Mahsoblee

July 5, 2011

 

Mahsoblee (Maw-so-blee) is a little girl who lives right around the corner from me.   She lives with her grandmother.  Her grandmother thinks she is six years old.  Her mother lives in a remote village about forty miles away and has two other children.  Mahsoblee needed extra care so she came to live with her gramma.  Most six year olds attend school.  Mahsoblee has not been able to because of her health.

I noticed about a month ago that Mahsoblee probably had severe malnutrition.  You see a lot of malnutrition here, but this was severe.  I talked to neighbors and Peace Corps Health Volunteers and we tried to come up with a plan for Mahsoblee.  We got her a supply of Moringa powder, which is kind of a wonder plant here in Africa.  It grows very, very fast and has loads of nutrition.  Jeremy (a health PCV) came and talked to the gramma and brought a chart with pictures that illustrated what Mahsolbee should be eating.  I would take something nutritional to her house every day.  Carrots, green beans, an egg, some fruit.

Nothing seemed to be working.  Mahsoblee was not getting better.  We took Mahsoblee to the clinic today to see the Tchekpo Clinic Director, Mathew.  Mathew examined her and said that Mahsoblee has serious problems and that they are all intertwined.  He said that she needs to be examined at the hospital in Lome and get a full assessment.  He said that she has complete internal blockage, she is running a fever and that her liver is involved.

We are taking Mahsoblee to Lome on Tuesday.  That is the soonest we can get there.  We will get a complete assessment at that time, and I would imagine she will have to stay in the hospital, possibly even have surgery.  Mathew said there was hope.  He thought they might be able to help her.

I have been drawn to Mahsoblee since the first day I saw her.  Really drawn to her.  Before I had any realization that she was sick.  It was if something was stopping me and telling me to pay attention to this little girl. There are many children who are not well, and we help as many as we can by offering nutrition classes and general health information.  I knew that Mahsoblee was getting worse instead of better.  Every day I go to her hut and she climbs up on my lap.  I can feel her little heart beating too fast, and feel that she is too warm, and hear that her breathing is labored.  It's very difficult.

We will need money for Lome, for the exam and possibly for her stay in the hospital.  I will be opening a checking account for Mahsoblee for anyone who might want to contribute.  I will have BorneFonden, an NGO (Non-governmental Organization – not-for profit) administrate and oversee the account.

I will post again on Tuesday or Wednesday and report on the assessment, and perhaps at that time you might consider contributing? I will post the account information and you can contribute anonymously if you would like.  But I would like to thank anyone who helps with this cause.   Money received that is not used for her medical care will be used for her education and well being when she is well

Mahsoblee is very, very smart.  You would fall in love with her if you met her.   Please help me save her life.

July 12, 2011

St. Joseph Hospital - Kouve, Togo

In my last blog I said that we were going to be taking Mahsoblee to Lome for medical tests.  We changed our plans.  Jeremy, the health PCV who has been helping me, advised me that I should think about taking her to Kouve.  He said there was a little hospital there that was founded and run by Italian nuns and he thought they could do anything that they were going to do in Lome.  It was easier to get to, and In addition it would most certainly be a kinder, gentler place than the Lome Hospital.  We talked to Mahsoblee's gramma about it and she was visibly relieved.  Kouve is not so overwhelming.  It’s about a 30 minute bush taxi ride, and then another 30 minute moto ride to Kouve.

PCV Kim and Mahsoblee

Kim (another PCV) lives in Kouve.  It’s comforting to have the help and support of Kim and Jeremy.  They both met us (me, Mahsoblee, her gramma) at the Kouve Hospital when we took Mahsoblee for tests.  Mahsoblee had already met Jeremy because he came to my village to see Mahsoblee and teach her gramma about nutrition.  Mahsoblee was happy to see Jeremy, and quickly warmed up to Kim.

Kouve could do all the tests except for the echo-graph (for her liver).  We still thought it would be better to start here.  Not so traumatic.  Mahsoblee (going forward known as MB) was not at all prepared for the blood tests and pin pricks.  She cried, and afterwards she was mad at me and would not talk to me for several minutes…but she quickly forgave me.  So…we accomplished the first step.  Tests were almost complete.  We needed to return the next day with a stool sample.  Then wait one more day for results.

PCV Jeremy

I returned to Kouve for the results on Saturday morning.  Jeremy (who lives about 30 miles away) and Kim both met me again.  I didn’t bring MB with me, thinking we would be going to Lome on Monday, and they didn’t need to make the strenuous trip just for the results.    I also had wanted to speak with the nuns about possibly setting up a checking account for MB to help pay for her care.  We got the results, and met with Sister Emma.  Sister Emma is tiny in stature, but has the nature of a smart, strong and sensitive woman.  I could see her concern and pragmatism at the same time.   Sister Emma said that MB was dangerously ill and that we could not wait until Monday.  She said I needed to go get her and either take her to Lome or bring her to Kouve right away…..right now.     Sister Emma went to speak with the doctor about which would be best.   The doctor encouraged us to come to Kouve to be assessed and get her stabilized and go to Lome later.  I remember feeling astonished at the news….and desperate, and angry that we had wasted so much time, and moved so slowly.   When I say we, I really mean me.   I’d been dealing with MB’s illness for six weeks.  I knew it was bad, serious, but I always thought I had time, mainly because MB was always sitting on the little step outside my compound, almost every day.  She was always smiling.  She would almost always jump up and come over and hug my knees.  I never once heard her whine or complain.  Only when the Tchekpo Clinic Director examined her did she show any signs of hurting.  But she must have been hurting a lot and feeling so bad.  I could also see the concern on Kim and Jeremy’s face as Sister Emma spoke to us.  It only takes one meeting to fall in love with MB.  After we spoke with the sister, I sat between Kim and Jeremy for a few minutes, with my head in my hands, as Jeremy rubbed my back and Kim just laid her head on my shoulder.  Yes they were comforting me, but we were also comforting each other.  I think each of us feeling a bit unprepared for this.  It felt surreal.  Here we were in a little hospital run by Italian nuns in bush country Africa making life and death decisions, and not making them very well or quickly enough.  A few minutes of pondering is all I needed, I got up and headed back to Tchekpo.  I was hoping that Mahsoblee would be at home with her gramma, but knowing that her gramma goes to the farm everyday from sunrise to sunset and usually takes Mahsoblee with her.

I made it back to Tchekpo, and lo and behold there was Mahsoblee sitting on the step outside my compound with a few other children.  She didn’t jump up, but smiled.  I walked around the corner of the building to her hut and knocked on the tin door.  Toussaint her grandmother’s husband was there.  He said gramma was at the farm.  He and the gramma only speak Ewe.  Best I could, I explained that I had been to the hospital and they needed to see MB right away, right now.  I asked him if he could go to the farm to get her gramma.  He understood.  I saw fear and love in his eyes.  He would go get her gramma.  In the meantime I took MB to my house, gave her some water and had her lay down on my couch to rest until her gramma came and we could leave.  MB fell immediately to sleep.  She looked like an angel.  I thought how sick and tired she must have been and yet was sitting out on the porch step.  Also, it seemed I could see the life draining out of her all of a sudden, right before my eyes.  Six weeks and all of a sudden everything is happening so fast.

Gramma arrived about an hour later with a worried look on her face, but she was ready to go and she was ready to do anything that needed to be done.  At this point MB couldn’t walk.  This was so crazy…how could she be going downhill so suddenly.  Thank god we were on our way.  Gramma, who is no bigger than a peanut herself, strapped MB on her back and carried her down to where we would catch the bush taxi.  It was scary.  MB was losing ground very quickly.   We made it to Ahepe in the bush taxi and then caught two motos to go to Kouve.  One for me, and one for MB and her gramma.  The moto road from Ahepe to Kouve is….well; it’s like many rural village roads that you have to moto.  I usually think it’s a lot of fun.  It’s like a crazy motocross path, with ruts, and hills, and twists and turns.  But on this day I only worried about how rough a ride it was for MB.

We made it to the hospital and walked immediately to the admitting room.  There were, oh, maybe 10 people waiting outside the room.  At this point MB seemed barely conscious, so of course I barged into the admit room and demanded to be seen first.  The orderly did not approve of my tactics, and took us out to the bench outside and was very dismissing and gruff.  OK…at this point I had to pull my best Shirley McClain (Terms of Endearment) dialogue.  In other words…you are not going to leave us out here on this bench and make us wait for ANYTHING.  Finally another orderly intervened.  They spoke in Ewe, so I could not understand them, but I heard Tchekpo, and I heard Corps de la Paix, and maybe I heard the words crazy white yovo…….the gruff orderly kept looking at me and nodding his head as the other man spoke.    We were then immediately taken into the room.  She was given an IV, and examined.  Gramma and MB stayed in the admit room and I sat outside on the bench, often turning around to look through the window at what was going on.  Gramma never moved away from MB’s side, holding her hand, looking intense.  I saw tears rolling down her face.  I had never seen a Togolese cry.  I called Kim and she would be coming, but Jeremy had to go home.  As I sat alone and waited I looked around at all the sick children.  Kids with burns, and open sores, and distended stomachs.  As I sat there, I got very emotional.  This hospital and MB seemed to represent everything that was wrong with Togo.  Such despair, such hopelessness and suffering.  The thought did cross my mind….why am I trying to save her?  What for?  For this??  At times like this, I always turn to God.  What am I supposed to do with this?  What were you thinking???  Why do you think anyone needs this lesson?  Certainly MB doesn’t deserve or need it, and then I just ask for the wisdom to change what I can and accept what I can’t….and maybe it would be nice if I could get some sort of sign???

