Today

I hope you’ll forgive me for the massive number of blog posts today in such a short time. The internet here is generally very slow, but for some reason this afternoon it’s blazing fast. I write a few blog drafts off and on, but so often don’t upload them because getting the pictures online is torturous. Somehow this one ended up as a very long rambling post about my day. In any case, here goes.

This morning  (a few days ago) our friends from Ashland, KS, left Karanda to return home. They had been here for ten days installing screens in the Karanda Mission Hospital Guesthouse where we and other volunteers stay. 

The building is quite large, and they designed and built wood frames with screens for approx. 50 windows. Toward the end it became apparent that only 4 of 12 boxes of staples needed for fastening the screens made it into the luggage, but God provided through Dr. Stephens who happened to have wood staples at his house. They finished with about 50 remaining. It reminded us of Jesus’ feeding 5000 with the loaves and fished. The crew consisted of three- Ben and Kaila Anderson, he is a hospital administrator and she is in school for social work, as well as Chance Wilkinson, who works in maintenance at the Ashland hospital. All three are great people who love Jesus, and have hearts willing to travel halfway across the world to serve us and the people of rural Zimbabwe.

After breakfast with Lisa and Jude, I headed off to devotions for the nursing students at 7am. There are usually 60 or so in attendance, plus miscellaneous other staff. Thursdays have been my day to lead, so this morning I spoke about Jesus teaching that we should be salt and light from Matthew.  Many of the nursing students are believers, but not all.

The next item of the day was hospital rounds. The last week or two we have noticed that the census is dropping off, both in the number coming for outpatient clinic visits as well as inpatients on the wards. A few weeks ago the wards were full and we were working until 6pm every night, but since the rains have started it feels like a different place. The local staff say this is because, with the rains, people are now working their fields, and travel is more difficult due to high rivers.

Each of the medical providers here takes a different ward each month, and this month I am rounding daily in female ward. Each day brings a mixture of patients waiting for or recovering from surgery, older patients with chronic illnesses, acute infections or illnesses, and then many patients with HIV and/or Tuberculosis and the opportunistic infections that accompany HIV. Accurately diagnosing and treating these conditions here is the most challenging medicine I have seen, as the infections are complicated, and the available laboratory and diagnostic tests are very limited. Nonetheless, we do our best, praying and trusting God to give us wisdom and use the treatment resources to the best of our abilities.

After rounds, I stopped by theatre (OR) and scrubbed in to a VP shunt surgery that was in progress with Dr. Stephens. These are the kids I wrote about earlier with the “big heads,” swollen with cerebrospinal fluid that their bodies don’t drain correctly. We broke for teatime and them came back to finish another VP shunt placement on another child.

Each day  at 10:00 am we break for “tea,” a religiously observed custom in Zimbabwe carried over from the days of British colonization. Some days we actually drink tea, but most days it means a 30 min. break to walk home and see Lisa and play with Jude for awhile. This is one of those elements of Zimbabwean culture that I wish I could transport to America, since we’ve so much enjoyed the extra family time each day.

The rest of the day held an assortment of other surgeries and procedures. For some reason the hospital water system was turned off at 1 pm, so after that we had no running water. I walked out of an operating room, taking off my gloves to find that there was no running water to wash off the latex powder. There were still several procedures to be done and patients to see, so this meant no hand-washing in-between. There is a large trash can filled with clean water that can be used if needed, but I left that for the scrub techs who were dipping into it for water to clean dirty surgical instruments before sending them to the sterilizing machine.

We finished up in theatre mid-afternoon, so I headed to the outpatient clinic to help out by seeing any remaining patients. There I visited with a young male patient in his early 20s, complaining of blood in his urine as well as genital warts. He was well-dressed and from Harare (the capital city), but had ridden the half-day bus-ride to Karanda seeking treatment, not uncommon here. After a urine analysis we discovered he had Schistosomiasis, a tropical disease contracted after swimming in freshwater lakes or rivers infested with this parasite. They burrow through the skin, into the blood vessels, and this particular form eventually live in the bladder lining, where they cause inflammation leading to blood in the urine, and if left long enough, cancer of the bladder.

