In my flip flops

So more than a few of you are wondering what I'm doing here...beyond the obvious which could better be explained as why I'm doing it: because my Heavenly Father told me to and I'll be here serving the poor, orphaned, hungry, and lost in Mozambique until He tells me otherwise....but beyond that, WHAT do I do? Yes, yes, I'm the nurse/medical director for the baby house and toddler house (and soon to be nursery)...but what does that look like? Every day is different and challenging, and mostly my schedule gets thrown out the window and physical time means nothing. So I thought I'd give you "a day in my flip flops" kind of synopsis:

(precursor: I was really sick all this weekend and was barely out of bed all weekend long for more than 6 hours...Tues I was up at 7am and in the baby house all day or in Portuguese lessons. Wed. I was up at 4am to make a run to the border of South Africa and back before my full day started since I have to leave the country every 30 days)

@6am Rolled out of bed, brushed my teeth, dressed, stuffed a breakfast bar in my mouth, gathered everything i needed for the day, and ran out the door to leave for consults with the other Erin and 2 tots under the age of 2 by 6:30am. It takes about an hour to drive into town where the hospital is and the specialists's clinics and it's pouring down rain. Today we are going to see the ear doctor for our two little guys that we just can't get rid of ear infections for. We have to be there soon after the doors open (at 7am) to put our card (consult card with the kids name on it and medical record number for the hospital system) into a giant pile with the rest of the people trying to get a consult today. There is no such thing as appointment time here-it's first come, first serve...always. A nice gentlemen gave me his seat on the crowded bench since I was holding a very squirmy 14 month old (Thanks and God bless!). We wait for about 3 hours total. Thanks to the other Erin's planning we had bolaches (crackers), sumo (juice), pao (bread) com peanut butter, and leite (milk for antonio); 2 toy cars, 2 books, and diapers. It's a good thing too because apparently the tias got confused and didn't feed Antonio his 6am bottle plus he usually has papino (a breakfast cereal kind of poradge) @ 7:30am....he tore into the pb bread and juice like he hadn't seen food in ages, then he got cranky cause he hadn't had his bottle still but we were saving the only 1 we have for his 10am one. Then he got tired...and he can throw a mega fit when he wants to. Blessings, he let me rock him to sleep after about an hour of being fidgety cause if 2 white girls with 2 mozambicans babies in a room full isn't enough of a spectacle...add in hissy fits with screaming kids sprawled out on the floor....finally we saw the doctor...Praise God they were competent today (well at least for Antonio) and ordered every test we wanted...then off the the lab to schedule a time to come back for tomorrow for Antonio's test.

@11am we're back at the center....just in time for me to catch my last hour of Portuguese Lessons.

@12:00 I stop by Jannie's room (another nurse on the base who used to be the babyhouse nurse but now is starting a community home health program but helps give out meds in the babyhouse a few times a week for me) to catch up on how the tot's where in the am...bad news....

@12:30 I'm in the baby house giving out 1p meds, eyeing over a few kids and discussing results of consults, changes we need to make this week in dietary for a few kids, room changes, and other house keeping issues with the babyhouse director (like how one of the tia's cut the entire top of all the nipples to the bottles and it might as well be a cup we are feeding them with...not good for the 3 month old twins, and my other 2 6 month olds)

@1pm I'm in my kitchen trying to heat up food....Jannnie stops back by while I'm eating and we discuss a few of the chronic tots and therapy suggestions (I'm uploading videos of a few of them to 2 friends back in the states who are pediatric physical therapists to get recommendations on exercises to help them)

@2pm I head back to my room wanting to take a shower and a quick nap before 3 when I need to take 2 of the kids over to the clinic to see the md, instead I answer a few emails and by 2:30 the other Erin comes by to say that the md's here and waiting.

@3pm I'm waiting in the clinic with 2 of my kids to see the doctor(thank goodness it's the one NOT trained in Mozambique, he speaks English, has a lot of experience with pediatrics, and is studying to be an anesthesiologist)...15 min later I take them in, discuss a new ear infection with Alfredo (who's microcephalic and has an under developed brain) who seems uncomfortable and usually NEVER complains (we have a pediatrician consult at the hospital to get a neurology consult next week...thank God for small miracles since he's been growing more and more uncomfortable and having frequent spasms of all his muscles, problems swallowing his saliva, ect). Then on to Ryan who was bit yesterday on his cheek, his face swelled up on one side and got hard (he has a history of this happening without the next symptom), but now it's gone and he started wheezing...but he also has a snotty nose and cough along with the rest of my tots...is it an allergic reaction, or a respiratory issue?? Then I get his opinion on my 6 month old that I suspect might have a cardiac defect and how to go about getting a consult at the heart institute in town.

