where there is no burn unit

I already don’t like this post, and I haven’t even started writing it. It goes against my blogger ethics to share personal stories like this with a broad and unknown internet audience, but I’d like to say that I have obtained permission from each person featured in this post. My friends pictured here want your help. I want your help. We both want the first world to know the rural third world reality.

Please read, and feel, and respond. I’m praying for a flood of advice from real live Peds and PTs, ER nurses and good Samaritans.

~~~

I started to post more info about this on facebook and realized that I do not have the space (or patience of thumb typing) to make this happen.

Let me start with the background info: a story of three burn victims.

Michael’s foot and leg were burnt by boiling water that tipped from the fire. His mother took him from the clinic and they kept him over night for observation. They gave him acetaminophen and washed the wound with bleach water. Before sending him home the next day, they drugged him up with sleeping pills so that he wouldn’t be too active and get the wound dirty. After a time, the wound got infected. He had been discharged from the clinic a few days prior with no instructions, and so his mother turned to traditional medicine. She put toothpaste and ashes on the wound and left it. The infection got worse and Michael’s pain increased. I asked if I could wash the wound each day, which the family was glad for and it eventually cleaned out and healed.  The skin around the ankle grew back tight and he has thick scaring at the site, but is otherwise fine.

Kalunga tripped into a pot of boiling water and burnt his leg from hip to toe. His mother also took him to the clinic where they also gave him acetaminophen and washed the wound with bleach water.  After being discharged, his mother took him to the clinic for regular cleansings with bleach water during which Kalunga screamed so badly at the pain, breaking his parents’ hearts. They could not stand watching the clinical cleaning procedure. They kept him at home and used ash to pack the wound and after a time it got severely infected. I offered to help him clean the wound and kept Neosporin on the area, re-bandaging his leg twice a day for two weeks. His skin did heal, though the area around the knee has limited range of motion and he limps a bit when running.

Bana Miri lost consciousness and fell into an open fire. No one knows how long her arms were laying in the fire, but her flesh was incinerated to the point that we could see bone. She was referred directly to the hospital where they gave her acetaminophen and washed her wounds with bleach water. After a few days, she was discharged. The family cared for the wounds with toothpaste and ashes. After a few weeks, the family called me because her wounds were so rancid that anyone who walked into the house commented on the rotting fish smell. I took her straight back to the hospital where they continued to soak her hands and arms in bleach water. After a few more weeks of negative progress, they transferred her to a hospital in Kitwe where the doctors started talking amputation. The family pleaded that she be able keep her hands, so after getting the infection under control, the hospital sent her home. Bana Miri no longer has any functional use of her hands.

Do you hear the commonality in each story? Tylenol, bleach, end of clinical care, ashes and toothpaste, infection, and permanent damage.

When Bronwyn was burnt in similar manner a few weeks ago, many people urged me to take her to the hospital. I hope you can appreciate now why I opted not to. If Tylenol and bleach were the solution, I could have done that myself. Thankfully the water that fell on her was not fully boiling and her skin never burst and nothing got infected. We are thanking God for this mercy.

But the prompting of this post comes from a more recent story.  Please keep reading.

Four days ago, Patience’s sister dropped a pot of boiling oil and the oil splashed across Patience’s legs. Her mother was not home, but the neighbor lady immediately covered the burned area with toothpaste and stared walking with her to the clinic. At the clinic, the nurses scraped the toothpaste off and kept the wound clean with bleach water. One tube of Silver Sulfadiazine was in the cabinet (and no one knows where it came from, so I’m calling that a miracle) which they put on the child’s knees until the tube ran out and they sent her home. (Note that Silver Sulfadiazine did not exist in Mansa at the time of the first three burn cases, which is why there is no mention if it in their stories.) Now at home, her mother is too afraid to hurt her child, and she has asked me to be the home aid nurse, which I am certainly not.

