Friday, August 22, 2008

Little Gwame and Bob the Horse

A young boy with twisted legs. An old horse with a twisted
pelvis. Neither was expected to walk again. But their story has a twist of its own.

From James:

I was riding my horse Bob when I came to Gwame's house. Bob was an old horse who had been slightly handicapped by trying to jump over a six-foot-high fence. He didn't make it but hit the top of the chain link and flipped over. His knee popped out of joint and his pelvis was twisted. Somehow, he recovered enough to not only walk, but trot and gallop. The accident also made him gentler. Every once in a while, though, Bob still thinks he's a young stallion and he wants to race.

Today was one of those days.

I'd finished work early at the hospital and took Bob out to the river. We rode across the African plain at a slow gallop. There are no giraffes, elephants, zebras or lions. The local villagers hunted them all down years ago. The only dangerous animals are snakes and hippos.

After arriving at the river, I carefully looked up and down to make sure there were no hippos and then took a long swim. The day was hot and the water felt cool. I got out and got back on Bob. Bob had just eaten the only green grass to be found in the dry season here in Chad so he had a lot of energy. He took off at a mad pace. The wind was whipping in my hair and I was holding on for dear life.

We finally slowed down as we entered the village of Béré. Gwame's house is just on the outskirts. His house is made of mud bricks with long bundles of straw tied together for a roof. Around the house is a mud brick wall surrounding a courtyard. In the courtyard a bunch of chickens run around. There are also a few goats, two cows and a horse tied up to a pole. The horse stares at Bob wondering what it must be like to be free. There is also a round mud brick storage bin with what looks like a chimney coming out the top. It has been placed three feet off the ground on piles of sticks. That's so the rats can't eat the grain stored inside.

As I ride up, I see Gwame run out to meet me. I remember the first time I saw Gwame. He could barely walk, much less run. It was a year ago and I was with my friend, Troy. We went to Gwame's house to visit his family. Gwame was carried in by his older sister. His skin was covered with parasite bites. He was skinny and his eyes were dull and hollow. Both legs were angled towards the left at the knees as if something had hit them from the right side. It left him a cripple, unable to walk. His twin brother was also there reminding us of what Gwame should be like. When we said "hi," he didn't look up and barely said "lapia " in reply.

Troy wanted to help. So he found some friends back home in the USA who gave money for Gwame. We took him to N'Djamena, the capital of Chad, and got him a passport. Then, we sent him to Kenya to the CURE hospital to be treated. The CURE hospital does surgery on kids who have bone problems or who are crippled.

There they cut one of Gwame's bones in each leg and twisted his legs back into the right position. Then they put both legs in a heavy plaster cast for two months. Gwame came back after one month. He had eaten a lot of food in Kenya and now was a chubby little dude.

Six weeks after he came back, we took off his casts. He was scared and cried a lot. We tried to get him to walk but he was weak and frightened. He wobbled a few steps and then had to be carried home by his mom. Maybe the surgery didn’t work.

But today, a few months later, as I ride up to Gwame's house on my horse, Bob, Gwame comes running out to meet me with a huge smile on his face. There is no limp. His eyes are bright. He holds his arm high above his head with anticipation all over his face. I lean down holding my hand out and he slaps it a big "five".

"Gwame, ma gei ere lemga ga?" I ask if he wants to ride the horse. He nods solemnly. I lean way over and grab his still skinny, but healthy arm and haul his five-year-old healed body onto the saddle. He sits in front of me and squeals in delight as we trot off towards the hospital.

Tuesday, August 19, 2008


From James:

Why did I choose to wear shoes? I thought it would protect my ankle which had been smashed by Jason last week forming a superficial blood clot leaving my left inner ankle and foot swollen and different shades of purple and green.

Now as I send the ball skimming back across the grass, in the general direction of where I want it to go, I feel some burning pains on the sides of both small toes.

As Bond, Gabriel, Klevin and Stephan continue to play with some of the neighbor hood kids I step behind the two broken bricks marking the goal posts and take off my shoes. Sure enough, blisters have already burst leaving raw flesh where the side of the toes should be. I jump back up from the ground and join back in the game. As I look up past the other goal defended so well by Bond things sort of go into movie mode as four well muscled, lean teenage Chadians stroll up slowly from past the end of the fence. I almost feel like things should go in slow motion with sinister music from some gang flick plays in the background. The brief moment is burst, however, as they flash large smiles and I recognize Koumakoy and Frederick's "little" brother along with some of the normal neighborhood soccer thugs.

