Tuesday, October 29, 2013

The beginning of ortho!

So this week I started working with the ortho patients mainly instead of the plastics patients.  And boy, what a entry in Monday was...  We overwrapped 2 patients' casts, overwrapped and placed our experimental pelvic bands on 2 more patients, wedged 2 other patients casts, windowed casts for pin care, the whole 9 yards...basically, any crazy casting things that need to be done was done, giving me a good taste of what the next 6-8 weeks hold!  (And there is no way I could have accomplished all of that myself - Nick instructed me, dayworkers and nurses also helped...funny how it can take up to 4 people to get a small kid's cast exactly how it needs to be.)

Ortho is pretty awesome because you see a very obvious result with the surgery - curved bones are straightened.  It definitely can be hard work...I could use a rolling stool to help the little kids walk as they're a little shorter than is good for bending over to help with their gait as they learn to use a tiny little walker or crutches for the first time.  Often you have to move their legs for them, sometimes they're very painful, and currently we've had a couple patients go ballistic with itchiness (of course we tell the nurse who gives them some benadryl or the like and it calms down).  I might go ballistic with itchiness, too, if I keep on getting fiberglass stuck on my skin...I currently look like I have a massive scrape on my forearm...but it's just because I was using red fiberglass to overwrap a cast today!

One of the sad parts about starting with ortho is having to say goodbye to my plastics patients...  Most of my plastics patients are in outpatient now, but I had about 5-6 still inpatients as well.  I would love to ask for ya'll to pray for Geril.  He's one of my favorites...teenage boy with a super sweet nature, he tries really hard and doesn't complain, but he's been in the hospital a long long time with areas in between his fingers that are taking a very long time to heal.  He will continue having therapy, it just won't be me because I'll be switched over to ortho.  But with the healing, his movement is limited because you can actually see the finger movement pulling at the wounds when his dressings are down...such a hard balance sometime to figure out wound healing vs. preserving/regaining movement.  But he needs your prayers to protect him from infection as his wounds are still quite deep, and protect his heart as well - I can only imagine seeing many of his friends discharge to the Hope Center or home would get very frustrating after a while...  Yet in the ward church service you see him smiling and singing along, and he always is ready to tease me or give me a smile.
Geril is in the yellow shirt with 2 other of my patients (Eliezar and Wame), a baby sister of another patient, and a nurse.  Eliezar is featured in the awesome video I will post when it becomes available...which apparently now isn't until December 3rd.  Sadly you will have to wait!  (But it's such a good video...and I'm even in it!  :) )

Thank you for your continued prayers and encouragement!!  I am definitely missing the fall (Mama put up some amazing leaf pictures!), but have been indulging in some pumpkin and apple goodness.  I'm organizing a 4 on 4 beach volleyball tournament for this Saturday...sadly my 3 on 3 dream team will not make an appearance.  Thursday our rehab team is heading to one of our dayworker's houses to have dinner with him and his family so that should be fun!

Nick is leaving in less than 3 weeks...it will be so weird to be here without him as he's the only boss I've had here and who tends to know the answers to everything I need to know.  And all those strange Australian quirks I've picked up without meaning to.  Like today actually calling a walker a "hopper" ( then afterwards I had to explain to my dayworker today that only Australians call them such things), saying "Whoa!" too often or "no dramas" or "are you happy to do ______".  Talking smack and having a good foozball partner.  I think only his girlfriend will be more sad to see him go...

So with that God is stretching me definitely in how I take on work and prioritize things...so please pray for me to learn these lessons quickly!!! :)

Sunday, October 20, 2013

Dolisie and Biking to the Beach: 3 off ship trips

A pic of the rehab team at our open house a few weeks ago...

So it's been quite a while since I've blogged, as tends to happen, I get caught up in life in Africa and the thought of sitting behind a keyboard waiting for a blog to upload is hard!  But I am lying on a bed in a hotel about 3 hours north of Pointe Noire watching Kenyan TV (the only one in English) and resting before dinner. 

Driving back from Dolisie in "rush hour" market traffic
 There are 4 of us up here checking out one of the 4 general hospitals located in Congo.  The health system here is set up in tiers of types of hospitals - at the top is the University hospital in Brazzaville, below which are 4 general hospitals which have a fairly decent number of surgeons usually and can give somewhat more specialized care.  Beneath that are many other health clinics and smaller hospitals.  Private hospitals also exist - including some of which are mission based.  Two of the 4 general hospitals are in Pointe Noire, 1 is in Dolisie, and 1 is in Wondo (sp?) further upcountry.

