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Friday, July 15, 2011

Final thoughts

It is almost midnight Friday night and all are packed (almost) and we are ready to make our return home tomorrow. It has been a wonderful trip and we have lots of stories to share with our families and friends. We miss you and will see you Sunday night!

Tuesday, July 12, 2011

Puff Adder

Tuesday, July 12

It was late when Doug, Andrea and Cindy arrived back at our rooms last night so we’ve just been able to catch up with them and the results of the last surgery. It appeared there was a power surge during Andrea’s procedure but, as it turns out, TANESCO’s power went off and the generator kicked in almost immediately. That is great news, to know that it will work as intended. But we found out the cautery machine doesn’t work correctly under generator power. Doug said it is almost as if the AC and DC are reversed. Andrea was able to finish, but the lack of cautery meant that the procedure took much longer than expected.

We had hoped to get started earlier today, but it was still about 9 am before the staff in the theatre took Rosemary, our first patient back. Rosemary is someone we met last year, also, so the team was glad that we were able to help her. The plan was to remove fibroid tumors, but once the surgery was underway, Andrea realized the problem was uterine cancer so she performed a hysterectomy. We are all praying that all cancer has been removed and that we will, again, see Rosemary’s smiling face next year.

There was a bit of drama after our lunch break yesterday. Walking back to resume our work stations, we saw a crowd of very excited Tanzanians gathered looking at something on the walkway. As we drew near to join the crowd, a snake slithered off into the corner. It had coloring similar to a rattlesnake with the addition of beautiful golden arrow shaped markings on the back and its head bore the distinctive arrow shape of a viper. One of the guards killed it with a push broom and, on closer look, we learned it was a puff adder—very deadly. We think it is not common here because all of the Tanzanians were taking pictures of it using their cell phones.

Cancer has reared its ugly head several times since the weekend. In addition to Rosemary, Andrea had a patient with cervical cancer and another one, Zainabu, with a very advanced case of breast cancer. And Doug was consulted by the Mazimbu doctors for a second opinion on one of their patients; he thinks it is probably colon cancer. We are working with Zainabu on some testing and treatment to lower her blood pressure. If we are able to bring it into an acceptable range, Andrea and Doug plan to do a simple mastectomy on Friday. Although her cancer is very advanced, the procedure will give her a better quality of life; the tumor is large enough that it is presenting externally, so this surgery is palliative.

The doctors worked later than any other night tonight, returning to the rooms after 11pm. The rest of the team had dinner with Barbara at The Morogoro Hotel and we ordered take-out meals for the surgical crew.

So far, seventeen surgeries have been performed and there are twelve more scheduled. We have almost 200 patients in clinic and have two more full days of work at Mazimbu. We ask for all of our families, churches and friends back home to remember the team and our patients in your prayers.

Special patients

Monday, July 11

It may seem like a small thing, but the addition of millet porridge to our normal breakfast was very welcome. The doctors had to finish quickly, catching a taxi to arrive at Mazimbu in time for the morning report. The rest of the team had time to linger over coffee as we waited for Barbara and her Land Cruiser for our ride. Barbara’s car is set up with a bench seat in front and middle and 2 vertical benches in the far back. That is Barbara plus two passengers in front, four in the middle and three on each bench in the back. So we can almost fit our whole team in Barbara’s car!

As we have come together as a team over the past few days, we have all become familiar with our system and we can set up and begin work very quickly. Our front waiting area was full when we arrived and we quickly began triage and reception.

We were delighted to have the tailor arrive at the hospital to work with us on our custom clothes. Gertrude, who is working with the team as a translator, jumped in to help with communication. She also has a flair for fashion and had lots of suggestions for style and fit. We can’t wait for our new clothes to be delivered Thursday!

Mary, Andrea’s first surgical patient of this trip, was well enough to be discharged today. Pati visited her room to wish her well and was surprised when Mary presented her with the gift of a shawl, which was given to express her gratitude for the blood donation. Mary rejoiced at her health, giving thanks to God for bringing the team to Africa.

