Nalerigu Day 26

Esabisia (how did you sleep)?

Allafia Bene!! I slept VERY well!!

Early this morning I awoke to a cool breeze coming through my window. What a special treat. It was so “chilly” that Jessie put on a sweatshirt and I used my second sheet to cover up. I think it was about 80 degrees.  Rounds were good again today as most of the children were doing well. Most of the ward is filled with children who have malaria, typhoid, malnutrition or burns. We are getting pretty good at treating these conditions as they are certainly the most common. After rounds, we headed over to the theatre again for more procedures. We had a few ultrasounds to do, an incision and drainage, lipoma removal and a twin c-section that several of the wives and other volunteers came to see.

After we were finished with most of the procedures, I went over to visit Moses (Dr. Hewitt’s interpreter that I talked about yesterday). Moses was still looking ill this morning and his hematocrit was low enough that he was in need of a blood transfusion. They did a lab to obtain his blood type which was A+. The problem here, as you may already know, is that we don’t have a “blood bank”. We just send a family member into the community to try to find someone with the same blood type. This can be quite difficult as you might imagine and can take a lengthy amount of time. Moses was in no condition to wait around for someone to go find a donor, so I decided to give a little of my own since I’m O positive. I figure that I won’t be able to donate for a long time after I return home because of the risk of diseases I may have acquired during my stay, so I might as well give now to someone I know that needs it. I certainly was an interesting experience. The lab tech brought in the bag with tubing and a need attached (don’t worry everyone, it was a brand new needle). He then put a glove around my arm as a tourniquet and had me hold a toilet paper roll to improve blood flow. He then put the bag on the floor and let the blood pour down. He told me I was a slow bleeder, but I was able to get a unit of blood out for Moses which made me happy. I’ll make anemia the disease of the day today.

By the time theatre was finished, we headed over to the guest house for lunch. After lunch, I came home, took a 20 minute cat nap and then headed with some of the other volunteers to market for the last time. I found a couple more small things that I wanted to bring as gifts and took some pictures. I then returned home to gather the whole group of temporary volunteers as Terry (one of the med students) arranged a meeting with the chief/king of Nalerigu. I will spend most of my time discussing this experience as it will certainly be one of the most memorable experiences outside of the hospital.

First off, the chief’s palace is right outside the market area. In order to get into the palace you must have an elder of the community escort you inside. We had connections as one of the medical assistants at the hospital is second chief. Unfortunately, he was at a conference today, so he had planned for another elder to meet us outside the front of the palace. Unfortunately, due to Ghanian time or lack of communication, there was no one to meet us at the front when we arrived. We stood outside for quite a long time while a group of children and others surrounded us. Terry spent some time calling our connection and trying to figure out why we didn’t have anyone to meet us at the front. After some work, an older gentleman finally showed up brought us into the palace.

The palace is not really a palace at all. In our world it would just be a glorified union of mud huts. We walked through the entry until we came to a square building. We were told to remove our shoes and then enter the building. Upon entering, there were three men on an elevated cement slab at the front of a large room. The center man was obviously the chief as he was sitting high on pillows and had a hat with a gold marking on it. Two other men sat to the side of the chief, one being an elder who could translate and another whose job we could not understand, other than he held the staff of the chief. There were large leather chairs and sofas lined up along the other walls of the room which we were told to sit in. The elder then asked us what our mission was for this visit. We couldn’t really tell them that we just wanted to see the palace a take a picture :), so Terry our group spokesperson told him that we would like to learn more about Nalerigu. The chief told us that we should know about Nalerigu by having read books about it prior to our arrival. Not a good start. Things got better, when the chief thanked us for the cocoa seeds (caffeine) that we had brought him. He initially told us that it is custom to all share in eating the seed which we were all worried about since we had heard that some people have hallucinations from eating it, but he soon asked Terry if we had ever had the treat and Terry smartly said “no” so we were able to leave it that way.

