for them something of what had been done for her. She began by starting to do bible lessons with them at churches in the area; this led to helping them with food, meeting their families, and more and more loving them with the love of Christ.
This mission gradually led her into the Cerros of Lima, where many of them lived, and she saw their lives of hopeless poverty, and asked God what she could do. She felt led to start a school in those Cerros, to help educate the children, many of whom did not have a school to attend. The Cerros, until recently, were not considered part of the city by the Lima government, because they were mainly inhabited by poor people from the countryside, or other indigenous peoples often marginalized (literally) by the government. She started in a wooden shack, teaching the children about how God loved them, how they were precious to Him, and doing all of this out of her own monetary resources.  This work became too big for her small shack, and she began seeing how powerless the people in that community felt concerning appealing to the government for water, trash collection, etc.  Over the past few years she has been an ardent advocate for the people of the Cerros to have access to water (before, a truck would come up and people would bring theircontainers and buy water as their only water supply), to have roads paved as they are in the city (since it was all dirt and in a hard rain, entire communities could be wiped away as well as the roads), to plant trees - which are now growing bigger with the water supply that the community has due to her tireless efforts.
Her shack has become a 4 story cement building, made by her own hands (literally), brick by brick, using large cement blocks that her husband could obtain from the factory where he worked. It is still in progress, but it is magnificent and a beacon of hope compared to the shacks surrounding it. This center serves as a school, a meeting place for their church, and a symbol of what is possible with God, and faith and perseverance. There are about 100 children involved in her programs, who continue to learn, to be fed spiritually and with nutritious food, and whose families are also being touched by hope and by the Spirit of the LORD who dwells in this place.

Wilma's school - in the center with the banner

At some point along the way, my new friend Clay (part of the team, with Faith Comes by Hearing) met her - I think through the missionary family who had adopted her. He and several others from the US, including David and Stephanie, started visiting her when they would come through Lima, and this year was no exception. I am deeply grateful for the several hours we spent with her, hearing about her work, meeting her children, meeting the children involved in the school/church there, and praying with and for many of them during the afternoon we spent there.
I will post pictures of her and the school when I am home.
She witnesses to the truth that the light of Christ shines in the darkness and the darkness has not overcome it.

Where to begin...

This will be the first of several posts. trying to share bite-sized portions of a very full experience, in places full of memories, now from yet another season.
I am a believer that one´s first impressions, the things that come to mind first when asked a question like, ¨So how was the trip?¨ are very important to notice... of course there are also treasures that surface after reflection and time.  I´ll start with the former, since those are still quite fresh.

Where to begin? I´ll first say that I know many want to see pictures of where I´ve been and what I saw, but the limitations of an internet cafe, with a spanish-based keyboard, and a sometimes-unreliable (or suddenly absent) internet connection make picture uploading problematic. I´m thankful for this moment, in which all seems to be functioning! I will save the picture sharing for when I am home, and am able to gather pictures from other members of the team as well.

Chronology is important to me, and especially since I didn´t know the details exactly prior to leaving, I´ll start by sharing some of the basic framework for my time, which will help later to fill in with more stories and pictures.
The people: Our team consisted of David and Stephanie (brother of Kathy, my doctor friend, and directors of Renew Ministries, have been working with the U* for 10+ years)), their 17 yr old, delightful son Josiah, Clay (VP? of Faith Comes by Hearing, master of fixing things, and long-friend of the U*), Lee and Sarah (a young couple who work for Renew Ministries, in charge of logistics), Kathy (doctor from Duluth), Anny (from the DR, now living in Iquitos for 7ish years and working w- the U*, also the team logistics), a team of 5 young men from the DR [Dominican Republic] who helped with mens' ministries/teaching, futbol, and preaching; Elliot and Alexa (a couple involved in education & agriculture, currently training with Echo Ministries which is worth looking up! they do amazing work with sustainable, resource-appropriate agriculture in developing countries), Jerry & Kathy (missionaries with LEI, the ministry my Great-Uncle Robert Rice started to teach literacy through simple bible stories), Alexia (a Peruvian dentist connected with iTech organization), Jazna (architect from Peru who has recently trained in bible translation and will be working with the U* on various things. she was the amazing childrens coordinator during the week, for 60+ kids!), Bridget -a RN from the UK now living in Nauta, who felt called to join this work, and has been there 1 year, working with the U* (she proved to be a dear sister, and was a huge blessing to me!), a father/son pair from Maine who were there for a month visiting Crystal - also from Maine, who has been living in Nauta for several years, serving in various capacities and with our team was invaluable as a translator (english to spanish) & pray-er.
We joined the Peruvian (Iquitos)-based team led by Pastor Marcos, a Brazilian pastor who has been shepherding and discipling the U* believers and leaders for the last 10 years, and his amazing staff of about 10 Peruvians who did much of the cooking & cleaning for ... 200+ people every day! 
The U* people numbered about 175, far more than were expected, but the LORD knew exactly who needed to be there, and we trusted that.

