Friday, April 19, 2013

Last couple weeks in Nepal

Malnutrition Screenings
We completed many treks out to the villages to screen for malnutrition.  I enjoyed these treks which allowed me to see the surrounding areas and where/how people live.  Everybody was very hospitable as we wandered through their homes.  The days were both physically and mentally exhausting.  I much prefer going down the mountains than up the mountains, but as we kept going farther down, you know that you must go up at the end of the trek! Our typical day would just include us going from one house to the next and measuring all children 6 months to 5 years old.  We got lots of crying kids that were afraid of us, but they are still so cute!!! If a child is moderately malnurished than they got some counseling on what kinds of foods to feed the child, if they were severely malnurished we give them the same counseling and strongly encourage them to come to the hospital for further care and treatment.  There are many reasons why malnutrition is a problem here, and after walking through these villages I have a much better understanding of the challenges and difficulties that families have in providing for their families!


taking arm circumferences

such cute little ones =)

This little girl was severely malnourished - now she is moderately malnourished and making small improvements

The Hospital
The hospital here has 45 beds.  There is a small Emergency Room, one Operating Room, a Maternity ward, a Post-op area, 2 general wards, a waiting area, outpatient exam rooms, pharmacy, lab, a nutrition room and a leprosy exam room.  One of the unique things to me is that on the general wards, beds are given to the next person in need - so men, women, and children all share the ward.
Most of the hospital staff are Nepali, and all of the nurses are female. 
There is no place for women who are in labor - so they have to labor in the streets until they are ready to deliver. 
There is also no food service, families have to provide the food.  A project is underway to complete the construction of a small cantine attached to the hospital where food can be easily obtained for patients and families.

Front entrance of the hospital

The hospital

Waiting room

One of the hospital wards

one of the delivery rooms

Out to eat in Dadeldhura
Besides the Manna Bakery, there are not a lot of options of places to eat out.  There are a few hotels that can have decent food - sometimes it makes people sick, othertimes it doesn't.  One night we ate at a little place run by a family from the church, and it was so good and a really fun time!

our restaurant

A typical Dal Bhat meal

Making roti

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Leaving Nepal
There was a group of us leaving Dadeldhura and the hospital at the same time.  It was nice to travel together, and I was thankful that the motion sickness was not as severe as the trip to the hospital.  Just before I left I had the priviledge to be at a home birth of one of the missionaries.  She delivered a beautiful baby boy, but he needed a little medical attention and we were watching him closely both at the hospital and at his house during the days after his birth.  He seemed to be doing better when I left, but then began to have problems again after I had left Dadeldhura, it was decided that he needed to be transferred to the capital city for additional testing.  Since I was in the capital city for a few days I was able to visit the parents and hear updates about how he was doing.  It was a blessing to see them again, although we all would have loved for it to be under different circumstances!  The little baby is now discharged from the hospital and doing well, I'm so thankful!!! 
I enjoyed my time in Nepal and was so thankful for the month I had there.  God allowed me to meet some amazing people and see breathtaking scenery!!!   

My roommates

Enjoying a pizza party the night before I left

My traveling buddies

We stopped at this little place along the way for some yummy rice pudding


Wednesday, April 3, 2013

Daily life in the Valleys and Mountaintops

This has been an interesting week living in rural nepal.  Life here is simple, yet difficult. 
The main road in Dadeldhura
I live in a house with another american nurse, a nepali nurse, and another nepali hospital worker.  There are 2 rooms where we sleep and a bathroom and kitchen.  No space for a table or living room.  We do have an indoor toilet, running water, and electricity, although sometimes the electricity or water goes off randomly.  There is a gas stove for cooking, but no oven and a fridge that kinda works although our freezer is working good!  We get a liter of buffalo milk delivered to our house every morning which has to be boiled before we can use it - but then we've been saving the cream that rises to the top of the milk to make ice cream!!! It's fun to try and be creative with meals and cooking!!!

Manna Bakery
One huge blessing is the Manna Bakery.  This bakery is run by a Nepali couple from the church and they make yummy treats like bagels, bread, cookies, and cakes.  They also serve lunch and will even make pizzas if you order ahead! 

Lunch with Melanie and a great view!!!

Typically we'll eat lunch at the bakery which is either Dahl Bot, a traditional nepali meal of rice and lentels and curried veggies, or soup and bread - this meal along with some chiya (black tea with milk and sugar) and a cookie is less than $1.50 and so yummy!!!  

