Monday, January 25, 2010

Up most mornings by 6, this morning 5:30, the sky just starting to lighten with a faint pink blush. Clear view of Lake Tanganyika and the Congo this morning although there is a moist haze over all. Days are equal length as we are so close to the equator. This is the rainy season, so it rains at some point pretty much every day. The good news is that there are also periods of sunshine as well. Very humid, my hair is curly.

Went to pick up the 5 babies and one adult that we had sent to a nearby (two hour drive) hospital for blood transfusions. Unlike most hospitals in the states it is not just one big building but several small wards, most with the doors to the patient rooms opening to the outdoors. The maternity ward being the exception which had an inner corridor with patient rooms on either side. The buildings are made of concrete and metal bars and are in obvious disrepair. As we (Elvis, one of our translators, and I) were walking down the corridors heading towards the pediatric ward I saw one of the moms of one of the babies. She saw me as well and came running towards me giving me a big hug. Very excited to see me knowing that I had come to get her, and very anxious to leave. Elvis said that they did not like the hospital. Getting out turned out to be a three hour process. It was Sunday and the doctor who had to discharge them was no where to be found. After asking several people we found out where he lived, drove there, found out he was in church got his phone number, which he didn't answer for an hour, and met him at a hotel for coffee to ask him to discharge the pts. He drove back with us, by now it is pouring down rain. He discharged the babies, and because they were all under 5 years old, we did not have to pay any bill for them...however none of the moms/fathers/parents/grandparents had any sort of documentation to that fact but with the promise that they would get that in the near future we were given permission to take them. The adult woman was another story. She did not have proper documentation saying she was indigent (if she had she (actually we meaning VHW...she has no money) would have only been responsible for 20% of her bill) so I ended up paying the full amount to get her released. If I had not had the money she would have had to stay. If patients can't pay they can't leave...! The billing process seemed pretty random, not sure how they came up with the final price but I paid $38,700 Burundian francs =about $26.00US for her 5 day hospital stay which included 3 units of blood...and that was considered expensive!
On the way back stopped at a market in Rumonge and bought 50 lbs of flour. We have a hot pot (a solar cooker) that I want to try out...baking, so wanted to have enough flour to experiment.
I ended up making banana bread and it turned out great. Took about 2 hours to bake and was delicious.
There is somewhat of a food focus here....because of the lack of variety. We usually get chipatis for breakfast (1 each) coffee or tea with sugar, lunch is rice, beans, sometimes, french fries or boiled potatoes, cooked cabbage or some sort of cooked greens and water, then dinner a repeat of lunch....everyday. So the banana bread was a welcome addition. It is good food, filling and I am thankful but I have to admit, I miss salads and fresh fruit. We can on occasion get mangoes, bananas and pineapples, so that helps. Oh and one night we had chicken. OK enough food talk. We have it good compared to the Burundians. Their staple food is cassava....and it is pretty much void of nutritional value. The do eat rice and beans but the fact that cassava is their main source of food is very telling in their state of health or lack there of. There is a food program in the works here to really concentrate on teaching the people other choices of nutritional food to grow. An agronomist from the states, Will, arrived recently, and is busy getting it organized. There is a large two acre garden already in place but the things planted in it are not plants that the Burundians are familiar with or necessarily want to eat. So the goal is to have some staple crops that grow well here, have high nutritional value and that people will grow and eat. The need for better nutrition is vital.

Monday, January 18, 2010

In the thick of it....

I am not going to even try to remember as to what has happened when, but just to ramble about some of the events to try to share a sense of this place. It is lush and green, green, green. Hot and humid when the sun is out and sort of cold when it is raining. Torrential rains, at times, just pounding, with mini rivers running everywhere and a lightening strike the other day so close that it caused the oxygen machine to spark????

Have been in the malnutrition ward all week taking care of malnourished children (marasmus and kwashiorkor cases) and some really sick kids, with malaria, pneumonia, severe anemia...and ??? The lab tech's newborn baby just died so he isn't here, plus I don't know all the things we can or do test for here, plus often it is the shotgun approach to treating people. You can assume that all the kids are somewhat anemic and have worms and are malnourished to some degree and then they get malaria or something else and they can be pretty sick. We sent several babies to get blood transfusions (we can't do those here) but they haven't returned yet.

The families stay with the patients, sleep in the beds with them, yes really, help take care of them, and often help some of the other patients. They patients take their own meds and the moms were doing the feedings and medicating their kids...except for the IVs, and the first day I figured out that they weren't exactly measuring the correct amount. I then taught the moms the correct amounts and we had a staff meeting and it was decided that the nurses needed to be giving giving the meds. We are getting there. It's like nothing you would EVER see in the states. Confusing to say the least and the first day I couldn't figure out who one of my little babies was because her mother had left her with the mother of another baby and I thought she belonged to that mom and wasn't a patient. Lots of noise, babies crying, moms talking, babies peeing on the floor, or on their bed...diapers do not exist...their version is a piece of cloth tied around the butt and then like a plastic bag wrapped around this...if that. I have gotten over the smells pretty quickly as they are rather permeating. All the commotion doesn't seem to stop anyone from sleeping if they want to. The babies just get covered completely and are just this little bump in the bed.

