Tuesday, March 29, 2011
Hypothetical Michael
Visiting the Fistula Hospital in Addis
This morning we visited the Fistula Hospital (http://www.hamlinfistula.org/). This is the same one from “A Walk to Beautiful” (http://www.walktobeautiful.com/; http://www.pbs.org/wgbh/nova/beautiful/) and the one Oprah Winfrey has supported (http://www.oprah.com/spirit/Inside-the-Fistula-Hospital_1). I can honestly say it’s one of the most impressive organizations I have ever seen. It is so comprehensive it’s amazing. They support women who have developed fistulas from birth and other traumatic experiences. All of their care costs nothing to these women—they come from all over Ethiopia after being shunned by there communities and their families, often after having lived in small huts, alone, due to the odor because of the incontinence. They develop foot drop and contractures from lying in curled up positions on dirt floors for months or years. They are malnourished due to the fact that they eat and drink very little because of the incontinence.
They come here and they are given nourishment, physical therapy, surgery, post-operative care, and education. They learn to make handicrafts, which are then sold and the profits go back to the women. And one of the most important things is they receive counseling and education about their condition. The emotional toll of losing a baby after 5 days of horrible labor and then the months or years of pain and discrimination takes a great emotional toll on these women—many who are very young, but really they are all ages. The woman I spoke with said the emotional counseling is often more important than the physical therapy.
The PT room had the birthing balls and exercise bike and heat lamps for contractures. It was amazing, and they had ‘before and after’ photos of women which would just blow your mind.
We saw the post-operative ward and the pre-operative ward. The other incredible aspect of the hospital is that they only require two things of these women in return for the weeks or months of care (it’s different for everyone, but the average stay is 34 days). First, is that they go back to their village (they provide the transportation) and tell everyone they know about this place because usually the referrals come from the women who got care. Second, is that when they become pregnant they must return by the time they are 6 months along. They will get nutrition and care and education and will deliver their baby by C-section at a hospital here in Addis so they do not damage their repairs. We also saw the maternity ward, where there were pregnant women and women with young newborns as well.
They also have a midwifery school, and this is on another campus where some of the women whose repairs were not fully successful live and work a trade and run a cafe. We may visit there later this week. Midwives require 4 years of training, and through this institute it is free if they are willing to work in a rural area for 2 years after graduation. They have 4 satellite centers in various regions of Ethiopia.
The hospital has a 95% success rate, and the other 5% are able to stay and live on that satellite campus. Those women may have ongoing ostomy care needs (http://www.ostomy.org/ostomy_info/whatis.shtml) that would be difficult to provide in a rural village.
The school room, counseling offices, and various wards were all so impressive, and all of the women were so well cared for and it really warmed my heart to see how one couple could reach out to a group of some of the most marginalized populations in the world and TRULY make a profound difference in their lives.
We will also be visiting AHOPE later today. I look forward tp sharing about that trip soon.
Love, Emily
Sunday, March 27, 2011
What A Day We Had
Again on someone's laptop which costs them money and so I can’t type as nearly as much as i would like So, very briefly—what a day we had!
One thing I neglected to mention in my last message was that we were NOT able to meet Michael's brother. That was a shame, because we came all that way, and if we had one more day, and a little more stamina, we might have been able to make it happen. But we just couldn’t swing it.
Today was so precious. Our first visit was to family who are cousins of Yabsera—but really the direct relatives of the Daubenmeir’s little girl: her father, her family. We were there a long time, so I have many photos and stories for them. I spent the day with Fitsum’s father (handsome guy—and with two daughters and a son, younger than Fitsum . . . all so beautiful).
Then we went to Yabsera's home. When we walked into the home of his grandmother, they all started chirping, "Lululululululu" . . . kind of a high—pitched song of excitement. I can report that his Ethiopian family is "so Yabsera.” His grandma kept kissing me and was so sweet and looked just like him. Not kidding. His grandfather has passed away (I just realized I never asked what his name was). But wait till you see her—so sweet, so amazed at seeing his pictures. I also met his uncles and some aunts.
