4.day weekend

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

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

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

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

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

“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!

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!