I learned the phrase, TIA, from my friend who was shopping for some plumbing supplies.  The Gambian salesman was showing her the parts, but they weren’t quite fitting together right.  This was mentioned to the salesman and he shrugged and said, “TIA.”  My friend didn’t understand, so he said, “This Is Africa.”  No more explanation was needed.  Since then we’ve found numerous uses for this phrase.  My week of holidays was the epitome of this phrase, so I will paint for you a picture of what TIA looks like.

Margit reading at the beach

Before I even left for holidays, I had a TIA moment during our day of prayer and meetings.  Margit (midwife and fellow Blue House resident) and I were on for worship and for one song, we wanted to make it upbeat and have a drum as part of the music.  There aren’t really any drummers in the team though, so I was volunteered to do the drums while another flute player played what I would have played.  For the record, I have never played the drum in my life other than banging on my steering wheel or knees.  I have enough music experience though that they thought I could do it.  As we were preparing, I thought someone had said that there was a drum at headquarters, and so I didn’t bother to try to bring one down from Sibanor.  I come to find out the morning of that there is not a drum there.  Hmm.  That was a pickle.  So we found a bucket.  A green and yellow 2-gallon bucket.  So for the first time, I drummed… on a bucket…for worship.  Hope that joyful noise was music to the Father’s heart.   TIA.

Janjangbureh (Georgetown)

For three days of my holidays, Cheryl and I went further upcountry to Janjangbureh, and stayed at a camp right next to the river.  The accommodations were very pleasant and homey.  We spent a lot of time reading and just hanging out together.  The second day, we decided to go on a canoe trip on the river.  There was one canoe that the staff usually used to ferry guests to and from the island, so we asked if we could just take it out for a couple hours.  The river was so calm.  The tide had just come in, so there was little to no current at all.  It was like boating on a pond.

canoeing on the River Gambia - still as a pond!

It was lovely to hear the birds chirping all around and the loudest noises were our oars moving through the water.  The canoe was very solid, and only let it maybe a gallon of water over the three hours that we had the boat out.  When we returned, we decided to go for a walk to give an equal workout to our legs and then sat and read by the shore, watching the monkeys and lizards come and go around us, until the sunset came.

The view over my book - both worth looking at for a while.
reading and eating groundnuts by the river. The head-tie is more culturally expected up-country.

About that time, the staff were getting set up for dinner, so we decided to go take our showers before dinner was served.  I went to close the curtains, and found that a frog had made the journey into my bed.  We chased him out the door (along with a couple more that had wandered in and were hanging out on the floor.  The threshold of the door was too high for them to jump over, so they hid in little holes at the corners of the doorframes.  In an attempt to scare the frogs further into the holes (and ideally outside), I slammed the wicker door behind them.  I thought that business was finished so I went for my shower.  I had just started to get wet when the water pump died.  I hoped it was only a temporary thing, but it persisted, so I asked Cheryl to go ask for a bucket of water to wash with.  She goes to the door and tries to open it, but because I had slammed it, the door had jammed, and she couldn’t get out.  Then she sees that all the frogs had re-entered the room and were all hanging out on the floor.  I had to come help pry the door open with a pocket knife.  After a couple minutes of wrestling with the door, we finally got it open.  Cheryl went to ask about the bucket and returned.  A few minutes later, the bucket of murky water arrived; complete with fish.  I decided it probably wouldn’t be very nice to try to shower with a fish in the bucket just in case I ended up pouring it on my head instead of the water.  Thus ensued the battle of trying to get the fish into the toilet.  This fish was a fast little guy and it took us five minutes to extract the fish from the bucket.  By this time, we had figured out that the water was river water (thus the fish and murkiness), and I decided that I wouldn’t quite feel clean if I showered with river water, so I opted for waiting to shower for the next day.  This wasn’t the end though.  We still had to chase the frogs out once again before bed, and stuffed the holes that they disappeared into with a towel so they wouldn’t return in the night.  TIA on steroids!

On holidays, got to visit Chamen as well to see what my friend, Cheryl does there with the skill center as well as what the other nurses do in the nutrition center there along with working to develop agricultural diversity in the area.   Chamen is a small Fula village that is in a very rural part of Gambia.   My friend Cheryl is working with ladies there to them started with small businesses (tailoring and making soap now). The house they have is very nice with plenty of room and a nice garden.  The downside of working in a rural setting like this is no running water and no refrigerator.  This means I got to experience the world of the squat toilet and bucket shower (though I mostly got used to that in Sibanor), and learning how to prepare enough food, but not too much to worry about leftovers.  They do have a “refrigerator” which is a large jar with a pocket around the mouth where water sits.  When the breeze moves over the water, it cools the water, making the inside of the jar slightly cooler than room temperature.  We measured it one day when the room temp was 36°C, and inside the jar it was 28°C.  You have to be a lot more creative in that setting.  A nice challenge 🙂

the walk through the "magic forest" to get to the toilet and shower 😀

I decided as a result of visiting them there that I am super spoiled to have running water in Sibanor.  I also feel more prepared for moving into a family compound next month.  I’m still nervous to move, but I think it will help make my experience here more complete.  I only have three and a half months left, and I want to make the most of it.  I want to emphasize that it is no less safe than when I stay in the clinic.  I will probably be even safer with a family.  The compound is extremely nice, and is not too far from the clinic.  I now even have a bike so it will make it easier to get to and from work in a timely fashion.  🙂  As I prepare to move, please keep me in your prayers; that I would have a good experience with their family and that this experience would be a blessing for those around me.

Also thanks to those who have been commenting and letting me know what you would like to hear.  I am on it trying to get some of that typed up and put up.  I don’t want to put up too much at one time though, so you will just have to be patient.  Keep sending the ideas and let me know what you like hearing about.  Thanks for all your prayers.


The weekend of camping on the beach lived up to expectations!  After the language class finished for the day, Levi, his mom, and I packed up and headed out of headquarters.  They were going back to Sibanor, but they were kind enough to drop me off in Brikama so I could meet up with James, Mez, and Simeon for the weekend.  In Brikama, we grabbed a few more groceries for the weekend and then caught a couple gellies to get to the lodge we were going to stay near.  We weren’t planning on actually staying at the lodge, but the guy in charge of the place gave us a good deal for camping (and being able to use their showers and toilets!) so we set up our campsite on their property.

the campsite - the boys got the little black tent, girls got the orange and brown one.

After we set up the tents, we went to the beach (even though the sun had set for the evening) and went for a swim in the ocean with the fabulous waves.  The moon was full so we could see really well even though the sun had set.  After swimming, we got out and built a fire on the beach and made baked potatoes with garlic and beef jerky in tinfoil.  Once they were cooked, we melted a bit of cheese with it too.  Very tasty except for the bits of sand that sneaked in.  Then we hung out and talked on the beach until 11 while we made s’mores (none of them had ever had a s’more before!) for dessert.

