Sunday Team Day & No Cargo = No Set Up

Today was our team day & we took the exact same 2 hour drive up toward Axom to the same Rock Church but it was a COMPLETELY DIFFERENT EXPERIENCE!!!!

This year there was no one there, the church was quiet - the Sunday service had occurred before we got there 7 there was just one priest there & a few other worshipers  Last year was the pilgrimage & literally hundreds of people were all there - I am now realizing what an AMAZING opportunity we had last October to be there at that time. Today I did get to see the church more since it wasn't jammed with people & it was a more quietly sacred experience.

We went straight from the church to Karibu for pizza lunch...really I am eating pizza more than anything else in Ethiopia - by my choice :) After that we came back to the hotel & had 20 min to change into scrubs to go set up the Recovery room, OR. etc...but a slight glitch...all the Cargo hadn't arrived. So after waiting for about 2 hours they sent us back to the hotel & we will set up tomorrow & perhaps get a little bit later start on surgery.

we noticed the 3 week old & her mom sitting in the hallway of the Emergency Dept (which is where the Recovery Room is...I didn't think too much of it but mentioned it to both Leila & Dottie (the 2 who had been most involved) when I got back to the hotel that maybe she needed $$$ for "transit" which we had been giving some people & they were heading to the hospital anyway & were going to check on her. A few hours later at our team mtg I sat with Dottie & the story just got more heartbreaking...after staying overnight the hospital sent the baby (& mom) home...through a translator they found out that she lives 120 km away & has a 9 year old son at home who has some sort of leg deformities that a neighbor is caring for & that when this baby was both with a cleft lip & palate the dad/husband left her. I am not sure how she got to Mekele but in Ethiopia once a woman is married she cant return home to her parents or it is a disgrace to the family so this poor woman literally had no money, no support & NO WHERE to go....Leila & Dottie talked to some Op Smile leaders & there is an orphanage called SOS but they only take children where both parents are dead so they baby could be "placed" as we would think in the states & there are no "shelters" or any of the resources we would think about in the states so literally she was sitting in the hallway of the hospital & had no options & with the chaos of that hallway I am thinking she could sit there for days without anyone noticing her or doing anything for her.

They decided to take her to the patient shelter for the week to buy some time but as Dottie said...then what? We are all saddened & upset, Leela is especially tearful as she has been the most invested - the goal is really to keep the baby nourished & alive to 5 or 6 months of age so she could have surgery.  BUT the awful reality is that there is so much poverty here (someone said Ethiopia is the poorest country in the world???) & situations like this are likely rampant here & we are only seeing this one instance & there are no resources so there is a real possibility we can do our VERY BEST to help this woman & her baby but there still may not be a positive outcome for them - it is a very sobering thought   She can stay in the shelter for a week & then what? Perhaps we can get her back to her son but she doesn't have a place to live there???. There are some things that no matter what we try to do we cant change. we could maybe get the baby to Addis but is that the best option to take the baby from the mom - it is obvious she loves her baby...these are situations we just never think or experience in developed countries....yes hopelessness is felt I know but resources are available...not in Ethiopia :(

We had a brief team mtg cause everyone was a bit tired & our day tomorrow will start early & go late with set up & the 1st day of surgery/ Quite a few people are already feeling queasy or getting sick. I am sticking to my "safe diet" of Oatmeal for breakfast, protein bars, tuna or pnut butter & crackers for lunch & dinner & a few other snacks...trail mix, krispie bars etc (thanks to Cheri  I did venture out & get tomato soup tonight at the team dinner :)

Tomorrow is GO DAY....the start of surgery week :) I am excited to be a art of this mission. It is Mothers Day & I have gotten sweet posts on FB, messages & texts from my kids...it is weird to not be home for Mothers Day - the 1st time ever...my kids have not been home on Mothers day if they were away at school etc but I have always been there???  We will celebrate next Sunday & right now I have the opportunity to give some moms in Ethiopia every mothers wish...a brighter future for their child as we correct their cleft lips/palates so missing this one mothers day for other mothers seems like a good option although I do miss my family :)  Happy Mothers Day...I am so grateful for the 4 wonderful kids i Have for for my wonderful husband. Being a mom is what brings me the greatest & most eternal joy....



