Help From a Distant Land

Cashew season has begun. Cashews are the main crop for GB and most people here have large cashew orchards. Cashew season is full of long days in the orchard collecting the nuts. Americans do not know what they are missing when it comes to cashews. Attached to every nut is a delicious juicy amazing cashew apple. They are only good for about a day once picked, so they are quickly eaten or made into a delicious sweet, tart juice.

Clinic in Bisseral

The last four weeks have been very busy with different medical teams visiting. We had two Doctors, Ron and Troy, and two Nurse practitioner students Jamie and Danielle, here for one week. This was spent traveling to different far out villages to have clinic days. We developed a pretty efficient system with Jon handing out numbers, getting vitals and main complaint and then we had three different patient care areas and a pharmacy. With this system in place we were able to see up to 60 patients a day. We were overwhelmed at most villages with many patients and sadly had to send people away at the end of the day.

This child was much more
cooperative than others

The second team was Dr. Ron and five of his medical students. They spent two weeks doing physical surveys in Catel and other villages. Measuring malnutrition, malaria and many other health indicators, we hope to take this data to the village officials, presenting the problems and helping to implement change.

With the coming of the teams came many much needed supplies! Jon and I’s bedroom is now also the most well stocked pharmacy in GB. We have everything from cough medicine to Malaria treatment.  The clinic is now also able to test for HIV, Syphilis, Malaria, TB and Typhoid fever.  Before this I was only able to advice them to travel to larger villages to be tested. Lack of finances to travel and then pay for a consultation and tests often kept people from seeking further care.

However, with the ability to test for HIV, I also have the hard task of telling individuals that they have HIV. Two weeks ago we diagnosed my friend and her five year old daughter with HIV/AIDS. The hopelessness these people feel upon hearing this diagnosis is right there with a death sentence. I cried. In one weeks time we diagnosed three people and a possible fourth with HIV/AIDS. 

Theoretically AIDS treatment is available in Guinea Bissau. This being said, no one in Catel or the surrounding area knew anything about this. So last week we took my friend and her daughter to Bissau (capital city of GB) to hunt out a treatment center. What we found was better than I even hoped for!  A very well run Aids clinic offering the latest in testing and medication. Thank God!  Even with free medication, testing and consultations, the patient dropout rate is very high. Patients get tired of taking medication and turn to traditional medicines, or they don’t have the money to pay for the trip to Bissau every month. 

Some days it is hard for me to keep going. I look at these people with real sickness, real problems, real suffering….. my heart breaks. I know they deserve so much better than a simple nurse with a cupboard and a bench. Please join me in prayer that God would raise up more medical doctors and nurses for Guinea Bissau. 

A Funeral In Guinea Bissau

Several weeks ago there was a death in Catel. No one knew the exact age, but I was assured she was “very old and needed to die.” In Guinea Bissau, when there is a death of an older person, the funeral is a celebration as opposed to the mourning of a younger death.

                The woman was the grandmother of a youth in the church. Jon and I were invited to the funeral so I grabbed my camera and we set out. Once again my eyes were opened to the extreme bondage gripping Catel. Upon arrival at the funeral, the spiritual darkness was thick enough to slice. I immediately felt extreme heaviness. The drums, the dancing, the chanting, many rituals to worship the dead…. people continued to pour in. A little after we arrived, young men placed the body on a sort of bush stretcher and took of running down a dirt path. Hundreds of people ran after them chanting, drumming and dancing.

                It is believed in the that the spirits of the ancestors live at the door of each house. They ran with the body to each relatives house and lifted the stretcher up, holding it at the top of each door so that the deceased can communicate with the ancestors to see if there was any foul play (curses) related to her death. The deceased is also supposed to communicate her coming and see who should take care of the family now that she is gone. After several hours of running from hut to hut, the procession arrived at the house of the witch doctor. He told them what sacrifices needed to be done and how they should proceed. After many more rituals, they laid the body to rest right outside the front door. Jon and I walked home, however the constant drumming and chanting over the next five days continually reminded us of the surrounding darkness. Later that night, a woman came to the clinic with a gash on her head from a large beam in the house falling on her. Over the next several days, many animals were killed, many people were drunk on palm wine and many fights broke out.

