7/4/14

Independence

Today is the 4th of July. I (somewhat) explained in French to some people today what this day means to Americans & how we would celebrate. 

  In Bere, Chad we didn't barbecue or watch fireworks but we did gather together with a nice potluck meal complete with  homemade ice cream, red, white, & streamers, and cake. We also celebrated a 3yr birthday for our good little friend Zane.  So we celebrated the birth of a nation & the birth of a boy. 

  It made me think of the founders of our country: the rich and the poor who risked everything for the greater good. They abandoned comfort and security 

for the dream of better things to come. 

  Personal sacrifice & the belief that change can occur & things will get better if we work together... It was true then in America & it's true today across the globe.  Have fun today with friends & family. God bless America and each of us. 

 Mason, Kim, Grace & Emmie

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Tough day 7/1/14

Spoiler Alert: very rough day today. 

  We have many successes here and more lives are saved because of the work being done each day.  But the deaths are surreal & painful in ways we don't experience each day in the U. S.  so I find I write about suffering to unload my emotions & to report how hard life is for others in this world. Count your blessings & hug your children tonight. 

  When I arrived this morning to set up the OR & arrange the surgery schedule there was a young girl already on the OR table.  She's maybe 16yrs old & pregnant & her baby is definitely dead. The mom may have a ruptured uterus (labored for days--not at our hospital). A forceps delivery of a dead baby is really tough to watch. The scent of death filled the OR immediately & left a permanent scar on my heart. I felt sick with grief. Frequent death is still new to me. They closed up mom with no rupture but things just seemed "off" with large belly & pain after delivery but she was stable & not bleeding. 

  An hour or so later we were called to the OB ward to see her again. She looked bad-- like sepsis creeping up. We hand carried her to the OR just a 100 feet away. Definitely septic. Ketamine anesthesia. Not bleeding, normal hemoglobin, but laparotomy found lots of fluid, swollen bowels, no perforation but her tissues look bad. Did I mention we could not obtain her blood pressure for probably 5 minutes? We were pretty sure she would die in the OR. I found some Levophed in the drawer (one of only 2 bottles in the country), mixed my own drip and titrated the medication with no pump, just a roller clamp. 

I kept her in the OR for hours as our mini-ICU. We cancelled elective surgeries & I stayed with her all day until I was called out to see a child gasping for breath in pediatrics. Actually he was laying on a mat by the fence outside-- kind of near pediatrics. He was maybe 8 yrs old & struggling for breath. I had them carry him to preop so I could give oxygen, medications, &monitor him. He struggled for breath as we treated him for maybe 20 minutes, working through treatment algorithms & working out why he was so ill. I held his hand & stood beside him the entire time. For a few minutes he looked like he was slightly improving. That sweet boy died literally right in my arms. One moment struggling & in the blink of an eye he was still & silent. I was shocked by the speed that death occurred & I saw it coming. His eyes & face changed & he was gone. As I confirmed with my stethoscope what I already knew, I felt the now familiar sensation of my tears rolling. We called in his mother & grieved with her, choking back my own sobs that tried to break through. It honestly tore my heart apart. 

  We ended the day with another C-section--but with a happy ending. Strong baby boy & healthy mom. We debriefed a bit afterward to help the team cope with the boys death just an hour earlier, I cleaned up & walked home.  It's 530pm & I haven't had anything to eat or drink since 7 am. I stripped off my scrubs, stepped into the shower, & cried again. 

This is "slow season" in Chad. 

 -Mason

P.S. I really, truly love it here. 

Making Bread 6-30-14

Many of our recent posts have identified the daily hardships that Chadian people suffer through. In just 2 weeks we have learned so much, felt new "stresses".
Eating is no small task either:
Making bread in Chad

Bread is a mainstay for our family. With local peanut butter, it is an easy breakfast toasted on the stovetop and also a quick dinner as PB&J when you don't want to heat the house any further using the stove or oven.  But, the process of making our bread here has several steps which are a whole new experience.

Step 1: Dress for the market. 

This means changing out of our comfy and preferred shorts or capris into a long skirt or dress.  The girls and I also cover our heads; they prefer bandanas and I opt for a scarf. Though not all the women on the mission team do so, I believe covering my hair is why I received the lowest price on a SIM card to date from an Islamic vendor, Abdullai, over any other mission team member. Of course, it could have also been the fact that Grace is beautiful and only a year away from an acceptable age for marriage. I've been told we could fetch 10 camels for her which Emmie thought reasonable and worth discussing.