And Joyce came back to see us this year! If you read the blog from 2010, you will see the story about Joyce. We removed a 25 lb ovarian cyst, which had been preventing her from any type of normal life; she was even unable to eat and was emaciated. Now, a year later, she is in great health and shows lovely roundness to her limbs as she is filling out. She praised Christ over and over and thanked us repeatedly. We were so happy to see her and to see tangible positive results from our work in Tanzania.

We have also been working with another patient from last year, Magari, whose high blood pressure prevented him from qualifying for the surgery he needs. Leslie has seen him three times so far, working with his medication to try to lower his pressure. He is a very patient man and he has really worked his way into the hearts of the team. And the medication is working! So he is scheduled for surgery tomorrow and we are all rejoicing with him.

Dani was touched today by our translator, Nova, as she witnessed his interaction with a mother and her two young sons. Evidently, the mother could not afford the small token payment required before being seen by our doctors so he reached into his pocket and gave her the money. It is good to know that our fellow Tanzanians join with us in wanting to serve and help those in need.

Sunday, July 10, 2011

Worship at Majengo

Sunday, July 10

Update on surgery last night—when the electricity went off, Doug was able to finish the procedure with the use of caving headlights. He was far enough into the procedure that he was done with the cautery machine, so was able to complete his work without the use of electricity. Lisa was circulating for him and, when the power went out, she came flying out of the theatre with a stricken look on her face, calling for the team to bring all available flashlights. The hospital staff wanted to continue as planned and bring the final patient into the theatre for his surgery, but the generator did not engage and Doug felt the risks outweighed the benefits so we have all agreed to get an earlier start Monday morning and squeeze an extra procedure into the schedule.

Now to today!! Today was an amazing day, beginning with another beautiful Tanzanian morning after a longer night’s rest. Breakfast was 30 minutes later than normal and had the addition of boiled eggs to our bread and tea.

Our Dala Dala arrived at 9:15 to take us to Majengo for worship, a parish close to Mazimbu. This is a congregation that has worked to build a church, using only their own resources. So they have not requested contributions from European or American organizations, which is unusual. When we arrived, all of the children of the parish were gathered in a large circle, holding hands. Barbara explained that we were observing the Sunday School class. We had very little time before we were asked to find a seat before the service was to begin.

A group of 4 men and 7 women sitting to the side of the altar was the choir, and the service began with music from the choir, accompanied by choreographed movements. This is acapella singing with varying harmony and rhythms and is so wonderful and inspirational for us to be a part of. This was followed by morning announcements and greeting of visitors. We were invited to stand and introduce ourselves and after the last team member was seated, the congregation responded with “three claps.” This is an East African way of special recognition where a group gives three loud claps in unison.

Barbara and Eliyuko (one of our translators from Mazimbu) were translating for us throughout the service, so we could use our bibles to follow the readings. So we were able to follow the sermon, also. The message today was on Grace and we heard again that Grace is a gift, not something to be earned, and it is available to everyone. The only requirement is that we must accept it. We were all moved by the message.

The team is blessed with many fine singing voices and we all love to sing. We wanted to give the gift of music to Majengo in appreciation of their welcome and acceptance. Our new friend, Tiffany, a Peace Corp volunteer from Austin, Texas joined us in our song. Our plan was to sing “Sing to the Lord” but, as a response to the message, we sang “Amazing Grace.” During our song, the congregation rose to make the first offering. In Tanzania, there is always more than one offering and a plate is not passed—each person gets up and processes to the front and drops their offering into a basket in the front of the church. After we took our seats, the choir took our place at the front of the church and another offering was taken while they sang another song.

In Tanzania, if you do not have the money to give an offering, you can bring goods that will be auctioned off after the service. We saw an unusual offering today of a live rooster. The parishioners had tied the rooster’s legs together and brought it in a blue plastic “Walmart” bag. Throughout the service it would occasionally let out a very loud squawk. After the offerings, the elder calmly gathered up the money, along with the goods, and the rooster in its bag was scooped up and brought up to the altar.

After worship, we processed out of the church with the congregation and formed a large circle outside. One of the elders began the auction of all the goods donated. The team got into the spirit of the auction and won several items: Pati was high bidder for the chicken and donated it to Eliyuko’s family. Barbara and Anne got into a bidding war for laundry soap, but Anne backed down and Barbara now has soap to last for months. Susie won a bag of oranges, which she donated to the Pastor’s family. And Andrea won a second bag of oranges which she kept for the team to enjoy.