                According to the animistic belief, it is so important to give your ancestors a proper funeral because the belief is that they have much power over your life. This often causes the family to go into great debt. So many animals are slaughtered and fed to the 1000 people, when it is all over the family goes hungry.

                Please pray that there would be freedom from this darkness in Catel. 

...but what will the pigs eat?

In the Spring of 2009 I graduated with a Bachelors of Science in Nursing from Waynesburg University. I soon started my first job as a nurse in the hospital and there was no doubt in my mind, I had received a quality education. I am very thankful for the nursing program at WU. 

However, today I feel the need to sit down with Dr. Mosser, Dr. Small, Dr. Morris and the rest of the gang. I would like to review some areas where I am fairly certain they failed to cover. Nausea, shortness of air and fever… I know these. There is a whole set of symptoms out there that I was never taught. Here are a few I have faced here in Africa:

-          “I have a worm crawling in my arm”

-          “The pigs don’t eat my feces”

-          “The bottom of my feet are hot”

-          “There is a small animal in my stomach”

-          “I have pain in my entire body” (85% of patients)

It has been said that over 80% of the sickness and disease here in Africa is preventable. Upon my arrival I have been excited about education. I love explaining to my patients how babies and pigs living together leads to skin problems and other sickness. I love explaining the importance of a balanced diet. I love going to the different compounds and explaining how to live better, healthier lives. Unfortunately I am finding that these problems run so much deeper than mere lack of education.

Upon explanation of why it is so important to have a latrine, and how these can greatly improve their lives, one compound politely refused stating “We could use latrines… but what would the pigs eat?” (Pretty certain I will never eat pork again) There is an astronomical number of various fungal and bacterial skin infections; many of them carried by the numerous animals that live in and around the mud huts. I try to explain that as long as the animals are kept with the children, they will continually be sick. A simple pen would solve this problem. They then explain how they cannot fence the animals or they will have to feed them (they currently are scavengers) and they will get stolen.

Guinea Bissau is one of the most undeveloped countries in Africa. With zero industry, no university, no electricity, no healthcare; people here survive. It is not uncommon for government workers to go months to years without being paid. This results in many of them not showing up to work including teachers. Education in GB is a travesty. Many people have speculated as to why there is this extreme lack of development. The rest of Africa has given up on them and refuses to accept immigrants from GB.

Community Health Evangelism (CHE) is a highly successful program that has taken on the task of solving these problems. This week from 8:00am-5:00pm you will find a group of young men and women sitting on hard wooden benches with no backs in the heat of up to 120˚ eagerly learning how to be educators in their own villages. CHE has prepared thousands of lessons ranging from health and hygiene to family relations to money management and agriculture. Each lesson is Biblically based and introduces Jesus to the community. Ultimately, He is the only one who can truly free these people from the bondage they are held in that is preventing development.

We have had the great privilege of having Dayo Obaweya with us from Nigeria to lead this seminar. CHE not only teaches the problems and solutions. This program has a unique way of addressing worldview and explaining the difference between relief and development. It encourages the people of Africa to stop simply wanting handouts. Dayo has truly motivated and empowered these young men to make a difference. He taught that God has given them the ability to think and to solve their own problems. He taught that they need to stop looking at the white man as the solution to their problems but to instead look to Jesus. He showed them that they do have the ability and intellect to bring about change.

There is a noticeable change in an African once the truth is revealed and believed. The bondage here is so real. They believe that they are simply impoverished and incapable of change or good because they are African. This fatalistic attitude has stunted development.

Each man has a village that he will go to and speak with the village leaders, discover the top four problems, (catel = no food, clean water, no latrines and lack of agriculture) form committees and solve the problems using the resources available. The program’s success is based on it being locally led and implemented. Once the community claims this as their own, real change happens. How different this is from white people coming for a week, building latrines and digging wells that no one cares to maintain or use and soon break. Jon and I are beyond excited about this program and how God is going to use these young men and women to spread the Gospel and aid in development.

