What's In Your Cast?

Some of my favorite patients on the ship are our pediatric, orthopedic, patients. My little coffee colored babies are so cute lying in bed with their tiny legs casted and elevated on pillows. Their legs are so small and and I love the fact that after a few months, they will be able to walk straight for the first time in their lives. When the surgical pain passes most of the babies don’t want to lie in bed anymore so we let them crawl. I laugh and laugh watching them attempt to crawl around with huge, florescent colored, casts on their legs. They don’t get very far and most of them end up content to sit with a pile of toys around them. (Toys many of you have donated!) After a few days, the kids are ready to go home and we give them appointment cards to return to the ship after a few weeks for a cast change.

It is priceless to see them tied on their mama’s backs when they come in for cast changes. All you see is a beautiful African women walking toward you with two huge, casted feet sticking out on either side of her hips. The little kids are all smiles until they reach the cast change room, which is right next to my cabin. Thank goodness the wall separating us is a firewall, or I would hear screaming all day long. It isn’t that the cast changing process is painful, but it is scary when a saw is coming toward your legs and you cannot stop it! Two of my friends are on the orthopedic team and they do their best to comfort the kids during the cast changing process, but sometimes screaming is inevitable. Once the casts are sawed open the screaming stops and the mood in the room drastically changes. The fear is gone and the babies stop howling.

When we discharge orthopedic patients from the ward, we teach them how to take care of their casts. We give strict instructions in oral and picture form instructing our patients and their parents to keep the casts dry, to keep weight off the cast, to elevate their legs, and to come back to the ship if the cast breaks. We also tell our patients not to put their hands, or sticks inside the cast. If you have ever had a cast you know how itchy the skin under the cast gets and you will try almost anything to reach the itch. In the States, most people would never imagine putting a stick down their cast, but if you don’t have something flat like a ruler, a stick is the next best option! In Liberia I could almost guarantee most people didn’t have access to a ruler because most of them struggle finding food, shelter, and clothing for each day, but apparently people here have access to rulers because we found bits of one in a baby’s cast! Finding stuff inside a cast isn’t funny because having stuff inside our patient’s casts, next to their surgical wounds, can cause infection. But, it has almost become a game where we guess what we may find in the next cast we open! My friends have started to take photos documenting all the random stuff our little African babies stuff down their casts. We are not exactly sure how the stuff gets in there, but it is hilarious. To date, we have found sand, CFA (the local money), chalk, more sand, a piece of a ruler, more sand, a smashed bottle cap, live worms, and more sand. We never know what may wait lurking underneath the surface of our patient’s plaster casts.

I guess in the future, we are going to have to be a little more creative and specific when we discharge our orthopedic patients from the ward and we teach them about caring for their casts. But that is why I love my job! Never at home, would I ever have the chance to tell a patient take your pain medicine, see you in a few weeks, and “Oh, yah, make sure you don’t put money, sand, dirt, smashed bottle caps, or chalk in your cast!”

If you want to talk about rice, chocolate, or diapers, I am willing to chat with you!

I have been back in Africa for almost four months now and I thought I should let you know how my French is progressing. You will be proud of me. My vocabulary is expanding daily. I am not progressing as fast as I would if I actually lived off ship and was required to speak French to survive, but I am slowly working on acquiring some useful phrases in French. One of my favorite questions is “Did you poop today and was it big or small?” Although this phrase does not appear on the “Top Ten List of French Phrases to Learn,” it is very important to me as a nurse. It does become awkward in conversation though when someone greets me and says,” how are you?” I can say, “I am doing well thank-you and you?”, but then the conversation ends because my only real conversation piece revolves around body excretion. Actually, my French isn’t that terrible. I can also ask, “are you feeling pain, did you eat, did you swim, and did you pray?” I pick up random words here and there, but my vocabulary remains small. I am starting to understand the majority of conversations, because of my knowledge base of Spanish and the similarities of French and Spanish, but I struggle to actually say anything intelligent in French. I want to respond to questions, but it almost always comes out in Spanish. You can pray for my desire to learn French and motivation to work on it. I have been reluctant to really dive into French language study because I am afraid I will lose my Spanish if I start to learn French and I still have a deep love for the Spanish language and Latin people. I also am so busy; it is hard to devote my free time to study, when I need to relax. A poor attitude, I know… I am working on it! Despite my poor attitude, I am eager to use the French vocabulary that I have so, if you want to limit your conversations subjects and phrases to talking about chicken, fish, rice, fries, apples, bread, water, chocolate, beautiful things, gifts, diapers, see you later, good-evening, Mr. & Mrs., my friend, or the word for dry (which is very important when assessing my VVF patients), I am willing to have a chat with you. If you use any words other than those I just mentioned; we will have to stick to conversing in English or Spanish for now.

WHY NOT GET INTO A HAND-CARVED BOAT WITH AFRICANS THAT BARELY SPEAK ENGLISH?

