Friday 8 March 2013

Unprocessed Events of a Weekend Past


Long weekends are suppose to mean an extra long rest period. I had been looking forward to the March 3rd Martyr's Day Long Weekend since I went back to work in January. Not that I hadn't taken a few afternoons off here and there over the last two months, but I was looking forward to an extra morning of sleeping in and lazing in my p.j's.
I suppose you wont find it surprising then that at 6am on Monday morning I received a phone "flash" from a co-worker (meaning, whoever is calling you does not have money to pay for the call, so they "flash" you their number and expect you to call back), which I ignored, and at 7am, Florence texted me asking: What is our plan for today?
Isn't that how it often works with our best laid intentions to sleep in?

Now, let me back up a little, to late Saturday night.
Florence texted me in pain. She didn't elaborate, but her text sounded urgent. When I talked to her, she minimized the pain and discomfort and confessed she was sure it was psychological due to now knowing her neck was indeed fully fractured. She had just been wondering if the whole "surgery" process could be sped up some.

Sunday morning I woke up and immediately texted her to find out how her night was. She was completely fine and no longer in panic mode. That was great, but having already contacted the doctor who got us the updated x rays, I now knew that the surgeon in Blantyre we were suppose to be seeing, saw her case as extremely urgent and serious. He wanted her to come to Blantyre by ambulance asap!
When I told Florence this, she cringed. Her idea had been taking a car to Blantyre. Because she was able to move and had been mobile for a month already, the idea of being confined to a back board and unable to attend to simple movements or needs, was daunting and discouraging. The drive to Blantyre, though only 300km, is at least a four hour drive...if lucky. The maximum speed is 80km and at every town that you pass through, the speed limit drops to 50km. There are pot holes, rumble strips, bikers, goats, walkers, cattle and police stops at random. A four hour drive is generous.
Anyway, I spoke directly with her and her family. I explained the doctors position on the situation (as I had somehow become the correspondent between the surgeon, the private clinic who did her xrays, and Florence), and strongly suggested we err on the side of caution and take an ambulance.
I had some money to offer toward the cost and thought it would be wisest to proceed immediately.

I contacted the ambulance company (private service) and was quoted a price of nearly $1000 for the drive to Blantyre. Suddenly, I didn't feel so competent! $1000! I did not have THAT much to offer. I felt horrible. I felt I had let her down. I felt like a pea. I hated to have to call and tell her the cost. And when I did, she was immediatly against taking the ambulance.
The day continued in this whaffing, oscilating manner. I will spare you the continued dialogue between myself, the clinic and Florence, because it felt like it went on forever and ever.

I did manage to discover that the first man's quote was way over priced and in reality, it would only be about $500. However, that was still too much for Florence to consider being spent on her behalf and she downright refused.
We had attempted to contact the surgeon directly and clarify his understanding of the situation. He was under the impression because the x rays had been sent to him from a private clinic, that Florence would be a private hospital patient.
I had to explain to him that she would not be coming to his private hospital...but she would be a patient at the public government hospital where he also worked. In explaining this, I also explained that paying for a private ambulance was not feasible.
So, we were back to waiting. Waiting to hear what the surgeon suggested, waiting for a chance to possibly get a second opinion. Florence, proving to be much more patient than I, left things Sunday night by telling me to relax and trust God. She said we would wait to hear from the surgeon before making a decision.

Thus, when I got a wake up text Monday morning asking me what we were going to do, I was a little bit annoyed at having been woken up! Truthfully, I had figured that because it was a long weekend, we wouldn't hear from the surgeon until Tuesday and we would have to make plans to go to Blantyre later in the week.
But, by 7am Monday morning, Florence had decided she wanted to get on with it, and drive to Blantyre TODAY!
Suddenly my relaxing day was replaced by a frantic morning of packing, arrangement making with steadfast prayers that she would be safe in my car! The responsibility of driving a patient with a broken neck on the Malawian highway was not something I took lightly. I constantly had to remind myself that God had brought her safe thus far, He was not going to let her down now!
This whole experience has already brought to mind so many questions for God, but at this moment I needed a bit more understanding.
Was my willingness to drive, and Florence's steadfast assurance that God would protect, foolishness, or just an overwhelming strong faith!?
I wanted to believe it was a strong faith, but I wondered at the same time, was $500 really that much money to spend in order to be more safe?
I realize that there is a country full of people that have to make these decisions in faith because they have no way to financially support the other option.
But had God put me in Florence's life and allowed so many people to give toward her needs, in order that we opt to drive to Blantyre instead of taking an ambulance?

