Saturday, June 21, 2014

Hospital, funeral, being sick, bus rides, beach, Walter, drunk man, nurse work: it's a big one.

So much has happened since the last time I have blogged that I made notes, so prepare yourself, it is going to be a long one. Also because I do not think I can even remember how things fit together, they will be broken into sections. Sorry if this makes it confusing. As always I will add pictures if you do not want to read, I know that is what I would do!

Hospital:

In the last blog post I had written Rebakah was doing better. I went on Monday to see the clinical officers when they did their rounds. Mary had to take the girls anyway, so we went together. Clara had been complaining about her eyes and headaches, so I did a very technical test by making her stand across the room and try to read my box of wine. She failed. Mary was not ready at the time I said she needed to be. She told me and the girls to go ahead and she would catch up. As usual Clara was all excited about walking on the way there, we did a lot of running, I told them their mother would never catch us. But she did, she told me that everyone had warned her we were playing the whole way and she would have to be fast, I was pretty impressed with how far and fast she had to run. When we got to the hospital Rebakah was alert, talking, and asking for drinks. This was very good for her. Luckily I saw the same clinical officer I had seen before. He said he wanted to take her off of ARVs (drugs used to keep viral load down in HIV patients) for two days and then start a new regimen. I do not know much about ARVs and HIV so I agreed and said that whatever he thought was best, I just thought it was important that we switch regimens. I did not stay long that day, because things were going well and I was not worried. Then we headed back. Of course the moment we got off of the bus, Clara went into full meltdown mode. This has been my experience with her both times going to Ntcheu, she is fine walking the approximately 4 miles to the road, but going home she is never ok with doing another 4 miles. Which 8 miles in a day is a lot for a seven year old, but suck it up girlfriend we have to get back somehow. She stormed off down a different road and Mary asked what we should do. I said she is not my kid, do what you want. Mary came back carrying her seven year old like a baby. I bribed both girls by saying if they walked well they could get peanut butter and honey sandwiches at my house when we got back. That still did not snap Clara out of it, but she sure got her enthusiasm back when we got to the cabbage field and I had the camera out. She also had no problems getting her legs to move on the water pump. The rest of the way home, I got a dried up corn stalk and herded her like they do the cattle. It made her laugh pretty hard and keep moving. Finally we all made it home in one piece.

I took the next day off, I had been going back and forth everyday, walking 8-10 miles and not getting home until dark almost every night. I was exhausted. When I went back on Wednesday I came to find Rebakah very much declined. She was refusing food, and not as alert. The clinical officer (a different one) came around and said, "This patient has been declining since she has come in." I said, "No she has not, she was doing better, then I come into today and find her much worse, her chart also says that she was febrile and either unable to pass urine or they placed the catheter for incontinence, they wrote both. I said she was taken off of her ARVs a couple of days ago and she needs to have something on board, she cannot fight off anything right now." The clinical officer I think knew at this point I am not one to argue with, he said he had asked the ARV/HIV team to come and see her. I asked when, he said he would make sure somebody would see her today. I smiled and said, "Don't worry if you don't I will make sure you will." His coworker laughed and out they went. Within an hour he was back with the district medical officer, if you remember this is one of the only two doctors in the whole hospital. I told him that I think she has a hospital acquired infection now. He said yes, you are probably right. We do not do well with keeping patients on isolation, we do not have the supplies or room. I said I understood. He then made some plans, I at this point am not even sure I remember what plans were made. But I was ok with them. I left to go get some food. When I came back a nurse (he is my favorite, seems to care and pay attention to things!) had gotten a sat monitor and saw that she was in the 70s so decided to put her on oxygen. Her aunt was refusing and wanted to get her mother first. I stepped in and said, no you need to put it on her. I will explain to them when she gets here. Through this experience I have learned even more how much Malawians believe crazy things about medical treatment. One I heard was, she is probably weak from having so many fluids. No, but it is why she has a blood pressure and pulse now. So I am not sure what they think of oxygen, but I had the nurse translate for me. I told Margaret (her mother), "I am sorry if you feel like I did not wait for you, but her oxygen levels have gone down. This is a serious situation and if we let them stay down, she could have damage happen in her body that cannot be reversed." I showed her the monitor and told her what numbers we wanted. I also said, "I once again am sorry that I did not wait for you, but I am here for Rebakah and to do what is best for her, it is my job." She took it all ok and agreed to let the oxygen stay. I listened to Rebakah's lung sounds and realized that she had no air movement in the right lower lobe. I believed it was from being so weak, her respiratory drive was also failing, and staying in bed for so long. At that point I decided to stay the night and monitor her more closely. I knew that the nurses would not do anything.