Mulu (Yabsera’s first mother) recently moved to Khartoum, only about two weeks ago. I just missed her, which made me very sad, and when I heard the news my heart sank a bit. But then we were outside the round mud home taking some pictures and I was getting "Mulu's family" together and they pulled this little boy into the picture and I said, “who is he?” And they said, “he is Mulu's son.” So, yes, I met Yabsera's brother! Mulu’s first son. He is just a little older. They first said he was 6 and later said 10. He can’t be much taller than Yabsera . . . very handsome and very shy. I did get him to smile and showed him pictures of his younger brother, and I have photos of Michael with him. So, a little surprise that apparently Tshay didn’t even know about. I asked what he was like and they said, "he likes football, riding a bike (never saw a bike in Sodo, so not sure if the interpretation was right) and he likes to eat food and drink milk. Sound familiar? Before we headed back, they all sang for us and I can’t wait for Yabsera to hear and watch this—he would have joined right in singing and dancing.
When we got back to Sodo, we went to a home-visit and saw the baby, Tamrat (from the Miracle Baby series on Sophie’s blog that I link to in one of my early posts on my blog). The experience was just amazing, and I can’t wait to write more about what they do here at the hospital and in the clinic. It’s very exciting and quite amazing and frankly hard to even believe. This baby should not be alive but is thriving and I will show you pictures.
So Michael has had a few days of full exposure, up close and personal, to what his life might have been like. On the way home, we bought mangos and bananas. He was eating a mango (his 3rd) and he just said, "I am so lucky." I said, "because you have a mango?" And he said, “yes, I am lucky for three things: that I have this mango, then the 2nd reason is because I was adopted, and the 3rd reason is because I have you and daddy." I think all of what might have been sunk in. I was quick to tell him that in fact Mark and I were lucky, and he asked why and I said, “because we have you and Yabsera and that makes us so incredibly lucky.” (We also like Maddie, Cal and Phoebe, so blessed all around!) But I do feel so lucky for these boys that we brought home 5 years ago. Michael has been so good with so many hugs and kisses from strangers, and just having to be hot and be around a lot of flies and be really, really patient.
We leave for Addis in the morning. I will see a bit more of the hospital here and then in Addis I have some orphanages yet to visit and may visit again with Dr. Sophie if I can. It has been so interesting to learn about HIV care here in Sodo and I look forward to sharing all about that with my friends at CHIP and HIV To Home.
Michael and I miss you all.
Love,
Emily
Saturday, March 26, 2011
Our Family in Wolaita Sodo
Typing from a cafe at the hotel in Sodo on Sophie’s little laptop. I won’t be able to type long, however. In short: we arrived Thursday and met with Dr. Ruth, Sophie and Dr. Stephanie. Just hung out for a bit and gave them many donations which they were very, very excited about.
On Friday we set out in the AM and I was kind of on a mission to connect with the woman we knew about who was related to Mulu—Yabsera's birthmom. We had some phone numbers, and I’ll write the whole, long story later, but at one point we were at this bank where Ruth told us to go which was supposed to have a cafe but did not (turns out the new Dashan bank has no cafe). At that point we called the man who was the father of the Daubenmeier’s kids and he answered and came down. He took us to see this woman at Tsheay's house, and we went there. This is the home where Yabsera was born. This made Michael a bit jealous—because he would like to see the home where he was born.
This woman was very gracious: she gave us shiro and injera and Fanta and coffee with milk. She was happy to see the photos of Fitsum Grace. We all talked a lot—well they all talked a lot and I just tried to listen. So, at some point she said, "I have a photo of Mulu." I was like 'Ummmm . . . can you please show me?” I was trying to contain my excitement. She pulls out a huge album and a photo of not just Mulu . . . but of baby Yabsera, too . . . and, yes, it was so clearly Yabsera . . . his eyes . . . his big ears and the extra little dangling finger. He is maybe 3-4 months in the picture? But so cute, and his mom is beautiful and tall! I can’t wait to show you. I took pictures of this and many other pictures on my camera (many for Fitsum). There was also another photo . . . a baby from many years ago . . . he looked so much like Yabsera that Michael actually said "that’s Yabsera!" However, it was actually the daughter of Teshay. I have a photo of her all grown up. Tomorrow we will actually go and visit with Mulu's parents (Yabsera’s grandparents). His grandfather is a church elder and Mulu sang in the choir (of course!). So excited.
