The OR

In my "free time" when I wasn't trying to build water filters, I would pop into the OR to see what was happening, sometimes I ended up doing some sort of assisting and always documenting...



An essential in any Nigerian hospital is some sort of insect killer. You just never know when a stream of ants is going to march through your surgical field or try to get into your sterilized instruments...









Here I don a super extra large set of scrubs donated by some Canadian hospital. I know I have lost weight recently but this makes me look like a poster child for Weight Watchers! I am with some of the visiting staff at Peace House hospital. They have volunteers that come on their days off from other jobs to help. The hospital is run completely by volunteers - no one gets paid a salary. I learned a lesson about living by faith...




To get into the OR, you have to change into sandals - yes, sandals. They do have a couple of pairs of rubber boots but those are reserved for those actually doing the surgery, and often they don't wear boots. A couple of patients had some major blood loss and I had to make sure nothing dripped onto my feet!







I'm sorry if surgical pictures make you sick to your stomach - this one isn't too bloody. It is a uterine fibroid. It was attached to the top of the uterus and several times the size of a uterus. In this case the uterus was saved, and hopefully the woman will be able to have children in the future.


I also watched a leg amputation (yakubu's), an appendectomy, and the most disturbing was a goiter removal. They don't have intubation at Peace House, so they use something called Ketamine which is a sedative. But not all people are completely sedated during surgery. One woman in particular did not "take well" to the ketamine and kept waking up and struggling during surgery. I had just stopped by to see how it was going and ended up coming into surgery to hold the woman's arms and legs down and trying to suction her mouth with a bulb syringe (no suction either) under a sterile field (I was in my everyday clothes), during the surgery. The woman was fine post-operatively despite her struggle and major blood loss.
I learned I never want surgery under minor sedation!
But I love watching surgery and seeing all the "parts" I only seen drawn in books. God was pretty imaginative when it came to designing the human body!

Soul food

People have often asked me what kind of food I eat in Nigeria. I will offer you a little smorgasborg of photos. Be careful not to drool on your keyboards!!

Below are yams for sale at the Adoka market. These are a staple food in southern Nigeria. They are quite large, not like the yams you buy at Safeway. You can eat the yams fried on the fire, or "pounded". With the latter you peel them, boil them, then pound them in a large mortar with a pestle. It is pretty bland, but you eat it with a soup...


Above you see "pounded yam" on the left and a soup to accompany it on the right. You pick a piece of pounded yam off your ball, roll it in a small ball, make a divot with your thumb and dip it in the soup. This particular soup was served to us at a hospital we visited. I thought it was fish inside at first, then noticed the skin was a little too thick for that. I ate it anyway and it tasted like chicken. It was "bush lizard", which I later saw for sale at the market....

mmmmmmm..... lizards-on-a-stick or shishkabob-lizards.... whatever your pleasure:-)


Another soup is "draw soup" which can be made from various vegetables. This particular one is made from a bush/tree that has white stalks. It is also made from okra. It is not my favourite as it reminds me of secretions that I suck out of people's tracheostomies at work...

And then we have "bean cakes" (below) which are made from mashed up beans which are then rolled into a banana leaf and baked. Sometimes they put a boiled egg in the middle of it. To spice it up, they mix in salt and pepper and HOT red peppers which clean out my sinuses and make it look like I am weeping about how good my lunch is.




Leanne, Jenny & I nicknamed this snack (above) "peanut poo sticks" for obvious reasons. They are actually quite good. They are made from the left over peanut oil and residue and pressed into these stick formations. They are very hard and crunchy, and taste, well, like peanuts:-)

Speaking of another nut, did you know where cashews come from? Being a city girl, I thought they came out of the bulk bin at Safeway... but they grow on the top of this fruit. Perhaps there is an african name for this fruit, but we called it "cashew fruit" (geniuses i tell you...)
The fruit has kind of a smoky flavour, and I guess you can just pluck off the cashew and roast it.

The fruit in Nigeria (and every other developing country I have been too) is OUTSTANDING because it is fresh off the tree and not covered in pesticides. I love mangos and bananas and oranges and pineapples. I probably eat at least 10 servings of fruit a day while in Nigeria (where it is available). below is my somewhat pathetic attempt at creatively peeling a mango.



Nigerians can peel an orange top to bottom in one piece. Normally, they suck the juice out of the top and discard the rest of the orange. It is affectionately referred to as "sucking an orange"

My last week in Adoka, Nelvia and I learned how to bake without an oven. She brought dry brownie mix from Canada, we mixed it up with some eggs and oil and put it in this ingenious little oven. All you do is take a large pot, fill the bottom with about an inch of sand, put your smaller pot inside, cover it and put it on the stove. 30 minutes later we had delicious fresh brownies! It was a little piece of heaven:-)

That is just a little taste of what I have sampled of the wonderful African cuisine (i say wonderful with a mischevious smile).