However, the most sought after item in the auction was fabric which Cindy brought from the states. It generated a bidding war between two different families and eventually went for Tzs 37,000. Which is definitely more than Cindy paid for it!
Our time in Majengo ended with “tea” shared with the pastor and Mama Pori, a parish worker. That is equilivant to an assistant pastor. We had our choice of Pepsi, Black Currant, Fanta, Mountain Dew, Bitter Lemon or Sprite soda with cupcakes. After listening to our casual conversation, Mama Pori had a great suggestion: she has a friend who is a tailor who will come to Mazimbu tomorrow and work with us to make custom clothing from fabrics we purchase. We are so excited!

We took the opportunity for a private moment with Barbara to present her with a gift of appreciation, which was received with tears of gratitude.

The plan for the afternoon was to spend time in Morogoro, which our schedule has not made possible before today. The Dala Dala dropped us in downtown Morogoro and, armed with a hand written map, we walked to the shops we had been hoping to visit. After Tanzanian fast food lunch at the Lucky Star Tea Room, the doctors were whisked away to Mazimbu because the staff was concerned about one of our patients. However, all of our post-op patients were recovering and all was well.

In Morogoro, our first stop was Barbara’s fabric shop, where the team made the owners very happy. Following that we visited a grocery store to sample local products and proceeded on to a shop to purchase a few bottles of wine.

Our shopping trip ended with a welcome walk back to Amabilis, a distance of about 1 mile. During our walk, we were greeted by four different people who had met us in prior years and recognized us, making a point to welcome us back to Tanzania.

It was good to stretch our legs and we arrived home with time to relax and meet for devotions and fellowship.

Eph 2: 8-9 For it is by God that we are saved by faith, it is not of ourselves, but a gift from God, not by works that no man can boast.

Saturday, July 9, 2011

Saturday at Mazimbu

Saturday, July 9

We have all fallen into our regular routine in the mornings. Some still don’t have hot water, and there is a group consensus that we miss our “American” breakfasts. We gather onto the bus and head off to the hospital for another blessed day.

Andrea performed a major surgery today, removing multiple fibroids from a young woman, one the size of a soccer ball. The woman who had the surgery also had a sister we saw yesterday. Both of them speak English and were here early this morning. Paige had been in the examinations with them yesterday and was able to talk with them before the surgery and afterwards. The sister brought her five year old son for all of us to meet, and it was such a privilege to be able to connect with the people we help. Paige went to see the sleeping and recovering patient, and on the way out, the sister told her how thankful she was for helping her sister because all of her previous doctors refused to help her. The way we have shown Christ’s love has touched everyone here, patients and team members.

Doug also had a very busy day, and was scheduled for four surgeries. It is about 5 pm as we are writing this blog and Doug is in the OR, or theatre as they say here, finishing his third procedure. But the power has just gone off in the hospital—another example of TANESCO’s power management—and the newly repaired generator has not yet kicked in to restore power to the theatre. This may make it impossible to finish his last surgery. We’ll update that in our next blog.

Chelsea, Dani, Pati, and Paige had the privilege of observing different surgeries today and Doug and Andrea were really great about explaining the procedures to them.

One satisfying experience came from Pati. Andrea’s surgical patient needed blood, and Pati was able to donate hers. An interesting aspect that was discussed was that when we give blood in America, most of the donors don’t know who their blood goes to or how it actually helps others, but today, Pati was directly able to see the impact she has made for the patient.

It’s amazing how our team can come together, with all of our talents and gifts, and share with each other and people of a completely different way of life. We are working nonstop, but smiling and loving every step of the way. We are staying in tonight, and all of us are looking forward to a night of regrouping and relaxing.

God’s work. Our hands.

1 John 3:18- My little children let us not love only in word and in tongue but in deed and in truth.

Surgery begins

Friday, July 8

Our first “normal” day began with a typical Tanzanian morning tea of bread, eggs, and coffee. The doctors made an early start, arriving at the hospital for morning report. Remaining members of the team followed, arriving to a line of patients waiting to be seen.

