Catching up on Wed the 4th Day of Surgery

Wednesday I woke up with a sore throat = not good!!! and as the day went on I seemed to be getting a cold but I powered thru the day. My first patient was a cute little 9 month old girl Risha with a simple lip repair but unfortunately NO ONE could get an IV started on her - they had 20+ attempts (about 5 people each tried 4 times) so Julie the intensivist ended up starting an Inraosseous line in her tibia.  That was new for some people so when she came to recovery quite a few people took pictures.  Because she was tiny for 9 months and exposed so much in the OR with all the IV tries she came back to Recovery really cold (her temp was 34 ( normal is 37) so I spent over an hour trying to get her warm and having her skin to skin with mom. My 2nd patient was an 18 month old boy Filemo, he was a palate repair who did really well. His mom was quite young and I noticed she was wearing the "jelly shoes" that my girls wore when they were little. IF they have shoes at all they are either very tattered & worn sandals or these jelly shoes. The more traditional women from the outer areas also have a cross tattoo on their forehead (signifying they are Christians) and a gold ornate looped earring in their left ear signifying they are married.

Our "project" for today was a sad little 7 month old who arrived late yesterday after travelling several days with his mom. The baby had diarrhea and was dehydrated and while the mom was trying to breast feed she has malnourished herself and her milk had dried up. There was no Way we could do surgery so we started some intensive Oral Rehydration Therapy just to get him to perk up. Some of us decided to pool some money together to get some formula for them and is he is better and its just dehydration he could possibly have his lip repaired on Friday.  They don't have formula for the babies in the hospital...it is expected that the mom is breastfeeding and if not you would have to bring your own formula & own food. Op smile is providing food for the families in the post op ward and at the shelter...BUT it's not anything I would ever eat :)

Another patient was a 22 month old Tamrayo...who was dressed all in pink with a pink blanket and I assumed it was a girl...as I certainly cant tell by the names...however it was a little boy. They simply wear whatever they have available or have been given there are no cute outfits or even extra clothes they typically have the outfit they are wearing only - honestly most people in the states couldn't even fathom how they live here day to day. It is very humbling and causes you to be realize how blessed we are and how much we have. Even those who are homeless and the poorest in the states many can go to a shelter to get a meal or maybe an outfit etc - nothing like that exists here it is simply all about survival and what is even more amazing is that we have been told they are "dressing up" to come to the hospital and wearing their best clothing and most are thread bare.

My last patient was a 27 year old woman brought here by her younger sister. She had a horrific cleft lip - I took before & after photos. When she woke up after surgery & I showed her the repair in a mirror tears immediately flowed down her face & she grabbed tightly on to my hand & wouldn't let go....she was so grateful and thru the interpreter kept saying "Thank You, Thank You, Thank You" the surgeon Dan happened to come by the recovery room & we told her that he was the one who did her surgery & she grabbed his hands too it was very tender. She had lived  life for 27 years where she was shunned and now she would be accepted in her society...all because of a 1 hour surgery...of course I was all teary during all of this too. Their pure gratitude and joy just pierces my heart and I fell such an immediate LOVE for them. I dont know them, I will never see them again and they dont know me but for this one day our lives intersect and we are both changed by the experience we share.

The surgeries seemed to go well today and it seemed to be sort of a "normal" surgery day (if there is a normal in a 3rd world country with less then ideal set up by us according to US standards although it is MUCH BETTER than the country would ever have on their own) The afternoon things slowed down & what we thought was going to be an 8 pm finish left us with 2 more patients at 8:30. BY then I was REALLY feeling BAD and if I didn't think the beds had "germs" I probably would have just layed down on one of our beds in the recovery room. I ended up leaving at 8:30 with Carol & let Barb cover the last patient....Tylenol before I left the hospital, dayquil when I got to the hotel, some tomato soup, a shower & bed - hoping I wake up feeling better for our final day of surgery.

So grateful I am able to be here despite missing all the comforts of home & my family & friends - I feel their love & support though from continents away and that gets me thru each day. Honestly seeing all this need is heartbreaking - I am glad there are SO MANY organizations like Op Smile & so may churches who are reaching out to the people of Africa...their needs are so great here.     

Tuesday Surgery Day #3 - Long But Good Day Despite Roaches, Flies & a Rat

Okay so after hitting a wall yesterday an extra hour of sleep made ALL the difference - it was a new day - Carol & I took a Bejaj (little blue car - in Kenya they were called Tuk Tuks) and went by the Internet cafe en route to the hospital. According to Carol we almost got killed on the way - there seem to be no driving rules here & we had a "reliable" driver - Michael. I had hoped to be able to get Wi Fi and connect my CHOC computer - silly me that was not an option but I still felt better once I was able to blog and feel connected to the world outside of Ethiopia. It worked out great and we arrived at the hospital at 9 just as the 1st patients were arriving in the PACU.

Yes about the title of this post...I am definitely in a 3rd world country & almost don't take too much notice of it until today's rat encounter. It was another busy day & for lunch I just wanted a little peaceful break vs the activity of the lunchroom so I went into Trina (Speech Therapist) office. She came in right after & slammed the door & said there was a rat outside the door & we both screamed!!! She needed to go back out to see a pt. so she had me slam the door as she left to "scare the rat" and then she told someone it was there & about 5 min later comes one of the local guys who beats & kills the rat with a stick - I was safely inside of the room but heard it all!!! I assumed it was all taken care of but when I left it was still dead in the corner - disgusting!!! I HATE rodents!!! Batting flies off of my patients just seems normal and for the post op girls killing roaches is a sport - they have a kill count paper on the wall & are keeping track - they got 40 in just one night!!!Aside from those problems the electricity seems to go out routinely, there are armed guards at the hotel and the hospital and I am not really phased by much of it - except the rat!!!

Today in recovery was a totally different day - Barb was back & we were fully staffed and we even had some quiet moments - Julie our PI wants us to try to have a quiet environment as the kids are waking up out of the black hole of anesthesia which I agree with but achieving that is at times a challenge.

My 1st patient today was Aynom a Cleft Palate repair. His dad was so AMAZING - the dad was a huge big man about 6'4" or taller with big beautiful hands and weathered worn feet kneeling at his sons bedside gently wiping away the oozing blood - if you saw him on the street you would probably not see the tender man/dad in that rough exterior. They came 36 hours by bus from Tselmty after hearing about it on the radio and he just hoped it was true. He was very grateful & I card for him for 90 min & we took some nice pics together.

My 2nd Pt Michala was another little boy and had a very pretty & young mom who was so sweet - we told her that her baby would now have her same beautiful smile. Another patient was 12 yer old Freheymit (no I cant pronounce it well) & she was there with her aunt who was nicely dressed in "western clothes" & spoke some English & seemed very sophisticated - this was a first although we have seen people dressed in western clothes all around the hospital, hotel etc. Even thought perhaps she was "well to do" she said there were no resources (ie plastic surgeons) anywhere in Ethiopia to help her niece for the past 12 years..and they has waited all this time to have her life changed and now maybe she would have a "normal" life.

We only had 6 girl patients out of the 25 surgeries today ans\d since it had been so busy I gave the dresses to the students who were going to an orphanage today & they gave them out.  They weren't allowed to take photos but they said the girls were so so happy & probably had NEVER had a new piece of clothing in their entire life.  SO no pictures but definitely great feelings about my friends helping girls continents away.

Later in the afternoon I had a 3 1/2 year old boy Cleft Lip repair also from Tslemty with his mom who was in her traditional clothing. I guess there was a group that came together. She grabbed my shoulders & pulled me to her & kissed me twice on each cheek & tearfully bowed to me - I really thought I should be honoring her... One of the last cases was a 14 year old boy & before we sent them to post op the dad walked around the room to all of us and shook our hands & then you touch shoulder to shoulder & he also bowed and kissed each of our hands - they are such humble & grateful people here. We ALL teared up.

One of the later cases was a 25 year old boy who traveled 1800 km & just was screened yesterday for a lip repair - he came from Dansha 2 days by bus and a burro cart. Our last case was a complicated lip & palate - she had been in surgery for 5 hours & didn't even come off the OR table until 8 pm - we recovered here for an hour or so, picked up the recovery room & left the hospital at 10. Still a very long day but it was much more manageable for me just with the extra little sleep, getting online etc. :)

I feel so honored to be here helping - we have a really experienced team and it is so rewarding. I miss my family but it its a small sacrifice of time for a HUGE difference we are making collectively as a team - we will change 125 individual lives, their family now & their future perhaps with what we can provide...not sure where else i could do that :)

Monday Surgery Day #2 Hit a Wall Tough Day

If you read this blog please know that it is really my "journal" of my journey so when I write things it is not for either sympathy or praise it is simply for e to remember and to share with family and friends.

WOW 5:30 came early..and I wasn't at all "organized as far as my stuff in my backpack" to go to the hospital - so I was late to breakfast and missed the team meeting - oops! Maybe that is where Sarah gets her morning tardiness haha. Once at the hospital I went to the Pre-Post area to help since we wouldn't have patients in Recovery for an hour and I got to take some fun pics of the patients we cared for yesterday. They actually LOVE having their photo taken especially when you then show it to them on the camera screen - some even ask you to take a picture.