(background music: corrine baily rae and moby)

the biosand water filter in the making

How is a biosand filter made?

With dust and sweat in 37 degrees celcius, here is a small look at what goes into making a filter.

On the right, I am sieving rocks and sand so that we have the proper size of gravel and sand to make the filter itself and also the "media" inside of the filter.
We had three different sieves made - to sort out gravel into 1/2 inch stones, 1/4 inch stones, and sand.
Although this is the "easiest" and most straight forward part - my nigerian counterparts made comments about how doing things "the canadian way" took much longer than a typical "nigerian way." They joked that "their way" is to find the shortest and fastest way possible to finish a job (whether or not it is done "the right way"), then go home as soon as possible. Joking aside, I told them we were going to do it "the right way", no matter how long it took:-)


Next, you pour a filter.
We mixed small stones, sand, and portland cement and filled our steel mold.

A steel mold can be used thousands of times if taken care of and used properly.

We let each filter set for 18-24 hours, then removed the mold, filled it with water, and let it set for another 5-7 days.

At the right, we are pouring cement in our first filter.


I demonstrated then how to work the cement into all the crevices of the filter and how to "bang out" the air that gets trapped in the cement. Air pockets will weaken the strength of the filter, so you do your best to remove them.

We banged the sides of the mold with rubber mallets until we saw fewer and fewer air bubbles coming up to the top of the fresh cement.

It often sounded like a drumming party, and I would throw a little dance in here and there to get a laugh.


Here is a "snap" (nigerian word for photo) of our very first filter! It was probably also the best one as people were diligent in their work and excited about the outcome.

The work got a bit sloppier as time went on as I tried to supervise less, and the "nigerian way" started to take over. I had to repeatedly reinforce that each step of the filter making had to be followed exactly, not what steps they felt like doing.

A particularily frustrating day was when for some reason we could not get the mold off the filter. I demanded that the guys stop trying to remove the mold as they were on the verge of breaking it. A mold costs about $400 to have made and the cement inside is worth only about $3. They finally consented and started the process of removing the mold a different way in order to break the cement off. But as soon as I left for the market, they put the mold back on and started again trying to force it. They ended up breaking a piece of the mold, stripping the nut and part of the metal plate. Thank goodness it was a smaller piece of the mold and not the large part. It cost a few dollars to fix, but I was very upset and disappointed. The hired mason (cement worker) apologized the next day, even getting on his knees, and I told him I hope he would take this as a learning experience and not make that potentially costly mistake again.

After allowing the filter to cure, you fill it with specific levels of washed gravel and sand, place a diffuser plate on a ledge to properly difuse water into the sand, and start pouring contaminated water into it. It does not require a pump as it works by siphoning effect. The tube coming out of the nose is fed through the cement, down to the bottom of the filter. When the water level is above the curve of the tube at the top, the water is automatically pushed out. When the water level equalizes again, the water stops running.

All the parts and equipment are made from locally available supplies (although not always easy to find as home depot does not exist there) and therefore can be built anywhere in the world.

Through a simple, yet complicated process, it removes up to 98% of bacteria, 99.9% of viruses, and 100% of protozoa and worms. It requires simple maintenance that requires the user to drag their fingers through the top layer of sand. If maintained properly it can last for decades.
All for about $20. The families are required to pay for it, but the cost of the filter is a fraction of what it would cost them to treat one bout of typhoid.

It has the potential to revolutionize drinking water and eradicate water-bourne illnesses in the area. If successful in Adoka, the program can be implemented in new villages and towns.

That is the filter in a nutshell....

the water in adoka

The first day in town, while looking for filter supplies,

Dr. Aba stopped some girls who were walking by and
had them put their bowls down on the ground.
The young girls had just gone to the stream to collect
drinking water. This is what it looks like to the naked eye.

Can you imagine what it looks like under a microscope?

Above is a photo taken less than 50 metres from a river/water source. Nigerians seem to think they should dump their garbage right beside streams and rivers. The garbage ranges from plastic bottles to batteries, to paper, to rusty buckets to car parts. The children are walking through the garbage to get down to the river. In the top third of the photo, the river is inbetween the garbage and the bushes. Then, not 50 feet from the garbage dump and the river, we saw children relieving themselves...After relieving themselves, the children run down to the river to bathe and do their laundry. Many people also relieve themselves in the stream when no one is looking, or their "gifts" left on the banks are later washed into the river during the wet season. After bathing, washing laundry, and relieving themselves, the women and children load up their buckets full of water to take home to drink....

