Cara's Travels

final interactions

2009-05-01T17:47:00.001-05:00

I have been avoiding this blog entry, I think since the day I arrived here. This will be my last entry from Cape Town, South Africa. Many of you have asked if I will continue blogging after I get back to the US. I will, I’m sure in the week to come, record my feelings as I begin to realize what I’ve experienced and actually have time to sit and process the difference it has made in my life. I’m not sure what will happen from there. I really don’t know where life will lead me from this point. I’m trusting, however, that whether I am in some foreign country around the world or at home in the Midwest, my life will continue to be a great adventure. So, check back every now and then. Perhaps you’ll stumble upon something worth reading (no promises, though!).

It has been very hard for me to sit down and record my feelings and experiences from this last week. I keep writing words and deleting them – not able to fully express what I’m feeling and not really sure myself what emotions are stirring up inside me. I feel very disconnected from the words I’m writing, so please bare with me as I attempt to sort through them while I share some of my final interactions from the week.

Tuesday, 28 April

The Pain Management Team had a goodbye tea for Taylor and I this morning. My favorite part about tea is the excuse it gives you to eat rich chocolate desserts at 10 in the morning. It was very nice to hear the kind words from everyone. They have so embraced this project and it has been such an honor to be a part of it. I had a whole speech ready to share about how I came to Africa to teach about Child Life, but have learned so much more in return. Unfortunately, in true Cara fashion, I started crying the moment I sat down and was only able to squeeze out a few “thank you so much” s. I think I did manage to say that the changes occurring in South Africa would ripple into other areas of the world, including the change it has made in me that I hope to take home and apply to my own work with patients and families. But then I started crying again and decided to focus on eating the cake sisters instead.

Missy and Joe were back for an outpatient visit again. Missy was in such a good mood. She was playing and laughing and talking. It was so great. At one point, she was sitting on my lap, giggling and blowing bubbles. One of the sisters walked by and asked Missy a question in Afrikaans. Missy smiled really big, nodded and said something back. The sister told me she’d asked Missy if she was really glad to see me today. Missy said that she was. It was really nice to hear. Missy can be so reserved sometimes and we don’t speak the same language, so sometimes it’s hard to know how she feels about our interactions. As I prepare to leave, it was nice to know that Missy had been positively affected by our time together.

Wednesday, 29 April

Another goodbye and another excuse for a tea. This morning we said goodbye to the C2 staff at tea after ward rounds. Prof said some really nice things about the Child Life project. He is the one who wasn’t totally sold on our involvement when we first started, but has now become one of our biggest supporters. He usually sights our presence in theatre as one of the biggest impacts we’ve made; claiming the children are much calmer and cooperative when we’re there. He recently attended a meeting in Durban where he gave a two hour presentation. Thirty minutes of that time was spent talking about Child Life and what he calls “complimentary medicine.” It was just so exciting to see the transformation of someone unsure of our presence on the ward to someone spreading the word about Child Life around South Africa. Later that day Prof also asked if we could process the length of stay a couple of boys will have to endure at the hospital. They will be there for approximately 2 months away from their families. Prof wanted us to use play to help them understand that and work through their feelings. How awesome is that?! He really gets what we do!!

Prof went on in his speech to talk about the ward. He mentioned how wonderful C2 was because the staff works as a true team. There is no hierarchy. Each profession is respected and valued for the expertise they bring and everyone is treated with the same respect. Sometimes that means everyone is equally rude to each other, but at least they’re all treated the same. ☺ Seriously though, that is the one thing I have appreciated so much that until this moment I hadn’t been able to put my finger on. When each member of the team is truly respected and given voice, they are freed to perform their greatest works, and the patients truly benefit. I’m not saying the ward is perfect, there are definitely challenges to bringing change, but for the most part, people have bee so open to new ideas and experiences. I hope that I can remain open in my own work to accept those ideas and suggestions of others, and in turn have the confidence to speak my own ideas with confidence.

I found myself speaking up a number of times to advocate for the kids. Situations like these have filled me with a confidence to go back and do my job well, to speak up and not be afraid; to have courage and confidence to do my job; to create a team where people aren’t afraid to talk to each other – no matter their position.

Thursday, 20 May

Today was my last day at the hospital; my day of final interactions. It was very bitter sweet. I had some wonderful play opportunities with the kids. I did about 4 surgery preps and 2 procedures supports in my first hour of the day. The kids were responding so well. It was the perfect way to end my time here. A number of kids came in today to receive their pressure garments, including Joe and Missy. It was kind of a neat ending to my time here, to see the kids I had started with progress to the stage where they were ready for their garments. There has been such a transformation in them, physically and emotionally. It was so wonderful to see.

I had a huge medical play session on the floor in the bay I worked in today. It may have been more fun for me to watch the reactions of the parents than it was the kids. As the mothers watched their children play and interact with eacth other, their stress turned to sheer joy. They were smiling and laughing right along with the kids. We often realize the positive affects of play on kids, but in this situation the positive effects on the parents were just as powerful. I think it was also good for many of the mothers to realize their kids are still the same kids.

I was feeling pretty good after all the successful interventions of the day. Other than dropping a crib rail on my foot, leaving it bleeding, bruised, and with a nice goose egg, my day had been pretty successful. I began my goodbyes to both the staff and the kids. One of the mothers said, “Shame. Only 2 months” when I told her I was leaving. I heard a lot more “Shames,” as I said my goodbyes. The most difficult goodbye was with the two little friends here from Zimbabwe awaiting surgery for the keloid scars. They greet me every morning with a running hug and their hugs flow abundantly throughout the day. I told them I was going home to America and today would be my last day. They just laughed at me and said, “You’re so funny.” They asked if I was coming back, but I told them no, that this was a forever goodbye. They asked when I was leaving. I said Saturday. One of them said, “So you will come tomorrow.” I explained the next day was a holiday and I would be getting ready to go home. They finally understood (as much as they could at that point) and gave me giant hugs and kisses goodbye. One of them climbed onto my shoulders and wouldn’t let go. I gave them final hugs and said my farewell to them, to the staff, and to the hospital. I cleaned the toys one last time, walked through the pointless metal detector one more time, took the bus home one more time, and let myself cry one more time (okay, so maybe more than once!).

When we got back to the apartment, my friend Tami was preparing to leave for her flight. We all sat around for a while talking and looking at old pictures, remembering our favorite moments together. When it was time to go, we walked her out to her taxi. It finally felt real that this would goodbye. She cried and we cried and she drove way from this adventure.

Saturday, May 2

Today is my last full day in South Africa. I’m not at a point where I can tell you what I’m feeling. That will have to come later. I’m also really tired. I am trying to stay up late tonight to help myself transition back to Central Time. It’s hard. You all are just getting home from work and I’m going insane, I’m so tired. ;) Hopefully I’ll be able to sleep in tomorrow and use the flight home to my advantage. I’ll be home Sunday at noon for those of you wanting to make sure my lawn is mowed and my house clean (hint. hint. ☺)

This morning Jamie, Danielle and I tried to hike Lion’s Head one more time, but it was foggy and started raining by the time we made it half way up. The rocks were pretty slippery, so we headed back down. I spent the rest of the day tying up loose ends and just enjoying my friends here. Caroline is gone for the weekend, so we said our goodbyes over the phone. It’s not quite sinking in yet, perhaps when I get to the airport, or walk on the plane, or maybe off the plane at home…or maybe a few weeks from now.

At any rate, I hope to find the time to truly realize what I’ve experienced here. I hope that I have accomplished what God had for me to do here. I still feel inadequate, but I know that God uses the willing, not always the strong. I pray that the experiences I have had have truly touched the lives of others, and that my life in turn has been changed for the better.

I hope that each of you has come to realize the ability in each of you to impact the world around you, whether you’re in Cape Town, South Africa or Kansas City, Mo, or where ever you may be. I never thought I would be able to do something like this….now I don’t know why I ever waited so long!!

Thanks for walking with me on this journey. God is SO good! His Love is so vast!

I’m signing off from Cape Town.

4 girls, 3 mongoose, 2 craigs and a land rover

2009-04-28T15:56:00.004-05:00

AMAZING!!!

That’s pretty much all I can say about this last weekend. I’ve been trying to decide how I can capture everything from the past 3 days into one little blog entry. I have decided that I just can’t. This is the one thing you will have to ask me to tell you about in person. It was definitely one of the best experiences of my life!

Here’s a brief attempt to capture my safari…

Our small propeller plane landed in Hoedspruit, South Africa about 1:30 pm, the last of the 2 flights that day (or any day for that matter). We stepped out of the airplane and walked down the stairs into the wide open field with a small brick building and a runway – known in this town as an airport. The e.mail we had received instructed us to look for the skinny ranger named Craig. We were the last people off the plane, so as we rounded the fence we were pretty confident that the skinny man with no shoes and a giant grin was our ranger! We greeted each other with huge hugs and followed Craig out to his land rover. Craig was the envy of all the other rangers with his 4 American girls carrying all their belongings on their backs. There really wasn’t anything special about us, except that we were under the age of 60. ☺

The ride to the campsite was filled with energy, animal sightings and laughter. Back at camp Craig 1 introduced us to Craig 2, the other ranger at our camp and the 3 pet mongoose. To fully understand our experience on this safari you must have a clear picture of the Craigs. They are completely offensive, politically incorrect men who’ve been living in the African bush without electricity or any modern amenities for years. They smoke a pack of cigarettes a day and drink rum like it’s water. But you couldn’t help but love them! They’re also brilliant and the best safari guides we could ever ask for. Craig 1 used to be the top dog in conservation in South Africa – i.e. head of whatever they call the environmental department in SA. We fell in love with them the moment we met them. They took such good care of us and taught us so much in our short time with them.

The camp was centered around the fire pit and kitchen. The pit was where all our meals were made and also served as our gathering place for long evening discussions and entertainment. The path behind the kitchen led to the 2 outdoor bathrooms, fully equipped with flushing toilets, running water, and showers. The walls were made of reeds, with no roof and a beautiful view of the African wild. We stayed in raised chalets with 2 beds a piece. It was absolutely perfect.

We went on our first game drive a few hours after we’d gotten to camp. Craig 2 was our leader and introduced us to giraffes, zebra, kudu, elephants and rhinos. We were so excited. At first we couldn’t help but squeal, but we soon learned to contain ourselves, so as to no frighten the animals. Craig had so much information to share about the animals, the wild life, and the way it all worked together to sustain life in this place. I couldn’t help but stare in wonder at the beauty of God’s creation. He is so creative!!

That night we gathered for steak cooked over the fire and a late night of conversation ranging from politics and religion, to bad jokes and funny stories. We heard the leopards as we headed off to bed that night. The stars were absolutely amazing. There was no moon, so the stars were the only thing lighting the sky. We learned how to find south based off the Southern Cross. It was such a perfect day and night.

I don’t have time to go in to as much detail as I would like, but the next day we went on 2 game drives - that is after we pushed the land rover to get it started (think "little miss sunshine"). We saw tons of giraffe and zebra, warthogs, and other animals. We never did see any of the cats, but we did hear a momma lion calling for her cubs and lion’s at night. Every game drive we went on included a stop for tea and snacks. When we stopped for our evening tea, we sat in a field watching the impala play and the sun set over the mountains. As were looking at the vast stars, we saw a meteor with a huge tail streak across the sky. It was such a perfect moment. We didn’t get to see all the big 5, but we wouldn’t have exchanged the moments we had on this trip for anything.

We went on a final drive the morning we left and then packed our bags and headed back to airport. We considered trying to miss our plane so we could spend more time in the wild, but we had to get back to work. We gave our final goodbye hugs and passed through security – which was a couple ladies opening one of our 2 bags (it’s harder to get in to a Royal’s game). As we boarded the plane we each shed a couple tears, sad to be ending our adventure.

I really hope the goodbye to Paradise Camp and the 2 Craigs will not be a forever goodbye. This safari was the first time I truly felt like I was in Africa. It was the Africa I came here to see and I had a very hard time walking away from it. It was the Africa that gave me a greater understanding of just how big my God is. It was the Africa that some day I hope to return to. I felt more safe the last 3 days, living in the wild with the animals than I have the whole time I’ve been in Cape Town. I can't explain everything that went in to the emotions of leaving on that plane. I think it had to do with an understanding that I would soon be leaving the Africa I am learning so much to love. As I was pondering these feelings of sadness and not wanting to leave Africa, I opened my journal. The passage Caroline had written for the day stated -

Trust - in His timing
Rely - on His promises
Wait - on His answers
Believe - in His miracles
Rejoice - in His goodness
Relax - in His presence

Perfect council for me in that moment. God's plan is far greater than any I can imagine. So, I will trust in Him.

I’ve just read back over this blog and have so much more to share for you to truly understand how awesome that adventure was, but I don’t have time and will have to just offer what I’ve written…and promise to tell you more when I get home.

We’re planning on coming back for a 21 day traveling safari with the Craigs some day. You’ll have to join! ☺

also...

2009-04-24T15:40:00.001-05:00

just wanted to let you know that my friend jamie is also keeping a blog of her time here, so if you want to hear her perspective on the trip, check it out at jamie-day.blogspot.com.

also. some of you were telling me you wanted to comment, but couldn't. i changed some of my settings and you should be able to comment now. so do. it makes me happy. :)

the first of the lasts

2009-04-24T14:57:00.000-05:00

Today was my last Friday at the hospital…and thus begins the lasts. I’m not quite ready for all the lasts, but they’re coming regardless, so I will embrace them and enjoy them. Today was definitely a cherished day.

The ward was extremely slow today, most of the kids having had their wound checks yesterday and only a couple scheduled for theatre. I spent a large part of my day with Wednesday. His good friend had gone to theatre, so he was left without a playmate and needing some major attention. We pretended like cricket pitchers (I don’t even know if that’s the right terminology) and threw the ball back and forth down the hallway. He wore me out just watching all his energy buzzing around the unit. Sunday thrives on love. I can’t tell you how many sticky hugs and snotty kisses I received from him today. He was upset when his friend came back from surgery crying, so we spent some time just sitting together blowing bubbles. He was very sad to see us leave today, but I assured him we would be back to play next week.

For part of my playtime with Wednesday I was holding Bona (I wish I could write his real name on here because I love to say it!). He was so playful and would mimic everything that Wednesday did. It has been so great to watch how far Bona has come under Danielle’s care. He used to be a baby who just lay in his bed and watched the world pass by. But now he is so engaged and interactive. He sits up and plays and giggles and talks and mimics. It has been so great to see.

Joe and Missy came back today for physio. They looked so great! They were shy at first, but soon warmed up and I got my fair share of hugs and kisses. I was really glad to have such an uneventful day so I could spend some quality time playing and saying goodbye to them. I tried to tell Joe that I would be going home to America next week, so this was our forever goodbye. I don’t really think he got what I was saying, though. He repeated America and home and smiled really big. He did give me a big hug, though. It has been so amazing to watch him heal – physically and emotionally – during his time here. He was with me from the day I got here and has come such a long way. He used to be so withdrawn and scared. Now he is confident and full of life. It has been such an amazing transition to watch.

I also spent quite a bit of time with Lindy. She is a the little girl who had one of her legs amputated due to meningitis. She has such a sweet spirit and is always smiling and waving when we walk by. Caroline has been doing a lot of work with her and will actually be using Lindy and another girl, who had her legs amputated due to the same disease, for her case study to present to the hospital trust. The other little girl was never prepared for her amputation prior to surgery. She went in not knowing what was happening and came out with both her legs gone. Needless to say, the majority of interventions with her were centered on damage control. It’s difficult to help a little girl trust again when something like that has happened. I can only guess what she was imagining was going to happen each time she went in for surgery. Lindy on the other hand benefited from a great prep session with Caroline. They used a blank cloth doll and, with the help of a translator, performed surgery to remove the doll’s leg. Lindy was not happy with this thought (understandably so), but Caroline explained the need for her “really bad sick” leg to be removed and Lindy eventually came to understand. She has coped remarkably well since the surgery. Her story is such a contrast compared to the other little girl. There’s no doubt that Lindy will continue to encounter challenges and obstacles, but she is in the process of developing the coping skills she has gained to face those challenges as they come. It is great to see.

Tomorrow I leave for my safari in Kruger National Park, so I won’t be back on the blog until Monday night or Tuesday. Craig – the self described skinny ranger – will be waiting at the airport tomorrow to take us on our adventure. If we don’t come back, try checking with the lions! Have a great weekend! It’s your last one without me! ☺

walk in love

2009-04-23T15:24:00.001-05:00

This morning before going to work I read Ephesians 5:2, which says, “Walk in love.” A few verses later, Ephesians 5:8 says “walk as children of light.” I decided to center my day on these two verses and focus on walking in love and light.

Today’s little revelation: you never know how someone will respond to you or your actions, or what little thing you do will make a difference in someone’s life. But as we walk in love and light, we can be assured that lives will be touched by the spirit we bring.

It’s always interesting to walk on the ward after a weekend or a holiday. Faces brighten up and begin smiling as soon as the Child Life team walks on the floor – light. One little boy saw me from the end of the hallway and set out in a dead sprint straight into my arms. He clung on to me in an amazing hug. I finally pulled away and saw that his eyes were watery. I asked what was wrong, but he just hugged me. I had spent a bit of time with this little boy and his friend on Tuesday. To me it just seemed like normal every day interventions. We played and laughed. I tried to set boundaries. They tried to push limits. There wasn’t really anything out of the ordinary. His perception of what we shared, however, was obviously much greater. The little 7-year-old boy doesn’t have any family and has come to the hospital to await surgery to remove some of the keloid scars that have formed all over his body. The small amount of love and attention I was able to share with him obviously had a much bigger effect than I ever thought it would.

After my hug session was over, I went to see why there was crying coming from the bay I had been assigned to. Mo, a 6-year-old boy I’ve been working with, was sitting in his bed, staring out his window and crying. Mo has been pretty traumatized by his experience here in the hospital. Only within the last few days has he begun to open up, laugh and play. His mother, however, is usually with him and I noticed she wasn’t around this morning. One of the sisters got Mo down from his bed and took him into the hall. I think she was trying to get him to stop crying, but it didn’t help. I followed them out and took Mo with me. He wanted to go to the end of the hall to the doors that exited off the ward. I held him up so he could look out the windows and watch for his mother. I kept reminding him that his Mother would be back, that she had only left briefly. He began to calm. I walked him back to his room and held him on my lap until his mom returned. I wasn’t really sure what Mo thought of me helping him this morning. At first he was very resistant to my attention and he never completely appeared to feel comfortable. But later today, he finished a game I had given him to play and followed me out to the hall to give it to me. His mother told me that he wanted to be sure to return it to me himself. It was a small gesture, but I took it as a symbol of the trusting relationship we have built. I was talking to some of the mothers later that day and informed them than next week would be my last week at the hospital. Mo’s mom said, “You will be missed. You are nice for the children.” Simple words, yet to me they were precious. Up until this point, I had never been sure how Mo and his mother felt about my interventions. I really didn’t think what I had been doing was making much of a difference. But as we walk in love and in light we are able to impact lives far greater than we ever imagined.

A little (I should say big) baby in my bay today was tearful when her mother stepped out to take a shower. I walked over to her and placed a block at her feet. She looked at the block and then stared at me. I tried to engage her in play, but she just kept staring at me with this “who are you and why are you not my mom” look on her face. I did everything I could think of, but nothing seemed to amuse her. Rather than scare her, which was what I thought I was doing, I left her alone. As soon as I walked away, she started to cry. I went back to her crib and this time she moved toward me like she wanted to be picked up. I held her on my lap and she rested her head against my shoulder. We played and played until her mom came back. Again my perception had been off, but as I continued to focus on walking in love (no matter what kind of response I felt like I was receiving in return) I could be used in a number of ways to bring comfort. It was a good lesson for me to learn to always walk in love and light – no matter what the response from others.

Harry, a 10-year-old boy, came in over the holiday. His family is not around, so he has been alone during his admission. Older children, even in the US, are often held to much higher expectations by staff. We forget that the hospital environment can be just as frightening to them. I could tell Harry was nervous, but trying to act beyond his years. I followed him and a sister into the treatment room for his dressing change. He was trying so hard to hold it all together, but as soon as the dressing started to be cut away he began to cry. I asked if he wanted to hold my hand and he squeezed it tight. I sat down next to him and let him lay his head against my shoulder. He only speaks Afrikaans, but I reassured him, with some English and a couple Afrikaans words, that he was brave and it was okay for him to cry. After his treatment we went back to his room and played a game of Connect Four. Again, I couldn’t really tell how deeply we were connecting – sometimes the older kids take a while longer to build that trusting relationship. Between games, I prepped Harry for theatre. He nodded that he understood, but I could tell he was worried. The porter came to pick Harry up. I walked him to the trolley. He looked up at me and asked, “Will you come with me?” Again, it was such a small request, but it verified that Harry knew my role and had learned to trust me as a support system. My role with him in theatre was very minimal. We tried to talk, but our languages were too different. I basically just held his hand and spoke with an assuring voice as he received the anesthesia and drifted off.

I think my experiment to walk in love and light today really worked. Even in those times I didn’t feel like I was making an impact, that attempt to walk out love in all situations proved effective as kids and families responded in positive ways. What a great day!

voting day

2009-04-22T14:12:00.000-05:00

Today was Voting Day - another public holiday here in South Africa (only 2 more to go during my time here). I have heard a little about the politics involved in this day, but not enough to blog my opinions. I have actually learned to avoid political conversations most of the time - especially with cab drivers. They usually end up centered around US politics (which I hate anyway) and how George Bush started all the wars in Africa - even the ones before he was president if you can believe it. It's pretty ridiculous (even for the non-Bush supporters) to listen to and usually leads to really awkward cab rides, so we try to stick to the weather. :)

All these public holidays are not as great as they sound. I would have much rather been in the hospital with the kids, but instead spent it hiking up Table Mountain. Don't get me wrong, it was a blast and an awesome workout, but I only have 5 days left in the hospital. It was just Jamie, Danielle and I on the hike. We made it up in 1 hour 11 minutes, so we felt pretty awesome. :)

I know this is a short blog tonight, but I think I'm craving some sleep and my day really wasn't that eventful. I mean, I enjoyed it, but I'm not so sure it would be that exciting from the other side of the blog. :)

Back to work tomorrow, so more fun to come!

the little things

2009-04-21T11:52:00.000-05:00

Any Child Life Specialist can tell you what a big difference the little things make. Letting a child sit up for a procedure, giving a patient the choice of which arm to try an IV in, allowing mom or dad to hold the child’s hand, explaining what you’re going to do before you do it, changing a word to be more child friendly: these are all little acts which can result in big differences in a child’s ability to cope and cooperate.

I was helping a little boy finish up with his dressing change today when Lindy was carried in for her dressing. She saw the boy I was working with was tearful and immediately began to cry. Unfortunately there is not the time, nor the space here to keep treatments private. There are often 2 or 3 children having their dressings changed at one time. There aren’t curtains to close, so the kids end up watching the other children and seeing their wounds. It definitely makes the experience scarier for many of them. Lindy’s mom laid her on the table and I stepped in to provide support and ease the transition away from her mom. Lindy recently had one of her legs amputated due to meningitis. Her other leg is severely infected and the doctors are fighting to keep it. Her dressing change today was for the wound on her nonamputated leg. Lindy cried when her mom stepped away, aware of her treatment to come. She laid on the table and looked at me with scared eyes. She only speaks Xhosa, but I spoke to her anyway, trying to put her at ease with the sound of my voice. I walked over to her and helped her sit up. I positioned myself behind her on the bed and allowed her to lean against me with my arm around her in a protective embrace. She calmed immediately. She remained calm throughout the whole procedure, sometimes watching the removal of the old bandages, sometimes blowing bubbles. The simple act of allowing her to sit up made a huge difference in her ability to cope. Often times kids are made to lay down because staff think they are more cooperative or easier to hold or that’s just the way they have always done it. However, if you think about it, the simple act of laying down puts you in a very vulnerable position. Imagine laying down, not being able to see what was going on and being expected to just trust that the painful event being done to you was somehow helping you get better. Pretty scary. The simple act of allowing a child to sit up for a procedure gives them control, comfort, and aids in their cooperation. Lindy was a perfect example of this. I was so proud of her!

