Today’s day at the hospital began a little later than usual. There was a confusion when it came to who was leaving to drive into the hospital when, so Priscilla and I ended up waiting till 9am to go into 666[;;;;;;;;;;;;;;;;;;;;;;;;;;;;;;;;;;;;;;;;;;;;;;;;;;;;;;;;;;;;;;;;;;;;;;;;;;;;;[[[[[g00\06g88gll8;8;;;;;;;;;;;;;;;;;;;;;;;;;;;;;;;;;;;;;;;;;;;;;;;;;;;;;;;;;;;;;;;;  by;;;;;;;;;;;;;;;;;;;;;;;;;;;;;;;;;;;;;;;;;;;;;;;;;;;;;;;;;;;;;;;;;;;;;;;;;;;;;;;;;;;;;8/8llb [ßthat line of random things is from the Harvey’s cat laying on my computer, I decided to leave it in, she really wanted to say that] the hospital, it wasn’t the end of the world…sleeping in was nice!

Once at the hospital we jumped right into helping Dr. Henri Samoutou again with inventory and preparation of the Eye Clinic. We actually spent most of the time in the Bloc in a specific operating room only for eye surgeries. It was pretty cool and the instruments were different from those I had seen in our previous week in the Bloc. There seemed to be a lot more medications on hand and stored in the operating room too. I swear I have come across 70 different kinds of eye drops after working with Dr. Henri all week.

We worked with Dr. Henri until around 11am, that is when we headed over to the ER to help out, the usual. When we got there, there was a girl in need of a NG tube (feeding tube), so I volunteered to do it! The girl who needed it was in a coma, and had a ton of fluids in her lungs. The nurses had been routinely using a suction machine to remove as much of the fluids as they could, but the girl was still in pretty bad shape. The assumption was that the girl had aspirated (the inhaling of vomit), causing an infection in her lungs, resulting in a coma and other problems. So since she could not consciously feed herself, she needed assistance—thus the NG tube! One positive of putting an NG tube into an unconscious person is that they don’t have to go through the uncomfortable placing of the tube. When you put in the tube you put some lubricant on the end and then insert it in one of the nostrils. Before you actually put it in though you make a general estimation to how much you will push the tube in. You do this by starting at the nose and then wrapping it back behind the ear and then down to the xiphoid process. What is the xiphoid process you ask? The xiphoid process is the bottom tip of the sternum, and the sternum is the middle bone where your ribs meet (or for those who just need a picture, it’s the red thing on the picture, ya’ll).   When you have measured this distance, you mark it on the tube with tape and then you can start putting the tube in. You push it down through the nostril and down through the esophagus until the tape mark is at the nostril. You then need to make sure the tube is actually in the stomach, so you push air into the tube using a syringe WHILE using your stethoscope to listen over the person’s stomach. You should hear a forced bubbling sound as the air stirs up stomach fluids. Wahlah, you’ve done it!

After working in the ER for a while we headed to lunch and THEN we prepared ourselves for an afternoon adventure! THIS adventure was mudding! Here in Congo, people do actually live in mud huts like most people stereotypically imagine when they think of African housing. Making these mud houses takes quite a bit of time and labor, it literally takes a village to make one! So because it takes many people, and because it is just plain fun, we decided we wanted to help! Mama Sarah took Priscilla, Miles, and I to help for the afternoon in the Aka village. We were mudding the village’s recently dugout community toilet. It is a 6-meter deep hole that you squat over, and we were going to mud the “outline” of walls that had just been made. To mud, you first need to make the mud mixture. It is similar to squishing grapes to make wine...kind of. You pour water on dug up dirt/clay, then you squish it together with your feet. And then you fill in the mud outline with the mushy mixture! Pretty straightforward, but it takes a really long time and a TON of mud. Pictures bellow! The bottom picture shows an Aka man named Papa Simon, you can definitely tell that the Aka people are indeed very small in this picture because I am only 5'3'' (they are called pigmies).  

After mudding we all headed back to shower and make dinner and then crash. We were pooped after mudding for hours in the sun! I made it till 8pm and then fell asleep.

The battle continued this morning. I woke up feeling well rested and my stomach even felt fine; but once I started moving around a lot I started to feel uncomfortable and had to force-feed myself a small piece of bread, I knew the fight was not over. So once arriving at the hospital I gritted my teeth (and clenched many areas of my body) through morning devotions before deciding that I should not attempt to sit through morning report. Morning report is where the nurses from the previous shift tell the new shift of nurses, as well as the doctors what has happened in the past 24 hours. They tell about the medicines given, the vitals, the patients medical history, and I’m sure a lot more but that is all that the doctors write on the large whiteboard during report. The doctors write down these things on the board in English—well mostly—and then they explain what it all means to us interns afterwards. They go over tons of stuff, teach us, and answer questions; it is seriously so awesome of them to take the time to explain concepts that are so elementary to them but unheard of to us. This time of morning report usually lasts from 7:30 till 8:30, so yes even though I love it and was sad to sit out, I realized I would have been a real disturbance because I would have had to scat to the bathroom a bajillion times! Woopieee!

