The thoughts of a woman trying to live simply yet abundantly, contentedly yet expectantly, wisely yet adventurously... all for His glory.


fish lips

Continuing to blog about my time in Niger working with the Worldwide Fistula Fund.

Saturday (day 10): fish lips

After all the hullabaloo of riding camels yesterday, we had to say goodbye to part of our team as they left to fly back to the US. Our team is splitting up now, before our patients are fully healed, because we have to maximize space (and thus finances) on the small plane it takes to fly from Maradi back to Niamey, the capital of Niger. It also doesn't take as much manpower to care for our patients now that the surgeries are finished, so it makes sense to have a smaller team. Three nurses (including myself) remain, and Dr. Steve.

From L to R: Dr. Steve (surgeon), Alainie (RN), Sarah (RN), myself (RN), Ginger (RN), Dr. Lewis (surgeon), and Greg (anesthesiologist)
Although today is Saturday, those of us that are still here in Danja still have to work. After breakfast we head down to check on our ladies and do whatever nursing tasks need to be done for the day. But today is much more leisurely than last week and we spend more time playing with the kids than anything. 

So without any further ado let me introduce you to the phenomenon known as "fish lips." This is Sarah's brainchild and a great way to make people laugh, regardless of culture or language. 

Sarah (on the right) started it all!

Everyone in Niger that we've met loves having their picture taken, but all smiles disappear when you aim the camera (except Sharifa on the far left--I caught her off guard).

But little girls love to laugh, and when the crazy nurses start making fish lips of course they will join in!

Hauwa and Sharifa with varying levels of success... but trying really hard!

Me and Hauwa, two of the bestest fish-lippers you ever did see.


queen of the orient

Friends, I've been traveling with only intermittent internet access for the last several weeks, so I'm sorry for the long pause! Continuing to blog about my time in Niger...

Friday (day 9): queen of the orient

Today we did three surgeries on Abou, Marimouna, and sweetly timid Miriam from the Tuareg tribe (one of the nomadic desert people groups). We have arranged to ride camels after finishing work today, so we do two surgeries before lunch so that our afternoon workload will be lighter. It's only after our third surgery is over that we realize that we're done, not just with that particular surgery but with all of the surgeries for our trip! It's been so hectic that few of us have been really keeping track of the days, but we're now halfway done with our time here in Niger.

Since we front-loaded our work, we are able to leave our patients a little earlier in the evening in order to meet our camels. I have desperately wanted to ride a camel for, oh, about five days now since we first heard it was a possibility. As we're walking up the road towards the guesthouses we suddenly see camels, three of them! The camels have an eclectic group of men, teenaged boys, and even a school-aged boy caring for them. My particular favorite was this one sporting a snow-coat hood as his head covering. Only in Africa!

Gotta love the snow-coat hood. (Just in case it snows, you know.)

The camels themselves are ever so much bigger than any of us imagined and we each begin to have second thoughts. Then the camels notice us and start making the most un-animal braying, gargling, and even drowning noises we've ever heard. At this point I'm remembering all the stories I've ever heard about camels being bad-tempered, mean, and loving to bite.

I count the knobby joints in each sinewy leg and inspect the saddles, precariously secured with one lone leather strap around each camel's ribs. The saddle seats hardly look big enough for anyone's rear end, much less mine! But now that I see the camels in real life I imagine turbaned people riding these ungainly creatures through the vast expanses of the Sahara and Sahel deserts, trading spices, leather, and salt. My mind is made up: I can't wait to experience this!

Since there are only three camels, Sarah, Greg, and James (our Australian physical therapist missionary friend who lives on the compound) bravely volunteer to go first. Greg swings his leg over the absurdly high saddle, and before we know it he's miles high in the air but as relaxed as anything. Sarah's camel makes all sorts of dreadful sounds-- and Sarah makes all sorts of faces-- as she gamely tries to climb into the saddle in a skirt. The rest of us in are hysterics, including the men holding the camels. Finally all three are seated on their camels and the men lead the camels down the road for a quick jaunt while the rest of us take pictures in between bouts of hysterical laughter.

