Looking for you

Halima is a petite little grandma...not much left but skin and bones and tumor.  I can feel each of her ribs through her dress as we embrace - the same bright dress she was wearing when we met in the market between here and Mamou. I have been looking for you, she tells me, for a month I have been looking for you.  She takes my hand and places it on her tumor and it throbs warm and alive beneath my bare fingers.  This pains me and chuks (pricks) and suffocates me at night...I just want it to be gone.  Will you take it away?

Halima, I have been looking for you too.

Every day for the last month I have thought of the morning we met in the market, when we came in the land rovers and asked them to find you, when you rode up on the back of a motorcycle and unveiled your face for your neighbors to see your shame.  Every day I think of the first moment I saw you and realized the lump on your face you had covered so carefully was almost as big as your face itself, and I looked past into eyes so full of life and impossibly joyful.  When I lie in my bed at night I remember you told me you had trouble breathing when you sleep, and I looked in your throat then and could not see an airway, only tumor and palate, and I wondered how you were breathing still.

My heart remembers you. 

I have often thought of the morning I unfolded a square of gauze on the rubber mat of the land rover floor, between the backpacks and baskets of food and guitars, and laid out the laboratory equipment in my island of clean white, when I pressed a lancet to your wrinkled finger and read your blood test in the main street as your whole village watched.

I saw them rejoice with you when we gave you the golden ticket: a patient card with your name and a screening date in four days.  I met your husband and your granddaughter and that man who translated for us from French to Pular.  I cannot remember his name...do you?  What do you remember of that sunny morning when we met?  What captures your heart in the darkness as you struggle to breathe?

When your screening date on ship came and went and you were not here, I asked what had happened to you and no one knew.  Did you forget to come?  When your surgery date arrived and you still had not, I wondered if a night had passed when you finally fell asleep and did not wake back up.  Were you lost and alone?  I looked for you but I did not see you.  I prayed for you...God sees you.

Now you are here and your voice has changed and you still struggle to breathe every night.  You tell me the Hope Center is a good place with plenty of milk to make you fat, and you pinch your arm proudly in display.  You look at me with a spark still in your weary eyes and ask me to take away the monster that pains and steals your breath.

I send you away with pillows to prop your head at night and paracetamol and a promise of hope.  Just a few more days, Halima, and the operating rooms will open again.  A few weeks only, and Insha'Allah you will no longer cover your face in shame.  After looking for the last month you have finally found us, and I welcome you with open arms.  

Interior screening: Lemon tree thorns

It crept up on me slowly, barefoot on the cool tile floor
Tiptoeing in the near-dark to where I stood
Lighting the gas stove with a match
To boil filtered water for coffee.

It whispered warm across my face
A breeze that bent the rice stalks
And blew fingers of fog through the vines
Hanging looped in the forest,
Waiting for Tarzan to swing through.



And then it hit
With a flip-flop smack that killed the bathroom spider,
Cold water splashes of dipper baths under the stars,
Splatters of mud from under a motorcycle tire.

I was comfortable.

Comfortable in an environment most would find a hardship
Rejoicing in a lifestyle mistakenly called primitive.

I can transport live chickens and run barefoot through the mud
Tie my backpack to the top of a land rover
and pee in the prickers without getting hurt.
I can chew the rocks out of street rice
Or perform a blood test in the middle of a busy market street.

I cherish my nights without electricity as a gift
A chance to see so many more stars
To meditate without the distractions of modern convenience.

The eclectic collections of skills I have so carefully collected
Filed away like scrapbooks on a living room shelf
Start to fit together
In a complex puzzle of belonging.

The idea niggles in the back of my mind
A lemon tree thorn caught and driven deep
Until I turn on the headlamp to dig and find
An epiphany hiding underneath.

Interior Screening: N'Zerekore to Kankan to Mamou

There's a space of time before dawn when the world seems to stop - just to take a moment and breathe - before jumping into a new day.  In sandals and scrubs in the twilight before the morning, I turned off my night-vision headlamp, ignored the chatter from my radio earpiece, and prayed for wisdom.  The whole purpose of this trip is to find surgical patients, but we came with limited surgical slots, a few handfuls of hope to share among hundreds.

Because these hours of dirt roads in between town, a minor inconvenience or adventure for me, are the difference in medical access for thousands.