I had finally decided to sleep a few hours, because the monitor said that her sats were in the 90s and her lung had seemed to open up a bit. I was charging my phone and in an empty bed. A nurse came over, she said, "I feel so sorry for you, were you here all day too?" Immediately I was annoyed, why do you feel sorry for me specifically? I was in a bed with my iphone charging on the wall, plus I am healthy. I think I have it better than anyone else around the place. I said, "Yes, but I am ok, just happy to be able to charge my phone. If a patient comes, please kick me out of the bed. I would be sleeping on the floor but I did not expect to stay the night so I have no blankets or anything." She said, "Oh no we would not make you sleep on the floor." I said, "I am no different from anyone here, if a patient comes, I am moving to the floor." She then said she wanted to come work in America, I told her that she would not like it because we cannot sleep at work and have to work very hard, even in the night. I must have had a feeling for what was coming. I then drifted off for a few hours, when I woke up I put the sat monitor on Rebakah and her sats were down in the 60s after they finally picked up. I tried to sit her up, do percussion on her chest to loosen things up and make her cough. I went to go get a nurse. As I suspected they were sleeping, with their head nets on and the blankets pulled over their heads. I asked for a suction machine and some glucose to be pushed (this is what they do and I am not sure they have much else.). She finally got up and came to the bed, she said, "The suction machine is not here, it is in maternity." I said, "Well then I guess you better go get it." I was already fuming about their sleeping while at least one patient that I know of was rapidly declining. She got in and then we found an old, nasty catheter, I knew at this point it probably did not matter. She said, "Will you help me?" I knew this meant she has never suctioned a patient before, which is fine, at least she was awake and brought the machine. I tried to deep suction a few times, I got no cough or gag reflex, I pretty much knew at this point it was not good, but I still felt inclined to try. I had asked for a bag, to try to give her breaths in the hope that some positive pressure would open up her lungs a bit, oh she has never seen a bag while she has worked here. All I could do was shake my head, what kind of unit or even a clinic does not have a bag available? Whatever, not the nurses fault. I then started texting my nurse friends. They gave lots of good suggestions, most of which I had tried, or hadn't thought of, but we did not have the proper equipment. Also I know nothing about drugs, and all of the drugs they said, we did not have. After lots of work, it seemed that her sats had come up and I had breath sounds again. I had to go back and ask the nurse for more fluids, her bag was out. They were already fast asleep and acted as if I was the most annoying person in the world. The nurse said, we only have one bag. I said, "I guess that is the one you will hang then." A couple of hours later I started to lose pulses again and her sats were not even picking up on the monitor. I was still feeling like we should try. I jogged to the nurses station and asked them to call a clinical officer and come bring glucose. They just looked at me and laughed. Well I am sure you know this pissed me off, I said, "I suggest you do it, and I also suggest you stop fucking laughing." I went back to the bed, after ten minutes they did not come, so back to the nurses station I went. They said, "We called, he is coming." I said, "Fine but I asked you to do something, push meds!!" They just stared, so it took me coming to the nurses station a third time. I knew I was mad, but I even surprised myself at what came out, I screamed this time, "I TOLD YOU TO COME TO THE FUCKING BEDSIDE!!! YOU NEED TO LEARN TO BE A FUCKING NURSE!!!" I walked back absolutely shaking and knew that if I went back a third time I would do something I should not do, such as throw things or just punch one in the face. I knew at this point she was going to die, there was nothing I could do. But I was so fed up with the lack of caring. I understand that they do not have many supplies, but you can try with what you have. You are a nurse, I am also a nurse, so I take the role of the job very seriously, going to work to sleep all night just to get paid while people lie and die, does not sit well with me. It kills me to know that they do not care, therefor people do not get the proper treatment. Why do we even send them to the hospital? Maybe a witch doctor is better. I bet it has about the same success rate. It is also sad because Malawians are not like westerners, they do not have access to internet easily to google what should be done in a medical situation. They are left helpless and have no knowledge of even knowing things are not right. Plus they are afraid to speak up. My screaming made lots of people smile, I think it was surprising to them plus they were happy I said something. The sad thing is, if they screamed nothing would be done anyway.

I had finally decided to walk away because I could not take it anymore. I went out the unit crying. I then called Mary who was coming with Rebakah's father. I told her I wanted to talk to him to prepare him. I was crying so hard I am surprised he could hear me. I told him that I had done what I could and I was so sorry but she was going to die. He was very composed and said, "Well we appreciate you and this would have happened at home without you."  I told him I planned to go to hospital administration about the issue of the nursing staff, and all of the other failed times that she had come. Of course I have put a letter under the office door, and texted twice with no response. What I would love to do is to come in a night or so a week and work almost as a nurse manager for the hospital. But I need to get the ok with the hospital administrator first. I am thinking if I do not hear from him this week I will park my ass outside of his office until he has to see me. During my anger that day I decided I needed a slogan for this new model of work for the nurses, I decided it should be called, "rise and shine, mother fuckers." I think I will keep my slogan from the hospital administrator when I propose the plan.

Rebakah was rather restless this night, so most of my time was just sitting next to the bed holding her hand. 

I spent a lot of time rocking this little guy. His mom was going through some psychosis and I was afraid she would hurt him. I bought bottles and formula for the family as a back up. He was the sweetest little thing and what I needed to stay sane.  
Working the water pump to water the cabbage field. Clara's legs were magically working again. 

Funeral.

After being at the hospital for over 24 hours I decided to go home. I do not think I will ever complain about driving my couple of miles after a shift again, I had to walk about five miles home. I figured at least walking and falling asleep would be safer than falling asleep behind the wheel. Then I got home and refused to get in bed dirty, so I had to light my charcoal to make warm bath water. Then I thought, well if I am already heating a fire I might as well make some food. I think finally around 1pm that day I got into bed. I will never complain about taking a shower and eating some quick food after a long shift again! When I woke up that afternoon, Maxford had come over. He was wailing, he said, "Rebakah has died. When I left the hospital she was still in this world, this is not something I expected." I of course told him how sorry I was and asked if there was anything I could do. He said no and went home. I thought, of course he knew this was going to happen, I told him that it was happening and I also told him to prepare her mother and aunt who were at the hospital the whole time. When I had left that morning feeling absolutely defeated I noticed they acted as though nothing had changed. They saw me running, heard me scream, I know they could hear the panic in my voice. I had once been told that people here do not tell a family the patient is dying because then it is believed that you caused them to die. I decided to go against this and tell Maxford because I wanted him to be prepared. But for some reason nobody seemed to care or even worry until the moment she finally stopped breathing. Then it was mad chaos. I heard the wailing from the home for two nights. There were tons of people in and out of the home and the night before the funeral there was a group there singing until 2am. I attended the funeral on Sunday afternoon. I am not a person to be shocked by culture, but all I can say was it was so strange to me. One of the things I noticed was, the extreme acting and wailing of people. Rebakah has been back in this community for one month, she has lived in another town for at least 10 years. I know people may have known her when she was younger, but I have a hard time believing that many people were close to her now. There were probably about 200 people gathered around the house for the funeral. I sat with Queen (Mary's 16 year old niece) and Esther (Martha's mother). I noticed a lot of people would only start their screaming and wailing before they entered the home, it was almost as though it was a sign of respect or to prove that they were really grieving. I did notice that even Queen and some of her friends were laughing as people were doing it, this confirmed even more that it was just an act. But then the family came out, yes I do believe that some of it is also over the top, but I knew they were really hurting. Her daughter who is about 12 kept wailing, "My mom, my mom!!" I could not hold the tears back from this one. Earlier that day, Amos her 6 year old son and her nieces, Mercy and Evie came over and played at my house for a bit. I felt bad that they had to be around all of the screaming and wailing at their homes. The funeral was a few hours total, the service was rather similar to what we would have in America. A sermon, singing, I was even mentioned that I had spent a lot of time caring for her, prayers, and then people went to the burial site. It was the dramatization of the whole thing that got to me. It is something I just do not understand. We are taught to cry and grieve quietly, while they are taught to be outward. Well until after the funeral, now I see no tears, and no mourning, they are all back to their daily lives.

Church group singing and bringing flowers to the coffin.


Headed to the grave site. 


Being sick.