And now it's my turn, along with Ginger and Alainie. My camel is the tallest of the bunch and a beautiful off-white color with the longest eyelashes I've ever seen. I've learned from Sarah's experience  and have on a pair of scrub pants underneath my skirt, a fact for which I am immensely thankful as I try throwing my leg over the insanely high saddle. The men place my feet on the neck of the camel, and as I hold on tightly the camel slowly begins to make its way to a standing position. It's rather like riding a seesaw and I tilt precariously backwards and then forwards as the camel unfolds its various knobby joints. Already I love this! I can picture myself riding across the desert, shielded from the sun by robes and a turban. Ginger, Alainie and I joke that "we three queens of orient are," and we set off down the road.

Holding on for dear life as the camel see-saws its way to a standing position.

Our ride on the camels is over much too quickly in my opinion. The camels saunter away with their owners, and our bellies are aching from having laughed so much. I imagine we have provided the camel owners with some stories to tell back home!

a queen of the Orient... or something like that!
What a gift this whole experience in Niger has been so far. I'm realizing that as I continue to explore the Nigerien culture and worldview, I keep falling more and more in love with it all. I love the Hausa language, I love the relaxed yet conservative nature of the Nigerien people, and I even love the head wraps. I hardly notice my own head wrap any more, and am quickly becoming proficient in various ways of tying it.  It's amazing how much I've experienced in just nine short days, and I can't wait to see what next week holds.

Heading home after much laughter.


I think I want to go home

Continuing to blog day-by-day about my time in Niger... 

Wednesday (day 7) and Thursday (day 8) : I think I want to go home

Wednesday went well--our first time doing three surgeries in one day. Two women had their surgeries after lunch, so for Sarah and I on the ward it meant most of our work was stacked at the end of the day. Everything went smoothly, but after twelve hours, I had nothing left to give. And still we had to come back in the evening after dinner to check on the women for the night and pass out meds.

I've begun to realize just how few resources we have here. There's no one to come and replace me when I have finished my shift. It would be easy in circumstances like these to feel like everything stands or falls on me and how much I pour myself out. Of course I don't have the resources or sheer will power to accomplish these things; only God does. But can I recognize that? Can I seek Him in the midst of need? That's always, always the rub.

Hard at work in the OR
Thursday promised to be similar to Wednesday's routine--three surgeries, one before lunch and two afterwards. But when Sarah received the first patient back from the OR, it became rapidly clear that this would not be a good day. VVF surgery is an art, and unlike some other surgeries you are never guaranteed a good outcome. Things started poorly in the OR with scarred tissue that wouldn't hold stitches. By the time she was with us on the ward, she was wet. And all we could do was start her on a medicine and hope against all hope that the surgery hadn't failed.

This is the line we choose to walk in working with VVF. We exist moment by moment in the space between hope and despair, joy and sorrow, dancing and mourning. Most of the time we walk in light, rejoicing with the women as hope transforms them. It's easy to praise God in the light. But sometimes we seem to walk in darkness and pain. Only God can right some wrongs, and of course you have to wonder why He chooses not to do so. And when the answers are not clear (are they ever?) you have a choice. You can trust that He can and does work all things for good, despite appearances to the contrary. Or you can decide that because He allows pain and suffering in the world, He doesn't actually know what He's doing.

I choose to trust. But it doesn't make it any easier to sit and just be with a woman as her hopes shatter.

I choose to trust, but I also don't know how much of this I can take. It's all well and good when things run smoothly, surgeries succeed, women are dry. But on days like today, I think I want to go home.

next post (Friday) : queen of the orient


two surgeries and a stick shift

I'm working on blogging about my day-by-day experiences in Niger, but the sailing has been a little rough recently so it's been a couple of days since I last posted.  I'm making up for the silence with an exceptionally long post.  Enjoy!

Tuesday (day 6): two surgeries and a stick shift

Spirits are high as we head to the clinic area. We have our first two surgeries of the week today. The rest of the week we'll do three surgeries per day, but seeing as it's the first day we want to make sure that everything works well.
Foure, our first VVF patient of the week in Danja!

