Our last entry

The Mission Hospital at Ngaoundere has approximately 250 beds, meaning that it houses about the same number of patients as most metropolitan hospitals here in America.  Yet there are only 8 doctors and about 100 healthcare workers, half of which are nurse aides.  It is not one big building like hospitals here, but rather a composite of many smaller buildings spread over a large complex. There is even a tuberculosis ward that consists of 6 patient buildings each filled with 4 to 6 patients.  I think to myself, good at least I can avoid this area.  But in reality they come out of that ward and up to the Emergency Department to receive their daily medications.  So much for that thought.

                                                           

In this hospital, the nurses round on patients like doctors.  They write orders for medications, IV fluids, procedures and lab tests. In some specialty units, a doctor will round on patients daily, but in most other units perhaps once a week. In most cases it is the nurse who decides what the diagnosis is and how to best treat the patient. Now there is a lot of variability in each nurse’s level of training and experience.  Sometimes the diagnosis is incorrect and other times the wrong treatment is given. Tests ordered by the doctor or nurse, must be performed by the nurse or nurse aid. If a spinal tap or ultrasound is needed, the nurse must do it.  If blood work is ordered, the nurse must draw the specimen and take it to the lab.  Doctors complain that the nurses give no care, but the biggest reason for this is that it the nurses are too busy practicing medicine. 

In this country the family does most of the cares for their patient and also gives them their oral medications.  There is no standard of care and each family cares for their loved one as best they can, but often they do not have the knowledge to do it right.  There is no linens provided by the hospital, so if the family does not provide a sheet to lie on the mattress, then the patient will be placed on the bare plastic. The family is responsible for cooking for the patient and for cleaning them up.  Most rooms at the hospital have beds for 4 patients, and many family members stay in the room with them the whole time.  So in a typical ward in any given room there are usually 20 plus people staying in there.  On the hospital complex there are a couple of cooking houses where families prepare food and a water spigot and large rocks for them to wash dishes and do laundry.  Definitely not an American laundry mat!  Having the family provide the care has been the custom in this country for many decades and I don’t see that changing soon. Our mission there is to help them to better function within their own means. And rather than insisting that the nurse give all of the cares, much can be gained just by teaching families what to do and by telling them what is expected. 

There is no health insurance here and before any treatments or medications can be rendered, the family must first pay for it.  It does not matter if the patient is near death from a low blood pressure that can likely be fixed right away with IV fluid bolus’s, no treatment can be given prior to the family paying. Nothing is supplied for free or included in the room charge.  If it is an IV that is needed, they must buy not only the IV fluids, but also the needle and tubing to infuse it with. It is hard to stand by, waiting and wondering if the family will come up with the money.  Sometimes one is just compelled to reach into your own pocket to come up with the few dollars it costs to begin life saving treatment.

This trip although short was very busy and despite the time crunch we were able to accomplish many things.  Steph was able to train over 100 healthcare workers in basic life support, helped organize the store room and somehow managed to get them to type out an entire list of the supplies there, trained ambulance workers to be better prepared for emergencies and was even able to go on an actual ambulance run with the crew. She also spent some time working in the Pediatrics ward (can’t keep her away from the kids) and somehow also found the time to help out with the massive amount of burn care we had to perform every day.

I spent most of my time working with and training nurses in the Burn Unit and ICU.  In our time there we treated patients with burns, strokes, heart attacks, gastrointestinal bleeds, active hepatitis, malaria, tuberculosis and AIDS.  Many of these patients we would be caring for in full body armor at our hospital, but there is no such thing as isolation in this hospital. No negative air flow rooms, no gowns, masks or face shields. Gloves were our only protection.  Culturally medical illness is treated very differently in Cameroon.  My own practice of preparing families for the worst, yet hoping for the best is not in their mind set.  Even though you think it likely that their family member might die in the night, it is taboo to tell them so. Also if a family does not have the money to treat AIDS, then to diagnose the patient with this disease is to sentence the patient to death.  So a husband might die with a diagnosis of pneumonia and even his wife does not know that it was AIDS that killed him and that she likely has it too.  I haven’t checked lately but I think the average deaths from AIDS in this country are reported at around 17%.  That number is likely low due to the appropriate diagnose never being made. 

