Thursday, February 14, 2019

27 Dresses

27 Dresses
Twenty-seven dresses. Okay, well, it’s really 28 dresses, but I really love the 27 Dresses movie. So I went with that.
Plus, I’m secretly hoping that someone will turn me in for copywriting problems. They will contact the lead actress of 27 Dresses, Katherine Heigl, and she’ll give me a huge donation of 27 dresses. I mean, what is she gonna do with those dresses anyways?
I swear, what girl doesn’t LOVE that movie? Weddings. Romance. First world problems.
But I’m here in the third world. And I have 28 women who have been operated on during our fistula week at Bere Adventist hospital. Plus two more that I did this week, and more and more that are coming with the news of our fistula surgeries.
If you’ve read our blog, I’ve explained to you what a vesico-vaginal fistula is. If you’re new to us, a vesico-vaginal fistula (VVF) is a hole between the bladder and the vagina. It is most often caused by prolonged labor, something common here in the third world simply due to the difficult logistics of getting to the hospital for advanced delivery care when home births don’t work. In those cases, the baby usually dies during labor and the mother barely escapes with her life. In first world countries, a VVF is very rare and most often caused by surgery or cancer.
I have been operating on VVFs for seven years now, but usually only do about 10-20 per year. I had some harder cases that were not healing due to their urethral involvement. I was able to find the fistula expert in the country and invite him to our hospital. Normally he works out in Abeche, a 2-3 day drive from here.
Hoping I would get at least ten cases to do together, I made a few announcements on the radio. I had already had six patients waiting, so I needed just four more.
To my surprise, there are more VVFs here than I thought! We ended up doing 28 cases in one week, many of them quite complex! It was a busy week. And all of the other non-urgent cases had to wait until the following week since we only have one operating room to work in! (Although some amazing people are organizing a container of supplies for us to have THREE operating rooms functional by December! If you have access to a massive warehouse of medical equipment, let me know!)
Dr. Valentin was very easy to work with and I learned a lot of techniques to apply to my vaginal repairs. He works with a few NGOs, and one of them donated some money to help with the cases. I was able to get $70 per patient to help with medicine and food (even food for their family members!) for their 3-4 weeks stay. So it was a great help. The hospital still had to eat the cost of the consult, hospitalization, supplies, labs, surgery, etc, but it was rewarding work!
Each story is touching. There are several older women who have been leaking urine for over 20 years! They had never been operated on. They didn’t know that someone could fix them! One lady came in with a pretty simple fistula. But get this. Her daughter now has the same problem. Both of them operated on in the same day! A mother-daughter special. Both healing well.
Another lady gives a heart wrenching story of having a rope in her hand ready to hang herself. She just couldn’t do it, but she was strongly considering it several years ago. Now she is on her way to recovery.
These women live tough lives. They leak urine. Therefore, they smell like urine. They sleep in wet, smelly clothes. Everywhere they sit is wet when they get up. They can’t get a normal job because they smell. Most of their husbands leave them. They can’t have more kids usually. Their life is a mess.
And now they have a second chance. A second chance at life. A second chance to be clean. And I want them to go home in a new dress.
So I’m in need of 28 dresses. Katherine’s dresses would do just fine. But they would probably cost about 200-300 dollars each I’m guessing. My dresses would only cost $20.
I would like to thank Dr. Valentin for coming to help me with these cases. We are planning another fistula week in May together.
I would also like to take this time to thank Mission Regan for donating many ureteral catheters/ stents (keeps the tube between the kidney and bladder open when the surgery is right next door). I was looking everywhere for these, and was about ready to buy them at $200-300 each when I was put in contact with Mission Regan. Sometimes the ureteral openings are very close to the edge of the fistula, so you have to put a ureteral catheter in to know the location and to keep the urine off of the closure postoperatively. Other times you have to reconnect the ureter to the bladder abdominally. Without these stents it would be impossible. Thank you Mission Regan!!!
Let’s just assume that Katherine is going to read this and donate all of her dresses to me! But in case she doesn’t, there is a donation button on AHI’s website. Just write in: “Bere Fistula Fund” to help with this special project. The donation from the NGO is special, but it doesn’t cover any of the OR materials, and certainly none of the dresses.
And a girl’s gotta have a new dress for this special occasion of being DRY! Out with the old stenchy clothes, and in with a new DRESS!

Wednesday, January 9, 2019

Christmas Baby

A volunteer asked me last month, “Which is the more important work in Chad, public health work or running a hospital?”
You can argue both sides. So many children die from malnutrition here that it makes you want to quit everything that you are doing and TEACH. Teach about clean water. Teach about proper nutrition, even with limited funds. Teach about hygiene. Teach about parasites.
On the other hand, I see the change between life and death all of the time working here in the hospital. Medicines save people’s lives. One day they are on their death’s bed seizing, and the next they are sitting up and eating. One moment someone is hemorrhaging, the next, after a life-saving surgery, they are perfectly fine.
How can you choose between the ways to save people?
So if I had to choose I would choose both. Both are equally important. I suppose it depends on your passion and training.
But it would be super difficult to just let someone die while knowing how to fix them.
One of the cases today was actually a GYN case. A nice change for a while, although this case tried to be super dramatic on me.
Three weeks ago Sarah asked me to see a patient who was in her first trimester with a mass on her cervix that was bleeding a little bit. I examined her and found what seemed like a prolapsing fibroid originating from the cervix. It was bleeding some, but not too much at the time. We made plans to see her later and hoped she didn’t bleed too much more. We discussed that she may end up needing a c-section due to bleeding risks.
Last night this same patient came back in hemorrhaging. She is 13 weeks pregnant with the baby doing great on ultrasound. Her silly prolapsing cervical mass (of which I have no pathology to biopsy) was bleeding quite a bit. The nurse had already packed her vagina several times and the bleeding had soaked through them. Fibroids don’t like to be moved at their base. And when they do get moved, they bleed more.
I go examine the patient again and gently yet firmly pack her around the mass and very firmly in the vagina. It took several tries to get her to stop soaking through the packing. Finally she stops bleeding. I stick a foley in to encourage no movement, wait a bit longer and decide I can sleep the night without doing anything more to her.
She was my second case today. We discussed the possibility of a hysterectomy (intact with her 13 week old fetus). I told her I would try something vaginally first, but there was a good chance that she would end up with a hysterectomy. This poor mother had 9 children. Five of them had died and four are still living. She wanted more children, but accepted that the hysterectomy might need to be done due to bleeding.
After a spinal for anesthesia I examined the patient with retractors. She has a 4cm protruding mass coming out of her cervix. Her outer cervix was all stretched out and out of shape due to this large mass taking up residence there. How on earth did she get pregnant past that thing anyways? That’s beside the point. I want to save this baby for her. But if she bleeds too much, I will save the mom’s life by doing a hysterectomy. And she will never have any more children. She accepted it. I accepted it.
But this baby. This baby is important too. So I have to try.
The more I manipulated the mass, the more I was convinced that it was a fibroid and not cancer. Sometimes you can put an endoloop over the prolapsed fibroid, cinch down on it and then just lop off the fibroid. But not this thing. This thing had quite a broad base. So I try to clamp in towards the base. No luck, just tears the tissue. So I break out the cautery, stick a tenaculum on the mass and put some traction on it.
Not the type of thing you want to be manipulating while someone is pregnant. But I had no other choice. Either take it out, or she keeps bleeding. So little by little this crazy prolapsing cervical fibroid comes out. It bleeds some at the base after getting it out, so I put a few stitches in.
Wow. It came out. It’s not hemorrhaging anymore. Her external cervix is really dilated, so I put a cerclage in to hopefully keep things put.
We don’t know what will come out of this. Today, my work in the operating room was more important than the work in the field. But tomorrow, tomorrow will be for the public health team. This woman has already had five children die. Today this unborn baby got a second chance at life. But what about tomorrow?
It is an impossible task to do it all. Thankfully we are a team.
Running a hospital. Operating. Rounding. Nursing care. Nutritional program. Fixing electricity. Evangelism. Cleaning the grounds. Public Health. Watching the kids.
It’s all important.

Monday, December 31, 2018

Little Donkey

Clip clop. Clip clop. Clip clop. Clip.

Clop.

Clip.

I know the story. The little donkey caries the Savior of the world.

Clip.

Clip.

Clip.

But my leg hurts so bad.

Clip.

Man I wish I wouldn’t have made that snarky remark to Uncle. He bit me. I mean I’ve been bad, but did I deserve this?

Clop.

Ouch. That hurts.

All donkeys wish to be like that story of old, carrying Mama Jesus. Or carrying King Jesus. With this hurt leg and all...

I would never even have the chance to be in a Christmas program. A few years ago some humans organized a Christmas play in Bere. That pregnant donkey delivered her BABY donkey DURING the play! Talk about a star! How am I supposed to do something memorable when I’m so lame?
I don’t even feel like walking on my hurt leg! Just a limp. Clip.

Clip.

I’m getting a little woozy. I think I’ll lay down.

Wait, what is this? A big crowd? It must be those nasaras again. They are a pretty fun group, bringing songs and laughter to the village. Telling stories about the great donkey who carried mama Jesus.
I’m confused, they just came here yesterday. I was nuzzling up to the little one they call Addison. I just had no energy to run away. Stinking leg. They did say they were coming back with help.
There’s a few more of them today. The ones they call Andrew and Olen gave me a shot! Ouch! It hurt, but not as bad as my leg. I just have no energy to move. I can’t walk. I can’t move. What am I good for?

 Wait! What is this again? Andrew has picked me up! He’s carrying ME! In most stories of old with humans, it’s the DONKEY that’s supposed to carry the human! This human is carrying me! He said he wanted to bring me near the well to wash off my leg that was bitten.

I’m supposed to be the helper, but he is helping me. He must be a surgeon because he took one look at my abscess and cut it open. Right then and there!

The other nasaras said they needed a surgeon to help them with their work. Could this be him or her? My mama said it must be true because she read his shirt, “Bere or Bust.” Or maybe that means he was going to bust me up in Bere. I don’t know. But I somehow ended up in Bere, at the house of Olen. Andrew is not really busting me up yet, just changing my dressings where Uncle bit me. Now the woman is doing them.

Clip clop clip. Clip clop clip.

I’m getting better. I can actually walk on all four legs now. It’s been two weeks living and learning about the nasaras.

Clip clop. Clip clop.

But where is Andrew? I sure hope he comes back to help my humans when they need cut open too.

I think of the stories of old. Of the donkey who carried mama Jesus that starry night on the way to Bethlehem. Jesus came to help our world. And now I can be a helper too because I am no longer sick. Now maybe I can be in the Christmas program to help people know about Jesus’ birth. Now I can carry sick people to the hospital. Now I can......

Clip Clop. Clip clop. clip clop. clip clop...

Ps. Little Donkey has fully recovered. He plans to be in a nativity program that we are having mid January this year for our Happy New Year/we couldn’t do it earlier program. Stay tuned!! 
We love the animals in Bere too!! 

Pss. Drs Andrew and Megan were here visiting Béré for the first 2 weeks of December. We love and welcome visitors. Shoot us an email and ask how you can be helpful too! And pray for them and others who are planning on serving long term in the mission field.  Getting there is sometimes the hardest part. 