I’ve decided one of my favorite moments here is when a child sneaks out his or her first smile. There seems to be a transition period when the kids are too sick or too scared to engage, laugh and smile. But with consistent support they finally reach that moment when they slip out a smile. It’s so much fun to see! Sometimes that one smile opens a flood gate of happiness and laughter and everyone looks on in amazement. Other times it takes a few more days of trust building and support to finally release unrestrained smiles, but eventually all the kids have reached that smiling point. I had a couple "first smile" experiences today and it made me so happy. One little boy who had been so quiet and reserved laughed and played for quite a while today. He even waved goodbye to me when I left. It may seem like a small success, but these are some of my most treasured moments.

The one word that all the kids learn very quickly to say in English is “bubbles.” I don’t know what I ever did at home without bubbles strapped to my neck. These kids can play forever with a tiny bottle of bubbles. They blow them, pop them, spill them, play alone, play in groups, fight over them. Bubbles are seriously my best friends. It has never been easier to build rapport. I just walk up, blow a bubble and am immediately best friends with a patient and his parent. Kids who have been away from the hospital and come back for outpatient clinic come running up to us as soon as they walk through the door. For a brief moment I humor myself enough to think they are excited to see me, but then they plunge for the purple dolphin hanging from my neck and scream “BUBBLES!” instantly bursting my personal bubble. ☺ The lack of bubble mania in the US will definitely be one of my biggest adjustments.

--

I’ve decided everyone in Cape Town is in marketing. Whether it’s the guy in the mini bus hollering “Cape Town!” while hanging out the window, or the “stranded visitor” trying to scam you out of your money – everyone has a marketing scheme and a story to sell you at a negotiable price. There is no greater place to witness the world of marketing than the market – I just realized that’s probably where the name came from! ☺ Unfortunately, all the vendors appear to have gotten their degree from the same university and therefore have the same marketing plan. I can’t tell you how many times I have been the “first customer of the day” and therefore entitled to a discount price. Every tent I went to said the same thing. “Take your time. Free to look. I give you good price. Special price for you.” I must be the luckiest girl in the world because I happened upon every special offer there was today! I started to determine whether or not I was going to buy things from people based on the originality of their marketing gig. I can’t tell you how tempted I was to buy the candle from the guy who told me, “Don’t walk in the dark,” just because it was one I hadn’t heard yet. Needless to say, I am definitely not the best market shopper. I feel horrible about haggling and even worse when I don’t buy things. So I bought a couple things I knew I wanted and decided try get up my nerve to try again another day.

People keep asking me what I miss most about the US (other than the obvious friends and family). I have to tell you it’s kind of hard to make that list. Cape Town pretty much has all the amenities of home, but I have come up with a very short list of some of the small items…

1. Being able to walk without having my ninja moves ready and waiting to spring on any unsuspecting mugger. Along with this is the paranoia that sets in every now and then which drives me crazy. Today I freaked out in the market thinking my wallet had been stolen from the purse I had been clutching the whole time. I thought it must have been a pretty amazing pickpocket until I remembered I’d left my wallet at home for that very reason.

2. Being able to tip my waiter based on how well they keep my water glass filled. Asking for tap water makes me feel like I have a horn growing out of my forehead and getting the glass filled up again is relatively unheard of. One waitress actually brought us a pitcher of water the other day – she received a very large tip. ☺

3. Paying for electricity after you use it – not before. The opposite is true for cell phones and internet.

5. Having the right of way when crossing the street. Pedestrians NEVER have the right of way here…even in cross walks. The little green walking man may be beckoning you across the street, but what he isn’t tell you is that car that’s about to turn the corner doesn’t really care that you’re half way across the street. In fact, he finds it necessary to speed up and lay on his horn just to remind you that you do NOT have the right away. You literally take your life in your hands every time you step off the curb.

That’s the top 5 at this point in my day. ☺ Seriously though. I love this place and I have a far greater list of things I will miss from here than things I can complain about. It’s a beautiful city and I have to go now so that I can take advantage of my last few opportunities to experience it.

stepping in for a moment

2009-04-20T16:44:00.000-05:00

From Friday 17 April

The kids were in a very peculiar mood today. Joe was especially grumpy – fighting with the other kids and totally testing his limits. I have a suspicion it had to do with him having to share my attention with other kids, since it seemed to peek at times when other kids were sitting on my lap. It caused quite a scene during our attempted playgroup though. One minute all the kids are having a blast and the next their flipping each other off and saying words in Afrikaans that I’m are not nice words. I know most of their frustration comes from having to share when they are used to not having much. It’s a difficult concept to be teaching them. At one point today I had to put Othathali and Joe in their beds (which are over sized cribs) with the rails up and the curtain drawn. I think we had all just had enough. Taking a timeout from them did give me some time to give some personal attention to Missy though. That made her happy. She came alive again, smiling and laughing with me. I was glad to see that positive turn around.

Othathali was discharged today and Joe calmed down a lot after she left. At one point he was sitting in bed singing to himself. I heard him singing the “Cast your burdens. Come to Jesus, for He cares for you…. Higher, higher, higher, higher, etc.” song. You know the one I’m talking about? Everyone sings it when they come back from Africa. Anyway, I had learned it from my cousin when she came back from Africa, so I started singing it with him. He was so excited that I knew the song. After that he sang, “I’ve got peace like a river.” It was really fun to sit there and sing with him. I absolutely love African voices singing – especially the kids. It was also a neat connection to make with Joe. When a patient makes it apparent that they cope with spiritual tools, it opens a door to offer ministry that I’m not always allowed to give, which is a neat connection.

Friday night Tami, Caroline and I set out for our “Girls Weekend.” Tami and I thought it was funny to call it that – since we don’t have any other kinds of weekends here, but the concept was the same. ☺ We rented a car and drove to Stellenbosch. It’s an adorable little town out in the vineyards. We settled in at a little hotel and ate at a really cute bistro before calling it a night.

From Saturday 18 April

We woke up Saturday and explored Stellenbosch. It’s an adorably quaint town with lots of shops and restaurants. It felt so peaceful after the hustle and bustle of the city. No matter how much I’ve tried to blend in to this city – I am definitely a country girl at heart.

After exploring the town, we continued on the rest of our road trip around the cape. It was a little rainy, but still beautiful. Along our drive we passed by some of the townships in the area. This was the first time I had the opportunity to observe life in these areas. It’s very different from the city. People live in tiny tin houses crammed together. It’s very dirty and not very safe. My one regret about this trip was that I didn’t get the opportunity to get in and work in the townships. It’s not a place you can go on your own and the opportunity didn’t present itself, so I have to accept that perhaps it wasn’t the place for me this time. Danielle, one of our new CLS’s, however is going to start burn outreach and education programs to some of these areas so I’m really excited to see how that turns out. There is so much poverty in these townships and they stretch for miles and miles. It made such an impact on me just to see them.

We stopped at a number of beach, fishing, cape towns along our route, taking our time and exploring what the area had to offer. We visited the penguins at Boulder Beach. They were everywhere! We ended up in Simon’s Town and stumbled upon the cutest bed and breakfast - Cornerhouse. The French woman that owned it was named Briggitt and she took us in for the night.

Oh! I almost forgot! I was able to drive on the left side of the road today for the first time ever. The hardest part was remembering the turn signal was on the right side instead of the left. I only turned the windshield wipers on a few times trying to trade lanes. ☺ It was almost weirder to drive after not doing so for 6 weeks than it was to be driving on the left side of the road. I had a fun time (not sure if Caroline and Tami felt the same way)! ☺

From Sunday 19 April

Sunday we woke up to find the cape totally covered in dense fog and rain. We had planned this to be the day we took the big trip down to Cape Point and the Cape of Good Hope. We were slightly bummed, but decided to proceed as planned – regretting that we hadn’t brought the appropriate rain gear with us. After a breakfast of coddled eggs, we headed to the tip of the continent (well – the southwestern most tip at least). It rained most of the time, but the fog lifted enough ever now and then for us to see where we were and add just a bit of mysteriousness to the morning.

At Cape Point we found a trail out to the old lighthouse, but the sign said it was a dangerous trail and would take 1.5 hours to complete, so we didn’t take it. I was pretty bummed because I felt like I hadn’t really been to the tip of the cape unless I walked to the end. We all had flip flops on and the fog kept rolling in and out, so we decided it wasn’t safe. When we got to the gift shop, though, I asked one of the workers about the trail. She said it wasn’t dangerous, we could do it in 40 mins out and back, and our flip-flops would be just fine. We made sure she knew what we looked like before leaving for the hike – just in case. ☺ We kept thinking what a great scary movie the three of us would make, but thankfully we made it to the end and back – in the 40 minutes without any problems. The fog even lifted enough for us to see some of the other mountain ranges. Caroline commented that God must have lifted the fog for us because by the time we got back it had settled back over our path. We were very grateful.

After Cape Point we drove to the Cape of Good Hope – the most southwestern tip of Africa. Some people think it’s the most southern, but if you look at a map you see it’s not – hence the most southwestern. It was so beautiful to watch the waves crashing against the rock…and to feel so close to Antarctica. ☺

We continued our trip along the cape – watching baboons and ostriches along the way. It was such a wonderful time with my good friends. We were discussing on the way back how amazing it is that just a few weeks ago we didn’t know each other and now we are great friends. It has been such a blessing. I told them how worried I was about the friends I would make on this trip, and that they had been a wonderful answer to my prayers. I can’t say again how thankful I am for them and for the wonderful time we’ve been able to spend together.

From today, 20 April 2009

My last Monday at the hospital (next week is – you guessed it – another holiday!). I was able to spend some quality play time with a couple of the boys and saw some amazing turn arounds. Play has become such an integral tool for me here. I know that’s what CLS is all about, but sometimes at home some tend to shay away from that role because other see it as – “just playing with the kids.” But when you understand the importance of play, the purpose it serves, and the impact it has on kids and their ability to heal, you realize that there is no greater tool than the ability to “just play.” So I have embraced that role in my work here and hope to take it back to the US in full force. ☺ The 2 boys I played with today had really rough weeks last week. One of them, Will, had spent last week just lying in his bed. He didn’t want to play, but would just lay and let people rub his legs. Today, he was full of play! He laughed and sat with me, read books, and blew tons of bubbles! It was so amazing to watch his interactions and see what a difference had occurred in him. The other little boy I had mostly worked with in dressing changes. He never really seemed very fond of playing with me. I think he associated me with the treatment room and didn’t enjoy that reminder. But today we were able to make huge play strides. He read books, blew bubbles, and laughed and played in ways he hasn’t done since he’s been here. It will be interesting to see how his dressing goes tomorrow. Now that I’ve had the opportunity to build that trusting play relationship, I hope he can accept my support in the treatment room as well. It was amazing to see and an awesome reminder of the power of play!

I’m having quite the range of emotions as I prepare to leave this place. This South Africa Project is not mine. I was just here to provide support to those who are developing the program. However, it’s difficult to come and invest yourself in something and then walk completely away from it, never knowing if it will cross your path again. But as I’ve struggled with this – I’ve realized this experience is not about me – it never has been. This experience is about the opportunity to touch the lives of others and lift them up. If that means stepping in for a moment and then stepping away for a lifetime, then I am thankful for that opportunity. I’ve learned the importance of not lifting myself up, but lifting up others. Not worrying about my own success, but how to help others succeed. I think in the world I come from, we focus so much on our own successes and how to get ahead. But while I’ve been here, I’ve been learning the lesson of how much greater joy comes when we help others succeed and when we lift them up. I know that my life lies open before me. I trust that as I turn it over to God, He will continue to guide me through this fabulous adventure of life in ways far greater than I ever imagined!

p.s.

2009-04-16T15:30:00.000-05:00

Mom, Erin, and anyone else who reads my blog so diligently and worries when I don't write,

I will be out of town this weekend. Caroline, Tami and I are driving to the Cape of Good Hope. I won't be back until Sunday night, so I won't be blogging all weekend.

Just thought you'd like to know. :)

2 weeks notice

2009-04-16T15:23:00.000-05:00

Today I am officially giving my two weeks notice. Two weeks from today will be my last day working at the Red Cross Children’s Hospital in Cape Town, South Africa. Wow. Writing that feels very real. I’ve known in my head that the end is coming, but my heart is just starting to realize it so I cry pretty easily these days. I apologize that every blog entry from here on out will probably begin with a very similar statement about the ever-nearing end of this journey. Thanks to all of you who have traveled with me. I know some of you will miss my daily ramblings (others probably can’t wait for them to be over!), but hopefully this is only a pause in my adventures and there will be more to come in my life (whether at home or abroad). I am very excited to head home and see you all. I have missed you very much. But I know I will also leave part of myself here in Africa when I go. It sounds very cliché, but these kids have definitely captured my heart and it is very difficult to face leaving that behind.

(I really can’t see what I’m writing right now because the tears are coming full force now, so give me a minute to regroup…)

Joe and Missy were readmitted to the hospital today. They are the siblings I’ve worked with from the day I got here who have totally won my heart. When Joe got to the unit he saw me at the end of the hall. A big smile spread on his face and he ran to greet and hug me. Before I knew what he was doing, he’d planted a big wet one right on my lips (not something I’ve ever let a kid in the hospital do, but it came out of nowhere and caught me off guard). Missy was much more reserved. She looked extremely cautious when she walked on the floor. There was no grand hello from her. She just walked up to me and stood between my legs. She was connected to me for most of the rest of the day – either when I was holding her or she was just standing near enough to touch me. The hospital is such a scary place for her and she needs a little time to readjust to her surroundings.

Othathali went to surgery again today. She has made such improvements in the few weeks we’ve been working together. She was pretty sleepy for surgery today, so I just had her stay laying on her cot when we rolled into theatre. When the mask started blowing air on her face, she turned her head, buried it in the cot and fell back asleep. Rather than fight with her, the doctors simply covered her head with the blanket and placed the tubing inside with her to create a tent with the anesthesia pumping into it. It took a little longer, but it totally worked and Othathali was able to fall asleep peacefully. Have I mentioned how much I love these doctors?!

I’ve been thinking lately of all the encouraging messages I receive from home. Some tell me things like – you’re exactly the right person to be doing this, or we couldn’t have sent anyone better. But I need to take a moment to clarify that for everyone. There is absolutely nothing special about me when it comes to doing this job. There a million of Child Life Specialists more capable of providing better interventions for these kids and education for the staff. I can think of a number of people from my hospital alone who I have wished were here instead of me to provide the care these kids needs. Anyone could be doing the things that I am doing here. The only thing that separates me, and the others here with me, from the others is that we chose to come. We saw a need that we thought we might be able to assist with and we allowed ourselves to be used. We found a need and placed ourselves in a place to meet it – despite our potential inadequacies. As you’ve read in my blog, the interventions that I’ve been able to provide aren’t amazing. The majority of the time, I’m just here to hold a hand, to speak an encouraging word, to offer a shoulder to cry on, or an opportunity to laugh and forget the stress of this place. But because I have been here, and because the need is so great, those opportunities have turned in to life changing experiences. The awesome thing is – anyone can do this, in any place, at any time. You don’t have to come to Africa. You don’t have to work with burn patients. You just have to be able to step into a situation when see a need and allow yourself to be used to fill it.

Today I was on my way out the door when I remembered a couple of stacking cups I had left in a patient’s bed. Since they aren’t technically a big item, I considered testing my luck and hope they were there in the morning. But for some reason it nagged on me and I decided I needed to get them today. I went back to the bay and found that Joe had been taken to the treatment room to have his clips (staples which hold the graft in place) removed. He had been scheduled to have this done in theatre the next day, so I had no idea that it would be going on. I went to the treatment room and found him screaming in pain and fear. Once again, I didn’t use my 6 years of schooling to fish out an amazing trick to make his pain go away. At that point there was really nothing I could do for his pain. The resources are so limited that often kids are just asked to cope with things far beyond what children should have to cope with. So, I sat down and just grabbed the hand he was holding out to me. He looked at me with longing eyes. I sat next to him, put my arm around him and let him bury his head in my shoulder and just cry and scream. There was nothing magical about my intervention. It didn’t make the pain go away. But having someone willing to step into that moment, gave him enough strength to make it through. After his treatment, Joe and I went back to his room. He was quiet and tearful and just wanted to lie in his bed. I helped him up and told him how proud I was of him. I reached into my pocket and pulled out some Superman stickers I’d stashed there that morning. He took them and a huge smile lit up his face. “Superman,” he said. I smiled back and said, “You are Superman.” He laughed and said, “Joe. Superman.” He put his fist in the air as if he were flying. I realized in that moment there was absolutely nothing special about me. The true heroes in this story are the kids that deal with these traumas every day. They are the ones who will continue to be here long after I have gone. They will continue to face their fears daily and come out victorious. And hopefully, we as Child Life Specialists and medical staff get the opportunity to walk with them along the way. Joe, you are Superman.

finding my voice

2009-04-15T15:40:00.000-05:00

Today I found my voice in the treatment room. It was a busy Wednesday – the busiest we have had. There were 20 outpatients kids and 15 inpatients. I estimated that I did about 25 procedures supports. It was so busy, but it was an amazing day. At times there were 3 kids, each with a sister and a CLS getting their dressing changed at the same time, but I was able to find my voice today and speak up for the kids. We all worked hard today to advocate for comfort holds. Whenever possible we would suggest a more comfortable way to hold and position the children. By the end of the day, the sisters were asking us to hold the children on our laps, or instructing the mothers to hand the kids to us because we would comfort them during the treatment. It was so thrilling to see.

I also spoke up to help deescalate a stressful situation by reminding the sisters that the little girl’s response was not because she was being defiant, but because she was scared. I’m not sure if they agreed with me, but they did soften their approach and what could have been a high stress situation was diffused quickly. It’s often hard for me to find my voice in those situations because my role is to advocate for the child, but to do so without alienating other staff. To find my voice successfully in that situation was a very empowering feeling.

One little girl stood up during her dressing changes and just clung to my neck. I couldn’t pry her off. I took her back to her bed and she was so sweet and smiling. I walked by later and she was crying. A doctor was standing by her bed and said she didn’t know what was wrong with the little girl. I asked if she wanted to be picked up and she raised her arms toward me. I picked her up and again she just clung to my neck. She held on so tightly that at one point I thought she was going to choke me. I tried to move her, but that just made her hold on tighter. She began to calm and the other mothers commented that it was finally peaceful. One mother noted that “they just need comforted.” It’s so true. So much of what these children need is just someone to hold them and make them feel safe in this threatening environment. She began to fall asleep and I tried to adjust her in my arms, but every time I moved (even though she was asleep) she would cling to me tighter, so I remained with her and just gave her the opportunity to feel safe.

Later today we were discussing how the day had gone with the Child Life team. It was an extremely busy day and we all felt as though we’d been pulled in a million different directions. It is both emotionally and physically exhausting to assist in these treatments, but at the end of the day we all felt the positive experiences and improvements far outweighed any negative. We counted it as a very successful day.

I also decided today that maybe it’s a good thing I decided to stay with Child Life and not pursue my nursing path at this time. A sister gave me some medicine to give to a child through a syringe. Normally this would not be something I would do at home, but when there is such limited staff, everyone has to end up helping out with somethings they normally wouldn't. I do have my limits of course, and won’t do anything that could be perceived as potentially threatening to a child, so I only give meds when they kids are willing recipients. Anyway, the little boy I was holding was sucking on the syringe as I slowly pushed the meds into his mouth. It became difficult to push the syringe further so I took it out of his mouth to see what was wrong. There was quite a bit of air at the front of the syringe, so I pointed it up and tried to push a little of the air out. It wouldn’t budge, so I pushed a bit harder. All of a sudden there was a pop and the brown meds went spraying up into air all over the ceiling. I started laughing as the meds began raining down around me. I called Danielle in to look at the ceiling and asked her if she thought it looked like a significant amount of meds. We both just laughed and laughed. Guess I’ll stick to Child Life. ☺

This evening I went to my first ever book reading. It was held at the little bookshop on the corner by my apartment. The book is “Invisible Earthquake” by Malika Lueen Ndlovu. It is a collection of poems documenting the authors experience with stillbirth. It is a pretty powerful book and gives voice to a topic that is often suffered through in silence. The description of the grieving process was especially moving. It offers hope and healing and, while I haven’t read the whole thing, the parts that were read tonight were wonderful. I went up to Malika afterwards to tell her how much I appreciated her readings and how the book had meaning in my roles as a CS. As I was walking home, I realized that I had actually gone up and talked to this woman – something my shy self would not usually do. I think I might actually be growing up here – and finally finding my voice.

better

2009-04-14T15:52:00.003-05:00

Today was an awesome day; one of those days that reminds me why I do the work I do. The day didn’t start out that way, however. I woke up rather discouraged. I was starting to doubt my ability to accomplish all I want to accomplish here, and even more nervous about going home. I’ve talked so much about the changes that have occurred in me – I’m getting scared that you all will be disappointed when I come home and I turn back into the same old Cara. ☺ I may not be what you may expect, and if I am I worry I won’t be able to maintain the desires I have to allow this experience to truly change me. I was worrying about all these things and feeling discouraged, when I realized that those feelings do not come from God. He would not place those thoughts within me. So I prayed that He would take them from my heart. I had read a scripture previously this week from II Corinthians 12:10 that said “For when I am weak, then am I strong” because Christ’s’ strength is made perfect in our weakness. I prayed that in my weakness, today I would be made strong.

God is so good. This day was truly amazing and those feelings I felt this morning were swept away. I walked onto the ward this morning and was immediately greeted by Othathli who jumped into my arms and covered me with kisses.

Then I moved to the treatment room where I spent most of my morning. My time there was filled with perfect Child Life moments. The kids seemed so responsive to the interventions, the parents were appreciative of my presence, and the sisters were completely open to my suggestions. I was able to provide comfort holds for some of the patients and the sisters didn’t make any of the kids lay down unless there was no other way to reach their wounds. It felt so wonderful and I could tell it made a positive impact on the kids.

One little girl, Molly (8 years old) had a particularly hard time with her dressings this morning. They were very dry and stuck to her skin – causing extreme pain when they were taken off. She appeared to have a very difficult time coping. A while later she had to get her blood drawn from a femoral vein. I couldn’t think of a comfort hold for that, so she laid down on the table and had to have her legs held to keep from kicking. She was very upset by all the morning procedures. I was concerned about her coping, so we did some medical play later that day. I brought her a blank cloth doll and her face lit up. She used the markers to create her own buddy and then jumped in to using the medical equipment I had brought for her. When she picked up the bandages, she asked where she could be them. I let her know that the doll was hers and the bandages could go wherever she wanted. She placed them on the doll exactly as her bandages had been placed on her, wrapping it around the dolls chest and then around its arm. She smiled a big smile when she was all done. She continued to play with the other medical equipment, laughing and smiling. Her mother was so pleased with the intervention. It was another wonderful Child Life moment.

This afternoon we took our pictures for the positioning for comfort poster I am making. We got one of the sisters involved as a model for the photo shoot that I think will prove to be very beneficial in the long run. We had to tell her all about what we were doing, so it was a very good way to share the concepts of positioning for comfort. She is a well-respected sister, so I think her involvement in the project will encourage others to support the concepts just by knowing she is supportive. Others stopped by the treatment room to see what we were doing, so I think there was quite a bit of positive PR going on just through the photo shoot. I am so excited for this project. It feels like a way I can leave something tangible behind that will continue to influence the staff and patients long after I leave. I think it makes that transition home a bit easier because I can see that I at least made one identifiable contribution. Don’t get me wrong, I know I’ve been able to make so many more through the interactions I’ve had here, but it’s just nice to be able to actually see something.

I have been reading a book while I’ve been her called “Better” by Atul Gawande. I highly recommend it to everyone. It is written by a surgeon and discusses a number of issues in the medical field which can be applied to any life setting. Like the title suggests, it has challenged me to be better in my profession as a Child Life Specialists, but also in all areas of my life: as a friend, a daughter, a sister, a Sunday school teacher, a volleyball coach, etc. If we settle for average in our live – we will receive average results. But that’s not fair to us or to those patients and families we work with. The challenge is for us to be better – to do better. I’m not saying I’m going to come home and feel like I have to be the best the world has to offer in all these areas, but I know I can be better. And so I challenge myself to do that.

The chapter I was reading today was talking about Cystic Fibrosis facilities around the country. One such medical facility has challenged itself to be the best in the country. At the time the book was written, this facility had gone nearly a decade without a single child or teenager dying of CF. Their oldest patient at that time was 67 years old. That’s pretty amazing! The doctors and nurses at this facility didn’t have any different research or medical equipment than any other hospitals in the country. They had just challenged themselves to do the best for their patients with the resources they had. They didn’t allow themselves to be content with average results. They demanded the best and obviously it paid off for their patients and families.

