Hands and Feet

Instead of individual rooms, the hospital is made of wards – one for women, one for men, one for children, and one for obstetrics. There are around fifteen to twenty beds in a ward, meaning that the TB patient rests only a few feet away from the AIDs patient occupying the bed next to him. The beds themselves are more like old cots with thin plastic mattresses wrapped in stained sheets that don’t fit. I often find my patients lying in a crumbled mess of browned  sheets filled with crumbs, dirt, and sometimes body fluids.  Their heads rest on the bare mattresses because there are no pillows. Anywhere.

In the nursing station, the papers are hung on the bulletin board with old needles. When you don’t have push pens, you might as well use what you would normally throw away.

To do wound care on one of my patients, I had to gather my supplies from all over the hospital. I found a basin in the women’s ward. I retrieved some hydrogen peroxide from the one supply station in the entire facility. Luckily, I found some extra gauze while I was watching Dr. Steven cast a patient's arm. I had to get tongue blades from the supplies back at the house while I was on my lunch break. It took all morning to find everything I needed, even though those supplies would be at the touch of my fingertips in the United States.

In the lab, the sink is full of used specimen cups. They wash and reuse them so they don’t run out.

I watched a nurse start an IV without even cleansing the skin before inserting the needle. They don’t have alcohol prep pads. We only have the alcohol swabs that we brought, so I have to conserve them by using the same alcohol pad to wipe the thermometer between patients.

When I assisted Dr. Kent with his episiotomy repair, my job was to keep cockroaches off the sterile field.

If we had a suction in the delivery room, we would have been able to save the baby that died a few days ago.

You don’t want to even know what the bathrooms look like…or smell like.

It didn’t take long for me to discover that nursing care in Tanzania is a little different from nursing care in the United States. Documentation is pretty much non-existent. The nurses don’t perform ongoing or continual assessment.  Clean technique is mostly out the window. Medication administration does not include the six rights, checking allergies, or checking patient armbands. When hanging blood, the nurse makes sure the letter matches, then hangs the bag and walks away. Needless to say, things are a little different.

But what stood out to me most of all was the lack of comfort care. In my training as a nurse, I have been taught to care about hygiene, cleanliness, mouth care, foot care, and things like that.  When I walk through the ward, I find patients who smell of feces. I see dirty feet, cracked lips, dry mouths, and unkempt hair. So in our spare time, my nursing friends and I try to offer some extra care. We straighten beds, offer water, and wipe sweaty brows.  The patients and the nurses notice, and they thank us for doing the dirty jobs. I think about the woman who washed Jesus feet with her tears and wiped them with her hair. She did it for Jesus, and so do I.

Even though many things about health care and nursing care are different, some things are still the same. The facility and the resources are shockingly different from the conditions in the United States, and I really really wish I could changed that. But at the same time, some things cross all national and cultural borders. This is because we are all people created in the image of God. We all want relief from suffering and healing from illness. We all need a tender touch and a genuine smile. We all long for love – to love sincerely and be loved sincerely.

This is why I love Africa, why I love being a nurse, and why I have committed my life to being a missionary. God’s kids live all over the world, and His love for each one of them is unconditional and extravagant. Each one is precious and beloved in His eyes. It is my honor to meet them, learn their names, shake their hands, and then pat their arms and wipe their blood. All in the name of Jesus.

When things were slow in the ward and we had nothing to do, Kellum and I walked up and down the ward and prayed with every patient and their families. Even though they didn’t understand our English, they understood what we were doing and who we were calling upon.

At the end of the day, that’s what it is about. Yes, there are ants in the beds and strange smells in the halls and you can’t even find a bottle of normal saline when you need one.  Yet even when the differences seem outstanding, you look into the eyes of the people in the beds, and you see the face of Christ in each one. They are God’s people, made in His image, in need of His love.

What an honor and blessing it is to give blood and start IVs, but how much greater it is to pray with them, touch them, and love them. This is the wetting with tears and wiping with hair. This is the hands and feet of Jesus.