Fall

 Dear friends,

It's been a while since I've written. The main reason is that the last few months have looked like submitting doctorate assignments at midnight after working a 12-hour shift, printing nursing school exams mere minutes before it starts, squeezing hospital beds into new corners of the hospital, and researching the lifecycle of a malaria parasite for hours at a time (it's fascinating!). Since I haven't posted in 4 months, there's a lot to catch up on. 

Big theme:
I listened to a sermon recently wherein the pastor said something to the effect of "worry is atheism" (Pastor DeWitt, Bethel Church). Turns out, I'm prone to fits of atheism while I look at nursing staffing or the length of my to-do list. I forget the omnipotence of God while I'm failing to solve complex issues or feeling like I'm barely keeping my head above water. That whole "worry is atheism" thingamajig has been the needed reminder that neither my personal worries, the hospital worries, nor the problems of the world are out of God's control. 

Nursing school:
This fall I taught courses in the nursing school on the cardiac system, the hematology system, and IV insertion/medication administration. Prepping for the courses teaches me so much as I try to anticipate the dozens of questions my students will ask (my Togolese students are like toddlers asking college level questions..."why? but why? then how? why?". It's a good thing...mostly). The students have been working so hard, and our program is not at all easy. They're also fearless and willingly let another student put in multiple IVs I've come a long way from where I started as a teacher. I'm better at writing test questions and engaging and interacting with students. I've found that a lot of my best ideas appear while standing in front of my students. Despite all efforts, cultural differences still can cause conflicts and misunderstandings. I'm still learning. 

Drawing the anatomy and blood flow of the heart

First IV insertions

Hospital: 
Malaria season is just now starting to wane. Every year, the hospital has seen more patients as well as more patients with a higher acuity level. This malaria season, every department was stretched thin, and our staff is tired. Often, once a child was discharged from a bed, they were moved to the floor to make room for the next. There were days of heavy losses and disappointments. Our emergency room area was regularly overflowing, and so growing lines of stretchers lined our hallways as we tried to find more room. For months now, there have been some difficulties with obtaining enough blood. Malaria causes severe anemia (Hematocrits as low as 6 or 7%), and the blood shortage has been a challenge.  

Despite everything, God has provided. A lot of our long-term providers returned this fall and were able to staff the hospital. Some amazing short-term nurses have come and made staffing possible. We're hiring more personnel to relieve the burden on some of the departments. And even on the overwhelming and heavy days, God helped us make it through.  

Starting an exchange transfusion

Doctorate program:

School. Sigh. Who let me sign up for this? I'm getting there though. I'll start my doctorate project this summer and hopefully, potentially, possibly, prayerfully, maybely, return to the States in 2024 with my doctorate degree. 

Friends:

Can I just say that I have the best team? Sometimes it is really really hard to be away from family. I miss the good moments and the hard moments. But since I live across an ocean, I cannot be thankful enough for my community.  I have my Christmas stocking right next to my Togo familys' stockings, ukulele lessons with 4 (and counting!) teammates, standing meal invitations, prayer times, daily ping-pong matches, and incredible support. 

One recent highlight of my time with Togolese friends was my roommate's birthday party. We got together with our Togolese friends to eat a meal. And, as it often happens, somebody put on music, and we started dancing. Even my African grandmother with her old, arthritic knees danced and waddled and shimmied.  

Duck duck goose during a team outing

God sightings: 

Yesterday, I had a young patient who seized non-stop for over 3 hours despite every medication and intervention. She stopped breathing, so we gave rescue breaths for about an hour. When I thought the situation was nearly hopeless, the doctor ordered one more med as a last resort, and it worked. She stopped seizing and started breathing on her own. She is still very sick, but we hold on to those encouraging moments and thank God. 

The picture above is my little friend A who had severe congenital heart issues. My teammates worked fervently to get him to the States for corrective surgery, but when he arrived, they were not able to do the surgery. Sadly, he passed away while in the States. We might not yet understand what God is doing, but so many people were touched by this little guy's life. Pray for his parents who have heard the Good News so many times but don't yet know Jesus.

What's Coming: 

The nursing students will be taking a Bible course next week on the life of Jesus. They've taken multiple other Bible courses that have led up to this. They will be challenged to think about their beliefs, so please pray for their hearts next week. After that is their exam week, so please pray for them to be able to demonstrate all that they've learned. In January, I will be training a group of new nursing aides and more teammates will be coming and going. Life is full and fast-paced and never boring. A personal prayer request would be for perseverance and continued energy to try to accomplish all that is on my plate. Thank you so much for your continued prayers and support. Y'all are amazing.

In Him,

Caroline