17 November 2015

I'm a Glutton for [Cross-Cultural] Punishment

I guess it was not enough that I live and work cross-culturally, so I had to go and marry a man that not only is of a different nationality, he comes from multiple cultures as well!

You see, Maiguida grew up in Niger, but his family is actually European.  So while he ate with a knife and fork at home, he's a complete natural when it comes to the Nigerien tradition of sharing a common plate and using one's right hand to consume a meal.

He is comfortable holding his wife's hand in public . . . and also walking down the street, hand-in-hand with a man.  Because in the West, hand holding is a romantic act, but in Niger it is reserved for close friends of the same gender.

And while he is a natural cultural-chameleon, there has been one very surprising cross-cultural nuance that we have come to discover about each other in the short time we've been married.  And we're struggling to get past it.

15 November 2015

Status Update

I am well aware that it has been [far] too long since my last post.

But there is good reason for that.

And it's not what many of you will think.

I got married about a month ago . . . but that's not why I haven't been writing.


Rewind that!

Deb. you did WHAT!?!?!?!  And you didn't tell us?!?!?!?

03 April 2015

Lessons on Palm Sunday

I started treating M. on 12 December 2013.  At the estimated age of 40, she had been sent to us after having a severe stroke which left her unable to move her right side, walk or speak.  

We worked together regularly for five months, and each time she had a check up with her doctor, she and her husband and her sister would pop by the gym to greet us.  

By the time she plateaued in therapy, she was walking by herself with the use of a hemi-walker.  She was able to do a good amount of her self-care on her own, and had figured out how to navigate around her aphasia.  I was impressed at how much we were able to communicate despite the limitations of her mono-word vocabulary.

The stroke had affected the portion of her brain that is responsible for expressive language, and while she understood everything we said, M. could only respond with the word “yes”.  She would change her tone or facial expression to convey her meaning. 

I loved when M. came by to see us.  Her face was bright with joy despite her difficulties.  No matter how difficult a task was, she persevered.  And her appreciation came across loud and clear in her “YYYEEEESSS!!”

05 March 2015


I'm not sure if it's just me . . . or if it's cross-cultural living in general, but each day seems to be full of hiccups and speed bumps and continual changes-of-plans.

Today I was supposed to take a flight back to Galmi (an hour an a half-ish trip) after spending a week in the capital doing a workshop on facilitating trauma-healing support groups.  But the flight got delayed to later in the week which meant I was on the bus (a seven hour bumpy and exhausting trip).

So, when life hands you lemons, make . . . a photo essay.

01 February 2015

A Shepherd Needs His Shoes

Using an inner tube and foam from his mattress, our
patient rigged up a 'shoe' to cushion his steps.
A few weeks ago, I saw a young man -- maybe 16 or 18 -- limping through the hospital.  I was walking behind him, analyzing his gait pattern.  On the left foot, he wore a DarcoShoe which we had given him a while back.  His right foot wasn't visible as the leg of his pants encircled what remained after a midfoot amputation.

I didn't think much more about him, until a couple hours later he and his father showed up at our gym.  He didn't want the Darco any more . . . the wound where they had removed his left big toe, was all healed and the wedge of the sole made his limp worse.

Walking, for this young man, isn't just a form of transportation . . . it is his source of income and identity.  He's a shepherd, and his life is spent roaming the wide open spaces of Niger, leading his sheep and goats out to pasture.

As we asked him some questions in order to best gauge our intervention approach, he began to sling a little rubber disk around the ring finger of his right hand.

'What's that?' I asked.

'My shoe.'

'Where'd you get it?'

'I made it myself.'

17 January 2015

Niger in the News

Niger has made the news again.  This time in response to the happenings in Paris.  Churches and the private homes of many Christians in the large cities across the country have been burned.  Please pray the peace of Niger!

To read one report of the violence across the country, click here.

30 November 2014

Lessons from the Widow and her Mite

My favorite thing to do in Niger on a Sunday is drive an hour up the road, weaving around broken-down-trucks and boys-driving-the-harvest-home-on-donkey-carts, to attend a tiny village church.

Humble, in every sense of the word, this small community of brothers and sisters faithfully meets to give thanks for the little they have; together they learn how the Living Word of God should change their daily lives.

We were some of the first to arrive, which gave us ample time to greet others fully and to be received with great welcome and joy.  As we were invited to choose our benches, a small elderly woman approached the side door of the church.  I didn't know it then, but this Little Old Lady was about to teach me a profound lesson.

01 November 2014

The View from Here: OPD Portraits

Took the new camera for a quick spin around the Outpatient Department (OPD).  Still trying to figure out all the diversity with ISO and other perks of the upgrade . . . but not too shabby for the second use.

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.