10 pm, May 16, KMH

Do nothing out of selfish ambition or vain conceit, but in humility, consider others better than yourself. Each of you should look not only to your own interests, but also to the interests of others.
Philippians 2:3-4

Today was another good day in peds ward. I gave a lot of IM and IVP meds, as well as nebulizer treatments. I got to watch a 7 year old girl, Martha Mosi, with osteomyelitis, get her dressing changed. No fainting. We also reconstituted quite a few meds, went to the pharmacy and central supply, and cleaned/reorganized the drug cart.

Gijimani and I talked a lot, comparing programs and hobbies. We both like to bake, so she gave me her pumpkin bread recipe. and I'm giving her my mac n' cheese, as well as a lemon bar recipe. Tomorrow after lunch, we're giving out toys and candy to the kids and nurses in peds ward. So excited!

Pumpkin bread recipe in metric

After work, Steph and I went to see Talent. I actually got to see his dressing change, and was totally fine. Proud of myself. He asked us to be there next time, if possible. We ended up leaving partway through to take care of a man with hematuria who was vomiting. Strangely, I felt like a real, capable nurse then.

We talked with Talent for a while. He seems bored and discouraged. his accident was January 22nd. That's a long time to not be well and he's worried about not being able to walk again. He used to love to read, but he's tired of it now.

Made chicken stir-fry tonight. Yum. Had prayer meeting with the senior staff, which was pretty awesome. Had some good laugh about a father picking up lobola (bride price) in Dubai, instead of down in the valley.

Dinner with Kristy, Naomi, Sarah,
Steph and Jenny

Chicken stir-fry...mmmmm

8:40 pm, May 15, KMH

Blood draw for a rapid HIV test
(no worries, no HIPAA in Africa)

Today has been a pretty cool day. I started in male ward "with" Muchaya but not really. I was placed in charge of Male Ward B, as well as blood draws and dressing changes for the entire unit. I didn't know where to start. Thankfully, Naomi showed up and helped me do blood draws. She took me off dressing changes and I ended up taking BPs for the entire unit instead. One thing that was rather sobering was the fact that the large adult BP cuff was much too big for most of the men's arms. Sometimes it wrapped around twice. We ended up getting one from peds.




I was able to see Dzindza again. He asked how I was doing and said he had been worrying about me. He also asked why my face was long and told me that I was too big for being 21 years old.

After tea time (a standard here. Dzingdza was shocked that we do not have it in the States.) Naomi reassigned me to peds ward. I worked with Gijimani, who was also in her first day of peds. You could hardly tell, she is so on top of things. I was able to give meds IM and IVP, as well as PO and per nebulizer. I reconstituted and diluted. I saw a couple of hydrocephalus babies as well as one with myelomeningocele ("meningomyelocele"), a baby who was HIV+ and two who probably have TB. One kid who we gave an IM shot to had kwashiorkor so bad that he looked like a burn victim because his skin was peeling off. The hardest thing was making kids cry.

Melita (center) and Judy (right) having a traditional Zimbabwe meal 

Tonight we went over to Melita's for dinner. Her stew and Judy's homemade bread were delicious. Then I went over to Kiersten's for her nursing student Bible study. Gijimani had invited me and Muchaya was there. Because some of the girls are going to Harare for psych, we ended up talking about demons, and the difference between oppression and suppression, and schizophrenia and depression, and whether a Christian can be possessed, and what being bought by the blood of Christ means, and neurotransmitters. Its cool how Christ and medicine can be common denominators. I felt like I learned so much tonight.

May 14, KMH

The thing that ought to make the heart beat is a new way of manifesting the Son of God. 
-Oswald Chambers

Walkway through the hospital compound

Today is the day I looked forward to and dreaded, at the same time. We worked in the hospital today 7:30am-4pm. 7am was chapel, with Shona singing and a message from Judy. Then we all gathered in the duty room to get report. I could only pick up snatches here and there.

Medicine cabinet where all drugs are stored

The day was very full. I gave quite a few meds with Muchaya, plus made beds, brought a patient back from the theatre, did post-op vitals and watched a dressing change. It was very interesting. I do not feel super helpful yet, but I feel like I'm starting to get the hang of things.PCM is paracetamol, or tylenol. I recognized the TB meds and a new NSAID. I know how rounding works, vitals are taken, and meds are passed out. Its still hard to understand people and to know who to direct questions to and when to step in. And when to wear gloves. Haha. They don't wear them nearly as much here as we were taught to at school.