I have so much more to write than I probably have time for. I may get a chance later to write more. Michael has been so excited, and yes, in my exhaustion I have had to say things like, "I know how excited you are, honey, but you have to realize how exhausted I am and please just be quiet for a bit," and he does, God bless him!
We left with Kebede and Dr. Stephanie and went to the market which was so much fun—and a bit scary. We bought fruit and veggies and lentils and a chicken! Michael picked out the chicken, and was very concerned on the bumpy road to his grandfather’s about the chicken’s well being, saying "Ummmm, you know we have a chicken in here right?" as we bumped along. There are many details which I will skip for now, due to time, but Ato Ashango was so happy—when he saw Michael he could hardly contain his joy, and scooped him up, saying, "Maren! Oh Maren!" We were mobbed . . . many people kissing and grabbing Michael. I was admittedly very nervous that Michael was going to freak out, but he handled it all with such grace.
I have so much more to tell, but for now I’ll just tell this story. Later in the day, towards the end we realized there was a cow in Michael’s home and so he wanted to see it so we went into the house and while in there we heard they had just lost their beloved cow . . . yes, this was “Maren’s favorite cow" which we heard about from Heidi, and that we have a photo of. And then someone taps on my shoulder and they gesture down and sure enough there is the hide of "Maren’s favorite cow" spread out on the floor. Stephanie and I could NOT stop laughing . . . I can’t tell you how funny it was . . . for us . . . but not for Michael—this was his favorite cow after all!
One last sweet thing before I have to go—they all told him he looks just like his father. And his mother looked like Ashango. Last night, Michael drew a few pictures of his Ethiopian parents—wanting so badly for the photo that Yabsera now will have and he never will.
I gotta run. Much love to everybody.
Thursday, March 24, 2011
Sister's Of Charity
Wednesday, March 23, 2011
Children's Heaven
World Wide Orphans Clinic
Monday, March 21, 2011
We Made It!
Bekah and recovering from the lengthy but enjoyable flight. Aside
from losing a crown on the first of three legs, everything you can
imagine went so smoothly. We were on a brand new and very nice
Ethiopian Air plane which Michael loved (lots of gadgets) and we had
the whole row to ourselves which I loved. The visa and customs went
so smoothly. We didn't have to pay for any of our luggage and after
my trip to Romania several years ago when I lost all my luggage for
the entire two weeks, I always consider it a minor miracle when all my
bags arrive on the other side. So all 4 50 pounds bags with mostly
donations and items people requested made it...including a tube of
I look forward to seeing the folks at Addis Kiddan later today- they
were the midwives in our adoption and it will be fun to see them.
Tomorrow the work, which is also fun, begins.
Saturday, March 19, 2011
Kidane Mehret and Sisters of Charity
On my agenda is to spend some time at two other orphanages which care for kids with HIV. I chose these two because we have kids who have come home to Colorado from these care centers. I am excited to learn more of what life was like for the kids who came home before they got here. I will be meeting with the nurses and directors and providing some teaching based on case studies of children who have come to live in Colorado.
Friday, March 18, 2011
Big thank you to Westerly Creek 2nd graders and Kindergarteners!
Thursday, March 17, 2011
Our newborn baby pictures of Michael
Michael was wearing size 18 month clothes but was really 4-5 years old. He was so tiny- but grew and grew that 1st year he was home.
Michael loved being on his new daddy's shoulders. This made him feel comfortable. Whenever he felt sad this was helpful in cheeering him up. They spent hours walking around like this in Ethiopia.
