Andie and Kristin trying the infamous Maui fruit -  A sour, extremely slimy seed that you suck off and spit back out.  Kristin, Jamie, and Lily all played chubby bunny afterwards. They also double quite well as bowling balls....

The female ward in Macha - about 40 patients to 2 nurses

 

Nothing beats these beautiful African sunsets!

One of our favourite past times - sunset watching!

Abby and Haley with a Zambian midwife the baby the girls delivered!

Jamie A. and Ashley all ready to catch a baby after a C-section

Chipego breathing on his own :)

“Shall we accept good from God, and not trouble?”

The bright African sun beat down from its perch in the cloudless blue sky as the usual haze of red dust circulated about my feet and clung to my shoes and scrub pants. I smiled as I pondered the irony that every day I was blessed to walk in 90 degree weather on a rocky, dusty path through the African bush to get to clinicals, while my American counterparts were driving their cars through the chilly Indiana rain. Despite the many difficulties of living life and participating in health care here in rural Africa, it is a huge, huge privilege for us to be in Zambia. 

On our first day of clinicals in Macha over three weeks ago, I was doing rounds with the doctor in the morning and we came to a young patient who the doctor explained was 24 weeks pregnant and diagnosed with an “inevitable abortion” (miscarriage). He then asked me, “What is an abortion?” I replied that in Zambia, the word “abortion” was generally used to refer to either the unintentional death of the baby (miscarriage) or the intentional termination of an unborn baby. (Only recently legal in Zambia). The doctor rather indignantly replied, “why do you keep saying ‘baby’?? At 24 weeks it is a fetus. You can’t keep calling it ‘baby’—only after 28 weeks can you say ‘baby’. This is just a fetus. What do you think?”  It took me a second to realize what he was saying. I was a bit shocked at his forwardness about this topic, but firmly replied “No, I disagree – I believe this is a baby from day one. On day one there are living, human cells, and I believe that they are always babies from the moment of conception.” Laughing at me, the doctor moved on to examine the next patient. 

Later that night, a nurse walked into the Maternity ward that I had rotated to for the evening, carrying a tiny little baby that wasn’t breathing. The baby turned out to be that very same 24-week-old “fetus” that I discussed with the doctor earlier that day. The nurse placed him on the scale to weigh him and kept standing there. His tiny lifeless form was quite blue, and I asked her several times if he was breathing. She did not really respond, and eventually stepped aside. Immediately I checked his heart rate—and his little heard was beating hard and fast—he was still alive! I put him on the warmer and Jamie and Marguax helped as we began to try to stimulate his tiny body and get him to start breathing. I kept getting a bunch of meconium-stained fluid out of his airway (basically poopy, amniotic fluid). We ambu-bagged him (emergency resuscitation), prayed and prayed, stimulated, suctioned, ambu-bagged, put in a bit of oxygen, and kept repeating the cycle. Finally, I will never forget the moment that he gave a tiny gasp, his skin retracted against his tiny rib cage, and he took a breath! What a miracle! Preemie babies do not have a big chance at life here in Zambia, but life is definitely gift from God. God gives and He takes away. Blessed be His name. I am thankful that even for just a little while we could give this baby life. Almost this exact situation happened to 2 girls of our team just a few weeks ago and so it was an unreal situation to walk through, and difficult to process and sort out in my heart and head.            

 I hope that the doctor came around the next morning and saw the living, precious little human life. Over the next several days,  we checked in on the baby, rejoicing at the miracle of this little life. One day I went in, and he was no longer in the warmer. I searched every room, and he was gone. We asked the nurse and she said that he had “expired.” Originally I had my hopes up that he would make it, but knew his chances were slim. His internal organs were so underdeveloped and no sophisticated machines exist over here to help keep him alive. The father never showed up to name the baby before he passed away, so, (at least for my own sake) I named him Chipego, which means “gift” in Tonga. God graciously gave Chipo a few days of life, and in His wisdom decided to let Chipego’s human body die. I have been encouraged by reminders from Isaiah, recognizing that God’s ways are higher and far above what I often think would be best, and I have been challenged by Job’s assertion, “Shall we accept good from God, and not trouble?” God is good, always. 

