A Real Update

Bonjour! I’m writing from the nursing instructor office back in Tsiko! I realized a couple days ago that I haven’t given many of you a very good picture of what is going on or what I’m doing or what life is like…. My bad. It’s the same with my family- I think I’ve told a story or explained something, but I actually only told one person.  I could start writing and just keep writing and never stop writing about everything that is going on, but I’ll try to make this so you can have a clear picture of my life but also read it in the 5-10 minutes before you have to go do your next thing.

So. Where in the world is Caroline SanDiego?

For most of the 8 months that I am here, I will be spending my time in Mango. Mango is a town of anywhere to 10,000-40,000 people in the northern part of Togo. (that number fluctuates because the size of house does not account for the number of people living in it… there are huts with 8-10 people, so it is difficult to count.) The Hospital of Hope or Hopital de l’Esperance is just outside of town. The hospital is in the front of a large compound. Behind the hospital are many buildings that include the guesthouse, missionary houses, the pool, maintenance, the missionary kid school, etc.

 I live a mile away from the hospital right on the edge of town. I live in a house called Maybury with 2 other nurses, and there should be another roomie arriving very soon. My house is very nice with a kitchen, a fully functioning bathroom, and my own bedroom. Last year, a doctor took pity on the nurses trying to sleep after a night shift in the 115 degree heat. He did a fundraiser and was able to install an air conditioning unit in one of the rooms. We call it the AC room (very original), and any short term nurse is welcome to use it. Apparently 90 degree days aren’t even considered hot, so I am truly grateful for that option. There is a guard in our yard 24/7, and I feel very safe even though I live in town.

Last Saturday, I headed back down to the southern hospital in Tsiko. I am teaching a weeklong course in oncology at the nursing school down here next week. This week, I am doing a lot of preparation and studying. In order to make the most efficient use of my time, the nursing school is not doing clinicals the week that I am teaching. This means that I will have 4 full days of class to teach everything I can about oncology. While there are breaks during the day, they are still 8-9 hour days. Also, everything I say will be translated into French. While I am comprehending more and more French, I have a very hard time forming real sentences. Also, I’ve never taught a course like this before.  Yay for breaking out of comfort zones!

When I head back up to Mango, I will be working two 12 hour shifts per week. I will also be doing at least 2 days of clinical shifts in the hospital with the nursing students. They are in their final year of school.  I have the privilege of working with these students very closely as they continue to learn nursing skills, critical thinking, and take care of a full patient load. Towards the end of October, I will be teaching the same oncology course up in Mango to the students up there. I’ve been told that once I finish, there is a large list of projects that have been put off for a while. Hopefully, I’ll have the opportunity to tackle some of those.

Working in the hospital is so very different from the States. Because labs and tests are expensive, we rely a lot more on physical assessments. There is only an ultrasound and xray machine. No CT or MRI.  I get assigned a ward or two or three and take whatever patients are in there. One day, I started the day with no patients! An average is 5-7, but I’ve had up to 9. There are a lot of pediatric patients, so even the adult wards will have children in them. My first day on my own, I had two women who had delivered babies that day as well as their newborns! I was looking up newborn and maternal assessments during my lunch break because I have never taken care of that population before. One huge difference is that the patient’s families do so much of the work for the patient. They are responsible for feeding them, cleaning them, and taking them to the bathroom. I couldn’t imagine it being like this back home… it would change nursing drastically!

The Togolese nurses we work with are wonderful and so smart and helpful. One thing that surprised me is that many of our patients speak absolutely no French. There are many tribal languages, and I think that all of them are spoken by someone on the staff. There have been times where I greet a patient in French and they respond appropriately. I assume they actually speak French. Then, I try to use broken French and gestures to communicate something, and I get the idea that they are not comprehending anything I say. After a while, I discovered that they don’t really speak French either, and gestures are not a universal thing. This makes communicating and teaching very tricky.

The patients we see often come in very sick. They wait too long or it takes too long to get to the hospital. This means that something simple becomes something complicated or impossible to treat. I arrived in the middle of malaria season. It is a devastating disease, and I have seen far too many children die. Anemia is a complication of malaria… I worked oncology back home, so I thought I had seen a lot of anemia. I have seen hemoglobins of 3 multiple times here. Hematocrits of 6. I didn’t even know your body could function with it that low…

I bought a moto! It’s basically a glorified mo-ped, but it’s purple and pretty  and I love it. It took me a bit to figure out the whole shifting gears thing, but I got it now J. I also can get around on my bike. It’s not a mountain bike by any means…it’s the kind you’d ride around Mackinac Island with a basket and a bell, but it does its’ job.

Before I came, I thought I would lose a lot of weight because of the limited food options…. That is not true. Whenever I don’t have food or don’t feel like cooking or packing a lunch, I have the option of eating in the guesthouse which provides delicious food. It’s food I’d get back at home with just slightly more limited options (no berries in Togo). It’s delicious. Also, there’s a wonderful woman that comes to my house once a week and cooks different dishes for me and my roommates. She makes some mean chicken pot pie. I’ve started getting braver in the kitchen and actually used the oven last week! It doesn’t have numbers on it… you literally light the fire in the oven, stick something in there, and then you wait and hope it doesn’t burn… So far I haven’t burned anything! If you know me and my cooking history (cooking a pizza upside-down), that’s actually pretty impressive.

It’s hot. It’s ridiculously hot. I keep saying it’s hot, and the people who have been here a long time tell me it’s not even close to hot yet… I might sweat all of the salt out of my body.

I am getting more comfortable interacting with the Togolese. I can manage to get out the normal greetings and can understand more and more French. I am slowly making friends with some of the women who live close to me. Market is still a little overwhelming, but I am getting better.

There isn’t a movie theater, a mall, a gym, or much else nearby, but I am so impressed with what people come up with to do. Between sports on Sunday afternoons, Bible studies on Thursdays, waffle breakfast on Saturday mornings, movie nights, and many more activities, the social butterfly in me is quite satisfied.

I am making more friends. I am getting more and more comfortable. I helped deliver a baby. I am having great devotional times. I am learning and growing. I am still being stretched.

Thank you for all of your prayers. Thank you for asking about me. Thanks for making it to the end of this post.

Prayer requests:

1. Pray for my class next week. I want to do a good job for the students.

2. Pray for my relationships with the nursing students and the people in my ‘neighborhood’.

3. Pray for the many ministries in Mango and Tsiko. God is at work. And when God is at work, the devil finds ways to attack.

Praises: 

1. I felt a little sad when I left Mango to come down to Tsiko. I think that is a good sign that I am settling in! 

2. There are wonderful people here who have been so nice and encouraging. Making new friends is hard, but they are making it easier.

3. Internet and AC are conveniences they didn't always have here. Hallelujah for modern conveniences! 

4. So many more, but this post is too long already and you are probably skimming at this point cause you got to go to work or something.  

I love ya and miss ya. 

-C-