Trixi's Story: Leishmaniasis

 

Have you ever heard of Neglected Tropical Diseases (NTDs)? It’s possible that the term rings a bell, but you aren’t particularly sure what it really means. Unfortunately, the source of your uncertainty is found within the name: neglected. These diseases are neglected – ignored, passed over, relegated, obscured, etc and therefore do not harness a lot of worldwide attention. Some of the most popular NTDs you might recognize are dengue, hookworms, rabies, venomous snake bites, leprosy and leishmaniasis. These diseases similarly affect people and animals.

For the past 14 years my husband and I have worked closely with leprosy. It is a complex diagnosis because it affects a person not only physically, but also emotionally and spiritually. The cure is free, but information and medical care travel slowly. 

In 2010 my husband was diagnosed with leprosy. Fortunately, we happened to be working at a hospital specialized in leprosy at the time and he received a timely and proper diagnosis. Fortunately, also, because as a neglected disease, leprosy is not well known. Our reality could have played out so many different ways, if it had not been for that present situation in life. 

Through this experience, my husband was profoundly moved to work in advocacy with and for persons affected by neglected diseases – most specifically leprosy.

Fast forward to 2023. We now have a decade and a half of life experience and collected professional resources with neglected diseases. Unconsciously, I think I had a mental Life List where I had already proudly ticked off the “affected by an NTD” item. It somewhere on the list above visiting BC, Canada and putting together a 2,000 piece puzzle. It’s done! 

In April our family dog, a lovely hazelnut brown dachshund named Trixie, gets the sniffles. It was the beginning of our southern hemisphere winter, so we assumed it was just a simple cold. It wouldn’t go away, so I took her to the vet. The vet checked her over and said it was a cold. But she began to get weak, gunk started to seep out of her eyes and hair was falling out. This is when I started to suspect leishmaniasis and I brought it up at the next appointment. The doctor told us it was likely an allergic reaction to the construction we had going on at home. She injected her with a steroid, gave us allergy medicine, drops for her eyes and a multivitamin to boost her immune system. I asked about leishmaniasis and it was a clear “No. It’s not that.” Regardless, I insisted and offered to pay for the lab work. Even though (according to her) it would come back negative. Once again, I was dissuaded. I humbly reminded myself that I am a people nurse, not an animal nurse. I took poor Trixie home, where she continued to get worse. She lost interest in food and her skin began to develop sores. My husband and I talked and we decided to take her back to the vet one last time and insist that they do the leishmaniasis test on her or we would quietly go somewhere else to do it. I went back with her and, once again, had to insist to have the test done on her. This time I didn’t take no for an answer. The people at the vet were always kind and attentive to us. But at that moment, I felt judged and labeled as an exaggerated and histrionic pet owner. 

27 June, the test results came back positive for leishmaniasis. We silently changed vets and began her treatment. 

We sat in speechless wonder with my husband. How can it be that it took so long to get to the truth? We went to the right place. We did what we were supposed to do as responsible owners. We weren’t in financial straits and didn’t have to cut corners to save money. We even took the time to educate ourselves and were an active part of the appointments, suggesting a possible diagnosis. Why did our lovely Trixie have to suffer so much before getting her proper diagnosis?

The answer is in my opening statement - Neglected Tropical Diseases. 

It was a bad luck of the draw; for us and for Trixie. Notwithstanding, we don’t want to dwell on the unfortunate experience. It’s over. But we do want to make the experience as useful as possible. An important part of ending systemic neglect is sharing. When we share and people listen, they learn. Consequently, whatever we have learned continues to be shared and eventually produces change. Change is our unified goal. 

So, in Trixie’s name, this is what I am sharing:

- Leishmaniasis still happens.

- You don’t have to euthanize your pet because of this diagnosis.

- There is no cure for leishmaniasis, but there are several good treatments.

- Listen to your gut. Get a second opinion.

- Yes. Your pet looks ugly at the moment, but she will get better. Don’t forget to care for her. She needs your support. 

- Share. Others also need to know!