So after morning report, everyone went their different directions, most to morning rounds. When my pipes were squeaky clean (that is a metaphor), Priscilla and I headed to the Eye Clinic to help out Dr. Henri (pronounced “on-ree”) Samoutou! When we got there, there were dozens of boxes to go through, the whole clinic was stuffed with boxes that had not been there the day before. They had all come from the Container, bum bum bummmmm! I put the “Container” in italics, because for the first two weeks here Priscilla and I had no idea what this was when people would say “I’m going to the container to get ______.” We literally thought this mysterious and magical Container was some sort of large Tupperware or large plastic bin that just held a never-ending supply of anything and everything—medically speaking. However after bashfully asking Millie where this “bin” was, she laughed and told us/showed us the Container. The Container is literally a large boxcar that you would see carried on a train or barge; and a barge is exactly where it came from! The Container holds tons and tons of stuff that has been requested (and then often donated) by and for the hospital, and then it is sent via boat. It usually takes many months or more to get one Container to Impfondo; travel/transportation is one of the more stressful aspects of being a missionary in Congo. Here are some examples:

1)    Millie has been in Impfondo since March, when she left Brazzaville to come to Impfondo in March she had to leave stuff behind at Bravo (the guesthouse for missionaries) because there is a 20 kg bag limit for the small planes to Impfondo. When Millie left Bravo they told her she would receive her stuff on the next flight, probably the following week…it is 5 months later and she has not seen any of it. This is the same for all the people here. When you leave something in Brazzaville, you won’t see it again until you return there on your way back. Sam Lunsford thought he would receive his clothes the following week so he only brought 2 pairs of pants, it has been over 2 months and Sam still only has two pairs of pants.

2)    This Saturday I may or may not actually get on the plane out of Impfondo. The plane might not even show up, that has happened too many times to count. Two weeks ago the Harveys spent 6 hours at the airport trying to convince the pilot to let 4 interns on the plane, THAT THEY HAD TICKETS FOR. Traveling is crazy and corrupt and nothing happens when it is supposed to. Dr. Harvey even said today that the flight schedule changes every single day even though planes only come to Impfondo around twice a week. 

So if there were anything concrete that the missionaries here in Congo needed prayer for it would be travel and transportation stability. Please pray.

On to more about my day. So once at the Eye Clinic we started going through the boxes, taking inventory, and learning about the equipment. Here is a picture bellow of some fake eyes Dr. Henri opened up to show us! So neat! Throughout the morning he explained different procedures he does, different medications he uses, and some anatomy of the eye. About halfway through the boxes Joyce Samoutou walked in and snapped a picture of us! She is wonderful and such a joy to be around! The first thing she said to me was “Ah YAY James’s girl!!” and gave me a big hug (James is my boyfriend who came here last summer so Joyce knew him, Joyce and I had not yet been introduced). The Samoutou family is super cool, Joyce is from China and Henri is from Ghana, so they have three beautiful mixed children! Their children are very smart too, they speak English, French, Lingala, and Manderin AND they are all younger than 12!

The unpacking and inventory took us right up until lunchtime to finish, I was writing it all down while Priscilla counted. When lunchtime rolled around I was exhausted and nauseous so I headed to the guesthouse where we eat lunch to take a quick nap. After my nap I was actually able to eat some rice and keep it down too, so that is a victory for Faith!

After a successful lunch I headed to the ER to see what was going on. It was time for vitals! The ER was also in the middle of an art project courtesy of Claire Harvey! Claire is a junior art major at Cedarville College; so this summer she has been painting murals in all of the wards, they are beautiful! Claire had drawn all the murals out already and was now starting to paint with the help of Lauren Lunsford. It was kind of like paint-by number!

After spending the afternoon in the ER I headed back to the guesthouse for our big weekly missionary meeting that is always on Wednesdays. During this time news, prayer requests, and goals are shared. It is a great time to catch up and refocus…and it is nice to have a lot of English speakers in one spot haha.

I have a praise! A few days ago, the hospital received an X-Ray machine!!! It was like a parade watching as the custodial men rolled it into the used-to-be-empty-but-now-actually-has-a-purpose Radiology Room (pictured below!)!

Well that was pretty much my day.

