Furah na Amani! Joy and Peace from Bukoba, Tanzania!
I’m so sorry that I’ve been out of touch with you for so long! Please forgive me! A lot has been going on and though I should have been better at keeping you posted on my adventures here in Africa, in some ways I think it may have been good that I have had time to process some of it before sharing it with my support team. I’ve been here a little over eight months already, and I can honestly say in retrospect that I have been through a lot of culture shock in the past months. Some days it has been difficult to remain positive about my service here, but I feel like those feelings are starting to diminish and I am able to be a little more objective about life here. I know that this is normal, and that everyone goes through periods of ups and downs with regard to culture shock, but sometimes it’s hard to recognize it for what it is when you’re in the middle of it! I have really missed writing to update all of you, and I’m glad that I am starting to feel more like talking about my life here. In my last update I promised to write to you about our October medical team. Instead of doing that right now, I’d like to give you a summary of what’s been going on here from October until February.
As I said, in October the four missionaries living here in Tanzania helped to welcome a short-term medical mission team from the US and Canada. We had a great time visiting and working with them to provide medical care to people in rural parts of the archdiocese. The people we served included members of Orthodox communities and also people who were of all different faiths. We were welcomed with enthusiasm everywhere we went. Many of you have seen pictures from that team on my Facebook website and I’d like to go into more detail in a separate update about the logistics of hosting a team, as well as what a medical team experience is like. More on that soon! The two weeks we spent with the team were wonderful—exhausting, but at the same time refreshing. It was good for the missionaries to have the opportunity to visit with people from “home,” and it was even better for me, personally, to feel like I was able to put some of my medical skills to good use. It has been difficult to focus mainly on language and cultural acquisition. As a nurse, particularly a labor and delivery nurse, I am used to a fast pace and to “immediate gratification” in my professional life, if you will. I know that God has been teaching me patience, but I have been a reluctant student to say the least!
In November, I got back to my “normal” schedule of daily language study, as frustrating as it was not feeling like I was making a lot of progress. It’s difficult to learn a language when you’re not in an immersion environment. Living with two other American missionaries is good for my emotional health—I need the socialization! But it’s a challenge to force myself to speak something other than English when I have them around. Part of it is that with two missionaries who have more experience living here than I do, it’s easy for me to get comfortable and allow them to do the tasks I would find challenging but which they have managed to navigate. For instance, something as simple as going out to buy phone vouchers or bottles of water was something I was avoiding in November. It was scary to me to be out and about on my own, to have to negotiate prices and basic conversations—especially alone and without the “backup” of a fellow missionary. However, both in October when we hosted the team and also in December, I was pushed to get more involved in everyday life here, to actually put my Kiswahili to the test! In October I’d been asked to help purchase medications we would use for the clinics, and it involved several trips into downtown Mwanza to negotiate that, as well as leading the short-term team members on expeditions to collect the meds. I’d been nervous about it, but managed it without much trouble. As it turns out, it was good that I became more comfortable with Mwanza, because by December I would be back (unbeknownst to me in October!).
Part of November was spent working on various administrative tasks to prepare the Orthodox clinic for registration and re-opening. Many of you know that the Orthodox “hospital” I was asked to come work in was suddenly and unexpectedly closed last year. We have since learned that it does not qualify as a hospital due to staffing and facility limitations. After much frustration, the local Church administration and members from a Greek NGO which finances the hospital came to the conclusion that a new application for registration needed to be submitted—this time as a “health center” or outpatient clinic. That work has been an ongoing process, and in November we welcomed a representative from the Greek NGO who has been working feverishly to help gather the documentation needed to get the registration. Felice, my fellow missionary and another nurse, has been working closely with this gentleman, as have I. We are dealing with every logistical thing you can imagine—from trying to get a reliable water supply for the clinic to hiring staff, to organizing supplies and medications and preparing for an inspection. I was more involved in this process in the beginning, but in the early part of December plans changed unexpectedly.
One night in December I got a text message from James, my fellow missionary in Mwanza. He had been travelling in Kenya for about a month and had recently gotten over malaria. He texted to me to say that he was having trouble breathing. I Skyped with him and could tell from the video that he was really having some significant respiratory symptoms. It was ten thirty at night, though, and James didn’t want to go in search of medical help that late at night. I encouraged him to make sure that one of his friends in Mwanza knew he was ill and that he would have someone to help him in the middle of the night if he needed it. James agreed. By the next morning I learned that James had, in fact, gone to the doctor and that he’d been told he had malaria. James didn’t think it was an accurate diagnosis, and he was feeling much worse so he sought medical care at a different hospital. I then received a text message saying, “Have been admitted to hospital, on oxygen.” I was worried, but not alarmed. I asked James if he wanted me to come stay with him, expecting that he would say yes. James wrote back that he was okay, but he would appreciate company. About an hour later, as I was trying to figure out travel arrangements, I got another text: “Being admitted to ICU. They are taking away my phone. Please come.”