  

DAY #2 Screening Ethiopia Round 2

Okay this is going to be a long post...again this is mostly for me...so much happens in a day that at the end of the night when I try to jot down notes I often forget things.

A couple of other special patients from yesterday - day # 1 of screening...one was a 3 week old with a bilateral cleft lip & a cleft palate. She was SOOOO TINY and weighed only 5 lbs... which was less than her birthweight. It was really her whole story that broke my heart. Someone put a tube from her nasal opening to her stomach at birth & "taught" mom what to do but it wasn't working & the tube was clogged. Mom was trying to manually express her breastmilk & put it in the tube, plus mom had a C Section (very primitive process here) and was walking around with an infection around her incision wound & needed help herself. She felt like she wasn't doing enough for her baby & she herself just looked SAD. Luckily we have a 3rd year Peds Resident Leila from Walter Reed Medical school here with us on our mission as sort of an "extra" person & she totally took this situation on while the rest of us were busy with screening. We wanted to buy them formula but were told not because it costs $10 for a can & the mom would likely never have $$ to buy it again & would dilute maybe a tsp in 8 oz of water. We needed to get her to express her milk & put it in a special cleft feeder bottle & teach the baby to suck & swallow. Leila got them to admit the baby overnight & was totally focused on doing what she could to improve the chances for the baby. I am so glad she was here or I know that baby might not have gotten the care it needed.

There was also a 34 year old man with a Cleft Lip who was fairly "well to do" was staying in a "hotel" here on Mekele but it seemed crazy to me that he was never able to have surgery until now???

Okay on to today...Saturday...Doctors Without Boarders in Addis arranged for a bus to bring 18 patients  from Somalia here to Ethiopia for this mission. They came from 2 different areas of the country one area was 2000 km away & the other 3000 km away. They traveled 10 DAYS in a SMALL bus to get here driving day & night - they all came with 1-2 relatives so that means almost 50 people squished in seats & on the floor with their own food & supplies. Its not like us taking a 10 day road trip on paved roads stopping at motels and restaurants....it was on some paved & some unpaved roads in areas that were at times dangerous. Then add that they traveled to another country with a different language to be with people of a culture with whom they don't typically associate & then they will stay in the shelter (basically a warehouse room) with 100 or more other people. All for something that is so basic to us???

The good news is that all 18 will get surgery - on Monday is the plan right now so they can stay here for post op & then make the 10 day trip back....they will all return to their small villages with their lives changed no longer outcasts or shunned all because of Op Smile & the 46 people here on the volunteer team from Australia, So Africa, Honduras, India, Denmark, USA, Italy, Ethiopia, Netherlands, Kenya, Sweden, Canada, Philipines, & Ghana all who have come together most without knowing one another but with a singular purpose to help others & be a TEAM...plastic surgeons, anesthesiologists,nurses, pediatricians, dentist, speech, child life, medical records, biomed, & students & other volunteers - a small army for good :)

A few of the Somalia patients that touched my heart....an 11 year old boy & his 2 year old cousin both with cleft lips & thru the translator he said he didn't want her to be teased like he was...a CUTE little 8 mos old boy with a cleft lip who was ALL SMILES - I took several pics of him :) A beautiful 12 year old girl who held her hand over her mouth the whole time she was in the screening process - thru the translator her mom said she has done this her entire life...oh my...how her world will change when she sees her perfected lip. And a 5 mos old baby in ALL PINK...who was a boy but the mom didn't seem to care - I happily gave them some of the layette clothes my friend Leslie sent with me. There was also a patient who had been on the mission I was on last Oct for a Cleft Lip repair & now we will do his palate & the mom remembered me :) I didn't remember them honestly but that warmed my heart & she thanked me for coming back to help her baby...ahh that teared me up!!!

A couple of people already are getting sick & I am doing all I can to remain healthy & grateful for the blessing I received from Doug & Ryan before I left. AS always I didn't come 10,000 miles to not be able to work every day.

Other things not to forget from today - sweet Abrahem a volunteer I knew from last time who lives here in Ethiopia who spent the better part of the morning going to local "Techno" shops to track down a universal charger for my camera battery :) - it works & in the mean time Bryant a nurse on the team gave me his "extra camera" that I put my memory card in & used today  so not a single photo op was missed!!!

