...photos at last

gift bags for days

(L to R) Auntie Sue, Hope, Auntie Kay & Jess

Our Livingstone travel clothes.

rainbow

Jess and the Auntie Sue crew.

Of course they also wanted a picture with their "son-in-law." Oh and that's a Hannah Montana backpack Hope is grinning about. Thanks, Uncle Stig (and Amazon)!

J & S

Hi Friends,

Taking care not to disappoint, “crazy Kitwe,” as I’ve come to affectionately call it, welcomed my husband with a barrage of classic chaos. From “third-world” travel to rain-induced power loss, medical tragedy (in the form of two more maternal mortalities this past week) to heartwarming displays of gratitude, Stig’s first week was a baptism by fire. I’ve invited him to co-author this week’s blog, so in his own words here are a few details.

“Most of my days for the past week have involved “shadowing” Jess and following her work routine from day to day. On Monday I visited all the wards and met all of the nurses and midwives Jess works with. Not surprisingly she told everyone I was coming, so I was met with very warm handshakes and even hugs. During these visits I had a chance to see each ward and learn how the hospital is run and put together. Having some medical experience in the U.S., this was an eye opening perspective to say the least. I can see why so many things have been difficult and frustrating for Jess and her work in the study.”

That last bit seems to be Stig’s kind way of saying our hospital is rather a mess, which was starkly exhibited this week by the entirely preventable death of patient admitted after 24 hours of at-home bleeding from an incomplete abortion. It was thoroughly depressing when Stig and I arrived on the GYN ward Monday afternoon to learn of the story of the poor woman who spent nine ours at the hospital without a single recorded blood pressure measurement, or pulse reading. Furthermore her hypovolemic shock was not treated with a blood transfusion, a manual vacuum aspiration (a procedure frequently performed to remove retained products in the case of miscarriage/abortion), or really any other treatment to speak of. She collapsed in her hospital bed, which provided not even enough support for effective resuscitation, and she died soon after. Admittedly this was one of the hospital’s truly low points. Nonetheless, and marked by that distinct interplay of contrasts I have witnessed throughout this journey, it was only one side of the Zambian coin. Stig and I also witnessed great hospitality this past week and deeply genuine appreciation from a culture of people who do care.

One of the things that I have been most excited about for this trip is the fact that I brought about 20 recyclable Whole Foods bags, each of which read “Peace on Earth,” to distribute to the people who have loved and welcomed Jess. The bags included donated items from a variety of people and companies in the States. They were filled with perfume samples, Starbucks Via coffee packets, hand sanitizer, tea bags, chapstick, dish detergent, peanut M&M’s, Famous Amos cookies, Bvlgari soap rounds and more. There were even 15 white baseball caps from Blue Shield, which just so happened to perfectly match with the starched and pleated white nursing uniforms. As we handed out bag after bag everyone was extremely excited and thankful. One nurse even called Jess the evening after she received her gift and was so overcome with excitement and gratitude that she said she had both cried and jumped up-and-down as she went through her bag. Another male midwife said that Zambian’s don’t give each other gifts very often, and he had not received anything in a long time. That being said, he was extremely appreciative of this offering.

Stig is so right. Not since the Zambian championship at the African Cup of Nations have I seen such delight. One of my favorite clinic coordinators texted me a few hours after we gave her a bag; she wrote, “Jesse, I want to thank you so much for the gifts given. I am really humbled.”

