What Helplessness Sounds Like

SONY DSC I couldn't sleep last night. I lay awake in my bed on top of the covers with the windows open on a warm night in the village. Tucked beneath the mosquito net, I listened to the bloodcurdling screams of a child in pain. The ward is just a few hundred feet from us, and you don't have to listen too closely to know what helplessness sounds like.

A two-year-old boy in desperate need of an IV had severe dehydration. It was nearly impossible to find intravenous access on his body. Baby Alfred wailed as multiple attempts were made on his tiny little hands. Eventually, the clinicians succeeded and breathed a sigh of relief, and they moved on to the next patient. Our over-worked and exhausted clinicians served through the night as the hours eked by. Every bed was full. Patients continued to come through the night, whether on the back of a motorcycle as it hastily passed along the dirt path to the hospital doors or on one of the multiple runs of the hospital ambulance.

Earlier in the day, a 25-year-old woman had been found unconscious in her cornfield and was carried nearly lifeless to the hospital. Upon seeing her lab results, one of our Vanderbilt medical students reflected that this woman's condition was the kind of case that might have come by helicopter and immediately given attention by an entire medical team in the US. But here, there is no such resource, no such protocol, no such expert team.

On most days, the noises here in Lwala are the songs of small triumphs, murmurs of hope through the daily work of transforming this community toward health and healing. But last night, staring into the darkness, through the sounds of rushing vehicles, crying babies, and colleagues shuffling through the dorm to grab juice and bread for the overwhelmed nurses, I could only hear the deep, dark voices in my heart that spoke about defeat and injustice and inadequacy.

The infuriating reality is that there are angels here. In the form of more than a hundred committed Kenyans who are trying to tear away a corner of darkness through clinical care, community health outreach, economic empowerment, nutrition and education - but their limitations, our limitations, are severe. We do what we can with what we have. We often hear the voice that reminds us that it just isn't enough. Nine children under 5 died here last month alone.

Baby Alfred's father left the room, and the baby ripped that IV right out. So the nurses tried again and again and again, without success. More deafening screams.

And then the sound of weeping. My own. This is what helplessness sounds like.

For baby Alfred, for the unconscious woman, for the clinical officers, for the nurses, for the community health workers, for the patients on motorcycles, for the parents who worry about the fate of their children, for you, for me, for James, this is the voice that ultimately spoke to me last night:

Fear not, for I have redeemed you; I have summoned you by name; you are mine. When you pass through the waters, I will be with you; and when you pass through the rivers, they will not sweep over you. When you walk through the fire, you will not be burned; the flames will not set you ablaze. - Isaiah 43

The waters here are deep and murky. The fire, impassable. And yet, there is a promise given to us here. I yearn to believe it.

Let's Let Them Try

To say that it's hard to be an African girl would be a gross understatement. SONY DSC

This is Verona.

Her greatest fault is that she was not born a boy.

Her greatest contribution is household labor: carrying water, cleaning, cooking, working the fields, caring for siblings. And then, staying out of the way.

She is powerless to defend herself from abuse of every kind. You would puke with disgust at the rate of rape among our young girls here.

She is precious. She is delightful. She is worthy. She is valuable. She just doesn't know it.

There is no silver bullet here. Trust me, decades of do-gooders have tried to find it. But the closest thing we have found?

Keep a girl in school.

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This is Diana.

She will be less likely to get pregnant as a teenager or marry early.

She will have a lower rate of HIV/AIDS and lower transmission of the disease to her future children.

She will produce higher crop yields of up to 25%.

Every extra year of primary school increases her eventual wages by at least 10%.

She will have more power against a man when she is earning her own income.

Every extra year of her education decreases future infant mortality by 5-10%.

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Proven ways to keep a girl in school? New uniforms (to replace their irreparable ones), clean water supply at school (so they can return from school with water for the family), latrines and re-usable sanitary pads (most girls skip school during menstruation for lack of facilities and supplies), and community education about the benefits of girls' education.

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This is uniform distribution day at Kanyadigiro Primary School.

The girls in grades 6, 7 and 8 are given a special ceremony in front of the teachers, parents and community members to receive their uniforms.

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They are privately mentored from the women in the community about menstruation. And they are each given bags with their own set of reusable menstrual pads. Latrines, rain tanks and health outreach are already in process.

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These are our girls. They are your girls, too. They are beaming with potential, and I truly believe they have the greatest ability to shape the future of Africa. Let's let them try.

(If you are interested in learning more about issue, check out this blog post on the amazing book, Half the Sky by Nicholas Kristof and Sheryl WuDunn.)

Thirty-One

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I turned thirty-one on the thirty-first of January. The golden birthday, as many call it. I've had to wait the longest, being born on the final day of the month. Maybe like having a last name at the end of the alphabet. I don't know what a golden birthday represents beyond the clever age and date connection, but regardless, this birthday was special.