Wednesday, March 16, 2011
Visiting AHOPE
AHOPE was the first orphanage I knew about which cared for children with HIV. This was back when they would not integrate kids with HIV and kids who do not have HIV. Many places still will not do this. But some have come around. I was able to visit AHOPE when I traveled to bring Michael and Yabsera home. You can read about that here. I was excited to meet the nurse and talk about adherence and the medications they use, We talked shop so to speak and it was really nice. AHOPE has gone through as many changes as many of the other orphan related and adoption related program in the last 5 years but the biggest change is that families can adopt kids with HIV now with much greater ease and so there are actually families on wait lists for young children with HIV. Anyone who knows me well knows I don't like to sugar coat things and AHOPE has also has many struggles and challenges over the last 5 years. I hope though, like with any challenges we face, that we can learn and grow from them to create a better home for the children with HIV while waiting for families to adopt them. AHOPE has a supply list which I will post. We are doing our Band Aid Drive to bring band aids to AHOPE! I love this photo of the cook making piles and piles of Injera- the round spongy flat bread eaten in Ethiopia.
Supplies Update
For the month of February and March 2011
Gloves (Surgical and Disposable)
Hand sanitizer
Liquid Hand Soap
Multivitamins (gummy type)
Tablet cutter
Alcohol swab
Adhesive plaster
Hydrocortisone 1% cream
Antibiotic cream
Antifungal cream
Augumentin Syrups (156mg/5ml and 312mg/5ml)
Augumentin tablets (375mg)
Griseofluvin tablets (125 &250mg)
Stool Specimen Collector
Complete nurses gown
Nutritious and Sweets
Milks (infant formulas)
Candies, chocolates, lollipops
Cookies
Hygiene and skin care Supplies
Tooth past
Baby body wash
Diaper (Large Size)
Wipes
Diaper underwear
Aveno lotion
Shampoo & Conditioner
Liquid Soap
Hair bands
Towel (medium size)
Educational Supplies
Drawing/writing board, drawing pad
Stickers
Paint
Markers (permanent and removable)
Story books
Hard construction Paper
Pen (Blue & Red)
Puzzle
Dot pencil
Scissors
School glue
Clothes and Shoes
Trousers, pants, skirts, Dresses for older children (7-15 girls and boys)
Jackets, Sweaters, T-shirt, tops, blouses for older children (5-15 girls and boys)
Shoes for children size 6 above (10 years and above)
Slippers (crocks)
Shoes (7-15 girls and boys)
Shorts (7-15 girls and boys)
Pajamas for children (5-15)
Socks 7-15 (girls and boys)
Underwear 3-5 (girls and boys)
Swimming wears 4-15 (girls and boys)
Recreational and Psychosocial Supplies
Toys, Puppets
Cars big and small (with remote controls)
Video games
Toddlers/kids, Tins, Children movies, National geographies (VCD/DVD/VHS)
Diaries
Bubbles
Balloons
Puzzles
Scotch tape (transparent)
Paper Masking tapes (Big)
Sports
Basket ball
Foot ball
Magnetic darts for older children /teens
Others
Watch for children 7-15 (girls and boys)
Flash disks
Empty CD-R and DVD-R
Re writable CD
We brought them a bunch of little cars when we went last time!
Saturday, March 12, 2011
Children's Heaven
Hanna has been to Denver where we have raised money through Ethiopian Orphan Relief to help her with funds to build a new home. Here is a photo of when she came.
The best blog posts about Children's Heaven are on my good friend Heidi's blog. I encourage you to read about Hanna and Children's Heaven here - especially the post about the Dumpster Girls. When we visit we look forward to meeting all the girls and finding out from Hanna how everything has been going with the new building space. I hope to have wonderful photos and stories of this when we return. These girls always need money for school uniforms. You can sponsor a girl through the website. She will send you letters and you are able to stay in touch with the child you are sponsoring. It is a wonderful organization.
Thursday, March 10, 2011
BandAid Drive
We are doing a BandAid Drive in Yabsera and Michael's class. We thought it would be a fun way to teach the kids about Ethiopia, adoption, and health care issues in Africa. Many years ago, when I first went to South Africa in 2003 for the roll-out of Antiretrovirals in the pediatric population, it was hard for Phoebe to see me go. She was little - only about 4 and was really sad. So she made a "Phlat Phoebe" which I brought with me. Who knew how famous that flat girl would become. We made her into a story about going to Africa to work with some of the nurses and doctors to help the sick kids...when a few years later we brought home Michael and Yabsera the story grew with a new "chapter" talking about their adoption.