Much of my visit was planned to evaluate how departments we have helped them re-model or build in the past are functioning and to assess the overall operation of the hospital from the ground level.  It can sometimes be easy for them to prepare administrative reports that make things appear better than they are.  Some things are going well, but many problems continue to exist. Workers are not being paid on time, and sometimes not at all.  There are big disparities in how they are paid, and it has little to do with the job they perform at the hospital and more to do with what tribe they are from. Tribalism, like families delivering most of the care, seems likely that it will go on forever.  This holds them back in so many ways and I am discouraged because how can they progress if they refuse to move forward.

They lack basic equipment like stethoscopes, blood pressure cuffs and thermometers.  Supplies of gloves and dressings are very limited.  X-RAY and ultrasound equipment is in poor shape, much of it very used and too old to find replacement parts. More training is needed for nursing staff, managers and bio-medical technicians. Administration tends to deal with any and all problems by shuffling all workers around within the system and therefore it is hard for any of them to become truly good at any specialty. The needs remain great, and so now the next step is to make on going plans for how to best spend time and money and figure out what supplies will best help them in the future. 

 Plane schedules from the north to get us back to Douala did not work at all with our departure back to the USA, so we had to take a very long, overnight train ride to Yaoundé, then rush to the bus station with all of our luggage crammed into a taxi along with us and then wait for the next bus to take us to Douala.  We paid extra to get on one of the supposed nice buses only to find that the air conditioning stopped functioning as soon as it started moving.  Another 5 hours in sweltering humidity and heat on that bus and then another taxi ride with all of our luggage to get to the hotel.  We had pulled out of the train station at 620 PM the night before and did not arrive at the hotel until after 2 pm the next day, we were wringing wet with sweat and totally exhausted. 

After checking in, we celebrated brushing our teeth with actual running water and showered.  Despite that our feet were still black, so we decided to go soak in the pool awhile.  For sure this hotel looked at least ten times better on the way out than it had on the way in!  This was Saturday night and our plane did not leave until one AM on Tuesday.  We hired a taxi driver recommended by a former missionary and drove to Limbe to see the black beaches. Beaches created by the active volcano known as Mount Cameroon.  Today the mountain is obscured by clouds as it often is, so on the drive, we can’t see the mountain.  The sand was definitely black and a sight to see.  The amount of garbage being washed ashore was not so pleasant, but hey we found lots of sea shells because nobody seemed interested in picking them up there.

The humidity all along the coast is almost unbearable at least for me, but we made a day of it and saw a lot of the country that I had never seen before.  We saw banana plantations and others filled with rubber trees.  They are tapped for rubber much like trees around here are for maple syrup.  Pretty interesting because I never before realized that rubber actually came from trees.  Along the way we also saw sand extractors who took large canoes up the river and filled them with sand, and then brought it back by the boat load to near the highway so that trucks could easily pick it up,  Coming from such an industrialized nation it surprises me how much physical labor is required for such common products.

Without question, to perform this mission, we endured many hardships, totally left our comfort zone, faced miserable conditions, unbearable travel and at times dangerous situations, but for certain we grew stronger in our faith. We hold tight to our children, the dogs, and our families, somehow loving them all even more than you did before.  We are more appreciative of all that we have and are thankful for the talents and opportunities that we have been given.  

The only thing that I can compare it to really is child birth.  You somehow forget all that was so bad about it and are left mostly with what was good.  You remember the smiles of the people you were able to help, the friends you made, and the beauty of this land located in the midst of so much hopelessness.

We have been back at home for a couple of days now and we take pleasure in all the comforts that we have here. I think I am still brushing my teeth like every 2 hours, just because I can.  We have heaters for when we are cold, air conditioning for when we are too hot, fresh water to drink, reliable electricity and internet connections.  If we want to go someplace, we need only walk to our car and drive and can be pretty certain that we will get there. If we are ill we can get the best medical care regardless of our ability to pay for it.  The differences in our nations are pretty much the exact opposite.  They live in the land of too little and we live in the land of too much. 

For sure a journey such as this makes one much more appreciative of all that you have and all that you typically take for granted.  It opens your eyes to see a world that is so much bigger than just us and helps you to see that coming from this land of plenty that there is more that we as individuals and as a nation could be doing to help others.  Whether it be our neighbors that live right next door, or the homeless and hungry right here in our own country or those who are underserved in other parts of the world, we should all try to do something more than just talk about helping out.  By suffering very little, there is much that we can accomplish.  

 Trying the star fruit right off the trees at the botanical gardens in Limbe.

View of the palms at the botanical gardens in Limbe, Cameroon.

