Tuesday, August 7, 2012

5-6-6-5

-5665-

That's how many miles we've DRIVEN since landing in Atlanta, GA on June 9th!

5,665 miles -- what a trip it's been!

Our apologies for neglecting this blog during our travels.  It's been quite the journey.  But we are happy to report that we're back online, posting from our new home in Wichita, KS.


Why all the driving?  Here are the highlights:

168 miles  
Homecoming drive from Atlanta, GA to Aiken, SC
Celebrated Gracie's 2nd Birthday -- Noah's Ark take 2!

300 miles
Round trip to Folly Beach for fun in the sun with family and friends!

1,125 miles
Aiken, SC to Wichita, KS
Via Christi International Fellowship Graduation -- Congrats!
Moving - phase 1

1,125 miles  
Wichita, KS to Aiken, SC
Time for more reconnecting with our family and friends
Moving - phase 2

1,134 miles
Back and forth across SC spending quality time with those we love

568 miles
SC to OH
G's first visit to a long-horn cattle ranch -- thanks DD!
Celebrating the gift of life with the Millers!

377 miles
OH to Wheaton, IL for a week at TEAM
An amazing time getting to know The Evangelical Alliance Mission, the missions agency who will support our home church in sending us to CHAD.

MUCH more on this SOON!

297 miles
Wheaton, IL to New Hampton, IA for time with former Via Christi co-workers

379 miles
New Hampton, IA to Lansing, KS for a night with JAM!
(JAM = Josh, Anabel & Michaele Kubacz)
Looking forward to many more visits during this next year!

192 miles
Lansing, KS to Wichita, KS
Home again, Home again.  
Moving - Phase 3 - FINALLY complete!


5.665 MILES!


We are settling in to our new routine and our new home.  An SPECIAL thanks to our dear friends, Jared & Melissa, for welcoming us to share their home -- what a BLESSING to us!

Dean started work at Grace Med last week.  Dianna started work at Grace Med yesterday.  And Gracie started "school" at ParkPlace Childcare & Learning Center TODAY!  That may not sound like a slow pace but after our last 8 weeks on the road, it feels like it to us.

This is an exciting new chapter for our family as we prepare to return to Africa -- hopefully by this time next year.  Many of you have heard us talk about how God's at work in Chad while others of you have not.  In the near future we will share MORE with ALL of you!

DD&G

Wednesday, June 6, 2012

Good News

Our last blog post was about Gracie’s birthday party and the great time we had with our Galmi family... pretty good news in our book.  But the two prior posts did not have such cheerful stories.  Children, younger than our bright and healthy two-year old, dying in ways that would seem inconceivable at home.  It’s a different world here (read Marc Carrigan’s post from May 31st at thecarriganslife.blogspot.com to learn more about what it’s like to be a mother here in Niger). 

But how about some good news - news about people who lived.  Let’s start with THE Good News, the Best News, really.  The Son of Man (Jesus) did not come to be served, but to serve, and to give his life as a ransom for many (Matthew 20:28).  This verse says so much - Jesus came to serve during His life and then to give His life, to die, as a ransom for many.  This is a good start to the Good News - Jesus taught us how to live by being an example and then He died for us.  But that’s just the start.  By His death and resurrection, He conquered death.   He gives us the chance to die with Him, so that we can truly live with Him (Romans 6:8-9).  

A few brief stories about people who lived...

It was a typical day in the Pediatric Clinic: plenty of sick kids, some not very sick at all, some with bizarre conditions unlike anything I’d seen before.  And many in between.  Dianna and I were working together, treating as many as we could and enjoying having each other for 2nd opinions.  Then Rufai walked over from across the room carrying a motionless bundle.  Inside was 10-day-old Lamsarou.  Rufai was pretty sure that she was dead, but he wanted one of us to confirm it.  With the help of a stethescope we could hear a faint and slow heartbeat - she was barely alive.  We rushed to the resuscitation area of the obstetrical ward on the opposite end of the hospital campus.  We prayed as we ran and as we watched her take an occasional agonal breath.  The tools available are quite basic by American standards - an oxygen concentrator and an bag-valve with a poorly fitting mask.  We could help a little but, as always, it was up to God whether this one would live or die.  We prayed that she would live.  
Slowly she began to come around - her pale and cold hands and feet began to regain color.  Her heartbeat quickened to a rate that was almost normal.  She began breathing more rapidly and with greater vigor.  We continued to pray, thanking God and knowing that it was only by His grace that she would live.