Oh boy..careful what you ask for.  So I’m sitting on the bench, and all of a sudden I see the most beautiful African Man walking towards me….floating towards me is more like it.  He had stunning African pagne on that flowed gently in the breeze.  Everything seemed to be in slow motion for a few minutes.   I swear if there had been a sea in front of him, it would have parted; and was that Rachmoninov I heard as he approached? As he passed me, he held his hand out to me without looking at me, and introduced himself, and he told me not to worry.  He was gone as quickly as he had arrived.  It was the doctor.  He’d come in just for the purpose of examining MB.  I did not see the doctor leave, even though I never left the bench.  I don’t know what to say about that.  But the gruff orderly came out and told me what the plan was.  She was going to have two blood transfusions and she would need to stay for two weeks until she was stable enough to travel to Lome.  At that time we will go to Lome to have an echograph and determine the condition of her liver.  Gramma would need to stay with her for two weeks.  I was to return the next day and bring cooking utensils and clothes and Gramma’s husband.  They would feed MB, but gramma would need to cook for herself.

I stayed for awhile and comforted gramma best I could.  MB was uncomfortable and sleeping fitfully, but I knew she was in good hands.  I returned home to Tchekpo and walked around the corner to speak with Toussaint (gramma’s husband)  He had such a look of concern on his face.  He was anxious to hear news.  I had Leah my little water girl help me explain to him, that MB was going to stay in the hospital for two weeks, and that he needed to go with me tomorrow and bring some things.  He understood.  We arranged to leave at 10am the next morning.

At 10am the next morning we set out in the bush taxi and then moto to Kouve.  When we arrived  I could not believe my eyes when I saw Mahsoblee.  Her IV was no longer attached, though she still had the needle in her hand, just in case it’s needed.  She was up, walking, smiling and alert.  When she and Toussaint saw each other there was pure joy and happiness on their faces.  Toussaint scooped her up and hugged and held her.  She likes me a lot, but it is so obvious that she loves and trusts her gramma and Toussaint.  It was a very, very sweet moment.  I stayed for awhile but then left them to be together.

I could not go to Kouve yesterday.  Kim went, and spoke to the doctor for me, and she also put MB on the phone to talk to me.  That was funny.   It started raining shortly after I returned home on Sunday.  SO glad I made it home before the rain.  I could have easily been stuck in Kouve, as the roads are impassable when it rains. 

MB continues to make progress according to the doctor.  I am in the process of setting up a bank account for her to help with her medical and transportation bills.  I will be posting information on that in the near future….hopefully by next week.  My sister Nancy who has a HUGE  heart has volunteered her time and skills to help with raising some funds for MB.  I don’t know, but I think all this is not just about MB.  It’s about Jeremy and Kim and Nancy and the people who so very well represent the kindness of humans.  The people who go out of their way to help someone less fortunate.  Maybe that’s part of the lesson? 

July 13, 2011

Sister Emma (on left)

Just returned from a trip to Kouve to see Mahsoblee and her doctors and also Sister Emma.  Mahsoblee looks good.  She was happy to see me, and I her.  She spent a lot of time holding my hand, and laying her head in my lap, and just touching me.

I spoke to her doctor.  He said that Mahsoblee’s spleen is enlarged, that she has a high level of malaria and this causes her cells to be sickle like in shape??  I don’t know if this then would be like sickle cell anemia??  Michael, Laura??  At any rate they have to wait a bit to retest because of the blood transfusion.  It’s possible that she may have to have surgery and have her spleen removed.  I think this is separate from her liver problems, which still need to be assessed in Lome.  She felt warm to the touch to me today and her little heart is still beating too fast.

Michael my nephew and his wife Laura are both Physicians.  He replied:  Terry -- spleen enlargement common in malaria & sickle cell ( the blood cells get trapped in there). Sickle trait patients often are protected from getting malaria, but if she has sickle cell disease, the stress of malaria could give her a sickle crisis = bone pain, weakness, etc. Either one could give her severe anemia. Sending our prayers. (written in consultation with Laura, "the good doctor".)

The good news is that the Sister Emma is letting me use their checking account for donations for Mahsoblee.  She got permission from Italy???  And said that we could use it for as long as we needed to, and also when we go to Lome.  So this will make things so much easier.  Sister Emma is just a little saint for sure. 

I think we have a long way to go, but it seems to me that we continue to get positive signs along the way that we are doing what we should be doing, or another way of putting it is, it seems at times we have God’s blessing on this endeavor, and this child.

I’ll be posting information today or tomorrow on how you might contribute if you would like to.  Prayers would be just as welcome.

July 18, 2011

Mahsoblee and Leah

I went to Kouve this morning to talk to the doctor.  When I went to the hospital on Friday the orderly told me to come to the hospital by 8am on Monday.  That would be the best time to catch the doctor and get a report on Mahsoblee’s condition.   I asked Leah (my little teenage neighbor, friend, water girl, laundry girl) if she’d like to go with me.  It’s a close knit community here, and Leah would see and interact with Mahsoblee every day.  I thought Leah might enjoy the little trip and also enjoy seeing Mahsoblee.  Leah was thrilled that I asked her to go.  I could see that she thought it was something very special for me to ask her to accompany me. 

She and I left my house at 7am this morning and arrived at the hospital at 8am. The moto road from Ahepe to Kouve is especially bad right now. We’ve had so much rain that the road is an obstacle course fraught with danger at every turn, with ruts and mud and puddles. There is a lot of weaving in and out and around. The moto drivers are experts though. They drive masterfully and with little hesitation. I still think its fun. I can’t help it. At the age of 60, it’s just a crazy, fun thing to do. I’m usually listening to my ipod. When not helping the driver drive I am taking in the sights of the African bush. It always kind of seems like a nice segway before the hospital and after and gives me a chance to think about and appreciate where I am.

R to L - Leah and Ama

I tracked the doctor down when I arrived. He told me he was getting ready to make rounds and asked if he could talk with me around 10 or 10:30. “Of course,” I said. So Leah, Mahsoblee, her grandmother (Ama) and I sat outside MB’s room on a bench for a couple hours. Mahsoblee wanted to be either right next to me or on my lap the whole time. I love cuddling with her as much as she does, so it was nice. While waiting I taught MB how to count to ten in English. She said the numbers really well, but I’m not sure she knows exactly what she is saying. I also taught Leah and Ama (MB’s gramma) how to play tic-tac-toe. That was fun!!! They loved it, caught on very quickly and we had some good laughs when one of them would start to make the wrong move and I would say..noooooooooooooooooooo. MB was hungry, so I walked across the street from the hospital and bought some bananas and some hard boiled eggs for Leah, MB and for Ama.

Finally the doctor got to our room. There are usually 4 patients per room, so he saw the other three before MB. After he examined MB he came out and spoke with me. “Mahsoblee can go home today” he said. He told me her HIV test was negative. I was relieved about that. He told me that she tested positive for sickle cell anemia and that she would need to have an operation and have her spleen removed. We still do not know what the condition of her liver is. The doctor suggested we go to Afanyangan instead of Lome for the surgery and for the echograph for the liver. Afanyangan is a large village several hours away. It has a large hospital and the doctor thinks Afanyangans hospital is much better and easier than Lome. Everyone certainly always steers us away from Lome. I’m not surprised and I’m always glad to hear there is an alternative.

I had no idea that Mahsoblee would be released today. I did not bring any extra money to pay for any remaining items. They would not be doing a final accounting until after 2pm. So I came home. The orderly is going to text me how much I owe, and weather permitting I will return to Kouve this afternoon to pay the bill and help Ama and MB get home. If it rains, I and they will have to wait until tomorrow. The road from Kouve to Ahepe will be impassable if we get any more rain today.

On my way out, I ran into Sister Emma. Sweet, wonderful Sister Emma. I gave her an update on MB and she seemed happy that we were making progress. Sister Emma always makes me feel like there is hope…….or maybe it’s more that she makes me feel like it’s not even an option to give up or give in.

I will be taking MB to Afanyangan by the end of this week. Don’t know how long she will need to stay or what we will find out about her liver. I am optimistic. Mahsoblee looks good....although she is still having abdominal pain, which I think is the liver problem. But it seems like we are finding things out and diagnosing things and fixing things....so maybe?????

July 20, 2011

I picked up Mahsoblee and her gramma yesterday morning and returned to Tchekpo for two nights.  Tomorrow (Thursday) morning we leave for Afanyangan.  Afanyangan is a large village about three hours from Tchekpo.  Mahsoblee has Sickle Cell Anemia.  The doctors in Kouve have recommended that she have her spleen removed and that we go to the hospital in Afanyangan for her surgery. 

Mahsoblee, her gramma Ama and I will leave at 8am 'Thursday morning.  At this point I have no idea where we will stay, how long we will be there or how much it will cost.  I am going with about $60 in my pocket and as they say on a wing and a prayer. 