 A restaurant along the way in Douala

 Vegetables for sale in the market.

Washing laundry in the river near Garoua.

The end is here

Hello to all,

We are on our travel days again. We had our last couple days in Douala and it has been very hot and humid. Inland the temperatures have been about the same, but the difference is the dry heat inland vs the humidity closer to the Ocean. Still no sun, and it’s hard to take the humidity. It almost takes your breath away. We must have lost several pounds alone by just sweating. Our last day in Douala consisted of some souvenir shopping at the local flower market, which Llonda teased me thinking I was ready to go out on my own as far as bargaining. I was proud of how well I did, but I am still not as good as she is. They all tell her that when she comes back she should change her nationality to Cameroonian because she is so good at it. We made some really good purchases, but there will never be enough money to buy for all of the people we would like to bring things back for and we can never have enough stuff or room to pack it in. In actuality we had plenty of room to pack more, but as most of the stuff is wood, it’s heavy so our bags are all pushing the weight limit once again.

I had to laugh at the end with all of the marriage proposals I received and how many times I heard “But I love you!”. As I tried to explain to them in the little English they could understand that, they don’t even know me, but anyone is looking for a way to get to America. Most people in America don’t understand how wonderful of a Country we have until you spend some time somewhere else, myself included. I can complain about the gas prices, the high electrical bills, and not having my brand of peanut butter in stock. But in the big picture of it all, we all have an opportunity to work no matter what kind of job it may be, a cashier, a cook, to a lawyer or doctor. It’s very hard to imagine all of the people in the US who can get a job, but CHOOSE not to. Where here you have a country where there is virtually no opportunity for them, even if they do go to school. For example one of our interpreters who can speak many languages, is smart and has gone to school and has a certificate for it, and is such a hard worker. Yet, he cannot find a job, and the years and money that he has spent in school do nothing for him. Where in the US you can find a job with no schooling (maybe not a great job, but it IS a job), and with schooling you can find a good paying job. Benefits are unheard of there, and the life expectancy for a male there is 50yrs. Can you imagine having a life expectancy of only 50yrs. It’s sad all the way around and I only wish there was more we could do for them all.

After the flower market, we went back to change and then get something to eat at the Le Glacier Modern. It’s almost like a Dairy Queen. They have burgers, fries and some of the best ice cream I’ve ever had. Our waiter (who we had the other day) helped us get a taxi, and then it was off to the hotel to pack. We had to check out of our room at 7pm, but didn’t want to go the airport too early so sat down at the lounge with all of our luggage and making one final deal with the boys across the street to try to use up the rest of our CFA.

We finally boarded our plane and left at 1am Monday (which was 8pm at home) and rode the long hot smelly ride to Brussels. At Brussels it was rush rush to try to go through security again, and then make our way to the other side of the airport to get checked in. There was hardly enough time to go to the bathroom let alone anything else. Once again, we were nearly the last people to board the flight to Newark NJ. I can hardly wait to get back on American soil. I miss all the familiarities of home. My kids, my bed, my bathroom (mostly being able to actually sit down on a toilet!), my church, and work (yes I miss work even). Basically I miss it all! Most of all I miss being able to have a conversation with someone who I can actually understand

I am grateful for the time I had there, I would very much like to go back someday if the opportunity presents itself, but until then I will continue to pray for my new friends in Cameroon.  

Saying good-bye to N'Gaoundere

Bonjour from Africa!

It has been a long journey and one that is coming fast to an end.  I would like to say that I have learned some french but the truth is it's hard for an old brain like mine to catch on, plus when they are speaking so many languages, how can you focus on just one!  So I have learned a few words from a few different languages, none of which I'm sure I'll remember once I get back home.  But like I've said to everyone here, I'm trying:)  It has been a real eye opening experience and as my new friend Jim tells it: "they are very much living in the old testament here".  He is ABSOLUTELY right.  I will be honest is saying that I have not read the bible front to back, but I do know enough to know that he is right.  I wish that in America we took our religion our seriously and faithfully as they do here.  I cannot imagine going to Chapel everyday before work, but at this moment in life, I believe that it would help us ALL.  They are very close and would do anything for anyone in need no matter what the cost to them, and do it all so unselfishly.  We as American's can really learn a lot from them in that matter!

