Karibu Zanzibar!!!

So Chris and I set out yesterday for an adventure to Tanzania with our final destination being Zanzibar. We arrived in Dar Es Salaam last night and stayed in a freezing cold hotel room which I seemed to be the only one that minded that! Chris cranked the AC!!! The city itself reminds me of how underdeveloped Malawi is. Dar is big with lots of tall buildings and overall it is nothing special to see, so I wasn't disappointed when it was just a quick stop over. So this morning Chris's sister and husband Mark arrived at our hotel and we hopped a ferry to Stone Town, Zanzibar on the earliest boat over. The weather here is far hotter than Malawi and about 100% humidity to boot! So the sweat just rolls off of you. Zanzibar is about 95% Muslim, so there is no skimping on clothes. Knees have to be covered and shoulders ideally too, but as for the latter I had to let this one go. It didn't seem to cause any problems as it is such a touristy destination, but I always try to remain respectful. So after arriving in Stone Town we wound around these crazy streets to find our hotel which used to be a rich merchants mansion, so it was full of antiques and beautiful wood carvings. We settled in and then set out on foot to get lost in the maze of streets and curios shops. Zanzibar was once know as a trading destination for spices hence the name "Spice Islands". However as the tourist industry has taken over, I can't exactly say the aroma of vanilla, cloves, or cardamom filled the air. We did find a little man walking on the street who was selling whole vanilla beans fairly cheap, so of course I bought some and later a few more spices from the spice market.

Being here really does make me feel alive and this urge to soak up every bit of this amazing cultural experience. I plan to do just that too. It is amazing to discover far off places like this and see the lives of the people that live this every day. Everyone greets you with a "Jambo", "Hujambo", "Mambo", all of which have different replies but they all essentially mean hello. So everyone would throw a different greeting at you and then laugh as you scrambled to find the appropriate reply. Just as I would get one down they would come at me with a different one. They have a fun time messing with us. Speaking of messing with us, there is plenty of that too. Men constantly following us trying to get us to go here or there, after a while it got to be a little much. I was happy not to be a sole female traveler. All in all though, we are taking in this city for all of its rich history and unique characteristics. We have one more day here and then we are off to the other side of the island for some R & R on the beach!

Little Ella

Today as I woke early in preparation to participate in the Mobile Medical Clinic Ministry of Hope launched earlier this year I had no idea my day would go in such an opposite direction. The Mobile Medical Clinic goes into the villages and provides basic medical care to the people who would otherwise not have access. I was teasing them about wanting me to go along. I told them that I had no idea what to do with an adult, I just know babies. I was interested to see what it was all about. So, in true Africa fashion, things did not happen at my American pace. As I was waiting around (over an hour and a half) at the office to leave we received a call to rescue a baby from a village about an hour away. The nursery had reached its capacity so they were not accepting new babies. I however could not handle the thought of this baby not getting care. So I took matters into my own hands and made a deal with the administrator that I would go get her, take her home with me for a couple nights and ensure that she was "safe and healthy" to be amongst the general population at the nursery. I was told that she was 3 months old and her mother had died quite a while ago and the baby was deteriorating. So needless to say I aborted the Mobile Medical Clinic and in no time I was bouncing down a dirt road on my way to get this baby.




When I arrived the whole village gathered and I explained what was going to happen and how long baby Elimati "Ella" my nickname for her, would be cared for. From asking several questions, what I could determine is that the mother probably passed away from anemia. She was 31 but the father looked very young. Ella will return to the village when she is old enough to take solids. They had been giving her cow's milk for 3 days. She looked healthy and well taken care of, not deteriorating like I had once thought. As I was speaking with the people of the village, Ella was on my lap and smiling so big at the sound of my voice. It was so sweet. So she spent a few nights with me and I must say she is a pretty easy baby. It was a piece of cake. The next day I had some errands to run in town so I strapped her on my front in my African sling, drove a stick shift and balanced a bottle in her mouth while I drove. ONLY IN AFRICA!!!! I kept thinking if only people could see me now. I guess Ella is officially added to my list of babies I have fallen in love with.

The Simple Things

This is what happens when you give a nanny Tylenol and baby formula. They were singing "God bless the white girl". It just really puts things into perspective of how much we take for granted. This really made me smile, I hope it does the same for you.

My Day with Mada

 

As I have mentioned in previous posts, Mada has been the source first, of so much joy and happiness, and secondly so much heartache. Sometimes I wonder why I love this little soul the way that I do. Most of it I can't explain, but I do know she is my definition of love. It has been a year since I have last seen her and so much has changed in her life. Some of you may know and most do not but I tried to adopt Mada earlier this year. The government has very strict laws about becoming a resident for 18 months before you adopt any children from the country. I pretty much got slammed down. When I had made calls to the social worker here he had told me that her father consented to the adoption, which now I know is probably not true. In April she went to live with the receptionist from the nursery where she is currently being fostered. I had gotten word before I came back to Malawi that she was in the village with her father, which I also found to be untrue. From what I understand is that he does want her back, but he just wants the grandmother to raise her and not really take any responsibility. He has no money, no job even though he is a capable man to farm or do other work. Mada needs to get her meds twice a day and be seen for her doctors appointments once a month. He has no way to take care of these things and selfishly (at least I think) wants her back anyway. She is happy in her home and is well taken care of as it is now. It breaks my heart to think of her going to the village with her father.