Please continue to pray for my health, especially as I am approaching this long weekend of traveling home. Also, please pray that my traveling goes smoothly and according to plan. I know my plans are not the end-all-say-all, God is in-charge, so if things do not go according to plan, please pray for good and patient attitudes during the process.

Today I woke up and was exhausted, every part of my body hurt from the previous day. My bones and joints seemed to rebel against walking, but my stomach felt ok, so I headed to the hospital.

Today was also a rainy day, and not just a small drizzle. In Chicago we often have these hurricane-like storms that take out power and take down trees everywhere! Everyone’s basement floods, and the streets become rivers. Those storms are intense and powerful, but they usually only last for a half-hour to an hour before the sun comes out and everyone runs outside to see the damage.

In Congo, they have these storms too, but they last alllllllll day. From 6am till 1pm it rained like God was bringing another flood. If you took one step outside—you were instantly soaked. Also, the cars/trucks here are well worn out. They go through so much just trying to drive down the roads here, and they carry so many people, so basically their water-proof-ness is limited or nonexistent.

So this morning Priscilla and I ran out of our house to our ride, trying to avoid the rain, and then got into the car and realized it was leaking water from everywhere. It was hilarious. We were riding to the hospital with the Tenpennys, and the whole time we just laughed at how wet we were getting!

Once at the hospital, everything seemed to be at a standstill. Everything and everyone was soaking wet. There were no morning devotions or morning reports; it was pretty much just a morning of sitting-until-the-rain-lets-up.

Once it did let up, I was exhausted and slightly dizzy because I was super dehydrated and hadn’t eaten for over a day due to my diarrhea and upchucking fiasco. So I went to one of the guesthouses to lie down for a little and eat some bread. When I started feeling better, Priscilla and I headed to the Eye Clinic that just opened today at the hospital. Dr. Samoutou is an optomologist, and he started the Eye Clinic. So now that the Samoutous are back in Congo, the Clinic is open again! So we went there and learned a little bit about the equipment, helped take inventory, and just hung with Dr. Samoutou for the morning.

The rest of the afternoon was spent wandering around the hospital, helping out here and there by taking vitals.

After the hospital we headed back to the Mission for dinner and just some good old hanging out with the Harvey fam (here is a picture of their house).

Goodnight!

If you want to become a missionary, or serve at all in Congo, there is a

Right-Of-Passage

This right of passage is a required day(s) devoted to diarrhea and throwing up.

Everyone must experience it, endure it, or become destroyed by it.

Cause: usually food or worms.

Priscilla conquered her right-of-passage our second week here.

I was conquered and destroyed today.

Battle began at 9am.

I spent the entire day at the Wegner’s house rotating from bed to bathroom.

I had lots of people taking care of me.

Everyone here is a doctor or nurse, so that was helpful.

And that was my day.

Please pray for strength and recovery.

Yesterday we went to an Aka village that was about 6 miles south of the Mission to do the clinic, and today we went to an Aka village around 8 miles north of the Mission. Driving in Congo is always an adventure; it is almost like a video game. There are enormous potholes all along the road, they are more like craters than holes and they are often filled with thick mud or water. If you get carsick easily, driving in Congo is not your cup of soup. And if the potholes weren’t enough to avoid, there are also tons of crazy motorcycle drivers, goats, and often herds of cows (pictured below)!

Today we were headed to an Aka village on the opposite side of town so that we could visit their church and go on a hike through the jungle.

Oh, also, when you drive somewhere, you never have less than 10 people in the car! So while we were headed to the Aka village we picked up about 20 Aka children to come to church with us; so there were about 27 people packed into Mama Sarah’s truck! It was such a blast because we taught all the children how to sing “In the Jungle” as we were driving down the bumpy road! Well…we actually just taught them the “wee-ma-wet-a-wee-ma-wet” part of the song and us mundeli sang the harder lyrics, but hey, they got it down!

Today we were headed to an Aka village on the opposite side of town so that we could visit their church and go on a hike through the jungle.

The church was small, had a dirt floor, and benches were made of plywood balanced on large stones (pictures below). People dressed in the best apparel they had, which was sometimes very close to nothing. Most of the younger children had a large shirt but no pants or underwear. The service was so joyful and so real. People worship God all over the world, but I’ve never seen such a passionate and real form. These people have absolutely nothing, but they still sing the loudest praise to God; one song often continues for 10-15 minutes!

After the church service, we all changed into pants and gym shoes, ate some small snacks, and then headed out on a hike through the jungle behind the village’s “medicine man” and a bunch of Aka children. I say “medicine man” because the Aka like to use a lot of natural plant-medicines to bring down fevers, soothe aches, draw out poisons, and much more! So on our hike this man pointed out those plants and what they are used for (they use the bark of this “bleeding tree”—pictured below—to soothe eye pain; I took this picture though because like WOAH the tree is bleeding!). There is also another picture of some leaves…but it’s not just leaves, can you find the surprise?