Gentamycin (an antibiotic) ampule
and the syringe used to draw it up

I had two bad incidents today. First, I crushed an ampule cap in my hand, cutting both my thumb and index finger. I think that the thumb was rather deep; both bled a lot. I had to scramble for my bandaids.

Supply cupboard in one of the hospital wards

I also basically passed out in Ward D. Muzhmata was doing a dressing change. Talent (Dzingdza) has osteomyelitis (a bone infection) from a tibia-fibula fracture caused by a car accident. He returned after developing the infection during his time at home following his previous two-month stay. His wound was deep, to the bone. We had just had a friendly conversation and then there he was, groaning in pain. I suddenly felt hot and almost passed out. I barely remember it. I felt much better soon after, but took a break to rest before lunch.

Had taco salad for lunch (didn't exactly know how to explain that to the nurse I was working with) and ramen for dinner. Spent some good time talking tonight, and then went an info meeting for teh half-marathon this Saturday. I'll be manning one of the check off stations , trying to keep track of runners. Now I'm going to go write an email or as much of one as I can. I'm wiped. Another early morning tomorrow!

6:30 pm, May 13, Karanda Mission Hospital (KMH)

What a day! Its been so exciting, sobering, humbling and interesting. This morning we woke up to the sound of Shona worship songs. I love the sound of their language and their singing style. We got up and ready by 8:30 for our tour of the hospital. We saw the OPD (outpatient department), antenatal, maternity, peds, female and male wards. This place is amazing in how they make the best of what they have.

The guesthouse and gazebo

Maternity had a little baby in the incubator. Apparently in December, they had a baby born at 800 grams that survived.

Peds was such a sad, yet happy place. Its cool to see all those kids getting treatments, but sad that they need them in the first place. We saw a hydrocephalus baby ("hydrokef," as they write) with a manual pump. There was a kid with a femur fracture who was in Gallows' traction, and another with an open reduction.

I will be working in the male ward tomorrow. It is very new, only two-three weeks old. It is split up into four sections: surgical, medical, HIV+ and I'm not sure what the other is. We will be with Chumaya, a senior nursing student in the three year RGN program here. More about that later. In the male ward, the patients are more likely to speak English. We also saw a chaplain lead a service in D Ward. It was quite loud, with singing from a group of three women dressed in blue.

The compound also has a chapel where outpatients meet in the early morning for a devotional, and are then assigned numbers in line (the "queue"). That way, it benefits them to come to devotionals and hear the gospel message.

There is an opportunistic infection clinic for HIV+ patients to receive government-funded ARVs, education and checkups. Mr. Christiansen, Julie's dad, runs a shop fixing things up, next to the new building which will be half bike shop, half oxygen concentration. The hospital has a laboratory and an xray room, as well as the "theatre" or operating room. I will be in theatre next Wednesday.

They do so much work here, with peds immunizations, male circumcision, malaria, TB, HIV, fractures, infections, malnourishment... The old male ward is being turned into a new peds ward, with isolation rooms for TB and Kwashiorkor (these rooms also have a heater for the malnourished kwashiorkor kids.) People come from all over Africa for their low rates and quality care.

Their nursing school is also in high demand. Over 1000 people apply each year and only 10-12 are accepted into the nursing program and the post-graduate midwifery program. It is a three year program that will end in their gaining a Registered General Nursing diploma. Its a very intense program. Many hours of dedication and high standards. Only one month off a year, with 3 month rotations between class and in the hospital. They even have to take physics and pass a national written exam.

The hospital is mainly staffed by students but most of them don't stay once they graduate because Karanda is too rural for them. They run on a British system here, so the nurses wear white uniforms. The females wear skirts and pantyhose. The head of each ward wears green. All nurses are called "Sister ___" or "Brother ___." They wear epaulets on their shoulder signifying their rank. One to three bars for students, indicating their year in school, and certain other symbols for RGNs and post-graduate work.

Mrs. Chim, head of female ward

There is more to do here than just at the hospital (haha..."just.") There is a kids Bible club which meets Monday, Wednesday and Friday. Nursing student Bible studies are held Wednesday nights. April and Kirstin each lead one. Awana meets on Saturday. There is also a half-marathon this Saturday, headed up by Dr. Dan Stephens, who we met tonight. We might be helping and Steph might be running.

Then there is just playing with the kids. Last night, we met many of them when playing "flag-flag." Patricia is the seventh grade leader, tall and able to translate for us. Praise is a little girl, deaf, mute and possibly autistic. Her siblings brought her along with a leash on her ankle.