So the reason for me being here is because on screening day we saw 1 patient had a very good brace, and they had said it was from Dolisie.  So since Mercy Ships will not be in Congo forever, and our patients sometimes need braces or orthoses of sorts for a longer time than the lifespan of the brace or 2 that we would give them, we are on the lookout for in country options.  Unfortunately once we had the tour and asked about the brace making in person instead of just over the phone, it turns out it is actually done in Brazzaville and not Dolisie, so I was a little bummed about the decreased options for our patients.  Thankfully there is 1 place in Pointe Noire that fabricates some AFO's (ankle foot orthosis) and the like, however, while quite resourceful in using the plastic from yellow water/gas jugs, it's not quite as sturdy or as moldable as some of the other plastic options out there. 

The big tree in Dolisie

The hospital tour of Dolisie hospital is quite impressive however...The director is quite proud of his very, very clean hospital which they clean 2x/day!  They also have >100 toilets, and >200 beds.  The hospital is blessed with continuously running electricity and water, which is sometimes quite hard to come by, and most of their equipment works, which again, is pretty impressive.  Even the mission hospital in Kenya that I was in was not this clean.  It did seem to be lacking generally in patients, however, for the size.  There were a few people in the wards, some in the ER/observation rooms and some having consults with the general medicine doctors.  However specialists come very rarely in from Brazzaville, so not often are all the facilities used.  They only have general surgeons regularly, however if they really need to transport someone to Brazzaville for an acute orthopedic surgery or the like, they can cast them to hold a position, then fly them to Brazzaville (which is about 12 hour drive from Pointe Noire, so I'm guessing about 9-10 hours from here?).

Simbissi waiting to be cooked at Dolisie hospital

sunset at Food for Life
We got to go meet up with Eliphaz, the head of the agricultural program while here and see where the Food for Life site is - it is still under clean up/construction and will start in a couple weeks.  They work with NGOs and government groups to promote and teach good practice with crops (composting, crop rotation, organic pesticides), animal raising (chickens, rabbits, goats), things you can do with products besides just the straight produce (like yogurt, cassava flour). 
Now I am finishing writing this a few days later
I got to go out with Eliphaz and our 2 daycrew that were with us to a restaurant later that evening.  I tried Ngoki which is a small crocodile that lives upcountry in the muddier rivers and such pretty tasty kind of like a cross between pork and chicken.  Earlier in the day I had eaten Simbissiwhich wasnt as tasty, and best I can figure out is kind of like a ground hog.  Apparently they serve that in the hospital, too, because we saw 2 in the kitchen.  J

Now a couple weeks ago I got to go to Dolisie for the first time with Steven, Myriam, and James.  We went up on a Friday night via taxi, got to explore Sat and Sun.  It is always so nice to get away from the hectic-ness of city life (yall know Im a country girl), and to be able to see mountains always makes me happy.  Congo has much better visibility than Guinea, allowing you to actually see the mountains more easily.  The road to Dolisie is pretty awesome twisty, curvy but very few potholes, though plenty of speed bumps to slow you down near any town, and on the trip to Dolisie this past week I got to drive part of it myself!  (not quite as much fun in a Land Rover as a car) 

But anyways, on the first trip to Dolisie, we got to check out the market, I bought a little bit of fabric, camped and had a great campfire meal, jumped in a pond Lac Blu, and hiked around a bit, meeting some of the locals from about a 200 person village near where we camped.  One interesting meeting involved winding our way down a little trail and coming across a family pulling manioc out of the water.  Manioc/cassava is the staple starch around here its a root that the family collected from a nearby forest, then soak for 5 days to get the bitterness out of it.  I think at that point you can cook it to eat it, but you can also pound it and get the juice out and make foufou out of the manioc flour.  Foufou kinda looks like a grey-ish drop biscuit.  I personally like foufou better than cassava because it doesnt have quite as strong of a flavor.  But anyways, this family was quite happy to explain their process to us, found out about what we were doing there, and we gave them a couple apples we still had, so everyone came away happy.  J  We also met the head of the village, who happens to be the brother/brother-in-law of the family that was retrieving cassava.  They offered us some fresh peanuts.

So that's a little of my upcountry adventures.  Last weekend Krystal, Juan, Missy and I biked about 40 km up to a nicer area of beach and spent some time relaxing, strung our hammocks up in a little shack, and spent the night.  I was definitely the slow poke of the biking group, at one point a man with a very nice bike came up behind me.  We had a half conversation in French, and at one point he tried to push me faster on my bike.  Now that was kind of embarrassing...  :P  He has something to do with the Total petrol stations around here...but he said he doesn't work, so I didn't quite figure out if he's an heir to a lot of money (judging by the look of his bike), or what.  It was an interesting scenario.  But it was really nice to get away once again.  Funny how sometimes this ship feels so big (when you have to repeatedly go from floor to floor), and yet other times seem so small that you have to go far away to clear your mind and rest a bit. 


We had delicious fresh-caught-that-morning fish for dinner, I got a multitude of sand flea bites and sliced my big toe open (thankfully it has healed up without any signs of infection despite the inability to keep it clean for about 18 hours following the injury), burned a ton of random wood, ate campfire pancakes and eggs, and collected sea shells and something else that my mom will receive in the mail so I can't write it here...  :)