 A story that isn't really funny, but you have to laugh at while living here - one of the Nepali doctors was in the ER overnight.  He had gotten some food and left in on his desk while he was taking care of a patient - only to realize that a rat was stealing his food =( 

Another interesting thing about Nepal - they have a different calendar than we use.  So currently they are in the 12th month of 2069 - it will soon be the year 2070!  I thought it was hard to adjust when returning from Togo after 7 month, just imagine the transition of going back in time 57 years =)

Typical daily life for what some refer to as "hill people" is very difficult.  This past week we got to spend two days trekking out to visit some of the surrounding villages.  The two areas we visited had been found to have the highest percentages of malnurished children coming to be seen at the hospital and we wanted to survey the area to see if it would be feesable to do some projects and nutrition screenings in the villages.  As you approach a typical home you will first notice the water buffalo, cows, and goats tied up around the yard.  Then you will notice the two story home, typically made out of clay - as you get closer you realize that the lower portion is where the animals sleep and the upstairs is where the people sleep.  Daily life means caring for the animals, washing clothes, preparing food and cooking, working in the fields, caring for children, gathering firewood, pounding rice, and many other chores.  They work very, very hard!!!  We often saw women walking on the narrow winding mountain paths caring heavy loads of firewood, brick, rice, or things they have gathered in their fields; one women was carrying 50 kg (110 pounds) - they carry things by placing a strap around their forehead which then wraps around the load resting on their backs. 

such a heavy load!!!

group of school children

little guy playing with a wheelbarrow

As we walked from home to home the people were very friendly and welcoming and offered us a mat to sit on and something to drink or eat, we only took tea at a few houses because there wasn't time to accept every offer.  The first day we started out walking and then caught a jeep to a path the went off the main road, from there we went winding down the path from house to house until we got to the bottom of the valley.  There were of course amazing views of the surrounding mountains as we walked!!!  Then once we got to the bottom we started our ascent up winding our way through the houses on the other side of the mountain until we reached the top and the main road - we walked for about 5 hours that day.  From there we caught a van ride back to the hosptial. 

Our paths

The second day was much the same, until we started our ascent up from the bottom of the valley.  Instead of winding our way back up the mountain we took the rugged trail straight up this mountain for two hours straight.  We had run out of water, it was around 2pm and we had only a few snacks but no food, and i'm still adjusting to the altitude - it was a very difficult 2 hours!!!  Part of the time I could only look at my feet forcing them to take the next step up because looking up or around me was too discouraging since the mountain was never ending.  Othertimes we'd stop for a rest and I'd look around amazed at the scenery and the beauty surrounding me.  It's understandable why the people that live there have a hard time getting supplies or seeking medical care - they are very isolated and it is so difficult to get anywhere!  The good and bad is that we will be doing both of these treks again this week!   There is a group of high schoolers coming and we are going to take them out with us to do the actual malnutrition screenings in each of these homes.  Please pray for a productive time and interactions as we go, as well as stamina and strength for the treks - we'll be going on Friday April 5th and Sunday April 7th - thankfully not two consecutive days!!!  For those of you in the states we are 11 hours ahead - so praying for us the nights before would be about our mornings as we will be getting started!!!

The beautiful valley

View from the mountaintop

Easter was celebrated for 3 days straight by the Nepali church here. There was a Good Friday Service, Saturday service (their normal day for church), and then a Easter Sunday Sunrise service.  Easter morning we were awakened at 5am by a group of Nepali women coming to start making breakfast at our house so that after the service there would be egg sandwiches and tea for everybody.  The service was held outside the house I’m staying in because it sits up on a hill overlooking the mountains.  At 6am a group of around 50 gathered to celebrate Easter and Christ’s resurrection.  The songs were all in Nepali, but I recognized a few tunes – This is the Day and He Lives.  It was special to be able to celebrate the hope of Christ's resurrection with these believers while overlooking the beautiful mountain backdrop at sunrise!!!  Later that day we went to the taylor so that I could have a nepali outfit made and then we stopped to buy chicken for our Easter dinner.  We gathered that evening for a cookout and enjoyed the time with other foreigners and Nepali friends!      

Easter sunrise service

Easter cookout

Monday, March 25, 2013


What an interesting journey this has been so far!  Nepal is a very different culture than I have ever been in before.  The Hindu have over 30 million gods - I can't even imagine what all is a god!  Their beliefs permeate everything they do and all of the daily life.  It's been hard to not know how to greet people, to not know the language, and feel like I know nothing about what is culturally appropriate.
I'm finally starting to feel a little more adjusted to the time difference and feeling more normal instead of exhausted all day long. 

The first couple days in Kathmandu were interesting because it allowed me to see a little bit of Nepali culture.  I did take Nepali lessons for 1.5 hours, but not sure how much that really helped =)
The rest of my time allowed for me to get to know some of the missionaries here, shop for some food items to bring with me, and attend a conference for rural healthcare workers.  The day that I was there they were learning things like suturing, ortho casting, neonatal resuscutation, eye emergencies, etc . . ., it was fun to see over 100 Nepali rural healthcare workers getting this training!!!
temple in Kathmandu

Nepali healthcare workers practicing neonatal resuscitation
The trip from Kathmandu to Dadeldhura involved flying 2 hours to a small airport and then 4 people and 3 suitcases cramming into a tiny car and driving 4 hours up and down windy mountain roads.  There were amazing views of the mountains as we drove, but sadly I was car sick after about an hour which continued to get worse for the next 2 hours.  We finally stopped to give me a break from the constant swirving feeling.  That helped for the next 30 min and we stopped again for a short break to eat rice pudding and then another 30 min. and we made it to Dadeldhura!  I was so excited to step out of the car and not have to get back in!!! 

