Note to Self: Hands Make Great Bladder Blades

I am not sure really where to begin, but I can say that these past few days have been one experience after another that has left me in constant awe of God`s unfailing love. I am struggling a bit to process my emotions, mainly because I pendulum swing from empathy to heartache, sheer amazement to fear, uncertainty to clarity. How can the time in each day rapidly pass, yet I have only been in Angola for a week?

To start off the week, before I was actually in Kalukembe, I spent some time with Dr. Sarah (OBGYN) at the C.E.M.L. hospital in Lubango. While scrubbed into a hysterectomy case I asked Sarah a very personal, yet crucial, question: How did she decide to follow the call to mission work right out of residency? Why didn`t she wait a bit, get married and have children before giving her life to medical missionary work? Her answer was raw and thought provoking. Her reply: I would have loved to been married, start a family and feel more secure in who I am. Instead, I decided to dedicate myself to truly follow God`s will. I have been called to mission work from a very young age, and I know this is God`s plan. If I fully trust God, then I know that He will help provide in other ways – safety and support. I am so thankful for sharing that conversation with Sarah, as she is a wonderful role model. I cannot be naive to the sacrafice of medical mission work, and this trip has already smacked me in the face wtih that realization.

You may very well be curious to know how I got from Lubango to Kalukembe. Well, you know me…always up for a little bit of adventure. And this is how it all went down: At about 15:30 on Tuesday afternoon, Betsy and I greeted a man in the parking lot of C.E.M.L. Hospital who drove up in a Kalukembe ambulance. He wasn’t exactly on time. In fact, I was supposed to be in Kalukembe the day before but the car/ambulance was in the shop…. Where was I?… He shows up and Betsy informs him that my Portuguese is very poor. Emphasis on the poor. Turns out, Zachariah`s English is very poor. Just imagine: a 3 hour jeep ride, in silence, while I hold a flat of eggs for a family in Kalukembe on my lap. Was it commical? Absolutely. It was also a perfect time for me to see more of the Angolan landscape, laugh as Zachariah avoided the numerous pot holes that formed after the hard rain, and the painful attemps we had at trying to communicate. Do not worry mom and pops, I was totally safe and arrived at the doorstep of the Drs. Cummings right as the beautiful Angolan sunset cast a pink glow over the entire countryside.
My accommodations are modest. I am staying in the villiage in a simple home. No running water and electricity that is only on for a certain amount of the evening. I am coming to peace with the idea of showering every few days, bugs as my companions and unique nature sounds to lull me to sleep. Every morning I take a short, yet beautiful, walk to the Cummings’ house to share breakfast, passing the locals and offering my greetings of `Bon dai`!

Internet access is rare and weak at the Cummings’ home, so I will Spark Note my most memorable moments over the past few days. I am spending my days working alongside Drs Priscila and Dan. Although they are formally trained in OBGYN and ER respectively, they are the only doctors at the hospital, running all services.

– I have learned that every woman has lost at least one child, either in childbirth or at a young age due to a tropical disease or infection. They understand what it is to suffer. I can only imagine the heartache they feel as they recover feet from other women in the post partum floor with crying babies.

– I helped Dan (remember – originally ER trained!) with an emergent c-section. Scrubbing is really just washing your hands well. The only anesthesia is local for the incision and ketamine for the procedure. There is no caudery. My hands surved the purpose of being a bladder blade and then pitocine (aka manual uterine massage). Dr. Dan let me close fascia, so I was in medical student heaven!

– One morning, Dr. Priscila and I were greeted with a long line of patients waiting to be seen. In the front of the line was an elderly woman dancing for joy. What made her so happy? Her fistula surgery was a success. At the end of the exam, she pulls out a chicken to thank Dr. Priscila! I never thought I would get emotional over a chicken, but I was blown away with the woman’s generosity and realized the difference Dr. Priscila is making in their lives.

– A woman in labor had a uterine rupture, and instead of being able to rush her to the OR immediately, she sat on the delivery bed bleeding internally until her surgery. There are three main reasons why her surgery didn’t happen immediately. 1. Lack of resources. 2. Lack of personnel. 3. Not a clear understanding by the medical staff what is critical. Taking part in that c-section about brought me to my knees. My heart broke for the baby that passed and the women who would find out when she woke up from her Ketamine slumber. Unfortunately, this is not a rare occurance.

– On a happier note, I did my first colposcopy with just a headlamp and acetic acid! It was nifty!

Not to be obvious, but I stick out a bit here. No big suprise. Many do not try to hide their stares, while the neighborhood kids try to form their noses to match mine. People talk about me to my face, calling me a mulata which means I am half white and half black. My hair gets touched a lot too, because it is `original` and not a weave like many women.

More soon!

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