My 1st patient was Brak a 7 month old boy that I remember getting pre op pics of when he was on his moms back in a Mahthel - a traditional leather and shell baby carrier that is made and used in smaller villages.  They believe that carrying a baby that way makes them stronger - especially their back as they rear up to try to get out?? I am sure it makes the moms backs strong too as I have seen moms with 2 year olds in those. He had a cleft lip repair and did great- such an immediate difference.  Once the babies wake up we let them breast feed and with some of the moms in native wear breastfeeding I felt like I was having flashbacks to all those photos I saw in National Geographic magazines growing up - never did I imagine I would be here!!! I got some great pics after...Kevin was the surgeon - he too is LDS and from Alberta Canada. We told the mom the baby was PERFECT and she was so teary and grateful - thru our translator Samson (love him) she told us "God Bless you for coming to my country to help me and my baby, I will not forget you"

My 2nd patient was a 4 year old cleft palate repair who did not have an effective block and was in pain and screaming for nearly 2 hours despite about 10 doses of our precious pain meds - finally we got him comfortable.  Mom cried as he cried & I felt so bad :( I told everyone he counted as 5 patients!!! After him I slipped out to eat...tuna from home never tasted so good!

It seems like we have mostly boy patients - I a not sure if Clefts are more common in boys??? I will have to look that up. I did get to give my 1st dress away though.  I hadn't brought them yesterday as I knew the 1st day of surgery would be a bit chaotic. I brought about 20 dresses with me from 2 friends this first dress was from Heidi and Young Women in her congregation and I gave it to a 7 year old from this local area of Tigray - the mom was so grateful!!! The 2nd dress I gave away later in the day & it was a much larger than normal denim one my friend Carole made - sh gave it to me before I left and said "I don't know if there is a u for one this size but I felt like I should make it"  Carole is ALWAYS inspired and follows those promptings - that dress was meant for Zariya a 15 year old who literally was in a ragged long smelly dress - the mom was so thankful - I told her my friend made it & she said as she touched her chest then mine "from my heart to your heart to hers tell her I love her" I gave away  few other dresses after that but in the afternoon things just sort of went crazy...we did 24 patients today but at 5 pm we still had 10 to go on the tables and only 2 of us in Recovery - Barb had come in the morning but wasn't feeling 100% so we sent her home about noon. Kristen from pre post came to hep us but poor girl she ended up with a migraine & was on one of our beds until it needed to be filled by a patient. I am SOOOO GRATEFUL and feel SOOOO BLESSED that I am staying healthy.

One of Carols patients was an older teen who had a palate repair and stayed with us in recovery for 4 hours cause she was having alot of vomiting and some bleeding. Finally at 8 pm they decided to take her back - she had a tough day of it!!! Julie our Pediatric Intensivist Physician is so incredible helpful (actually EVERY PI I have ever worked with has been hands on & FABULOUS). She knows we are working short handed  and has changed sheets on beds given eds & done all that we are doing - she said today she was "channeling her inner nurse :)" We are  strong and united team of 3!!!

It was simply a LONG DAY!!! we finally left the hospital about 9:40 and as I got into the van with the others who stay til the end like me (the PC, CC, PI, Carol, Kathy & me) I just was teary and looked out the window....it was nothing specific just a combination of jet lag, being sleep deprived, working long 17 hour days, feeling disconnected and missing my family as I can only text them, etc etc. BUT I reminded myself that I can do BRAVE HARD THINGS - I tell my kids often that they can do hard things and this is my turn.

When we got back to the hotel the other team members who had returned hours before were in the restaurant visiting after dinner - Carol & I couldn't even go there - we were on the same page and had had the same day in recovery. We talked to Lisa the CC and asked if we could go in at 8 the next morning on Tues instead of 6:30 with the rest of the team & she was so kind & said yes.  We both just needed an extra hour of sleep and wanted to come to the internet cafe for 30 min to connect with the outside world!!!

At my room Jae as already in bed bu woke when I came in & we talked a bit - it is great to be in a mission with a friend even if you have different schedules - it is just nice to know you have someone in this with you who you know!!! Keep those prayers and good thoughts coming - I definitely feel that I am loved and supported in this journey.  Tomorrow is a new day!!!

Sunday Day #1 of Surgery in Ethiopia!!!

It is unusual to start a surgery week on Sunday but her we had to do it to get space at the hospital. Today was BUSY!!!! perhaps because the 3rd recovery room nurse Barb started feeling sick last night when we were setting up and wasn't able to be there today so it was a 2 woman team with me & Carol & our wonderful PI Julie. We were supposed to have 2 local nurses but we didn't so we WORKED HARD!!!It made for a crazy busy day!!! that started at 5:30 and ended at 10 pm - yep 16 1/2 hours. Good hing I was well rested when I started but now I am beat!!! and even thought I cant post my blog I am writing it on my computer so I don't forget as every day is filled with experiences I don't want to forget.

Before I tell you about today here is the follow up to the teaser from last night... as of 10 m we weren't even sure if we would be able to start the mission today as we didn't have safe oxygen cylinders from which to run the anesthesia!!!  The hospital was supposed to get them 6 mos ago after the initial small mission at this location and they didn't...they sent them to Addis yesterday for repair and refilling and they wont be back until Tues - day #3 of surgery. At the risk of "calling off the mission" ( I don't now if that has ever happened before?) they were able to get 5 tanks from somewhere in the country that were set up & ready to go this morning....unbelievable.  Also Sara our coordinator was bringing several of our narcotics in her luggage and they were taken from at customs so we have very limited pain and sedation for all of our patients an some limited anesthesia....so goes mission medicine and nursing & we just adapt because even the little e have is far more than what is available here.

We did 24 cases today - hence the late night in recovery as we are the last to leave after we send our final patient to post op - the post op nurses leave about 8 when the night shift comes in & surgery eaves after their last case. Usually the 1st day is a lighter slower start but not this mission we hit the ground running - the needs are tremendous.

Many of our patients today were part of the group that came on a 3 day bus ride from Somalia....stories of great distance traveled and sacrifice to get to the mission site are ones I have heard before but still each time the faces are unique and situations heart wrenching., I think there were about 20 or so on their bus and 9 or 10 needed surgeries...they were scheduled at the beginning of the week so that they can be housed at the shelter and get some follow up before returning to Somalia. There was a translator just for them as that speak a different language her ...their dress is very modest and nomadic and the women's hands are all black & covered with henna (a beauty ritual) and ALL their feet are weathered and rough.  I really cant imagine their life or the 3 day trip here. It is interesting that many of them are here with their fathers rather than mothers as the travel her would be too dangerous for a woman and a child which makes sense, only 2 or 3 had mothers with them.  I thought of those mothers so far away from their children not sure what is happening to them & how amazed their will be when they return with beautiful new smiles - I am sure tearful joyful reunions will occur.
My 1st patient had the sweetest dad ho cried openly when he saw his son - I expect to see oms cry but dads crying was a whole separate experience. and made me ore emotional.  I did gt some photos with that dad :)

There was the absolutely most darling 3 year old who had the worst bilateral cleft lips I had seen - also from Somalia who was repaired today...he looked like a completely different child. His was a long 3-4 hour case for the extensive repair - cant wait to post pictures!!!. He was with his mom who was pregnant and after the stress of the ravel here and the emotion of the surgery she got sick...really sick in the recovery room with him, so we had 2 patients in his bed.  After a few hours and some food and drink she was better - she hadn't eaten much in her travels or since arriving, had no one with her and I was able to give her some TLC and support :)

Another special fiend Makala was a beautiful 7 year old girl from Somalia also with hr mom and the mom us cried and cried and kept pointing to my heart and her heart to express gratitude - yes heart to heart we communicated.. When it was tie fr her to go to post op instead of putting the little girl in a wheelchair the mom wanted to carry her on her back. Carol has bee on LOTS of missions an had NEVER seen that before...we both got a little teary & those are the moments that make Missions amazing. after all this mom did to get her daughter here sh e wanted to carry her up on her back up to post op...yes a parents love for their children is universal and transcends all cultures but it seemed t manifest itself a little ore purely between Makala an her mom - yes photos were taken.

There was a really FUN dad who I of course couldn't communicate with but he just kept giving me the "thumbs up" sign each time I went to care for his son - and he had a GIANT SMILE on his face the entire time. I thought the people here have a REALLY HARD LIFE but here he was so genuinely happy - made me think about the little things I sometimes let bother me.

The PACU/Recovery room is basically periods of complete noise and chaos when all 5 beds are full of crying children each with a parent plus the 3 of us and maybe 1 or 2 other volunteers all in 250 square feet of space...then every now & again we get 15 min of calm with only 1-2 patients.

Sometime this evening there was a huge cheering and when I asked out translator what it was he told me Ethiopia just beat Sudan in soccer - foolish me I asked if the stadium was near the hospital - it was that loud!!! But NO...apparently t was on TV & probably every TV in the hospital was on that channel (didnt even know that had TVs thee) and it was ll people at the hospital cheering. Apparently Ethiopia played another Sudan team recently in Sudan & lost so this was the rematch and determined who would go to the African Cup & Ethiopia hadn't been there in 31 years - most of these peoples lifetimes . SO for those of you who are sports fans - rivalries are alive and well all over the world!!!!

My nearly last patient after the soccer celebration was a 7 year old from Somalia also there with a mom who had her other child a 2 year old on her back!!!  The 2 year old seriously seemed to know when I pointed my camera at her & she smiled!!!

we got back to the hotel at 10 om - lots of the team was there eating -I was equally tired and starving so I joined them and actually had some yummy pasta - 1st thing I have eaten here besides the pizza!!! I need to shower and get to bed its almost midnight & my 5:30 door knock wake up call will come sooner that I'd like...even thought it was a busy day and I worked hard I thanked Sara for inviting me on this mission...wouldn't want to be anywhere else right now!!! even thought I miss my family like CRAZY!!!