The chief then talked more about the town of Nalerigu, but mainly talked about the hospital. It was actually quite amazing. He had only wonderful things to say about what the hospital has done for not only the community, but the entire Northern region of Ghana. The people here believe that people come to the hospital and are healed. Those that die at the hospital were either taken too late to be cared for appropriately or it was their right time to die. He feels that the hospital has a 100% cure rate for those that are able to be cured. Definitely an interesting way to look at things! The chief also talked much about going back to our homes and appealing to the people to come and help in any way they can. He made the point that one physician cannot see 100 people in one day and possibly care for them appropriately, so we need more volunteers to come. He took special interest in saying that we also need further training for the people who work in the hospital. He compared this to teaching someone to farm. You would not go to farm on someone else’s land only to leave a short while later and go back to farming on your own. You much go to their land and teach them how to farm. So that when you return home they are able to sustain themselves. This is the epitome of what is needed in developing areas and I certainly could not have said it better myself.

Overall, it was a very interesting and excellent experience, but it was definitely NOT without a plethora of awkward moments!! First, we really had no idea the proper way to act around the chief. One of the funniest parts for me was after the chief first started talking, the other men at the front starting clapping at one put. We silly sulamingas had no idea what to do, so we just started clapping too! I thought this was terribly funny and felt as though I was at some place where something is funny has just happened, but it would be completely inappropriate to laugh which just makes the situation that much funnier and you can’t contain yourself. I had tears rolling down my face. Another interesting moment was when the chief was done talking and we asked if we could take pictures. He said that it was no problem. Well, there was one problem in that we weren’t exactly sure how to take a picture. We didn’t know if we could go up to the king, give him a high-five and put our arm around him or if we should stand in front of the cement pad with him in the background. Eventually, we figured out that we could go onto the slab and sit near him for the photos. Everyone teased me as I sat about two body lengths away, afraid I would get to close. Now, for the most awkward moment of probably the entire trip….

Just as we finished photos and were about to leave, Terry asked the elder how to properly say goodbye (whether you clap and say na). The elder then told us all, “you must sit down in the chair and stay a while”. Darn! We thought we had successfully made it through the even without difficulty and now we have to sit again. We all looked at each other in utter horror. But, soon after we sat down, we realized why he wanted us to wait. The chief had sent one of his men to gather a treat for us. The chief told us that unfortunately, he did not have dinner prepared so instead he would have to offer us two life guinea fowl that we can eat at a later time. Yes folks! Just at that moment, a man walked back into the room with two live fowl in his hands!!!!!!!! We really wanted to just die of laughter at that point, but this time I was able to control myself. As none of us really wished to hold the live fowl, we made a deal with one of the other men in the palace named “John the Baptist” to come with us, sit in the back of our truck and bring the fowl himself to our home. He agreed to help us with the birds for only a small fee and a ride back to his home. On the way back to the house, several of us stopped at Joyce’s shop to get our final orders in (I got a baby wrap), while the rest returned home with John the Baptist and the two birds.

I am sort of sad that I didn’t get to see what happened when they returned home, but I can tell the story that was told to me. Apparently, when then made it to our house, Chinny (the mentally delayed, but not in soul man that is also known as “strange horse” and “hallelujah” and “man without TB who still lives in the TB village” and “keeper of the monkey”) was sitting outside the guest house. Chinny was so excited when he saw the fowl and jumped up to help. He clapped at the birds and then quickly cut off their heads. The cooks in the kitchen then finished cleaning the bird and creating the meat and now we have guinea fowl in the deep freeze waiting for us at tomorrow’s dinner. Now that was a crazy day!

We had a great dinner (with chicken, not fowl) and then headed over to the Wichita house where nearly all the volunteers gathered to sing praise songs. We even had Caleb (one of the cooks and the keeper of the house for Jessie and myself) come over with his guitar to sing. Eventually, we gave him one of the African drums that had been bought which became a concert in itself. You’ve heard the term white men can’t jump? I will transition this statement to white men can’t play the drums like this!!!! It was absolutely amazing. What rhythm and pure talent!! I’m now blogging, planning to pack a little and then want to head to bed. Tomorrow, we have clinic all day except for a side excursion with Dr. Hewitt’s wife Mona to the witches’ village. Should be another interesting day!! I will apologize now as I may not have the time tomorrow to blog depending on the business of the clinic, how much packing I get done tonight and how many events we have planned for tomorrow evening.