Step 2: Find a local guide as many vendors do not speak French and I've yet to learn prices for everything. Yesterday, I found Papa, who is a childless, young teen living on the compound as a semi-adopted child of another mission family.  They provide love & financial support, lodging, school fees and such for him.  Papa speaks English well, along with French and several other local languages. We spent the 15 min  walk to and from the market conversing in Franglais as I tried to increase my French vocabulary.  My first solo trip I hope to be armed with the knowledge of fair pricing for any item I plan to purchase

Step 3: Preview first before vendor selection

Once entering the open market area, you will pass by the tailors and cloth vendors, women selling produce, oil, doughnuts, and other vendors selling a variety of items from hardware, packaged noodles, bar soap, powdered milk, flip flops, plastic bins and cold sodas for the hot walk home.  It is advised when shopping for flour to first make a "window shopping" pass of all the merchants and their flour bowls. Of course. choose the vendor whose flour seems the least buggy. It is also acceptable and advisable to sift with your own hand and smell the flour as well. Once your best option is selected, choose your amount from filled nesting bowls stacked on top of one another (flour, sugar, spices, rice, beans, all dry pantry items are sold in this manner.) Watch as the merchant uses his bare hands to fill your bag with the amount desired. Pay for your buggy, open to dust and dirty hand sifted flour . Voila, we now have flour to bake bread. But the process isn't over... Part two will be tomorrow. We are too hot and tired from our trip to make bread today;)

From good to bad. Just...like...that. 6/27/14

In the OR until 5pm today. Home to eat & shower & ready to relax...

645pm called to see a ~18month old baby girl who aspirated a peanut. 

Deep retractions, blood oxygen levels very low & falling. I was able to hand ventilate & let her breathe Halothane (with my draw over vaporizer kit). Intubated no problem but after multiple multiple attempts we couldn't remove that peanut. We tried every trick in the book & made up some new ones but nothing worked. Physically & emotionally exhausted,  we finally made the hardest choice and had to quit.  There is no plan B here. No bronch equipment. No ventilator. No helicopter. 

I picked up that baby and carried her to her mother & explained all we tried. Mom nodded & with tears in her eyes she turned and carried that baby off into the darkness to die. I came home & cried. Who wants to cry with me?

-Mason

Well that was quite a first week!

We have so many new experiences to write about but we have limited effort remaining at the end of each day. Here are some bullet points to try & catch you up. (follow us: 

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Despite the difficulties we are making good friends, adapting to the languages, and trying to show Gods love in everything we do. 

-I saw a laboring mother referred to us from an outside hospital with a "hand first" presentation. The baby died before they arrived but you could clearly see the dark blue lifeless hand protruding from between the mom's legs. She wept as we delivered her lifeless baby. It's one of many heart-wrenching sights I will never forget.  

-Grace got bitten on the butt by a monkey named Charlie - kinda funny and reminded us of that you tube video with the British kids "Charlie bit my finger."Charlie bit Grace again on the waist a few days later - not funny! 

I gave Charlie a ketamine anesthetic a few days after that and our general surgeon castrated Charlie. Hopefully he will mellow out now. 

-The girls were on the porch sorting dried beans-- keeping the good and tossing rocks and the beans with worm holes onto the dirt or sidewalk. A man working nearby approached and asked if he could keep the beans we didn't want. He picked up each one and saved them in his pocket. That was a humbling moment. Kim lovingly shared our "good beans" with that man. 

-Some of you may have heard that Emmie has been sick. High fevers  cycling up & down for almost 3 days. Having a sick child is never easy but add malaria and other tropical diseases in the mix and it is more troubling. She bounced back well by late today but unfortunately had an allergic reaction to a 2nd med we added. Luckily I caught that early enough & treated it. She's such a trooper. Thanks for all of your prayers. 

-A sweet 9month old girl had complications from her IV quinine. She returned to the hospital several days after being discharged -sadly her entire hand was ischemic...it could not be saved and was eventually amputated at the wrist. She's pretty sick. Please pray for her. Chad is challenging enough without physical limitations and her life will be very difficult (if she survives). 

Kim is taking over the nutrition center ministry. She will have plenty to write about that but it is a joyful and gut-wrenching ministry. She meets families every week to provide homemade formula to severely malnourished babies. It's exactly what you imagine and worse. The sickest ones are also provided medical care at the hospital. Perhaps you will be able to help financially and give to this ministry. Details to come. The need is great and our resources are limited. Pray for those families & ours as we try to help them. 