We left N'Gaoundere on Friday evening.  It was rush rush all day, trying to get to the market one last time to pick up any gifts we may see, and get to the hospital for a last round of good-byes and one final meeting which was suppose to start at 1pm and didn't actually start until 2pm.  Again, living on African time!  We had hoped to go get something to eat before leaving so raced to the house to get cleaned up and some money and before we knew it we had a house FULL of guests.  How can you kick your friends out to go eat when they have cared so much to come and say good-bye.  So I cooked all the left over macaroni noodles to eat with butter, Wesko (our German Dr in training friend) and Catherine (the German gal) cut up some fruit, and I cooked the last package of biscuits we had.  Really all the rest of the food in the house!  It needed to go anyways, but as Llonda said, I am totally crazy for cooking as she would have said lets go out and I'll pay!  But we had a good time and it was all worth it to spend our last time left with them.  We cleaned up and literally threw everything into bags and went on our way in the hospital truck with Samuel driving, Adda and Danielle, Eric, Ousman and both of us.  We definitely fit in as African's riding crunched in together:)  We got to the train station and said our good-byes and headed out to the train.  We had a sleeper car, which was hard to get but worth it in the end.  As we stood outside not wanting to get in yet, Jean Baptiste (the Chief supervisor) and Dr Danki (Chief medical Dr and surgeon) met us by the train to say good-byes.  It was very special and amazingly nice that they came to see us off! 

The train was an adventure in the least.  It stopped many times along the way, and rocked so hard I had to laugh thinking that it was surely our weight loss plan of our belly's jiggling so much:)  We left the station at promptly 6:20pm and arrived in Yaounde (the capital) at 7am.  All in all it wasn't that bad, but neither of us slept much, a half hour here or 15 min there.  It was hot, sticky and by morning we both smelled really bad and were in much need of sleep.  We headed straight from the train station to the bus station.  It was like from "Bad to Worse!".  At the bus station JB (who just got married) met us there to say good-bye and Eric, Llonda and I aboarded the bus for the 4hr bus ride to Douala.  The bus was hot and sticky and the air didn't work and for some reason we kept having water leak by our feet which got our bags all wet.  We had hoped to go straight to Kribi, but with our luggage thought it would be best to go to Douala first then a day trip if time allowed.  We go to the bus station in early afternoon around 1pm and loaded our bags and three of us in ONE car!!  The pictures don't do it justice and it is too long to upload, so while I have connection I will just write.  Because we hadn't planned to stay in Douala we didn't have reservations anywhere so where taken to a roach motel where Llonda, the driver and Eric went to check it out, while I stayed outside with the car and our luggage and was greeted by a man wearing a ratted old trench coat wide open and ONLY the trench coat.  Welcome back to Douala! I thought to myself.  Llonda and the others quickly came back and Llonda said we would head straight to the IBIS to try to get a room. 

We made it to the IBIS and all was good.  We got a room, checked in showered and felt slightly better only still hungry and tired.  We hired a driver and went to find some food, then came back and went swimming.  It was Eric's first time swimming and I enjoyed very much teaching him some basic swimming skills and he was ecstatic about it.  We got back to the room, sent off a quick email and were in bed by 8pm.  We awoke early the next morning to get ready for a day long trip to Limbe, a town west of here.  There we went to the Atlantic Ocean where the sand in fine and BLACK.  It is black due to the volcano eruptions.  Mount Cameroon is still an active Volcano here, and we went up the mountain a little ways to see all it had to offer.  The last time it erupted was in 1999.  They are still selling rocks from when the volcano last erupted.  We went to the Botanical Garden which is full of beautiful age old trees of all kinds from around the world, which one was over 900 years old.  It was started in 1892 by a German man who wanted to perserve the land and the wildlife.  The pictures are wonderful and I only wish I could share some.  When we get home, we will post more.  We headed back to Douala and found a nice american burger place to eat, which was the first real full meal I had probably eaten so far.  Said good-bye to Eric who left on the bus back to Yaounde and then back to the hotel to swim a little and relax.

Heading home tomorrow, and I am very much looking forward to coming home, even though a part of me will miss this place.

In Llonda's Eyes

No internet for most of Sunday, but still It is hard to complain because it is the first time I have had it available here on the mission station.  Even when it is working well, it is about the equivalent of having one bar of service on your smart phone.  We are thankful for it when it does work, and it helps us to feel less isolated from home. 

The people we work with at the hospital are Christian and that is a requirement to be employed there. Each day of work starts with chapel.  Before going to your department to get report from the previous shift, you first go there. Some days it is packed in the chapel and on others only like 10% of employees show up.  It is a common way to start the day here.    Praying and singing together is not a bad way to start the day.  Some days we go, on others we don’t.