The awesome thing about being better is that it can be applied to any life, at any time, anywhere in the world. You don’t have to travel to Africa, you don’t have to be saving lives in a military medical unit (another example from the book) – you can become better in whatever area of your life you desire.

So, I’m ending this day on a much different note than I began. I am so excited to make my life better. I can’t wait to be a better Child Life Specialist, a better friend, a better contributor to my community…better! ☺

I was writing down all the ways I wanted to be better as a Child Life Specialist – tangible things I want to implement in my practice when I return home. I started thinking about reasons or excuses that would stand in my way of what I wanted to do. But then I realized that people who do become better are able to acknowledge who they are and have a vision for where they want to go – without excuses. So, I’m committing myself to being better.

Thought I would also include the quote Caroline wrote in my journal today, “If you’re a woodpecker, get out of my boat!” I'd always thought of that in the sense of others telling me I couldn't do something, or providing negativity. But today I realized that applies even more to the negative or discouraging thoughts I often allow myself to have. So I'm applying this quote to my own thoughts today! :)

Love you all.

4.day weekend

2009-04-13T15:40:00.000-05:00

Public holidays are quite popular in South Africa. We’ve just made it to the end of a 4-day weekend including Good Friday and Family Day Monday. I think there are about 6 public holidays in the month of April alone, so these people take their rest time seriously. :)

The time off has produced some surprising feelings for me. It’s nice to have the chance to explore some of the areas of Cape Town that I would not otherwise have time to experience, but I feel guilty taking time away from my purpose in coming here. I even experienced a bit of mild homesickness this weekend. When I’m working at the hospital, my purpose in being here is so clear, I am able to focus all my energies on that, and haven’t felt the longing for home. But this weekend my focus was more enjoyment centered and so purpose was less evident, giving me a chance to think about and miss all my wonderful friends and family at home. It felt more like I was on vacation and I wondered why you all had not come along with me! In all my activities I kept thinking about which of my friends and family members would have enjoyed the various moments with me. After you read all the events of the weekend, you can decide for which one I was wishing you would have been with me! ☺

Friday morning I woke up at 6 am and took a cab with my friend Jamie up to Signal Hill. We joined with the little church we had attended on Sunday for a Good Friday sunrise service. It was a spectacular view and a wonderful service. It has been so neat to worship with this little congregation. They have made us feel so welcome and special. They are so excited when we join them and have really made an effort to make us fill at home. I am sure that if we sat down together, we would disagree on a number of doctrinal issues, but I’m reminded of the council given in the scriptures to agree on as much as we can and build from there. So, I have focused on those points we agree on and because of that have truly been able to worship with my brothers and sisters in South Africa. We were sitting on this hill, singing praise songs and I was just filled with a love for them – in awe of how I can feel so at home with people that I hardly know, through the love of Christ. The Gospel brings people together. I can be a world away and feel at home with these people because we meet together and agree on Jesus as our Savior. How much more should we be able to do at home when we meet together and agree on so much more? Yet we often find it hard to worship together. It seems that we so often choose to focus on our differences and those ideas that separate us. I spoke with some friends from home this past weekend who were discouraged and saddened by feeling like they had to pick between 2 separate communion services and worship services this past week – both of which were supported by people they love. When will we chose to love one another, focus on those things we can agree on and allow God to work through us? Just think of the work he could do through us!!

After the service I drove with Tami to the Kirstenbosch Botanical Gardens. We spent the day walking around the gardens, taking pictures of every green plant there was, and just enjoying the beauty and peace of the area. It was so difficult to capture everything with my camera, but I tried to at least take enough photos to spark the photos I tried to remember in my mind.

Our cab ride home taught us the lesson of never talking politics in a taxicab. The drivers are very particular about their views on American politics and the conversation soon becomes very uncomfortable. I must say it was very interesting to hear the views – you would find them surprising no matter what your political affiliation. However, if you know me at all – you know I absolutely hate politics because I feel like they divide people before they even have a chance to listen to another person’s views, so I’m not going to type the content of our conversations. If you really interested, I’ll tell you when I get home. ☺

Day 2 of the 4-day weekend was extremely relaxing and uneventful. Tami, Therese and I took Jamie and Danielle to Camp’s Bay for their first trip to the beach. It was an absolutely beautiful day and we spent it relaxing in the sand. We tried to pass around volleyball, but the one we had felt more like a basketball, so that quickly ended. I did venture into the freezing cold water and even put my head all the way under, just so I could say I had truly been in the ocean. The rest of the time we laid in the sand writing postcards, chatting and listening to the guys who wander the beach selling food and drinks. “Lollipop Ice Cream!” (aka popsicle). “Ice cold drinks from Iceland!” ☺

Easter Sunday Jamie and I walked to church at the little congregation we’ve been attending (this is only our second week going, but that counts for “been attending” ☺). We bumped into Dawn and Diandra on our way. They were the ones we followed to church the first time, so it seemed perfect to walk with them again! I was pretty sad knowing this would be my last Sunday to worship with the congregation (the next 2 Sundays I will be out of town – and the 3rd I’ll be flying home). I wish I could have found them earlier, but I’m just grateful I was able to be with them in the time I was – and that now Jamie will be able to continue worshiping with them. The sermon today discussed Jesus making water into wine and how we each need to be converted into new creatures through Christ. I feel as though I have been changed in this journey and I just hope that it will be a permanent change. Just imagine if the wine would have turned back into water – no good. ☺

After church, Jamie, Tami and I went to Robben Island. It’s the island that held the political prisoners who fought against Apartheid in South Africa. The prison was used for other purposes throughout the years, but most people visit because of it’s role in Apartheid. Robben Island actually only held the Black, Colored, and Indian political prisoners. (note – the term “colored” is acceptable terminology here for and non-black/non-white individual). White prisoners were held elsewhere. This is the prison Nelson Mandela was imprisoned in for so many years. We saw his cell and the cells of so many others. Our tour guide was even an ex-prisoner. It was so interesting to hear the history and stories behind the island. The ex-prisoner told us that they guards used to have different menus for the black prisoners and for the colored and Indian prisoners in order to encourage dissension and segregation among the prisoners. The black prisoners were given less and did not receive things like jams. The guards hoped that this would cause division. But instead, those with more shared with those with less, so that everyone was even. This was their way of showing that they were all in the fight against oppression together. It strengthened their comradery and frustrated the guards. It just goes to show the power of having all things common and the unity that can bring. There was so much more to share with you about Robben Island, but I don’t have the space, so you’ll just have to read up on it yourself. I am so glad we were able to go. It was definitely a must see in Cape Town.

And now we end with day number 4… Today is Family Day. I guess that means you hang out with your family. ☺ We decided to hang out with a Capetonian family and hike Table Mountain. Jamie met a guy named Murray through Mercy Ships – an organization she will be working with after her time in Cape Town. Murray is from Cape Town, so he and his dad, brother-in-law, and friend decided they were up to the challenging of taking 6 American girls to the top of Table Mountain. It was quite the challenge, but we had a wonderful time. The hike ended up taking us about 8 hours. We traveled up the back side of the mountain via Skeleton Gorge. We walked all along the top of the table and then down Platteklip Gorge. It was an amazing hike! Definitely one of my favorites I have ever done. There was such diversity in the terrain. At one point we were scrambling up the rocky gorge and at the next we were standing in a giant dam full of sand. It felt like we were on the beach on the top of the mountain. We were able to reach the highest point in Cape Town and then walk along the top of the mountain. The trip back down was super steep down the gorge, but we eventually made it. Exhausted, but happy at our days worth of hiking. I absolutely loved it!

Tomorrow begins one of my last weeks at the hospital. Many of the kids that I’ve been working with have gone home, so I’m prayerful that God will continue to lead me and open the doors He would desire for me to walk through.

Love you all.

the goodbyes begin

2009-04-10T03:11:00.000-05:00

Written 9.4, but couldn't publish last night...

I’m incredibly tired as I sit down to write this blog tonight, but I don’t want to start this busy weekend off behind in my documenting. Jamie and I are getting up early to join the church we went to last weekend for a Good Friday sunrise services on Signal Hill. I’m trying to get to sleep at a reasonable time, but it’s already 11:30.

I just returned from a very fun night. We decided to have a potluck tonight with some of the girls. It was so much fun we’re making it a weekly occurrence called “See You Thursday.” Not really sure why we named it…it must have been that much fun! ☺ We sat around with some of the new people and old people and talked for hours. We laughed and ate and just spent time enjoying the company of new friends from around the world.

The goodbyes seem to be beginning at work already. Perhaps I’m just in the frame of mind to start preparing myself for my return trip home, but it seems as though I’m beginning to have to start saying goodbye. A number of the kids that were new when I arrived are now getting to go home. Joe and Missy were already gone by the time I got there this morning. They were transitioned to the medical facility many of the patients go to as a step in the transition home. It was weird not being able to say goodbye and participate in that transition home, but discharge is so sporadic it’s hard to know when things are really happening.

The little boy who has been here with his mother for 3 months is finally going home! He has to come back in a few days, but the mother feels so blessed to join her family for the Easter holiday. We started our goodbyes to him, knowing that the time is short for him to remain in the hospital.

Nelly was back from the medical facility for an outpatient appointment. We learned that her parents had contacted the facility to come get Nelly. This was surprising news as Nelly’s family was thought to be non-existent. It is good however to watch her get ready to transition home. She gave me a big bear hug today and we said our goodbyes - this time for good.

We also said goodbye to our first patient to die while I’ve been here. The burns were just too massive for his little body and last night his fight ended. I had not worked closely with him, but did spend time yesterday blowing bubbles and singing with him. I know he is finally at peace and I pray for his family as they cope with the grief of their loss.

I’m thankful for these moments to begin the goodbye process. I think it would be too hard to do all at once, so I pray that I will have the wisdom to utilize these last few weeks most effectively and the courage to say goodbye to this experience.

I did another comfort hold today. This time I didn’t even ask. I just picked the child up and held out her hand. The sister told me, “she must lay down.” I asked if she thought she’d be able to do the dressing with me holding the little girl and she actually agreed! It was fabulous.

Today Prof told Caroline – “I don’t like you being on C2. I love you being here!” He has just been full of compliments today! :)

I know this was a brief blog with random jumps in thought, but my eyes are so heavy, they are closing and I’m not really sure what I’m writing.

I just need to send a couple shout outs…

Thank you so much for the wonderful e.mail you sent me Deborah. It was a wonderful pick me up and so nice of you to remember me!

I did get my birthday cards Mom and Dad, Erin and Pete, and Brett and Becca. Thanks!!

Nana – I thought about you a lot today because they use “Monkey Blood” on wounds to help them heal. ☺That doesn't give you permission to start using it again, though.

That’s all for now – I think I might actually be asleep as I’m writing this! ☺

Love you all.

ran out of ink while journaling

2009-04-08T15:44:00.000-05:00

Keeping up with blogging and journaling has been such a struggle lately, but I know it’s so important to document all these experiences that I am going to stay up late tonight and get all caught up. I ran out of ink while I was journaling last night – is that a sign that I’m writing way too much?! I hope not. I hope these blogs are still exciting to read and haven’t run out of spunk. The experiences I’m having our definitely still exciting. I do feel my self wearing down a bit though. We work so hard and it is extremely emotionally draining. I have to keep reminding myself to take the time to rest and care for myself in order to best care for the kids. But tonight – I’m not worrying about all that. Tonight I’m catching up. ☺

Yesterdays happenings..

Yesterday was an exciting day for so many reasons. We had a meeting in the morning with the pain management team. A couple of women joined us from a hospital near Jo-burg. One of the women used to be a nurse, but learned about Child Life and taught herself through research and molding her studies around Child Life knowledge. She has been working very hard to start a program in this hospital near Jo-burg, so we all met in hopes of collaborating to bring Child Life to South Africa. It was an awesome meeting with some exciting events. It was also a challenging meeting as we try to decide the best way of bringing CL to South Africa – especially as far as the council and certification issues are concerned. I hope we can come to a conclusion that makes the profession valid here, but is also reasonable and works within the South African social structure.

As part of the meeting, Professor Jenny (the head of the pain management team and the anesthesiologist that has opened the door for us to come) stated that the question is no longer IF Child Life is need here (she said that has been made blatantly obvious to the staff and families) it’s how are we going to make it a sustainable program. She even teared up a bit when she was recanting some of the awesome changes she has seen take place through the guidance of the Child Life team. It was really amazing to sit there as part of a valued team and see our hard work truly appreciated. During this discussion, an announcement was also made of an attempt to keep Caroline on for a full year and provide her with a paid position. Many more tears fell around the circle at that announcement. We have been in a state of limbo – working so hard to bring this program about, but not knowing what will happen when we leave. Knowing Caroline will be able to stay on and provide consistency to this program makes is much easier to leave, trusting that our good work will continue. What an awesome blessing!

There has just been so much support throughout this process. It has been so awesome to witness and be a part of.

Yesterday was also exciting because I was able to do my first medical play session with the blank cloth dolls we often use for such occasions. I got a blanket and sat on the floor in one of the bays with Othathali, Joe and Missy. They love the dolls! They each decorated them on their own (many including nipples and belly buttons, which I don’t usually see at home). Othathali’s dolls even had tears streaming down her face. The kids laughed and played together for quite some time. Missy giggled and giggled the whole time. It was such an awesome moment! I have never seen her that way and it made me so happy. You can tell she was so freed from her environment and circumstances during her play – it’s such a powerful tool! We had a small scrap of bandages I divided into three for the kids. For those of you who don’t know – medical play sessions are intended to by child directed, thus the term play instead of preparation or something else. So I don’t give instructions during these sessions, I’m just present to facilitate while the children freely play. The interesting this was that – totally unprompted by me – each of the kids put the bandages on their doll in the same location they themselves were bandaged. Some even came complete with drawn on wounds. It was such a powerful moment of play. Many people stopped by to observe and comment on the change they were able to see in the kids when they were at play.

Joe was supposed to go to surgery today. We had already done the prep that morning and played with the mask because there is never any notice was to when a child will go to surgery. We waited around most of the day and the time came for us to go home. Joe still hadn’t gone to surgery, but we had to leave. I went to his bed to tell him that I was not going to able to be present when he went to surgery. I gave him a hug and said goodbye. He began to cry (one of those soft cries where the tears stream down the face, but no sound comes out – the ones where you can just feel the sadness). I sat down beside him and he sat on my lap for a while. He was quite and calm in my lap, but I couldn’t hold him much longer, so I put him back in bed and said goodbye. He started crying again. It was such a difficult moment for me. I had to go and we weren’t even sure if or when he would have his surgery. It was so hard to walk away and say goodbye. Later that night I was thinking about the difficulty I had in leaving Joe there. It made me realize just how difficult it’s going to be walk away from all the kids when this time is over. I’m starting now praying for that transition home because honestly it’s kind of scary. I just have to trust that God has a plan for what comes next in my life and that these experiences will have a lasting change in my life.

Last night we had a popcorn and cards night with some o f the girls and then walked down the street for some dessert. It was such a comfortable night. I commented to the girls on how blessed I am to have their friendships here. It has been such and answer to prayer. I love them!

Today was another Wednesday day. ☺ If you don’t remember – those are the ward rounds days. We actually seemed to get the dressings done in record time. It’s so neat to see how far some of the kids have come in their coping skills. The treatments are still painful, but today didn’t seem as rushed - which helps the kids remain more calm and able to utilize their coping skills. One of the social workers was talking about some recent research showing that when kids experience trauma it significantly affects their brain development. Traumatic experiences included those where there was separation from parents and physical pain, etc. The treatment room truly is a traumatic experience for many of these kids – and to think that is affecting their brain development motivates me to be more bold in my advocacy for a comforting and supportive environment.

I had another play session with Othathali, Missy and Joe today. We did an art activity and then attempted to play games. The kids ended up fighting over them, so the playtime quickly ended in hitting, time out and tears. It was kind of stressful, but really fun while it lasted. It’s just so hard for the kids to share here. They have so little that when they are presented with something, it’s difficult for them to give it up. But the play session truly was fun – with lots of giggles from Missy again. The kids like to climb up on my lap when we’re playing together so today I had Othathli and Joe while I was reading a book. It was one of those snapshot moments I try to tuck away in my mind to take home with me.

I’m so incredibly tired. I have to go to bed. Tomorrow is the last day of the workweek, followed by a 4-day weekend! We have so much to cram in to those four days. I can’t believe I will only have 3 weeks left here after that. I have cried numerous times during the day thinking about what it will be like to leave, but I’m trying to live in the moment and truly appreciate each moment and experience I have.

a mother's love

2009-04-07T15:44:00.000-05:00

From yesterday, April 6 (i'm sorry - internet excuses again!)

Othathali went to surgery this morning. Thankfully the premed worked and she was knocked out for the majority of the wait outside the theatre. The surgery before hers ended up taking a long time, so we waited in the hallway for about an hour. Othathali’s mom was there, so I just sat with her and talked while Othathali slept. We had plenty of time to talk, so her mother told me all about Othathali’s story. Othathali was burned by fire when she was about 3 months old. She is now almost 6 or 7. She spent the majority of her first year of life in the hospital, undergoing numerous surgeries and painful procedures to save her life. Due to the social situation Othathali came from, she was not able to go home with her parents. One of the women working in the cafeteria heard Othathali’s story and ended up adopting her. Her mother told me about the way she felt God had been preparing her and her family for Othathali’s presence in their lives and that her addition to their family was truly orchestrated by God.

Othathali’s mom also told me about the role she plays in advocating for her child – both in and outside of the hospital. Children can be cruel to those different than them anywhere in the world, but it seems like physical disfigurement takes on a greater social stigma here. Tolerance is not a key topic in children’s education, so burn survivors often have a very difficult transition home. We’ve even heard of children being shunned by their families and communities following burns. Othathali’s mother told me how she had gone to the schools and spoken with the parents (spoken – threatened…it’s all the same around here. ☺). She also told all the children in the neighborhood that she had gone to the police station and filed an open case, so that any child caught making fun of or hurting Othathli would immediately be prosecuted and their parents would go to jail. I’m not suggesting this is the newest model we should use for school reentry, but it does illustrate what a mother will do to protect her child from emotional pain. She is doing the best she can what she has in order to protect her child.

Othathali also discussed her role as an advocate for her daughter in the hospital. She is constantly asking questions and wanting to be at the forefront of her daughters care. She told me that she worries that the doctors think she is annoying or bothersome because she always needs to know what is going on and feel in control. I encouraged her in taking leadership of her child’s care, reminding her that she is the expert on Othathali. I said I wished there were more parents able to take on the role as advocate for their child. I think that is often a difficult role for parents to navigate. We as medical personnel need to take it upon ourselves to encourage parents in that role and give them the tools necessary to achieve success as the expert in their child’s care. Parents should never be made to feel bothersome because they are seeking information or wanting to take part in their child’s care. True family centered care recognizes the family as the constant in that child’s life. Doctors come and go with different ideas and different messages. The one consistent member of the team is the family and child and they are therefore the experts.

After our talk Othathali’s mother started to cry. She wouldn’t look at me because crying is not openly displayed here. But I could see her wipe her tears. I put my hand on her back and encouraged her in her role as mother. She told me she was usually so strong that people didn’t realize how difficult it was for her to watch her daughter continually go in and out of surgeries. She told me how her husband had died a year ago and that he was usually the one that accompanied Othathli to surgery. It had been over a year since Othathli’s last surgery (not counting the one a few days ago). It seems like so much for one person to handle, but she handles it with such strength and courage.

We accompanied Othathli to the theatre. She slept for most of the time, waking occasionally but calming with reassurance from her mother and I. The environment was so soothing and the sedation went very smoothly. I accompanied Othathli’s mother back into the hall where she gave me a hug and thanked me for listening. So often that’s the best thing I can do.

There is another mother on our ward that displays this strength and courage. Her son has been in admitted on the burn unit for over 3 months. She has been with him almost every moment of that three months. Every now and then she goes home to care for her other two children. She feels torn between her child in the hospital and her children at home. She sleeps on a mattress by her child’s bed that they bring her at night. She is so patient and kind and often looks after the other children who do not have parents at the hospital. Her son has some horrible itching problems. He scratches and scratches at his wounds. The medications don’t help much, so he is often miserably uncomfortable. His hands have been bandaged to keep him from digging through his dressings. His mother remains so patient as she tries to comfort him and support him. She, too displays so much strength and love.

The display of love and strength by these mothers is not unique to Africa. I can think of many mothers on my unit at home who have endured the stress of a difficult medical diagnosis, who battle with the daily struggles of long term hospitalization, who balance caring for their well and hospitalized children, who try to keep it together when they feel like the hospital is making them crazy. I don’t know how they do it. I have the benefit of leaving every day…of seeking renewal outside of the hospital walls. The hospital doesn't have to consume my life, but when you have a child in the hospital - it so quickly becomes your life. Many of these mothers relocate their lives to a small hospital room and continue to manage their daily responsibilities from afar. It truly is amazing. They truly are an inspiration. The least we can do is offer a listening ear, an understanding hug, a brief respite, an encouraging word, and always a respectful response to their expertise as the mother of their child.

In the last few days I have heard from a number of friends about struggles they are experiencing at home. It makes my heart heavy not to be there to provide the comfort that I so want to give. As I was thinking about my friends, I began to think about these mothers. There are times when the things they must do for their children causes them discomfort and even pain. The children become very upset and don’t understand why their mother’s would keep them from the comfort they seek. For example, Mark’s mom must battle with him daily to keep him from scratching his wounds. He cries and hits her, not understanding why she doesn’t assist him in the comfort that he seeks. But his mother knows that in order for his wounds to heal, and in the long term for him to find the comfort he seeks, she must not let him scratch. There are times she has to scold him or even swat his hands to help him understand the importance of following her commands. I think that often this same struggle occurs between our Heavenly Father and us. We feel like we know the answer to the comfort we seek. We desire the immediate relief from the pain we feel. But he says – wait. I know what is best for you. Wait…and while I know the pain you feel now seems unbearable, in order for you to heal, you must endure this for a while and the healing that will come will be a far greater blessing the temporary relief you seek. So for my friends who seek comfort – I pray that you will find the strength to endure this trial, that the blessing that comes will not only strengthen you, but will provide an even greater healing than you can imagine!

My afternoon was spent trying to share love with the kids who do not have mothers or whose mothers are unable to be with them during their hospitalization. At one point I had two large children (7 and 8) sitting on my lap and one standing between my legs. They were all participating in different activities, but just wanted to be close. The closeness got a little too much to handle at one point. ☺ The little girl on my lap accidentally hit me in the face. She felt so sad and started rubbing her hands all over my face trying to say she was sorry. The little boy on my lap must have been feeling protective and didn’t like the way she was touching me, so he hit her. She cried. He cried. They all sat there trying to get their emotions under control while they little girl standing by me stared in confusion and another boy on his bed just laughed. It was actually probably a very funny picture. I wish you could have seen it. We took a little break after that and everyone returned to their own areas for a little bit of personal space time. ☺ There are just some times when it’s hard to see just how these kids are craving love in their lives. And it’s hard to know that I have to walk away from it every night…and that soon I will be walking away from it for good.

All this talk of mothers makes me miss mine immensely. I love you mom! Thank you for filling my life with so much love!

I hope you dads aren’t filling left out in all my talk of moms. Your role is just as important, it’s just that moms were the center of my interactions today. Dad – I love you, too! You are definitely my biggest supporter in the entire world! I can’t help but picture you when I play with these kids. You would be so excited and they would love you so much!! ☺

catching up

2009-04-05T13:07:00.000-05:00

My punishment for not writing the last three days is trying to remember everything that has been going on in my life. The internet has not been working well and the prospect of fighting with it every night leaves me very unmotivated to blog. My apologies to all those who follow so diligently.