There are several places in town that have large tanks with "Buy your clean water here" painted on the sides. I don't know where they procure their clean water or how they ensure it is clean. But I certainly was not comforted when I saw this tanker trunk on the other side of the stream. The men dumped one end of the hose in the stream, hooked it up to the truck and started pumping water into the truck. Who knows what the destination is... I would probably just get more angry...

Below is me beside one of the rivers where people get their drinking water from. January to March is dry season, so the level of the river will only go down and the water will become more and more disgusting... but people have no other options due to the complexities of poverty (i.e. no money, no education, no understanding of hygiene)

how diarrhea and dehydration kept me motivated...

There were many times during my time in Adoka that I wondered why I was there, was I really doing anything worthwhile, was it really worth the frustration?

My last weekend in Adoka kept me motivated and reminded me of the reason that I was sent to start the water filter program.

Nelvia (at right) came from Mkar for a week to work at the hospital in Adoka. She is a GP resident in training and was doing an international placement with the medical team. We were "on call" one weekend to try to give Dr. Aba a break. We spent most of saturday night at the hospital trying to revive babies. This first picture is of Monica, who came in with severe diarrhea and even more severe dehydration. During the evening a nurse had attempted a "cut-down" IV with no success. Nelvia tried an intra-osseus IV as a last resort. This is done by driving a large bore needle into the leg bone. You can rehydrate for 24 hours until you can get a regular IV. Hers went into the tissue, so we had to teach the parents how to feed her 20mL of IV fluid every hour and hoped that it would keep her a bit hydrated until the morning when we could try a scalp IV.

Then it was onto Joseph. He is 9 months old, but not much bigger than a 4 month old. It was at that time that his mother introduced some baby food to him - mixed with stream water. When you see the photos of the stream water, it will be no surprise why he started getting sick.
He stopped growing and became consistently ill for the following 5 months. As you can see, he is severely malnourished, not much more than a skeleton. He had been doing well during the day; eating and playing with the balloon. But sometime late in the night, he took a turn for the worse. The night nurse came to get Nelvia and I to try to intervene.

Joseph's whole body had started shutting down. He was so dehydrated that his eyeballs were dry and they rolled in his head like a doll. His limbs were flaccid - they just flopped around, and he was not responding to touch. Nelvia started a successful IV into the bone and we started to rehydrate. We had the generator turned on so that we could give him some oxygen and had his mother come and hold him.

After a couple of hours he started to perk up just a little, enough to make some eye contact with Nelvia and his mother. We started some blood donated by his mother (after I had to practically beat off his abusive grandmother who was screaming that he was no longer human).

It was during this time of trying to resusitate Joseph, that I looked down at his tiny body struggling to stay alive - and realized HE is the reason I was there to clean the water. Throw the frustrations of working on "african time" and the obstacles of getting the program off the ground... and focus on the real reason I was there. The helpless babes being fed stream water, getting diarrhea and dying by the thousands. I had to keep going for Joseph, whether he lived or died.
Unfortunately, Joseph lost his struggle only a few hours later. His body was too weak to keep going. Monica, on the other hand, recovered and was smiling and laughing the day I left Adoka.
Although I deeply grieve Joseph's death, it was the motivation to keep me going. I don't write this to try to depress people, but to give some hope - clean water will save the future Joseph's from ever knowing dehydration, malnutrition or death.

yakubu

Although I went to Nigeria to start a water filter project, I could not stay away from the wards for too long...
I had seen Yakubu sitting outside many days - his left leg wrapped in a huge piece of guaze, his face a picture of pain when he tried to move, stand or walk. But his shy smile and quiet nature intrigued me and i asked more about him.
He had been abandoned by his parents for reasons unknown to me, and was discovered by a good samaritan woman who brought him to the hospital when she saw the state of his leg. He was being cared for by an aunt who came after he was admitted.

His lower leg, tissue and bone, was completely ravaged by a horrific infection with no hope of healing. The only option was amputation, which was done when Dr. Verbrugge, an American doctor on the team, came to visit adoka for a day. We knew he could do well if he had access to rehabilitation and a prosethic leg, but considering he was abandoned, there were no financial resources to pay for such things.

Dr. Verbrugge told him that within one year he could have a new leg and be playing football (soccer) with friends. This didn't sink in for Yakubu until the next day when he motioned for me to come to his bedside. Through an interpreter he asked if it was really true that he could get a new "rubber" leg and be walking without crutches. When I affirmed this, the look on Yakubu's face was one of astonished enlightenment.

I had been trusted with funds from various sources to help pay for treatment for needy people, and Yakubu continued to tug at my heart. I knew that without financial help, Yakubu would be on crutches for the rest of his life, with no chance of running and playing like a 13 year old boy should.