I spent the day in the Lwala hospital, shadowing my friend Japolo as he served patients with precision and care. As we traveled through the crowded ward, I was reminded that we are not guaranteed any breath beyond the one we have just taken, and to live past each breath is a miracle.

As we made the rounds, I met a man with a severe case of malaria which causes a bit of a psychosis along with horrible pain. His groans of physical suffering were small compared to the ones he had wailed just two weeks ago when his one-year-old son died of anemia.

A malaria outbreak. An increase in anemia deaths. We are full here, all beds in the ward occupied. Non-contagious babies sharing beds together. Two babies born this morning. Four born here through the night.

We each have one precious life, one light to shine in the world. Some burn steadily through the years until the wick is no more. Others are gone with a breath. For thirty-one years on this thirty-first of January, I give thanks.

Health & Hope

This is post 9 of 10 in the Broken:Beautiful series.                              DSC_0383

Like, James, I am honored to see the vision of Isaiah 65 lived out as I walk alongside the villages and organizations we partner with through Blood:Water Mission. So much of the progress we see is slowly, but steadily pushing back the darkness and ushering in bits and pieces of a "new heaven and a new earth." Progress like this:

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In the Cyanika district of northern Rwanda, water has been one of the greatest challenges for its people. They live on the side of a mountain, so in order to obtain their daily water, the women and children have had to walk down the mountainside and to a lake that is 18 kilometers (11 miles!) away from their homes, only to walk back up the mountain (11 more miles!) with buckets of water on their heads. And most days, they make this trip more than once. Moreover, the water from the lake is contaminated and contributes to many diseases that plague the Cyanika district. In the midst of this, small groups formed together through the local church and our local partner - they called them solidarity transformation groups. As they analyzed the challenges of water together, they decided to build rain tanks that could capture clean water during the rainy season. These small groups began a long campaign for providing, not only the tanks for their surrounding neighbors and community, but also for the marginalized pygmy people that are ignored by the rest of society. Slowly by slowly and brick by brick, these communities have worked together to achieve 100% water coverage for the entire district - something very difficult to attain anywhere in Africa, much less in village located on the side of a mountain. Children can go to school and women can care for their community because neither has to walk for water. Those who suffered stomachaches, diarrhea, skin infections, eye infections, typhoid and cholera are now enjoying a life of health and hope.

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Are You Tired? Get Outside (Of Yourself)!

image John Muir observed that:

Thousands of tired, nerve-shaken, over-civilized people are beginning to find out that going to the mountains is going home; that wilderness is a necessity.

I couldn't agree more. I have an insatiable love for the mountains because they save me from myself, they humble me, they push my comfort zone, and they paint Glory like I have never experienced before. They remind me I am alive.

And today, I was especially alive. James and I have the privilege of traveling together during my sabbatical. Right now we are in the French Alps as part of an 8-day layover to France before heading to Kenya. This morning, I woke up to a winter wonderland and felt a sense of awe catch my own breath.

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I generally like to calculate risk before stepping into the world, but this time, I am glad I chose otherwise. Without a plan, we rented a toy-looking car, drove past Geneva and found ourselves in this Eden of Winter. James even convinced me to go skiing - a sport that definitely pushes my comfort zone. But as you can hopefully tell from the picture above, I had a blast!

Do you find yourself tired, nerve-shaken or a little over-civilized? I would never have planned a day like today - it's not practical, it's not convenient, it's not cheap, and it's not even comfortable. But dear friend, days like these are a necessity.

The Friday Five: How to Pack for Travel to Africa

photo 2 James and I are headed to Lwala (by way of Paris!) and will be there for almost a full month. This is the last leg of my Sabbatical, and I am so looking forward to spending time with our friends in a place that has become our second home!

Of course, the downside to travel is all the packing and prep that goes into it. Since the beginning of Blood:Water over eight years ago, I've traveled to Africa more times than I can count - and over the years, I'm proud to say, I have perfected the art of packing. I even have a famous "Packing for Africa" tutorial and demonstration that has helped many first-time travelers pack everything they need for two weeks of travel in rural Africa - all in carry-on luggage only! I can say with full confidence that it is better to travel to Africa with less, than with baggage! James and I have learned he hard way: it's just better to bring what will fit in a rolling carry-on and backpack than checking.

Don't forget that Africa's climate varies, depending on region. So this is a general guide, but make sure you are aware of the specific climate and season to which your traveling.