Arrival in Mekele and Saturday

So the Internet does exist in Ethiopia it just doesn't like to connect to my CHOC computer...an IPad may be in my future!!! The internet (and electricity in general where we are at) is not that reliable but I will take what I can get. I have to catch up on my truly miraculous flight from Addis to Mekele.

After being put on standby I went back to the main terminal and exchanged my US $$$ for Ethiopian Birr about 18/$1 US. I tried to get Internet in the main terminal and was able to make my first blog post and spent about 4 hours people watching, having a "coke light" (the only one I have found in this country so far) and eating some of my snacks cause nothing looked good. I went back to the domestic terminal at 2 pm as I was told & it was all new workers at the Ethiopian Air terminal counter. I retold them my plight & they seemed less than encouraging & told me to step aside until 2:30. I watched the people coming in imagining that they were all going to Mekele and at times getting nervous but I kept reminding myself that what is meant to be will always find its way. I moved back closer to the counter and asked a new person what it looked like, then another person called for everyone going to Mekele to come forward  and several were in line. I was getting nervous but tried to reassure myself. At 2:50 the person I spoke to motioned me over and told me to go to another desk for rebooking, there they asked me to pay a 100 Birr rebooking fee ($5 US). This was a process all done by hand and seemed to take forever I asked if that meant  I was on the flight all the while thinking the flight could already be leaving. I took my receipt back to the counter was given a boarding pass seat 30A and told me to RUN to the gate - which I did. It was a small plane we boarded outside and I got the last seat on the last row of the plane!!! I had text my family and a few friends earlier to please pray I got on that flight & I was praying all day too so as I walked on to the little prop plane I was pretty emotional as I realized I was getting on this flight cause prayers were offered and answered for me that day I had no idea there were only 60 seats or I may have been even more nervous while I was waiting. I text the Op Smile folks that " I made it" and to get me at the airport. When I got to the hotel everyone said that they were told there was "no way I would get on that flight as they are always oversold" to which I said " I was prayed onto that flight" to get here today. Had I not gotten on I would have accepted that but I 
knew I had to try...I didn't travel 10,000 miles from home to spend a day where I wasn't supposed to
be.  How grateful I was to get that flight and arrive in Mekele. It was a small prop plane a 60 seater
and a very bumpy flight. I got to the hotel and got settled...it's definitely much lower quality than any 
other country I have been to even Kenya but it has running water and not too many bugs. I got an 
update from my roomie Jannae about screening and went to bed

I thought I was sort of on a good schedule after getting sleep on both red eye flights but I woke up at
3 am and could not go back to sleep not matter what I tried. We had a team breakfast at 7 a.m.  And I
was introduced as the new arrival no one could believe arrived:) we had our team day Saturday and it
was AMAZING!!!

When I drove in from the airport I thought this seemed a lot like Kenya but today I realized it was much different& seemed more impoverished. We started an hour drive to Wukro & on the way we
saw the tiny huts some people live in, there were people washing their single out fit of clothes and also themselves in the stream that ran by the town ( yep buck naked). There were lots of burros pulling carts & young children herding small groups of cows or goats. Very few seemed to have shoes or if they did they were old and broken.

We went to our first stop an archeological site where a temple was discovered and that was very interesting with lots of symbolism. Then we went to our " real event" which was to see an old church from 400 AD ....it was a deeply moving experience that I certainly didn't expect to have. We were there on Sat Oct 13th and Oct 14 th is the Feast Day & a Day of Pilgrimage so as we got closer to the church there were more and more people walking towards the church. I asked if this was a local event & our guide said no it was for all of Ethiopia and that some people would walk 1350 kilometers to get there over 2 months time from places farther than Addis. I was stunned and it made me wonder if my faith was such that I would do something like that? How far would I walk to worship?

After parking & walking towards the church we heard loud chanting coming from the church and
there were clearly many sick, blind, I'll and debilitated people there sitting on the path and steps to
the church...as they do believe in healing powers on this day. We went inside and it was pretty full of people mostly men & there was a back room where only the men gathered to chant and play musical instruments 
(many of the musicians were blind) while we were in there the "high priest" came in and removed the 
scriptures ( the book of psalms) from the alter and began to accept people's offerings (which varied from $$ to animals and all sorts of things) and then he would bless the people and they would be able to go to the alter and pray. Jae and I decided to give an offering and get blessed out of respect for their culture and it was a sweet experience. Inside the church the walls were covered with fresco paintings of Adam & Eve in the Garden of Eden, Christs birth, life and crucifixion.  There is quite a bit more history as well but I wont go into that.

We spent much ore time at the church than was planned then we went back to Mekele and had Pizza (yes that seems to be universal I think I have eaten pizza on every mission). Then we went to the hospital to finish the Recovery Room set up - it isnt bad actually a little better than Kenya and not as nice as Mexico or Bolivia. We didnt get back to the hotel (using that word loosely) until 7:45 and had a team mtg at 8:15 and there was no electricity but I was determined to shower before the mtg since I was dead tired so ya I showered with the light of my mini flashlight!!! I stayed at the mtg until 10 then when they broke into the all nurse group I left as I was n hour #20 of being awake & we were to have a 5:30 a.m. wake up call (which is someone knocking on your door til you acknowledged them & we had a 6:30 bus to the hospital.  I CRASHED & dont think I moved much before the door knock & my phone alarm went off - it is  amazing what sleep does for you.

So now we are off for Mission Day #1 which almost didn't happen due o lack of oxygen and some necessary meds  - more on that next post. I haven't touched or seen a patient but walking up to that church and seeing all those in need made me know I was supposed to be here - it is impossible to see needs like this and not be catapulted into action. I know not everyone can have these experiences....it truly is a blessing to serve in this country with some of Gods children who have tremendous needs but I realize there are similar needs in the states but it seems that we have so much ore of just our basic necessities even in the worst situations - I know there is homelessness and children going hungry at home and medical needs and I want to try to be more aware of that at home as well as abroad.  I don't have to travel 10,000 miles to serve but here it seems nearly everyone is in a desperate situation. It is once again great to be a part of an international team of strangers who are all here with a united goal of changing individual children's and families lives one smile at a time.  Not sure when I can post again...love you all! Nurse Nancy

Arrived in Addis Ababa Ethiopia - TRAVEL BLESSINGS!!!

Well I am in Ethiopia and thinking this may be the only time I have internet service so I better make a blog entry.  I have been at the Addis airport for about 4 hours and had an lost internet service about 20 times...I sort of gave up for awhile but I have had it ow for about 30 min and even got on Facebook so I thought I would try although I just got an error message so I may be typing for naught.
First thing don't ever have 3 trips or events you are trying to pack for or be involved with all at the same time.  When I left home I had a bag for LA, my giant bag for Ethiopia, a bag for the 2 day London stay on the way home & 2 other bags of everything else I knew I needed but had no idea where to put it!!!  I enjoyed the Magnet Conference for a few days - he highlight was hearing Stephen Covey Jr. Speak on Trust...I had his dad (who died recently) as a professor at BYU & he was the nicest man. I got Stephen Jrs new book & had a chance to talk to him about my memories of his dad 30 years ago :)
Red Eye flight to London was FULL & I was tired & knew I had to sleep. I had a window seat next to a nice man & as we talked I said I was hoping to sleep - I went to get water in the back of the plane before take off & when I came back he had moved across the way & said a family was just upgraded & I should take this now empty row of 4 seats he was "holding for me". The stewardess moved a young man to the other end but there were still 4 empty seats in between us on an otherwise full flight. I took some sleeping medicine, put my seatbelt on & was asleep after take off skipped the 2 meals & while I tossed & turned alot I definitely got good sleep!!!
Arrived in London - found the "Tube" & took it to a stop them walked successfully to my nephew Petes flat in London - pretty proud of myself for that!!!  Visited, took a shower - BEST THING EVER, organized 3 of my bags so I could leave one there, we went out for Fish & Chips at a famous Pub then I made my way back to the airport.
Red Eye flight #2 from London to Addis was even more full - I was in row 40-the LAST ROW!!! I told the stewardess I really needed to sleep - she said see how it fills up.  They boarded by row & after 30-40 had come in I found a middle row of 3 seats unoccupied & put some of my stuff there & also 2 seats on a side & put other stuff there just to see if there would be late boarding people...we approached take off time & Ihad secured the 3 seats on an otherwise VERY FULL flight - just anther little miracle. Slept most all that flight - although they did wake me up each time they served food????
Arrived here, went thru immigration & customs and straight over to the Domestic terminal as i had been told 2 days before that my flight to Mekele was overbooked & I was taken off of it and might need to stay overnight in Addis - I REALLY didn't want to travel 10,000 miles to have a day "waiting" so called on my family & a couple of friends to PRAY PRAY PRAY that I could get onto a flight but would accept whatever was to be. There are 3 flights a day from Addis to Mekele - the 7 am one had already departed, the noon (my original) was now cancelled & the 3 pm is overbooked.  Still praying & knowing others were as well I spoke to the agent at 7:30 this morning - they took my big bag & gave me a standby ticket & said "it looks good". I will go back there in 2 hours at 2 pm & with great FAITH  I will HOPE prayers have been answered and my travel miracle comes to pass.
I have an International Ethiopian Cell phone I ordered before I left that seems to be working in the country & I called Dougs office but there was no answer & I realized it was 1 am there - I need to figure out this time difference.
I am missing screening today...I am anxious to get to Mekele and meet the rest of the team and do what I can to help. Again I am doubtful I will have any internet service once I leave Addis - even a few locals I have met in my 4 hours here in the airport "lobby" say it is sketchy. It does seem to work a little better if I log o to google & then try to navigate to another site...THANK YOU GOOGLE (& my nieces husband Jon who works there!)
Anyway - I am feeling good, rested and ready to work once I get that 3 pm flight :)
THANKS for the LOVE, GOOD WISHES & PRAYERS - I  feel the power of all of them!
LOVE & HUGS from Addis Ababa Ethiopia

Back to Africa...Ethiopia this time...