 The Muslim population is very high here in northern Cameroon.  Most of them, at least as far as I know belong to the Fulani tribe and speak Fulfulde.   All of the nurses speak French, but probably it is the second most common language spoken here.  Each day on rounds at the hospital, speaking with patients, 8-10 languages are spoken.  To be effective we must use interpreters.  Most everyone here is multi-lingual and our interpreters speak 10 languages, the only thing really different about them, is that they can also speak English.  A real problem with the multiple languages spoken is that for us, instead of just being wrapped up in and learning French we learn a few words from many languages.  How to say hello and how are you, how bad does it hurt…that is about it.

Even though I have met many Muslims and have been somewhat immersed in their culture, I do not fully understand their religion.  What I do know is that they are very dedicated to worship & prayer.  There are many mosques located everywhere and they have calls to prayer at least 5 times a day starting at 430 am.  These calls are played over loud speakers at all hours of the day and night,  and if one did not know better, you might think that at times it is a record playing that is stuck.  From those who can understand what is being said, they assure us that it is live and not a recording.  There is also a call to prayer at 1 pm every day and the whole town literally shuts down.  All the shops are closed, and there is no way to buy anything.  The mosques are so full that you see people all lined up in the court yards outside on their prayer mats praying.  If they have a family member in the hospital they do not leave there, but one can see them laying out their mats & praying wherever they are.  They use prayer beads and pray in a ritualistic style.  I do not know what it truly is that motivates them, be it fear or just love, but one cannot help but be astounded by their devotion.

Polygamous marriage is common among the Fulani and many men have at least 4 or more wives.  They typically have 20 children or more.  Their families of wives, from what I can tell all live in an enclosed compound, each with their own sleeping house, yet many common areas.  I’m not sure where the children sleep, but for sure the man sleeps where he chooses on what night.   The wife’s duty is to cook, clean, raise the children, pray and serve their man.  There is more to it than that, but that is more than enough for this story.  For certain not many of us American women could live this way, nor would we tolerate such a setting.

Work at the hospital is very challenging for us and we are expected to be experts on everything.  Of course we aren’t, but both of us have a lot more training than many working here.  Here it is reality that one must mostly learn from.  I guess the school of hard knocks.

Steph has been training workers in basic life support (CPR), and trying to get the store room full of goods sent from Global Health Missions & SMDC under control.  That alone is a job that one could spend a full year at and I do not even have the patience to attempt it. Her organizational skills go far there, and she is able to get the guys working there to at least do something,.  Global Health now sends containers twice a year to this hospital system, but there is a real tendency for them to hoard things as they never know when the next boat will arrive.  Those who run the store room do not work at the bedside and many valuable things lie there rotting. Many things are way past the expiration date, yet are very useful for patients in the hospital. Just knowing what is there will be a huge help to the nurse Majors in each department.

Tomorrow Steph will also begin special training for the ambulance workers.  The ambulance is only called when there is no other choice as it must be paid for out of pocket.  Many arrive at the Emergency department in a taxi as that is much less expensive.  So all I can really say about that is that when they are called, they are needed in a most desperate way, and the workers arrive on a bad scene with very little training or practice.  She has brought safety vests and other emergency equipment donated by the ambulance service she works for and it will all go far in helping them to do a better job at transporting patients.

I have mostly concentrated my efforts in the Burn/ICU department that I traveled here and helped them open back in 2006.  It is very interesting to see the transformation into an ICU specific for this area, but thus far certainly not what I envisioned it would become.  The burns they see are unimaginable and I wish I had refreshed my advanced burn life support and went to work some shifts in the burn unit before coming here.  Everyone cooks on open fires and use kerosene lanterns for light, so yes there are many burns.

We continue to care for the 2 small girls burned by tipping over the teapot.  They are our special cases.  Because of the wedding we did not work the weekend and so on Monday, we had to change their initial bandages.  The 4 year old with burns to legs, feet & bottom had gotten urine all over the dressings.   We wanted to insert a catheter to keep the burns from getting infected; Of course they have nothing of that size available even for sale at the hospital.  Luckily Steph finds one that is small enough in a box in the store room.  She brings it to the ICU when it is time for the dressing changes. We decide to put the catheter in first. Because the catheter is old and for sure not that sterile, we clean the area with lots of betadine first.  