Neglected tropical diseases around the world need people like you and me. They need our stories; stories that tell of struggle, triumph and defeat. Our words are are powerful and can advocate to produce a real change in this world. 

 

         

Pre-Lent Resolutions

Tomorrow is Ash Wednesday and the first day of Lent. Last year for Lent I gave up Social Media on my cellphone. I did allow myself to use it on my laptop, but not on my mobile, ever-present device. It was an interesting experience that led me through times of abstinence frustration and then interestingly a gratifying satisfaction that I didn't need to always be connected. By Easter, though, a new feeling arose... The whole effort felt petty and cheap. Jesus gave his life for me, walked on water, invited me to sit at his banqueting table... and I, in return, gave up Facebook? I was proud of making it through the 40 days of Lent, but I also realized that for the next year I wanted to do something a little more significant. 

Thus, here I am. Still pondering at the last minute what I am going to do. I joined a group on Facebook called 40 Days of Giving Up. Its a sort of Lent Support Group. The group objective encourages us to reflect inwards and see what it is that we need to concentrate on to Give Up. Upon deep reflection, I realize that I need to give up my same-ol' routine. I need to enter a phase of renewal.  My kids are getting older and don't need me as much, I don't work full-time anymore and I recently assumed a position on my church council. Aside from having to tend to my home, my days have become meaningless. And unless I give up leaning on my old rhythm of life, I won't be able to move forward. 

So, my goal for this Lent season is to search for myself and for my place in this new season of life. 

Chit Chat Prayer and Fear

Its been almost two years since we have moved back to the city and our lives have changed from being Quiet Country to Rapid City. I still miss the meadows and dirt roads. I miss the cackling chickens and bellowing cattle. The sunsets... (·sigh·)

And so our new rhythm in the city is hurry-hurry with new jobs, new schools, new friends, etc. Its as if time has no clock, it just keeps going and going.

Our ministry in the church has also changed from being protagonists to semi-benchwarmers. Its been 2 years of respite and spiritual renovation. But little by little the desire to return to leadership is itching at my heart.

A couple of weeks ago the leader of our Womens' group asked me if I could help out with the music for our upcoming meeting. I felt honored and accepted the challenge. While serving at the Leprosy hospital for 6 years I would often help out with the music for church services, youth meetings and other events. But it has now been 2 years since that time and my fingers are a little rusty on the guitar strings.

Picking songs to sing isn't so easy. One doesn't just open a hymnal or songbook and randomly pick a couple of songs. In preparation, I spent days in prayer and meditation over the selection. I would open the books and read each verse of songs that would jump out at me, waiting patiently for God's whisper in me saying, "This one!" Some days I would close the books and put them away without a single selection because He hadn't shown me anything. And I would patiently return another moment to continue my search. And so little by little 3 songs came to my heart.

The Day arrived and along with it anxiety and nervousness. I gave the speaker a call to see how she was doing with her preparations of her message. No answer. This created more anxiety in me because I also wanted to run my songs by her to see if she was agreeable to them. The rest of my day went by in a flurry of activity between patients at the hospital and the kids.

3pm came around soon enough and I pack my car to go to the meeting. Not even half way there I begin to panic and have the following conversation with God:

