.Zakouma#2

The vast flat scrubby expanse of Zakouma is flooded during the rainy
season. Scraggly trees wind their way up through lakes of mud and
elephant tracks curve giant bendy pathways through the marshlands - each
footprint a tiny reflecting lake.

.Zakouma#1

Much needed pinch-myself-so-incredibly-lucky-to-be-here tag along to Zakouma with Gary Roberts (pilot extraordinaire who pretty much facilitates or runs all mission projects in Africa), his lovely wife Wendy (who runs the Second Chance Learning Center - Malnutrition center I've been blogging about), and their little blond bombshell of a 6 year old - Cherise (who insisted on wearing a polka dotted flowered headband because she didn't want to look funky!). 

Myself and Julie Andersen, Marci's sister-in-law who holds Master's in Nutrition and Public Health from Loma Linda, got to go.  We have spent the last 2 days in Am Timan, observing the malnutrition center and outreach program that MSF is running here in eastern Chad.  The malnutrition rates are 3% in this area (and also in Bere I suspect if we did surveys).  We got to observe their outreach program, watch rounds on the pediatrics ward, access all their protocols, and learn all kinds of valuable and life-saving information that Wendy and Julie can use as they start the center. 

For myself, well, I think I got to go because it is no secret that my dearest with is to work with MSF (Doctor's Without Borders) one day.  I think people were tired of hearing me talk about it and thought this just might shut me up! Its my life's dream and kind of the reason I came to Tchad - that, and seeing James' original documentary about the hospital here.  So, it has been such a wonderful and rare privilege to be able to see their work first hand, meet the team at Am Timan, and I have gone away both daunted and encouraged but also with overwhelming clarity that this is indeed the organization that I want to work for. 

Then In between flying to Am Timan we have had the awesome and rare opportunty of staying at Zakouma National Park.  The amount of animals here both rivals and exceeds those of the more well-known game parks in Kenya and Tanzania.  Unfortunately, it is the rainy season here - so the animals are dispersed and many not even in the park.  During the dry season, the only source of water is in the park so the concentration and variety of animals is said to be truly rare and breathtaking.  It is logistically challenging and expensive to get here so I cannot express how lucky and blessed I feel to have this opportunity.

So far, we have seen giraffe's twice - a large "herd" (i don't know the proper giraffe group-age expression), then later today saw three magnificent giraffes running.  They are glorious and although lanky were wild and graceful, galloping over the grasslands as Gary kept circling the plane.  Seeing that was one of the most breath-taking and glorious things I have ever seen - their orange/brown and white spotted coats was shinning in the sun, contrasting with the lush tall brilliantly green grass - they were so beautiful and free. 

We saw a herd of male elephants that has been hanging out near the park - it is reportedly the older ones that have been kicked out of the larger herd.  Zakouma used to have the largest number of elephants in the world, but now their numbers are dwindling because of poachers, many of whom come in from Sudan or surprisingly enterprising Chinese businessmen who supply the poachers with guns in return for the ivory.  There is currently a large-scale conservation project underway at the park and many of the elephants wear tracking collars. 

We saw ostriches, water buffalo, gazelles, wart hogs, and various birds. 

Tomorrow at sunrise we are going to fly around more and continue the search.  Gary has been so amazing about taking the time to try to let us experience the park.  I have my fingers crossed for a lion. 

I am laying under a much-needed bug net as the insects here are fierce, unsympathetic, large, frantic, and determined.  I am enjoying the fastest internet I've ever had in Tchad, drinking water that is actually ice cold and am lodged in a cute little round hut with pink trim decorated with copious amounts of slimy clinging slugs. 

I am grateful to be away from the madness and surrounded by so much natural beauty and splendor. 

there is freedom with the wild things

.read

Please read the blog written by Dr. Olen Netteburg about the events
surrounding Minnie's death. He has said it far better than I ever
could. To read this blog on his site and the many other fascinating
blogs click on the link I have on the left page of my site. Their blog
is http://missionarydoctors.blogspot.com. Olen is a fantastic writer
and presents a raw, clear, funny, hopeful, searing, and honest portrayal
of their life as the sole doctors at Bere Adventist Hospital.

