Wednesday, October 28, 2009


Zitsile (the church secretary and my "Swazi daughter") and I stopped by the hospital this evening to see how Nonjabulo is doing.  I am so thankful to be able to report that Nonjabulo is doing better.  On Tuesday they took her off the oxygen, her fever was gone and her mom reported that she was drinking and eating without crying at every bite.  This afternoon, she had the oxygen back on and her chart said her afternoon temperature was 100, but her eyes were big and bright and she wasn't missing a thing that was going on in the room.  She held my finger with a good grip and she "played" with the little toy that Deb bought her. Played is probably an exaggeration, but she did reach for the toy, hold it and try to put it in her mouth.  So, overall, she is doing much better.  Still no smiles and she doesn't have much strength, but I feel so encouraged that this will come.

Zitsile had never been to the children's ward at the hospital.  She didn't like it.  One reason is that hospitals bring back the memory of her sister's last days and watching the woman in the bed next to her sister die.  She couldn't believe the conditions.  She asked where the mothers sleep.  I told her on the floor, under the crib.  She was shocked.  She talked to the mothers of the other children so I got the scoop on them.  They all have TB.  (I'm not sure Zitsile figured that one out.)  One little one about 2 has a huge sore on his head where they normally put an IV on small children.  The mother said the nurses did something wrong with the IV and caused the sore.  A second little one also about 2 was dropped by a care giver when he was 4 months old.  They did a brain scan soon after the fall and said there wasn't damage.  However, he can't sit up.  He has been in the hospital for a month and he has also been waiting for about that long to get a referral to the Mbabane government hospital to see why he cannot sit up.  I'm guessing he has some brain damage because he is obviously developmentally delayed.  The third child is a boy of 12 years old.  He is extremely sick.  I'm sure he is HIV+ in addition to having TB, but there is probably more going on.  He is nothing more than a skeleton.  Literally.  Think of the most severe case of anorexia that you have ever seen and then take more weight off.  I've had a hard time talking to him and looking at him, but I try to wave and talk to the kids equally, but down deep I know that I can't face the physical sign of his illness.  I am so amazed that the child is alive, but he did seem to be a bit better today than he has been.  He sat up for a while and ate a little.

I sat there and a part of me wished I could take pictures to show you, but the other part of me, the part that always wins out, just can't do that because I feel it would be too much of an invasion of their privacy.  Maybe one day they'll develop a device that can print the pictures in one's mind.

Please continue to keep these children, and many more like them, in your prayers.

Sunday, October 25, 2009

Update on Nonjabulo

Yesterday, (Saturday) I took Thini, Thoko, Gladys and two other circuit stewards to visit Nonjabulo.  When we arrived, There were several people in the room and a woman was holding Nonjabulo praying over her.  Nonjabulo was completely still.  My instant thought was that she had lost the battle.  The woman was praying mostly in SiSwati.  Her prayers reminded me of a typical TV Evangleist.  After she prayed for Nonjabulo, she handed her back to her mom, and then started praying for the next child in the room.  When she handed Nonjabulo back I could see that her eyes were open.  She actually looked at me and at Thini and the best part was she lifted her little hand up towards Thini's face as Thini was leaning over her kissing her and talking to her.  She was still very weak, but that was more than she has done since being admitted.  We all prayed over her again, and then I left because the room is so small there really wasn't room for us.

After church this morning, I stopped by the hospital on my way home.  Nonjabulo was sleeping peacefully.  Her fever was gone.  She did open her eyes and wake up for a little bit.  She looked at me with her big bright eyes.  Then she reached out for my hand and actually gripped my finger.  Not real strong, but once again that was more than she has done since being admitted this time.  Her mom fed her a little bit.  She has some cereal thinned with formula and she gives a little bit to Nonjabulo whenever she can.  After she ate I asked if I could hold her.  I held her and rocked her for a few minutes and then gave her back to her mom.  Her mom and I both agreed that a big "Praise God" was in order. 

Her little mom must be so exhausted.  But she is so dedicated and always sounds hopeful.  I thought back to when my oldest son Christopher was about 2 1/2 and was hospitalized with meningitis for a few days.  I remember how hard it was and we didn't have near the severe conditions that they have in this hospital.  I had a comfortable chair that reclined, decent hospital food, air conditioning and heating and Doctors and nurses who actually kept me up to speed on what was going on.  Nonhlanhlana has to sleep on the hard floor or sit in a hard chair with the back broken out of it.  The nurses come in and don't say a word.  I so admire the women in this country for all they endure.

Praise be to God for Nonjabulo's improvement.  Please continue to pray because she has a long way to go to be considered even slightly healthy.  Usually after about 3 months, the ARVs have done their work and the health of the person stabilizes.  And it generally takes about 3 to 4 months of treatment for the TB to clear up.  Unfortunately, because we are dealing with both scenarios at the same time, the body has to fight harder and it may take longer.  We will continue to pray for the best.

Saturday, October 24, 2009

Please pray for Nonjabulo

I spent last evening at the hospital with Thini, Nonhlanhla and baby Nonjabulo.  The Dr. put her on oxygen in the afternoon.  I had stopped by her room, briefly around noon.  She was sleeping, but very congested.  The mom said she was doing "a little bit better."  I wasn't sure I agreed with her but said nothing.  Then around 3:00 I got a text message from Thini that they had put her on oxygen and she asked me to come.  She is a very sick little girl.  The oxygen is helping her breathe better, but her breathing is very shallow and quick.  She doesn't like to be moved and periodically she either has coughing spells or she is trying to cry.  I can't really tell which it is, but she sounds awful week.  She does fight when they try to give her some hydration fluid by mouth or when they try to feed her.  She won't nurse.  She is a petty good fighter, but the fight wears her out and then she drops back into sleep for a while.  She did open her eyes for about ten minutes and just looked at Thini and then me.  Thini waved a little toy Deb bought her in front of her face and she would look at it but didn't attempt to try and touch it.

