Death as Transition

January 17


I wrote this in my journal in early December. Thoughts running through my head. I wanted to go back and write more/springboard off of these raw thoughts, but then I read it today, and I kinda like it just how it is.

Also, since it is the end of our time in Africa, I am in the middle of experiencing a transition myself. Closing the file, etc. So it is kind of suiting and appropriate to come across this and post this at this moment.

We are confronted with death a lot here. So naturally, I think about it more, and am drawn to explore this concept.
Here it is.
I hope this will be -- encouraging.



december 7th

Death...

During worship I was thinking about death... we had communion, and I was thinking about how Jesus
died.

And how there is a cycle,
even in our seasons (winter) before there can be new life.
And even every day,
there always must be night before there can be morning.

Death and life,
such a natural part of the cycle,
uprooting and planting, waiting for the sunrise.

So, I’m just thinking,
In my own life, grieving about things is healthy.
The death of a childhood to become an adult.
The death of the old life to enter the new.

The winter season of transition: to embrace it, because it is the very thing that will hold the new seed.
Finishing chapters, closing the file. It is to be welcomed and embraced.

So death, then,
we perceive is not the end,
it is a change.
A transition that will bring forth the sunrise and new day. In every other circumstance, that is the case.
So how then, should it be with our lives?

I feel like there can be so much fear surrounding death, scared of dying, etc.
But we are only on the beginning side -- “this side of heaven”, as Christa says.
How do we arrive in heaven? Must die first. And heaven, what is to come after death, will be so much more amazing than anything in this life!

I feel like this life is only the rehearsal, the training ground, the shadow,
“the evening” if you will... and we have yet to see the glorious sun rise,
how it will burn hot and bright, illuminating everything, exposing colours and creation...
yes, we have not seen the full of it yet.

“For we know in part, and we prophesy in part.
But when that which is perfect is come, then that which is in part shall be done away.
When I was a child, I spake as a child, I understood as a child, I thought as a child: but when I became a man, I put away childish things.
For now we see through a glass, darkly;
but then face to face:
now I know in part; but then shall I know
even as I am fully known.” 1 Cor. 13:9-12


Death is the hard gate that opens to a more fuller, broader, deeper, wider life than could have been imagined before.
Approaching the gate, human perspective says, “No!”
After coming through the gate, we say, “How could I have not?”

For as those who look back, we realize that death was the means to get us through to the other side, and no other means would simply accomplish the same result.

So it is the same as birth.

The fetus grows for nine months, but even after nine months he is not yet a baby.
The only way forward is through the tight passage of the birth canal. It is only when the fetus can say goodbye to his home that grew him, then he can make the hard journey forward.

Through the laborious descent, perhaps the fetus has deduced that his previous womb-room was much more comfortable than this one.
But those on the outside, eagerly awaiting his arrival, say,
“Keep coming, don’t shrink back, fight through...wait till you see this place! The possibilities and opportunities and experiences of sight, taste, touch, love, choice, thought, movement, creativity are incomparably beyond that which was possible in your previous home. Trust me.”

And this is how we enter the world.
Making the tight and laborious descent, from our comfortable starting point to something indescribably -- more.
But the only way out is through the abandoning of one habitation and the pushing through (no matter how blindly) to another.

Perhaps this will be how we enter heaven.
To be birthed into eternal life.
Yes, we are both living before and after the tight, dark passage, yet the first home is merely a preparation for the second.

And though the ones approaching the death of all they’ve ever known could have reason to fear, it is from the perspective of the “other side” they must need to keep in mind.
And once out, he too will say,

To now be here, was worth the passage.
For here,
I have truly arrived, and Life has just begun.

And thus the Kingdom law is confirmed, there must first be death before there can be life:

“Truly, truly, I say unto you,
unless a grain of wheat
falls into the earth and dies,
it remains alone;
but if it dies, it bears much fruit.

Whoever loves his life loses it,
and whoever hates his life in this world will keep it for eternal life.”
John 12:24,25

In order to truly enter Life,
you must die first.

So do not shy away from “the end”, “the close”, “the finish” of something,
because the end is serving its purpose as a means of transition
to prepare the way of the glorious fulness of what awaits you on the other side.

And it is better. Than what you knew before.

“Now to him who is able to to do
far more abundantly
than all that we ask or think,
according to the power at work within us,
to him be the glory in the church and in Christ Jesus
throughout all generations,
forever and ever. Amen.” Ephesians 3:20,21

And God reminds us with this
everyday,
each evening and each morning;
every year with each winter and subsequent spring.

How quickly we ignorantly, distrustingly, and fearfully choose to believe
that death will be the end.
When God has faithfully shown us in every instance for all of time before us,
that death is merely the gate
to open the way
for us to enter into an even

fuller

Life.



***

a poem follows..



December 31 poetry jam/January 17
inspired by contemplations on being with newborns in the first minutes of birth, feeling the absence of this with stillborns, and experiencing an unforeseen maternal death. And the only time we stop to really think about Life itself is when one starts or another ends.


“Tension” (colossians 1:14-17)

what is it about life;
how do you measure it?

is it breath
or the beating in one’s chest
the ability to open your eyes?

oh the joy it brings to hear
the strength of a cry
to see a pattered bundle of cloth
squirm.