I've met some great people and right now at the hospital there is a fun group of people to work with!
Church here meets on Saturdays, so my work week is really Sunday - Friday.  That will take some getting use to!  I'll be spending time in the hospital as well as doing some community work.  I don't really know what each day will hold, but I'm excited for how God will orchastrate all those details!!!  Later this week we'll be heading to some villages - more about that later!
Here is a little glimpse of the scenery:
This is the view from outside my house!
I've been in the hospital two days and it has been interesting, I saw a lady who was attacked by a wild boar, a child with severe malnutrition, a delivery of twin B (twin A born at home), assisted with casting many broken arms, and an assortment of other things.  We discovered that one little baby had pyloric stenosis (results in the baby throwing up everything they eat and can be fixed with a simple surgery), but that surgery cannot be done at this hospital.  My heart dropped when I realized that the only option is for the family to make the long journey to Kathmandu (for them a 24 hour bus ride) or for the baby to go home and die.  Not all families would be able to make the journey to the capital city, mostly because of a lack of money.  Thankfully, this particular mother told us that they would leave for the capital that day.  But what about the families that can't make that journey . . . those are the hard things that I'll never be able to get use to.   
Nurse Melanie preparing a cast for this broken arm
Twin B is in blue
Little guy with pyloric stenosis

Thankfully internet has been working good since I've been here, allowing for me to blog and post photos =)

Thanks for your prayers!!! I appreciate continued prayers for knowing how to best spend my time while here and how to best serve others.

Wednesday, February 27, 2013

Leaving Togo and Transitioning Home

Nursing Students

Decorating for Christmas at the nursing school
Making smores

Awa and her baby

Ruth Aku and her mom

The last few weeks of my time in Togo were very special and yet very difficult. I had to figure out how to say goodbye to the nursing students, the Togolese nurses and hospital staff, patients, fellow missionaries, and a culture and way of life I had come to love. Some special memories were: decorating the nursing school for Christmas and having a Christmas party afterwards, picking beans with the CHE (Community Health Evangelism) group, making smores in The Cuisine, having a Fulani women and her newborn baby stay in our home for a couple days, time spent with fellow missionaries and friends, and last clinical days with the students and translators. Little Ruth Aku and her mom came to the hospital the day before I left to say good bye to me. Angele traveled 3 hours over horrible roads to see me the last couple days I was in Togo. It was hard to leave, and I wasn't really ready when the time came. After spending 7 months in a place that you work hard to get to know people and be part of their lives, it is just simply hard to leave.
I rearranged my flight home a bit to stop in Zurich, Switzerland to visit a friend I had not seen in a long time.  It ended up being a nice transition time, to the cold weather, but also to the idea that I was not in Togo anymore and had to start preparing myself to return to the life as it was before I went to Togo.  I loved getting to see family and friends upon returning home and spending the holidays here.  What hit me hard was how out of touch I felt with everybody.  Others lives had changed or things happened that I knew nothing about.  It was and still is difficult to know what to say about Togo when asked general questions, especially questions that require me to summarize the entire 7 months into a sentence.  Because I extended my leave of absence from the hospital, I didn't return to my normal work schedule and there have been so many unknowns, so everything seems different, yet the same, yet so very very different.

I came across a quote from The Lion, The Witch, and The Wardrobe by CS Lewis that seemed so very applicable to how it has felt coming back from Togo:
"When Peter, Edmund, Lucy, and Susan stepped out of the wardrobe, they were shocked to find out that no one seemed to know anything about the world from which they had just returned.  In Narnia, they had experienced the breathtaking beauty of the place and its citizens; they had discovered things about themselves they had not known before; they had conquered evil; they had known love on new and different levels; they had met friends that had challenged all of their normal ways of thinking.  They had been important people there.  They had completely become a part of that world.  So when they walked out of the wardrobe, they were shocked to find their changes were unapparent to everyone around them.  When to the children, the changes they saw in themselves were so great that they were now almost completely different people."

For me, it has just seemed like a slow process of transitioning from one culture to another and re-entering peoples lives here.  Because of planning for Nepal, there are times when I feel like Togo has kinda disappeared, or been forgotten about.  But, things in my heart and my life have been forever changed by my time in Togo and the people I met there and those things will never be forgotten!!!
And now I'm just a few weeks away from leaving for Nepal where I'll spend about 4 weeks.  It will be another challenge to step into that culture and peoples lives knowing that I have such a short time there, and at the end will have to return home again.  My prayer is that I embrace this opportunity and don't avoid opportunities in order to protect my heart from the pain and difficulties that come along with transitions and goodbyes.  The Lord offers us unconditional, abundant, sacrificial love, and it is only out of His love that I can love others.  I John 4:7 " . . .let us love one another, for love comes from God . . ."