Love,

Mason, Kim, Grace, & Emmie

Fresh off the bus

We survived the bus ride from the capital to Bere! Praying for travel mercies here is no joke. The driver's goal seems to be to make the fastest time possible without regard for safety. A bus is one of the larger items on the roadway so anything smaller must yield: pedestrians, push or ox carts, scooters, motos and autos. Only larger trucks and buses or animal herds would give the driver slight pause and then only with the horn blaring.  The driver made very adequate use of his horn for the entire seven hour journey. This trip was made in a very dilapidated and dirty bus; two seats on left and one seat on right with a folding jump seat to complete an entire row. The padding was minimal with tears and many jump seats were broken or sat at tilted angles, including the one directly if front of me. I rode with my knees on either side of the seat in front of me or scrunched up with my feet on my seat. Our family occupied the back row; we squished ourselves into the four seats with 5 carry-on bags minding no storage under the seats. Every seat on the bus was sold. During our wait on the bus while they stacked and strapped luggage on top, a variety of vendors would shove their arms into the windows displaying their wares: bananas, soap, tissue, candy, water in plastic bags, unknown fruits and vegetables, eggs, clothes, packaged cookies and more. The bus station was teeming with people: countless vendors, ticketed riders and families sending them off, official employees and unofficial workers hoping for tips for assisting with baggage. It was a ramshackle building with an orange dirt parking lot in complete chaos. Only half of our cases were granted space being tied on the roof and the residual were left laying in the dirt (essentially we paid excessive airline fees only to have them abandoned at a bus station.) Not to worry, they used a black sharpie marker & wrote directly onto our suitcases & duffle bags: L'Hopital Bere.  I looked back out the window as we pulled away saying a prayer over the cases in hopes of them following us soon but really thinking that they are goners.  Thankfully, they arrived 3 days after us, covered in orange dust but intact. We arrived in the same fashion but also sodden with sweat and achy from our cramped seating. The last hour of the bus ride was on dirt so the dust, as we flew down the road, blew in through holes on the floor and sides of the bus. I hadn't been this filthy since a young teen working in my father's fields. I also have never been so relived for a journey's end. Thank you for your prayers. Please continue to lift us up as we transition into our new life here. Specifically: adapting and sleeping in the heat, the container with household goods still on its voyage to Cameroon, and learning the language(s).
Love,
Kim, Mason, Grace, Emmie


110 degrees & 2 girls sleeping on Mason's lap :-)

6/10/2014

 Goodbye Paris. Hello Chad... Or maybe not! Following a truly wonderful week of family vacation in Paris (with beaucoup pastry & gelato), it was time to get moving to our mission in Chad.
 All was well at CDG airport: we had 8 free bags checked & paid for 2extra checked bags for 200 Euros each! Then we hit the security checks & they weighed everything we were carrying-- we had too much carry on weight (almost double the allowable weight limit) so we scrambled to repack our carry-on bags & checked 2 more for another 400 Euro. I could have purchased a motorcycle in Chad for the 800 Euro we spent on luggage in one hour.
Our departure was delayed a day out of Paris when our 415pm flight to N'Djamena cancelled after repeated 1 to 2 hour delays. Air France kindly gave us food vouchers & a 20 minute bus ride to a free hotel for the night. They bused us back to CDG in the morning. No problems until we realized someone (ok, it was me) left all 4 passports in the hotel room. Luckily we were early to the airport. Unfortunately there was a planned cab strike that day! No cabs to be found at a major international airport. I ran everywhere trying to snag a limo, private car, anyone to drive me back to the hotel. With the clock ticking I found a guy with a motorcycle to drive me. We managed to make it round trip in good time thanks to his lack of concern for safety, speed limits, or driving toward oncoming traffic in the wrong lane. Ahhhh gay Parreey!
 So I made it, we checked in-- flight is posted as "on schedule". We ran to security-- got our carry-on weighed AGAIN (seriously?) and got hung up because of the bomb shaped anesthesia equipment I was carrying... We had to take a train to our terminal then sprinted full speed with 8 bags to the gate so we wouldn't get bumped or miss the flight. We arrived breathless & sweaty just in time to discover our flight was postponed again a few hours.  C'est la vie!

-Mason & family