I am happy to report that a fund was set up at a Rehabilitation hospital in Mkar for Yakubu to receive physiotherapy and treatment for two months, and he will receive a prosethetic leg once his therapy is completed. His aunt agreed to accompany him so that someone is caring for his daily needs while in hospital (in Nigeria, the family must provide all food, bathing and personal care). Yakubu will be in Mkar by Feb. 10 to start treatment!

Yakubu and his aunt were deeply humbled and greatly appreciative of this help and encouragement, and he promises to work hard in physiotherapy so that he may soon be running and playing.

The seemingly small gifts of several people in Canada have contributed to an enormous change in a young man's life. A boy abandoned by his own parents is being cared for by an "international family" who has never even had the pleasure of meeting him. Yakubu's life is renewed not only because he will be receiving a new leg, but because he has received a new heart and hope where he thought there was none.

the power of prayer

besides completing the basics of a water filter project in 2 1/2 weeks, not getting killed on the roads in nigeria, and arriving safely back home, i witnessed quite an answer to prayer that i have neve seen so readily and quickly before!
while i was still in mkar in mid-january, waiting to go to adoka, i spent some time going on rounds with the doctors in mkar hospital. the first patient we saw on ward six (male medical ward) was an unconcious man who had apparently suffered a stroke. with a history of hyptertension and consistent blood pressures of about 210/110, the three canadian doctors and i thought he must have suffered from a devastating intracerebral hemmorhage. on exam, he did not repsond to speaking or pain stimulus, had zero movement or pain reponse to to any limbs. the nurse and the wife said he had been like this for over a week. one of the doctors had the nurse tell the wife that we would treat him aggresively for a couple of more days, but that his prognosis was poor and he would likely die very quickly. another doctor suggested we pray for him and the family, so we offered an open-ended prayer up to God, then moved on to the next patients.
about 20 minutes later the wife came and tugged on my arm. "he's talking, please come and see" she said. i highly doubted this. i figured he was probably moaning and she misinterpreted it as speaking. but to appease her and settle my curiosity, i went with her to the patient's beside.
"good morning, how are you?" I asked in his native language of Tiv.
"nothings going on" he replied in Tiv.
my mouth agape, i asked if he had any pain and he quickly replied "no".
i went over and informed the other doctors that we need to pray for ALL the patients!!
i left for adoka the next day but learned that within a week he was talking and walking around the ward and was slated to go home within a week or two.
never doubt the power of prayer!

things are picking up

i just have a few minutes to try to update and this keyboard has alot of sand dust stuck in it so it is difficult to type.

things got off to a slow start - i got out to the village of adoka on wednesday, and spent thursday - saturday looking for the right supplies. unfortunately there is no home depot here, therefore the efficiency of locating materials is a bit slow. but we did manage to find everything. finding the right sand for the filter has been tricky - at the moment we are not using the optimal sand but it will do the job.

we took the first filter to the catholic women's group yesterday - first swayed the 'reverend father' first. i gave a little introduction about the filter to about 100 women, then demonstrated by pouring dirty water in and clean water coming out. i felt like i was doing a magic show as i was standing in the back of a pickup truck and the looks on some of the older women's faces was priceless. their jaws dropped - weren't quite sure what was going on inside of the big cement box...
they were very interested and asked when they could get one and how much they would cost. so we have several potential orders already!
networking with people in the community is just as important as making the filter, so we have been meeting with alot of people. i met the chief of adoka the other night - that was a classic story all in itself. no time to post it now. i'll just say i sat on red velour couches in a room lit by a single red lightbulb and was served 'bubbling wine' with a taste reminiscent to laundry detergent...
it is going well though and people are very excited about clean water. i have seen what they drink out of the stream and it is not pretty...
i don't know when i can post again - we are in a different city right now..
we plan to start pouring the filters today - sift more rock and sand -
have a great day!
alida

17 minutes

do you ever get impatient with the slowness of your computer?
let me give you some perspective.... it just took me 17 minutes to get into my blogger account and now i have 12 minutes to try to type up a message and actually get it posted. wish me luck..

i arrived safely with the team, we again had no problem in customs which is always miraculous. i was supposed to go to adoka yesterday but due to mechanical problems with the pickup truck i am going tomorrow morning. it actually worked out very well because i was able to see several friends this morning and distribute some asked for items (LED flashlights are popular).