Triage, worked primarily by Dani and Lisa, begins the patient's journey through our system, followed by reception as Susie and Noni take vital signs and record the patient’s information. Next they are seen by one of our three providers; Dr. Leslie, Dr. Doug, or Dr. Andrea. We have helpers working with each doctor to record their diagnosis and recommended treatment. Today Anne recorded for Leslie, Paige for Andrea, and Chelsea for Doug. After the patient’s consultation with our doctors is finished, their care continues at the pharmacy where Glennis and Karne dispense our meds under the doctor’s orders, and sometimes with Pati or Susie, who are managing the scheduling of the surgeries our doctors will perform. Occasionally, also, the docs have other recommendations or referrals that may need extra attention by many of us to accomplish. Andrea and Doug spend many busy hours performing our first surgeries with the help of Cindy and Lisa, who circulated in the OR to hand the doctors the instruments requested, and the Tanzanian medical staff providing support. We were relieved that TANESCO was not an additional challenge to contend with today and we were able to complete all three of our scheduled procedures.

As the hospital was closing down, seven of us were able to return home while the other six stayed to finish their work. At the hotel, the early group received a phone call from Barbara telling us we were eating out and the restaurant where we were to meet for dinner. We took two “registered” taxis over to the restaurant, where we had to negotiate (argue) for prices. It was a new and interesting experience for most of us. We went to a lovely Indian restaurant called “The Greens”. As usual, we were on Tanzanian time and spent about 3 hours dining. With the help of a restaurant employee’s vehicle, we all traveled back to the Catholic Center, crawled under mosquito nets and rested our eyes in preparation for another busy day.

Phil. 2:3-4—Let nothing be done through selfish ambition or conceit, but in lowliness of mind esteem others as better than ourselves. And let us look out for not only our own interests, but also the interests of others.

Saba Saba

Thursday, July 7

SABA SABA!

We woke up today around 6:30. Many of us hear the morning call to worship for the nuns, and all of us hear the rooster that never fails to wake us all. We go down to breakfast to have our usual pieces of bread and coffee.

Barbara told us last night that we might need to move to a different location to stay because of miscommunications about necessary accommodations, so we all packed last night just in case. This morning we were told that we were staying put, so we had to unpack our entire luggage.

We made our way to Mazimbu, observing the surroundings: people, animals, mountains, and buildings. Many people live in extreme poverty, but they go about their day, trying to stay busy and support their families. When we arrived at the hospital, we were amazed to discover there was no electricity. Evidently, there is a shortage of electricity and TANESCO (Tanzania Electric Supply Company) manages the shortage by rotating blackouts. July 7 is Saba Saba in Tanzania (saba means 7), a national holiday, so the blackouts were more extensive today. Barbara jokes that TANESCO’s slogan should be “Keeping the power on….sorta.” There is, in fact, a generator, but it is currently not working and the part to repair it is not readily available. We were supposed to perform five surgeries today, and all of our patients were there, with empty fasting stomachs, waiting for their scheduled surgeries. We had to reschedule all of them because of the electricity situation. These people are truly a patient and caring people. They never once complained when our doctors explained the situation to them. The positive aspect of the situation was we got to see so many patients in the clinical setting.

While at the hospital, many of us were privileged to see our first Masai, Nasaa. He was a very tall and thin man, and his “regular clothing” was so captivating. He wore a wrapped skirt and a shirt and vest. On his belt hung a knife and he carried a staff which looks like a pole. We took him to Dr. Doug; the next Tuesday, he will come back for surgery. He gave Anne a particular greeting and offered her his hand in parting.

The whole team has worked constantly. The work is demanding: keeping records for surgery, conferring with the doctors, checking patients who have been referred to us, and treating our patients. Through all of our busy times, the work is absolutely rewarding, gifting, and priceless.