Well in just over a week I will be headed back to Africa with Operation Smile and again it has been one of those times when...."what's meant to be will always find its way".
The end of June I was contacted by Sara the wonderful mission coordinator from my Bolivia Mission to see if I wanted to  join the team she was putting together for Ethiopia...she knew I wanted to get back to Africa & I was super excited UNTIL I realized the mission travel dates conflicted with the Magnet Conference that CHOC is Co Hosting in LA which is largely my responsibility.  I tried & tried to make it work but ultimately had to say "I don't think I can go - it just wont work to do both".  2 weeks later my friend Jannae from Salt Lake (we were in Kenya together) call me to tell me she was offered a mission to Ethiopia & I should see if I could go...I had to tell her I had given Sara her name as a fabulous Pre/Post nurse but I couldn't go :(
talk about regrets...I mulled it around in my mind for a few days & re contacted Sara to see if there was ANY WAY we could make it work - to which she said..."I had contacted you first but when you said you couldn't go I filled my team & Jannaes spot was the last one I had to fill".  I said "no worries it just wasn't meant to be"...but I was REALLY disappointed.  I wanted to get back to Africa & I knew the needs in Ethiopia are tremendous, I wanted to go on another mission with Sara as coordinator & I REALLY wanted to go on a mission with Jannae BUT I just kept reminding myself it just wasn't "meant to be" and Sara said perhaps I could go to Thailand with her in Nov. So I tentatively blocked a week off from work then in hopes that would work out - but I couldn't get Ethiopia out of my mind.

3 weeks later I was in a mtg at CHOC and my phone vibrates & I see the Op Smile phone # so I step out & it's Sara who says "one of my Recovery Room nurses just had to drop the mission - if you can go I will work it out for you to travel & arrive late - it will be  different mission for you, you will likely miss screening but I would love to have you go".  I didn't even think twice & I said "I am 90% sure I can go plan on me just let me talk to my family & my boss at CHOC & I will get back to you in the next day". I asked Doug & the kids what they thought & they supported it 100% so the hard part would be CHOC - I looked at the Magnet conference schedule & my responsibilities, talked to my manager & Admin Asst to see how they felt covering for me for a day then asked my boss (the CNO) if I could move that week I scheduled off in Nov to Oct & leave the Magnet Conf a day early to go to Ethiopia...I told her I NEEDED TO DO THIS...this was why I became a nurse to relieve suffering and make a difference in children's lives and learn "the healers art". This I told her would "refill my core of who I am" & when I got back I would totally focus on the administrative things she needed me to do but I really had to go. She thought for awhile cause with the new hospital tower going up I have alot of responsibility but I assured here my team was great & could carry on without me. At the end of the day she called & told me to "go on & get it out of your system" then I need you back here 100% until we open the new tower. Without hesitation my reply was "You've got a DEAL" and so "WHAT"S MEANT TO BE WILL ALWAYS FIND ITS WAY". Ethiopia for me was meant to be :) and that was almost 2 months ago.   

I have had a crazy few months & consequently have done absolutely nothing to prepare to go, not even made my packing list!!!  A friend from church made some dresses for me to take & another group of Young women are making some too. Just this last weekend I printed out all 3 of the "team packets" and read them on my fight to Utah for Parents weekend.  I am both excited and somewhat anxious to go & serve in Ethiopia - the situation there seems dire.  I just found out that there is no Internet service at the "hotel" or "hospital" we will be at & cell service is spotty so "tell your families if they don't hear from you not to worry". That is so not my MO...even 10,000 miles from home I want to be connected to Doug & my kids & CHOC. On every other mission I have been on I have always been able to be in pretty good contact & knowing all was well at home allowed me to focus on my work there - but despite having a global phone Verizon cant guarantee me service and a "data plan" for Ethiopia doesn't exist - YIKES!!! I am hoping maybe the phone I bought in Kenya might work if I buy a sim card there??? and in my mind there has to be some "internet cafe" somewhere nearby??? The non communication potential is my biggest concern.

My second concern is the travel - I will basically be taking 2 back to back "red eyes" LA to London one night then after a 7 hours layover another red eye from London to Addis Ababa Ethiopia then a "domestic flight"aka small plane from Addis to the more remote area of Mekele where the mission is in the northern most  part of Ethiopia right next to the countries of Yemen, Sudan & Somalia. I will be travelling by myself - the rest of the team is leaving 2 days before me..so that makes me a little nervous but really it is just navigating the Addis Ababa airport that may be a challenge & hopefully someone will meet me at the airport in Mekele??? I don't have that flight info yet.

Sara told me from the very 1st call that this was a "rustic site" and I am not sure I can fully conceptualize that but with these facts about the area we will be in it's clear to me they need us there...20% of the population there live on less that $1 US a day for a family of 6-7 who typically live in a 100 square feet mud & thatch huts. 50% of children are underweight & 75% of families share their sleeping quarters with livestock. Only 12% of homes have cement floors 88% are dirt and most children sleep on the ground where night time temperatures average 40 degrees F. In the capital City of Addis Ababa 55% of the people live in slums and further out where we will be that % climbs to a much higher #. Infant mortality is 10% - 1 of every 10 babies die??? and the life expectancy is 48!!!  Sanitation is nearly non existent - which is probably why they asked us to bring soap so we can give the kids baths before we do surgery :)  in ALL of Ethiopia there are on average 2 .5 physicians for every 100,000 people and there are MANY Orphans & Vulnerable Children who cant attend school unless they have school supplies.  I read all of this & despite seeing ALOT of poverty in Kenya I don't think I can fully conceptualize all of this & it makes me think of all we have, all we take for granted, and how we spend or waste money on things everyday that we dont need - while $1 would sustain a family of 7 for an entire day....it is incomprehensible & I get emotional just thinking about it. If we just skipped a trip to In & Out we could support a family there for almost a week without really making any sacrifice of all we have & often dont appreciate.

Since I am taking a "domestic flight" once I get in the country I can only take one 50lb suitcase - I have always brought 2  very full 50-60 lb suitcases mostly filled with items to give away but a 2nd suitcase would cost me $160 American - is that crazy??? that $160 would sustain a family for almost 6 months - so do I spend the $$$ and take a suitcase of cloths & school supplies for the orphans or is is better to just take the cash & use it to help them once I get there? But the Peace Corp volunteers say they need school supplies & love children's books which leads me to doubt that they have school supplies there I could buy after I arrive - I have alot of figuring out to do in this next week! Actually I just have alot to do in general....so I just wanted to let all my family & friends know as I haven't talked about to to too many people until recently.  I would appreciate your prayers and positive thoughts this week as I prepare & of course next week when I leave - I absolutely cant do this on my own and am looking to my Heavenly Father for strength and direction. If it is meant to be I have to have faith it will all work out...I firmly believe that when God takes YOU to it HE will get you thru it!!!. I think I will be reminding myself "this mission is meant to be for me" & repeating the "If GOD has taken me to this HE will get me thru this" phrase hourly this next week.  I will blog again before I go so stay tuned if you want to stay in touch on this next adventure with me :)

Last Bolivia post...a few months delayed!

Soooooooooo 4 months later I am finishing up my last blog post from my Bolivia Mission. I am usually really good about blogging when I am on a mission & during the days I make little notes of things I don't want to forget but the last day typically leads to my travel home & then I am in recovery mode and then back in "real life mode" and my blog goes untouched....until I am getting ready to go on another mission and then I remember that I never finished blogging about my last mission (more on that in another post)

Anyway the last day of surgery in Bolivia went really smoothly we did lots of cleft lips which are simple 45 min surgeries but make such a HUGE difference in these children's lives!!!  we actually had some older teenage lips that we did & that always makes my heat happy cause I know these kids were probably teased or even worse shunned and now they have a chance at a more "normal" life. The other nice ting about Fridays is that we get to do some "extra" surgeries if we have the time.  We removed an "extra thumb" that a 4 year old boy had & his mom said the other kids made fun of him, we also did a removal of a large facial hemangioma on a teenager that also would change her life and we did the surgery on my little friend the teenage girl who I mentioned in another post was the last surgery called on the day everyone was notified.  She just needed a scar revision - actually sort of a lip do-over & she was SOOOO HAPPY to have the surgery - I felt like I could actually see her self esteem rise as we gave her a mirror to look at herself after surgery.  These are truly some of the most rewarding moments when older kids see themselves differently than they ever have or perhaps ever imagined.

