Saturday, March 29, 2008

Answered Prayer

My morning started bright and early, for me that is. I asked God to give Jim and I wisdom and the ability we needed to restore water to our compound. We headed to the tool shed to gather items we would need. Then it was off to the watershed. I had turned all the systems off last night, since nothing was working. This morning upon arrival at the watershed. I turned on all the switches for the solar. As Jim and I were reviewing Duane's notes, we heard music to our ears. The solar pumps were working!

It was time to face this beast. The Lister generator. Takes two to start, you have to hand crank it. Jim and I worked in unison and praise God it started on our first attempt.

The next step was checking into the electrical panel. Can you believe it, Duane had such detailed instructions for me. Jim and I checked and double checked. We replaced a capacitor... sounds more difficult than it was. The big conclusion.... the pump needs replacing.

However, we could not find the replacement pump. I placed a phone call to the team on the south bank. We have water. (The sun isn't the best today, but we will be able to shower and drink!)

They will begin the search for a pump. Jim and I may still get to replace it.

Thanks for your prayers!

Urgent Prayer Request

One thing we have always been very thankful for is the clean, good source of water that is available to us. Yesterday I was doing some routine things in the water shed: start the generator, see that it works; power up the other equipment there while the generator is running, etc. I looked at the water tanks and all though they were not full, they were almost full. It seemed to be a right amount for the time of day.

Tonight, I returned home after being in the office all afternoon. I ran the water at my kitchen sink to fill a water bottle. Only a small trickle came out. I dropped what I was doing and went to the watershed. The tanks were just about empty. I checked things out, started the generator (my adrenaline must have been pumping through my veins, I normally can't start get it to start) and tried to get our pump to work. The solar pumps were saying the tanks were full.

I called Max and Barney (on the south bank) and sought advice. I asked if they had the phone number for Duane in America. They didn't but, it was still early enough that if I called our home office, I should be able to get our administrator's assistant AMY and she would have them. I did and she was there and I had the numbers within minutes. I had to wait a bit before I thought Duane would be home. I called and he came to our rescue. A few minutes on the phone and two wonderful emails.... a lot of prayer tonight... and tomorrow morning Jim (here for two more weeks) and I will attempt to solve the water problem.

I praise God HE is in control. The village has water if we can't get it to work. Megan (Jim's daughter) was a bit concerned about that. Thanks to Duane for answering my call.

Stay tuned for more details as they happen tomorrow.

Thursday, March 20, 2008

Welcoming the newbies

Friday, I went to Banjul to meet Stacie and her family. I had met Stacie a few times at ABWE in Harrisburg. She is a pediatrician in the Lancaster area. The family was eager to come to The Gambia. Usually we like to ease people into life in Ndunug Kebbeh. BUT due to ferry construction, Stacie's family was thrown in feet first. We crossed them as foot passengers. Two of our employees from NK came out to help with the baggage. They had driven a vehicle to Barra. It allowed everyone a ride to NK, except me. I had the joy of a bush taxi. I don't mind the bush taxi. It is usually just a hot experience. Monday, I had a new experience as a fellow passenger got travel sick. Yes, and I was a bit close to her. I chose to get off a mile before my stop. It was a little too nasty in the van.

Tuesday, I deserted our visitors and headed to literacy to do some work on their electrical problem. Praise God changing the inverter worked! I had some interesting interruptions... two trips to Barra and a termite mess to deal with. Joanne's employees actually cleaned up the termite stuff for me. But I still had to stick my hand into the cabinet, it was a bit gross.

I have a friend I can email for suggestions on electrical problems, a provision from God. Pray for our prefielders.... we have a family on prefield (Van Horns) and Chris is more than capable to do this kind of work. We also have a family, the Byrums, on prefield, when they arrive in The Gambia, Dan will be our hospital administrator. He can do lots of the stuff I am doing now. : )
Amanda is raising support and will be working in the area of community development.
Sarah is raising her support and will join me in the clinic. She is a RN in Michigan.