I’ve officially reached the half way mark and it seems like time is speeding up and everything is being crammed into my last 4 weeks here. I’ve been starting to feel it, as I’ve been somewhat lethargic the last couple days. I’m hoping to get a good night sleep after blogging and be refreshed for the week. It’s only a four day workweek because Good Friday is considered a holiday. The Monday after Easter is Family Day – another holiday, so I will get a 4-day weekend! We definitely need to adopt that practice in the US! ☺

So lets reach way back and dig up the events from Friday…

Joe (Missy’s brother) was admitted back on to the unit. It’s amazing how quickly kids can regress through readmission. Joe had been doing so well. He seemed to be coping more effectively with treatments and always seemed so happy when he visited the hospital. As soon as I saw him Friday morning back in his hospital gown and sitting in his bed, some of his sullen expressions had returned. He was very sad and withdrawn. He did perk up when I came to talk and play with him, but it wasn’t the same smiling kid who had been here for outpatient visits. To make matters worse, he has to be in isolation, so his sister and his new best friend he met at the medical house he’s been staying at have to stay 2 rooms down. Windows separate the rooms, so he can see them but can’t be with them. They keep motioning for him to come down, but we tell them he can’t. It’s been pretty sad for him. He sat a chair right outside his door and just sat there for a large part of the day. We did do some fun activities and he engaged, but he just kept looking longingly at the room two doors down. Joe had a rough time during the dressing again. He tries so hard, but it is just so painful. He looked at me and then just grabbed on to my hand and buried his head against me. I was able to get him to take some big deep breathes by modeling what I wanted him to do, so that felt successful.

I had a number of theatres that went very well today. The anesthesiologist commented specifically on one child I accompanied to theatre. She said Child Life had made a world of difference in his coping – that he was a totally different kid from the one that was admitted a couple months ago. It’s so neat to see the progress. I keep hearing over and over again that we can’t understand the impact we’re making because we weren’t here to see what it was like before. The surveys have been so positive and the staff is so supportive in wanting to fill them out. It’s so great to see that we truly will be leaving a lasting impact here.

Missy had a great day today. She was unattached from tubes, and was able to move about more freely. She sat up in a chair and we looked at a book together. She even talked to me, which was a huge breakthrough. We identified fruits and counted. She mimicked words I said and I tried to copy the ones she said (she was way better at it than I was!). It’s so great to see her improving. I think it helps her to know that Joe is back. She realizes she’s not totally abandoned here in the hospital. Missy has been having a lot of itching from dry skin. I thought she was just always shaking her head no at me all the time, but then I realized she was trying to scratch the back of her neck. I got some lotions from the OT and have been massaging them into her neck daily. She will just sit there with her head hanging, so I can easily rub on the lotion. She seems so relaxed when we’re done. It’s such a simple act that makes such a difference in her comfort and therefore her coping.

For those of you waiting for the update on Othathali’s second surgery- she ended up getting canceled for surgery today. It was too bad because the pre meds she was given this morning totally knocked her out – which will be good to know when she comes back tomorrow.

As my time here gets shorter, I’m feeling the need to find more tangible ways to leave behind lasting change at the hospital. I know that I’ve been able to bring change into the lives of many of the kids here, but I want there to be impact for kids to come. This week I’ll be working on a positioning for comfort poster to hang in the treatment rooms. We’ve been trying to implement those practices in procedures and hopefully a more concrete visual aid will assist with that when we are not present.

Friday night we got dessert at the Mount Nelson Hotel. It was (until the One and Only Hotel just opened up this week) the top notch hotel in Cape Town. All the stars stay there. I ate the best brulee I have ever had. It was amazing!! The hotel is beautiful – I definitely felt the country girl in me as I looked around at how the other half lives (and for the record, I definitely prefer my half!) ☺

On to Saturday…

Tami and I went to Camps Bay in the morning. We were in search of her favorite – eggs benedict….and boy did we find it! It was so good; definitely on my list of top foods since I’ve been here. (why is everything about food in this post!) I don’t ever remember having my eggs this way until earlier this year. I’ve now decided it’s my favorite way to eat eggs. Yummy, yummy! The tall glass of mango juice that accompanied only increased my shear happiness – not to mention the view of the ocean as we sat in the open air restaurant. We spent the rest of the morning on the beach trying to plan for our African safari. A friend of mine contributed money to my Africa fund specifically for me to go on a safari while here because she had always wanted to go and never thought she would be able to. In order to do the real deal, Tami and I are trying to work out a trip to the Kruger National Park. We found a really great deal, but are just finding the best way to actually get there now. I am so excited for that little get away!

Saturday night we attended the taste of Cape Town event. All the top restaurants in the area were there to offer samples of the foods. You got a certain number of tickets and used those to pay for samples. There were some free samples, however, so when we found those, we jumped on the opportunity to eat whatever it was. At one point a woman offered us a free sample of pig’s cheek. The free part registered in my brain first and I put the whole thing in my mouth. That’s when the “pig cheek” registered. I felt a little sick to my stomach. Not because it tasted that bad (definitely not good, though), but because for some reason the cheek of anything makes me a little nauseated. I’d never even thought of pigs having cheeks before – let alone thought of eating them! Anyway, I definitely took a few moments to think before eating any free samples after that. I later found out they were serving a free worm dish at a S. African restaurant’s booth – so sad I missed out on that free sample.

We ended our night of tasting with some crème brulee ice cream served by a couple of guys without shirts (not really sure why). One of the guys heard our accents and asked where in the States we were from. I said Kansas City – and started to explain that was in the middle (since most people here only know the coasts). He said, "I know someone from Kansas City." He went on to explain tell us about a pediatric doctor from the US that comes over and works in the townships around Cape Town. I told him I worked at the pediatric hospital in the US and actually knew another of the guys he was talking about. Small world!! I tried to find out more, but the lady in charge was yelling for us to move on. It was a cool little moment to be a million miles from home and meet someone who knows someone who is somehow connected to you – no matter how stretched it is. ☺

And finally, Sunday…

This morning my friend Jamie and I decided to go to church at the Mormon church in town. I’ve never actually been to a Mormon church, but my sister’s friend from Illinois served his mission here in Cape Town, so I thought I would visit the ward. The website said it started at 9 am. I tried to call the number and confirm the time, but there was only a machine. So, early this morning, we headed out (with another girl named Liz) to find the church. We had to take a taxi to one of the suburbs, but it only ended up being R55 (about a 5 USD cab ride). When we got there the church appeared all locked up. The gates were locked and everything. We tried to find people to ask, but no one was really around. Luckily we’d asked the cab to wait, so he took us back to town. We asked him if he knew where any churches were, but he didn’t. He even radioed his taxi friends and no one could help us. We thanked him for a R110 Sunday morning drive and began our search for a church (fyi. As you know, I’ve been attending the Hillsong church, but they were not having services this morning due to the jazz festival). We asked one of the guys that works in the coffee shop under our apartment, but he was Muslim and said he didn’t know of any churched around. The security guard wasn’t much help either. Liz dropped out of the search at that point, but Jamie and I were determined, so we started walking toward an area we thought had a church. We looked and looked and could not find any churches. I was starting to feel like we would never find a church and felt very sad about that. I said a little prayer and kept walking on faith. Finally we saw a woman and her daughter walking down the street. The woman was carrying a book called, “The Harvest.” That sounded churchy enough for me, so we started following them. We caught up to them at a light and asked if there was any chance they were going to church. I’m sure we caught them off guard, but our American accents make us less threatening. They said they were, so we asked if they would mind if we tagged along. I know – you all are probably thinking… Cara? YOU did that? You can’t even call the Pizza Delivery Guy! I never would have done it alone, but with Jamie we were feeling pretty brave. ☺ They took us to the Calvary Chapel church which meets in the gym of an old school. They made us feel so welcome! We sat with Dawn and her daughter Diandra (the ones we had followed). Everyone made us feel so welcome. They are a small church and could immediately tell that we were visitors – especially after hearing our accents. They loved the story of how we had found them and invited us back again. We are planning on joining them for the sunrise service on Signal Hill on Good Friday. When one thing doesn’t work out – God opens other doors for us to receive a blessing!

I wish I could be more insightful tonight, but I’m struggling to keep awake. Only 4 weeks until I come home. I am missing you all, but so excited for the remainder of my time here. I love you more than you can imagine! God bless.

comfort

2009-04-02T14:13:00.000-05:00

“God comforts us in all our tribulation that we may be able to comfort them which are in any trouble, by the comfort wherewith we ourselves are comforted of God.” II Corinthians 1: 4

This is the scripture I read when I woke up this morning, and the center of my thoughts throughout the day today. It lead me to remember a very difficult time in my life when I prayed and literally felt wrapped in the arms of the Holy Spirit. That same feeling of comfort I felt in that moment is the feeling I challenged myself to take to the children today.

I don’t believe that God causes all the horrible things that happen in our lives, but I do think He is able to use those experiences to bring about good. Perhaps some of those moments when I have felt troubled and then comforted have been used to help me know how to comfort others. Whether it was through God working in others or through His Holy Spirit, I have so often been comforted and now it is my turn to comfort others.

Sud is a little 2-year-old boy burned to his head, neck, chest and arms. He is not one of my patients, but today Caroline needed to be in theatre with another patient, so I took her place by his bedside. His parents are not able to be present as much as they would like and he often spends a large part of the day crying for them. He seemed to be content lying in his bed with the rails up. Any movement to lower the rails made him more upset. They were probably serving as a safety barrier between him and any unwanted procedure. I knew it would upset him temporarily, but I lowered the rails and picked him up, hoping that the long-term positive interaction would override any temporary upset. I figured some of the tears would be fear of movement and some would be anxiety at leaving the safety of his bed, but I assured him I was just going to hold him and picked him up. He cried very briefly, but soon calmed and nuzzled his way under my chin. I held him and sang to him for almost an hour. At one point I tried to shift him in my arms to what I thought would be a more comfortable position for both of us, but he put his head back where it had been and said “here.” At another point I tried to sit down because my back was getting tired, but he said “pick up, pick up,” so I stood back up. “Like this?” I said. “Yes,” he replied. I didn’t even know he spoke English, but evidently he did enough to communicate what he wanted. I was reminded in that moment how important it is to comfort people in the way they feel and accept comfort. I thought it would be just as comfortable for Sud if I held him while I was sitting down, but obviously he wanted me standing, so that’s what I did. The great thing is that God knows exactly how we need comfort. I have to guess at the best way to comfort others, but God knows us well enough to see our needs and provide the comfort. I’m also reminded that often comforting others may mean sacrifice on the part of the comforter. It may mean stepping outside our own comfort zone or doing things for others that leaves us exhausted – but we remember the way God has comforted us in our time of need and with that comfort we in turn comfort others.

I was holding Sud and started thinking of all the times I have been comforted – all the times I’ve just needed to be held. In that moment, holding Sud, I felt the Spirit come over me and I began to cry. One of the sisters was watching me, so I had to turn away so she wouldn’t think – there goes the crazy American. ☺ I continued singing and rocking Sud until he fell asleep – only to be awakened a few seconds later by one of the sisters for no apparent reason. I decided to press my luck and put Sud down to play. He sat on the edge of the bed and I used his glitter wand to tap on the rail of the bed. He thought that was great and was soon laughing and smiling and tapping along with me. We sang and played, “Knick Knack Paddy Whack, Give a Dog a Bone.” I’m not sure he knew what we were singing, but he copied my sounds really well. He played and laughed. People were stopping by the room to comment on how much better he must be feeling and how good he looked. At one point in our play he got so excited he whacked the crib with the wand, causing it to burst and sending oil and gliter all over me head to toe. He thought that was hilarious, so we laughed and laughed. It was wonderful and I thought of all the times I have been comforted by laughter.

We actually had a number of opportunities for laughter today. We do laugh a lot here. ☺ I know I often write about the tearjerker moments, but the funny laughing moments are just as moving. One of the little girls (I can’t remember if I’ve given her a fake name yet - Nelly) took one of the rolling stamps we have for art and gave herself some bright red lipstick. Anytime someone would look hat her, she thought it was hilarious and would laugh and laugh. Nelly, Othathali, and I danced through the halls today. That was fun until I accidentally whacked Nelly in the head – which is where her wounds are. Great. She cried and I held her for a long time. I actually think the tears that came out were for more than the pain I caused her, so it turned out to be a good release for her – not that I’m suggesting hitting a kid to help them tap into their feelings. Oops.

Nelly also had a lot of fun with medical play today. She loves to take care of the one little baby doll we have. She dresses it and puts a nappy on it. I’m actually very impressed with her nappy folding skills. She just took a washcloth and folded it all up and put it on the baby. She asked me if I was doing it right. I was like – you got me kid. I only do Pampers. ☺ She loves to use the tiny bit of bandages we obtained and wrap it around the baby’s head so she looks just like Nelly. It’s pretty neat to watch. The best part of the play was when they tried to show me how to wrap the blanket around me so I could carry the baby on my back the way women do here. They thought it was quite hilarious to see me toting around a doll on my back. I can’t wait until we can get some medical buddies so the kids can process their medical experiences more frequently.

Comfort also came in the form of advocating today. Othathali (it’s so funny to call her that because of all the kids she has the most American name) had to get her blood drawn today and her mother was not here. As you know, any medical procedure for Othathali can be quite anxiety producing. The doctor asked for her to come in and lay down. I asked if it would be okay for me to hold Othathali on my lap in a comfort hold. The doctor looked somewhat skeptical, but told me it was okay, but she had to hold still. I had Othathali straddle me while I hugged her leaving her one arm free. She cried, but she held perfectly still. The doctor was thankful and we all felt successful! Othathali kept telling us that she was going to tell her mom what we had done – as in tattling on us. I tried to explain to here that the blood draw was not punishment, nor something done to be mean. So often medical procedures are perceived as punishment and it is so important for us to not only address that, but make sure our treatment of the children reinforces that.

Our newest edition to the team- Jamie - came today. We were wearing the same shirt when we met, so she must be pretty cool. :)

Well, that’s all for now. I hope all of you feel comforted and are in turn able to provide comfort to those that need it.

april fools!

2009-04-01T14:34:00.000-05:00

Problems with the internet again...sorry this is late.

In honor of April Fools Day, I was going to write out 3 scenarios and have you guess which one really happened today (I’d already started one about staring in Matt Damon's movie, meeting the love of my life, and signing a contract to stay here indefinitely), but then I got worried that some people wouldn’t get it and would be spreading stories about things that didn’t really happen. I didn’t want to be the cause of confusion, so I used my better judgment and will just stick to the facts today. ☺

Wednesdays are usually the crazy days, but we had far fewer kids on the ward, so it was much more manageable. We have tea after ward rounds every Wednesday. Someone brings in chips, cakes, juice and tea. Today we even had fat cakes - basically fried bread - awesome! We all meet in the OT room and hang out before continuing on with the rest of the day. (This isn’t the only tea time – it seems like some people take about 10 teas a day, but who knows. ☺) They even have a little teacart set up outside the OR, so the doctors can step out and have a cup of tea between cases. That’s one cultural phenomenon I’m yet to wrap my mind around.

Anyway… one of the nurses was retiring who had been there for about 30 years, so we celebrated with her. Prof was asking her about her time here. She mentioned the stress of the treatment room and how the kids just fight against the sisters. She discussed how it was just too much in too little time for too few people to do. Prof asked what could make that better and she said she didn’t know. I was like – I know! ☺ Hopefully we’ll be able to use that discussion as a jumping off point for future recommendations. It does benefit the nurses as well as the kids when there is a supportive environment and I think framing it that way for the nurses will help them to be more receptive to those ideas. Prof also discussed the difficulty in making those treatments better, as there are such limited resources as far as manpower and anesthesia, etc. He mentioned how he wished the kids could be sedated for these treatments, but they just don’t have the staff available for those types of sedations, nor the budget for those medications. I felt so humbled in the moment he said that. I often find myself thinking…well in the US we do it this way. Why can’t these kids have the same treatment? Well – the answer is there just aren’t the resources available here. The staff is doing the best they can with the resources they have available. Don’t get me wrong; there are always areas where the care of patients can be improved. That’s why Child Life is such a great asset here. There is so much we can do to improve the experiences of the patients at this hospital with minimal cost!

Today I tried to work with Othathali again in mastering her fear of theatre. I gathered together a number of medical play supplies and a baby doll and spread them out for us to play. Othathali eagerly joined me, but as soon as she saw the oxygen mask she turned and walked out of the room. She would not return to play until I had removed the mask. I put it back in the prep box and invited her to play. She engaged in a great medical play session for quite some time. When we were done play, she helped me gather up our supplies. However, she refused to even carry the box which held the oxygen mask. Later that day, some of the other kids decided to play with the medical equipment. One of the little girls was using the oxygen mask. Othathali left the room and would not return until the mask was gone. The moral of the story is…we seem to be getting nowhere in mastering this fear. ☺ I was able to talk to Othathali about her surgery for Friday, though. She doesn’t speak of it with as much anxiety as she did the day before. I told her what a great job she had done in theatre the day before and praised her for being so brave. She agreed that she had done a great job and commented that all she had to do was sleep. I asked her where her fear came from. Again, she mentioned the lights – no mention of the mask. I reminded her how the lights had been pushed away before her surgery and she said that helped. I asked her what else would help her not be so frightened for surgery. She stated that the lights were her biggest concern. She confirmed that if we took care of them again, she would probably be less scared in theatre this time. I’m not really sure if that will be the case or not - she seems to be centering all her fears on this one object, but I am glad that we were able to discuss her anxieties a bit.

Missy smiled really big today! Her hands are splinted, so she looks like she has two giant paddles for hands – making it difficult to participating in some activities. Her hands were very sore today, so she did not want to move them at all. The music therapist addressed that issue by putting jingle bells on Missy’s feet. I’m not sure if it was the thrill of being able to participate or what, but she laughed and smiled. It’s so good to see that emotion, because it is rarely revealed with her. Unfortunately the play session had to end and Missy returned to her sad state, crying when we left. I’m hopeful that we can continue to find ways to help her express her emotions and cope with the stress of being alone in the hospital.

One of my biggest challenges today seemed to be setting boundaries with the kids for some of the supplies. It’s really hard to introduce toys here because families and patients often misunderstand that they need to be returned before we leave for the day. Many of the orphaned kids don’t have any person possessions, so they hoard the supplies (often hiding them in drawers, etc). It makes it very difficult to promote sharing and often turns me in to the bad guy when it’s time to go. Kids bargain with me all the time, telling me things like – “You can take one toy, but you must leave the other with me until tomorrow.” When I explain that we have to gather all the toys for the night, they become very cross. I know it’s good for kids to have boundaries, but it’s so difficult to explain to kids who don’t have anything why you can’t just give them the bubbles around your neck. I mean really – but our resources are limited and it is important to maintain them for the future kids to come.

Caroline has been gathering feedback from the staff about our presence here to include in the program evaluation. The staff has been so amazing and supportive – from doctors to nurses to physios. One of the doctors today went on and on about the important role we play here. He mentioned how there are so many patients he only has time to focus on the physical needs and we have been able to remind them that there is more to healing a child than their physical needs. He appreciates the consistent, supportive presence we have been able to provide for the kids. It’s so great to hear that feedback. We are constantly reminded how life is so much different since we’ve come and how they can’t see any other way than for the hospital to allow us to stay on. Hopefully the trust feels the same way!

Tonight we went to the free jazz concert at Greenmarket Square. It kicks off the huge international jazz festival that is held in Cape Town every year. It was a fun evening and the one group we listened to was very good. But now I’m really tired and not even sure what I’ve said in the blog, so I hope it’s coherent.

Our new addition to the Child Life team comes tonight, so we are all so excited to meet her and welcome her to our team. So, welcome Jamie! We’re so glad you’re here! ☺

Goodnight from South Africa!

after the last tear falls...

2009-03-31T15:13:00.000-05:00

note: there are two posts for today. the other one is actually yesterdays.

It’s quite fitting that this song is what’s playing as I sit down to write my blog tonight. If you’ve never heard it before, you need to download Andrew Petersons “After the Last Tear Falls.” I have a really hard time picking favorites, especially when it comes to music, but this is definitely one of my favorites. Just a taste of the lyrics (note- this is my interpretation of the lyrics. I used to think the song Whoomp There It Is was Whoomp Aid Adidas, so some words may be wrong…):

After the last tear falls
After the last secrets told
After the last bullet tears through flesh and bone

After the last child starves
And the the last girl walks the boulevard
After the last year that’s just too hard
There is love

And in the end is oceans of love and love again
We’ll see how the tears that have fallen were caught in the palms
Of the giver of love and the lover of all
And we’ll look back on these tears as old tears
‘Cause after the last tear falls, there is love.

Today was definitely a day of tears. They started when I walked on the ward. My first job is usually to walk through and write down which kids are in which bay and then help divide the list among Caroline, Taylor and myself. My kids are usually in the last bay, so I had almost finished when I walked into their room. There are only 3 kids left in there now as many have gone home. Missy was one of those. As soon as she saw me, she started to cry for me to come pick her up. How could I refuse?! I greeted her with a good morning hug and a little TLC. I had to put her down though, so I could get some of my morning responsibilities done. She cried, but I put my finger up in my “I’ll be back in a minute” way and she settled down. We’ve developed a bit of a sign language so that we can communicate without speaking the same language. She knows the sign for “all done” now and we use it when she’s done eating. I went about some of my morning duties, but every time I walked by her door, she would start to cry. At one point I was playing a game with another little girl out in the hall and Missy started crying because she could see me through the window. I flashed the “just a minute” sign and she quieted, but she just lay in her bed and stared at me with expectant eyes. I’m pretty worried about her. While she’s starting to show more emotion (which is good), I worry about her attachment. Her parents came to visit this weekend and the other mothers told me she was very cross with them. (note- cross is the word of choice when kids are angry or sad or any similar emotion). They said she wouldn’t talk to any of her family members. I’m sure she doesn’t understand why she’s been isolated in this hospital away from her family. She doesn’t understand that they live far away and the mother has a newborn baby she has to take care of. I’m sure she perceives this as punishment and I’m not good enough at charades or signing with her yet to address her misconceptions. ☺ I’m glad that I can be here to provide a consistent support for Missy. I worry what would have happened before Child Life services were available. The staff are very caring, they’re just so short staffed it’s difficult to provide all the care these kids need. Missy needs love an attention, but I know that I can’t provide all she needs. So, I give what I can when I’m there and try to remember that there are oceans and oceans of love available for Missy and pray that she will feel the waves of that all throughout her life.

I accompanied Missy to theatre today. Again, I have to brag about the surgery team here. Missy cried when I tried to put her on the stretcher, so I was allowed to carry her to surgery and hold her on my lap while she got the anesthesia. She was calm the whole time. What could potentially be very stressful for her wasn’t stressful at all.

Othathali (it’s really hard to make up African names, but that one’s for you Caro) on other hand was a very different story. She was burned about a year ago and after an extremely long hospitalization has had to return to the hospital for numerous surgeries to help wounds heal, as well as reconstructive surgeries to minimize the scars which cover her body. Othathali has spunk, though! She is feisty and funny and always getting into trouble. She’s probably about 5 or 6. She’s very brave when it comes to dressing changes, but the one thing that scares her more than anything is theatre. Guess what today was? Theatre day for Othathali. I tried to prep her with the mask and the prep book. She looked through the book, but would have nothing to do with the mask. She would watch as other kids played with it, but refused to touch it herself. When they came to get Othathali for surgery she cried and cried. Her mother carried her and I was able to briefly distract her, but as we got closer to theatre she became more and more anxious. One of my favorite anesthesiologist was her doctor today, so we began brainstorming what would be best to ease Othathali’s anxiety. She asked how the prep went and I told her about the fear of the mask. Othathali also reported that the lights scared her. The anesthesiologist prepped the room for Othathali, moving away the big lights and turning all the lights down. She turned on music and had everyone leave, except those directly involved with the sedation (there are usually a lot members from the burn team present). Othathali’s mom was given a chance to talk to her, then she was slowly brought into the room. She sat on her mother’s lap and while she cried, she remained still. The anesthesiologist slowly brought the mask forward, allowing Othathali choices when she could (she was so comforting!). Othathali cried, but she didn’t refuse the mask. It was much smoother than any of us expected. Her mother said in the past she had to be held down and the mask forced on her face (I wonder where her fear comes from!). While Othathali’s sedation was still stressful for her, I’m hopeful that with the help of a supportive staff, she will continue to overcome her fears. I could tell her mother was stressed, so I spoke with her afterwards. She told me Othathali has just gone through so much medically, that she can’t really say anything to make things better. I validated her feelings and assured her that while those negative experiences obviously have had an affect on Othathali, we will continue to work with her and give her opportunity to master those fears. I couldn’t help but wonder, however, what it would have been like if Othathali would have had Child Life available from the beginning of her hospitalization. If she would have been prepped for the first surgery, would she still be so afraid of the masks or the lights. If she’d mastered her fears with medical play, would it still create so much anxiety in her to walk the halls to the theatre. The answer may very well be yes, but I can’t help but wonder. We haven’t given up on Othathali, though. She’s coming back in on Friday for another surgery. They are going to try a different pre-med to help her rest before her surgery. I’m trying to come up with new medical play ideas and preps to assist her in overcoming her fears. Hopefully together we can empower Othathali to cope with her fears! After Othathli’s surgery, she was very weepy waking up in the recovery room. The anesthesiologist allowed the mom to come back to help assist in the wake up process – another amazing example of family centered care!