When we finally decided to go to bed, the guy in charge brought us to use a shower.  Then we walked back to the tents to get set to go to bed.  The boys in the little tent and the girls in the big tent (what gentlemen!).  As we were getting ready though, Mez all of a sudden sees a HUGE crab crawling over her stuff!  We didn’t scream too loud, but the boys came to rescue us and toss the crab out.  We thought about cooking it and eating it, but it was too late to cook and eat it at that point, plus, our cooking pot was way too small to fit the crab in it.  Oh well.

Saturday morning, we woke up about 7:30 and lazed around the campsite making breakfast and chatting about our countries (James and Mez:  Aussies, Simeon:  Swiss) and other various things until about noon.  When we finally decided to head out, we decided to try to rent bikes for the day so that we could travel further.  The lodge we were at didn’t have enough for all of us, so we walked up the beach to another lodge to see if they had enough and would give us a good price.  They had set prices that were too expensive for us so we settled for taking foot transport.  We walked down the beach to the Senegalese border (a river).  The guys walked ahead of us girls and we had an awesome conversation about all sorts of things.  I’m very sad that she was only here for a month visiting because she would have been an awesome person to get to know better.  Once we got to the river we walked inland to the coastal road and stopped for lunch at a restaurant (on the river).  Although I would like to say that the meal was wonderful and we had an awesome time there, that would not be true.  I would honestly have to say it was the worst meal I’ve eaten since arriving here.  There was sand in the dough so every bite was crunchy and the cheese tasted funny.  Everyone else was able to finish their pizza, but I had to give the second half of mine to Simeon to finish.

Mez, James, and Simeon; pizza on the river note the half eaten pizza in the foreground.

After we finished, we walked back to our campsite via the coastal road and grabbed a few groceries for dinner and breakfast in the town.  On the way, we asked each other random questions like “if you could be a fruit, what fruit would you be?”  It was a blast.  We are all pretty different so we had a lot of crazy answers but it was cool to get to know all of them better.

When we got back to camp, we quickly went for a swim as the sun set (I didn’t get any pictures of the sun setting on the beach 🙁 ).  The waves were bigger and we swam out further, because it was so relaxing to swim after walking all day.  Then we made a fire and made our dinner of tapalapa with potato and mayo as a filling (actually quite good, especially compared to lunch).  We continued asking each other random questions during and after supper, but got tired earlier so headed for bed after taking a shower.

Sleeping in the tents was not the most comfortable arrangement but I slept much better the second night (I was exhausted from walking and swimming).  As anyone who has gone camping knows, it’s not very comfortable to sleep on the ground, and I am pretty bony, so it’s almost impossible to find a comfortable position to sleep.  The other thing that made it hard to sleep was worrying about rain coming in the middle of the night.  Rainy season is leaving, but it still means that rain is possible.  To make it worse though, we had set up camp under palm trees that rustle like pouring rain when the wind blows through them.  I had left a few things out to dry so I kept thinking that I had to get up and run to grab them in the middle of the night and rearrange our bags to keep the rain from leaking into the tent, but it was only the wind.  Whew!

Sunday morning we woke up and had porridge for breakfast (yum!), and then had church on the campsite.  We sang songs and had a discussion for the teaching part.  Then we chatted until about noon when we packed up and got a private gelly to take us to the tourist area (pretty close to headquarters) to get good pizza and dessert at the supermarket before taking the gellies back to Sibanor.  The weekend was awesome, but it was exhausting.  I’m glad I went, but I’m glad I got to sleep in my own bed that night.

my completo. been meaning to put this pic up for a while to show you what I've been wearing 🙂

“homeschooling,” birthday, and other such craziness


I have enjoyed my homeschooling job so much this week.  I really enjoy hanging out with Levi anyways, and this week was no exception.  He is 7 years old and is king of the facial expressions (just like his dad).  Every day begins with schoolwork for him which takes him about an hour to and hour and 15 minutes to finish.  During this time, I usually read while he is doing his lessons because I can do little to help (unless it is math) since it is all in Dutch.  Then we usually read a book in English and color and play with Duplos or Knex and watch a film.  The first three days, we watched Ice Age 3, 2, then Incredibles (in Dutch).  In that order.  His choice.  We’ve also been playing a lot of games.  Monday we played Boggle (probably a bad choice considering my extensively broad vocabulary in comparison with his) and a Dutch fruit game.  Tuesday and Wednesday we played Battleship.  He won Tuesday and I won Wednesday.  It was more interesting than I thought it would be because we were playing half English, half Dutch.  For saying coordinates, he didn’t know all his letters, so for a while when I said a letter we had a piece of paper with the letters he got confused with to point at to help with understanding.  Plus we used the Dutch words for hit and miss.  Quite amusing if I do say so myself.

Today was a little different because we went to the beach for the afternoon.  We brought sand toys to make a sand castle or a sand animal with, but the sand had too many broken shells and wasn’t wet or dry enough.  Even so, we found a bunch of clams and had fun discovering how they burrow into the sand and trying to see what they looked like inside.  It took a while, but we finally were able to pry one little guy open.  It’s hard to believe such a funny blob of goo can live in a shell.  Then we went and played in the waves in the ocean.  They were just right to make it an adventure but not dangerous.  We had a blast.  Once we were done swimming, we rinsed off and had a milkshake, then changed into dry clothes and came back to headquarters.

Levi playing at the beach

I’ve been learning a little Dutch here and there – not so hard when we have so many people on our team who are from Holland.  Plus, I know that my mom’s side of the family will be thrilled that I’m learning at least a little bit.  Might give me a reason to go back and visit again.  😀  My vocab is pretty poor, but I can sometimes follow a conversation.  Pretty fun.


birthday pizza

Despite the fact that this birthday was not exactly as expected, it turned out to be an awesome day in which I felt overwhelmingly loved and cared for.  I have such an awesome team to work and live with, and my birthday did nothing but reinforce that.  Since I wasn’t quite sure when I was supposed to be at the apartment to hang out with Levi, I got up at 6:30am and got breakfast (tapalapa from the bitik behind the headquarters compound and chocolate spread with my coffee), did my devotion, and went to the apartment at 8.  Levi’s mom, Thamar wasn’t there, so I just sat and talked with Levi about what we would do that day until she got back.  When she did arrive, she brought one of our other Dutch team members bearing gifts and singing Happy Birthday.  Then Thamar pulled out presents that other team members had left for me to open on my birthday:  body wash, shower set, fudge, body butter.  Wow, I already felt spoiled and it was only 8 o’clock in the morning.  Then since I wasn’t actually needed until 9, I went back to my room and started reading a novel (sidenote:  The Zion Covenant Series by Thoene is pretty sweet – Totally got sucked in this week).  When it was time, I went and hung out with Levi for the day, only interrupted by breaktime/ second breakfast,  and lunch (super yummy Gambian meal with birthday cake – was sung to again).  At 4 in the afternoon, I was released of my duties with Levi so I got on the internet and got to chat with people back home for a while.  During the day, my friend Mez came down from Sibanor during the day and the plan was to go out for pizza to celebrate.  At the appointed time, we walked out to the parking lot where I was greeted with a crowd of almost the entire team that was down in Kombo singing Happy Birthday (yet again) to accompany us to pizza.  I had a tricolore pizza (spinach, onion, and sweet pepper!) and proceeded to get presents from 3 other people (candles, and chocolate).  At the end, someone told our waiter that it was my birthday so they sang Happy Birthday twice (don’t ask me why) and the DJ played a birthday medley for the rest of the time that we were there.  Throughout the day, I handed out birthday treats to the workers at headquarters and to the staff at the restaurant.  I really had a good day, and am very grateful that I have such awesome friends here.  Also received a package yesterday so that was a good continuation of my birthday.