I have read this story to my kids classes every single year since 2003. There is usually something embarrassing- like when Phoebe was in 5th grade and I was reading it to her ENTIRE school and she did not want anyone to know that SHE had made Phlat Phoebe. We had to call her Phlat Maddie. Now she is famous among the children in Westerly Creek.
The most current point of embarrassment is the photograph showing Michael eating his 1st Dorito. He emphatically did NOT want this shown to his class. Of course I obliged. But will post it here since no one in his class is reading my blog. (She whispers)
I love reading the story because the kids get to see all the similarities and all of the differences and we get to talk about clean water and healthcare. We talked yesterday about why kids like bandaids and why they are good for us. The Kindergarten teacher said, "Remember class just the other day when we all went into crisis mode here in class because WE ran out of bandaids?" The looks on their faces of very grave concern were enough to prove that they did in fact, understand.
Another funny moment was when I was showing the class a photo of Michael's village in Ethiopia one of the children raised his hand and said, "I didn't know there were such things as 'villages' anymore." His eyes widened as I told him there are way more villages out there than there are big cities.
In the end all the classes were mostly interested in the fact that Michael can carry things on his head. He was forced to demonstrate this amazing skill to the collective oohs and ahhs of his classmates (and very real admiration from his teachers.)
I Was Not Their First HIV Health Care Provider
I have wanted to meet and talk with this doctor for years. I hope to learn more about the care the kids are getting while they are still in Ethiopia and share with her how they look when they come home. I want to talk to her about what we do here to help the children with some of their medical needs while they try and adapt to new families, new cultures, new foods, new rules, new routines. This is all happening while these kids are missing their best friends, their caregivers, and their Ethiopian families. They have suffered inexplicable loss, trauma, and fear like we can't imagine. The kind of stuff that just a lot of hugs and kisses alone won't heal.
I hope to share with Dr. Sophie the wonderful stories of families who persevere, who handle audiology, cardiology, radiology, and endocrinology visits with grace. How they navigate TB clinics, mental health visits, developmental screenings and mail order pharmacies (which if you know me well you know that those are the true bain of my existence), massive co-pays, and endless trips to the lab with stool samples and small frightened kids who have to stick their arm out once again for yet-another-poke.
If you would like to donate to help us bring some much needed medical supplies please click on the HIV to Home link to your left. Today they emailed and requested some pediatric sized IV bags so they can better serve the children in Soddo. We are leaving in about a week and are very excited.
Sunday, March 6, 2011
Medical Supplies Needed
Life and Death in Soddo
This is Mark Karnes MD’s newsletter that went out on January 23, 2010. We have had so much interest in this letter that we wanted to also post it on our blog. At this writing, the mother that we gave blood to is doing quite well.
January 23, 2011
15/5/2003
I wish I were writing you a witty, cheerful newsletter this week, but the fact is my heart is breaking. Let me tell you about the events of yesterday. It was not all a disaster and there were many high points during the day. It began by Dr. Stephanie Hail asking to take first call and wanting me to “have a day off.” But that is a tad optimistic; because Stephanie, at this point, does not have her Ethiopian medical license so cannot take care of patients without my supervision. Also we had been inducing our doctor from the Netherlands, Dr. Ruth for three days and I fully intended on monitoring and delivering her baby. Because of significant chronic high blood pressure issues and thanks to our ultrasound we could tell that it was very necessary for her baby to be born, even though it was three weeks early. Alice had prepared supper for her the night before and breakfast yesterday morning. I took breakfast to her at the hospital and Alice came to meet me for a walk in the town. The morning was crisp and we had a lovely walk near the orphanage doing a circle at the edge of town looking down at the Great Rift Valley spread out below us. As we walked along the dirt road we chatted with many children and stopped to play table tennis with a few of them. Just as we were nearing the hospital my cell phone rang. It was Stephanie. She told me a patient had been referred from the government hospital, a woman with twins…the first one breech. Upon arrival I saw that Dr. Ruth’s blood pressure was getting higher and necessitated other medications. We took the patient to the operating room and while Stephanie stayed with Dr. Ruth, Dr. Teddy (the PAACS surgical resident) and I did the C-section. The mother was HIV positive. I wondered as I looked at her thin, emaciated body waiting for her spinal anesthetic on the operating table just how long she would live. Would her small breasts supply the needed nourishment for her two sons? She had two other children and this would be number 3 and 4. We have excellent antiretroviral medications now, but they have to be taken. Also, would she be able to give her two sons the ARV medications every 6 hours and give them a chance to grow up and experience life?
