Monday, March 25, 2013

Playground, Hospital and Hope

So we are in Zambia. As we mentioned before we have our own house WHICH IS SUCH A BLESSING!! I can’t even begin to describe what it's like to have our own place after 9 months of living dorm style.  It's truly a blessing on multiple levels. Since the kids have been living dorm style with us they're used to seeing all their aunties all the time, sharing meals and playing with them constantly. That's all going to end in 9 short weeks and this separation of our family from the rest of the team is really going to help the transition to go much smoother. It has also helped them transition into Zambia. They really relaxed right away and settled in. We have not experienced a lot of the usual backlash after a move and they have pretty much treated this as home from day one (or is that a bad sign?). The kids also LOVE the playground that is a 2 minute walk away. This is something they haven't had since Perth and they are having a blast. There are also a lot of local kids to play with who live in our compound.
Here are a few shots of the house.

Sunrise from the water tower by our house.

Abbie playing barbershop with J

It's still really hard to believe that we are about 10 weeks away from completely finishing this adventure and moving on to the next one. We are very much looking forward to being stateside from mid-June to at least January. We can't wait to be visiting family and friends and (sorry, this may be the pregnancy talking) eating foods we love! We are also looking forward to some relaxation after this intense school and welcoming our new little one.
The weather in Zambia has been great! It's almost like Fall weather in the Midwest! Such a nice change from the heat and humidity of the Tanzanian coast. With that said allergies and asthma flare up have come with the territory. I had a terrible first 2 weeks before Bruce realized we had a whole bottle of Zyrtec which is pregnancy safe!! Feeling much better now!!
pics from the park
being silly

Monkeys playing in the trees at the playground

Monkeys playing on the ground.

Bruce found some friends.

Abigail found a friend.. big surprise I know.. this is a daughter of another missionary family that lives minutes away. They were fast friends.