It appears as if her fever has come down although it felt like she might be getting a small one back in the evening.  It is so frustrating not to be able to get any information from anyone.  The nurses don't want to speak to anyone and visitors aren't allowed when the Dr. visits.  The only way I could speak to the Dr. is IF I happened to in the room when he arrived, which is very unlikely.  They lock the doors to the ward when it isn't visiting hours.

So I have to exercise extreme patience and faith.  Please pray for little Nonjabulo to recover.  Her body is so little to be having to fight so hard, but she is trying.  And please pray for her mom, Nonhlanhla who is with her night and day, sitting on a hard chair without a back and sleeping on the floor under the crib.  There are 4 patients in that room, and all the mothers have to sleep on the floor under the small crib because there is not room for them to sleep any other place.  Please pray for them as well.  And please pray for Thini.  She is so worried and "just doesn't know what to do."  I can't help her other than to pray because I don't know how to help Nonjabulo either.

Thursday, October 22, 2009

Another new baby!

Tuesday, while Thoko and I were driving to Lutfotja she told me that her oldest granddaughter, Zwakele who is 19 years old, was pregnant and due this month. She is not married and after telling her that she was pregnant, she kind of isolated herself from the family. Zwakele works in the restaurant of one of the bigger hotels in Swaziland. Thoko says she really likes it and had a dream of perhaps going into the catering business. Like any mom or grandmother she was disappointed because she had hoped that her granddaughter would be able to achieve that dream. She was also concerned because she was so young and didn't realize how hard and expensive it is to raise a baby.

This morning I sent her a text message to ask what the plans were for today. She called me and told me her day yesterday got all mixed up because they had rushed her granddaughter to the hospital and she delivered the baby. So Thoko is a great grandmother! Meet Sibonelo. He is less than 24-hours old in this picture. Hopefully before too long I'll be able to get a picture of him when he isn't crying! As my mom would say, at least we know he has a healthy set of lungs.

While at the hospital, I went to see how Nonjabulo is doing. Her mom was holding her and she was sleeping. You could tell she still didn't feel well because whenever her mom tried to move her she would cry. But as long as mom was holding her upright, she was able to sleep. Please continue to pray for this little one. She is a very sick baby and the survival rate of a baby that is HIV+ and has TB is not very good. But we have faith that with all of the prayers going up for this sweet baby girl and with all of the love around her, she will get better.

Tuesday, October 20, 2009

The Lord is my strength

I woke up this morning to the most beautiful blue sky and sunshine. After several days of cloudy, wet weather, the morning seemed even more beautiful. The sun was warm, but the air still had a touch of coolness in it. The hills have suddenly turned green. They are the type of green that almost hurts your eyes because it is so rich. The leaves on the trees and plants by the side of the road were still green after having the layers and layers of red dust washed off them by the rain. Our plan of the day was for Thoko and I to go to Lutfotja to get information on all of the kids that are part of Lutsandvo Lwa Krestu and check on the Nhlengethwa kids. We thought it wouldn't take long.

While at Lutfotja we were given information on 10 additional children that are all "sick and taking the tablets" (HIV+ taking medication). Most of them were in grade 1. We also learned more about a child-headed household of 8 children. In reality, they are two families sharing the same homestead. The mothers of the children were sisters. The fathers of the children are "late" (deceased). Before the mothers death they told the children to stay together to help each other out. The oldest child is 16, and the next oldest is 15. Then the ages go down as follows: 13, 11, 10, two are 8, and 7. None of these children appear to have health issues but are very vulnerable meaning they have no means by which to feed or support themselves. My mind started going into "understanding mode." At one point I kept asking questions such as why this, why that, I don't understand, didn't you say blah, blah, blah. Then I reminded myself that I had to stop trying to figure it out, trust God and take things one step at a time. Today has it's own troubles. I stopped asking the questions.

On our way out of the head teacher's office we saw several of the kids that we support under Lutsandvo Lwa Krestu. I counted 6 girls that are in serious need of a new uniform. I didn't bother counting the boys or those that need new shoes. I said to Thoko that I don't know how we are going to do it, but I would like these children to get new uniforms as part of the Christmas parcels we will be giving each family just before Christmas. (Unfortunately, I won't be around for the delivering of the parcels because I will be in the States.)

From Lutfotja we went to check on one our of kids (Ncamiso) who was not at school. He is a double orphan and lives with his gogo and an older sister. He is HIV+ and on medication but he has been very sick for over six months. He was getting his monthly ART medication at one of the rural clinics. They gave him the wrong dose several months ago. Evidently they gave him adult medication because they were out of the children's strength. I don't really know if that is true or not, but that is the story we've heard several times. We've been trying to get him healthy again ever since that event. The gogo had gotten a message to Thoko that one of the new medications that had been given to him required that it be taken with milk. So I bought some powdered milk to take to him. I couldn't buy regular milk because they don't have electricity so there would be no way to keep the milk cold. The gogo told us the Dr's suspect that he has TB again.

From Ncamiso's house we went to the High School where Mthokozisi Nhlengethwa goes to school. We wanted to see if they gave a spot in the high school to his sister, Nozipho who will be entering form 1 (8th grade) at the start of the new school year in January. They had given her a spot. A fee of 20 rand had to be paid by the end of November to hold her spot. The vice principal who is in charge of admissions, is a very caring woman. She went to check with the principal to see if I could pay the fee early. (They didn't have the formal receipts ready yet.) She came and said that since it was me, they would accept my payment early.
Thoko and I were so happy, but we also felt honored that the principal and vice principal are so willing to partner with us to take care of these children. (Thank you, Lord.)