This morning i saw the lady with the huge goiter lined up for surgery. so gilbert, wendy and family, she will likely have it tomorrow and i will make sure the other team members take photos. when she saw me she screamed with delight and gave me a huge hug! it was a joy to see her, she has an amazing joyful spirit that exudes out of her pores!
i went on rounds this morning - already have seen some interesting things - another child with burkitts lymphoma - a pediatric, african cancer. so i may use some sponsor money to help with chemotherapy. it is easily curable if treated early.

i am heading to adoka tomorrow to start on the water filters. the doctor, dr. aba, is so excited! he wants to drag a 300 pound filter around to communities to demonstrate it - i think we may have to bring the people to a filter rather than haul it around. but it is going to be interesting. he has a young woman who is a mechanical engineer lined up to learn about it, and as water is a "womans's job" here is is really aiming to get all the women on board (first convince the men it is a good thing, then implement with the women..
i gotta go, my time is almost up!!

i'm off to clean some water

i am off again to nigeria from january 10-feb 3 on a different mission of sorts. i am going to a village called adoka to "teach the teachers" about a biosand water filtration program. we already have the steel mold built and test poured a filter - so that is ready to be up and running.

i will be teaching through the manual i used in the course i took - splitting time between theory and talking to building and testing water filters. i really just want the potential program managers to have a very good hold on the filter, understanding how it works, trouble shooting, setting it up etc. It will be up to them then, to implement the program in the surrounding communities. I will be working with people from a local nigerian organization called peace house - they have already acheived incredible things in other ventures. i am quite confident that this program will be carried out effectively. Dr. Aba, who runs a small mission hospital, is so excited i am sure he will be the motivating factor in getting the program off the ground.

i am a little nervous as i have never done this before and don't have "concrete" (sorry for the pun) plans in place. but i see this as a total "God thing" as my visa was renewed in a miraculous way, funding has come in without me really asking for it, it is now getting really cold the day i leave (so that i can roast in 40 degree celcius) :-) But i know God will work through me - it is not of my own doing!

I don't know how often i will be able to access the internet there as i will be in a smaller village... but i will try to keep you updated as often as possible..

Have a wonderful month - see you in february!

for more information about the water filter go to www.cawst.org
it was even featured in the calgary herald last week!

alida, turn your (red) light on!!

I was able to visit a good friend, patti and her family in germany for a few days on the way back from nigeria. i had a great time of relaxing, hanging out with her children and husband, drinking real coffee, getting used to "western" life again.

I took a train to amsterdam on monday evening as my flight left midday on tuesday, and i decided to stay at a hostel in the heart of the red light district as it is close to the station, cheap, (and christian, therefore no crazy drunk tourists). i was dragging my bags down a street and accidently took a wrong turn so i pulled out my directions. an old, innocent looking man approached me and in dutch told me he was "not an amsterdamer" but perhaps he could help me. he directed me to a pub a few feet away and it being tiny suggested i not take my large bag inside. i put it on the ground but before i even took a step inside the bartender and a customer were yelling at me not to leave my bags outside as theft was rampant in the area. i backed up and what do you know, the nice old man had disappeared (thankfully without any of my bags!!) i should have clued in as i have never seen so many people on hard drugs in one place outside of east hastings in vancouver. i even saw a woman eating dirt out of a flower pot. i guess they have to steal their drug money from somewhere!! (this is the part where i should have turned my brain/light on, and been more aware of my surroundings!)

the customer and a stoned guy on the street were trying to figure out what street i needed to go to and the stoned guy apparently knew where it was. the customer suggested he might take me there for two euros... ya, i don't think so... i said i didn't have two euros and what do you know, the stoned guy went back to his friends who were snorting things beside the aforementioned flower pot.

i had to walk through the heart of the red light district which i found quite repulsive. i had been there many times in the past (when i lived in holland) but apparently i had only ever been on the fringe of it... there is some raunchy stuff there and full of male tourists checking out the female wares. i passed one really lovely gentleman who was the door guy for a live sex show and he had a scar from the left corner of his mouth to half way to his ear and it had been deep enough that it obviously cut his entire cheek. i walked a bit faster by him....

the hostel was quiet and clean and safe though and i had a good nights rest...

when i left the next morning at 9:30am there were no less than 6 people cooking crack cocaine on tin foil less than 20 paces outside the hostel doors. pretty sad stuff...

i am now back in calgary in one piece although my insides were almost frozen solid when i stepped outside the airport. i knew it couldn't be good when i saw amy dressed in a 3/4 length down jacket, hat, scarve and mitts. only a 70 degree difference from nigeria! i have not braved the outside yet today, but i need food so i am going to have to leave the house at some point!

i am returning to nigeria in january to try to start a biosand water filter program in a small village. i am a little scared as i have never done this before! we were able to have a steel mold made in november which is a huge part of it, so now it is about teaching about the filter to some designated teachers, and pouring and testing the mold. i pray it will be a success!

i am trying to sort out all my thoughts and experiences from this past month, and will try to put a short summary on my blog in the next few days... thanks for reading!!