And they came, as the sun began to rise.  Young and old, wearing their shame under a carefully wrapped lappa or nursing it along on crutches or hidden under a keffiyeh.  There were the cleft palates and noma patients I rejoiced to find, a boldly written MAXFAX across the top of the pink screening sheet.  An alcohol-cleaned finger held out in a prayer that the HIV test would be negative and the immune system strong enough for surgery.  A tentative smile that danced in brown eyes with a carefully held patient card - the golden ticket for a screening slot on ship and a chance at surgery.

And there were the moments that ripped my heart in half again and again and again.  A double line on an HIV test, a plastic surgery desperately needed but no spaces in the surgery schedule and a waiting list already too long, a medical illness with no medical doctors or medication available to help, a brand-new baby in my arms and no orthopedic slots to straighten tiny deformed legs.

 From town to town the schedule steadily filled with the carefully reserved spots I had counted out for each location.  From town to town they came, and the need was great.  My own wisdom could not possibly have been enough to make the choices on which so many lives depended, and I was left in freefall - trusting in the wisdom and guidance that could only come from the One with the power to see and touch every life, the only One who can truly heal.

When Jesus heard what had happened, he withdrew by boat privately to a solitary place. Hearing of this, the crowds followed him on foot from the towns. When Jesus landed and saw a large crowd, he had compassion on them and healed their sick...And when the men of that place recognized Jesus, they sent word to all the surrounding country. People brought all their sick to him and begged him to let the sick just touch the edge of his cloak, and all who touched him were healed. ~ Matthew 14:13-14, 35-36

Interior Screening: Conakry to N'Zerekore

It was almost midmorning on day 2 of the interior screening trip when I found myself belly down over the spare tire on top of the Land Rover, hooking ratchet straps into the frame and rearranging our waterproof backpacks under the tarp.  I could feel the sun starting to bake through my tee-shirt and kilted skirt, warm on my bare feet.  Swatches of grass line the road back over the hill to warn approaching trucks of our presence: a creative African version of the reflective orange warning triangle.

Our first day had gone very smoothly: 12 or so hours in the car from Conakry to Faranah, with around 25 potential patients to screen when we got there.  We spent the night at a guesthouse, after a late evening of unpacking and talking in the wide open field out back, while fireflies danced with the blanket of stars.

We hadn't even hit unpaved road yet the next morning when a loud CLUNK from the front Landie (Land Rover) had us pulled over in the tall razor grass on the side of the road.  A verdict of broken rear differential had us splitting our team - two to stay behind with the vehicle waiting for a tow, and the rest to continue on.  We had two stops for screening that day before driving on and through mudholes and more holes all the way around the northern border of Sierra Leone, out of the sunset and almost to the Liberian-Cote d'Ivoire border.

The first two days (Part 1) in light purple.  Guinea is a big country, and an incredibly gorgeous one!

The morning of day 3 we met a few patients at the beautiful little clinic in N'Zao and met with the hospital director and officials to prepare for the "big" advertised screening planned for the government hospital in town the next day.  Only 3 days, and already we had several patients scheduled at 4 stops, with a month's worth of dirt road in between.  My back was a bit sore from being airborne between holes so much of the trip, already I had earned a designation as "trunk monkey" from swinging off the handles above the Landie doors so I wouldn't land in other people's laps quite so often.  Already my heart rejoiced in the mountain greenery and endless rice fields that filled the drive.  I went to sleep that night tucked into the mosquito net, with my headlamp by my bed and bag already packed, scrubs laid out ready for the early morning screening the next day in N'Zerekore.

The medical team prepares patient cards in N'Zao.  Sorry, no patient closeups for privacy reasons!

Adventure to the interior: A beginning

Well the land rovers are packed and our team is ready to head out early tomorrow morning at 0430.  Two weeks of guesthouses and camping, muddy dirt roads and plenty of coffee, large crowds and lots of potential patients...

In short, two weeks of incredible crazy adventure.

The meetings and planning of the last two months fed neatly into the increased pace of the last week...spreadsheets and plans and meetings, the glaring orange of the medical bags in my camp chair under the window and the boxes of pregnancy tests and yellow patient cards sitting on my desk under a small pile of very conservative clothes.

It started when I offered to help, two months ago.  Just mentioned that I would be willing to work with the screening team again if needed.  And here we are, headed out with a team of nine crew (including three nurses), hitting up cities throughout Guinea to screen for patients.