God’s plan is better than mine

On Wednesday, I received an email that my mom was in the hospital with chest pain.  That was about the scariest thing that could happen while I am away from home.  It turned out to be all right – only minor blockage of small arteries – nothing that a month on warfarin wouldn’t fix (btw, I did experiments in Pharmacology with warfarin so I know it works well).  Whew.  She is now out of the hospital and doing well.  I really discovered how well the crisis management team works here though.  They made sure to check on me to make sure I was okay and to get updates.  They were ready to send me back home at a moment’s notice if necessary!  I was blessed to be here when I received the news though because I would not have been able to get updates as easily.  God really knew what he was doing when he sent me here for the week.

I am super excited because this weekend, I will be camping on the beach with other short-termers from my village (James, Mez, and Simeon).  James is bringing the tents, I’m bringing the junk food (since I’m nearest the grocery stores), and so we should have a blast this weekend.  Don’t be too jealous!  I will be able to be on the internet again November 3 to 5 or 6, and then again the week of November 15.  Hope to catch some of you all then!  Have a blessed rest of October!  Miss you all.  Keep in touch!

Semper Gumby, music, and bugs

Got the pics.  Enjoy!

Semper Gumby

I’ve already said that I’ve been learning to deal with change better while I’ve been here.  This weekend has been the epitome of that theme.  Less than 36 hours ago, I was planning on having a busy birthday – the clinic has been getting busier and busier with the rainy season coming to a close, plus there is a station meeting that day.  I didn’t anticipate a whole lot of time for relaxing and enjoying the day, but that was okay with me.  As long as I got to spend it with people I enjoy, I didn’t mind having the majority of my day taken up with work-related activities.

Then my plans got tossed to the side during work yesterday.  My station leader came and told me that for this week, they need me to go to headquarters with one of the families at our station to home school their youngest child, Levi for the week while his mom takes a course, and his father works in Sibanor.  A couple of the nurses in Sibanor were willing to take over my responsibilities and my room and board are paid for this week.  I’ve never tried to home school anyone (much less a boy with Dutch as a first language).  I get along with him well, but I’m just not sure exactly how this week will look.  It also means that I get to Skype with my family on my birthday and get to catch up with people from home while I am here.  🙂  On top of that, our visitor in Blue House will be coming down to hang out for my birthday evening!  On top of that,  I wouldn’t have been able to have proper internet until November had this not come up, and I know that my family would REALLY like to chat with my on my birthday.   So even though my plans got turned on their head, God knew exactly what I needed and I’m so thankful that He is in control and not me.  I’ll try to update at the end of the week to let y’all know how it all goes.

At the end of the week, I’ll be going camping on the beach with other Trekkers from my village for my weekend off, so I’m super stoked about that.  I plan on updating again at the beginning of November before I go “up-country” to visit my friend Cheryl and the rest of the Chamen team for a week.  I’m excited to visit and get the “real Gambian experience.”


I knew that it was a good idea to keep playing my flute and I also knew that it has always been a good stress reliever so I decided to include it in my packing list.  I’ve been using it some but not as much as I thought.  Since it is so hot, when I practice, I have to stop playing every couple minutes because my lower lip has gotten so sweaty that my flute starts slipping off to wipe the sweat off my chin and mouthpiece.  Makes the whole experience less pleasant for playing.  😛

Even so, at the beginning of very month, the entire country team has a day for prayer and meetings together.  At these we also have worship and I’ve been playing my flute and singing for every one I’ve been in the country for.  It’s fun to help get this put together for the rest of the team.  Music has always been a big part of who I am so it’s cool that I can use my gifts here as well.

In general, people here like Bob Marley-esque reggae or something rhythm-based.  Other than the Jola dancing group, I haven’t gotten to experience a whole lot of music.  I intend to try to get more exposure to different music here.

When I came to Gambia, I brought my mp3, but it was always a little finicky.  It has proven to be more of a hassle than what it was worth though.  It has worked up until this week.  It all of a sudden decided to delete all but five random songs off of it.  Grrr.  Now I can only listen to the songs that I’ve found CDs of in Blue House (mostly classical – not so bad but I need a bit more variety most days).  So as I type (since I have internet), I’m appreciating MySpace music since I’m deprived most of the time of much of music from home.


dancing at a football game. Gambian version of cheerleaders but WAY better:)

Though the people tend to be pretty shy to begin with, they really love to dance.  Dance is part of celebrations from naming ceremonies (8 days after the birth of a baby) to weddings to any other big celebration (eg. after Ramadan).  It doesn’t happen at every celebration, but the people here look forward to dancing.  You always know it’s a good worship time when there is traditional dancing in the aisles.  🙂  Love it!  It’s so cool to see them really get into the worship of our God.

A while ago, I had the opportunity to see a group of Jola drummers who normally lead the dancing at such festivals (see the pic in the previous post).  I saw it in an open place where there weren’t spiritual undertones, so it was perfectly okay.  The drummers kept up a basic rhythm and sometimes lead some singing and the women in the circle would take turns dancing in the center, dance-off style.  When someone would start dancing, the people in the circle holding clappers (thick reeds cut in half and banged together to help create the rhythm) start to bang them in a faster, more intense manner to help encourage the dancer.  It was pretty awesome to watch.

Insect adventures

came in the kitchen to find these three jumping spiders hanging out. note the size of the middle one compared to the screw!
bag of flour. note the little patterns all through it. weevil tracks. have to sift every bit of flour you use.
the hundreds of bugs killed during get fit (so they wouldn't stick to our sweaty bodies as they flew by)
the centipede-looking insect

I came to Africa expecting all the big bugs.  Rainy season has not failed to produce a wide variety of bugs in a variety of shapes, sizes, and abilities to annoy me.  Here ensues a description of some of the most common perps.  Beware to the faint of heart.

The bites you really have to watch out for are from the medium sized black ants.  When they sting you, there is no mistaking it.  One day a black ant decided to bite me in 7 spots in an area the size of a silver dollar on my leg.  These bites don’t really itch, they HURT like crazy though with a stabbing pain that can last from 10 to 60 minutes.  Not fun.