So I had arranged to meet her foster mom in town today and pick up Mada. It was sort of a weird feeling to be taking her because I didn't want her to be scared. Mada smiled when she saw me, but I don't think she remembered me. When I took her and put her in the car she cried for a little bit and I wondered if I was doing the right thing. She quickly calmed, and by the time I got back to the house she was okay. I sat on the couch and she sat on my lap and I pulled out the toys that Courtney had so generously bought her before I left for Africa. She was entertained for over an hour, just sitting there playing. Her favorite was the appropriate little black baby doll Courtney found. There were none in Santa Barbara when we looked, so sad. Then she fell asleep on my lap for a while and it felt so good to just hold her. I started to cry and tried to fight back the tears. It is so hard to grasp an understanding of why this little girl has been plagued with such a terrible disease and never given a fair chance? Why she is so displaced, and why the laws are the way they are?
When Mada woke up we took her to lunch and then to get ice cream. Two things she has probably never gotten to do, and most likely won't get to do in the future. The whole day was just so good. Her little personality is still so cute and happy. She would mimic everything I would do and she liked to do a lot of pretend play. She kept feeding me imaginary things and we had to "feed" her baby doll too. She is talking some and would repeat stuff I would say, and Chris would speak some Chichewa to her as well which she understands better.
When it was time to take her back, I loaded up the clothes and toys Aunt Becky and Courtney so graciously bought her and a few things I had purchased and it pretty much filled the back seat of Chris's truck. I was a little embarrassed, but thought oh well, she loves it all. When we picked up her foster mom, she showed her her new dress right away. I had also printed out pictures of Mada and some of them being us together and put them in a little photo album. It made my day when Mada unprompted, kissed me in the picture that I was holding her. Maybe it was random, but I am going to believe it wasn't. Today was probably the biggest Christmas she will ever have and I told her foster mom that if she wanted to save any of it for Christmas she could.
I hope somehow love can span the globe and Mada can feel my love pouring inside her. Since leaving her it has been more difficult than I imagined and it has taken me several attempts to get through this entry. I am so sad inside, but I am happy to have had this special day. I will never forget it.

Today we are 1!!!

 

All of the babies at the nursery are sweet, but Julius and Juliet (twins) are about as sweet as they come. I was reviewing each babies health passports and when I came across theirs, I noticed that they were 1 today!!! I told the nannies and we all sang Happy Birthday to them. Thank goodness for Aunt Becky, she bought a lot of clothes for the babies and today they were decked out in their finest!!! Thanks Aunt Becky!!! It is so cute to see Julius and Juliet interact with each other too. They know they are brother and sister, something surprising when it isn't just the two of them. Of all the babies around them, they play with each other, it is so cute. Today they were playing with a rubber ball and just giggling. They are sitting up but not yet standing, which isn't too alarming; most children are developmentally delayed but eventually do catch up.




This is little Tanache. She is so sweet too. She is going to be 1 soon, but still can not sit up without support. She has really poor tone and is very weak. I have been trying to get her to bear weight on her arms (as you see here) and her legs but she needs leg braces for the exercises. She was really sick the first several months of her life and now she is well and trying to catch up. A few weeks ago she started taking milk, apparently she would only take yogurt before that. I don't know what they had been giving her in the village.

As far as the rest of the babies, they all seem to be doing okay. The three babies with impetigo are healing and I am working with a few others that are small to get added calories in their diet. Some positive things I have noticed at the nursery are the things that I instituted last year are still in place and functioning for the most part which makes me feel really good. To get things the way they need to be however would take a much longer stay than 1 month. There are so many things to improve on it is hard to know what to tackle first. I am doing what I can in this short amount of time. It helps that I already have a foundation and relationships at the nursery, so I don't have to start from scratch.

Finding Peace

 
Yesterday I didn't arrive until about 10 am which is late when you rise at 6. I spent most of my morning trying to get pictures to post to my blog, but the connection is so slow and my camera is high resolution and those together are like oil and water. So, I was rather frustrated, but I will keep attempting to give you all something to look at. Anyway, it didn't take me long to get my feet wet at the nursery. When I arrived at the nursery it was the usual routine of changing dirty nappies, feeding babies either milk or lukuni phala (porridge) and trying to assess and get to know each of them. So, as the day went on, some volunteers came in the afternoon. As I was speaking with one of them she mentioned her husband was a doctor and he loves to come see the babies. So immediately I perked up and asked her if she could call him to come to see the three babies with the skin blisters and also another one that I was worried about since Chris is still gone. In talking to her I found out that she lives right next to Chris (where I am staying) and knows many of the same people I do here. Funny how connected you can become in such a short amount of time. He came about an hour later and diagnosed the babies with the skin blisters with impetigo, so this morning I went to three pharmacies to get antibiotics for them. Hopefully we will see them improve in the next few days. Then a baby that I was worried about generally looked like he was "checking out". He is a twin, his mother died when he and his brother were 6 weeks old, she was HIV+ but I am not sure if she died from that or something else. He was breast fed for the first 6 weeks which puts him at a much greater risk of being positive. Overall, his eyes are glassy and weighs 9 lbs at 5 1/2 months of age, and just looks ill. He has had poor weight gain, actually a loss in the past week, upper respiratory infections, he was treated for malaria, and the list goes on. So the doctor was actually familiar with this baby which was good because he knew more of the history than I did. So he wanted to get a chest x-ray to rule out Tuberculosis, which brings me to today.

I loaded him up in Chris's truck and took him to the Baylor HIV Clinic (they see only HIV kids). I was hoping he could be seen there because initially he was HIV exposed even though his testing had come back negative. He still could be positive at this point and this is something that we want to rule out for sure. I knew some of the docs from last time and through Chris so that helped my plight with getting him seen there and not at the central hospital. So I found Maria and she saw him right away and got him into the system which is great because it is a really nice facility with American doctors, and free care. So he had another HIV test done today and tomorrow I will take him to the Central Hospital for a chest x-ray. Which I can't even explain what it is like there. I wish I could take a picture of the wards to give you some sort of idea. It is not a place where you would ever want to see your child or loved one. Your chances of dying drastically go up if you are patient there, at least I am convinced.

I did not get to see Mada today as there was a conflict with the schedule and I was busy. I have arranged to pick her up on Saturday and she is going to spend the day with me which will be nice and hopefully not too emotional. I am very excited however!