Today, I am thankful for the cultural experience I have had here which has only reiterated the fact that although we all appear so different from the outside, we are so very much the same. I am reminded of a verse in a song that says:

“We teach the young our differences, yet look how we’re the same. We love to laugh, to dream our dreams. We know the sting of pain.”

What are you thankful for today?

Jill

Nalerigu Day 26 Pics

Me carrying Jude on my back with my new baby wrap

My friend Joyce with her daughter Susan and Jude outside her shop

John the Baptist with Jude

The chief's children and grandchildren (he has 19 wives - what a tough job!)

Outside the palace

Part of the palace

Outside "the room"
Me with the chief


All of us

The chairs at the palace

Funeral procession

Little girl showing me her beads

Cameleon that the Nyhaus family

Chinny in his glasses. Yes, these are surgical glasses. He thinks they are great. Chinny does not do surgery.
The guinea fowl

It's the end of life for the the guinea fowl

At the market

Cocoa beans

At the palace

Nalerigu Day 25 - Pics

Must stop getting fabrics!! This is me bargaining with one of the women at market. I've bought most of my fabrics from a very sweet, quiet women with good quality fabrics and none "Sulaminga (white person)" prices.

This is me blogging. Thought you might like to see it in action.

Lisa and I

One of my patients who took 3 days to find the funds to go home. We became friends.

Child with osteosarcoma of the leg. The disease is metastatic already, but the family wishes to do an amputation for symptomatic relief.

Me with a family of (by my diagnosis) Marfan syndrome patients. I do see a slight resemblence to me here! (A friend at the hospital took the picture and since they aren't used to cameras got it a little crooked. I love it because of that!)

Child with a facial tumor of unknown type seen in clinic today

Mary...one of our favorite patients. She had severe skin infections with osteomyelities requiring bilateral leg amputation. She has such a great attitude and is loved by all. She also has an adorable little brother! The exciting thing about Mary is that she was discharged home today. Her mom will help carry her around and help her roll from side to side to not get bed sores. We hope for the best and will miss her!

Nalerigu Day 25

Hello friends and family!

Well my call was again much better than my first. PM rounds went quickly and I didn’t get contacted again until 6am this morning. Unfortunately, I am too neurotic and awoke every half to one hour thinking I heard the nurses knocking at my door. I wasn’t correct until 6pm when a nurse from the OB ward handed me a chart. The chart had no writing inside other than a note that said there was a female woman who was pregnant with twins. She delivered the first twin at home, but then developed severe bleeding and became unconscious so was brought the med center for further evaluation. The note at the bottom of the page said, “Please doctor, kindly please come to assess this patient. She is bleeding and unconscious. There is malpresentation with a retained second fetus.” The bells went off in my head saying “this is not something a pediatrician can handle”. So, I went over to the Wichita house as they are excellent at obstetrics patients, but unfortunately could not wake them up, so I headed (quickly) to Dr. Dickens’ house as he is the staff OB and his house is also on the way to the hospital. I knocked as loudly as possible, but everyone must have been tired from the evening before since there was again no answer. By this time, I had spend a few minutes trying to wake people, so quickly drove our “on call” truck to the hospital and figured I would stabilize the situation and in the meantime have someone go to try harder to get the help I would need. As a side note…I am very thankful to my father for insisting/forcing I learn how to drive a manual transmission or I wouldn’t be using the “on call” truck. When I arrived in the OB ward, the patient was alert and there was a large mass of tissue on the bed. I went over, realized that the bleeding had stopped and the patient was awake and then looked down at this blob. What was it you ask? The second twin (twin B) had been inside its own sack and the sack was attached to the placenta. The baby delivered still inside the sack with the placenta. Unfortunately, due to the placental bleeding the baby was already gone at the time of delivery. We still removed the baby from the sack, started chest compressions and bag mask ventilation, but there was no response. It was a sad story, but I was thankful that the mother was able to live through the problem and the first baby (twin A) was also doing well. You have to look at the bright side here.