There could be thousands waiting for us - some already with surgery dates and so many others hopeful.    It is impossible to go in my own strength, my own wisdom: sure recipe for disaster.

So I kneel in my weakness at the foot of the cross and rise in thankfulness that He has already gone ahead of us.

I pray that I would see through His eyes, to see him there in N'Zerekore and Kankan and Mamou and everywhere in between.  Would you pray with me?

Yu sabi?



Ortho kids from Sierra Leone with Melinda and Michelle

Christiana stood at my elbow, stethoscope around her neck, watching intently as I entered the assignments for the night nurses into the computer and started printing them off.  I had already warned a few kids away from the computer with my newest Krio phrase, Lef am, dis no fo pikin (Leave it alone, that's not for children).  After a few deleted censuses and an amazing thankfulness for automatic retrieval, I've learned never to walk away from the computer without locking the keyboard.

Two of our peds patients play "mama" with balloons tied on their backs



B ward is lively and full of fun and kids, 20 patients aged 15 and under, most of them in bed with blue and white and purple casts sticking straight up off the pillows with small brown toes wiggling at the ends.  Most of them I know already from ortho in Sierra Leone, some I've met here.

Laura, we de go na waka-waka? Ar wan go waka-waka wit yu! Can we go on a walk now?  I want to walk with you!  Christiana radiated excitement, and I decided some of the kids could use a little excursion.  Yesterday Christiana and I had gone on a "waka-waka small" through the hospital, visiting her friends on other wards and discovering the delights of an automatic ice machine. She and her miniature walker are unstoppable, roaming through the corridors with an escort or stubbornly taking the stairs one step at a time, four flights up to sunshine.

Usai yu wan go? I asked.  Where do you want to go?  Na office.  Her favorite place, the staff office has plenty of people working there during business hours, and all sorts of fun things to interest curious kids.    So I set off with a small flock of casted ducklings to retrieve my nursing assignments from the printer in the office - around the corner and 50 feet away.  I paused to help Sheku manage his crutches and heard a small voice behind me, Adam, Adam, usai yu de go? Adam, where did you go?  5-year-old Bindu was trying determinedly to catch up, using a small stool as a modified walker for support.  My followers all chorused na office, na office...yu sabi office?
Sabi means to know, to understand...and in this case, perhaps know how to get there.  4-year-old Adam persisted that he sabi office, and after trying the stairs, the laundry, and the kitchen, finally found his way there.  He stood in the doorway in awe looking at the computers and repeatedly washing his hands with the hand sanitizer from the automatic dispenser by the door.  Every one of those 5 kids slowly worked their way to the door of the office, tested the ice machine and squealed when it dumped a bit of water on them, then thoroughly washed their hands with sanitizer.  Adam proudly carried my assignments back from the printer to scatter them across the desk and nearby floor before announcing again with conviction, a sabi office.

It's easy to claim knowledge of something without ever having experienced it.  In Adam's case, he was convinced he "sabi office" even though he had not been there, had not experienced it, and had no idea where it was.

Later that evening one of our day workers asked me if I sabi Krio. 

I sabi Krio small, but I want to learn more.  How many other things in my life is that true of?

In color

It would be easy to turn and walk away.  Escaping reality with the TV turned up just a little louder, telling stories of the good old days and ignoring the hurt in front of us. To walk through a day without ever seeing, and to give care without ever loving.  Because without love there can't be loss - or at least that's what we tell ourselves.

Too easy.  Too safe.

So many choose the path of less resistance, not realizing with hurt and heartache there can also be joy; unwittingly imprisoning themselves in a world of gray.  Never knowing the richness they have carelessly traded away.

I want to live in colors brilliantly painted with a bold hand on a canvas of my own life.

My hands, cupped in prayer, catch raindrops together with blessings, trickled down between my fingers and onto my palms to mingle with the warm salt of my own tears.  Above my head, all I can see are storm clouds dark with promise.  But out across the ocean, in the midst of the rain and storm, the bright pinks and blues of a beautiful sunset still shine persistently through.

I want to go into the world of distractions and toys, of ignoring problems and hoping they'll go away, the world of make believe and masks.  I want to tell people there is more to life than the safety of grey.  It's worth taking a risk to live life in color.  They may miss amazing sunsets if they're too scared to stay out in the rain.