I gave him a prescription to treat the parasitic infection, and then took him to a procedure room to remove his genital warts. During the procedure I asked him what his plan was to prevent himself from getting HIV. (He hadn’t yet been tested, but I was being optimistic). He said circumcision (a new finding in recent years that is being promoted here in Africa) as well as “not sleeping around. I told him those were both good ideas. We finished up and I headed home. As I walked away from the hospital, we met on the sidewalk again, so I walked with him out to the parking lot. As we walked out, he thanked me for his treatment and asked, “So what should I do about her?” I asked who her was, and he said it was his girlfriend. He said he had had sex only one time, and was concerned about sexually transmitted diseases. I told him the best thing they could do was both get tested for HIV, wait to have sex until they were married, and then be faithful to their spouse, since that’s the way God designed it to be. I asked if he had any spiritual beliefs, and his reply was, “I am a Christian,” and “I read the Bible.” He then said, “my girlfriend called me recently and wants to go to church.” I encouraged him to be a leader and take her to church soon. He seemed encouraged by the entire interaction, and asked for my Zimbabwe cell phone number. I told him that I was only in the country for a few more weeks, but if he had a reason to come back to Karanda during that time I would be here. Unfortunately we only had a short time to talk, as he needed to catch a ride back to the city.

Interactions like this make me wish I was here longer, as medicine is a great avenue to meet people during their time of need and provide encouragement toward living a healthy life, as well as to introduce them to Jesus, who created them, loves them, and alone can truly bring the fulfillment they are seeking for their lives. This is difficult to do with the short amount of time available with each patient in the hospital, but from time to time opportunities arise to move beyond the physical condition at hand to the inner issues that are often plaguing patients just as severely.

I headed home a little after 5 pm, feeling the need to wash my hands after going an entire afternoon without running water. Thankfully there was water left in the hot water tank of our house that served the purpose well. At that moment I realized that I’ve adjusted to the intermittent/lack of electricity without much of a problem, but running water is something I’ve rarely been without, and I’m finding it harder to let go of, especially in a hospital setting. Thankfully this doesn’t happen very often, even here, but it raised all kinds of questions when I realized that running water is still a relatively new invention in our world, and even more so in rural Africa. There are in fact numerous families living without running water or electricity barely 100 yards outside the hospital compound. It’s one thing to see others live that way, but it’s different when the experience becomes personal.

 
Just the night before we had eaten dinner with Ben, Kaila, and Chance (our friends here to install window screens) in the home of Mai Kedere, who lives with her two sons and niece in a mud-brick house about a mile from the hospital.  

She gets her water from a hand-pump about ¼ mile from her house, and her electricity come from a solar panel on her roof, which powers a small radio and a single bare light bulb in the living room. Nonetheless, the food was excellent, and her hospitality was great as always. Her husband died ten years ago from HIV. He passed it to her before he died, but she is healthy and doing well on medication, and working hard everyday to expand her gardens and subsistence farm to the point that she can sell crops to support her family and send her kids to school. One of the local missionaries has become a good friend of hers, and often provides her with bags of fertilizer and seed to help support her farming endeavors in ways she could not on her own. Whether you visit in her home or see her walking past the hospital, she is always quick to greet you with a big smile and a hug, and talk about how the Lord has blessed her and been good to her even to today.

So, I arrived home to find that Lisa and Jude were out visiting friends, and decided to go for a run. I headed uphill toward the airstrip (Karanda sits on the side of a small mountain/large hill) to see a beautiful sunset beginning over the top of the hill with massive clouds trailing the sun. Looking out over the landscape from up on the hill I could see a sea of African scrub forest, with occasional clusters of huts dotting the landscape. I was struck again with the strangeness of my surroundings, but also with how familiar they’ve become after almost four months. The run was refreshing and tiring, and I arrived home to find Lisa and Jude returned and supper in process. After supper I put Jude to bed while Lisa went to a prayer meeting that is held every Thursday evening for the missionaries and senior hospital staff. It is a time of prayer regarding any issues occurring in the life of the hospital, and we usually take turns going or staying home with Jude. The electricity was off, and when Lisa returned she found me fast asleep on the couch in the dark.

It’s hard to believe we’re coming down to the final weeks of our stay here. We’ve met many wonderful African friends here that we will miss. I don’t think I’ll know what to do with myself when I have fast internet that doesn’t require waiting several minutes for my email to load and make uploading pictures a huge exercise in patience. At the same time, I think I’ll actually miss not having electricity at nights, which means eating supper by candlelight and finding ways to spend the evening that include mostly reading and relaxing with friends and family. This pace of life has been much healthier for our family than residency was, what a blessing.