Just a day after attending “Youth Meeting” our family went through a tragic incident that led me to question God’s Kindness. The youth meeting was held for three days, and I was so glad to attend all. The speakers were spiritually gifted; some were locals, whereas others were from outside the UK. I had a fantastic time, privileged to meet new people and happy to reconnect with old friends. Spiritually, I learnt a lot about myself and the gaps that I had in my spiritual life; it also helped me to gain confidence in Christ. Some questions were answered, and prayers were heard. Sitting on a chair listening to the speakers, testimonies was such an encouraging example. I was so pumped up with Holy Ghost and decided to live for Christ. Having attending those few holy days; I had no idea what was instored the next day!
I remember waking up the next day; hearing about our pet “Logan” who had been in a car accident and my brother was injured. I remember precisely the journey back home; waiting for the train at Andover station- I didn’t care how I looked without makeup or how frizzy my hair was. I cared less about the people walking passed me; watching me when the constant spring of tears flowing down my cheeks. The journey from Andover to London was the longest journey I recall. I had nothing but red eyes pouring out tears constantly, blowing my nose non-stop and a big head with lots of questions jumping out!
On 6th April 2018, our beloved pet Logan passed away. He was involved in an accident the day before. He had been hit by a car and was unable to walk. The X-ray later showed that his spine had been fractured very severely and would not be able to fix by the Vets. They suggested that even though we would love to save Logan, he would have had suffered a lot and he would have a very low life expectancy. They suggested it would be better to sedate him and euthanise him to give a dignifying death. Even though it was a heart-piercing thing to hear at that time but my brother chose to let go Logan respectfully. Today, I saw a brother grieving from losing his beloved pet. Today, I saw a mother grieving from losing a son’s pet, a family member, a family guard and the injuries caused by Logan on her son. Today, I grieved over an innocent Logan who knew nothing but giving love and joy! I wish I could just turn back the clock and I wish I could bring Logan back! I wish things were different! Sometimes, I wish that the Vet must have lied us, maybe Logan is still alive out there somewhere, somewhere safe and in a better place. I wish it was that simple.
It felt like someone just pricked my faith balloon with a needle. At that point, my faith had already shaken, and my three days of youth ministry’s faith was under the rubble. I had nothing left except to me on him because losing Logan felt like losing a part of yourself. It indeed left a significant scar on our hearts.
Remembering Logan
Nearly a year ago, my brother brought a new pet home (in the dark) because my parents didn’t like the idea of owning pets. We always had pets at home in Nepal, but ever since we moved into the UK, we have not had pets. The reasons being: a) not enough space b) not enough time for pets c) can be expensive d) pets can be challenging to look after. Despite the fact, Sulav brought a baby “Siberian Husky” inside my small Adidas gym bag. The puppy was just a few weeks old, he was very tiny, but it was the most beautiful puppy I had ever seen. They say homes are graced with the presence of a pet. Yes, there were many days Logan had brought us happiness and joy. I have seen my brother is happy and engaging like in ages….In fact, I do believe that Logan was therapy for Sulav, which was great.
On the other hand, our house was a mess. We loved him, but there were times where we all got furious at him. Times, where he messed around in our garden (which is very small), the house would smell his odour, he chewed on everything (shoes, envelopes, clothes, furniture, you get the idea). We used to scold him, tried to threaten him; he showed that he was guilty, and quietly hide in his hiding place (underneath the dining table). Regardless, our Logan, always loved us even though I was cruel to him. He gave us company when cooking:- his favourite thing to do was to lie right on our feet and lie his head. He used to use our feet to make his pillow (that was his comfort and relaxing place). Logan was always the first to welcome us home after our long tiring /bad days. He was always the first to welcomed us wagging his tail and sniffing crotches.
Ever since the incident, I began to question God, about his kindness, about his nature, about his existence! Moreover, to be honest, this experience isn’t the first time I felt like this. Every death is suffering, and suffering is hard. I had witnessed many deaths in my nursing career and more so when I was in “Hopital de l’Esperance.” I have witnessed innocent deaths resulting in unexplained pain and suffering among the livings. I have written a diary from some experience I have encountered, but I always feel like it’s not what I would love to post! As I would love to remember my days in Togo was a happy and fantastic adventure.
To deal with my emotional and grieving battles; my missionary friend Laura Stephens suggested to listen to a song called “Even if” by Mercyme. To help with my heartaches at Hopital de l’Esperance, I read a book called “Where is god when it hurts?” by Philip Yancey. This song and a book caused more sadness at first, but it did become my healing therapy as days passed by.
And today, when I lost Logan, I too needed something to put my heavy heart on rest. I would be lying if I said I prayed to God. No, I did not. I questioned him. I googled if my pet goes to heaven? If God cares for Logan? If God would consider Logan? However, I now see that I was covered with such big clouds of darkness!
How can we doubt a God who is so GREAT and yet so humble? The one who created heavens and Earth but also loved you and me and all living creatures. This love of his is hard to explain. God could have easily erased humanity during the time of Noah and could have created new Earth. However, being so kind and generous, he asked Noah to build an ark and commanded to bring animals with him. Yes, God cares for animals, and he looks after them. Psalm 147:9 says that our God is concerned for all his creation, and he provides food for them to survive. But in reality, grieving for a pet is not yet openly acknowledged, and for this reason, many people suffer in silence. As a Christian I believe, it is human nature to grief (in all living beings) as the Bible says that both man (Genesis 2:7) and animals (Genesis 1:30; 6:17) have the “breath of life” that is, both man and animals are living beings. Even in Proverbs 12:10 says “A righteous man regards the life of his animal….). I feel very guilty for not spending more time with Logan, not being kind towards him. If an almighty God cares for the animals, and if we are created in God’s image (Genesis 1:27), then how are we not supposed to care for the animals? God commanded humankind to, “ …..to have dominion over the fish of the sea, and over the fowl of the air, and over every living thing that moveth upon the earth.” [Genesis 1:28]
Even in an old testament, [II Samuel 12:3]; the Bible talks about this poor man who “had nothing, save one little ewe lamb, which he had bought and nourished up: and it grew up together with him, and with his children; it did eat of his meat, and drank of his cup, and lay in his bosom, and was unto him as a daughter.” This verse always reminds me of Sulav and Logan. Sulav bought the best treats, adorable toys and he gave Logan a loving companionship. My brother gave Logan a great life, and he indeed went above and beyond to make sure that Logan was always happy. I have seen that the baby Siberian Husky was raised to become a beautiful young Husky. These two were like brothers; they used to do things together; they used to go out together; they played together. I have seen that the depth of a relationship between an owner and their pet is profound and overwhelming. There is an unseen force of love, connection, and companionship where only an owner and pet experience. And the pet loves his owner unconditionally; it does not look for good looks, or a big house, how much money his owner makes. The pet is happy with his owner whatever the circumstances are, and the pet never leaves his owner. It was Sulav who truly gave Logan all the attention, unconditional love, and care.
Logan, you will always be loved <3
Our Logan always loved us even though I sometimes was cruel towards him. I just loved how carefree he was and always hyper! Logan always loved people; he loved us! What an incredible living being our God had created! In Genesis, we know that when God created Earth, and it is creatures he said it was “good” SEVEN TIMES. I believe that God brought Logan into our lives, into our house for a reason, so that he could teach us a lesson, to show his everlasting love and grace. Even though Logan had a short life on this Earth, I do know that now he has been taken where God wants him to be. I know that God does care for our pet Logan, and I want to believe that he is now safe and happy in his resting place. I miss him every day; he sure will be remembered on Earth by many.
Having travelled (few countries) around the world, using the wifi has given me many advantages. Moreover, I appreciate the power of the modern-day internet, and it sure has changed the lives for better in many ways. I remember our mum telling us that back in her days, they had to wait for 4-6 months to receive a letter from her father (he used to serve in the Brigade of Gurkhas). She told us that all the hot news would have become the old history by the time they received the letter. I have been cleaned from social media (Facebook/ Instagram/ Snapchat) for almost two years!