The times and places:  
We began in Lima, arriving deep in the early morning hours of Sunday, and after too little sleep, went to visit a long-time friend of this crew named Wilma who works in the ¨cerros¨outside Lima... these are the hills, but don´t think of green, lovely hillsides.  They are barren, water-less until recently, dusty, desolate aside from the thousands (?millions) of poor Peruvians who live there, eeking out an existance. Wilma will have a post of her own soon.
Sunday evening (3-3-13) we flew out of Lima to Iquitos, the bustling city at the headwaters of the Amazon where I´ve spent more time than anywhere else in S.America. Upon arriving, I was met by an old friend John, who I know from my time there in 2006, and we were able to have dinner with Dr. Ronald who I also worked with during March 2006 (see prior posts from that time if interested!).
Monday morning we went to Nauta (2 hrs by bus), all 24 or so of us, and then boarded a lancha (boat) for Aurora - the ¨camp¨ where we would meet the U* and spend the next 3 days for their annual meeting. Aurora is a property owned by David & Renew Ministries that is intended for equipping and training for the U*. They don´t live there, but have met there for the last 4 years, gradually accumulating more people from the 40 U* villages, who are interested in learning about God, growing in various areas, and having an annual ¨meeting.¨  The 175 U* stayed in cabins at Aurora. We stayed up the Rio Marañon about 15 minutes by boat at an Eco Lodge, which was amazingly comfortable, and not super jungly at all. We were blessed!

Impressions:
> The jungle and Amazon basin are amazing parts of the Lord´s creation... lush, vast, deep, teeming with creatures, and home of some of the yet-unreached peoples on our earth. Those peoples, which include the U*, are amazing in their history, cultures, ability to survive in ways of which we have no understanding.
> The Lord is able to make Himself known to people who don´t read, who don´t have a church building to meet in, who have never before heard of Jesus or a Loving, Strong, Almighty Creator-God. ... And He is doing just that among the U* and no doubt other peoples.
> Our team was an incredible collection of talents, a real picture of the Body of Christ, in all its different functions. I thoroughly enjoyed working with them all!
> Being in Iquitos felt very natural and familiar, and was especially sweet because I was able to visit with my 3 main friends from the month I spent there in 2006 - John, Ronald, and Nimia!  They warmly embraced me, we caught up, shared 2 meals, and were able to reconnect easily after 7 years.  Also in Iquitos, I spent time with Jerry and Kathy Manus, the LEI [Literacy Evangelism International, now directed by my cousin Sid Rice] missionaries who have been in Peru for 19 years, mainly working with the U* and just recently beginning to teach literacy to the women U*. My cousins Sid and Christa Rice had asked me to try to visit the Manus family if possible when I was in Iquitos... better than that, I worked near them daily, operated¨on Jerry´s toe (which had a minor infection), shared meals, and had coffee at their house at the end of the week.  It was a beautiful gift from God to have such sweet connections!
> My Spanish skills were well used, and feel more and more accessible.  This has been such a blessing, and I just love this language, and the people who speak it. I´m so so so thankful for the investment I made 7 years ago (spending 3 months in Latin America) which continues to bear fruit.
> Equipping and empowering are tricky, and hard to do well, without "adverse effects" ... I have a lot of thoughts about this, which need more time to simmer.  Toxic Charity is a book I´d commend to anyone who wants to delve into the issues surrounding how we do ¨charity¨ ... but be warned: it will be potentially uncomfortable and very challenging.
> I  love connecting people...  I so enjoyed introducing my Peruvian friends to the team, especially Bridget, Anny and Marcos & co. who live in Iquitos/Nauta and potentially fostering some cooperative efforts between their works. My friend Dr. Ronald with whom I worked for 1 month in 2006 is now the Director for Amazon Hope, a medical boat outreach into the deep, remote jungle villages, offering medical & dental care to their inhabitants. 