Please pray for these CHE participants. That God would continue to work in and through them. That this excitement they have will not fade.

Dry Compost System = Best Thing Ever

Since my first large, swollen, tender spider bite on my shoulder, my fight against the spiders continues. I killed 22 in the kitchen in preparation for our guests. I am constantly greeted by them when I open the cabinet doors in the clinic. (which is actually quite handy… right by the first aid supplies if I were to be bitten). I have often debated… should I continue this fight? Or should choose to live at peace? The answer evades me.

Another area of question is faced regarding the very affectionate children. Hygiene is very different here. Without the use of diapers, what do I do when I am handed a child to hold? Do I push this fact to the back of my mind and try hard to ignore the permeating wetness in my lap? Do I pick up these babies up as they crawl to me knowing the risk I face? Do I grab the extended hand of the child smiling up at me who has just used that very hand to wipe his dripping nose? (or worse) So far my motto has been “grit my teeth and love” (needless to say I wash my hand vigilantly and was ecstatic to find antibacterial soap in the neighboring country)

Ginny and I working in the clinic

Judy (RN) was truly wonderful in the clinic!

The mission feels very oddly quiet. For the past fourteen days there have been an extra 8-13 people here. A mission team came from Pennsylvania and was much appreciated. The team included two nurses, Judy and Ginny. It was truly wonderful to have extra help in the clinic. I was ecstatic over the chance to be able to dialogue over different diagnosis and treatments. There was also a much welcomed break from the constant “on-call” status. We were able to take first aid/hygiene lessons to different compounds and talk with the women.

Along with the nurses, were several women who started a preschool (which is being continued by Mario), Lloyd and Elaine Hoover who did an excellent job assisting with the structure and leadership of the growing church of Catel; several men who worked extremely hard pouring concrete in new church buildings and worked on various other building projects; and last but most certainly not least, two amazing cooks! We had such a great time of work and fellowship… even managed to fit a couple board/card games in. Beryl, Andrew, Jonathan and I have been so blessed by each one. It is interesting to see how each person had a unique set of skills that was used in a specific way.

I try hard not to pick favorites….. Alas, I failed.  My favorite team member is Jim. He is fun-loving and full of wisdom… an all around great guy, but more importantly he is a master mason and built me an incredible new outhouse that I love dearly. No more chickens pecking at my feet, lizards in the toilet or snakes slithering on by as I sit. Beryl is excited about it because it is a dry compost system and in one year’s time should supply us with excellent fertilizer. Very progressively green. Since outhouses are quite rare in Catel, we are hoping to use this as a prototype and to get many other people excited about dry composting systems.

Jon enjoyed learning the art of pouring concrete. He quickly caught on as they painstakingly drew water from the well, mix that with gravel, cement mix and sand and then transported it on a half broken wheelbarrow (fixed with some extra rebar) and poured on the site. All of this done with no power tools… no cement mixer etc. in extreme heat. They were able to teach several other local men this art and they will be able to work on the cashew processing plant and other various jobs.

please note the knife held in the mouth.... previously used to end the life of these chickens

Everyone loves these very unnecessary knit hats 

Last week, Andrews’s hard labor and careful planning finally paid off as we slaughtered three scrumptious chickens. Jon enjoyed this entirely too much. Meat was a welcome addition to our vegetarian diet. We have now learned how to take a small chick and turn it into a delectable meal…. From start to finish… every step completed.

Last Thursday night we introduced the Leaders of the church council. Over the past months, Beryl has been teaching what the different roles in the church council look like and what kind of qualities would make a good administrator, pastor, teacher, evangelist etc... It is so exciting to see the different qualities in the different people in the church and to see how they are matched with the different roles.  Each man stood and gave his testimony and what his vision for his position was. I am continually amazed at how God has changed the lives of these people. Jon and I believe we have an exceptional group of leaders in the church of Catel.

Jon and I covet your prayers. Please pray for this new group of church leaders. Pray for the women, we have had three Bible studies and more women show up at each one. Pray that I would be able to relate to them despite very different cultural backgrounds.