One of our countless gifts happened when Anne was sitting on the bench feeling a little sleepy. Two young boys joined her. Suddenly, Noni, one of our young and talented translators, came to Anne with a request: she had been approached by a women in the ward, who was there caring for one of her family members (an inpatient) and she wanted to know if the team could help her 15 year old daughter, Grace, who has never walked or spoken. Anne was overwhelmed at the request because she has a grandchild who has special needs and is also named Grace. She went with Noni to meet the woman and shared her story. Anne asked her if she knew Jesus, and the woman responded that she did, and Anne said she would pray for Grace.

All in all, it’s been another amazing day as we all work as a team to share the love of Christ through our medical assistance with our beloved patients.

God’s work. Our hands.

1 Cor. 15:58- Beloved brethren, remain steadfast, immovable, ever abounding in the work of the Lord; knowing that your labor is not in vain.

Friday, July 8, 2011

Friday Night at The Greens! And talk to us!! Please

Hello friends and family! We are eating Friday night dinner here at the Greens Indian Restaurant. We are behind on posts so we apologize but will upload some soon! Life is great and we are all doing well. No one is sick and our first few surgeries have gone well, all patients are being treated (96 so far) and we are happy and busy. We are tired of the rice and sauce, cold showers, broken fans but we are so appreciative of everything we are experiencing, plus it is cooler here than in Oklahoma and Arkansas and Texas!!!!! No humidity. The people are great and we are loving what we are doing. (Love the 'relaxed' hospital atmosphere where there is less charting) Working Saturday but have Sunday off and will be worshipping with Bishop Mameo's congregation most likely. Thinking of you all. Blessings from our team to everyone. Love and Hugs. Please comment at the blog site because we are lonely for our friends, family and fans! : )

Wednesday, July 6, 2011

Work begins

Wednesday, July 6

Bishop Jacob Mameo is the head of the Morogoro diocese of the Evangelical Lutheran Church in Tanzania and leads morning worship daily for his staff. The team was able to join in the staff worship this morning, and met with Bishop Mameo afterwards to exchange formal greetings.

Our arrival at Mazimbu hospital in mid-morning was marked by more formal greetings as the returning team members renewed their relationship with Matron Siguru and the hospital staff and the new team members were introduced. In Tanzania, the highest value is placed on relationships. As Americans, we sometimes struggle with this concept, wanting to dive in to our work as we excuse our impatience with the tradeoff of helping just one more person. With coaching from Barbara, we are learning to slow down and enjoy getting to know our co-workers.

Once introductions were completed, we changed from our Sunday-go-to-meeting clothes into our scrubs and headed out to our bus to unload all thirteen team bags. The next couple of hours were spent organizing, unpacking, inventorying our equipment, working to get our work spaces set up and assigning work stations. Our lunch caterers, Grace and Deanna, delivered our meal at 12:30 and we began our work with patients at 1. Lisa and Dani worked the screening desk, taking histories and making sure that our patients were a good fit with our doctors. Pati and Paige were assigned to the reception desk, entering personal information into our records and taking vital signs. Anne would then guide the patients to the waiting area for the doctor they were consulting: Andrea’s speciality is gynecology so most of the women were directed to her bench; Doug’s speciality is surgery, so he consulted with patients that looked likely to need surgery; and Leslie’s speciality is family practice so her patients were all those who did not fit into the previous two categories. Susie and Chelsea worked with Leslie and Andrea to record their diagnosis and treatment. Karne worked with Glennis in the pharmacy, dispensing our meds in accordance with the doctor’s prescriptions. And Cindy hovered, going from station to station to answer questions and help wherever needed.

We were able to consult with 24 patients today, and scheduled 9 of those for surgery, beginning tomorrow. It was a very busy afternoon, but we all felt like it was a great day and we have a great plan in place to follow for work for the remainder of our time in Tanzania.

Note to all our friends and family--we have not had internet access until now, close to midnight on Wednesday evening, so there is only time to upload the blogs about our time so far. Check our blog tomorrow for pictures that we will have to share with everyone!

Arrival in Dar and travel to Morogoro

Wednesday July 6

After our arrival at Dar es Salaam Monday evening around 10, we were happy to see Barbara (Robertson), the liaison for our team. Barbara is from Washington State, but has lived in Tanzania for 12 years and works for the ELCA as a missionary assigned to the Morogoro diocese of the ELCT. Her fluent Swahili and intuitive understanding of Tanzanian culture and customs paves our way as we meet and work with our new Tanzanian brothers and sisters. All 13 team members and all of our personal and medical bags arrived safe and well.