Interestingly enough, this time I seem to feel more emotional about things than I did last time. Not that I didn't feel it last time, I think I was more in a state of shock and it seemed to hit me more once I had left. I found myself starting to cry when I had this lethargic little baby in my arms at the clinic. Things are so unbelievably sad and unfair. I wish that more could be done. The Malawi government has tightened up even more on adoptions because of recent child trafficking in the villages (similar to what Madonna did in my opinion). I wish that they could see that if they made it easier for people to adopt these orphans then people wouldn't be going elsewhere. The government has to pay for these children as well, so I just don't get it. The number of orphans is escalating each year with the increasing rate of HIV, so this problem is only going to get worse.

At the end of the day I guess all you can do is your best, and some where in all of that, you have to find peace.

A Warm Welcome!

 

My first day back at the nursery and I was greeted with open arms. They all remembered my name and were jumping and singing to greet me. It was the cutest thing ever. It made me feel so happy to be back. There are currently 20 babies at the nursery and not accepting any new ones at the present moment because some are sick. Three of the babies have been quarantined for really bad skin blisters that look like MRSA to me, but doubt it do to the lack of broad-spectrum antibiotics. Maybe impetigo? Who knows what it could be?? I am not used to seeing stuff like this. I will be working on it today however! A few babies have high fevers and colds too. Most are young or appear to be so because of their small size. I brought with me several cans of formula with increased calories so I am happy that some of the smaller babies will get an extra boost to help them to grow. Only one of the babies remains from my time last year, (Delori) and the nannies say she is their boss. Yesterday she had on this taffeta dress on and I asked her if she got all dressed up because she knew I was coming. At some point, it must have been some little girls Easter dress.
The rest of my day was in pursuit of my luggage that didn't arrive. Chris is still in the United States and won't be returning for another 2 days so he has been gracious enough to let me borrow his truck while he is gone. So, as I navigated around on the left side of the road, dodging Africans, goats, and crazy drivers I made it to the airport to find both of my bags there, all things intact! What a relief!! My day continued to present with a few other encounters. One of the first things I saw on my drive to the nursery was a woman collapsed in the road with a baby on her back. Two people sauntered up to help with no sense of urgency. I saw one woman take the baby off her back and another guy walk up. The worst part of it all is that I had to keep driving. I was alone and it isn't safe to stop. It made me so sad. I am not sure if she fainted or actually passed away. Her eyes were rolled back in her head and she looked completely lifeless. It was a reminder of the realities here.
I think I am finally on the Malawi time clock. Last night it was all I could do to stay up until 9pm, but I finally feel rested. So, I am off to the nursery again and will be meeting up with my friend Kat there later this afternoon. More to come on the babies and Wednesday I will give an update on Madalitso. I get to see her!

The Long Haul

Wednesday, October 29th:
The day had finally come and I loaded about 250lbs of luggage in the car and headed for Santa Barbara Airport. I said all my goodbyes, boarded the plane, took one last look out the window towards the mountains with emotion stirring inside of me. I was a little sad to leave, but I was ready to get to Malawi. I was not to excited about the 40 hour trip there however. We sat on the plane for a while and then were informed of a mechanical problem with the plane and it would be a while. So we deplaned and went inside. I immediately knew inside the trip was not going to happen. I had a short connection in L.A. and any sort of delay and I would not make the rest of my flights. So, I went to the counter and the agent could see in my eyes I was sad. I started to well up and he took me back through security to the ticketing counter (crying always works btw)! So, to make a long night short, I had to end up going home and rebooking my ticket. I soon found out that my only option was to leave two days later departing October 31st.
Sunday, November 2nd
So what can you do? Here I am writing this in the Johannesburg Airport, now on African soil. My trip thus far is sort of a blur, which I am fine with. I managed to sleep a good portion of my flight to London and once there I had a 4 1/2 hour layover where I found a bench and took a little snooze. Then I got an English Breakfast tea (when in Rome...) and that helped perk me up. I negotiated for a bulkhead seat on my next flight to Johannesburg which they graciously gave me, and I was seated next to two elderly women from Wales. They were so sweet. I took care of them the whole flight; helped recline their seats, turn on the reading lights, open food containers, propped up their feet, etc, etc. My favorite part was that they called me “Love”. The British always remind me of how we do not take advantage of making English as beautiful as they do. One of the ladies was 83 and traveling to South Africa to see her siblings and 60 year old daughter. I asked her about her life and what it was like. She said that her husband had passed 11 years ago from cancer. She said he wouldn’t give up smoking. So she has spent the last 11 years alone. All of her friends have passed away and she said she spends most of her days doing nothing. She is blind in one eye and has macular degeneration in the other so that keeps her from doing a lot of things she loves. She kept saying she was worthless and I kept correcting her saying no you aren’t! She did fill me in on the Madonna/Guy Ritchie saga, that I knew very little about and thought it was funny she did.
Monday, November 3rd:
So, now I am in Malawi and excited to be here. All of the things that I remember being so shocking last time are more familiar and normal. It is kind of like that flash of that familiar smell or memory that reminds you of being a child and how good that makes you feel. Sort of the same thing because inside I get this wonderful happy feeling about being here even amidst the poverty and famine. Maybe it is selfish because one can feel good about themselves for giving service, maybe not. However, what I do know is there is so much beauty in the people of this country. From what I have learned from being in Africa, it is as hard as it is soft. It is all about what you choose to look at. And so, the adventure begins...

Malawi Bound!

As a short year has come and gone since leaving Africa, I will be embarking on yet another adventure to Malawi at the end of this month.  It has been an amazing year with a lot of transitions, but the cumulative of all of these experiences has been insurmountable.  As some of you may know I have had periods of ups and downs in dealing with feelings from my experiences there.  Through this time I have had confusion, clarity, doubt, trust, and an ever persevering pull to return.  The imprint was made and I guess it simply explains why I have spent most of my time since leaving, working towards going back.