Ants in general are a constant problem.  Even after a rain, within hours, the ground outside is covered with little anthills.  Needless to say, we have to be really careful, especially in the kitchen, not to leave food out and to wipe up spills ASAP so that the ants don’t come and find them.  We have to even be careful that we clean up the bugs that we kill because the ants will come to tear apart the remains of the other bugs to take back to their hill.  Whew.  I’ve gone on a couple cleaning rampages in the kitchen in the morning because I hate having them run over my feet while I’m making breakfast in the early morning light, but it’s actually quite a fruitless exercise because they are hiding in the cupboards and the floor as well.  It sometimes makes me feel better though.

There are plenty of mosquitoes, but I don’t get bitten as often as you might think.  It just depends on the week.  There have been weeks when I’ve only gotten one or two bites, and there have been weeks where I have gotten a few dozen.  It seems that the shampoo I use makes a difference too.  I got some lemon-scented shampoo when I got here and used it as body wash as well, and I hardly had any problems.  I switched to a different one, and I’ve been getting bitten more.  I can at least use the lemon stuff for body wash in the afternoons so maybe I won’t smell quite as good to the bugs.  🙂

We also have trouble with cockroaches.  Not so many big ones, but lots of small ones.  They like to hide in the back of the silverware and dishtowel drawer, so we have to periodically set the drawers out in the sun and have to wash the dishes before we put them in and after we take them out of the drawers.

Those who know me well know that the one insect that I cannot stand and those are centipedes.  There are plenty of centipede-esque insects running around.  The ones I see most often are red and black striped.  I think I have officially conquered my fear of them though 🙂  I haven’t even tried to kill one of these (though I was quite afraid that they were poisonous when I first saw them).

It seems like there are waves of certain kinds of insects as well.  For a couple days, we had a terrible time with some moths that liked to find holes in our screens and come to swarm around the kitchen light during dinner-time.  Then last month, at keep-fit, there was a HUGE swarm of flying black ants that were attacking the light and the TV.  We had to turn off the light and then we could hardly see the TV with all the bugs in front of it and the ones that would fly by us would stick because we were hot and sweaty (it was impossible to go two seconds without one sticking), so Debbie sprayed them with insecticide so that we could finish our exercise in peace (though I gagged on the spray and almost lost my lunch).

Thank you all for your prayer support.  I am SO grateful for you all.  It really makes me thankful for all of you who are faithful friends even when I’m so far from you.

Change is the only constant

our feet after tromping through a rice field to get to the river to swim 🙂
Jola drumming group I got to see. Very fun to watch. The women love to dance!

Change is the only constant

The past few weeks have been full of some big changes in our team.  First of all, one of our team members went on furlough.  On the same day, all but one of the team children (out of 9) were brought to Senegal to go to school there.  The loss of all these people has taken a small toll on the entire team.  Every one of them is missed dearly (especially the families).

We have also had some additions to our team.  One is a Dutch midwife who is living in the Blue House with Rosemary and me.  She is about my age, so we have already enjoyed getting to know each other a bit.  We also have the return of one of our nurses from a trip home for a wedding, and the arrival of a friend of his that will also be staying in the Blue House for the month that she is in the country.  That means that the house will be full for a while.  🙂  Fun time.  It should be fun to have a full house again.  The most exciting addition to the team has been the adoption of a set of Gambian twin girls by our station leaders.  They are almost six months old and are wonderful babies – not too fussy and already sleep through the night.  They are super cute and have made life a little more interesting for their parents and for the team.  Their names are Elaynia and Jarinia (with a German j sound) though I probably mutilated the spellings.

Change in me

Since I’ve arrived, I also feel like I have changed a lot as well.  I’m already starting to get nervous to go back home to see how you all will react to the changes you see in me.  I feel as if I have grown out of my bubble and become more willing to try new things and experience an adventure.  I’ve always been known to be pretty introverted, but now I ask questions and speak my mind more readily.  Dr. Jamie has even remarked that he thinks I’m a good mix of extrovert and introvert – both extremes cause more work for the team by either not asking for more work or talking too much and not getting things done.


Before I left for orientation, one of my assignments was to fill out a form with my expectations for my experience here.  This was probably the most helpful activity to prepare me for what was to come.  I didn’t know a whole lot about what I was getting into and this was a little scary.  The activity made me think about what I did and didn’t think would happen and how I would react in various situations.  It also made me realize that I couldn’t really expect anything.  God may use this experience in a way that I never would have expected.  I realized that I needed to be flexible so that I can make the most of the time here.  Even when I was at training, one of the main points was that on our treks, we needed to be “Semper Gumby” (always flexible).  This has also been a main point that I’ve learned while here.  I’ve had to be flexible with my schedule, duties, other people’s expectations of me, and everything in between.  Even settling into a real rhythm is impossible here:  Things are always changing.  It’s good stuff.

Other stuff

I won’t be able to get proper internet for about a month now because there are plans in the works for a camping trip to the beach on my weekend off (right before my bday) :D, so I won’t have internet access for a while :(.  If that changes, I will update y’all.  Then next weekend I plan on taking some holidays and travelling up-country to visit my friend, Cheryl and see what she is working on up there.  I will also be taking some time down at the coast so I hope to do another post and some catching up with people then.  Exact dates are TBA.  When I know, I will have my dad put it up on here so you all know.

I am starting to get to the point where I am not as sure what to write about anymore.  Let me know if you have ANY suggestions.  Hope you have a wonderful October!

Sir Emily

    Funny moments/ Firsts since I’ve been here

  1. I was called “Sir” for the first time in my life a couple weeks ago, and it wasn’t someone trying to be funny; he was actually trying to be respectful.  In Mandinka (not sure about all the other languages) there is no differentiation between he, she, and it.  Those pronouns are all the same word.  For this reason, men get called “her” and women get called “him” on a very frequent basis.  I usually hear this mistake several times every day.
  2. First time being away from home for so long (I passed the previous record a couple months ago)
  3. First time enjoying peanut butter since I was 5 (I remember the day that I decided I didn’t like it pretty vividly).
  4. First marriage proposal.  Actually, I’ve started to tally all the times that I get a marriage offer and I’m up to 11 so far since I arrived (or family members who say they have a husband for me).  No worries though, Mom and Dad, I haven’t accepted any of the offers.
  5. first time being called “mate” (by one of our Australian team members)
  6. first time being wished “Cheerio” without trying to be funny
line of people to get tickets and then I either weigh them or take their blood pressure inside the waiting hall
in the pharmacy; the pharmacists for our clinic
eating sour sop for the first time. looks funny but tastes much like an apple

Normal clinic day

Clinic starts with staff prayer at 7:40am in the OR (not used anymore obviously).  This means that I get up at about 6:30am to have a little breakfast with my malaria meds and do my devotions before I go to the clinic.  Then at 8, the clinic starts.  Usually I go with the doctors and nurses on the ward rounds (lasting about 10 to 40 minutes depending on how full the ward is – lately, it has been taking at least a half hour with the rainy season boom in patients). I usually learn a lot about treatment and culture norms.  The doctors and nurses have a wealth of knowledge (especially Dr. Jamie – he is a walking encyclopedia!).