The New Hippo River

 The New Hippo River, a blog hand-written by Lyol Netteburg (age 9), typed by Mommy

One day we went to the river where we love to go swimming. When we got there I jumped out of the car and ran around the river with my brother. My Dad went a litter farther down stream. I had just stuck my foot in the water when my Dad said to my Mom, “Get the kids in the car!”
We all ran into the car. I saw little waves that got bigger and bigger. Then the hippo came up and was about 30 feet away from us. After it passed us I got out of the car and went to my Dad and Mom. My Dad showed me where he had seen the hippo before this. It had gone about 300 yards in 2 minutes.
My mom did not want to go swimming any more. My brother did not want to get out of the car. Zane did not let Addison get out of the car. Juniper was just relaxing in the back of the car.
So we had a looooong drive in the car instead of swimming that day.

Market Guy

During the first two weeks of the Smile Train team, we did three huge head tumor cases (along with many other head and neck masses, but not the HUGE ones like these). Two were big mandible tumors. Not little ones. BIG ones. They ended up with plates in place of a large portion of their mandibles that needed to be removed due to their tumors. Another was a man with a huge 3 kg bony tumor growing off of the side of his head.
None of this would have been possible without our amazing anesthesia team. And of course our visiting surgeon.
When you see one life changed from such an impossible surgery, you have to wonder who else is out there who hasn’t come in for a consultation. Olen and I were both in the OR when I wondered out loud, “Isn’t there a guy here in Bere with a big mass like this?”
Olen replies, “Ya, that guy in the market...Market Guy.”
We go on to explain that we have seen someone with a larger-than-life tumor on his face. It was so large that it has turned his mouth sideways. We go on to explain about Market Guy, and wouldn’t that be cool if we could find him?
Bill is only here for a limited time, but... he did decide to extend his stay by a week. And we will have an anesthesiologist here next week. I asked some of the nurses and they seemed to think that he still lives here in Bere.
I ask my guards the next day if there is someone in Bere fitting this description.
The next day, who shows up but Market Guy. Now market guy has a name, but we didn’t know his name before, so we called him that for short.
The tumor started to grow on Christophe’s face when he was ten years old. And for the past TWENTY years, it has continued to slowly grow. Disfiguring his face more and more. It was a large maxillary bony tumor, an amelioblastoma.
Christophe is a very open and likable guy. He’s not shy about his looks. He doesn’t cover up or hide. But this tumor has had a toll on him. He told me he wasn’t married because no girl would want to marry him. Not because of his looks only. But because they didn’t want to become a widow. The whole town knew that eventually the tumor would grow so big that it would kill him. And nobody wanted to become a widow knowingly. Nobody would let him marry their daughter. No one would give him a real job because everyone just gawked at him. No one took him seriously.
Several years before, he had a church family. He went to church. He believed in God. His church family saved up a bunch of money to send him to some specialists in NDJ. Everyone that he saw told him it was impossible. His tumor cold not be removed.
So he drowned his sorrows in alcohol. He didn’t drink a lot because he didn’t have a lot of money, but he drank as much as he could afford. The locals later told me that Christophe was the one in the market who could be found picking a fight (probably because he was drunk). He didn’t care. He quit going to church. His life was over already. He was doomed to die.
Until he wasn’t.

 That’s when the Smile Train team take two came along. Dr. Bill and Dr. Geech. Bill only had three more days left, so we reserved a whole day for Christophe’s case. We went in at 5am to prepare him. Get his IV, get him shaved and washed, etc. Jonathan did his amazing anesthesia (actually managed straight direct laryngoscopy). Bill did his wonders as God has blessed him to do.
No one could believe it! Everyone and their donkey stopped by to see the guy from the market who was said to be inoperable.
Now he has a second chance at life. Now he can get a real job. Now he can get a wife.
Christophe now wears a mask out and about. His mouth is still turned sideways because of the effect of the tumor growing for years, though he doesn’t have the tumor anymore. Prior to this surgery a mask would not in any way cover up his tumor. Bill plans to do more reconstruction on his face next year when he comes back.
Christophe went to church last week all dressed up in an old shirt of Olen’s. I don’t think that going to church alone can save a person’s soul, but now Christophe is searching for something to fill the void of emptiness that has filled his life for so many years. Please keep him in your prayers. I know Satan is unhappy about this change in Christophe’s life, but God is stronger and does the impossible so frequently.

Wednesday, December 26, 2018

Flappable

Flaps
Flaps. Where have you been my whole life?
I’ll tell you.
You’ve been hiding out with those plastic surgeons.
I mean, I’ve done a few for fistulas and a couple for exposed bone in an emergency, but now...
Now my eyes are open. Born as an ob/gyn and grown into a general surgeon of sorts by necessity, I feel like my hands have been freed, untied. Everyone needs a flap! You get a flap. You get a flap! YOU get a flap! Everybody gets a flap!!!
In the short time that Bill was here, I have learned so much from him. And the key is in the flaps! Now you can’t just start cutting into tissue and expect any old place to be a successful flap. You have to know your blood vessel anatomy! (And preferably nerve anatomy as well.) Or it dies.
One of the first cases that we did together was Charlot. Charlot became my patient postoperatively after he had had a repair from his antral gastric perforation. I re-repaired him quite nicely I thought. I took down the whole repair site that had broken down. I freed up the edges and closed him how I normally would. It was a large perforation, 2cm and along the superior border, so maybe that’s why it didn’t work in the first place. I didn’t let him eat for five days. Then I slowly advanced his diet. He was doing fine for a couple of days on liquids. Until he wasn’t. I planned to take him back that morning for a wash out. But when I removed the dressings, I found stomach contents. Then I realized that Dr. Bill had arrived in the night. He was a general surgeon, with a plastics speciality. Did he just want to do cleft lips and head tumors? Or would he help a girl out with this complicated case.
It turns out he was eager to help out in any way he could! And he did! Charlot became one of our complicated patients who, to this day, I have no idea how he survived without proper nutrition. We re-repaired him (#3). Tried a J tube via his nose, which Charlot ripped out some during the night, so it was no longer a J-tube. We put in a proper J-tube for a while, but it didn’t seem to be working properly. Finally on his 5th and final repair, Charlot was surely lacking nutrition, which makes healing anything a nightmare, Dr. Bill re-closed his perforation and made an abdominal wall flap to cover his stomach perforation. He made it 7 days after this 5th and final surgery NPO. There is no TPN here. We pulled his NG tube and advanced his diet VERY slowly. It worked! Abdominal wall flap to reinforce the gastric perforation’s 5th repair. All of this with the minimal supplies, labs (no chemistry here yet), and nursing care. Charlot is a walking miracle. The miracle is that he is walking and eating and very much alive.
Koumakang was also a case we did together early on. He is a young boy who developed a bad scalp infection. All of his scalp was dead from the infection. He underwent a debridement for dead skin and infection on this head. (Essentially, scrubbing his scalp with soap and water removed most of the skin.) After a few days, Bill and I grafted and flapped his head! His whole head, well, at least the part that grows hair. He had a large portion of his skull showing. Bill showed me that you can split the scalp into a few layers to make flaps. (I hadn’t heard the word ‘Galea’ since medical school.) This allows the skull to have a layer of tissue over it, onto which you can graft skin from other parts of the body. So we grafted his whole head.
So many cool flap cases. The list goes on.
 Suzanne. Suzanne was the victim of domestic violence. Her husband, who she’s been separated from for four years, used a machete to cut her left forearm almost entirely in two. He had been waiting for her and followed her home from the market one night and hacked hard at her as she was entering her compound. She went to the hospital in Lai, and we aren’t certain what they did there, but there isn’t really any evidence they did anything. Her family isn’t super supportive either. She ended up at home with an open fracture of her radius and ulna and all of her extensor tendons exposed to the world.
When she first arrived late one evening, Olen saw her at the door to the operating room and smelled something unpleasant. So he sat her down on the step outside the OR and took down the old, smelly, rudimentary bandage she had over her arm. She very literally had 2cm of radius and 2cm of ulna sticking out of her skin proximally and 2cm of radius and 2cm of ulna sticking out of her skin distally. I don’t know how that hand didn’t rot off on it’s own. Sometimes they do here. She was fortunate.
Bill wanted an X-ray of the arm before surgery, which is no small feat to accomplish, as it would involve traveling 25 miles by motorcycle over rutted dirt road, only to then have to take a Corolla filled with seven people for two hours to the next big town, then walk across town to the hospital, then repeat the trip in reverse. The family refused. Not because it would be too painful for the patient. Because they just wanted the arm chopped off. Olen tried to explain until he was blue in the face that we wanted to try to save this poor woman’s arm. They tried every excuse. Then they said they didn’t have money for the trip. So Bill and Laura actually gave them $50 so they didn’t have any more excuses and had to go get the X-ray.
Remember my hippo patient who I didn’t know how to do an ex-fix on? Well, now I do. We did an ex-fix on Suzanne’s radius. We tried to do one on her ulna, but it wouldn’t quite work, so we had to put a small rod in (to be removed later). After a few days... THE FLAP. This one is the ultimate flap. The one Olen’s wanted to do for years. The one where your mouth drops open in amazement that it can actually work. And not just work. Work in dusty, rural Africa. Because there certainly is a difference. But this surgeon has been in Africa for 20 years! He knows Africa and knows how to improvise! That is the key. We didn’t have the right parts for the ex-fix, so he used casting plaster to weave in between the pins and the rod to keep the radius fixed to the rod. Improvising. That’s the key. Along with flaps. The second key perhaps. To the same door.
Suzanne had a large open wound with exposed bone on her posterior forearm. So... flap from her abdomen of course. We created a flap (well, Bill really, but I assisted) from her inferior abdomen. Then sutured her arm to her abdomen! It’s still sutured to her abdomen by the way.
Ada is a little one-year-old who had a bad infection in her right groin. It was debrided and then developed into a hip contracture. She had a granulated (not skin-covered) area of about 8x8cm on her groin and abdomen. So... careful de-contracturing of her hip and then tensor fascia lata (TFL) flap! And graft her abdomen and leg, and voila. Another child saved from not being able to walk! And with a flap!
Odette had a large nose tumor. Take the tumor off and... you guessed it, flap! Pulled a flap from the side of her mouth! Leave for a month and then carefully cut if off. It’s still brewing!
Zachee, our ex-cook, had a tumor on the bottom of his heel. It was most likely a type of pre- melanoma or maybe even melanoma by now. He needed a wide excision of the tumor. So... you guessed it again! Flap for the win. This was so cool. A lollipop flap. A flap from his mid calf. He has an extra large skin pedicle for a month to bring blood supply to the flap.

Of course, nothing here is without challenges and complications. At some point during the three weeks of cleft lips and cleft palates and insane tumor resections and flaps and... our dermatome went for a swim. And dermatomes are not meant to swim. (A dermatome is a machine, ours is run on compressed gas, that vibrates a blade to take a thin slice of skin from one place in the body and put it onto another place that needs skin. The host site loses such a thin layer, that it heals quite quickly with minimal intervention. Without a dermatome, one must take a ‘full-thickness’ skin graft from a donor site, which means the original host site needs extra work to heal, and the graft itself is a much more painful process for both surgeon and patient, not to mention drastically more time-consuming.) Some exceedingly helpful and overworked nurse in the operating room was trying to do a great job and clean our instruments really well... and didn’t speak English... so didn’t read the ‘Do Not Submerge’ warning on the dermatome. So bleach water got into all manner of places where it shouldn’t have. And now we don’t have a working dermatome, which is a losing situation for Danae, who now has to spend copious time carefully removing full-thickness grafts and then treating the place she took the graft from, and a losing situation for the patient, who now has to heal up where they lost a thick hunk of skin.
So... if anybody has a spare dermatome lying around and collecting dust...