Also today they were taking many of the post op photos from Day #1 of surgery before patients began their sometimes very long journey home.  Seeing them for their post op final pictures was new for me - usually that is set up far away from the recovery room but in this case it was right outside our door across the "magic wall!  So we got to see the patients come full circle from screening to surgery to heading home.  The little orphan boy "everybody's baby" was there with the sweet woman from the orphanage...he was so precious - I just wish I could adopt him & bring him home with me!!!

I gave away the last few fleece blankets to some of the older girls and some of the beanies that were small gave to Christina the head OR nurse to use for the newborn c section deliveries in the OR - she was so grateful :)

Since it was a slower day - as it always is...we had time to take pictures with other team members & also Ankour one of the Plastic Surgeons from the UK is in the Royal Army there & has had several tours of duty in Afghanistan - he had a video montage that he put together that brought the injuries of war to our young soldiers VERY MUCH TO LIFE...soldiers with all sorts of body parts blown up or off...remember he is a plastic surgeon so he's not dealing with anything minor...he said that was the opposite of his Operation Smile...it was very sobering but I am glad I watched it...made me immensely proud of all of those in harms way for the freedom's I sometimes take for granted.  I also spent alot of time with Claudia out Pediatrician - LOVE HER!!! I don't remember if I already posted about this but she told me that MD's in Bolivia working full time 7 am-5 pm earn about $500 a month...some nurses in the US can make that in a 12 hour shift!!!  That is why she is not working here - she is from Colombia & there working part time 7 am-1 pm physicians could earn $2000/month.  I certainly do not understand the disparity between those 2 countries!!!

It was rainy today & the mosquito's were out in full force - I swear I have 100 bites & it is a miracle/blessing I have not gotten Dengue fever!!!  We finished by about 3 & got the PACU torn down & packed up pretty quickly. Claudia took Gayle and Erika & me shopping to some of the "local" places...I found some wonderful things to bring back, and we ate some local food from street vendors she new were "safe".  we "rented a taxi & driver"who took us wherever & waited for us for the 3 hours we were gone for about $12 American!!! 

We got back to the hotel showered and packed up since both Gayle & I were leaving at midnite for our 2:30 am flight.  We walked to a different area of the hotel and there was a double decker "party bus" waiting for us - everyone was so excited!  The took us on about a 90 min tour of Santa Cruz & I saw places there that I never knew existed in Santa Cruz...areas of affluence and prosperity, colleges, high end shopping etc - an entirely different world than what I had lived in the past week. After the city tour we went back to the restaurant of the man who is the Op Smile President - where we had been earlier in the week. The gave the normal talks, showed the slide show, etc - it was really nice.  Gayle & I had to leave by 11:30 to get back to the hotel change into comfy clothes & get our bags & take the bus to the airport.  I took an Ambien so I slept well.  We had one connection and were in LA about 16 hours later - got thru customs pretty easily & made it home.  I was ready to be home - my work was done & I was pretty tired.

Just like that another mission done...lives changed, a wonderful team of new friends met all of whom love to serve and help others.  Again I am INCREDIBLY GRATEFUL for this opportunity..there are people I will never forget, stories that have changed my life and smiles that were created.  I LOVE THESE CHANCES TO SERVE GODS CHILDREN IN DIFFERENT PARTS OF THE WORLD!!!

Thursday - Day 4 of Surgery less CRAZY? than yesterday 27 Patients!

I ABSOLUTELY LOVE Op Smile missions but I have decided they are alot like Childbirth you sort of forget how hard it is until once again you are in the thick of it...like on day 4 of 5 surgery days...

The night nurse (who is from CHLA) has the absolute hardest job of everyone - she was supposed to have another international team member who cancelled last minute so it has been her & a Bolivian volunteer who works a full time job then comes to volunteer at night.  As you can imagine the volunteer needs a few hour nap in the night leaving Lorena with about 50 patients -  the 25 from one day & 25 or so pre ops & a few hold overs...so Linda from the recovery room went to nights with her leaving Erika & I in the recovery room - but since Linda & I did it with 2 yesterday we figured we would be fine with 2 today & tomorrow.

The morning excitement (for some) or interruption (for others) was that "Miss Bolivia" came to visit & do a photo shoot...she was very nice but at the time she came in the PACU we had 4 "screamers" & it wasn't a pretty sight - oh well....it was a steady flow of patients today & less chaotic that yesterday - probably because we didn't lose a single IV :) HOORAY!!!  I did however hang abut 30 new IV bottles - that was part of today's theme for me...not sure why but everytime I looked up an IV bottle was empty...we had some wild patients but typically not all at once.

The definite story of the day & perhaps the mission was Juan Jose - the little patient from La Paz with the low hemoglobin that Gayle got the team to add on. He was supposed to have surgery on Tues then got sick so we started him on antibiotics & weren't sure if he'd get better for surgery by Friday or not but he did & today was his day!!!  A few more details to the story of mom's 30+ hours of travel...on that bus ride the reason it took so long was there were  2 roadblocks on their journey.  At the first one many on the bus persuaded the driver to try a new route which would add time but they were all willing - so the driver complied.  The 2nd roadblock however was later in the trip when many were tired or hungry & I think she said it was in the middle of the night & many were sleeping.  The driver was going to turn around & Juan Jose's mom & I think a few other women were awake & asked the driver to let them try to clear the road.  They spent several hours in the dark removing whatever it was blocking the road so they could continue their journey...talk about doing whatever it takes to remove the obstacles in our paths to achieve a goal...WOW!!!  and they weren't even guaranteed that there wouldn't be another roadblock ahead....all I could think of was would I do that...do whatever it takes to get to my destination or would I be deterred??? What is my level of commitment to my ultimate goals??? what am I willing to do to make sure I achieve them & who else do I get to help me??? when I get past one roadblock do I muster up even more resolve to get past the next one or do I get discouraged???

When Juan Jose was passed "over the wall & into surgery" today we were all there taking pictures & she told us that she wanted to save her money so that he could become a Doctor & help people like we were doing...another tearful moment...when he came off the table about 90 min later the transformation was AMAZING!!!  we knew his mom would be so happy with his new smile & couldn't wait to bring her in the recovery room - as expected she got very teary when she saw him & said - that is my baby?  & she thanked & hugged everyone...that was one of  my defining moments this mission.  She also said "everyone in my town told me when he was born that I had an ugly baby but he was never ugly to me and now they will see he has always been beautiful"  - another life lesson... It was a neighbor who told her about Op Smile & told her to come to Santa Cruz - her husband told her she was crazy & no one would give them surgery for free - that she was going on a crazy trip...we think that was why she couldn't have returned without the surgery or she would have been shunned & scorned even more....I am fairly certain I will never forget Juan Jose & his mom...before leaving tonight I had to take some supplies up to Post Op & saw her again - & he looked SO SO CUTE...I hope she & her son have a bright future the best they can in their world - some friends from church had give me $$$ to use as I thought best & I gave her somethings to help them on their journey.
I will share before & after pictures when I get home!

There were many other memorable patients today...a darling 1 year old boy with a sweet 18 year old mom & very sweet grandparents who were there with her - they asked if I was LDS & I said yes & they said they were too & were from about 10 hours away...it was busy when I was caring for them & discharging them from the PACU but I also saw them tonight & was able to help them on their journey - really others at home are helping them thru me.  Near the end of the night we had some 12-16 yer old girls - they always remind me of my own kids & I often think of how these teenagers lives are changed in a one hour procedure...
I finished giving out all the dresses I had today - the last one was to the sister of our last patient & she was so excited to get it she put it on immediately & I got a picture :)  I still have a few CHOC shirts & a few toys for tomorrow.

A few other things about the day.  Gayle started the day fine but by 2 wasn't looking so good - we ended up starting an IV on her & I infused  4 liters of IV fluid (8 of the bottles I hung today). She is feeling better - a few others are down & I recognize how blessed I was to have such a mild case of whatever it is we are all getting! Claudia the Colombia pediatrician told me we are in a VERY DANGEROUS part of town...I knew it didn't look good & there are guards at the front of the hospital but when she said that she rides the bus to our hotel & then get a taxi from there it going an hour out of her way it was a bit of an ah ha moment for me...we are serving those who perhaps need it the most but I have felt safe.

Its almost midnight...I am tired....and tomorrow we have our final 20 patients plus take down.  We are only doing lip repairs tomorrow no palates & also some are just local anesthetic...so hopefully we will be done & out by 5 or so.  The final team party/dinner is at 7:30 & then Doug was able to change my flight from leaving at 2:30 am Sun morning to leaving at 2:30 am Sat morning (really just late tomorrow night) SO in 24 hours I will be en route to the airport & then a few hours later start my journey home...it seems unreal.  But I am ready to be home, with my family, in my house & in my bed....after one more day....

Feeling Much Better & a short day!!!!

So I woke up feeling MUCH better...however Gayle..not so much.  seems like today it was her turn & Erika another Recovery Room nurse too.  They both had exactly what I had maybe even worse!!!  all day yesterday as I felt sick I just kept praying that I would get thru the day & I think I was blessed to do just that. I was scheduled to go on the later bus so the folks who arrived at the hospital 1st sent back Gatorade & meds for the "sickies" & I got Gayle settled before I left & didn't even know Erika was here sick!