It must be the Spirit.
for a pump can give breath
and a machine can pump blood

So it is God
that sustains this
intangible concept
that,
yet
is so normal and obvious:
what keeps us afloat,
us breathing
beating
blinking
thinking
feeling.


And now
we want to talk about it,
think about it.
we want to even sing,
and harmonize about it!
because it’s us,
all of us:


Walking this tightrope
-what we know as earth-
held in the tension
between here
and there

unaware
of the crowd below
and the crowd above
watching

and it seems like the only time we notice
and turn our heads
and become
aware

is when we feel a quiver on the rope:
an adjustment to the tension;

a weight is added,
or a weight is lifted;

when someone steps on,
or when someone

falls.

The Battle to Love

.



(end of December)

Some days are more frantic than others.
I don’t know why, but it must be a combination of things.
This particular day, the labour room was not very busy,
many open beds,
no need to rush or cut corners.... but there was such a strange tension in the room.

There was disunity among the nurses.
And I could feel it in my spirit.

One nurse in particular,
the one with the thin braids and the scowling eyes,
was doing her own thing,
taking things into her own hands,
and not communicating her actions with any of us.

It was like watching the beginning stages of a tornado.
Small swirls of flurry,
feathers being ruffled,
and as she was spinning,
she was sweeping others into the midst of her chaotic whirlwind.


I had recently started monitoring a woman that morning,
who was progressing nicely and was just moments before giving birth.
Nothing seemed to be wrong,
but the nurse with the scowl left quickly without a word,
and reappeared with a syringe.

!
whoa, whoa.
This is never a nice sign.

”The baby is not coming.” she says.
”Yes it is, it’s crowning--”

(Hey, this is my mama! What are you doing??)

She doesn't speak much English, nor does she look at me.
She breaks an ampoule of 5 IU Oxytocin, and loads the syringe.

She grasps the woman’s wrist,
stretches her arm flat
and jabs this needle into the thin skin where the arm bends.
The mother is going through a contraction.
She is getting poked with a sharp steel needle.
Try not to move your arm, mama.

I look on, watching and wishing I had the authority to stop her.

She’s trying to find that good vein where you usually draw blood from,
but she keeps missing,
and re-jabs her over and over again.

The mother,
receiving no communication as to why this treatment is being done to her,
quietly clenches her teeth
and winces.
She doesn’t make a sound, but is quickly starting to spiral into a quiet panic.

The whirlwind of nurse Tornado is hitting yet another victim.
What was a calm labour, has now been assaulted with no explanation.

Finally,
she hits the vein she was looking for,
and empties the potent oxytocin into her arm.

Then she left.


I am horrified, bewildered, angered, and shocked by what I had just seen.
So many questions...
Why?
Why make such a drastic and traumatizing move?
Why stir up a perfectly calm labour into a storm of worry and fear?

I am left with the aftermath of the situation.

A shaken mother, moments to giving birth, in her most intense, vulnerable, and painful minutes of labour.
And now she has 5 units of oxytocin in her blood. It's a powerful drug.
All at once like that?
Usually, for oxytocin therapy, 5 units is diluted with 500ml of a water-based solution and administered through a very slow drip for hours.

After the baby is born, a dose of oxytocin is usually given intra-muscularly (absorbed slower than bloodstream), but this is to help the uterus shrink back strongly and quickly,
and it's different because the baby is out by then.


I don’t understand why this action was made.
It was so... victimizing. And I felt helpless.
And oxytocin is strong stuff!

I had to take a deep breath. And ask the Lord for help.
I felt so paralyzed, and small, and violated because she just started
taking matters into her own hands,
taking my mama,
not communicating with me or even really acknowledging my presence.

How do I love her?

I did not want to have some grudge, but I was truly shaken.
Like someone took a scoop and hollowed out the inside of me.
And somehow, I was standing on two frail legs.
Left foot,
right foot,
take a step,
breathe.

God I need you.
I need your strength. I need your wisdom.

He said to take authority over
the spirit of chaos and confusion.


This terrible thing,
chaos,
confusion,
panic,
like a lingering bad smell,
did not need to dwell here.

I could open the door and bring in new fresh air.


The baby delivered, with a healthy high score,
the mother was fine,
and I did all I could to make it a low-stress birth for her.
Everything became peaceful again.



Later that day,
there were two births side by side that Whirlwind spun over to
and everyone also got worked up into a lather.

The two girls giving birth were 16 and 18,
their first pregancies,
and things just kept escalating.

It got to the point where all the nurses were shouting and being rough
and Whirlwind actually took it upon herself
to climb onto the tiny bed
and use all her force to press on the top of the girl’s uterus to push the baby out.

Hysteria.
We were all praying under our breath,
aware yet again of the spirit of chaos and fiercely praying against it.

The corner of the bed broke.

Hallelujah!
Whirlwind’s knees were right by the 18 year old’s head.
A little frightened, but they were both okay.

Everything in us was resisting the pulsing urges to snap at them,
but,
moving in the strength of the Lord,
we actively chose peace,
and showed them how well the girls were pushing
and they are strong enough to do it themselves.


The two babies did come.
They needed resuscitation, but revived well.
Praise the Lord.



After that day,
I had to sort some stuff out with God.

I had reserve against Whirlwind.
Even her face looked cruel.
When I saw her, I didn't see a beautiful human being.
I saw her in her green uniform, furrowing her brow, and being rough with the patients. I saw fundal pressure and the fear of the women.