We had many medications donated to us for the trip, and we gave this little girl a small dose of the narcotics before we begin.  We started to pull the dressings away and she is so brave.  The dressings are very dry and for sure they debride the wound as they come off. She barely cries and our interpreter says that he is surprised because even at her young age, she prays for strength for herself and for us.  Now any one of us would have been praying that we would just survive this and not really even think to pray for the nurse…  Another lesson learned, and this time from a 4 year old.  The skin on her legs, feet and perineum are badly burned.  What does not peel off with the dressings, must be cut away, with a tweezers and scissors.  Both of us are near tears, but again we do the best we can. With the next dressing changes, there will be little if any skin left.  For sure once the skin is peeled away we are all of the same color underneath.  The parents of these 2 little girls are Fulani and Muslim’s.  They are nothing but respectful of us and thankful to us.  They think that their girls are getting the best treatment because we are here. I don’t think that we know more but for sure we are more persistent at doing what we are capable of for them.

 There are German medical students at the hospital, they are watching us & learning.  We are starting to work with them & hope they will continue with the burn care once we go.

The head nurse of the ICU yells at us because we use too much ointment and Silvadene and too many dressings to treat the wound. “You will use it all up for this one patient and we do not have more for the next patient. We do not know when more will come!”  In our country we really have no concept of what she is saying as we slather the dressings with special ointments and use as many dressings as we see fit.  Who cares if one too many? Seeing some of the amazing burn recoveries here, I start to think that perhaps less is more.    I need to try harder to wrap myself around this concept.  God knows I want the best of everything, ask for even more and accept nothing less.

We all say that we want to help, yet when it is time to dig into our pockets there is no money there.  Most of us are not that good at putting our money where our mouth is.  Seeing what we see here, I am certain that we can do better.  Steph and I, have spent tons of money, burned up our vacation time and traveled over 10,000 miles to get here & I think to myself, perhaps we should have just sent a crate of medicines,  Pain killers and burn ointments.  Now this sounds good in theory, but I know that without managing to where things will go and teaching and training, that none of it will ever get to the very people we have set out to help!

Corruption is a way of life here, not just among the common people, but also the police, Army, Government etc..  Anyone can see how things will benefit themselves or their own family, but there is really no one looking out for the good of all.  Much of what is sent here, just as it is to other 3^rd world countries somehow just gets lost in the bureaucracy.

We're still working:)

March 15^th, 2012

It is early this morning, and the Muslims are singing over the loud speaker like a broken record. Haven't had a whole lot going on the last couple of days. Wanted to update you all on the little girls with the burns, as many of you have asked and care so much, Thank you for that! Everyday we change their dressings, and everyday gets a little bit better. Llonda gives them a pain pill quartered up so it's not too bad. A special thank you to those who were able to send some with us, they have been a blessing!  The other day the 4yr old says “I'm flying”, while we were changing her dressings. At that moment we knew the pill was working:) We had brought with some little toys for the kids over here, and had given them each one and they both held onto them like it was the greatest gift they have ever gotten. Llonda has spoken with the German Dr in training (Wesko, pronounced Vesko), to keep up with the dressing changes after we leave to ensure that they get done. Otherwise who knows if they will get done or not, and they need to be done daily. He assured us yesterday that he will keep us posted by email, or facebook on how they are doing.

Llonda has been working on another burn patient, an adult male who was using kerosine and burned his hand all the way up his arm. He had went to the government hospital first then 3 days later came here. She also gives him a pain pill before dressing changes, but he is definitely not as strong as our two little girls, and yesterday when I popped in to see if she needed help, he was pulling the skin up himself while she cut it away.

   

I finished up in the storeroom and have been teaching CPR everyday.  They seem to enjoy it, and it seems a little strange to me training Dr's and Nurses in such a basic skill, but they are eager to learn it, and ask many questions (all that I've been able to answer so far knock on wood:).  I will finish up with my last two classes today, as tomorrow we leave and have to pack. 

I have been working with Ambulance crew, which right now consists of the driver, Samuel who they call all the time day or night, and two nurses from the ER.  We spent some time looking over the ambulance, going through their supplies, and I took them to the storeroom to replenish their stock and thanks to my boss Sue at home who let me take some supplies, they have a good start but need so much more!  Here we are below with a box full of goodies.  Samuel loved his vest so much he wore it all day long.  He felt so special and proud and loved bragging to everyone about it.