We continue to enjoy Africa. As I watched the team leave, Sadja (12 year old boy) asked me if I wish I was going back to America with the others. I truthfully stated, “No, I will cry when I leave.”

                 

Dominga

Yesterday for the first time, I did not want to be here. It was a hot saturday evening I was craving some hang out time with friends. I decided to put away the many projects and relax. I was at a loss for how to relax in Africa. The children kept coming to the gate and begging for Jon and I to play with them. I wished so badly that I was home, on my couch with some popcorn, a good movie and friends. Reluctantly I started supper, potatoes and beans. We had just sat down when Mario came and asked us to come see his sister who was very ill.

This was the first weekend that both Beryl and Andrew were gone. So Jon and I gathered supplies Upon arrival at kasa de Mario, I was momentarily stunned at the conditions.  The room was dimly lit and I could barely make out dominga lying on mat on the dirt floor. Dominga was barely conscious, assessment showed a fever of 105.2, blood pressure at 58/35. I quickly called for some water to be drawn, started her on several medications including Tylenol. We sat her up and began to try to hydrate her with a recipe Jon had mixed up earlier.  Mario, Jon and I began to pray fervently that God would heal Dominga. The water soon arrived and we began stripping away the many layers she was covered with…. Several blankets and jackets…. then began to bathe her with cool water. The long night began. It was a struggle to be able to get her to eat/drink anything. Her mouth was ridden with painful blisters all the way down her throat. Because of these, and severe abdominal pain, she had not eaten or drank anything in three days. Jon retrieved my one bottle of chloraseptic spray (I had randomly packed this in case I had a sore throat) With this spray, she was able to eat and drink.

How I longed to pick her up and take her to my previous job on 7 East at University of Kentucky Hospital. The lack of resources and primitive conditions nearly got the best of me. At times my mind would wander…. Page the primary team, 2 liter bolus of normal saline, draw two sets of blood cultures, stat IV antibiotics… is there a unit bed available?

Within 2 hours of constant spooning bananas and hydration mix into her and continual bathing with cool water, her blood pressure was up to 65/50 and her temp was down to 102. With careful instructions to Mario, we headed back to the mission for a rest. Within five minutes after we sat down, four men appeared at the gate, one with blood pouring from a 3-4 inch gash in his head. Unfortunately no one spoke English. With many hand gestures and our broken Kiriol, we discovered that 30 minutes ago he had been trying to break up a fight and was smacked on the head with a large stick. My stomach turned and my vision blurred when I examined the wound and was able to see a large portion of his skull. Jon boiled water and I cleaned the wound, created as best of a sterile filed as I could, gritted my teeth and started stitching him up. Thankfully I had 1 bottle of lidocaine and several insulin syringes. By 12 am we finished cleaning up, 8 stitches successfully in place; we headed back to check on Dominga.

By 2 am her fever broke. With the sunrise, Dominga was sitting up and talking some. She and her family, along with Jon and I praise and thank God for her recovery. We continued to check on her every four hours. Her blood pressure is up to 85/60 with no fever. Praise God. Today Dominga’s father stated “God has healed Dominga.”

I am so humbled by this experience. Here I was, exhausted, wishing to be home and comfortable. It is clearer to me now than ever. God passionately loves his people in Catel. I am so privileged to be his hand and feet, to be his expression of love to Dominga and her family. Understanding Gods heart for the people of Guinea Bissau and relying on his strength is what has carried me through another night in Africa.

Life is sweeter with a renewed realization of Gods calling on my life. I challenge you. Who is God loving through you? Galations 6:9 “Let us not become weary in doing good, for at the proper time we will reap a harvest if we do what is right.”

Isaiah 40:31: “but those who wait upon the Lord will renew their strength, they will soar on wings like eagles. They will run and not grow weary. They will walk and not be faint.”  I recently learned that the original Greek word for “wait” means “to wait upon, to serve”. The renewed strength isn’t for those who sit around doing nothing… it’s for the workers, those who get up every day with the purpose of showing God to the nations. What an incredible promise! I thank God for making this promise true in my life.