After rounds are done, I go to the waiting hall to help the waiting hall nurse get started with the day.  We weigh screaming children and adults and take the blood pressures of all the adults.  About half of the children under the age of five scream bloody murder when they have to stand on the scale, hang in the hanging scale, and/or be near my strange toubob skin.  The ones who have to stand on the scale are the worst though because they will do everything in their power to not stand on the scale:  arch their back, move their feet away, or run (if they can escape the grasp of their mother).  I think it’s hilarious though because I’m not going to do anything to them.  All they have to do is stand on the scale for two seconds and let me look at the reading and then they are done.  I don’t even have to give them an injection or even touch them.  As a result, I’ve learned the phrase “kana silaa” (don’t be scared), though it doesn’t do much to calm down hysterical children.

At 10 or 10:30, all the staff go for second breakfast break.  We get tapalapa with the toppings and coffee or tea, and every once in a while, a bit of good fruit (like the sour sop in the picture).  It is a good break from the craziness of the clinic and gives a good opportunity to ask questions or learn more about my team members.  After break, I usually go to the pharmacy to break/wrap tablets or do work on the HIV database (see below for a description of how that project is going), or observe the doctors or nurses treating the patients.  Regardless of what I do, I always learn a lot.  Wrapping tablets is usually the most boring job, but it is really necessary.  To wrap the tablets I have to cut up scrap paper (usually from an old book) and fold the paper around the tablets and then label it.  As I’m wrapping I always read a little of what is on the pieces of paper and I always wonder if people who ultimately get them actually read the pieces of paper that their tablets are wrapped in.  The most recent book I’ve been using is an old history dictionary, and I’ve also used a book on treatment of sexually transmitted diseases.  Sometimes I hope they do, because it is good info, but most of the time, I’m not so sure I want them reading it (either because I’m embarrassed of the info or they might take the info out of context).

In the afternoons, I usually do a bit of reading or studying or other small things that need to get done in my room.  It is too hot to do anything else, so I try to use that time well.  Then around 4 or 5 when it is just starting to get a little less hot, I go out and visit people.  I have several compounds that I try to visit at least once or twice a week, and two days a week, I have language study for an hour.  I never know what I will do once I’m in a compound though.  Sometimes I have just sat and listened to conversations in Mandinka or Balantes and try to pick up a few words or phrases, and sometimes, I end up helping with shelling beans or cooking or keeping children occupied so that their mother can get stuff done.  They are always honored to have people come visit though, so this is the most important part of my day or week.

On Mondays, we usually have a meeting with all of the team members in Sibanor and on Thursday we have fellowship time.  Fellowship time is a couple hours set aside to pray together as a team or learn about each other’s home cultures.  I always enjoy this time to get to know my team members even better.

office where I work on the database for the care project.  Mami and Mama (foreground) work in the same office


As most of you know, one of the things I was expected to do while I’m here is to create a database for the HIV care team here in Sibanor.  It is mostly to make doing end of the month statistics easier, but initially they were hoping that it would be able to keep patient histories as well.  For that reason, when I started my project, it was more than a little daunting.  Since then, it has become more defined and a little less ridiculous guidelines.  I wasn’t sure what I would have to work with when I got here, so I brought my computer equipped with programs that I thought would be helpful, but it turned out that Dr. Jamie had a much more user-friendly program from the CDC that I could use.  As a result, I have been able to get the database up and running.  I just have to work out the bugs and make it more streamlined and teach the rest of the staff on the team how to use it.

Flying chickens and more adventures with animals

one of the crazy roosters running around the compound
Guinea fowl - crazy birds sound like a squeaky wheel

I didn’t think that I would ever see the day where I saw a chicken flying, but I have witnesses to attest to what we saw.  I first noticed something larger than a normal bird in a tree.  Then after some rustling, it flew down from the perch it had in the tree.  Not only that, I saw another chicken fly UP to the same branch that the other one had been on.  Wow!  That’s some major evolutionary progress.

Chickens are normally not kept in a pen here.  They roam freely around wherever they please.  I still have no idea how on earth the people here know which chickens are their own.  It’s pretty funny though because these roaming chickens come wandering in the clinic all the time.  I’ve had to chase chickens out of the ward and out of the waiting hall (while there were 50 people sitting in it – they have no fear).  The funniest chicken is a hen that has a brood of guinea fowl that are “her chicks.”  Guinea fowl are funny looking and sounding enough but this little family makes me laugh every time.

not in Kansas anymore

    Things to get used to/ vocab:

    home, aka. Blue House. Note the goats chilling on the veranda!
    the bathroom. don't be fooled by the shower head. I have to use that little green bucket to shower. yay for fun adventures.
    our lovely little kitchen
  1. Bucket shower:  when a shower head is not available, a bucket shower is a good option.  To accomplish this, one fills a large bucket with water, then using a cup, rinses, washes, shaves.  Even though in Blue House, we have running water, we have to take bucket showers because our shower head doesn’t work.  On top of this, although we have solar power, an animal in our ceiling ruined the wiring for the light in the bathroom, so we also take our showers by candlelight (or flashlight, if you so desire)
  2. Ironing:  although you may think you know why one irons clothes, you are only partly correct.  Here, after clothes are washed, they are ALL ironed.  This is not an OCD characteristic, it is out of necessity.  There is a bug (mango fly if I remember correctly) that lays its eggs in clothes while they are on the line.  If one doesn’t iron the clothes, the developing mango fly will worm its way into one’s skin and back out whenever it pleases.  I won’t ever complain about having to iron a couple articles of clothing back home again.
  3. Here in Sibanor, because we only have solar with a smallish battery, our fridges and stoves are kerosene or gas respectively.  I didn’t know before that you could have a refrigerator run by kerosene, so this was pretty intriguing when I arrived.  Getting used to cooking with gas has been fun though.  I’ve gotten very good at lighting matches (even in this humidity).  Cooking with our stove is complicated though because it has no real low setting- so you have to watch your food very closely to make sure it doesn’t burn!
  4. Solar power:  Having solar power with our smallish battery means that we have to be careful, especially during rainy season (b/c not so much sun) with using too much electricity otherwise the battery can die while you still need it (one of the Blue House girls that went home had the electricity go out when she was in the bathroom and had to find her way back to her room with the lights out)
    • Note that the power lines are going up around the country so Sibanor will have power soon and the clinic won’t have to rely on solar power so much (antenatal clinics on a cloudy day don’t work so well because the ultrasound machine takes a lot of power)!  Everyone in Sibanor is very excited for this progress!
the electricity is coming!!!