My addictive thumb had a mind of its own; swiping and scrolling through endless newsfeeds, photos of friends, relatives or even random strangers. I regularly was posting my thoughts, recent travel photos and selfies to seek revalidations, waiting for those likes and comments, wasting unbelievable time editing/ looking at the pictures of myself- it’s weird! I felt like I was missing out more and never able to catch up with reunion, invites, birthdays, parties, it was an on-going cycle which was overwhelming.
Honestly, though, as soon as I deleted the apps, I was miserable in the beginning. Social media is a drug, and quitting is hard- it needs patience, but the end result is beautiful. From my own experience, I concluded that I do not need these addictive apps to be happy, become confident, and seek revalidations from others. If you care for someone, you will make an effort to reach out regardless. If I miss out on some events, parties posted on social media->I do not know about it, so I don’t care; therefore, I am not missing out on it! Logic? 😀
2) I will be using my sexy French often
I do not know how people are fluent in multiple languages, whereas I am still struggling with one. Nepali is my mother tongue, and I speak it every day, but it’s sad that I still am not great at writings. You know the feeling you get that you are torn between nations, always on the move, not settling down properly, and continuously adapting to the changes. I feel like I can not fully understand neither my Nepali nor English!
I had literally no French before I went to Togo. One of our purpose volunteering in Togo was to learn French. But living in a local community, meeting Togolese I did learn a bit of French but “African French”. My First French tutor was a volunteer from Taiwan (whom we met at the same NGO). She was lovely and helpful; she did all the translations when we were with this NGO.
My second French tutor was Mrs Hanga; I booked classes twice a week. She was a very hard working woman and very patience with me. I was somewhat confident with my French by the time I got back to the UK. My friends and family were very impressed with my French, and I felt great! But if you don’t use your skills, you will then lose it! That is what has happened.
3) Yes, I would totally wear that attire back home
When I walked in the streets of Lomé, it immediately caught an eye of gorgeous ladies, children, a gentleman wearing those fashionable African textiles fabrics. I honestly fell in love with all the vibrant colours, patterns, gorgeous textiles and African prints dresses.
Living in Togo’s capital, I had to buy those beautiful fabrics and tailored fit them for my own body. I had tailored fitted so many of these beautiful African textiles; you guessed it- I even gifted my family with these babies when I got home for Christmas!! YAAASSS!!
When I moved to Mango (Northern part of Togo), me and other missionary expats agreed to meet up with our African Attire when we have our rendezvous in the western world. We believed that we would rock with our African textiles fashion in the modern community. Has it happened yet?? Yes, we did meet up but not with our African dresses- still pending!!!!
PDH, Lomé
With Yaovi, senior in-charge Nurse, HOH (Mango)
Nogbedji’s Sewing School
Nogbedi and his son
4) Become a master chef (at home)
I remember when I was younger, my mum calling me a “fussy eater”. Whereas my siblings ate random kinds of stuff, tried new foods and over towered me on every side; I was comfortable with what I knew was acceptable for my body. I.e.: boneless meat, No milk- or dairy products, meat FATS NO! NO!! I was scared to try new food for fear of not liking them, so I usually was comfortable with my old routined food menu. But now, my taste buds have changed, and so have I. One of my passion is to try new cuisines in the local markets.
I grew up in a large family with lots of females in the house. I grew up with my dad’s side of the family; I had my grandma, four aunties, my mum and my older sister; so you can tell there was no room in the kitchen for the new chef. My sister and I were also enrolled in the boarding school where we did not have to worry about cooking and doing laundry, but we were told to focus on our studies (which again, I was not great at either). Even though I have an excellent cook in my house but I failed to inherit the cooking genes from my family, yes it is not very reassuring.
However, when I moved to my second house (Mayberry House) from our (Beyoncé’s house) in Mango, I had to cook for myself because no cooking meant no eating. First, I felt it was boring and didn’t like it, but I started enjoying it as time went by. I was learning new skills and tricks every day from the survival cookbook guide “Mango Style.” Later, we also hosted dinner parties and called guests over to our Mayberry House, followed by late-night movies, it was fun.
The prep
Banana Pancake
Walla!!
Aaloodum and chicken chilli (own recipe)
5) Become a regular blood donor
We all know by now that giving blood is considered a “life-saving act”. Fact: According to the research, you can save the lives of as many as three people by donating blood. Becoming a blood donor never crossed my mind, as living and working in a developed country, if required blood in an emergency, the healthcare professionals will magically transfuse pints of blood to sick patients. However, it’s not the same case in developing countries, at least not where I was working in Mango, Togo. So, if sick patients’ required blood, we would check family members, blood groups, if the blood grouped matched- then transfuse that blood. There are many reasons why this is the case: for instant; there is a lack of education, therefore, lack of donors, lack of time, stigma relating to HIV, the problem with electricity for storage. You are lucky if they have a blood bank- with your blood group, or finding O +ve blood (universal donor).
My blood donation story occurred when a patient was admitted following a Road Traffic Accident (RTA- so common in a developing world). The man was losing blood, and his hematocrit was dropping needing a blood transfusion. Unable to find his relatives, someone had to donate blood which then I volunteered. The patient did have a blood transfusion, got better and was discharged home. The second time I donated blood was probably after a month for storage, and I heard that it was used for a paediatric patient. Just rolling up your sleeve, pumping those veins for 40 minutes can save someone’s life, it makes a difference; you make a difference!
Universal Donor 😀
6) Get back into a healthy routine
While I was in Mango, my primary form of transportation was a bike. The route to reach the hospital would involve: cycling in my long skirt using headlamps in the nights, dodging majestic potholes, avoiding accidentally swallowing night insects, trying to avoid falling off the bike into sand, dirt and swerving around the puddles. Yes, it was a decent workout also great fun too! I keep procrastinating to join a gym membership that still hasn’t happened yet, and it’s only been six months. Procrastination is one of the significant issues that I battled with every day, which I now need to start working on it.
Beautiful Miriam and me cycling to get those sexy thighs in shape 😉
7) Stay in touch…
It takes a fair amount of time to start a friendship as an introvert, but once I build that relationship, I guess I am a loyal friend. I have given countless farewell hugs and genuinely yelled “stay in touch” as waving goodbyes. But staying in touch with a new travel friend can be challenging because I will not keep in touch with everyone I met while I was travelling, just a reality check. A handful of people have made my travel experience grand, who had an impact on my life. I carry thousands of beautiful memories with me, playing swimming pool soccer, worshipping the same Lord together, that late-night girl’s chats, cycle rides to the hospital, trips to African caves. Proud to say that I have those close travel friends whom I get updates from; who match my efforts to stay in touch. We even have a small reunion when they visit the town. So far, so good.
Single ladies in Mayberry House. So blessed 😀
8) Organise a Bible study group
I can not thank those beautiful souls enough who have helped me grow spiritually in a most psychologically challenging environment. Our time in Togo was simple yet profound. It was beautiful; we lived, worked, ate, prayed, and grew together. Our time in Togo was harsh; we fell ill, we saw young, old, babies die of known/? Unknown cause! We watched babies die because we didn’t have enough ventilators. Every night, there were shared stories, tears that were shed, hugs that were needed, prayers that were requested, and every morning there were hearts that were mended. It was heartbreaking, but we held onto each other. We started girls’ bible study night at Minister’s House once a week. It was uplifting, motivating, and it has helped me in so many ways. All of these memories on this trip are some of my most cherished memories. Because of these girls fellowship and their constant love, I was able to tune my heart to God again, and I feel closer to God now. I can feel his comforting presence in my life, and I can listen to his word.
The more bible study we attended, the more experiences we shared, our friendship grew stronger, and my relationship with God was more profound. These days, I feel I am getting more relaxed because every day is not a struggle. I pray a prayer of gratitude, but life gets in its way. I notice that everyone is so busy that I have not been able to keep up my passion for starting a bible study group.