The stress level was getting pretty intense all over the ship, so a few buddies of mine and I decided we needed some distance from the ship and it was time for a break. Most people would aim to hit a white-sandy-beach or rent a room at a five-star hotel with room service, but that isn’t really an option on a missionary budget, nor is it likely in Benin. After checking out our travel options, we hired a local taxi driver to take us to PASSOTOME, a little village about 2 hours from Cotonou. Our taxi driver arrived at our pick-up point on time, which was surprising and a great start to the weekend. Although we thought we had booked the car for just the three of us, our taxi driver, being a businessman, thought he should fill the car and sell all the “space” in the car, not just the spaces with seatbelts. He was lucky we had some thin passengers in our group and that we are flexible, in every sense of the word. The car ride was incredibly smooth. We picked a great taxi, the car had air conditioner, clean seats, space in the trunk ( and he didn’t carry extra gasoline in glass jars in the back of his trunk, like in Liberia), and he had a great taste in music, slightly out-dated, but all my favorite songs from high school! It was great getting to see more of the local countryside. I find pure joy in just observing the African culture. At one point we were stopped at a stoplight (an amazing invention, pretty much non-existent in Liberia, but quite common here; even more incredible when people obey the lights.) Anyway, I looked up and saw something moving in the back window of the car in front of me. I turned to my buddy and said, “What the heck is that?” Oh, yah, it was a goat. The cutest little goat was just chillin in the back of the taxi cab and was staring at me. I couldn’t help but laugh my head off. (I guess some goat therapy is just what the doctor ordered, my brother had some and now I got some too). You don’t see goats in the back of taxi cabs everyday! I turned my head away in another direction for a moment and when I looked back, I saw my little goat friend wasn’t alone, there were at least two other goats in the back of the car with him. Great times! We stayed at a very modest hotel in PASSOTOME on LAC AHEME. The main attraction at PASSOTOME is the lake itself. We had heard about the opportunity to join some local fisherman for a few hours out on the lake and despite my fear of water, I thought the idea sounded great. Why not get into an amazing, hand-carved, fishing boat, with my buddies and a few Africans that barely speak English? It was an incredibly hot day, so being out on the water was ideal. We had done some research and learned that LAC AHEME was supposedly parasite free and we could actually get in the water if we desired. I decided I would most certainly not touch the water, but I would ride in the boat. One of the first things I noticed on the water were random areas all over the lake that were closed off by rings of wooden poles sticking up about a yard above the water level. The fishermen explained that each village surrounding the lake had designated rings of wooden poles that belonged to them. Apparently, the villagers believe that the water inside of the ring is sacred and the “spirits of the water” reside there and it is forbidden to fish in that area. The worldview of these people is obviously very different from Western worldview. Saddening to me in many ways… The fisherman explained to us the lifestyle of local fisherman. They told us to observe the red areas on the water; those were the best fishing areas. I was sort of confused, I thought the water just looked absolutely filthy, manky, and polluted, I didn’t see any “red” areas. We rowed all over the lake and watched the fisherman cast his net and pull in load after load of tiny fish. I thought he would throw back the tiny fish and only keep big fish, but he kept all the fish and there weren’t any big fish to speak of. After an hour of watching him, the fisherman turned to us and said, “It’s your turn!” We each took turns casting the net. It is heavier than I expected and to throw it properly you have to stand on the edge of the boat. I was afraid I was going to throw the entire thing in the water, or I would go in with it. I was congratulated on my casting technique. I didn’t catch anything, but I was the only one out of my group of friends to actually have the net hit the water in the proper manner. I was proud of myself! The fisherman showed us another technique of catching fish. He cast the net into the water, tied one end of it to the boat, and then jumped in the dirty, cloudy, water. This mystified me. The fisherman dove under the surface of the water and a few minutes later, he came up with a handful of fish and threw them into the boat. Then he continued to dive again and again, bringing up handfuls of fish with each dive. Apparently, when only fishing with the net, some fish can escape as you pull it in. On the contrary, when the fisherman throws the net in, lets it sink to the bottom, then dives in and finds it under water with his hands; he can pull the fish out that would sneak out. With this technique he catches more. The entire process still confuses me and I want to know how he sees anything in that dirty water. The fisherman invited us in to swim with him and try his fishing technique. I thought, “Yah right!” But then the blazing sun’s intensity increased and in some freak moment of mental deterioration, I decided it would be great to cool off. And after a few deep breaths and a “self-pep-talk,” I slowly, lowered myself out of the boat and into the water! An act of faith, craziness, and an attempt to conquer more of my fears! Wow! The coolness of the water was refreshing but its consistency was slimy. Yuck! My fisherman friend swam over and started telling me how to dive under the water to catch the fish. I just laughed at him and smiled (there is no way on this planet that I was going to stick my head under that dirty water.) It was a big enough step for me to get into the dirty water; I wasn’t going to immerse my face and head in it. I did rally enough courage to hold one of the little fish he caught, but it scared me and made my insides squirm. I don’t like to eat cooked fish, or even smell it, let alone touch it when it is wiggling and squirming! The rest of the time I was in the water, I just kicked my feet around and held them close to my body so that nothing would nibble on them! The fisherman kept coming in and out of the water with handfuls of fish; I stayed in one place very close to the boat, treading water. The fisherman saw me kicking around a lot and said, “Can’t you touch?” He then showed me that although he was shorter than me, the water only came up to his chin. I knew this the entire time, but wasn’t brave enough to put my feet down onto the mushy, gooey, lake bottom. I am stubborn! After hours out on the lake, the fishermen were finally content with their catch of the day and they rowed us back to shore. Maybe the trip would have ended sooner if my buddies and I were any help in the process, but we didn’t catch anything. I guess I won’t be giving up my nursing job anytime soon! We thanked the fishermen for sharing their time with us and we went back to the hotel. I concluded my day of adventure with a cool shower and prayer that I won’t get any parasites from my day of conquering fears and exploring Africa!