I have managed to keep in touch with Ministry of Hope throughout this time and have received updates that the babies are doing well and progress in building the new nursery is underway.   I am excited to see the changes that have taken place and hopefully seeing some familiar or grown up faces too.   Mada is returning to the village with her father and I will hopefully be paying them a visit.  Chisomo, the baby I resuscitated is apparently doing great!  He is healthy, chubby, and sitting up!  I am not sure if he will still be there when I return as he is supposed to go back to live with his family, but I will be sure to post updates as often as I can.  Thank you all for being supportive of me through this time and thank you for listening to all of my stories over this past year.   It has been a wonderful experience and I truly feel blessed! Next stop...Malawi!

A Parting Shot

This picture was taken at my last day at the nursery. It was a beautiful day so I took every baby that was awake and brought them outside. Seeing this photo stirs up emotions for me, as it has been emotionally difficult since I have returned home. I miss all of the babies terribly and the way their sweet faces were always excited to see me. I am beginning to feel the impact that this whole experience has had on me as Malawi is on the forefront of my mind every day. I start to wonder whether the difficulty came in being there, or is it now here? I easily get emotional talking about my experiences and time in Africa. I feel forever changed, as the blessings I have received from being there are greater than anything I could have ever imagined.
I have received a few updates that the sick babies have all gotten better, with the exception of one of the tiny babies, Jeffery. He has gone on to a better place. He was sick and placed in the hospital, but the resources were not enough. I did not have any pictures of him as he had arrived shortly before I left. The babies continue to need your prayers, for that I can not thank you enough.

Hello, Goodbye.

On Thursday I set off with two British girls to go to Cape Maclear on Lake Malawi for two nights. It was about a four hour drive with about two hours of it being, once again a far from smooth dirt road. We had the most amazing time kayaking the lake, snorkeling amongst the world's largest population of fresh water tropical fish, and lying in hammocks reading books. It was just what I needed before my weekend became hectic. I arrived back in Lilongwe on Saturday. On my way back I received two phone calls to come to the nursery because babies were sick. I dropped my stuff at my house and in two minutes time I was at the nursery with babies being brought to me before I could get in the door. Five were sick with diarrhea and fever and one with all of the above including respiratory distress. The fevers ranged from 101.7 to 104.9 and the same baby with the respiratory distress started seizing due to his high fever. So, immediately my work from last week at the nursery began to pay off. With a group effort, we had moved the existing Clinical Officer's office out into the reception area freeing up an extra room to put babies in . I immediately quarantined the sick babies into this room and assessed each one and treated accordingly. I phoned Chris to see if he could pay a visit to help me out, as all of the regular staff and clinical officer were on a retreat at the lake.
I waited until Chris arrived and he gave recommendations on each babe. It sure pays to know a pediatrician in Malawi!! He and I ended up taking the baby (Stephano) with problems breathing to the clinic only then to decide he would be better off with me than there. So, back to the nursery we came. I spent the night on a piece of foam in the middle of a diarrhea swamp and soaked nappies. I didn't get much sleep, or any for that matter and eagerly awaited the morning arrival of the Clinical Officer that was supposed to arrive at 10 am. Well...in true Africa fashion no one is worried about time and things come up. So, in her defense things happened that were out of her control. Apparently the minibus ran out of gas, broke down which then resulted in a 3:30pm arrival. You can only imagine how great I am feeling at this point. Being up for close to 40 hours with no sleep and diarrhea all over me. I did survive and so did all of the babies. I am happy to report that they all maintained hydration and the fevers lessened. I was up all night because of it, but it was worth it at the same time. They will all be fine, as I am assuming it was just a viral bug. No other babies have gotten sick, so hopefully this new "Isolation Room" is working. Good changes have happened since I have been here and I see things moving forward. I have done what I can and feel good about my efforts even though sometimes I wish it was more. In many ways it feels like I was just arriving and now I am preparing to say goodbye to all of my new friends. It has been the most amazing journey of eye opening experiences, emotional tugs on the heart, and spiritual growth that I could have imagined. I thank each and every one of you who have followed me on this journey. You have been a crucial part of this experience for me and I feel blessed to have been able to share this with you. Thank you for your prayers as that is the most powerful thing we can offer.

Blessings,
Briana

***I will continue to post updates on the babies as I receive information, so check back!***

South Luangwa, Zambia

My weekend safari trip to Zambia went well. The road was every bit as bumpy as I expected, but we all survived. We spent three nights in safari tents at the Flatdogs Camp right outside the National Park. The camp was situated right on the Luangwa River which feeds into the Zambezi River creating one of the seven wonders of the world, Victoria Falls. This time of year it is the hot season in Africa, which is great for seeing wildlife as there are few watering holes left. The rains had just started a few weeks ago, but was still rather dry (although it looks nice and green in this picture). It was the hottest I have been in my entire life too. I can't ever remember experiencing heat like this. The only break in the day was from around 4 am to 6 am, the rest of the time...miserable! Thank goodness for the pool at the camp, it was my only saving grace during the day. So every day we went out on game drives from 6-10 am and then again from 4-8pm. We saw lots of elephants, a baby leopard, lions with cubs, impala, kudu, water buck, bushbuck, cape buffalo, hippos, crocs, giraffe, zebra, hyenas, mongoose, badgers, warthogs, eagles, lots of birds and probably a few others I am forgetting. Seeing the leopard was a treat too, as it is rare to get to see one. Probably my favorite thing to see though were the elephants. It is just something about they way they move their massive awkward bodies. I learned that the gestation period for an elephant is 22 months. Can you imagine being pregnant for almost 2 years??? It was a really nice trip with fun people and a good way for me to debrief before I make the long journey home next week. I am in the process of getting my November slideshow on my blog so keep checking.