I then returned home where I showered, ate breakfast, took my anti-malaria medication and then headed back to the hospital for am rounds. Rounds were good this morning. I discharged most of my children today. One child who had severe respiratory distress was singing for me this morning!! It was wonderful! After rounds we headed over to the theatre to do some procedures before clinic started. Well, I only did one procedure that took an exceptionally long time. There was a dilation and curettage to be done on a patient who had a failed pregnancy. For those of you who don’t know, a D&C is where you go in to remove the remainder of the fetal tissue as this can be a source of infection or bleeding if left in. I’ll be quite honest, this is not a procedure I enjoy doing and I enjoy it even less today. John (one of the Wichita residents) and I decided that we would team up and he would be my mentor to complete the D&C. The problem was that this particular D&C was exceptionally complicated. I won’t go into all the details, but the procedure took us about 4 times as long as normal and was very sad. Thankfully, the patient did very well and didn’t have any problems. Getting the tissue out was the difficult part.

After we finished the D&C we all headed off to our prospective spots in clinic. As usual there was a vast array of people to be seen in clinic. Jessie was in the pediatric area today so I saw mainly adults which the exception of some scattered kids in between. Patients had the usual complaints of generalized body pain, waist pain, dizziness, scanty urine, fever (but not really fever), etc. The most interesting patients of the day were the following:

1) Child with a slow growing facial tumor of which a biopsy was done and sent to the US. We’re still waiting on the results.
2) Family with obvious Marfan syndrome
3) My baby with Down syndrome returned with her mother and is doing very well. She is now tolerating nursing which is very exciting!
4) Child with severe hepatitis due to a prior blood transfusion for whom transplant or treatment are not options here. We gave her extra stickers today. She melted my heart.
5) The most interesting patient of the day….untreated osteosarcoma. See the pic for more information.

Clinic was exceptionally busy today. We got our usual 1 hour break in the middle for lunch, but stayed much later than usual since there were so many patients. After clinic finished, we all headed back to the theatre to help out with any further procedures that needed to be completed. Here’s where things got interesting again and where I realized what an absolute wimp I can be. Drew saw a patient earlier in the day with puss draining from his scrotum. I knew this information, because you could smell the patient down the hall. Well, lucky for all of us, he was left to the end of the day to have his abscess drained. The minute he was brought into the theatre area I began to gag. Not kidding, this is the absolute WORST thing I have ever smelled. Dr. Dickens, who has been working here for 2 years, says this one was in his top 20 which is definitely saying something because many things smell here. Thankfully, John and Drew VERY kindly said they would help out with this one. He apparently had the diagnosis of the day, which is necrotizing fasciitis of the scrotum (google this for more info). I couldn’t even be around the room without honestly gagging. Lucky for me, a nurse from the hospital came to ask for help in a different ward for which I raised my voice quickly to volunteer my services. What I didn’t realize is that the patient I was going to see was someone I knew and he wasn’t doing well. I grabbed the chart from the nurse, read the information and then asked him to show me to the patient. I was very confused when he walked me into the OB ward when I knew the patient was male. That’s when I realized I was headed to the “VIP” area. It was dear, sweet Moses, Dr. Hewitt’s translator in clinic who was lying on the bed. Unfortunately, Moses has a chronic disease for which he has intermittent times of worsening symptoms. Today, he was admitted by Dr. Hewitt because of similar concerns. I was called to his bedside as his blood pressure was dropping. I have a particular fondness for Moses as he is one of the people in the clinic who encouraged me on my first day when I had absolutely no clue what was going on, but was left to see patients on my own. He is truly a kind and gentle soul. I am wishing the best for him. We all are. After a bit of talking, I wrote some orders and then headed back to the theatre for more smelly-good.