Thank you to everyone for your prayers, emails of encouragement, and for
letting us know you are here for us, even if it from thousands of miles
away.

Minnie continues to be missed and remembered.

.Minnie

I am staring at a blank screen because I don't know how to write this.

One of the volunteers here, Minnie Pardillo, died Sunday morning at
12:45 AM from cerebral malaria.

From every avenue and angle - everything possible was done by everyone
involved to save her life.

Her death is surreal, shocking, horrifying, senseless.

There are no words.
Yet a thousand pages would not be enough to fully express everything I
am feeling

I was the nurse primarily taking care of her.

I am professionally devastated.

Everyone here is trying to grapple with this and its ramifications in
their own way.

Don't ask us if we are okay because none of us are.

I'm not doing okay.

Not in any way, not even a little bit.

I have never felt as completely wrecked as I do right now.

I feel like all my strength, willpower, passion, love, and endurance has
been emptied onto the dirt and that I'm just sitting there staring at mud.

Myself and everyone here could use your non-judgmental love, support,
encouragement, and prayers.




Minnie was a rare individual in that she was genuine and pure in her
passion for people, and she was dedicated to serving her God no matter
the cost to herself.

She was loving and and kind and steadfast in what she believed to be her
calling - to follow her Jesus no matter where he led her - and to
unselfishly share that Jesus.

She radiated peace, joy, and love and saw people as individuals -
demonstrating in countless ways how much she cared about them personally.

She cared deeply for the Tchadian people, and they for her. She always
prioritized relationships.

I would like to extend my sincere condolences to her family. Please
know that many people's lives were changed and their suffering was
lessened simply because her path merged with theirs.

If there ever was a child of God - this was one.

To quote my friend Cristin: "...she truly believed she was fulfilling
her purpose in life, and that is more than most of us ever achieve."

.starvation

through the streets they often linger
searching for a bit of bread

I am the mother
that can't feed her child

and i am the child
that cannot be fed

.about

so I think perhaps I owe everyone a bit of a newsy blog - something a little lighter and less, "hey people somehow make yourselves care about death" blog

Life now, is, well, life as normal now.

Its normal to have no electricity after dark
Its normal to shower with buckets
Its normal to pee behind trees at night because the latrine is crawling with cockroaches
Its normal to walk to work, dodging barefoot boys driving long horned cattle
Its normal to sit on the ground more than a chair
Its normal to eat rice with my hands
Its normal to speak in French
Its normal to wait 2 hours for an "urgent" blood transfusion
Its normal to get malaria
Its normal to always have something wrong - so much so you barely notice it
Its normal to pause every night to look in awe at the stars
its normal to boil water over an open fire
Its normal to sleep every night on a little back packing mat that always deflates by morning
Its normal to wear clothing with holes in it
Its normal to go without showering
Its normal to walk around barefoot
its normal to wear the same clothes 3 days in a row
its normal to be soaked in sweat
Its normal that you taxi is always a motorcycle
Its normal to pass the time without entertainment, just talking
its normal to greet everyone with a handshake, to ask about their family, an mean it

this is life now.  I don't find it incredibly hard.  I guess I have toughened up.  falling into latrines, getting toxic hepatitis, break bones falling off fast horses, burning myself on tipsy motorcycles, and an endless procession of mystery ailments and rashes will do that to you I guess. 

changes:

I can now at least be in the same vicinity as a cockroach
I am beginning to believe the lie that rats are scared of me too
I am 50 pounds lighter
I can speak French, although not fluently
I am far more intimately acquainted with Bob Dylan and have developed a life-long love affair with Eric Clapton
I am absolutely and unequivocally single and am content to remain so


and so many other small changes - some for the better, some for the worse - some i don't even realize

updates:

2 nights ago finished my last night on Peds.  I have been working there since I got here.  it is bittersweet.  The most intense portion of my experience here.  And I wouldn't trade it for anything.  It built me and broke me and I will never be able to do anything else with my life - except be right in the middle of where life is the most intensely fought for and lost. 