I didn’t understand her actions, her stubbornness, her heart.
How do I love her?

So, does that mean that I love people off of what they do or don’t do?
Conditional?
I hope not.

Jesus says, Love your enemies. Pray for those who persecute you.
It means nothing if you are able to love the people who are lovable.
Anyone can do that.

Loving your enemies is the power of God demonstrated.
It is only Jesus
who can infuse our frail, feeble, conditional love
and give us the strength to fiercly and completely
Love the unlovely.

Besides, God does not love us because we are lovely.
Our actions have nothing to do with it.


His love is unconditional,
everlasting,
pure,
true,
perfect.
It is with this Love that I can forgive and see beyond action.
It is with this Love that the kingdom comes.

”A new command I give you:
Love one another.
As I have loved you,
so you must love one another.
By this,
all men will know that you are my disciples,

if you love one another.”
(John 13:34,35)

Love is the evidence of Christ.




once again, I wrote a poem to help me process this, and seek God about the changing hospital environment.






“The Battle to Love”


the flurry
the frantic
the jabbing
the slapping
the pushing
the yelling
the angry eyes.

How can I love you?
when everything in me
wants to use quick force
push back your hand
stop you
raise my voice
and return the angry eyes.

How could you do this?

and I want to use my justice
do the quick fix

become hard
disregard love
and therefore become brittle
to the point of shattering,
worse than when I started.


But if I choose to love ---
--no, I do not have it in myself.

The only thing I can do
is choose to receive Your Love
that You have
for her.

It is only then
when I allow Your strength
to pour into me
that we create this mysterious alloy:

Strength in the weakness
Love in the temptation of hatred
Grace in the place of judgement.


Seeing a better way,
understanding
a more excellent kingdom

where my actions
are not out of a critical
controlling heart

and my motivation
is as sure
as the knowing to take another breath
as faithful
as the steady pulse of my heart.

To be motivated by love,
by His love.

I am a branch that reaches her
but He is the tree.

I need the lifeblood
flowing through me
(to be of any use to anybody!)


Therefore I choose
I welcome
I receive
the choice
to love:
in action
in deed
in speech

and let the gentleness
kindness
sweetness
patience
warmth;

melt

the violence
yelling
the harshness
the frantic pace so commonly
felt

and oh! to watch His justice coming;
where dishonesty halts
and fears are ceased

this is how I can love her.

and shine
with a light that is humble and free

not because of me
but because God sees

and “apart from Him --
--I can do nothing.”

Truth Be Told.

late December

I was the go-between person today. I sorted out people’s IV lines, cleaned beds, weighed babies;
you know,
the bits and bobs of a labour room.
As I blew through the green curtain on the search for a card or a glove, I saw ...
a breech.

The baby was half way out and stuck there. Legs, trunk, but no arms or head yet.
Since I am fascinated about the mechanism of breech deliveries, I stayed around to observe...
and quickly discovered that I was there to start to pray.

I saw the cord pinched between the baby’s stomach and the outlet. Probably cinching the blood supply?
It was like this for 5 or 10 minutes.
But the thing with breeches is you can’t rush them, it’s all hands-off until the ribs and then you deliver the shoulders and the head.

The first nurse gave it a go to deliver the head and started pulling on the body.
I am wincing. And praying.
The baby’s once moving body is now limp.

It is quiet in the Labour Room.
For some reason it is empty, and the silence hangs overhead, thick with the awareness of the absence of the fulness of sound.

There are a few hushed squeals, and the nurses talking rapidly in Swahili under their breath.


Another nurse gives it a try and manages to get the arms out in a manner robbed of gentleness.

There is panic in the air, and all the while I am holding the mother’s hand encouraging her to push. She is, but...
Then the nurse hesitantly tries again,
probably wishing someone more confident would be here to do this
-- but time is of the essence, and the baby’s head is stuck.

She purses her lips, furrows her brow, and goes for it.
She bends the baby up and backwards so far that its little ribs start bending in towards his chest.

The whole thing seemed like guesswork;
watching the poor little neck becoming painfully extended back,
and witnessing the nurse wrench his little body this way and that, ---it got so bad that I actually had to leave.
Swallowing the scream inside.

Everyone was tense, including the nurse.
Though I understood a hard exterior,
I must believe her unkind actions were only because she was deeply scared and frantic for the life of this boy.

I walked urgently and swift to the admission desk, and with desperation and pleading in my voice,
spoke to the head of Gynacology that happened to be visiting.

“There is a really bad breech delivery going on in there.
It’s --not good.
It’s really scary.”
I hoped that she would drop everything and rush to take over,
but she just calmly turned her head and acknowledged my concern.
She peered through the break in the curtain and with the wisdom of many years, said,
“That is how it is. Breech is a scary delivery.”


With a bewildered sigh of non-comfort,
I looked back and saw --pop-- the head come out.
The body clutched in the tight fingers of the grim-faced nurse.

I ran back as she was laying the limp baby on the mother’s chest.
Another student followed me and we were praying fervently in Jesus’ Name for the breath of Life!!

No muscle tone,
no breathing,
no colour
and a very wobbly head on a very weak neck.


I put my hand on his chest and felt a slow beat pulsing back to my fingertips.
He has a heartbeat.
Thank you Lord.