On another evening shift later that week, we had an incident where the victims of a car crash were brought in to the hospital, several already dead and one lady in a critical condition… she ended up coding and a Zambian doctor and Haley, Kristin, and Abby rotated doing CPR on her, but she passed away. A week ago, while pushing a patient to Surgery, a procession of women, wailing loudly, wheeled the covered body of a small child out to the morgue. I have seen more death here than in my entire life combined. In the West, death is viewed as the ultimate enemy, and we do everything we can (especially in the medical world) to fight it, avoid it, and delay it. For the people here in Zambia, the idea and concept of death is so much nearer and tangibly real—people are almost fatalistic about it all. I struggle to reconcile these differing cultural views, remembering the fact that we live life in a broken world, and yet simultaneously clinging to the truth that Jesus won victory over sin, suffering, and death through His perfect sacrifice—and that as believers we have ultimate hope beyond the grave. 

One of my friends in the States put it well—“nursing itself is hard enough [emotionally], let alone doing nursing IN Africa.” I have never seen so much physical suffering in my life. As a team we covet your prayers that God would help us to process through things well, and that lessons and themes would emerge out of the weeks and months that we have been through so far. Every day is so full of so many new experiences it is so hard to sort things out and make sense of all of the pain and suffering we witness. I have been so encouraged by 1 John 3:20: “For God is greater than our hearts, and He knows everything.” When my heart flails for answers and I can’t figure things out or make sense of them, I can rest assured in the understanding that GOD knows everything. HE is in control, and He has reasons and purposes.

Please also pray that, as we wrap up our final 15 days left in Africa, that we would still be present and make the most of our days, hours, and opportunities while we are still here.

love,

~Elisabeth

It's a Bug's Life! (Musings from Macha)

Hello friends & family!

Well, no one has updated the blog since we’ve been in Macha, so I figured it was about time. I’ll give a brief review of some of what we’ve been up to.  It’s been a challenge processing through some of the difficulties, so here are just some of the experiences of daily life here.

Macha is a much more rural area than our previous locations. We’ve been doing our clinicals at the Macha Mission Hospital, a teaching hospital associated with a nursing school here. We’ve also had good learning experiences from the Macha Malaria Institute, and many of us have been able to go on field outings with the researchers. In 1998, malaria was the #1 admitting diagnosis at the hospital, and the #1 cause of death in 2000. Through the Malaria Institute’s work, malaria has been 97% reduced here. Pretty amazing!  

The hospital is quite a bit larger than Zimba or Choma, so we’ve had some more interesting clinical experiences. Many of us have gotten to deliver babies! We have particularly enjoyed one of the midwives, Gladys, who encourages us to jump right in. Whenever it’s time for a baby to come she asks, “Who’s delivering this one?” and one of us enthusiastically (or maybe not so enthusiastically if it’s 3 am) puts on an apron and mask and has the incredible opportunity of assisting brand new life into the world.

One thing we will NOT miss about Macha are the creatures. Evenings are often filled with the shrieks and screams of girls tormented by spiders. ENORMOUS does not come close to describing these fuzzy, fanged devils. Abby, Hannah, Jamie A. and Lily also saw the first snake of the trip (a spitting cobra) one evening at the hospital, and they watched from a few feet away as a brave woman hurled large rocks at its head.  

Personally, one of my favorite things about Macha is being able to walk through the rugged, African landscape and experience the beauty of this country. I enjoy passing by the little villages and seeing the faces of people who live so differently than me. A few of us climbed a nearby water tower and soaked in the view as children below yelled repeatedly, "How are you?! How are youuuuuuu?!" We stand out enough as it is, so I can only imagine how humorous it looks for a group of “mzungus” (white people) to congregate on top of a water tower!

One of our projects for our community health class is to do a teaching initiative. On Tuesday, a group of us  are going to a local girls school to teach the tenth grade class (about 100 girls) various topics including nutrition, hygiene, how to handle stress, and purity. We’re also planning a conference, “Helping Babies Breathe,” coming up in several weeks for 12 traditional birth attendants. HBB is a curriculum that teaches neonatal resuscitation. It will be neat to educate the birth attendants, and we are even providing them with ambu bags (bag-mask resuscitating equipment). We were trained in HBB back in the states and have, ourselves, been able to use what we’ve learned in clinicals. Please pray for both of these initiatives!

Tonight we are going to a nearby restaurant and a local band is going to play for us. It will be a nice break from the rice, cabbage, and mystery sausage that we frequently have here!  (Who knew you could eat cabbage in so many different forms?!)

We appreciate your continued prayers for our team, and we are eager to see our friends and families in a few weeks!  

-Lauren

Cute, isn't he?!

Andie, Hannah, Lily, & Jamie enjoying the view from the water tower!

Nurses to the Rescue...