Learning Mandinka

Here in Gambia, there are four major people groups:  Mandinka, Wolof, Fula, and Jola; Mandinka and Jola being the most common people groups in Sibanor.   Mandinka is spoken by about 70% of the people and it is used as the main market language.  In Sibanor, as you leave the main road, you run into a lot of Jola villages (Sitta, Kiemo, Gifunga – the closest villages that we have anything to do with on a regular basis- I will probably refer to these in other updates).  Anyways, since I’m only here for short-term, Mandinka is more useful for me to learn while I’m here.   Learning the language is incredibly important for people trying to work in another culture in order to show that you are not too proud to learn another language, and makes communicating a lot easier in more rural areas where most people do not speak English fluently.  Although

In the last couple months, I’ve come to understand that I’m not so good at learning languages as I thought.  We learned some phrases in Korean as practice back in the US that I failed to really learn.  Here, I’ve been completely overwhelmed at how much I would have to learn to become fluent.  I am now completely comfortable with the greetings (don’t scoff, they are quite long and involved compared to our greetings back home).  I’ve learned a few commands and a few objects, but that’s about where my skills fail.  I can catch a few words, but I have still failed all the tests that my language helper has thrown at me.  Arg.  I think if I was more focused and practiced more outside of my lessons that I would do much better, but I don’t feel motivated enough.  I’m learning domanding domanding (Md. slow slow) even though I want to understand saaying saaying (Md. now now).

Since it is Ramadan now (see the section later), my Mandinka teacher needs to cook the evening meal which is a lot of work, so my lessons have been suspended until the end of the fasting month.  Hopefully I’ll be able to learn some from other people.  My American friend, Jessi is good at Mandinka and knows a lady, Kaddy, who was really helpful for her, so I will be able to practice my Mandinka with Jessi and Kaddy.  This makes me excited.

“change, even change for the better is always accompanied by drawbacks and discomfort”

I’m really having to rely on God the last few weeks to maintain the strength to go and get to know the people here more and learn the language.  It’s really easy to stay in the “safety” of Blue House and make excuses about the weather or things that I need to do.  I find that I’m always better off when I venture out and greet people in their compounds and work on my Mandinka learning, but it is hard work.  I always feel a little overwhelmed, but know that my effort was worthwhile.  Keep praying for the courage to go out and sometimes get laughed at, but learn from the experiences.

I’ve been considering trying to live outside of the clinic compound with a Gambian family in another compound.  There is no difference in the safety level, but it would give me more opportunity to get to know the people and the language better.  I feel like I live in a bit of a bubble because I live in the same compound that I work in.  It was nice to get used to living in this environment, but I didn’t come to live in a bubble apart from the people.  Contact with people in the clinic isn’t enough – they don’t want to be there, and it is only a short contact.  There are other team members who have or are living in the village, so it is for sure doable and the rest of my team is supportive, but I just need to find a place that has a space that I can live in.  If nothing else, I will try it for a week and see how it goes, and we’ll see where I go from there.  Please be in prayer that I will find a space that not only has the space and is willing to house me, but also speaks Mandinka so that I can get more practice.

Ramadan (take a pic of a mosque – Sib or Pipeline)

For those of you who are not familiar with the Muslim practice, we are in the middle of Ramadan.   Ramadan is the fasting month in Islamic tradition and since 90% of the Gambian population is Muslim, this month is a big deal here.  All Muslims fast from sunup to sundown from food AND water (I’m REALLY impressed considering the climate here).  People who are sick, children, and pregnant or nursing mothers are exempted from this practice if they feel that they cannot do it.  This makes treating people in the clinic a little tricky.  Many times the common practice would be to give the patients the medicine they need when they come, but in order to keep their fast, they have to wait until sundown to take the meds.  For those who take regular meds who want to continue to fast, we have to figure out how they can take their meds only in the morning and at night.  Managing diabetes during Ramadan is ridiculously hard.  Dr. Jamie gave a seminar previous to Ramadan on the topic; what the patients should try to eat in the morning and the evening and how to take their medicine to try to keep their blood sugar in a decent range.  Extremely complicated, but I’m always amazed at their endurance during this month.

As I’ve learned from fasting back home, I can get pretty crabby when I’m hungry.  The same is true here.  We have to be careful not to do anything to frustrate those who are fasting.   It’s also important not to emphasize that we as Christians are not fasting so that we don’t make it harder for them to keep their fast.  Since almost all of our Gambian staff at the clinic are Muslim, we try not to remind them when we take breaks for second breakfast or lunch.  We are trying to be as respectful as possible of them all.

Life in the shoes of Niyma Manjang

I hope you all are enjoying the summer and are enjoying these updates.  Your prayers are all appreciated.  Let me know if there is something else you want to hear about.  I’m trying to give y’all a good glimpse into my life here, but I need help to know if that is what you would like to hear.  Feel free to send me an email or snail mail.  I enjoy hearing from you all.

Gambian name

My Chaco tan so far

Since I’ve been here, I’ve found out that my name is hard to pronounce.  Especially older Gambians are confused when I say my name is Emily.  They also do not have the ‘th’-sound in their language so my last name gets butchered.  It is pretty normal for toubobs to take on a Gambian name so that the people can pronounce and remember them.  It’s also a way to honor the Gambians to take on a name and shows that we live here.  The thing is that you are named rather than actually picking your own name.  My first week in Sibanor, I finally got my first name, and then a week later, since the surname is the most important part of a name, I received my surname.  My first name is Niyma (pronounced like Nemo, but with an -a at the end instead of -o) which was given by Jessie, the girl in the Peace Corps.  I took the surname of Manjang from the Gambian surname of Robyn (the Australian nurse practitioner).

Running and “Get Fit” Sessions

The Road to Sitta

I’m sure there are several people who have been wondering if I’ve been able to run here in Gambia.  I have gone running a couple times; the first only a couple miles to get used to running in the climate, and then I ran almost six miles with James last week (he has much longer legs than I do, so we ran at a pretty good clip).  Running here is more complicated because I have to first of all comply with the modesty standards.  Because most of the country is Muslim, women are supposed to keep covered well.  This means that my knees and above are not to be seen, so I have to wear longer pants than are comfortable in the hot climate.  There are few hills (at least compared with home) so it is not too strenuous, but it is hot enough to make me sweat much more than normal.  Also, an important element of the culture is to greet everyone you meet if you are out walking or whatever.  This also means that I need to greet while I’m running.  Needless to say, my greetings tend to be pretty breathless.   Anyways, despite the difficulties, I might be more prepared to train for a marathon when I get home.  😀

The last few weeks, all the women at our station have been getting together for get-fit sessions.  We’ve done some calisthenics and a exercised along with a dance video.  The videos are from England and are a little old, so half of the workout is laughing at the outdated or very posh English phrases they use.