Naturally, I am terrified. I am terrified that her knees will not heal properly, that she will not be able to bend them. I am terrified that she will be in unnecessary pain. I am terrified that I do not know what I am doing. As I asked for help on facebook, many responded that I should take her to the hospital. I hope that the above stories shed some light on that option. The one difference in Patience’s story is that I now know about and have access to Silvadene. A newer pharmacy in Mansa now carries it and, after Bronwyn’s burn, I stockpiled. (It’s a shame that I am willing to buy this medicine, but the Ministry of Health is not. But that is a post for another day.)

Please know that all of these people are dear to us. Michael is named after my husband. Kalunga has the most contagious laugh and has been on my top-five-people-on-the-planet list for a long time. Bana Miri is the wife of one our former staff members (he stopped working with us to care for his wife full time) and she is the BEST. Patience is one of Bronwyn’s friends – they have played together since birth. These people are important to us – they are not just names or pictures or case studies.

But I am not a medical professional and other questions remain. Questions about the sloughing that the clinic seems obsessed with – scraping back the clean-but-dead tissue until her knees bleed. Questions about their wrapping technique. Questions about the Silvadene application. I don’t want this little girl to end up like the others. I cannot distance myself emotionally from this situation either. Her cries are fierce and I’ve wept for her pain. I look at her laying miserable and imagine Bronwyn and I can’t not commit to her healing.

There are complicated sub-stories woven tightly into each of these burn scenes. Stories of poverty and the daily hazard of cooking on fires. Stories of inadequate health care and sub-par patient education. Stories of apathy in resource sparse locations. Stories of traditional medicine and witch doctors and mothers that would do anything – try anything – to make their babies feel a little better.

And these are stories that also need to be told and hopefully will be told at some point. But right now the clock is ticking and I have one hour, thirty three minutes until I am due to arrive at Patience’s house to “help” her mother and my cheeks are tear stained and my hands are trembling.

This is me reaching out. Who will skype facetime with me from inside Patience’s house? Who will look at pictures and advise wisely? I have access to google and I am using it. I’m looking for specialized advice for individualized care, not because I think webMD is wrong but because I can’t stand being involved in another burn victim story without reassurance of a qualified, live person telling me that this is the best anyone could do.

Please.

And thank you.

where there is no children's church

On any given Sunday morning in America, thousands and thousands of families will file into churches, depositing their kids in the hands of capable care-takers who will teach and entertain and subdue the wee ones while the adults engage in a more mature form of worship. For some parents, dropping their kids off for Sunday school or children’s church - or whatever blessed child-friendly programming the church offers - is THE saving grace for the adults that have been wrangling their offspring all week long. Fellowship is certainly a gift in and of itself, but fellowship minus anyone asking for snack/potty/nose wipes is a small morsel of the heavenly realms.

I grew up in children's church. I volunteered in the nursery. I helped with the kiddos class. But never did I really learn to appreciate this feature of most American churches until I had a child was no longer nursing. Nursing baby in church? - no problem. She ate, she slept, we sang, we listened - all was harmonious. But it was after the tumultuous weaning juncture in our relationships that I no longer had the magical powers to keep a busy-body quiet in the Fimpulu churches that we attend. For over half a year now, I have not heard a single sermon in its entirety. I have been some form of disruption in every single service. I have not thought any high spiritual thoughts apart from where is the closest exit and how can I scoot out with Bronwyn without drawing all eyes towards me. 

I fully understand why there are precious few children present at village churches on Sunday mornings. Parents would rather leave the kids at home than lug their too-heavy-to-carry-five-miles-carcasses just to sit outside with them so as to avoid embarrassment and scolding from deacons. For entire seasons of parenthood, families either do not go to church or find some other church avoider to take care of their wild-ones so that the parents can attend.

corralling her behind bars might be the best option 

We do want to go to church and we are not comfortable leaving Bronwyn with someone for hours at a time, especially if we are unreachable. And so, we lug her to church with us. Every week. We lug. Jeremy and I take turns playing with her outside. We play in sand piles, climb trees, and generally have a jolly good time.  Occasionally we find ourselves in a bind when the outside parent has just been called to the front to pray/read/talk/preach and we have to do a rapid switch, which usually involves Jeremy (bless him) rushing in from outside, figuring out the directions and standing to deliver something inspirational with about 60 seconds of harried preparations.

