Under the Mosquito Net

Under the mosquito net

Three years ago I received the official “call” to be a missionary doctor in Béré, Chad. Two years ago, my handsome Brazilian boyfriend joined me in Chad for my first month to help me get settled in. One year ago, that handsome Brazilian came back with me as my husband. This year, we brought our little son with us. I would never have imagined, three years ago, how much God would have blessed me as a result of being here.

Our little son, Elijah, spends the majority of his time underneath the mosquito net. Sure we take him out for baths and walks, but sleeping, nursing, and playing are most frequently done inside the protective covering of our mosquito nets. (Thank you US government for donating them to this country so that we could buy them in the market for a good price.) Every month that passes, I breath a sigh of relief as he as grown a little older and a little stronger for the time which will inevitably come when he contracts a tropical disease.

Our hospital is rural, really rural. Therefore we have no governmental power supply and our hospital and housing compound power comes from a large generator. Normally there are three generators, but as is normal here in Chad, things break frequently. Somehow a few weeks ago, we found ourselves with all of the generators broken. Our Chadian hospital mechanic tried his best to fix it without success. The local mechanic also had no success. There were broken parts needed from the US that would not be able to get here for a matter of weeks. At first the power shutdowns were temporary, somehow the mechanics could get one of the generators patched up after the break. Then finally, they couldn’t.

That night before the was the night of the death of our beloved OR tech’s 14 month old daughter. He and his wife are both nurses and more loving and attentive than any of their neighbors. But she had sickle cell disease and when her malaria came on this time, it was fast and furious, and she was dead shortly after arrival to the hospital. 

My cell phone service has been acting up and we didn’t get the call about her death. I only found out in maternity around 11pm that night when I came to see a newly arrived lady. This lady had a history of two c sections and had already tried to push this third baby out before arrival without success. So I started preparations her for surgery and then followed the sound of hymns being sung by loved ones to the house of the newly dead. 

Life is communal here in Africa, and so is death. Many church and family members were in the courtyard of the family’s house gathered around the young couple. They sang hymn after hymn, in preparation for the burial that would happen later that night. I sang with them, being a little surprised by the shakiness of my voice and the tears in my eyes. I’ve gotten pretty calloused about death here in the past two years, but this death was a bit closer to home.

I returned to the hospital when I thought my lady would be tanked up with fluids and ready for her cesarean section. The generator had gone out so Danae and I did her surgery in the black of the night with a headlamp. 

Once we finished I rushed home expecting to find a crying baby, as with the dryness and heat I don’t hesitate to nurse him in the night. Elijah was peacefully sleeping when I arrived but the moment he started calling me a few hours later, I grabbed him eagerly and clung to him tightly, so he could feel well the loving squeeze of his mother.

Unfortunately, this time, the generator did not start humming again a few hours later. Day after day, we had no power and along with no power, no running water as the well pump requires the power of our generator. Gabriel borrowed the small generator of our missionary friends in the next town over which was just strong enough to power the water pump for an hour or two to allow us to store water each day. The growing dirty cloth diaper pile loomed like a small mountain in front of me.

We like camping, for sure, but worried day after day about the contents of our deep freezer. Neither of us dared to open it in hopes it was insulated well enough to continue to last through day 3, then day 4... 

We said goodbye to the little we lost in our small fridge but our donated deep freezer has a decent stock pile of frozen mangoes and bananas to get us through the 110 degree days. 

Gabriel, like the hero he is, took a quick trip to the nearest city with good supplies about 3-4 hours away. His goal was to find, purchase and bring back a small generator for our deep freezer and to share with other families as needed. 

His return trip, however, was in typical Chadian style, and the rusty Toyota taxi he joined broke down for hours on the side of the road in the blazing sun. Somehow, also in typical Chadian style, the driver brought the metal piece of the car that had literally broken in two to a mechanic who soldered it back together. Then the driver placed it back in his car, and they all continued on their way. 

Gabriel arrived the evening, started up our new generator, and powered the deep freezer and our cell phones. Having one close to the house made quite a racket, but the comfort it brought was worthwhile. 