Saturday, December 22, 2018

The Béré Train

The  Bere Train
Chug-a chug-a. Chug-a chug-a. Chug-a chug-a. Chug-a chug-a. Choo-choo! What train is that?
Oh it’s the smile train.
What? Wait, there’s no train in Bere. There’s not even a paved road!
We had a lot of reasons to smile in the month of November. We were also very busy. Hence the delay in writing many of the following blogs. A big part of both being busy and having reason to smile was our SMILE TRAIN!
Was that start too cheesy?
SMILE TRAIN is an organization that helps fund repairs of cleft lips and palates all over the world. We were lucky enough to be a recipient of their special generosity this year.
Probably one of the biggest hurdles (well, we had bigger hurdles, believe me) was figuring out what to write on the welcome sign that translates Smile Train into french. THERE ARE NO TRAINS IN CHAD! So we went with ‘station’ instead, kind of like a bus stop. The sign read, “Bienvenu à la gare de sourire.”
Introductions to our Smile Train team.
Aubrey, an ED doctor from Arizona here to help with the flow of patients just prior to the Smile Train’s arrival. She helped with rounds, delivered babies, and assisted in surgery also. She took the initial pre-op history and physical on many of the patients. Thus, she knew the patients’ names and histories better than most of us.
The anesthesia team. Dr. Ian from North Carolina, a professor in CRNA school with his two anesthesia students, Jenny and Ben. Ian is a friend of our old BFF, Mason. They work together in America, and Ian is one of the few people in the world who can put up with him. We are the other two people in the world (well, Kim... and Grace and Emmie... and everybody else who’s ever met him, everybody loves Mason McD). Ian gained notoriety when he calmly slipped in a completely blind nasotracheal tube after an old lady’s airway filled with blood from a bleeding oral mass during attempt McGrath intubation.
Bill and Laura Rhodes. Missionaries in Kenya for over 20 years. Laura is the surgical assistant and organizer of many of their Smile Trains. Bill is just the guy that does all of the surgeries. No big deal. You have a 3 kg bony tumor on the side of your head. Sure, let’s take it out. Piece of cake. He’s a plastic surgeon with a love for head and neck tumors. Or pretty much anything that anyone else can’t do, send it to Bill.
Together, this visiting team made miracles happen in Bere.
It’s impossible to tell all of the stories of patients that were helped. It was sure something special to be a part of the SMILE TRAIN this year in Bere. The first annual SMILE TRAIN! We were able to see the twinkle in the eyes of the healed cleft lips. (They weren’t able to smile well yet because they were post-op and not supposed to be moving their sutured and derma- bonded lip).
Cleft lips and palates are a malformation that these patients are born with. It’s no one’s fault. Yet the whole world looks at them as if they are a freak. In America, these patients would have undergone surgery early on. But two of our patients this year were adults, having lived their whole life being gawked and stared at.
The sparkle in their eyes when they looked into the iPhone on selfie mode and no longer saw a deformed lip. They saw a normal boy or girl. Just like everyone else. Priceless.
The first group was here for almost two weeks. There was so much work for a specialist such as Dr. Bill that we asked him to stay for another week. He said he would if we could find another anesthesia team as the first group already had tickets back to America.
Wait. What? Serious? You’ll seriously stay? I don’t think Bill thought we could pull it off. He thought that was a safe bet for sure. This is the morning of November 13.
Olen was on the phone immediately. ‘Hey, so I know it’s November 13 and all, but can you fly out in four days to come to Chad on your vacation time over Thanksgiving and work like a dog for free?’
We found a guy in TN who had done anesthesia school (just for you Geach). I went to Southern with Jonathan and Belen way back when. Then I followed them out to medical school at Loma Linda. Dr. Geach agreed to come with the other Dr Geach for the week of Thanksgiving at the drop of a pilgrim’s hat. And faster than you can baste a turkey, we were into our 3rd week of speciality surgeries. More head and neck tumors. Thyroids, masses, and more clefts. And everything else under the sun.
Three weeks of starts anywhere between 5am and 6am every morning and going as late as 7pm to 10pm every. single. night. We worked HARD. God was good to us, however, and blessed us with miraculously few emergency cases to do during those three weeks, although there were some.
Here are some before and after pictures. There were 13 cleft lips and 2 cleft palates. And so many other crazy surgeries from the brain and hands of Dr Bill.
(At some point, and we will make it at this point, we should mention what amazing people Bill and Laura are. They are the most encouraging and positive and uplifting people we have ever met. And low-maintenance! We spoiled them with electricity and running water! They have raised four children in Africa, all of whom have grown up to be wonderful family-oriented Christians contributing to society. They take probably close to a dozen trips to various mission hospitals every year, which must be exhausting, but they still seem so energetic! The night before they left, they invited us in and talked to us for a very long time, encouraging us, hearing our visions, making us dream even bigger and possibly convincing us to commit to Bere even longer than we had previously imagined. You never know...)

Tuesday, October 23, 2018

Home Sweet Home

Home Sweet Home
For our sanity and for our longterm survival, we took over three months of vacation this year. And it was awesome.
And then it was time to leave ‘home’ in America. We left Dad’s ‘home’ in DC. We left the lake ‘home’ in Virginia. To come ‘home’, whatever that means. And we were ready. Nothing has brought purpose and meaning to our professional lives like working in Tchad, and nothing ever will. And nothing will probably ever be as challenging, frustrating, rewarding, fun, infuriating, blissful or... hard. Just hard. We are bipolar here. But we still believe this is where God wants us for the time being.
So we packed up all our twelve checked bags and six carry ons, we remembered all four children, plus a father, and headed to the airport. Uneventfully checked in, we said our goodbyes to Dad and started ‘home’. Wheels up at 10am and wheels down in N’Djamena a little before noon the next day. We are a mess. But we want to get back to Bere as soon as we can, so we register the two new passports, Lyol’s third of his life and Addison’s second, with the national police. I then head out to James and Sarah’s place to pick up the in-laws’ 4Runner and drive it back to our ‘home’ at TEAM. We set out to do some shopping, jet-lagged zombies in a grocery store.
We finish one grocery store in the dark and head to another, brains fully on auto-pilot. Danae has decided she will buy me a new stove, as our current one is down to a single burner. $450 later, and Danae’s anniversary present to me in the bag, we are outside in the dark trying to load all our grocery purchases plus a stove into a Toyota 4Runner. I strap the two replaced tires onto the roof and we cram the stove and all into the back, although I’m none too happy the stove is on its side. I want it standing up. It’s a good thing Danae gave our suitcases to Laurent. We’re chuck full as it is without them.
Our day of torture not yet finished, we go to eat some Lebanese food a mile away and manage to enjoy the meal. At least, nobody is awake enough to complain. Finally ‘home’ to TEAM and into our two different rooms, me with Zane and Danae with the other three.
Danae gives me an oh-by-the-way right as I’m falling asleep... ‘Oh, by the way. I can’t find my phone. I think it was stolen outside the store.’ Well there goes our plan to leave early in the morning. I switch on Find My iPhone on my phone and lock Danae’s and leave a message for whoever has the phone: ‘This phone was stolen. Please call me at X to return it to me. Thank you.’ Whoever had the phone had switched it off, so GPS had no signal on it. I also send some internet credit to her phone so it would pick up, since she was probably out. Whoever they are, they now have something no more useful than a paperweight and I am going to sleep.
The next morning, we go back to the grocery store and the nice Lebanese owner looks at the security footage with Danae and they see Danae cram her phone into the bottom of her purse as she paid and walked out. Ok, so she had it then. Nobody was anybody near us at the restaurant and Danae was too tired to pull it out then. The car had been locked. Must have been in the parking lot.
Well, we give up the phone for lost and start driving to Bere. But wait!!! On the way out of town, my phone buzzes. Danae’s phone has been located! I call it immediately. ‘Hey, you have my phone. How can we meet up?’ He jabbers on for a few seconds before the call drops. Dang it! I’m out of phone credit! I sent my last money to Danae’s phone for internet credit. Ok, so I turn on Find My iPhone and I locate Danae’s phone. Piece of cake. I will just take the blue dot to the white dot on the map and confront the guy with the phone.
 Except. Wait. Hang on a sec. No. That can’t be right. This thing says Danae’s phone is in Cameroon?!?!?! Lemme refresh and see where it really is. No. It’s still in Cameroon. Well, isn’t that special.
So I pull over and put some more phone credit on my phone. Except this vendor with the Airtel sign isn’t actually selling Airtel credit. Nor is that guy. Or that guy! Ok, Airtel, stop giving people these Airtel umbrellas! So misleading!!!
Well, I drive over the bridge toward Cameroon as I’m looking for phone credit. I finally find some and buy it. Ok, back in business. I call Danae’s phone. Wait! He turned it off again!?!?!? Grrr... ok, it’s game on now!
I drive to customs and patiently explain my situation. They wave me on to the border. I talk to the emigration guy at the gate, relating the hilarity of the situation. He takes me to his boss. I explain the situation again, bemoaning the troubles of theft. He takes me to his boss. How many bosses are around here? Oh right, Chad. Ok. So I explain the situation again, emphasizing my desire to respect international law, and also to put the fear of Allah into this bozo and help him realize he’s actually trafficking stolen electronics across international borders and I have my CIA satellites tracking him. I impress them with the GPS location on my phone, showing Danae’s phone in the left room of a house just on the outskirts of Kousseri, about four kilometers from where we are on the border.
‘We have no authority there.’
Of course you don’t. But maybe you can go and talk to your comrades over there and explain it to them and then the kind folks on the Cameroon side of the border can escort me to this house and back to the border. Or let me go and chat with them and see what we can arrange.
‘Oh, no. We can’t do that. But here’s what we should do. You go to the Cameroonian embassy and explain the situation. They will readily understand and give you permission to enter their country. Then return with a written complaint. Then we will write a complaint to the Cameroonian authorities under my authority and we will go and get your phone.’
Mmmhmmm. Yeah. I know the Cameroonian embassy. I’ll need to pay a visa and it will take another day. This doesn’t sound like fun. I nod my head in agreement at their inefficient plan and walk out, without any intention of following their well-intended advice. Instead, I call Laurent.
Now if you’ve visited us, you’ve probably met Laurent. He’s our taxi driver. He picks you up at the airport and gets you registered and changes your money and finds you lodging and gets you on the bus to us. Laurent has done a lot for us. He’s even gone to jail for us. Literally. A volunteer once brought an air gun into the country. He somehow got it through customs at the airport without being caught. Laurent then sent his luggage to Bere in a minivan. The minivan was stopped and searched by customs, who found the air gun, not realizing the difference between an air gun and a firearm. They put the driver in jail, who then called Laurent, who admitted he was the responsible party. Laurent called us and we flew up in the plane and they didn’t release Laurent until I laid down and told the customs police I was sleeping there. They didn’t want a foreigner on their hands all night long, so they let Laurent go. (And as an aside to the aside, we ended up getting the air gun back, but not until I told the customs chief to shoot me with it as proof it wasn’t dangerous. He refused to shoot me, but was impressed enough with my insistence that he gave it back.)
‘Laurent, are you willing to drive your taxi alone to another country and then confront an unknown person at an unknown house about stealing our phone?’