To all you weary workers, be encouraged. My prayer for you today is the promise that God has given. That you would run and not grow weary, that you would walk and not be faint; that your strength may be renewed.
Here is a link to our pictures: https://picasaweb.google.com/100217601093466491231/ThirdImpressions?authkey=Gv1sRgCN-pnqzhhNjIFQ#

Crayons, snakes and rice

Did you know that walking out into the village of Catel with a bag of crayons and two coloring books is a is not exactly a smart plan? This is something I learned this week. Beryl showed me some crayons in a box at the mission. Thursday I took some and started coloring with the neighbor kids… apparently the word spread. The rest of the week kids kept coming to the gate and asking to color. I told them I would again Sunday afternoon. So Sunday, I innocently grabbed my bag of crayons and set out to meet the kids. I was then mobbed by 40+ kids all jumping up and down, yelling, huge smiles and grabbing at the crayons and coloring books. Overwhelming!!! I was grossly outnumbered. (Kiriol words I need to learn: sit, be quiet, and wait)

The big happening this week was Bible School. Beryl, Andrew and several of the new believers from GB have been traveling to outlying villages to witness and have church on Sunday mornings. We have quite a number of new believers at these villages, but do not have the people to disciple them. This is a huge need. Beryl decided to do a monthly bible school. The first one was last Saturday. It was a great success. Two believers from every village came. They arrived Friday night and stayed till Saturday evening. The curriculum was very basic… what it means to be a Christian… This week we started with the creation of the world and went to the resurrection of Christ. We also taught basic Christian disciplines, how to pray, how to become a disciple, how faith grows, worship as a lifestyle and what the Christian life looks like. These two believers from each village are then responsible to go back to their village and teach the other believers there. There were about 15-20 people present. Beryl, Andrew and Jonathan all taught different segments and then many of the believers from Guinea Bissau gave their testimony of how God has changed their lives. Please pray that God would continue to raise up strong Church leaders here in Guinea Bissau. Pray for more workers.

While the men were in seminar, Kinta and I prepared the food. I learned how to cook Africa style. (see pictures) It was hot and exhausting. Rice, fish and vegetables were on the menu. Let me just say that long skirts, wind and cooking over an open fire do not go well together.

The clinic continues to be busy. We are really looking forward to a team of doctors coming in March. I am saving up patients that are to come back to see the Doctors.  This can be confusing, because they all think that I am a doctor. I have given up trying to convince them otherwise. Our last trip to Senegal for medications proved to be unsuccessful. My supply has dwindled quite low; hopefully this trip will be a success. I am continually confronted with completely new and foreign situations. One case this week was a 6-8 year old girl (they don’t celebrate birthdays here so no one knows their age… frustrating) a boil that opened into a sore with a kind of white string hanging out of the middle. I then grabbed forceps and pulled a 3.5 inch worm from this ulcer.  Flagyl and amoxicillin were given and all is well. I have decided that this was a simple case of Guinea Worm. (Though I may be wrong… pretty new at this) I treated a rat bite this morning; unfortunately there is no access to rabies vaccine or tetanus shots. I then had four machete wounds in a row.  Malaria, possible TB, and much worms and parasites… and that was my day in the clinic. Our “hours” are from 8am-2pm; however, I have yet to have a day where I did not treat emergencies later in the evening.

Lack of health care education continues to astound Jon and I. We have noticed many people with large scars on their temples. It is common practice to slit your temples to relieve a headache. Essentially release whatever bad spirit is inside.  Several people have debated taking Ibuprofen because the pill I have is red. They believe this means it will give them more blood. We burn the trash from the clinic and apparently this is a problem because to burn blood is messing with the spirit of that person…. the list goes on and on.

Another big event in Catel was the slaying of a 13 foot (12 inch circumference) python. Unfortunately, we were unable to take pictures until it had already been skinned and eaten. More of highlight for Jon than I. Don’t get me wrong…  I celebrated its death… but alas, I did not appreciate the reminder of its existence.