When we arrive, Mariama (one of the local midwives working with us on the ward) tells us that our first patient, Foure, is all showered and ready for surgery. The OR team quickly heads off to starting prepping the OR. On the ward, Mariama, Hannatou (one of our translators), and Sarah and I pray with Foure, then walk her across the courtyard to the OR. Before Foure enters we have her step in a bucket of water to rinse the sand and dirt off her feet. Everything in this part of Niger is so sandy that your feet are always filthy, and the water bucket was Sarah's brilliant solution to that.

So she's off. Now we settle down to wait the several hours before her surgery is finished. We have plenty to do--go chat with the ladies under the tree, play with the adorable kids, and even a little nursing work making a plan for when Foure comes back from the OR.

In a western hospital setting, after surgery the patient goes to a recovery room (aka post-anesthesia care unit or PACU) for about an hour to be closely watched (think blood pressure checks every 5 minutes!) while the anesthesia wears off. After the recovery room the patient arrives on the ward where we check blood pressure every 30 minutes for a while, then hourly, then every 4 hours, and so on. But this is Africa, and this is not a hospital--not yet anyway!) Hopefully the hospital will be completed in the summer of 2011.) So the patients will come straight from the OR to Sarah and I on the ward. We ARE the recovery room!

Dr. Steve previously instructed us that our whole time in Niger is meant to be laid back, and he's given us the freedom to do what we feel is right and appropriate on the wards. We both have a lot of experience with VVF patients, so he's also trusting our nursing judgment to guide our practice. In light of this, Sarah's and my sophisticated plan for our post-op patients is this: check her vitals signs when she comes to the recovery room, aka ward. If everything is fine, we'll check her again later. If there's trouble, we'll check her again sooner. We're both confident (arrogant?) enough in our assessment skills to be able to catch any trouble before it actually becomes trouble.

A VVF patient is transferred from the OR to the ward.

After a while we hear people outside the ward, so we investigate, hoping Foure is out of surgery, which she is. She's being wheeled across the sandy courtyard on the stretcher, Greg the anesthesiologist at her side. We settle her into bed, and I check her vital signs according to our plan. And she's fine! Our recovery room plan is working brilliantly so far.

Foure back from surgery and doing well! (And I'm nursing in a skirt and a cap... Florence Nightingale would approve!)
While I check on Foure, Sarah gets Zina off to the OR for her surgery. Then we sit back to chat with the ladies under the tree again. I check on Foure, but she's dry and doing well so I have nothing to worry about.

The recovery room peanut gallery.
The rest of the day goes smoothly and Zina also does well when she comes back from surgery. After Sarah and I get both Foure and Zina settled for the evening and tomorrow's three ladies are brought into the ward, we head back to the guesthouse for dinner.

After dinner, Sarah and I drive back down to the ward to check on the ladies once more before we go to bed. Everyone is doing well, and we tell everyone "se anjima" ("see you tomorrow") before we head back to the car. Again, this is a very non-western hospital occurrence, where nursing shifts are 24/7. I've never left a patient before and just gone home. But there are some local nurses on overnight, and our team has a cell phone so we'll each take nights on-call.

I climb into the driver's seat. I've never driven a stick shift, but I've always wanted to, and now's a good time to learn. One of the unofficial policies Dr. Steve has is that everyone has to be able to drive on the compound. So Sarah talks me through it, I let out the clutch while pushing in the gas, and...success! I manage to stall a few times, of course, but for the most part I love the challenge and it feels surprisingly natural.

So... as the stars start to come out in the inky black sky, I am in the middle of Niger learning how to drive a manual car. Who would ever have guessed?

Just another chapter in this wonderful, wild adventure that God is walking me through!

tomorrow (Wednesday): I think I want to go home


under the tree, into the ward (screening day)

Thanks for your patience with me friends! I arrived back on the ship from Niger last Friday and then we set sail for South Africa last Sunday... I'm writing to you from the middle of the ocean. But, with the comparatively-fast ship internet I can now post pictures! Enjoy!

Monday (day 5): under the tree, into the ward (screening day)

Today the rest of the team arrived: both surgeons and the anesthesiologist. After they'd settled in and eaten a quick lunch, we headed to the clinic area to start screening the women.