8 days later she left the hospital with her mother, bright-eyed, nursing well, looking as if nothing had ever gone wrong.  We praise God for preserving her life and for the chance to give Jesus the glory as we spoke with her mother and the other women in her room.


Saidou ran into a burning building in an attempt to save the lives of a young brother and sister; he was burned along with them, but not as severely as they were.  (There is a sad part to this story: the young girl died within a few days; her brother lived for about a week and a half).  He was stoic and depressed initially, and understandably so.  But his countenance began to lift during the month or so that he received care.  God spared his life while others around him died. We pray that He will come to know the one true God who has numbered His days.




Nafissa has kwashiorkor, a form of malnutrition that occurs when there is not enough protein in the diet.  Millet, a grain, is the staple food for many Nigeriens and some mothers don’t know that their children need other sources of protein.  With education and access to better foods, Nafissa is healing.  She did have a short stint in the hospital, but has spent most of her time in the malnutrition center, the CREN.  Her grandmother, who recently began caring for her in the CREN, is an inspiration to us and such a role model to other mothers and grandmothers.  We joke with her that she worries about any little change but, in truth, we are so encouraged to see her care so much.


Getting better!


This man was bitten in the face by a viper - he laid down in his home at 10:30 at night and got bitten by a viper!  I asked the nurses with a bit of scepticism if this could even be a true story.  They told me “yes, the snakes come into the house and when someone lays down in the dark they have no idea that a snake is there.  This is one of 3 viper bites in the last few weeks.  It is hard to imagine having to worry about getting bitten by a snake when you lie down in your own house, but...




This picture is as it appears - a young child with a large “dent” in his skull.  Earlier in the day he had been run over by a donkey cart.  If you had seen him from the other side, you wouldn’t have guessed that anything was wrong - he was as playful and cheerful as you would imagine a 2-year-old child to be.  His “dent” was later repaired in the operating room.




An eight-year-old boy being carried into clinic on his mother’s back - never a reassuring sight.  This young man had developed weakness from his neck down beginning several days prior.  There was not clear cause and no clear treatment.  We sent him home with a medication that we hoped MIGHT have a small beneficial effect.  More importantly, we prayed that God would restore him to health.  He returned to clinic 10 days later, able to walk on his own but not completely back to full strength.  We very bluntly told his mother that we could take no credit for his healing.  Again, it was Jesus, the One who created him, who chose to restore Him to health.  That is always the case, but instances like these are vivid reminders of the peripheral role that we play as God heals those whom He choses to heal.



We thank Him for life and for healing.  And we praise Him even when there is death, but we long for the day when “there will be no more death or mourning or crying or pain, for the old order of things has passed away (Revelation 21:4)


























Monday, May 28, 2012

Two by Two

Happy Birthday, Gracie!



We have had quite the celebration over the last few days.  For pictures of Gracie's "Noah's Ark" themed second birthday party (Niger-style) check out this post.

We are so thankful that God entrusted Hannah Grace to us and allowed us to welcome her into this world 2 years ago today.  What a FULL two years it has been!

___________________________________________________

What's the latest news (aka funniest quotes) from G?

"I got chocolate pudding in my pancake!" -- said last week while enjoying a chocolate-covered blueberry (thanks Chels & Joe) pancake

"Daddy, look at my belly" -- which means sono my belly OR let me sono your belly -- "dat's daddy liver"

"It's my happy birthday... get presents"

"It's ohhtay, it's ohhtay" -- while watching mommy clean up frosting/cake crumbs after a mini fridge disaster

Visiting a newborn baby at the hospital.
Loving life as we enter year 3 with G!
DD&G

Sunday, May 13, 2012

Mahamadou


In the most recent post I told you about the death of the child in bed A6.  His name is Ma’azou.  And I mentioned the mother of the child in A3, expressing concern that she was witnessing such frequent death.  Her child’s name is Mahamadou.  It is still his name, even though he, too, has died.