Yesterday we went to the hospital early to do rounds and change the burn dressings and then had to get our train tickets and then go see some sights.  Llonda and Eric went to go get the tickets, while I packed up the cooler of snacks for all of us, then Samuel came to pick us up.  There were no sleeper cars left on the train, so Llonda decided not to get the tickets.  So far nothing has been easy for us.  Samuel has a contact at the church that he thought could help us out, which he did.  It took a few hours to get it taken care of, but we had to pay for the tickets right away up front which ran us out of money (AGAIN) so had to borrow from Wesko.   We had to stop back at the hospital for Samuel to take care of something and while we were there, asked Wesko to come with us.  He was happy for the offer and came right over.  When Samuel came back he said there was an emergency and he needed to take a patient over to the government hospital by ambulance for an X-ray.  Not sure if I had said before but the hospital here their X-ray machine is currently broken.  I asked Samuel if I could go with to see how it worked and he was happy for the company.  The patient was man who lives out in the bush and was in a motor bike accident more than two weeks ago.  He stayed back at home and tried the witch doctor healing then finally decided it wasn't working and came in by bus.  He didn't want any help, so got in and out of the ambulance by himself.  We waited for the X-ray and when they put it up, I was shocked at how he didn't complain of any pain.  His wrist was fractured as well as his femur (right in half). 

We dropped him off at the hospital again, went back to pick up Llonda and Wesko, and we took off.  We were going to a water fall about an hour out of town.  The road was not good.  I was sitting in the back seat in the middle of Llonda and Wesko.  At one point I told him I was a ping pong ball and they were the paddles.  Every once in a while I'd let out a "Ping", when it got really bad.  Samuel did a great job driving, and at times hitting 65mph on this what seemed like a 4-wheeler trail.  It reminded Llonda and I very much of the time we were in Sedona, AZ and rented jeeps to drive out in the desert.  There you pay money to ride on roads/trails like that, here it is everyday living.  We made our way up there and had a picnic in a buckaroo, then walked the trail down.  One person had to stay with the car the whole time so it wouldn't get broken into.  I hadn't seen a sole for miles, but wasn't going to take a chance either.  They had just burned the grass so it was nice and clear.  I asked who burns it, and they told me either the village people or hunters, so they can chase the animals out.  They hunt porcupine and hedgehog mostly around here.  

The falls are called Chutes de Tello, and they were amazing!  Truly one of God's greatest natural wonders.  I could have stayed there all day.

We were lucky enough to be able to see it from every view.  Behind the falls, the bottom of the falls and the top of the falls. To see the top we had to cross a bridge that neither Llonda nor Wekso liked much at all.

It was a great day, and I'm thankful to have been able to see such a beautiful sight.  So off now to get ready for our last day at work here.

Update on our little girls with the burns

Just a quick update while I can't sleep again.  It's 12:30am here and the dogs are going crazy outside along with the sounds of many other things.  I spoke earlier of two little girls coming with bad burns.  Everyday they have to have their old bandages ripped off, yes literally ripped off of them and we have to cut off their dead skin then scrub the burned area and re-bandage them.  I did not help Llonda with this yesterday, but she waited until after I got done teaching my class so I could help.  We cathed her just before and gave her a bon bon then started what felt like torcher to her.  She cried and cried and said a prayer over and over with her mom "give me the strength to survive and make it through this."  It took every ounce in me to not cry and at one point I may have even shed a tear, and then the mother started praying louder and my translator told me she was now praying for us to give us strength.  She must have seen in my face that to hear her pain was unbearable to me.  It took what felt like hours and before we knew we had many hospital staff coming to watch us.  The German Dr in training came to our place later that night to thank us for allowing him to watch us, as he had learned more in that two hours of us taking care of those two little girls than he had in a week of working in the pediatric unit.  As bad as I had felt about it, I was glad that someone can learn something from it.  It took nearly and hour and half to do the older girl, she has mostly 2nd and 3rd degree burns, and only about a half hour on the 2yr old.  She is mostly burned on the one leg, and even though it is bad, it is not as bad as the other.  

The mother came up to Llonda while we were getting ready to leave to thank her, while we were sure that the two little girls will not like us anymore.  Tonight I prayed for strength all the way around.  

Here is a picture, which doesn't even come close to how much pain she is in.

Wedding Day!