Since Erika & Gayle stayed back that left Linda & me & Claudia a Colombian Pediatrician who now lives with her husband in Bolivia & regularly helps Op Smile on missions here.  She was nervous to be in charge but she did great.  We also had our 3 volunteers who each took a bed that they would "man" for basics while we did the medical care - BUT....it was a CRAZY day in there with alot of chaos.  We decided it was a myriad of things - it seems that all the Palate repairs who came back had their nerve blocks wear off before they got to recovery so instead of coming to us somewhat sedated they came to us crying & screaming.  These same kids we also decided were also the strong personality patients who fought just about everything we did & 5 of them managed to get their IV's out...which we had to restart usually with a team of 3.  Isabella who at screening seemed like a delightful little girl was brought in by her surgery team & in Spanish they called her a wild devil child...I seriously gave her 4 doses of pain med in the span of an hour & she still screamed even after I brought her mom in to held her - the karma was definitely not working in our favor.  Another patient lost quite a bit of blood & had a low blood pressure so I had to give some fluid boluses.  Several had respiratory difficulties & I gave about 6 aerosol respiratory treatments,  A few had fevers...is was as I sad a crazy day...and our volunteers...well I trained Villa on the fine art of pulling fluid from an IV bottle to help me with the 2 fluid boluses I had to give trained all 3 of them in holding/giving resp treatments & they all helped all of us with IV starts..so much for them "Manning a bed for the basics" they were a crucial part of he recovery room team & we took a picture of the PACU "Wednesday team" at the end of the day - one of the few pictures I took today & I didn't take many yesterday when I was sick so I have to make up for it the next 2 days!

4 patients were cancelled today because either they were sick or didn't return...so we only did 22 cases today & it was a miracle we were done by 6:30 & back at the hotel by 7.  I had never left the hospital when it was still light.  Rumor has it tomorrow will be a long day! 

A few fun things...one of the patients from yesterday came back to "model" her dress for me (I did get a pic of her!)  They have these great things Cunapes at breakfast every morning &  often as a snack in at the hospital..they seemed like cheese rolls to me but today I asked Claudia about them she said they are made from yucca & queso (cheese) & butter - sounds fattening & probably is cause they are yummy.  I had one today when i was feeling better.

Other things I have noticed...last night when I was getting home close to 9 pm I couldn't believe that on many corners there were young mothers usually with a toddler nearby standing who were selling fruit or other things on busy street corners.  The streets are crazy & because they done have money for signals (except in the main big cities) all streets lead to roundabouts because that way you have to (in theory) slow down & merge - to me it seems like a big game of :Chicken" cause no one really slows or stops - its completely crazy!!!  There are also ALOT more stray dog wandering the streets than I initially realized - especially in the barrios near the hospital.  As you pass peopled 10x10 place of "business" electrician, vet, car repair - whatever it seems they all just stand or sit in the doorway waiting for a customer to come to them...and then as we left the hospital tonight there was a young girl cooking meat in a grill that was over a wheelbarrow w/ the fire portion in the wheelbarrow - I wish I had thought t take a picture of that....

Its already 10:30 & I want a good nights sleep for a busy day tomorrow but I was glad I got to make some phone calls via Skype to my family & my office at CHOC & TT..all is well in my absence & that allows me to focus on what I need to do here...Buenos Noches from Bolivia! 

2ND DAY OF SURGERY 25 PATIENTS & why I didnt blog yesterday

No it's not because I got called in Monday night when I was on call - THANKFULLY I was NOT called in.   Monday night I went to bed feeling fine but in the middle of the night I started feeling queasy & getting the chills - I was hot then cold.  By the morning my stomach was rumbling but I was determined to push thru it cause after all there are only 3 of us in the recovery room.  On the bus to the hospital I got a little worse not better & wondered if I was to get sick how exactly that would work sitting on a bus with about 30 other people...when I go the the hospital I told Gayle my symptoms (aside from being my roommate & the Dr in the recovery room she is also the "Team Dr") She gave me some meds & they offered for me to go back to the hotel - I said I'd see how it went as I thought I could work in the busy spurts we get and it sort of worked.  I kept myself on clear liquids all day to rest my gut & also stay hydrated.  A few times I got chilled & wrapped up in blankets but it passed.  All day they told me I looked terrible but I said no I only feel a little bad...denial...yep I was in it...

The 1st patient of the day was Damian & once again I helped carry him (actually his stuff  - IV & Chart) out to his mom & once again she cried & then Gayle & I cried...something about the 1st patient of the day???? so emotional....

As if being sick wasn't bad enough (If you have a queasy stomach move to the next paragraph) Craig one of the anesthesiologists came in to share with us in great detail how he went to intubate a patient (put the breathing tube in) & pulled out a worm!!!  I left the room for that conversation - but it got worse...when "worm boy" came to recovery I told Erika there was no way I was helping w/ him & good thing cause as she was caring for him she kept seeing something in & then not in his throat & it was another worm that they took out - I seriously had to leave the recovery room....we did get meds to treat him for that but definitely not what my stomach needed on Tues!!!

Linda who is also in the recovery room said she knew I was sick cause I wasn't "dressing the patients" (with the dresses, hats & shirts I had!) But when I was in the hallway 2 little girls - siblings to a little boy having surgery were so stinking cute & so I called them to the wall between recovery & the "transfer hall" & gave them dresses - they were so excited.  I also sent about a dozen dresses with the 2 students on this trip to take to a small orphanage for girls run by a sweet nun Sister Corazon (Sister Heart) - they said she was so appreciative & was going to save them & give them to girls on their birthdays as their "birthday outfit" (Cheri Spjute you are making a difference here in Bolivia!)

I have found it refreshing that it seems the very well to do (the Op Smile Board members with all the $$ & ranches & restaurants etc) are here with us at the hospital doing absolutely whatever is needed - mopping a floor, holding a baby, running to get me or anyone else something we need, etc) They definitely are not just for show - they may be very important people by day usually or off playing tennis etc but for these 2 weeks they put their time where their hearts really are & that is with the children & families of Bolivia most of whom are from very desperate circumstances.  The entire "local team" has been amazing!!! Mercedes (the owner of the ranch we went to & her friends Villa & Sabe  plan to be with us in the recovery room all week.

Another funny thing - I understand alot more Spanish that I speak but I know some Spanish & a few of the other nurses here are so impressed that I can ask a taxi driver to take us somewhere or tell him we will call him to pick up up or when I talk to some of the Bolivian nurses - they have no idea I am really talking Spanglish or Spanish at about a kindergarten level!!!  I really wish I had spent more time on Spanish now!!!

Today was the day of "bleeders" & I had 2 of them - we had to call the surgeons in the re evaluate & do some other treatments & one actually went back into the OR (not mine)

I kept taking medicine & drinking water but by 8 pm when the final 2 cases were coming off their OR tables I was "done" & all was well so they sent me home - by the time I arrived my head was killing me so I took more Tylenol, emailed my family to say I wouldn't be calling, skyping or on Facebook then went to bed...fortunately you will see in my next post I woke up feeling much better - it was just a 24 hour thing...but it was a pretty miserable one!

1st Day of Surgery...27 new smiles!!!

It has been a LONG but wonderful day...we arrived at the hospital, had our mtg then our mock code & got started.  We ended up reorganizing the Recovery room a bit for better access to our 4 gurneys & got our 1st patient about 9 a.m.  Our 1st patient was Cristian a 10 mos old little boy with a cleft lip that I remembered from screening - he did great! Our set up is similar to Mexico - the parents pass their children over a half wall to go to surgery & when they are stable in the recovery room we either invite the moms in to hold them (especially if they are fussy) or if we expect it to be a quick lip recovery & they are resting well for the 30 min-1 hour they are there we just wait til they are ready to go to the post op ward & carry them out to their mom who sits in a wheelchair & hold them as they are wheeled up to the ward.  Cristian was the first baby I carried out & when I handed him to his mom & she saw his repaired lip for the 1st time she burst into tears of joy...which of course caused me to get teary...it was a tender start to this 1st day :)

My next memorable patient was Adrian an 11 mos old boy from an Orphanage who weighed barely 11 lbs - the "matron" of the Orphanage brought him here & we all fell in love with him...he was "Everybodies Baby" & we showered him with clothes I brought a beanie & a blanket - it was hard to let him leave the recovery room & just broke my heart thinking of how he might grow up here - something that I am sure we never even think of in the States...

There were 2 Bolivian Nurses in the recovery room with the other 2 Op Smile Nurses (Erika Linda) & me
we are "credentialing them" - 3 missions are required so they be full volunteers - they were only with us from 7 am-1 pm but did great.

Another cutie was Luz - which translated means "Light" and you could see the light in her eyes when she smiled - we got her all "outfitted up" with a dress from my Friend Cheri in Boise & added a hair bow to - some of the surgeons accused us of "playing dress up" with the babies - we were just updating their wardrobe!  Sebastian was another lover boy...& I remember him from screening too :) & got some photos of him.

We did 27 surgeries - they all went really well - no complications &as a team everyone worked really well together.  One of the girls who is from the Op Smile office is sick so we treated her in the recovery Room with IV Fluids & 3 doses of IV Antibiotics & she is feeling a little better & hopefully is even better tomorrow.

My day ended much like it started - I am on call tonight so I got to leave at 8 in case I get called out (fairly rare) but the last patient I took care of before I left was Kristel a little 8 mos old cleft lip baby & when I took her out to her young mom she looked at her face - smiled, kissed Kristels forehead & started crying...and so did I....it is such a blessing to be able to have these experiences & be a tiny part of changing lives...I will never see these people again & most don't even know my name but I hope they feel the love & compassion I have for them.  They are touching my heart & changing my spirit when I am in their presence

Good Night - cross your fingers I don't get called out - its 11 pm - so far so good!