Unable to sway Florence's determination, I chose to err on the side of FAITH and completely abandon all fears of the potential dangers and trust that God would be with us.
Our agreed departure time was 10am, so I had a couple of hours to find myself a place to stay in Blantyre. I know no one there. And the one missionary family that Matt (my guru) knows was actuallly facing a crisis of thier own. The husband had been diagnosed with one of the most dangerous stages of Malaria earlier in the weekend, so of course staying with them was not an option.
Still not having heard from the surgeon or from anyone taking pity on me for accommodations, I set out to pick up Florence. I was a few minutes late and felt bad that I was running behind schedule. But no worry was necessary. We didn’t leave until 11:30 – perfectly on-African-time!

The drive felt long; it took us five hours – which is remarkably good time – but seemed to be forever. It was hot, and then it poured rain. We were stopped by the police twice, just because. Florence in the front seat with her neck collar helped the cause as the police didn’t bother us for much more than a quick “hello” and registration check.
But by the time we got to the hospital just before 5pm, I was wasted. I had heard by then that there was a lovely lady willing to let me stay at her place, but until Florence was checked in as a patient, I wasn’t willing to go anywhere.

I’d like to paint a lovely picture of myself at this point. One that depicts me drawing from the well of reserved patience and kindness and being overwhelmingly supportive. But truth is, that would be a bold face lie!
I was so beyond patient by this time that the government hospital system nearly did me in.
It took one and a half hours for us to be registered.
Absolutely NO ONE was willing to help….
Each person we asked for assistance passed us off to another line, who passed us off to someone else because they were on break, or it was shift change. Finally they told Florence to sit against a wall and wait. Well, that was stupid…we hadn’t even given our names yet. So who were we waiting for? It was completely obvious that the staff were not willing to work unless it was literally staring them in the face, so sitting off in a corner was not going to get us any help.
Internally I struggled with pushing for the kind of care I expect at home and practicing African patience. I have watched the azungu in this country demand a lot in name of “proper” care. I’ve watched them bully their way to get preferential treatment and to belittle those around them who are not willing to speak up for themselves. My biggest concern was Florence, and I knew she needed to be seen by a doctor. But I also knew that any movement I made at all while in the hospital would be observed by everyone. I was the only mzungu there.
And I did not want to be a stereotypical pushy and rude and arrogant white person!

After an hour of waiting in numerous places, with no further assistance than those who had just walked in, I decided to just stand in line. Even though I was pretty sure that it wasn’t the line we were supposed to be in, I thought if we could at least get our names on a “list” we would eventually see a doctor.
And once Florence was registered, it took less than twenty minutes for her to have a bed in the ward.
I couldn’t believe it!
If only I had ignored all the original instructions we were given and just stood in this line from the beginning. No one would have ever known I was impatient at all!!!!!

The reception area where we sat for an hour and a half was a very nice clean hall. It was spacious, with many benches (not individual chairs) and about seven private triage rooms for the incoming patients to be assessed.
It gave the illusion that the hospital was in better condition than the government hospital here in Lilongwe.
Florence even commented on how nice it was.
However, sadly, as is the case I have found all too often, that what is on the outside is not necessarily a true reflection of what is on the inside.
The moment we walked out of the main reception area and headed to the orthopedic ward, a whole new image was painted.
And our spirits fell.
The hallways were blue painted cement with fading directions. The floor was nothing more than a concrete slab. The door to Ward 5B opened and the putrid smell of body odor immediately filled our noses. There were about six to eight private-ish rooms along the corridor, each filled with three or four patients. These might have been the rooms one could pay extra to stay in. At the end of the hall, another set of swinging doors opened to the massive hall of madness and mattresses.
Nearly fifty beds lined the walls and created a center aisle down the middle of the room. Women on each bed, some care givers attending to them. Few with blankets, most just lying on the plastic covered foam mattress. Those who were not able to get a bed frame, were laying on their mattress on the floor, in between the beds of others. Those with IVs had the bags hung by a nail in the wall and sat idly under their drip.
This room smelt even worse. The body odor was masked by the smell of dirty bodies, feces and vomit.
In government hospitals nothing but services are free. There is no food provided and one must bring their own bedding and personal hygeine items.
Not one medical person could be seen. No nurses, no reception desk. Nothing to show us where we might need to go or who we should talk to. Unable to be patient any longer, I walked around through the rooms looking for someone who was wearing a disposable white apron. I found no one, and was greeted by so many stares of indignation and curiosity that I actually felt uncomfortable. I walked back to the bench where Florence and her sister were waiting, took one look at their faces, and cringed.
Was I really going to have to leave them in this place, Lord?