Me: God, what am I doing???
God: What do you mean?
Me: What was I thinking agreeing to do this?
God: Do what? Play the guitar?
Me: Yes! DUH!
God: Cindy, there is no need for the attitude. You KNOW why I asked you that. Because...?
Me: Because I have already done it before?
God: And because...?
Me: Its by far not my first time?
God: Yes. Its not your first time. You have done this millions of times before out at the Leprosy hospital.
Me: Yeah, but...
God: Ok. Now we are getting closer to the truth. Your problem isn't really your "lack of experience." What is all this nervous mess REALLY about?
Me: Nope. Its really just that.
God: Cindy....
Me: Well... Its just that... Its just that I am afraid.
God: Of what?
Me: Of the ladies
God: Which ladies?
Me: The ladies that will be at the meeting. Good grief you sure do ask a lot of questions!!!
God: Well, you asked for my help. Let's keep going... What specifically makes you afraid from this specific group of ladies?
Me: Well... I dont know if it makes sense... But... These are "My People"
God: So?
Me: Well, they are going to SEE me.
God: So?
Me: And I am going to be in front of them and I have to speak German and I have to lead them in song to You. I am afraid that they will be disappointed and I wont measure up.
God: Cindy, remember in first place that you are doing this for Me. You will always measure up because I love you the way you are - with and without clumsy mistakes. In second place, you yourself said that these are your people. If you cant say everything in German, go back and forth. They know that you dont speak German fluently and no one will blame you for doing it all bilingual. And in third place, if you reaaaally are so stressed out about standing in front of all of these ladies, take yourself back to your time at the Hospital and pretend its them. You had no problem there.
Me: I hate it when you have all the answers.
God: No you dont. Thats why you keep coming back to me.
Me: ....you're right...
God: Just GO! I am with you and however it comes out I will be proud of you. This is your service to Me.
Me: Thanks God. I love our conversations.

I arrive to the meeting place and (I KID YOU NOT!) the first people I see are two guests from the Leprosy hospital. I can't resist, let out a loud laugh and my smile reaches from ear to ear.

Me: God!!!! You sneaky little guy!!!
God: (--belly laughs--)

I quickly pick out the Guest Speaker from the group of women and approach her. She apologized for not answering when I called and told me that she had been in meetings all day and had been overwhelmed at the moment.

"Did you need something?" she asked.

"I had wanted to run the songs by you to see if you had a special request or an opinion of the ones I had chosen," I explain.

"What did you do, in the end?" she asks, looking a little uncomfortable.

"Well, I asked God to guide me with his Holy Spirit, hoping that He would link our spirits together and that the songs would be the ones that were meant to be."

Her eyebrows raise a little and I can tell that she finds my conversation with God more than a little interesting. We finish our conversation with some pleasantries and settle down to begin the meeting.

As I begin to play the songs I am taken back in time to all the other times I have done this. I feel comfortable, although a bit rusty.

The Guest Speaker comes forward to share and has tears in her eyes as she begins to speak.

"I have to tell you guys something. Cynthia called me this week and I was in a meeting and couldn't answer. It was a really rough week. During the storm last thursday, lightning fried my computer and in it was my speech for today. I had to write it all out by memory in one day. And through it all I had a song in the back of my mind that kinda filtered through my thoughts and wouldn't let me go. At one point I thought about calling Cynthia to let her know that I wanted to sing it for our Womens' Meeting; but I never got around to it. What a surprise it was to find that God told her what the song was. She chose it and I never told her anything. I guess you were right, Cynthia (she looks at me), the Holy Spirit joined our spirits and guided you in your selection. Thank you very much! May we all keep our hearts open to His voice and guidance in our lives."

It's just so amazing how God works in our lives when we put ourselves in His hands. He desires to have an intimate relationship with us. He wants to chat, just like we do with The Girls... I will never get tired of being surprised by what He has up His sleeve.

Truly Amazing!

LEPROSY - A LIFE STORY

Tomorrow is World Leprosy Day. Here is the story of a great person :)

Goodbye...

Life.

It rolls in with the morning tide and rolls out at the end of the day. There is no starting it. There is no stopping it. It has a rhythm of its own.

As the tide rises and our lives begin, it fills empty spaces everywhere. The ocean seems to reach unreachable places with its breadth. It is full. It is itself.

Yet as much as we enjoy its majesty, the tide must return to itself. To where it began.

It is a melancholic and painful goodbye.

Oh how I wish to hold on… just for a moment longer.

But then its gone.

I sit on the empty beach.

Stranded.

Alone.

Trying to remember with all my strength how it all was,

Desperate for a sign that it ever existed.

As I catch my breath amidst my bitter, soul wrenching sobs,

I see something sticking out underneath my foot.

A sand dollar.

A tiny, yet astoundingly exquisite memento left behind by the receded tide.

What is gone is gone.

No one can bring it back.

My life is forever changed because of you.