We quickly divide into "us" versus "them" as they are intent on preserving the national Chadian football honor on this warm, Friday afternoon. In fact, warm is an understatement as the humidity from last nights downpour hangs like a suffocating blanket over the ratty field as a cloudless sky lets a merciless African sun slowly broil us alive.

Needless to say, a few minutes into the match and my scrub bottoms are already soaking with sweat from the waist down and the top has long since been discarded. Along with our great Brazilian hope, Klevin, we are the only barefoot ones on our team. Stephan is our version of a gangbanger with his recently shaved-head-except-for-monstrous-sideburns look intimidating the opposition almost as much as his bare bear chest and cleats. Gabriel and Bond also are wearing scrubs and tennis shoes. Our opposition is lean and mean wearing only shirts and the occasional t-shirt along with bare feet and/or flip flops of various sorts.

We score first, a beautiful pass from Klevin after some footwork only a Brazilian could imagine setting up Stephan for a nifty tap in. Second blood is a breakdown in passing on my part setting up an easily intercepted ball across the middle and an easy angle shot off the bricks. From there on out it's back-and-forth with the Chadians controlling the ball the majority of the time before losing it through too much dribbling and not enough passing. We on the other hand make the most of our few opportunities and are soon up 3 to 1.

A loud thunder from the East makes me look up to see angry clouds forming quickly casting a slight shadow over the millet jungle that Bere has become and sending a cool breeze across our sweaty bodies. A perfect rainbow encircles the encroaching storm and as brilliant footwork and sometimes stellar passes continue beneath the now menacing sky, small pellets of water began to drop into the dry dust of the road making up the Western part of our playing field.

I quickly run over and put my Bible and songbook into the open doors of the church just to the Southeast, then grab my shoes and barely get them in before the downpour starts. We have not yet begun to play.

The game goes on.

We are drenched within minutes and passes start to get sloppy and slow down as the earth turns boggy. The rainbow has dissappeared but there is still clear sky to the West where the sun is almost changing color into sunset. The rain is coming down almost parallel to the ground drilling into our welcoming flesh from the East.

The western part of the field (formerly the road) is now almost unplayable as any pass hazarding into its slimy clutches is instantly stopped in a puddle of water and muddy sand. The chadians with flip flops are starting to slip and slide dangerously while the barefooted ones continue with no loss of traction. A huge grin splays across my face as Bond looks on from the eaves of the church having retreated there with the first of the downpour.

I haven't had this much fun in a long time.

Eventually, the Chadians say they are done. Down now 5 to 1 I don't blame them. They rub their tummies and give mournful looks as they say they haven't eaten since the strength. I mock them comparing our sagging bodies to their chiseled frames but they just laugh and insist. We finally agree to meet again sunday, slap hands all around and I head back over to the church as the torrent continues.

The noise inside the tin-roofed church is deafening. The only people who've made it for Friday evening prayer meeting are Lazare and a few kids who come around me as I sit in front of Lazare and say we should sing or something.

Shouting out loudly as we belt out songs in Nangjere I can tell that the kids are loving it, especially one-armed-boy. Finally after a few rounds of "Ka Ama Kouma Kwani Teri" and "Kela ka dane ma ei kera...dul kang ddi, Jesus, Jesus-Christi". I tell them the story of David and Goliath using Lazare to translate from French into Nangjere.

I end with teaching them "Only a Boy Named David" in Nangjere (Kware kusi ne David) by holding the songbook up to the last rays of light coming in the slit that serves as a window on the church. Then, one of the boys prays, Lazare locks up and I walk back slowly home through the mud and the mist.

Friday, August 15, 2008

Ahhhhh, The Weekend

You would think that I had completed a sewing project of mammoth proportions this week instead of just a size 4 children's dress...I just no energy to do anything else.

Finally drug myself over to DD's classroom to help her rehang her Cowboy wall of pictures that fell down while we were up north this past weekend. It was a nightmare of tape, paper and pictures that took up a wall that measured about 10' x 10' - what a mess. We were able to get it back on the wall and the pictures don't look too bad from a distance.

Then somewhere I got the wonderful idea that I needed to bake bread yesterday - after an absence of 10 or so years of doing it. The good part is that I used my Bosch so it wasn't too bad a deal to do. The not so good part is that I used too much flour and if you dropped a loaf on your foot it could do some serious damage. Oh, well, I will know next time that I need to stop adding the flour even when the dough isn't cleaning the sides of the bowl.