I´ll stop there for now. If you´ve made it this far, well done. More to come, in story-form, hopefully soon if the connections remain.  Thank you for your prayers and interest. Until next time...
Çiao!

There and back again - literally

So it's been some time now since I've posted but due to the miracle of the internet and blogs and cyberspace, it's still here...  waiting.  I've decided to fire up the old blog again, because the time is right.

I am returning to Iquitos, Peru on March 2, 2013 to work with an indigenous people group in matters of health promotion and needs assessment. It will be unlike anything I've ever done and yet hopefully the beginning of what I'd like to do more of: serving as a consultant, a listener, an adviser, and an empower-er of others.
For some who are coming to this blog for the first time, you may wonder about the title: There and back again.  It has several meanings/origins. 
One - it is unashamedly and humbly borrowed from JRR Tolkein in the Fellowship of the Ring, which holds beautiful images of our journey toward Distant Shores and the struggle between dark and light along the way.
Two - I started the blog when I was traveling to 3 different countries in 2006, Guatemala, Ecuador and Peru, and the name seemed so apt, since I was spending a month in each country and would return after those travels to begin my residency. I have used it since for various other trips (Bolivia, Niger) and happenings.
Three - now I very literally am going back to one of the spots I was before (Iquitos) ... again! 

I had no idea at the time, in March 2006 that I would return in this context in March 2013, as an assistant professor of Internal Medicine and Pediatrics, Core Faculty in the Global Health Department at the University of Minnesota and recently awarded a Certificate of Knowledge in Tropical Medicine... all of which have only come about within the last year and by the generous, wise, kind and providential designs of the Wonderful One. 

So I will be posting as possible during the next few weeks regarding my trip, the team, lessons learned, thoughts and musings. 
Thank you for reading - it's nice to be 'back again'.

Iquitos Peru at the headwaters of the Amazon River

busy summer

So after a long lapse in any sort of blogging (read: april, may and june i worked so much i could do little else), i have a number of lovely things to post about here, many of which happened in the last few weeks.

#1 a completely spontaneous trip to Chicago with Teresa (see picture) my roommate, where we enjoyed 24 hrs of food, shopping, rest and a delightful sit at the outdoor tables of a coffee shop in Dena Wangberg's neighborhood (north part of the city) where we stayed. delightful!









#2 trip to Bethany beach Delaware - grandparents, aunt pat, uncle doug, cousins, and dad and judy. a great time, lots of sleep, sun, wonderful food... a proper vacation!






















#3 home improvements! with some help from Molly Piper (thanks!! so much - what a blessing), my bathroom project is nearly complete - we painted this past weekend and all but the tippy-top edge remains. i love it!
I also have done some landscaping, gardening, and much-needed deep cleaning, leaving Teresa in amazement of how much one can really get done when working "normal person hours," as i have this month and last. something to look forward post-residency!









So... that's a bit of the update... how's your summer been?

at last...

the completion of my long-awaited bathroom tiling project!

Strange how hard it rained...