9) Treat London like a tourist would
So, coming home has been grand, but times those post-travel blues hits me hard. Traveling has given me freedom, excitement, a new perspective, and a lifetime opportunity. So, to beat my loneliness, I planned to see my home town, London, from a tourist perspective. I want to keep up to date with the new local news and visit local exhibitions, events and historical sites. I want to get excited just like a tourist searching “what to do in London” on TripAdvisor.
10) Get excited to be home
When I was away, I missed my family a lot. I also want to believe that my family, friends and my pets (Logan and fishes) missed me too. I am so grateful to have such a loving and caring family who always remembered me in their prayers. I am thankful for all the support from my church about getting home safely. I am so glad to eat my mum’s cooking again, which I missed a significant time for six months. I am so lucky to have my privacy and my own cosy bed where I do not need to share with others. I have missed out on so many things- for instance; my nephews birthdays, uni reunions, friend’s engagement, The Bank of England releasing a £10 plastic note!!
The Hospital Of Hope is a 30,000 square foot hospital that holds 65 in-patient beds. HOH offers a trauma centre,4 Resus (Réa), general medical, surgical, acute care unit, 4 operating theatres, post-operative unit, urgent care, ITU (basic), 3 isolation rooms, neonatal intensive care unit, paediatric wards, wound clinic, 11 triage unit and consultation rooms, a digital/portable X-ray imaging, ultrasound machine, Pharmacy (to order drugs for patients and for staffs) and basic Laboratory (for blood tests, blood bank). We send some specific lab tests to the States.
Staff parking lot
HOH solar panels
HOH Cargo
Local goats chilling at the HOH site
HOH left wing
Fluids room
Sterile NaCL
The net to hold the fluids
When I started in the HOH, we had two Medical Mission American Doctors (paediatrician), two American (Adult doctors) one French medical doctor (paediatrician), two surgeons, one GP (often doing surgeries), one American midwife and one American obstetrician and gynaecologist. There were no local doctors at that time. There were 3 contracted missionaries doctors and three visiting doctors (from the States/ and two foundation year one French doctor). Even though these doctors were trained as peads/ medical doctors in their allocated countries but they all took turns to cover for the whole hospital sites on their duties. Only surgeons and obs and gynaes were referred accordingly in emergencies.
Réa
I have had exposure to a wide range of tropical diseases; including malaria, typhoid, severe anaemia, snake bites, schistosomiasis, HIV and TB. I was able to perform the fundamental duties as traditional nurses but in undeveloped and poor resource settings. Every nurse on duty had around 8-10 patients on busy shifts (including paeds).
I had opportunities to care for vulnerable adults and paediatric (had never worked with paeds before) presenting with all sorts of medical emergencies with limited resources available. I learnt time management skills and how to work under pressure ensuring the safety of the patients. The nursing director of the hospital entrusted me with putting me as a nurse-in-charge of the department (A&E, Surgical, Orthopedics wards) just after a few shifts in HOH. I am able to run the shifts allocating the staff, delegating the tasks, supervising them, organising and performing the teaching session with other volunteers with the support of the local and overseas staff. I am still learning how to run shifts and lead staff in high-demand situations by delegating tasks and responsibilities accordingly. Supported mentors and preceptors in their role, ensuring learning opportunities were effectively utilised. Being a nurse in charge of a well-facilitated developed hospital in a city is already stressful enough here the nurses have to be able to work in a cost-effective and cost-aware manner in less resource settings.
Aisha my friend
with Manon
Starbucks caramel frappe->Youki lemonade
Joy at work
Joy <3
Forgot your toothbrush?
chew twig Togolese style
Queueing up….Ain’t Nobody Got Time For That.
This experience has taught me to listen and drawn me closer to God. It also taught me to value differences in others. It has given me the courage to embrace new changes and challenges. I have learnt that he is not giving us worldly things to make us happy, but rather he is giving us valuable resources; just enough for a day. Every day is a new struggle at Mango but when I focus on Jesus, he gives me new strength to continue for the day. He gives me the wisdom to make decisions, and he gives me the love to care for my patients every day! Even when we don’t have resources like in the West; he is Enough! As Laura Davis (Physical Assistant) from Kentucky once said, “Jesus is all we have and Jesus is all we need.”
A few weeks ago, the entire country was in turmoil because the president (Faure Gnassingbé), son of the former president, is already serving his third term. My Togolese friends say that “the president can not run the office more than two terms under their constitution.” A small peaceful town such as Mango was the site of intense violence. The first protest which I found myself (literally) in the midst of the protest!!!! (More info later on the blog)!
We were pre-warned regarding the “planned protest” in Mango. Each house was allocated a “leader”, and they were given a “walkie-talkie” (just in case the phone network/power went out). The big bosses, the HOH directors and leaders decided to evacuate us from the “Minister’s House” because of the traffic issues and our safety reasons as our house is on the main road, we have to ride our bikes to the hospital every day, which is like 2 miles! So all the single ladies from the “Minister’s house” were put in the auction, and the Drakes (American Missionary couples) generously picked us and opened their doors for us. We felt like an orphanage looking for a perfect family to be taken care of.
So, Laura Davis (American), Laura Stephens (Irish), Jess (American) and I were hosted by the Drakes for the protest period. We can not thank the Drakes enough!!! They are a pro-active hard-working young couple with four children! They always host fun activities at their place like: “Single-game night” on the first Friday of each month. So, single people can hang out, play games, exchange numbers, get to know each other and stuff like that! However, there are way more single ladies missionaries here in Togo than single guys missionaries!! So, we end up exchanging numbers (females, of course) and plan our “ladies day out.” The Drakes have been so sweet and caring. They prepare us meals, drive us to work and pick us up, allow us to watch the telly; and they have a working warm shower, y’all!!
So it was DAY 2 of the Mango Protest (20th September), and it was my DAY 3 OF 4 Long Days at the HOH! During this protest, many innocent victims were wounded with gunshots, including? A nine-year-old boy was shot and died during the anti-government political riots. More details on
https://www.bbc.co.uk/news/world-africa-41332072
The HOH was overwhelmed with the countless number of trauma victims, family members, and highly interested locals who just wanted to see what’s all the kerfuffle about. Local colleagues and missionaries jumped into triage and started the treatment ASAP! Security guards brought up protest victims with injuries from a machete, tear gas attacks, physical assaults, minor injuries like cuts, burns to potential pneumothorax!!! The presentations were remarkable, with the highest attendance recorded in the HOH history so far.
There were no physical beds to keep all these patients. So we had to register these patients quickly. And guess what? 90% were born on 1st January but thankfully on different years! We have no luxury for printing out white or RED (Allergies warning) wristbands; we have to improvise what we have! So each patient was given a number which then was taped (Hypaband sticky tape) on their foreheads! (yes, and this WORKS too).
Some nurses were allocated to draw blood/ cannula.
Some nurses were deligated to prepare drugs; others were deligated to administer medication (mostly IM tetanus, IM/IV antibiotics). We were treating patients on corridors such as suturing wounds, cleaning and dressing wounds, closing minor skin wounds with staples. Some patients were rushed to theatres, some needed transfusion, some, unfortunately, could not make it! That day (20th Spt 2017)- Many lives were lost and many were saved!!!
Everyone, from missionaries to local staff, came together and volunteered. Bless the teenagers’ missionaries hearts- they cleaned the trolleys back-to-back! They stayed with the patients for comfort! We taught these teenagers how to check and record vital signs! Everyone laboured so hard, we were all exhausted, but my heart was full of gratitude and contentment! Honestly, though, it felt like a holy spirit that fervently displayed within these teenagers, in which my heart swelled with pride.
Why should those of us who live in the west have access to nurses and doctors of every speciality when millions of children worldwide live their entire lives without meeting a medical professional? Yes, money can buy houses, expensive cars, but it can not buy love, can not buy freedom, it can not buy free spirit! Apostle Paul writes a letter to a young Timothy encouraging him to live a contentment life. Paul writes, “For we brought nothing into this world, and it is certain we can carry nothing out. And having food and clothing, with these we shall be content.” 1 Timothy 6:7-8. We have received a gift that must be given away.