There were more tears throughout the day. I often just follow the sound of crying to take me through my day. The hard part is tearing yourself away to comfort another child. I can’t help but thinking about that song I mentioned – after the last tear falls is oceans of love. Can you picture that? I’ve had the opportunity to spend some time at the ocean this last week – it’s vast! It’s deep! It’s powerful! I just want to throw these kids into that ocean of love and have them engulfed in it. I have a lot of love in me, but I’m pretty sure it wouldn’t fill an ocean! But I give the trickle of love I have and pray that God will provide the ocean.

I have to leave for work at 6:30 tomorrow for the infamously exhausting dressing day, so I need to sign off, but wanted to include a couple neat conversations before I did…

The other day Caroline was accompanying a small boy to theatre. He’d been given a premed that caused him to sleep, but his surgery ended up being delayed until later that day. He woke up right before surgery and Caroline encouraged the mother to hold him. He went right back to sleep. He stayed calm and restful while the anesthesia was induced and everything went smoothly – seems like no big deal, right? Well Prof (the head burn doc) wanted to know when he’d received his premed. No one knew, so he made Caroline go find out. Caroline wasn’t really sure why he wanted to know, but she went to find out for him. She reported the time back to him and he said – See! The premed wore off a long time ago. This is because of you! He is calm because of you. ☺ It was a huge compliment…especially since Prof was admittedly uncertain about our presence here in the first place.

This afternoon I was also able to report back the progress I’ve seen in Larry since we began our work with him. I’m getting so confused with these made up names- but Larry is the one that was so weak, but now is sitting up playing and had the huge break through of singing bye-bye to me the other day. I was able to hold him for the first time yesterday. When I picked him up, all I could feel were ribs on his front and back. He laid his head against me and I sang to him. He continued the moaning that he so often does, but every now and then his moaning would match my song and he would sing a long for a while. He also explored my skin with his fingers. I’ve mentioned how tactile he is and as I held him, his fingers traced my face and up and down my neck and arms. He would sit up every now and then, but then rest his head against me and take a deep sigh and rest. It was an awesome intervention. Today I went back and he was sitting up in a chair eating his lunch. His mom was there and I think he might be going home soon. Anyway, I was talking to Dr. Jenny about this (the head of the pain management team that helped to bring us here). She was so pleased with his progress and complimented me on my role in that. I thanked her, but told her I wasn’t sure I had anything to do with it. She said that we too often don’t take credit for our work – that the impact we have had here is so great, that our presence is impacting these patients.

So to my Child Life friends – allow yourselves to accept the impact you have in the lives of the kids you serve today. The work you do is so great! Until you see what it’s like without you – you don't fully understand the magnitude of your work, but take it from me. It’s powerful! While the focus is on healing the children’s bodies, don’t underestimate the impact you have in healing their spirits!

And to all my other friends – may you be engulfed in an ocean of love today, and as you feel that love be able to spread it to the lives of others. Just image how wonderful this world would be if each person was allowed to swim in that love!

inadequacy

2009-03-31T13:11:00.000-05:00

This post is actually for yesterday, 30 March. My internet wasn't working so I was unable to post it then. Sorry to all of those who were disappointed by that (namely Mom and Erin!).

Today I was walking in a state of inadequacy. I felt insignificant and ineffective. The dressing changes these children endure daily are extremely painful. I’m not sure how to put it into descriptive enough words for you to understand. I myself don’t know first hand. The best I can even try to relate is when people touch a really sore sunburn, but I know the pain is far worse in these burns. I’m not sure if I’ve described what is entailed in burn dressing change for everyone, so I will just give a brief description of treatments here. First the children are brought back to the treatment room and their old bandages are removed. This in and of it self can be very painful as the old dressings often stick to the wounds and have to be peeled away. The children are then sprayed with water to wash their bodies and begin debridement of the wounds. The next step is to debride using cotton 4x4s. Essentially the dead skin is wiped away. Not only is the painful, it’s often very scary to watch. It’s good when blood is present because the skin is beginning to heal, but that’s difficult for kids to remember when they’re looking at frightening wounds. After debridement, new medicines and dressings are placed on the wounds. These dressings vary in function and the effects they have on kids. Some burn or sting, others are itchy, and some are actually soothing. Finally the children are wrapped back up in bandages and returned to their room – only to repeat the process the next day. Needless to say, this is an extremely painful process. The really deep burns don’t hurt as much because the nerves have been damaged, but as the skin heals it becomes more painful. In the burn unit I work on in the US the children are consciously sedated for these procedures. They’re usually given an IV pain medication that helps them relax and not feel as much, as well as a medication that helps them forget what is happening. I’m not exactly sure what medications the children here receive, but I know they are oral – they are not very sedated and feel much of these procedures. My whole point in explaining this is that I often feel totally inadequate here in helping these children cope with their pain –it would be pushing my coping limits if I were in their place. The treatment room becomes a room of torture and children cry just from stepping in the room. Often times I find that the best I can do is offer a hand to squeeze or a reassuring comment and reminder to breathe. Much of my work comes after the treatment in helping children calm quickly and return to a safe environment. I just wish there was something more I could do to help ease the pain and facilitate coping.

I returned home from work feeling like there was so much more I should be doing to help these children, but not really sure what that was. When I got back I was greeted by an e.mail from my sister, Erin. I’m going to include that e.mail in my blog because the words she shared were exactly what I needed tonight. It’s kind of long, but please read it because the words I think will have meaning in your life as well.

Erin's E.mail:

"Okay, here is my sermonette for the day. This is in no way to diminish that God has great things for you to do. The purpose is to take joy in what you might consider the small means that you are doing, because God can use those small things to make great things happen.

Alma 17:35
…but behold I say unto you, that by small and simple things, are great things brought to pass; and small means in many instances, doth confound the wise.

36And the Lord God doth work by means to bring about his great and eternal purposes; and by very small means the Lord doth confound the wise, and bringeth about the salvation of many souls.

Isn’t this scripture awesome! Is there a coincidence that the context of the scripture is talking about the purpose in writing down their testimony? They were just regular people writing the spiritual record of their people. Many times they even say how inadequate they feel in their writing. Could they have had any clue to the extent that it would be published and read today? I know that you blog is touching many hearts and that you have a wide array of friends reading. As you said in your blog, who can imagine the awesome ways God could use your blog!

Talking of the Liahona…
Alma 17:73And behold, it was prepared to shew unto our fathers the course which they should travel in the wilderness; and it did work for them according to their faith in God;

74Therefore if they had faith to believe that God could cause that those spindles should point the way they should go, behold, it was done; therefore they had this miracle, and also many other miracles wrought by the power of God, day by day;

75Nevertheless, because those miracles were worked by small means, it did shew unto them marvelous works.

79For behold, it is as easy to give heed to the word of Christ, which will point to you a straight course to eternal bliss, as it was for our fathers to give heed to this compass, which would point unto them a straight course, to the promised land.

80And now I say, Is there not a type in this thing? For just as surely as this director did bring our fathers, by following its course, to the promised land, shall the words of Christ, if we follow their course, carry us beyond this vale of sorrow, into a far better land of promise.

This scripture says that it is as easy to heed words of Christ as for forefathers to follow a compass. I think he is saying that they just had to believe the Liahona would work and it did. I know that you are heeding the words of Christ and seeking his Spirit for guidance. Something that might seem so small. But look at the promise. “Shall the words of Christ, if we follow their course, carry us beyond this vale of sorrow, into a far better land of promise!" You don’t need to worry about the end game or how God is going to use you. Continue to follow Him and He will point you in a straight course. He will take care of preparing the land of promise and the manifestations of how He will use you in His work. In summation, "by very small means the Lord bringeth about the salvation of many souls, by small and simple things, are great things brought to pass."

I know your small hugs, rocking, singing and playing are a HUGE blessing to those children that you touch everyday. Rejoice in the small ways that God is using you to touch people and pray for the big ways that your seed will grow. I know that as you remain prayerful God will use all of you for the full extent of His purposes. I love you!"

That's the end of Erin's e.mail...

Isn’t it amazing how God knows exactly what we’ll need in the time we need it. This was exactly what I needed today. That has happened so often on this trip – whether a card from a friend (I got yours today, Ditter!), a call from a home, a chat on facebook, a message in my journal – God is using so many people to bring encouragement to me. One of my friends often says that he would rather be helped by a person than an angel, because that means that God’s people are still responding to His movement in their lives to reach out to others. So thanks to each of my for listening to the promptings of the Spirit and blessing my life in so many ways! I love you.

I'm encouraged to go and continue in the small ways, praying that God will use those to bring big blessings.

P.S. I also wanted to send a shout out to Nana. I heard you walked down to the computer at the Groves just to check my blog. That meant so much to me!! I miss you – TV is not nearly the same in SA. ☺

sunday, sunday

2009-03-29T13:08:00.000-05:00

After such and eventful Saturday, my Sunday turned out to be very relaxing and low key so that I could recuperate for the work week ahead. I was supposed go with some girls to a church in one of the townships, but that fell through so I went back to Hillsong. My roommate Elizabeth went ahead early and Mwaka wasn’t going today, so I was on my own to get to church. I hate spending the money on a cab if the place is in any sort of walking distance, so I decided to trek out on my own to find church. I’ve walked home from church before, but never to church and never alone. I memorized the map in my head and started my walk – it’s probably a couple miles. I found my way perfectly and walked the whole way without anxiety or fear. Part of that is probably me getting used to the city, but I think much of it comes from the prayer I’ve been praying for God to fill my heart with love for all the people of this country, including those I pass by on the streets. Because “perfect love casts out all fear,” I feel like my anxieties are gone and I have love in my heart and an assurance of protection from someone far greater than me. What a blessing.

I ended up spending the afternoon on the roof, reading and catching up on journal time. The comment from Caroline in my journal today was, “Eye hat not seen, nor ear heard, neither have entered into the heart of man, the things which God hath prepared for them that love him.” I Corinthians 2:9. I have a pretty big imagination, so to think that God has prepared something greater for me than I can imagine is mind-boggling! I feel like I’ve accomplished some of what I imagined for myself on this trip, but I know that what God has planned for me is far greater and I pray that I will be open to His revelation of that to me that I might be able to accomplished the great things He has in mind. The next verse of that scripture goes on to say, “But God hath revealed them unto us by His Spirit.” I pray that my heart would be open to that revelation.

Our 2 new additions to the Child Life team join us this week and I am so excited for that! Hopefully we’ll be able be inspired by fresh team members and expand and improve our services throughout the hospital. Speaking of which – I forgot to mention something that happened the other day and wanted to include it before I forgot. The head burn surgeon was talking with Caroline the other day and told her that at first he wasn’t sure what to think about us coming in and providing services he didn’t really deem necessary. However, after he has seen the affect it has had on the kids – especially in surgery, he is a big supporter of Child Life. In his own words – “there’s no more of that crying and carrying on” in the operating room. ☺ How great to have that affirmation.

I got a chance to talk to my friend Caroline from home tonight. What a blessing to hear a familiar voice. ☺ I am so appreciative of the support she has been for me on this trip. She has challenged me every step of the way to truly accomplish great things here and I am so thankful for that. In our discussion she asked me to pray for some things in her life, stating that she knew I had lots of other things to pray about here. I wanted to make sure you all knew that while you are praying for me – I have not forgotten to continue in my prayers for you. Even though I’m far away, I daily remember you and your needs and pray that God’s blessing will be upon you.

I love you!

if the rest of this year is anything like my birthday...

2009-03-28T16:27:00.001-05:00

Today is my “golden” birthday. For those of you who don’t know, that means I turned 28 on the 28th. While my birthday has never really been a huge deal to me, I was a little nervous before coming on this trip that I would be here for my birthday. I pictured myself in some little café ordering a cupcake and signing Happy Birthday to myself. That would have been awesome in and of it self – I mean who spends their birthday in Cape Town, South Africa! Well… a lot of people do, especially the ones that live here, but you get my point.

Originally there was a possibility we would be painting a school in one of the townships, but that got canceled. I was pretty bummed about that, so imagine my surprise when today was the best birthday ever!! I started off the day by celebrating 28s. I took 28 flights of stairs, ran on the treadmill for 28 minutes and then rode the stationary bike for 28 more. I tried to think of all the other 28 things I could do, but 28 bottles of water sounded like a bit much and 28 phone calls home would have been too expensive, so the 28s ended there.

My friends and I met for breakfast to plan out the rest of our time here in Cape Town. After breakfast they asked what I wanted to do for my birthday, hinting that our evening plans had already been made, but that the afternoon was open. We decided on a relaxing day at the beach since I hadn’t done that yet. It was a beautiful day. We laid around on the beach, reading and talking and just enjoying the lazy afternoon. Then we headed back home. I was instructed on what to wear and told to meet back down in the lobby in a few hours. I ended up chatting with a friend from home, so I rushed to get ready in about 15 minutes, just barely getting the sand rinsed off my legs. My friend had called a taxi and told the driver were to take us without giving me any idea. I think the taxi driver took us a backwards route to try to throw me off – little did he know I have no sense of direction in Cape Town, so it was no use. (p.s. he was not scamming us – the price was the same as usual. ☺) On our way there they asked me what I thought they were surprising me with. I explained that I’m pretty hard to surprise – I usually make up such lavish surprises that when the real ones come, I’ve already thought of them. I told them that I’d tossed around the idea of someone from the US coming to surprise me … or maybe even some celebrities joining us to celebrate my big day. They thought that was pretty funny and said they hoped I wasn't disappointed.

We ended up down at the waterfront and walked along the water by all the sailboats. At the end of the row, we stopped in front of a boat. My friends had arranged for a sunset sail in the bay on a cute little sailboat. How perfect!! We had a few minutes to mill around before time to leave, so we walked up and down the water. As we were walking, I saw a man with an earpiece talking into his sleeve. I thought that was odd and looked up to see another one a few feet in front of us. I brought it to the attention of my friends who looked around to see who could possible be that important. Tami spotted Matt Damon in a group of people and tried to point him out. I assured her it wasn’t Matt Damon. We could only see his back, but I was sure it wasn’t him. Then, he turned – totally Matt Damon! Right there in front of us. He’s shooting a movie in Cape Town. I never thought I would be so star struck in a situation like that, but I totally was. We tried to shoot some nonchalant photos, but were blocked by his body guards. We had to walk back by him to get on our boat and the body guards followed us. I know – we look like shady characters. ☺ We still couldn’t get a picture, so we decided to get on the boat. He sat down at a table on the water for dinner and we climbed aboard our adorable sailboat with the cutest old man captain. From our seats on the boat, we had a direct view of Mr. Damon. He looked over at us and we waved. I yelled out – “It’s my birthday!” He said. “Happy Birthday!!” We giggled and smiled and acted like totally idiots. ☺ He let us take some pictures of him and even smiled for the camera. He was very nice. Then as we were about to pull away he looked at us again, smiled, waved and said, “Have a happy birthday!” Caroline says he also said “You look smashing” but Tami and I were a little to excited to notice. We told him to have a great dinner and waved as we drove away. Caroline insisted that he said “You look smashing.” I said he probably said, “You look smashed” because it took me a while to get my sea legs under me and I ended up a bit sea sick, but she’s pretty confident, so we’ll go with what she said. ☺ Anyway…I guess they did surprise me with my celebrity appearance after all. Needless to say, we were pretty excited. I’m sure Matt Damon will remember my birthday for many years to come. ☺

The boat ride was perfect. No one else had bought tickets for the night, so it was like we’d chartered the sailboat for ourselves. There were beautiful views of the city and Table Mountain and we watched the sun set over the ocean. The girls had brought some snacks and even some sparkling grape juice for me. ☺ The waves were huge, so there was quite a bit of rocking and I was just thankful I didn’t topple over the side of the boat. It was my first time on the ocean in a sailboat and I didn’t quite master the skill of walking without having to lunge out and catch myself on ropes and cables along the way. I started to get a little seasick at the end of the journey, so spent the last few moments concentrating on not throwing up, but I loved the experience and the company so much!!

After the sailboat ride, the fun wasn’t over yet. We headed back in to town and ate supper at an Addis in Cape, a wonderful Ethiopian restaurant. We ate with our hands and had a great time. They brought out these long flaming ropes and sang happy birthday to me. I even get a free Addis shirt out of the deal! It really was the perfect night.

I had my first day at the beach, my first sailboat ride on the ocean, my first Ethiopian food…not to mention my first encounter with Matt Damon. But the best part of the day was my wonderful friends that took the time to make this day so special. As many of you remember, I was so nervous to come here and not know anyone. One of my prayers was to make good friends and as always in my life I have been abundantly blessed! Throughout my life, God has continually blessed me with the gift of wonderful friends and this place has been no different. I know I don’t deserve the love I receive, but I am so grateful for it. I can’t thank Tami, Theresse, and Caroline for caring enough for making my 28th birthday the best ever! I love you!!

Thank you as well to all my friends who wished me a happy birthday from far away. Along this trip I have been continually reminded of how much I appreciate my friends at home. I have traveled half way around the world and have officially decided that you are the best. I am by nature a very shy person, and I remember when I was younger specifically praying for the gift of friendship in my life. I have received abundantly in response to that prayer. As I look around at the different friends given to me at different time of my life – whether high school, college, grad school, work. church, and now Cape Town – I am humbled by the love you show to me. What wisdom God has in placing people in our lives in the moments we will need them.

I also received a call from my mom and dad tonight. This trip has also given me an even deeper appreciate for my family. When I came on this trip one of the most common questions people asked was – what does your family think about this? Are they okay with you going? At first I was surprised by this question. Of course they are okay with my going. They are my biggest encouragers and number one fans! It never crossed my mind that they would be hesitant about my leaving. I am so thankful for a family that supports me, prays for me, encourages me to dream big, and assists me in following through with those dreams. I love that you read my blog every day and that you share in this adventure as if you were here. I am so humbled that I was allowed the opportunity to be placed in such a loving family. I love you all!

So…happy birthday to me. If my birthday is any indication of what this year will be like – I am so excited for the adventure!

theatre day

2009-03-27T15:49:00.000-05:00

Today was theatre for many of the kids I was working with. One little 8 year old was particularly anxious about surgery. I got there just as she was going back, so I kind of walked behind her showing her pictures and letting her play with the mask. She mostly just laid in her mom’s arms and cried, though. We had some time outside of theatre and I let her hold the mask. She didn’t keep it very long, but at least she was able to become familiar. She speaks limited English, so it was difficult to provide comfort, but we blew bubbles and that calmed her for some time. She like my glitter wand, too so I let her hold on to that (when she woke up, that's what she remembered and asked for me to bring it right away). I know I’ve mentioned this before, but the surgical team is just amazing here. They gave her something to decrease her anxiety and when she had calmed, had her mother carry her into the operating room. Her mother held her while the anesthesiologist administered the gas. She was a little anxious about the mask, so the doctor put it on mom and then the girl’s arm, then forehead, then cheek and finally mouth. By that time she was pretty comfortable. It’s so wonderful to see that kind of care and willingness to work at the child’s pace. I walked mom out when we were done and saw her crying. I gave her a hug and praised her for the support she provided for her daughter. It was such a comforting environment – truly family centered care at it’s best!

I also accompanied Missy to theatre today. She wanted me to carry her, so I took her from her room and she clung to me as we walked to theatre. I showed her the picture of the operating room so she would know where we were going. I also let her carry the mask. She placed it willingly over her mouth, showing that she remembered it's purpose as was comfortable with its use. I held her in my arms as she hugged me and they administered the mask. She rested so peacefully.

I also had quite a few very active kids in my bay today. We did some group medical play with a doctor’s kit and traced each others hands with crayons. Many of them had burns on their hand, so it was a nice therapeutic activity – both for touch and for normalization. You could just see a craving in these children for attention and play. Many of them are without parents in the hospital and some are from the streets. It’s so great to see those needs fulfilled while they are here.

There is such a need for community education; both for burn prevention as well as reentry into society for burn survivors. That is something we foresee addressing in the future, but we have to take things one step at a time. It is so neat to watch this program grow and develop and to dream about where it will be able to go from here.

Tomorrow is my “golden” birthday. I was hoping to spend it painting a school in one of the townships, but that plan fell through. I guess just being in Cape Town will have to be cool enough. ☺ I’m so thankful to have friends here to celebrate with, and am thankful for all of you at home who have sent wishes and I know are celebrating from a world away! ☺ Love to you all.

magic moments

2009-03-26T15:42:00.000-05:00

My back was really hurting last night. When I’m not holding kids at work, I’m bent over the dressing room table. I got up in the middle of the night and when I bent to pick something up, I could tell there was something wrong. Normally that’s something I would be administered to for, but I’m in the middle of South Africa, so I prayed that God would use that same power to heal my back. I got up this morning and was totally fine. I ate a fabulous mango and was energized and ready for work. I lifted kids all day and didn’t notice my back once. Praise God!

Today was a day of magic moments. The first started off with a little (maybe 6 year old?) boy named “Louie.” (You can tell I’m making all these names up because the real names are much more African and exciting). Louie has severe delays. I’m not exactly sure what all his underlying conditions are, but I know he has frequent seizures that have affected his a ability to function. He is nonverbal and often moans and rocks in his crib. Louie is what I would call the “forgotten child” on the unit. It happens in the US as well as Africa and I am just as guilty as the next person, so I am in no way passing judgment. We often shy away from situations that make us feel uncomfortable or that challenge us to work in areas we may feel inadequate. Knowing that fear within me, I have tried in the last year to become more educated and capable in working with all children, especially those similar to Louie. So today I picked Louie to be on my case load and I was determined to help others (as well as myself) see him more clearly. When I walked into Louie’s room, he was rocking and moaning. I gowned myself up in plastic and covered the rest of me in a blanket to protect myself and the other kids from the pretty bad infection he is fighting. I cradled Louie in my arms and rocked him and sang in his ear. His body was stiff and he moaned for a little bit, but soon I felt him relax and the moaning stopped. He took a few deep breathes and then cuddled himself into my arms. I continued singing and soon he fell asleep. He was more restful than I had seen him, especially during his wakeful moments. It was such a magical moment. I even cried a little as I was holding him and looked at his peaceful face. I was sweating from my elbows with all the layers, but I held him for some time. I was thinking as I held him how much God loves each of the kids on that ward equally and it challenged me in my heart to do the same. Louie cried for a while when I put him back in his bed. That’s the hardest part about being here is leaving the kids every time I have to step away. I know it’s going to be even harder when it comes time for me to leave for good. ☹

My other magic moment occurred today with Molly. We have been bonding quite well, but she still displays such a flat affect. Today her brother Joe came back to the ward for a follow up visit. He has been moved to a medical home where many of the kids transition when their burns allow. He looked awesome! It was so great to see him happy and smiling. I asked Joe if he wanted to visit Missy and he followed me to her bed. She was playing with a book, but when she saw him her face lit up. She smiled and even laughed! It was the first time I’ve seen her personality since she got here. They played together for quite some time. Joe was so attentive and tried hard to make her smile and laugh and to lead her in play activities. At one point they started talking about their burns. I don’t know what they were saying, but Joe pulled up his shorts and showed Missy his donor sites. She started touching her bandages and he touched them too. I became quite tearful again as I witnessed this magic moment. It was such a huge difference from their first reunion I blogged about earlier. I stepped out and watched them from the door because they seemed to talk more when I wasn’t right by them – even though I had no idea what they were saying anyway. ☺ They laughed and talked. It was wonderful. It came time for Joe to leave and I knew the transition would be difficult. Joe said bye and Missy waved back at him. When I came back from dropping Joe off, I could hear Missy crying. I went to see what was wrong and one of the other dads was putting her back in her crib. (That’s one really neat thing about the bays – there is a really tight knit feel of community. The parents become very close and often support each other and their kids.) He said that he looked over and he thought she was about to fall off her chair. He wasn’t sure why, but I think she was probably trying to follow Joe and I out the door. I took some blocks to her for play, but I could tell she was mad – even though her affect was pretty flat again. I stacked the blocks and she would knock them down. It wasn’t in a playful way, but in a very cathartic, angry way. Soon she started throwing the blocks. I allowed her to continue with her angry play, glad she could have an outlet for the emotions she so often represses. It’s so hard not to be able to communicate with her. I’m guessing she sees her time in the hospital as punishment and I fear she thinks she’s been abandoned here. I tried to walk away from play, but she became so upset that I stayed for a while. I’m so happy for her joyful moment today, but it saddens me to see the pain that followed. During her dressing later that afternoon she kept yelling for her brother. I’m sure she thought he was still there and would be able to come save her.