He came in on the 10th day of his life, his abdomen severely distended, with its tight, thin skin permitting his blood vessels to easily be seen.  He had passed stool during the first few days of his life, an encouraging sign.  Then, according to his mother, his urine output began to diminish.  So he was taken to be circumcised, a commonly performed rite, but not typically done at this young age.  Mahamadou was circumcised in an effort to increase his urination.  The desired effect did not occur, as you can imagine.  But the traditional medicine he was given during the circumcision appears to have produced a predictable effect - his intestinal function decreased and his belly began to expand like a balloon.

There was no blockage at the outlet and he did not show signs of needing surgery.  We hoped that patiently waiting would be the most effective medical intervention we could offer.  And while his abdomen initially enlarged even further, it then began to decrease in size.  He was nursing, passing urine, and even beginning to pass stool.  Things were starting to look better for him.  But he was so small to begin with and had so little reserve.   

There is a fear among many mothers here of a nasogastric (NG) tube being used for their babies.  When a baby is vomiting or too young or weak to feed, an NG tube is passed through the nose and into the stomach so that milk or other food can be given to the baby.  While it makes sense to us that this is a beneficial and often necessary intervention, many women here are very resistant.  And even when a mother has been convinced, she often pulls it out prematurely.

Mahamadou had stopped nursing, his abdomen began to swell again and he was becoming more and more wasted.  We discussed the need for an NG tube with his mother and she agreed, but began to cry after it had been placed.  It is not the norm in this culture for a mother (or grandmother) to cry as it is in ours.  Mothers experience so much loss here, but seldom do they cry, at least not publicly.  Mamane, one of the translators, did his best to reassure her and explain why this needed to be done.  Her concern is understandable.  Sometimes, but certainly not always, a child that needs an NG tube is quite sick.  And some of them die, not because of the NG tube, but because they were so sick to begin with.  In their minds however, mothers make a correlation between an NG tube and impending death.  And that rumor circulates.

There are fears of western medicine in this country.  (There are also so many people who come to this hospital in such a vulnerable state and readily accept whatever treatment is recommended to them.  Most are extremely grateful for the care they receive.)  Some mission hospitals were once known as the place where “people went to die”, often because the sick were only brought in when everything else had failed and death was, by that point, imminent.  But by God’s grace and through the dedication of those He is using, that impression has changed.  Many come here first and they see the difference in compassion and love that they receive.  

It is sad to think that unfounded fears cause people to resist the medical treatments that could help them.  It is more sad to think that people resist responding to the spiritual healing that the one true God wants to provide them.  Maybe they have been taught  things that aren’t true about God, or maybe they haven’t even heard of Him at all.  We pray that people will see the love of Christ in the care that is provided here and that the Holy Spirit will move in their hearts to understand the message of God’s love that is spoken here.  

Mahamadou died during the night after we placed the NG tube (one night after the children in beds A6 and A4 died).  He and his mother were gone when I arrived at the hospital the next morning. 

Please pray for Mahmadou’s mother.  For the people in her village.  For the people who come to this hospital and for those who don’t, for whatever reason.  Please pray for us to be aware of and understanding of the cultural differences that are obstacles to clearly sharing the Gospel (and providing the best medical care).  And please pray for us and for yourself, that we wouldn’t take for granted the amazing blessings that He has given us - bountiful access to His truth and to material resources.  He has given us those blessings so that we would be a blessing to others (starting way back in Genesis 12).

Monday, May 7, 2012

2:43


It’s 2:43 a.m. here.  Or at least it was when I left our little duplex to walk the dimly-lit dirt road to the hospital.  Not an unusual occurrence here, walking to the hospital in the wee hours of the morning.
But tonight I am not on call.  Tonight there was no call from the nurse to say there has been a motorcycle accident, that some young mother needs an emergency C-section because she is having seizures, or that another child has arrived in the late stages of meningitis.