The other racket that we are hearing lately is that of falling mango branches. Loaded with mangoes, this is the time of year when they break. First comes the kkkkkk... reak.... then the ssshhh WHOPP, as the branch falls to the ground or sometimes our metal roof. Several tree branches were just over our bedroom, and each time I would hear the beginning kkkkkrreak I would throw my body over the baby in case the branch came crashing through our roof. 

The tree branches are so very high that we don’t dare hire anyone to cut them. If he were to fall, it would mean certain death, and the death of a local on our property would mean certain death to our ministry here in Chad. But thankfully, as of the writing of this blog, the majority of the branches over our bedroom have already left their lofty positions above. 

We do tend to have a handful of kids come into pediatrics after having fallen out of a mango tree this time of year. Somehow every kid who I’ve seen fall out of a mango tree has managed to land head first. It’s a puzzle. But perhaps it’s a simple as the other kids not coming into the hospital as they aren’t hurt as seriously. I have one kid who’s basically comatose now on peds after a fall. There’s so little I can do for him but pray.

Thankfully as this is a Christian hospital, I can always feel free to offer a prayer for families, during the stay of their loved ones. Elijah joined me for one such prayer about two weeks ago.

Gabriel has been teaching and video recording a Bible training school in the neighboring small town to us with some other missionaries. He is in his element there, and it’s such a joy to see him do something he is so gifted with. As a result of his work at the Bible school and my work at the hospital, we have needed to help of two wonderful ladies, our student missionary, Miranda, and neighbor, Megan. They have both graciously pitched in to help care for Elijah. 

One afternoon before Gabriel returned and just after I picked up Elijah from next door, a maternity nurse came running to the door. She described a patient that basically I could sum up with the thought - she is dead.

I tossed Elijah into his carrier and we ran to maternity. On the way I grabbed a resident and medical student who were in my path to help with resuscitation. By the time we arrived, however, the family had already covered the woman’s body up with a sheet and it seemed she had been dead for longer than just a minute. We searched in vain for a pulse. I struggled fiercely for a few seconds on whether to start CPR. In the end, I decided against it as the time lapse seemed too great from her death to when we found her. But as her belly seemed big enough that a baby inside might survive on the outside, I ran to grab the ultrasound, just on that rare chance that... We frantically wheeled the cart with the ultrasound over to maternity only to find the baby inside dead as well. 

Through it all, Elijah sat contentedly in his carrier pressed against me, unaware of the scene his eyes had just witnessed.

He does, however, seem to be a bit more anxious when I have challenging days or nights. Perhaps he can feel the catecholamines radiating off my body from the previous weeks of crazy cases on maternity. One interesting new twist is that I am already having return customers. Several of the ladies I helped in 2018 are back now with their 2020 pregnancy. Glancing through their little medical record books they bring with them, I have flashbacks to those scenes. One was a late night first time mom, about 16 years old, who couldn’t push out her baby. We took her to the OR and Danae tried to get the baby out with forceps. I think it was the only time I’ve seen it not be successful. Danae is a ninja. 

The baby was already dead. She pulled, I pulled. We all pulled and it just wouldn’t come out. Finally we were forced to convert to c section and cut it out. 

Another was a lady who had intense repetitive seizures after delivery with an only slightly above normal blood pressure. Given our very limited testing abilities, we treated her for all of the possible bad things we had capability to - eclampsia, meningitis, cerebral malaria...

She actually survived that episode and went on to have a fifth pregnancy. Just a few days ago, I delivered her healthy baby boy, who Elijah met today. Rarely I do maternity rounds with him when Gabriel’s gone, as there are generally fewer airborne diseases there. The mamas all laugh and smile when they see me with him, as perhaps it makes me a little more human and like them, carrying a baby around.

On the whole, Elijah is doing great. We try hard to make up for the stress he may feel on us as we come in the door by laughing and playing lots with him. Most of this is done underneath the mosquito net around our bed. He smiles with his mouth so wide open that I can almost see his tonsils, and a flood of warmth and gratitude wash over me. 

Oh, and a better mechanic from several hours away patched one of our generators so that we have power most of the time again. 

"But I will sing of your strength, in the morning I will sing of your love. For you are my fortress, my refuge in times of trouble." Psalm 59:16