Enough

Tuesday October 21st & Wednesday October 22nd-

Tuesday and Wednesday were amazing and hard.  We split up into groups both of those days to allow some of the team members to work in the clinic and others to visit schools or do home visits.  I was lucky enough to be able to go to the schools both days.  Rob, our trip leader, knew how much being with those kids meant to me and gave up his spot on Wednesday just so I could go again.  I am a pediatric nurse.  It is part of how I define myself and my worth.  Worthiness came up so much on this trip and weighed heavy on my heart these two days.  You see, during our meetings to prepare for this trip we talked a lot about things we would do, patients we would help and what skills people had etc. I felt a little under-prepared to serve the adult population we would encounter mainly because I haven't cared for an actual adult since nursing school.   We were assured numerous times during our meetings that specialty area didn't really matter.  Anyone could do any of the jobs.  In fact, the three doctors going were all specialized.  A neonatologist, a pediatrician and a perinatologist and all three would see patients from all walks of life and they were dang good at it I might add.  We also had non medical people on the team and they would also be able to help clinically and were, of course, amazing.  Despite Rob's best efforts to ensure me I would have a lot to offer the team, I worried.  So, when Rob told us we would be going into the schools to listen to all of the kids hearts and lungs I was ecstatic.  I could do that I offered and I would be good at it.

The first school visit on Tuesday was a whirlwind.  We were pressed for time, but even still, we screened 268 kids in 2 hours.  At each classroom we listened to each kids heart and lungs and screened their heads for ringworm.  They pretty much all had ringworm, but only the worse cases got medicine for it.  While we were screening the kids another group started preparing the meds.  We had the easy job.  These guys were busting their butts trying to rapidly prepare and disseminate medicine for all of the kids in each class.  It was mass chaos.  Each child and their teacher got a multi vitamin.  All of the kids got de-worming medicine and most of them got a weeks worth of antifungal for the ringworm.  They also had to educate each teacher on how to give the medicines, because it would be their responsibility.  We made it through 7 classes before we ran out of time.  We were able to screen all 8 classes, but we weren't able to finish handing out all of the medications.  We had to get back to the clinic to pick up the rest of the team and we couldn't be late.  We did not want to leave and Abraham, our 410 Kenya guide, nearly had to drag us out of there.  It was a terrible feeling not being able to pass out the meds for all of the kids.  We just needed a few more minutes, but we couldn't have them.  It felt so unfair and like we had let down the kids.  The feelings I was having were similar to the ones I had on Monday when we told that Mom there was nothing for us to offer her baby.  It just wasn't fair.  Several of us really struggled to focus on what we had accomplished and not be upset about what was left undone.  Dr Wendy assured us, once again, it wasn't about the medicine really, it was about the relationships and the connections.  It is so hard as a clinician to let go of "fixing" everything and I really struggled with that throughout this trip.  So much so at times I think I might have missed out a little.  I think God was trying to get me to slow down and connect.  To take in the beauty of what was happening around me.  To humble myself.  To accept that I am enough, not because I am a good nurse or because someone affirms me for doing a job well, but just because I am His.  On this day when I was really struggling I finally just went outside to take in the beauty around me and pull myself back together. When I did this I was quickly greeted by a gaggle of Ngaamban children whose smiles reminded me of why we were there.  I spent the rest of that day in the dirt surrounded by these precious children, painting faces, singing, taking pictures and being silly.  These kids didn't care what my qualifications were or what I had accomplished, they just wanted to connect. So I gave in and let go.  In those moments none of the other stuff mattered.  I stopped being so hard on myself and just enjoyed loving on these amazing kids.  It was one of my favorite parts of the trip and it had nothing to do with medicine, fancy that.

Our second school visit on Wednesday went a little more smoothly than Tuesday because we came up with a more efficient system for getting the medicine passed out.  This school, named Tzebini, was in a more remote part of Ngammba.  We had to hike through a dried out riverbed to get to it.  We saw some pretty amazing landscape and I can even say now I climbed in Africa.  In the rainy season this river bed floods making passage to and from school treacherous.  It was pretty humbling as well to see women carrying water and everything else their family might need over this terrain.  At this school I met a little boy named Jackson who decided with me we should have a dance party outside.  This made my day.  He reminded me of my Jackson with his feisty attitude and abundance of energy and joy.  I have a great video of him dancing and it has quickly become my Jack's favorite of the trip. For my CICU friends reading I did hear a murmur on a girl that appeared to be benign and found a kid with a fast heart rate.  We ended up asking her to come to the clinic the following day so we could follow up.  Her heart rate was still high when she came to the clinic, so she will be referred for follow up with The 410 Bridges' help.  That definitely felt good.