From the High School we took the two youngest Nhlengethwa girls home because I had some groceries for them. Our local CCS person told me on Friday that they were out of food except for mealie meal. The grandparents were not home. They left last Friday to go to a funeral for a relative and hadn't returned yet. I so amazes me how children are left unattended I'm not sure I can ever get used to that part of this culture.

While we were at the Nhlengethwa's house I got a text message from Thini telling me that Nonjabulo was admitted to the hospital again today. Thoko and I went by the hospital to see how she is doing. Her weight has dropped back down to 4.6kgs. I noticed she was more congested than she has been. I don't know if it is the TB flaring up or if she has contracted a cold on top of everything else. She is back in a TB room with 4 other children with TB. All I could do was stand there and pray for the children as Thoko and Thini talked in Siswati about the baby.

I got home about 7:30 pm. It was a very long day. It started with God's amazing beauty, and then the needs became overwhelming, but we held to the fact that we are not alone in this. We have caring teachers and principals who care about these children and look out for them, we have the Lutsandvo Lwa Krestu committee and most of all, we know that God is always with us. He will guide us and He will carry us when we can't go on. He was certainly carrying me for awhile this afternoon when it all got too overwhelming and the burden too heavy. And for that, I will be eternally grateful.

Please pray for our little Nonjabulo and all of the other sick children who are struggling so to survive.

Monday, October 19, 2009

Good news about Lomngeletjane!

Things are moving along with the teacher’s house at Lomngeletjane. The inside walls are all plastered and we now have a dropped ceiling and doors! Yeabo! We’re still wrestling with the plumber who didn’t finish his work which is now going to delay us, but we’ve had a lot of progress in the last couple of weeks. Tomorrow a glass guy is going to come and put glass in all of the windows.

Work on the septic tank is also underway. The hole that was dug was three times as wide as it needed to be. So John will have to fill that hole back in and tamp down the dirt so it will be firm and support the walls. He will also have to dig the pit for the French drain, but I’m pleased with the recent progress.

The best news is that the head teacher talked to the Minister of Education regarding a garden for the school. Not a 6th grade garden which is a requirement, but a school garden to feed to the children in an attempt to improve their nutrition status. The Minister of education referred her to the Agriculture Inspector for the schools and he gave the school several buckets, watering cans, gardening implements, etc. He is also going to give them some fencing. Even though the school is fenced, he says the garden should also be fenced to keep those who shouldn’t be in the garden out. (Whatever. As long as he’s donating the fencing I will most definitely agree with him!) I was talking with the head teacher about the severe malnutrition of so many of the kids in this area. We agreed that we have to put our heads together to come up with a plan. The children are getting soft porridge in the morning for breakfast and then mealie meal with maybe a few beans or black-eyed peas for lunch, but that isn’t adequate. The porridge and mealie meal are both just maize (a dense form of corn). Their diet is severely lacking in protein and vegetables. The head teacher was saying they would probably wait to start the school garden until January after the school break because if they planted before the break there wouldn’t be anyone to water it if it didn’t rain enough. In addition, the vegetables would be ripe during the holidays. The Holy Spirit kinda thumped me on the head to get my brain working and so I suggested to her that we make a deal with a few of the families that are part of our Lutsandvo Lwa Krestu program and ask them to tend to the vegetable garden during the school break and in return they could take the vegetable that ripened during the holidays home and plant more seeds in their place so the vegetables would be ready when school starts up again the third week in January. She thought that was a great idea! Yeabo!

The scripture from my devotional today was from Matthew 6:25 – 34 - the “thou shall not worry” scripture. The focus verse was 34: “Do not worry about tomorrow, for tomorrow will bring worries of its own. Today's trouble is enough for today.” That really hit pierced my heart this morning. Now I know why. God gives us the gift of time; of today. He also gave us the freedom to choose how we use this gift. I can keep worrying about things I can’t do much about or I can have faith that God will lead us to do the most with what we have. I thank God for that gift.

Sunday, October 18, 2009

Friday night in the ER

Friday evening I got a call about 6:30 from Thini saying Nonjabulo was very sick and weak. So I went to pick up Thini, Nonjabulo and Nonnhlanhla (the mom) and take them to the emergency clinic at RFM (the hospital in Manzini.) Nonjabulo was very hot and very, very lethargic. She looked like she was barely breathing. Thini wrapped a real thick, heavy blanket around Nonjabulo before she got the car. Unlike in the States, they keep babies wrapped in these real thick heavy blankets no matter how warm it is outside. Friday night was very hot and muggy. I told her to not put the blanket around the baby because her fever was too high. I was amazed she immediately took the blanket off of the baby. (The baby still had on the long sleeve footed one piece terry cloth sleeper and a light receiving blanket around her.) We got to RFM about 7:30. Nonhlanhla took the baby to get in the que to see the Doctor and Thini and I went to get in the que to pay and get her chart. They couldn’t find her chart because the accounting office had it, so finally they made her up a temporary chart. Because the baby has TB, there was no fee for the visit.

