We make do.

Well, another week has come and gone and I haven't blogged. EPIC fail. But, I have to admit when I'm in Africa free of cell phones and all the technology distractions, it's hard to sit down and write. I also can't get any pictures up today, sorry. The internet is having it's own way and I lose.

This week we also went to Kasoa, where they have a huge market for vegetables and foods of many kinds. I was able to get some headwraps and supplies we needed to make it these last few weeks. It was truly a cultural experience though. People were walking shoulder to shoulder down narrow aisles trying to carry huge bags on their heads. We found avocado, which made me very happy. I also learned that you can eat snails the size of my hand, and they won't be dead when you buy them. They will come out and slime away unless you are ready to eat them, then of course you throw them in boiling water. I learned that you can eat petrified sting rays as long as the tail is removed. And that meat, contrary to popular belief, does not have to be refrigerated. Lord have mercy on us! We stuck out like a sore thumb walking through that market. We learned that most obrunis (white people) won't shop at the open market. They go to grocery stores or convenient places. But not us! We want the full experience. It was so chaotic I couldn't even take a picture. I hope I can go back before we leave and I can catch the madness.

I absolutely love life here. It's so peaceful and laid back. No one is rushing you to be at a certain place at a certain time. And yet, everyone is responsible in doing their work, and doing it well. Most of them don't complain, or say like,"  ugh I don't want to work today." You just do it. Complaining won't make it go away, and despite what we Americans think, it actually doesn't make it any better. After you complain, it's still there.

For instance, I have a patient who's name is Charles. He has a very badly infected leg, most likely streptococcal that has invaded the fascia (the part next to the muscle). So, yesterday, we had to make an incision and drain the pus from his leg in two places. Mind you, once we decided to do this - we found out we were out of lidocaine. Which, would have been used to numb the area. So.... what do we do? Africans have a phrase, they say "we make do." So, in this instance as well, we make do. We made him as comfortable as possible by sedating him with ketamine. This puts you to sleep ... but not exactly. So, he is high enough not to feel the pains, and if he does feel pain - it's not nearly as bad. Ok, so, we give him the drugs and he starts to fall asleep. The doctor gets out a scalpel and begins to cut into the side of his leg. Pus drains out. It's not really bad, because he's been on antibiotics but I mean it. It poured!  We then had to do it again at a different spot on his leg. And the wound had tracked, so there was a tunnel connecting the two. Mind you, I do not really care for wounds so I was fine standing back and just watching on this one. We then had to  soak gauze 4x4s in saline and iodine. Then the gauze squares were shoved up in the wound and all around. All this to say, this dressing has to be changed daily and since we still have no lidocaine, we gave him 10 mg of diazepam IV. So, with diazepam he's relaxed but he can feel everything. So, Savannah is changing the wound and as she's doing it he is gritting and clenching his jaw, because I mean, this has to hurt. Savannah just keeps doing it and saying " I"m so sorry, charles." And every time she says it, he says ," It's ok you're just doing your job." That is so unfathomable to me. I mean, here we are shoving stuff in this guys leg, raw, and he's telling us we're ok and to keep going because it's our job. Not even allowing us to feel sorry for having to do it int he first place. The mentality of work and doing a good job at whatever you do here, is truly inspiring.

We also had another mother this week. She came into the clinic having what she believed to be labor pains. However she wasn't truly contracting and was only about 3 cm dilated. We felt the baby's head and it was far to large to fit through the birthing canal, so we decided she needed a c-section. We then found out she was about 44 weeks gestation. For those of you who don't know, that's about a month longer than the normal gestation time. This of course, explained why the baby was so large. The baby's heart tones were there so we called the anesthetist and asked him to come. He was busy with another case. So, from about one in the afternoon until 5:30, the woman sat and waited. Her labor did not progress, but the baby's tones remained present (as far as I could tell). When we got into the odor about 6:00 pm, Ma Josephine looked at me and said "you're catching it." When I found out meant I would receive the baby after the cord is cut. I was geared up and ready to go! Labor and delivery is sort of my thing, so I was pumped. The strange part about this delivery was that upon her arrival that morning, she had passed meconium-like fluid from her uterus. This means, that the baby had expelled it's first bowel movement. This of course is something you should do outside the womb. But is typical if the baby is left in there too long. The danger is that if the baby also then tries to take it's first breath while in the womb, it aspirates the meconium and gets fluid filled lungs. But since the anesthetist couldn't come, we had no choice but to wait for him and pray the baby didn't aspirate. So, I am standing there, ready to catch this giant headed baby, but they can't get the head out of the opening they've cut. That's how big this baby was. When they do they pass her to me, she is covered in meconium, and I run to the newborn table. We (Savannah, the anesthetist, and I) suction her throat and nose, and she's aspirated. We tried CPR, and even intubation but were unable to save her. She never took a breath. She had not been gone long, and we all felt the weight of the mistake of waiting too long. But, in Africa it's this way all the time. You make do. And at the end of the day, I had to think, " If this woman had not had us to section her and take the baby out, she would've been one of many who die in childbirth." And I know we were able to save one life, and not lose two.

So pray for us as we are ill-prepared in so many ways to be solely responsible for the care of so many. Pray that God continues to give us strength and wisdom to seek Him first in every patient encounter. That we would be bold and listen when He tells us the way we should go and the things we should say. And that we won't let the pride of our knowledge intervene, that we would be bold and speak confidently. We have been given the authority in Jesus' name, and sometime it's hard to know what direction to go. For without him we are nothing. We are ill equipped and petty compared to His abundant capabilities. We want to be his vessels, to go where he would have us go, and say what He would have us say. We are nothing without Love.