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Malaria season has hit west Africa full force, which means things have been very busy at the hospital. This month, it feels like all I have done is worked and slept. Unfortunately, malaria season also means a lot of loss at the hospital. Malaria, although easily prevented and readily treatable, is a nasty parasite that is also responsible for the most deaths in Togo every year. Why? Because when it hits more vulnerable populations - the very young, the very old, pregnant, and immunocompromised patients - time is of the essence. And so often, by the time we receive these patients, it’s already too late.  There are some things I’ll never understand this side of heaven. We delivered one baby who didn’t breathe at all for forty minutes, and only when we finally decided to stop resuscitating did he take his first breath. A few days later, he went come completely well, a miracle baby. Around the same time, we had three babies who were all born perfectly well and transitioned normally. B

When she walked in the door, she held out both hands and offered me a plastic sack full of guinea eggs. I squealed with delight, not because I really love guinea eggs, but because I really love her, and I knew what a significant thing it was for her to bring me a gift, and I wanted her to feel my thankfulness. And I wanted her to be honored.  I set the eggs on my table because what I really wanted to hold in my hands was her baby, who was snuggly attached to her back. She had covered her in a colorful piece of African fabric to protect her from the dust of walking down the road, but now that she had arrived to my house, she removed the cloth and uncovered a sleepy face poking out.  Her mom swung her around to her front, untied her, and placed her in my arms. She opened her eyes, and I started talking to her in my best baby voice. “Hey there! Yeah, we know each other! I was there right after you were born. I’m the mean nurse who kept messing with you and poking you!” Her mother

While running back and forth between patients, I peeked my head behind her curtain to check on her. “You okay?” I would say with a syringe in one hand and a medicine cup in the other, and she would nod and I would keep running.  After the emergency cesarean section was finished, another hypertensive patient delivered her breech baby and finally got her blood pressure under 200/120. I gave my postpartum patients their medicines a little late, and then finally turned my attention to my patient behind the curtain. I felt almost bad, like I had neglected her all morning, but the honest truth was that she just wasn’t as urgent as the other cases. I went in to hang an antibiotic and apologized.  I brushed hair away from my face and said, “Crazy morning! Sorry I haven’t had time to look at you.” She smiled playfully and said it was okay, that she had seen me running back and forth and understood that other people were more critical than her.  I hung her antibiotic, felt her abdom

Imagine that you just had an operation on your leg at the hospital of hope. You’ve been discharged, but you still need an antibiotic injection every day plus dressing changes every few days. All this has to be done at the hospital, but you live in village thirty miles away, and your family only owns one bicycle.  That’s why we have the cuisine.  This is the perfect place for patients like this who are not hospitalized but still need to have close access to care. Cuisine translated means “kitchen” and gets its name from the women who cook over open fires outside for their families and sick relatives as they stay there. The cuisine is basically a large barn-like structure with partitions inside to allow the people and families staying there some privacy and personal space. Everything else is done in community. In fact, walking through the cuisine is like walking through a colony of sick people and their families who have been there months and have really gotten to know each othe

She went into the clinic for her normal prenatal check-up, and perhaps she was starting to feel more and more excited about the arrival of her first baby, but not too excited because it wasn’t quite time yet. Little did she know that her baby would be born that very day.  A routine part of the prenatal check up is to listen to the baby’s heart rate, but when the nurse listened on May 29, 1991, she found that the heart rate was dangerously low. So she calmly called the doctor, put the woman in a wheelchair, and started running down the hall towards the labor and delivery unit. Since the pregnancy was still a little early and the woman’s body was not ready to deliver a baby, an emergency cesarean section was performed, and a baby’s life was saved that day. That’s how I was born.  ~~~ When I received report on this particular day, I had several patients who all needed something right away. A lady in labor who was progressing normally, a post-op C-section who needed pain m

Call it a phenomenon. We call it the plague of termites.  African termites are not like America’s little wood-eating termites. These guys are about one third body and two thirds wing, and the whole thing ends up being a couple inches long. They are black and juicy and nasty. They live in holes in the ground, but after it rains and when it’s dark outside, they crawl out by the multitudes to mate, and once they’ve found a partner, their wings fall off and they die. Sounds like a phenomenon scientifically, but in reality, it’s an infestation. An invasion. A plague.  After it stopped raining on the night shift (remember, this is the perfect combination - darkness plus after the rain), they started crawling into the hospital by the thousands. Once inside, they took to flight. The hallway became a black cloud of swirling termite affection. After thirty minutes of trying to take care of my patients with large winged insects hitting my face, their next cycle of life arrived and their

The nursing student leaned over the isolette and peeked through the glass at the baby who was born just the day before.  “How is she doing?” He asked.  “Amazingly well,” I replied, as I watched her chest rise and fall with regular respirations. “Do you know what happened with her?” I asked.  He shook his head no, so I started to explain how she was born with no respiratory effort at all. The team of health care providers - a doctor, midwife, two nurses, and an aide - spent forty minutes resuscitating the baby with stimulation, suction, and ambu bag with oxygen. Even with all that, she never took one breath. After forty minutes, they finally made the call to stop all interventions since their efforts felt futile and the baby was not responding.  But the very moment they set down the equipment and took their hands off the baby, she took a small breath and gave a weak cry! They rushed back to her side and watched as she seemingly came back from the dead. The nursing s

On this Fourth of July, I celebrated American liberty and freedom in the most sensible way possible. By going to prison.  Every Wednesday, I have the privilege of going into the women’s prison with a faithful African Christian woman and a faithful American woman missionary. We get to love on the ladies there and study the Bible with them. This Wednesday, just because it was the Fourth of July, was no exception. Except it was exceptional.   We were studying John 8 when the Pharisees are questioning Jesus and just really not understanding at all who he is or what he is all about. At one point, they ask Jesus specifically, “Who are you?” And Jesus basically tells them, “What I’ve been telling you all along.” (v. 25) So the question was raised, who has Jesus been saying that he is all along? After studying eight chapters of John together, these ladies have learned that he is the light of the word, living water, bread of life, the Lamb of God...and all those answers were given