I woke up at 4:30 am to the "call to prayer" & chanting that is played on speakers in the town??? & if that wasn't enough there was also the sounds of Hyenas near the same time & a VERY NOISY family of birds right outside my room. I am sleeping well at night but it seems that 4:30 am will be my wake up call!!! I am SUPER GRATEFUL that I have my own room & space. I played country music on my iPhone as I got ready (thanks to Kelli)

After screening a small group of us "walked to town" the students - Laura & Megan & their sponsor Dottie, Megan from Child Life, Will one of the Plastic Surgeons, the U Student Franni who is from San Clemente & goes to Yale & Plays Soccer there (& small world is a friend of Natalie Werners). I swear we walked for about 3 hours - maybe 10 or 15 km. All the kids in the town would tell us "HI" & want a High Five

Shortly after we got back we went down to the patient "Shelter" where they were going to tell the patients who would get surgery. It is basically a warehouse but a group of college age students here have taken on the responsibility of making the grounds look nice. The inside is a warehouse building with "mats" on the floor & about 160 people all staying inside. It was a very humbling experience & I took some pics there - despite having essentially nothing the kids were happy & they turned on some misc & we had an Ethiopian Dance party!!!  I missed this type of time at the Shelter last time I was here I am so glad I had this opportunity & I want to go back when I can.

It has been a FULL DAY & tomorrow is the "Team Day"

FRIDAY MAY 10th - screening Day #1

So I just logged on to my blog only to find out my post from yesterday didn't post....OOPS!

Today was our 1st day of screening & I jotted down some notes cause it gets so busy I don't want to forget things but my notes are in my room & I had to jump on the computer when I could so I will do this from memory... which means I may leave things out & have to circle back tomorrow :)

Wake up time was 5:30 - I slept well so that was great...breakfast at 6, team mtg at 6:30 & on the bus at 7. When we arrived there were maybe 50 people there for screening that started at 9.  It took a bit to get set up & since I was gatekeeper I had another 30 min before I would see my 1st patient so I got to go out & play with the kids & enjoy the people.  I missed that last time I was here I flew in later & want there for screening & forgot how much I liked that cause that's when you see the patients and families & hear their stories....

The first family that caught my eye was an 11 year old girl who did not have a cleft but she was taking care of her 2 year old brother who did...she had come with their dad - they traveled 2 days by bus & foot & the mom stayed in their village.  It all came back to me that in this area we see alot of dads with patients as it isnt safe for women to travel distances alone with their children.  The "big sister" was totally a mini mom & it was so cute to watch her with her little brother. I got some cute pictures of them. Another patient was a 30 year old man who had never had a repair ..he live in a far away village on the boarder of Sudan & came...all his life he has had a Cleft Lip - something that in the USA & many other countries would have been corrected as a child & he has had to live with this his entire life....he came all by himself because someone told him he "might" be able to get help....that always amazes me when I realize all they do to just go & HOPE FOR HELP. One sad case were 6 month old twins...one is fine & thriving & the other was very malnourished (7 lbs at 6 months) and the mom said people in her village told her she should "get rid of that cursed baby" since she had a healthy one????  I personally wanted to visit her village & have a conversation with some people (good thing I don't speak the language!!!). Unfortunately the baby was too small for us to do surgery but the therapists worked with the mom to help her learn to feed the baby with some special bottles etc & they were able to get some formula for them (no one here has formula they all breast feed) & we are hoping the baby will gain some weight & can have surgery on the next mission in 6 months. It was really sad I just wanted to bring her home make sure she gained weight & bring her back in 6 months!!!.   We actually had about 3 other babies brought today that were all less than a month old...in a way that is good cause they can get some feeding help & at 6 months they will be ready for surgery hopefully.