Just in case you were wondering, being sick is not fun in a village. I had felt sick a couple of days after the hospital, I am sure I got the same virus that killed Rebakah, I just have an immune system fortunately.At first I was just a little achy, snotty nose, you know that sort of thing. Then Monday I woke up and felt like somebody had hit me in the back with a baseball bat, I was nauseous, and had a fever. I went to my yard to my normal puke spot, ok I have only been sick once, but the corner works really well and has a lot of dirt to kick over the vomit. Plus my hole for my toilet is too small and I know I would puke all over it. I did not ever vomit, just the lovely nausea all day. I lied in bed miserable and could do nothing to get comfortable. I kept craving popsicles and apple sauce. Yes, let me hop in the car and run to the grocery store to get some. Yeah, not going to happen. Everyone knew I was sick, yet still decided it was smart to bring patients to me. A woman came with what I was sure was scabies, she kept putting her foot closer for me to examine it. Thank you, but I can see it is scabies from here and I do not really want to get it too. That night I took potatoes over to Queen and asked her to make me some fries, the only thing I wanted and it was easy for them to cook. I was able to get them down, drink a little, took some ibuprofen since my fever had stayed the same 101 F all day, and went to bed. I woke up the next morning and as I usually do when I feel better thought I was a super hero. I immediately thought, I bet I could run a marathon today. No you cannot dumbass, you have eaten once in about 36 hours and you can barely make your ass up the hill on the 8 mile run on a good day. I decided I would just use my energy to clean.

I have continued to stay better but now I think I have parasites. A girl I volunteered with a ripple was diagnosed with giardiasis, after looking it up I realized I am having several of the symptoms as well, it got to the point where I have been sitting awake in the middle of the night with indigestion and could not eat dinner for two nights. Let alone the other GI symptoms I have been ignoring (as usual) for the past couple of weeks. I have started taking an antibiotic, I figured it will cover a lot of possibility for little lovely things growing in my gut so I might as well. It seems to be helping quite a bit, I had indigestion again last night. I feel like a 90 year old woman sitting up because I cannot lie down to sleep. I am thankful it has been nothing worse though!

Bus Rides

First of all, if you ever see me on a bus, get your shit off of it and run. I have always had the absolute worse luck. One time I had to rent out an entire bus just to get home, it was terrible. So I decided to go to the lake for the weekend, a trip back to Ripple, see Anna, and head down to Kande Beach. I got the bus from the road by my house to Lilongwe, I wanted to stop there first. This ride was fine, then the next day I went to the bus station around 7 am, of course my bus was not there, it never is. The bus finally came around 8, we all pushed on as usual. I will never forget how in shock I was the first time, shins bruised and my stuff grabbed by everyone. Now I will follow suit and shove down babies to get my window seat. I had to laugh at loud at the kids with their faces smashed against the bus because their mothers were dragging them while everyone else was pushing. We all made our way on, with plenty of seats to spare as usual (the pushing is never needed), I made a bet with the guy next to me what time we thought the bus would leave (I could win a shit ton of money at games like these here), he said nine and I said ten. Sure enough ten o'clock we rolled out. In about the first twenty minutes we knew something was wrong. We could barely make it up the hills. The bus driver stopped and called for another bus to come get us, they said no, you have to go until you break down. So that is what we did. I was sitting with a child on my lap, we were both sweating, I had some baby pee on my leg, fanta spilled all over my foot, and the kid kept throwing his banana peels on me. About five hours in, everyone was losing it. This guy standing in the aisle turned into a stand up comedian. I had to get some of the jokes translated but they were hilarious. He said, you could go back to America by the time you will reach Nkhata Bay. The children are now crying because they have seen the sun rise and now it is setting and we have not moved. Maybe that cure all medicine the woman was advertising would fix this bus. I was laughing so hard I was crying. I think it was one of those times that we all thought, if we do not laugh we will start crying. There were literally school children chasing the bus, they would catch us with ease, then take a break, and catch back up. I thought I would go insane. The bus then stopped in a town about an two and a half hours away from my destination. We waited there for two and a half hours before another bus came. Luckily I found a place to charge my phone so I could keep Anna updated, she so kindly warmed up some food, had my bed made, and a pot of hot water on because I was refusing to take a cold shower. I finally reached Ripple road block at midnight. If you are counting that is about 17 hours after I started this whole journey, in a car the trip takes about 4 hours.

Then when I was on the way back, I caught my bus at the road rather quickly. I was feeling encouraged, it was a working bus and seemed to not be rolling backwards down the hills like the last one. I ended up drifting off for a bit, I was hopeful we would make it to Lilongwe around 2. I woke up and shortly after we were going over some bridge that was undergoing construction. All of the sudden the bus went down to the left and then stopped abruptly. The usual, "EEEEEEEEE!!!" was said from all of the passengers. We all got off and waited along the side of the road. There were a lot of people standing and staring at the bus, but nothing seemed to be happening. Since nobody could make it over the bridge the buses were going to the bridge, passengers were switching vehicles and then they would turn back around. Because of my previous 17 hour day I decided I was not sitting around and waiting. I went back, grabbed my stuff, decided I would just spend an extra $5 and get there before midnight. I did finally make it to Lilongwe around 6pm. I was thankful we did not all go tumbling down, but still thought, oh, only my luck would I be on a bus that would get stuck.

My final bus ride home was from Lilongwe with Walter, my new cat. I had gotten a basket at the market to put him in. I got in the bus that day around 10:30 am, I wanted to get home at a decent time. The bus usually takes four hours. Well it did take four hours, but first we had to sit in the hot sun for two hours before it left. I was so crammed in, I could barely move. I was doing my best to shade the basket in my lap and console the cat who was sure this was the end. He actually did really well for the situation, but I was rather over bus rides at this point. Finally we got to the road around 4, I had told two bikes to come get me, I had so much stuff to bring back. They came 30 minutes late, which is nothing, but those thirty minutes sitting by the road I just wanted to cry. Why does everything always take so long? The one bike was loaded up and I rode on the other carrying the basket while trying to make sure Walter did not escape from the top because the lid was not secure. Finally we made it home, he even purred a lot while I carried him along the way. Thank goodness he is a pretty easy going cat! I told him we do not have to travel again until December, and that one will be a big one. At least I will have a normal carrier!

I only felt this was appropriate, it was before all of the madness happened too. I always know something bad will happen.


Crammed in, the picture does not do it justice.

Being a good boy in his basket.

Most of my stuff on the bike.

A little further over and we would have been in trouble. 


Beach.