In a couple of weeks we need to go back north for a centennial celebration and another wedding so I thought that I should get busy figuring out what to wear for the weekend. I like to peruse the clothes on NM's website for ideas and when I saw this outfit it reminded me of a vogue pattern that I had purchased at the last pattern sale.

Do you think that this pattern will work? September is such a confusing time of the year to dress is usually still warm but can be cool in the morning and evening so I am not sure what type of fabric would be the best for this look.

Well, that is the plan that will hopefully be started next week...we'll see how adjusting the pattern goes!

Tuesday, August 12, 2008

The Dress is Finished - Finally

Even though I thought I would be finished with DGD's dress last week, life happened and it was only today (Tuesday) that I was able to have enough time to work on it and actually complete it. It was a fun little "frock" to make, although it turned out to include more handwork that I had anticipated. So I just rev'd up the laptop, tuned in to Project Runway Australia, and watched the latest episode while I did handwork. My DIL is really good about sending pictures so when I receive one of DGD in the dress I will let you see if it really did fit.


I feel like an idiot. What was I thinking! Of course, the wound would get infected. I was too optimistic when I wrote that the wound looked great three days later and maybe a miracle would happen. The fracture got infected the next day. I tried to clean it out again and cover the bone with some muscle. That got infected. I tried to cast it in various ways, the bone didn't stay in place and kept pushing out through the wound, seeking the outside air like a drowning man. Nothing seemed to work. I thought maybe we'd have to amputate. Finally, we just left the whole thing open and let diluted bleach dressings do their trick. Slowly the wound cleaned up and granulation tissue formed. We kept asking if anyone could send us an external fixator, no one could find one. Finally, the wound was clean but the fracture was still only partially stabilized and the bone was still exposed.

Luckily, I am temporarily not alone. Dr. Bond and Dr. Jason Shives are with me in Bere. We talk about the open tibia fracture and what to do. Finally, we come up with a brilliant plan straight out of the MacGyver archives. Abel and Simeon prepare the patient while I head over to the house. I find a long piece of two and a half inch pipe that seems pretty strong. I grab a saw from the tool box and we cut two pieces off, roughly the length of a certain man's tibia.

Meanwhile, Jason and Abel have brought out the small generator and the cast saw and have been spewing plaster powder all over the ward in an attempt to take of the full leg cast.

We rejoin Bond in the OR where we try out Bond's regional spinal anesthetic technique by having our patient lie on his left side, the side of the fracture, while we put in the spinal lidocaine and let him sit on that side so only his left leg will be numb. When it's settled in, we turn him back onto his back and I hand the leg off to Gabriel to hold while Abel preps the leg with Betadine.

Jason and I scrub while Bond directs and advises. I first pull out some pieces of infected sequestrum and chip off some of the bone sticking too far out with a rongeur. We twist the leg into a more anatomical position and Gabriel holds it steady. I follow Bond's suggestion and make four tiny incisions, two above the wound and two below. Then I take a regular, unsterile cordless drill with my right hand and insert a sterile, threaded Steinman pin into the drill with my still clean left hand. I insert the still sterile end of the pin in one of the incisions and push it against the bone. I then squeeze the trigger and thread the pin in and through the tibia till it pokes the skin on the other side. Jason makes a small cut with the scalpel over the pin and I drill it the rest of the way through till it's sticking out the same amount on both sides. I repeat the processes for the remaining three pins.

Then, while Jason holds the PVC pipe steady against the pins, I mark where they should go through and then drill holes through the pipe. I then force the pipe over the pins till the pins hit the other side of the pipe. I then try to estimate where I should drill the second holes and mark the pipe again. I drill again and this time get each pin to go through it's second hole with the help of a little hammering. I repeat the process on the other side.

Gabriel lets go his stabilizing hold on the leg and we confirm that the fracture is now stabilized. Jason wraps gauze with Betadine around the pins while I dress the fracture wound with diluted bleach and we take him back out to the ward. It's once again in God's hands.