SO about the gatekeeper role...I forgot how busy it was...the first 2 hours were just steady & I had only seen 18 patients by noon - it takes awhile for them to go thru all the stations & then they come to my & usually it is either utter chaos or a steady madness. By 5 pm I had seen all 90 patients we screened today - so another 70 patients in about 6 hours - it was crazy...making sure all the paperwork was done, labs were done, priority identified, returns flagged, special cases addressed etc etc. I had my hand made "excel spread sheet" that I was tracking everyone on & am proud to say that at the end of the  night I had every patient accounted for, with their dx, status & priority & any unusual details - pretty proud of myself   I "trained" another nurse to do this & I am pretty sure at times she thought I was a little OCD but in the end "she saw the light".  it really is a challenging job!!! We ended up with 66 of those who will get surgery next week & tomorrow we will be screening all day again -and I am supposed to train 2 other people...

Everything really is going well...last night when I was "on line" Kelli & Sarah were off getting Sarah's Sr Pics done & they send me some sneak peeks so I felt like I want missing out on that, I heard all the CHOC Nurses week went well & as much as I wish I was there I cant think of a better way to celebrate Nurses Week than to be here using my "Nurse Talents" to help the people here. I even got wifi on my phone at the hospital...things are getting better here in Mekele!!! Had a brief panic attack when I couldn't find the battery charger for my camera but the Bio med guys think they have a charger & if not they will take me to get one in the morning - cameras, Ethipoia & I have bad Karma!!!

This team is WONDEFUL and I am so grateful that I have a chance to be a part of it & change lives...one SMILE at a time!!!!  GOOD NIGHT

ARRIVAL IN ADDIS THEN MEKELE - Thurs May 9th

THOUGHT I POSTED THIS YESTERDAY...internet here isn't very reliable I guess...so a day late & going to post again now - weird that the PS went thru???

Well my flights went AMAZINGLY WELL!!! Doug & I drove to LAX without too much traffic - got a quick bite to eat & he dropped me off. I checked in my 2 bags & had about an hour to check out the LAX American Airlines Admirals Club lounge which was nice... until I realized somewhere between security & the lounge I had lost my personal cell phone (which I was really only taking for my contact list). After alerting the Kraus Family disaster response team I went back & found it with a nice TSA worker...it had been in my pocket when I went thru security, had to take it out & put it in a separate bin & LEFT IT...then FOUND IT...crisis averted!!!

My flight to London was REALLY FULL but I had an aisle seat in the middle group of 5 seats & with a little sleep medicine I did get some rest. I arrived in London & found the Admirals Lounge there & it was REALLY NICE!!!  As exciting as the London airport is with great shopping etc I was happy to stay in the Admirals Club so I could take a CHOC conf call & also enjoy the non stop flow of food & diet cokes.  I figured it was my last encounter with the Western world!!!  I decided that if you travel alot the Admirals club or whatever airline lounge you like is similar to booking a hotel room on the concierge floor...TOTALLY WORTH  every penny of the $50 for the one day pass Doug got me!!! I even took a nice hot shower before I left on my next flight :)

My flight from London to Addis wasn't very full but they wanted to charge me a ridiculous amount for my 2nd bag - we finally agreed on $100 as the flight was in the final boarding stage & I was fine with that. I managed to gt an empty row of 3 seats & slept some on that flight as well. I arrived in Addis, exchanged my money 18 Birr = $1, got my bags went thru customs & didn't even get stopped - I was SO HAPPY about that as I wasn't sure how I would explain my one suitcase of 50 lbs that included approximately - 24 pairs of flip flops, 30 baby blankets 20ish dresses, some boys shorts, 30 baby gowns, 30 pair of socks etc etc....all of that will bless SO MANY LIVES & it is because of friends at home, in Idaho & elsewhere who are giving these gifts - I am simply the lucky person who gets to deliver their kindness!!!

I had 3 hours in the main Addis terminal before I went to the domestic terminal - sad to say their internet hasn't improved....so I sat in a place called the "Yellow Spot" and bought a "Coke Light" the last for the next 2 weeks as it doesn't exist in Mekele. The young man who worked there started talking to me in very broken English & asked why I was there & then asked what religion I was - RANDOM. We talked for a bit & then he pulled out a Families Are Forever Missionary Track in Ahmaric that someone had given him - I said yes that was from my church.  There are not LDS Missionaries in Ethiopia (I don't think) we chatted awhile - it was a crazy encounter.