Missionary friend and his daughter

Josiah and Isaac

So the hospital… 
Its definitely the best we have seen so far in regards to cleanliness and order. With that said, we have seen some pretty terrible situations in our short 6 months of government hospital work. This is the main referral hospital in this area so they get EVERYONE. The staff has been very nice and helpful and great to learn from. They also seem very equipped to handle most of their tasks and motivated to do them. They still struggle with a lot of the same issues as other developing countries, i.e., they are over worked, under staffed and struggling to function with a significant lack of supplies. The mothers themselves have been so sweet and it’s been amazing to communicate with them as most speak English fluently!
I haven’t really shared many individual stories in these updates. Zambia is a bit different on the photo end of things. Tanzania was a bit similar but here it's even more difficult to take pictures. In the hospital they do not want us taking general pictures of moms and babies. The only way is if you have had a relationship with the mom and she consents but even then we have to be careful. I have been building some relationships with a few moms at the hospital so may be able to snap a few now and then but I just wanted to let you know that if you don’t see a lot of the people we are reaching out to, this is why.  Sometimes the mom stays for such a short time that you don’t have the time to build the relationship. But I’m hoping I can paint you a picture by sharing some stories and maybe along the way I will be able to get some “snaps”.
Here is one from this week.
Hope, (not her real name) is a 14 yr old girl who had 4 hrs previously delivered her 2.8 kg son at home in her village. She bled a lot during the delivery and her mom brought her to the local village clinic where they tried to assess her bleeding but she refused to let anyone near her.  Her baby was also grunting and needed medical attention. The clinic referred her to the hospital and she made her way into admissions on Friday.  She was scared, still bleeding and clinically shown to be anemic.  She had been bleeding now for 4 hrs.
 It was an emergency situation and as the doctor and I tried to assess her she kept tightening her body and refused to let us do any examination on her. I tried calming her down by talking to her. And I tried reasoning with her about the seriousness of the situation.  We held her down to give her an injection of a oxytonic drug in hopes that it would force her uterus to contract and stop the bleeding. But during the few seconds we had of an internal examination we found fragments of membranes which isn't good. Unless the rest comes out the bleeding will not stop. We also held her down to give her an IV for fluids as she was in desperate need of fluids and blood.  The doctor tried several times to examine her and each time I was talking calmly, explaining we were there to help, try to relax, etc. No good. Each time she tightened up so severely that it was impossible. 
I was frustrated. Here is this girl in serious trouble and not receiving the help she so desperately needs. Then I looked at this scared little girl and thought… no 14 year old child should ever have to go through this!  I don’t know the circumstances that got her there but I suspect by the way she responded to us touching her that she was abused.  Each time I would reach up to stroke her hair and she would flinch. Regardless, it takes two to make a baby and usually these fathers aren't in the same age bracket as the mothers. They finally decided to sedate her to complete the exam and hopefully stop the bleeding. I had to leave before it was all over. The baby was receiving care in the nursery.
There are many stories like these that break your heart. Another one from last week is a 17 yr old who is a double orphan. She lived about 30km from the hospital and walked there (!) because she was in pain.  She was 30 weeks pregnant with her second child. She lost her first child when she had an early C-section due to Pre-eclampsia (pregnancy induced high-blood pressure that can lead to seizures and death if baby is not delivered soon enough).   She had not received any pre-natal care up to this point and because she had no way of returning to the hospital for a re-check she had to be admitted for a complete work up. She's already at risk for Pre-eclampsia because of her first pregnancy and she had a severe yeast infection which, if left untreated can sometimes cause pre-term labor.  She laid alone on a bench and was terrified. Remember, this is a young girl from the village.
You wonder how these situations came to be but then part of you doesn’t have time to wonder because you're too busy. Sadly you know the cycle will continue unless these girls are educated about their bodies and pregnancy yet even educated many of them still wouldn't have a choice. Many of the staff at the hospital have become jaded to these situations. Many of them have adopted the attitude, “You got yourself into this situation so what are you whining about?” 
For me, I really believe these kinds of situations stem from the impact HIV/AIDS has on these developing countries. You have parentless children raising themselves, forced to be adults before they should be, sometimes taking care of multiple siblings and one of the side effects is premature mothers. My heart just goes out to them because having been through birth myself I realize they must be terrified!  
There are many other stories of normal deliveries and women with complicated deliveries. I have really enjoyed my time with the mothers and am learning a lot. Today I had my first opportunity to watch a C-section and assist with the baby.  It was a first time mother with Cephalo-Pelvic disproportion.  A fancy way of saying the labor was obstructed because either the baby's head was too big or the mother's pelvis was too small. Either way the baby was not coming out.  I really have been impressed by this hospital how quickly they come to make the decision about needing a C-section. I say this because at previous locations the mother would be in labor for 3 days with no progression and we were begging the doctors to come and assess the need for C-section and then once it was decided it often became an emergency situation before the patient would actually get into the operation theatre! Here, so far, it seems that the midwife detects the need for it and the doc comes on rounds and confirms it and the patient is prepped and off. There have been days were staff is low and only one theatre is in working order and it's not that swift and easy but as a whole, it seems to be the way it goes. 
Today Ruth (the mom) was scared and it was really great to stay by her, pray for her, and share my story of having my first by C-section.  It was an honor to help her welcome her little son into the world! Mom and baby are doing great!
Abigail's self-portrait of her teeth coming in. :)

Thursday, March 14, 2013

God Bless the Trains Down in Africa....