dutch police, drugs and diarrhea

So, what do these things have in common? me of course!! leave it to me to unknowinlgy cause some ``wahalla' without knowing it!!

just as we were leaving for the abuja airport, i started getting stomach cramps. the whole ride to the airport i was having violent stomach cramps and didn't know which end it might come out of. once in the airport i had to go to the bathroom five times before i even checked in!! i took 3 pepto bismal tabs, a bunch of maxeran (for vomiting which also makes one drowsy). i was feeling pretty dopey when i was checking in and kept doubling over my suitcase with unbelievable cramps about every 15 minutes. in one line up the wife of a swiss ambassador gave me some imodium which greatly helped. i had to ask for a seat near the toilet on the airplane and once i was sitting, all the stewardess were asking me if i was alright or tired. i told them i wasn´`t feeling well and had taken medication that made me tired. after a stopover in another nigerian city, a stewardess took me to the front of the plane to let me lie down in 3 empty seats.

apparently, as i was walking by, jenny and leanne told some people near them that i was their friend and not feeling well. a dutch guy who later identified himself as a dutch drug police agent said that all the KLM staff had alerted them to me as i appeared stoned in the airport. apparently, the dutch police had been alerted that alot of drugs were being taken from nigeria to holland and they were there to investigate. the police agents had been watching me closely in the airport. then jenny and leanne without yet knowing who he was told him that i had `taken alot of drugs`` and had ``overdosed`' in the airport, and was having stomach cramps!! so they probably thought i had bags of cocaine in my stomach!! when jenny and leanne were told who they were, they made sure they clarified that i had diarrhea and had taken legal medication that made me droswy!!

so while i was passed out on the three seats, i was being discussed and watched as a possible drug addict!! i had no idea any of it was happening as i was completely passed out!! i thought it was pretty funny and i was thankful that i was not subjected to a bodily cavity search!!

only i can seem to get into this kind of situation!!

i am now in germany, visiting a friend and will be back in canada on the 28th!!

see you then!!

there is a plan...

this week God reminded me that he has a plan and purpose for everything. one of my boxes was stuck in minneapolis for a good time, then the phone numbers i gave klm in nigeria for contacts in the country did not work, then the office at the airport was closed on the day the driver was in town.... finally the box arrived on thursday, the second last day we spent in mkar. i had been fairly irritated with the whole process because i wanted to hand out all the supplies. so on friday, i still had the majority of supplies sitting in the house still.

friday morning, i walked up to the house where we eat breakfast, and a man was laying on the sidewalk who looked like he was 15 months pregnant with triplets. he had the hugest ascites (fluid in the belly) i have ever seen. so much that it had started leaking from his belly button!! he was on his death bed, he could barely breathe as the fluid in his abdomen was pushing on his lungs. dr. reedyk decided that we would offer him some relief by tapping his abdomen on the front stoop. and what do you know, i had all the supplies in the box! we put a 16 gauge (really huge) needle in his belly, hooked it up to an IV tube and drained it into a bucket over several hours. i even had tegaderm bandages to cover the site with. over a period of several hours, over 8 liters of fluid drained from his abdomen on the front lawn. "real bush medicine" at work! it was disturbing, but cool. he felt alot of relief and his breathing improved. if we hadn't had all the supplies, we would have had to admit him (a family with no money anyways - you are really desperate when you drop someone on a doctors sidewalk for help).

a little later in the day, joe, our engineer was on the front porch was talking to his wife on the phone when he mistepped and fell off the porch. he dislocated his shoulder and they couldn't get it back in without some valium. jenny and leanne started an IV with the supplies from work, leanne ran to the hospital to get some valium, and we sedated him a bit to "reduce" his shoulder back into place. again, if the box had arrived on time i would have given away all the supplies and would have nothing on hand. God works in mysterious ways!

So to my colleagues at work, I have photos of all those discarded supplies that you have faithfully put in the box, being put into use! Thank you for your efforts!

This trip has carried with it alot more frustrations than last year with the nursing students and it was easy to get overwhelmed, angry, irritated. i have been questioning my desire or calling to work and live in africa. i talked with several people who have lived here for decades and ask how they cope. they have encouraged me to focus on the people that show hope, determination, desire, and mentor them. i did meet a few nigerians along the way that give me hope... a 15 year old boy who is head of the household as his mother died, his father works out of state, he is responsible to put his younger twin sisters through school. he shows a strong desire to work hard and suceed, and i really want him to pursue education. so i have invested time in my relationship with him, encouraging him... please pray that i don't get disillushioned with the
"bigger" more depressing picture...

we are heading up to "the bush" tomorrow and i am looking forward to seeing all my old friends in the village of mahula. apparently they have internet up there, so hopefully i will be able to update there...

peace alida

it's all in the name

some interesting store and church names i have seen around the country...