I hold you in my heart because you were a part of me.

And I will cherish the sand dollars that I find along the way as a reminder of who you were.

To never forget.  

Life, just like tides, cannot exist without leaving a permanent imprint on us.

I am branded forever.

Letter to a JAX CBS reporter

Today I came across this article posted on a Jacksonville, Florida CBS site. I've never written to a newspaper, but thought this one merited a bit of my time… 

And this is my reply: 

To whom it may concern: 

I am troubled by the article you published yesterday on the Armadillos and their part in transmitting Leprosy. Leprosy is, indeed, a devastating disease. But it's devastation is most awful due to the attached stigma it attracts. What your article neglected to mention is that Leprosy is not just treatable, but it is CURABLE. Your poor choice in words is a perfect example of how  the media and people in general label this disease as "devastating" and therefore perpetuate a sense of fear and panic in the general population. As I acknowledged before, Leprosy IS a devastating disease and if not detected on time and treated efficiently it can lead to debilitating consequences. 

I am a nurse and have worked for the past 6 years at a Leprosy Hospital in Paraguay, South America. Our patients who are affected by the consequences of Leprosy come in all forms and shapes. The severity of the disease in each of them range from unnoticeable to the popular google search images. All new cases are CURED with their initial dose of antibiotics. Physical affectations aside, our greatest devastation is NOT what the eye can see, but what happens behind the scenes in the communities from which these people come. The Great Devastation  I refer to is evidenced by schools who won't let the children of affected parent(s) attend, stores that will not sell their goods to those affected, churches that summon up old Mosaic law and label these people as "damned Lepers" and therefore judgmentally withholding the security of eternal peace from them, neighborhoods that report a diagnosed person to the Police and he/she is then picked up and dropped off elsewhere…far away, even families who reject their own by kicking them out of the house and sent to live outside with the dogs and the pigs. THIS IS THE GREAT DEVASTATION! 

So, please be careful next time you report on this disease. Please be sensitive to the other (more important) faces of this disease, so that we do not further a sense of panic and fear. We work hard fighting for the voice of those who's voices will not be heard. We welcome you most graciously to join us. 

"The biggest disease today is not Leprosy, 

but rather the feeling of being unwanted, 

uncared for and deserted by everybody." (Mother Theresa)

Sincerely, 

Cynthia Dück

Nurse 

Mennonite Leprosy Hospital

Piano Lessons

My 7 year old has ADHD. He was diagnosed last year in September, and since then our perspectives on "normalcy" have been rearranged. I'm sure that our experience is similar to those of so many others: the confusion, insecurity, frustration, long-suffering, hope, etc. It's a huge package that's filled with the pretty little bows and also the shady, uncertain pieces.

I don't consider myself a person who is musically inclined. My mother made me pick an instrument as a child and so I did - the piano. She said it was good for me. And so now that I have children, I tell them the same thing: "Pick an instrument." And they have - the piano.

Two years ago was the first time I tried lessons for the first time with my then 5 year old. He didn't even make it in the church building. I didn't make a big deal out of it and we walked back home. One year ago, my spirited boy sat down for exactly half a lesson before the teacher suggested that he was perhaps not "mature enough" yet. After striking out two times I didn't have the intention of striking out a third time and decided that his lessons would begin when he, himself, asked for them. So this year, he asked for them. I sighed in preemptive frustration.

"Mama, come with me," he begged.

I did.

His body was literally vibrating with excitement as he saw his teacher walk in the door. He barely said goodbye before remembering his fear. I took a seat on one of the pews, out of sight, and prayed.

Please, God, let this be the right moment for this. 

Let this also be something that's good for him 

and helps him grow!

I hear the teacher speaking softly to my son. Gently guiding him in his lesson. When he tries to act out and show off, she kindly reminds him what the task is. I can't believe her. I can't believe HIM! It isn't 10 minutes past the beginning of the lesson and he is already going up the scale for Do to Do doing the cross-over with his right hand. I can't help being emotional and can feel the tears stinging at the back of my eyes.