March 12^th, 2012

It is early am and I had a hard time sleeping again last night. There are constant noises going on. The cockroaches sing, the Muslims chant and sing their prayers, and all the other bugs making noises. I swear people never sleep around here. No wonder why I feel exhausted all the time.

Have you ever heard of the expression your running on African Time. This is something that I have a very hard time with, but almost all of my family would fit in well with. They tell you that church starts at 7:30am. Which actually means 8 or 8:30am. Everything runs late. I can't stand it. So Saturday was the wedding, which is an all day affair here. The Council was at 9am. The phone rang at 6am that someone was going to drop off our dresses. I hung up and literally there was a knock at the door. They asked for a “document of just married”, I had no idea what they were talking about nor did Llonda so we took the dresses and they left. A few minutes later we received another call that they wanted us to print “JUST MARRIED” on paper to put on the car. I started to print it then let Llonda finish as I went with Eric to go watch him play football. (our soccer) He invited me to play and I politely declined thinking I would have probably been trampled on as most everyone here is in good shape. After all, they walk almost everywhere. Eric and I got back at almost 8am, so it was rush rush to get ready and be out the door and to the Council at 9am. We left at 8:55 thinking we would be late, and showed up and where the first ones there. Everyone else is running on African time. A few more trickled in, then we got the call that we were at the wrong place. So we piled into the couple of cars there and went up the street to the Hotel DEVILLE. It was a nice government building and I guess that one has to have a council ceremony before having the church wedding as it is the only legal wedding. Each the bride and groom have two witnesses. Llonda was one of Adda's, so she sat up front with them. Once the ceremony finally got started around 10am (again we are running on African time) it was over in about half hour. We went outside for pictures, then headed home for a break before the church wedding.

The wedding was at the Catholic church here in N'Gaoundere, and anyone who has been to a Catholic wedding knows they are long, and almost every wedding its always hot in there. The wedding started at 3pm and the priest Friday night at the rehearsal said we must not be late as there was mass Saturday night. So we made sure to be there promptly at 3pm as our prior engagement with the priest was not a good one, and of course we were one of the first ones there again. People trickled in up to an hour later. We stood there in the heat with our gowns on and had wished we left later. I begin to hate this “African time” more and more. The wedding starts at 4pm, and drags on and on. The priest went on for an hour about some speech who knows what he was saying as it was all in French which we couldn't understand. Between the heat and the smell of body odor I started to feel nauseous. I made it another half hour and when it was time for the offering, we took our chance and bolted outside for some much needed fresh air. We stood outside for awhile, with others as well, then went back inside and sat in the very back so we had an easy escape if needed. It was after 6pm, and finally over. We congratulated the bride and groom, took more pictures, then back to home to change clothes for the reception.

The reception started at 8pm at the hotel du lac, which is far away from town. We purposely didn't leave the house until almost 9pm not wanting to be the first to arrive. We were going to be officially running on “African time”. We arrived there to find that alas, we were again one of the first ones there. “Are you kidding me!”, I thought to myself. So we stood outside again, and it finally started around 10pm. We didn't eat dinner until 12:30am. We couldn't make it any longer and were the first to leave at 1:30am and they hadn't even cut the cake yet! Apparently weddings around here are nearly a 24hr ordeal. We found out the next day that most started to leave at 4am. Even getting home at 2am, we slept most of the day away.

Sunday, after getting up at around 12 -12:30pm, we tried to visit the neighbor man who moved to Cameroon with his family in 1960 as missionaries, but wasn't home, and I still was not feeling well from I think being a little dehydrated and overheated, so I laid down for a nap. We finally were able to meet up with Mr Nelson and he showed us a very nice presentation of N'Gaoundere from back in the 60's and how it has formed into what it is today.

After visiting with him, we went into the market to buy some groceries, as we had planned to make cookies and homemade pizza for dinner. We came back and were not home long before we had a visit from Adda, JB and Danielle. It was a short visit, but we had brought some medical supplies for JB for his schooling and had some toys for Danielle. We gave them their wedding present and then they had to leave. We cooked pizza for Eric and then had some more surprise guests show up. The Dr in training from Germany and another gal from Germany who is on a year long expedition traveling every week to a different town and hospital doing some sports medicine training. They were more than thrilled to have pizza and cookies. As was Eric. We stayed up late again even though we knew we would have a long day at the hospital.

Good night all!

 Llonda and I just before the Dowry.

At the Dowry going through the gifts.

 The Mayor with JB and Adda and each of their witnesses.

Llonda and Eric before the Council Ceremony