The room is still.
There is an eerie quietness, a hasty panic in the movements we make, our rush to find a khanga, our suctioning out of blood from his mouth.
The only noise made is the
raspy,
rhythmic
loud
forced
panting
made by the mother. Her eyes are searching ours.

By our non-excited, partially tense, concentrated expression,
who knows what the mother is thinking.

It is then that I notice a thin black thread around her neck, with another pendant wrapped tight with black thread. Gifts from the witchdoctor.

The cord is still pulsing, and thank goodness the nurse is not cutting the cord yet.

The baby is now making irregular grimaces but is still not breathing...
The sterile blade to cut the cord fell from the nurses hands onto the soiled birthing kanga.
“Let me get another one for you---”
No need.

The “10 second rule” of our youth seemed to be applied for the sterility of the blade and the cord was cut in the same instant.

Once his familiar oxygen supply from the mother’s cord is severed,
He starts to make a weak cry and takes a labourious effort at breathing.
Slowly he gets stronger, a more consistent cry....
and it is like sweet music to my ears!

I assumed the role of mother hen and took the recovery of this little one under my wing.

It took hours,
but slowly his breathing became regular and
his limbs went from limp to strong.
His eyes went from rolling back into his head to being alert and deliberate.

By the end of the day he was breastfeeding.
A miracle.
Thank you Lord.
It was like watching a baby come to life.


From watching that horrific entry into the world,
where there was nothing but a heartbeat,
to seeing everything slowly start to kick in gear,

I seriously believe it was because we were praying.
Hope was a thinning thread.
It was so close there for a while.


In the meantime, the nurse had done the paperwork and told me to take her to Postnatal.

I helped the mother with her shoes, bundled up the wet khangas, and grabbed her card from the desk on our way out.


I didn’t even know her name.
I found out that it is Rehema.
I took a look at the delivery section of the card--
---and my face fell at what I saw.

The baby was rated as a 7 after the first minute,
and a 9 after five minutes.
Out of a possible 10 points.

It is called the APGAR score, and it is a way to measure the condition of the baby. It is on a scale of 10: rating heartbeat, colour, reflexes, muscle tone, and breathing frequency.

This baby should have been an APGAR score of 1 at one minute, and maybe a 3 at five minutes.

Discouraged, deflated and disheartened,
I took the mom and babe over and passed the card on to another student in the Postnatal Ward.
Frustrated to the point of despair,
I relayed my latest discovery to her.
“That is wrong, Fia! Go back and ask her why!”

With the card limply held in hand,
I went back,
found her,
spoke quietly as to not humiliate her infront of others,
but asked the nurse why she counted the baby as a 7.

The only thing the baby had at one minute was a heartbeat.
So his APGAR should have been 1.

Her lips that were smiling, cinched to a furrowed frown.
Her eyes that had a glisten of lightness,
frosted over and froze to an icy glaze.

“One is too low.” She says.
“if you write one, the baby will die.”

“But he didn’t die, he’s alive.”

She pauses.
“You can’t write one.”

“But all he had was a heartbeat.”

Becoming irritated and probably ashamed at the blatant lie on the page, she took her stance,
unmoving, unwilling to change it.
“He had heartbeat, he had colour--- So what do you want me to do now?”

“I just want to know why you wrote that.”

The books and records went unchanged.
I went back to Postnatal to check on mama and baby... baby was still a little dazed, blinking his eyes, getting his bearings in this big wide world.

As I was walking back I realized that there was this buzz of adrenaline vibrating all through my body. I could feel my heart beating through my ribs.
I felt a little shaky.
It was a demanding hour!

The volatile beginnings,
the crawl of recovery,
the dishonest paperwork.



The circumstances surrounding the birth were like blows to my fragile spirit,
but the untruthful documenting put me over the edge.
I felt like crying.

This is injustice.


It is injustice to lie about the condition of a baby.
It is injustice to make up numbers that seem good but are not true of the case.
It is injustice to know the protocol and write just the right numbers so the Ward’s books look good.


To not check blood pressure but write numbers anyway,
to say the fetal heart is audible without checking it at an exam,
to keep bad records,
or to keep none at all.

It is a strange position to be in when you’re witnessing a physical exam, and the doctors are filling in papers with hardly even touching the patient.
Temp: 36 C
BP: 126/87
Fetal Heart: positive

whoa. whoa. wait.
You didn’t take her temperature. Or her blood pressure. Or the fetal heart.
?
Each women’s card has minimal, basic information recorded,
but now,
it may or may not be honest.
What good is that to anybody?

What good is it to write a foundation laced with falsity,
knowing that everyone’s actions (or lack of action) will build on the information noted?

Or neglecting to record when medication was given.
Minimal records is hoping that ignorance is bliss.
Hoping with a feeble effort that nothing will go wrong,
therefore the records won’t have to be checked anyway.

If there is not much written,
there is not much to be accountable to if something goes wrong.
When there does happen to be a complication,
no one can really trace the steps to the problem,
because the footprints were never marked in the first place.


With this system, there are many places for responsibility to fall through the cracks.
Issues just become blurred, confusion dines in this place, and out of this unclear muddle of absent or dishonest information,
drawing conclusions is like throwing darts with a feather.
It totally diffuses. You don’t get anywhere.

It is unjust to make your own standard of care,
rather than following the one put in place...
to make rationalizations and justifications,
to cut major corners to shave seconds of time.