MacGyver Surgery 1
MacGyver Surgery 2

Monday, August 11, 2008

Fires in Paradise

It was the wedding of another one of our kids from the church youth group of several years ago that took us back up to Paradise this past weekend. We hadn't been back since the devastating fires that closed down the only hospital in town, destroyed homes and had the fire continued up the canyon wall destroyed the whole town. All of the motels in town were full so we ended up staying in Chico. This is what the parking lot looked like when we arrived as there were still other fires in Oroville and at Shasta. These are young guys that have been working so hard to save towns neighborhoods and agriculture in the area. Signs thanking the firefighters were posted all over the town of Paradise - on almost every corner and in between - very touching.

As we drove up the Skyway into Paradise here are the sights that greeted us...

Hope the fall rains will be gentle enough to encourage new growth and return it to "Paradise" soon.


From James:

Boom! Boom! Boom! The pounding on our cheap, metal front door jolts me out of a deep sleep. I glance quickly at my watch. 4:13am.

"James! Are you awake?!" I hear Dr. Bond's son, Gabriel, calling me, out of breath.

I pull on some shorts and fumble my way through the darkness out the bedroom door, past the bookshelf on the left, through the curtains covering the exit, out the living room door and onto the porch.

"What's up?" I mumble, trying to clear the cobwebs.

"Doudjé's wife just came in with seizures and we need some Magnesium from the pharmacy." I notice the shadowy form of Dr. Bond behind Gabriel in the moonless night.

"I'm coming," I reply and head back in to pull on some scrubs, grab my keys and a head lamp and back outside where I hear the voices of Gabriel and Bond fading around the corner of the container across the yard.

I push through the wet leaves of the bushes forming a hedge between our house and Lazare's little hut just outside the main house and stumble over his wire cooking "gounan". I make my way over to the fence, unlock the gate and head towards the dim light coming from the ER. I hear screams and wails and the sounds of a struggle coming from within that grow louder as I approach at a fast walk.

I push aside the bright green and yellow flowered curtain blocking the entrance to the ER and my eyes are instantly drawn to a group of 8-10 people surrounding on of the beds. Cries and moans are coming from inside the circle of bodies, a bottle of IV fluids hangs from a wooden IV pole and a tube descends into the crowd. Arms and legs shoot out here and there and are instantly seized by several hands and pushed back inside.

I push the people aside and get my first look. It is certainly Doudjés wife (and Koumakoy and Frederic's sister) but she is barely recognizable. I nod to Frederic and his mom who are part of the crowd.

"Lapia ei?"

"Lapie, Jamsuh," responds the mom.

"Ca va" is the reply from Frederic.

Doudjé hasn't arrived yet but his wife is swollen up like a balloon with edema everywhere and is alternately thrashing and lying moaning on the exam table. Just then she makes a violent effort and pulls out her IV causing blood to splatter all over the bed and floor as a nursing student rushes to stop the bleeding with a cotton ball.

She seems to vaguely recognize me as she looks at me, or more like through me, and mumbles "Jamsuh, jamsuh, jamsuh" over and over.

Augustin, the night nurse, informs me that she came in convulsing and with a blood pressure of 140/90. No question about it, it's eclampsia. I had just done an ultrasound on her a few weeks ago and discovered she had twins. There is definitely no time to lose.

"I found both fetal heartbeats" reassures Dr. Bond as I start to bark out orders.

"Augustin, call Simeon and Abel! Gabriel, you and the nursing student go get the gurney and take her to the OR! David, go call Sarah, tell her we need her immediately! Bond, I'll go get the Magnesium from the pharmacy, here's the keys to the OR."

We all split as the family continues to hold her down.

I pull out 6 ampoules of Magnesium and meet the gurney in the OR just in time to see the next seizure.

As she rolls through the door her body stiffens, her eyes roll back in her head and then she starts shaking violently with her teeth clenched. She starts bleeding again from the old IV site. Then, after a few seconds, the seizure stops and she falls unconscious.

"Now's our chance since she's unconscious. Let's get her clothes off, get her in the OR, start an IV and get her ready for surgery."

Sarah and Abel have both arrived now so an IV, a foley catheter and antibiotics are quickly done and she is transferred to the OR table.

I sidle up to Bond and ask him quietly if he minds if I do the surgery. Since I've been following her during her pregnancy and it's a friend of mine and I myself was a twin born by c-section, I request the privilege of doing the life-saving surgery on her. Bond is generous and concedes me the case. We scrub together.

By this time Simeon has arrived and I tell him to prepare one millilter of Ketamine. Doudjé's wife is still somnolent. Bond and I scrub and don gowns and gloves. Abel has prepared the surgical field and we drape the lower abdomen.