Among the more dramatic reactions to our gifts, Auntie Sue, Uncle Eddie, Auntie Kay and Hope jumped and shrieked with joy. Auntie Kay even went into a fit of repeating, “God bless you” and “Praise Jesus!” Furthermore their thanks extended beyond this celebration. My extended Zambian family reciprocated those small presents with unanticipated generosity. As Stig tells it…

Just a few minutes after we gave their gift bags Uncle Eddie and Auntie Sue said they were going to throw us a braai (BBQ). So on Wednesday night Jess and I turned chicken and sausage over a well-flavored grill and indulged in an embarrassingly elaborate buffet of everything from homemade samosas and egg rolls to fresh mango, potato salad and even a bowl of toasted caterpillars (well, Jess and I didn’t actually sample that Zambian “treat”). During that meal and at various other times, Uncle Eddie fondly referred to Jess and to me as his “children,” and said that we are always welcome to come and visit our Zambian “parents.” They even surprised us both with our very own traditional Zambian costumes, which they had hand-tailored in chitenge material. I was completely blown away by not only their generosity and thoughtfulness, but also by the fact that without any measurements they were nearly spot-on with both our sizes.

Needless to say, it wasn’t a dull week. A few other experiences included:

·      Two power-outages, one of which occurred just before we were to grill our cheese sandwiches.

·      Gelato in Ndola.

·      Travel by all possible means of transport from disoriented taxi to dilapidated minibus to ever bouncing “tour bus,” (into the window of which one very unfortunate bird met its shocking end). Stig was particularly taken aback by the number of “reclaimed” vehicles from his home country, which he duly noted…

I have been completely surprised by the number of cars that are obviously transplanted from Japan. They still have telltale stickers and other features that are found on cars only there. It is something I was not expecting and feels a little surreal to see so many Japanese products in Africa.

Now and at last we’ve reached the calm at the storm’s end. I’ll let Stig conclude.

I am glad to report we finally made it to Livingstone, and I am looking forward to spending some restful time in the home of Victoria Falls, one of the seven natural wonders of the world. There will be many things to keep us occupied including hiking, swimming, safari and exploration, but I think we are mainly excited to spend some down time together. Jess has worked pretty much non-stop since she got here, so this will be a great holiday. And fret not, because I am sure in another week’s time there will be plenty more stories to tell.

Sending our love,

Jess & Stig

He made it...

Downloading pics is a belabored process, which Stig has agreed to attempt this week while I'm at work. So, you can actually expect more shots to come in the near future. In the meantime, together at last!

Speed Humps

Hello All,

This has been a week of many great and unprecedented moments. A number of these I’ve spent in the reading of kind and inspiring words from so many of you. I am truly honored to be embraced by such an extensive community of fantastically supportive friends and family. This past week you have showered me with extra love, and I’m realizing many of you have been anticipating Stig’s arrival with nearly as much excitement as I have felt. So without further ado, by far the most thrilling experience of this past week, and perhaps this entire trip, occurred at about 7: 50am on Saturday morning amidst spattering rain when I recognized my husband’s searching gaze. As his wandering expression gave way to a brilliant smile, my steps quickened to a series of rapid skips over puddles and across the street to hug and kiss and just look at him. Then, in truest form, I ran in the opposite direction toward the nearest bathroom, leaving Stig to make his own introductions with our cab driver and sort the plan for transporting his things. That morning’s coffee and water bottle could only serve to hydrate and keep me awake for so long before also catching up with my notoriously small bladder. Too much information? Perhaps. Anyway, and with great relief on all fronts, we reunited a second time and proceeded to the Lusaka bus station to go home to Kitwe.

The bus trip home to Kitwe was not quite so smooth as our blissful reunion. Literally. For nearly six hours we travelled at a consistent trot over potholes and across speed “humps” with impressive, if disconcerting, speed. Nonetheless it seemed a rather perfect introduction to the certain reckless abandon, which can characterize this country and culture. And, after a few stops (at every one of which I deftly made ablutions), we finally landed in the thick of Kitwe Central Bus Station, a hectic circus of vehicles, people and trash coated in a thick layer of dust and whirling in all directions. With some effort we managed a taxi, negotiated a fair price home (all of three dollars), loaded a series of plastic-wrapped bags into our driver’s “boot” and drove to Auntie Sue’s Guesthouse.