When we arrive in Afanyangan we will consult with the doctors there and get their opinion on surgery and if they agree with the course of action the Kouve doctors have recommended.  We will also get an echograph to determine the condition of her liver, and I am hoping that we can also get some dental care for Mahsoblee, as I believe the condition of her teeth could cause infection and be harmful to her.  I would also like to send recommendations and information to my nephew and his wife who are both Physicians and get their opinion.


In the meantime my sister Nancy has set up and will adminstrate an account for contributions for Mahsoblee's care.  Any money donated will go directly into the Sisters of St. Joseph Hospital in Kouve's bank account.  Mahsoblee's gramma, myself and the Sisters of St. Joseph will make the best possible decisions in Mahsoblee's behalf.

If you would like to donate:

Make checks payable to : Mahsoblee Fund

Mail to:  Nancy Shaughnessy

             1266 SW Collins Ave.

             Topeka, Kansas 66604

Please also include your email address, as Nancy will send a quarterly accounting of how the money is spent.  Who donates money will not be disclosed.

Thank you for your support and prayers.  I hope there is internet access in Afanyangan.  I will post information as soon as I can on Thursday or Friday.

Very special thanks to the generosity of Roger Underwood for helping us set up the account, to the Sisters of Saint Joseph Hospital in Kouve for helping in so many ways, and especially to my sister Nancy.  We could not have moved forward without her patience, help and loving heart.

August 4, 2011

I would like to dedicate this Post to my sister Nancy.  Nancy is managing raising funds for Mahsoblee’s care.  Without her help I really couldn’t have done this.  Nancy was an inspiration to me.  When she was 21, in 1967, she joined VISTA, Volunteers In Service To America.  She went to a little town called Eagle Pass, Texas on the border of Mexico and worked primarily with financially disadvantaged Hispanics.   I was a sophmore in highschool and thought it was the coolest thing in the world. I lived vicariously through her stories.   I read every letter she sent home, and I thought….some day I want to do something like that.   Well it only took me forty years, but I finally followed in her footsteps.  Thank you for inspiring me Nancy.

Update:  The Short Version  (The long version follows this if you care to wade through the details of the day to day challenges)

MB  was released from the hospital on Saturday after eight days.  Her gramma and I are clear about instructions and next steps.  There is hope.

Basically the doctors said Mahsoblee must:

• Return in one month to be checked to see if the medicine has solved current problems, at that time they may consider surgery
• If she has abdominal pain she must return right away
• Take medicine every day because her blood is bad (for the rest of her life)
• Sleep under a mosquito net and do other malaria preventive things
• Drink a lot of water
• The shots/medicine I went to Lome for must be given again in three years.

There is still much health care and preventive health care needed for MB.   Sickle Cell Anemia is a lifelong chronic illness.  It is hard to maintain in the states, much less here in Togo. When it rears it's ugly head, it is very, very painful and life threatening.   I think we will need every penny we raise;  now, a month from now, and over time.

I am incredibly tired, and really very surprised that at this point there is hope.  Mahsoblee feels better.  Her entire demeanor and personality has changed.   Having relief from the pain caused by her Sickle Cell Anemia has made a notable difference in her.  She teases me every chance she gets, and giggles a lot.  I never heard her giggle before she started feeling better. 

I think just about everyone has heard the Starfish Story.  It is very simple. Forgive me if you think it might be trite.  During this time Mahsbolee seemed to represent to me everything that was wrong with Togo….. all the sick children, hunger, poverty, and suffering.  There have been so many times that I thought…what am I doing?  Do we make a difference here?   I would think of this story, and it would somehow sustain me.

The Starfish Story
adapted from The Star Thrower
by Loren Eiseley
1907 - 1977
Once upon a time, there was a wise man who used to go to the ocean to do his writing. He had a habit of walking on the beach before he began his work.

One day, as he was walking along the shore, he looked down the beach and saw a human figure moving like a dancer. He smiled to himself at the thought of someone who would dance to the day, and so, he walked faster to catch up.  As he got closer, he noticed that the figure was that of a young man, and that what he was doing was not dancing at all. The young man was reaching down to the shore, picking up small objects, and throwing them into the ocean.  He came closer still and called out "Good morning! May I ask what it is that you are doing?"  The young man paused, looked up, and replied "Throwing starfish into the ocean."  "I must ask, then, why are you throwing starfish into the ocean?" asked the somewhat startled wise man.  To this, the young man replied, "The sun is up and the tide is going out. If I don't throw them in, they'll die."

Upon hearing this, the wise man commented, "But, young man, do you not realize that there are miles and miles of beach and there are starfish all along every mile? You can't possibly make a difference!"
At this, the young man bent down, picked up yet another starfish, and threw it into the ocean. As it met the water, he said, "I made a difference to that one!"

There is so much suffering in Togo it is often hard to believe that we can make a difference, but we have “made a difference to this one!”.

Update:  The Long Version

Sunday, the morning after we arrived home from the hospital:   Ama, (Mahsoblee’s gramma), Toussaint (Ama’s husband) and Mahsoblee came to my house to greet me.  They were all dressed up in their finest, and all smiling ear to ear.  We sat on my porch.  The first thing they did was greet me in Ewe and they  wanted me to repeat to them.  “Indie,”  (good morning).  They then went through an entire greeting in Ewe and tried to get me to repeat.  Ewe is such a difficult language.  Oh my.  But, as they often say to me, “you try, you try.” And try I do.  So I sat there and tried to mimic what they were saying.  My next door neighbor  who was listening on her porch came over and joined in.  The entire time Mahsoblee was bending over, giggling at my attempts, and then we were all laughing.  Good hearty laughs.  Sharing a happy moment, all knowing that we had much to be happy about.  Once the laughing stopped, Ama knelt down on the floor in front of me and said Ack-bee, ack-bee, ack-bee, which is thank you in Ewe.  I took her hand and had her sit back down in her chair.  Toussaint, who is one of the gentlest, sweetest men I’ve had the pleasure to meet here in Tchekpo, just looked at me with the most sincere look in his eyes, pleading  gratitude.   Their love and care for Mahsoblee is so moving.  Their life is hard.  They work from sunrise to sunset in a very rough environment.  They have nothing, no personal belongings to speak of.  They have their matts on their floor to sleep on, and pots to cook in an open fire.  And yet they are just like us.  Their emotions, their fears, their hopes, their goodness, and sometimes their impatience and despair.

 I would like to say once and for all, here and now, two things.  We could not be experiencing this happy day without the help of so many, many people, and without some impossible to define energy that I will call God.   Second, there is nothing heroic or unselfish about my part in all this.   If I have learned one thing only, it is that pure, and I mean pure joy comes from random acts of kindness.  I receive in all of this, so much more than I give, and I knew all along that I would.  I knew that I would feel unmatched exhileration if we somehow could get Mahsoblee through this health crisis and on the road to recovery.  I do feel exhileration, and happiness and gratitude.  

But we have a long way to go.  This is not the end, this is the beginning. 

I will try to help you visualize what our last couple weeks have been like.

Last time I updated my blog we were on our way to Afangnan.  You might note that the spelling has changed since my last post.  I had looked it up on the Togo map before we left, and it clearly said Afangynan on the map.  When we reached our destination I could see that the entire village was spelling it wrong???  It is Afangnan.   Afangnan is a village about three hours from Tchekpo

Mahsoblee and Solomon

We left the Kouve Hospital on a Tuesday, came back to Tchekpo for two nights and left for the Afangnan hospital on Thursday.  Ama, MB and I caught a Bush Taxi from Tchekpo to Taglibo, which is about an hour ride.  I had not wanted MB to have to ride in a crowded, uncomfortable bush taxi all the way to Afangnan, which is at least another two hours.  I contacted  Solomon.  Solomon is a PCV who lives in Taglibo.  I explained the situation and asked him if he could find a car for us to take from Taglibo to Afangnan.   I also asked Solomon if I could borrow some money.  My August pay was not in yet, and I had no idea how much I would need at the hospital.  Solomon is a funny guy.  He doesn’t like anyone to know he is nice.  He’s gruff, and surly and complains a LOT.  But for this he said yes, before I’d even finished speaking.  He was also very upset when he learned that people  in Togo who don’t have money don’t have any healthcare at all. They get sick and they die.  So if not for  many of you reading this MB would surely die.  This upset Solomon so much, that now he is on a quest to start a pilot peace corps project that would provide non-profit health insurance program in one of the villages.  In other words for say $4 a month people can be guaranteed healthcare.  He wonders if this could work?  I think it’s an outstanding idea.  But I digress.  When we arrived in Taglibo Solomon and his community partner Daniel were waiting for us.  They had found a car and driver that would take us the rest of the way to Afangnan.  It was a nice car too, by Togolese standards.  Clean and had vinyl seats.  I took the front seat and Ama and MB had the backseat all to themselves.  This was a luxury for me, but it was probably a first for Ama and MB to ride in a car with no one else.  MB was very excited about it. 

The hospital in Afangnan,  like the smaller one in Kouve is a Catholic hospital managed and operated by Italian nuns.  The hospital is all on one level with many buildings, all connected by several courtyards.  Each building has a hallway and maybe a dozen patient rooms that open up to the outdoors.   Each room has five to ten beds.  It appears that patients are put in a certain room according to age, not degree of illness.  The building that MB was in was specifically a Pediatric unit.  It is very hot and stuffy, and there are no fans.  The only access to electricity is in the hospital offices.  Luckily I did have access to internet with my wireless key.  I was only able to connect a few hours a day, but it was a big help to feel connected and get support from the world outside of Anfangnan and the hospital.