April 19th 2009 was the GO! St. Louis Marathon and Half-Marathon. It was a rainy day of near-monsoon proportion. Regardless, we (me, Caron Easley and more than 15,000 runners/walkers) ran and i finished 13.1 miles in fair shape. For the soggy pictures, see (www.runphotos.com) and enter my last name or Bib # 8155.
Caron and i near our hotel and the famous ARCH the night before.
thanks to Lou and Brook for cheering me on!!!!

transformation part II

this process has been teaching me patience and gratitude for what is involved in transformation of any kind... the results are stunning and worth the wait!

Yoko

and in case you have been wondering about Yoko, she has been in communication with me and her supporters that she will be returning to Japan for a while. in typical Yoko fashion, she has said very little about her physical condition, but her communication has been good, and upbeat. Please keep praying for Galmi.

transformation

So i've been dreaming and hoping of this bathroom transformation since i bought my house almost 3 years ago. ... here are some pictures of the process:

more trials

this is only a quick little update - for those of you who happen to check... apparently the strike never materialized; though the threat lingers, i imagine.



most recently, i learned of several dear servants of the LORD there who were in a car accident in which a boy was killed. a Nigerien boy was running across the street, Mousa Dankayau (family doctor/ surgeon from Nigeria) swerved to try to avoid him and in the process the car flipped over. In it were Yoko (see my previous posts, in picture above wearing black) and Laurance (from France, a teacher, in pix below) and another person i didn't know. Yoko was seriously injured, to the extent that she had to be taken to Niamey to see a neurosurgeon, apparently for what sounds like treatment of an intracranial bleed of some sort. she survived, was back at Galmi last i heard, recovering and requiring 24 hour care.
Please pray for her especially - for recovery, hope, and for the enemy to be thwarted in his attempts to steal, kill and destroy. Yoko has/had a powerful ministry at Galmi, and was the only person leading a Bible study for nurses.
Mousa is awaiting the legal implications for the accident, and Grace and Jimima (see picture below) are back in Nigeria, awaiting the birth of their next child. they need prayer as well.

Our God reigns.





(Grace and Jimima - Mousa's wife and daughter)

update on the strike

for you who have prayed, thank you.
the update is from a few days ago, so i welcome comments with any more recent information.

the strike had not yet happened as of Monday. the details are: it boils down to money, and that the government had recently given a raise to healthcare workers at gov't facilities due to the 'contact with hazardous substances'.... a compensation of sorts for the risk. well, Galmi is not a gov't hospital, pays better anyway! and already compensates the employees with free testing/treatment and a workers' comp type of insurance.
Concurrently, SIM had already been planning to offer the hospital employees a raise (about 1/2 the government's raise) to help with cost of living expenses. Unfortunately, this was rejected by the employees representatives due to the rising demands and threatened strike. there is a long history of mistrust between the local community and SIM/hospital administration.

the prayer requests sent to me by the Krauses (2 family docs i worked with, great people!) are:

• see their work as ministry, and care about the patients (not just money)
• see that they are taken care of, even beyond that of the gov't employees, and be thankful
• have eyes to see that SIM/Hospital are not being "stingy"
• seek truth in the situation, and critically evaluate what the leaders (employee representatives) are saying
• to NOT STRIKE, but to seek God and do what is right; not to bow to social pressure, which is very very strong in the Galmi community

thanks again for praying! i was thinking and praying today about this situation, and the following came to mind:

The people who walked in darkness
have seen a great light;
those who dwelt in a land of deep darkness,
on them has light shined.
Isaiah 9:7

May it be... for Galmi and for each of us.
thanks be to God.

urgent prayer need at Galmi

hello, praying friends, please don't stop praying for Galmi!
i just received word that the national staff at the hospital are threatening to go on strike. i don't know over what issue; historically it has been because of money.
pray for:

• communication
• the Spirit of God to change hearts and minds
  
• maturing of Christians in the church/hospital staff
• wisdom for the SIM/hospital leadership
• for God's name and renown to be the desire of everyone's heart

thank you for your prayers -
i'll post an update when i have more information.