Stig says my bedroom seemed bigger in pictures. It also seems the photos didn’t quite do justice to a number of scuffed walls, cracked linoleum tiles and decrepit furnishings. Even so a fresh set of sheets, still wafting of nostalgically soapy scents from home, covered all manner of Zambian housekeeping. With enough unpacking to slip into more cool and comfortable denim and enough daylight to sustain a much-needed walk, Stig and I set off for dinner. This meal turned out to be the most splendid conclusion to our perfect day. We spent almost two hours in thorough conversation over exquisite butter-chicken, fresh veggies in chili oil and cashew cream gravy, marinated lentils and garlic Naan. Then we returned to my Kitwe “Castle” to bask in those soapy sheets. Too much information? Perhaps.

The story of Stig is, of course, the highlight of my week. Other happenings seem to fade, even as I now attempt reflection. However, a few more of those aforementioned “great and unprecedented” moments included the following:

·      Some really productive time spent with the new Copperbelt coordinator, whom, I recently learned, will be living with me here in Kitwe. This means I will have help and company through the duration of my last weeks in Zambia, a tremendous answer to prayer!

·      My first taste of sea salt, turbinado sugar and chocolate-covered almonds (on Zambian soil, that is).

·      My first Tagalong chocolate peanut-butter Girl-Scout cookie (also on Zambian soil).

·      The first and glorious dried apricot I’ve eaten in over two months.

·      My first Zambian kiss!

I’m signing off this week with a spirit of utter joy and contentment. Wishing you each all the same happiness.

With love,

Jess

Reflections in the Rain

Dearest friends,

As I write there is a deluge of water pouring onto my roof, threatening the spaces between windowpanes and drowning out the music playing through my laptop speakers. The lights in my room are spontaneously flashing bright, then dim and thunder is reverberating through the walls. Have I mentioned it’s rainy season in Zambia? And I love it. There have been very few occasions over years of mostly dribbling California winters that even began to prepare me for Zambian rainstorms. I recall perhaps one or two unique school days when the rain was so heavy that crowds of students and teachers alike cluttered in cautiously opened classroom doorways to stare at the weather. Here, however, the downpours seem too common to captivate an audience. Still I have slipped out the door to gaze from my porch from time to time. From the shelter of my own covered space it is so humbling to stop and to listen.  For me the rain induces spellbinding calm and cause for reflection, so I suppose it is serendipitous timing that a torrential soak has begun just as I have stopped to dwell on this past week’s stories.

Although I’ve spent countless hours learning about and investigating cases of obstetric hemorrhage over these past weeks, it was not until a few days ago that I actually witnessed profuse bleeding. Twice. The first occasion I entered a ward just as a woman was delivering her tenth child. She did an extraordinary job and her newborn burst into the world ruddy and screaming. We all three, the midwife, the mother and I, gave a smiling sigh. But in the space of a mere moment the beautiful birthing scene gave way to anxiety as the delivery of a less than healthy placenta was followed by gushing blood. Uterine massage brought forth only a new glove-full of expelled clots (more blood) and poor contraction. Consequently, the nurse tried one more massage and managed to slow the pouring loss, but oozing continued and we soon discerned an internal laceration. Throughout this time my hand was solicited and I moved to collect gauze, place clamps, take vital signs and ultimately help to hold open the writhing woman as she was sutured without pain medication. When the thread was tied and the poor mother’s legs collapsed together I finally convinced another midwife to empty a syringe of medication into the woman’s IV. At last the bleeding and pain subsided, and I went home. The following day, shortly after my arrival to the hospital, I witnessed a second case. This time I stepped onto the labour ward at Ndola Central to find a gaggle of midwives, student nurses, obstetricians and one anesthetist anxiously surrounding a severely hemorrhaging mother. I particularly noticed the anesthesiologist, poking away at an outstretched arm, which would occasionally spasm then relax. After at least six unsuccessful attempts I learned the patient’s veins had collapsed. Nonetheless, the scrub-clad physician needled on. He worked at her forearm as a team of nurses hoisted her legs into stirrups and another doctor sutured and clamped at the site of her recent delivery. The candy stripers huddled and dispersed in turns, murmuring over this mesmerizingly horrific sight. I did little more than observe this case and mostly stared at a drape of blood, which hung between this poor woman’s legs. I counted tick marks as I realized in dismay that at least 1 liter of that life-giving fluid had drained from her body. When my attention was at last drawn away, I still didn’t have an opportunity to see a resolution. So over two more days I followed up on this patient until eventually in her case summary I wrote, “Discharged home stable,” something I scroll at the end of nearly every data collection form. This time, though, was quite different. I had never written those words with such depth of understanding and true relief.