Safari

It has been a rather uneventful week at the nursery so I haven't had too much to write about, but in the morning I am off to Zambia. The South Luangwa National Park is there and it holds one of the worlds best game reserves. I am going on this safari with my three doctor friends that work at the Baylor Clinic. We are departing early at 7 am and it is unknown as to what our arrival time will be. The road from here to Zambia is dirt and if it is anything like the dirt roads around here it will be a long, bumpy ride. It supposedly takes around 5 hours. It should be a great adventure and we are really excited. I am sure to have stories when I return on Monday, so keep your eyes peeled for some blog updates. My time in Africa is nearing the end. I have less than two weeks remaining and my schedule is quite busy so I know the time is going to fly.

or·phan

"Mada" was on my heart tonight, so I decided to tell everyone a little story. I am sure you have seen her frequently in my pictures, as I can't help but be drawn to this little girl. Her spirit is so alive and full, yet she will probably will not live a full life. Born to a HIV positive mother, she too is infected. She had a rough start as sickness plagued the first 3 months of her life. Most were unsure if she would even make it, but she perservered. She is now on ARV's (anti-retroviral drugs) to treat her HIV and is followed closely at the Baylor Clinic. She is otherwise healthy, but needs physical therapy for her hips as they are hypermobile and the muscles are weak from malnutrition early in life. Her father is still alive and remains HIV negative, but we are unsure at this time if he has the capability to care for her. The care that she requires for her doctors visits, drugs, and good nutrition would be more than he could manage. If he did take her back, would he actually attempt to do what it takes??? He lives in a far off village over an hour from Lilongwe in a mud hut with a thatched roof, but ultimately he has the power to decide. Will he want her back? She has been the product of many sleepless nights for me as I have fallen in love with this little girl. It is not for me to adopt at this stage in my life, but it is hard to walk away too. I just want to see for her the best life can bring. She brings joy to everyone she meets. I think to explain the personality or soul of a human being is nearly impossible because of the complexities each individual holds is so great. Even in a child when typically their personalities are less complicated it is still difficult. But try to imagine the best possible personality with every desirable characteristic, and that is hers. She really is one of the most loving little ones I have ever cared for. Always happy... always. All of these babies need prayer, but today I just ask that you send up a special prayer for Madalitso. That her life would be blessed with health and happiness. That she would have a wonderful loving family, whether it is with her biological family, or another.

Life at the Nursery

Last night, right after I finished posting "Summer Days", I had a knock on my window. It was the clinical officer of the nursery. She had a baby that needed to go to the hospital. I had started an IV on the baby earlier in the day and had been giving antibiotics. She had become severely dehydrated, septic and was now breathing with great difficulty. I got in the car, took the baby to the hospital where I called the doctor to come in. Well...his wife had just had a baby 30 minutes earlier, so he told me to take it and run with it. In the US I would be terrified of this responsibility, but here I almost welcome it. The resources are so minimal, I am the best person for the job. So, we took Chisomo off his oxygen and gave it to this baby, Ruth. Chisomo is looking much better by the way. So Ruth was grunting and retracting with every respiration and I knew she needed more than oxygen alone but that is all we had. I started 2 IV's in the event one stopped working, gave more antibiotics, gave 2 fluid boluses, and started her on continuous IV fluids. I also put a tube down into her stomach to get out whatever was still in there. When I pulled back with a syringe I got back bloody formula. This was not a good sign. I worked on her until about 1 am and then left for home. I knew then she probably wouldn't make it and I was correct. She died around 3 pm today. She would have definitely survived back home, just not here. It was a sad day at the nursery but God had other plans for Ruth. Her mother is in a psychiatric ward somewhere but will be informed. The other two babies still at the hospital, Chisomo and Talandira are looking great. Talandira can probably come back to the nursery tomorrow and Chisomo needs to stay there to finish his 21 day course of antibiotics. Thank heavens for my friend Chris who comes every week to check on the babies, he was there today. He gives me reassurance that I am doing the right things. It is a big job, much bigger than I ever anticipated in coming here.

Summer Days...

The days are flying by, the weather is getting hotter and the rains have just arrived. It has become near impossible to stay cool making the mere act of movement uncomfortable. It has also brought babies to the nursery in droves, and small ones at that. I guess it is good I am here. Today we got little twin babies that weighed in each at about 1.5 kg=3.3 lbs. Too tiny to be around 25 other babies with runny noses. So far, one has been able to take his feedings by bottle, but I had to put a feeding tube in the other brother. Started a few IV's on other babies that were sick and then went back to the clinic to check on Chisomo and another sick baby I took to the hospital yesterday. Both are looking better and getting stronger. There is too much work for both of us (myself and the clinical officer at the nursery) and my work days just keep getting longer. The hardest part is not the work itself, it is the energy required to constantly explain why it should be done a certain way and why do it at all. The trained clinical officer was giving a baby too much fluid this morning and luckily I caught it before damage was done. She tells me this is the way we do it in Malawi. It is hard to bite my tongue and be as diplomatic as possible, when the comparison of survival rates is staggering. It is just scary the way medicine is practiced here. So by the end of the day I am drained and ready for a bath and bed. I think when it comes time for me to come home I will be both eager and conflicted at the same time. It is hard to leave a place that seems as if it is falling apart at the seams, but there also comes a time for the people here to step up. The western world is not the answer to their problems. We can help, but must empower them to look within. Meanwhile, I promise I will continue to give it my all and do my best every day to help the babies and people here.