Monday night was spent at the Catholic guest house in Dar es Salaam, just a short ride from the airport. This first taste of Tanzania, in the dark, gave us very few glimpses of the teeming city that would come alive the next morning.

The Catholic guest house is a walled compound that allowed each of us a small private room with a bath: very clean and utilitarian. As we will see throughout Tanzania, all of our beds were draped with mosquito nets as an added prevention against malaria.

Breakfast was our first chance to visit with Barbara, who took the time to coach us on the dos and don’ts of life in Tanzania before we did our last hop, a three hour drive to Morogoro. We had received an invitation from the family of a patient the team first met in 2008 and had treated each year since then. Jenifa suffered from Thyroid cancer, which ultimately claimed her life just a few months ago. Our intervention in 2008, and the subsequent treatment begun by our team and continued by her family, added several years to her life. During that time, Jenifa’s spirit touched everyone she came into contact with, and she never missed a chance to praise God daily for her blessings. So when we stopped at Jenifa’s house to join her family for a simple lunch, we made a solemn trek across the field to the communal burial site where Jenifa’s grave, the freshest one there, was well tended and decorated with flowers and mementos. Andrea led us in a prayer, as we honored the life of this spirit-filled woman.

We returned to Jenifa’s house to see sisal mats spread out for our comfort under the shade of the trees. Sitting crosslegged in a circle, Jenifa’s daughter served each of us by pouring water over our hands to wash before our meal--a large bowl of rice, seasoned with a few beans, sliced tomatoes, boiled potatoes and a small piece of chicken, washed down with fresh, boiled milk seasoned with sugar.

The end of our day found us at the Amabilis guest house in Morogoro. We unpacked and then relaxed outside under the Tanzanian sky (with a beer) while we had our first team meeting, prepping for our first day at Mazimbu hospital.

Sunday, July 3, 2011

Tanzania 2011 surgery trips begins!

Meet your 2011 Tanzania surgical team:

Cindy Pennie, Team leader and RN, Stillwater, OK
Doug Treptow, surgeon, Rogers
Andrea Doeden, obstetrician and gynecologist, Trinidad, Co
Leslie Menchetti , nurse practitioner, Rogers, Ar
Lisa Eccles, RN, Arcadia, Ok
Pati Murdock , helper (logistics), Rogers, Ar
Karne Beighle, helper, (Paige’s mother), Edmond, Ok
Paige Beighle, helper (PT student), Edmond, Ok
Anne Duhon, helper (Pati’s mother), Whitehouse, Tx
Chelsea Anderson, helper (pre-med student), Rogers, AR
Dani Shackleton, ,helper (student nurse) (Treptow’s family), Lincoln, Ne
Susie Stussi, helper, Edmond, Ok
Glennis Treptow, helper (Doug’s wife), Rogers, AR

As we begin our trip this morning, the team is leaving from 3 different airports and we will not unite until we meet in Amsterdam, early Sunday morning (late Saturday evening local time). The Arkansas team (Doug, Glennis, Chelsea, Lesli and Dani) leaves from the local airport in NW Arkansas and connects to Amsterdam through Atlanta. The Oklahoma team ( Cindy, Andrea, Karen, Paige, Susie and Lisa) leaves from Oklahoma City and meets up with Pati and Anne in Dallas, before travelling on to Amsterdam. Pati and Anne are flying out of Tyler, Tx, which allows Pati to take her daughter, Shelby, to stay with her dad, Anne’s husband, Bob, for a long visit together while Anne is gone. Once we arrive in Dar es Salaam, at 10 pm Sunday evening, more than 27 hours will have passed since we left our home cities. In Dar es Salaam tomorrow evening, we will stay at a local guesthouse, continuing on to Morogoro by car, a 3 hour trip. This will be the most dangerous part of our trip, as the two-lane highway between the two cities is a corridor that sees many vehicle accidents. Tanzanian drivers generally discount street and traffic signs as being merely a “suggestion”.