Again, I was rescued from the deadly odor when I heard a woman screaming from the pediatrics ward. Here is the story:

A child was admitted by one of the medical assistants for respiratory distress. The pediatric nurses (who are excellent) received the orders and started getting ready to initiate them when the father of the child who was intoxicated grabbed the child and took him out of the hospital. Sadly, when the mother returned with the child, he had already died. The floor was a disaster. The mom was hysterical as any mother would be and the nurses were irate at the father as they felt they weren’t given a chance to help the baby. I tried to help the mother first and then proceeded over to the nurses’ station. They were discussing their frustrations and wished for the child to be sent to the morgue as they didn’t want the child to return home with his father. I told them that we should do what is in the best interest of the child, which would most likely be to return home with his mother for a proper burial. There motive was mainly to teach the father a lesson, but I reminded them that the father was really in no state of mind at that point to be taught. They finally agreed and the situation settled. It was very crazy for a while and of course sad that another child had to die.

I then returned back to the theatre at which point the smelly-good procedure was complete!! Good timing on my part. We then all walked back to the house for some dinner which was one of our favorites, chicken enchiladas (not exactly a Ghanian feast). Now, I’m doing some blogging, hoping to skype with my hubby and then headed to bed for a good night’s rest. Tomorrow we have am rounds, several procedures to do and then we are hoping to all visit the chief (also known as the king) of Nalerigu. Should be fun!

Two more things that happened today that haven’t yet fit into my story. Today, we greeted another new volunteer to the group who is actually a fourth year medical student from Midwestern in Arizona!!! We even know some of the same people. Amazing.

Today, I am thankful that my husband allowed me to leave him for the month to travel over the ocean, to an unknown land, in order to pursue my dream of serving in Africa. I had compassion for people in poverty before I left, but now I have understanding and hope that change is not an unreal expectation. Thank you Joe for being such a loving husband! I’ll see you soon!

What are you thankful for?

Jill

Nalerigu Day 24 pics

The Dickens family

Baseball in the complex

Inside the nutrition center

Nutrition Center

Child with snake bite to face

Children outside church

Children climbing the mango tree

Outside the Fulani church

Children inside the church

Children at the front of the church (they know how to sing!)

Guy wearing a cycling jersey as a shirt! A nice cycling jersey!

The front

Nalerigu Day 24

Another wonderful day in Ghana!

Before I begin with today, I need to write a bit about last evening. We were invited over the Dickens’ Home for game night. It was a blast. We had some fun playing cranium and eating tasty treats (notice that I talk often of food because it is SO good). My new favorite drink is homemade limeade. Delicious. I now have a dinner planned for Joe when I return which will include groundnut soup with rice and chicken (not goat), mango cobbler and your choice of iced tea or limeade. Yum! After our evening, we headed back home and I made it to bed before midnight which was kind of a miracle around here.

This morning, we got ready and headed back to the hospital for rounds. Another child died of malnutrition last evening. This is one of the hardest deaths for me since it is SO preventable. The problem we have at the hospital is that they just get to us so late and monitoring for things like refeeding syndrome is not an option. There is enough food in this world that a child should never go without. There’s something very wrong with that picture. Thankfully, the rest of the children were doing very well. Although we had several new admissions, I was able to send a few home.
After rounds, we all got dressed and headed for church. Today the entire group went to the Fulani church. As you may have read previously, the Fulani people are sort of an oppressed group of people in the community. The church is very small, but is the primary church that the Hewitt family attends. The building itself is sort of on the outskirts of town and is extremely small. With all of the families and volunteers, the church was completely packed. The elders made the children sit on a rug in the front of the church which actually was great for us because we could hear their beautiful voices during the songs. I wish I was an eloquent, creative, descriptive writer as I could better describe to you the experience at a church here. First, the buildings are usually made of mud and some have cement floors. There is often a pulpit and a cross up at the front. This church had no musical instruments, but had hymnals that were in the language of the Fulani people. During the service we sang several songs, many of which I knew the tune for but of course not the words. Some of the songs today were “Jesus loves me” and “Blessed Assurance”. I sat beside a window (hole in the wall) during the service today and got to enjoy goats, donkeys and children running by. The pastor’s message today was about giving praise. The faith the people have during even the darkest of circumstances will never cease to amaze me. After the ceremony we talked with the children and the headed back the complex for lunch.