embryo book shop

senile youth corp

bature (white person) medical clinic and midwifery

sympathizers coffin and casket

semen fashion

catholic charismatic renewal centre

de final home - casket construction place

there is hope, but not at this internet cafe

so, once again, i typed out a big posting about good stories when only half the computers shut off, mine being one of them. i think i have to update my blog one sentence at a time...

ryan, the OR tech had someone pull his phone out of his pocket and hold it to his ear while he was putting blunt instruments in someone's abdomen. if i have surgery, i would prefer someone's attention is on me and not what the person is saying to his wife...

i have several "hopeful" stories which i have been attempting to share...

today i found some worthy patients to sponsor their surgeries.... gilbert & family, one is a really cute little lady with a huge smile but an even bigger goiter on her thyroid. it is almost the same size as her head!! but is a happy little lady.

when i taught the nursing students today, they were receptive and eager! even the head nurse was open to suggestions! we got the unconcious patient all comfortable and doing better and then he died right in front of me! i hope they don't connect my teaching with patients passing away! they won't ever want me back! that is the 3rd patient who has died in front of me...

there is doctor who runs a village hospital who wants me to start a biosand water filter program in the community, so i am returning in january to get one up and running. if anyone wants to donate some seed money to get it started, the program will be self-sufficient quickly. talk to me when i return if you are interested. the doctor runs a pretty amazing little hospital, it will be interesting to spend time there.

a very physically disabled guy whose community wanted to throw him in the bush when he was born is getting a degree in special education and has defied all nigerian odds of survival and success. he is the only one in his family to get a university education. the boy who was the biggest burden at birth is now described as the "biggest blessing" by his mother. he has a vision to transform the attitudes towards disabled people in nigeria, and he can probably do it!

the hospital engineer works harder than anyone there, and is donating several months of his own salary to fix the electrical work at the hospital. he is going up north to drill water wells on his vacation which is unheard of for a nigerian to do (without getting paid).

all of these people have humbled me, amazed me, astonished me, made me proud and re-instilled some hope that was fading away...

Ridiculous

every time i come to this internet cafe (the only one in town), something crashes. i had just written up a big long blog when the generator ran out of diesel and everything shut down. so it is not for lack of trying to update my blog, but something goes wrong every time. and i can't write much now because i was supposed to only take a "short" break.

only in africa

only in africa...

...does it take 45 minutes to wait for the blogger site to come up only to have someone shut down all the computers in the internet cafe by plugging in their cell phone.

...do i check my email with goats outside the door, and a compound of mud huts less than 50 feet away.

...see my 'alarm clock' cow killed for market 30 steps from my bedroom door (on a small garbage heap - will make me take a second look at beef soup here).

...it is not acceptable for men and women to hold hands in public, but it is okay to ask me to marry them every day without even knowing my name.

...the same guy proposes marriage to me every morning on my way to work and he doesn't understand why i am turning him down. for pete's sake, he has asked me, so obviously i should accept! and he fully admits it is because i am white and he wants me to take him to canada.

...do african women ask me to marry them so that i will stay in their country.

...a 3 year old looks up at me and in perfect english says "give me money"

...do you see a sign that says "catholic charismatic renewal centre" (catholic AND charismatic? i think my catholic friends will get a chuckle)

...do the OR techs answer their cell phones during surgery.

...do i calmly kill spiders while i am taking a shower.

i hope you get a little laugh! nigeria never ceases to amaze me!

a day in the life...

i haven't written in awhile as the computer is often down, and i am often busy. thought i would let you know what a day is like here.

every other day, some sort of insanity comes over me and i go out walking/jogging with len, leanne and jenny at 5:30am. leanne and jenny are marathon runners so they go runnning off into the dark, and len and i walk for 5 minutes, jog for 5 and manage to keep that up for 40 minutes in 70% humidity at 28 degrees, mostly in the dark risking ankle injuries with every step. on the other days i sleep into a whopping 6:00am.

we eat breakfast at 6:30 and are at the hospital by 7:30 for xray rounds when we look at the previous days xrays and the nurses in the group learn how to read xrays. we usually do some ward rounds until 9:00 and discuss some interesting cases.

on the days i am in the out patient clinic i see about half of the 50 patients (leanne or jenny see the other half), completing a history and doing the physical exam. dr. reedyk then comes in and either signs off, orders some meds, or if it is more complicated, do additional assessments and do some teaching with me about what is going on.