The hike took us about 2 hours because we stopped so many times to learn about the plants and also to try different fruits growing along the way. One of them is called coco, (not chocolate) that feels like you are eating a nut that was stuck inside a slug, but it was delicious!

After a long day of hiking and singing we headed back to the mission, showered, and then had Sunday Night Live. For this week’s Sunday Night Live, Priscilla and I shared our testimonies. It was kind of crazy telling my testimony to mostly strangers, but as a Jesus-lover I do believe that there is no better place to start when getting to know someone.

Goodnight!

Today we slept in till 8, then headed to the hospital to update blogs, send emails etc. After finishing we headed back to the mission to get ready to leave for the Aka village. Like I mentioned before, the Aka are a jungle-dwelling people who live very simple and humble lifestyles. We were going to the Aka village to open a clinic for the day so that the people could have access to free medical care. The Aka are some of the poorest people and they often don’t seek any medical attention because they know they cannot afford it. So Priscilla, Miles, the Lunsfords, Dr. Tenpenny, Mama Sarah, and I all packed up some gear to head to the jungle for the day. We drove about 6 miles to the Aka village, and when we got there, people started to crowd. The pastor of the church in this Aka village took us to the church so we could set up our stuff there, the church was the only “sheltered area” from the sun that wasn’t someone’s house. So we unloaded our medicine, set up chairs and tables to examine people on, and began the day. Lauren Lunsford and I took vitals all day and were situated at the front of the church. We both had a chair and then another chair facing us. We both had a stethoscope and blood pressure cuff, but we had to share 1 thermometer and one pen. It was quite interesting. Pens are like gold around here, for some reason no one ever has any, you would think we could at least have like a handful, but no, we had 4 pens total. So Lauren and I switched back and forth using one pen to write down vitals for a majority of the day.

One cool thing that Congo, and I’m assuming other African countries do similarly is that each person keeps a carne. You’re wondering now, well what the heck is a carne? A carne is a little booklet that holds that person’s ENTIRE medical history. When a person goes to the hospital, they bring their carne, and the carne is where the doctor or consultant writes vital signs, diagnosis, medications and more. It is so handy! Any doctor from any hospital in Congo or in another country can then look back at previous illnesses and care.

So today, every Aka person would walk in with their carne, we would write down their vitals, and then send them to Miles to explain what was wrong with them. Miles speaks fluent French and is learning Lingala fast so he is quite the help! He would examine each person, ask very specific questions, write down what he could grasp from the conversation, and then send them to Dr. Tenpenny to talk some more. Dr. Tenpenny would then go over Miles' notes, ask more questions, and if necessary prescribe medications or refer them to the hospital if they needed to have surgery. Dr. Tenpenny would then send the patient to Priscilla who would give them what was prescribed, explain when and how many to take, and then send them on their way!

We spent about 6 hours doing this process, I did vitals on 50+ people and so did Lauren…it was a longgggg day!

After finishing up the clinic around 5pm we headed back to the mission. A few of us watched a movie at the Tenpenny house, ate treats, and then headed to bed around 9 because we were all so exhausted!

Below are pictures of the line of Aka people waiting to be checked, us checking them, and also a stud of a kid who is carrying a gun made entirely of plant stems, what a dude.

Let me start by saying that if you do not find yourself drawn to in-depth medical descriptions, if you tend to feel dizzy at the sight of blood, if you don’t like action-packed movies—then this is NOT the blog for you.

Once upon a time there were two college girls named Priscilla and Faith who decided to go to Congo to learn about nursing. Faith specifically was very interested in the medical missions field and felt as though working at a mission hospital over the summer would shed some light on this desire of hers.

Each week of their month-long stay Priscilla and Faith had been working in different areas of the hospital—Maternity, the Emergency Room, and the Operating Room. This week was Operation Week, and today was their last day scheduled in such an action-packed area of the hospital!

Their day began at the hospital like every other day—devotions, reports, rounds—neither of them had any sort of inclination to what the day would bring. However, by the end of rounds it was concluded that four surgeries would have to occur today in the Bloc (Operating Rooms)! This was more surgeries in 1 day than had occurred all week, their excitement skyrocketed! So the dynamic duo immediately headed to the Bloc to begin preparing for a long and action packed day ahead!