After lunch, I caught a 30minute catnap (Awe) and then was awoken by a worker from the hospital that had some labs for me to review. Soon after, I headed off to the hospital for afternoon rounds. Today, I rounded by myself, which wasn’t as bad as I thought it was going to be. From the morning to the afternoon, we had only five admissions. There were two snake bites, a child with respiratory distress and two patients with sickle cell crisis. Today, I will make carpet viper bites my diagnosis of the day. I admitted a 10 year old child who got bit by a carpet viper on the cheek yesterday. Thankfully his blood clotted (bleeding is the main problem with this type of snake bite), but he had severe swelling throughout his whole face. I started couple more medications to try to help and will check on him again this evening. We’ve had a few snakes around the complex, so we’re all trying to be very careful about where we place our feet.
At the end of rounds, Dr. Hewitt and his family as well as the Nyhaus family came up to the hospital to hand out goodies to some of the children. It was wonderful. It’s so great to be around people that are so caring and compassionate toward other human beings. I finished rounds in about an hour and headed back to our house. Jessie and I worked on organizing our pictures and then headed outside where a baseball game was in action. Unfortunately for me, I somehow was standing in the catcher’s area and kept having to throw the ball back to the pitcher. Although Joe has worked very hard to help me not throw like a girl, I didn’t live up to his teachings today. Yikes!!! I am much better at foot sports.

As the sun started to set, we finished the baseball game and headed back to the main guest house for dinner. I’m now finishing my blog for the day and plan to head over to the Wichita house to play music and sing songs. I’ll do my pm rounds at 9pm and then will hope for a good evening with some sleep.

Today, I am thankful that I have had the opportunity to see true poverty first-hand, poverty that has and will always change the way I live and see the world. I know that this experience will help me to recognize real wealth and riches, not the material kind. My hope is that there may be just one other person reading this that will feel the same way and be inspired to help those in need around you. These children have not died in vain.

What are you thankful for?

Jill

Nalerigu Day 24

Another wonderful day in Ghana!

Before I begin with today, I need to write a bit about last evening. We were invited over the Dickens’ Home for game night. It was a blast. We had some fun playing cranium and eating tasty treats (notice that I talk often of food because it is SO good). My new favorite drink is homemade limeade. Delicious. I now have a dinner planned for Joe when I return which will include groundnut soup with rice and chicken (not goat), mango cobbler and your choice of iced tea or limeade. Yum! After our evening, we headed back home and I made it to bed before midnight which was kind of a miracle around here.

This morning, we got ready and headed back to the hospital for rounds. Another child died of malnutrition last evening. This is one of the hardest deaths for me since it is SO preventable. The problem we have at the hospital is that they just get to us so late and monitoring for things like refeeding syndrome is not an option. There is enough food in this world that a child should never go without. There’s something very wrong with that picture. Thankfully, the rest of the children were doing very well. Although we had several new admissions, I was able to send a few home.
After rounds, we all got dressed and headed for church. Today the entire group went to the Fulani church. As you may have read previously, the Fulani people are sort of an oppressed group of people in the community. The church is very small, but is the primary church that the Hewitt family attends. The building itself is sort of on the outskirts of town and is extremely small. With all of the families and volunteers, the church was completely packed. The elders made the children sit on a rug in the front of the church which actually was great for us because we could hear their beautiful voices during the songs. I wish I was an eloquent, creative, descriptive writer as I could better describe to you the experience at a church here. First, the buildings are usually made of mud and some have cement floors. There is often a pulpit and a cross up at the front. This church had no musical instruments, but had hymnals that were in the language of the Fulani people. During the service we sang several songs, many of which I knew the tune for but of course not the words. Some of the songs today were “Jesus loves me” and “Blessed Assurance”. I sat beside a window (hole in the wall) during the service today and got to enjoy goats, donkeys and children running by. The pastor’s message today was about giving praise. The faith the people have during even the darkest of circumstances will never cease to amaze me. After the ceremony we talked with the children and the headed back the complex for lunch.