Chisomo Update

I have been back to check on Chisomo the past two days, both times thinking it would be a quick stop in, he would be doing fine, and I would be on my merry way. Not the case, and my frustration is mounting as a result. Yesterday I arrived and his IV had come out and not to my surprise as they normally don't last too long. So I asked when it came out and they said earlier in the morning. The nurse told me she tried but couldn't get it. I said no prob, I will look. Sorry, but these nurses are about as worthless as they come. The baby had been stuck all over, leaving only a few places for me to try. I was not happy. I told them next time to call me and I would be right over. So I started the IV, recalculated the fluids and started the kid on some electrolyte replacement orally. By this point I am sure the kid's electrolytes were completely washed out after 3 days of straight D10W. I asked if they had even checked his levels and they said no, so I ordered that and today still didn't have results. Anyway, I played doctor and wrote about 5 orders and explained everything to the nurse. It is so weird by the way, that I can write orders here and people do it???? I also re-dosed the antibiotics with some help from Chris to treat for suspected meningitis, because he now has full fontanels and separated sutures, looks rather lifeless with poor tone. He is not looking so good and I am really worried for his little life.

Once again today I showed up and pretty much the same story, but now he wasn't making urine. I started another IV because the other had already come out, ordered a bolus of fluid, and warmed the poor baby up. I had communicated all this with the nurse, but she was more concerned with other non-priority issues, so I ended up doing everything myself as well as giving the bolus. That is just one part. I could go on and on about the infection issues. Ants and cockroaches in the med room, the bag of IV fluid running into the baby that had been cut into and sealed with a non-sterile piece of tape, then the uncapped end of the tubing she wanted to hook back up to the baby that had been on the floor with an ant crawling on it. You can see now why I am worried about his little life for more reasons than one. So, keep praying for Chisomo and I will keep going in every day and doing my best to clean up shop. It will truly be by the grace of God for him to gain his strength and health. I have not made friends with the nurses in case you were wondering. My expectations are a bit different and I refuse to accept anything but. Sorry for all the medical jargon, I tried to keep it understandable for all you non-medical people. I am sure I will have more on Chisomo and the issues at the hospital. For now, he is hanging in there, not getting necessarily worse, but not making big strides to a speedy recovery either. I will continue to keep you updated, so stay tuned for more updates.

LIVING! with the disease.

Yesterday I went with my friend Chris, who is working for the Baylor HIV/AIDS Clinic. It was a good chance for me to see what he does in treating these children, and also to learn more about HIV and AIDS. Once a month they have a teen camp for these children and some walk 2 hours or more one way to make their appointments and come to the camp. They get a good meal and plenty of activities to keep them busy. It also creates a good environment for these children to receive support from other kids their age also living with the disease. I think in this picture you can see how full of life some of these children are, while others don't feel well enough to participate in some of the more active of activities. The emotions I felt all day are indescribable. As these kids were eating their lunch, a number of them pulled out containers to put the rest of their meal in so they would have something to eat later. I didn't finish my meal so I asked "anyone hungry?", and four kids attacked my plate. These kids have such wonderful personalities and spirits, and yet they were born into a life of disease. It just seems so unfair. Most of them are severely growth stunted and you would assume they are at minimum 5-6 years younger than what they are. This picture does not really show a good comparison of their size, but I will post more pictures of them on my October Slideshow. The children in this picture are ages 13-16. This was the group I had and we discussed gender equality, what it meant, jobs only women could do, and then jobs only men could do. The jobs they were listing were definite "Malawian" jobs, that we wouldn't even have or consider jobs back home. It was cute though, and they came up with some really good things. I had such a good time interacting with these kids, learning about each one of them, and what they want to be when they grow up. It is so sad though too at the same time, because some are so sick you know that they will not even have the chance to fulfill their dreams. This for me is the ultimate test of trusting God's plan, when it is so hard to understand...why? It was a very emotional day for me in so many ways. I can not hold back the tears when I think of these beautiful lives and their will to survive one day at a time.

My little peanut.

What happened you might ask? Well...my night with Chisomo was one of little sleep, as I had expected. He began to become weaker as the morning drew closer and it was difficult for me to get him to eat appropriate volumes. His temperature was the other issue. As soon as I would take him away from my body to change him or feed him his temperature would plummet, no matter how many blankets I had wrapped around him. So I fed him at 6 am and tried to get him warmed back up. He was inside my tank top and sleeping for a while. He let out a little peep, I repositioned him and he was fine. A few minutes later I looked down to check on him and I had a blue baby pressed to my body. I pulled him out immediately and began to vigorously stimulate him. No response. So, I started CPR. This was my first experience not with CPR, but mouth to mouth on a baby in a very uncontrolled environment. I felt his little lungs open and continued to give him breaths and chest compressions. The cook where I am staying was already at the house so I yelled and instructed him to call the Clinical Officer of the Crisis Nursery and tell her to come immediately as this baby needed to go to the hospital. Well, in true Africa fashion, no one was in a hurry and no one knows what CPR means. The Clinical Officer came about 15 minutes later and I had already phoned the driver to take us to the hospital. In the meantime, we went to the nursery and gave the baby Gentamicin (antibiotic) to treat any possible infection. The Clinical Officer lightheartedly kept laughing and telling me that the baby is now fine, see they do this. I was thinking, you didn't see what I saw. He was essentially already in heaven. It is a good thing babies are so resilient. He had started to perk up a little. So, she decided that the baby would just continue to stay with me, I would take care of him and we would treat him at the nursery because he would be better off here rather than at the hospital. So she takes off with the driver to go get more antibiotics and leaves me at the nursery with the baby that continues to stop breathing every 2 minutes that I have to keep skin to skin or else he becomes hypothermic. At this point I am thinking, how in the world am I going to do this all day. I have no way of knowing the second the baby decides to stop breathing. It is all reliant upon me constantly checking him. The other part that becomes extremely difficult is that the knowledge I have of knowing what can be done for a baby like this, and then not having the resources to help the child is more frustrating than you can imagine. By our standards back home, this baby wouldn't even be that sick. They just die here. Everyone continues to go about their business. It is not that they don't care, their regard for life is just different. Death is such a part of their daily life they accept when such things happen they happen. This culture continues to accept sub-standard efforts and views, that it only keeps digging a deeper and deeper hole for itself. I can't even begin to explain all the ins and outs of the views here, because I am just coming to understand a small part of it.