 Well, what a silly question. Of course Laurent is down! I mean, come on, the dude’s Laurent!
So we sat on the side of the road halfway between the border and N’Djamena awaiting Laurent. And we wait. And wait. And wait some more. While waiting, I try to think of how I can show Laurent how to use my phone to bring the white dot to the blue dot.
‘Laurent, dude! What’s up? You still coming? What’s taking so long?’
So Laurent went to the Cameroonian embassy and had to wait for them to finish a meeting to talk to them and he’s got things in the bag. Sweet.
So we wait some more.
‘Ding.’
Wait. What? They turned the phone back on! I’m calling!!!
Hey, dude, what’s up with my phone? Bring it back to Tchad!
‘Francais mafi.’
Francais mafi, my foot! Dude, we were just speaking French on the phone earlier!
Ok, fine. You wanna play hardball? Ok, let’s see. What are the right words in Arabic. Yeah, there we go.
‘Go! Tchad! Phone!’ Ha! I guess I showed him! He didn’t think I could do it! That’s, like, fluent. He knows darn tootin’ well what I want.
I hang up and send a new message to the locked screen on Danae’s phone: ‘I see you. You have my phone in Kousseri. And I even see the house there where you are in the bush. Please, come back to Tchad with my phone immediately.’ Bam! What now, sucker?!
Oh wait! The phone’s on the move! He’s coming to the border! No way! It worked!?!?!? The white dot crosses the border! Wait! He’s coming straight at us!!!
We drive back toward the border. We’re gonna nab this guy. We’re now right across the street from the white dot. He’s clearly on foot. I pull over and Danae runs across the street to talk to three guys talking together, looking suspicious. I pull out my phone and call Danae’s phone, looking around to see who will pull out a phone and nab the suspect. But nobody’s reaching in their pocket or looking at their hand. Oh, man. They saw Danae too early and are now nervous and on to us.
‘Salaam Aleikum.’ Uh. Wait. Huh? I’m looking around desperately. He’s on the phone, but nobody in sight is talking.
‘Yo, Danae. Not here!’
‘Ummm... uh... Aleikum salaam. Yo, dude. Where you at with my phone?!’
‘Car.’ Ok, so he’s in a Toyota Hiace minibus. He must have just caught the minibus across the street.

 ‘So where’s your car going?’
‘Dembe.’
Click. Ok, he’s headed to the market. Danae, get in!
U-turn and we’re back on the chase. We chase down a minibus and pull it over.
‘Does anybody here have my phone? No? Ok. Sorry, my bad. Have a good day. We love America!’
Chase down another minibus. Dear, you’re scarier than I am. Go get it! Danae hops out and runs up to the minibus. Who’s got my phone?
Sheepishly, an early teen kid crawls out and walks back to our car. I immediately take the phone from his hand and place it into the middle console of the car. A crowd gathers. Danae wants to know where he got the phone. He insists he paid 90 cents for it in the market to buy it from some unknown girl. So you bought a phone you couldn’t unlock the screen of with a picture of a lovely (if I do say so myself) American family on the screen? Danae and the mob ended up escorting the young boy to the police, where Danae handed him over, almost certainly for the boy to be released. But whatevs, we had the phone back!
By now it’s awfully late to drive the ten hours ‘home’ to Bere, so we stay another night, this time at our ‘home’ at Lutheran mission, on the outskirts of N’Djamena where it’s a bit more peaceful. We meet a super-cool family there and spend the evening chatting with them while our kids play. They have four kids, all within a year of our kids’ ages.
The next day we drive ‘home’ to Bere. A road I’ve traveled in less than five hours in the past, now takes ten hours, as oil trucks and others continue to beat up the road to an unrecognizable condition. And we drive slow as we have unbelted children, two marginally strapped-down tires on the roof, and $450 of brand-new stove laying on its side in the back. It is so painful. But whatever, we finally make it, pulling into ‘home’ on the hospital compound in full darkness. Despite all our suitcases being on a cargo truck coming down at some future date, it still takes quite a while to unload the 4Runner into our ‘home’.
Every year we come ‘home’ to Tchad from ‘home’ in America, Danae always gets blindsided with the house. From the million dollar lake ‘home’ we stay at in Virginia to our ‘home’ in Tchad, a ‘home’ which would be condemned if were in America for so many reasons. And yet, it’s the nicest ‘home’ in this district of 200,000 humans. Danae is always shocked by the dirtiness of the place. I never even notice.
This year, for the first time in eight years, the roles are reversed. Danae sees it, but accepts it readily as routine. A nuisance, but one that can be anticipated and dealt with and accepted. I, on the other hand, am utterly shocked that we call this ‘home’ and raise our children here. I’m shocked at how dirty the walls are, how dusty things are, how stale, how simply... not ‘home’ it is. And I’m shocked that I’m shocked. And intellectually, I know this is probably the cleanest our ‘home’ has been in the better part of a year. Somebody must have worked really hard just to get our ‘home’ this clean.
But we get the kids showered and fed and into bed. And we unpack and put away the little we have. And eventually, I collapse into bed. Our bed. In medical school, I slept on the floor for the first six months on a backpacking foam sheet. Every week, I’d go to the mattress store and lay on every single mattress. And every week, I had the same favorite. And every week, I’d make

the owner the same offer, $700, with a smile. And every week, he’d laugh at my offer and kindly refuse. I’d tell him it was an entire month’s stipend for me and I literally couldn’t afford more. Finally, one Friday, after six months of our charade, he accepted my $700 for the most comfortable California king in the store. I don’t know if he lost money on it, but he certainly couldn’t have earned anything. I quickly called Steph to borrow her truck and got a buddy and drove it ‘home’ before the owner could change his mind.
Prior to this, my friend Paul had explained to me that a good mattress is a purchase you don’t want to be stingy with. If you’re lucky, you’ll be spending 1⁄4-1⁄3 of your life on it, and the time you spend on it will dictate how enjoyable many of the hours are you don’t spend on it.
I brought this mattress ‘home’ almost 15 years ago. The mattress then moved to our ‘home’ in Massachusetts. It’s the only mattress our marriage has ever known. Then it cross the ocean on a container ship, trekked across Cameroon and Chad, and ended up in our ‘home’ at the hospital.
Collapsing into it, there’s a familiarity. This is my bed. Beside me is the love of my life. Twenty feet away are four creatures I would give my life for without hesitation. There’s a dog beside me I’ve had twelve years. The fan is blowing on me just as it has for the last eight years. The cries of the pediatric ward are within earshot, just as they always are.
So I make a mental, emotional and spiritual effort to remove the quotation marks and embrace the fact: I am home.

Vacation 2.0

Vacation 2.0
From burying Mom, we had a great debriefing meal with the whole extended family and then our nuclear family took off driving. More. Driving. First we drove to Urbana, IL to visit some of our dearest friends. We weren’t there but one day and we hit the road again to Chicago to meet up with Aunt Janelle and Uncle Bill some more. I showed the family just how awesome Chicago is, including Navy Pier, a marina, the Shedd Aquarium, Soldier Field, Mexican restaurants, Grant Park, Lincoln Park, ‘the bean’, the Sears Tower or whatever newfangled name they have for it these days, a boat tour on the Chicago River, a walk out Union Pier, Michigan Avenue, McCormick Center (where we saw lots of old random friends and family and the educators’ convention!), Chinatown... all packed into two days! We were planning to stay a third day, but Bill and Janelle had to leave early and our vacation waits for no family!
So we took off for Madison, WI to stay a night with the Kings. We would have loved to stay longer, but our dance card was all full (and they have real working jobs anyway, I know, right, so lame), so we turned our wagons further north still to northern Minnesota (Da Mudderland!!!) and Becky’s cabin on the lake. Danae is getting pretty well-versed in the upper midwest and our weather was glorious. She just has an overactive imagination of igloos, penguins and polar bears starting in December, despite my insistence than isn’t the case.
After sufficient fun with old married lady Becky (married last year, woo-hoo!) we headed west for Addison’s birthday. For Addison’s birthday, we met up with Danae’s parents and summited the highest point in North Dakota, White Butte. Zane may have gotten a lame trip to Great Wolf Lodge for his birthday, but nothing is a cool as spending your birthday on White Butte, lemme tell ya, doncha know. Ya sure, ya betcha! We even had cupcakes on the summit! And to think Juniper slept on my back the whole way and didn’t even appreciate the summit.
We took pictures in sunflower fields, we went to the Black Hills and saw Mount Rushmore and we climbed 7+ miles round trip up to the high point of South Dakota, Black Elk Peak, also the highest summit east of the Rockies! (Guadalupe Peak is higher as east, but technically south of the Rockies and not east.) From there, we decided to drive to Devil’s Tower in Wyoming, arriving around midnight and setting up camp. In the morning, we trekked around Devil’s Tower, visited with a family camping in a retrofitted school bus (which is now on my bucket list), and kept on driving to Thermopolis, WY.
In Thermopolis, we spent the day hanging out at a hot springs pool and water slide, then put more miles on the car to go to Yellowstone, but we stopped short. We kept looking for a campground, but they all said no soft-sided campers. Bears! Finally we found a campground who thought we would be safe in our hammock and the kids in their tent. We set up camp and then headed back down to Cody, WY, Rodeo Capital of the World for... well, what else, a rodeo!!!
When I married an Oklahoman, I assumed she would be well-versed in rodeo culture. Turns out, I was taking her to her first-ever rodeo! What an honor! What a privilege! What on earth did that horse just do over there in the corner? Gross. Well, at least there’s cotton candy and enthusiasm!
The kids have had books about Yellowstone we’ve read to them since forever. Their favorite is, ‘Who Pooped in the Park?’ about a family having a blast walking around Yellowstone staring at scat (not the jazzy singer kind of scat, the kind of scat that comes from one’s backside). We were finally in Yellowstone, surrounded by more poop than you can shake a stick at. First stop... walking around... ‘Olen and Danae?’ I turn and look. Somebody recognized us from the blog and Facebook friended us and recognized us randomly in Yellowstone! Good thing I wasn’t lighting up a blunt just then, that would have been embarrassing! ;)
 At the same place, they found bison remains right next to a hot pot. People were speculating where it came from. Then a ranger came and explained the bison carcass hadn’t been there the day before and was more than a day deceased. No large animal would have moved it there. Except there were bootprints around. Some human had been playing a prank.
We saw bison (alive) and painter’s waterfall, geological activity to boggle the mind, elk, soaked in a river with freezing water on the backside and piping hot water flowing off the edge onto the chest, met travelers from everywhere, got caught in rain, saw rainbows in the sky and colors on the ground, saw geysers large and small, old and young, faithful and unreliable, and hit all the checkboxes for Yellowstone (except saw no bear or wolf). We left Yellowstone and discovered a great free campsite just between the Tetons and Yellowstone and froze our little fannies off, awakening to a bit of ice. The next day was a drive through the Tetons and Jackson Hole, discovering we aren’t nearly hip enough for such a place (although we did discover an amazing second-hand outdoor goods store, which is kinda like crack to me), and drove on to Vernal, Utah, one of many smallish-sized towns that should be dying in today’s America, but by all appearances is actually doing quite well, thank you very much.
We spent a couple nights in Vernal, soaking in the pool, eating at buffets and preparing for our big backpacking trip!
August 21 we hit the trail! The Uinta River Trail in the Unita Highlands Wilderness in Ashley National Forest. This is what we’d been waiting for! Starting out over 7000 feet, we hiked in 6+ miles and over a thousand feet the first day, setting up camp in the dark and rain on the sloping side of the mountain. The thing about the wilderness, there are no campsites! The next day was another four or five miles, in much heavier rain and freezing cold. We camped about 10,300 feet or so. I set up the hammock, but it was so cold and wet that all SIX of us slept in a two-man tent!!! What a night! The next day we just did a lazy two miles to Upper Chain Lake in the Chain Lakes Basin of the Uintas. It was so beautiful! We found the perfect campsite. Lyol and I hiked up to Fourth Chain Lake to take in the views and returned down. What a trip! But we weren’t done!
Danae and I decided to ditch the kids with her parents and go for Kings Peak, the high point of Utah. So the next morning, we carried the kids’ three itty-bitty backpacks, plus a fanny pack, plus a strapped-on tarp, plus strapped-on hammock and clothes and whatever else we might need, and we took off. And when I say took off, Danae has her own pace. She’s a bullet! Up and over Trail Rider pass. Through the Atwood Basin. Past Lake Atwood. Dressed up for rain. Undressed for sunshine. Dressed up for rain. Hide under the tarp... Up Roberts’ Pass. Back down. We made the decision to ditch what little of a trail there was and strike off cross-country. We invented a short cut to Anderson Pass, trudged across marsh and rock and hopping across streams. Back up on the other side until we arrived at the crest of Anderson Pass. From there we followed a theoretical trail, although it was really just trying to scramble up one massive boulder to the next. Finally, after way too long of this, we arrived at the summit of Kings Peak, 13,534 feet, the seventh-highest of the American high points, and about 300 feet lower than Mauna Kea in Hawaii, which we drove up last year.
By the time we got to the top, I was feeling seriously queasy. I blamed it on exertion, only having eaten a granola bar, a half a tortilla and a tiny hunk of cheese, and of course, the real reason probably had something to do with the altitude as well. Then all of the sudden, I felt my face and my hands go all numb and tingly.
‘Uh, Danae, I don’t mean to alarm you, but I think we need to go down. Like right now.’ I was pretty sure I was getting high altitude cerebral edema and was about to die. The good news is, I was wrong...

