Graduation Day

We wrapped up the training today, and we're very pleased with our students and the assessment of their skills. They're sharp! We have been so impressed with how far they have progressed over the couple of weeks. I certainly saw a marked improvement just today... with a few 'aha' moments. We presented them with their 'Certificates' and packed their ultrasound systems and battery packs for their village. They're all set to go!

It's a little overwhelming for us - Bill and I were honored in prayers this morning and also with a gift from them - the traditional Malian mud cloth - very beautiful handcrafted cloth. From our perspective, we are so blessed by this opportunity and really receive more than we give. We come to teach, yet we learn so much.

Bill started into this program about 10 years ago - really believing ultrasound can make a difference in low-resource countries. This is his 6th trip to Africa - and he's seeing this vision come to fruition, and impacting so many lives. As for me, I've been so thrilled to be part of this team. Stay tuned for the Basic Ultrasound Manual (with emphasis on OB) Bill is spearheading - we've made lots of progress on this manual during our time here. This resource is needed in this area and will help others learn and adopt ultrasound into their clinical practice. As Dr.Pierre (Bill's first student in Mali, 1.5 years ago) said, he doesn't know what he would do without ultrasound now... and is continually wanting to learn more.

So, the Medical Team is also wrapping up our time here. I believe we're all leaving Mali fully enriched with this experience. As Dr. Dan says to his patient's "Courage", with his hands up in victory... the team does as well.

Signing off, until home...

Blood, Sweat, Tears

Remember me saying anything can happen?... and that this team is adaptable, flexible and willing. Well... they came through yet again today. A patient was in real trouble (I'll spare the details) and needed emergency blood. Well... the hospital doesn't have any means to store blood (no blood bank), so any moving person is game. The visitors (us) are the first to be asked to give blood... that's because the staff give blood so often and can only give about every 3 months (time for replenishment of red blood cells). Paula was first in line as she had the right blood type. So after cross-matching, she donated... and then later Jeanie did, too. And they both received their jelly bean treats! That's how it works. If the patient doesn't do well through the night or tomorrow, Bill and I will be donating too. And for those of you asking... but they're on malaria meds.... it doesn't matter, because most people have had malaria here. This is the blood part.

The sweat part... did I mention it was 38degC today? That's 100degF for our American friends. Today was a bit more humid and since it really didn't cool too much through the night... it was balmy. This was OK... except all utilities become suspect. The hospital ran out of water today (several taps were dry)... not a good thing for sanitation/cleaning and staying hydrated. Fortunately, we found enough to hydrate. Whewh! We also intermittently lose power at the Guest House.

The tears... are tears of joy... for all the lovely babies born each day. What a blessing.

The Hospital

Peter has asked... 'how many beds in the hospital?' I'm not quite sure, but guessed they accommodate around 50 beds. The hospital is going though an expansion right now. Everyday we see progress on the new building. The plan is for 3 more building to make space for more patients/beds and rooms for specific functions (offices/mtg rooms/storage). But, today, this is the setup of the beds. Note they are all lined up, in overflow into the hallways. This is the post surgery recovery area. The NICU and Peds are each a small room, as is the OB recovery (mom's will deliver one day and be released the next). The beds are arranged side-by-side, with no curtains in-between, or any privacy. There are no sheets provided - patients bring their own and will do laundry at the hospital. You see very few men around (the fathers). The expansion plan for the hospital will include 70 beds.

We were treated to an African dinner last evening - yummy! We've seen them eat this in the cantina (and often scooped with right hand - no spoons). It's rice, topped with a sauce. The 'sauce' is meat/fish in a peanut type sauce - very delicious! We had chicken. The missionaries who had us over, Craig and Marilyn, had spent 25 years in the Ivory Coast. They've been here in Koutiala for a year. Craig is the Administrator for the hospital. It's alway fascinating to hear the stories of collaboration of this Christian hospital, within a Muslim community (and country) and the local Christians. (you must be Christian to work at this hospital).

Do Pigs Have Patellas?

You may be wondering... has she lost it? What about the pig? It's one of many conversations and debates of our team. Well, this evening, Paula outdid herself. She roasted a leg of pork for us with all the trimmings (corn, mashed potatoes and choc chip cookies!). And true to form for medical folks, the conversation turned to an anatomy lesson, thanks to Bill - 'here's the pelvic bone, femur, tibia'... 'is there a knee cap?' .... 'I don't know if pigs have patellas'. This will remain a mystery.

Another topic of discussion was related to whether people are happy here. In particular, we were curious about the women, given their position (or lack thereof) in society. They do live a difficult life and are very hard working. On one side, it is argued that they are happy, because this is the only lifestyle they know and know where they stand and are generally content. On the other hand, we have witnessed a sadness in some. It's things like: they can't make decisions without their husband. For example, in order to have a Cesarean section, the husband must give permission (unless it's an emergency). And when they marry, the women leaves her family to live with his family. After some time, he may bring another wife home. So then, all the wives live together. Some men leave for 2 to 3 years (work in Bamako) and the women are left to support the family. Oh.. the stories go on.

It was quieter at the hospital today, due to the holiday, but we made good use of the time in lectures and moving on to the abdominal ultrasound exam. And instead of line drawings, we simply employed Google to bring up all kinds of ultrasound images and illustrations. Thanks to the wireless connection at the hospital, this was a great tool! They are so thrilled to be able search for any pathology to learn what it looks like. Bill would ask, and we would view hydronephrosis, kidney stones, gallstones, cholecystitis, breast masses. And they really 'get it'. C'est bon!

Just love these kids!

Sunday

A quieter, restful day today... very hot. While I hear it's 38degF at home, it was 38degC here - very Hot!

Walked to the market again.