Gate to the Clinic

One of my days in the clinic, no one had anything specific for me to do, so I was sitting in one of the treating rooms just observing the people that came in.  I was only there for maybe 15 minutes before a woman arrived in labor, so the nurses sent me to watch.  The woman was a grand multiparous (a woman having borne more than four children) who was already 8 cm when she arrived.  She delivered about 40 minutes after arriving.  I was very impressed with the level of calm that she displayed throughout her labor.  Here in Sibanor (not sure about the bigger hospitals near the coast), there is no such thing as getting an epidural or really any pain medication.  Here, when someone is in pain, instead of saying “ow” they say “way” and this woman basically just said “way, way, way” and snapped her fingers to deal with the pain. Wow!  These people really have an amazing ability to deal with pain effectively.  Anyways, the midwife had me do some of the charting and had me listen for the fetal heartbeat (with a fetoscope – basically a little metal cone), and take her blood pressure.  Then within an hour of delivery, since the baby was nursing well, they went home.

I’ve also been amazed to find that they rarely do Cesarean sections here.  If one needs to be done, it has to be done at one of the bigger hospitals near the coast.  They deliver twins, some breech babies, and have even delivered at least two sets of triplets vaginally in our rural clinics!   I have been blown away by the things that back home I considered necessary to having a successful labor and delivery.  Hmm.  This is exactly why I am here.  I want to know exactly what is necessary and what is not when it comes to treating patients.  While working at the hospital in Sioux Falls, I had grown to only be comfortable with “advanced technology,” so this experience will bring me outside of my bubble and help me to understand the world of medicine a little better.

Right now, maternity is pretty slow because staff have been taking their holidays so weekend nights aren’t able to be covered.  In a week, we will be fully staffed again, so I might be able to do more with maternity on a regular basis.  I can choose which areas of the clinic I can concentrate on, so I might be able to follow the midwives enough to eventually deliver a baby myself (with the midwife there as backup of course).

Farming with Nehneh

Planting rice (me, Nehneh with Rutti on her back)
James trying his hand at plowing
Field in the compound behind Blue House

During rainy season, everything turns green.  When I arrived, there were little sprouts everywhere, but otherwise almost everything looked reddish-brown with the dirt.  The people start farming since this is the only time that the crops will grow.  Many people farm near the river, but not for the water in the river (because it is salty), but because all the water from the surrounding areas flows down to the river, so the crops closer to the river can soak up all the water that flows down from upland.  The people from Sibanor farm just outside the village (or in a plot within their compound if they have enough room for it).  About a month ago now, Daniella had made plans to help her English student, Nehneh plant rice.  Right before she left, she invited me to tag along.  At first, there wasn’t an extra hoe for me to use, so I entertained her daughter Rutti until she fell asleep.  Then, another hoe was found, so I got to help plant the rice.  It was hard work and I got some good blisters, but I’m really glad I got to have this experience.

A couple weeks ago, I went with James to Sitta to help farm again, but it turned out that they had it all under control.  The men were using oxen pulling a plow, so there was nothing for us to do.  James tried it out for a row (see picture), but wasn’t as good as the guys from Sitta apparently. 😛

One other time, I got to pound baobab fruit with Daniela.  Baobab fruit is kind of powdery surrounding seeds, so you have to pound it to get the powder off the seeds.  The resulting yellow-orange powder is used to make really yummy juice-reminds me of peach juice but much more sour.

The dirt is red with iron, so during the dry season, the trees near the road look red from all the dust and during the rainy season, the water turns red (comparable to tomato soup)

Learning to Live

sunset over Sibanor
the beach! lovely way to relax on weekends off

Internet Issues

I have to apologize because I have not been able to update as much as I would like.  Although I thought I would have dial-up internet in Sibanor, it has not worked yet for me for whatever reason.  I last checked my email since the 9th of July, so I’m sure I have ones that have been unanswered for that long, and I want to apologize for not answering them quickly.  The internet problems also mean that I will probably only be able to check my email every couple weeks when I make it down to headquarters until further notice, so please understand that this will be the norm for a while until we figure out how to get it to work here in Sibanor.

If you have a topic about life here that you’re dying to hear about, feel free to request!  🙂  I’m trying to make sure that the info I post is relevant and not too long or boring.  I have a ton of info in a document with several suggested topics that I’ve already written about, but just need to post at some time (not all at once – you would get bored).

I also love to hear about how you are doing.  I love getting emails and especially snail mail.  It makes my day.  Thank you for those who have already sent me letters!


Although there may have been worries that I might lose weight while I am abroad, with the awesome food I’ve been getting here, I don’t think that will be a problem at all.  Right now, it is mango season, so we are enjoying them for breakfast or dessert or for a snack.  I did not know before now that there are lots of kinds of mangos like there are lots of different types of apples.  There are some that are more like candy and there are some that are a lot more citrusy.  Yum!  The other fruits and veggies I’ve had are awesome too.  I had jackfruit for the first time yesterday (they are HUGE – I’ll try to take a picture of one before I leave since my camera wasn’t working when I had it).  I’ve come to actually enjoy cucumbers and tomatoes and peanuts.  This trip has forced me to be flexible and I’ve found that I’m not as picky as I thought I was.  There are very few things that I have found that I did not enjoy.

The one thing that I haven’t liked is cola nuts.  They are a very cultural food that they serve at weddings and naming ceremonies (I had one at a wedding).  They are very bitter.  My language helper likened them to wine served at weddings in toubabadou (non-African world), though they don’t carry the intoxication power (I’ve heard of people trying to get high off of them – gag).

We get fresh bread called tapalapa every day.  I think I described it in a previous update.  One of the more unusual things that I’ve eaten and come to enjoy is tapalapa with a bean filling and a spicy sauce.  I will have to ask my language helper if I can get the recipe to take back home so you all can have a taste.  🙂

In general though, we have to make our own meals in the evenings and on weekends.  I’ve learned how to be creative to make tasty dishes with less complicated ingredients than I’m used to cooking with at home.  Rice and pasta are staples.  Potatoes are pretty normal.  Tapalapa pizzas are pretty easy and good.  Hot dogs, SPAM, and fish are more normal than any other kind of meat.  I never would have thought that I could ever say it, but I’ve come to actually enjoy SPAM (as much as one can).

The schedule of meals is a bit different to get used to.   We usually eat supper/ tea between 7 and 9pm.  I’m used to eating between 5 and 7 at home so that’s a little different.


the kids love playing in the rain!