So yes after the long bus ride I made it to Ripple. After finally going to bed around 2am, I decided to sleep in the next day. Anna went off to the school and then came back in the afternoon and we headed to Kande. Kande is a resort about 4 miles right down the beach from Ripple. We always used to load up our backpacks and run down for the night, drink way too much, and then run back the next day. I had decided to camp this whole time I was away to save some money, you save about four dollars a night by camping, this is a fortune to me! We loaded up the bikes and biked along the road, the views along that road are pretty amazing. I have been going through this phase here where I am taken away by the beauty of this country, I love all of the landscape and especially the trees. When we got to Kande we learned it was booked and Anna could not stay in a dorm. That meant we were sharing the tent. Now this tent is technically a two person tent, yeah maybe two people spooning, or two children. But we crammed in and made it work. We spent the weekend on the perfect white sandy beach, and drinking in the bar at night. It was so relaxing and nice to have a western friend around. I love being in the village, but I do not really get to have conversations, too often the cultural gap is too much to have a good conversation. Let alone most of the people I am around do not speak English and are under the age of 10. When I go out to the cities I am constantly meeting people traveling through and I will not be seeing them again, small talk gets old, and I dislike a lot of people I have learned. So I definitely was appreciating the time I had on the beach just hanging out. It was a great way to celebrate my one year of making it in Africa!




Walter

Yes, I got a new cat. I had decided I was so tired of being sad about Goose being gone and I figure at this point she is not coming home. I realized that having Goose made me feel much less alone and I needed that again. So I decided to go to the Lilongwe SPCA this time. The cats there are already immunized, fixed, and microchipped. This comes at a price, but it is one that I felt was worth it. So I went to go pick out a cat. Of course I loved all of the dogs and kept saying to myself, you cannot get a dog, you cannot get a dog. It is just not doable while I am here, cats are low maintenance and can be left for a few days in the house and be fine. Well I got in to the see the cats and it was confirmed, in general, I am not a cat person. There was this nasty little cat, I compared him to a malnourished kid, he had nasty hair, a pot belly, weird features, and did not want to be pet but would climb all over me. I hated him. The others were not much better. I finally spotted the tabby cat that kept coming over to get food. He let me pick him up, and purred when I pet him but other than that he did not seem to care too much. I thought it would be nice to have a chill cat, Goose was definitely not a chill cat, and I wanted this one to be indoors. So I went back to pick him up on Tuesday before heading home. He is not quite the personality I thought at the shelter. When we first got home he just meowed and purred non stop, seemed a bit scared of everything but also very clingy. I do not know if it is me that turns my animals instantly clingy or what. He literally did not care about me in the shelter and now even five days later he cannot hardly stand to not be touching me. He is a very sweet cat though, I swear he purrs so much he will not be able to purr one day, and he is very happy when I come home. I was getting a rather evil look as I left today. I was giving him a lot of shit about not catching the mouse in the house the night before. I had come in from taking a shower and had heard the squeaking and him running. I was getting dressed and they both came running at me. I immediately jumped onto the bed, not remembering that I was naked waist down and I have no curtain on the window that goes right into my neighbor's yard. Yeah he was outside cooking, there is no way he did not see my extremely white ass in the window. Whoops, sorry. But Walter failed and the mouse stayed under the bookshelf all day. I made fun of Walter and asked him if he let the mouse eat all of his cat food that day. Well he must have felt he needed redemption because I woke up and almost stepped on the dead mouse. I told him to leave it on the floor and please do not bring it into the bed. I heard him crunching its little bones as I feel back asleep. I figured he is wormed and it will save me some cat food. Let's hope he keeps the mouse and critter killing up. This is also one of the main reasons I decided I needed a cat. I have been missing Goose even more lately, I loved her bad attitude. Walter runs scared when the kids come in crazy, Goose would run to attack them if she felt they were out of line. It was constantly entertaining. I guess I will just have to get another crazy cat when I get home. At some point I will have to draw the line so I do not turn completely crazy cat lady though.
His first night, I think he has settled in quite well. 

He also sleeps non stop. After having goose who would sleep less than me and go non stop the rest of the time I kept thinking something must be wrong with him. 

I think he is obsessed with me. 

He has a short tail, I am sure something cut off the tip.




Drunk Man.

The night I came home from Lilongwe I went over to Mary's house to charge my phone. I had my headlamp on and could see something shining. I knew it was not eyes of an animal as usual,  but I could not figure out what it was. I then got closer and realized it was reflective strips on a man's shirt. He was sitting on the edge of her yard with his head down. I greeted him and he did not look up. I went to get my phone and told Mary. She came out to investigate, the man would not answer her. As I had suspected he was just really drunk, which is nothing abnormal around us. Well Agogo, not Mary's mother, she was already there, but my other Agogo heard the commotion she had come out. I have always thought this woman is tough as nails, she has not had an easy go with two of her heavy drinking sons, which I think has given her even more of a fighting spirit. Well she marched over to the guy and grabbed his head and was trying to get him to look up and say who he was. He was not responding, she promptly went over and grabbed a large branch off of the tree and started hitting him with it. Queen and I were laughing pretty hard at this, after seeing so many women beaten by drunk men it was pretty funny to see this grandmother ready to take care of the other drunk man. All of the commotion of course brought everyone out of the houses and next thing I knew about 10 people were gathered around. They were all then pulling him in different directions and everyone was screaming. I could not figure out what the hell was going on. Then a man hit him in the face about three times. I still thought at this point he had done something wrong. They got a rope tied him up and took him somewhere. Paul my neighbor had come out, I asked him what had happened and he asked me the same thing. I said nothing, he was just sitting there. He said oh, well they decided since he was not talking that he was planning on stealing stuff. I said no he was not, he would not sit in the middle of the yard and not move when greeted if he was going to steal stuff. He could not even walk. The reaction of all of the people yelling at him and the cheering was a bit insane to me. When somebody actually does commit a crime, nobody steps in to do anything. I almost wonder if they feel empowered at time like this when they know he cannot fight back. I told them to stop shouting and just do what they wanted to do with him. The next day I told Mary I do not think that man was going to steal anything, I think he was just too drunk. She said, yes you are right (I do not think she condoned the hitting, she just decided he needed to be taken away) it was just a warning to him. I am fairly positive the man will not remember a single thing in the morning. And I am just left confused as usual. 

Nurse work.