WOW!! My ADHD son is having a real lesson and is really learning and no one is pulling their hair out. Actually, all involved seem to be enjoying it all.

This is all still new to me and I am learning every day new ways to cope and support the challenges my son faces. One thing I have learned, and I hope is of encouragement to other mothers who have similar situations, is that you have to take hope and strength in the small triumphs. You love your child as well as you can… and wrap yourself in the successes and breakthroughs you get. I felt covered in joy through this first piano lesson.

Just as I am

Herr, ich komme zu Dir, 

und ich steh' vor Dir, so wie ich bin

(Transl.) Lord, I come to You, 

And I stand before you just as I am

The security guard and I walk together through the dark night; silent and concentrated on the task on hand. The outdoor corridor which links the main building of our hospital to the morgue is long, but we eventually make it to our destination. All the way I can hear the shuffling of feet behind us as a family member of the deceased follows us. Out of compassion, I give him a "job" helping me push the gurney, so as to give him a sense of being a part of it all. Death is funny that way. It's scary and we want to run away from it. But when it's a loved one being wheeled away, we ironically stay put. 

****

(Earlier)

My shift is almost over and I'm taking shift-end vitals of my post-op patients. I'm about the retrieve the glass thermometer from under the arm of my patient when I hear the sirens. My co-worker shouts for me, "Hurry! It's an emergency!" I barely don't break the thermometer or totally drop my instruments tray as I maneuver myself out of the room. I rush into the Nurses' station, toss my tray to the side, grab my cell and don a pair of gloves. 

I can see the ambulance pull up, with its siren blaring and lights flashing. 

"Do I call the doctor?" I ask the other nurse.

"Yes!"

As I pull out my phone and dial, the back door to the ambulance is opened. It like a scene from Greys when I see two white, blond men practically straddling the patient, performing CPR. 

The doctor picks up the phone and for a nano-second I panic. I'm new. This is my first call-in for an incoming trauma. How do I explain to the doctor all he needs to know as quickly as possible? In the end my brain farts and fragments all forms of intelligent conversation: 

"Doctor! Emergency! Come quick!" 

He hangs up. 

I'm already in the ER when the man is rolled in by the paramedic and the two blonde men. I slip the oxygen mask on the patient and ask for a report. One of the blonde men tells me in learned Spanish that he isn't a doctor and points at the paramedic.

"English?" I ask him in English.

"Yes." He replies and continues to detail the sequence of events which led to the man's arrival at our hospital. 

The paramedic informs that the man was on a motorbike, drunk and crashed with a car. His apparent injuries prove this. I ask for a stethoscope and try to listen to his heart. Nothing. I reach to feel a pulse at his neck. Nothing. I open his eyes and check his pupils. Dilated. His lips are already turning purple. The doctor isn't present yet, but pending his confirmation, I call it: "Time of death: 18:34." The doctor arrives and checks the patient again, confirming his death. Instinctively and respectfully, I make the sign of the cross over the man's body. 

***

I concentrate hard on keeping the wheels of the gurney on the sidewalk. Off and on I hear them squeaking. Their rotation, along with the pounding of my feet on the pavement, form a rhythm in my mind. The rhythm translates into silent song as I recall the words to a popular German church song: 

            

               Herr, Ich komme zu dir und ich steh' vor Dir so wie ich bin. 

I can't stop my imagination as it visualizes this man literally standing before God "just as he is." What does God see? Unsolicited, I see the memory of the young volunteer from a couple of weeks ago (the young man from my previous entry) joining my jumbled Judgement Day thoughts. They stand side by side, two completely different people from totally contrasting lives. Yet similar... in death. 

Inevitably, the looking glass turns directions and I find myself looking at myself. What do I look like? Do I like what I see? Just as I am now, does He like was He sees?

Dad says that the moments of crises in life are the times when we are most malleable - most open to change. Trauma and death are definitely crises. I hate to wish anything unfortunate on anyone, but I do hope that experiences others have had or ones that you have observed from the periphery will impact your life enough to open yourself up to self-examination.

Because life is short. 