This past Friday, we left Zimba and encountered a surprising, life-changing adventure on our way to Macha, a rural town we will be in for 3 weeks. We had not yet reached Choma and were in the middle of the bush (the rural land a fair distance away from cities) when we came upon what appeared to be a large cloud of dust. Our first reaction was to shut all the windows on our little bus to prevent the dirt from getting inside. After we cleared the dust, our eyes all were drawn to a large object far off the side of the road with two people in front waving their arms at us—an enormous charter-sized bus had crashed into a small field 50 feet off the side of the road.

As our bus slowed down to park on the side of the road, one of our nursing professors said aloud, “everyone grab gloves!” and we all did as she suggested. We ran out from our bus with what we had from our nursing clinical supplies: gloves, gauze, tape, and even our own bottles of water. Instantly we could see that the whole front of the bus was gone. The windshield was smashed in and the gaping hole that was left behind now revealed injured, bleeding people who were still in their seats toward the front of the bus.

Working as a true team, we began to help people climb out of the open front end of the bus past the debris and broken glass. People were so shocked—the accident had clearly just happened and some people were even screaming. One woman had apparently jumped out of the bus with her young child in her arms in an attempt to escape the crash, but she had broken her leg from the impact of landing on the ground. She and her daughter were covered in dust and had some abrasions.

 Other people and cars began to stop along the side of the road and we were soon working amongst a large crowd of people. Some of them were helping the victims of the crash and the rest all looked in bewilderment at the crash site as they filmed and took pictures on their phones.

Our water bottles were put to good use for the victims of the crash. We used the water to clean off gashes and abrasions of all sizes of adults and children alike. Our team instinctively broke out into smaller groups in order to attend to the more critical patients. Gauze and tape were applied quickly to the gashes and cuts on various parts of bodies—mostly on the heads and legs of people. No wound was bleeding too excessively, but there certainly were some deep cuts.

The most memorable victim was a woman sitting at the seat closest to the gaping hole of the bus who had a clearly visible face covered in blood. A doctor who had been at the back of the bus quickly helped to assess this woman and called for some chitenges (the pieces of material that Zambian women wear for skirts) and sticks to fasten to the woman’s badly broken leg. A large metal pipe which had broken off the bus was tied to her leg to keep it straight and a group of men carefully lifted this woman off the bus over the sharp edges of the windshield. Our team kept this woman alert and talking to us to be sure she remained conscious. We applied pressure and bandages over her bleeding cuts, including a deep cut on her forehead and a bloody cut which was over halfway through her left thumb.

 Many victims were experiencing leg pain and difficulty moving as many of them appeared to have broken legs from the impact of the crash. We comforted these people and instructed them to remain still until we could get them into the back of the pick-up truck which was heading to Choma General Hospital about 10 miles away. Only the more critically injured people were placed into the truck that was going to the hospital. We carried people with leg injuries and supported those with upper body injuries and loaded many into the back of this truck. Victims were mostly concerned with keeping all their bags from the bus with them, but we arranged for these to be brought to the hospital at a later time.

Including small children, the bus had been transporting over 70 passengers. The front left tire of the bus had blown out and sent the bus off the road, through several large trees, and eventually went airborne and crashed down into the dirt. No one on that bus died in the crash, which is certainly an act of God. Our group of nursing students had arrived first on the scene only minutes after the accident had taken place.

We did not have time until later that day to discuss the event, but we realized how perfect it was that our group was the first to respond to this accident. We were even prepared with the supplies for first aid and gloves to protect ourselves to help treat those who were injured. The timing was also incredible-------Our group was originally planning on having several classes during this same time, but we had changed our minds and had class arranged for another time instead. Falling somewhat behind schedule that morning, we had left Zimba later than when our leaders had planned. If we had not changed our schedule or fallen behind that morning, we most likely would not have known about the accident at all. God had had a different schedule of time in mind for us and the people on that bus that day.

Even for those who managed to leave the accident with only small scratches, we served as a sense of comfort and reassurance of their well-being and safety. Some of the victims said remarks such as “God is present here” and “Thank you, God” in addition to thanking our group. One woman who survived the crash with only a bump on her head was overheard speaking to someone on her cell phone at the scene. Into the phone she said, “Luckily, a bus full of nurses just happened to drive by shortly after the crash.” She smiled with sincerity as she said this and looked at me….. all I could do was smile back with tears forming in my eyes. WOW.

God is so mighty and wonderful!!! He has a plan for all of us and we never know where our paths will lead us!! We know God meant for us to be at the scene of that crash so we could use our nursing talents to serve people in need. It was all done to the glory of our Lord Jesus Christ!

Later when we left the scene, in a choked-up voice our professor prayed—“Lord, earlier today before we left we asked You to send angels to protect us, but instead we became angels.”

-Samantha Lehman

Zambia Abroad Nursing Student