We have isolated ourselves from a beautiful world that God has created. These urbanised societies have filled our minds and souls with luxurious but meaningless things. Our modern lifestyle has made us unnecessary busy seeking satisfaction on business success, wealth, charity works, good relationships, etc. I, too, was blindfolded, in a constant race with the world, trying to satisfy my hungry soul with worldly pleasures. Even though I had a reliable job with a decent income, a loving family, a beautiful home, a sweet church, faithful friends, I still felt a deep void within myself. I would replace my emptiness with a Ted-Baker purse, Michael Kors bags, Chanel lipstick, Gucci perfume, Mac Foundations, latest gadgets and DKNY watch; always wanting more one worldly thing to another but was never enough! I worked hard. I worked in a busy London training hospital King’s!! I was working in ITU, on my days off, I would work as an agency nurse in posh clinics in Central London. I worked in Harley street clinics, oncology wards in London bridge clinics, outpatient clinics, literally wherever I got shifts. I saved up this extra money to go on holiday, to buy new gadgets in the market. The more I chased after my worldly pleasures, and the more my soul was miserably dry. While I achieved my goals, money and pleasures, there was still a feeling of emptiness that nothing seemed to fill my sunken soul. Feeling like something was missing, something lacking, something big, something important, then I was in a quest of finding that “something”. After constant searching, stumbling, disappointments, being lost, carrying doubts and questioning God.
It was an endless merry go round just like how Dave Ramsey says, “We buy things we don’t need with money we don’t have to impress people we don’t like.”
I felt the need to get away from it all, and I had an urge to run away far-far- far away. Runaway from 12 hours shifts, run away from the everyday routine and run away from a modern lifestyle.
Mango has not always rainbows and bursts of sunshine. I have seen hard days with a lack of staff, A&E over flooded with sick patients all at once. By the grace of God, there are so many witnessed Muslims who have converted to Christians but have to hide their new identity from their family and friends as Mango is a high Muslim influenced town. According to Luke 10:2, I can see that there are so many things to be done clinically and spiritually here in Mango, but there are not enough missionaries. Mango is raw, real and challenging, but overcoming these challenges with God fearing-loving, hard-working colleagues is rewarding. I am so proud of all the missionaries, locals and I cannot be more than happier to be here at this time!
I can not deny that it is tough for me to be away from all the loved ones, especially times like this chaotic period but I also feel like the need here in Mango is greater than my fleshly desires. So I should just put my wishes and desires aside and start following what he tells me to do because I know God knows the best and has the final saying. While working in the remote parts of Togo, I have encountered many tragic cases, but even during these chaotic moments, God has done miracles. Life here in Mango is not a smooth sailing experience but just being here, watching what God has been doing, witnessing all the changes in the community, patients and within my heart is beyond what I can explain!
After the protest, my heart was unsettled, and I had been contemplating either staying or leaving. I had just finished my devotion, while Laura Davis joined me, and we both shared how we were both feeling as we were leaving Togo soon. My flight back to London was due on 30th September, and Laura D was leaving for Tsiko (another sister hospital of HOH) in Kpalimé, then another trip to East Africa (specific mission and countries I am not allowed to write), but deep down we both felt our jobs here was still have not finished, we felt our missions were still not complete! So we were not ready to leave Mango just yet! So we both prayed for our decisions, prayed for guidance!
I feel God was nudging me toward this extended mission field. I think this is the perfect God’s calling for me to do some extended mission work while I am still single and not working. I think this is a grand God’s plan, and it’s an excellent opportunity to learn and fall in love with Jesus and glorify his love in my singleness. I believe that God has given everyone a gift, and I want to use my gift to serve him. For the past few days, my heart was swinging back and forth; I was in a constant dilemma and trying to decide on many different voices. I needed clear guidance from God, and I started praying and reading the scriptures. It happened that my morning bible chapter is on St. Luke; thus, he spoke to me by the chapters of Luke 8-12!
These chapters were an eye-opener and he truly emphasis/ and he CLEARLY INSTRUCTS what he wants me to do.
Luke 8:1 [Preaching the good news about the kingdom of God.]
Luke 8:15 [But the ones that fell on the good ground are those who, having heard the word with a noble and good heart, keep it and bear fruit with patience.]
Luke 9:1-6 [ He talks about sending disciples in the mission, giving them authority to heal the sick and preach the gospel.]
As I was reading through the scriptures, there was an explicit instruction on what I should do with the rest of my stay in Mango when he talks about a good Samaritan; Luke 10:25-37.
A few days later, me and Laura D finished our work and were riding our bikes to get home together. On the way home, we both wanted to share our decisions! We said it OUT LOUD……TOGETHER!!!!!…. I AM STAYING!!!! YEAAAHHHH!!!!!! We both shouted WE ARE STAYING!!!!!! We both were soo happy, and I felt we both were filled with a holy spirit at that time! We were over the moon! Me and Laura D decided that we should extend our visas together! We wasted no time. We went to our one and only local photo studio and took our glamorous passport photos 😀 I admit that I looked awful in that photo (sweaty face with no make-up, uneven and overgrown eyebrows, overdyed hair, dry lips not chapped (do not want to attract dust and dirt)! But believe it, or not this photo is one of my “prettiest” photos so far because- my heart is content!!!
“Life is what you make it” every day, you are given a choice- to choose what it is that you want this life to be. To wake up early, stay up late at night, stay positive or negative, love or hate, make or break, but this is also true- not every day is as crystal clear as it should be! Some days are foggy, cloudy, and sometimes you are aimless, but perhaps you just need to silence your mind, take heed of your inner voice, take a leap of faith, and accept your calling! When I look behind and reflect how all my decisions have directed me on different paths, some hard and some easy, there were blessings on disappointments but with all incredible life lessons…… I, therefore, am full of gratitude for where I am today!
In Mango, everything is limited. We often rewatch the same movies and listen to the same song repeatedly. I was encouraged to write this blog by this song from The Chronicles of Narnia: Prince Caspian (The Call- by Regina Spektor). I feel that this song resonates with the current conflicting feelings.
After a long 9 hours of a journey from Lomé, I finally arrived in Mango (28th August, Monday). I travelled on my own by a local bus which made frequent stops. Different scenarios were playing on my head on the way to my new home. I arrived in Mango in the afternoon in my trouser (there is a strict rule on how to get dressed). I should have read that prospectus “before arriving in Mango”. I was told that this was my stop and the driver’s assistant pulled off my luggage in the middle of the road, and the bus departed. I was on my own- WTH! I have never been on my own in Africa!! I tried calling my contacts which I was given. None of them picked up at that moment; I started to make my way…… to where… ?left ?right ?north ?south…? ahead? Which way is it??! Locals started noticing and tried speaking with me. I then tried to reply in my limited poor French; I asked them, ” où est l’hôpital de l’espoir?” but with my bad accent and poor French, the locals struggled to understand.
Also, there are many tribes; rich in their languages, cultures, beliefs, and traditions. I tried speaking in English, hoping there was someone who could help me. A young guy did answer, but again, with his limited English, I struggled a lot. We were lost in translation- in English!!!
I then received a call from Susan (Lead Nurse Facilitator) saying she was on her way to pick me up. I was so relieved and funny enough she was there. She looked at me and asked if I had read the hospital’s policy booklet. She asked me to hop on her jeep, and she drove me to my new home,” Minister’s House.”
Game night with missionaries at Minister’s House aka “Beyoncé’s House” because all the ladies here are single 😛
I, later on, found out why she asked me that question- I arrived in Mango in my trousers (not that it is forbidden), but this community is very conservative and wearing a trouser does not look modest (at least what we are told!). So there instant was a first- Red strike !! Ooooops!!!!Sorry!!!