 

Sunday in Santa Cruz....

It was somewhat of a low key day - our "team bonding" day they call it....we had breakfast at the hotel then at 10:30 went about 45 min away to a "ranch" that belongs to Mercedes - one of the Op Smile Bolivia Board of Director members (I really think everything is 45 min away from every other location?)

The ranch was 100's of acres...interestingly enough it is set up for entertaining but doesn't have a house on the property?  It has beautiful grounds - a pet Macaw that lives in a tree, a sports field & a BEAUTIFUL HUGE Stable that houses about a dozen horses, plus 2 large horse rings - someone mentioned that the Bolivia Olympic Horse Jumping team trains here? & that is probably the case as there were photos of them in the barn & I think Mercedes son may have been on the team at some point.

We relaxed, they had caterers BBQ what seemed like >100 lbs of meat, they played Bolivian music, we ate & had a nice day...but it was pretty warm so it was nice to enjoy the pool.  About 4 we played the "Name Game" - done on every mission & you really do learn everyones name which is helpful since we will be working so closely this week.  After that we had our team mtg & specialty mtg.

There are 121 patients scheduled 25 each day Mon-Thurs & 21 Fri so it will be a busy week - wake up calls at 5:30 a.m. & I don't anticipate getting back to the hotel til 8:30 or 9 each night.  I packed up my bags of stuff to give to the kids (thank you to so many friends!).  Tomorrow 18 of the patients are boys & only 8 girls...funny how that is but we have lots of girls he rest of the week!

I am going to help Gayle with the mock code for all the team in the morning & then we will get started.  I am excited for the work to begin - truly changing lives one smile at a time.  It is such a blessing to be able to participate in this mission & I am ready to work :)  Been gone 6 days...missing my family but so glad I have been able to Skype for calls & video....I will update tomorrow :)

WHAT A DAY!!!! HAPPY ST PATRICKS DAY FROM BOLIVIA!

Sleeping in until 7 was so nice....I actually "got ready" today (ie wore makeup & did my hair in something other than a pony tail) Had to be on the bus at 8:30 to go to another hotel fro the "Educational Conference"  I didn't really know what to expect since I had never participated in this before...I had put together a Pediatric Advanced Life Support (PALS) talk on recognition & management of pediatric shock.  There were about 35 Bolivian nurses there & I had a translator...I wanted it to be interactive & relevant to how they practiced & it went surprisingly well & was a great experience for me. With a case study & questions what I thought would be 30 min was just over an hour & they took notes & everything - I am really glad I did that :)

After my talk I took a taxi to the hospital where others were setting up etc.  On the way I noticed things I hadn't seen before...first of all the kids go to school on Saturdays here, there were a bunch of fruit stands & some big trucks of watermelon being sold on the side of the road along with some sort of cold juice drink in big jugs  - advertised usually on a handwritten sign as "...frio"  I passed a "Gymnasia" their version of a gym - quite different that LA Fitness I must say! and the way we went there were lots of areas where it seemed building materials were made & sold (wood, brick, stone)

When I go to the hospital the recovery room was looking really good & with just a few "tweeks" it seems like it will be just fine! The Clinical Coordinator (who is in my hotel "villa" with me) & doctors were finishing up the schedule & everyone was helping to put charts together.  We had told people to come back at 1 for the posting of "he list" but at 2 they were still finishing it.  I wandered out & saw Luz one of the patients we screened - a darling 8 year old who  had surgery here in Santa Cruz 6 years ago & was here for follow up - she & I took some pictures & she followed me around awhile :)  Loved that! I also saw a mom & baby I had talked to another day - they had travelled 20 hours to get there.

I had never been present for the "list posting" on my other missions so this was a new experience & one with experiences of both sheer joy & utter disappointment.  They first read the list of "rechecks" kids that had a cold or other reason why we might not be able to do surgery - there were about 12 of them & after recheck I think 4 were added to the schedule.  Then was the "too anemic for surgery list" that group Gayle the pediatric intensivist (also my roommate) spoke to telling the parents to feed them more green veggies etc & that milk & rice wont help & she also gave them all iron for their babies & told them to come back in June for a "local" Op Smile mission (smaller just done by a Bolivian team) & that their charts etc would be held.  Those 2 sessions seemed fine but NOTHING prepared me for "the lists"

They actually read off every name & pt # as they were scheduled day by day Mon-Fri.  Everyone anxiously waited to hear their name called & if it was they were filled with elation & quickly went to where-ever they were asked to "report to"  As each days "List" was read you could almost feel the uncertainty in the area build with those who were still left. The last name on the last day was a 15 year old girl who had a small deformity on her face (a hemangioma).  She was a priority 5 out of 5 (lowest) so when she came to me as the gatekeeper I knew it was remote but on the last day they will sometimes add some of those cases on...I watched her & felt SO BAD cause I was pretty sure she wasn't on the list then her name was read - in a 10 second period the look on her face went from complete sadness that she would always look that way to pure joy as her name was ready & she smiled the biggest smile ever...it was a truly miraculous 10 seconds & if that was all I got out of this mission it would be plenty...but I know there is much more joy to come

Unfortunately not everyone gets their "happy endings" & there were some disappointed & dejected parents & that just broke my heart...I stayed in the background just to observe but if it was clear you were a part of the medical team the parents of the children who were not selected for surgery would come up to you & hold out their baby to you with this look of "please cant you do something"...it was really more than I could take.
Even worse than that was the fact that about 20 of the "Not Selected" wanted more information & so Gayle (the intersivist) that was her role to talk to them.  Some were fine & understood but one young mom (she was 20 & looked about 40) had a heart wrenching story.  She had come on the bus yesterday from beyond LaPaz...the 36 hour ride because of several road closures.  Apparently the Chairman of the Bolivia Op Smile Board had gotten a bank to pay for the bus to bring that group here - she told Gayle she had no money & would NEVER be able to get to Santa Cruz again....her baby had a primary cleft lip - a simple surgery but the baby was anemic with a Hemoglobin of 8.2 & our cut off for surgery is 9.0.  She also told Gayle that her husbands family doesn't know why he married her & they believe there is something wrong with her & that is why the baby has this deformity.  she was sobbing that she could not possibly go back without the baby having the surgery...Gayle was awesome - she went & talked to the medical team & told them the whole story...since the the baby was big & healthy they decided to go ahead & do the surgery - the mom fully embraced Gayle & did not let go for what seemed like forever...that moment even 2nd hand was priceless...we really are changing lives one smile at a time.  The baby will have surgery on Tues & I know it will be an experience that touches many of our hearts.

Tonight was a team dinner at a very nice restaurant...we were all expecting to pay for ourselves but the owner is the same Chairman of Op Smile Bolivia who coordinated the bus & at then end of the night he took care of all the meals & drinks for all 50 of us...there are some VERY KIND & GENEROUS people all over the world - it is so nice to be reminded of that....Dinner was late & long (3 hours) & its already after midnight so I am off to bed as soon as I check Facebook to see the pictures Wendy took of Sarah before Mormon prom :)  THANK YOU!  My day was also made as I saw all the FB posts of my kids enjoying our traditional St Patricks Day celebrations & music in both Utah & Calif....Doug had green breakfast for Sarah & Kimmi & yes the leprechauns turned the toilet water green again this year! & Kelli & Ryan enjoyed a full course late night green dinner - LOVE that Doug & my kids are keeping the traditions alive! as for me I was seen in Bolivia with my green shirt on & at dinner with my Green hat & beads!  Happy St Patricks Day from Bolivia! 

2nd Day of Screening 131 MORE Patients Screened!

This will be a short post cause I'm a little tired & want to get to bed...typically the 2nd day of screening is a bit slower than the 1st but not so much here.  We had a pretty steady day & flow of patients...all very cute with such loving parents just hoping we could help their children. 

By about 3 pm it was winding down & we were getting ready to go unpack Cargo & start setting up the recovery room.  All day we had heard their was a "bus" of people coming but assumed it was just a rumor. Things were winding down & we had already screened almost 90 kids...then...THE BUS arrived.  At first I thought "really???" cause I was ready to move on to the next task & get into the Recovery room area but as I saw these VERY HUMBLE BOLIVIAN people get off the bus, in somewhat dirty clothes w/ their babies in one arm & their bag of belongings in another I stopped & reminded myself that the reason I'm here is to help people like them...unpacking Cargo & setting up could wait. We were told they this group had travelled by bus for about 36 hours from just beyond La Paz - probably on dirt roads because about half of the roads we travel on are dirt roads.  I appreciated the change in perspective as I imagined all they had gone thru to get here with their children...I was in awe of their determination & the HOPE they had for medical help and I immediately decided I was going to be extra kind to them & offer them water & just smile & appreciate that I could be a part of their journey....

In the bus of about 70 there were 40 children to be screened many who will get surgery this week & a few who are too small & will have to wait.  There is a "shelter" for those who have travelled from afar at a catholic church where they can stay for free & get 3 meals a day all this week & I think for a few days after we finish here - but the shelter is 45 min away so Op Smile has a bus that takes them back & forth.