We found the women waiting under the tree as usual. Some women had previously been operated on in May and were returned for a check-up; some had been screened previously and were already on this week's surgical schedule; some had simply heard of the fistula center and came seeking hope.

The ladies brought their mothers, daughters, sisters... 

Marouka and Aichatou

We set up our screening area in the maternity clinic, and one by one the women came through to be examined. I assisted the surgeons with the physical exam, handing them supplies and trying to anticipate their needs. We screened somewhere around 20 women, although I am not sure of the exact numbers. 10 will be operated on this week, and some of the others will return for surgery in November when the next VVF team comes.

Screening VVF ladies in the maternity clinic in Danja

At the end of the day we had a surgical schedule made up for the week, and we brought the first two women from under the tree into the ward that night. Similar to on the ship, we had to teach the women how to shower in preparation for surgery the next morning. One of the local nurses working with us explained that for many people in this region of Niger, you are considered clean if you have bathed your face, hands, and feet. This makes sense when you also consider the great distances that many people have to haul their water!

Tomorrow: the first two surgeries!



... more blogs about Danja are coming, I promise! Here's a few pictures of "the ladies" to hold you over until I have a chance to write more.

VVF ladies waiting patiently under a tree for the team to arrive

Some of the women who would have VVF surgery (and some other family members)

A caregiver (aka mom) for one of the VVF ladies--Tuareg tribe I believe. 

Thanks to Sarah for taking amazing pictures of the women!


the blind and the broken

For a while I will have to blog day-by-day about Danja, Niger. So far my time here has been so rich and full that I think you might enjoy some details! 
Sunday (Day 4): the blind and the broken (Hausa church)
There’s something incredibly rich about worshiping with believers in other cultures--each time I do, I see a picture of heaven where every tongue and tribe is represented. 
Church today was in Hausa, the local language. June pointed me to the Bible verses that the pastor was speaking about, but other than that I had time to simply read, pray, and absorb what was going on. 

Worship is more reserved and more laid back here in Niger than the churches I experienced in Benin. Each age group took a turn singing for the rest of the congregation, starting with the children, moving up to the adolescents, then the women, and then the men. But there was none of the booty-shaking, shoulder-pumping, exuberant dancing so prevalent in Benin and Togo. Instead, each group of singers stepped gently from right to left in time with the song.
"Reserved" does not by any stretch mean "boring" or "plain". I wish I could somehow portray to you the resonance of the drums the women played while they sang. As I leaned against the wall behind me I could feel every beat percussing through my heart and pulsing down my veins. One woman in particular had a beautifully haunting voice and I imagined the windswept desert underneath dark, starry skies while she sang. 
One of the ladies here for VVF surgery sat in front of us, and I gained a firsthand knowledge of some of the shame they experience. Just a subtle hint of urine at first, but as the service progressed the smell became more and more noticeable. She strove to keep a little distance between herself and the people sitting next to her. When she stood to sing a damp stain of urine appeared below her right foot, and it broke my heart. But she held her head high and sang nonetheless, a beautiful picture of hope and strength. 
Many of the people filling the church were patients; I saw many with bandages on arms or legs or eyes. I think the only difference at home is that many of our wounds are the hidden, internal kind... sins like pride, jealousy, anger. These wounds are easier to hide, perhaps, but potentially more damaging at the end of the day. I’m so thankful for a God who loves us despite our wounds, and who loves us enough to want to heal us, no matter how painful the treatment may be.
After church was over, I watched a woman let her children wander ahead of her on the path home as she led a blind man. He simply called out and lifted his stick, while she took hold of the end and began to lead him. A little thing, really, but completely beautiful to watch. 
Lord, let me not forget: I too have wounds in need of Your healing, and I too am blind in many ways. 

Come, restore my vision.

Come, heal my brokenness.


work, work, not dare to shirk!

For a while I will have to blog day-by-day about Danja, Niger. So far my time here has been so rich and full that I think you might enjoy some details! 
Saturday (Day 3): work, work, not dare to shirk! 

Walking down from our guesthouse to the Danja fistula hospital for the first time. Alainie managed to successfully carry our medical supplies on her head African-style.

