Sunday night, November 2nd

Just going to bed after finishing off journal #4. My Mac is glowing in my mosquito tent and the screen saver photos are scrolling. I am reminded of how rich I am with family and friends. Jeff, Casey, Chelsea and Luke… your photos are blessing me over and over and over. It gets lonely “in my own little corner” but your smiles make me less lonely…

The worship song “You are a holy God” is touching my heart as I settle to sleep. Oh how I love music.

You are a holy God
An all consuming fire
You’re robed in majesty
Bright shining as the sun
Your ways are not our ways
Your thoughts are high above
You are the fountain Lord
Of mercy, truth and love
And we cry holy… holy… is the Lord God most high
And we cry holy… holy… is the Lord God most high

You are a holy God
An all consuming fire
You’re robed in majesty
Bright shining as the sun
And we cry holy… holy… is the Lord God most high
And we cry holy… holy… is the Lord God most high

Good night...

• • •

This morning we were privileged to have breakfast with Felix, the Uganda in-country manager. God has certainly called him to do the work he is doing and we are blessed to have him be head of Medical Teams International in Uganda. His history is that when he was a young altar boy (he is now 52), Joseph Kony of the Lord’s Resistance Army, abducted him to turn him into a child soldier.

His faith conviction was so great at that time that he told Kony to his face that he would not kill for him because he was a Christian. That he would need to shoot him. Felix was spared and the story goes on to this day that he is accountable to God and won’t compromise his values.

Felix explains that “I have to answer to Him (he says as he points up) and so I cannot compromise what we do. I have 10 children but most of them are grown and can take care of the younger ones. So if they kill me it’s ok.”

WOW. It was a powerful morning and we were thankful for the gift of time with him.

• • •

Felix always has a way of making you feel like he’s not in a hurry and that this is the only thing he has to do that day. He’s on what we call “African time”. We talked about some of the differences of Ugandan ways versus American ways. Some good, some bad.

He thinks that Ugandans don’t work very hard, that they have to keep on people to do the job set before him, that they could learn a lot from us in this area. BUT “You people work so hard and it is a way of life for you, but the bad thing is that you don’t always have time to talk. If you see someone here and need to talk, you just go up to them and start talking. They will give you the time. You all work so much and don’t have the time to spend with people.”

He went on to express how we can have less of a community because of it. It’s true, sad but true. We are more isolated and less communal. The people here are more intertwined and interdependent. It’s hard to describe.

• • •

Oh, yes, my clinic days …

I had an 18-month little chub whose momma brought in for a high fever... and do I mean chub! She was groggy but responsive to me, and the $0.50 rapid test for Malaria was positive within a couple of minutes. I gave her paracetamol (african tylenol) to bring her fever down and brought her to the injection room to get an IV started for her first four hour infusion of Quinine.

About two hours later I was in the lobby and both Charles and Moses (nurses) were carrying out a very limp little girl. They smiled at me and said, “Janey, this is your little girl, we have just gotten an IV in.” I was shocked, had assumed she was already half way through her first treatment and she was going down. I watched them hook up the D5W and add the medicine. The volume wasn’t what I ordered, so that led to some discussion later after it got rolling.

Before leaving the clinic that day I went to check on her and prayed over her. What else could I do? The good news? I checked on her first thing in the morning and couldn’t find her on her gurney in the tent. Fear quickly arose and the cleaning lady saw my concern and led me outside to a momma holding my toddler… she was “almost”a bright eyed little girl again. Thank you Lord!

This prescribing thing is hard. I had missed ordering a bolus of D50 (high dextrose) before treatment started, since severe malaria patients can have blood glucose drops. She wasn't so bad when she went into the treatment room, two hours later was a different story. Moses was the one able to get an IV in, he’s a champ and it was in her scalp in the end.

• • •

Now on to my 20-year-old girl with a questionable STD. Not married, denied sexual activity. But when offered a pregnancy test she was interested… confusing history. Turned out she was positive and her story changed. She was married “for about a month” and lives with her husband. Why the lie? My translator and I were trying to figure this out. I'm thinking she's unmarried, pregnant and “in trouble”... or her husband wouldn’t be happy... or.... ????

A day later, I talked to Hakim, the nurse who is trained in counseling and had been to a domestic violence/gender-based violation class just the prior day. We were discussing his class and he said, “You know your patient, Janey? She came back today."

She was raped a month ago on the way home from choir practice at church. She is living with her brother who she feels will throw her out when he finds out she is pregnant.” I felt horrible, no wonder her story was so convoluted. Who’s the victim here?

She will fortunately get counseling, help with some supplies and I encouraged Hakim to have her brother come in so he would learn who the true victim is here. I also asked him to apologize to her for me. I would have wanted to be more supportive for her.