The other less significant, if yet traumatizing event of this week was the entrance of one extremely unwelcome rat into my bedroom. At an exceedingly inconvenient hour I nonetheless exited my room to inform the night guard, and refused to return until said rodent was removed. Alerting half the main house with my complaints, Hope and a few others stood at my side as we all watched the squirming shadows of two grown men in their quest to kill the little beast. 15 minutes later they proudly emerged, one pinching the tail of that very unlucky creature between his fingertips. My apologies to any offended animal rights activists who may be reading. If it’s any consolation, it seems all other like-minded cheese-lovers were deterred (and thus sparred) by their brother’s ill fate … To my own great appreciation!

And so are a few stories of this past week, with routine filling the gaps and, as always, a promise of the unexpected in each new day.

It is now with tremendous anticipation that I leave you with this exciting news. For next week’s blog Stig will be sitting beside me, perhaps even massaging my shoulders, as I write. That’s right folks, it’s a six day, seven hour countdown. Here is to great cause for hope and joy in each of your own lives.

With love,

Jess


PS My photos are not loading, so you can expect a few to come later this week.

Settling In

When I was perhaps four or five years old someone taught me the indelicacy of staring. With this enlightened understanding of etiquette I began to wonder at all the rude adults around me, who seemed to shamelessly stare at my own presence. On one occasion I even returned the gaze of a particularly focused onlooker and, with all the ridiculous authority of barely more than a toddler, exclaimed,  “What are you staring at?”

Every day of these past weeks I have found myself the object of unabashed staring. And in turn I cannot help but recall that lesson from early childhood. Unfortunately, at my present age and in this particular culture, I’m not at liberty to respond with such open admonishment. Rather, in Zambia it is not considered inappropriate to even gawk at things, which are out-of-the-ordinary. And in this country my pale skin, frizzy curls, REI backpack and BPA-free reusable water bottle are exceptionally out-of-the-ordinary. In response most natives are quietly transfixed for a few long seconds when I pass into and out of their sight, but the children are completely beside themselves when they see me. The children, filled with all the confidence and none of the inhibition, love to clamor. Troops of students walking home from school alternately stare, huddle and giggle. And littlest ones call out guesses at where I might have come from. Most recently, as my taxi was passing through a rural suburban village, a few enthusiastic toddlers called out, “China, China!” as they ran alongside the car. My driver informed me kindly, if unnecessarily, the kids thought I was Chinese. Later that same afternoon my driver asked what I missed about home. I miss feeling like I belong.

However, I have finally settled into this place. Not the kind of settling that suggests unpacking of things and adjusting to time-changes, but I’m referring to an emotional peace that recently washed over me. At some point this past week I seemed to let go of go of my struggle against this change. Since then I’ve relaxed into living here and discovered I can and do belong. I’ve nested into the idyllic calm of my Zambian bedroom, and arranged my hospital office until it became distinctly my own. Additionally, and after many weekly Skype chats and weekend blog postings, I also discovered a handful of Internet spots and favorite café’s, where I’ve earned familiarity and a warm welcome. Apart from all the ways this country and culture continues to feel foreign, I have found rest.

So, it is equipped with this refreshed grace that I embark upon the second half of my journey. Surely it will be filled with many more trying and triumphant days. You can depend upon an account of those days to come. In the meantime, thank you for listening. The ever-engaged support you have all shown has encouraged and inspired me endlessly.

May each of you also find rest this week and always.

With love,

Jess