It was hard to believe as Wednesday came to a close our time at the clinic was done.  It really felt like we had just started.  At the end of our clinic day the Ngaambans held a closing ceremony of sorts in our honor.  Just like the day we arrived they expressed their gratitude for our service and time.  The highlight of that time for my teammates was when one of the councilman saw me crying and stopped his speech to say "don't cry little one."  He pulled me into the center of the circle and held me tight, very tight.  He held my head in his hands and comforted me, assuring me we would meet again.  Despite the awkwardness of the closeness to his armpit and his tight grip, it was pretty awesome.  My teammates all stood by snapping pictures of it as it went down.  The situation brought a lot of laughter over our remaining days to my team....at my expense.  In fact, one of them told the guy I was their gift to him as a joke and then seeing my distress Dr Tim told him, no really you have to give her back.  I was thankful for the laughter.  It was even more funny, because the guy had introduced himself using his Ngaamban name which meant "big guy" essentially and I was kanini.  We made the perfect pair.

I know I probably keep saying this, but this experience was such a gift.  I learned so much and can't wait to do it all over again.  I know I will use what I learned on this trip to help me become more connected next time, to put the relationships as the priority and not worry so much on what we can fix or can't fix.  While the issues surrounding worthiness were painful to experience and left me feeling raw, I am grateful God opened my eyes and did so in a place where I was surrounded by people who loved me and was reminded of His presence every where I looked.

Being loved on by the kids

Using my other talents

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One of my favorite pictures from the trip

School visits

Working hard

Dr Wendy

Boys being boys

Dance Party

More of our dance party

Jackson front and center

The road to Tzebini

Dried up river bed

One of the many amazing African sunsets.  God's reminder to me of his presence and power.

Distracting the patient

Triage

Kubwa and Kanini

Our amazing team on our last day at the clinic

Putting It Into Words

Where to even begin.  I am finding it really hard to put this experience into words.  It seems so surreal.  I went to Africa.  I took a risk and it paid off big.  I know it will take me a while to fully process everything that happened, but I need to start writing things down before the chaos of  life starts to steal my memories away.  I figure everyone has been patiently waiting for a recap of what we did, so I will start there.  I will do it in a couple of posts.

Thursday October 16th-
My Mom and Jack took me to the airport where my team was gathering to board a plane for our long journey to Nairobi.  We would take two flights, one to Amsterdam and then one to Nairobi.  I knew they would be long and I was really anxious about not being able to sleep.  Unfortunately, my fears came true and the flight to Amsterdam was pure hell.  After settling in and eating dinner most of the team had a nice dessert of Ambien.  I am not exactly sure what happened, because I have taken Ambien before, but soon after taking it I got dizzy, the flight got turbulent and over the next 8 hours I christened every bathroom on that Airbus.  I literally threw up all the way across the Atlantic.  I was a mess.  I in fact felt so poorly I had decided I would just get a hotel room in Amsterdam and come home, because there was no way I could face getting on another plane for 8 more hours.  Thankfully, once we landed in Amsterdam my team helped me rally and God intervened.  When we boarded our KLM flight to Nairobi, I was in the front row, with two empty seats next to me.  I swallowed some dramamine and life began to flow back into my body.  I stared out my window at the beautiful sky and remembered His plan and my confidence returned, as well as my ability to keep down food :) At one point during that flight I walked around to see some of my teammates and Sarah commented "she is back."  I'm sure I looked 100 times better.  We landed in Nairobi late Friday night and after successfully collecting 23 people's belongings and all the team's medical supplies, praise Jesus, we loaded a bus for a short nights stay in a Nairobi hotel.  Oh and I must not forget the one eventful part of that flight. As we came in for our landing in Nairobi, right as our wheels were touching down, we suddenly felt the plane begin to pick up speed and ascend again.  I looked at the flight attendant in front of me, with what I am sure was a look of fear and said "is that normal?"  He said, probably not, but more than likely the runway was not clear.  Thankfully, after another approach we were able to land safely, this time with no planes in our way.  Who knew a 747 could get off the ground that quickly....