This week I have had one of my girls come to my house with pretty good burns. Her and her sister tend to drive me insane. They are one of the sibling pairs that have been left to be raised by their grandparents because the parents live in the city. I am guessing it is too expensive to raise children in the city. But I do not believe this grandmother is able to properly care for these girls. They are always at my house and often acting out for extra attention, recently I implemented the "you don't go to school then you cannot play at Kendall's house" rule. Ennifer the sister came because she was "sick" as usual. I gave her tylenol and told her to go home. I looked outside twice and she was playing at my house. Of course I yelled at her. Anyway, Ivy the younger sister came with burns to her legs, Ennifer was cooking and spilled the pot on her. The grandmother had them lathered in toothpaste, I guess better than dirt, pee, or eggs. I cleaned it off and then had to scrub a lot of the burnt skin off. I felt really bad for her, they do not even give pain meds when they do it on huge burns in big hosptials. So I knew with me or not, she was not getting medication. I did the best I could with what supplies and lack of pain relief that I could. Grandma was there the first day and helped a lot, Ivy was cooperative and would do lot of deep breathing with me. The second day Agogo (yes the man beating one) came over and was yelling at Ivy for crying, I yelled back at Agogo that it is ok for her to cry and it hurts very much. Well yesterday was a nightmare, she would not sit still and was kicking and biting. I was so afraid she was going to end up with dirt in her burns. I yelled at her to stop and told her she was going to end up very sick if she got dirt on her. That is about as much as I can say in Chichewa though. No other adults were around so I had kids holding her down. Some spots are looking pretty good, others not so great. There is really nowhere here I can get proper supplies either. The clinic does not even have them, they told me to put an antifungal on the burn. I said no. We will see how it does, luckily the spots are small and she is still eating, playing, and running with all of the other kids. It is rather comical how much I wrap the thing up to try to keep dirt out. I am just hoping for no infection!

Yesterday I went up to Memo to see some patients I have seen before. It is Karista's home area and she is always eager to work, so I was glad to walk the 14 mile round trip and spend the day with her. I had a woman tell me after I told her to drink water she now no longer has a headache (well imagine that!) and other people were glad to see me again. I cannot offer a lot when I go, most of the time it is for moral support of families with HIV positive family members or an elderly person in the home. Most of the elderly patients complain that they hurt after working in the garden all day, well no shit, you are 80 stop working so much! I absolutely love going to people's homes and just sitting with them though. I like the feeling of being apart of the community, and I do have to remember even the simple things I tell them like drink more water are things they may not know. 
Linda (9) is becoming an excellent photographer, she took this picture plus the one of me cleaning the burns. 

Day 1, when things were going pretty smoothly. I always have a crowd when I do any dressing. I am confident all of the kids will be able to be nurses by the time I leave. 


Jolly rancher and tear stains.






Day 2 we were still friends, day 3 a different story. We will see what day 4 will bring.

Racist baby, she hates me because I am white. 


Ok now that I have written a novel, I should get the rest of my stuff done and head home. I had walked about 3/4 of the way to the road and realized I had left my money at home. I did not even contemplate turning around. I just knew I would figure it out. It was actually really easy. I told the bus driver I did not have money and he would have to take me to an atm when I got here. First he said no, then they came back to get me. I gave him the equivalent of  $0.75 more than my bus fare and he acted like it was the best thing that had happened to him, win, win. It made me remember the Texas Christian college student from Zimbabwe sitting next to me on the plane coming over, he said, "Always remember, anything in Africa is possible." Yes it is true. 

Friday, May 30, 2014

"Don't be sorry, just don't let it happen again." Making friends with the medical staff at Ntcheu District Hospital.

A few times in my life I have been a patient (once here), for 8 years I haven been the nurse or nurse's aid, but this is the first time I have acted as a patient's friend/family member. I have previously spoken about Rabekah my neighbor who is HIV positive. I have grown close to her and her family. Because her husband left her, she came with her children to live with her parents (my neighbors) about a months ago. From when I first met her I suspected her ARVs were not working, she told me she does not feel right in her mind, and I noticed she was incredibly weak. I paid for a bicycle to come take her to Bilia clinic, here it was decided, yes she may need to be on a different formula of ARVs. So she was referred to Ntcheu District Hospital.

At Ntcheu District Hospital they have the ability to test CD4 count (amount of immunity the person has) if that is low, they will then test viral load (amount of HIV virus in the person's body), if this is high they will consider changing the formula. When they came back from Ntcheu I was told that did not do any testing, the medical personnel said, "All of your friends (Meaning others with HIV, it annoys me that when in a certain demographic you are considered "friends." Every white person they have known is my "friend," I always have to say, I have no idea who that person is.) are fine, you need to eat more and go to church." Yes, I also thought she has had problems with isolation and depression, but I was not convinced that is her main issue. They have phased out a formula of ARVs last year, this was the one Rabekah was on. Since September 2013 she has been on a different formula, that is when she reported to begin having weakness and other symptoms of treatment failure.

About a week after going to Ntcheu, she became very ill. She had gotten Malaria. She was transferred from Bilia to Ntcheu. When I saw her at Bilia she was still alert and orientated, my presence even made her smile. I then went to Blantyre for a few days and had not been in touch with the family. I saw her father on the road, I asked about her, he said he had a bit of improvement at first but now is worse. I said ok, let me go home, put my stuff away and I will be over. I was not expecting to find her in the state that she was in. She was lying on the floor under a massive blanket, after greeting the approximately 10 people in the room gathered around her. I went to greet Rabekah. Her eyes were glazed over and she did not even look at me. During the time I was there she was restless, rolling back and forth and moaning. I told her father this is serious and we have to go as soon as possible. Because she is unable to sit on the back of a bike we had to arrange a car to come. I said I was going to run home, shower, and eat in case we needed to go that night. After seeing her health passport (book they write medical info in) from the last visit where they did nothing, I was not letting her go alone. The car was unable to come that night so we decided first thing in the morning would be fine, there were really no other options.

The next morning I woke up at six (late!!). I knew the truck had to be there already, I think it driving past the house is what woke me up (moving back to KC might be a little rough at first). I threw on clothes, packed a bag, and was out the door in ten minutes. I threw my bag in the back of the truck while all of my little friends stood on the porch cheering. Seeing me and a car first thing in the morning is just too much to handle. We got Rabekah from the house into the car (It has been about five years since I have had to transfer an adult, thank you nursing home for giving me enough transfers in my few years to last a lifetime!) Maxford (her dad) said I should sit in the front, I said oh no, I am fine and jut happy to have a ride. After falling off the side into a grandmother sitting in the truck bed (I apologized profusely and everyone just laughed and laughed. I am glad I did not hurt her!) I realized it is bumpy and the floor is best. I called the medical assistant at the clinic and told him to prepare for our arrival. When we got to the clinic, we got her out of the truck and got to work. I checked malaria-negative, put in an IV and started fluids, and  the medical assistant started pushing glucose (I will always hate that they do this without a machine to test blood sugar!). Then I tried to get a blood pressure, she has bery weak pulses and I was not surprised that I could not get a blood pressure. The medical assistant gave antibiotics for a possible infection and I just waited, there was nothing else I could do. He said the ambulance would come to take us that morning. He was recording the data in her health passport when he asked, "What was her blood pressure." Me, "I could not get one." Him, 'Oh well I am sure it was fine." I can only imagine the look I gave him, I have been told more than once recently that I come off as a bitch (Of course by guys that think I am not approachable. No I really don't wish to talk to you, but you are more than welcome to send me drinks from across the bar.). Sorry I am not good at hiding my true feelings. I tried very nicely to explain to him about signs and symptoms of a patient in shock, I am no expert, but come on some of this is just basic knowledge for a medical person. I retook the BP and got 70/30. He said, "70/30?!" I said, "It is an improvement from no blood pressure, which is what she just had." He went home to get ready for his day's work. I sat and waited for the ambulance to arrive. When it came I did not expect everyone and their mother to be getting in, I was told only one other patient was being referred. Where the hell did all of the people even come from?! I went out and kicked everyone out so we could take Rabekah and lie her in the back. Once she was in the vehicle, I stood back and I swear people had to have been stacked on top of her. This time I requested to ride in the front.