on the other days i have been spending on the wards with nursing students attempting to teach them, instill some nursing values into them. i have been trying to help with their "nursing process" which is like an admission form they are supposed to fill out on each patient with nursing diagnosis and goals.
i do see glimmers of hope with some of the students (mostly the men), but some of them should never have been let into nursing school. i question some of the head nurses as well - the other day a confused man pulled out his suprapubic catheter and they left him leaking urine in his bed for 5 hours. i had to insist they change the bed, i ran around the hospital trying fruitlessly to find a doctor, finally dragged dr. reedyk there and he just had me reinsert it and try to teach what an emergency means.
today i discovered a 13 year old girl with massive congestive heart failure did not get any of her morning medications (a million excuses later) and she was starting to gasp for breath. i shake my arms in the air!! i bang my head!!

but today i played uno with some of the HIV patients and the students and most impressively, the students actually interacted with the patients and actually sat on their beds! so i hope to spend a little more time doing that, getting some interactions going on. when i first walked onto the HIV ward today all the women were lying in bed listlessly and i started blowing up balloons (provided by lucille) and i noticed that the women slowly started sitting up and taking notice. things were more lively after i had blown up 20 ballons. they just love the attention.

we finish up by 5:30pm and end up going out for dinner at someone's house at 6:30/7pm for some pounded yam and soup. (hence the need to run in the mornings as i consume about 5 pounds of yam)

i am in bed by 9pm at the latest. the cow likes to moo loudly outside the guesthouse at 4am, so i am usually half awake pretty early in the morning.

that is the day in in the life...

I need patience

I wrote in a previous post about my frustrations in trying to teach students, trying to figure out the best way to assist them. My thought has been to teach them assessments but I don't know if that will really benefit them as they are not really expected to do full assessments.
The difference in attitude and worldview is so dramatically different from mine, that I cannot wrap my head around it. They live a life that holds no promises; life here has no guarantees, everyday is a struggle to survive. They don't get paid on time, they have to wear the same uniform everyday because they can't afford one for every day of the week, their children get sick and die, or they can't have children, the grandmothers take care of their grandchildren because HIV has wiped out their own children... i could go on and on.
So I am trying to understand this, just as I am sure they are trying to understand me. but i need patience. i hope God grants this to me, or I won't survive!

On a positive note, many people from the village remember me from last year and greet me frequently and welcome me with open arms. When I stopped in at the orphange the toddlers all came running for me (often they are scared by white people) and the "mamas" who work there were cheering, so I look forward to spending some time with them.

I think I need to re-evaluate what I can get accomplished in three weeks. Perhaps my purpose is not to teach the students every detail of a head-to-toe assessment, but encourage them when i see them taking pro-active measures with patients. North Americans like to see immediate results though, and I am no different. but perhaps i am here to plant the seeds, and i will not be able to see the growth.

(I had planned on playing UNO with the HIV patients, but these patients are much sicker than the ones last year. Many of them cannot sit up in bed, so plans change, but the intentions are still there. I will need to get creative)

i am just alida

I have been listening to a song about a woman named esther who goes to africa, falls in love with it, but writes home asking friends and family to pray, help. The lyrics strike a cord as they say
"esther has 2.4 million children, she writes and asks us to pray and help any way we can, because 'i am just esther' "

in many ways i feel like i have 150 million to take care of here in nigeria. i have been spending alot of time on the wards this week, observing how things are run, how treatment is administered, how the care is given. we have absolutely no clue how good we have it in canada, because i NEVER pause to think if the patient can afford the 2x2 gauze or the tylenol, i just give it. many patients here cannot afford pain medicine, antibiotics or feeding tubes. a patient who has had a stroke is agitated and possibly in pain but the family has not bought pain medicine. the guy with tetanus can't swallow, but the family can't afford an nasogastric tube so he gets IV fluids sometimes. i would love to pay for all their medications and needs, but i don't have that much money and that isn't necessarily going to do any good. but it still makes me want to bang my head against the wall. watching people suffer is not easy!
i did break down yesterday though. i was in the OR to see a surgery when a family rushed in to have Dr. Scott check their child. The boy was unconcious and not breathing regularily. Dr. Scott gave him some adrenaline and then had to cut open his arm to get an IV. They boy stabilized a little bit and was taken to the pediatric ward. I went to check on him a few hours later and the boy had died about 15 minutes earlier. I have never seen a dead child, so it was a bit of a shock. I felt empty and hollow and I thought I should be crying my eyes out, but strangely I had few emotions at the time. The father looked like I felt inside. He didn't seem to know what to do. The bill for inserting the IV and all the medications came to almost 6000 naira ($45). This man was dressed in pretty raggedy clothes and had empty pockets. I told him I would pay for the bill that he must promise me that if his other child becomes ill, he must go to the doctor right away.
When I went to bed that night, the tears for Benjamin Asase came, but I know there are millions of more Benjamin's in Africa. How I am supposed to help them all? Am I supposed to help them all? Am I doing anything significant here? I am just Alida...