We arrived at the hospital on a Thursday and stayed for eight days.  We went to admissions armed with all of MB’s health records from Tchekpo and Kouve.  Admissons was not so different than a hospital admissions we would encounter in the states.  It was a medium sized room with a desk and couple nurses and orderlies.  There were four sectional areas with gurneys and surgical green curtains that could be slid open and shut for privacy.  We talked briefly with the admitting nurse, told her why we were there, and handed over MB’s health records.  They had MB lay down on the gurney and examined her.  I thought our primary reason for being there was to schedule surgery for removal of her spleen.  I thought that was already recommended and ordered by the hospital in Kouve, but that was not to be.  The staff at the Afangnan hospital said that she would need to be examined by their staff and their surgeon, and they would decide a course of action.  That made sense to me.  I thought of it as a second opinion.  However….they said this is Thursday and the surgeon will not be here until Saturday.   So we had a long wait ahead of us.  They explained to me that Saturday morning I should go to a designated office and pick up a number and that was to be our ticket to see the surgeon. 


Admissions then directed me to the cashiers post to get MB admitted.  The Cashiers office is around the corner from Admissions.  The cashiers are in an office, the people waiting  were  sitting on long benches outside in front of the cashiers office. Twenty or thirty people waiting.  MB and Ama stayed in admissions as I waited for my turn with the cashier.  The cashiers office had three dirty windows with a slit at the bottom so that you could pass paperwork or money back and forth.  I could barely see the cashiers because the windows were so dirty.    I got very close, squinted my eyes and tried to see who I was talking to, but I couldn’t see in.  Each window had a specific purpose for processing.   I would go to one to get or receive information sit and wait, be called to the next, until I reached the third window and actually exchanged money.  To be admitted we paid 50mil or $100.  That was to pay for two weeks stay in the hospital.  I also paid 5mil or $10 for the doctors consultation.  I had brought a total of 70mil with me including the money I borrowed from Solomon, so that left 20mil.  That was not going to be enough to get us through the next two weeks or for medicine and surgery if needed.  I would think about that tomorrow.

Once the admission and consultation fees were paid I went back to admissions and they walked us to the Pediatric unit and to what would be MB and Ama’s home for a while.  M.B.’s room had ten beds.  It was completely full.  Each child had at least one family member with them if not three or four.  So it was a big, busy room.  The beds all had mattresses with clean fabric draped over them which served as sheets.  Each patient also had a ponya (their own fabric they brought with them) over the sheets.  Visually the room was immediately African.  Lots of color, lots of noise,  lots of languages I didn’t understand.  There were some very, very sick children.  In fact MB looked the least sick of all.  The children ranged in age from four years to ten years old in this room.  Many of the sick ones laid in one position, not moving, glassy eyed.  A few had IV’s.  The room was fairly clean, but it did smell of urine.

The boy and his brother

One developmentally disabled boy, about eight years old was surrounded by and lovingly attended to by his mother and two siblings.  Later in the week an aunt came to relieve the mother for a few days.  The boy would often get distraught, and become hard to manage, gurgling his desires or uncomfortableness in unintelligible sounds.  His family would oh so patiently find a way to soothe him.  Their care of him was touching.  They took turns.  Not one of them including his twelve year old brother seemed to consider it a chore or an inconvenience.  His mother had one baby strapped on her back or was breasfeeding while taking care of the boy at the same time.  I would also see the twelve year old brother  strap his brother on his back and take him for walks.  The twelve year old being only a little bigger than the eight year old. I guess I bring attention to this particular boy because it was obvious how much his family valued the little boy, even though the boy could not communicate, or feed himself, or even acknowledge them.

The kitchen gazeebo

MB and Ama were very worn out by the time we got to the room.  They both looked very small and a bit lost in this big room with all these strangers.  I went out to the hospital courtyard, across the road to find them some street food.  MB loves hard boiled eggs, and they are good for her condition, so I bought four; 2 for her and 2 for Ama.  I also bought some bread.  I had made a little care package to bring with us, not knowing what the food situation would be.  From home my daughter Andrea has sent me little individual cups of applesauce and peanut butter which I brought with me.  When I returned to MB’s room we went out into the courtyard and had a little picnic of the hardboiled eggs, applesauce, and I made some peanut butter sandwiches with the bread.  Ama and MB brightened up a bit after this.  The hospital does serve food to the patients, but it’s not very nutritious.  Gruel, for breakfast, kind of a sugarless tapioca pudding, and typical African food mid afternoon which is all starch.  As in Kouve, Ama and the other family members all needed to cook for themselves.  There was a gazebo outside the Pediatric Unit where mothers would set up their little charcoal stoves.  Ama had also brought food to cook from home.  In fact that’s why we left a day late because she wanted to go to her little farm and gather some food to bring, remembering that’s what she had to do in Kouve, and possibly not completely trusting that I would be able to afford to feed her/them if needed.


I immediately found a male nurse who could speak French, Ewe and fairly good English. His name is Blaise.  He is tall, handsome and very, very pleasant, maybe twenty-five or so.   Of course I glommed onto him and made him be my friend and translator.  I have his phone number and am invited to call him now whenever I have questions about what I should do.  I can see though, that he at times gets exasperated with me, and feels as unable to meet my needs as I am unable to meet MB’s.  But we try…..we try.  For the first two days Blaise interpreted for me to Ama and he answered the many questions I had about how things work.  When he told me was going to have a couple days off…..he laughed when he saw the horror on my face.  “Du courage,” he said.  Have courage. 


After I got Ama and MB fed and settled in I went back to the waiting area where the cashiers are located.  There were still five or ten people waiting.  I took out my computer and connected to internet for awhile.  Then I just kind of sat on the bench and watched the goings on of the hospital, stared into space and wondered where I would sleep that night.  I decided right where I was sitting would probably be the best place.  There were long wooden benches, and it was inside the hospital grounds.  I was not at all worried about safety.  I’ve learned, in Togo, to always bring my own sheet with me; even to the hotels in Lome.  So I had a sheet, and I thought I’d be able to fairly comfortably sleep in the bench.  The waiting area emptied.  It gradually got dark.  As I watched the sun set over the roofs of the buildings of the hospital I marveled at the beautiful African sky.  I set up my little makeshift bed.  I had two magazines I used as a mattress under my butt and my back, and covered myself up in the sheet like a mummy, covering myself from my head to my toes.  Before I fell asleep I prayed to whoever was out there that might be listening.   I woke several times through the night.  It got very chilly.  A couple workers walked by and would greet me and ask me if I was ok, and kinda look at me like …. What in the heck are you doing??  For the most part I slept pretty soundly.  And while burrowed under my sheet I really couldn’t help but chuckle at my circumstances.  Whaaaaaaa?

Ama

Friday morning I woke up early as I heard the day workers filtering in, and felt the air getting warmer.  I unburrowed myself from my cocoon.  They allowed me to use the toilet in Admissions to freshen up and change my clothes.  I walked over to the Pediatric Building to visit MB and Ama.  Patients and visitors greeted me all along the way, as they always do, every day.  Ama and MB were happy to see me and said they had slept well.  Ama kept asking me if I’d gone back to Tchekpo to sleep, and where DID I sleep?  She couldn’t quite get a handle on it.  I’d say 90% of the time Ama looks at me with a confused look on her face.  We’ve even had a few squabbles which is really funny with the language barriers.  So we usually….usually end up laughing, but Ama holds her own and will not be patronized.  She and I have come to a point of trust and respect for each other.  It did not happen instantaneously.  Ama told me through Blaise that they were hungry and that she needed for me to buy her a little cooker so she could cook.  I walked outside the hospital compound, bought some street food and walked further down the road to find a little charcoal cooker to buy.  When I returned Blaise handed me two prescriptions to take to the pharmacy to get filled for MB.

Breakfast!

Every morning I would walk across the road and have an egg sandwich and their version of a café au lait from a street vendor.   After a few days the young girl who cooked started expecting me and we developed a fun little repartee each morning.   I would order, ask if I could take her picture.  She would laugh, say nooooooooooo, and fix me a delicious breakfast.  After the second morning, I didn’t have to order anymore.  She just knew what I wanted.  On the last morning I got my picture, but it took much cajoling and wasn’t easy, and only if her friend could be in the picture.  She the girl on the right in the picture.

The beauty shop

I spent a couple hours in the mornings and a couple hours in the afternoons with MB and Ama.  The rest of the time I sat over by the cashiers office and was on the internet or just people watching.  The first full day we were at the hospital I walked over to their room and they weren’t there.  People in the room waved me outside to a courtyard.  There I found MB, Ama and several other women.  MB ran up and hugged my knees.  She seemed to feel better.  She had me sit down on a little stump and she put her arm through mine, and teased me and laughed at me.   The women gather in this little courtyard every day.  There are always four or five standing around chatting and laughing.  This was just the second day we’d been here and Ama seemed to know everyone, and everyone knew her.  As we sat outside one of the women began to brush and braid Ama’s hair.  They chatted the entire time.  The woman who was fixing Ama’s hair had just finished with two other women, and they looked so pretty.   Ama, who is a very pretty woman was looking a bit haggard and her hair was just all over the place.  By the time she was finished, she looked and I’m sure felt like a new woman.  It struck me what a very nice thing this was for Ama and the other women.  It refreshed them and made them feel pretty.  The women who was fixing hair was very, very good at what she was doing.   I could see that it brought some lightness to their otherwise dismal environment. 