Once in the Bloc the team assessed the cases for the day:

1)    A woman was in need of a repaired ureter. The previous night this woman had gone into labor and was unable to push her baby out due to the fact that her pelvic region had swollen to threes times larger than normal! The baby was trapped in the birthing canal so the doctors preformed an emergency cesarean section around midnight. However, during the operation she began bleeding due to tearing in (literally squirting blood) her uterus and connecting arteries experienced due to the swelling and pressure. To stop the bleeding and future infection, the doctors removed her uterus (called a hysterectomy). After the removal, the stitching up process was complicated and tedious and one of the women’s ureters (the tube that brings urine from your kidneys to your bladder) was stitched too, causing a blockage in urine removal today. SO she needed to have that ureter unstitched and repaired.

2)    A man needed two hernias fixed. A hernia is when there is a weakness in around the abdominal area (occurring mostly in men), which causes tissue to penetrate the area, become stuck/pinched, and then lose a majority of blood/oxygen circulation. It is very painful, but pretty straightforward to fix.

3)    Two ladies needed to have abscesses drained. This required tubes to be put in so that continual drainage could occur.

So Priscilla scrubbed into the ureter repair and Faith scrubbed the hernia repair.

Priscilla would be working with the American/English speaking doctors Dr. Tenpenny and Dr. Wegner, while Faith would be working with all French speaking doctors and nurses—what an adventure!

Faith and her Congolese team prepared the patient by cleaning his abdominal area with betadine, and then covering all other areas that were not to being operated on with sheets and towels. They all prayed, and then the surgery began! Faith was in charge of passing tools to the doctor, and pulling skin flaps away from the area to be operated on. She was to pull on a hook that was placed under the skin flap. First the doctor cut through the layers of skin, fascia, and fat using both a scalpel and the electrical “flame-thrower” that Faith attempted to describe in a previous blog post. Then the real surgery began. The doctors cut out the spermatic cord (which consists of the sperm duct, the ureter, the inguinal ligament) so that it was free to grab onto instead of webbed into other tissue. The spermatic cord comes through an orifice (a hole) that is ONLY meant for the spermatic cord to come through. BUT often there is a weakness in this area due to the fact that in infancy a man’s testicles must descend through this orifice, so the hole must be pliable to some degree. Often the orifice does not become strong and tight, so it is an area prone to hernia formation.

So once you reach this area where the spermatic cord is located, it is easy to take the excess tissue (the hernia) that is coming through the orifice, stuff it back onto the other side of the hole, and then stitch the hole to be tight and small. Wahlah, that is it!

After the stuffing and stitching process, it was time to close the man back up. The doctor and nurse stitched the fat and fascia together, and then once it came time to stitch the skin closed, they handed the needle off to Faith! Faith had not yet been given full reign of the needle, so this was her time to shine! First the nurse showed Faith how to stitch so that the skin would come together tightly and neatly. He then handed the needle back to Faith. She made a stitch…decent but not great, so the nurse showed again. Faith made a second stitch...much better, but could still use improvement. Faith went for her third stitch…it was great! Faith’s fourth stitch wasn’t so hot…so the nurse held onto her hand for the fifth and guided it through. However, when it came time to pull the needle through, there was an inconsistency with how much force the nurse pulled the needle with, and Faith’s reaction time to the pull.

Now it is time to hold onto your seats people.

The needle came rocketing through the man’s abdominal skin and pierced through Faith’s glove into her finger. She froze. She stared at her finger as she saw blood begin to slowly ooze beneath her glove from the small hole that had just been made. She quickly informed the assisting nurse (his name was Ruffan) that she had been stuck, and he immediately ripped off her glove. He then yelled something at another assisting nurse (his name was Orcxance), who then sprung to his feet, ran to get some materials and then grabbed Faith’s hand! He submerged her hand in cleaning alcohol, drowned it in betadine, and then rinsed it under cold water while he squeezed out blood from the site that had been pierced. Orcxance then grabbed a towel, told Faith to put pressure on the site, and then he ran out the door to tell the lab! Meanwhile Faith prayed and went to tell the American doctors who were also in surgery what had just happened. The American doctors asked if an HIV test had been done on the man, and Ruffan yelled from the neighboring surgery room that Orcxance was running to see! Faith was worried. Faith tried not to panic. Then Orcxance ran in to the surgery room and made an enormous motion like that of a baseball ump that signaled to Faith that she was safe, the man was HIV negative! Everyone was relieved, especially Faith.

After this adventure, Faith went to lunch before returning to the Bloc for abscess draining. Abscess draining is quite boring, so this story will relieve you from having to read about puss-removal.

The rest of the story for the day pales in comparison to the adventures in the Bloc, however it was Claire Harvey’s 21^st birthday today, so celebrations did take place, pie was eaten, and gifts were exchanged!

Goodnight all!