We continue to muddle through language studies. Today Mario, (our instructor) told me my Kiriol was not clean. I replied that his English was not clean. He laughed and then said “but we are not in America.”

Please keep us in your prayers as we continue at the clinic and surviving in Guinea Bissau. Pray for the new believers and that God would raise up more workers for Guinea Bissau. 

Minjer, kal ku bu purblema?

One week has passed since Jon and I arrived in this different world of Africa. Lack of plumbing, electricity and so much more makes us feel like we have stepped into another time zone. Yet every day I have spent here my love of Africa grows.

Our trip to Catel was quite an adventure. The flight to Dakar went well. We arrived early in the morning; Beryl met us and took us to a mission house where we slept. We then boarded our boat for Ziguinchor. The only seats were a few benches on the deck, instead we had bunks. Beryl calls them coffins. Eight bunks to a 12x8 cabin. Beryl and Jonathan had it pretty good on the men’s side. Eight men, it was snug, I was on the women’s side with seven women and five kids. Now this was a hot and smelly crowd.  Ear plugs and a sleeping mask put me to sleep quite nicely and at 10am the next day we reached our destination. We spent the day in Ziguinchor buying visa’s and supplies. A long car ride and we arrived in Catel.

The village of Catel is basically one main road with many dirt paths branching off it leading to many different compounds. A typical compound has several brothers each with several wives (3-4) and several other elderly relatives and MANY kids. Each wife has an average of six children.  Since he purchases his bride, and builds another hut, the number of wives a man has is a reflection of his wealth. The women do 90% of the labor. Generally the men sit around all day drinking.

The Church is alive and growing in Guinea Bissau! Saturday night we have singing with the kids (40-50). They LOVE to sing and will bring drums and sing, clap and dance for hours. I think it would go longer but their voices give out. Sunday morning we have a small service, an hour of singing and a message brought by Tchalino. Tchalino works with Beryl throughout the week preparing his message and is a very effective preacher.  The attendance is much smaller than the actual church size because many of the young men travel to outlying villages to evangelize. The need for workers is great. I am currently planning and looking for ideas to start a children’s church/Sunday school. (I would love any suggestions) Today I fashioned a bubble blower with a stick, string and some soap. The kids went crazy. It was hysterical. I have seen little if any toys of any kind.

 Tuesday and Thursday nights we have Bible study. Last week we looked at what the Bible had to say about marriage. The Bible teaching about marriage… to love your wife… etc… goes against so much of their culture.  The Christian life is not easy for them here and calls for a lot of change. They are definitely persecuted. If one of them so much as tries to help his wife carry the water, he is harshly reprimanded. Please pray for these new Christian young men who are trying to live according to the Bible.

Minjer, kal ku bu purblema. (literal translation “woman, what is your problem”) So begins a day in the clinic. The days have been very busy seeing anywhere from 20-40 patients a day. Malaria, parasites, worms, rheumatic fever, bronchitis, many infected wounds, UTIs, eye infections, STIs, fungi, alcoholism, animal bites… I have seen SO much! I work with Tene and Julio. Both have been functioning as a sort of pharmacy for Guinea Bissau. Both have had a little medical training. Both speak very little English. We have many humorous moments trying to communicate. Either Beryl or Andrew is available to help translate most of the time. Today I treated village witch doctor. Due to strong animistic beliefs, he is very wealthy and took his sixth wife yesterday.  Sunday I went on my first house call. A woman had a miscarriage presumably from a raging STI that I discovered upon examination. She was very sick but is doing much better today.

Jon has been busy helping teach new believers and doing all kinds of work with the orange trees, helping with the clinic and a lot of maintenance work. He spent an entire day fishing a lovely rat (junkador) from our well. (see pic) After a day or two of noticing an odd smell to our water, Andrew discovered a large rat. It took the whole day and many unsuccessful ideas to figure out a way to remove it. By the time we succeeded, some decomposition had definitely taken place. However, it was a joyous occasion. Needless to say we have been walking to the school for our water these days.

I hope all of you are doing well. Please keep the church and the clinic of Guinea Bissau in your prayers.