It was some after 8:30 before a Doctor showed up. Thini and I had to wait outside because they would only allow the mom into the emergency room with the baby. Waiting brought back so many memories of taking my Christopher to emergency when he was a baby. He would get ear infections and spike a high temperature and of course it was always at night. I thought of how scared Nonhlanhla must be for her child and how blessed we were that my mom could come into the treatment room with Christopher and I. I thought of one particular time when they rushed us into a treatment room because Christopher’s temperature was so high. And they had us take off his clothes and continually sponge him down with cool water until the Doctor could check him. Christopher hated that and so did I but knew it was the right thing to do. I knew nothing like that was happening inside the emergency treatment room here. It drove me crazy to not be able to go in and ask the Doctor all kinds of questions and tell him everything I knew about the baby. I was especially worried because she didn’t have the chart that gave the history of illnesses and treatment that this little baby has been through in her brief little life. This was one of those times I had to just pray for patience and that the Lord would give the Doctor wisdom in treating this baby. About 10:30 they came out. I was surprised the Doctor didn’t admit her. Nonhlanhla didn’t know the diagnosis, only that they were supposed to get the medications prescribed filled and bring her back on Tuesday for a check up. I tried to glance at the medications, but couldn’t read what was written. I would have had to ask the pharmacist but instead I had to run and get the car because a thunderstorm had rolled through it was raining.

It is now Sunday morning. Thini says the baby is doing much better, but still not eating a lot. I don’t know how much she is drinking. So just when we got her weight up so she could come home from the hospital Thursday afternoon, she got sick on Friday afternoon and she has probably lost at least some of that precious weight gain.

Oh Lord, PLEASE heal this tiny, precious child of yours. Amen

The emergency room on a Friday night was much like what we would expect in our emergency rooms on a Friday or Saturday night except the basic facilities and resources are much, much worse. There was a group of people who had had too much to drink and were fighting with each other. Mainly one main was trying to go after two young women who had something to do with his friend who was lying on the floor while they waited to get the chart and pay the fee. A security guard finally came in. Security guards are usually pretty small people and they don’t carry weapons. I’m not exactly sure what anyone thought he would do but I guess at least his presence calmed things down a it. I told Thini that we had security guards or policemen in our emergency rooms as well, but ours carry phones and weapons including guns to back up their authority.

Here, when you wait in line to get your chart or see the Doctor, you sit on a bench at the “end of the que.” Every time someone is helped and leaves, the entire que stands up and moves up one position. It’s really kind of comical. I want to ask them if they have ever heard of giving people numbers, but I know that wouldn’t help. In Pediatrics, during the day, the patients first wait in the line to get their chart and then they go wait in another room for the child’s vitals to be taken and then they are given a number to go see the Doctor. The nurse at the Doctor’s door comes out and takes a half a dozen or so numbers out of the people’s hand at one time. She doesn’t take their name or keep the charts in any order so I’m not real sure what good the numbers are.

The waiting area for emergency is outside in the courtyards surrounding the emergency room. The emergency room is just a big room maybe about 1200 – 1400 square feet with a few beds sectioned off with curtains. Babies are kept in one section with as many babies sharing one bed as can fit on it. There are usually at least two or three babies on one bed. If the babies are smaller, there are more. The moms stand by them and move out of the way when the Doctor comes. If they are severely malnourished an IV will be started right there. They don’t group them by illness and there is no privacy. The nurses and Doctors try their best to be sterile, but there is no way they can keep up sterile conditions with all the people who come through there and the small cramped quarters. There isn’t air conditioning, so you can imagine how hot, stuffy and smelly it can get.

The US may have a lot of problems with medical care, and certainly not all clinics and hospitals are at the same level, but we have so much to be thankful for. Things could be much, much worse.

I mentioned earlier that there is no charge for treatment if the person has TB. That is because TB is so rampant in Swaziland. It is one of the more common opportunistic diseases as a result of HIV/AIDS. It also spreads very quickly because transmission is airborne. In an attempt to contain the spread of TB and to lesson the treatment time, they have made medical care free for TB patients. That is great. However, the cost of transport to get to the Doctor is still a huge issue. Most people, especially in the rural areas can’t afford the transport fee. And if they can, they crowd onto a bus or kombie (a van that is like a mini-bus making more frequent stops) thereby exposing everyone that is sitting around them to TB. Doctor visits and treatment for those who are HIV+ is also free. But the same issue of transport is still there. And then we have the issue of malnutrition which is huge in this country, not necessarily because of the lack of food, but because many live on a diet rich in maize (corn) and very low in protein, dairy products and vitamins from vegetables. It’s a complex problem with a complex solution. Conditions aren’t going to change any time soon. It will take years, if not generations, for changes of the magnitude that is needed to happen. But we can’t give up hope and our faith in the Lord to guide us day after day, and to help one person or child at a time.

Tuesday, October 13, 2009

A God-filled Day

I went to bed early last night (8:30) because I was ready for the day to end. I slept well and woke up renewed and refreshed. I took it easy this morning, drinking a couple of cups of (decaf) coffee while I read my chapter for tomorrow's bible study and then answered some e-mails. (If you have sent me an e-mail and I haven't responded, please know that I loved hearing from you, I just sometimes don't get around to answering the e-mails in a timely fashion.) Then about 11:00 John called me asking when I was going to bring up the plans for the septic tank and I realized I had to get in gear. The rest of the day went at warp speed.

First I had to "draw" up the plans for the septic tank and french drain for the teacher's house based on a conversation we had with the health inspector a couple of weeks ago. Who would have guessed that one day I would be sitting in the southern part of Africa making a technical drawing for a builder to make a septic tank? I certainly wouldn't have guessed that and I can assure you neither did my Junior High or High School teachers!

Before taking the drawing up to John I went by the hospital/clinic to give Thembie some money for Dr fees and lunch. Today she was there with a 14 year old girl who was raped a year ago. The girl hadn't been to a Dr. because of the lack of money. So we were bringing her to have a HIV test and also to get medication for a possible STD. Sipho's mom is the girl's step-mom so of course she had to be there again today. She was so excited to tell me and show me that Sipho's mouth was clear of sores! It was truly a miracle. We all rejoiced and thanked God. I am not kidding. I've seen some amazing things, but this is an absolute miracle. All the prayers that have covered this baby have been answered. He looked like a completely different baby today. The nurses in the clinic couldn't get over the difference.