I spent one day as the chief de chirgurie

I will spent 20 days working on Maternity with Bikaou - my Tchadian mother and Sage Femme excellent trying to learn how to get those slippery little babies into the light of day.  Oh and the powers have seen fit that I shall be spending 4 Sundays working totally alone in Maternity - so that will be a dangerous adventure considering I possess about the same amount of OB knowledge as a 6 year old from the 7th century. 

I will be spending the 20th of August to Sept 9 doing 3 week long intensive training programs for my Community health workers.  It will be their fourth training.  And then the Pilot Project 21 will be over - and then the CHWs will be trained to do dental screenings and we are hoping also for a self-sustaining water project that can start in January - lack of potable water is the number one stated problem in all the quartiers.  I created their entire training program, trained them myself, and now there are 42 functioning CHWs in the district of Bere (this was one branch of the project, ran in an extraordinary manner by Marci Anderson, MPH) so that is exciting - and Marci is working hard on the next phase of the project which will focus on making potable water accessible and affordable and sustainable.

I have volunteered a little bit at the Malnutrition Center in Bendele and helped them create some nursing intake paperwork.  I also keep doggedly referring although few ever actually go.  But I like spending time with the girls out there - they are doing a splendid job. 

I will be spending my last week until I fly out in the capital, NDJ, trying to interview women in governmental positions as well as those those that work for the branch that deals with women's issues.  Marci is going as well to get statistics for her malaria grant (this woman can and will eradicate malaria here)

I am working on a new hospital paperwork system, discharge papers, and post-surgery protocols and I am crossing my fingers hoping we can push it through and the administration will adopt it.  I spent a lot of time thinking of feasible, sustainable solutions that could increase the quality of patient care and have written a detailed report about my findings.  got to try, right?  don't want all that complaining to be for nothing. 

I am also frantically trying to get all the interviews I need for the book I am attempting to write on Women's rights abuses here in Tchad and specifically Bere.  I started out knowing nothing, still pretty much know nothing, except how not to go about the interview process.  the amount of things i need to do and find out and chase down is truly staggering.  to say I am daunted is an understatement. I am so close to it all I don't know if I have amazing stories or if I don't have anything close to the caliber that i think I have.  I pretty much have no idea what I'm doing.  But i am going to keep trying and follow this thing through to the end.  I have always wanted to write a book - I promised the women - and I have only one life to live - so, i will write. 

So, I am busy, for the most part happy, not in the least excited about leaving, and just trying to do my best to leave having no regrets in any facet of my relationships and experiences here. 

thanks again to everyone for being so supportive, sending me packages, prayers, encouragement, phone calls, letters, positive energy, love, emails, and pieces of writing.  You have all been my lifeline. 

xo

.being

here is to there
is
and we are everywhere
is
sweep is
the eye spiz
blink me dizzy baby
is

as long as
your lashes fall
you are
as long as you are
I am
as long as I am
we are
as long as we are
there is
to be

tick tock blink clock
last moments
to see

I blink you blink
 be
 been
 being
blinks

has been
 is now
to be as
true as
I saw you as
the last time as

tick tock blink clock
last moments
to be

don’t close your eyes
you’ll see what was
don’t open your eyes
you’ll see what is
don’t close them halfway
you’ll see what will be

tick tock blink clock
last moments
to see

blink you were and
blink you weren’t and
blink you won’t be
ever
you now are
as I
will be
forever

tick tock blink clock
past tense
your present since

and now you aren’t
but I still am
wishing everything was
as It were

frozen stare, empty glare
hell is
when your eyes no longer
open
purgatory is
when your eyes no longer
shut

tick tock blink clock
tell me what color
 is heaven

frozen stare, empty glare
would be
lives dead
as was
 
I am now
because you were
a different
kind
of being

am is are
was were
be been being
I will be
as you have been
so tell me you goats, 
what did you do with your being?