 All of a sudden, Danae dropped to the ground, trekking poles flying in opposite directions. ‘Well, I didn’t mean to alarm you.’
Danae told me she had sensed an ice pick of electricity going straight down from the top of the her crown into her brain. She was positive, and still is to this day, she was struck by some sort of lightening. I say ‘some sort’, because I didn’t see or hear anything like lightening or a thunderbolt, and I was standing about five yards from her. But she definitely felt something. And so did I. Once she flopped, the electricity in the air had apparently dissipated and I know longer felt the tingling.
Well, now this was excited. Thunder and lightening now started up all around us, as it will do at 6pm in the summer, when you’re on the highest point for hundreds of miles around. Here we were, thousands of feet above the surrounding area in a thunderstorm.
We decided to forego the ridge we had come up, as it seemed more exposed and where the lightening was mostly striking. We decided to go straight down the side of the mountain, a grade of probably 50-60 degrees of huge loose boulders, now wet in the rain. It took an hour to go down 0.3 miles, whereas we had been knocking off about two miles each hour walking across the flat basin. Slowed down by my nausea and fatigue, slipping and falling multiple times on wet and rolling boulders, once so badly I rolled over Danae’s trekking pole (borrowed from her mother) and snapped it in two, and sped on by Danae’s rational fear of being struck by lightening again, it was a stressful hour. We finally made it to the bottom over an hour later and had to go cross-country to find where we had stashed our fannypack with all the weight, by now in the pitch black. We kept on hiking down, this time following the trail for quite a ways down the valley. After zig-zagging long enough and not really making much progress toward our goal, we decided to make another short cut across the valley to the far side, this time in the dark.
We went up and over hills in the dark, across streams, boulder jumping. It was exhausting. We got to the base of the pass and found the first clump of ‘trees’ we had seen since Atwood Basin. We were planning to hike back to camp to surprise the kids by sunrise, but it was approaching midnight and we were exhausted. Down from altitude, my stomach was feeling only marginally better. We decided a 16-mile day that took us up three separate passes was sufficient and we hung our hammock in a stand of two juniper trees, neither one more than seven or eight feet tall. We crashed, listening to thunder and rockslides around us.
The next morning I felt great again and we chugged the 9+ miles back to the kids in a little over five hours, slowing down for the pass at the beginning of the day and the pass at the end of the day. We were happy to see the kids again, and the in-laws.
After their two days of rest, the kids were ready to head down the mountain. It was good they got a little rest from all the hiking while Danae and I killed ourselves. We hiked almost seven miles the first day down and seven miles the second day and covered the fourteen miles out to the car.
It was a pretty awesome trip hiking fourteen miles and fourteen miles out, going up to around 10,400 feet, with a two-year-old, a five-year-old, a seven-year-old, a 74-year-old and a 75-year- old for a week! Both old and young were pretty tough cookies, with everybody carrying their fair share. Well, I suppose the kids didn’t really carry their ‘fair’ share. Danae’s fair share was carrying Juniper, and Addison for a tiny bit, plus whatever else she could fit into the 3000 cubic inches under Juniper’s tushy. Zane and Lyol and Addison all had small backpacks with knife and whistle and compass and fleece and rain gear and food and water. Rollin and Dolores

 carried all their own camping gear and some of the food. And I ended up with somewhere around 110 pounds, although I could still keep up with the five-year-old. Actually, Addison proved herself to be a strong hiker, as did everybody. She probably surprised us the most, however. That girl can go!
We had to make our own campsites, occasionally make our own trail, cross log bridges, go miles on end of rocky trails, crisscrossed with tree roots... it was hard going. But we did it! This brought our summer backpacking total to about 90 miles for our family (plus the 25 additional Danae and I did), or 4% of the distance of the Appalachian Trail. Maybe we’re not quite ready yet. I think our kids could probably do a 13-mile day here or there eventually after building up to it. But even at that rate, we’d probably need all 8-9 months to finish the Appalachian. Some day.
Anyway, back in Vernal, we got two more nights in the same two adjoining hotel rooms, and we ate two more times at the all-you-can-eat buffet. Yum! And OOF-DA! We also completed the ‘Vernal Challenge’, which I know you have all dreamed of completing yourself. We went to Dinosaur National Monument, we hiked to the top of Moonshine Arch, we visited the Utah Field House Museum, we looked at Petroglyphs at McConkie Ranch (and met the amazing old lady who lives there!) and we selfied ourselves with T-Rex, the green dinosaur in town. Most amazingly of all, I got to show my in-laws places in Utah they had never seen before! I think they’ve officially seen it all now! And for our labors, our reward for completing the Vernal Challenge was a sweet treat in town (where we also spent a lot of money buying other sweet treats (those conniving geniuses!).
Leaving our precious Vernal, we headed to Colorado, where we drove through Rangely and wondered if Danae and I would have ever met had Rollin and Dolores chosen Rangely over Jay. We camped in the White River National Forest. We rode on the Silver Plume train and toured the silver mine. We went to Johnson’s Corner in Loveland and bought donuts and cinnamon rolls. We attended a gorgeous (if rainy) wedding of Danae’s cousin in Aspen the day before Labor Day. Congratulations Travis and Ruby and welcome, Ruby, to the family (us in-laws gotta stick together ;) !)!
Then things finally got interesting...
Sunday morning, just before the wedding, Danae and her friends, Emily and Heather, FINALLY settled on Iceland as their destination for a 40th Birthday Party for Emily. The plan was for Emily and Danae to go to Dublin for a few days before then heading to Reykjavik to meet up with Heather for another 4-5 days. So just before packing up and leaving the hotel for the wedding, we bought: 1) One-way ticket for Emily from Atlanta to Baltimore, 2) One-way ticket for Danae from Denver to Washington, DC, 3) One-way tickets for Danae and Emily to Dublin from Baltimore, 4) One-way tickets for Danae and Emily to Reykjavik from Dublin, 5) One-way ticket for Emily from Reykjavik to Baltimore, 6) One-way ticket for Emily from Baltimore to Atlanta, 7) Super-romantic Bed and Breakfast 50 minutes outside Dublin for Emily and Danae. I also went ahead and booked a smart phone photography workshop slash walking tour of Dublin for the day after they arrived and Riverdance VIP tickets and dance lessons for Emily’s birthday!
After the wedding finished in the late evening, we drove overnight from Aspen to Denver overnight, dropping off Danae at the airport and arranging for my dad to pick her up in DC, swing by his house for Danae to grab some stuff, and then drop her off in Baltimore to meet Emily. Then the kids and I, after sleeping in the car, started driving solo, four kids, and myself, alone, in the car, from Denver to DC. Yay! Fun fun FUN! We made it to Council Bluffs, IA and I decided the kids (and me too!) had been of great spirits and patience. So we got some Taco Bell and Wendy’s frosties for lunch, got a hotel (for $36!) with a pool and free breakfast, swam a

long time, ordered in Red Lobster (which is interesting for vegetarians, but possible), then slept. Then next morning was free breakfast, more pool time (the kids had been really good on the drive and earned it), then on the road to St Joseph, MI, where we stayed with my BFF Krystian, who had just bought a house and graciously allowed us to sleep on his bare floor. Along the way, I had decided we had done a bit much fast food, so we stopped at a grocery store and bought loads of fresh fruits and vegetables and water and made our meals out of that. Once at Krystian’s, we put the kids to bed and talked late into the night.
The next day was a beautifully wasted day at the beach. We walked out the pier, past the lighthouse, we swam in the water, which was pleasant, and even got sunburned in mid- September in Michigan! That night was pizza and some good exhausted sleep for the kiddos, and for us too, once we finally stopped talking, but you know how old friends can go on. We woke up, packed up, loaded the car, breakfasted at Cracker Barrel with Krystian’s parents (I lived in their basement for a year in high school) and hit the road again. We made it to DC and Dad’s house well in the dark and fell asleep, but not before stopping at a rest area and trying to get Heather to Iceland on-time despite her flight being canceled, and sending Danae directions to the various places they were supposed to go in Ireland.
We took advantage of Danae’s absence by going to the library, as well as scheduled appointments for all kids for dental appointments and vaccines, as well as dental appointments and vaccines for the grown ups.
We also hadn’t yet purchased Danae any ticket back from Iceland, so we decided to go and join her! Tickets were less than $300 each! So we flew out to join her the day Emily and Heather were leaving.
The kids and I packed into five personal items and two carseat bags, because WOW Air charges for checked bags AND even for carry-ons! So we had to put everything in front of our feet. That’s everything for freezing cold Icelandic rain, and diapers and clothes and everything else. I even squished in 33 pounds of food, since food (and everything else) in Iceland is crazy expensive.
Danae reserved a motorhome and I got a taxi with all the kids to go pick it up. The family renting it to us was incredible. If you wanna rent a motorhome in Iceland, let me know and I will put you in touch with them. They are awesome and immediately make you feel like family. We loaded our stuff in, unpacked, set up the carseats, familiarized ourselves and headed back to the airport to meet Mommy after being apart for eight days. Yay for reunions!
Our week in Iceland was awesome! First of all, I told Danae to screen all email and only tell me what was urgent. Otherwise, my phone was only used to fly my drone and take pictures! A week without email was tremendous. Fantastic. Highly recommended. But we saw waterfalls and icebergs and glaciers and hiked and saw whales and glimpsed the northern lights and swam in natural hot springs and ate lots of skyr and... we did it all! We drove around the ring road circling the entire island. What a week! Iceland definitely warrants its own blog!
After driving about 15,000 miles in three months, we spent the last couple weeks of vacation just lounging at the lake, going to appointments, shopping, packing, and spending some quality time together. And then, we came home!

