30 July 2014

How I Pray When No One Is Listening

Taking the bus is always an adventure and often comes with good stories.

B. and I went to the capital for a training on an appropriate technology initiative happening in Niger and other west African countries. We found out about it two weeks ago and have been looking forward to it since.

We were thrilled to get to be a part of the movement to improve the lives of disabled Nigeriens and we had high hopes for this trip.

That is until we got on the bus. 

28 July 2014

Ebola in West Africa: Five Ways to Pray

This weekend, we in the SIM family received word that a doctor and another SIM employee at ELWA Hospital in Liberia tested positive for Ebola.  ELWA is one of the west African hospitals also operated by SIM.  ELWA has been combating the virus since the outbreak reached Liberia, and has taken the precautions necessary . . . but the heartbreaking reality is, Ebola doesn't discriminate between who is the patient and who is the caregiver.

As the news is being spread around the world (you can read more hereherehere and here), the need for prayer is great.  SIM's motto is By Prayer . . . because we believe that our own efforts can only go so far.

We need you to pray.  Here's how:

24 July 2014

Niger in the News

This post in the NewYork Times came through on my facebook feed this morning.

What struck me at first was the advertised headline was 'Niger is poor and located in the desert'.  My first reaction was: well, NYT, at least you've got your first facts straight.

One line I can't get away from in the body of the text:  The country’s women, held back by their husbands and by imams who inveigh against “Western” notions like birth control, don’t demand it.  

"The country's women . . . don't demand it." 

Well, Mr. Nossiter, it's interesting to me that all the way from Dakar you assume Niger's women are free to make such demands.

Read the article here.

23 July 2014

A Dose of the Best Medicine

I did my undergrad degree in Athletic Training . . . also known as Sports Medicine or Sports Physio in some places.  So when I moved to Galmi to start up the therapy department, I didn't feel too out of my element when I needed to see just as many (if not more) traditionally Physical Therapy cases as I do Occupational.

There are still PT patients that stump me or who require knowledge way beyond my bag-of-tricks . . . and when that happens, I call in the virtual-cavalry and get expert opinions via email from Physio colleagues around the world.  It's kind of like our own form of distance learning, just without the exams or tuition fees.

About a year ago I started getting consulted for dysphagia (swallowing difficulties) with stroke patients.  It pulled me out of my comfort zone a little bit, but going off the advice of a Speech and Language Pathologist from my Philly days, I got by.   But last week a visiting ENT (Ear-Nose-Throat doc) arrived and that's when it got really exciting challenging intimidating stimulating interesting.

18 July 2014

The Big 'C'

'Uh, D├ęborah, what is cancer?'

I looked up from my teaching notes and blinked at the five men circled around me in the wound care room of the OR.

'What did you ask?' I question, assuming I must have misunderstood.

'You're talking about dressings for patients with cancer, but we don't know what that is.'

I looked at each one, hoping I'd get an indication that they were joking . . . but they weren't.  Four OR Techs and a NurseAnesthetist-in-training, and they didn't know what cancer was.

15 July 2014

Where There Is No Hospice

**I wrote this post over a month ago, but couldn't bring myself to finish it, let alone publish it.  I have detailed heavier cases . . . shared events I find more devastating.  But for some reason, this was just too difficult at the time.  It's happened before, just doesn't usually take a month to process.**

Our Little Girl of Peace passed away early Thursday morning.  Her burns were just too severe for her little body.  And her battle was over.  We just don't have the resources here to change certain outcomes.

That afternoon I sat next next to a mom who was cradling her frail child.  Pressed against her mother's chest, this precious one looked to be four, maybe five years old.  Her skin hung from her boney frame, eyes hollow and deep.  AIDS had ravaged her little body . . . malnourished and weak, the doctor admitted her, hoping to do something to ease her suffering, but recognizing the prognosis wasn't good.

On Friday, our last patient of the day presented to the gym with an atypical concoction of symptoms.  'Stroke' had been listed, but it became quickly apparent that the history I was getting was not what had been given to the doctor.  And as I transferred M. from the wheelchair to the treatment mat, the back of my hand, which was sandwiched between her left arm and her chest, could feel the enormous mass in her breast.

What started off as a localized cancer, had spread to her brain causing her potpourris of symptoms.  A quick chat back with the doctor--there wasn't much we could do.

14 July 2014

Confessions of an Educated Woman

'He says he has 17 children--no, wait, 18.'  B. translated, and counted, as my new patient attempted to list off the names of his offspring.

Trying to do cognitive retraining with a 40-ish year old man who suffered from a traumatic brain injury (TBI) two weeks ago can be challenging . . . attempting to do it in Hausa without wasting anyone's time takes a lot of creativity.

Since I'm limited by language and he's limited by severe immediate recall deficits, we ended up limping along together and some how he made progress.  I'd say it's because of my education; my patient and his friends, however, wouldn't agree.