I’m sorry that this beginning paragraph is repetitive, so I will summarize it really fast, here we go: breakfast, bike to hospital, devotions, reports, debriefing, rounds. One notable thing that happened though was that a lady came to the hospital carrying a random basket that had some sort of wild creature in it. She came to have a checkup done by one of the doctors and just carried this animal right on in with her on the off chance that she could maybe sell it to one of us crazy mundeli that would consider them awesome exotic pets (otters, owls, lizards etc.) but that most Africans would consider dinner. This animal was a pengalin. I would describe it as a mixture between an anteater and a possum. It had hard scales, long claws, and a very long tail (pictured bellow).

Today rounds took a verrrrrry long time, from 9am till noon…wowza! It was a very thorough morning, which is very good, but it was mostly because there were 5 doctors on rounds and one of them is a visiting doctor. On rounds there is a lot of teaching done for the interns, the Congolese doctors, and the nurses. The American doctors exchange ideas with each other and then with the Congolese and try to come to a consensus concerning the patient’s problem before explaining it to the students. Then the doctors decide what tests, procedures, and drugs they want to start and then the doctors move on. There are anywhere between 5 to 8 patients in one room. The rooms are small, medium, and large sized—but they are all shared with multiple other people.

After rounds we went to lunch and ate at lightning speed so that we could make it back in time for a procedure that would be happening in the Bloc at 1pm. We really didn’t want to miss it because there haven’t been any surgeries for a while (there was a surgery two days ago, but when you spend 9 hours at the hospital each day, 1 day can start to feel like multiple days). The procedure was to realign the bones that had been severely broken and displaced in a man’s arm (x-ray shown bellow that was taken at a different hospital). The whole technique to realigning was pretty creative because currently Pioneer Christian Hospital does not have an x-ray machine. So we used an ultrasound machine during the entire procedure to find, move, and examine the broken bones. At some points I would hold the ultrasound tool to the man’s arm, Dr. Wegner would twist and press the bone into place, and Priscilla would apply pressure.

[Side note: If you read some of my posts and become super confused when I say “we” for almost every situation but do not address who “we” is, do not fear, I am not crazy, I do not have an imaginary friend. “We” is almost always talking about “Priscilla and I.” Ok that is all]

So after the bone was back in place, Dr. Wegner put the cast on, and we put the man’s arm in a sling. Both Priscilla and I have never broken a bone (well I fractured my skull when I was a baby, but that’s different, and no my parents didn’t drop me on my head, I just decided to go on a fun ride down the stairs in a bouncy walker thing), and we were commenting on how we had always wanted casts, but had never had one. Dr. Wegner then said, to our excitement, that we could learn how to really put on arm casts by putting them on each other—so we did!! It was awesome, people were so confused, but we had arm casts for today! We used plaster that turns hard when it is wetted (dampened, moistened—all of these words sound odd), and then allowed to dry. So we dunk strips of plaster into water and then wrapped them around each other’s arms to make casts (there is a picture bellow of Priscilla pretending to be in pain right before I casted her, and then a picture of my finished cast with some fun fabric wrapped around it)! So today I broke my arm!

So that was pretty much our day. After the hospital we returned to the Mission, I ran, we ate at the Harvey’s, and then Claire Harvey braided my hair. It is really nice having your hair braided here, it is soooo hot having long hair and for some reason my hair knots a ton when it is wet which is all the time here because it is so humid that it never dries (try reading that sentence in one breath!)!

Goodnight friends!

There were no surgeries today, and there were also no American doctors at the hospital either. During the week each doctor is designated a day off and it is called their “alternative ministry day.” They can spend time with their family, spend time in the villages, get work done at the hospital that isn’t entirely medically related, etc. Today was Dr. Wegner’s alternative ministry day, so he was not obligated to work at the hospital; Dr. Tenpenny was sick at home and was throwing up most of the day; and Dr. Harvey was having visual disturbances (like seeing doubles/not seeing at all); so today was a little crazy! Priscilla and I rode our bikes to morning devotions and report and quickly realized that there were no doctors at the hospital. So there were no rounds to go on, or at least that we could understand. The Congolese doctors, Dr. Noah and Dr. Cyriaque (major guessing to how his name is spelled) always go on rounds with the other American doctors as well, but Dr. Cyriaque only speaks French/Lingala, and Dr. Noah speaks limited English. So we began by going on rounds with them for a little, but quickly realized that it would probably be a waste of time (not knowing what was going on) and we could be helpful elsewhere. So we went to the Wegner’s house and made some welcome home signs for the Samoutou’s house because they would be arriving today. So after making signs we walked to the Samoutou’s and began making beds, decorating, and cleaning for their arrival.