Monday, October 22, 2018

Vacation 1.0

Vacation!
So our original plan of nine months of extended sabbatical went kaput, but we still decided we needed some extra time off this year. And it seemed all the chips were falling into place. Sarah was here and settled and proving herself to be an excellent doctor and committed missionary. We were into June and the work at the hospital seemed to be slowing down for rainy season, just as it did every year.
So June 11, we decided we were going on vacation. And we decided we were going on vacation the 13th, two days later! Who says you can’t be spontaneous when you’re a missionary doctor with four kids?! We emailed our amazing travel agent (insert gratuitous advertisement for Nathanael Martin at Butler Travel here), who purchased our tickets roughly 70 minutes later! So it was decided.
We took the slow bus up to N’Djamena and were off! We landed in DC on Thursday and found ourselves lost in the woods of northern Pennsylvania with backpacks on Sunday! We even drug my dad along! We had had just enough prep time for me to set up a three-man three- season tent, a three-man four-season tent, a two-man three-season tent, a double bivy sac, a single bivy sac and a hammock and tarp in dad’s backyard first.
We spent four days hiking the West Rim Trail of the ‘Grand Canyon of Pennsylvania’. It was beautiful and fun. Juniper (and occasionally Addison, since Juniper probably walked more than half of it!) rode on Danae’s back, Lyol and Zane carried some small packs, Dad carried a hefty load and I carried the rest.
The kids slept in a three-man tent, Dad had a two-man to himself (along with a sweet sleeping pad we gave him and then promptly stole for the rest of the summer) and Danae and I slept in one hammock. One. Hammock. Two people. Sleeping. Or trying.
You think you know somebody. But you don’t. Unless you’ve spent a few nights in a hammock with them, pretzeled up butt to butt, feet in face, squished together by love and the tension of deep hammock walls supporting a lot of suspended weight, showers nothing but a distant memory and a future you don’t dare to hope for. You know how some mattresses you feel it every time your significant other rolls over. I could feel it every time her heart had the gall to disturb me with its incessant beating. Every breath created an ocean swell of rocking. Every bodily function, and I mean EVERY bodily function, even those we like to pretend our beautiful wives don’t possess, was magnified and felt, rumbles, vibrations and all. Yeah, I can now say I know Danae. And not the old ‘Adam knew Eve’ way. This is deeper than that. We’ve shared a hammock. I hope you all get the chance to know your spouses this way. Because misery loves company.
Anyway, we had a hoot with campfires and roasting and setting up and taking down and seeing nature and walking and getting caught in diluvian downpours and popping blisters and hopping barefoot around campsites and having a great time in general. We may have only made around 22 miles in four days, with a couple of 7-milers in the middle, but we had fun and got tired, and that was the point.
After all that fun, we went to Great Wolf Lodge for Zane’s birthday, which he LOVED, on the way to Asheville, NC, to stay with some ‘Chadian’ friends, Mason and Kim. After a couple nights with Mason and Kim, they had the poor enough judgement to trust us with their 14-year- old daughter Emmie during a week in the woods. So we took Emmie, as well as my sister and her three boys, into the Blue Ridge Mountains of North Carolina.
 We started the Art Loeb Trail up at the Blue Ridge Parkway and started downhill (I ain’t no dummy). But we didn’t start until late afternoon, so we dropped a car at the bottom, drove back up to the top and then Charity and the older boys headed off down into the woods while I parked, grabbed a backpack and ran back. We all hustled down after Danae and the youngers. Once at the bottom, we drove back up to the top and camped just a hundred yards or so into the woods off the parkway.
The next day was a drive back down to where we had stopped the previous day. Charity and I dropped everybody off and went to park a car halfway to the end, but then discovered everything was gated off. Our party of nine had taken off without any supplies, thinking it was just a short and simple day hike. But now we would need to overnight! So Charity and I had to repack EVERYTHING in the cars to fit all tents, stoves, food, bear canisters, warm overnight clothes, EVERYTHING into two backpacks. We dropped a car at the very end and skedaddled back to the trailhead. Charity hoisted a massive backpack onto her shoulders, I clipped a second backpack onto the back of my normal backpack and we took off, three backpacks between the two of us and our party with about a two-hour head start! We went double time and panted hard the whole way, up and over mountains with way-too-heavy packs on. We did eventually catch up, but it just about did us in. My sister is tough. The rest of the day should have been a lot easier, since we split up our weight a teensy bit with the others, but it wasn’t, thanks to a bit too much exertion on the front end of the day. But we had fun and everybody limped out to the vans the next evening.
After a third night in the woods, we spent Sunday as a bit of an off day. Our family plus Emmie hiked a couple miles up by the Blue Ridge Parkway, then we met the group, along with dear friends Neeta and Jim and Shiloh, swam in the river and ate yummy pizza. We said our goodbyes to Charity and boys, as well as the Hillmans, then drove back up to the top of the Blue Ridge Parkway to begin our adventure down the other side. And what an adventure it was!
By the time we were actually ready to start walking, it was after 9pm and all kids were asleep and it was raining. But Danae and I are terrible parents, so we decided to wake them up and get over the first hill to the next place with trees where we could put our hammock. Well, the next hill was over 6000 feet, as was the next one, and as was the next one. And their names all ended with ‘Bald’. As in, no trees. So we hiked for hours in the pitch-black rain up and over several mountains, encountering dogs masquerading as deadly wolves. And the kids actually were awesome! We finally got over the last 6000-foot bald and into a grove of a few trees. I set up the tents and tarps and hammocks. (Well, Emmie is tough, so she set up her own hammock.) We collapsed exhausted from the blowing rain, the midnight hours, the slog over high mountains.
The next day was a beautiful day. We hiked for a bit, then unpacked everything in the sunshine to dry out. We took a detour to hike up another mountain, Shining Rock, in the Shining Rock Wilderness. We were just a couple weeks too early for wild blueberries. I’ll bet the bears were getting excited and licking their lips. We hiked on and then finally slept just a couple miles from the end.
Finally we concluded our six days and hiked out of the woods and into a Boy Scouts of America camp where Mason and Kim and Grace rescued us. And fourteen-year-old Emmie pretty much carried her own stuff the whole way! 30+ miles!
After our second backpacking trip, we rushed back up to DC for Fourth of July, which was pretty fun to watch the kids enjoy a concert and a gymnastics show and the FIREWORKS!

 July 6-8 I flew out to Chicago to climb the highest point of the great state of Illinois, Charles Mount, with Krystian and his kids. And we did it without any supplemental oxygen!
Then the day after I landed back in DC, we drove back up to the West Rim Trail in Pennsylvania and hiked the final ten miles with the Trecartins. We knew Megan, although we didn’t know she could hike so far while 8.7 months pregnant! And we knew Russ, but this was our first time meeting Andrew. They seem perfect for Chad! And we’re very optimistic they will be here full time soon enough. Inshallah!
Back to DC from northern Pennsylvania, and then on to Oklahoma to surprise Danae’s parents at Oklahoma Campmeeting. (I got to drive all night to celebrate my birthday!) The kids had a blast there for a week, attending the activities and meetings, and hanging out with the grandparents and Aunt Janelle (and maybe even Uncle Bill, but he was a little busy). In the middle of the camp meeting week, Danae and I left one night to drive across Oklahoma, across Texas, into New Mexico, and then back into Texas near El Paso just before sunrise to hike up the highest point in Texas, Guadalupe Peak. It was surprisingly beautiful. Clear weather and could see all around. Danae ran up the thing like a mad woman. It was significantly harder than Charles Mound, being a few thousand feet up and about 4.25 miles each way. Danae was up the thing in a matter of a couple hours, but then we took about the same amount of time coming down. But then everything went wrong.
Driving back to Oklahoma Campmeeting through the town of Orla, Texas, we hit a giant pothole and blew out the tire. Noon. West Texas desert. Mid-July. About a hundred and way too many degrees out. Changed the tire pouring sweat.
Now there are some things you should know about Orla, Texas. First thing you should know: No matter what I say, you won’t be able to confirm or contradict, because ain’t nobody know nuthin’ ‘bout Orla. This is the place six-degrees-of-separation doesn’t exist. Second thing you should know: Everything I will tell you about Orla is 100% true. Orla ‘is believed to have two residents.’ I’m not making this up. This is on Wikipedia. And I met both residents.
Orla is literally an intersection where two roads cross in the middle of West Texas. That’s it. There’s a gas station at the intersection. And a... wait for it... tire shop. In the town with a pothole the size of... well, the size of Texas. No, not literally of course. Not literally the size of Texas. But literally that’s all that’s in town. The two residents are the man and woman running the tire shop. After we blew the tire, it wasn’t two minutes before a tow truck was there asking if we needed help. (We didn’t! I can change a dadburn tire!) Yeah, that’s coincidence.
We slap on the spare doughnut and head off down the under-construction-road. (Under construction, just please don’t fix our pothole as it’s the town’s sole source of income!) We drive on to Odessa and stop at a tire shop. They finally get to it near the close of business. And they see it’s an aluminum rim and it’s bent and they can’t risk bending it back. I need a new rim.
Now apparently Dodge made like 14 different rims for their Grand Caravans this model year, and we found the extinct one! The Dodge in Odessa didn’t have it, nor Midland, nor... well, I’m getting ahead of myself. We figure Abilene is a big city, so we go there and get a hotel, instead of staying with my sister in Dallas as planned. Our hotel is literally next door to the Dodge dealer. At the open of business, we call and ask for the rim, which they obviously don’t have. I call every single Dodge dealer between Abilene and Arkansas. Nobody has it. The central database says there are two down near Houston, one in Fayetteville (although when I call they say they don’t really have it), one in Indianapolis and two in California. Six in the world! Oh wait, there’s one in the central warehouse in Dallas! Great! We start driving. But the warehouse in Dallas will only ship. They don’t let customers come and pick up there. Ok, I call a Dodge