Saratou and Inassou (staff i worked with last month)

"the children in Africa..."

someone put a large bill in my hospital mailbox, with the following sentence written on the back of a used, folded piece of paper:

Kate: please use this for the children in Africa

whoever you are, Thank You. I decided to give that gift to the C.R.E.N. This is the place that the malnourished children go with their mothers to be fed and to help the mothers learn about malnutrition. they thank you as well... and everyone who gave, and prayed, and cared, and cried.













































please keep praying (and caring... and crying... and consider going...) :

• for nurses to aid the hospital work at Galmi
• for community health work to be renewed in the community
• for education of women
• for the Good News of Jesus to reach the land with its transforming power and love!
  

"newborn babies have no fat?!!?"

this was a moment of revelation for some OB nurse-aides i had the opportunity to teach on the morning i left. starting with prayer, i offered encouragement to these women that their job is very very important, as the children they care for are Gifts from God and the future of their people. Tassala (yellow, right) interpreted as i shared some basics about newborn care.

In one had i had a towel, in the other, one of those blue bulb suctioners. i told them that the 2 most important things they could have when a baby is born i was holding in my hands. i went over clearing the fluid and such out of baby's nose and mouth to help him breathe. and then went on to how important it is to rub, rub and dry the baby to help him stay warm. i was trying to think about how to explain the whole concept of 'heat loss', 'body surface area' and 'thermoregulation' to these Hausa women with minimal schooling/training (who had left numerous babies in the open air, wet and cold...). then i heard coming out of my mouth:
"when babies are first born, they don't have very much fat..."
mutter, Hausa this and that....
Tassala tells me: "this is new information. they had no idea that babies have no fat," she said smiling, "i think this is now making sense to them...."
Well, this isn't exactly true - babies do have some fat, but it was too late and not feasible to go into technical details of why babies can't keep themselves warm. Fact of the matter was - we were getting somewhere! the tone of the little group turned from down-cast eyes and seeming-inattention to engaged faces and some surge of interest.
i reinforced the need to dry off babies, put them close to mom's body, etc.
we talked for a while about breast feeding, including the reasons why babies should not drink water for the first 3 days of life.
they asked me at some point, "you have been here one month - why have you not taught us sooner?"

this whole scene was an answer to many prayers, as historically, the nurses/aides/midwives have been resistant to teaching. so i praise God for this and pray it opens the door for more education and improved care of the precious babies born at Galmi.


[the photo is of me holding a baby whose mother has HIV. when babies are born, they are wrapped up in mom's zunni (cloth for skirt, carrying babies, etc) and often not dried off nor put on mom's body. ]

Adamou and others

to give a few updates on patients for whom i've asked prayer...
(and finally! to add some pictures :) )

Adamou, a 7 y.o. boy with tetanus, who i've cared for about 2 weeks. he has been slowly improving, but on Wednesday morning (the last day i was at Galmi), when i saw him, his grandmother said they were leaving that day.
he needs ongoing prayer - his spasms continue, they need to continue giving him valium regularly and that is a challenge in a culture where many don't have a clock or know how one works to mark time. also pray that their family encountered Christ through their 2 weeks at Galmi. [in the picture, he is actually in some spasm, laying on his grandmother's lap. it didn't appropriate to smile for the picture which J was already taking when he started stiffening again, and it all seemed rather awkward to me. they didn't seem phased by his spasm, nor the photo.]


Rabi
Rabi is a 34 y.o. woman who made my post earlier in the week ("last call"). She died on tuesday, 29 october in the morning, soon after i rounded on her. pray for her baby, who is now an orphan. and her family, that they may find Jesus, the Son of God... the same God who is a Father to the Fatherless.

Fauera (also from post, "last call").
She was doing well as of Wednesday before i left. her abdominal swelling was less, and she will likely survive. i ask for your prayers on her behalf to continue, and perhaps to be a reminder to pray for the witchcraft and traditional remedies that are so so commonly used and often fatal. pray this stronghold will be broken.

