28 September 2014

Lessons on Unloveliness

'Is she the only child in the world like this?'

Sitting next to me on the bench outside of the therapy gym, the young mother slowly began to trust us with what was really in her heart.  B. looked up at me, waiting to hear the answer.

'No, there are other cases,' I assured her.

'Really?' she asked in disbelief.  'Cause I've never seen anyone else's child look like this!  Show me!  Bring me to the village where there is another child like this!'  Her tone was one of deep fear and deeper sorrow.  'My husband says she's cursed.'

I took a deep breath and silently prayed . . . how does one begin to explain the genetics of a rare skin condition to a mom who never attended primary school?  How could we convince her that this was hereditary, not a deliberate act of aggressive evil against her child?  How would we support her from afar as she feels isolated and alone, refusing to give up on her little girl?

I didn't know how, so I told her a story instead.

18 September 2014

Lessons from a Tetanus Survivor

'Thank you,' S. whispered to me in English before transitioning back to Hausa.  'I thought I was dead, but you gave me my life back.'

We were sitting on a mat, under a tree in the Ambulatory Care Unit behind the hospital.  Already today she had done her own laundry in a modified position and climbed a small set of stairs.  A world away from relearning how to swallow her own saliva.

I looked up from the patch of sand where I was etching designs with a stick.

Our eyes met, and I smiled.

'Thank you, my friend,' she repeated and she leaned her forehead against mine.

17 September 2014

No Free Shows in Therapy

When I worked at Temple University Hospital, as I helped my patients don a hospital gown over their bare backsides, I'd tell them that the first rule of therapy was: No Free Shows.

Things are little different here in Galmi.  Bare breasts are no big thing, and the fewer clothes children wear, the less the burden of the laundry load.  Kids come to therapy naked all the time.  And I've even had many older children wear nothing but an open hospital 'gown' as if it were a untied robe.  So it's always a bit surprising when I have a kiddo who is super specific about when he's all covered up.

16 September 2014

Three Therapists in One: A New Meaning to the Holistic Approach

One of the hardest-but-at-the-same-time-best parts of my job, professionally speaking, is the necessity to be a full-service therapist.  That would be an OT, PT and Speech Therapist all rolled into one . . . although, I'm pretty sure that's not what they mean when they say OT comes from the 'holistic approach'.

My work with S. is the perfect example of this.

S. survived tetanus, a horrific disease that caused all of her muscles to become rigid, including those required for swallowing and breathing . . . two functions necessary for survival.  Which is why I was consulted: chest PT for her aspiration pneumonia and speech therapy for swallowing.

When I went to see her last Monday for our session, she told me that she didn't like me and I should just leave her to die.

11 September 2014

A Local Legend

Since leaving the US in 2009, I've racked up my share of good stories.  Some funny . . . some unbelievable . . . some interesting . . . and some moving.

Every once in a while one of those stories becomes a bit of a legend.  And this is one of them.

I hadn't really thought it was that good of a story . . . it sort of was just one of those new-normal kind of stories.

That is, until I shared it with a group of summer interns on the eve of their departure.

09 September 2014

WhiteGirl and the Owner of Spiciness

As you know by now, I have a big soft spot in my heart for kiddos who have been extremely burned. They are the bravest and sweetest little people I get to work with.  Often they come to our hospital for a couple of months and we follow up with them each month for a year.  Needless to say, they quickly wriggle their way into our therapy department family.

Little H. is no exception.  

A four year-old who was badly burned in January when, wrapped in a thick blanket and unsupervised, she went to warm herself by a cooking fire.  The base of the blanket ignited and she couldn't get it off fast enough.  When her family found her, they thought she was already dead.

But Little H. is a fighter.

And I confess, I think it's her abundance of tanka (a mix of hot chilies and spices used in local cuisine) that I love most.

08 September 2014

It's a Girl

Well, it's official.  B. is a daddy!

For those of you who have come to Galmi and worked alongside us, you will know that B. has a soft spot for the kiddos that pass through our doors.  And last week he and his sweet wife finally got to take one home.

My camera broke in April, so I don't have any photos of her by herself yet . . . but B.'s sister told me that her kids have been saying that baby has my eyes.  Maybe it's time we have a genetics lesson!



29 August 2014
Barka da zuwa, baby Stephanie!
We're so excited that you're finally here!

21 August 2014

Ebola in West Africa: Five More Ways to Pray

It's been nearly a month since the world's attention was turned to a little corner of west Africa where the deadliest Ebola outbreak in human history has occurred.  Today the most famous Ebola patients in history were declared 'virus free' and released from the hospital.  But despite the spotlight and the thankfulness we feel for their healing and survival, the spread of Ebola continues.

The good news is, this outbreak continues to be contained within four countries . . . the devastating reality is that new cases are being diagnosed each day and people are dying.

And while most of you reading this won't be able to 'give a helping hand' to help bring this crisis to an end, you can play a very active role . . . keep praying.