Mass of Humanity

Friday was one of those days. I know you have had them too. This is what it looked like here.

I awoke to a casual Friday at the clinic. The only rush was that Teresa and I wanted to travel to Barra with the ambulance. We were headed to Banjul to meet our guests. A doctor and her family had arrived the night before and I was headed over to help them get supplies for a month and to travel back with them on Monday. All month we have heard that the ferry terminal was going to have some work done on the ramps. We wouldn't be able to use a vehicle. So we hitched a ride in our ambulance. We had a full vehicle, two patients, their mommies, one daddy and five staff, the driver, Teresa and I. No, we don't own a bus of an ambulance, it just felt like it.

I have crossed on the ferry by foot several times. You get packed into a waiting area, tuck your arms in and when the door opens, just move your feet. The mass of humanity will guide your steps. I made it safely onto the ferry and managed to find a seat. The man next to me wanted to talk. He complimented my Gambian dress, asked where I was from, how long I had been here, where was my husband, etc. All typical questions. When I replied I had no husband, he did what most do... he offered himself. I refused, nicely. He told me I wasn't getting a true Gambian experience nor did I know anything about Gambian culture because I did not have a Gambian husband. I gave my typical response (after five years I have gotten pretty good at this), I told him I was waiting on God. we debated that he was God's choice for me. I was confident he wasn't. After several other borderline rude comments, I told him I wasn't talking to him any more. It didn't phase him, so I left. Just an average day.

They were working on the ferry ramp in Banjul. When we were ready to dock, I noticed that we had passed the ferry dock and were docking at the Navy Pier (not as nice as Chicago's, just a cement jetty). We had to climb up a narrow stairway, to the top of the ferry's engine house, and then down a very narrow gang plank to the pier. Now, close your eyes and picture hundreds of people trying to do this at the same time. Survival guide, tuck your elbows, move your feet, push toward the gang plank so YOU don't end up having to jump three feet down onto the pier in a wrap around long skirt. Praise God, Teresa and I both made it. I feel like I should have a free T-Shirt. "I survived exiting the ferry in Banjul while the dock was under repairs!"

Picture me as one of the mass ahead of this vehicle, which was the one plus, we didn't have to compete with a vehicle for a place to walk. I had my camera with me, but decided it wasn't safe to get it out.

Teresa and I walked up to a Lebanese eating establishment and ordered lunch as we waited for Max, our team mate on the south bank, to pick us up in our van. He then took us to the "money changer" where we discovered once again the dollar value had dropped. OUCH! From there we went to the travel agent for airline tickets. Praise God we were able to get an NGO discount (we don't have to pay tax, a savings of $240) and cheaper seats for booking early. Why am I booking an airline ticket... well, I have been asked by our field to represent The Gambia at Medical Missions Interface at ABWE this summer (recruiting for .. a doctor, or at least some short term help) and my niece is getting married! So, I thought I would take my vacation to attend her wedding. May be I will see YOU this summer.

Thursday, March 13, 2008

Today was a great day! The temperature was moderate (only 94 in my house!) and there was a light breeze all day. I ran around a lot. Today was immunization day for the children of our village. The ladies all come in very nice clothes and chat as they wait in line. It makes for a loud, colorful morning. Some days the ladies from our village get a little pushy, but today, they were all getting along well.
I started our yard workers on some fun jobs. : ) They knocked termites off fence posts in preparation for creosote. The application of that will occur Friday, as I will be going to Banjul and would prefer to be gone for the worst of the smell. Then they began scrapping my duplex. It is past tiem for our buildings to be whitewashed. They decided their boss's home should be the first. I was glad it wasn't a really hot day. Their
work looked a little hot to me. They were happy with the job, especially after I found some protective eye wear and a face mask. I did tell them they looked UGLY. I also promised to print them each a copy of their photos. We have 13 buildings that need to be done. It could be a very time consuming job.
The shades are complimentary from my eye Dr at Wal-Mart. The guys thought they were a bit strange, they have no bows. But they work. The masks are compliment of the hospital. It comes in handy to have that near by. : )
A visitor arrived today. A Dr. and her family have come for a month. I will be heading into Banjul to help them prepare for their trip to Ndungu Kebbeh. In other words, I get to help her buy supplies for a month. It is a bit of an overwhelming tasks for those of you who live close enough to a store to just run out and get it.
The highlight of my day was at 5 pm. I started the teaching time with the children at our library. It was a fun time and I am looking forward to resuming a regular schedule of weekly clubs.
Have a great weekend.