So, back to Chisomo. When a British woman I know arrived at the nursery, I filled her in on what had just happened. I told her the baby needed to be seen at a hospital asap. She asked me if I needed her to take me and I said please. So, off we went to the American clinic at the African Bible College campus. She knew some docs there. We arrived and immediately pulled a Dr. out of an exam room and the baby was now getting admitted. So to cut out some of the details, there is no pediatrician here, but I didn't care. They were American and could relate. So, basically the Dr. looked at me and said you know what to do, get to work. So, I did. I started an IV, gave him dosing on antibiotics, told him appropriate IV fluids, and calculated the rate. They supplied the oxygen and the heat to warm the baby. The doc was grateful and then began to persuade me to stay or come back and help him run the pediatric clinic being built. I am beginning to see the needs are so widespread. I could run ragged everyday, but the answer does not lie with the white man, it is actually part of the problem. These people need to be empowered to change things for themselves, but instead just look to the westerners to do it. When the white man leaves, it all falls apart again. Not to say they are incapable, it is just the way that it is. They have learned helplessness.

If you look outside of what is right in front of you it becomes very disheartening. I almost have to have this narrow focus of taking care of what is right in front of me and not worrying about the rest. It may sound careless, but it will consume you to be any other way.

So, today I went back to check on Chisomo and he is doing much better. I gave the nurses there instructions on how to perform CPR and they gave me instructions on how to calculate a drip rate on IV fluids. I hadn't had to do that since nursing school, as in the US we have IV fluid pumps that we program in precise amounts of fluids to be delivered. I was very resourceful with my supplies too. I made a little arm board for his IV with a tongue depressor and made due with every thing else any way that I could. It has been an extremely long 24 hours and I am exhausted. Keep us all in your prayers. Thank you for all of the kind, encouraging words you are sending our way. Chisomo has given me a story to tell, and his life that I can rest assured say... I saved.

Keep him in your prayers and I will continue to post updates on his status. For those of you that I have worked with me in the NICU, yes that is a "Bree bed". I couldn't resist, I had to snuggle him in.

Life is Precious.

Chisomo

There was a problem with the picture when I posted it the first time, so I will try again. This is Chisomo, a baby I rescued yesterday from a far off village about 2 hours away. His mother died from complications and he is now the last of 6 children. He came home with me last night and I fed him throughout the night. His eating slowed down a bit and his temperature regulation became more of an issue. I had him skin to skin, aka African Isolette, or more familiar Kangaroo Care most of the night. The plan was for me to keep him with me for a few weeks until he gets bigger and stronger. In the next post I will fill you in on the events of this morning. Please pray for Chisomo to be healthy and strong.

Beautiful Kids!

This is a picture I took as I was sitting on the ground in the village of Chimwang'ombe today. The kids just stare at me. I look away from them, turn back and their gaze has not shifted once. They all giggle when I show them their picture too. They just can't believe that they can see it right away. Village children are some of the happiest children I have ever seen, but why wouldn't they be? Look at the kids they have to play with everyday.

We went to rescue a baby from this village this afternoon. He had lost his mother 1 month ago. The situation was not a typical one, as the grandmother had been trying to care for the baby and later realized she didn't have the means to give him all he needed. So we were contacted and then set out on this 1 1/2 hour journey down the worst dirt road you have ever layed eyes upon. At one point my head hit the ceiling of the truck. I count trips like this as my ab workout. Anyway...we arrived to take the baby and shortly before the aunt of the baby had arrived too. She was to attend a funeral in this particular village. She heard we would be taking the baby to care for it until he was out of his infancy stage. She voiced strong opposition which caused quite a bit of division between her and the grandmother. Needless to say, there was a lot of quarrelling going on, most of which I could not understand. The aunt would be there for only a month and then leave again, which would leave the grandmother to care for the baby. They paid almost $10 USD to get 1 tin of formula (this included transportation costs). I know that is probably more than they make in a month, so I am not sure how they will continue on with this. We were rather upset just for the welfare of the baby. The aunt acted as if she was worried they would not get the baby back, but I understand really what she wanted was us to give them things. So, the director of the nursery was very firm and said basically it is now or never because we will not waste our time, fuel, and resources if you call us again. We are happy to take the baby, give it good care, clothes, a bath, a diaper, none of which this baby had. Still said "NO". So we left without taking the baby. It was their decision... what else could we do but head back down the same bumpy road for another 1 1/2 hours?

Love

Today I am feeling better both physically and emotionally. I had a productive, long day at the nursery. The highlight of my day is revealed in this picture. This is Joshua. He arrived the same day that I did at the nursery. His mother died of HIV and his step-mother was caring for him... then she too became ill. So that is how we came to receive Joshua. He cries quite a bit (more than others), but also can have happy, quiet times. The hardest thing for me is looking into his eyes. He has eyes that are deep, that say "love me". What child's eyes don't you may ask? His are different. He looks back at you with these black eyes and the curliest eyelashes I have ever seen. Just sweet, innocent love.

He was crying today so I took him outside to get fresh air. I let him touch leaves from the trees and he immediately stopped crying. He held on to them tight. We walked around and then I held him on my lap on this bench where we sat for a good hour. I was so content, I felt like there was no place on earth I would rather be, than in that moment. I started to cry as I held him to think that this poor child will grow up not knowing his mother, or maybe not even having one. It just seems so unfair. Why such a sweet innocent child is robbed of something so sacred, a mother. So I sat, held him tight and thought, he may not get this attention, this love, this security that every child deserves. I gave it to him in that moment, and I think he felt it. It is another part of my daily battles in being here, as I had predicted it would be before I came. How can I just continue on with my selfish life, when all they need is someone to love them? I think that the life they would be blessed to lead in America would be better than where they are coming from, but maybe that is an ego-centric American view too? I don't know, but these babies are so sweet it is impossible to do anything... but love them.