Thembie also brought another girl that is 11 years old. She is one of 15 grandchildren living with the grandmother because their parents have died from HIV. The girl was being brought because of her "big stomach" but we were also hoping they would test her. When I arrived, they were both waiting to see the Dr. The first girl had been tested for HIV and Praise the Lord, she was negative! The second girl had seen the Dr. and he had sent her for a scan and x-ray of the abdomen and chest. I gave money to Thembie for the x-rays (almost $8.00) and then I bought some lunch for the 5 of them (another $8.00) and then I had to leave to get the drawing up to John at Lomngeletjane.

I took the drawing to John and then went to check on the twins. Several people had told me that one of the twins was sick. My little welcome committee, the twins' cousin Musa, ran out to greet me. The twins were doing fine. Tiphelele's sister, Tiphotakhe is now walking. Tiphelele is standing holding on to things. Their mom told me that Tiphelele had been sick the week before and she took her to a rural red-cross clinic. They suspect she has asthma, but they gave her some medication which has helped.

Tiphelele and her family live very near the Chief's Corral. The women of the chiefdom had gathered to finish the thatched roof on a traditional hut they are building for one of the ceremonies next month. They were gathering to leave at the same time I left the twins house. All the ladies waved hello to me as I passed them by and the kids that saw my car came running to the side of the road so they could wave and say "bye-bye" to me. What a gig this is. Every time I go to Lomngeletjane I get treated like someone really special. It always lifts my spirit and makes me sing and laugh.

I drove back to the hospital/clinic to see how things were progressing. The first child and her mom were waiting to get a prescription filled at the pharmacy. The second child was waiting to see the Dr. They called her in shortly after I arrived. As luck would have it, my favorite Dr. was the one seeing her. He said the scan of the stomach was normal, but the scan in her lungs was not good. He said he suspects it might be TB but he is going to treat it as if it is pneumonia and she is to come back in a week for another x-ray. If the x-ray is worse, then we will know it is TB. He poked around on her stomach and asked a few questions. He said the girl is in the beginning stages of malnutrition. He also asked if the girl could be tested for HIV. The grandmother said yes and as the Lord would have it, right about that time one of the nurses from the Baylor clinic at this hospital came in the room. The Dr. talked about how he, Thembie, the nurse and I were all Christians being guided by the Holy Spirit. The nurse took the girl and her grandmother to be counseled and tested. The girl is HIV+ which we suspected. The good news is, we have her into the right clinic that can help her. She will come back on Thursday to have her blood tested to determine her CD4 count. Depending on what her CD4 count shows, she may or may not start ARV's. If hr CD4 count is over 200, she does not need to start ARVs. We're all guessing though that her CD4 count is not that high. It will take two weeks to get the results of the blood test.

While we were waiting for the second girl's prescription to be filled, I went to the hospital side of the building to see how Nonjabulo is doing. As I started walking down the ward I heard women calling to me "stop, she is in here." At first I thought they were nurses, but then realized they were mothers of other babies who had been in the malnutrition room. They motioned me into the room they were in. Without thinking, I walked right in. She had been moved to a TB patient room. The room was very small. I'm guessing it couldn't be more than 8' x 10' at the most. It had 4 small cribs along the wall and there were chairs for 4 mothers to sit by their child. Nonjabulo's mom had stepped out of the room for a minute. As I was standing there it dawned on me that I was in a TB room with the door shut, with 4 babies that have TB and their mothers who probably also have TB, and that perhaps it would be better for my health if I waited outside in the hallway. The good news is, Nonjabulo is now up to 4.85 kgs. Unfortunately she will have to stay in the TB room for a while. No one knows at this point how long she will be there. I wondered why she wasn't put in the TB room right fro the start. It seems like they are closing the gate after the horses have escaped. But I'm sure they want all the malnutrition babies in one room so it is easier to keep an eye on them and the same for TB. Nonjabulo's

After seeing nonjabulo, I drove quickly to a pharmacy that is about 2 or 3 km's away and to get some Erythromycin for Shipo's mom because the hospital pharmacy was out. (Don't as me how a hospital can run out of that basic drug because I can't get my head around that one.) Then I went back to the hospital to pick everyone up and take them home. While in Lomngeletjane we checked on one of the kids we sent to the Dr. two weeks ago. She went for severe sores on her head. They were a bit better but a long way from being healed. It's lucky we stopped by because she should have gone back to the clinic for a recheck on Monday. So it will be back to the hospital on Thursday for this child and for the other one to get her CD4 count.

One of the really fun parts of the day was holding Sipho while his mom ate. He was sleeping so I could hold him without him crying. He did open his eyes and study me when I first took him, but then he fell back asleep as I rocked him and softly sang Jesus Loves Me to him. He is a precious little baby. Everyone is so amazed at how big he is.

It was a busy day. But in spite of the medical issues and having to hang out again at the hospital, it was a God-filled day. We have to figure out a way to get these children better nutrition and to get some of these kids to a healthier state. But with the Lord's help that will happen. The main thing is they know people care about them, they are getting proper medical attention and they are coming to know the Lord by our conversations and when we give Him the glory and praise.

Please continue to keep these children in your prayers.
weight was so low I guess that took precedent over the TB. Once again I can only shake my head.