Even for physical things:
When the line becomes so blurred between
what is healthy and
what you see everyday:
this is injustice.

When what is common and what is right
become meshed and overlapped until you cannot distinguish the difference;
a new accepted “normal” is formed,
but it has erred from the plumbline.

For example:
It is normal to be under 5 feet in Tanzania.
It is normal to be 17,18,19 and pregnant.
It is normal to marry when you are a teenager.

It is normal to give wrong apgar scores.
It is normal to write inaccurate blood loss.
It is normal for women to be overlooked.
?

The truth is...
there needs to be integrity.
Truthfulness.

Dishonesty; disregard for the value of human life leads to...
not keeping track
of records,
of fluids,
of medicine given,
not using clean gloves for internal examinations,
making low estimates of blood lost to avoid recording and treating for postpartum hemmorhage.

Or, the most absurd:
anticipating the patient dying, but delaying to refer to the larger hospital until the very last moments... so that she dies in the ambulance on the way there.

In transit.

This way, neither hospital has a bad report of a death in their books, and the responsibility has slipped away into the hands of nothingness.
All that’s left to do is close the file,
give a shake of the head,
and say,
“Too bad.”

Yes, the conditions are overwhelming.
There is the temptation to slack:

“There are just too many women.“
“I don’t have time to take blood pressure.”
“The antiseptic’s finished, and I don’t feel like finding any more.”

***

What we need is fear of the Lord.

Then there will be no more
slapping
no justifying
we would value life and honour people.

If the actions we made were made in view of the
deep,
unbridled,
constant,
pure LOVE
that God has for these women,
things would be different.


More antiseptic would be found.
The women would not be yelled at.
The babies would be checked for fevers.
Responsibility would not apathetically slip through the cracks.
We would not LIE and affirm it as truth.

it always comes back to God.
What we need is Him.
We have shown that left to our own devices, our systems fail.
Our rationale gets the best of us, and we suffer.

We are a people in need of a Saviour.

Sooner or later
everything starts to deteriorate
if the transformational, empowering, healing love of Jesus is not our motivation.

Knowing God’s Love changes things.

Integrity and truthfulness,
and actions made in view of God
instead of in view of man....

This is how Justice comes.

21!

December 31, 2009

Today is my 21st birthday.
In Swahili: Leo ni siku yangu yakku zaliwa.

And if I was Tanzanian, by 21 I would be married, have already had one child, and most probably pregnant with my second.
Different worlds, eh?

My day started out with sleeping past my alarm and awakening with a “Happy Birthday Fia” sign pinned with a clothespin onto my net. I had 25 minutes to get ready for the day!

We had a good day at the hospital: it was my birthday wish to be stationed in the Labour Ward, delivering a baby on my birthday... sharing the same birthday as them!

My request was granted, and I delivered a hefty 3.57 kg baby boy, vigorous and sweet. His darling mom had a red kerchief on her head like Aunt Jemima.
This was her 4th child, on December 31.
Just like me: 21 years ago. I’m the 4th child from my mom!

All along the day,
Everyone was being so cute, giving me little cards or gifts here and there. A juice, or a pack of biscuits, a little care package of Q-tips and bandaids and tea bags...


We came home, had an early dinner and got ready for our night. We were going to a city-wide, all night Christian prayer and worship meeting, in the stadium.
It was awesome.
It was more like a dance party.... all night long. If you wanna see joy, I recommend watching Africans praising God!

We took a daladala in the dark, and it was beautiful to see the passing villages at night... all the shops and fruitstands were lit with the warm glow of candle flames and many people milling about.

We got to the stadium, and got good “seats” (patch of grass) near the front.
This was my first experience with Astroturf.
It was a good experience!
We took a lay on the cushy, lush, artificial plastic ground, looked up at the open sky, welcomed the breeze, and squinted at the stadium lights bearing down.

It’s only 8 o’clock... the night is only beginning!
The band started to play and soon the whole stadium field filled up and we danced and danced! My family called while I was laying in the middle of the field, and wished me a happy birthday and new years! It was really nice!
A few minutes after, things started to really get going, and boy do Africans know how to dance! I love it! I’ve come to the conclusion that they never get tired.

On my birthminute, 9:55 pm, we were dancing with a thousand other African believers, worshipping and praising God.... African style!

When midnight came, we danced into the New Year! To the beat of drums and voices and tambourines and African melodies.

It was awesome!

There were times to pray also, and there would be this unified powerful sound of a thousand voices praying for the government, for Tanzania, for the healing of their nation. I’m so glad I got to be in the midst and pray with them.

Around 1 in the morning we went for tea in a different part of the field (on the track). There, drinking tea and eating ice cream, we watched all the guys dance their heart out in one big mass of movement!
There were lines and lines of men, dancing and jumping on the tips of their toes, it was full of excitement and happiness and joy!

We made our way back and I feel asleep from 2 till 4.
It’s so funny, the music’s blaring and the night never stops, but if you feel tired, you just lay down right where you are, sleep for a while, and then get up and dance again.
So the common sight all night long were bodies strewn everywhere, fast asleep, and inbetween them, people dancing and jumping and giving it their all, waving Tanzanian flags and singing. It was amazing. It lasted all night. There were two speeds: full on or konk out.