Monday, March 10, 2008

Job Titles and Job Stress

Friday was another rather busy day in the clinic. As usual, God gave me the strength to get through and the wisdom. Some days I wonder what He is doing with a Pediatric Nurse Practitioner as the Medical Director of a rural health clinic in Africa. I wore a lot of different hats. My sister has threatened to make a SHINGLE to hang, but comments that the jobs are too many.

I was a gynecologist, cardiologist, pediatric nurse practitioner, endocrinologist, urologist, lab technician, home health nurse... just to name a few. One of the biggest stresses from the day involved a diabetic patient of ours. He has been pretty sick for a few weeks, I transferred him to the hospital in Banjul. When they discharged him, they told him to come see me and sent him home with a vial of insulin. Thanks a lot. Friday was the day I had to start him on insulin injections. The oral medications just weren't being effective. How to explain to O J that he has to have a shot twice a day for the rest of his life? If he stops the medicine he will get worse again, but with it he could live a long time. Gambians are good at taking medicine until they feel better and then stopping it. Or taking it until the current bag of medicine, or in this case vial of medicine is gone. A refill before the medicine supply is gone is rare. I know, I try to stress it with my chronic patients all the time, but still they come after the meds have been finished for several days to weeks. It is a rare find to have some one return when there is still medicine at home.

Back to OJ, I spent time with him in the clinic discussing insulin and what it was going to do. I checked his blood sugar, we discussed his diet and then it was time for the injection. He went home when his questions were answered. I was on pins and needles, I told him I would be checking in on him in a few hours and stressing the signs of too low a blood sugar. I went to his compound twice that day. Each day since I have been morning and evening as I check his diet blood sugars and give his next injection. I told him it was important for him to learn how to give the injections. His reply was NO, I was the Dr. Ha ha. I asked him what would he do if I went on a trip... he wanted me to have one of my clinic employees do it. I told him no, he and his wife would have to learn. I asked what would you do if I died. he was shocked at that one. What here? In the Gambia? I said yes, God could decide to take me home. He didn't like that option.
Today (Monday) his daughter gave both injections. I am feeling a bit of a time crunch as I am suppose to go to Banjul on Friday to meet with a Dr and her family. They are coming to help out for almost a month. (yeah! and are considering full time service in The Gambia... pray with me!)

I can prepare the injections, but the family will need to know how to give them and what to do if his sugar goes to low. I will have back up available if he gets sick.

I broke up the day, Friday, with a mid afternoon trip to see an employee's son for a hernia referral. It was a hot day, but the car had air conditioning. Too bad I forgot about Friday prayer time (the men go to the mosque and my employee is male.) So as I arrived at prayer time, I sent him off and visited with the wife and family. It had been five years since my last visit to their home. It is a bit of a drive and the road is horrible. Teresa was my driver and we took along a young gal from NK whose family lives in the same village. So after my time at my employees home (and the imam had a lot to talk about) we had to go and greet her family. What is involved in greeting... I know it doesn't sound bad. I had to visit in the home of each of the elderly family members, her uncle, her mother and then we walked to her grandmother's home to greet her. We were offered lunch at each stop. NA was hungry and ate at her grandmother's. I was a bit worried about Gambian food (lots of oil) and a drive back home. My intestines are finally handling things but I didn't want to stress it, so I gracefully declined, promising another time.