Monday, October 12, 2009

Update on Sipho & Nonjabulo

I just got back from spending 7 1/2 hours at the hospital/clinic in Manzini. Thembie brought little Sipho and his mother, Khanyasilie, down from Lomngeletjane to be seen by the Dr. The thrush in his mouth is no better and he cries a lot. Actually, I think it is worse, but when we finally got in to see the nurse she said he was much better. Sipho has gained weight, although only .2 kg in two weeks which now moves him down from the 97 percentile for weight to the 50 percentile for weight. When we finally saw the Dr. he was the same Dr. that was on duty when Tiphelele was admitted back in June. He remembered me and even remembered that I was with the Methodist church. I was amazed. He asked me where I keep finding these babies. I told them they were families of kids that went to one of our schools. I asked him how a baby so young could get thrush, which is really why I waited with Thembie and Khanyasilie (the baby's mom), He said the most common reason is that the mother is HIV+, the second reason would be if the mother had taken a lot of antibiotics during pregnancy and the third reason would be if the mom had taken steroids during pregnancy. She hadn't taken any antibiotics or steroids. Khanyasilie had been tested for her HIV status in July when her husband passed away from TB. She was negative, but one must follow up the test in three months which she hadn't done. So he sent her to be tested. While we were waiting Sipho started crying. I tried to quiet him, but that didn't work. So she went to strap him on her back. He was crying and squirming so hard he almost fell off her back a couple of times it was so good I was there to catch him. I think he was too young to be on her back but I couldn't say or do anything. Finally a nursing supervisor came out from her office and told Khanyasilie to take the baby off her back and to hold him in front of her. He quieted very quickly. Of course, then out came the breast again. Some mothers here just leave the breast hanging out so the child can feed on demand or use it as a pacifier. Whatever works I guess. When the nurse called her back in for her results, she wanted me to come in and hear the results. She was negative which is a huge praise. I was so nervous sitting there waiting to hear her status. I can't imagine how nervous she must have been. The Dr. gave her another week's worth of medicine. Somehow we have to find the cause of the thrush.

While we were waiting, Thembie and I went to check on Nonjabulo. She is just the sweetest little girl. She smiled right away at me and let me hold her. Then she discovered the necklace I always wear. When my necklace fell down inside my blouse, she actually followed it to retrieve it again. We all laughed at how cleaver she is. (If someone is said to be cleaver it means they are very smart.) Nonjabulo's weight has gone up to 4.75. She is almost there. She has to be at 4.8, which is off the charts on the low end of weight for her age, before she can go home. We are thinking she will be able to go home tomorrow.

I had brought a book with me to read while we waited. There were hundreds and hundreds of people there. All of the benches were taken and so some people just sat on the ground. Not one person had brought anything to do. No books or newspapers or magazines or coloring books or toys. Nothing. Many looked at me as I sat there and read. Once again the stark contrast between our American culture and theirs was so striking. Most also didn't have anything to eat or drink. Finally about 2:30 I gave some money to Thembie to go buy something for her and Khanyasilie to eat. I didn't want to eat anything especially being around all of the sick babies. There is no personal space. Everyone is crowded into each other. I tried to at least sit where the breeze could hopefully blow a few of the germs away. I also didn't have anything to drink because if I did I might have to go to the toilet, which I REALLY didn't want to do there.

I finally had to leave them and come home because I had an appointment with the guy who is going to do the legwork to get my Temporary Resident Permit renewed before I leave for the States. And of course, he is now over two hours late. At least he called.

Please keep praying for the babies and their mothers and gogo's.

Friday, October 9, 2009

Fridays ups & downs - Life in Swaziland

The beautiful little birds start singing these days before 5:00 in the morning. It’s not a soft little chirp, chirp either, it’s like there are hundreds of birds outside my window. The plan of the day was to take some nails up to John at Lomngeletjane, stop by and see baby Sipho and visit Nonjabulo in the hospital. None of that should have taken much time so I was going to catch up on some e-mails that are very long overdue. I left my place around 8:30, went by the Post office to mail a letter and found out today is World Post Day and therefore all postage is free. (I’m impressed!) I was mailing a birthday card to my sister-in-law. I’m wondering if she will ever get it. Oh well, it’s the thought that counts. Then I went to the hardware store to get the nails and across the street to the grocery store to get a few things. I was done with these errands in record time and headed up to Lomngeletjane. As I was driving I thought about how quickly I could complete these simple tasks today and how long it took me just to go to the grocery store two years ago.

John and his guys almost have the drop ceiling put in one of the bedrooms of the teacher’s house, which is good. Then I stopped by Sipho’s house. I wanted Thembie to go with me, but I couldn’t reach her on her cell and no one knew where she went. I started walking down towards the little house/shack that Sipho’s family lives in and one of the toddlers saw me coming and got excited. I found the mom, holding Sipho and the two toddlers sitting next to a cooking fire drinking tea. They weren’t 3 ft from the fire and the smoke surrounded Sipho and his mom. Shipo was crying and the mom was shaking him like crazy. It drives me nuts when she does that. I want to scream “haven’t you ever heard of shaken baby syndrome?” I looked in his mouth while he was crying and his little tongue is still full of white sores. I asked the mom if I could hold him for a minute. I held him for a little bit and slowly rocked him while I half sung, have talked to him. He quieted at first but then started squirming. He reminded me of how my youngest son would squirm before we found out he was lactose intolerant. I couldn’t talk much with the mother. She either doesn’t understand or speak English or she was too shy to answer my questions. I think it is the former. So I left after a few minutes. The youngest toddler waved a little when I said bye-bye, but was pretty shy. Then I was about 20 ft away and he yelled out “bye.” It was really cute.