Although this is an entirely different part of the world, there are definitely days that I feel like I’m at home with the weather that we have.  Although I said that all the rain is preceded by a massive wind, this is not always the case we’ve had several gentle rains.  Robyn said that for being the rainy season, we’ve had less major storms.  It’s nice here to not have to worry about tornadoes and such here.  Storms still look impressive, but compared with SD storms, they are pretty wimpy.  Only the quantity of precip they can drop is impressive (though I’ve heard that SD is trying to rival the rainy season here).  Yesterday on the drive to the coast, we stopped in the market in Brikama, and there was water everywhere.  See pictures for details.

me in the Brikama market after a major rain

Gelly gellys

The major form of transportation here is by gelly gelly (also known as public transport).  There are only a few expats that have vehicles, and short term workers are not allowed to drive here (this is fine with me).  This means that if we want to go anywhere further than a few miles away, we take public transportation.  Gelly gellys are usually vans that carry about 15 to 25 people around the country.  They are inexpensive, especially when compared with the price of riding in a car with an expat, but less comfortable and take about twice as long (because of all the stops they have to make).  Any luggage beyond what fits on your lap goes on the top of the gelly (this can end up being a tower on top of the car – I’ll try to get a picture at some point).  This includes goats and sheep as well!  My first trip on public, a lady near me had a chicken under her seat too.  It looks a little comical, but it is the norm here.

I found it interesting to learn that the gelly gellys  do not honk randomly.  They only honk if they have space in the gelly for more people to ride.  This means that if you are looking to get a gelly on a busy road, all you have to do is walk in the direction you want to go and if a taxi honks as it passes, you flag them down and tell them your destination (generic; not always the place you are really going) and they will take you.  I think I’ve finally gotten the hang of the system so that I can even come down to the coast on my own.

Thank you all for all your prayers.  I appreciate you all a ton.  Please be continuing to pray for team unity, especially as we have staff who are going home on furlough or for a few weeks which will leave a gap in the work.  Especially since it is rainy season, the workload is increasing, so this will pose a problem for the clinic.  I’ve really been adjusting well to living here, but continue to pray for opportunities and boldness to get to know the people and the culture better.

the clinic

I started working at the clinic last week on Monday.  The weeks are relatively consistent.  On Mondays, we have outpatient day when all the adult patients come for mild complaints.  On Tuesdays, all the antenatal (pregnant) patients come for checkups.  On Wednesdays, we have a children’s clinic.  Patients who are acutely ill can come on any day, but in general these are the clinic’s working days.  There are two maternity rooms and they usually have one birth a day (usually around 400 births per year), but I haven’t gotten to observe there yet.

So far, I’ve become proficient at taking blood pressures.  My third day, the few adult outpatients that came needed their blood pressures, so this was my first real experience with trying to do manual blood pressures.  I wasn’t very good at them though.  Last Friday, I practiced on Dr. Margaret since the clinic wasn’t so busy, and that was helpful for getting the technique down.  This Monday and Tuesday, I had to take hundreds of blood pressures and now I feel confident about doing them.  Whew!  I even got a blister on my ring finger from pumping up the cuff so many times and got sore ears from having the stethoscope in my ears for so long!

My first day I was on the ward, observing what the nurse does on duty and what the tasks are that are associated with that part of the clinic.  Mostly doing vitals, giving out drugs and prescribed food (milk, sardines, sugar, peanut butter – mostly for the AIDS or TB patients that have funding available to give them this food).  There are thirteen patient beds on the ward.  During the dry season, the ward is relatively empty.  When rainy season comes around (now) there are many patients that go in and out.  At the moment, the ward is completely full, but on my first day, there were only four patients on the ward.  Since my first day of orientation on the ward, I’ve been accompanying Dr. Jamie on rounds in the morning after prayer, so it has been a learning experience already.

The second day, I helped wrap drugs in the pharmacy.  The general stock of drugs is too large to keep all of them right by the dispensing counter, and only a few tablets are given out at one time.  The typical dose and course for the drug given out need to be wrapped in separate papers and labeled in order to hand out in a timely fashion.  For example, I was packaging iron tablets in sets of 6 and 12.  The pharmacist has arthritis and cannot wrap the tablets very quickly, so I was sent to package lots of drugs so that all the pharmacist had to do was hand them out.  The job is incredibly boring, but necessary for the smooth functioning of the clinic.

The third day, I helped in the waiting hall with weights and blood pressures.  Since it was children’s day, there weren’t as many blood pressures that needed to be taken, but lots of weights for all the children.  I find that Wednesdays are the busiest in the waiting hall because we have to call up several children up at the same time so that we can read the weights in a timely fashion.  This also creates a very hectic scene because we have three scales that the children can be weighed on depending on their size.  For this reason, I have to be paying attention on all sides of me to figure out which baby I am supposed to  be recording the weight for.  This makes for a very stressful morning.  The bright part of the  morning is that all the women who come with their children (as well as on Tuesday with the antenatal clinic) all come wearing their nicest outfit so it makes for a very colorful and festive-looking place.  I haven’t had an opportunity to take a picture yet, but I will post one soon so that you all can see how amazing it is.

Friday morning, there were few staff back at Sibanor (we had prayer day down at headquarters the day before, and many people stayed to finish up business or to just have the weekend off), so I was with Dr. Margaret seeing patients in the doctor’s room.  It wasn’t very busy; we only saw four patients, but they were all very interesting.  There are about three or four nurses who see all the patients and they refer patients to the doctor only if they don’t know what to do with them.  We drained two abscesses:  one behind the ear of a five-year-old girl, and one on an older woman.  Both patients were put under general anesthesia, so we had to watch them while they woke up as well to make sure that they didn’t try to get off the table before the anesthesia wore off.  Then we saw a boy with bilateral juvenile arthritis in his elbows.  This is too rare and complicated for our clinic, so he was sent down-country to the research center.  There was also a woman with undiagnosed diabetes with an enormously abscessed foot.  This one was too big to drain at our clinic, so Dr. Margaret sent her down-country as well to have it seen to.

This week Tuesday, blood pressures and weights were done early so I was placed in the lab to watch what they do on a daily basis.  I observed their phlebotomy station and learned how to do hemoglobin, HIV, pregnancy tests, and malaria smears (they used to have 40 patients in a ward at a time with malaria, but now see about two cases per year)

Today, I helped a little with the storeroom organizing.  We just received a shipment of medical supplies so they all needed to be accounted for and put in their proper places.  The clinic has to order supplies once a year and has to be thorough so that the supplies will last that amount of time.  It isn’t like at home where you can get a shipment of supplies from the company in a couple days; it takes months to be ordered and shipped here.  Wow!

Well, I think that’s probably enough of an update for now.  I hope you all are enjoying your summer.  Please continue to pray that I would be able to find my place here at the clinic and feel a part of the team.  There are a lot of transitions continuing to play out so we will need your prayers as we navigate those issues.

Random note:  For any of you who enjoy animals, the cows, sheep, dogs, goats chickens, lizards are wandering around all the time.  It is uncommon to see them tied up or fenced into an area so they wander freely in and out of the clinic compound (I have to chase chickens and goats out of the waiting hall a few times).  This also means that they are free to give birth on the compound.  Yesterday, I was walking back to my house and saw a goat giving birth to twin kids.  I couldn’t grab my camera fast enough, but got some pictures (and one video) of them in their first hour after birth.

the main part of the clinic (the treatment rooms). The pharmacy is to the left of the picture; the waiting hall is behind me; the ward is behind the treating rooms