 dealer next door to the warehouse. Can they go pick it up for me? Yes? Great! They need me to pay for it first? No problem! My credit card is... What? It has to be check? You don’t take credit card? Is this still America? Ok, fine, hang on...
I call my sister at work. Hey, can you play hooky and go pay for a rim for me by check at the Dodge dealer? Yes? Great!
Wait, Mr Dodge Dealer? You’re saying it’s too late in the day and your order had to be in by 9am? Seriously? You’re like, right next to the warehouse? Not gonna work.
So I’m staring down the barrel of 700 miles on a donut. That’s not fun. So I call the nearby Dodge dealers for a spare donut in case this one blows. They don’t have any. I call the nearby tire dealers. They don’t have any either?!?!?! Seriously???
I call the biggest junk yard in central Texas in Fort Worth and they have one. I’ll take it! So now I have a spare spare tire. Yes, I’m that out of shape, but I’m not talking about my tummy. Anyway, we eventually make it back to Oklahoma camp meeting, forced to limp along at 55mph on 85mph roads!!! Oh, the pain!
The next day, my rim gets delivered from the Dallas warehouse to a dealer near camp meeting and I get set up. Finally. In time to drive the 24 hours back to DC.
We hung out in DC for a bit with my sister, we met up with more future (yay, Davenport!) and past (yay, Roberts!) missionaries, did some driving range, did some indoor skydiving, and then eventually went to the lake for a week with the whole family. It was our first week there without Mom, and it was a bit lonely, but we all still had fun.
Except, during our lake week, our staff in Chad decided to go on strike. We were always proud to say our hospital was the only one in the country that never went on strike, not even a pared down services in support of others’ strikes. We simply don’t do that. However, we had a few individuals make a power play, as somebody invariably does every time we go on vacation. It was so infuriating and discouraging. They needed a scapegoat, so they targeted one of our foreign volunteers, lodging old complaints and accusations against her we had already previously addressed and given proof showing their accusations were false. Regardless, they were determined this time. They rallied staff and showed their solidarity. In the end, only one of my nurses had the courage and integrity to come to work and treat patients. Others, those who had spent thirty years at the hospital, those who would go out and evangelize to tell of Jesus’ love, those who grew up a staff children and eventually became staff, those nurses who like to be called ‘pastor’, everybody decided their trite and false accusations merited them leaving patients to die. We were utterly disgusted at the stories. They wouldn’t treat our guard’s dying children. They wouldn’t come to operate on dying women bleeding to death. It was the most abhorrent behavior I’ve seen here. And when the regional judge sent his bailiff to ensure order, they actually physically blocked the bailiff from leaving the hospital compound until the bailiff was forced to call the police to give him an escort. Sarah believes some were devil-possessed and I believe it’s possible. Danae and I were prepared to not return if our witness was going to be leaving the suffering children of God to die. We want no part of that.
However, in the end, Sarah’s strong backbone and innate savvy and James’ experience won the day and reason returned to the hospital, but not until the lead instigator was fired, which is a very difficult thing to do in Tchad. Anyway, I don’t feel like devoting another paragraph to this most-shameful episode in our hospital’s history, so I’ll just leave it here. But it was helpful in showing us what is most important to the majority of our employees and which employees are actually committed. We are grateful for that.

Ok, on to happier subjects. Like burying Mom. Wait, no. That’s not really happier. But at any rate, that’s what we did. We caravanned three vehicles down to Collegedale, TN, where Mom has chosen to be buried and we plunked her ashes in the ground. Dad courageously led a small, intimate, personal, beautiful commemoration of Mom, and we said a bit of a final goodbye. Dad had chosen a beautiful cloisonné vase they had bought decades ago in China and sealed it. And then we all spit on Mom’s grave. Well, not exactly. We all ate watermelon, Mom’s favorite, then dropped seeds into her grave.
Then after that, we started our REAL road trip!!! The rest had all just been warm-up!

Tuesday, June 12, 2018

Camp Hell

Sunday, 8pm: 

Nuts. Juniper’s awake. I can hear her crying. You don’t hear that? It’s coming from outside? How’d Juniper get outside at night? Wait. Listen for it. Hear that? You’re right. It’s outside. Oh… it’s the sheep.



Flashback to Thursday night:

Do you want to know what my happy face looks like? Do you? You do? Ok, here… look at my face now. See it? Yeah, this is not my happy face. This is so not my happy face. This is like the opposite of my happy face. Imagine my face upside down. That would be much closer to my happy face.

I am not happy.

I am driving around on a wild goose chase in the pitch black moonless night somewhere in some seventh level of Sahel. 

And I am sooooo taking this guy’s man card. In fact, I’m taking all this guy’s cards. So not impressed.

My lovely wife is… lovely. Much lovelier than I am. Both in physical appearance and in generosity. And I hate it. Well, the physical appearance part I'm willing to tolerate. But this generosity thing is killing me. She’s also wildly in love. And no, not with me. That fling is past. Her new passion, as of the last several years, is all things Fulani. She wants to dress Fulani, she wants to… well, she just wants to be Fulani.

The Fulani are the nomad tribe that criss cross the country and the continent driving their herds from here to there and from there to here in search of greener pastures, greener for the grazing. My wife wants to move in with them. Except there isn’t really any way to move in with nomads. So she just wants to live with them. In America, we call it camping.

The theme of my wife’s life for the past several years is we-are-going-to-live-with-the-fulani-for-a-month-before-we-leave-africa. I agree, it’s not a very catchy theme. Feels clumsy on a billboard. But it’s consistent.

When we drive somewhere, we drive past people wanting to catch a ride in the back of the pickup truck all the time. And we drive right on by. Kids going to a soccer game? Nope, no ride for you. Guys headed to the market? Who’s got time to give them a lift? Not us. Women carrying massive loads on their heads home from the market? Sorry, ladies, but this is the express. Old ladies having heart attacks needing a ride to the hospital? Call a taxi. Unconscious kid with cholera needing IV fluids? Gross, he may diarrhea in the back. Can’t he ride on a motorcycle? Blind guy lost and trying to find his way home from church on his hands and knees with chapped lips and a parched tongue? Surely he’ll be just fine on his own. He looks tough. Roll up the windows, turn down the AC and keep driving! Can I see your iPod?

But drive past a Fulani, and suddenly Danae is the Good Samaritan, no, the Better, no, The BEST Samaritan who ever Samaritized. Pull over, pull over, Pull OVER NOW!!! Then jump out of the car and run over and hug these Fulani women who clearly do not have hugging in their culture and are extraordinarily uncomfortable and start snapping selfies and load them all up against their will into the back of the pickup, donkeys included and then proceed to drive an hour out of our way, in circles, just so she can have that ever-satisfying knowledge that she has Fulani in the back of the pickup.

I agree with you. It’s weird. And borderline-diagnosable. And quite probably requiring medication. But it’s my wife and it was in the fine print in the for better or worses. So I just bite my tongue and drive.

But now this might be the last straw. And when you’re dealing with nomadic herd-driving Fulani, you can be sure there will always be a lot of straw. Still, finding the last one was remarkably simple.

Danae corrected a hernia on a young Fulani boy, and wanted to drive him back to his village, along with his father and mother, because, well, duh, it would give her that ever-satisfying knowledge that she has Fulani in the pickup as referenced above.

I learn of this plan halfway through my first adventure making calzones. I rush them so we can make it there before dark, but they still turn out awesome. So awesome, in fact, I will never again make them for fear it may just have been a fluke. Regardless, my calzones and I were not the last ones ready. Oh, no. Danae’s Fulani-itis is contagious and we decided to take volunteers with us. All. The. Volunteers. I love my volunteers. So thirteen non-Chadians and innumerable Chadians, along with their unquantifiable Chadian belongings, piled into the pickup. Except Chad (an awesome American volunteer named Chad, ironically), who drove my motorcycle, so he could hustle Sarah back early in case of an obstetrical emergency.

By now, I realize we will be getting there in the dark.

First stop is the health center in Tamyo to drop off another patient and their family. Tamyo is twelve miles from Bere. Bere is the largest city and the capital of this district of almost 200,000 people. The family does not know the way to Tamyo from Bere. Neither does the nomad, who lives just a couple kilometers away. Fine, I have a vague notion and we make it there a bit before dusk.

As we roll into Tamyo, Chad’s motorcycle (well, my motorcycle) stops working. So we put that in the back too.

Now we need to find the way to the Fulani village. Except the Fulani dude has NO CLUE where his village is.

Wait. Wait. Wait. No. Wait, wait, wait wait wait. Hang on. No. Wait.

Ok. Ok. So… ok. So, ok. So, what you’re wanting to tell me… No. Wait. So… You mean to tell me that you don’t know how to get home.

Hang on. Wait. No. Ok, so… We are two kilometers from your house. You know that you live two kilometers from Tamyo, one of the four largest towns in a district of nearly 200,000 people. But you don’t know how to get there? Like, nothing? Anything? No?

Give me your Man Card.

I’m serious. Now. Right now. Hand it over. No Man Card for you.

Hang on. Wait. No. No, no, no. No, no nonononononononononono. You are a freaking Fulani. You’re a nomad. You know that, right? You walk, on foot, driving animals all across this continent. Hundreds of miles. Thousands. All the time. Every year. We are two kilometers from your house. You’re lost? Like, do you need me to take you a hundred miles away and drop you off with a goat? Then could you find your way home? Aren’t you people born with a GPS in your brains? Don’t you, like, navigate by the stars or something?

No. Give me your Nomad Card.

You know what? No. Just, screw it. Give me all your cards. Hand them over. Give me your wallet or purse or whatever you people carry your cards around in. Open it up. Turn it upside down. Shake it. Tap it on the bottom. No, smack it. Hard. Hard. You know what? Just… like turn the whole card carrying purse inside out. Yup. There you go. No more cards? Good. You don’t get any cards. None. No cards for you.

Flippin’ nomad lost two kilometers from his own dang house.

And this. Now this. You see this face? This is so NOT my happy face.

So we get the health center director, and he hops on his motorcycle and leads us to the Fulani village, all the while my dear Fulani friend, like he’s trying to prove to me that I was justified in stripping him of all his cards, is adamantly and angrily insisting his village is in the opposite direction of where we’re driving. Then the motorcycle in front of me turns right, off the single-track sandy wash that qualified as our road, and then drives a half mile across dry rice paddies. We stop in front of their village, which consists of a large grass dome built on a maize-stalk frame, a small grass dome built on a maize-stalk frame, and a small grass dome… but without any grass. Just the maize-stalk frame. And people. I don’t know where they come from, but there are a hundred people milling about, shaking our hands, thanking us.

I use the Fulani I know, ‘BAHR-kuh! DJAHM! OO-say! TOO-tuh!’ Which I think translates, ‘Peace! Health! Thanks! Vomiting!’ Because those are the only four Fulani words I know. Sometimes I smash 'BAHR-kuh-DJAHM!' together into one word, and then people act like it’s a whole new thing. So I’ll just go ahead and claim a five-word vocabulary. Well, I know ‘urinate’ too, but that clearly wouldn’t be appropriate in this setting, so I leave it out.

Danae, of course, is in seventh Heaven. She rushes off to mingle with all the Fulani women and tour their house. Naturally, she speaks none of the language, knows none of the culture, and the only house to tour is about 100 square feet. It doesn’t stop her from being gone for an hour in the pitch black night.

Meanwhile, I’m sitting on the ground with four hungry, tired and cranky children, clueless as to where the open well is, but quite certain there’s a toddler-swallowing hole in the ground somewhere nearby. And of course all the Fulani men come and sit with me. Juniper isn’t a huge fan of the dark, so she wants me to turn on my flashlight on my phone, which I do. Then she loses it completely because all the bugs for a hundred meters around are drawn to the sole source of illumination and we immediately find ourselves in a swarm of various flying and crawling critters.

To make a long story only marginally shorter, Danae finally returns and we find our way home Thursday night.



Sabbath Morning, way-too-early-for-the-weekend AM:

It’s official. Danae has lost it. She’s gone native. We are going to sleep with the Fulani tonight. We will become nomads. Danae has decided this. But yet she is the one still sleeping in bed. I am getting food and cooking implements together (we have no camp stove nor camp cookware), mattresses, mats, sun shelter, tent, mosquito tent, mosquito nets, diapers, wipes, changes of clothes, etc. The truck is now loaded. Danae wakes up. And we are off.