One more thought: 

What do YOU look like just as you are? 

(Lifetime) Endings

The ER on the day of the accident

It's been 9 days. 

216 hours. 

12960 minutes. 

Just a short memory ago, really. 

Yet, literally… a lifetime ago. 

Dressed in my hospital scrubs I rush over to the Emergency room at our hospital. There's been an accident. A crash. A motorcycle. A young man… one of ours! I am pretty sure I won't be of much help, but I feel compelled to see it with my own eyes. My pace slows down as I arrive at the door. My eyes glance at the door handle. I know, instinctively, that on the other side is a scene that will shock me and touch the depths of my heart. But I am a nurse. I need to see the clinical facts and absorb it all to understand. I open the door and am received by silence. The young man is lying on a gurney in the middle of the room. I take in the obvious procedures done on him and the demeanor of those present and inconspicuously take my leave. 

With a heavy heart, I return to my work station and am quickly immersed in my duties. An ambulance pulls up and through the window I see the gurney pass by, surrounded by our doctors, nurses and the newly arrived paramedics. The hospital chaplain flits back and forth between the staff and worried spectators, offering what I can imagine are words of comfort and hope. It's not an easy day on the job for any of us! The ambulance drives off, its bright lights reflecting off the glass from my window. People are still milling around - still looking out in the distance in the direction where the ambulance drove off to. It's like time has stood still and no one knows what to do. No one can believe that something like this has happened here… to one of us. 

An hour or two later we receive the news that the young man barely made it to the hospital in the city, and died. A part of me recognizes that this was an obvious possibility, but the reality of it all is that I (along with all the others) had been hoping for a miracle. There is a sense of finality and resignation in the air. 

The thing about tragedies in life is that they don't always happen "for a reason." That's just what they are: events that cause great suffering, destruction and distress. There aren't always lessons to be learned which neatly make everything whole again. Our lives are definitely not Hollywood or Disney movies with "happily ever afters." It's probably more accurate (if we continue to follow film analogies) to consider our lives an independent film; like those on Sundance that don't always have a good ending. 

But, human and naïve as I am, I stubbornly and almost desperately seek out my healing in the form of at least a decent ending. 

These are the short scenes of my ending: 

***

I walk out to the breezeway and am stopped by a lady waiting her turn for a doctor's appointment. 

"I was watching. Is the boy going to be all right?"she asks. 

I am momentarily confused. Who is this? I see the hunched-over and frail body of the elderly stranger and I am struck by her profound concern. It amazes me the compassion we innately have towards those around us. So great is its force that even strangers are pulled in. 

***

I observe from afar as the hospital administrator and foreman receive the family of the young man and physically guide them through the events of the terrible day. They are patient and obliging in their time of need. Meetings are set up with the young man's roommates and friends so that the relatives can rescue remnants of their loved one's life in the form of friendships, memories, items, etc. I can't help but feel proud of the compassion of our people. 

***

The ambulance returns from its trip to the city and I rush out to help unload it. Our nurse steps out of its side door, her movements slow and heavy. I stand in front of her and look her straight in the eye. 

"How are you?" I ask her. 

There is deep, deep sorrow in the pools of her eyes. I hear her sigh and can almost physically feel the weight on her shoulders. It clutches at my soul and I can feel my heart rising in my throat. 

"I kept him alive until we got there," was her answer. 

I knew that this minute success would indubitably be a balm to her soul. Although the young man had not survived, she would be comforted by the fact that he hadn't died on her watch. Tiny comforts. 

I pull her in for a hug and hold her for a long time. She doesn't cry, being so exhausted as she is. But she clings to me and I know that this is exactly what she needs. I thank Jesus that I am allowed to hold her up in her time of need. I, myself, feel unexplainably lifted up. 

***

A memory returns to me as I remember the previous Sunday services, just 3 days before the accident. I am sitting in the last pew and in front of me is this young man sitting next to a beautiful blonde with gorgeous hair (bc her hair is all I see from behind). The person leading services asks if there are guests among us and the young man stands up, proudly introducing his girlfriend to the congregation. They are planning on getting married soon and she has come to visit him. 