I am having the time of my life...really, some the babies are sooo cute, I am in love.....filling my heart for sure. The kids as they get stronger start to play and wander outside. This evening all the moms and babies were out sitting on the grass and they started singing. They tried to teach me as well....with mixed results...they certainly had a good laugh, as did I.

I also went out with Alex, the computer guy to do some GPS plotting of the homes of accompagnateurs in a village about a two hour circuitous drive and then another hour walk up,down, up down...some of these people live 3 to 4 hours away from the VHW clinic. They help take care and distribute medication (for TB and HIV infected people) and educate people in their community about the diseases. Most of the accompagnateurs came to Kigutu this morning and Helen and Brad gave them a power point presentation about malaria, signs and symptoms, prevention and treatment and distributed ponchos and bags.

The Burundians in this area are very poor, live very simply, have very little, are very proud, yet humble, and continue to amaze me..

Friday, January 15, 2010

In Kigutu

Arrived in Bujumbura day before yesterday about midnight...flight from Brussels delayed by 4 hours of sitting on the runway...cargo door problems,snow, deicing, losing departure slot, but pleasant flight nonetheless. Arrived in a substantial rainstorm and picked up by Nestor, the in country director, Cory the new (has been here a week) site coordinator and Daniel the driver/?. Had a great nights sleep (sound of rain helped), cold shower (get used to it:)) coffee and bread, and then a quick trip to exchange money, buy some Nido (full cream powdered milk...manna from heaven...really...wish it were available in the States) and then attempted to drive the normal route, along Lake Tanganyika, south to Kigutu. Totally foiled by a rock road block...some sort of land dispute...lots of police, shots fired, cleared the road...attempted again but almost got caught between two road out and took a much longer route. Took 6 hours instead of 3. Beautiful, lush green to accompany this post. Arrived in Kigutu at 3pm, had a quick tour of the residence, the computer room, the clinic, pharmacy, depot (storage room), and then the wards. There are 8 or 9 adult patients, with a variety of illnesses...Malaria, TB, HIV, shingles, fungal infections, pneumonia, weird skin leisons, and then several kids in the "malnutrition" ward, some malnourished, others with malaria, HIV positive and I can't remember what all else. Then lunch and then a visit to the baby goats and a gigantic garden. Harvested lots of radishes, mustard greens, carrots and onions. Dinner of rice, beans, french fries,cooked cabbage...which is pretty much what we had for lunch, substituing potatoes for rice...and which will pretty much be what we will have every day. Good thing I like beans and rice. Helen and I did a show and tell of all the stuff we hauled over and then to bed. Read from my Kindle (jury still out) for about 2 minutes then to sleep. Slept well, awake by 6:30, shower (yeah cold) then breakfast of a sort of chipate/crepe and tea.

Then rounds which are a little tricky. Most of the patients only speak Kurundi, occasionally a little French so they would talk to the doctor then someone would translate for our benefit into English. Most of the staff speaks French, so I am reaching into the depths of my brain to pull that out....and when in doubt I say it in Spanish, which noone understands except for Brad (an RN who has been here 2 weeks and will be staying for a month)and Alex (the computer guy, who has been here for 3 months and will be here another 3 months). I am going now to help in the wards with Hilary (a Burundian nurse)...will post more later.

Friday, January 8, 2010

Almost there

I head out in a few days for a new adventure with my friend Helen Weld. We are traveling to Burundi (Central East Africa) to work at the Village Health Works clinic in Kigutu. Burundi is one of the poorest nations in the world and is slowly recovering from devastating internal conflict, similar to that which happened in Rwanda. Burundi failed to receive the world's attention, (and aid) until now. Recently the Pulitzer Prize winning author Tracy Kidder wrote a New York Times best seller, Strength in What Remains about the amazing man Deo, who left Burundi during that time of conflict and against all odds came to the US. became an American citizen, is becoming a medical doctor and returned to Burundi to start the village clinic and help start the heath care system and the nation of Burundi on the road to recovery. I feel very honored that I have this opportunity to go for a month, and volunteer at this clinic. Helen is a public heath nurse and recently spent 6 weeks there in Sept-October '09 and it is mainly because of her that I am going. We met 13 years ago, in Yungaburra, Australia (where she still lives with her family) when I lived for a year with my family, became good friends, and have remained in contact ever since and I am thrilled that we will be working together.
Helen will be returning for 4 1/2 months.

I am packed....taking two 50 lb rolling (thank God) duffels, both full of items....water filters, 50 hand crank flashlights, a solar *hot pot* cooker, aluminum foil, diaper rash medicine, baby clothes, fleece blankets, wash cloths......for the clinic.
I will do my best to share this experience. I am not sure just how much reliable Internet access I will have, but I will post when I can.
Until next time.....when I am hopefully*on the ground* in Central Africa.