Florence’s first comment was a recognition of being duped by the front reception, but before I could apologize, she immediately told me not to even think twice about leaving them there. She was going to be seen by a doctor, get the medical attention she needed and it was all going to be okay.
Ah, to glean from that sort of attitude!

A few minutes later, nurses appeared and a few more minutes later, she had a bed. Thankfully she wasn’t in the big open hall that greeted us, but in behind, in a semi private room with only seven other patients. The doors could be closed ensuring that at least some of the noise from the other fifty women would not keep her awake at night.
As her sister and I brought the luggage from the car, I was overwhelmed with emotion. The conditions of this hospital were deplorable. If a Canadian hospital looked even twice as good, it would be shut down and condemned. I couldn’t imagine myself staying in such a place and it broke my heart to consider that no one in our country would ever be grateful to have a bed in those conditions.
How is it that such a place exists? And how is it that one country can attend to its citizens with such pompous care that they continually demand better standards, while another country in the world neglects its own mothers and fathers and children? This is so much more than an issue of money, or resources or human rights violation.
And until I can process this further, its where I'm ending today.
I welcome your thoughts, your opinions and even your challenges to my words. I need to process and am willing to dialogue if you have some ideas to share (if you dare!)

Friday 1 March 2013

What THANK YOU really looks like


Ephesians 5:20 says, 20 And give thanks for everything to God the Father in the name of our Lord Jesus Christ.
Until today, I always struggled with this concept, merely in remembering to give thanks for the small things. Thank God for my job, or a place to call home or a meal to eat. Thank Him for simple pleasures and for small surprises. Thank Him for the things we tend to overlook and forget or take for granted.
Slow down enough, and give Him thanks, for everything.
But today, I learned an AMAZING lesson in giving thanks.
So HUGE indeed that I must share it with you!

My friend Florence, the one who lost her sister in a car accident in January, and also dislocated one of her vertebra  in that same accident was released from the hospital after a month ago after spending only three weeks in traction.
My boss, Kathy, encouraged me to have her x rays looked at by one of the orthopedic surgeons from Blantyre (another Malawian city, five hours south of Lilongwe) because she thought three weeks was a premature release.
It took a couple of weeks for me to obtain the x rays and meet with the doctor, as his visits to Lilongwe are on a rotation of once every five weeks. When he did see the xrays, he was immediately concerned that she was no longer in traction and that she wanted to travel back to Zimbabwe soon, which is her home country where most of her family reside as well as her sister, Everjoy’s children have now been moved there.

This doctor (John) referred us to another surgeon in Blantyre, who casually responded to our request by suggesting we visit him one Tuesday as this was his day to see patients (and not schedule surgery). However, he mentioned he might refer her for an MRI and that it is a costly expense. He warned us to be prepared financially.
So, given that information, I decided that I would rather pay for Florence to have recent and better quality x rays from a private clinic than to risk taking her poor originals and needing an MRI.

We went to the clinic this morning, and had an “appointment” of sorts. We still ended up waiting an hour to see the
 x ray technician. When he first looked at the x rays that were coming out, he was hugely alarmed. He pointed out immediately that there was a fracture and a bone piece had been dislodged.
Confused, I went to the car to get the old x rays. There had been no sign of a fracture on those ones. Just a dislocation from what the doctors at the hospital had first told Florence.