From there I stopped by my place to make myself a cup of tea. When I was finished it was time to go meet Thini at the hospital so we could visit Nonjabulo. We were walking towards the children’s ward and saw Nonjabulo mother walking towards us with Nonjabulo wrapped to her back with a blanket. Nonjabulo looked so cute all tucked in with those big eyes so alert. Nonjabulo is in the malnutrition room of the children’s ward. There were 5 cribs sitting end to end. A child was in each bed. Thini took Nonjabulo off her mother’s back and gave her right to me. Nonjabulo watched me and then started making her little gurgling sounds at me. She took a hold of my finger and started chewing on it. My first thought was that I was glad I washed my hands before coming. And then I realized how bizarre it was to have that thought considered all the dirt, germs, etc. they live with each and every day. It is amazing what a strong grip that little one has. She was admitted to the hospital on Wednesday because when she went in for a follow-up appointment her weight had dropped for 4.7 kgs to 4.3 kgs. This morning it was back up to 4.5 kgs. Her target weight before she can go home is 4.8 kgs. I learned today that she is 7 1/2 months old, not 6 months old. And today is her mom's birthday. We enjoyed talking with her and watching her. She has the cutest smile with two dimples. She really talks a lot and is just the sweetest little baby.

The malnutrition room is just an empty room with cribs along one wall. It’s a pretty small room. The mothers or gogos stay with their children because they need to feed and change them. They sleep sitting on a small bench resting their head on the baby’s mattress or on the floor. There is no privacy. Two of the little ones slept the entire time we were there. The other two were awake. One was crying off and on. I’m guessing he was probably around 2, maybe older. If I looked only at his fat little stomach and ignored the fact that his stomach was bloated, not fat, he looked normal. However, his head was a bit too big for his body and his eyes too big for his head. The sight I won’t ever forget though is how thin his little arms were. They were much too thin for any of his other body parts.

When we left, Thini said she had to go someplace to get some disposable nappies (diapers) for a child near where she lives that is very sick. We went to a government clinic that was supposed to have them but they were out and didn’t expect to get anymore in this year. So I took her to a grocery store to buy some which isn’t as easy as it sounds. Three stores later, we got the best that we could find which were x-large baby diapers that had a stretchable waist. We took them to the child and her family before I dropped Thini off at her house. Thini lives in a peri-urban area outside of Manzini. It’s a rough looking neighborhood. The dirt streets are almost impassable in some areas, most of the houses are nothing more than shacks and there is a lot of garbage on the streets. We drove into the yard of the girl’s house and found a great little garden. The inside of the house was very clean and tidy. The little girl is 10 years old. She was in the hospital, but the hospital sent her home. In Thini’s words, they said she was too sick. I’m translating that to be there is nothing more they can do for the child so they sent her home to be with her family the last days of her life. The little girl was sleeping on the couch under a blanket. She never moved a muscle while we were there. Her breathing was very rapid and shallow. They said she is HIV+ on ARV’s, has TB and has skin cancer. Her gogo was also sitting on the couch. I’m guessing that she is HIV+ as well and may not have a lot more time left based on her looks. We visited for a few minutes and then Thini sang one of the hymns to lead us in prayer. Her family was very grateful that we brought the nappies and that we prayed for them. The child didn't even move a muscle.

Walking through the children's ward and then again at the little girls house I couldn't get out of my mind the stark contrast between our lives and conditions in the US and here. I'm sure the worst of our hospitals is better than the government hospitals, and especially the community clinics here. There are some nice private hospitals, but most of the people can't go to them. The conditions that so many people live in, even near the city where the roads are dirt and almost impassable, many houses nothing more than a worn down block structure or shacks made out of tree limbs, rocks and tin roofs weighted down with more rocks or blocks are scenes that are sometimes hard to shake off.

Friday ended. The day was over and I never did get to my to do list. Oh well, tomorrow is another day and as always God's plan was better than mine even though it was hard to deal with and stay positive. (The Joy of the Lord is my strength. I bow down and worship you now how great and wondrous is He.) I do have the wonderful memory of Nonjabulo chewing on my finger, gurgling, trying to roll over and play with the curtain and her darling sweet smile. I thank God for that blessing.

Tuesday, October 6, 2009

The Joy of the Lord is our Strength

That was the theme verse from my devotional yesterday (Tues, Oct 6). A song that is written off that verse immediately started going through my head (Holy is the Lord), which is amazing because half the time I can't remember a thing! I should have know right then that God put that verse before me for a reason.

The morning started early with Bethuel and I going up to Lomngeletjane to see the progress and talk with John. It had been a couple of weeks since the three of us could meet and we had a lot of unfinished business. The sun was out again and it was a perfect morning; not too hot and not too cold. We had a good meeting with John settling some cost and labor issues that I had with the work he had been doing. Actually, he had been hiring the work out and not supervising it which he finally admitted although we already knew that. His actions have cost me money and project delays and I have not been happy with him. But we resolved those issues. He is now finishing the work and accepted a little lower payment for his work to compensate for the extra cost I incurred because of his several "mistakes." Bethuel and I were very happy with the quality of the work he has done recently and we came up with a good plan to get this house finished. The head teacher came over to say "hi" and Bethuel told her she needs to go to the electricity board to get in the que for having the electricity connected to the house! That's exciting, and yet overwhelming because now we are coming to the point that it is all the things required to actually finish the house and make it livable that have to be done such as water, kitchen sink, appliances, bathtubs, counters, geyser (hot water heater), etc. Ish! I haven't planned on those things! The Lord will provide.

Bethuel and I were also very impressed at the number of blocks the parents made last week. The parents decided they would make the blocks to finish the second teachers house (the other part of the duplex) as a way of cutting costs. This is a HUGE change in their attitude and we were so pleased that they wanted to help. The new head teacher is truly a Godsend. A new plan is emerging in my head and heart to get the slab poured for the next four classrooms so that while I am in the States the parents could be making the blocks for the walls.