As I reflect on this memory, I am wowed by the timing of it all… It was an unknown final goodbye between the almost-engaged couple. A final weekend in which they most likely made lovely memories drinking tereré together, going for walks, talking, hugging, etc. A gift of sorts, if you will. 

***

There are so many more short scenes that I could add, but then I would never get to the end of this entry. 

Endings are hard. They aren't neat or simple. They are horrible and unfair. 

Dear Reader, I don't have a good ending for you this time. It really is a Sundance film. The drapes fall and signal the end of the show on a cast of confused and hurting actors. The only silver lining I could find was... each other. In every single one of my scenes, there are no lone actors. I dare to presume that real life is much the same. We don't act alone. There are others in the cast. 

Even though I still can't make heads or tails of it all, as I look back on the scenes… no one was ever alone. Perhaps our greatest challenge in times of grief is to remember this. There are others around us grieving along, also uncertain of how things should or will end. 

That's it for today. Perhaps a more cheerful entry will come soon :) 

"What are you doing for others?"

Today's experience was hopefully the first of many. 

As a nurse, my primary section here at the hospital is working MedSurg. For those who don't speak "Nurse" this means that I work with sick patients and those who are going to go into or have just come out of surgery. In a sense, they are "easy" because they have something wrong with them that I have to help fix (disease or operated wound). The hospital where I work at (here) is a hospital that specializes in working with people affected by Leprosy - a disease considered in many parts of the world to be eradicated. It has two wards: MedSurg and long-term Hansen (aka. Leprosy). 

This morning I headed over to our long-term Hansen ward to learn how to do wound care. In our MedSurg ward I have seen my fair share of wounds, but because of the specific nature of my job, I don't do a lot of the deep wound care. The wounds that people affected by Leprosy have are special wounds. Most of the time they are so deep and extensive that they require grafting and occasional debridement (basically, stripping of the bad parts of the wound). They can smell bad and look mangled and gruesome. 

First off, at 9:30 every day, the patients are wheeled into the Foot Wash room and they set their wounded feet into warm salted water for 20 minutes. They take off their own bandages (or sometimes with the help of their family assistant) and gently clean their wounds. After the soaking they cover their feet with vaseline (Petroleum Jelly) and head over to the Wound Care room. 

I have had a quick peek of the patients in the Foot Wash room and I am already surprised by their wounds. It's my first day and I want to make the patients feel a welcoming spirit and not one of disgust. I have already been praying through the night for this moment. 

I gown myself and head over to meet those who have finished their foot wash in the Wound Care room. 

The first man has an enormous smile on his face and directly tells me that he wants ME to do his wound care because his wounds will certainly heal faster with my lovely touch (Gah!). I banter with him and take my place at his feet and to the side of the male nurse who is teaching me. The man has half a toe... That's it... 9 1/2 of his toes are gone. I watch the male nurse as he uses a new gillette to shave off the calluses around his open wounds. The wounds will heal better if there is tender skin around it to help it close. I flinch every once in a while, as I am unaccustomed to the patient's insensitivity to pain. It should hurt. But it doesn't. That's what Leprosy is like.  

Next up, and my first, is a 70 year old lady who doesn't have nor has had Leprosy. She has an enormous (diabetic) ulcer that won't close on her leg. I can plainly see a necrotic tendon and perhaps also a bit of bone peeking out. I'm not sure. But because she doesn't have Leprosy, every time I touch her… It hurts. She flinches and pulls back and I'm only wiping her gently with Simple Saline and a small gauze. I encourage her, chit-chatting - trying my best to distract her from my work. I can see tears in her eyes and am amazed that she hasn't cried out already. I realize that she is most likely accustomed to this and her tolerance is already heightened. Just, wow. 

Call it gross. Call it nasty. Call it whatever you want to call it. 

Everyone has a heart for something. Your heart (or your stomach) might not lead you towards the kind of work that I do. But, with an honest self-examination you'll find yourself inclined in some direction. I feel blessed when I can help my special patients. 