I have chosen my man-capris today, because they are awesome pants, and because one can wear one’s man-capris and still carry one’s Man Card in Europe. And even cross one’s legs knee-over-knee. I am simply that internationally-sophisticated and this is a francophone country, thereby, inherently more sophisticated than most and ready to embrace me, man-capris and all. Danae may hate my pants, but my man-capris have so many cargo pockets, she won’t even know where to start looking for my Man Card. It is safe.

First stop is Guissa Kalia. We’ve been coming here for several weeks now. It’s the village where the monkey forest is. One day, we told a Bible story. Then we started going every Sabbath morning to share some Bible stories, teach some songs, pray a little bit. It’s fun.

After ‘church’, we carry on southeast through a different forest, where we turn off the road and drive through the trees a little bit to park right behind a massive termite mound, hiding us from the road 50 meters away. Here we have a delicious lunch of soymeat sandwiches and other delicacies. It’s starting to get a bit warm. It’s April, the hottest month, and it’s coming up on noon. It can get as hot as 50 degrees here (122 Fahrenheit). Today it’s probably well over 40 Celsius already (104). Picnic weather.

The kids are beginning to complain it’s a bit hot, and I’m willing to admit there’s no chill in the air today. But fortunately, we have a massive cooler full of water bottles frozen solid, so we’re good. Drink up!

Without a herdsman in the pickup, we find our way to their ‘house’ much quicker this time. Along the way, we stop near a couple different isolated Fulani houses, where toddlers run screaming away from us and teenagers come running toward us. Once we start handing out mangos to children like lollipops from the back of the van of that creepy guy who lives down by the river, only the most timid stay away. They are grabbing mangos like presidents grab ladies.

Once at our destination, we exchange the same 4.5 words I know in Fulani, then stare at each in awkward silent confusion, but our eyes carry on the conversation:
His eyes: Ummm… dude, I see you have more stuff in the pickup than I own. ‘Sup?
My eyes: Ummm… yeah, so like my wife wants to sleep out here with y’all.
His eyes: LOL. You trippin’.
My eyes: Nope. I’m for reals for reals. Check it. Mattresses and whatnot.
His eyes: Dude. I’ve never seen a mattress before in my life. You soft and squishy. If my 7% fat body doesn’t need padding, why does your 20% fat body need it?
Both our eyes: Blink, blink, blink, blink, blink.
My eyes: So, ummm… yeah. Like, cool if I pitch a tent here?
His eyes: Do what you want, but you will be miserable.
My eyes: How do you know? Is there like some ancient Fulani prophecy about visitors coming and spending a horrible night among you and changing the course of all history?
His eyes: No. You’re wearing man-capris.
My eyes: Touché. But check out the cargo pockets and mid-calf drawstrings!
His eyes: Blink. Your wife must be so proud. Eye roll.
My eyes: Which reminds me… get lost walking ten feet away from your hut lately?
Both our eyes: Blink.

Danae, oblivious to our entire ocular repartee, strolls off to embrace the wife like a long-lost friend. The wife obviously thinks Danae has not been lost long enough.

Meanwhile, I set up a sun shelter and toss a plastic woven mat underneath it. The kids gather under it, so I toss out another one. They are both full of kids and men. So I stand. Because, you see dear reader, nomads drive their herds. And when they camp, they camp surrounded by their herds. And their herds graze. And after they graze, they digest. And once digested, they poo. As such, I find myself completely surrounded by bull poo. And my mats are full of nomad. So I stand.

Danae returns from her emotional reunion with her unwitting BFF and get out a couple Bible books we had brought to have church with the kids. She starts reading the stories to our kids, but it would appear the Fulani men around have deeper interest. My kids are both hot and distracted. Danae carries on as if the Fulani are following her every word, in English. Realizing we aren’t in Kansas anymore, or any anglophone place, she starts trying to translate the book from English into French for them, intellectually completely cognizant of the fact they couldn’t understand a word of French to save their souls, but also so intellectually aware they don’t speak English, so she naturally can’t just read it to them in English, but needs to find some middle language she doesn’t speak perfectly and they don’t understand a whit. It’s all perfectly logical.



Saturday night, 8pm:

Well, that was gross. It might be pitch black out, but that sound and the wet feeling on my shins, the part my man-capris don’t cover, tell me Addison just vomiting all over my legs. That ain’t cool. That means it’s all over my man-capris too, in all likelihood. Poor girl has malaria. Again. Like third time this bloomin’ month.

Oh well. It some how seems terribly apropos. We spent the day in the blistering sun. Late evening, some of our volunteers came out to join us. Then after it got dark, we decided to eat. With our new BFFs. Danae decided to make burritos and salad for everybody. The Fulani absolutely refused to eat anything prepared by a non-Muslim. Our bad. But they did want to cook for us. One of our nurses came out with the volunteers and translated our lousy French into Tchadian Arabic. Then there was one dude in the village who spoke some Arabic, and he in turn translated into Fulani. Via this highly efficient system, Danae let them know we are vegetarian. In reality, she and the kids are vegetarians, but we all became guilty by affiliation and had to eat vegetarian. When Danae showed her BFF a carrot, her BFF acted like Danae was a martian pulling a four-headed peacock from her chest. Apparently, she didn’t know what a carrot was. Or any vegetable for that matter. So we had rice. Plain rice. Although it was extra special, in that it had more grains of rice than grains of sand, which is not always the case. After this scrumptiousness, the volunteers and translator all left, save for two hardy women who stayed the night as well. 

So considering how the evening is going up until this moment, a little vomit on my legs doesn’t seem out of place. I figure it’s time to collapse into bed and sleep the sleep of the just.

Addison and Juniper and Lyol and Zane are tucked into their tent on sleeping pads. I have a sweet setup rigged with mosquito net under our sunshade. Danae lays down on the crib mattress, and I lay down on the hospital mattress, because, well, I’m such a gentleman. And it is super romantic. 

It is also super still. And it is hot. It is so hot in fact, even the air molecules do their best impression of Danae and all the girl air molecules say to all the boy air molecule, ‘Ewwww! Don’t touch me! It’s too hot! You’re all sticky! Gross!!!’ And so not even the air molecules twitch a single air molecule muscle. (And yes, I’m nerdy enough to know that typically air molecules start vibrating faster when their hot, but this is so hot, the whole thing is actually working in reverse. True story. That’s science. And you can’t argue with science.) That’s how still it is.

So I lie there. Danae lays there. The kids lay in the tent ten feet away. The volunteers lay on the far side of the pickup. The Fulani lay next to their hut fifty yards away. And Danae’s BFF has a hair that’s a little bit too long in her left nostril. I know this, because I can hear the wind going past it as she breathes. The air is just that still. And I can hear yet another drop of sweat coming out of Danae’s pore. That hot. That still. I’m laying there topless and spread eagle, listening to the cells of my epidermis weeping and begging for mercy.

A few minutes later, we hear the pitter-patter of little feet. Danae gets up and asks the volunteers to move a hair, so they don’t get trampled by the bulls walking a few feed from their heads.

The kids moan and fuss incessantly. We pull Lyol and Zane out, pop up their mosquito tent, stick them in, kindly ask them to shut up and stop their complaining, we’re all hot, what do you want me to do about it? We debate about withdrawing our entry for parents-of-the-year.

At the strike of midnight, my fairy godmother finally arrives, in the form of a sweet, slight breeze. Oh divine. It’s still hot, but there’s hope.

Oh, and looky over there. Is that hope too? Does hope flash like that? BOOOOM! Nope, I guess that was lightening. Well, fancy that. We are on the top of the highest rise for miles around, under a metal sunshade. I’m no Bear Grylls, but this might not be ideal.

And my fairy godmother turns the soft and gentle breeze into a tempest. The sunshade is now airborne. I grab the corner as it flies by my head, and I wonder if I’ll turn into Mary Poppins. Thankfully, all the rocks I just ate with my rice has given me sufficient mass to weigh down the sunshade just before it fully takes flight. Danae and the volunteers help me collapse the thing as the wind picks up further and the light show eliminates any need for headlamps (which we don’t have anyway). We dig the kids out of the tent and collapse it down. It gets shoved into the pickup cab, along with the cooler and everything else I packed into the cab.

We all move out to sleep on the carpet on the low side of the pickup, and we watch the light show.

Oh dear. Well, it’s no big deal. It will pass. It’s just a drop. It’s just a couple drops. It’s just a few drops. It’s just… screw it, that’s alotta drops. 

Danae’s BFF comes out to save her and the two volunteers. I pile the four kids into the pickup. Along with the tent and the backpacks and the… sheesh… there’s a lotta junk in this car. The kids are situated and soon fall asleep, with me staring in the window.

I pull the mattress back out of the pickup and throw it on the ground and wrap up in a fitted sheet. By now there’s some serious wind and rain and lightening. At some point, there’s a mini-stampede right by my noggin. But I’m actually the most comfortable I’ve been in a long time. I might not be sleeping, but I’m finally comfortable. I love being cold.

Danae knocks on the… on my head… to see if I’m sleeping. Well, I wasn’t, but if I had been, that wouldn’t have helped.

We’re now three hours into this storm, it’s 3AM. Danae takes Lyol and Addison and retreats to the hut, where everybody is apparently dry and warm. I take my sopping self and slog into the driver’s seat, with two-year-old Juniper as my copilot and Zane sprawled out in the back. They are blissfully asleep as the wind buffets the pickup. I try to hunker down in the driver’s seat and do the little dance every man (or woman) must do to fall asleep in the driver’s seat. 

Put the steering wheel up, tip the seat back, but not so much you squish the six-year-old in the back, make sure the car is in gear, roll left. Don’t move for a few minutes and maniacally tell yourself, ‘I can fall asleep. I can do this. I am sooooo comfortable. I am most definitely not uncomfortable. Yep, I’m drifting off blissfully to sleep. I’m practically asleep already. I’m like 90% asleep. I can feel my body being refreshed and getting ready so I will be completely rested and bright-eyed and bushy-tailed in just a couple hours, that’s how good I’m sleeping right now. Curses. Dang it. This isn’t working. I’m so wide awake.’

Roll right. Repeat mantra. Lay on back, repeat mantra. Sit up straight. Stare at the windshield blankly. Put the steering wheel all the way down. Scoot your butt to the bottom of the seat. Fold up your knees like you’re still a young man and then put your feet up on the dash. Repeat mantra. Fold the knees back. Turn left. Turn right. Try to pile up something between the driver’s seat and the passenger’s seat. Hear your two-year-old start squirming and moaning and realize you’re about to wake her up, which is guaranteed to make your night much, much worse, so immediately abort that effort. Realize the rain on your clothes has evaporated and been replaced by sweat. Crack a window. Feel the rain pour in on your clothes so the sweat gets rinsed out to be replaced by rainwater again. Repeat ad nauseam.



Sunday, 5AM:

No, thank you. I do not want more rocky rice. I’m good. I swear. I promise. I just want to go home. A sheep? Seriously? You’re giving us a sheep? No, we’re good. I promise. I swear. Remember, she’s a vegetarian. I know the sheep eats vegetables. Doesn’t make it vegetarian to eat it. Doesn’t work that way. Really? You’re just gonna tie up in the back of the pickup like that? We go home.



Sunday, 8PM:


Nuts. Juniper’s awake. I can hear her crying. You don’t hear that? It’s coming from outside? How’d Juniper get outside at night? Wait. Listen for it. Hear that? You’re right. It’s outside. Oh… it’s the sheep.