Some of our fellow soccer enthusiasts

Tonight the boys came over and asked us to play soccer. This was my first time playing in a skirt and flipflops. Innocent, or Ino, is obviously their leader. He is tall for a seven year old, even in the States, and stands above his older comrades. He was abandoned at the hospital and adopted by one of the missionary families, who fed him on goat milk, which is what gave him the nutrition needed to grow as much as he has. He and the other boys, Lyle, Tipenda, Twonga and others, are especially good at soccer.  We started out
just kicking it around, then played "chumama", some game where you can only touch the ball once and never let it stop. Finally, our game morphed into the classic "keep away." I am glad to say that I was able to steal the ball a few times. the night ended when Lyle and Tipenda had a scuffle. Ino and Twonga remembered my name from yesterday, which was exciting. My legs still hurt from these past two nights.

Jenny in the rehab building
having fun with the
equipment!

It was fun working together with the other girls to make tacos for dinner tonight. We work really well as a team. Plus , its my favorite dinner.

It was great to hear Jenny's stories of her first day at work with Charity, the therapist. She got to work with our little friend in Gallows' traction, who managed to wiggle around and even break one of the strings holding her legs up. Karanda rehab is very improvisation focused.

Steph and I in front of male ward

I'm somewhat nervous about tomorrow. I hope the sights and sounds and smells do not bother me. I want to be a help and not a burden, but perhaps that is the humility I need to learn. The men's ward is not where I planned to end up but I know You can use me there. Please Lord, help me be prepared, alert and teachable.

8:30pm May 12, Karanda

We're at Karanda! What a day. We are finally here.
Its early afternoon back home, the family is done with church, Bethany should finally be starting summer vacation and Sarah is graduating. I hope she knows that I am thinking of her.

Our trusty load-bearers

On the other hand, my day has been almost too busy to think. We packed up and headed out this morning. It took us about two and a half hours to make it to Karanda in our two loaded up vehicles. I was lucky enough to fall asleep along the way.

Traveling out into the country

Our passing view of a popular animist cult. They often
dress in all white when at worship.

The drive was beautiful. The land looked more like Africa the farther we drove. Lots of scrubby trees. Brown and green mountains. We saw Mount Darwin. Thatched huts sat in clumps beside the road. We had to pass through several police roadblocks on the way, but were merely waved through (probably because of the Karanda sign on the side of the truck). The last seven kilometers consisted of graded dirt path between and through fields, and then crossing a river and climbing a steep hill.

The supplies I brought over in my extra suitcase. Friends from
my church and school donated everything
from toys to medical supplies to coffee.

There is quite a big compound here. I'm not sure what to think of it. So many houses, and of course, the hospital and the school. We're sharing the guest house with the McQuillens, Paul and April (both doctors) and their two kids. Sarah and I are staying in the dorm. We had six beds and four closets to choose from! I like the quiet of this room. My ability to spread out and not be cluttered.




Tonight we played "flag-flag" or capture the flag with the kids. They were disappointed when we weren't here Friday to play, so we made up for it today. The kids haven't played in six or seven months, so theur grasp of the rules was a little off. We played as the Zambian and Zimbabwe teams. I was on Zimbabwe, the winning team. I made myself a little friend, Rutenda, or Ruru, in the process.

The dorms of the nursing school within the hospital compound

Poor Kristy twisted her ankle, so she spent the rest of the night elevating and icing it. We made some delicious grilled cheese for dinner, had some more info given by Naomi, and now have the rest of the evening to ourselves. Tour tomorrow at 8:30 am.

Tonight, I switched from Philippians to 2 Timothy for devotionals. Dr. Russell said it is a good book for the mission-minded. 2 Timothy 1:7 "For the Lord did not give you a spirit of fear, but of power and loves and self-discipline."

May 11

Today was certainly an eye opener. We got to see the westernized side of Zim culture while grocery shopping, which was not at all what I expected. They played American music in the store (Fun., Pink, T-Swift and JBiebs) and even at the craft fair (Michael Jackson, anyone?)

Kapenta: basically dried anchovies

The orange Sunny D-like drink is Mazoe. It comes in several flavors,
but the classic orange is most popular,

But they sold mealy meal, oxtail soup and chakalaka in the stores. They also sold the fried caterpillars and dried fish (I forget the names...) which look gross but are more for nutrient intake than taste (62% of your protein...)

Bags of rice: the staple food of native Zimbabweans

Vegetables from the open market

It was a very cool experience, as was eating Chinese (yes, Chinese in Zim) with the town missionaries tonight.
So excited to go to Karanda tomorrow!