Our objective today is to clean and set up both the operating room and the ward. The rest of the team is due to arrive on Monday, at which point we’ll screen the ladies and make up a surgical schedule. We are using temporary facilities here until the new hospital is built, so all our supplies are packed away in one closet in the OR. Turns out that the closet is also the local party palace for termites! Everything in the closet is covered with red dust, and there are substantial piles of termite leavings/poo. Not to mention that there are definitely bugs everywhere (in our house too, by the way)... spiders, mosquitos, beetles, ants, earwigs, and moths. We unfold the drapes for the surgical table, and insects fall out. We sweep them out from the cupboards. They are hiding between the catheters and the glove boxes... basically everywhere. We clean and bleach everything, and attempt to kill or shoo away as many bugs as possible. 

Ginger, Sarah, and Alainie hard at work double-bleaching the OR.

Next we go to meet the ladies who are all sitting outside in the shade of a large tree. Some of them have been waiting for a week for our arrival, and all have brought mothers and children. They are thrilled to see us and warmly welcome us in Hausa. Of course none of us speak Hausa, but this is one of those times when words aren’t really necessary. 
As a preface to the next little story, let me tell you about the bulls. We often see bulls grazing all over the compound, and we’ve been astounded by the fact that very small boys armed only with sticks are responsible for keeping them in line. Some of the boys look to be about 4 or 5, some perhaps 7 or 8. All are fearless as they boss around these massive horned bulls. So, now for the story. After cleaning everything in the OR and ward, we’re walking up to our house for lunch when one of the bulls starts to follow Sarah and I. Sarah peels off the the side and I walk faster, but the bull keeps following me. At this point I figure that if a small boy can keep a bull in line with a stick, then it’s really all about the attitude and about showing no fear. So I turn around to face the bull and put on my stern face and simply say “no!” The bull stopped, but he also didn’t seem inclined to wander away. At this point one of the boys came charging over, stick flailing madly, and shooed the bull away. Thank goodness for small boys with sticks! 

Staring down the bull who by the way was not tethered. I appear to be smiling for some reason, but it was not amusing at the time.

My favorite part of today was going into town with James, the physical therapist from Australia. He took all of us girls to a local tea “shop” in Maradi which turns out to be a couple of benches under a pink and green umbrella with a tea kettle heating over a small wire basket of coals. Our tea, called “shiya,” comes in shot glasses and is sweet, a touch spicy, and wonderful. We sit on the benches, drinking our tea and watching the people passing by until the owner of the shop comes. He speaks small small (a favorite French-African phrase of mine) English, and proceeds to quiz us on which states we’re from (he’s stumped by Idaho). He tells us that he used to be in politics, but wanted a break so he quit and opened this little tea business. Now he wants to get back into politics, so he’s running to be the mayor of district two in Maradi. After two shot glasses of tea, we’re ready to leave, and we have to haggle with him to allow us to pay him--he insists that we should pay next time, not this time. He finally lets James pay for his tea, but he doesn’t accept money from us girls. I think the notoriety he gets around town for being the tea shop that the white women go to is perhaps payment enough, but I can’t exactly ask him, of course! It was just so wonderful to be able to sit and watch the world go by--something that I miss on the ship.
At the tea shop in Maradi with James and the girls. I wondered if the local Nigeriens thought we were his wives, especially with our matching headwraps!

We end the day by going to the French Club for dinner and a swim. Some of the other SIM missionaries are there with their families, so I chat with them for a long time about living in Niger. As the light fades, we are preparing to leave when someone notices that there are some small lemur-like monkeys in the trees. It’s just dark enough that we have a hard time seeing them, but we watch their silhouettes leap from tree to tree until the mosquitoes finally chase us to the car.
It’s just another normal day around here-- cleaning the OR, a showdown with a bull, tea with an aspiring mayor, and lemur monkeys in the trees. Oh, and let me not forget the sheep in the trunk of the car in front of us as we drove home... the passengers were all dressed up like they were headed to a party when all of a sudden a sheep sticks its head up in the back window of the car, then settles back down again. (Maybe you had to be there to understand it, but it really was hilarious.)
Like I said, it’s just another normal day in Danja. It's just that normal looks completely different here!
Tomorrow: the blind and the broken (Hausa church)


come fly with me

For a while I will have to blog day-by-day (internet access permitting) about Danja, Niger. So far my time here has been rich and full so I think you will enjoy some details! Warning: long post ahead