Tonight I went to the hospital as a “regular” guy.  A guy who, at home in Kansas (where it would have been 9:43 p.m.), would have been winding down after having a family dinner at home and putting my two-year-old daughter to bed.  A guy who expects cool, clear, clean water to flow when he turns on any one of the many faucets in his climate-controlled apartment.  A guy who expects to get at least 3 solid meals a day.  A guy who wouldn’t expect his child to die before the age of five (or before him, for that matter).  
Tonight I tried to go in imagining that I hadn’t been here for the last 4 months.  That I hadn’t got used to the combined aroma of urine, feces, infected wounds, and foul dressings.  That seeing people lying on stretchers filling a crowded, narrow hallway wasn’t an everyday sight.  That hearing the midwife say “the baby is not alive” in broken English wasn’t a phrase that I was expecting to hear, again.  That this was all new to me.




Tonight I hoped to go in and see that the little boy I admitted earlier today, the boy in bed A6, was still alive, though he had many good reasons not to be.  I thought maybe I could pray with him and his mother if one of the English-speaking nurses was around.  Or maybe I could just pray for them.  But bed A6 was empty.  He was dead.  He was gone.  I had tried to warn his mother that his situation was dire, but I hoped that he would somehow still be alive.  No.  He was gone.  And so was she.  And while I was there, hoping to see his thin little chest rise with each labored breath, the nurse told me that the child in A4 had just died.  I can’t help but wonder what is going through the mind of the mother of the two-week-old in bed A3, as she watches other children die around her.



His mother was the first I've seen show emotion with tears, but she did so thinking that she wasn't seen.   The scars on his forehead are from traditional medical treatments.  His bed was empty at 2:43 a.m.


I didn’t plan to go in at 2:43; I didn’t even plan to be awake at this hour.  But I haven’t made it to bed yet.  So many things on my mind.  Reading “Radical” by David Platt.  Reading the Bible.  Contemplating some of the creeds of the Christian faith.  Contemplating what it means to follow Jesus Christ, to be His disciple.  To go and make disciples of all nations, baptizing them in the name of the Father and of the Son and of the Holy Spirit, and teaching them to obey everything that Jesus commanded us.  And wondering how close I am to obeying everything that He commanded me. 
Wondering if we get it.  Follow Jesus.  Obey His commands.  Teach others to do the same.  Baptize them in His name.  
Wondering if we realize that we are worlds apart in a world that is getting smaller every day.  The Gospel of Jesus Christ.  No knowledge of the Gospel.  Healthy kids, soccer camp, school plays. Malnutrition, epidemics, fears of modern medicine.  Clean water, abundant food.  Dirty water, no water, disease.  
God’s truth is true.  His love is real.  His promises and His commands stand firm.  At 2:43, at 9:43.  In Niger, in Kansas.











Wednesday, May 2, 2012

May Day

Perhaps most of you are like us and unaware that May 1st is International Worker's Day (aka "Labor Day").  Well, we'd like to enlighten you (as we were yesterday) and share a bit of how Nigeriens commemorate in Galmi.

Our first clue that something was brewing came over the weekend when 7 rams appeared in a pen (which previously housed a pet tortoise) adjacent to the basketball-tennis court on the Galmi compound.  Gracie enjoyed observing these "sheeps," as she called them, and quickly learned that "sheeps eats weaves (leaves), no (not) poop;" this is true, the pen stayed full of fodder and waste.

Yesterday morning we ventured over to the pen around 7:45 A.M.  Seasoned ex-pats had informed us that local butchers (who previously owned the rams) would begin the slaughtering process early in order to have the meat prepared and fully cooked in time for the late afternoon celebration.

And a process it was!

Once again we should provide a disclaimer for those who are squeamish about blood as well as those vegetarians out there who are anti-animal killing.  These pictures are literally "in the raw."

By the time we arrived, the process was well underway.  We missed the throat slitting and from what we heard (from MKs who made it on time for the start) this was not a bad thing to miss (well Dean may not completely agree with that statement).  Anyway, this is what we did see:

Gracie (with mini box of raisins in hand) watching the butchers at work.