Her surgery went well but in the meantime I was informed of another patient who can just come in whose water had broken the day before. She had a high temperature and was dilated to 5 cms., but her baby was alive. We placed her on IV antibiotics and watched to see if she would make cervical changes but thinking that most likely she would need a C-section. As we were planning her care, we received word that a woman with a ruptured uterus had just been admitted to our “ICU,” which in reality is our recovery room. This was her fifth pregnancy. She had one 7 year old girl and the rest had died. She was acutely ill having travelled over 150 kilometers to get to Soddo. Her dead baby was coming “face first,” and she could not deliver it. Her abdomen was rock hard, filled with blood and her breathing was shallow and rapid. She asked me, “Can you save my life?” I told her there is only one Savior, Jesus Christ. After praying for her we got her ready to go to the OR. As she lay on the operating table, I held her hand and our eyes locked upon each other. As the nurse anesthetist was putting her to sleep, she started vomiting and I could see bile in the endotracheal tube. I yelled, “Suction her!” The anesthetist could not ventilate her lungs and she died right before our eyes; just a few short minutes before we had been looking at each other. Now she was gone. She had told me earlier, “I came here for you to save me.”
There was no time to grieve, however, because I had to get back to Dr. Ruth and check on the other patient. Stephanie had to stay at Ruth’s bedside because of the medications she was receiving and the fact that our OB nurses were not familiar with them and did not know how to take care of an acutely ill patient. Also, we have no IV pumps by which to monitor the rate of flow of medications. I was grateful that we had Magnesium Sulfate (brought into the country by Dr. Paul Gray) to help prevent seizures.
The patient with the high fever was now dilated to 8 but the baby’s heart rate had starting decelerating. It was time to get her to surgery. We delivered a live, big baby girl. But while still in the OR we received news that another patient that had arrived with a ruptured uterus! I quickly went to the “ICU” and this patient also had traveled over 150 km. to our hospital. This was her fourth pregnancy and she had delivered one baby the day before. She could not deliver its twin and in the process had ruptured her uterus. Her bare feet were caked in mud from squatting on her dirt floor trying to deliver her baby who refused to be born. Her respirations were shallow and rapid. Her abdomen was exquisitely tender. Her blood count was dangerously low. Her mother asked me, “Please save her.” I told her husband and relatives she needed blood and called Alice to come down that her O+ blood was also needed. All gave. This time, I had a different nurse anesthetist and she put down an NG tube into her stomach before putting her to sleep, draining a tremendous amount of bile. She was successfully intubated and upon opening her abdomen I discovered a 15 cm rent in her uterus. Her abdomen was filled with blood. I grabbed a foot and delivered her stillborn baby boy. Upon closing her uterus the electricity went out and I held my hand firmly on a bleeder while waiting in the dark for our hospital generator to kick in. Ninety seconds later it did and we were able to finish the operation. The mother is still alive this morning and has one unit of my wife’s blood in her.
The highlight of last night was the delivery of Dr. Ruth’s tiny baby boy, Ephraim, all 4 ½ lbs. of him! I was so grateful we had induced her labor because upon examining the placenta afterwards a portion of it had infarcted. It was a blessing that we had a live healthy baby boy and mother.
I’m sorry this is long but wanted to share some of the events of yesterday with you. We have so many pressing needs here…good blood pressure cuffs, good light sources (I used a head light flashlight for the delivery of Dr. Ruth), decent surgical instruments that work, and an IV pump. We are desperately low in suture. These are the realities of practicing obstetrics and gynecology in Ethiopia. Thank you for your prayers and continued financial support. We cannot do this without you.
Mark and Alice