um, yeah, your sermon notes look ok, dad

The end result of this mad scurrying and strategizing and here and there and please hush, darling child is that neither of us has actually engaged in corporate worship in what feels like eons. As we are Professional Church People – this feels to us like a slip in quality control and we have considered scrapping our ministry to adults and creating our own children’s church. But when I think of the children’s ministries that have curriculum and crafts and organization and all I have is a pile of sand -  I see more clearly my limitations and accept that this is just the season of our life. Because, for the love, we don’t even have cheerios, which tells me that clearly, children’s church is not amongst our cards.

she's building a fire. fabulous. 

And so, dear church going friends who attend awesome churches with awesome kids programing – count your blessings and name them one by one, and the next time you cross paths with the children’s ministry people who have dedicated their sanity to your child’s well being so that you don’t have to -  HUG THEM. Hug them and tell them that they are wonderful and request that their photo be included amongst those of the Saints, for that is what they are. 

AND.

To the not-yet-parents and parents of older-kids-not-requiring-a-one-to-three-adult-to-child-ratio, I beg you, volunteer in the children's ministry. If you have benefitted at all from corporate worship, learned anything from a thoughtful sermon, or felt uplifted in the least from the gathering of believers, you have the children's ministry to thank for it. Return the favor. The staff that organize it all – they need you. The moms that have been at home with their kids all week – they need you. The congregants that have no idea how distracting it would be to have seventy two Bronwyn’s running around like banshees needing a tree to climb – they need you. The children that would otherwise be left at home and are instead learning about Noah and Jesus and miracles and the cross – they need you. Every time I sit in the sand pile outside while the drums beat and the choir sings and the preacher preaches, I pray for you – potential volunteers – that you would answer the call and be the blessing to us all. 

love her.

  

And so, to the dedicated ones that are loving on my friends’ kids and to the volunteers everywhere that sacrifice a bit of them selves to serve the larger church body –- may your crowns be decorated with the most brilliant of jewels. Thank you.

a celebration of union

It started in a Land Rover. 

The first dozen times the old beast of a machine got stuck in a mud rut, my job was to encourage and hold the wrench – it was in that mud that love’s seeds were first planted. Over time, the seeds germinated and blossomed and I said “yes” to “will you marry me” and soon we were taking our first look and exchanging vows and cutting ice-cream cake.

In five years  since, we’ve made a life overseas, establishing a home out of a mud bricks and a ministry out of grass roots. We've combined our DNA to create three lives and have had the privilege of rearing one.

We have spoken harshly and gently, encouraged and forgiven. We have held the mirror up to the other, revealing and refining our true selves. We have adventured and risked and come home to roost. Partner, spouse, friend, beloved we have called each other.

This is our marriage and it is a gift. We still kiss in Land Rovers, and thankfully get stuck a lot less.

Happy Anniversary to my loving husband, Jeremy Michael.

living simple, living small

I don’t function well amidst clutter. I can’t work. I can’t think. I can’t sleep – not if there are piles of things laying where they don’t belong. Sometime post-college and after I started living alone, ordering my surroundings became a hobby. I’d arrange and rearrange my few belongings and all of life would be put on pause if something disrupted my sense of order.

After getting married, Jeremy and I had to work out our “stuff” related issues. While Jeremy is not nearly as OCD as I am, he still values an uncluttered life, particularly given our limited square footage.

While living simply and living small is par for the course in rural Zambia, we've noticed that many of our American friends struggle with the desire to downsize. Hip designers have rebranded small homes as “space efficient dwellings” and Pinterest has taught us a thousand new ways to creatively store all our crap. There are clearly ways to shrink your life, and yet... THE STUFF. The real struggle doesn’t seem to be in the floor plan or in finding clever storage cubbies. The battle for simple and the battle for small is waged primarily at point of purchase.

This is something Jeremy and I learned early on, cohabitating inside a petit abode. With every pending purchase we stopped to ask, “where are we going to put it?” We knew that if we were going to live unencumbered by junk (or treasure) we had to be diligent on this point. And for the most part, it has not been that hard – especially since, truth be told, there isn’t that much stuff to buy in the Luapula region.