• • •

Saturday clinic was odd, we arrived late after having the car overheat (in the boonies by the way), and we were there for about an hour adding our water bottles to the radiator and then some darling boys helped us gather VERY brown water from the roadside ditch to help out.

The engine was so HOT that it was sputtering the water out of the tank. The treat here was the pleasure of watching them be so helpful to Mazungos and have no hesitation. They just wanted to help. We exchanged names (cryptically) and then I was able to treat the 4 with power bars… gooey 30 gm bars with a lot of sugar.

Hope they got it off their teeth later. They were so politely grateful. 4 little angels to help us…

• • •

Our patients were few that day, especially since we were so late with the breakdown. BUT Deanna had a kid with 106.3 fever and I had two kids in a row with 104.6!! After the second one, I checked my own temp to see if it was accurate. Both my kiddos had pneumonia (haven’t seen much of this actually this trip) and then my next patient was a 19-year-old with a 103 temperature and 6-½ months pregnant with malaria.

THIS IS DANGEROUS and she was my first pregnant gal with Malaria. Thank God for my “cheat sheets.” The protozoa can cause ischemia (clumping of blood and death of tissue) and can block blood flow to the fetus. Our driver Peter’s wife lost an 8 month old in-utero last month because of malaria.

This gal got treatment right away and I hope is doing well…

• • •

Tuesday evening -- 3 more clinic days to go!!! My highlight patient today was a 16-year-old girl (Ugandan, non refugee) who had a pass from her boarding school to come and be seen for her eye irritation. She was timid but I confirmed right away that she knew English.

I invited her to explain to me what she came for. She leaned in close, our cheeks almost touching opposite each other, and spoke almost in a whisper to say “I have problem with my stomach” I was fearful the next thing would be some sort of abuse and so I inquired a bit more.

“What can you tell me about your stomach?” “I think I have worms, I can feel them moving around in there”… oh my gosh, I thought. At first I thought she may have been raped or whatever and it was worms. She was SOOOO sweet and shy about it. I was able to treat her and in further questioning discovered she also had exercise induced asthma.

“I have a hard time breathing in the cold” and “hard to breath when I run”. She had some mild wheezes there and so I got to train her on how to use an inhaler…

• • •

...These last 2 days have been VERY emotional for me. I’m “smelling the barn,” as they say, and getting ready to go home.

I have had a couple of days struggling though (some of you know about it), as I am caught between two worlds: one here with minimal living standards and the other one that I’m coming home to.

This is not new. It seems with each trip the struggle changes. I guess most importantly, the Lord is working on my heart and my perspective on life. Same lessons again that I didn’t seem to grasp well enough before???

• • •

You can get numb to what we are seeing, and at times I’ve surprised myself.

Driving through the villages or glancing through the crowd as we arrive and go to our exam rooms, the smiling faces or the somber little faces on these dirty little cherubs is all I see. I used to be shocked at the clothing, and now it is normal.

Seeing a sick child waiting for hours in their mom's or dad’s arms is normal now… a 1-liter jeri-can bottle beside them for the day, with dirt around the rim and shadows of dirt inside are normal...

The sickest ones get brought in first, especially the high fevers.

I wonder, what will coming home be like this time? I’ve shed some tears in my little mosquito tent these last two days, and am praying for the Lord to come along side me in my state of confusion.

My kids, Jeff and a few of you know the struggles of my heart… thank you for your encouragement to me... I’m going home to 2 houses, and yet am working here with people who walked long distances, leaving their mud/stick dwellings where a family of 5 may be living in a space just a tad bigger than the room I now lie in… life is just so unfair. Why do these kids smile at us so much when we drive by?

Day after day they run to greet us. Today as we drove in, I took a 3-4 minute video of the faces we pass, I want to capture them.

The beautiful children who run to the edge of the road just to get a glance, smile a huge smile and wave excitedly…often yelling “Mazungo, Mazungo” or “HOW R U” with bold pronunciation (for most the only English they know). I feel honored and yet humbled, I feel like we are on a float in a parade and yet they are the stars in my eyes, brave little souls that don’t even know they are brave… and mommas who work so hard to feed and care for their families… a mom with such straight posture strattled on the dirt floor in front of her home splitting pea pods in a plastic basin… a threesome of siblings in a row along the road carrying graduated bundles of sticks for firewood on their heads… little siblings with littler siblings strapped to their back and playing as if they are one… a row of 5 women in long skirts bent over at the waist working in the fields with infants strapped to their backs…

I will miss these beautiful scenes along the way to Nakivale, today's ride was oh so rich. Lord, please come alongside me and prepare my heart to go…

With love,
Nurse Janey