Well, the last week in Dar es Salaam was a blur of tying up loose ends, saying goodbyes, organizing last details involving our train trip and the ever-dreaded packing. All in all it was pretty stressful to be honest. Now, at this time of writing we’ve been on this train for 3 days and realistically won’t be arriving in Lusaka until tomorrow morning.
Currently we are in a Zambian town called Mpika, waiting for workers to clear the track of a train that derailed here two nights ago. Thankfully there were very few people on the train and it was only luggage cars that went off so nobody was hurt.  We’ve gotten different stories as to why the train derailed but nothing clear or satisfactory. One theory was put forth as, “Well, the line is almost 40 years old,” it being understood that the line doesn’t get proper upkeep.  Another story is that the driver forgot that this particular stop has several tracks and at the last minute forgot which one he was supposed to take. Either scenario is not comforting. We are just thankful that other than boredom of sitting on the train at these long stops the trip has remained uneventful.
The Tazara (Tanzania/Zambia/Railway) Line connecting Dar es Salaam, Tanzania to Zambia was built between 1970 and 1976. 51,500 people worked to complete this railway including 38, 000 Tanzanian and Zambian, and 13,500 Chinese. Uh, Chinese? Yeah, see, after independence Tanzania decided to go the socialist way during the Cold War and so Chairman Mao decided to gift this railway for their wise decision. And I guess the Zambians made out with it as a kind of wooing from Mao. So anyway we’ve been riding a Chinese communist train through Africa and it’s been long but a blast!
The first day right around sunset we rode through a game park and managed to see some zebra, giraffe, a ton of antelope and a family of elephants. The only problem is the train is going so fast that you’ve got to be lightning speed with the camera if you want to capture anything. The scenery has been beautiful and the kids have managed not to go stir crazy for the most part. It’s been a great adventure and if we had the choice we still wouldn’t trade it in for a 3 hour plane ride. Of course, I’m saying this believing this train is going to move in the next hour or so (it’s been almost 4 hours here now) so we’ll see where this update ends. Once we start moving theoretically it should be another 9 hours on the train and then 3 by private bus to Lusaka. Here’s to Africa!!  
So the train took off after a 10 hr stop to clear the track and put us arriving at around 7am the next day; We were then picked up by our lovely staff that were waiting for us and took a rented bus the remaining 3.5 hours to Lusaka.  After our unplanned 10 hr stop adding to the unplanned 4-5 hour stop that happened the day earlier and the 2 nights and 3 days of planned travel we were rationing supplies such as toilet paper, water and kwacha (the Zambian currency) which was used to purchase the food from the train car. The parts of the chicken that were given when we ordered chicken were starting to get interesting as time went on. I think at one point we were given a chicken back???  Apparently the kitchen was running low on supplies as well. 
Also, during the stops the train bathrooms get locked because the refuse goes right on the tracks and understandably a moving train is better suited for that kind of that kind of thing. But remember, we were stopped at one point for 10 hrs! Thankfully we have a Romanian on our team who broke us into the bathroom when needed.  Near the end of the trip, hour by hour, the train was returning to its communist roots. J 
All this to say that although the train ride was quite the adventure and we had a great time seeing the scenery of Africa, train travel here is not for the faint of heart! I’d put it more in the “extreme sport” travel category. So if your looking for interesting bathroom experiences, almost flying off your bed every time the train hits the brakes, hunting cockroaches before bed and seeing a bit of village life out the window with the occasional elephant then this train is for you!  All in all we are really glad to have experienced it. And thank the Lord it’s over.

just getting started

just woke up cuteness

hanging out.. because that's about all you can do on a train

what do you do when you are stuck on a train for 70+hours? you lose your mind and buy a turtle off of some kid out the window. Meet our team mascot Louie. Our team purchased him. He is currently MIA and I am hoping he made a break for it!

waiting for the train


look in the back for antelope? bushbuck? kudu?

blurry wildlife

some sort of birds.

blurry elephants on the right

Blew this one up so you could see her shirt. Selling water? Yes we can!

Hard work farming in the rice field.

This western Tanzania and it was beautiful!

we went through 22 tunnels on our journey

front of our train as we were on a curve

We are here safe and sound in Zambia and are loving both the cooler weather and the fact that we have our own little house!! Waking up in the morning and making tea in your pajamas is so relaxing! Add a hot shower and a washing machine that we have access to twice a week and we are pretty much feeling spoiled.  The house is in a beautiful compound that is owned by a theological seminary. My classmates are divided between 2 other houses and there is a park for the kids!  We have taken a tour of the hospital we will be working at and will begin work Monday.  Right now we are just trying to settle in and get used to the surroundings. We’re taking our time.
Thanks for your prayers for a safe journey!! We will update more on Zambia soon! Love,
Bruce, Heather, Josiah, Abigail & baby bean