Friday nights are a time of bonding for the SPTs (see previous blogs), dinner - pizza, and a movie. After my long day of clinic work and home visits I was grateful to sit back and relax. Joanne shared about her day... her job titles are also varied. One of her surprising ministries has come in the area of counseling. (You can check out her recent blog at You just never know what God may ask you to do. Good thing He will also give you the strength to DO IT! That isn't to say you will never have growing pains or failures. Joanne offered to give me private sessions on her couch instead of her office's empty chair. Nice friend!

Saturday the job hats continued. I made home visits, went to the market for the first time in months and worked on clinic finances. It was another long day. I need to teach this family how to give injections so I can sleep in. A morning person I am not!

Today I made home visits, did compound work (maintenance stuff) and continuing education. But the highlights were.... kids singing to me and five women came for a visit and we had attaya (hot green tea that has oodles of caffeine and served with lots of sugar) and Lae (hot sweetened milk).

It is Common Wealth day in the United Kingdom. Here in the Gambia it is celebrated in schools. the children dress up in the clothing style of their particular tribal group.. including hairstyles. They each bring food items in to share. Then they go around the neighborhood as a group and sing for donations to add to their party.

Wednesday, March 5, 2008

Attending a Medical Seminar in The Gambia

As Medical Director for the Ndungu Kebbeh Health Centre, I work with the Department of Health in The Gambia. This past weekend my division held a training seminar on Intermittent Preventive Therapy (Malaria Prophylaxis in Pregnancy). I decided I should attend and learn about the new medication The Gambia will be using to combat Malaria. The seminar was scheduled for Friday, Saturday and Sunday. I was not thrilled about going on Sunday.

I discussed this with my fellow missionaries and then advised my Gambian staff that I would be going to the meeting along with one of them. I told Alhajie I would pick him up on the way. The course was to start at 9 am. I have been in the country long enough to know that wouldn't happen. I left here just after 9. The meeting was a half hour away. We were one of the first to arrive. I think that it started a bit after 10 am with opening remarks and an overview. One of the best opening remarks... we would be paid for attending the workshop (D300 a day = $15). At almost 11 am, we broke for breakfast. We were served a sandwich similar to tuna fish. Fish, mayonnaise, onions, and boiled potatoes. It was very good. they served warm, sweetened milk tea. I could have done without the tea, but everyone wanted to make sure the tubaab (white person) didn't go without. Class was called back together a little after 12 (yes, notice it was along breakfast break). We had an interesting lecture on the reasons for focused care. At 1:40 pm we broke for prayer and lunch. I wanted to get a picture of the prayer time at the mosque but I didn't. When lunch was ready I was called into the office lounge to join the program planners in sharing their meal bowl. It was my favorite Gambian dish. Rice, with a sauce made with palm oil, white fish, sweet potato, cabbage, bitter tomato, eggplant, hot pepper. It was a bit intimidating to eat with the planners but again great care was taken to make sure the tubaab was treated well. After lunch we were given a soda. The meetings started back up around three fifteen. An hour later, the effects of lunch kicked in and our presenter instructed us to stand. He then told us we had to repeat what he did and said. He broke into a song chant with motions. It was funny to watch us all (I didn't know the words but tried to be a part of the group) follow his leading. Another Kodak moment missed. It was his way of getting us to stretch. he then went on to say if we didn't want to come Sunday... some people actually voiced their objection to the plan, which was why he had this statement prepared.... we would have to come early the next morning... 8 am. I groaned. Mornings and I don't mix. At 5 pm, he finished for the day. I had a few patients to look in on and then a bit of shopping to do in the nearby town. I made it home by 6:30 pm to find a patient of mine had returned from the hospital in Banjul. I made a house visit to see his medications and make plans for him to see me Monday.
By Friday evening I was ready for bed!

I had asked my employee what time he wanted me to meet him in the morning. I figured he would know better what the guy meant when he said be there at 8. I was shocked that Alhajie wanted to be there at 8. So, I made plans to meet him on the way. Saturday was to be the monthly Clean Up The Gambia day. You can't drive any where from 9 am - 1 pm. So, it was probably good we went early. I later found out they cancelled it.