All the women were very curious about me.  They ask Ama who I am, why I’m here.  They know my name, and by the second day half the people I encountered would smile warmly and say ah-fwa (hello) Adoowa!  It helped me get through the week, having everyone be so warm and welcoming.  The staff wasn’t quite as welcoming.  Maybe they were just too busy.  At any rate they pretty much ignored me unless I planted myself in front of them to ask a question.    I think even Blaise, would occasionally hightail it another direction when he saw me coming.  It did not deter me.

Erik and Mahsoblee

Saturday morning, as instructed I went to the building to pick up my lottery number to see the surgeon.  We were number 61. Mmhmmm.  I then went to MB’s room and got MB and Ama.  We headed over to the surgeons office to wait our turn.  We were sitting on a bench in a an open hallway with probably a hundred other people, not really knowing how this was going to work.  My thought was that the surgeon would look at her records, check Mahsoblee out and schedule her surgery.  Of course, I was wrong.  While waiting a young man about twenty sat down beside me and started speaking English to me.  His name was Erik and he was from Benin (a country just over the border.)  Did I just here trumpets???   He told me he was there with his brother and his mother.  Both had come to the hospital to have minor surgery.  He told me many, many people from Benin travel to this hospital for surgery because it’s such a good hospital.  That alone made me feel better.  He asked me why I was here.   I explained our situation.  Blaise was off work for the day, so I asked Erik if he would help me with translation when we meet with the surgeon.  I wanted to make sure that both Ama and I understood exactly what was going on, and also that Ama and I understood each other.  He spoke English, French and Ewe. (I did here trumpets…and a harp, and a chorus of angels!!)  He was a very kind, thoughtful boy.  Well groomed, good manners.  He seemed to instinctively know that we needed help, and just how to help.  He said he would be at the hospital for the week, and he would help us through the process.  In addition he was good friends with the surgeon.  The surgeon happens to be an Italian nun.  He left me for a few minutes and when he reappeared we were all of a sudden at the front of the line. The boy had connections.   We went in to see the surgeon, but there was a bit of a mix-up.  I had been confused and not understood what we were supposed to do.  The surgeon could not examine MB until the doctors in her unit had examined her and done a new assessment, and until she had her echograph which was to examine her liver.  The doctors would not be examining MB until Monday.  This is Saturday.  We’ve been here since Thursday.  Uhhhh, ok.  We can roll with this.  Luckily Erik could explain the situation to Ama so she wouldn’t be confused, ha! And to me so I wouldn’t be confused.  Because Erik was friends with the surgeon, she said that after she had finished seeing all these patients she would come over and look in on MB just as a favor and to reassure us.  Erik and I exchanged cell phone numbers and we kept in close touch every day.  Whenever I needed him, he was there to help me.  He fell in love with MB just like everyone does, and she him.  I will never, ever forget the gift of Erik.  I hope he and I somehow can keep in touch forever.



Thursday night and Friday night I slept on the bench.  I couldn’t face it another night.  And I was beginning to stink.  Oh, don’t think I didn’t notice when people backed up as I approached.  There were two Peace Corps Volunteers within moto distance.  Christina lived closest in Amergnan, just eight miles away.  Ben lives in Anfoin about thirteen miles away.  I contacted both of them.  Christina was going to be out of town until Sunday, but Ben was home and said I was welcome to spend the night….in a bed, take a shower, eat real food.  I went to Bens  Saturday afternoon, and had such a nice relaxing time.  Ben’s an NRM (Natural Resource Management PCV)  He’s a great kid.  He reminds me of the main character in The Great Santini.   Full of energy and ideas, and he spent  semester in Italy, which he loved, so he spends a lot of time talking about Italy.  He’s also a good cook!  We just sat around for awhile then went into his village and met a few people, went to the marche to pick up some fresh vegetables for dinner.  Then we visited a friend of his who has a bar down by the river.  His friend is in the process of building a nightclub with a deck that goes out over the river.  This river happens to have crocodiles.  The deck and building is half finished, and for Togo, especially rural Togo it is very cool indeed.  Ben’s friend, Ben and I sat down by the river and the half-finished deck, drank a couple beers and chatted.  It was so pleasant.  The weather was nice, the beer was cold, the company was interesting.  What a nice break for me.  I also thoroughly enjoyed the moto ride to and from Anfoin.  Thirteen miles on backroads of bush country.  So fun.

Path from Christina's to the road

Now it’s Sunday and I’m back at the hospital.  Nothing really happened on Sunday except for that fact that Ama told me I needed to go somewhere to buy a thermometer so they could take MB’s temperature.  Geeeez.  Sometimes it gets to be too ridiculous!  I mean at the very least I would have expected them to have thermometers.  I went to the hospital pharmacy first, and they did not have any????  They told me I could go the pharmacy down the street to buy one.  Which I did.  Sunday was just kind of a long, tedious day.  MB wasn’t feeling as well.  Seemed like she was getting worse.  She had a fever, and was coughing, and was complaining about pain in her abdomen.   She didn’t feel like taking a walk or playing.  I visited with Ama and MB for a while in the morning   and a while in the afternoon and then I went to Christina’s house for dinner and to spend the night.  Christina had just returned from a conference, and would only be home this one night, then she was off to an annual Peace Corps Childrens Camp, Camp Unite, to be a counselor for two weeks.  We had a really nice visit though.  She fixed a delicious dinner and offered me the key to her house to use  for the duration of the hospital stay.  She has a nice house, but her electricity was not working.  I would sleep there the rest of the week.  Get there just before dark, fix myself some dinner,  shower, read, go to bed when it got dark, and then up early the next day and moto to the hospital.  It was a bit lonely, but also very nice that I had someplace comfortable to stay.

Doctors Rounds

Monday morning I checked into the hospital early so I could catch the doctor.   I called Erik and asked him to meet us in the Pediatric Unit.  Of course he did.  I watched as the doctors made their rounds.   The doctor made his rounds with a cart that held each childs records.  He had an entourage of three people with him.  Two nurses and someone who recorded the condition and next steps for the patient.  I was impressed with their professionalism and seriousness.  The doctor, in MB’s wing alone saw at least sixty patients that day.  He was slow and meticulous.  I also saw him stop more than once, bend over touch, tease or just talk kindly to one of the many little children who were wandering up and down the hallway.  Some were patients, some were visitors.  With all that he had to do, to take the time for that impressed me.  MB’s room was the last room they visited.  When he was finished he stood outside the room and patiently listened to Erik translate my questions.  He gave me thorough answers.  That afternoon MB would have the echograph and Tuesday she would probably see the surgeon. 



Anticipating surgery, and knowing that everything had to be paid in advance, and being all but out of money made me focus on what to do about that.  I decided to travel to Lome that afternoon so I could go to the bank.  My monthly Peace Corps allotment is deposited into a bank in Lome.  My August money was there, and it would be more than enough to pay for anything we needed for now.  I caught a bush taxi from Anfangnan to Lome.  It was about a three hour ride in a full taxi (16 people.)  It was interesting though because I’d never seen that part of the country or gone to Lome from that direction.  Half of the trip ran parallel to the oceon, so it was a scenic and calming ride.  Once I got to Lome I went to the marche to the bank.  I also did my monthly shopping.  Every month when I go to the bank I go to the yo-vo (white person) stores and buy basic staples; olive oil, oatmeal, honey, etc.  I did my monthly shopping…someday I’ll be home.  I caught a taxi to the Peace Corps headquarters, spent a while in the lounge checking internet and just relaxing and then met with Aurelia. 



Aurelia is the Peace Corps Nurse Practitioner.  She is Togolese.  I just love her.  She’s helped me with a few other projects.  She’s a smart, savy, sweet knowledgeable woman.  She had heard a little bit about MB from Solomon.  She invited me into her office to talk.  We sat on her sofa.  Even that was a kind gesture.  She’s a very busy woman, even more so right now with a brand new crop of PCV’s getting ready to go to their posts.  She dropped everything to sit and talk with me.  First she said, “how are you, tell me what’s going on.”  I said I was fine, until I had to talk about it, then my voice cracked and I started to cry, but quickly composed myself.  I told her everything.  Everything we had been through.  Kouve, the blood transfusions, Afangnan, the difficulty communicating, the traveling all over Togo, my worries and frustrations.  It felt so good to be talking to someone who was Togolese and also knew the frustrations of being a Peace Corps Volunteer (not to mention a 60 year old volunteer.)  She knew a lot about sickle cell anemia.  She said she had several friends who had children with sickle cell, and how difficult it is, and how painful it is, and she explained how it worked and manifested.  I told her that I wasn’t sure if I was doing the right thing’ because it is so hard to maintain that maybe I should not have interfered, but let it take a natural course.  She said, “Oh no….you are doing the right thing, thank you for helping this child.”  She gave me more valuable advice on what to do next and offered me her phone number for anything that I might need.  She was wonderful.  I’m so grateful to her.  I slept soundly at a hotel in Lome that night and left early the next morning to return to Anfangnon.  The hardest thing about the trip home was trying to find where to catch the bush taxi.  I had a good seat and enjoyed the ride.