After lunch, I caught a 30minute catnap (Awe) and then was awoken by a worker from the hospital that had some labs for me to review. Soon after, I headed off to the hospital for afternoon rounds. Today, I rounded by myself, which wasn’t as bad as I thought it was going to be. From the morning to the afternoon, we had only five admissions. There were two snake bites, a child with respiratory distress and two patients with sickle cell crisis. Today, I will make carpet viper bites my diagnosis of the day. I admitted a 10 year old child who got bit by a carpet viper on the cheek yesterday. Thankfully his blood clotted (bleeding is the main problem with this type of snake bite), but he had severe swelling throughout his whole face. I started couple more medications to try to help and will check on him again this evening. We’ve had a few snakes around the complex, so we’re all trying to be very careful about where we place our feet.
At the end of rounds, Dr. Hewitt and his family as well as the Nyhaus family came up to the hospital to hand out goodies to some of the children. It was wonderful. It’s so great to be around people that are so caring and compassionate toward other human beings. I finished rounds in about an hour and headed back to our house. Jessie and I worked on organizing our pictures and then headed outside where a baseball game was in action. Unfortunately for me, I somehow was standing in the catcher’s area and kept having to throw the ball back to the pitcher. Although Joe has worked very hard to help me not throw like a girl, I didn’t live up to his teachings today. Yikes!!! I am much better at foot sports.

As the sun started to set, we finished the baseball game and headed back to the main guest house for dinner. I’m now finishing my blog for the day and plan to head over to the Wichita house to play music and sing songs. I’ll do my pm rounds at 9pm and then will hope for a good evening with some sleep.

Today, I am thankful that I have had the opportunity to see true poverty first-hand, poverty that has and will always change the way I live and see the world. I know that this experience will help me to recognize real wealth and riches, not the material kind. My hope is that there may be just one other person reading this that will feel the same way and be inspired to help those in need around you. These children have not died in vain.

What are you thankful for?

Jill

Nalerigu Day 21, 22, 23 -pics

Lisa, Rukaya and her daughter Rita at the front of her home.

Cute child at Rukaya's

Inside Rukaya's home. Each of the rooms is a place for one person to sleep. I didn't see it, but Lisa described it as a rug on a cement floor with one small dressor. There is about 2-3 inches of clothes (her entire wardrobe) stacked on the dresser. She has a small area to the side of her mat which she calls her shower. It is merely a place to stand with a small hole for a drain so she can take a bucket of water to her head. Rukaya has a nicer home than most.

Child at Rukaya's home

Little boy with my sunglasses on

Little boy who latched onto me at the market today and followed me around the entire time

This man hit heads with another guy (not pictured) while playing soccer. This is my version of plastic surgery in Nalerigu. I got to stick them both. Then one of their friends asked me to marry him. Of course, I'm taken. :)

This child does not have heart failure (notice the swelling of the face and legs). She has severe protein malnutrition or kwashiokor. Her mom just had a new baby and is giving all of the feedings to the new child, so this girl has not been given appropriate food. She was admitted for milk feeds and is doing well.

Cute child in clinic. The mom offered to give me another dress like her daughter's :)

Cute baby in clinic

Unicef people came and were finding children at the hospital and in the markets to update their polio vaccination and give them vitamin A

My little child with the neck abscess

Bird on the way to the hospital

Stephanie wrapping Jude on her back the day before she left

Lisa, Stephanie and I with our matching dresses. I searched for a couple hours trying to find three fabrics to match. After I found them, the other girls thought it was a good idea as well. We love our matching dresses!!

Closer look at the fufu

Yisah and Caleb (our cooks and helpers) pounding our fufu. One person has to keep folding the fufu with each pound. I have seen a fufu injury in the clinic.

Oluu, Adam and Adam's brother Alfred. All of the volunteers are so thankful for their excellent translating skills.

Oops! I bought another piece of fabric from a woman on the street of Nalerigu. I have promised Joe that I will leave an item of clothing for every piece of fabric I have acquired.

Drew and Terry doing a debridement on a man who was the lone survivor of a bus crash where 13 other people were killed. He was treated locally and came to BMC for a second opinion. He had live maggots crawling under his dressing. I left the close-ups out for those that wouldn't enjoy.