Highs & Lows

This week has been exciting, at times full of hope, and at other times, seemingly full of despair. However, even when things looked the worst, I was reminded that God has the perfect plan, and thankfully I am not in control.

I attended my first STAT c-section two days ago. It was a young lady with a term gestation, but the baby presented as a footling breech (the baby was positioned legs first, one of the legs was already out, and it was rapidly losing blood supply). We rushed to the OR expecting the worst, and miraculously, within 10 minutes, we had not one, but two healthy, pink, and crying babies on the warmer! Mother had looked more pregnant than anticipated, but given a lack of prenatal care, it was not certain that she was indeed carrying twins. The children survived what could have been a disastrous entrance into the world, and have been thriving ever since. That was a high.

That same evening, one of our late preterm infants who had been making strides towards recovery - a 36 wk old male, now 10 days old, with suspected neonatal sepsis - developed acute respiratory failure.  Despite our best efforts at resuscitation, the child passed. The mother's pregnancy had been complicated by placenta accreta, and she underwent a hysterectomy to prevent fatal hemorrhage at the time of delivery. She wept and wrestled that evening, not understanding why she had been lead to hope, seeing her child's daily improvement, only to have it dashed, and knowing now that she will never have another child. That was a true low.

This morning, I returned to the nursery, and shamefully, wanted nothing more than to avoid contact with the bereaved mother. I did not want to become emotionally engaged, did not feel able to share with her in her loss. She called me over to her bedside when she saw me enter the room. My heart stopped. I took a deep breath and walked over to her. I opened my mouth to give her my condolences, but before I could speak, she said to me: thank you for trying your hardest. You all worked to save my baby. You did everything you could, but it was God's plan.

I often do not understand why things work out the way they do; I have no comprehension of God's decisions. However, I know that God is the God of comfort, and that He is sovereign, and that His plan is much better than the plans that I could make. I am eternally grateful for that.

Blessed be the God and Father of our Lord Jesus Christ, the Father of mercies and God of all comfort, 

who comforts us in all affliction, so that we may be able to comfort those who are in any affliction, 

with the comfort with which we ourselves are comforted by God. 

For as we share abundantly in Christ's sufferings, so through Christ we share abundantly in comfort too.

- 2 Corinthians 1:3-5

Family Update

Well, we wanted to keep you all apprised of our family while we're off in Cameroon as well. So rather than talk about work, here's a little update on the family.

Cathen is doing great. She is now 6.5 months old, is taking solids (she loves rice cereal and avocados, and should start sweet potatoes in the next couple days), sitting on her own, and coming dangerously close to crawling. It'll only be a matter of weeks before she is completely mobile... we need to start baby-proofing! Lindsay and I are adjusting to being parents in a new home. Lindsay has had the daunting job of being the primary caretaker for Cathen and working part-time on the pediatrics ward, but she has graciously entered into her new schedule, and has been tremendously resilient to the challenges of motherhood and work in an unfamiliar environment. I have been enjoying life at Mbingo: hiking, playing guitar, eating new foods, experiencing new customs, and yes, also working.

Here are some photos from taken in our front yard today:

Culture & Adjusting

Well, after about a month in Cameroon, we have come to "appreciate" some of the cultural differences we are exposed.

1. Today, there was a herd of cows eating our grass and pooping in the front yard.

* this is the same group of cows. Last week they stayed on the other side of the road out of people's yards.

2. Keys: we have a total of 6 doors in our house. We have a different key for each door in the house. We have only 1 front door key and 1 back door key. We have a key for the refrigerator. We have a key for the laundry room. We have a key for the safe. We have 9 keys to make our home functional, and no spares for any of them.

* our keys

3. Phrases:
     a) "Aasha." This roughly translates to "my condolences for your hard work," or "that is rough, keep your chin up," or "I'm sorry for your load." When in doubt, you can always respond with "aasha" and it seems to make sense.

     b) "You're Welcome." If "aasha" seems to fail you, "you're welcome" seems the next best phrase to use when unsure about what is appropriate. We are often greeted in the hallway with "you're welcome!" - much like: "you are welcome to work here, thank you for your time."

     c) "Purging." I finally discovered that "purging" was in reference to diarrhea and not vomit. Many of my patient's stories make a whole lot more sense now.

     d) Stool. Stool is at times called feces here in Cameroon. "Poop," however, has no meaning. More commonly, our friendly four-letter word beginning with an "sh" and ending with a "t" is the common vernacular. This is taking some getting used to. What wonderful things is Cathen going to be saying when we come back stateside?!?

4. Time: Time seems to have little bearing on how things operate... with the one exception of morning chapel, which starts promptly at 6:40 every morning. Otherwise meeting at 11:30 might mean 2:30, a STAT lab might come back the next day and as "O/S" (out of stock), and a chest radiograph might take a week to obtain. However, everything gets done, and everyone works on behalf of their neighbor; but our typical urgency simply does not translate.

5. Fire: two weeks ago, Mbingo mountain was set on fire. We thought it an interesting spectacle, but assumed it was a controlled burn. Apparently it was not. Many people fought the fire overnight to prevent property damage and injuries. Today, after a few days of rain, the entire mountain is green and lush.

* flames on Mbingo Mountain

We are adjusting and learning to live more comfortably in a new environment. Thank you for your thoughts and prayers. More later.

Week 2 Update

We are over two weeks in to real work on the pediatrics ward and the neonatal unit. It has been humbling to say the least. We often have a good idea as to what we would like to do, but sadly are unable to do it due to lack of resources. Other times, we are seeing diseases more common in developing countries and aren't as clear what to do. Thank you, for those of you who have fielded our internet consults! However, we are eager to learn and are excited about our time here at Mbingo.

Perhaps the most exciting thing about Mbingo is that it is a true teaching hospital. Our role here is not only to serve as pediatricians, but more importantly, to train the Cameroonian residents and nurse practitioners. We are also blessed to be neighbors with many of the training staff, and have the opportunity to become friends and not just co-workers. There are a number of small children that live across the road, so Cathen will have plenty of friends to play with as she gets a little older.

In addition to working, we've been trying to get outdoors and enjoy the hiking.