The traditional method of skinning a sheep is rather ingenious (though not particularly hygienic).  We had heard about "ballooning of the ram" but did not fully appreciate how literal this term is until we observed the process firsthand.  After the ram is dead, a stick is used to make a hole under the skin in one of the hind legs.  Then (far right in picture above; center in picture below) one blows air into the hole, which inflates the ram along the fascial plane between the hide and the meat.
And by the end, the ram truly looks like a balloon!

Ballooning of the ram

This makes skinning the ram fairly easy -- at least these professional butchers made it look that way.

Local butchers skinning the rams.

Next, the rams were gutted and then splayed open like this:

Finished product -- great anatomy lesson!

Nothing goes to waste (as later pictures will attest).  
And as you can tell from these pictures, this was a well attended spectacle!

Visiting pediatrician (Dr. Sam) showing off a ram head while men, women and children watch, amused.

This little boy, who is a son or grandson of one of the butchers, was close by throughout the process.
A little bit of everything -- ram head, hide, entrails, meat as well as the mats and rods used to transport  the carcases -- is displayed around him in this shot. 

Let the cooking begin!

All seven rams were "smoked" by a fire -- a process that took most of the day.

Raw rams at the beginning of the roasting ("smoking") process
Well done rams ready to be carved and served

While we waited for the evening's main event, Gracie investigated the other preparation happenings that were underway.

"What dat?"
How does one explain sheep entrails to a 23 month-old?
More ram parts

So far G was a bit disappointed that despite all the food prep she'd struck out on ready to eat options.  Ah, but, press on she did until she hit a homerun: ladies making sauce.

Tasting the tomato paste...she had at least 3 finger-fulls
Begging some tomato slices from Auntie Deb
Not even finished with the tomato she just scored and already heading to the freshly peeled onions.
Yep, she ate some of those too!

While many men and women from the hospital continued to prepare for the main event, we retired to the pool followed by lunch and a nap before setting back out to join in the festivities.

Between 5 and 6 PM, folks began to gather on the compound basketball/tennis court.  All hospital employee's were invited to this hospital sponsored "banquet" in honor of May "Labor" Day.  Everyone was excited, and as the various departments (surgery, maternity, pharmacy, etc.) gathered, it was clear that they had been planning for this event.  Each department (at least the female reps) had chosen a fabric and had matching outfits made which they wore to the banquet as a symbol of solidarity.  Chairs and benches were arranged in a large circle so everyone could gather around for the music, speeches and games (never expected to see musical chairs played in Africa!) which proceeded.  While these activities were underway, the ladies who'd been food-prepping all day began to serve the evening meal.  Each person (including ex-pats like us who were in attendance) received a bottle of "coke," hunk of baguette, bowl full of "sauce" (which has been appropriately named "organ stew" by one of the MKs) and a plastic baggie with a hunk of roasted lamb.  Most folks enjoyed the soda, bread and sauce while watching the program -- the meat was saved to be taken home and shared with each worker's family.  A few people poured the sauce into a separate bag and took all the food home with them -- again most likely to share this special treat with the rest of his or her family.  And a handful of others (like Dianna & Gracie) nibbled the bread and enjoyed watching everyone else (especially Dean) chow down!

May Day Celebration
Only about 1/3 of attendants are shown from this vantage point.
The large basins in the center contain bread and sauce.

We are really glad we could participate in the day's events.  And we are thankful for all these hardworking men and women who contribute to the work and success of Galmi Hospital.  Hopefully, the day was successful in letting these folks know how appreciated they are.

Now, for one more random picture of G that we've been meaning to post.  
Over the last couple of weeks, G has spontaneously attempted to mimic the local ladies by carrying various items (nalgene water bottle for instance) on her head.  Here is a shot of her congratulating herself for a successful attempt:

G with Old Rabi

May Day blessings,
DD&G

Tuesday, May 1, 2012

Sad Things, Real People


Let’s begin with a warning: graphic pictures are in this post.  

Not inappropriate pictures, but medically graphic pictures.  These are not put here for shock value alone, but to show that incredibly sad things happen to real people.  And to remind us of just how blessed we are.

If you want some less graphic images, I might suggest you search Google Images for “Care Bear Stare,” or something similar.  I cannot personally verify that this is a safe, non-graphic search, but judging by the people I know who know so much about Care Bears, I assume that it is.  