Bassirou

Tuesday, my last full day, was a busy, crazy day of things similar to the rest of the month. 2 of the short term MD's had left monday, though, so J was on OB call, leaving me to most of the peds without him. the afternoon shift, however, seemed to cluster several pediatric seizures, blood transfusion needs, a general spirit of chaos and desperation with the death of one of my patients. it happened, for the first time this month, while i was actually on the Ward - the relative came to the nurses station where i was sitting and said the child had died, could she have their papers.

when she said the name/bed number (ER24 - a bed on the floor in a hallway, see photo) - i immediately knew who it was. it was Bassirou. a 5 month old boy who i had seen on several occasions - first in the clinic, treated for diarrhea and malaria, sent home. he had come back still ill, and i admitted him. i had been caring for him the 5 days since, and during that time learned his mother was on ARV's (i.e. on medication for HIV/AIDS). so i tested him, and he was positive for the antibody, which could have been because he had his mother's antibodies from her breastmilk, but his condition seemed to not respond to our antibiotics nor anti-malarials, making me/us suspect he actually did have HIV. the CD4 counts are only run on thursdays, so we were waiting until yesterday for that to come back, to determine where he was on the spectrum of disease. when i saw him on tuesday morning, he was kind of whimpering and didn't look well, had been febrile again, and mom said wasn't eating well. she thought he was whimpering because of the IV that had been in his foot. i again prayed for him as i examined him, at a loss to know how else to treat him.
he died that Tuesday afternoon, 29 october 2008 at 5pm.
as soon as i heard the bed number, i went to see the family - again, the first time i had been nearby when a patient died. i found the mother and other relatives, packing up their few belongings, the mom with tears on her face. an older woman kept saying something in Hausa which i think included "Allah..." - which i had heard is what they say when someone dies, "it was Allah's will, it was Allah's will..." and that they usually don't cry or wail or mourn visibly. they don't even say "i'm so sorry". if you read my earlier post, they say, "sanu."
well, on top of the chaos of the afternoon already, i was in tears, and wanted the mother to know that i had loved her child, too, that he is precious to God and that his life mattered. i gave her a hug, kept saying "i'm so sorry, i'm so so sorry you have to lose your son to this ... "
the family kept saying things in Hausa, packing up, walking toward the door.
i looked for the baby - he was strapped on the older woman's back, as any other child is most of their first few years... yet now unlike all those living, breathing, squirming children. his little feet were sticking out like any other child, still warm. but his head was covered by the cloth, and not sticking out. the mom's eyes met mine, both with tears, and she made a small brief smile. they took their papers, their belongings, their Bassirou, and left. sanu.

my grief was interrupted by the phone - i answered to hear, "Doctor, emergency in OPD". so i went running to the clinic, to find another child seizing, looking horribly pale... the chaos continued to swirl.


(the photo is not of Bassirou, but of the way children, even babies, are carried on the mother's backs. please pray for the chilren of Niger)

things i'll miss and things i won't

things i'll miss:

• the Nigerien children
• the greetings every day, all day (see post)
• the level of acuity/degree of illness (see "things i won't miss" for the other side of this)
• feeling like i'm really meeting a need, engaged in a real battle every day
• wednesday morning gathering for cinnamon buns and coffee
• making yogurt in a jar on the kitchen counter
• the community of missionaries here
• working with others to share the hope of Jesus Christ being the focus of our task
• the quietness and slowness of life (outside the hospital)
• the lack of paperwork (compared to my work in the US)
• the break from 1-3pm each day
• the pastors who preach the Gospel and pray with patients every day

things i won't miss:

• the smells as one walks to and into the hospital
• the flies in the one part of the hallway just outside of B Ward
• the limitations of the hospital (nursing care, staffing, resources)
• the weight of death every day
• malnutrition
• fighting against deep-rooted beliefs and superstitions and lack of education
• the heat
• the bugs - though i've been a victor over a lot of insect life this month
• the lack of value on life
• the scarcity of green vegetables
• call every 3rd night :)
• checking my shoes (and shower and clothes and bed) for intruders every time in put them on
• being far away from loved ones. i'm looking forward to coming home.