We are able to contrast our Zambia life, however, with the  consumerist culture that so totally dominates America. Even in the few weeks of sojourning in America every year or so, we absolutely feel the marketing pressure coming from every direction telling us to buy more stuff and put it in a suitcase and haul it back to our too-small house in the bush. Every blessed time we have traveled to the states we have said, on the front end, “I don’t think we’ll have much to carry back this time…” And then we end up stuffing our luggage to max capacity. Why? Because America is flashy and we are weak and the struggle is real.I may or may not have lugged 50 lbs of Wegmans across the ocean in May. 

Staging our own form of intervention, we've given extended thought as to how to conquer America, how to stick to our guns, to keep living simply, and to keep living small. We're developing habits now that we hope will serve us well, particularly if we ever move our of Zambia and into a first world country. To share with you all some of what we've come up with, I’ve compiled here a list of ideas and tactics that we use somewhat in Zambia, but particularly in America, to combat the compulsion to buy stuff and expand storage and clutter our lives.

14 habits to develop towards simple and small living

1. Develop the mental discipline of NOT comparing. Size, quantity, expense, niceness. None of it. Comparison is the gateway drug to both discontentment and justification, both of which inevitably result in shopping therapy.

2. Turn off the TV and put the magazines down. It is near impossible to look at pictures of beautiful people and all their beautiful things without lusting after it all a little bit.

3. Change the question from, “Can I afford it?” to “Can I live without it?” The answer to the first question keeps your bank account in check, but the second keeps crap out of your closet.

the living room. that's all she wrote.

4. Make penny pinching a game. An albeit weird game, see how little you can possibly spend this quarter and then try to beat your record next quarter. Every time you pass up a sale or go without the upgrade you get to squeal, “I’m winning!”

5. Don’t celebrate how much you saved – celebrate how much you didn’t spend period. Similar to number 4, but with a twist. Many bargain shoppers love to purchase items that are on sale just for the thrill of the 50% off, not because they needed that item. Garage sale-ing is perfect for finding a very specific item but is clutter suicide when you’re just hunting deals.

6. Budget like a fiend. If all the pennies are “locked” into another category/account/budget line item, they just aren’t available for unnecessary purchases. Revisit the flexible areas of the budget often to see what else you can trim down and throw into savings – or generous giving which brings me to my next point:

the play area.

7. Find excessive amounts of joy in giving money away. When you commit to tithing a certain amount and giving regularly to charity or missions or child sponsorship, that money is less likely to be used on stuff for the basement. Establish biblical convictions about tithing and stretch your limits. Consider increasing your giving amounts each year. Don’t know where to give? Choshen Farm is a FANTASTIC option.

8. Engage the one-in-one-out rule in as many areas of your life. Fine, buy the new dress, but another one has to leave the closet before this one comes in.

9. Set time limits on unused items. Haven’t golfed in 5 years? To Craigs List the clubs shall go.

10. Seize the moment. That irrational/angry moment when you look around and feel like you are a candidate for hoarders? That’s when you need to go on a rampage, throwing out everything you don’t use without thinking twice about what ends up in the trash or donate bin.

the homestead at a glance.

11. Find accountability amongst like minded friends. Talk about your shopping habits and confess your materialism. Play the penny pincher game with your besties and surround yourself with people who are a positive influence – not a stumbling block – in this area.

12. Determine in advance which will be your bulky or splurge items. We built an entire separate building to house our king sized bed so that we could bed share under the same mosquito net. No qualms there because it was intentional and right for our family.

13. Hand write the values/priorities/mantras that will keep you in check.  “I value storing up my treasures in heaven,” “no new shoes until we are debt free,” “where moth and rust will not destroy…” Write it, post it, ponder it often. And as a way of creating a less materialistic vision for your life… (see 14)

14. Spend more time in the Bible letting those thoughts dominate your own. When you are compelled to mission, sacrifice and God’s glory, everything on Amazon just looks so much less attractive.

the culinary corner.

What about you? What tips can you share for cutting down on the clutter and living simply and small?