After that, Dr. Harvey called us and told us that he wanted us to come to his office so that he could teach us about tetanus. Dr. Harvey had come in late to work due to his lack of sight, and had been meeting with some outpatients for a while by the time he called us in. There is an 8-day-old infant in the ER who had contracted tetanus, which is why he wanted to teach us about it. He began by explaining that this baby had been born in the village of the woman because she couldn’t make it to the hospital on time. He hypothesized that a random knife probably cut the infant’s umbilical cord, and that the knife was likely not very clean. He then went on to explain that Clostridium tetani (an anaerobic bacteria = can’t live in the presence of oxygen) can be found in the dirt, and any dirt (and the bacteria) on the knife used to cut the umbilical cord could then find its way inside/live inside the umbilical stump. This gives the bacteria a perfect and easy entrance into the baby’s body. Dr. Harvey explained that it is not the bacteria itself that causes one to have tetanus, but it is the toxins that it releases that causes the harm. The toxins affect the neuromuscular junction (where your nerve meets up with your muscle to tell it what to do) and causes uncontrollable spasms that look similar to seizures but are not sustained. It is a full-body muscular contraction that cannot be controlled or stopped. The danger is that during the contraction, muscles in the trachea (airway) contract as well and close the airway. So the main ways to treat tetanus as a nurse are to 1) clean the wound so that no further bacteria can enter the body, 2) maintain an open airway within the patient, and 3) eliminate excess stimuli (light, sound, touch) that would cause the patient to unnecessarily contract. Further treatment involves giving a pre-cultured antibody blood serum (in America this can be cultured in human serum, in Africa it is cultured in horses because it is cheaper) against the bacteria’s toxin. On his day off, Dr. Wegner spent all afternoon searching for the horse serum and eventually found it! 

In the afternoon we helped out with vitals at the ER since there were still no surgeries. It was another sad day at the ER because during the middle of vitals a young girl suddenly died. Priscilla and I took her vitals not 10 minutes earlier and they were normal, so we were completely stunned when we heard wailing from the room we had just left. We were taking vitals in the ER observation room when multiple cries were heard. We rushed to the opposite room to find Dr. Noah listening for a heartbeat, the heartbeat that I had just heard strongly beating a few moments earlier. The girl was cold, and her chest had ceased to rise. She had passed. It was so sad and so unexpected. She had been unconscious when we had seen her before, but she was breathing properly and her heart sounded strong, so we were all very confused. When the cries and wailing started, everyone, literally everyone and their grandma (no joke, when someone comes to the hospital the entire family comes too) came to see what was going on at the ER. All the ladies in maternity, all the other nurses, all the lab technicians, every random person at the hospital came to see what the commotion was about. Women were crying everywhere and yelling chants, it was like nothing I had ever seen. The ladies would run in to see the girl on the bed, yell chants, wave their hands, and then run out sobbing and shaking. It was so sad and slightly disturbing not knowing what they were yelling.

The rest of the afternoon was slow; we stuck around the ER for a while and then headed to the Wegner’s to be measured for skirts and other clothing by Corentin. Corentin (pictured bellow in front of the storm that hit us about 5 minutes later) is our hospital handyman, mechanic, plumber, seamstress, and carpenter. If you need something done, chances are he can do it…or figure it out. He is making clothes for us with the fabric we bought on my birthday; I can wait to see how it all turns out!

After that we headed home, I ran (put some extra distance between myself and a random man carrying 4 machetes today on the road), we showered, we ate some leftovers at the Harvey’s house, and then waged war against three cockroaches—it was a two-thirds victory.

Prayer: That Dr. Tenpenny would feel better soon, that Dr. Harvey’s vision would return or somehow be fixed, and the Mrs. Harvey’s strep throat would get better as well.

Goodnight!

Today we woke up at the hospital grounds; we spent the night in the Samoutou’s house. It was super nice being right where we needed to be, not having to bike 3 miles in the heat to the hospital at 6:40am. I slept till 6:20 before rolling out of bed, making coffee, and heading to morning devotions and then morning report.

We again started our morning by going on rounds with Dr. Wegner and Dr. Tenpenny. In the surgery/recovery room I saw a women who has been here for 2 weeks and today I witnessed her smile for the first time since her arrival. It was seriously such a joyous thing to see. For the past two weeks she has just pursed her lips and scolded us whenever we walked in, but today she almost seemed excited and happy to see us! Beautiful.

After rounds we headed to the Bloc (OR) to observe and help in some of the surgeries going on today. So here goes, the first surgery I have ever observed ended up being….drum roll please…..wait for it….removing a cyst from a man’s testicle! It was interesting and kinda hilarious because Dr. Tenpenny was doing the removal and Dr. Wegner walked in and dramatically screamed “ahhhhhhhhhhhhh” right as Dr. Tenpenny stuck a needle into the man’s scrotum (it’s a little weird writing this knowing my mother is reading this blog…). These two doctors are like teenage boys sometimes haha.