03 August 2014

Today I had Leprosy

When I was 20, I went to India to be the project photographer for a children's book about street kids.  I was studying SportsMedicine at the time, but was still secretly very much on the fence between a career in physical rehabilitation and a life of freelance adventures all captured on film (yes . . . film . . . I'm older than I look!).

It was in India that I new I wanted to work in a developing country . . . with populations that are underserved . . . and with people that are at a great risk for being overlooked.  It was in India that I knew for sure I wanted to become an Occupational Therapist . . . because I saw, with my own eyes, the havoc that disease and injury could do to the human body.

Diseases like leprosy.

Only today, I became the one disabled.

30 July 2014

How I Pray When No One Is Listening

Taking the bus is always an adventure and often comes with good stories.

B. and I went to the capital for a training on an appropriate technology initiative happening in Niger and other west African countries. We found out about it two weeks ago and have been looking forward to it since.

We were thrilled to get to be a part of the movement to improve the lives of disabled Nigeriens and we had high hopes for this trip.

That is until we got on the bus. 

28 July 2014

Ebola in West Africa: Five Ways to Pray

This weekend, we in the SIM family received word that a doctor and another SIM employee at ELWA Hospital in Liberia tested positive for Ebola.  ELWA is one of the west African hospitals also operated by SIM.  ELWA has been combating the virus since the outbreak reached Liberia, and has taken the precautions necessary . . . but the heartbreaking reality is, Ebola doesn't discriminate between who is the patient and who is the caregiver.

As the news is being spread around the world (you can read more hereherehere and here), the need for prayer is great.  SIM's motto is By Prayer . . . because we believe that our own efforts can only go so far.

We need you to pray.  Here's how:

24 July 2014

Niger in the News

This post in the NewYork Times came through on my facebook feed this morning.

What struck me at first was the advertised headline was 'Niger is poor and located in the desert'.  My first reaction was: well, NYT, at least you've got your first facts straight.

One line I can't get away from in the body of the text:  The country’s women, held back by their husbands and by imams who inveigh against “Western” notions like birth control, don’t demand it.  

"The country's women . . . don't demand it." 

Well, Mr. Nossiter, it's interesting to me that all the way from Dakar you assume Niger's women are free to make such demands.

Read the article here.

23 July 2014

A Dose of the Best Medicine

I did my undergrad degree in Athletic Training . . . also known as Sports Medicine or Sports Physio in some places.  So when I moved to Galmi to start up the therapy department, I didn't feel too out of my element when I needed to see just as many (if not more) traditionally Physical Therapy cases as I do Occupational.

There are still PT patients that stump me or who require knowledge way beyond my bag-of-tricks . . . and when that happens, I call in the virtual-cavalry and get expert opinions via email from Physio colleagues around the world.  It's kind of like our own form of distance learning, just without the exams or tuition fees.

About a year ago I started getting consulted for dysphagia (swallowing difficulties) with stroke patients.  It pulled me out of my comfort zone a little bit, but going off the advice of a Speech and Language Pathologist from my Philly days, I got by.   But last week a visiting ENT (Ear-Nose-Throat doc) arrived and that's when it got really exciting challenging intimidating stimulating interesting.

18 July 2014

The Big 'C'

'Uh, D├ęborah, what is cancer?'

I looked up from my teaching notes and blinked at the five men circled around me in the wound care room of the OR.

'What did you ask?' I question, assuming I must have misunderstood.

'You're talking about dressings for patients with cancer, but we don't know what that is.'

I looked at each one, hoping I'd get an indication that they were joking . . . but they weren't.  Four OR Techs and a NurseAnesthetist-in-training, and they didn't know what cancer was.

15 July 2014

Where There Is No Hospice

**I wrote this post over a month ago, but couldn't bring myself to finish it, let alone publish it.  I have detailed heavier cases . . . shared events I find more devastating.  But for some reason, this was just too difficult at the time.  It's happened before, just doesn't usually take a month to process.**

Our Little Girl of Peace passed away early Thursday morning.  Her burns were just too severe for her little body.  And her battle was over.  We just don't have the resources here to change certain outcomes.

That afternoon I sat next next to a mom who was cradling her frail child.  Pressed against her mother's chest, this precious one looked to be four, maybe five years old.  Her skin hung from her boney frame, eyes hollow and deep.  AIDS had ravaged her little body . . . malnourished and weak, the doctor admitted her, hoping to do something to ease her suffering, but recognizing the prognosis wasn't good.

On Friday, our last patient of the day presented to the gym with an atypical concoction of symptoms.  'Stroke' had been listed, but it became quickly apparent that the history I was getting was not what had been given to the doctor.  And as I transferred M. from the wheelchair to the treatment mat, the back of my hand, which was sandwiched between her left arm and her chest, could feel the enormous mass in her breast.

What started off as a localized cancer, had spread to her brain causing her potpourris of symptoms.  A quick chat back with the doctor--there wasn't much we could do.