At 5 am we caught the daladala back home, I felt so sweaty that I had a bucket shower as the sun rose.
Then, at 6:26 am, I crawled into bed.
The last time I looked at the alarm clock was at 6:25 am, the previous morning, 24 hours earlier.
I slept so soundly and woke up at 1 pm, and had a wonderful relaxing day. That night I had my “birthday party” on base, Jan 1, and we ate spice cake. My friend Orissa did a wonderful job MC’ing and said so many nice encouraging things.
A paper pelvis was placed on my head as a birthday hat.


(We found this pattern to make a 3D pelvis out of paper as a teaching aid, and the joke was that it would be a good thing to wear on your birthday.....)

Because everyone goes through a pelvis on their birthday!
(yes, we are midwives.) Here's the 3D view:

Emily from England read a snipit from a lovely British book,
Reinette, our Israeli-South African said a prayer in Hebrew for me, others prayed for me and the new year ahead, and it was all so lovely!

We then ended the night doing -- my favorite-- 10 minute poetry jams, inspired by remembering the year gone by.
We also played guitar and sang and tried to write lyrics for a lullaby. By then it was getting far too late, and we hopped off to bed.

That night it was so hot that I woke up at 5:36 am (while it was still dark) and decided to use this opportunity to see the new year “in a new light”.
I walked through the fields to the well and watched
the sun
rise.


I wrote a poem about it,
and now that I read it,
the sunrise can be likened to Jesus. We’re in a foggy darkness, and He is coming.
Anyway, here it is.



“The Whisper to Wake”


The dark humidity
beared down on me
like a hot moist breath
and I woke;
not to be reconciled again with slumber

And I rose
as the moon still shone
the evidence of night rapidly fading.

I climbed out of my net
wrapped another khanga round
and took stumbling sleepy steps
down the sandy path

past the schoolhouse
and through the pineapple fields
adrenaline now punctuating
my rhythmic pace
and I can feel
my khangas
loosening.

Firm fists full of fabric
I walk past the watchmen’s wall
through the passion vines
and down the twiggy trail

until I reach
the well.


The sweet stillness of water
greets me
and I walk the handmade wall.


Balancing the beam
I lay on my back
and stare up at the sky

the clouds tint purple
pink orange yellow


sound the trumpets!
prepare the way!

“Behold, the Sun comes!”

I’ve been let in
on a secret the whole world is asleep to see

a new day comes in majesty


and I make the journey home.

Simply Christmas.

Christmas Eve

Christmas Eve was a day of preparation.
We were having a feast.
You know it’s a special feast when you have meat, and you know you’re having meat when the locals leave and then come back with a handwoven cage filled with white live chickens.

So the food on Christmas Eve was the works:
people went to work cutting fruit,
making fresh fruit juice (pineapple, mango, soursop),
shelling peas,
sorting beans,
frying peanuts,
making chapatis,
method of cookery: two open fires.

Under the mango tree we were roasting cashews.
First they are handpicked from the cashew tree, then roasted on a piece of tin on the fire, and then each shell is cracked with nearby jagged rocks.
(It’s an extensive process...no wonder cashews are so expensive!)


And, another big part of the day was of course plucking the freshly killed chickens.
I spared myself the discomfort of sawing off their heads with the axe, but I did help de-feather.

It was an emotional experience.
Not that I cried, but it was a strange thing to hold a warm little body with bones and feet, just previously watching them flap around with such enthusiasm.

Living close to the land.
I think doing this brings a new reverence to eating meat.
There are no supermarkets where you can pick up your de-boned, de-skinned, pre-sorted chicken parts.
Nope, if you want it, you kill it. You pluck it, you remove its organs.
You feel the warmth of its body slowly growing cold.

It made me wonder about the meat lovers that I know... if they would eat as much meat freely if they had to do this long process themselves.

Anyway, turns out we actually didn’t even eat the chicken. They just needed the extra hands to help prepare them.
It was for a Christmas feast in a few days for the orphans in the village.

There were other girls slicing beef chunks off of unrecognizable anatomy parts of the cow in the kitchen. That's what we had for the Christmas feast that night.

Anyway, enough about the meat. Why am I writing so much about meat!?
It seems like such a big deal because it is so uncommon here, but I suppose you eat meat everyday over there.

Moving on.
So the night:
Christmas Eve we ate outside on the sand with white tablecloths and red fire flowers.
The power went out and it was getting dark so we ate by the glow of candle flames and enjoyed the deliciousness of our day’s labour. Each one got a glass bottle of soda if they wanted, too.

We got dressed up and dined under the stars,
and then transitioned into singing praise songs and dancing around the tables in a big circle on the sand, African style.

We then put on an impromptu Christmas play made visible by the shine of a big flashlight. I narrated it and everyone participated, it was a big hit.

And then we had a small gift exchange with the Africans on base.
Maximum amount to spend: 1000 shillings, aka 1 dollar.
I ended up with two small packets of toothpaste.


It was a neat Christmas Eve.
I love that we could spend it outside, with the glow of the moon, and our feet in the sand.
And that we could dance, and sing glory to God.

Dark, starry, humble, basic, middle of nowhere, outside.
It was kinda like the night Jesus was born.




Christmas Day:
Joy to the World, the Lord is come!


It was so humid that morning!