The next surgery we helped with was stitching up a huge laceration that a baby had behind his ear due to an abscess removal. Dr. Tenpenny sutured (stitched) and it was incredible. I have always thought that suturing was very similar to sewing, like hemming pants or something, but it was very different! I mean in many ways it is similar, there is “thread” and a very tiny needle, but the whole technique is very intricate and you basically don’t use your hands at all. He used multiple metal instruments (which I need to learn the real names of), and just made different loops and picked up different ends of the thread to make super smooth and tight stitches. Suturing is seriously an art.

The last surgery was to remove a baby, placenta, and all other dead tissue from a mother who had experienced a spontaneous abortion (also called a miscarriage). The baby was less than 3 months old so I couldn’t really even recognize that a fetus was taken out, it was mostly loose tissue and clumpy blood that needed to be removed. The placenta was smaller than the size of an egg. It was such a gruesome process, so many long metal instruments ranging in diameter were used to soften the cervix and increase its width so that everything in the uterus could be scraped out. This procedure is called a DNC = Dilate and Scrape (in French). I would almost describe it as violent, even Dr. Wegner said that we should be grateful to be women who can receive medical care in America. There is a picture of the ultrasound we used to make sure everything was scraped out, the red is circling the uterus which is a small oval inside, and the blue is the actual instrument of Dr. Wegner inside of the women, and the black area above the red oval is the women’s bladder.

The DNC didn’t even compare to what I got to do this afternoon though! After lunch Dr. Wegner found Priscilla and I and said he and Dr. Tenpenny would be opening up a girl’s abdomen because she was having lots of pain and pressure in her bowel area (large intestines). AND I got to scrub in for real, not just observe! Scrubbing in takes a while, you have to wash your hands for a while in a particular way, from your hands down to your elbows so that dirt doesn’t run down to your clean hands. Then you walk to the operating room with your hands up and open the door by pushing it open with your back. You then dry your hands off (also in a very specific way) so that nothing is wiped with the same part of the towel twice. Then you grab onto your gown, which is somehow folded like a book. You stick your hands in these holes in the folds of the gown and then when you drop the gown it somehow falls perfectly for you to just stick your arms into the sleeves. The gloves take forever to put on so I will spare you from any more boring explanations. So once I was finally scrubbed in I helped prepare the place where the doctors were going to cut. We placed a bunch of large abdominal compress pieces around the area and checked to make sure the lady was fully anesthetized by poking her belly with a forceps. Then the cutting began. They used a scalpel first to cut through the skin, and then an instrument that was like a miniature flame-thrower (that’s an exaggeration), but it burns through fat, fascia, and other stuff I don’t remember the name of. And when they had cut through all of that, we were staring at her intestines. It is crazy how much surgeons dig around inside their patients during surgery; no wonder people are so sore post-surgery! They began by sucking out all of the pus and excess fluid, and then they began feeling around for what could be causing the pressure and pain. They found it. It was an enormously hard and node-covered area of the large intestine and its peritoneum (connective tissue). They even had me stick my hand way down inside of her abdominal cavity to feel it. It was rock hard and would not move. Both of the doctors where shocked and extremely disappointed with the find because they knew that there was nothing they could do. They proposed that it was either cancer or lymphoma, and that this 27-year-old girl would probably die very soon, maybe less than a month. So they placed a tube in the side of the girl to suck out pus after the surgery. I got to assist in the suturing process; there is a picture bellow.

After the surgery Priscilla and I left to go back to the mission. When we got back I ran while she biked. At one point I had to run around two goats bucking-it-out in the middle of the road…oh the things you see in Congo haha. After we returned from the run, we showered (Fun Faith Fact: I shaved my legs for the first time in 3 weeks. Africa turns women into men) and then we began making dinner. For dinner we made fried bananas, it took a while, but they ended up tasting soooo good, almost like candy! We are often forced to be creative and resourceful here. There is basically no such thing as paper napkins or bags here because those things are banned to prevent excess waste. Sooo we used lady’s (unused) sanitary pads to dab the excess oil off the bananas after frying them! The creativity never ends people!

Prayer:
  For the 27 year old girl who I scrubbed into surgery for. The doctors are actually praying she has tuberculosis instead and not what they think it is, it seems really bleak that we have to pray in this manner, but that’s how life is here. Please pray that no matter what the outcome is, we would be able to comfort her and support her. It is so tragic that she might die at such a young age!

Goodnight!