We did get in to the operating room & the recovery room - in comparison it is better than Kenya & worse than Mexico...its very small, we can fit 4 gurneys in the area but not real beds, there is not a sink in the room but there is one outside the room & down the hallway. No chairs for us & really no place for our equipment - it is going to be cozy :)  But it will all work out - it always does

The best news is that our wake up call isn't until 7 am tomorrow - that seems like sleeping in!!! Tomorrow morning is an Educational Conference - I am giving a 30 min talk on Pediatric Shock complete with a translator - wish me luck!!! That is scheduled to finish at noon & then we will finish our set up & there is a group dinner tomorrow & our team bonding day is Sunday so it should be a not too stressful weekend!
before a very busy week....I'm off to bed & its only 10 pm here woo-hoo! Night all!   

1st Day of Screening 159 Patients!

My oh my 5:30 came early! the drive to the hospital is 45 min on an old bus thru some very poor areas where there are horses, pigs, ducks & dogs roaming in the streets.  Then in the middle of it is the Hospital Frances (the $$ to build it was donated by some wealthy Bolivian who now live in France?) So it is fairly new & nice in this very poor town.  But apparently the govt hasn't paid the staff there (nurses doctors etc) so they are out protesting & there is no one in the hospital - unusual?  I didn't really see the hospital area today as we were really out  in a patio/clinic area for screening.

When we arrived at 7:15 or so there were over 100 people already waiting.  I forgot how chaotic the 1st  morning of screening is...you figure for the 159 patients we saw many come with 1 or 2 adults & 1-3 other children so really there was a crowd of about 600 or so in a very small area - I took pictures.

Pt #1 was Franklin...a cute little boy who I also took a picture of.  Some of the people we saw are from only 30 min away, others 6,8 or 10 hours which requires many different buses, some 20-24 hours or 2-3 days.  It is always humbling & amazing to see what these parents & families do to get their children the help they "might" get..there are no guarantees & the hardest part of today is there were 5 or 6 kids who REALLY need surgery but their blood counts are too low from their poor diets so we cant do the surgery :(  We are hoping to get Iron drops to give them so they can have surgery at the next mission here in 6 months.

One sight I was not prepared for was a large population of Mennonites....they live about 9 hours away & came her from Germany?  They have German names & speak German & Spanish.  Their dress is very unique...the men wear overalls & plaid shirts & hats & the baby boys are in matching outfits.  The women wear long skirts in a unique material with aprons, hats, long sleeves & sort of tights...all in a very humid 80 degrees.  The women aren't allowed to talk & the men don't look at you when you talk to them.  They don't like having photos taken & when holding their babies with Cleft Lips or Palates they put blankets over their faces so people dont see the deformity.  I was not expecting that one....and after travelling 9 hours some of them then say they cant stay until Monday for surgery????

Some other interesting patients were identical win boys who were 4 years old with identical cleft lips, and in screening we ask the families if they have any idea why their child was born with this abnormality & let me tell you there are some interesting answers...mom got hit by thunder? (yes thunder not lightening), dad works in the fields, its Gods will, mom had a bad spirit visit her, they had an argument while they were pregnant...the list is quite long.

Ethicon (a Johnson & Johnson company) has donated suture materials to Op Smile for 30 years = several million dollars.  7 Ethicon people are here visiting & volunteering...they are quite nice but you can tell a couple of them had no idea what a mission was like & were pretty overwhelmed today.

We had 2 DARLING 17 year old girls help us as translators Estefania, & Paola.  They attend a private International (American) high school & are part of the Operation Smile Club at their hospital.  They were with us from 7 am-6 pm & were such a big help & so much fun to talk to. They are from well to do families here with siblings at prestigious colleges in the US & Europe & parents who are professionals.  They were FABULOUS & so kind to all those we saw - they will be back again tomorrow :)

That's about it - just a busy long day - we got back to the hotel at 7:30 pm.  I love being here & having the opportunity to do this - thanks to my family & friends at home & work etc who are covering for me in my absence! 
Oh P.S.  Verizon fixed my phone so now I can text but this great International Blackberry has no Internet capability & calling is super expensive so I am basically carrying around a texting device??? 
THANK GOODNESS for Skype calls - its been great to talk to my family :)
Yikes wake up call in 5 hours & I still need to shower! Good Night from Santa Cruz!

The MANY Tender Mercies that got me to Bolivia & Day #1

Well I have almost been in Bolivia for 24 hours (not quite) the flights went well LAX to Panama then Panama to Santa Cruz...and while I will get to that its really the day before I left that I need to blog about...I made my 1st blog entry about this trip late Sun night/early Mon morning...I had so much to do seriously about  85 things on 4 different to do lists (CHOC, TT, Home/Family & Op Smile Prep) creating those lists was the last thing I did before I went to bed.  I only got about 3 hours of sleep that night & was running late but knowing that SO MANY things stood between me & boarding the plane I stopped that morning & prayed that I would be "helped" in getting thru all that needed to be done cause I knew I couldn't do it alone - despite feeling tired I felt peaceful & knew I would be taken care of.

I had a nearly full day of work at CHOC in front of me....& about 20 things on that to do list - I did 2 of them on the way to work...& went straight to a mtg - at the mtg I went to pull out the lists & cross those 2 things off & the lists weren't in my pocket - I really did panic - those lists were my "brains" & what would get me out the door the next morning  I excused myself from the mtg  hung onto that peaceful feeling from the morning & retraced my steps believing I would find the lists...in the stairwell of the parking structure leading to my car I found the lists which must have came out of my pocket when I pulled my phone out (Tender Mercy #1).  I had several back to back mtgs & told my asst some of the things on my list - as I finished a few mtgs she came in & had taken care of 3 or 4 things - activating my phone, getting handouts for a lecture I will be doing here etc etc (Tender Mercy #2) I was able to leave CHOC by 3:30 with everything on that list done.

A friend in Boise was sending me dresses to take & they hadn't arrived & were mailed a week before when I got home there they were (Tender Mercy #3) Once I was home I decided if I was going to get everything done I needed a "power nap" I slept from 5-6 & when I woke up felt energized & ready to go  I gave myself from 6-9 to pack & that was a challenge as I stuffed the suitcases with all that I had bought or been given to bring here (dresses, blankets, beanies, toys, etc) - I could have 51 lbs a bag & they were very overweight & I decided I would just pay the fee & when I spoke to the Dr I'd be travelling with from LA about meeting at the airport in the morning she told me she was in business class & could check a 70 lb bag - so Id check one of hers & she"d check one of mine  - after packing & repacking with Dougs help & weighing them at least 10 different times - we got everything in w/ one bag at 50 lbs & another at 70 lbs (Tender Mercy #4).  By 10 pm I needed to stat of my store list (TT) deposits, notes, emails etc & that took me til midnite, then I needed to start on the home/family list & I was going at the list line by line feeling totally awake & positive the entire time until I went to bed at 2:45 am (Tender Mercy #5) there is NO WAY i could ever stay up that late on such little sleep the night before & feel so positive & be so productive without heavenly help - needless to say despite how late it was & that I'd only get 2 hours of sleep I stopped to offer a prayer of thanks before I went to sleep.  The alarm was set for 4:45 - I got up 2 hours later, got ready feeling good & got the the airport & met Gayle & checked our luggage & went to our gate.  At that point I KNEW that the prayers of friends who I knew were praying for me that day plus my own prayers were answered & I had really been carried through that time for everything to fall into place to get me out the door  (Tender Mercy #6)

I slept a few hours on the 1st flight - had a row all to myself (Tender Mercy #7) had an hour layover & an uneventful 2nd flight & arrived in Bolivia at 1 am  We had to go thru immigration, get our luggage & then go thru customs & yes when I pushed the customs button I got a red light meaning all my luggage was o be inspected but the inspector only looked thru 1 of my4  bags - the one with all the stuff I brought   After seeing what I was bringing for the children of his country he didn't even open the others & let me go thru (Tender Mercy #8).  By the time we got to the hotel & got checked in it was about 3:30 am - we took an hour to unpack a bit & get settled & went to bed at about 5: 30 a.m. Bolivia time.

We slept til noon then got going & since this was one of only 2 days we have any time Gayle & I went into Santa Cruz to see what we could  Bolivia is larger than Texas but has only about 1/6th of the population that is in LA County - Santa Cruz is the most populated but even that is sparse.  There is a typical "Center of Town" that includes a central park & is bordered by Govt buildings & a church.  LOTS of people sitting in the town square.  Quite a bit of poverty is evident but we felt safe.  Gayle speaks fluent Spanish so that was a huge help.  The taxi driver that took us to town from the hotel (a $2 fare) just ended up staying with us for the 4 hours taking us different places including a traditional Bolivian restaurant - we ended up paying him at his request only about $20 for all he did...

We had our team mtg tonight - as always the team seems great - a mix of Bolivians & international.  Our wake up call is 5:30 every morning with the bus leaving for the hospital at 6:30. The next 2 days will be screening for patients & they expect we will screen 200 children tomorrow AND..I was asked to be one of the "Gatekeepers" again (I did this in Kenya) so 1 other nurse & I will review every patient to be sure they have had everything done & score them for prioritize base on all the findings & the Drs recommendation - its a BIG job so I better get to bed!

Sorry this post is so long...but i needed to mostly remind myself that YES I AM SUPPOSED to be here & all those tender mercies were clear reminders to me!  Oh one last thing...my cell phone isn't working so well but I have great Wi Fi in the hotel & have been able to get onto all the websites I need to for CHOC & otehr responsibilities I have to keep up on plus I signed up for a month of free Skype international calling so I got to talk to all my kids except Kimmi today :( plus Doug, plus CHOC & TT....I have complete peace of mind & can focus on the task at hand here :)   Good Night - wake up call is in 5 hours!