Saturday October 18th-
After a restful nights sleep the team was ready to get the party started.  It was time to get to work.  We loaded back onto our bus and begin the drive to Ngaamba to see where we would be working over the next week.  I don't think any amount of preparation could have prepared me for what I would see or feel when we got to Ngaamba and I touched on it in my post, Worthy.  The welcome we received was incredible.  It was definitely the first time anyone danced in the streets in my honor.  After a beautiful welcoming from the people of Ngaamba our team jumped into action.  Some of our veteran team members told us it would take awhile to get the clinic set up and be able to see patients, but the 23 of us got the job done in record time.  We saw 61 patients in around 2 hours that first day.  When we loaded the bus at the end of the day we were exhausted and fulfilled.  It was amazing what we had accomplished in such a short time and how incredible it made us feel and it had only been a few hours.  We still had 4 days to go.  Each night we headed back to our hotel, the Myriam Inn, in the town of Sultan Hamud.  We had to leave the clinic around 4:30-5 each day in order to make it back before dark, as ordered by the Kenyan government.  I think that was ok with all of us, because by 5:00 we were toast!  Every night we would clean up and relax before having dinner together and then spend some time debriefing the events of our day.  Our hotel was right next to a mosque and I will say the call to prayer freaked me out a little bit at first.  It was both haunting and beautiful at the same time.  At times I felt a little like Claire Danes in Homeland.  Just kidding.  Our debriefs were a special time where we could process what we had seen and felt over the course of the day.  I usually cried.  Shocker I know.  It was impossible for me not to cry.  I was feeling so many different emotions.  It was hard to process it all.  The very first patient Dr Tim and I saw just broke my heart.  A mother brought in her young child, around 1 yr.  Through the interpreter she told us the baby was not walking, sitting, crawling or talking.  The baby was very hypotonic save for his arms which were drawn to his side.  After Dr Tim and his wife Wendy looked over the baby, we decided most likely he was born with a genetic condition and there was nothing we had to offer.  We then told the Mother her child would never be normal, never walk and maybe never talk and then sent her on her way.  It seemed so unfair.  In the US we would have exhausted all testing and resources to attempt to come up with some sort of diagnosis, whether it would have changed the outcome, who could say, but at least there would have been some options.  It was a big slap in the face.  This was a tiny village in Africa.  There would be no expensive diagnostic tests or interventions for this child, I mean, there wasn't even running water.  It was hard to tell what the Mother was experiencing as we talked to her.  To say the Ngaamban people are stoic is an understatement.  She just wrapped her baby back up and went about her day.  I am sure she had a family to care for and there was work to be done.  There would be no time to grieve the loss of "normal".  The other remarkable thing about these people is their faith in God.  I could spend a whole post on that alone.  After the patients were seen by a clinician they went to a different room to be prayed over.  One of my teammates remembered praying with this woman and her baby and just like the rest of the Ngaamban people she expressed her faith and trust in God and His ability to heal her child and provide for her family.  I was angry and she was grateful.  Isn't that interesting....It was the first of many experiences that I would struggle to understand.  It was a totally different world with a completely opposite set of circumstances than my own.

What a week this was going to be.  I knew my life was going to be changed by this trip, but I am not sure I could have ever prepared for exactly how impactful it would be.  I have to stop here, because I want to make sure I don't leave things out and honestly, just thinking about this small piece of the trip exhausts me, or maybe that is still just the jet lag.  Either way, I want to be thoughtful about journaling my experience, so I will work on it in stages.

Thank you again for your support.  For providing for me financially and your thoughts and prayers.  I know it was uncomfortable for many of you to send me across the world, especially to Africa, especially right now.  Thank you for being supportive anyway.  Thank you for standing behind me as I stepped out of my comfort zone and my comfortable life and took this daring adventure.  I love you all.

Here are some pictures from the first couple of days.

The road to the clinic

Our warm welcome

Waiting for us to open the clinic

God's children

Where Feet May Fail

Tuesday we had the opportunity to go to one of the schools in Ngaamba. We were there to screen the kids hearts, lungs and heads for ringworm. A team of 7 of us screened and handed out meds to 268 kids in two hours. Talk about efficiency. There still wasn't enough time though and some of the kids didn't get medications. We didn't have enough and we ran out of time. I didn't want to leave. It didn't seem fair.

The truth is however, it really wasn't about providing healthcare. It was about connecting with these children. Loving on them in a way no one else does. Teaching them to "blow it up" or fist bump, singing songs and making them giggle as we tried to pronounce Swahili. Their sweet hands reached out for us, begging for touch. We also got them to sing for us. The class one kids, the 5-6 year olds sang head, shoulder, knees and toes. I melted. Then the class 5 kids belted If You're Happy and You Know It. Thank goodness I got it on my go pro, because IT WAS AMAZING!

There is so much more to tell you, but I am bumping up and down the road on the way to the clinic. Today is our last day in the clinic, so pray we continue to touch lives and they continue to bless us.