We woke up and spent the morning greeting each other and eating a big slab of non-sweet “chocolate” cake. We sang Christmas songs, read the Christmas story, and opened our handmade stockings.

We each put something in everyone’s stocking, recommended amount to spend: 100 shillings per gift, aka 10 cents.
Which goes farther than you would think.

So we got 20 small delectable gifts of nuts, chocolates, candies, an orange, hair elastics, nice notes, creative cards people had made... I liked it a lot. I liked the care and the thought people put into them.

Opening our stockings...

Then we walked a kilometre or two down the sandy path to this nice resort place in the middle of a village (I don’t know how tourists find it!!), and had a lovely Christmas lunch.
We opened our big present there; we each drew a name and bought for one person, 5000 shillings... 5 dollars.
It was so fun to watch everyone open them, because it was all Secret Santa. Most gifts were handmade and really unique for that person.

I got the most thoughtful present! Two vintage British books found on the street corners of Dar es Salaam. There are secondhand book stands here and there, and if you look long enough and hard enough, you’re sure to find a gem.

“Good Housekeeping: Running a Home is Fun” by a London Home Economics teacher in the 70s. Great hand drawn illustations.
And a book with a red fabric cover worn with age:
“Junior Modern Essays”, a literary treasure of compilations on the most interesting of topics!

Then, after lunch, I layed down my khanga, had a nap on the grass, and then had a nice conversation with Orissa about the future, medicine, midwifery, missions, and hospitals.


and Boxing Day,

we spent here.
Boxing Day we went to the beach and chilled under a woven hut and enjoyed the breeze.
And swam in the ocean among the jellyfish.


It was a simple Christmas, and I loved it.

Christmas is in the Air!

Merry Christmas!

It's December in Tanzania, which means that you can now go to the village and buy mangoes for 30 cents. And pineapples for a dollar. Sweet deal!

It also means that it's Christmas time:
and that we are busy making our stockings to hang by the window,

drinking hot cocoa at night and putting our scissor skills to work making Christmas tree decorations out of free Airplane magazine pages. Paper chains, woven hearts, snowflakes...

Yesterday, I finished knitting my stocking, so it's ready to hang and bulge with packages of home roasted peanuts, fruit, and encouragement notes.

It’s been a wonderful Christmas season. It’s been very special to spend it over here with all the girls… we are quickly becoming a close-knit family. It’s like having 16 sisters.

Also, the weather has taken it up a notch:

It’s getting very humid over here. Sweating a lot.

We’ve decided the only time you feel fresh and clean is immediately after a shower. …Within the hour you’re fully drenched again. It’s a – unique—feeling.

I wrote a silly poem about it:

“I’m dreaming of a white Christmas, just like the ones I used to know”

What does a winter kiss feel like?

I’m starting to forget

the frostbite toes

and rosy noses

and frosty inhalations.

The creak of ice

the chill of bone

all this is starting to be unknown

when I have lived in this foreign home

and all I taste is salt

and all I feel is sweat

I’m swimming in my own ocean

over here

and I’m tired of getting wet.

What does a winter kiss feel like?

I’m starting to forget.

We sing a lot of Christmas songs, are having fun finding letters from overseas on mail delivery days!! Thank you all!

We decorated the dining room with snowflakes and stars… it kind of looks like a children’s art classroom!

And of course, the hospital is amazing. We’re really enjoying it and getting more fluid with our skills.

May you have a fun, creative, love-filled, Christ-centered Christmas!

Here are some photos of us in uniform…

Here is a team photo of us looking mighty official.
And here are my roomates and I.

We are 10 to a room.... nice and cozy!

We're still loving working at the hospital... it is crazy that we have less than a month here now.

Merry Christmas and Happy New Year ....... from East Africa.

Behind the Veil

.

.

.

.


Baby #7


Her name is Fat-Hiya Aly Salum.
She is a beautiful young girl, thin, lighter olive skin, 19 years old, and she is pregnant.

Her hair is long and whimsically braided in big sections that swell and twist and taper into thin air, like the ebb and flow of woven raw silk.
She has deep round eyes with fluffy dark eyelashes, and when she smiles, her full lips part to reveal her sweet little grin, with spaces between each tooth.

When she stands to walk around, her long legs take careful steps as her knobby knees wobble under the pain (and her top-heavy tummy), like a young foal learning to stand on its own. Her long neck cranes and her elegant limbs extend to stabilize herself in her new surroundings of metal shelves, flat beds, and the smell of antiseptic.
.
She has been fully dilated for a while now, but she has taken local medicine which has toyed with her regular contraction pattern. So she has been writhing in unending pain since I saw her in the morning. Her contractions have been very strong and unnecessarily painful for hours.

It is her first pregnancy, and she is markedly fearful. Her eyes flash wide with the searing pangs that overtake her tummy... the baby is coming soon.

I keep a watch on her every time I walk past, and once I see her membranes bulging, I prepare all that is needed for delivery.

Her membranes are bulging (her amniotic sac is intact and now looks like a water balloon coming down the canal.) At this point we rupture them (for they have not broken on their own) with the tip of the cord clamp, but manage to only get a small puncture, so the water is squirting out of a small hole.

Slowly, slowly, the baby’s coming down.
It’s painful for her, often there’s a look of horror on her face that sometimes she cannot even make a sound. The perineum looks tight and I question whether it will be able to stretch.
In this moment, it dawns on me that here I am, experiencing with her probably the most excruciating moment of her life.