When arriving to the hospital we went to see the clinical officers, I have recently been informed there are only two doctors in the hospital and they are both in administrative roles (yes, that makes sense). I knew we did not have long with them, so I just laid out the situation and what I wanted. I have learned in the country they hate confrontation, it is not really in their culture (unless you are a drunk man). Usually when I get confrontational they just five me what I want to shut me up. They agreed to admit her, run fluids, check blood for infection and CD4 count. They told me if the CD4 count is low they will then send a viral load sample off. All of these things sounded good to me. We got to the ward, which is familiar to me, it is where I stayed back in November when I became ill. They assigned her a bed, drew labs, took vitals (Bp now 90/60, improvement!). Then the team of clinical officers came around. The main guy kept speaking in Chichewa and was not involving me even when I said, "Sorry my Chichewa is not good, when you are finished can you please tell me in English?" Finally I got fed up and went through my spiel with him. Oh sorry for asking question and demanding to know the plan. I would love to send these medical people back to 2 Henson for a day, when we do our job we get threatened and screamed at. I have not even raised my voice! So the plan had not really changed, we were waiting on blood results, I was told the CD4 count could take a couple of days. I stayed until two in the afternoon, made sure her fluids were changed when the bag was low, brushed her teeth (I tend to be a freak about oral care on patients, I always think when I am unable to care for myself, you should shoot me. If you won't do that as least brush my damn teeth.), changed her bed and clothes. I have been getting quite the looks in the ward as I sit next to a very sick Malawian HIV patient's bed and perform the care of a guardian. Nurses do not even do these things here. A guardian must be with every patient at all times. Guardians must also bring the following to the hospital, bedding, towels, soap, dishes, and anything else needed. Needless to say, it is all very different from home.

Yesterday when I came back to the hospital I wanted to see CD4 count and make sure she was being cared for and in a stable condition. I walked with her sister who was bringing firewood. We stopped to pick up a friend. Two and a half hours later we were at the road to catch a bus. It normally takes me one and a half hours to walk to that road, and I do not know the short cuts! Nothing with Malawians goes quickly. When arriving to the hospital I immediately saw her IV fluid bag was dry. I went to tell somebody, I also told them I was angry because this patient came to the hospital in shock and critical, she needs fluids. He said yes, he would find out. I waited 15 minutes, they rolled the drug cart by and did not stop. Yeah, my blood was boiling. I went to the cart where three nurses stood. I said, "Did you get IV fluids? It is completely unacceptable that a patient who came in, in shock does not have fluids going since yesterday! This is just poor nursing care!" Like I said confrontation is their least favorite. I was brought fluids pretty quickly. The poor guy said, "I'm sorry." My response, "Don't be sorry, just don't let it happen again." Immediately after I said it, I thought where did that come from? I sound like somebody's bitchy mom. I do not wish to be rude and demanding, but it is necessary if I want her to get better and be cared for.

Today when I came, of course I was told that her fluids had not been running since last night and her IV had fallen out. I was pleased to hear that she was eating a bit of liquid food when spooned into her mouth and she did a great job swallowing her meds. I knew the clinical officers would be rounding again today, that is one of the main reasons I came. When I walked in, I was told visiting hours were over. I just said, oh sorry and kept walking. I have no idea why people think I am bitch. Also when the clinical officers were rounding I believe they said, everyone who is not sick go outside. Well I pretended to not know any Chichewa and stayed put. I had already told the nurses about her IV and fluids, of course nothing had been done. I was glad the clinical officer from Wednesday was not doing rounds on my side. He shot the other guy a look as to say, good luck with that one. Once again, so sorry for wanting decent care. This clinical officer was actually pretty great. I let him review her case before saying a word. I then told him I was upset about the fluid situation and I wanted to know her CD4 count results. He immediately started an IV and ran a 1 liter bolus, then sent a nurse to get the blood results from the lab. Her CD4 count was 280, this is extremely low, when a patient is first diagnosed with HIV if their CD4 count is below 500 they put them on ARVs. He suggested we switch her formula of ARVs (yes please!!), he did not really think a viral load was necessary since her CD4 is so low. He also wanted to do a spinal tap to rule out meningitis. He even took her blood pressure right then, it was 120/80, so she is very stable now. I was very pleased with him and thanked him a lot for taking the time and seeing her (see I can play nice). This afternoon I slowed the bolus way down because I did not want the bag to run dry and then run the tubing dry, when it was nearly gone I just clamped it. I figured a whole liter that fast with a stable blood pressure it was not a huge deal to get a new bag right away, I had also pushed enough for one day. One of the male nurses came by within an hour of me clamping the bag and said he would bring a new one. This is major progress!

During this experience I have learned such a sad truth. Patients do not get the care they need here. Yes supplies are limited, I almost freaked out when I learned they do not even have feeding tubes at this hospital, how much more basic of a piece of equipment can you get?? Maybe I will just have to make one. But even the simple things they do have, are not used to help people. I believe that most clinical officers and nurses look down on sick, poor, people and their families. I am sorry but just because you got an education and have a job it does not make you better than anybody, not start being a decent human and giving a shit about other humans. Nobody advocates for these sick people, they families are afraid to do so. They literally lie and die while nurses are washing windows. Yesterday morning a body was rolled out of the unit, I thought, was this a necessary death or poor management? It breaks my heart. Nobody in this world should be afraid to fight for proper medial care, or should they have to. I believe it is the job of everyone on the medical team. I especially take this role seriously as a nurse. If it is not in my patient's best interest, then no doctor, we are not doing it. Also do not tell me you can not order pain medication right now, I know you are not in an emergency, so you will do it right now. After telling off the nurses here, I hope the peds nurses are ready for when I start working with them. I think they will hate me within the first five minutes, I may have to buy their love with things. But maybe they will practice some better nursing care!