I started to feel poorly from the day I arrived; from day 2 in Mango, I developed diarrhoea, increased lethargy, nausea, insomnia, had nightmares. This is the second time in Togo where I have been very ill. My housemates were very caring; they prayed for me, cooked, and checked on me now and then. They advised me to check myself in the hospital- but nurses do not want to do that, right? I gave myself a diagnosis:- Heat Exhaustion, food poisoning and nightmares- (maybe a side effect of doxy I had been taking for malaria prevention). I was all well and recovered by 2nd September.
I first heard of Mango from an American Missionary living in Lomé while still volunteering in PDH. She said there was a newly built hospital, and they were looking for volunteers, missionaries. I got interested mainly because it was an opportunity that resonated with my profession. Later on, I found out that this was the same hospital that my lovely kiwi friend Miriam (in 2016) asked me if I would be interested in and proposed that I tag along with her in the future.
I pictured Mango as a very relaxed tropical place with greenery, lush and full of Mango trees. However, the reality could not be further from the truth as I discovered that Mango was total the opposite of how I had imagined. Mango is raw, overwhelming and very challenging. Mango is very dry, humid and very hot. I have been experiencing hard, tough, frustrating days [ in clinical settings and personal levels]. In Lomé, there was a completely different lifestyle. People are more open, educated and accept the modern lifestyle. Mango is very different- it has a tightly knitted community, everyone knows everyone, highly influenced by strict Muslim beliefs, young girls are often given for marriage to older men. It is prevalent for a man to have multiple wives. Togolese are Animists; they greatly influence voodoo culture (even though it is Muslim). People do not come to the clinic, hospital unless they can no longer treat by a shaman or Voodoo magic.
We have witnessed parents bringing their critically unwell children, often babies taking their last breaths, and we have even seen babies dead on arrival. It is heartbreaking when parents beg missionaries health professionals to bring them back to life. We are just humans (just like them) broken, exhausted, weary and vulnerable.
On my first night shift, I was just handed over and checked on my patients. I heard people rushing and shouting “Code Blue” I had NO IDEA what code blue was!! Okay, if I have not mentioned this hospital earlier, I apologise. Americans build this hospital- in the States, “Code Blue” means a medical emergency/ immediate resuscitation, for example, cardiac arrest.
One first RIP baby (a few days old), we wrapped him with the hospital sheet, and the doctor handed the baby to his mother (younger than me). The mother holds her cold, still, dead baby in her hands. She was still as a rock- no emotions shown at all……. I was very shocked! The scene was so painful to watch. You could hear many babies from that unit crying, apart from hers! Every single time other babies cried, my heart pierced one more time; it was just unbearable.
In this culture, they believe that Allah forbids them to cry when someone dies because if you do cry, you are questioning Allah. So, therefore, you are saying that Allah is making a mistake!
The mother did not cry; she was there- motionless, her dead baby on her lap. I was there with my heavy heart, unable to utter a word; only our eyes were communicating a million words that we could not speak! I was with her silently, trying to support her: tears rolling down my cheeks, my nose producing an excess amount of bubbles, blowing nose frequently. At first, I felt like maybe I was offending their culture, their beliefs, and I feared that if they believed that because I cried, this child would not enter heaven. Of course, I do not believe it is true, but I feared that maybe I was delivering that kind of message! Either I had to remain like a Robot- with no human emotions, carry out working or holding this young mother showing my sincere condolence. What could someone do in this situation? I gave this mum a big, tight hug and prayed silently in my heart for this beautiful baby’s soul. That night was the first night of many I encountered children deaths.
I remember Deborah (older missionary) comforted me; she said one beautiful phrase, “When God squeeze your heart, you will bring out your emotion- tears.” And crying, weeping is okay! It is okay! Letting your tears out is natural; it is the human response to overwhelming emotions. Even Jesus himself showed an example of these emotions as he wept in front of his beloved friend Lazarus tomb.
Even though Mango is very remote, poor and dusty, it is also one of the prettiest places on Earth to see a bit of God’s beautiful plan. Moreover, what an excellent opportunity to participate in his grand plan!
We have shared emotional journeys, we have witnessed heartbreaking stories, but yet again, we have encountered wonders in the west! I feel like this is it! This is my calling! This is my destiny!! I feel content!!
I had a privilege to travel to the North of Togo last weekend with fellow volunteers from PDH. Jyoti had to leave for the UK on 3rd July, as she needs to go back to her ITU job (she should have quit just like me) next week, me and Iris have planned for a weekend away in the North. After constant research on Lonely planet guidebook and good reviews from our Togolese interns, we planned to visit Kara. The interns also advised us that we three shouldn’t travel that far on our own, therefore, we asked Ulrich (Male Togolese interns) to give us a company.
KARA
Kara city lies in Kara region; 413 km north of Lomé, close to Benin on East. I had a privilege to travel to the North of Togo last weekend with fellow volunteers and Ulrich from PDH.
Getting There:
Well, there are many ways to get to Kara. Did you know that there is an international airport called Niamtougou International Airport; which is also Togo’s second-largest airport after the main Lomé airport. You can get hire a taxi from the airport to your destination. But if you are a budget traveller like us then, you can easily get a bus ticket from Lomé. There are many bus companies that you can choose from. We had purchased our tickets (5,500CF/P) from the office the previous day.
We three girls woke up early in the morning because we didn’t want to miss our bus. We took a taxi (1000CF/p) in a quest to find a bus station for (La Poste). Finding a bus stop was difficult as there was no signboard for the bus stands. It was a maze and we thought that the bus already left us, at this point we three girls were panicking. Whereas Ulrich was relaxed and asking other locals giving us a head message that “we are fine girls- chill foreigners.”
We realised that the La Post bus was late (which is common here). Finally, we got into our bus from the collecting point and the bus boarded at 6:00. I hated the “La Poste” experience as it made frequent stops and allowed other passengers in without pre-paid tickets. Not to mention that our bus did break down on the way. We had a replacement microbus after nearly 2 hours of the incident, standing on heat.
Iris and Jyoti still smiling and posing while waiting for the replacement vehicle
Finally, we reached Kara after approximately 8 hours.
Where to stay?
Googling hotels/ accommodations on the internet wasn’t pleasant for us. There were only a handful of hotels published online. Please don’t rely on the webpage, (it could be many years old updates). I have realised that Togolese aren’t bothered about advertising their business online. Truth be told, the network in Togo is very bad. Hence the reason why people doesn’t bother to grow their business online. But good news folks, when you get to Kara you will find many hotels in Kara ranging from the budget- to the high standard accommodations.
Day 1
Playing cards while waiting for the rain to settle down
We were gutted that we had to stay indoors and cut our trip short but we were thankful for the cool environment. We entertained ourselves by playing card games and eating pringles.
The weather cleared up later, we hired a taxi for 30,000CF for a whole day (we did use Ulrich’s help for the bargain). Great tip- if going abroad and you can’t speak their language then get your local friend; seriously it helps a lot. From physical protection to buying stuff in a local range.
Tamberma Valley “Tatas” aka Clay castle
One of the highlights of the north is the UNESCO heritage site; Fortified compounds in the Tamberma Valley. Placed at the foothills of Atakora Mountains in the north-east of Togo, we find Kutammaku region, home of the Batammariba, people of ancient traditions.
We enjoyed and participated during the Tamberma Valley Dance performance. It was great fun! After visiting Tamberma Valley, we drove to Sawakara National Park around 17:00. We were just in time for the afternoon jeep safari.
Sunset at Sawakara National Park
A moment like this makes me feel like sitting back, soaking at the moment and seeing the world pass by; it is just so beautiful.
The price breakdown for Kandé and the Tamberma valley
Tamberma Valley (Entrance Fee: 1500CF)
Togolese (500CF). Student: (300CF)
Guide (10,000 CF).
Tamberma Valley Dance performance (5000 CF).
Drove to Sawakara Park at 17:00
Safari at Sawakara Park (25,000 CF) 5000CF/p + 5000 jeep
So, Jyoti and I have been in Lomé for nearly three weeks now. We are doing well apart from getting food poisoning, heat exhaustion and the constant worrying of developing malaria, leishmaniasis (sandfly), trypanosomiasis (tsetse fly) and all those tropical diseases that we recently studied in LSHTM.