I can’t believe tomorrow if Friday, the end of another week. Usually that’s exciting news, but I feel like my time is going too quickly. I’m prayerful that I’m accomplishing all I was sent here to accomplish and am so thankful for each of you for your support and encouragement in that.

too exhausted for words

2009-03-25T15:29:00.000-05:00

I’m too exhausted to blog efficiently tonight, but don’t want to get behind because it will be hard to catch up. As I’ve mentioned before, Wednesdays are ward round days, so all the kids’ dressing are opened, they’re wrapped in plastic wrap and covered in a sterile towel, returned to their beds, wait for the medical team to assess them and then returned to the dressing rooms to have their bandages replaced. We got there at 7 am this morning and the goal is have all the kids opened by 8. There were about 18 inpatient kids and 11 oupatients. That’s 29 kids for a total of 58 procedures. That doesn’t include the blood draws that often occur in the other treatment rooms. I thought I knew what busy days were from my time on the burn unit at home, but nothing compares to this. Caroline and I were the only ones there today, so we split those procedures between us, with Caroline doing the majority as I tagged along on ward rounds. The nurses often take a tea break in the morning and then lunch around noontime, so it’s very much a speed up, slow down kind of day. Needless to say we were both exhausted and I honestly don’t remember the majority of my day.

I do remember a few things…

* Missy did both art therapy and music therapy and seemed to love them both, but her affect still remains pretty flat. They do have art therapist and music therapists here are a part time basis. It has a very positive effect on the ward. They also have clowns that visit a couple times a week. The other day, one touched me with her foot (I put that in for you Caroline - you would have freaked!).

* Larry sang “Hello” to me this time. ☺ He was sitting up in his bed and looked so much more engaged today. He is doing so much better!

That’s about all I can remember. Sorry. Good night. ☺

shout out

2009-03-24T11:24:00.000-05:00

My friend Dana requested a shout out on my blog....so here's to you Dana!! Thanks for chatting with me today. PS. Mow the lawn. :)

Also, keep forgetting to tell you all that fanny does not mean the same thing in SA as it does in the US. The whole idea I suggested about us wearing fanny packs to tote our stuff around - could have been awkward! :)

Warning: this girl CAN be too much fun! :)

2009-03-24T10:46:00.000-05:00

Taylor was sick today, so Caroline and I divided the busy unit. Tuesday mornings are also when Caroline has the Pain Management team meeting, so I did dressing changes most of the morning. The sisters loved the CD I made for the treatment room. It was actually pretty cheesy because it was limited to what I had on my i-tunes, everything from instrumental to Rainbow Connection. One sister asked if I would be able to leave the CD after I go back because it created such a calming environment. I assured them that I had made the CD for them. They were very pleased.

We had some victorious moments this morning. I was doing a dressing with one little baby boy. He was very squirmy and very fussy. Finally after all but one of his hands was bandaged, I asked the sisters if I could pick him up. I was picking him up as I asked. The sister was concerned that he wouldn’t hold still and that I was too tall. So, I did a deep knee bend and he held perfectly still. It was perfect. She commented on her surprise at how cooperative he was in that position. My thighs were burning, but it was worth it for our first comfort hold! I know it’s a small one, but every step gets us closer. It felt like a big victory to me. Later that day, Caroline was able to comfort hold for an NG placement, with much pleasure from the sisters, so we’re making steps. It’s actually pretty hard to comfort hold in the treatment room because the kids are on more of a tub/table than a treatment table. They get washed and have their new bandage on all on the same table. So, to climb up and comfort hold, like we do at home, would result in soaking wet pants for the rest of the day. We’ll do the best we can. ☺

We also had our first official playgroup today. It was a huge success in my book. We did syringe painting and the kids loved it! Only two actually participated, but others watched and the parents really enjoyed it. I think it was good for the staff to see as well. Unfortunately one little 2 year old girl may have had too much fun. I introduced myself to her earlier that morning and she seemed pretty leery of me. She didn’t want to engage very much. However, as soon as I walked away she started crying, so I went back and picked her up. After I gave her a while to warm up, we spent the morning looking at books, laughing and talking (once again, we don’t understand each other ☺). One of the other mothers told me I would have to stay the night because this little girl didn’t like anyone, but her mom and dad. She told me I was the first one for her to like. She was attached to her feeding tube, which here means the kids are limited to their beds because they don’t have IV poles. One of the sisters was happy to unhook her, however so she could go to play group. When we got down there, she had a blast and made a mess! It was great. She made three pictures and played with the ball. She would come back to sit on my lap every now and then, but she played and played. It finally came time for me to take her back to her room. Sad times. She screamed and kick and hollered – throwing the biggest tantrum I’d ever seen. I’m usually pretty calm and can outlast most tantrums, but this was the record. I sat with her for at least 30 minutes calmly trying to help her calm and she just wailed and wailed. At one point I had to blow some bubbles…not for her sake, but to calm myself. ☺ The other moms were looking at me like – what did you do?! I felt horrible, but I knew if I took her back to the playroom we’d have to go through this all over again. It literally felt like I was breaking that spirit that we’d taken all morning to rebuild. I think she probably thought if she went back in bed she’d never get to come out again. I finally just had to put her in her crib and walk away. It took a bit, but she eventually calmed herself. I’m hoping that providing another play opportunity tomorrow will help her realize that this will be a consistent option and she won’t have to respond the same. We’ll see what happens.

I thought my day was going to end on that note, so I was a little bummed, but at the last minute I decided to stop in and see the little boy I’ve been working with on one of the other floors. Have I assigned him a name yet? Let’s call him “Larry.” Larry is the 4 year old boy who is so weak and small and my big goal has been just eye contact. Well, today I went to see Larry, just wanting him to see my face, so I could stay a familiar, safe person. When I got there he had just finished physio, so he was laying in bed moaning. I sat next to him and started reading from this African Tales book we bought. It’s the rhyming one with the nice rhythm. I’m still not sure what language he speaks, but the kids seem to like the book. He continued moaning, but I could tell he was following the pictures with his eyes. By the second story, the moaning had softened and slowed a bit. I had only planned to pop in and out because it was time for me to go, but I decided to do a bit more and began singing Old MacDonald. I had some rubber animals with me, so I would hold them up and make the noises while I was singing. Larry lifted his little hand barely off the bed and waved it around as if he was conducting my music. It was awesome! He maintained eye contact with me during the whole song. It wasn’t even that looking through me eye contact; it was true contact! After the song I decided I really had to go, so I transitioned with a goodbye Larry song. I figured it could be his cue for me to leave after our daily meetings. I sang, “Goodbye Larry. Goodbye Larry. Goodbye Larry. I’ll see you again real soon.” (I know my sister is probably totally irritated that I said “real” soon, but "really" didn’t fit.) I repeated the song inserting Cara instead. He seemed to be mimicking the shapes of my mouth, so I repeated the whole thing. By the time I got to goodbye Cara the second time, I thought I heard him singing with me. I sang “bye-bye.” He mimicked “bye-bye” in a singsong voice. I almost peed my pants! We sang bye-bye back and forth for quite some time. I hated leaving during such a highlight moment, but I had to go. As I was walking out one of the doctors stopped me and asked, “Was that him singing that?” I told her it was and she said that was a HUGE breakthrough! Yes!!! Patience and perseverance does pay off. I’ve been praying for Larry (and each of the kids I work with), that I might have wisdom in my interventions with them. I feel like I was guided in that one today. God is good!

Caroline and I were reviewing the successes of the program as we rode the bus home this afternoon. I got a little teary eyed thinking about having to leave it in the not so distant future. It has been such a wonderful experience and I feel so blessed!

Day of Play

2009-03-23T10:01:00.000-05:00

Happy Child Life Week my CL friends!! I hope you’re having a great time celebrating and feeling appreciated at home. Please package up our free lunch for me, label it and keep it in the fridge until I get home. I don’t want to miss out on that goodness! ☺ You really are amazing at what you do. I know sometimes you feel misunderstood or under appreciated, but having seen what it’s like without you around I appreciate more than ever the work that you do. Don’t let yourself get caught up in the mundane. Really use this week to remember what you do and why you do it. So many people have been telling me that portions of this blog have moved them to tears, but the funny thing is – each of you is impacting lives in the exact same way, just in a different area of the world. Take a moment today and really appreciate yourself and the powerful way you impact the lives of kids – you’ll inspire yourself! ☺

Today was another good day. I learned a lot about myself as a CLS. I only had three kids assigned to me this morning. Some of the kids had gone home, and with 3 of us working on one unit, sometimes the distribution makes numbers sparse. I’m also working mostly with the kids in the isolation bay, so I try not to mingle too much with the other kids. Anyway, you would think with only 3 kids I might have the opportunity to feel bored or think there was nothing to do (probably a typical response when I’m at home), but here I feel like I have to take advantage of every moment I’m here, so I had plenty of time to do some very quality interventions with the three kids I had.

I fed and played with a little baby for quite some time this morning. She 8 months old, but looks about 2 or 3 months, so we were able to work on all sorts of developmental fun. She worked on holding her head up, grasping rattles, babbling, waving, clapping (with lots of assistance), and she thoroughly enjoyed the awe and wonder of peek-a-boo. She even tried to cover her face with the blanket a few times, but wasn’t strong enough to get it there. ☺ It’s amazing to see the progress she has been able to make in the last few weeks with good medical care and some quality stimulation and TLC.

"Missy" and I read books most of the morning. She speaks Afrikaans, so I know she doesn’t know what I’m saying, but the rhythm of the stories was melodic, so she stayed attentive for a long time. She looked at all the pictures and I hope just being able to hear my voice was soothing. After reading, I held her until she fell asleep.

Both those examples of what I did today I know seem very simple, but it’s amazing to see the power behind those simple acts. Slowly, but surely theses kids are responding and making positive improvements based on these interventions. So once again CL friends, don’t sell yourselves short!

Later in the morning we ended up having a spontaneous playgroup. A lot of kids ended up in this long room with windows next to the bays. They were playing games, kicking balls, laughing and moving in ways I hadn’t seem the willingly move in a long time. Play is such a powerful tool, especially group play. I think it’s interesting to see how these kids can lie next to each other in their rooms and see each other’s wounds, yet not truly relate or begin to form bonds until they have the opportunity to play. That’s when they feel accepted. That’s when they get the chance to feel normal. It’s awesome. Tomorrow we’re planning our first official scheduled playgroup. It’s been one of my goals since I came here and tomorrow it will happen! We’re even going to try and see if part of the long window room can be converted into our official play area. We went shopping for group supplies today after work. I’m so excited! I know it’s weird – when is the last time I got this excited for playgroup?! ☺ But that’s the point I’ve been trying to make all along. Being here helps me see what a huge difference the things we do on a daily basis have on the kids. Because of that new vision, my role becomes less of a job and more of an opportunity. I’m not doing things because I have to anymore, I’m doing them because I want to and because I can see the difference they make in the response the kids have to hospitalization. No longer am I doing bedside play because I need to get a certain quota in during the day, I’m doing it because I can see the healing and therapeutic power it has for these kids. I really hope that this new vision remains with me when I go home – you all can keep me accountable! ☺

Well, that’s all my ramblings for the day. I’ll step off my soapbox and go make a CD for the treatment room. The other day one of the sister’s turned on the radio for the treatments, but unfortunately the only station that came in was heavy metal – not so soothing. I’m hoping I have enough relaxing stuff on my i-tunes to make it work. Do you think Mmm-Bop translates into Afrikaans? That song always makes me feel better! ☺

Lion's Head

2009-03-22T14:04:00.000-05:00

It’s a short blog tonight, kids. I had a nice Sunday. Went to church this morning and then spent the afternoon reading by the pool. My roommate gave me a book to read, written by the man who started the church she attends in Zimbabwe. It’s been very interesting to read and caused me to do much reflecting and thinking. I’m sure I’ll have more to write on that later, but for now I’ll leave you with that.

I know so many of you have been praying for me along this journey. I can’t tell you how much I appreciate that and how much those prayers have been felt every step of the way. I feel like I’m adapting to life here smoothly, that I have made some good friend, that I’ve seen an impact on the hospital and the kids there, and that have many more blessings still coming. My prayers recently have shifted away from my own needs and desires and are focused more on accomplishing all that God has for me here in the lives of others and for His work. I’ve been praying to hear His voice more clearly, so that He might guide me in whatever work He has for me here. I’m trying to make more time to spend in study and reflection, so that I might be more in tune with Him. I think so often we get caught up in the business of life and the day that we forget to take the time to center ourselves on Christ. But as we do this, our lives are so much greater. The first few weeks I was so focused on being here and experiencing everything there was to experience for myself, I let that daily study and prayer time lax, but I’ve refocused and am sure I will have many blessings to share related to that change in my daily life.

Tonight we hiked up to top of Lion’s Head. It’s the smaller mountain next to Table Mountain. It was such an awesome hike. The whole way up I was thinking of all the people I wished were here to hike it with me because I think you would have loved it so much. I’m thinking Mountain Camp should move to South Africa next year! The hike itself was a blast! There were all sorts of different terrains – the open path, the rocky climb, ladders, chains to pull your way up the mountain, rock scrambling- it was such a blast. Nothing however compares to the views all the way up and once at the top. We went for sunset and watched the sun set over the ocean and change the colors over the clouds on Table Mountain. It was just breathe taking! Cape Town is so beautiful with the mountains and the ocean right next to each other! I tried to take pictures to share with you all, but I’m sure my camera won’t do the view justice. Isn’t amazing how we try so hard to recreate the beauty we see all around, but no one does it quite like the original Creator! The hike back down was slightly treacherous as it was getting dark, but we had a great time. The views of the city lights were amazing from the mountain. We were far enough outside the city to see the stars! It was a great night!

I think I’m headed to bed early. Another work week awaits! It’s weird to think the kids will be there waiting when we arrive in the morning. Our lives get to go on outside the hospital. I get to go hike a mountain and spend the day at the beach. I get to go home at night and rest in my bed. The kids and families don’t get to. Their life totally shifts for this moment in their lives. Many of the moms sleep in the chairs at their kid’s bedside – not like the lazy boys we have at home, straight up chairs. They have to hunch over and sleep sitting up with their heads resting on the kids’ beds. Seeing this side of things makes me more empathetic to the needs of families in the hospital and the importance of our patience and support in our interactions with them.

Good night.

you can't scam us...and stepping dog poo

2009-03-22T08:31:00.000-05:00

Posting this a day late because the internet wasn't working last night..

My friend Caroline had rented a car for the night last night and didn’t have to turn it in until noon today, so we thought we would take advantage of the freedom and drive along the coast. If you have a handy dandy Cape Town map available ☺ we drove down Victoria Drive, past Camps Bay and ended up at Hout Bay. It was an absolutely gorgeous morning and a beautiful drive. We tried to go further past Hout Bay, but Chapman Road was closed for some reason. We saw the sign, but went a little further. There was a guy on a moped who hollered at us and let us know the road was closed ahead. We started to turn around and he was talking to us letting us know how to get around. We told him we didn’t care that much and would go back in to town. Then he started talking a million miles a minute to tell us who he was and where he was visiting. His story was very detailed and he was going on and on. In the back of my head I thought – where in this story does your money get stolen and you ask us for some cash. As soon as I thought it, he reached the part of the story where his camera got stolen along with money and he needed gas, etc. Caroline and I gave him a few Rand and drove on. It’s that same situation I’ve been talking about earlier. It’s so hard in those situations to know what to do. Everyone driving by looking at us gave us one of those…he’s taking advantage of you looks, but we’d gotten sucked in so easily. And if someone is in need, aren’t we supposed to give and not judge? It’s such a source of confusion for me!

Anyway…

We found a little restaurant right on the beach and had muesli and yogurt. The mist was still rising off the water and the mountains framed the little bay. After breakfast we dipped our feet in the freezing cold ocean water and tried to continue on our journey. We met a guy from Amsterdam who’d just sailed his boat from Brazil, so we took a picture of him. I don’t even know if that’s true. I’m so skeptical of everyone over here. I’m always second-guessing and doubting. It’s a really awful feeling because I’m usually such a trusting person. It makes it hard to meet people because you’re constantly wondering what they want from you.

Anyway…We headed back toward our apartment because we had to have the car there by noon sharp so Caroline wouldn’t get over charged. On the way back we stopped by some roadside beaches and trails…some were sandy, some were boulder-y. One even had a sign that warned us nudity was not allowed along the trail…not sure what that implied about the end of trail – we didn’t make it far enough to find out! We also stopped along the road at some of the markets people had set up so sell some of the traditional African souvenirs like soap stone and ebony carvings. It was such beautiful stuff. It’s so hard to say no. I’m such a sucker! And I think that’s obvious. I did say no, but it was really hard.

Anyway…I’m showing too many of my weaknesses in this blog…let me get to my bold smart traveler story. ☺ On our way back to the apartment we were driving on the super narrow road and a big truck came barreling at us. Caroline swerved to get out of the way and hit the curb with her tire. She’d paid for zero reliability coverage – which had become our motto for the scary Africa driving – so we didn’t worry much about it. We made it back to the apartment by noon but the guy was nowhere in sight. We milled around out front and in a shop next door, but finally went upstairs after about 20 minutes, figuring the guy would call. I went up to the apartment where I found the door to my room was locked (I share a room and couldn't get ahold of my roommate) and I had no way of getting in. I went back down to Caroline’s and luckily had things with me to change out of my beach clothes. Caroline got ahold of the company who said they had no documentation of her renting a car, but she could just drive it in and drop it off at the office. We’d decided to go down to the Waterfront that afternoon anyway, so we thought we would drop the car off on our way. We went to get in the car (not before Caroline warned me not to step in the freshly made dog poo right beside the car) and the guy we know from the coffee shop and one of the security guards from the apartment both ran up to us to tell us the car guy had been looking for us and we were supposed to call them at the number they’d been given. We called him and he said he’d be there in 30 minutes, so we milled around the coffee shop to be sure we didn’t miss him.

Note: I’m realizing this is a really long and detailed story. I promise I’m not going to ask you for money at the end. ☺ but I hope you don’t get your hopes up thinking that the longer and the more detail this story has, the better it’s going to be. It really doesn’t get much better, so please don’t get excited. You’re welcome to stop reading now. If you want to continue I’ll try to make the end a little faster. ☺

Continuing with the story… In the mean time my roommate came back and let me into our room. That’s another story for another time (again not exciting, I just don’t want to post it on here). I walked into my room to get some money and turned around to see there was something light brown on the floor…very similar to dog poo. I looked at the bottom of my shoe and …you guessed it. Yuck!! Caroline had reminded me not to step in the poo when I got into the car, but I had totally forgotten when I stepped out just a few seconds later. I should have known where this day was going by this point. Anyway…the guy finally came to get the car. He looked around it to see if there were any damages. He came to the front tire and noticed the hubcap had been bent from the curb check when we were escaping the big truck. The guy started talking to Caroline about paying for the damages. She questioned that due to her zero liability policy. Evidently the fine print of that policy says that damage to tires and other specific areas of the car are not covered. Now – don’t worry. If the car is stolen – covered. Mess up a little rim – not covered. The guy told us we should have just reported the car stolen and then we wouldn’t have to worry about it. Why didn’t we think about that?! Anyway… by this time we were tired and frustrated, so Caroline asked the guy if he would drop us by the Waterfront on his way back. That was our first mistake. Once inside the car the guy started telling us about a friend he had that would fix the car for Caroline and then this guy would take it back to the dealer and they would never know it had been damaged. He said it would be way cheaper for Caroline and she wouldn’t have to worry. Unfortunately, with the accent and the way he was talking, things were confusing and we weren’t sure if he was saying that’s what we had to do or if it was just an offer. Anyway, he told Caroline it would be R1000 (about $100) and then he explained a whole bunch of ways we could take care of the transfer of money. It ended up being “best” if we just gave him the R1000 up front and he would take care of it all. I know this seems pretty cut and dry as I write it out, but you have to understand it’d been a long day and we were really confused by what he was saying, etc. Caroline agreed but had to run to the ATM to get the guy the money. I got out with her and told her I thought this deal sounded pretty shady. Once we were able to get away from the ordeal and think without the guy talking, we could see more clearly. She went back out and told him she just wanted to go through the dealer. He kept trying to persuade her, bringing up more damages, letting us know he was the guy that took care of making sure the cars ran correctly, so he knew what he was talking about, etc. He was so adamant about helping her get the better deal that it made him even more suspicious. Somehow in the discussion it came up that if he did fix it, when we went in to the dealership, Caroline wouldn’t be able to let them know that there’d been damage, etc. Caroline finally convinced him we just wanted to return it to the dealership and he left us. It kind of ruined our day, but I was convinced we’d done the right thing. Later Caroline got ahold of the car place and they were looking into it. Anyway…we felt somewhat scammed and became very suspicious of anyone offering us anything. The guy at the Indian restaurant we went to even made us both change our minds about what we ordered and we were defensive about it. ☺ We tried hard to get over it and it looks now like everything’s going to get worked out, but it just kind of ruined the fun. By the way – did I mention that when I got back in the car to go to the Waterfront, I stepped in the dog poo again – I should have known!

I just hate how cautious and even suspicious you have to be here. Tonight we were walking down the street and some guys pulled up and hollered at us, so we just kept walking. Typically, I don’t make eye contact with anyone. So a few minutes later when another guy came walking toward us waving his hands and saying hello, we just ignored him. We realized after he’d passed us that he’s the guy that works in the coffee shop below our building and we talk to every day. We yelled after him and were able to say hello and apologize, but we felt horrible that we’d ignored him. It’s so hard to be so untrusting. I think that’s the one thing I don’t like about living here. I miss the safety of home.

My battery is dying on my computer and our electricity is getting low, so I think that’s all for tonight. Sorry that was a really long story for no real reason at all. ☺ Good night. Love you.

you are energy; you are light

2009-03-20T10:33:00.000-05:00

Caroline gave another survey about our Child Life program to another parent today. When the mom handed it back to her she tried to explain what she wanted the survey to convey. She said… “You are energy. You are light.”

“To the world you may be one person. But to one person you may be the world.” I’m not egocentric enough claim that I am the world to anyone, but that familiar quote (which just happened to be in my journal today) has taken on new meaning on this trip.

Yesterday I had some great interventions with that boy I have been talking about. Let’s call him Joe because saying he’s “the boy who’s hand I hold and who hugged me during that treatment who…” gets kind of long! Anyway, Joe typically has a pretty flat affect during that day. If he shows any emotion, it’s a pretty sullen expression. I’d gone out and bought a ball at a local toy store, so I took to Joe yesterday morning for some play. He immediately lit up! We threw the ball back and forth and I made my arms into a basket and he shot hoops. He was laughing like I’ve never seen him laugh before. The little girl in bed across from him was eyeballing us, so I had them throw the ball back and forth between their beds…a make shift little play group. It was as so much fun. They were laughing and interacting. It was great. I got the bubbles out for the two younger kids in the bay to play with. Soon Joe let me know that he wanted to play as well. I went over to his bed and began blowing bubbles. He came alive!! His little personality came out of nowhere. He started punching the bubbles and making little cartoon punching noises. Soon he was kicking and moving. I had no idea bubbles could be so cathartic. It was so great to see. His burns cover his legs and one side of his body up through his armpit, so moving has been very difficult for him. He was moving all over that bed in ways I’ve never see. At one point I had to move him back onto the bed because he was hanging off. Usually he cries out in pain. This time he grimaced, but it was hard to see through his giant smile!! ☺ It was a giant breakthrough! He had his treatment later that day, and it seemed like all the ground we had gained was lost…he was back to his old sullen expression, but I know that progress is still there and slowly his spirit will return!