@4pm I'm back in the baby house trying start a nebulizer treatment on Ryan to give him a little relief before the rest of his new medications kick in, but he's screaming in sheer terror (totally helping his respiratory effort) because the machine makes a really loud noise and my Portuguese isn't good enough to reassure a 3 yr old that it's ok...my "medical pretend play" that is supposed to be a universal language did nothing for me either.

@4:20 I'm done and double checking the 6 new prescriptions I have for 3 of my kids today since the mds aren't usually right and I'm not familiar with these meds....hooray they weren't too far off...I just had to change them around a little. So I mix up their new meds for my evening doses and start making all 35 meds I'll be giving at 7:30am tomorrow morning. Next, on to cleaning up the baby clinic, checking back in on Ryan

@6p I start handing out the candy (I mean medicine)....We have too many on antibiotics right now and too many that aren't loving taking their medicine...one that just got started on ARV's for HIV and hates the taste, plus they make his throw up....

@6:15 I check back in on Ryan, clean a few gross ears from ear infections, and wash all the syringes, put them back in the sterilization solution and clean up again

@6:30 the other Erin comes by to help me catheterize Antonio (14 months) cause we're supposed to bring back a urine specimen in the AM and we are out of urine specimen collection bags and unfortunately he is neither potty trained (HAHA!) or taught to pee on demand....yeah right...it's didn't work...but I have to admit he was very patient with us. We finally gave up and said they would have to deal with it and we'll have to go get some more bags tomorrow.

@6:50 I help the other Erin get everything ready to bring Antonio back to the hospital tomorrow for xrays and labs in the early AM

@7pm I'm about to head out the baby house door when I eye Sina (who had a major unexplained seizure for 1 hour despite medications and then on and off for the next 5 hrs last Thurs and just came home from the hospital on Monday) who's looking a little odd at the moment, walk over and she feels hot; I whip up some paracetamol (their version of tylenol) to give to her just in case despite the fact that my thermometer reads normal...meanwhile the other Erin goes to talk to Tracey (the babyhouse director) to see if she doesn't mind taking her for the night so that someone can eye her periodically just in case since she just doesn't seem right; we make the decision that she'll pick her up after church and bunk for the night...call me if any problems

@7:15pm I finally head back to the kitchen (praying the entire time that nothing happens to Sina tonight cause I'm too exhausted to cope) to make a little dinner. I grab it and head to my room to check email (while I eat) for the first time today and I'm exhausted. I've got to be up by 7am tomorrow to give out meds again and find all the nipples that have been cut by the Tia and replace them, then make 16 bottles for the twins since they are on a special formula involving weighing sugar, oil, and formula to help boost their calories (the girls from the clinic that usually make the 50 some odd bottles most every morning can't figure this one out) before they eat at 9am; and weigh 10 babies before their 10am naptime.

@7:30p I decide that I'm too exhausted to go to church tonight (we have one just for all the kids on the center every thursday night) and I still need a shower and want to get in bed at a descent hour, plus I'm in need of some good God time.

Plans for tomorrow (besides the above mentioned before 10am): make meds for the afternoon rounds and evening rounds, give 1pm meds, make a grocery list, go with visitors to shoprite(grocery store) from 2-4p so i can have a ride and get food (it's been over 2 weeks and I have nothing of nutritional value); try to figure out which of the 14 tots missing immunization records for bcg's (to prevent TB....i know. i didn't know there was a vaccine either...go figure) have actually had them (it leaves a pretty nasty scar on their arm most of the time) and plan how to make a mass immunization clinic run asap to get everyone caught up; update my records on weights from the last 2 weeks, make medicine changes and print out new medicine records for the next week; See if Dionisio has many any progress in the weight department and assess for a murmur (after treating him as if he had anemia (low blood count that carries the much needed oxygen) for 2 weeks and hoping that helped with the murmur and wt and NOT a real heart issue) before heading back to the clinic in the afternoon to get a consult for the cardiac institute if he's had no change; and try to get some more laundry done since it's rained for the last 2 days and clothes don't dry outside on the line if it's raining (and it's too damp inside to ever dry clothes)...yikes....off to shower, have God time, and get a little shut eye before the morning! Hope everyone else's day/week was so crazy!

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