Okay, let me paint the picture of how things are going on here in Lome’s Central Social PDH (Promotion Et De’velopement Humain). Bit of history now, this NGO was first developed by Antoine Dzakas in 1999 for the sole purpose of helping the vulnerable communities by dealing with requests accordingly liaising with beneficiaries and donors to meet the target. We get numerous clients at the centre asking for help (financially, socially, physically, etc.) In simple terms, this centre is an NHS with limited facilities we can provide.
This is how we start our day. So let’s dive in:
6: 30am Togolese interns start coming to the centre.
We live in the centre with Antione and his family, so it gives us that advantage, that extra sleep in the morning. We usually wake up around 6:30; we slowly drag ourselves from our cocoon; we crawl downstairs and have breakfast (thé and miche de pain).
Our typical breakfast-thé and miche de pain
7: 00- 8:30
Attend morning meetings. The interns usually report on the following task they had been given: how it went down if they were able to achieve the goal, any outstanding tasks to be completed, and if so, how we can achieve it. Mind that none of this is happening in English. So, Jyoti and I sit there doing what British people are best at doing- sip our tea. Antione reviews all these reports, and he then distributes the daily activities to each volunteer, whether that be a Visite à domicile (Home visit), Visite à l’hopitâl (Hospital visit), or an enquête social (Investigation).
8:30- 12:00
After the meeting is over, we pair up with our partners for a field trip (usually via scooter or motorbike), which is the best part! This is very exciting because we are on an adventure and it is very crucial. Moreover, it is crucial because we have gathered information about the people’s requests (financial support as the husband died, or asking for school support for their kids, medical support, etc.)
Pictures from the field trips
Fire aftermath in the neighbourhoodFireman coming for the rescueFloodingToddler left by his fatherHospital visit
Beautiful baby girl left in the Catholic monastery
We get to see the real people and actual patients and do our mini-investigation. I want to think that we are detectives, and now we are about to crack the case. It just sounds so cool and motivates me to do our investigations. I have had many funny and heartwarming moments on this journey. This information is now collected and presented to the rest of the team this afternoon.
12:00pm – 15:00 – Lunch/Siesta
I had never known that this most extended break-even existed!! We hardly even have time to empty our bladder at work, and here in Togo, you have entire time on your hands. You literally can cross over the border to Benin and Ghana and still attend your afternoon meeting. So during the siesta, interns usually go out to get some lunch and hang around with their friends. Some prefer to stay at the centre, do their work, or take a nap.
These are some lunches that Rachel prepares for us.
couscous au poisson et aux légumesspaghetti au poisson et aux légumesoeuf et saucisse au couscousquartiers de pommes de terre à la sauce tomateChips à la sauce de poissonBuying lunch local styleInterns enjoying Siesta
15:00 – 17:00
So after enjoying our long siesta, each pair of volunteers will now share their designated field experiences. Then, finally, they present their case with a proposal to fund their case.
The rest of the groups will vote if they are willing to invest in their presentations and how important the case is. When every team has finished presenting their cases, the whole PDH inters/ international volunteers need to prioritise the case. The voting will determine whether or not to contribute funds or supplies to this case. The most priority cases will be highlighted, and then the international volunteers are asked to set up a “go fund me page”. Our job is to assist and support the NGO in designing fundraising proposals, letters, presentations, flyers, newsletters, and websites ideas for the “Cours de soutien” project.
17:00- 19:00
After the afternoon meeting has finished, we bid goodbyes to our interns. Then, we three (Jyoti, Iris and me) go out for fresh air and our afternoon walk. We also try some Lomé’s street food (which Rachel has been avoiding us doing). Finally, we have our dinner around 19:00. After dinner, we freshen up (having three showers a day is entirely NORMAL here), play board games, practise some French, have girlie talks, do girls’ stuff like try facial, massage and write a short journal before heading to our bed.
Facial beginsJyoti and Iris playing Adito
My roommate Jyoti is leaving soon, and we want to visit more of Togo while she is still here. So, after hearing good reviews from Togolese friends and Iris, we wanted to go and see a place called ” Kpalimé.”
We were told that Kpalimé is a gorgeous place in forested hills surrounded by cocoa trees. We are sad that Iris is not joining us as she has visited Kpalimé already. However, there has been a massive advantage of having Iris around. For the starter: 1) She knows French. 2) She can bargain with shopkeepers and get us reasonable rates. 3) She knows local people (she has connections). 4) She is a great protector. 5) She has beauty products and facemasks. 6) Great French teacher.
Jokes aside: She is a great friend, and we both are so grateful that she is here with us!
So how did two Nepalese girls with ZERO French get to Kpalimé?
One of our Togolese interns (kekeli) is from the Kpalimé region. Although unfortunately, he couldn’t come with us because of his commitment; instead, he asked his sister to accompany us. So we hired a car for a day and went on a fantastic trip to Kpalimé. We stopped by a small hut to taste local wine on our way there.
beautiful road triptasting the local productwine break
I hate to say that this picture is very misleading and funny even. Kids here like to run around naked, and it’s not a big deal! It’s called being comfortable in your skin! Okay, to the topic now, these two are siblings, and their parents have decent earnings by selling fruits, vegetables and homemade wine. That drink was a strong, strong odour but was tasty!! Jyoti even bought two bottles and supported this family!
This family also gave an alcoholic drink to our driver as a welcome gesture which is very casual in this country. There are no traffic police, no rules on wearing seatbelts; people have far worse things to worry about here! Although even our driver had a few glasses of alcohol (I don’t know how much), he did drive us to Kpalimé and back to Lomé in one piece.
The reviews and rumours were genuine. Kpalimé indeed is so beautiful, scenic and surrounded by lush greenery. After living in 40 degrees heat in Lomé, I felt like Kpalimé was a different country. The atmosphere was chilled, the environment was clean, and people were so relaxed and laid back.
Cascade de Womé
To get to this waterfall, we had to pay the admission fee to the Association Akatamanso at the entrance of the village of Womé. This is one of the great attractions in Kpalimé; however, the waterfall was not as gigantic as I heard because of the dry season. Dismal but exciting- the way to the waterfall itself was a beautiful experience.
Cascade de Womé
After visiting an iconic waterfall, we all were starving at this point. We wanted to try an authentic Kpalimé dish, so we headed to the market. We were recommended to try a la pâte (food made with maize), a popular dish in West Africa. This dish can be served with a stew (fish, chicken) or eaten with a dipping sauce. To my surprise, I enjoyed la pâte with chicken stew.
la pâte is made from a maize
Kpalimé lies close to the Ghanaian border; hence, you can find a mix of both Togolese and Ghanaian merchants. We went to the local markets and bought some souvenirs from Kpalimé.
After our quick souvenir shopping, we went for a small hike towards Kikele’s village before it got completely dark. Usually, it sunsets around 18:00 here in Togo. kekeli’s sister was kind enough to show us her home town, and she even took us to the cocoa and coffee forest.
local chillingKekeli’s hometowncocoa forest
Togo has the highest mountain called Mt Agou (986m) in Kpalimé. It’s best to take a local with you because it’s a long hike (which we didn’t make to the top) as it was already getting dark, and we were also exhausted. It is advised to go for a hike early in the morning to get the best out of it.
Driving through steep drop-offs down the winding, narrow, bumpy Himalayan roads and experiencing landslides and aftershocks along the way is not what anyone has in mind when they look forward to their annual leave. My a/l plan included neither waking up around 3 am on a chilly morning with heavy rain, thunder, and lightning. Yup, during our one project, we were woken up by lightning, thunder and heavy rain. Our tents were destroyed, and our sleeping bags, equipment, and personal belongings were flooded- We were cold, frustrated, and miserable, but why did we still volunteer?
