Wednesday, October 31, 2007

Chicken Street

Hope all is going well at home.
Today was a great day. We started out at 7 am sharp (Holly and I) at CURE hospital, where I will be for the next month. I must say that I am extremely impressed at this point with how organized everything is and how they truly are attempting to run it as a legitimate teaching facility. We went to morning report this morning, which is where an interesting case from the night before is shared. Ok, for those of you non-medical folk, you may want to tune out for the rest of this paragraph. The case presented was a patient who is 20wks pregnant and presented with shortness of breath. Long story short, she has severe mitral stenosis from rheumatic fever with severe tricuspid regurgitation and pulmonary hypertension. Her prognosis for this pregnancy is very poor, with a mortality rate of approximately 40%. So, now it becomes an ethical dilemma - they may raise money to send her to Pakistan for a balloon valvuloplasty. It was an interesting discussion.
Ok - non-medical people can tune back in now. Following morning report, we went on morning rounds with the team and then Dr. Hill, the OB/GYN who will be supervising me, gave Holly and I a tour of the hospital. It is comprehensive and I am impressed at the organization. We discussed goals for the next month and I am very excited to get started. I think that I will have some to offer, but I will definitely learn a lot. I will start there on Sunday and will be involved both in hospital work as well as clinic work. One big project will be to help develop protocols - both for prenatal visits and for inpatient.
Following this, we went back to the school and had some interesting spaghetti prepared by Peter. It was very spicy! While eating, we enjoyed several stories about his many exploits over the years. For those of you who know Peter, I'm sure you could imagine. We then went to an orphanage to take them cookies and fruit as well as gloves/scarves/hats that children from ECS had collected. This was one of the things I was looking forward to the most. It was an all-boys orphanage, and although we were told that there were 280 kids there, when we arrived, we found out there were actually 420! It was heartbreaking to think that most of them were likely there due to the years of war that this country has been through. It was not like my orphanage experiences in Romania and Myanmar - the kids kind of looked at us as though they weren't quite sure what we were there for. There was no attaching themselves to us or coming up to us. They were excited about the treats, but we were whisked out pretty quickly, so we did not get to spend much time with them at all. Hopefully we blessed them with a few moments of happiness.
Ok, now if you're wondering where the title came from (don't worry, this will be brief). After leaving the orphanage, we went to a place called Chicken Street. It is a large outdoor market. It was a little crazy and one of our drivers hit another car. We were able to find a few things and made it out unscathed. We are definitely a novelty here, though.
Ok, I'll stop rambling. I hope that my blogs haven't been too wordy. I'm really happy with how things are going and continue to be humbled by the workers who are here all the time and live in these difficult conditions.
More later!

Tuesday, October 30, 2007

A Bumpy Ride

Hello from Afghanistan. It is day #3 and things are going well. I'm actually almost sleeping through the night already. I've figured out that that is one benefit to the crazy sleep schedule that comes along with being a resident - huge time zone changes are easier to deal with.

Today, I saw the real Afghanistan. The morning started out with Pastor Bret going to the airport to retrieve the one bag that didn't arrive with the rest - the one with his 14 year old daughter's clothes in it. Needless to say, it still hasn't arrived. But, Madison is being a trooper about it and they are currently out in search of some jeans and shirts.

Then, we headed to Istalif, a village about "1 hour" north of Kabul where SoZo (another NGO) has a health clinic. We arrived there about 2 hours later. First, after we had gotten out of the city and were on the highway, we hear a loud blast. Don't worry, it wasn't a bomb, but it was our tire blowing. As we looked around, we saw all kind of interested bystanders. Thankfully, we had a spare tire and our Afghan driver along with a couple of the men with us were able to change out the tire. Just as we thought the hard part of our journey was over, we turned off the highway onto a dirt road. To say that it was bumpy would be about the biggest understatement ever. We rocked up and down and side to side for about 45 minutes. Each time we passed a cluster of roadside houses, we though "Great, we're finally there." But no, there was more to go. Then came the windy road up the mountain that was only wide enough for one car with a steep cliff off the side. (See pics below). At long last, we arrived at the clinic. Oh, did I also mention that we had a woman who is 38wks pregnant in the van with us for the whole bumpy ride?
I was very impressed with the clinic. They have special rooms for treatment of tuberculosis and leishmaniasis. They also see kids and adults as well as do prenatal care for women. Also, they do normal deliveries there (5-10/wk). The bed they deliver on is an exam bed like you see in a doctor's office. And, the typical postpartum stay is 6 hours! They were very happy to show us around and you could tell they were proud of the work they are doing there. They keep meticulous records and seem to have a huge emphasis on patient education.
The ride back was much easier, and we even stopped at an American-like coffee shop for a snack (as our lunch had consisted of trail mix and cheese on wheat crackers).
So, that was my day. Along the way, it was like driving through biblical times. There were mud houses surrounded by mud walls everywhere. What a hard life they must live!
So, here are my impressions so far:
- I am amazed by the resilience of this people. Just 5 years ago, major war was going on here and nearly everything was destroyed by bombs and gunfire (evidence of this is still everywhere). But, they have survived and the amount of new construction everywhere is amazing.
- The chinese that are here reaching out the people have amazing conviction and passion. They work tirelessly against much opposition. They truly are an inspiration.
- I have been humbled to see how good the medical care that is being given is. What they lack are supplies and continued education. So far, everything I've seen, as far as medical protocols, have been consistent with American standards. I do think I will end up learning more than I teach.