Goose news; thank you all for your concern! It means a lot to me. I was told that Goose was seen drinking water at the borehole near my house last week on Thursday. This made me feel a billion times better. At least nobody had her or had hurt her. When they tried to catch her to bring her home she ran away. I am hoping they are right and it was Goose, I am sure it was, nobody has ever brought me the wrong cat home before. I believe that she was in heat and went out to breed. I hope that she will come home soon, but something could have happened to her in the last week, who knows. I was woken up two nights ago by hyenas "barking" nearby. I hope she is smart and stays in trees at night and away from people. I have not offered a reward for her return, I can only picture a whole bunch of people hunting her down and breaking her legs just so they can catch her, I figure it is much easier to only tell the women at the boreholes that she is missing and to ask again if they have seen her. They all decided, oh she is just getting pregnant and will come home later. I hope they are right!

Also, I need more sponsors!! I only have three and I need 12. I do not want to be annoying and ask all of the time. But that time will come very soon. I need to make an adjustment to the payment amount. I have decided that the girls should only receive an allowance while in school, not during holidays, it will make it slightly cheaper for the first term. If you are interested in any way please, please contact me!

I better get back to the hospital and check that things are running smoothly. Maybe I will be nice and bring the nurses some oranges or something. They will probably think I have poisoned them. Then I should head home before too long, I have been getting home right at dark every night. It seems nearly impossible to get things done. Yesterday on my walk I accidentally peed in front of a group of boys, I checked the road for people, but did not think to look in front of me. I heard laughter and looked up, a couple hundred yards away there were two boys looking at me. I almost waved, but I just laughed and went on. Then I told some kids (half jokingly) when they asked me for money, "I will beat you." They started chanting "I will beat you! I will beat you!" There seriously is never a dull moment.

Blantyre

Too many kids in my bed.









Friday, May 23, 2014

The icing on a shit cake.

I have always been a lover of animals. My whole life we have had so many pets. In my adult life I have had Douglas, Rosie, and now Goose. If you have had one conversation with me you know about them, my animals are like children to me. They become one of the most important things in my life, I love and care so much about them. I think the almost three thousand dollars in meds and vet bills I spent on Douglas are pretty good proof of this. Living here, and not having a pet for so long was so hard for me. I spend so much time alone, and I knew having the company of an animal would make this much easier. I am a dog person, and have never been very attached to the cats I have had throughout my life. But I thought having a cat here would be much easier than having a dog, I would not have to worry about who would watch her when I leave or feel so guilty about leaving her for a few days. Cats are independent and can deal with it. I also did not anticipate that I would become so attached to the cat, I figured I would just leave her with somebody when I left. Well since about the second day I had Goose I realized I was wrong about how I would feel. She has the biggest personality and is just pretty darn funny. She is also very loving and rather attached to me. I have been shopping for cat airline carriers and doing my research on how to bring her home, it is safe to say I am attached to her also, this may be a slight understatement.

 Well, this week has been my hardest one so far. I feel worn down and isolated more than the usual amount. On Saturday I went to town to do my normal shopping, I locked Goose in the house because I do not trust people in the village with her anymore. I have seen her kicked so hard by a teen boy, that I was sure she was paralyzed when she came dragging herself home. I also believe one night a while back she was taken by somebody, she came home after about 13 hours and smelt just like the bags they have at the grocery, they smell weirdly like the country of India, so it is a very distinct smell. I was also told that one time somebody else was kicking her when she was traveling up the road. She has been wandering more and is still not afraid of people like she should be, this is my fault for showing her too much love and security. When I came home on Saturday she did not run out the door like usual, she greeted me and ate some of the meat off of the chicken bones I brought her. Then she wanted out, so I decided I would let her out while I went to take my bath. Once I heard what I thought was her meowing, so I yelled her name, I was suspicious that somebody picked her up to take her. Whatever the situation she came sprinting home when I yelled. So I went to take my bath, I found her in the tree next to the yard, she refused to come down. I figured in the tree she is at least safe and she probably hunts from them at night. She was there even at four thirty when I woke up that morning (I know it is insane to wake up this early, I am definitely developing a village lifestyle in some ways). She did not come in to eat or drink, I figured out of rebellion and knowing I would lock her up. Well that is the last time I have seen her. I have been sick with worrying what might have happened. I would be able to cope if a snake, hyena, or dog even got and killed her. But to think that she would be mistreated by a person, taken, or even killed is the most upsetting thing to think about. It has made me not trust the people I am not close with, I also do not trust and have begun hating men. The drinking in the village is out of control, they are drunk almost everyday by even ten in the morning. The drunk men can become aggressive and just assholes who feel they gain power from hurting anything they believe is below them, this list includes; women, children, and animals.

That is the other thing that has worn me down; people. Just within the past two weeks or so people are now asking me for things constantly, and when I say ask it is more like demanding that I give it. Children now yell, "Give me your money!" Sometimes in English and other times in Chichewa. I have been in this village for almost seven months, why is this happening now? Drunk men are becoming more forward and teetering on the line of being aggressive towards me. I am anxiously awaiting the day one goes to grab me so I can just beat the shit out of somebody and feel better. I did have a man walk up to me and try to take my chintenje off from around my waist, the response he got was, "Don't fucking touch me." as I slapped at his hand. When men come by or to my house and are obnoxiously drunk I make sure to tell to leave and they are not allowed to be at my house or talk to me while they are intoxicated. I am not afraid of them, they do not have the balls to do anything to me, I am sure they suspect they would be in much more trouble than if they hit a village woman, and little do they know I would surely not sit still and take it the way women do here. Even the other day when I asked the girls to go with me to the grocery, I decided to treat them and get them each a coke. This is something I never do! The girls even know not to expect or to ask for things from me. I give the girls their cokes and adult women came over and started very aggressively telling me (in chichewa) to buy them cokes because they were hungry and their stomachs hurt. Well I have been lying in my bed depressed for three days and have barely eaten, when you do not have food it shows. These women each had about 30 lbs on me and what the hell is a coke going to do for you anyway? I was so angry at their aggression and asking me for things, I yelled at them that they were rude and I just took the girls home where we could drink our cokes without being harassed.

I have also been seeing sick children at my house daily, often they come as early as five thirty. I do not mind seeing these children and I have tylenol and ibuprofen I can give them, but I am not a clinic. I will say that most mothers are very grateful even for the advice to go to the clinic or if I tell them their child is too sick and they need to go to the district hospital, I always give them transport money to go. I do not ever want to risk the parent taking them back home and the child becoming critical. One woman asked if I was giving her the money on a loan basis, I was pleased that she did not expect the handout. I of course told her no and that I just wanted her little boy to get better without her having to stress about finding the money. But sometimes people leave in a hurry without as much as a thank you, or even ask me to give them things while they are there. What do they think I am? Providing them medical advice and medication for pain or fever is not enough for them? It just gets exhausting.