*****************************************
27 patients

He died before I even had a chance to try

It was all stacked up against him anyway.

Moments, choices,conversations,  countries, stacked, as  collective a death.

This one was rigid, clenched fists splayed out

Eyes half closed that  locked into nothing

The kind of stare where you only realized gradually that they aren’t blinking
The kind of stare  that sears through all the lies
The kind of stare that makes explanations for why the world is the way it is turn and slink away
The kind of stare that  scorches the excuses crooning on the tip of your tongue
The kind of stare that  brands you, that cauterizes the arteries of the deep
The kind of stare that dares you to look back, look through, at what is
The kind of stare that tears through your soul with scorching clarity
The kind of stare that doesn't judge, but makes it impossible to plead not guilty
The kind of stare that will have to be crunched into submission by the calloused thumbs of crying grandmothers
The kind of stare that will have to be blindfolded by a strip of green fabric from the mothers skirt
The kind of stare that cannot forgive that which you can never forget
The kind of stare that solemnly meets the eyes that are already floating outside the hollows of their sockets, of all those  of those for whom we proclaimed "never again," of all of those who were butchered and hatched while the world debated the actual definition of "genocide," of those who slipped away rotting and forgotten - that meets the eyes of the robbed masses and locks with a deadly kind of knowing
The kind of stare that knows that one day, all those eyes will be turned on us, all those billions of eyes will bore right through us, all those eyes will not let us blink, all those eyes will be locked onto us, staring the question, demanding the answer, what did you do with your being?

He died with eyes wide open
Its braver that way -
daring anyone to meet his gaze
daring anyone to save him
forgiving that which he knows can never be forgiven

He died with eyes wide open
its braver that way
and I let him

****************************************

malaria
it needs a name
it needs a face
it needs a footprint
it needs a foe
it needs to be illuminated
sucked out of its crumbling rat infested hospital
wrenched from its gasping breaths on the floor of mud huts
put under the brightest
whitest light
placed writhing under a social microscope
i want their faces painted on the walls of every building
i want the screams of the mothers blasted from the rooftops of every city and on every radio station
I want every news channel to focus on sweat pouring off hot little bodies, on rolled back eyes, on jerky frothing convulsions
I want their stories in every book
I want their histories, their names, their pictures, in a museum
i want bricks made of their footprints to form a path that circles the world, and I want everyone to walk on it.  to know that just by not knowing they are stepping on innocents.
they say genocide is when an ethnic group is purposefully wiped out
but how about a generation
how about 1 in 5 children in Sub-Saharan Africa
what do we call that?
genocide?
its doesn't fit the criteria
but its the most potent term yet coined
but we should call it something else
but there isn't a word
isn't anything to depict the horror of this silent slipping shadowy evil
and so
we call it
Malaria

***************I*******************************

In the US - would we let 1 in 5 of our children not grow up?
would we?
of course we wouldn't
we have the resources
so why do we let 1 in 5 of other people's children die?

is it because declaring a "war on malaria" seems just as ambiguous as the "war on terror" or "war on drugs"
well, guess what - terror ain't going anywhere, drugs are everywhere, but the mosquito, we know where he lives, breeds, hides

we eradicated Malaria from the US decades upon decades ago.  And anywhere else that had resources did the same.  And guess what - you can go to war with malaria - its proven.  its been done. In the US - in the swamplands and marches that are now your neighborhood.  there are large geographical sections that are now free of it. 