My Weekend...

Well, my weekend started with a call from my friend Bethany that I met on my first days in Africa. She invited me to a potluck that a large group of Americans have every Friday night. There is a college here called the African Bible College (ABC) where many Americans work as missionaries. So, I went excited to have a little taste of home. It was really fun, I met a lot of really nice people, but it was what happened to me later that wasn't so good. I figured all Americans, food would be safe right? WRONG! I became really ill, to the extent you probably don't care to know. But I have spent all weekend recovering and I am feeling better now. I think when you get sick, no matter where you are, you just want to be close to home with Mom taking care of you. It has been a hard weekend for me in more ways than one. I have felt really homesick. This internal battle plays in my head that God has brought me here for a purpose, but sometimes it is hard to see why. It is almost embarrassing to write this because it is hard to admit that this is difficult, and the picture of why I am here some days is not clear. Sometimes I think it is just too difficult. What am I trying to do, save the world? But just as God has not completely revealed to me all the reasons that I am here, it is a test for me to surrender to His will, let go and trust. Something that I battle with often. As I was sitting in church this morning thinking about the people around me, they don't seem to have the same struggles we as Americans face. Life is simpler. Purer. Not clouded by superficial wants and desires. Their wants are for others, happiness, and health. They hold a grasp on what is really important. Sometimes these perspectives come in strange ways, but the last time for me was when my sister Rose died. I don't know, I guess in some ways I am answering my own questions. There is not one reason that I am here, there are many. I, myself have a lot to learn from the people here, but at the same time I hope and pray that I can leave a little something behind too.

My Girlies! Madalisto & Mirriam

As I look a bit run down in this pic, it is only a reflection of my day today. Yes, that is spit up on my left sleeve. It started as a normal day at the nursery, followed by a mid-morning jaunt to the health clinic. 9 babies needed immunizations and there were 3 of us, 2 nannies and myself, giving us 3 babies each. We loaded up in the minibus, I had 3 on my lap (no carseats here!) as did the other nannies. It was a sight, and I would have snapped a pic if I had a free hand. I am thankful for having 6 years of nursing practice and a lifetime of holding babies for this trip, because without it, I am almost certain someone would not have survived. As I have mentioned before, most of the roads are dirt, very few paved and they have large potholes and crevasses making a smooth ride more of a concept than a reality. What else should I expect? I am in Africa. So, we were bouncing around, as was the seat I was sitting on that was not bolted down and we pulled up to the clinic. The nannies were laughing because everyone was staring. I wasn't sure if it was because we had so many babies or if it was me. The nannies were certain it was me. They kept joking with me, telling me "They think you are Madonna!". The people stare not out of rudeness, but more out of disbelief that I am there. As Americans we are exposed to diversity all of the time that we don't even think twice about seeing others of a different race or nationality. Here there is very little diversity. It would be fair to say that almost every person here of a different race is doing some type of mission work. An example is from an encounter I had on my walk home this evening. First, Malawians are very friendly. A "hello" is not complete without a "how are you?". This is the greeting that is exchanged upon seeing just about anyone. So I passed this guy and said "hello, how are you?". With wide eyes he replied "fine, how are you?" and quickly asked if he could ask me a question. I said sure, so he asked me my name. He proceeded to tell me that I was the first white person he has ever spoken with. He was so excited. I thought it was neat too.

Good changes are happening at the nursery. The babies are doing great and most are growing. I am still concerned about a few but we are making some nutritional changes to help them grow. They are all such blessings. They thank you for your prayers.

..."My grace is sufficient for you, for my power is made perfect in weakness." 2 Corinthians 12:9

School Kids

The warm welcome I received from school kids upon my arrival at Chimwang'ombe village. All I could hear was "mzungu, mzungu!" They had me pinned up against the truck, just so excited to see me. They are all really sweet and innocent compared to most other kids in developing nations. These kids have not learned the tricks of the trade of begging for money when you take their picture. They are just excited to get to see their picture. I was in this village today to do HIV screenings and counseling. I did the screening part, as Chichewa is not coming as easily as I had hoped for counseling.

This picture was taken, only because of the consent of the guardian. I feel torn about whether I should even post this, but I feel it is important to give an example of the devastating effects of HIV and the lack of medical care here. She was the only positive person in the group of 50 we tested, and we assumed she was before the results had even come back just by her appearance. We learned that her mother died of the disease and it now has been passed along to her. She was born without even a chance. The right side of her face has been scarred from shingles and she has lost complete eyesight in her right eye. She was never taken for treatment even though it had been advised. The grandmother is the guardian and she underwent counseling today for the importance of her granddaughter to be followed up for treatment and proper nutrition. Ministry of Hope will help arrange that she has transportation to be seen at the Baylor Pediatric HIV Clinic and access to good food. Her sister sitting next to her tested negative. Pray for her and her family.

Mzungu with the village kids.

The kids came running when they saw there was a "mzungu" (white person) in the village. They were so excited. The older ones kinda stroll by and check things out, but I know they are curious about me. This happens to be an atypical village if you can even call it a village. It is in the city of Lilongwe, so most of these families are doing well. There is electricity and running water. In my other pictures you will see more typical views of Malawian village life.

Me, Chris, Kevin, Carrie,& Sam - Hammer Rock/ Lake Malawi

Last Sunday I rode to Salima with my friends who are all doctors working at the Baylor Pediatric HIV/AIDS Clinic here in Lilongwe. Sam, our guide took us on an amazing hike. Later we went for a swim in the lake. It was a good day, really hot though. Oh, how I wish women could wear shorts here!