The biggest thing that becomes exhausting is the lack of support from the organization. I am working for an organization that does not function. I understand the lack of funding, but there is no support or direction from the founder. He also does not keep a single promise that he makes to me. I do not doubt that his intentions are in the right place, but why did he even want me to come here? I cannot fix that people do not work and that community things do not function. I am a nurse, not a business manager. Working at the clinic does not help the organization in anyway. I have also had the stress of dealing with the director of this branch of the organization, in my whole time here, he is the first person I now refuse to work with. I do not trust him for a number of reasons and I do not wish to work with somebody I do not trust. If I did not love the village and the people around me, I think I would be looking for another placement. But I have decided a huge reason of why I came here was for the experience and what I will gain from the cultural experiences. I want to remain in this village for the rest of my time. Starting over will just put me behind on getting anything done. I have also been trying to work around this and work with places I know people must show up and I have translators, this is why schools and clinics are the best options. Hopefully with the help of some of the school girls I may be able to get some community work done as well. I am desperately trying to keep my head and up "just keep swimming."

After crying the third night in a row, after lying in bed for three days, and not being able to function like a normal human being, I decided I was going to give it one more month and if I still feel the same way, I am going home. This week has been the first time in my eleven and a half months were I said, "I want to go home." I figured this is not too bad considering the situations I have dealt with. When I got the call to come back to immigration (yes they finally approved my temporary residency permit! It only took them an hour to find the file that they at first claimed to have lost, but it is done!) I decided I am going to go and stay in Blantyre for three nights. I have an amazing group of coworkers (I promise they are better than the people you work with) that have sent me too much money and I can spend a few nights away and not worry about the costs. Thanks guys! I love you all!

During my state of lying in bed and not moving, I had a little knock on my door, it was Martha. I opened the door, happy to see her, and we went to lie in my bed together. She so sweetly asked me if Goose had come home yet (She really is not found of Goose, and is scared of her.). When I told her no. She said don't worry she is coming, she is probably just at the church. It was the sweetest thing for her to ask and try to reassure me, she knows I love Goose, and I think because Martha loves me, she feels the need to care about Goose as well. We ate some starbursts, read magazines, and practiced colors using uno cards. She stayed for about two hours, while she kept saying I am leaving, finally when it got dark she did run home. I love and cherish the times that I have alone with Martha, it is so funny the bond that we have despite not speaking the same language. I am getting better at Chichewa, and she is very sweet and understanding that I do not know too much. She does still talk quite a bit, but she knows to show me what she means if I am not getting it. She will also listen to me, I think just to hear me talk. I laughed out loud one day when I asked, should I have curry or stir fry for dinner. She screamed, "Stir-fry!" She does parrot me sometimes and it is rather cute.

The night I took the girls to the grocery, it was the day I had decided if I am not happy I will go home in a month. I know this will not happen, I do not want to leave feeling defeated, and really I do not want to go home. I was carrying Kate on the way to get the cokes, Clara and Debora were walking in front of us, holding hands. I thought, this is why I have to stay. My love for these girls is so overwhelming. I have been so lucky to get to know them all so well. Yes, some days they drive me crazy, Clara was doing a rather funny impression of me yelling at the to get out of my house the other day. I was over them that day, but she knew I was just in a bad mood, and it was of course not the kids that are usually over that were driving me nuts, it was some other ones. I love the way when I walk home from work or a trip to town they all run out and throw their arms around me to welcome me home. Martha and Kate have to constantly be held and sit very close. And one night while at Mary's house this week I was sitting with them helping pull corn off of the cobs so they can mill it into flour. It was a chilly night and both girls were sitting on either side of me very close, Linda was resting her head on my shoulder and Clara had her arms on my legs. I feel so apart of their family when I am there, it is the best feeling. I know that I am so cared and loved her, Goose is too by everyone that is apart of our lives. Everyday when Esther comes to bring me water she asks if Goose has come home. Both Agogos also ask everyday. They all always greet me in the morning and would greet Goose as well. It is just so sad that some people have to be assholes.

I know I will be fine and I will get over it. I sat at the bar last night and had such a great three to four hour conversation with a man from South Africa, he was around my dad's age. It was so refreshing to have a good conversation, I do not get this in the village, with both language and cultural barriers, it is nearly impossible. I also have a hard time relating to a lot of the travelers my own age, I think having an old soul has something to do with this. Plus most travelers are just annoying people. I have had some thoughts about doing a blog about how much I hate travelers and giving examples why. Maybe during my few days here doing nothing I will get bored and enlighten you how terribly annoying people are to me. Having a hot shower, running water, cold drinks, food cooked for me, and electricity have never felt so refreshing. I stood in the shower an extra long time. I can tell that I am worn out because I do not usually even appreciate these things when I have them. I do not care enough about not having them, the village life is not one that bothers me. I am pretty low maintenance. The hardest things are the isolation, and lack of food variety is getting to me lately. I could care less that my toilet is a hole in the ground or that I have to do things by candle light at night. I know Goose being gone has just stressed me out and highlighted every other problem, if she comes home I will be so relieved and will get through the next six and a half months just fine! I am really hoping she is just out getting pregnant, she was maybe acting like she was in heat. I have informed Agogo that they will be getting a kitten as a present if this is the case! I have decided in my desperation to offer a reward for finding and bringing her home. I am not wanting to do this because I know it will make her even more of a target for kidnapping hoping to get another reward. Sorry Goose, this may turn you into an all the time indoor cat. I am pretty sure this will make us both want to kill ourselves and each other. But it will be worth it to keep her safe.

I am going to leave you with some pictures of Goose and the night at Agogo's when she was playing with the kids after they had their cokes. It was the sweetest thing watching her play with them. Most adults here do not really engage with children in this way. They care for them, feed them, bathe them, hold them, but usually they do not engage, have many conversations, or play. The cokes turned the kids into little monsters, you can tell they do not get sugar or caffeine. It had a pretty immediate effect, they started sprinting and would scream, "Kendall!!" then just go into a fit of laughter. This night was definitely one that was needed. They seem to know just how to take care of me.





I had tried cleaning her face, I think she felt the need to return the favor. It made me laugh so hard.


Her personal training includes, when they stopped doing mountain climbers, she attacked. I think it was a good method.

Not wanting me to go to work and lock her up.


Martha doing her best to play nicely with her.

This is exactly how Martha feels about her.

And this.

Debora and Clara pounding the maize.

Kate and Martha giving it a go.

Nelly and Agogo dancing with the cracked out kids.



They were pretending to be grandmothers, it was so cute.