We have siblings on our unit. They are in different rooms for infection control, but yesterday they were allowed to spend some time together. The sister’s face is completely bandaged, so it’s difficult to tell her expressions. Her eyes are often sad and she typically just lies in her bed. When the brother came in to visit her, they just sat and looked at each other. I could tell the boy was kind of scared by how his sister looked. So I whipped out my trusty bubbles (I wear them around my neck here and don’t know how I ever went without them at home!) and began a spontaneous play session between the two of them. They blew bubbles at each other and tried to pop them. It was wonderful how play could help them look through the bandages and the burns and remember their sibling on the other side. That was the most play I’d been able to engage the little girl in since she’s been here, so I was very pleased. She even spoke to him to say goodbye. It was a wonderful time!

Today was my theatre day, so I spent most of the morning in the OR. Again- I have to say how wonderful the staff is at this hospital. They are so inviting and allow us access anywhere we want it. They quickly recognize the effect that our presence has on the children and always remind us of that. I love them! ☺ Yesterday one of the sisters in the OR pulled Caroline aside. Caroline thought she might be in trouble, but the lady just wanted to tell her how sincerely she appreciated us being there and the positive effect we had on calming the children before and after surgery. How great!

Being able to be available in theatre has been a great experience in seeing the difference Child Life’s presence makes there. We don’t have that luxury at home in many hospitals, but being here and seeing the difference it makes is awesome. Today I took a little 2 (almost 3) year old back to theatre. Her mom was nervous and didn’t want to accompany her, so I went. (just a reminder that kids are usually sedated in their parents arms in the OR – awesome!) Anyway…she is just the cutest thing ever. She only speaks Afrikaans, but we’re able to communicate usually pretty well. She calls me (and everyone else) nurse. So, I’ll be walking by her room and she’ll yet out – NURSE! I would get excited if I thought it was me she was excited about, but whenever I get close she just reaches for my bubbles. ☺ I took the bubbles with us when we went to theatre. We had so much fun playing for the first 25 minutes, but we were both wearing down after that. She was having a typical 2-year-old response to me not wanting her to spill the bubbles, so I took them away. Oops! ☺ She began crying and carrying on. I was thinking – oh great! Here I’m so supposed to be showing these people how calming and comforting CL can be and I’m making this kid throw a temper tantrum outside of the OR. Thankful I got her distracted with something else right before we went in. We’d played with the anesthesia mask quite a bit that morning, so when we went in the room, she was sitting up her bed and grabbed the mask and stuck it on her face. She giggled as she breathed in and out…and then she was out. It was great! ☺ I’d gone back to the ward during her surgery, so I wasn’t there when she came to recovery. They called back over to the ward to get someone from Child Life back because she was waking up. It was just awesome to see the staff not only accepting our presence, but requesting it. How great!

I had another holding marathon with my little 3 year old friend. Caroline had been helping with her dressings while I was in theatre, so I came to relieve her. Caroline told me that (let’s call her…) Missy had said something during the dressing change (she doesn’t speak very often). The nurses translated for Caroline that Missy had asked Caroline not to stop singing. We often sing to Missy and it was just great to find out she finds comfort in that – enough to say something about it! I held Missy for awhile after her dressing change, but then I had to see some other patients. When I walked back by her room later, she was crying. Again, Missy doesn’t usually show any emotion – happy or sad. So I went in and asked if she wanted to be held (I’m really glad my family is so good at charades!). I picked her up and held her for quite some time. She hugged my neck as usual. I could feel her relax and her breathing slow down as soon as I held her. I tried to put her down at one point, but she just cried and cried. I was so happy that she was showing emotion at all that I picked her back up – I didn’t want her to regress again if I put her down. I held her forever. I had sweat dripping off every part of my body, but I couldn’t put her down. I started thinking about how much love my parents have for me. It was totally humbling because I could see how much love I had in my heart for this little girl and I know the love my parents have for me is so much greater. The thing that leaves me most in wonder, though, is that God loves me even more than my parents. Is that possible?! That’s a lot of love. And he loves each of these children more than my heart has room to love. Wow! That’s power.

Caroline was telling me about a book one of the social workers here was talking to her about the other day. I guess the woman who wrote it was on Oprah or something. (Oprah’s pretty big here.☺) If you saw her on Oprah and if I’m telling the story wrong, than please post a comment and correct me. Anyway…this woman is a neurologist and I guess she suffered a stroke. She tells the story of her experience in the hospital after that stroke. She wasn’t able to communicate and she couldn’t understand who people were or what their role was in relationship to her. I’m not even sure she could understand what they were saying, but I’m not sure. Anyway, in the darkness and confusion, she said the one thing she could understand was the presence people had with them when the interacted with her. For example, she could tell when a nurse was having a bad day or lying to her. I guess at one point her mother came to visit her and the woman had no way of knowing who this person was. But her mom laid down in bed with her daughter and she said a feeling of comfort and safety came over her. I think kids are totally the same way. We often talk about babies being able to sense the stress their parents are feeling, but I’m realizing in the country where the kids don’t understand what I’m saying – they understand me in that same way. There is a comforting presence I have felt with me on this whole journey and I pray that His peace is what the kids are feeling when I am with them.

I am working with another little boy on another floor as a referral from the anesthesiologist that brought us here. He is very week and very small for his age. He typically just lies in his bed and moans or cries softly. My goal the first couple days was just to get him to make eye contact with me, so you can see I have to have much patience in our progress. Although improvements have been slow, I go every day and just sit and sing or read, or blow bubbles. I’m not able to hold him right now because he is in so much pain and usually throws up when he’s just moved to a sitting position. I’m not really sure how he feels about me yet, but I figure if I stay consistent he’ll understand my intent and eventually we’ll breakthrough. I noticed the other day he was feeling my hands a lot, and I wondered if perhaps he was feeling for textures. Today I took him some squishy blocks we have with various patterns on them and spent much of our time together helping him trace the patterns. I squeezed the block for him and it made a squeaky noise. At first I was afraid I’d frightened him, but then he started mimicking the movement of my hand when I squeaked. I followed his command and squeezed the ball when he moved his hand. We did that for some time and he seemed very pleased. That’s play my friends. I know I was doing it for him, but he was definitely directing our play. Tiny success, but success all the same! ☺

I’m ¼ of my way through this adventure now. It has already gone by so quickly, I’m holding on to these last 6 weeks as tightly as I can! I know they’re going to fly by and my time here will be over. I feel like my moments to accomplish what I wanted on this trip are dwindling quickly. I think I’m most nervous about making sure these changes I’m feeling within me, both personally and professionally are long lasting and don’t just go away as soon as I get home. Caroline’s message at the end of my journal today was – “Growth means change and change involves risk, stepping from the known to the unknown.” It’s funny how being here feels more like the known now and I’m nervous to go back home and the unknown of the lasting effect of these changes. Oh well - I still have 6 weeks! I’m not letting myself think about going home yet!!

nighttime fires

2009-03-18T13:55:00.000-05:00

Last night I went to bed early in hopes of being able to wake up refreshed this morning – I think the jet lag is finally starting to catch up with me. The wind outside was whipping violently – I don’t really know how to describe it, it is SO powerful. It shakes the doors in my apartment even when the windows are closed. Sometimes with the windows open, you have to throw your weight against a door to get it to open because the wind is pushing so hard against it. Anyway, last night was one of those overly crazy wind nights. I was able to fall asleep soundly, though. About 1am I woke up to the intense smell of smoke. It smelled like someone was having a campfire right outside my window. You could smell the burning wood and everything. As I was becoming coherent, I also noticed the whaling of sirens in the street. They were coming from everywhere. I looked out my window to see what was happening and Table Mountain was literally on fire! There were red blazing flames popping up all over, some of them very large. The whole city was covered in a smoky haze and the mountain had red smoke billowing from it. It was quite frightening. Everything else was dark, and I couldn’t remember where on the mountain the houses began. I said some prayers for those in potential danger, I could tell some of the flames looked very close to some tower apartments. We don’t have forest fires in Iowa or KC, so I was pretty worried. I went back to sleep momentarily, but woke again around 2:30am. My roommate woke up, too and we watched the mountain. It looked like the fires were growing – if that was possible. Every time one would go out, another would pop up. The wind was blowing so fiercely, I don’t know how they ever kept up. I have to send a shout out to the Cape Town Fire Department. I don’t know how they even got to some of the places they did, but when I woke up this morning, there didn’t appear to be any more flames, just some smoking areas. This morning you could see the helicopters swooping in and out pouring water on the mountain. The mountain is completely charred on one side. This morning as we drove to work we could see the damage. It got very close to some homes and may have done damage to some according to some reports. They had to evacuate those apartments I mentioned earlier, and some other homes. I heard about 60 people were evacuated, 6 people injured, and perhaps one death. There is more information and some pretty amazing photos at http://www.nowpublic.com/world/fire-breaks-out-table-mountain.

Today was another day of being present with the kids. I had more hands to hold, more opportunities for my neck to be squeezed and even some moments to help kids laugh. There were 2 highlights from the day as far as progress on the unit is concerned. I was working in the treatment room with 2 sisters I have worked with a number of times. I left to get a patient a gown and when I returned they told me they had just been talking about me. They said they thought the surveys Caroline had handed out for feedback from staff were missing a portion. The sisters continued by telling me how our presence in the treatment room does more than just comfort the children – they said it brings a calming influence to the staff as well. One sister told me how Wednesdays can be particularly stressful with so little staff, but our presence in the treatment room brings such a calming effect that she hadn’t felt the stress that day, she was just calm and comforted. She stated that by calming the children, we were also calming them. The other sister confirmed what was being said and told me she hoped someone could always be there. They went on and on about how comforting it was to them. I hugged them and told them I was so happy to hear that – that our role was to make a more calming environment for everyone and what a soothing effect that had on the children. YES!!! I don’t know about you guys, but I thought that was HUGE!! Later the sisters asked Caroline if her “tall colleague” had told her what they’d said. I had told her, but she wanted to hear it from them, so she said no. They repeated it to her and to the ward sister (aka combination of nurse manager/charge nurse). Victory! ☺

The other compliment and highlight of the day came from a patient. Caroline has been working with a little boy who only speaks Xhosa and whose eyes were swollen shut for the first part of his admission. When he first came in, she would read to him. He would sit on the side of his bed, and sit close to her like he was looking at the pictures in her book even though his eyes were swollen shut. She continued to read to him daily, so that he would recognize her voice as safe. When his swelling went down and he could open his eyes, he recognized Caroline as his friend. She has continued to play with him and support him despite the language barrier. Today the little boy was talking to one of the nurses and asked who the nice girls were. He told the nurse that he had no idea what we were saying to him, but he thought we were so nice and loved that we played with him. I laughed when I heard that – I just thought it was funny that he acknowledged he had no idea what we were saying. ☺ What an awesome compliment. Over and over again, we’re seeing how you don’t need to speak the language to communicate. Don’t get me wrong, it would be super helpful and I’m all about being able to speak to people in their native tongue, but just because you can’t speak, doesn’t mean you can’t communicate. That’s something for me to remember when I go home. I often shy away from patients that don’t speak English because I’m intimidated by my limited ability to communicate, but now I’m learning to do just that without having to use words!

I don’t have anything exciting to report from this afternoon. I came home and took a hard solid hour and a half nap. I figured that was in order since I zonked out at work when I put my head on my desk during my break. Oops. ☺ An early to bed is in order tonight. Until tomorrow…

the art of being present

2009-03-17T14:58:00.000-05:00

I’m not sure if I’ve mentioned this in my blogs before, but this trip has taught me over and over again the importance of being present in a child’s life. It seems so often in the US I allow myself to get caught up in the bells and whistles of Child Life. Here in South Africa, those bells and whistles are not available and you’re left with the internal skills you possess and a few small items. More than anything I have been mastering the art of being present. So many times we think there are things we must do or say to engage or make our time worth while, but so often – the most important gift we can give these parents and children is our presence. During painful dressing changes with very few meds on board, a simple hand to hold or face to look at offers the support these kids need to make it through with their spirits in tact. When parents come in devastated by the trauma they have experienced when their child is burned, their not looking for resource materials or experts on this topic or that…they’re looking for someone to be present with them in the grief.

Today I witnessed this art displayed in numerous ways and truly feel I am a better Child Life Specialists and person because of it. I have been working with a little 3 year old girl who is badly burned. Most of her face and arms have been burned. She typically just sleeps throughout the day. I was present for her dressing change. This is one of the few times I can look in her eyes because they clear away the goop that has crusted her eyes shut. After her treatment I carried her back to her room and just held her. I think it had been a long time since someone had done that. I sang to her and rocked her. I think at first she wasn’t sure what I was doing, but soon I felt her holding tightly to my arm with her bandaged hand. She started to whimper and move around. I was trying to guess what she wanted, so I pulled her away from me. She moved her other splinted hand out from under the blanket and wrapped it tightly around my neck so that she was hugging me. Wow – the art of being present. We stood there for what seemed like forever- to her I’m sure it passed too quickly. I sang to her, but I’m not sure she could hear me because her ears were stuffed with cotton and banged, but she relaxed in my arms and seemed content to just allow me to hold her. The song that kept coming to my mind during this time totally illustrates what I was feeling in that moment….

“Make me a servant, humble and meek.
Lord let me lift up, those who are week.
And may the prayer of my heart always be,
Make me a servant. Make me a servant.
Make me a servant, today.”

I had to put her down eventually because some of my other patients were headed back for treatments. She rested peacefully. Later that day, I heard her crying. I walked into her room and knelt by her bed. Immediately she stopped as I rubbed her back and began humming again. It didn’t take a spinner or bubbles or anything that cost any money. It didn’t take me years of experience to learn what I was doing – it only took someone willing to be present in the life of a child.

I realize that may sound somewhat over the top, but I wish you could have experienced the power in that moment today.

I had some similar experiences with the little boy that smiled at me yesterday. Today was rougher for him because he had to have dressing changes. I had played some with him that morning. He was excited to see me, but I think he got a little jealous when I had to spend time with some of the other kids in his bay as well. ☺ I missed the beginning of his dressing change because I had gone up to the office to grab lunch. When I walked in he was crying on the dressing table. When he saw me walk in he immediately reached his hand out for me. I walked up and held his hand, stroking him and encouraging him in his breathing. He did such a good job of taking big deep breaths…I think our medical play from yesterday helped. I can’t communicate with him in words, but he mimics my breaths and did such a great job. At one point he had to stand up for his dressings, making him about level with my face. He buried his head in my neck and just cried. Again…all I’m doing is consistently being present with these kids in their most difficult moments. When we went back to his room, he was very uncomfortable, so I sat by his bed and held his hand. He moaned and moved. I rubbed his tummy on top of his bandages. He showed me where on his stomach he wanted me to rub instead. I rubbed there and sang to him. He placed his hand over mine and moved it along with mine – maintaining that touch as I tried to help his body calm. When you can’t communicate with someone in words, you find other ways to share compassion. I hope that I can remember this art of being present when I get home and all the bells and whistles are again at my disposal. Going back to the basics makes you appreciate what really matters and reminds me of the real role I fulfill in my job.

So my challenge to both my CL friends and all those reading my blog – just be present in someone’s life today. Forget about the distractions that keep our minds occupied…Stop trying to entertain or guess at what someone needs. Don’t be worried about not being adequate – just BE PRESENT. It’s a powerful art.

There were other good moments today, but I think I want to end with those 2.

I feel like there should be 2 separate blogs… my cheesy inspiration morning and my adventurous afternoon. They’re totally unrelated, so I’m not even going to try to transition into this… just go with me. ☺

I had the goal of being adventurous all on my own today. I’d been putting it off long enough, so today was the day! It was beautiful out today – some people are complaining it has gotten cold, but it was probably still in the 60s and 70s for most of the day (the wind, though - crazy!). After work I studied one of the walking tour maps in my tour book and decided to explore the company gardens. The gardens are located behind parliament with a lane of tall oak trees running by. I was a little nervous about heading out on my own – but embraced my new boldness (hoping to make my nephew proud) and gathered my things…trying to look as local as possible. ☺ I didn’t really know where I was going, but I made sure not to look that way and eventually found my way to the gardens. It was a very beautiful spot. I have to admit I was a little nervous, so wasn’t able to totally enjoy my time, but I did walk quite a ways through the garden. I even had someone call out to me in nice velvety accent “Hey there beautiful.” Now I realize that could have been the love of my life – so my ignoring him was taking a gamble, but I took my chances assuming what he was really saying was – “Hey tourist – come over here and let me see what’s in the purse of yours!” So I moved on. ☺ The walking map had me going on some different streets to make a loop and tried to follow it, but ended up on a totally different street. I was getting a little nervous, but said a prayer that I would find my way back and started walking.

I stumbled upon some really neat places – like Long Street, which has a number of the restaurants and cute shops. On my way back home I headed down a street and a little boy came up to me asking for Rands. Now everyone will tell you you’re not supposed to give these kids anything- usually they’re working for someone else and don’t keep the money. If you give them anything it’s supposed to be food. I didn’t have food and I didn’t feel comfortable reaching into my purse on the somewhat secluded street I was on so I said sorry. He kept saying, “Please, Sister. Please, Sister.” I know that he probably chose me because I was alone and looked like I didn’t belong, but when I looked into his little face all could see was the little boy from the hospital…especially since he was calling me sister. I told him I was sorry again and walked away, but it has haunted me since. This is something that I have always struggled with! I know the reasons for not giving to beggars, especially in this city, but I also know that as a Christian I’m called to a different standard of living – part of which is giving to those in need…especially children. I resolved myself to carrying a couple Rands in my pocket in the future and stuffing a couple snacks in my purse, but I’m still unsettled about the whole incident.

Anyway…I finally made it home safely. I’m not sure if I feel any more confident in my independent exploring abilities or not, but I did accomplish a goal nonetheless. I talked to a friend about what I’d done today. She shared with me her own concerns about that area of town. She used to walk to work via that route, but stopped when someone threatened to cut her chain off her throat and her phone was stolen twice. She said she hated to become a taxi rider, but she wasn’t sure what else to do. It’s such a struggle traveling by yourself and weighing the adventure with the safety. I felt pretty good about the day, and I’m sure I’ll go explore again, but my friend also said she would be happy to have someone to do the random touristy stuff with, so I’ll most likely drag her along next time. Woo! What a day. ☺

Hope all is going well back home. It has been so much fun to hear from all of you and see who all is following my blog. You’re quite an eclectic group and I love you all!

He smiled at me ... and other happy moments

2009-03-16T14:34:00.000-05:00

So today it happened. He smiled at me!! Don’t worry…I’m not having a “He’s Just Not That Into You Moment.” ☺ I’m talking about the little boy I’ve been working with all week and have had very limited response. He’s the one that I talked about earlier when I was so excited the day he held my hand and wouldn't let go. My interactions with him after that seemed to be going progressively worse. He wasn’t responding and seemed to be withdrawing. I’ve learned more than ever during this last week the importance of just being consistently present in the lives of the kids I work with. Although I wasn’t getting much response, I continued to make sure I had daily interactions with this boy. I always made sure to tell him before I left the unit and remind him I would be back the next day. Slowly I think I’ve gained his trust and I’m so excited! Today I took a book to look at with him. It’s kind of a look and find book with bright colorful pages of fruit, animals, trucks, etc. We were looking at it together and all of a sudden he smiled at me! And then… he laughed! I know to most people reading this that won’t seem like much, but to me it was a HUGE break through! We continued looking at the book and he even started to talk to me. We counted objects, identified fruits in our various languages…it was so great! Later that day we played with a medical kit. It was so wonderful to watch him act out so much of what he’s gone through. He poked me with toy syringe about 50 times. I just sat there and took big deep breaths every time he did it. He mimicked me, breathing along with me. He also mimicked the sounds I was making to represent a heart while he was using the stethoscope. I really think we’re building a trusting relationship and I’m so happy to see the payoff of just being persistently present. ☺

Other happy events from the day…

* I am definitely noticing a change in the nurses already. They’re starting to tell kids before they perform various steps of procedures and I’ve even noticed them acknowledging and validating fears and expressions of pain. Today a sister even told a child. “Listen to her love, listen to auntie – she’s telling you you’re doing a great job.” FYI – I was auntie in that situation. I was really pleased with that.

* I do get to do a lot of baby holding while I’m here as well. I even accompanied one of those babies to the OR because her mom wasn’t here today. She was so playful with me before they gave her the anesthesia. It was nice to be able to be there and offer that comfort and support in the OR. Once again I have to praise that OR team for the welcome reception!

* I received my first real mail today. Cara Ditter is getting her own real life shout out in this blog! Thanks friend! I was so excited to get my card on Cara stationary!:) Thanks also to all who have been e.mailing and facebooking. It means so much to have your support.

The weather turned a bit chillier today and I’m not sure it’s turning back. ☹ We’ll see. It was rainy on our way home, so I just stayed in for a relaxing afternoon/evening. Hopefully tomorrow I can get busy on some more sight seeing.

That’s all for tonight, friends.

Love from Africa!

BTW_ If you’re reading this Maddie – I wrote back to you in the comment section of the last blog, so make sure you read it!

Phone calls from home and other weekend highlights

2009-03-15T15:26:00.000-05:00

First, I must apologize for missing a day of blogging yesterday. I didn’t think anyone would notice – but evidently some of you did – so I apologize for my slackness. The good news is – not writing means I’m getting busy and involved in life here, which is exciting! ☺

We’ve been having some difficulty figuring out how to call my cell from the US, but after much investigation, I finally got the correct number to some friends and family and received my first phone calls from the US today!! I was so excited when I saw familiar numbers pop up on my “mobile” (say it with a SA accent, it sounds cooler). Caroline was the first one to call, so I must give a shout out to her on this blog (don’t be a hater, Ditter, you can have one, too even though you didn’t call☺). It was so wonderful to hear her supportive and encouraging voice on the phone- I can’t tell you enough what a strength you’ve been to me in the adventure Caro. I love you! Caroline was getting ready for a busy day with the CL girls. We’re in desperate need of some buddy dolls in Africa. These are the blank cloth dolls we use in the hospital to help kids process and cope with hospital procedures. The fabulous people I work with decided they would have their own little manufacturing party and sew a bunch of these dolls for us. You don’t know how much I wish I could be there to watch that circus. I’m not sure anyone in our department has ever sewn anything other than high school home ec. projects, so you can imagine the chaos that I’m sure will ensue. They have also collected supplies we’re in need of – like stickers, distraction items, and bubbles to ship with the dolls. I cried when I found out what they were doing. I have told everyone I know in SA about it. I’m sure people get tired of hearing how wonderful my co-workers and friends are, but I don’t think I can say it enough. Thank you, thank you, thank you! I wish I could take pictures of the kids when they get their dolls. They are going to be so excited!!!

My second phone call of the day came from Mom and Erin. Mom is Illinois visiting my sister, so they were together when they called. I cried…of course. It wasn’t as much as Erin was crying, but still tears nonetheless. ☺ It was really good to hear their voices. The one thing I have realized here is just how thankful I am for the family and friends that I have at home. I know I am prayed for and loved and that my family reads my blog more quickly than I can write it. ☺ You don’t know how supported that makes me feel! Thank you. I love you!

So the excitement of the phone calls makes the rest of my weekend dim in comparison, but I know you’ve been waiting for a braai update, so I won’t make you wait any longer…

Saturday was the seafood braai at Strandloper. You should google the sight to see the fabulous pictures, since I’ve yet to be able to download mine. It’s an open-air restaurant on the beach. There are tents to shade the tables and fire pits for the cooking. It’s located right at the edge of a rocky beach over looking a lagoon. It is so beautiful! I felt like I was walking through the line at a Disney World fantasy ride when I walked into the place. There are old boats and wrecked ships lining the walk. The tents are strewn with fish nets and I only hit my head on the dead fish mobile a couple times. ☺ There is a guy with a guitar that walks around to each table and sings songs with his thick Afrikaans accent. He knew almost every request. ☺ The ambiance was fabulous, but the food… amazing!! We started with mussels… a first for me. They were good, but I was able to hold back from eating too many, knowing there were 9 more courses to come. I don’t know if it counted as a course or not, but was also had the most amazing homemade bread ever! They were topped with homemade jams – strawberry, marmalade and watermelon (I didn’t really like the watermelon). The rest of the courses went was followed…

Bokkoms
Mussels in wine and onions
Mussels with garlic butter
Weskus Haarders
Seafood Paella
Braaied Snoek with potatoes and patats
Waterbloemmetjie Bredie
Smoked Angelfish
Stompneus
Kreef
Moerkoffie
Roosterkoek, fresh bread, farm butter and home made jams

Well...that's the list from the website, anyway. I'm not sure what half those are and whether or not I ate them. The barracuda and stopmneus tied for my favorites! I only had one bite of the lamb stew because I was getting really full, and the poo looking stuff coming out the crayfish kind of scared me a bit. The guy said it was totally edible, but all I could picture was an ostomy bag, so I didn’t quite finish that. The food is cooked right in front of you in courses and the utensils are empty mussel shells. It was so great. Between courses and after our meal we would walk up and down the beach, trying to make more room for the rest of the food! Really, though, I did pretty well for myself. I wasn’t disgustingly full by any means. I really enjoyed myself and was able to make a couple friends on top of that! Last night I even went to a movie with a few of the girls…it only cost me 40 Rand…that’s about 4 US dollars. It’s nice to feel friendships forming (with the people and the movie- not the Rand and the dollar – that sentence was kind of out of place). The weird thing about the movies is you get assigned a seat. Well…that was different for me anyway.