The Pediatric Unit

Tuesday morning Erik met me in the Pediatric Unit so that we could talk to the doctor.  The results of the echograph were in, and we caught up with the doctor after his rounds.  We talked for a long time.  He said that MB’s stomach was so swollen that it was pushing against her organs causing her pain.  He didn’t specifically say anything about her liver.  Erik went back and forth translating between me and the doctor.  The doctor was very patient waiting for Erik to translate things back to me.  I appreciated it, as busy as he is that he would have patience for this.  He said that he was not recommending surgery for removal of her spleen at this time.  He wanted to try her on some meds first to see if they would work, and that surgery would be their last resort.  He gave me two more prescriptions to get filled.  At the end of the visit, I asked Erik to ask him how long he thought MB would be here.  The doctor then, in very clear ENGLISH said to me that he wanted to keep her a few more days.  Huh??  I looked at him stunned.  I said you speak English???  He laughed and said, small, small. 


Erik and I then went in to talk with Ama.  This was the most helpful conversation I had.  Ama and I were both frustrated that we couldn’t talk to each other.  We both had questions.  All along I’ve wanted to make sure that Ama knew I was only helping, but that she was in charge.  I never wanted to seem like I was bossing her around or taking over.  I told Erik to tell her that I know it’s been very difficult and frustrating because we can’t talk to each other.  She told Erik that she would stay as long as they needed to, but that she didn’t have any money and didn’t  know how she would ever repay me.  I told her not to worry about that.  I told her there were many, many people in the United States who were helping, and the most important thing she could do is make sure MB was taking her medication like she was supposed to and that together we would learn things that she can do that will help keep her well, like having her sleep with a mosquito net and eating the right food.  That conversation lasted almost an hour Ama and I came to terms with each other, and understood each other better that day.  



I took the prescriptions to the hospital pharmacy, and was told that they did not have this medicine.  “The only place you can get it is in Lome,” they said.  I could have cried.  I think maybe I did cry…I’m sure I let out a little scream.   That meant that I had to make another trip to Lome that very day, when I had just returned the day before.  There’s that yin and yang of things….The hospital pharmacist saw and heard my dismay.  He was very nice to me, and wrote down where I could go in Lome to get it.  He talked to me awhile about why I was here, and where I was from, and then he told me a little bit about himself.  He had studied for the priesthood but decided it wasn’t the right decision for him, and is now a pharmacist.  I tell you this little side story because all along the way through all the trials and tribulations, I kept meeting people who were kind and helpful.  His name was Silver and he gave me his phone number in case I needed help while I was in Lome.  He then told me if there was anything I needed he would be happy to help.  As you might have noticed I have now acquired quite a few S.O.S. phone numbers.  I'm literally only a phone call away from many people who have offered their help.

I told Ama and MB goodbye and set off once again for Lome.  This time I took a small passenger car.  They pack six passengers in car taxi’s.  These are usually little Toyotas.   Two in the front seat plus the driver and four in the back seat.  I much prefer a bush taxi for long rides.  Only a car taxi was available.  I got In the back seat and on this trip there were four in the back seat plus a little girl about seven.  She sat on my lap, just because it was easier as we were all positioning ourselves in the car.  She sat on my lap almost all the way there, until I couldn’t feel my legs anymore, then I handed her over to her mother.  I wondered if my legs would hold me up when I got out of the car.  They did.  I went straight to the Peace Corps Headquarters when I got to Lome.  I spent some time online and visited with other volunteers who were there.  I talked with Aurelia about the medicine, and she told me it was too late to get it today, that I should rest, stay in Lome for the night and get the medicine first thing in the morning.  It was good advice.  I ended up going out to a dinner with four or five PCV’s.  The food was delicious and the company was great.  It was a nice diversion.  One of the PCV’s, Becca was staying in the med unit.  She told me I could stay in her room.  It’s kinda against the rules, but I did not have the energy to go to a hotel.  I got to take a hot shower, and I slept so deeply that night.   I was up at 5:30, and on my way by 6:00 the next morning.  I caught a taxi and explained to the driver that I needed to go to this specific pharmacy.  I showed him the paper that had the name of the pharmacy written down.  I was very dubious that this driver knew how to find where I needed to go, but he said yes….I know, get in.  They will say about anything for a fare.  Well my God I was in that taxi for an hour, and he stopped every fifteen minutes to ask where this pharmacy was.  We finally found it.  I was there at 6:55 A.M. and the sign outside said it opened at 7:00 A.M.  Perfect.  When I saw men unlocking the doors they told me it didn’t open until 7:30 and pointed to the sign.  Sure enough one sideof the sign said 7:00 and one side said 7:30.  I must look pretty pathetic sometimes, because they let me in about 7:10 and had the medicine  and filled the prescription.  I was on my way back to the bush taxi stand and then back to Angfangnan.  I had the bush taxi drop me off at Amergnan where Christinas house is.  I had arranged to meet Solomon there.  He was coming down for the day to visit, and to also bring some meat for Ama and MB.  The doctor had said that MB needed some red meat, and there was none to be found in Angfangnan or surrounding villages, so Solomon volunteered to buy some in Taglibo and bring it to us.  He rode his bike from Taglibo…(a two and half hour bike ride) and wanted to shower before we went to the hospital….so we coordinated the timewe would meet at Christinas house.  He was at Christina’s house when  I arrived.  He took a quick shower.  We moto’d to the hospital and arrived about 11:00 am.   I took the medicine to the nurses station, pretty proud of myself for having accomplished this task, though no one else seemed impressed.  

Ninja Stars

We gave Ama the meat which she was very happy to get.  Lots of the kids gathered around when Solomon got there.  He had brought stickers and colored pencils and paper for them to draw with, and he made Ninja stars out of paper for each of them.  They were thrilled.  He made one for every child in the room.   It was a fun afternoon.  Solomon and I moto’d back to Christina’s.  We sat on her porch and visited for awhile.  He took off in time for him to get back to Taglibo before dark.

On Thursday I was sent to the hospital pharmacy for more medicine, and prayed on the walk over that they would have it, so I wouldn’t have to go to Lome.  They did.  Silver was there.   I told him with his help I was able to find the pharmacy in Lome, and it all went well.  He was pleased.  When I returned MB and Ama weren’t in the room.  Some of the women told me they were over at the cooking station.  The cooking station is a big gazebo.  There were and are usually ten to fifteen women in the gazebo cooking food for themselves and whoever else is there with them.  They all have their own little charcoal stoves.  Ama smiled when she saw me, showed me what she was cooking.  Some sort of stew in a tomato sauce with the meat we had bought.  It looked really very good.  She asked me if I’d like something to eat.  I thanked her, but declined.  MB was sitting next to her watching.  She jumped up and hugged me.  She looked better, I thought.  Didn’t seem to have a fever, and it looked like her tummy wasn’t quite as big or hard.  Could this be progress?


We were to meet with the doctor again on Friday morning.  Erik came over to assist.  The doctor said that MB was doing a better, and that he was going to send her home.  I was surprised, and a little nervous, but happy.  He gave us a list of instructions, a sack of medicine and said that we should return in one month or right away if she started to have abdominal pain. He also gave me a couple more prescriptions to have filled.  Erik listened very carefully and translated both to me in English and then to Ama in Ewe.  Erik is by far the best translator I’ve worked with.  Once we felt we knew everything we needed to know, we said our goodbyes to Erik.  MB and Erik had become very fond of each other.  It seemed as if they really cared about each other.  Erik picked her up and gave her a big hug then turned to me, took my hand and thanked me.  Thanked me??  For helping MB.   I had given him my email address and asked him to please keep in touch.  He said he would.  I hope he does.  I know that Erik was not an apparition.  Of course, I know that.  But he could have been.  It’s like he was just there in front of me when I needed help so much, and he was there every single time I needed him, and then he was gone.  I hate it that I will never see him again.


I went over to the pharmacy to get the last prescriptions filled and hopefully see Silver.  He was there, and happy for us as well.  I asked him if he could help us get a private car to go home in.  He found one for a reasonable price.  So we were going to have the luxury of riding straight home in a car.  Just the three of us and the driver.  But first I had to check out.  Ama busied herself packing everything up, and MB wanted to go with me to the cashiers to check out.  It took us two hours to check out.  MB grew impatient, and everytime they called someones name she elbowed me to go up there.   Finally it was all done, and we were on our way.  On the way out, I stopped and told Blaise goodbye, and the nurses in admissions who had let me use their toilet.   I probably told a half dozen other people I’d seen every day goodbye. 



On the way home MB seemed so happy and excited.  She seemed a lot better than when we had arrived.  She had more energy, and she was giggling at everything I said.  During the week I had taught her some words in English.  Where’s your nose, ears, eyes etc.  So we went through that about twenty times in the car.  She’d tease me and point to the wrong thing and then giggle some more.  One last thing….it’s about Mahsoblees giggle.  I’ve known Mahsoblee now for a year, and I’ve seen her almost every day.  While she always had a big smile on her face, I never heard her laugh.  A few days after she started feeling better she started giggling, just bending over, and laughing, mostly at me.  I would do just about anything to hear her giggle.  Mahsoblee’s giggle is worth every single hardship we endured. 