I cannot believe that it has been almost two years since the terrible earthquake struck Nepal. A developing country was hit by a catastrophic earthquake on April 25th and May 12th 2015, almost after over 80 years since the last destructive earthquake was recorded in history. These earthquakes had 7.8 and 7.3 magnitudes with epicentres in Gorkha and Dolakha districts. The earthquake was followed by several aftershocks and landslides which severely affected 14 districts and resulted in over 8,891 human casualties, missing 198 people and approximately 22,300 injuries; additionally, it displaced over 2.8 million households across the country. Among many districts, Nepal’s central and western districts saw the highest casualties. Consequentially, the health sector of Nepal faced more significant challenges physically and strategically. Physically, the physical development structures like roads, hospitals, health centres, clinics, and schools were flattened and destroyed.
classroom that had been affected
On April 25 2015, I woke up to check my Facebook newsfeed to discover that a tragic 7.8 magnitude earthquake had struck Nepal, which left me emotionally stunned. I felt my heart was weighed down, chained with compassion and disappointment simultaneously! I was frustrated with how the Nepalese government dealt with the emergency crisis. Nepal faced strategic challenges in organising health campaigns and coping with a sudden increased need for direct health care for those injured and dead in the disaster. Availability and accessing health centres have always remained challenging in rural parts of Nepal. However, the earthquake severely damaged approximately 1085 health facilities in the most affected districts. My heart was unsettled, and my spirit was troubled with this terrifying news. Sometimes you hear a knocking on your heart, and there are different types: quiet, gentle, sharp, and soft. This time though, the knock was constant, louder and more apparent. Finally, I knew what I had to do- after a lengthy conversation with my family, I decided to travel to Nepal.
I requested to take time off from work (and use my A/L), and my matron generously accepted my request. I have a fantastic unit (LITU) that has always been supportive and offered its willingness to Help Nepal in the present situation. Then I started raising funds, and this was my very first voluntary effort towards supporting the earthquake survivors of Nepal. I came across a non-profitable Nepalese voluntary organisation collaborating with Naya Yuva and BCC UK (Buddhist Community Centre). I met other volunteers soon after, and we quickly began to get closer. My church and my family sent me fervent prayers and blessings.
Despite our lack of experience, we had determination and took risks, faced our fears and tried to experience new things. So, with limited funds in our hands but we had sincere hearts, off we flew to Nepal on May 16th 2015. After 10 hours and flying over 5000 miles, we finally reached the “Himalayan kingdom – Nepal.” Sadly, it wasn’t the same Nepal I used to know from childhood. The country had been torn apart, cultural heritage was destroyed, and people were in great suffering.
Nepal is home to the eight gigantic tallest mountains in the world. With this amount of advantageous mountains, Nepal has an enormous source of water potential for producing hydropower and hydroelectricity projects. However, despite the high potential of hydropower projects, Nepal’s low economy and slow GDP growth rate, in combination with environmental and socioeconomic constraints, ineffective government policies and political instability for implementing an existing system to reach the sustainable development goals of the county is exceptionally challenging. Furthermore, Nepal is also exposed to the most extreme landscapes and fragile environment, and the heaviest monsoon rainfalls (June- September) result in flooding, landslides, and sedimentation every year. Likewise, the lack of infrastructure makes it harder to reach people with clean water and sanitation.
Water-based diseases are caused by parasites found in intermediate hosts living in contaminated water; for example, helminths and guinea worm, which are Neglected Tropical Diseases (NTDs). Water-based diseases are commonly found in Nepalese children and young adolescents. We knew that the risk of transmission would increase post-disaster because of a lack of clean water and sanitation. However, most of these infections are preventable and treatable by controlling snail populations, reducing surface water contamination and safe drug administration. In the post-earthquake crisis, the use of the cholera vaccine is still controversial.
Nonetheless, our team distributed oral cholera tablets, which is always a common practice in an emergency crisis such as earthquakes. In addition, our team took immediate action to intensify treatment and water supply hygiene awareness. While on the projects, we taught victims simple yet effective practices like how to drink clean water and taught the importance of handwashing, sanitation, and cleanliness, which we think are standard practices in a developed country.
Our team emphasised the importance of educating the public on chlorinating water to kill bacteria, viruses and protozoa to make safe drinking water. We also demonstrated how to make a live-saving Oral Rehydration Solution (ORS), “Jiwan-jal”, an effective homemade remedy for diarrhoea and dehydration! Jiwan-Jal literally translates to “Life- Water”.
HOW TO MAKE JIWAN-JAL:
1L of boiled water then let it cool
Mix 6 teaspoons of Sugar
Mix Half (1/2) teaspoon of Salt
The majority of the people we saw lived in tents in cramped areas. We were also concerned about the vector-borne transmissions caused by insects that breed in water or bite near water, including yellow fever, dengue, and malaria. We were worried that these people might be at high risk of dengue due to inadequate shelter, increasing exposure to vectors. Therefore, it was crucial to prevent or control epidemics of vector-borne illness, which can be done by destroying breeding (spraying), using mosquito nets, or other methods. Our team distributed mosquito nets and insect repellents such as mosquito coils to each household. Dengue fever is a paramount public health concern in Nepal. However, there were no deaths reported following the earthquake.
Every day was a new challenge and learning experience for us. To make our project run smoothly, we had many improvements to be made on site. After visiting many villages and setting up medical camps, our team needed to be mindful. Some victims could not physically come to visit the health camp, and our team saw the need for a change in approach. Hence we decided to bring a health camp to them by splitting the group into two creating a mobile clinic. The mobile team packed their backpacks with the usual standard medical equipment and walked to the affected areas that were harder to reach and had less aid. Surprisingly there were a considerable number of victims that were treated. We visited a young mum and her newborn baby with pneumonia (Neonatal pneumonia) on our mobile clinic project in medical terms. This condition is a prevalent respiratory disorder in newborns, which can be easily treatable in the western world. However, if left untreated, the baby can develop severe sepsis, multi-organ failure leading to intubation, and in a worst-case scenario, it will cause premature death. Our doctors were very experts in choosing the right medical words (in Nepali) and explained them to the mum. We advised mum to take the baby to the hospital for Chest X-ray- and told her that the baby needs broad-spectrum antibiotics. The mum was grateful for the advice she promised to take the child to the hospital. We gave money to the mum to make sure that the baby got the proper treatment.
We met this lovely old granny, the Earthquake survivor victim on the journey. She broke her right leg (not sure where she had a fracture), so she needed to have the above-knee plastered. We gave some tips and advice on how to look after her plaster cast, for example: avoid using any objects inside, regular pain killers, elevating the injured leg, small exercises moving her toes.
We also encountered a young pregnant teenager expecting her first child soon. It was mind baffling; she should be studying at this age and not having babies. We found out that she used to go to school, fell in love with her classmate and became pregnant! It is taboo to talk about the menstrual period, sexual health, STDs, and contraception methods (mainly in a remote regions). The young lady looked healthy and happy. We told her the importance of staying healthy during pregnancy- eating food rich in vitamins, minerals, iron and protein. Advised her to avoid medicines if possible other than recommended by a midwife/ or a doctor. She was aware of some common problems during pregnancy: hyperemesis, low back pain, anaemia, and swollen feet. Our team warned her about RED flags emergencies in pregnancy: severe Abdo pain, bleeding, severe anaemia.
Nepalese Army appealed the need for help in Singati (a place in Dolokha district) which was the epicentre of the earthquake that hit Nepal on May 12, 2015. These armies opened their barrack to facilitate our health clinic project. On our arrival, we treated minor secondary injuries like cuts, wounds, bruises, burns, lacerations, fractures, skin tears and crush injuries that emerged after the earthquake. We noticed that these Armies had ringworms (fungal infections). Ringworms are mildly contagious– For prevention, we advised:
– Wash the infected areas with soap and water
– Maintain good personal hygiene
– Shave their heads
– Wash their beddings
– Sleep in clean bed linen
– Avoid sleeping close to one another (easily spread)
– Avoid sharing clothing and combs.