its possible - but now that your children are safe and happy and tucked into their beds with little superman sheets and swirling ceiling fans and glow in the dark stars and dull golden nightlights - now suddenly you are in your world - the one you created, the one you love, the one where you don't think every time you take your son fishing it could be the last time -  now the other worlds seem more distant

and now the people with the resources don't have to worry about it.  this is Africa, after all.  let the Africans sort it out.  except oh, there aren't really that many producers of DDT anymore.  And the environmental lobbyists have a stronger voice than the millions already silenced.  and now we deny the rest of the world the exact same opportunity that the Western world wouldn't have dreamed going without - eradicating Malaria.

eradicating malaria

malaria CAN BE ERADICATED

terrorists are a dime a dozen
people will always get their drugs
but children can stop dying

but this war, even though it is just as faceless and nameless and seemingly futile
this war does have a culprit
this war does have an enemy
this war does have geographical borders

this war must be fought

how will we answer, to the searing judgement of hindsight, to the future generations, when they wonder how we could have allowed this gap between rich and poor to grow wider and wider, deeper and deeper, more and more impassable?  When they wonder how in this age of such stunning advances and achievements the other half of the world could be allowed to stagnate and wallow in deep suffering and despair?

wrap your mind around this.  at this very moment, you are sitting at your computer.  maybe you have on comfortable slippers.  maybe you have nice carpet petting your toes, maybe you are leaning your elbows against a lovely oak table, maybe you are eating ice cream, maybe you have a fan blowing on you, or are in front of  a crackling fire.  maybe your TV is playing in the background, maybe you are blasting music from your Ipod, maybe you are stealing a moment at work.  and this is all very routine.  and, its a well deserved rest.  no one is denying you didn't work and sacrifice and gut it out for your family, your dreams, for all you had.  no one is denying that you deserve the small comforts that make it possible to get through the day - and no one is judging it. 

but at this very moment - a little boy of 4 is taking gasping drowning breaths.  he has pulmonary edema.  and cerebral malaria.  he is drowning.  and now he is dead.  at this very moment, a woman is dying in childbirth because she didn't have 50 cents for a prenatal visit.  at this very moment, the pediatrics ward is overflowing with almost 30 patients, quinine is dripping into every hand, foot, and head, half of them are being transfused, several will die tonight, roaches are crawling over legs and hands and foreheads, rats are scurrying flash along the shadow of wallcorners, there is old food, and dust and trash, mothers, fathers grandmothers are sleeping on grass mats in every available space, stepping over snoring bodies trying to see your patient.  children stop breathing, the screams are ushered outside, the drips continue largely unchecked, and this is normal

but how do you wrap your mind around this? 

around the 2 worlds?

its not your fault, i just can't figure out how we got here, how we get out of here

but how can a world that sent a man to the moon, that built the space needle and spits students out of Harvard and eradicated smallpox, this world with its dizzying array of wealth and opulence and private jets and high heals, this world with sleepy dreamy rose gardens and American dreams

how can this world be the same world that lets millions of children die every year just because they live on the wrong continent?  how can this world let the other half subsist on less than a dollar a day?  how can this be the same world where you know you will die at 45.  where you don't go to school because you are a girl.  where you do backbreaking physical labor your whole life for one meal a day? where a child lays burning with fever, in a coma, convulsing, drowning in his own secretions, laying on a filthy black mattress crawling with tiny white worms, the same world that when he takes that last rattling groan of a breath there is no oxygen to give.  where there is no oxygen. 

how can a world that grows groovy human ears on the backs of mice and spends billions of dollars on medical research be the same world in which there is an entire country without oxygen in its hospitals. 

how is this the same world? 

how do you wrap your mind around this? 

where do you fit into this equation? 

no, how can you change the outcome of this equation?

this is the same world

but we must make it different

we must build a bridge over the gap

we could build it out of bones

femurs, maybe

or make a swaying bridge by stringing rattling teeth like swinging popcorn

or just heap enough skulls into the canyon to crunch our way across

we must build a bridge over the gap

so,

tell me,

sheep,

 or goat,

what did you do with your being?