For the sake of the faint-hearted who will not endure the pictures at the end of this post -- here is one of our little "care bear" caring:

Gracie loves to "go see babies;" here she is visting kids at the CREN.
She's also learned "Jeeza make baby feew betta" and often spontaneously reminds us of this truth
(for those needing translation, "Jesus makes babies feel better").

Okay, so now proceed at your own discretion.

Kids break bones here, just like they do all over the world.  Some breaks are bad, some not so bad.  And parents, of course, seek help when their child has a broken bone.  There are traditional bonesetters here who often do a remarkably good job at (as their title implies) setting bones.  They are to be commended for the impressive results that they often accomplish with no X-rays and with rather primitive materials.

At times, however, the outcome is quite disheartening.  And this is due, presumably, to a combination of factors working together against the favor of the child.  Perhaps the bonesetter applied the splint a bit too tight or failed to recognize a vascular injury.  The child may have complained of pain, an early warning sign of a worsening condition - but as the parent expects pain from a broken bone, and as the cultural expectation is to be quite stoic, the child’s complaints are scolded and ignored.  And even when the limb began to swell and blister and perhaps even drain pus or exude a foul smell, the parent may have hoped it would just get better.  Or maybe they didn’t have money to come to the hospital.  Or maybe the husband wasn’t home so the wife couldn’t get his permission to bring her child in.

In any case, the result is the same: a young child who loses a limb.  A limb that, if cared for properly, often would have healed with no noticeable long-term sequelae.  A limb that in some cases would have done well with no treatment at all, not even a splint.  A limb that, obviously, will be absent for a lifetime.

We are not used to seeing these kinds of cases because they don’t happen (if so, quite rarely) in our society.  We are blessed with relatively convenient access to health care.  We are educated enough to seek help when things are looking worse.  We don’t live under such harsh conditions that we have developed a pain tolerance that in some cases can be pathological.  And even if we are afraid we cant afford to pay, we still go in because we know that our society just doesn’t tolerate these type of disasters and someone, somewhere, would bail us out if it got really bad and we couldn’t pay.

So here goes, a brief look at some of the arm and leg disasters here in Niger.

A traditional splint made of bamboo-like grass stems.  The arm and hand are mummified in places and draining pus elsewhere.  A purplish dye has also been applied, presumably for some medicinal effect.

A few days later, after the amputation.
This young man had a greenstick fracture, often treated with a splint but will quite often heal well with no treatment at all.

Zakari did quite well with his daily dressing changes.

Following-up in the clinic after being discharged from the hospital - he has healed well.

Osteomyelitis (bone infection) of the tibia (shin bone) in a young boy.
The entire right side of his jaw bone was also infected. 

This young girl had a splint placed on her leg after a minor injury approximately one month before she arrived at clinic.
Her lower tibia and upper ankle are exposed beneath dead skin.  Her entire foot is mummified and shrunken.
She was taken for amputation the next day.

An older lady who had broken her tibia and fibula (leg bones between knee and ankle) after slipping on a step - not typically a mechanism with enough force to break these two bones.
She had received treatment in her village and came to our clinic after about three months.   

This is her first X-ray.  Both bones are broken but there appear to be some signs of preliminary healing.
However, there are also some concerning signs.

Her follow-up X-ray five months after the first X-ray (she has now been unable to walk for two months).
This X-ray was taken on the same day of the picture of her leg shown above.
You can see a tumor on the X-ray and missing portion of bone.  At this point, amputation was her only option.
She refused and is living out her remaining days while the tumor continues to grow.

Lady with neurofibromatosis (condition involving numerous, small growths along nerves).
Her case is rather unique in that she also has this large "related" growth on the back of her leg.

Hopefully (those who hung with us this far), you are as thankful as we are for how richly God has blessed us.  Again, this was not an attempt to overwhelm you or guilt you; it was an attempt to share with you what life is like for others.  Please join us in praying for the people in this post as well as the many others who suffer in ways that seem unthinkable to us.  Pray that they may come to know and experience TRUE comfort, hope, healing and peace which comes only through Jesus Christ.

For HIS glory,
DD&G