- Life here is hard - there are no modern conveniences (except internet and cell phones), it is dirty everywhere, your lungs are full of dirt, and most of the work that is available is hard labor, and they continue to live in fear of suicide bombers. But, when you look around, you can see rays of hope - a child smiling, new homes and businesses being built, people serving others. It sure does make you realize that many of the things that we get upset about are meaningless.

Here are some pics:

Bombed out Darulaman Palace

The reward of a grueling drive - a beautiful view

Monday, October 29, 2007

Ahh....clean clothes

Yes, I finally have on clean clothes. After wearing the same pants from Friday afternoon until Monday morning, I finally have on clean clothes, and man, does it feel good! With all the dust everywhere, though, I'm sure they won't be clean for long.
Today was a good day. We woke up to mini pancakes for breakfast and peanut butter - what a nice surprise. Then, we were off in search of hospitals serving women. The one that proved most helpful for me was one that we were not originally planning on going to. It is close to the school and one of the teachers at the school works there occasionally as a midwife. The sister of our dentist here also works there as a nurse. It is a comprehensive hospital, but has a significant OB/GYN ward. We were introduced to some of the midwives as well as the head physician, who was so welcoming. We talked to them about how they do things and what the biggest problems they see are. They were very willing to talk and eager to learn things from us. This particular hospital is supported by an Italian organization and are not lacking for much. (For the medical bunch among you, their biggest problem is pre-eclampsia/eclampsia.) We then went to Malalai hospital, which is a government-run hospital. They do between 80-120 deliveries/day! They have VERY limited funding and are supported only by the national Ministry of Public Health, which does not have much to give them. They are hurting badly for supplies. We started to go on a tour and talk to more people, but were cut short as we were informed that we needed a letter from the Ministry of Public Health in order to be there. So, we are working on that now.
We are coming up with ideas and are starting to think that the area we might best be involved in would be in training midwives, as they are key in serving women here. We are looking into how we could best do this.
Tomorrow we will be headed about one hour north of here to a village community that has started an outpatient clinic that has OB services. I'm excited for this.
One close call today - we were riding in a van and got pulled over by the police. Thankfully, I think it was just a traffic stop, but boy was I praying! Praise the Lord for His protection.
One more prayer request - pray for protection of my GI tract. I forgot to use bottled water to brush my teeth today :)

Sunday, October 28, 2007

I'm here!

Well, it is almost 10 am in the morning on Sunday in Indy, and I'm here in Afghanistan finally. For those of you wondering, I am 8 hrs ahead of Indianapolis. We have been here for about 7 hours now. The trip was uneventful - I just barely caught my connection in Detroit. But, all was well. We had an 8 hr layover in Dubai, which is one of the nicest airports in the world. We found a place to take hot showers, and they were heavenly! Then, on our flight from Dubai to Kabul, we met a delightful Afghan woman who was very willing to talk to us and tell us her perspective of Afghanistan's history and current state. It was definitely enlightening!
The scene coming into Afghanistan was a beautiful one - lots of mountains. Then, as we got closer to Kabul, it became a vast of brown dust with no relief of green. The airport wasn't too bad. Peter Chun was there to meet us - for those of you who don't know, he is a missionary from my church back home that has started the work here in Afghanistan. The only hitch - our luggage wasn't there to meet us. We had to transfer it over in Dubai, and we're hoping it gets here tomorrow morning. Time to be flexible.
Today, we went to the school that Uncharted has started and met the staff there. Their hospitality and joyful spirit were amazing to me. We also went to CURE hospital to look around and I was able to meet Dr. Hill, who will be supervising me. I will be going back on Wednesday to do morning obstetric rounds with them and meet everyone. I'm very excited about that!
It seems like doors are opening - tomorrow we will go to 2 government women's hospitals to see what care there is like and what the needs are. On Tuesday, we will be going to a village clinic that was started by the organizations that is housing us (SoZo) that has an OB clinic. I'm getting excited about getting started.
Thank you all for all your prayers! I can feel them. Please continue to pray for safety - so far, I have not felt threatened at all. Also, please pray for wisdom for me that I can compassionately and critically look at the situation here and give my best advice to the team from Uncharted about how they could potentially fit into the medical scene here. Speicifically, we would like to do something that would meet the needs of the people, while being able to establish meaningful and purposeful relationships.
Until later - I'd love to get some comments! I'll try to post pics next time.

Thursday, October 18, 2007

A little overwhelmed

Ok, so I never claimed to be a good blogger. I'm hoping, though, that once I get to Afghanistan, I'll do a better job.
Things have been very crazy as I prepare to go. I'm paying for being gone for a month in that I've been on call pretty much every 3rd night this month. For those of you outside the medical field, that doesn't just mean that I'm on my pager. It means I'm in the hospital for a 30 hour stretch and up pretty much the whole time. So, that has been tiring. To add to that, last week I was more sick than I have been in a very long time. It lasted for a week and made being at work and on call very difficult. Thankfully, I am feeling much better now and ready to be productive.
I have raised all of the funds that I needed, so that's a huge praise. The OR team here at Women's has been collecting supplies for me to take and I think I probably have enough to fill several suitcases. Also, the nurse manager at our clinic, who just happens to be Afghani, has collected about 150 bottles of prenatal vitamins for me to take. So, packing should be interesting. It really has been amazing how everyone has pitched in and help.
Other than that, my life is just full of preparations. It's not easy getting your affairs in order to be gone for an entire month! I'm just making list after list, feeling better as I'm able to cross off each task. Is anyone else as weird as I am about that? I love lists.
Well, since I am supposed to be working, I should probably go. Hope this satisfies those of you who are actually reading this (Amanda :) And, just in case you were wondering, I use Colgate Extreme and so far today I've only delivered one baby.