Interestingly, there's quite a bit of irony in all this bit of doing things for others. You give and give… But it doesn't matter how much you give, you always get something back. You will never be able to empty yourself. 

In the words of MLK: What are you doing for others? 

Need an idea of something small you can do to start? Create awareness! Check out The Leprosy Mission UK's Feet First initiative. No money donation needed (if you don't want). Just a cool 24hr challenge. 

Waiting…

It's 5:00pm on a Sunday afternoon and I am on the floor. I have at my charge 2 clinical patients and 1 post-surgical. One of the three is giving me a run for my money. His O2Sat keeps dipping and I am forced to check on him every 15 minutes to make sure nothing worse happens. I have tried taking him off of oxygen two times, but apparently he literally can't live without it. By 5pm he has started to stabilize and I finally have a moment to breathe.

As is my custom, I move over to the side window of the Nurse's station from which I can see out into the main courtyard of the hospital. I see people arriving. I keenly observe them, trying to figure out what their emergency could be - because I am also in charge of the ER during my shift. They are carrying brimming feed sacks, like those 25kg ones filled with chicken feed, and travel bags. At this point it's only two of them and they don't seem to be in a hurry to get medical attention. In fact, they head over the the waiting area, put down their bags, and proceed to prepare tereré (a national communal tea prepared with loose-leaf herbs and drunk through a metal, filtered straw). I am about to go out to them to see if there is anything I can help them with, when the hospital guard walks into my Station. I simply ask him about the new arrivals.

"They are here for tomorrow. They've taken a number and are going to wait their turn for the morning consultation hours. Some of them have been traveling all day to get here."

I had heard about patients such as these, but hadn't had the opportunity to see them for myself.  For some reason, I had stored these stories in a mental box of ancient history. It's one of those stories that is told in churches about how things were in the "old days" when people would walk for kilometers and travel cross-country to make it to the mission hospital; arriving bedraggled and exhausted. But this was just yesterday evening, May 25, 2015. The "old days" were staring me in the eye.

Lost in thought, I don't immediately notice the on-call Doctor walk in. He walks up behind me next to the window to see what I am looking at and looks at me quizzically.

"Why do they come so early?" I ask him. The question is basic, but my interest drives deeper. He doesn't disappoint me with his straightforward answer. I insist.

"It costs 60.000 ($12US) for an ER consult at the hospital and 40.000 ($8US) for normal hours. Why would they go through all this inconvenience and discomfort just for 20.000 ($4US)? Why not just pay the extra and go home?"

I can see the doctor's gaze glaze over and can sense a long answer is being processed. Thus, I take a seat.

"This hospital is well-known to a lot of people. The efforts of those who came before us, going out deep into the interior of the country, seeking out patients and offering them hope and healing has poured over into today. These simple people have heard the success stories from their neighbors, uncles, aunts, friends, friends of friends of how they came to km81 and were healed. Many of them have been screwed over so many times by their local health services and are tired of it all. They are willing to travel for days just to get treated fairly and by good doctors who will fix them up. I have heard it said by humble people (el campesino) that the eucalyptus trees that line the entrance of this hospital filter the evil and sickness. Just by entering this place, your healing begins. Then they get here to us and are received with such enthusiasm and love and care, and another part of them feels healed. All this happens even before they speak a single word to a doctor! Sometimes we are able to fix their problems, sometimes we aren't. But, nonetheless, we take the time to listen to them and to appreciate them as a whole. Sometimes the patient just wants someone to listen to them. And thus the legacy continues… Getting back to your question: They come because they know that there is hope, blessing and healing at this hospital. And they want that."

I was speechless and so moved by his words. I could literally feel God's invisible presence stroking my arm encouragingly as if saying, "I am here. These are my people. This is MY work."

I didn't want to forget this moment and so I stood up, left the Station and inconspicuously put my cell phone on camera mode.

There they are. 

Some of them are sleeping already, while others sit around chatting. All of them waiting... to receive hope, blessing and healing. 

I just gotta say that I love being a part of it all  <3 p="">