Friday (Day Two): come fly with me

After a night filled with thunderstorms, we wake up early in preparation for flying to Danja. We don our ankle-length skirts and make sure to pack our head wraps in easily accessible locations, since these things are necessary for women in this part of Africa. Our pilot, Ed, shows up at 7am to pick us up and we head back to the airport again, only this time we pass up all the commercial planes and head for a back hangar. I’ve been anticipating this for months now--we get to fly in a six-seater Piper Saratoga from Niamey to Maradi (Maradi is only 15 kilometers--a quick car ride-- from Danja). 

Ed opens the airplane hangar and proceeds to pull (yes, pull) the plane out onto the tarmac. We’re all a little giddy, seeing this tiny plane that will somehow manage to hold us and our luggage. It's a little hard to scramble into the plane in our long skirts, but we manage. I have the immense pleasure of sitting in the copilot's seat in the cockpit. At my feet are pedals, at my knees the steering console, and above that are numerous dials and knobs. I buckle in and put on the headphones, and suddenly I’m listening in on the chatter between the flight controller and Ed as they confirm preflight details. I am literally giddy with excitement!

Yours truly, "copiloting" the Piper Saratoga. 

Ed starts the propeller, and we taxi to the runway. I can’t help but hold my breath as we smoothly lift off the ground, and the next thing I know I am watching the desert below, dotted with villages with footpaths to connect them. Sometimes the land below is green and lush looking, sometimes bare and sparse, but it’s always beautiful. I think I could watch the land scroll by below for hours. This Nigerien flying experience is such a beautiful gift from God!

An aerial view of Niger (brown part; less developed and irrigated) and Nigeria (green part; more developed).

After sitting with my eyes glued to the window for two hours, we land in Maradi, the second biggest town in Niger. As I step out of the plane I notice that we have an audience of farmers and their children, all watching us curiously. We’re met on the tarmac by Burt, the local SIM director, and a local airport official who informs us (Burt translating) that he would be happy to find us all good husbands. We laugh, and thank him for his offer, but politely decline. Although, on second thought, none of us have been able to find husbands yet on our own, so maybe we do need some help in that department!

After landing in Maradi, but before covering up our hair with headwraps.
We wrap up our hair in scarves and pile into Burt’s truck for the quick drive to Danja. Before we leave the runway, we meet yet another man who asks Burt in all seriousness “where are you going with all those brides?”  Apparently all the single men have been living in Niger all this time... who knew?!?

Burt delivers us safely to the Danja hospital compound, and we get settled in the house of a family home for a year of furlough. We’ve met the other missionaries currently living on the Danja compound-- James from Australia is a physical therapist, and June from England is a nurse. Both are very warm and welcoming, and show us the ropes. In fact, we meet all the missionaries in this area because we're invited/requested to attend a monthly SIM prayer meeting. I'm amazed at the fortitude of these folks--these are the ones who live in the bush, so to speak, treating their own heart attacks (true story) and doing all sorts of other amazing things. It's interesting to meet people who have lived in Niger long enough that they call it home.

Talk about a full day! Once again, I'm exhausted, so I fall into bed, after tucking in the mosquito net, of course. Tomorrow we plan to clean the ward and the OR, meet the women here for surgery, and try to relax a little before the week begins.
Tomorrow: work, work, not dare to shirk! 


there is no 27B

The Danja team after a logistics meeting-- still on the ship in Togo at this point!

For a while I will have to blog day-by-day (internet access permitting) about Danja, Niger. So far my time here has been rich and full so I think you will enjoy some details! Unfortunately I can't currently upload pictures, but will keep trying. Let me try to bring you up to speed, starting with last Thursday, the day I left the ship for Niger.
Thursday (Day 1): there is no 27B

My time in Togo came to a bit of a whirlwind close as I worked my last few shifts and said goodbyes to lots of people, including my good friend Ben from home and my dear roommate Steph from Cambridge, England. 