We still have a lot of work to do to keep this disease managed so that she can grow up healthy and happy and pain free,  and so we can hear that giggle.  I love Mahsoblee. 


Thanks for your encouragement, help and prayers.

To be continued

August 8, 2011

A short update on Mahsoblee…..She developed a nasty rash all over her body. It itched and she was very uncomfotable.  We took her to the clinic here in Tchekpo on Saturday and they prescribed some medicine.  I also called Aurelia the Peace Corps Nurse Practioner for advice.  We discontinued two medicines temporarily.  The medicine that was prescribed worked!  However it seems that Mahsoblee is experience abdominal pain.  The doctors in Afangnan told us that we should return right away if she started to have abdominal pain.  Tomorrow morning we will go to Afangnan back to the hospital.  The doctors were hoping that medication would solve the problems, and said that surgery would be a last resort, but it looks like we might have to go that route.

August 15, 2011

We returned to Afangnan last Wednesday.  Mahsoblee, Ama and I.  MB’s rash was completely gone, but her stomach was very, very big and hard.  She had also been complaining about abdominal pain.  Ama said that MB didn’t want to play with the other children because it hurt if they touched her tummy.  When we checked out of the Afangnan Hospital a couple weeks ago, they said to return right away if she had abdominal pain.  So we did.


Wednesday morning we walked down to the main road in Tchekpo.  I had hoped we could just get a car to drive us all the way there.  After waiting for an hour I decided to catch a bush taxi and then catch a car in Taglibo like we had done the last time, but finally a man in a very nice car stopped and offered to give us a ride.   It was a comfortable ride from Tchekpo to Taglibo.  The car even had air-conditioning.  Other than the Peace Corps vans, that is the first time I’ve ridden in an air-conditioned car since I’ve been in Togo.  The man’s name was Justin.  He was such a nice, gracious man.  We chatted all the way to Taglibo.  He even handed me 10 mil (about $20) for MB's care when we got out of the car, gave me his phone number and asked me to let him know how she was doing.  We then took another car from Taglibo to Afangnan.


The Afangnan visit was very quick.  We didn’t have to wait very long, about an hour.  While waiting, there was a woman who was doubled over, kneeling on the floor, with her head on a chair writhing with pain.  Everyone just ignored her.  The intake worker kept coming out of her office to call the name of the next patient to be seen.  Each time she did this she didn’t even look at the woman who was wailing.  The intake worker reminded me of a prison warden.  Mean and nasty.  None of the healthcare workers smile.  I guess maybe if I were them, I might not either.  I just kept getting angrier and angrier as the woman’s wails got louder and no one, no one helped.  Finally I barged into the exam room.  The prison warden and a nurse were sitting at a desk.  I said, “Someone needs to come out here, there is a woman in serious trouble.”  I swear they just looked at me with disdain.  The prison warden, after several seconds, and because I wouldn’t leave, finally got up and came out of the office.  She looked over in the woman’s direction, turned around and went back into the exam room.  I couldn’t believe it.  Finally about five minutes later another nurse came and got her.  They walked her into an exam room.  She was doubled over and moaning.  I don’t know what became of that woman.  It was awful. 

The prison warden came out and called Mahsoblee's name.  I had moved down a bit to sit on a chair that had some padding.  I was reading a book and I didn’t hear her name called.  I glanced over and noticed they were gone.  Again, I barged into the exam room.  Again the prison warden and the nurse looked at me with disdain.  Whatever…..  They took her temperature, felt her tummy, and proceeded to tell us that she was normal.  That her pain and the fact that she looked nine months pregnant was “normal for this disease.”  I said, “Our instructions were to bring her back right away if she had abdominal pain???”  She said, “that's a different kind of abdominal pain.”  Awwww.  I see.  Hmmmm.  I guess they didn't tell me there might be two different kinds of abdominal pain???  The prison warden never looked at me or us.  She just sat in her chair and stared into space.  I asked the nurse, “How will we know when to bring her back?  If not by abdominal pain.”  She said, “If she is running a fever.”  I had her look at the echograph pictures of her liver again.  The nurse said it was enlarged from the anemia.  It was all very frustrating.  A long hard trip.  I just didn’t know what to think or if MB was really ok.  We went back to Tchekpo.  Mahsoblee was in a fun, playful mood on the way home.  She thought that since the doctor touched her that she was cured.  I think that’s what happens in voodoo-land, and that’s what she was relating to.


When we got back I sent Aurelia the Peace Corps Nurse Practitioner an email and told her what they had said in Afangnan.   She had wanted me to let her know.  She emailed back and said that she thought I should take her to a Pediatrician Specialist in Lome.  She said she would call someone and get back to me.  She emailed later that day and said that we could go on Thursday or Friday.  It was in Lome.  She said once we get to Lome to call her and she would give the driver directions.   So, once again I had to go over and talk to Ama and tell her that we were taking yet another trip.  Ama knew that the nurse in Afangnan said that Mahsoblee was normal, so I think she was feeling pretty good about it.  I had an interpreter go with me to speak to Ama.  Ama looked a little dubious, but through the translator she said, “If someone offers a gift you must receive it, so we shall go, and we thank you.” Toussaint, Ama’s husband asked if he could go also.  “Of course,” I said.


I had my translator hire a driver to take us, wait for us, and bring us back from Lome.  He had a nice car, and the trip back and forth was very easy.  Easiest trip we’ve had thus far.  We called Aurelia when we got to Lome and she gave the driver directions.  I don’t know how he ever found it, to tell you the truth.  I’d never been to this part of Lome.  It was a four story hospital at the end of a residential neighborhood.  Lot's of twists and turns to get to it.  This was a private hospital.  There was a stark difference between this hospital and the ones in Kouve and Anfangnan from beginning to end.  It just felt more professional, maybe more effective, and the employees seemed more professional and caring.



The doctor’s visit went well.  Dr. Wossonou was a very, very kind, gentle man.  I saw him come out to the lobby himself and get each patient, as he did with Mahsoblee.  We went into his office where there was a desk and a couple chairs.  No windows.  A nurse stayed in the room with us also.  She was fully engaged in what the doctor was saying..  There was a ceiling fan, but it wasn’t on, so it was very stuffy.  Dr. Wossonou looked over all of MB’s records, including the echograph and he examined her.  Then he talked to us for a long time, at least an hour, in a very unhurried, soft-spoken voice.  He spoke first to me in English and then to Ama in Ewe.   He said MB is ok for now and then he gave me more information about sickle cell.  I think her gramma and I have a full circle of understanding on what to do, and what to expect.  It's not pretty...her disease, especially in Africa.  I came right out and asked him about MB's life expectancy.  He paused and somewhat skirted the question, but left with me the impression, that only God knows.  We can just do our best to help her keep the disease at bay.  Have her take her medicine daily, really focus on getting her to drink lots of water.  He said experts think that this really helps.  Mosquito net and all the malaria preventive things.  He said we should probably take her to a hospital once a month to be checked.  If she started running a fever that we should take her right away. “In Europe” he said, “and probably in the U.S. they've been having good results with bone marrow transplants from siblings”....but he said ..."nowhere in Africa."  He then went on to tell me how difficult the disease is here in Africa and that he had recently treated a woman with sickle cell who was pregnant with twins.  All three of them died.  He choked up when he told me this.  It took a few seconds for him to compose himself.


He spoke just as unhurriedly and carefully with Ama.  He also told Ama they shouldn’t do anymore scarification(1) rituals on Mahsoblee's tummy.  He told her this ritual was bad for MB, could cause infection and make her condition worse.  Scarification is a widespread ritual in Africa.  It is done for many reasons, and often over time.  Almost everyone has scarification somewhere on their body in Togo.  Mahsoblee has tiny scars on each side of her tummy.  The doctor also cautioned us about too many blood transfusions.  He said here in Africa the hospitals tend to give blood transfusions to sickle cell patients too often.  



I would like Mahsoblee to continue to go to Dr. Wossonou, and his hospital for all follow-ups.  I think we all felt very comfortable with him.  We trusted him.



Anyway....she's doing very well right at the moment.  I asked Doctor Wossonou if she could go to school in September.  He said, “she can and should, as long as her teachers and the director of the school are aware of her condition."  In the meantime we just do everything we can to keep her from getting malaria, and help her eat right, and drinking lots of water.  She will have more sickle cell crises......

Mahsoblee and her BFF Charlotte

I'm kind of in denial about it all, because right now she's bright eyed and full of energy.   Sunday I asked Ama if MB could walk to the market with me.  We had such a fun time.  She held my hand the entire way there and back.  When some other kids called me yovo, she yelled...noooooo yo-vo.  Adoowah, Adoowah, then she looked at me and giggled.  Oh the giggle!



Scarification is a long and painful process, and a permanent modification of the body, transmitting complex messages about identity and social status. Permanent body markings emphasise fixed social, political and religious roles. Facial scarification in West Africa is used for identification of ethnic groups, families, individuals, but also to express personal beauty. It is also performed on girls to mark stages of the life process, such as puberty, marriage etc. They can assist in making them more attractive to men, as the scars are regarded as appealing to touch as well as to look at, but also as testimony that women will be able to withstand the pain of childbirth.