8:45 pm, May 10, Marlborough, Harare

Today was a good day. I'm so tired, I hardly remember any of it. Cold shower this morning, breakfast at the guest house, orientation this morning at the town office. We had a "proper" cup of tea at the orientation, where we learned about the history of Rhodesia/Zimbabwe, the Shona culture, finances, bartering, religion, and language mistakes. We also had sadza and muriwo (meat) for lunch. It was delicious! And filling. We tried the cherry plum soda, which was yummy. And fried caterpillars. Gross.

Sadza, muriwo, and rape (a kale-like vegetable)

Madora, fried caterpillars, a cheap source of protein

This afternoon, we went to Billy's for a month's worth of meat (30 kgs!!!) Dinner was at an American Style dinner, with pictures of Elvis and Marilyn Monroe on the walls. I had a Deano's Cheeseburger, which was a 200g (~1/2 lb) cheeseburger with cheese cooked into the middle. I even managed to eat it after picking off onions and tomatoes.

Deano's Diner

When we returned, we saw the Southern Cross. After a long ended sessions, during which we all almost fell asleep, its time for bed.

Hmmm...

This semester, I am taking African, Asian and Latin American Literature online as my literature elective and last gen ed. Its been a great experience, both because I've been able to read some African books that told stories of a people near and dear to my heart, and because of the unique insights of my fellow classmates.

In this module, we are reading Paulo Coelho's Veronika Decides to Die. Its been a thought-inspiring read so far, exploring the meaning of sanity from the inside perspective of a mental hospital patient admitted for a suicide attempt.

Author Paulo Coelho, from his website:
 www.paulocoelho.com

While this is a serious subject which I appreciate the gravity of, especially after my psychiatric nursing clinical rotation last year, I need to take a moment to appreciate the humor of the picture on the left.

This picture is on the opening page of the current module, with a caption notifying students of the class that this image is "available as a free wallpaper download" from the author's website.

Am I the only one that: A-is not sure why the author created a wallpaper image of himself, B-would find it creepy if someone actually had this picture on their laptop? People these days...

8 pm, May 9, Harare, Zimbabwe

We made it. =) After a bit of nerve-wracking time getting through immigration/customs (questions asked like such as "are you leaving anything in Zimbabwe?"), we met Nancy Everswick, our ministry supervisor, Dave Jereb, one of the new missionaries in Harare, and John Christiansen, whose daughter graduated from Cedarville this year. We packed our belongings into the cars and headed out. We saw some giraffes along the way. Nancy explained a lot of things.

The name Zimbabwe is derived from the Shona word "dzimba-dza-mabwe", which means "large houses of stone." This term is in reference to Great Zimbabwe, an ancient city whose ruins are now a protected site. This tower at the Harare airport is a modern structure built in a style reminiscent of the structures once found in the city.

We got to the mission house alright. Its a lovely place. Roomy and welcoming. We met Baba and Amai Perfect, who work at the house. Shared our testimonies, expectations, and fears. Unpacked and reorganized. Ate Zim pizza (peri peri chicken!). Experienced our first power outage, and got to use our headlamps. =) We just wrapped up our food planning. Now I'm wiped out. Orientation tomorrow!

Scenery on the road from the airport into Harare.

9:30 am, May 9, Ethiopian Airspace

We're on our way! Its crazy to think...we're in Africa! Slept in Ethiopia last night. Got up this AM for breakfast (with Ethiopian coffee and mango juice to drink) and headed off to the airport with few problems. Those few problems being: A-Steph and Sarah blew the fuse in their hall last night. B-returning to the hotel twice. The first time for a man who missed the bus. The second was for a man's wallet, but really, we think he was feeling bad for the first man's companion, who also missed the bus, and wanted to help him out. :P The second missing man turned out to be my "seat buddy" from the flight before, aka the guy who had his seat wayyy far back and didn't put it up when we landed. :P

Ethiopian coffee is da bomb.

 The bus ride was fun. We were able to hear from a recent speech therapy grad who is going to work with kids in Cameroon. We also talked to a woman who is returning to Zimbabwe after 20 years in the US. After one month there, she started on the path from CNA to LPN to RN. She now runs her own personal care home in the US, but is returning home to Zimbabwe to start a clinic.

Sudoku-one way I pass the time during flights

I'm enjoying this plane. Its a Boeing 787 Dreamliner (?). More leg room, a USB charger for my itouch, and touchscreen tvs. Woah. =) Oh, and an Ethiopian country music mix? Win.

Our touchscreen computer/tvs that welcomed us in multiple languages!

Father, thank you for all you are showing me in your Word. I don't want this to be merely a mountaintop experience.