– Buy and apply anti-fungus cream (we, unfortunately, did not have it)
– Keep the infected areas dry, exposed to the air/ sunlight
We discovered that wound infections were mainly caused by a lack of clean water and infrastructure for injury care, as immediate health care is either oversubscribed or destroyed in such disasters. In many cases, the outbreak of tetanus has been reported in the post-earthquake crisis. Tetanus is the result of wound contamination. To prevent tetanus, victims should receive complete management and tetanus prophylaxis!
So, what has happened so far?
In 2015, Nepal Disaster Report (NDR) mentioned that the government of Nepal established various legislations and policies but have resulted in devastative events because of natural disasters or human negligence. There has been slow progress in recovery post Earthquake in Nepal. Nepal established the National Reconstruction Authority (NRA) was established 235 days after the first earthquake because of political conflict over its leadership and an ongoing constitutional impasse. The delay affected aid delivery and further led to deaths, especially among the elderly. NRA was designed to provide social justice by resettling and translocating families displaced by the earthquake. In addition, NRA announced rebuilding all individual damaged structures, public houses/infrastructures, and heritages damaged by the earthquake in one year, two years, and five years. However, there are no clear guidelines on money disbursed, yet affected districts still await financial assistance to renovate their damaged houses. Hence, the Nepal government needs to review and formulate proactive policies, legislations, and institutions to effectively prepare and respond to future emergencies, including coordination, collaboration, volunteer management, reconstruction, coordination, information; collaboration and volunteer management.
What have I learned?
A bit of Politics
One of the fundamental reasons developing countries lag behind developed countries is that they severely lack sufficient investment and proper management of development infrastructures like health and education. As a result, this creates a vicious cycle of poverty and underdevelopment, in which people cannot generate sufficient income due to poor health and cannot afford quality health care due to lack of income. In the face of such challenges, natural disasters exacerbate the risk factor of disease transmission and overwhelm existing services. However, after the earthquake, we often saw services interruptions following disasters. Furthermore, it made most remote villages and vulnerable populations inaccessible due to various aftershocks and multiple landslides, blocking the major road and air transport, further delaying providing relief supplies and disaster cares.
A bit of health
Infectious diseases can be expected to become a global health concern in all disasters. In particular, developing countries are more prone to transmitting such conditions. But in the case of Nepal, there was no major communicable diseases outbreak post-earthquake. Whether the natural disaster is a significant factor in deciding whether diseases spread quickly or not, water, sanitation, and hygiene are critical aspects of health care management. Water and sanitation will continue to be an essential topic for research and debate in disasters, particularly in developing countries. Hence, re-establishing safe water and adequate sanitation should be a priority list in an emergency crisis in any country. Our project taught that prevention and control of water-related diseases could begin with a simple yet effective method like handwashing with soap and water. Furthermore, adequate sanitation facilities should also be provided equally in improved and well-maintained latrines or designated protected defecation areas. As a result, although disaster-hit sites offer a fertile ground for rapid water-borne related transmission, educating and creating awareness on simple methods can prevent such outbreaks easily.
A bit of mental health
Although the risk of water-borne diseases increases significantly following the natural disaster, several other factors are severely overlooked following such calamities as post-traumatic stress and immunisation. The earthquake had killed many villagers and damaged almost every house, passing sleepless nights camping outside. They were terrified of buildings collapsing on them, and ongoing aftershocks had traumatised the villagers. People were turning to alcohol and witch doctors for comfort! Apart from providing them with food, shelter and medical assistance, they urgently needed psychosocial support. Being kind and listening to them means more than anything else you can do! Henceforth, I learned that mental health services must also be accessible for routine, emotional support for victims experiencing traumatic events.
healing without medicines
A bit of remote nursing
I have always been passionate and motivated to deliver the best possible care to the most vulnerable people. I love my nursing job because I get the opportunity to make a difference through both the treatment and care I provide and educate patients to lead better lives by promoting health education and providing health information (Chuck of my CV, right there, if someone wants to hire me :D). But jokes aside, I have always worked in NHS and sometimes agencies in some “fancy clinics- with good pay scales.” I have always worked in a comfortable area where we get all the fancy, emergency/ non-emergencies pieces of equipment.
During our project, I had the opportunity to work with some of the most wonderful doctors and dedicated healthcare professionals. I was impressed with the knowledge of my co-workers and their ability to treat the trauma victims so professionally, which led me to realise the importance of nursing in the developing world. It was an excellent occasion for me to transfer the best practices of British nursing expertise to the developing world; it also gave me an insight into the Nepalese health care system. We were exposed to many medical conditions that I would not usually see here in the UK, and the villages we worked in were hyper-endemic in malaria, cholera, typhoid, etc.
Nursing is still the same; always use your basic traditional nursing skills & know your LIMITS!! It is still possible to make a difference in the world’s most remote places by doing what you know how to do!!! You need the HEART to care, not just the fancy equipment.
Nursing is still the same; always use your basic traditional nursing skills & know your LIMITS!! It is still possible to make a difference in the world’s most remote places by doing what you know how to do!!! You need the HEART to care, not just the fancy equipment.
A bit of folk beliefs
When I was young, my granddad used to put on neem bark oil on his legs. I never knew why he did that, and I never asked him why. Then, many years later, I realised that not only modern medicines like paracetamol, ibuprofen and aspirin could lower your fever but applying some tree oil to your body brings a fever down. TRUE that NEEM tree has natural remedies to help bring down fever, STOP pain, and ALSO help keep mosquitos AWAY!! How crazy is that!??
Another home remedy I discovered was that garlic could relieve diarrhoea and treat vaginal infections. Again, these folk traditions? Myths sound a bit silly, but hey, it is still possible, right!? Just because we live in the modern world does not mean that the old practices do not work! No matter where you are or where you go, be adaptable and positively embrace change.
A bit of humour
I learnt that kindness and laughter often help more than medicine. “A joyful heart is a good medicine.” [Proverbs 17:22] Many research studies have shown that there are many benefits of laughter, humour therapy helps maintain a positive attitude and helps lessen the pain, and in some studies, it has been shown to cure loneliness. Even in the bleakest moment, good banter and positive vibes are effective ways to help us with mental and physical stress. Good humour is good medicine.
Kids from Singitiwith Dolokha’s kidsSiblings from Toplang, Dhadingthe dirtiest feet wins!
A bit of research
It is essential to understand how locals view illness, pain, suffering, and death in that community. Custom, social, cultural, and traditional beliefs take a vital role in every country and not to mention in Nepal, a small but culturally diverse country, ignorance of their cultural understanding can lead to ignorance of diseases and consequently result in deaths. People are slow to change because people are loyal to what they feel is right! If you want to help, try to learn them, study them, examine their ways of living, and respect their traditions and ideas; you will win people’s love and respect! Only then you will be able to introduce your practice, new technology, and modern medicine. Learn from them and encourage them to learn from you. Only then you can work hand in hand with government and public health officials to spread public health awareness. The fascinating thing that I saw was that these people still have hope. These people were kind and welcoming.
The aftermath!
I have learned that hope sustains life, and I hope to have touched those beautiful souls as profoundly as they have touched mine. I have learned that this life is too short; we need to try new things, take risks, face our fears and always follow our hearts. It does not necessarily mean that you have to fly thousands of miles to a remote place to help; you need to open your eyes and listen to your heart because charity begins from your heart. Irrespective of the size of donations, any help from volunteers can make a massive difference to these victims of a natural disaster. Unfortunately, we could not reach some remote villages as they were inaccessible simply because of their geographical locations. It was a roller coaster ride from start to end, widening my knowledge and giving me a glimpse of a natural disaster. The thing is that natural disasters can happen anywhere and without any warning. Indeed it was a wake-up call for Nepal, and there is a long road to recovery ahead. I am incredibly fortunate to be a part of such a fantastic project. I have learned to appreciate life and what it can offer; compassion, love, hope, and trust make life go around.
Single ladies in Mayberry House. So blessed 😀