I was so exhausted by the time I got home last night – hence the blogless night.

This morning I went to church with Elizabeth and Mwaka. Again – I have to mention what a blessing it was that I ended up with Elizabeth as my roommate. We went to Hillsong. Many of you have probably heard of that church from it’s Sydney location, but they also have them in London and Cape Town. It was very typical to an larger American church, so nothing culturally to report there. But it was a really great service. I had been feeling a little bit homesick the night before for the first time and I was disappointed in myself for those feelings, but going to church today took all those feelings away. It’s amazing how even a million miles from away, you can feel at home with people you don’t even know. It’s just a reminder that God is everywhere and moving among His people in all areas of the world. I truly felt surrounded by His love.

The sermon today was exactly what I needed as well. The topic was “Enlarging Your Capacity.” It was all about allowing ourselves to stretch and grow so that we have a capacity to do all the things God would call us to do. There were 4 points discussed as necessary to understand in order to enlarge your capacity: 1) it is a choice to grow; 2) you must embrace the change; 3) you must understand the power in the mundane; 4) you must build the right priorities. A few things really stuck with me from the talk. In understanding the power in the mundane – the speaker discussed the need to continue serving in whatever way you can find and as you are faithful in that small way, God will work with you and give you more to be responsible (i.e. the parable of the talents). That got me thinking about my work here. Sometimes I feel like there is so much more I need to be doing and I get overwhelmed. But as I do what I know how to do to the best of my ability – God will work within me and open the door to do more. It seems so simple, but it allowed a mind shift in me that has already changed my attitude for the week.

I journaled when I got home from church today and once again, Caroline’s note to me had special meaning. She’d written from Matthew 15:16 – “you did not choose me, but I chose you and appointed you to go and bear fruit…” I thought that really went along well with what I had heard in church today. God chose me to go on this journey and opened the doors to make it possible. I don’t feel adequate for this challenge, but as I do what I am able to do with the talents God has given me, He will enlarge my capacity and allow me to be part of a marvelous work.

Tonight I went to the Kirstenbosch Botanical Gardens with some friends. You should google that, too – beautiful! Its’ a botanical garden located at the foot of the mountains. We didn’t get to walk around much because we were there for a picnic and outdoor concert, but just sitting outside for the concert was breathtaking. I can’t wait to go back and explore the beauty of God’s creation captured in those gardens. Wow!

I think that might have to be all for tonight. I’m getting sleepy and have a new exciting week awaiting me. I’m really excited for this week. I feel like last week was my opportunity to settle in and get to know the ward and the routines. This week I’m so excited to go and just enjoy myself with the kids, families and staff…and share love with all I meet! Goodnight! I love you.

if only for that one...

2009-03-13T15:49:00.000-05:00

It’s weird for me to think you all are still at work and I’m blogging before I go to bed. Craziness!

Okay… just took a temporary break to watch Elizabeth put on her hip hop show for my flat mates. But I’m back…

Today was my “If I only came for that child it was worth it” day. I have been working with a little 7 year old boy who was burned on his legs. Today he was scheduled to go to theatre, so I prepped him. The prep basically turned into a medical play session because he doesn’t speak English and I (as I have made very clear) don’t speak Xhosa. I showed him the pictures in the prep book Caroline recently completed and then just let him play with the items in the prep box. He put on a surgery mask and hat and then played and played with the oxygen mask and tubing. He put it up to his face and my face and would smile and laugh. Prof walked by as we were doing it and grabbed his camera so he could capture the picture. It really was a picture perfect child life moment. Later that day, M ended up getting his staples out in the treatment room rather than theatre. He’d been given some morphine, so the sisters said he should sleep, but he didn’t. I went to the treatment room with him and tried to comfort hold, but was told he had to lie down. So I just held his hands, sang to him, and tried to help him relax. He did pretty well – but it was very painful for him. At one point he tried to kiss me, though. It was pretty cute. Then at the end after the staple were removed, I let him sit up and lean against me with my arms around him to keep his hands away. He just held my hand and stroked it with his head on my shoulder. That was my “If I only came for that one” moment. ☺

All around I had some great interventions with many kids today. It was a really wonderful day and I am so thankful for it. I really focused today on trying to share love with each person I met (not that I was successful, but I will continue to attempt it). After work I walked to the market by myself and got some more groceries. It was really fun and I felt pretty cool walking back. Oh the things that thrill me these days.

Tomorrow is the big seafood braai. I’m really excited because Caroline and her husband decided to come, so I will know a couple people. Isn’t that exciting. God blesses us so much – even in the little things.

I couldn’t end this note without making mention of the best e.mail ever which I received from my sister today. She was catching me up on all the fabulous things in her life right now… like Millie waving and Eli having to play with the “mean boys” at recess. The best part of her e.mail, though was when she told me how she was trying to explain adoption to Eli. My aunt and uncle are in the process of traveling to Africa to adopt a girl from Liberia and Eli was curious what that was about. Here’s the interaction as told by Erin… “We were talking about Ron and Di adopting Ruth and Eli wanted to know what we were talking about. Adoption had come up for some reason the day before and I had tried to describe what it was. We said that there were children in Africa who needed a home. Eli immediately said that he was going to adopt Cara from South Africa. :-)” How much do I love my nephew? I would love for him to adopt me any day! ☺

Well, that’s all that I have for today. Just wanted to thank you all for you continued love and support. I’ll think about you tomorrow when I’m sitting on the beach eating seafood for 4 hours! I’ve heard the weather has been super cold at home. Hopefully I can send some sunshine your way! ☺ Love you all.

last minute update

2009-03-12T14:35:00.000-05:00

okay...so i couldn't leave the day with that blog. :) the bad thing about blogging is people are going to just how crazy i am!

after i wrote that i went and worked out - which always clears my head. i started thinking about the weekend and the potential it holds - with the seafood braai and church and i'm excited about the possibilities.

then i came back and hung out with mwaka. she asked me about church and i explained my background- not very well, but explained it none the less. i was happy for that opportunity.

i decided my goal tomorrow as to show everyone i run in to the love i have for them.

i'm not having the lonely day i just wrote about anymore. thanks. :) God is good.

the lonely day

2009-03-12T12:06:00.000-05:00

I knew this day would come soon enough. I’m NOT writing this so that everyone feels like they need to pump me up, I’m just trying to document what I’m truly feeling while I’m here in South Africa. It was a very good day at work, but we got off a little early so I’ve had the whole afternoon to relax and spend some time alone – not that that type of time is hard to come by at all. ☺ We left work about 130. Caroline and I went to the bookstore to buy some books for the hospital. Then I came home and took a long nap. I felt a bit guilty doing that because I feel like I’m here I need to take advantage of each moment. But then I decided that I also needed to give myself a chance to rest and adjust to this new schedule, etc. After my nap I headed up to the roof (where I remained despite my fear of blowing away!) to journal and look through my book on South Africa. I decided if I am going to be adventurous while I’m here, it was time to start planning my adventures. I found some things around here that I feel like will be safe to check out on my own, so I’m making a list of things to do in my free time. Unfortunately a lot of things close down by 5 and we don’t get off work until 3 or 4, but on those days I get off early, I’ll now have things to accomplish…and there’s always the weekends, but those seem to be filling up fast. Anyway, while up there I was just thinking about how nice it would be just to have one good friend here that wanted to explore the city – then we could tackle it together and go and do whatever we wanted. I came at a funny time in that many people already have an established friend set or have seen the things they want to around here. Many of the interns are pretty young and interested in exploring different things than I am. Don’t get me wrong though – I’m aware I’ve only been here 3 days and have been so blessed by friends in that time (especially Caroline the other CL girl), so I’m not complaining – I’m just excited for that time to have a travel companion. ☺ (Are you reading this Jamie?! No pressure!) I’m also not making this my final statement – I still have yet to give this whole Connect thing a chance – starting with this trip Saturday. We’ll see what happens. This is just a momentary bump in my first week adjustment.

Aside from that…today was a great day! Thursdays are “Theatre” days on the burn unit – aka surgery days. The doctors and sisters are amazing at this hospital. They are totally open to us being part of any process. During theatre days we accompany the patients to the OR and stay with them until they receive their anesthesia. Even better than that – the parents are allowed to be with the kids in the OR until they fall asleep! I know – my CL friends are amazed right now. ☺ Following surgery, we stay with the kids while they wake up in recovery and then accompany them back to their rooms. It’s awesome. I was with one of the kids I’ve been working with when he went back to theatre. His mom wasn’t able to be with him, so I held his hand while he fell asleep. The doctors all thanked me as left. How awesome to be working in this environment!

I have found that there doesn’t seem to be any territorialism as far as we’re concerned in the areas we’ve been working. Everyone is open and inviting to our services and seeing how we can all work together to make things better for everyone. How great!

I did meet a really nice nurse when I was waiting with a child in recovery. She was amazed that I had to fund the whole trip by myself. She didn’t know why the hospital (especially one in the US) wouldn’t have at least paid for my ticket for an opportunity like this. She said that her hospital had funds set aside to assist staff in such volunteer endeavors. She said the US has so many more resources; she couldn’t believe that I didn’t have help. Don’t worry- I told her that I had wonderful friends, family and coworkers that helped me raise most of the funds I needed to travel her. I told her that I sold cookbooks to raise the money. She thought that was pretty funny. This led to a discussion about people who have more don’t always give more. That got me thinking about my own giving. This whole experience has caused a desire in me to be more giving to others. It has meant so much to have people walk up and hand me a check for my trip (no matter how large or small). It is so humbling and creates in me a desire to provide that love and joy to someone else. When I get home, my budget (that I promise to make!) will now include specific funds for random needs I see in others.

Speaking of giving – I received the best e.mail from a friend today. My friend Bethany told me that she was contributing to my trip by contributing to a world hunger crisis fundraiser. She mentioned that she was pretending the child she was helping was in South Africa – thus the connection to me. ☺ I didn’t ask Bethany if I could do this (so I hope that’s okay b.lar – I don’t know why I just called you that!). Here’s part of what she said,

“Anyway, it's something that I've never done before, to give a substantial amount, but I was just thinking about how quickly we spend money on shopping, or movies etc. So I decided to just not think twice about it and give. I learned that there are over 900 million people, 300 million being children in the world who are starving and that someone dies of starvation every 7 seconds. That number is just too big to comprehend, but then John & Sherry were talking about those people, even though we don't know them, will be our "neighbors" in heaven. I thought that was such a unique way to think about it, we don't have to know the person to do our part to help.”

I was so proud of her I cried. There are so many ways to help out this world, from traveling to South Africa, to making financial contributions to good organizations, or finding people in your own community who just need a helping hand. It’s about loving others – that’s what this whole trip is about. Realizing that God IS love. Where love is – God is. Where God is – Love is. If we don’t have love – we don’t have God. It’s so simple, yet so difficult for us. So my inspiration note for this entry- Go right now and find a way to show God’s love. I promise you’ll feel it 10 times in return! I love you all!

Range of Emotions

2009-03-11T15:43:00.000-05:00

This may be short tonight. It’s late and I had an exhausting day. I apologize because I usually journal earlier in the night and then blog right before I go to bed. I’m doing both because there are things I want to record that I don’t really want the world to read, but I also want to be sure to share with those who are interested. So by the second time writing things down tonight, it may sound a little stale. ☺

Tonight I had supper with my roommates, Sabrina and Elizabeth, Mwaka from down the hall, and Sabrina’s boyfriend. Part of the night was spent trying to learn the different clicking sounds of Xhosa- one of the local languages. I’m horrible at it, fyi. But now it’s died down and I have a few minutes before I pass out to catch you up on a very busy day.

Wednesdays at work are Ward Rounds…which means that all the children (we have about 24 right now) have their bandages removed, are wrapped in saran wrap, draped in sterile towels and returned to their beds until the “Prof” (the head doctor) and his students pass through to look at everyone. After this, the kids are returned to the treatment room to be washed, debrided and re-bandaged. There are also a number of outpatient kids present who go through this same regimen. We started before 8 and I walked out the last treatment was done at 4.

There were some rough moments today… It’s difficult because there are so many cultural differences that clash with the principals of Child Life and I am having a difficult time resolving those in a respectful way while advocating for the emotional needs of the children I work with. Especially among the boys, there is an expectation for them not to cry or cry out. These boys, and actually most children in general are reprimanded when they show negative emotion during their treatments. As you may guess – burn treatments are very painful and these kids are much less sedated than what I’m used to on my unit at home, so crying out is very understandable. As a Child Life Specialist, my job is to create a supportive environment for kids to express emotions in a safe way. It has been a challenge to give a child permission to cry when he is being threatened for expressing that emotion. I want to be culturally sensitive, but I also don’t want these kids to have to live in fear of their medical treatment, or have to bottle up the emotions that naturally occur with pain. The pain management doctor made a good point the other day when she said a way to be culturally sensitive is to allow children to know that while in their society those emotions are not expressed – while that child is in a safe therapeutic space with a CLS or other psychosocial team member – they are free to experience and express emotion as they will. That totally makes sense, but I’m still finding it hard to communicate that same idea with the sisters at the hospital. I don’t want to swoop in and make them feel like they are wrong – but at the same time I can’t stand to watch the children so fearful. Any suggestions are much appreciated. ☺ I will say that by the end of the day, one of the nurses had softened her approach in my eyes, so perhaps patient persistence and modeling will have some effect.

My friend Caroline gave me a journal for my trip and periodically wrote in it, so that I would find her notes as I was writing. The one for today said – “Do not tell the man who is carrying you that he stinks.” –Sierra Leone proverb.

I did learn a game from one of the girls I was working with today. It’s called OMO. It’s like tic tac toe, but you use O’s and M’s and the grid is much bigger. The first person to make the word OMO wins. You continue on the same grid until all the boxes are filled…just in case someone was looking for a new activity during church (just kidding – pay attention!).

After work I fulfilled my goal of a new activity a day and went to the bookstore on the corner to look for some children’s books. It was about to close, so I just walked in looked at a couple books and walked out. So, tomorrow I will go back…and maybe I will go out to eat somewhere- even if it is by myself. ☺

So – recap of the day and the range of emotions I mentioned at the beginning of the entry. I started the beginning of my day thinking – I love this! I think I will live in South Africa forever and continue in this role. To… What am I doing here? There are people who could do much better than me. To…What’s my next adventure, this is my new life! ☺ So…we’ll see how we end this adventure feeling.

I’ll end with my inspirational thought of the day. The inscription at the beginning of my journal entry today said…

“You are the salt of the earth….You are the light of the world.” Matthew 5:13-14

When I read that I felt quite overwhelmed by the responsibility that seems to accompany that. But I was reading in “Whosoever Repenteth” this evening and realized making this journey about me and my ability is sin. It’s about God and His ability to work through me as I align my life with Him. As I do that – he will be able to use me for a work much greater than me. The purpose is not for me to be successful, but for His work to be done in His way.

I just wanted to thank all of you who continually send me words of encouragement. They are much appreciated. I wish I could write you each back individually, but time is limited…and I imagine as I become more engulfed by my experience, my time to write will feel even more limited. But please know how much I love and appreciate each of you!

Initial Ramblings

2009-03-10T14:59:00.000-05:00

I’ve written and re-written the introduction to this entry. I’m having a difficult time conveying the experiences and the responses those created in me today, perhaps because I have yet to sort through them myself. This trip has yet to feel real to me…I’m not sure it ever will. Despite my weakness in communicating the events of my day, I hope you feel a piece of what I felt.

Here is my disclaimer to this entry: In no way are these words written in judgment, but in love for those doing the best they can with the resources they are given.

This day has made me realize what a blessed and greedy people we have become in the United States. I was speaking to my roommate tonight. She is from Zimbabwe and was asking me about the economic crisis we are currently experiencing in the United States. She asked me how it compared to the way people lived here. We had to laugh, because there can be no comparison between the crisis we currently face and the every day lives of many of the people of South Africa (not all obviously - especially not in Cape Town). I am in no way belittling the hardships and struggles experienced by those that have lost jobs in the US, but have been given a new perspective on my life. So often when we talk about the economy, the government, etc and we create a sense of panic. Many like to discuss “conspiracy theory” and evoke mistrust and fear. But aren’t we called to be a people who speak love and hope to the world – not fear and mistrust? Aren’t we – even in the most fearful of times – to look up and rejoice, trusting in the one who is bigger than our trials and hardships? And…how did I get off on this tangent? Back to my day…

This morning I started my day by going down to pay for my electricity. I was given a number that my roommate typed into a box on our wall, prolonging our ability to see at night a little longer. I tell you what – you conserve energy a LOT more when you watch it tick away in front of you every day. Warning to the roommates at home… ☺

Then I joined Caroline and Taylor and headed out for my first day on the job. Caroline is the one heading up this project. She is currently finishing her Master’s Degree at Wheelock. She’s completed all her internships and is a Certified Child Life Specialist. Taylor is completing her undergraduate degree and will be doing an internship in Toronto this summer.

We arrived at the hospital and walked through the metal detector…which beeps for everyone, but no one gets stopped. ☺ The hospital is interesting because there are some new, beautiful wings, like the “theatre” (OR) located just above the older areas of the hospital. The newer areas are the ones I saw when I looked at the website. The older areas are what I imagined I would be working in. The burn unit is one of these older areas. I don’t know what era to compare it to in US hospitals, but kids stay in bays of about 6 kids. There are a couple isolation rooms. The burn unit is very hot – not because the temperatures are regulated like at home, but because the windows are closed to aid in infection control and Cape Town is very hot right now. There is one small room where windows are opened to allow a little breeze. There is a very small room designated for Music and Art Therapy and supervised play, but we haven’t really used it yet. There is also a room for PT/OT. I’m not doing it justice. You’ll have to see the pictures. It reminds me very much of what you all probably pictured I would be doing.

Caroline toured me around the unit including the treatment room. She introduced me to some staff she knew. There are nurses and sisters. Sisters are nurses who have been at the hospital for some time and have more respect/ responsibility. We call everyone sister because it would be seen as disrespectful to call someone a nurse if they are a sister. Then she took me to the pain management team meeting so I could meet some of the other staff – including the lead doctor, social workers, art therapist, etc. This team is amazing! They have a very clear and accurate view of Child Life. There is so much respect given for our profession. It’s very refreshing.

After the meeting we returned to work. I only interacted with one boy today, as I really just wanted to observe, but that one interaction was so simple, yet so powerful. A little boy was lying all alone in his bed (similar to a stretcher with crib rails). I went in to say hi and he did not respond. I asked if he spoke English and he still did not respond. So, I got out my bubbles and began to play. Play IS a universal language. He began interacting right away – popping bubbles with his feet and blowing them when I would hold the wand to his lips. I noticed he was not willing to move his burned arm or hand. I handed him a glitter wand to hold in his burned hand. He held it but quickly reached for it with his unburned hand and began to play. I asked if the other girl in the room was his sister. He said yes and began speaking to me more. I couldn’t tell if he was speaking Afrikaans or if I was just having a hard time understanding, but I encouraged him in his communications. I reached down and stroked the nonburned fingers of his burned hands. He flinched and pulled away. I reached down again and held on to that hand. At first I think he wasn’t quite sure what to do, but soon he continued with his play. When it was time for me leave, I went to pull my hand away, but he was holding it tightly. I tried again and he pulled it back. I assured I would be back to play again and waved as I walked out the door. He waved back at me. He did not smile during this interaction, but he played and he engaged. It was awesome! I can’t wait to go back tomorrow and continue progress. There is so much to be done here!

I’m realizing this is a super long entry, but I had to add a testimony for all who have been praying for the various needs I’ve had in this journey. Originally I was supposed to be in another apartment, but at the last minute I was changed to the apartment I am currently in. One of my roommates I am living with is named Elizabeth and is an intern from Zimbabwe. She is so sweet and wonderful. I couldn’t imagine a better roommate. Tonight we were talking and I asked if she went to church around here. She said yes – that she goes to Hillsong (the very church I was hoping to visit while I’m here!). I asked if I could come along and she said of course! I was so anxious coming here that I would find a friend willing to go to church with me and my prayers have been answered so abundantly! Praise God!!

My other update…there’s a Connect event I wanted to go to this weekend, but no one I know wants to go, so I signed up to go by myself. Those who don’t know me will probably think that’s no big deal – but those who do are probably still lying on the floor in shock. ☺ I’m telling you…you won’t recognize this girl when I get home.

p.s I’m sweaty and needing to go to bed, so I’m not reading this before I publish it, so please forgive me if there are mistakes or if I said anything wrong.

p.p.s. I'm trying to learn some of the Afrikaans and Xhosa. The Xhosa is much more difficult for me because I can't do the clicking part.

And so it begins...

2009-03-09T06:01:00.002-05:00

The good news… I’ve finally arrived in Cape Town and started up my blog, so that you can all enjoy this journey with me!

The bad news… My cable that connects my computer to my camera will not be accompanying me on this journey and therefore, pictures will be temporarily unavailable. I will be have to be super descriptive in my blogging and you all will need to be very creative in your imagining…It might be a good practice in guided imagery for us all (that’s for you child life friends). Perhaps we should start with the view of Table Mountain which I woke up to outside my bedroom window this morning. You don’t even have to use your imagination…just google it and you’ll see what I saw!

My travels thus far have been graciously uneventful. Mom, Dad, Nana and Bethany sent me off from the airport. They were all weepy, but I held back my tears…well, at least until I was on the other side of the glass divider thing. Then a few snuck out. The real ones came when I was sitting on the plane getting ready to fly off. I was trying to decide where they were coming from…I’m pretty sure I wasn’t afraid or even anxious at that point (maybe 10%). But the majority of them came from the overwhelming love I have felt from the moment I decided to go on the adventure. Love from friends, family, and coworkers that in return caused a deeper love in me for them. It has been such a blessing to feel so supported. Thanks to everyone for the parties, the prayers, the support, and the love.

The planes all ran on time, the leg room was bearable (although the poor couple who sat on the outside of me on our 11 hour leg of the journey probably wished I would have had the aisle), and the food was never ceasing – they feed you like every 4 hours! I never quite felt like James Bond or an international spy maneuvering my way through international airports (the way one friend said I would) but it is pretty empowering to travel around the world by yourself. I guess I shouldn’t say by myself, because I did feel His peaceful spirit with me the whole way. I never felt alone or afraid.

When I got to Cape Town, my driver was waiting to pick me up. He told me all out drag racing through Cape Towns streets, taught me some familiar Afrikaans phrases, and gave me some advice – like grab on to a pole when the wind blows through Cape Town so you don’t get blown away! He told all about the club scene available. I told him I wasn’t a clubber. He told me I could dance. I told him I couldn’t really dance. So his final advice to me was to, “Find a black man, he will show you around and you will leave Cape Town knowing how to dance.” I wondered if he’d been talking to Caroline…

This morning I met with the Gabby from Connect 1-2-3 for orientation to the city from the apartment city. I can’t wait to get out and explore, but was warned I should get to know the city a little better before doing that on my own. I may wonder down to the book shop she told me about, though. Hopefully this evening I will meet with other Child Life girls here for the program. Tomorrow I begin work at the Red Cross War Memorial Children’s Hospital.

Well, the battery on my computer is running low, and I need to get a converter (sorry Caroline – I think the one I needed was the one you didn’t have in there, but at least I lugged that heavy box half way across the world!). So I’m signing off for now.

Love you all!