So, in comparing the x rays, I discovered a MAJOR blunder. The original x rays were a terrible quality x ray. We knew that from the start. But what we didn’t realize is that because of the poor quality of the picture, the fracture was completely unnoticeable. Imagine! For eight weeks now, Florence has been living with a fractured vertebra because her original
x rays were too poor of quality to even see that part of her neck. It was all just a blur of bone and mass in the picture.
While I was examining the old x rays another doctor walked by (probably wondering why I was playing with the x ray light and photos) and so I had to explain myself. He took one look at the pictures and was alarmed.
“Why is she walking? How is she moving? Does she have a neck collar? She should not be moving at all!”


Alarmed at what was being discovered, the other doctors all congregated around the pictures, throwing out their ideas of emergency, ambulance, surgery! Poor Florence, sat there listening, not being allowed to look at the pictures because standing would require her to make movements that she was suddenly no longer permitted to make.
I felt terrible for her. I had brought her here to get new x rays, praying that the pictures would show she was healing fantastic, and instead, she is told that because of the negligence and primitive machinery of the original government hospital, she is in serious condition with a fracture and a poorly healing dislocation.

There wasn’t much I could think of to reassure her. I asked the doctors who were all chatting amongst themselves to at least explain the situation to us, but immediately they all suggested they weren’t the specialist and resisted giving us an sort of diagnosis. Fair enough, but the fact that they were all sharing their panicked suggestions with each other in front of us (Florence especially) was hugely discomforting.

When they finally all left to go work out what was to be done next, I turned to Florence and in a timid manner asked her how she was feeling. If I were in her shoes, I would have been angry and scared. I would have been so mad at the original hospital for their failure to diagnose correctly and the obvious mistake of discharging me without even taking new x rays. I would have been scared at the prospect of having emergency surgery and being bed ridden for a few more months in a foreign country. I was trying to prep myself for a similar response from Florence and mentally placing myself in to the best supporting role.
Instead, both Florence’s response, and her sisters (who had accompanied us), immediately were:” This is such a testimony for God. Let us give Him thanks. If we had not come with you today, we would not know this news. We would have been blind to what was really happening and Florence would have been in serious risk.”

As I picked my jaw up off the ground, I processed what I had just heard. Both, unquestionably accepted the situation of potential surgery and the severity of her fracture by thanking God that it had been discovered.  IMAGINE THAT!
IMAGINE not being angry at the injustice and negligence of professional doctors!

IMAGINE not wanting vengeance or justice or even considering suing the hospital!

IMAGINE praising God that you’ve discovered your neck has been broken for eight weeks without you knowing!

IMAGINE THANKING HIM for revealing this truth to you!

I was shocked.

AND HUMBLED of course.
All my inclinations went right out the door and I too just accepted their patience and praise and thanked God for showing us that her situation is much more serious than we originally thought.
How could I get mad and angry when she was not reacting in such a way? Who was I to suggest that she allow all these negative feelings to overwhelm her and take over her calmness and peace?


And as we sat there for another two hours, waiting to hear back from the doctor in Blantyre (John) about the immediate course of action, all I could do was apologize for the length of time it was taking and the fact that she had been restricted to her chair and was not permitted by anyone to get up and move around. I felt so bad that all we could do was just wait, and again, their patience and their calm came over me as well and seeing as I could do nothing to speed up the response of the doctor, I too reconciled myself to wait.

And, while I was waiting, I decided to give thanks to God!

May each of you choose to do the same today!

***********************************************************************************************

Prognosis:

Dr. John finally returned the email with instructions. He is sending the xrays to the specialist he had first contacted regarding Florence’s case and we will wait for his first appointment to go see him. I will be taking her as soon as we can make that happen – provided he approves her to ride in a car for five hours on pot holed roads.
The alternative, she will be put on a back board and transported by ambulance to Blantyre, or she will have surgery here at a private clinic that works in conjunction with Dr. John.
Perhaps we can persuade someone from Blantyre to come here and do the surgery…I'm not sure. But we will wait and see. In the meantime, Florence is at home, resting and moving minimally, and of course, giving thanks!

While on the subject of THANKS: I just want to thank all of you who have given towards my ministry here, and especially those who have given lately. The extra funds I have received will undoubtedly go towards the medical costs Florence now faces as the surgery at a private clinic will not be free, nor cheap. Travel to and from Blantyre will also be an additional cost to my budget, so I just want to thank you for listening to God’s prompting to give as He has prepared for these costs in advance, and has given me peace that He is in control! I give Him thanks with ease for His continued provision!

In Christ,

meLissa