Scarification can be regarded as a boundary marker in terms of life stages, but also as an accepted cultural differentiator between the self and the other, or the civilised self and the natural self. As Susan Vogel states, "Scarification and other forms of body decoration were traditionally considered marks of civilisation. They distinguished the civilised, socialised human body from the body in its natural state and from animals." (Vogel.1986.p.25)

October 22, 2011
Milestone for Mahsoblee

Mahsoblee is six years old, or so her gramma thinks.  Most kids in Togo start school at age 4 or 5.  Mahsoblee didn’t go to school until now because of her health.  She was too sick, too fragile to attend. 


If you’ve read some or all of my posts about Mahsoblee’s journey, you will know that it has been quite a challenge.  My goal was to get her well, and then help educate her gramma on how to maintain her health.  Mahsoblee has sickle cell anemia.  It is a lifelong chronic illness, with the age of 30 being the life expectancy here in Togo for those who have sickle cell.  Many, many die before they reach five years of age.  All suffer with daily pain.  Sickle Cell is difficult to maintain in the United States.  It is a monumental effort to maintain in Togo.  Medicine, nutrition, water, malaria prevention….



Since July she has endured two blood transplants, twenty days in three different hospitals, pin pricks, IV’s, and a myriad of consultations from doctors and surgeons, poking and prodding her tiny body.   Until at the end we were armed with information, knowledge and a plan that we could only hope will help maintain her health and keep her disease at bay.   She will continue to go to the Kouve Hospital once a month for doctors consultation and for laboratory tests.  When I leave in August 2012, I have recruited the nuns from the Kouve Hospital and a person here in Tchekpo to help Mahsoblees gramma maintain Mahsoblees health, education and well being.


The last doctor we saw in Lome was Dr. Wossonou.  He is a pediatrician specialist.  He explained to us the challenges Mahsoblee has in front of her.  He also emphasized the degree of pain that she endures every day.  I asked him if she could start school.  He said that she could and she should start school, but that Director and her teachers should be aware of her illness.  I was excited about this news.  All last year I would see Mahsoblee sitting on the stoop in front of my house when the kids were going and coming from school.  I wanted her to be able to go.  She’s a very, very smart little girl. 

Touissaint and Mahsoblee

We used some of the donated money to have a school uniform made for her, and to buy her some school supplies and a book bag.  Each day for five days before school started I gave her some little thing for school.  The day before school I gave her, her uniform and her brand new book bag.  She was very happy, very excited, and I think she could not imagine what this new adventure would be like.



The first day of school arrived.  She came by my house early in the morning dressed in her uniform with her bright pink book bag.  She looked scared, apprehensive and happy.    She and Toussaint waited patiently by the water pump for the school bell to ring.  I watched as she ran off with all the other children, to her very first day of school.  She doesn’t have to sit on the stoop this year and watch everyone else pass her by.

BFF's Regina and Mahsoblee

December 26, 2011

It’s been a while since I’ve been able to post anything.  My computer cord got fried during an electrical storm and I was without a computer for almost six weeks.   That’s right.  My brother taught me to accelerate through the stages of grief.  I did, and I carried on. 


A lot has happened during those six weeks.  Mahsoblee is doing well at the moment, but she had a bad sickle cell crisis a few weeks ago.  She had malaria and everything started to shut down.  We got her to the hospital in time.  Everyone knows her now, so they knew just what to do.  She received a couple blood transfusions and stayed in the hospital about a week.  She was so, so sick.  Such a brave little thing.  It was a great relief for me to have funds ready to pay for Mahsblee’s healthcare.  She wouldn’t have survived these problems without your help.   We have to find more solutions to help prevent her from getting malaria.

Now she’s feeling really well.  She told David to tell me that she needed a Christmas dress and shoes, and she does!  Her clothes are rags.  I went to Lome last week and found a dress and shoes, and hoped that I was picking the right sizes.  I had eyeballed her shoe size before I left.  There was a lot of so-cute things to choose from.  I settled on a springy, white sundress with bright flowers, and some lavender sandals that were very stylish!!  I couldn’t wait to show her.  And she was so excited.  She tried everything on immediately.  The dress and shoes fit like a glove, the dress being almost…almost, too small.  I’m tellin you she looked like a million dollars and you could see that she felt like a million dollars.  She came over Christmas Day, all dressed up and her hair had been done.  Ohhhhhhh she looked so cute, and so happy.


She’ll be back in school next week.  Toussaint (her gramma’s husband) tells me that she LOVES school, and that every day she comes home from school and shows them what she learned and then  does her homework.

March 19, 2012

Mahsoblee and her Gramma, waiting to be seen at the clinic.
Always connected.

I haven’t had any updates on Mahsoblee lately. She’s been very gradually getting better and better. I’ve almost not wanted to say anything. Superstition I think. Cautious. When she comes over, I always touch her forehead to see if she’s warm, and I try to take a peek at her tummy, and always look at her eyes for signs of yellow, for potential liver problems. The whites of her eyes have been noticeably yellow since we started this process…..and NOW they are clear. They are white!! I think it’s a big accomplishment. To me, it means that her liver is healing. Even her tummy is less distended. It’s now less distended than most the kids around here. Could this medicine and regime of medical care be working?? I can hardly believe it!

Mahsoblee comes over every day.  More often than not her BFF Regina is by her side. They come by early evening when the sun is just going down, but it's still light enough to see. We sit on the front porch where there is usually a little breeze. They just act silly most of the time.  Teasing me, and running around. They always ask to do bubbles, and when we do, five or ten more children appear out of nowhere. I’ve taught MB and Regina to count to ten in English. They want to recite it each time they visit. I can’t help but marvel that Mahsoblee, today, appears to be healthy and happy. Going to school, playing with the other kids, often the leader. She’s sumpthin else.

Check out her pose

Today we went to Kouve for her monthly check up, and to refill her medication. When I was in Lome last week I bought her two little sundresses. Other than the Christmas dress I bought her (which is already too small) She has only two raggedy dresses that she wears every day. She doesn’t seem to mind, always showing up at my door with a kind of radiant self confidence. However….she’s a girl, and most girls have a gene that makes them love to look glamorous, and feel glamorous, at least once in awhile. Culturally I’ve seen that around the world. Mahsoblee is no different. This morning she showed up in one of her new sundresses. It was the first time she’d worn it. She had a smile a mile wide, and her eyes were full of fun. I told her I wanted to take her photo, which she always loves. And I swear to goodness, Mahsoblee assumed this pose all on her own. Ha…that girl knows that she is sumpthin else!!

Mahsoblee takes charge!

She also carried a little pink furry purse. We keep all of her records in that purse, and Mahsoblee is the one who carries them and gives them to the woman in admitting at the Kouve Hospital. She takes responsibility for her health and treatment. We had great news today. As I suspected, she is doing better than ever. The doctor said, at this time the only medicine she needs to take is iron for her blood, and he noted how clear her eyes were.

Kim is a Peace Corps Volunteer who lives in Kouve. She has come to visit Mahsoblee in the hospital and she’s also helped me out from time to time. She has gotten to know Mahsoblee. I called her when we reached the hospital and told her we there. She rode her bike over. Mahsoblee saw her in the distance and ran out to greet her. They were happy to see each other. Kim went in the doctors office with us, and got to hear the good news. I thought that was nice, that she was there. It was a sweet moment. We were all happy. Ama, Mahsoblee, me and Kim.




January 2, 2013

Mahsoblee
I do have news. Good news!  Sister Modesta has emailed me two times.  She works at the hospital in Kouve.  She tells me that Mahsoblee has been to the hospital for her checkups and is doing well.  She thanks me for my support and offers God’s blessing.  Knowing that I have a pretty solid line of communication to Mahsoblee’s health eased my mind greatly. For the first few months I was so on edge, for many reasons, but I think what made me the most restless was not knowing if my plans to continue to help Mahsoblee would work. It did work, and it does work.


Father Apolo, the Catholic Priest in Tchekpo emails me at least once a month.  He sends his greetings and gives me little updates on Mahsoblee.  I took Mahsoblee and her gramma to meet him before I left.  He agreed to be part of the process that will keep her well.   Mahsoblee and her gramma go to him once a month and get money from him for the bush taxi and moto to get to the hospital.  It also gives him the opportunity to encourage both of them spiritually and emotionally. 


I did manage to set up a nice little chain of caretakers for Mahsoblee.  For those of you who helped  and followed her story; she is doing well.  In addition to Sister Modesto and Father Apolo, I also have been in contact with Honou Koffi and David.  They all have visited with Mahsoblee and her gramma.

When I left Tchekpo, during that final week; many friends and acquaintances came by my house to say goodbye and wish me well.  I sold most of my things, but there were a few nice things I gave away to favorite people.  They were grateful for the gift and they would ask me if there was anything they could do for me in return.   I asked them to please help take care of Mahsoblee.  Please stop in and visit with her gramma and make sure she has enough vegetables and eggs to eat.  Remind her to drink lots of water and to sleep under her mosquito net.  Hug her.  They all promised me they would  take care of her and not to worry.  So I picture that happening.   I picture the whole village watching over her.  I believe Mahsoblee will have people looking out for her for many years to come.   Mahsoblee’s sweet, sweet nature and her strong self confidence inspires people to want to help her.