We pause for prayer and then I take up the scalpel. Two slices later and I see the uterus. Bond stretches the peritoneal opening wider as I insert the bladder retractor. I make a small transverse incision and poke through with a hemostat. I then insert the index finger of both hands and pull out and up opening the uterine wound. There is the upper back and neck of a tiny baby. I insert my hand down into the uterus till I find the head and lift it up and into the uterine wound. Bond pushes the top of the uterus and the baby slides into the world with a gasp and a scream.

Here's where things go temporarily wrong. Bond has grabbed the clamps for the ombilical cord and tells me to go for the next baby. I see the bulging amniotic sac and try to break it with my fingers with no success. Then, for some strange reason, I do something I never do, I reach again for the scalpel and as I bring it up to the surgical wound, Bond reaches down to grap some scissors to cut the cord and the scalpel collides with his finger. I'm horrified but Bond signals me to keep going as he finishes cutting the cord and handing off the baby. I put the scalpel down, burst the sac with another instrument and deliver the second baby who also comes out with great tone and grimacing and crying. Bond calls for another glove and we suture closed the uterus, the fascia and the skin with no further complications.

By the end of the surgery, her blood pressure has already normalized. Bond goes off to wash out his wound. We call in the lab to do an HIV test which is negative and Bond starts on post-exposure prophylaxis. By the next day, the edemas have started to go down, the twins are breastfeeding and Doudjé is the happiest, proudest man in town giving praise to God for his blessings

Tuesday, August 5, 2008


As my energy begins to return I thought I should make myself do some sewing. Being able to fit myself (the nightmare that it is) didn't fit into the present energy scenario so I decided to make the DGD a little dress. The dress straight off of the pattern fits her just great which makes it such a pleasure to sew for her.

I chose fabric that I already had in my fabric closet (would you believe it once served as table cloths for a bridal shower YEARS ago!) and thought that the blue would be a great color for her. The pattern is Butterick 4680

As you can see, I just made the sleeveless version without a cape. The dress is turning out cuter that I expected. I was just drawn to the dress because it had a purse to go with it and DGD LOVES purses so I always try to include a matching purse with each dress.

This is the state of the dress as of today - needs a zipper, hemming both the dress and lining, button and botton hole for the belt on the back and fine tune the bow.

The dress seemed a little plain and I was wondering what I could do to spruce it up a bit. I remembered a thread on SG that talked about appleannie and her wonderful piping and thought I might give it a try. Although not perfect, I was pleased with how it turned out. I had never basted the cord inside the bias tape before sewing it before, but I must admit that taking the time was well worth it.

This was a kind fun dress because of the lining with netting ruffle that makes the dress stand out from the body. Do you think it just brings back memories of the crinoline era?
Despite what the pictures shows - it is even! Hopefully I will have it completed by tonight and can show you the completed version.

Just a few pictures of outfits on the internet that I think have some great style.

This is an outfit from Neiman Marcus - I love the jacket.

A jacket from Burda 7764 that is really classy.

This is an Oscar de la Renta that is shown on Neiman Marcus. An interesting combination of fabrics for sure but I was drawn to it after seeing the yellow beauty knitted by Ann Rowley on SG.

This is another Neiman's suit that has a great use of trimmings. I am such a sucker for black and white that there was an immediate bond when I saw this pic.

Well, before I can sew I need to help DD get her classroom finished as she reports for duty on Monday. I always look forward to the first weeks of August and spending the fun time with her getting ready for the students. It's a great way to be creative - if you can get the out-of-the-box ideas past the principal.

Friday, August 1, 2008


On Wednesday my husband, daughter and I went to Oxnard to visit the Dallas Cowboy Training Camp. The daughter had been in touch with someone in the organization who arranged for VIP passes so a couple of her students could interview some players for the new Service Learning dept at her school this coming year.

Well, the students were not able to come at the last minute so in the afternoon the three of us plus one of DD's friends were invited to the corporate space to view the practice. (They had no corporate sponsors for the day!) Just letting you know that they couldn't have been more gracious and accommodating. What was cool was to watch the employees of the organization do their job and represent the DC's.

Now I have never been a great fan of Jerry Jones, but after hearing how his employees spoke about him and specifically how much of a man of his word he is I thought I might have to reconsider. I was especially impressed with his player education program that takes troubled players under their wings and work with them for 6 weeks to help education them in all walks of life.
It was a fun afternoon and we couldn't have been treated any nicer...Thanks Bryan and Megan