I spent the next two weeks in Mwanza, the first few days in the company of fellow missionary Michael Pagedas. I was really grateful to Michael for travelling with me and for helping me to navigate the logistics of getting on the overnight ferry, finding my way to the hospital, and then searching all over an 800 bed hospital to finally locate James! Michael ended up returning to Bukoba a few days later, and by that time I was starting to feel like I could handle staying in Mwanza alone. It helped that I was familiar with the city, with the hotel staff where I stayed, and that I had developed a relationship with the Church staff. Everyone was very helpful, including a cab driver Michael knows well. I was also grateful for the help of the hotel driver, who took me to see James every morning at 6:30 am and even came in to visit him with me!
I learned a lot from visiting that ICU and from trying to glean whatever medical information I could from the brief visits I had with James, and occasionally with his nurses or physicians. I was actually really grateful that I was able to use even a tiny fraction of my professional knowledge to advocate for James and to communicate his wellbeing to his family and friends in the US. James told me later that it was helpful to him to feel like he had someone with him who understood what was going on medically and could help make decisions if need be. I will say, the first few days that I saw James, I was seriously considering whether I needed to prepare to get him transferred to a different medical facility if he didn’t improve soon. In retrospect, he was in very good hands and his care was entirely appropriate. But when someone is diagnosed with atypical bacterial pneumonia and they are in an ICU on 15L of oxygen and barely able to talk from being so short of breath, one does begin to wonder whether a backup plan should be considered! The main reason for my concern, too, was that African medical culture makes it difficult for patients and family members to really understand the plan of care or what’s going on at all. I was blessed to be put in touch with the attending physician taking care of James only because he was a friend of some other missionaries James’ family knows! It’s quite frustrating for anyone medical to see a close friend so ill and not be able to ask any questions! It would be difficult for anyone, but even more so for those of us who are used to advocating for our patients and who understand how necessary that can sometimes be to a good outcome! I was allowed in to see James for “two minutes,” once or twice a day. I was obnoxious and wouldn’t budge when security would ask me to leave after literally two minutes! I usually got somewhere between 5 and 15 minutes, and even that was difficult. In the end, though, James started improving after a few days and was discharged within a week.
I stayed an additional week in Mwanza with James, where he recuperated at the hotel I was staying in. I helped gather things from his house and helped him pack to travel to Bukoba, where he stayed with us over the Christmas and New Year’s holidays. We had a wonderful celebration with James and other guests, and it was nice for me to have a break from all the travel and running around I’d been doing. I was sorry to have put language study and writing to my supporters on hold for so long, but I knew that taking care of James had been a priority.
Just as things were about to get “back to normal” here, my computer crashed and James graciously took it back to Mwanza with him and worked on it for two weeks to see if he could spare me from having to travel to Nairobi to get it fixed! He managed it, with the help of some good friends, and I am ever so grateful to them all! The two weeks of sharing a computer with my fellow missionaries was good for me, and helped me put things in perspective, but it meant that I was yet again delayed from spending much time writing to all of you! I am happy to report that of course, it’s back in working order, which is why you’re finally hearing from me!
I’m back to language study now, as well as working on various issues to get ready for the clinic’s registration to go through. We expect to get the official approval to open by the end of February, God-willing! Please continue to keep us in your prayers! Language study is also coming along. I didn’t realize it, but the time in October and also in December actually forced me to use the language a lot more, and my lessons are actually going really well. I have moved on to a new phase of study where I am telling stories in Kiswahili using picture books. I talk for about 30 minutes at a stretch using only Kiswahili, then I have about a five minute break to go over anything my teacher thinks I said wrong or didn’t understand, and then I do another 30 minutes! My classes are about 2 hours long, four days a week, and I am grateful to be on to a new phase where I am starting to notice my own language abilities. I’m trying hard to use Kiswahili in everyday use as much as possible, too. Hopefully this means that I will be at least partially prepared to start talking to patients soon!
Thanks for bearing with me through a long and much overdue update. I thank each and every one of you for your prayers and for your love and support of me here in Africa. I have been praying for you daily, and even though you may not have heard from me, please know that I thank God for you every day. I feel the effect of your prayers for me, and I have been sustained by them and the knowledge that God is with me here, even when I feel overwhelmed and sometimes underutilized. I know that the “busy” time of my service is rapidly approaching, and I ask that you continue to pray for me and for the people I will serve here. Thank you for investing in mission work, for valuing it, for helping to answer our Lord’s directive to go forth to love and serve others in His name.
More regular updates coming soon, I promise! Please feel free to write back. It has been far too long since I communicated with you, so I will understand if you don’t get back to me quickly, but I do so appreciate hearing from you!
God bless you and grant you strength as we prepare to enter Holy and Great Lent!
Yours in Christ,