Everything is going okay, it’s just not that fast. It’s good that the skin is slowly stretching, letting the birth take its course, not doing anything unnecessary...
The baby’s head crowns. This is the most painful part of the whole birth, termed the “ring of fire”.
This goes on for probably 10 minutes. Her eyes plead to mine but we reassure her that everything is going great!

I cannot imagine the pain. At this point the nurses would probably do fundal pressure, pulsing hard in forceful jolts on the top of her belly to get the head out. No, I’m not going to anything of the sort. We just wait and let baby come as he wants. My goal is to watch the perineum. It looks tight, but we’re trying our best to take it slow and do all that we can to help it not tear.

The head crowns... and baby delivers soon after. What a handsome baby! He is so cute, he’s captured my heart at the very sight of him!

I am thankful for the way I could take my time for this delivery. Especially for care after the baby was born. I didn’t have to be anywhere, the labour room wasn’t busy, all I had to worry about was Fat-Hiya and her having the best first delivery experience she could have. I knew she was scared and fearful and skittish, so I stayed with her, smiled a lot, and was very gentle in everything that I did. You could literally see her nerves calming down as we became familiar faces and pillars of trust to her, offering a comforting smile and a soft touch.

We brought baby over as soon as possible and she got to lay with him. It is so beautiful to see the sweet bond established as this young girl now becomes a mom.
I cleaned her up, changed her khanga, and when I checked her for tears, I was amazed! No tearing.

I was amazed, mostly at God, that our bodies are so well-made!

She looked so tight before, I was even wondering if she would need an episiotomy, but here she is, tear-free, with only a few scrapes that will heal on their own. Praise the Lord!

It was a long day for her. Hours and hours of pain and discomfort, but now,
she has a healthy, handsome little son beside her,
and she doesn’t need stitches.
Yes, this is how it is supposed to be.
She smiled at me with her young, bashful eyes, her childish braids going this way and that.

After she had rested, and was ready to go the Postnatal Ward,
she hopped off the bed,
fished through her basket, and the next time I looked she was all intricately wrapped up in a saffron scarf,
covering her whole body and leaving only a window to
see, breathe, and talk.





Suddenly, this woman that I knew, her beautiful hairline and elegant neck, the shape of her shoulders and the look of her hair, now was hidden.
Even though you could see her features, the scarf was distorting the loveliness of her face into a contrived shape, that she didn’t even look like herself anymore.





I then realized yet another reason why the labour room is a special place.

We get to see women with their heads uncovered, before they put on their veils and become a shapeless figure out on the street.

The labour room is a place full of rawness, transparency, trust, and where guards are let down.
A place of intensity,
vulnerability,
and nakedness.

Where it is safe to show your shoulders and reveal that which has been covered.

What a privilege, what holy ground,
to be in the place where
the veil comes off,
all is known,

and new life comes into the world.

Baby on the Go...

Another new day in the Antenatal Ward, another day full of surprises.


My Danish friend and I are at the examination table to check women’s dilation.




As per usual, the ward is packed, many to a bed, and the bodies have overflowed to the floor and inbetween beds.


There is a large woman with a scrunched up face, obviously in some degree of pain. The intern doctor points innocently and says, let’s check her.

We find her card, and she hasn’t been checked since 1 am last night, and she was 2 cm dilated. It is 9 in the morning now.... so it’s been 8 hours since she was looked at.
We get her off the floor, up onto an examination table and find out that she is fully dilated now.

!!
A quickness begins in our steps and we get her bag to get over to the Labour Ward as soon as possible so she can deliver. When you’re fully dialated, nothing is stopping the baby from coming at any moment.

She gets off the table, takes two steps, and then her knees give way....down she goes to the floor.
No no no no! Don’t sit down!

On her way down, I turn around and see the baby shoot out like a waterslide!


Right onto the dirty hospital floor!

The baby, still in its complete little sac, is in slow motion as it slides in its bubble across the floor. Then there’s kind of a bungee cord retraction effect as the cord reaches its end and then rebounds back towards mom.
We all freeze there for a split-second, as time stands still.


Then, I snap out of my shock as I hear,
“Khanga! Get a clean khanga for the baby!...”
I only have examination gloves on, but the nurse is holding the baby up by one leg, so I grab a khanga and quickly let the baby rest in my arms.

Somehow, a birth-kit from the labour room arrives, and we finish the delivery on the floor. Melisa, who is conducting the delivery, tries not to bend down too far with her long skirt touching the ground, awkwardly dodging the amniotic fluid pooling around her feet.

Cord is cut, and I’m standing over mum, holding baby and getting him all clean and warm.

There is a hush over the ward; I look up at all the labouring mamas.

Their little faces are peeking out from their place on the beds or on their pieces of floor, looking on with wide eyes and anticipation.
Valiantly, I hold up baby and show him to the on-looking crowd of mamas, and smile.
The tense silence is broken by laughter.
Their furrowed brows relax into a grin.
Joy is in the house.

The mom is flat on her back, -- on the bare tile floor laced with footprints and dirt and who knows what else -- happy and exhausted.
We clean her up, mop the patch of floor where she was,
and then carry on with the rest of the morning.

Wow.




What a way to start the day.



A little go-getter baby who’s on the move and can’t wait to come into the world!