Without further ado, here are my top five tips for packing:

1. Clothes to Pack

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  • 5-6 short-sleeved t-shirts (Ladies, remember to keep it classy and modest! Gentlemen, button up shirts with a collar are preferred)
  • 2 long-sleeved t-shirts
  • For Women: 3-4 lightweight knee or ankle-length skirts (most women wear skirts, but be sure that your knees are always covered, as anything higher is considered immodest in rural Africa) plus 2 pairs of lightweight pants or capris (comfortable for the long plane ride )
  • For Men: 3-4 light weight khakis (WITHOUT zip off shorts or cargo pockets) or semi-dress trousers with a belt (most men dress formally even in rural settings
  • 1 t-shirt and 1 pair of shorts/boxers for sleeping
  • 1 pair of jeans for days in transit or in a city
  • 1 fleece or zip-up outer layer
  • 1 lightweight rain jacket
  • 2 bandanas
  • 10 pairs of underwear
  • For Women: 3-4 pairs of socks For Men: 7-8 pairs of socks
  • 1 pair of comfortable walking shoes
  • 1 pair of semi-dress shoes (flats for ladies, loafers for men)
  • 1 pair of sandals or flip-flops
  • Sunglasses and/or hat

2. Gear & Documents to Pack

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    • Quick-dry towel (you can find this at any camping store like REI or LL Bean)
    • Headlamp with extra batteries
    • Nalgene (or other) water bottle
    • Alarm clock (or watch with an alarm)

iPod or smart phone (remember that you likely will not use your cell phone; you can plan to purchase an inexpensive cell phone in country rather than deal with international roaming charges - but it's nice to have music)

  • Earplugs
  • Camera
  • Universal electricity plug adaptor (REI carries an all-in-one adaptor that I prefer)
  • Granola bars or Power Bars (or any other small snack that is familiar and comfortable for you)
  • Passport and Driver's License
  • Additional copy of passport and driver's license, kept separately from your originals
  • Travel Insurance card (or make sure the person/group you are traveling with has it for you - Blood:Water provides insurance cards to everyone who travels with us)
  • Notebook and pens
  • Book (or eReader, which is a fabulous way to travel with multiple books)
  • ATM card (remember to call your bank before you leave so they know you are traveling internationally and won't hold withdrawals placed out of the U.S.)
  • U.S. cash (make sure that any $50 and $100 bills are dated AT LEAST 2009 - anything printed before 2009 may not be accepted
  • Inoculations proof (you will receive a yellow card - just keep it in your passport)

 

3. Toiletries to Pack

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  • 2-3 packs of travel-size baby wipes
  • Toothbrush, toothbrush cover, and travel-size toothpaste
  • Floss
  • Hairbrush/comb
  • 3 packs of travel-size Kleenex
  • Mini travel mirror
  • 2 razors and travel-size shaving cream
  • 2 travel-size packs of hand sanitizer
  • Contact solution and eyeglasses (if applicable)
  • Sunscreen - at least 30 SPF
  • Insect repellant/li>
  • Deodorant
  • Travel-size hand or body lotion
  • Travel-size shampoo and conditioner
  • 1 small roll of toilet paper (you can roll your own or get Charmin’s travel-size version)
  • 3-4 travel-packets of dry laundry detergent (Tide or Shout both work great)

4. Medicines & First Aid to Pack

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  • Malarone - Malaria pills (remember to take one every morning with food)
  • Sleep aid (I generally take one on my first two nights in Africa to help me settle into the new sleep schedule)
  • 1 small bottle of Pepto-Bismol pills - stomach aid (I generally take one every morning to coat my stomach)
  • 2 rolls of travel-size Tums - antacid
  • 1 broad-spectrum antibiotic (I use Cipro - you will need a prescription for this)
  • Small bag (10-15) of cough drops and/or throat lozenges
  • Travel-size tube of Cortizone - anti-itch cream
  • 3-4 packets of Emergen-C (or other)
  • Various size band-aids - 2-3 of each size
  • Neosporin

5. Packing - The Main Event!

p17total4I would highly recommend traveling with only carry-on luggage. This will practically erase the possibility lost luggage and will make traveling while in Africa infinitely easier. I know it may sound crazy, but, I promise - you CAN fit all of the above into one small/medium-size rolling duffle bag or suitcase (make sure to confirm that it matches size regulations for carry-on luggage!), one backpack, and one purse or messenger bag that you can carry with you every day in Africa. Here are some helpful tips on how to do that (hint: it all comes down to plastic bags!):

  • Gallon-size Ziplock Bags: roll up all your clothes and seal them in Ziplock bags, squeezing out all the air to create a vacuum-like pack.

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  • Carry-on Liquids: Remember that (A) All carry-on liquids need to be less than 3oz and (B) they need to fit into a quart-size bag.

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  • Medicine: In order to save space, I put my medicines in little pill bags that you can buy at drugstores like Walgreens. If you do this, remember to make sure each bag is labeled so you don't mix up your medicines! I like to take the label or sticker off the original packaging and include it right in the bag with the medicine. Once all your little bags of medicine are ready, just put them into one of your ziplock bags!
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And there you have it! Jena's famous Packing for Africa 101!

Au revoir until next time!

 

Wise Words for Your Day

DSC_0218 I love this quote from Anne Lamott. It reminds me to slow down and actually look around at the broken and beautiful world around me. It reminds me to notice the details and rest in the ordinary moments.

There is ecstasy in paying attention. Anyone who wants to can be surprised by the beauty or pain of the natural world, of the human mind and heart, and can try to capture just that - the details, the nuance, what is. -- Anne Lamott