The Danja team--Alainie, Ginger, Sarah and I--all piled in the Land Rover and proceeded to sit in traffic for a while before finally reaching the airport. Once aboard the plane, I discovered that according to my ticket I was meant to sit in seat 27B... but there was no 27B. Fortunately it was a misprint, but still I had to laugh at such a TIA (this is Africa) moment. 

Our flight from Lome to Niamey, Niger took just over an hour. Definitely not long enough for any of us to process all the goodbyes we’d said, the fact that we were finally going to Niger, or that our time in Togo was over. At the Niamey airport, we stood in lines called “police” and “health” which you might know as passport control and yellow fever card control. After we collected our bags, we had to once again put them through an xray scanner. The duffel bag packed with medical supplies sat in the xray machine for a while, but fortunately no one hassled us about it. 

We were picked up at the airport by the director of the Niger branch of SIM, who took us to a SIM guesthouse for the night. We had dinner with a lovely missionary couple who run the guesthouse, and also with another couple who had spent the last two months out at Danja working on building the new fistula hospital. 

As I settled in for the night I could hardly believe I was in Niger; everything seemed so surreal. It was so hot that I simply lay there sweating for a while, listening to the downpour on our corrugated roofing, before finally falling into a restless sleep.
Tomorrow: come fly with me (in a very small charter plane!)


I never dreamed of Africa

Over dinner with a friend this past week, I marveled at the journey that God has been leading me on over the last several years in particular. I never knew that following Him would be such an adventure, and I will be the first to remind anyone who asks that I certainly don’t deserve this kind of joy. 
I never dreamed of Africa. I dreamed of traveling to Thailand with its rice paddies and elephants, and of India's tigers and kaleidoscope of colorful saris. 
I never dreamed of being a nurse. Earlier dreams included bus driver, flight attendant, and dentist. In college I thought I would earn a biochemistry degree then launch into discovering cures for various diseases. After realizing biochem wasn't for me, I then proceeded to dream about becoming a doctor, a dietician, a physician's assistant... and finally, finally nursing.
Through all my 27 years I have struggled to place God at the center of my life. I’m no model Christian, not by a long shot. Yet somehow I always return to the fact that I am my Beloved’s and He is mine. Each time I wander away He comes to bring me back, sometimes gently whispering and sometimes using the megaphone known as Pain (my thanks to CS Lewis for a great metaphor). 
I have no idea why He has chosen to be so gracious to me. Call me naive, call me rosy-eyed, call me idealistic, but I can’t help but think how stunning the grand adventure of life is with God! Most days are not page-turners, of course. There are chapters I wish I could have skipped. And I am holding my breath for some plot developments (romantic tension, anyone?). But I wouldn’t trade my journey for anything. God has written stories for each of us, and only as we walk through our own pages--and not those of others--are we truly content and truly alive.
I never dreamed of Africa or of nursing, yet tomorrow I fly to Niger to work as a nurse for two weeks at an up-and-coming fistula hospital in Danja. I have fallen in love with VVF ladies and with the transformation that happens in a woman when hope blossoms anew. I’ve fallen in love with the least and the lost. My heart beats for the outcast, the unloved, the lonely. 
I never dreamed of Africa. And I certainly never dreamed that God had dreams ever so much grander, more satisfying, more everything than mine.   

(Photo from Worldwide Fistula Fund)


VVF by the numbers

I don't tend to like numbers much; I prefer words. Words make sense to me, whereas numbers have any number of troublesome qualities like imaginary and irrational.

But I thought I might share with you some numbers now that all the VVF surgeries are over and done with and all of our ladies are journeying home.

Learning how to make soap while staying at the Hospitality Center either before or after surgery. The Hospitality Center is for patients who are from too far away to travel back and forth to the ship.

Why am I using numbers instead of words to talk about VVF? Good question. The truth is that I've had such a different role this year than I did last year when I was in the thick of things, so to speak. I pantomimed questions to my patients when no one spoke their language. I emptied catheters by the hundred. I learned to see things with new eyes through relationships with patients like Eugenie. I shared in the joys and sorrows of women I knew by name, simply because I was their nurse.