I m,et the rest of the team at the Domestic terminal for our noon flight - they all seem GREAT!!! of course if you are willing to do this kind of work you have to have a good heart so I have yet to encounter an Op Smile Volunteer who wasn't wonderful & welcoming.  3 of the nurses here were ones I worked with in Kenya - that was a nice reunion & my 2 Anesthesiologist friends are here & 2 nurses from my last time in Mekele. They assigned us rooms & I got one to myself - THAT NEVER HAPPENS!!!!  At first (for about 15 seconds) I felt bad cause that is one way to "bond" with one person on the team but once I got there & started "setting up my space" I was happy to have gotten that room :)  I unpacked everything, set up my bathroom, my food area, hung up clothes, organized all that I brought to give away & took a 2 hour nap without worrying about a roommate   I really feel like I have my little home away from home for these 2 weeks & I wont worry about staying up late to journal or bothering anyone - its just me for the few hours a day I am in the room YIPEE!!!

I KNOW one reason why I am here -Doris a Kenyan Nurse is the Clinical Coordinator for this mission - she is AMAZING & KNOWS EVERYTHING but...she has only done Kenyan Missions not missions in other countries & now she is here & in charge of an international team - I have no doubt she will be great but as I visited with Craig (Anesthesia lead & my friend) & Vince I realized part of what I need to do is whatever I can to help Doris be a successful leader of this international team. She is a bit quiet & unassuming but knows so much & I want her to be just as confident here as she is in Kenya.  Also she asked me to be...TH GATEKEEPER - that is the CRAZY JOB at Screening where I need to make sure every patient was seen by every specialty, all signatures are on the chart, labs drawn & pt prioritized 105.  For Doris I will happily do this.  So I better get to bed is 10:30 here & we have a 6 am wake up call * then a few hundred patients to screen tomorrow.

I am SO SO G:AD I am here where I am supposed to be for these 2 weeks - so many things have pointed me back to Ethiopia & everything has gone so well on every front - I even got EVERYTHING of my pre-departure "TO DO LOST" done before I left (a few things were don as we drove to the airport but till they got done - that in & of itself was a major miracle :)

P.S. for Thurs May 9th

I put this on FB but want to remember it for me :)

One update from last time I was here....the hotel has a single computer with internet - no wifi but I am thinking I will be able to "stay in touch" without having to go to an internet cafe this time...& that was one of my biggest challenges last time. It is yet another blessing. They charge 30 birr (about $1.50) for an hour - I'm totally happy to pay that & more!!!  The sweet owner of the hotel when I told her how happy it made me that she now had a computer here said "I will do anything for you who come to help our children of Ethiopia" then she brought me a flower from the grounds...it doesnt get much better than this! 

Ethiopia Round 2....Meant to be

I am just about to board my 11 hour flight from LAX to London then a 7 hour layoveand a 10 hour flight to Addis Ababa Ethiopia then another 2 hour flight to Mekele...right where I was 7 months ago on another Op Smile Mission J 

It wasn’t in my plan but it seems it was in “the Masters Plan”…here is the story

I wanted to go on another Op Smile mission in the spring. I knew my window of opportunity was in May after the opening/activation of all the new services at CHOC because of my responsibilities there that would require my presence thru April & before Sarah’s Graduation events in June. So in January I put in availability for May missions that I thought I would enjoy:  a few in South America knowing that would be “easy travel”, also Vietnam as I heard in there you stay in 5 star hotels & they treat you like royalty & Russia & Egypt as I thought those places sounded interesting. Really though it was all about what missions were occurring in May.

I got a few offers to go on missions in March as there were several occurring this month but I had to turn them down. Then I started getting nervous that I wouldn’t get on a spring mission in May so the beginning of Feb. I sent some emails to a few of the coordinators I knew about the missions I had “made myself available for” & still not much of a response. I thought oh well maybe I will have to wait until the summer & see what missions were happening then.

On Feb 18^th I got an email from a new program coordinator saying I was referred to her by Sara (a darling coordinator I was with in Bolivia & Ethiopia) & that Sara said I was the Recovery Room Nurse she needed for her 1 remaining spot on the Mekele team as I had been there & could be a leader for the Recovery Room team.  Perhaps that was true but I saw & didn’t sign up for the Mekele mission – I REALLY didn’t want to go back to Ethiopia…that was by far my most challenging mission….the travel is brutal, there is no internet on site & limited cell service so no communication with home, the accommodations not so great (guards with machine guns are near the rooms), can’t drink the water & I didn’t eat the food, it borders Sudan, Yemen & Somalia – those are places they talk about in the news because bad stuff happens there, no flushing toilets even at “the hospital”  & you may recall my camera was stolen there. Yep no love in my heart for Ethiopia.