I am sure you will be shocked to hear that Alhajie and I were the only ones there at 8 am. I went in and visited with out patients and greeted all the other patients. They enjoyed talking to a tubaab that spoke Wolof. Many people are shocked when you start speaking to them in Wolof. It cracks me up.

Alhagie and I were kicked out of the ward, by housekeeping. We went and sat outside. We had a great discussion on Islam, Christianity and our view of God. Later Alhajie brought up American politics. He told me he liked conservative views, agreed with the war, but would vote for Hillary. I stopped that conversation. UGH, good thing he can't vote! At 9:15 am the speaker arrived and class began. It was much different than the day before. Breaks were shorter and the lecture time more intense (so to speak). Breakfast was a red meat and fish sandwich (I think it was cow, but could have been goat). Again we broke for prayers and lunch at 1:45 pm. Lunch was Benecin and I sat at a bowl with the guys I was talking to at the time. I ate Gambian style, with my right hand. The food is really best that way. Again we were treated with a Coke/Fanta/Sprite. Class went until 5 pm. We took a post test and then we were instructed to go to the office for our Vitamin M. (money... the guy had a sense of humor) We were paid for three days as we covered all the material. The registration process was a joke, but that is the American in me.

All in all, I did pick up some new information. I networked on the availability of the new drug, i.e. Could I obtain stock from them (it is more money than my yearly medication budget). I learned what documentation we should be doing. I will make sure it gets done. So, it was helpful that I went.

That doesn't mean I am actually looking forward to the next one I have to go to.

Monday, March 3, 2008


Okay, seems to me I left you hanging about our Field Council meetings.

Oh, and I have to say, it was not my cousin who mentioned feet photos. It was a friend from NY. Yeah, that narrows it down!

So, on Sunday, Monday and Tuesday we met for prayer, evaluation and future planning.

Only one pair of feet are missing. I should let you see their faces, but this was just too much fun. I happened to find a mood ring at a shop while in Banjul that weekend. I purchased it and wore it to help others know how I was doing. I even had a bunch of those little slip of papers to tell you the colors... but I forgot to give them out. The SPTs enjoyed a few laughs becasue of the ring.

This is Barney and Adelia Robison. Barney is from Canada and LOVES Tim Horton's coffee. They have been in The Gambia for years. This summer they head home on furlough and to the weddings of two children and the birth of their first grand child.

This is Nola and Max (hiding in the shadows) Tucker. They also have a daughter getting hitched this summer. It is the year for weddings on the Gambian team. Their youngest, Abby, is the only MK on the field right now. I try to spoil her. (She lets me be a kid!)

After FC, the SPTs finished our shopping and errand running. Wednesday morning we loaded up the car and headed home. We had a three hour wait at the ferry. It was a bit HOT! and sunny that day.
I had the backseat with the luggage, once again. Taking a picture of yourself is always a fun time. You might wonder what we do while waiting at the ferry. I will let you check out Joann'e blog for that. She got some great shots. I was hiding from the sun.

Teresa likes to crochet. Usually we all have a book or two. Joanne can go through a book really fast. Makes it nice for me. She can read it and then I can get it after her, I won't have a long wait.
We recently had some visitors and when they came out to NK they walked onto the ferry. I met them in Barra. They brought us some goodies but couldn't fit them into their hand carry on. So, we had the bag of goodies with us for the return ferry trip. It had Triscuits, which made for a great lucnh, especially when added to some Joanne's tuna fish.

The best find, was a Mad Lib book. It was funnier in that it was on Ice Age and we were sweltering in the heat. It provided some great entertainment.
Now, the guys loading the ferry really do it TIGHT. It is a little nerve wracking for a newbie. I remember one visitor who was so shocked at how tight we were. That day she couldn't put her arm down between our vehicle and the one next to us.

Getting off the ferry is more of a challenge. Foot passengers and vehivles are all trying to leave at the same time. Makes it very interesting, especially if you are following a mother with one child on her back and the toddler walking along beside.

Now what do you suppose a aviation fuel truck is doing in Barra? Who knows! We thought this was a picture perfect moment.