On our way back to St. Paul's, I had to stop and pick up baby Sipho, his mom and Thembie, the Rural Health Motivator for Lomngeletjane. Sipho had thrush already and could not suck very well. He is only a week and a half old. I don't understand how that could happen so quickly. Well, actually I do. There's no clean water, inadequate nutrition for the mom, his living conditions, etc. I was concerned about his health from the beginning, but I didn't think there would be problems so soon. The mom's cough is still terrible so I asked Thembie to please make sure that she got looked at as well as the baby while they were at the hospital/clinic.

As we were driving back I was so amazed at how beautiful the jacaranda trees are. They are in the peak of their bloom and too beautiful for words. The following is a picture of the tree in the hospital parking lot. It was so in-my-face magnificent that I couldn't help but stop to take a picture to save that beauty for all to see. I started singing again in my heart and head..."For the Joy of the Lord is our strength. We bow down and worship him now how great and wonderful is he....."

Then we went to one of our schools to pay school fees for some of the kids. We had tried to expand our Lutsandvo Lwa Krestu program to this school but discovered that the children the teacher gave us, though they were very vulnerable, they were not sickly or HIV+. We discovered quickly that she was looking for a way to get some kids school fees paid, which is not the prime focus of the program. But some how there was mis-communication and the parents were expecting us to pay school fees for 19 children. As a committee we decided we had no real choice but to pay the school fees this year, but we would clearly state that we would not pay the school fees again next year. Our intention was to verify that no one, other than the Government, had paid anything towards these children's fees. (The government only pays a certain amount of the school fees and the parents/guardians are supposed to pay the balance which rarely happens. When the balance isn't paid, the kids are sent home from school during the third term.) The head teacher showed us a ledger that didn't make any sense, wasn't complete, and wasn't an accurate picture of the money received from the government. We're talking simple bookkeeping here, nothing that should have been unclear. Soon we were arguing about how she was applying the government money. I must confess I was so frustrated and angry at the blatant mismanagement of money. I finally had to sit down, keep my mouth shut but I figured out myself how much we were going to pay to "top off" the children's school fees. The amount was one third less than what she wanted us to pay. I got further frustrated and angry when the head teacher called in another teacher to do simple math (550 - 325) on a calculator and they couldn't even do that right. The skills of some of these teachers scare me to death. So we decided we would settle this with her later in the week so we could leave. The head teacher wanted a ride to catch a bus - going home early as usual. I told her we were going the other way and she said, "no, only down to the end of the driveway." Or atleast that's what I thought we agreed to. And though I was irritated that she couldn't walk the 500 ft. or so, I said ok. We got to the end of the driveway and I stopped, ready to turn to go to our next school and she says "No, Chris, the other way." I asked her what and she said down to the intersection of the larger (dirt) road which was a couple kilometers away. I quietly but angrily turned the car around and drove her to where she wanted to go. I was quiet but everyone knew I was angry. I'm sure how I was driving gave them a very good clue to my emotions. Then the Lord convicted me of my anger as he reminded me of the parable in Matthew of the two brothers: The one said "no" to what the father asked him to do, and the other said "yes" and didn't do it. Yep, I was busted. I should have said "no" instead of angrily doing what I was doing. If I had said no, I probably would have thought of it and changed my mind to yes without being angry. So in a conscious attempt to triumph over my anger I started saying over and over "The joy of the Lord is my strength." As always, it helped.

On our way to the next school, after crossing the second creek, we saw this cute little baby donkey. He was so cute I couldn't resist taking his picture and once again we laughing and marveling at the wonders of God's creations. "The Joy of the Lord is our strength. We bow down and worship him now, how great and wondrous is he?...."

Nope, it's not over yet. We arrived at Lutfotja. The school fees and bookkeeping weren't an issue, but when we discussed the dates for our children to return to the clinic for their monthly ARV's I could tell there were issues being discussed. One of the girls the teacher had brought in to tell us when her next appointment was left in tears. When we left the school Thoko told me that mother of Sebenile, the girl who left the office in tears, had been taking the money for transport to go to the clinic in Mbabane and not going with her to the clinic and that the child was going to the clinic in Manzini by herself. (Manzini is closer so the transportation costs are significantly cheaper plus we had been giving her money for the mother and the girl.) She also told me that the father of Mxolisi now has a girlfriend living with them and that the father is very sick. He is HIV+ and a few months ago he was not on medication. He probably needs to be on ARV's now, but everything now has to go through the girlfriend. Mxolisi had a terrible cough and had sores on his head. As I sat looking at Mxolisi's sweet face I couldn't help but think that he is 10 years old, but as a result of severe malnutrition and disease, he is the size of a 4 or 5 years old. (I just kept singing to myself for the joy of the Lord is my strength.) And then we discussed Mthokozisi and the girls. The father hasn't been to see them once but we were told he is finishing his house which will have 5 rooms. No rooms for the kids though. It was another day when the needs, the issues, the actions of adults were overwhelming. The joy of the Lord is my strength.

Finally I arrived back at St. Paul's. Parked my car in the garage and went into the church office to say hello/goodbye to Zitsile, the church secretary who is one of my "adopted" daughters. She was very quiet and had tears in her eyes. Not good. She is usually so talkative and happy. One of the church stewards had yelled very loudly and harshly at her in front of other people. I sat and talked with her a bit. Shared some of my experiences and how I handled the hurt and pain of others and encouraged her to always turn to the Lord in any situation. I also shared how the simple verse from Nehemiah had helped me cope with the day. She left to go home and I walked to my place. I was glad the Lord put that verse in front of me that morning to help me get through the day, but I was glad the day was almost over. I sat down with a book to get my mind off of things (my weakness is good murder mysteries) and went to bed very early. This morning I woke up early at the first sign of light (5 ish), listened to the birds sing and watched the sky get bluer as the sun rose higher. The joy of the Lord is my strength.