I did  LOVE the kids & the humble people who literally have nothing but to me it was a one-time experience….

So I sat on the invitation for a few days which is unheard of – when a mission opportunity comes up you say yes as there are hundreds of nurses waiting to get on missions….finally I looked at our family calendar for things that might not work with those dates & when I realized it was Sarah’s Senior Prom I thought “I can’t miss that” so I asked Sarah what she thought  – her response “go mom they need you more than me”. I mentioned it to Doug & he asked how long it would be I said 2 weeks & he said we’ve been fine before for 2 weeks - GO, then at a family mtg with everyone I brought it up & they ALL said GO….Kelli would be home for Sarah & Prom, Ryan & Kya would be here too & Kimmi is always supportive. I REALLY think I was waiting for someone to say “No don’t go” but it didn’t happen.

Then I thought about CHOC – is that gonna be okay for me to be gone…and when I looked at my calendar those exact dates (within a few days) I had already blocked for vacation back last June when because of the tower project we had to schedule all our potential time off a year in advance. We were considering a spring family trip so I blocked that time….really there was nothing stopping me at CHOC????

What about my store…how would that work…I do scheduling one week & payroll the next & would miss one week of each - again they have done it before & Kelli would be here to be the Timeless treasures back up….

Hmmm I had stalled all I could & needed to give an answer so I said Yes – half heartedly knowing an Op Smile friend of mine wanted to go to Ethiopia & was “waitlisted” as a Recovery Room Nurse so if I backed out she would go & it would all be okay. I was still looking for a reason NOT TO GO…I even re-emailed some of the coordinators I know about a few other missions in May looking for a “better option” & I didn’t even get any replies??? I really didn’t want to go back to Ethiopia that much. A week after saying yes I was still on the fence. The thought came to me – do you really want to  use your PTO – wouldn’t you rather just go on a relaxing vacation – I am always so busy & doing so much I deserve a relaxing vacation???. I ruminated on that for a day & then had the thought “really Nancy its not an either/or situation you could do both”.  Again not the roadblock I was looking for.

Sat March 2^nd I was thinking UGHHH  We have some financial challenges right now how can I “justify” spending about $1000 on a mission – the team fee is $500, Visas can be another $100-200 & then just random $$$....maybe that was what would stop me. The next day at church a dear sweet older woman came up to me (she is someone who I love & who always tells me she wants to know when I am going on missions because she wants to support me in doing the hard things she can no longer do). She asked me when I was going again – it was my moment of truth….I very nonchalantly  said “well I am thinking of going back to Ethiopia in May”  and she immediately said “Great I want to give you $500 to help support your service” & she pulled out her checkbook & started to write a check….I instantly became very emotional & I am again as I type this…she was basically offering to pay my “team fee”, without even knowing it. She by that act unknowingly removed the last barrier I was putting up and it became perfectly clear to me….I am supposed to go back to Ethiopia….I don’t know why, I would still rather go to a new, nicer more comfortable mission site but these missions have never been about me – they have always been about going where I am needed or “supposed to go”.

Over the last month or so I have had many experiences that have confirmed to me that I am supposed to be on this mission and as I prepare to board I  I getting excited to go on another mission & change children’s lives one smile at a time J. I have realized there are some benefits to returning to a mission site…I know exactly what I am getting into J, I LOVED the people, the needs there are tremendous, and there is not any part of me that doubts Mekele Ethiopia is where I am to serve again & next.  If I needed an added confirmation I got 2 emails yesterday saying the other 2 missions I was trying to get on in May  have both been canceled….Egypt because of unrest in the area & Russia because the hospital is not supporting the timing of that mission as planned.

So off I go again….I will update you as I arrive & again ask for your prayers, good thoughts, positive vibes & those who are local to keep an eye on my family – they are always fine but I still worry…

Lots of Love!

Nancy

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.