But this year was different. I've had two jobs, both of which were administrative. As a charge nurse, my main responsibility was to look after the nurses and to keep the shift running as smoothly as possible. As the Assistant VVF Coordinator (big fancy title, I know!) my job was to help handle paperwork, keep track of data, and be a clinical resource for the nurses.

So instead of stories, right now all I can offer you are numbers. But believe me, the numbers tell their own story!
  • We did VVF surgery on a total of 99 women (many of them had more than one operation, too--that brings the total up to 119 surgeries on those 99 women). 
  • Of those surgeries, 90% were successful (the fistula was closed and the woman was dry). That is exceptional, because VVF surgery is highly specialized and is always, always difficult.
  • Thanks to a generous loan of a bladder scanner (a specialized ultrasound machine that measures how much urine is in the bladder), we were able to detect and treat urinary retention in our patients. (Urinary retention is a common post-op complication and can cause infection or failure of the repair. Without a scanner, the only way to check for retention is to insert a catheter into the bladder, which poses a risk of infection. And of course it's miserable for the patient!) 
  • Using the bladder scanner meant that we caught and treated the 22% of our patients who developed retention after surgery. Look at it another way: we saved 78% of our patients from needing catheters inserted after their operation! 
(Let me pause to offer a belated apology for talking about catheters and bladders and urinary retention. I should probably consider having a "medical disclaimer" on my blog somewhere.)

So although the numbers don't tell the whole story, they do show this: all of the surgeons, all of the nurses, and every one of you who prayed for these women-- you did well. God used each of us to pour love and life and hope into their lives. I wish you could have seen them, standing in front of a crowded room in a new dress to praise the Lord for being dry. I wish you could have heard the drums pound and seen shoulders lift in dance and smiles radiate joy.

The numbers just don't do it justice.

I first met Rosali (in green) last year in Benin... her surgeries that year failed. But she returned to the ship this year and is now dry! Also pictured is Clementine, a patient discipler & counselor on board who loves the ladies with every iota of her being.


the road to Danja

This is the road to Danja.
(picture from Worldwide Fistula Fund)

This is the fistula hospital under construction in Danja, and I'm going to work there for two weeks in August.

The fistula hospital is being built following the red outline. (Picture from Worldwide Fistula Fund

Is your mouth hanging open like mine??

The VVF surgeon on board, Dr. Steve, is one of the surgeons behind the Worldwide Fistula Fund, and it's through this organization along with others that the hospital is being built.

Until the hospital is completed, surgeries will occur in other buildings on the compound. The compound also houses SIM missionaries and a leprosy clinic.

I'm so excited to see a different kind of Africa than I've experienced so far--the kind with sandstorms, camels, and turbaned nomadic peoples. But in researching it a little online, I've also found some tough news: Niger currently has the dubious distinction of being the least developed country in the world according to the Human Development Index.

A Nigerien VVF patient. (Picture from Worldwide Fistula Fund)

Please pray for me as I sort out the details of heading to Niger. I've booked a flight, but I also need a visa. Originally we thought that obtaining said visa required travel to Cotonou, Benin (where the ship was docked last year) because that is the closest Nigerien embassy. But we just found out there is a Nigerien Consulate here in Lomé (anyone know the difference between an embassy and a consulate?). So our passports are currently at the consulate, awaiting their official visas. I'm also praying that the return flight from Danja to Lo goes smoothly, as I will arrive back on the ship just a few days before the ship is due to sail for South Africa.

And now for a quick topic change. One of the things I love most about blogging is the fact that I can give whoever reads my blog a small glimpse into another corner of the world. I can tell stories of God's faithfulness, of what He is teaching me, and of the work He is always, always doing. So I just want to say a quick thank you to you all who take the time to read what I write and who pray faithfully for me and who encourage me in a million little ways.

We are all part of the grand redemptive work that God is scripting, whether or not you realize it. May you live your life Soli Deo Gloria-- for God's glory alone--wherever He has placed you, whether it be in Seattle or Rochester or Houston or Togo. Or Niger.