Michael and Amanda O'Neal

Our Neighbors in Uganda

Michael and Amanda have been in Masindi for just over a month. We had the chance to meet them while we were there last week and are excited to get to live and work with them. Michael is PMI's project manager and they will stay in Masindi through the completion of the new hospital. Amanda is working on her master's in counseling from Liberty University and is also a pilates instructor, so she will be a wonderful friend and resource for us. 

Pictures from Africa!

Here are a few pictures of our patients last week

  (courtesy of Amber Henderson, Michael Overcash, and Josh Drake's excellent photography):

a real live hippo...as seen from our Nile River cruise on Saturday:

the whole team (+translators, drivers, and clinic coordinators):

...and here are a few more gory medical pictures. 

I've made them small on purpose so that 

people who don't want to see them don't have to.

Click if you want to see them bigger:

"Welcome Home"

I look forward to traveling back to the US and going through Immigrations and Customs and hearing the words "welcome home."  Even though I was only gone for 10 days, it's so exciting to hear those words said.  I love traveling and living in other cultures, but the United States is my home and I'm grateful for it.

So, we made it back safely!  It was a wonderful trip and now begins the processing, debriefing, and preparation for the next phase.  Mandie will go to Orlando, FL on Sunday to attend PIONEERS' Candidate Orientation Program. Hopefully, we'll receive approval from the Area Leader over Uganda to pursue this new adventure.  From there we'll begin raising support.  We're confident the Lord is leading us both to do this, but finding investors requires more humility, perseverance, and trust than either of us currently have.  We are looking forward to how the Lord will work in the next couple of months as we step outside our comfort zones!

I will begin nannying on Monday for three teachers with three infants between the ages of six months and eleven months.  I'll be living in Charleston with Mandie's family till the end of the school year.  I'm so thankful for my second family and their willingness to open their home!  Much of the time that I'm there, Mandie will be continuing her travels (Orlando, FL and Brazil). 

Thanks for your prayers and loving support! We'll keep you updated as we figure out things.  Having seen the medical need in Uganda, we can't wait to go back and start serving.  Our time there this last week was fruitful for the kinds of things we need to be prepared to do and to see.  We've started making a list of the books and equipment that we'll need to function there.  We didn't have any time to figure out where we'll live or what kind of things are available, but I'm sure that will come as we email back and forth with Michael and Amanda.  Our housing decision is dependent on the Bishop of the local Anglican Diocese.  From what we understand, he controls the housing situation and will probably just tell us where to live.  Worst case scenario, we'll live at the Masindi Hotel for a couple weeks while he decides where we should live and while renovations are being done to make it livable (eg. running piping into the house so that we don't have to go in search of water every day).

Hopefully we'll have a few pictures posted soon!

Mandie's Birthday and Murchison Falls!

I (Rachel) “accidently” let it slip that it was Mandie’s birthday today….she wasn’t happy with me. She was lavished with unwanted attention and got to spend her 24th birthday on the Nile River. We spent two long hours in the car up to Murchison Falls swatting at Tsetse flies (which are very resilient) and sweating with the heat. It was worth it to see the Nile River pounding through a narrow 20 foot wide canyon. The amount of energy coming through was unbelievable. We walked around the top of the falls and enjoyed the spray misting up from the pounding water. The hotel had once again packed us a marvelous lunch and we ate in a little thatched open hut with the sound of the water behind us. From there we spent another hour or so in the car going down to a lower point in the river where we took a 2-hour boat cruise up to the bottom of the Falls. I was so tired that after only a few minutes of being on the boat, I crawled under one of the benches and fell asleep for about an hour. It was a beautiful day on the river and we saw hippos, crocodiles, water buffalo, elephants, warthogs, cranes, baboons and a plethora of birds. We traveled up to the bottom of the Falls and took a team picture on a rock. From there, it was only about an hour downriver back to where we had started.
Mandie now:
I’m 24! I rather knew that with Heather and Rachel on this trip it was not likely that I could escape birthday attention. They set me up for an impromptu counseling session with our team psychologist, Rachel Darrow, over breakfast and she reminded me that birthdays are a time to let other people celebrate the fact that I was born. I liked that definition and actually enjoyed the several times that Son initiated a round of “Happy Birthday” or the many team members who reminded me it was my birthday throughout the day. It really was a perfect birthday: slept in a bit, had a delicious breakfast, a fun bus ride to Murchison Falls (with lots of baboons along the road!), the breathtaking Falls and Nile River, good conversation on the 3.5 hour boat ride, a long and crazy drive back (with 2 hours of group singing from our rather extroverted bus group – Richard, Amy, Erin, Derek, Ansley, Roxanna, Christian, Brian, Rachel, myself, and our poor driver, Steven), an amazing dinner of shish-kabobs, and cake to go along with the “life story” sharing at the end of the evening. Son (for the team) bought me a beautiful handmade Ugandan bead necklace and a paper bead coin purse at Merchison Falls and presented them to be at dinner, in his sweet humble way, “on behalf of the team”. Then the Masindi Hotel staff gave me another beautiful necklace and trinket box.
The day was a perfect end to our time in Uganda. It was sweet to spend time with the amazing people on this team. After a whole week of being thrown together (and working well together) at busy clinics, we were able to sit with each other and have more conversations, enjoy the relaxing boat ride, and SLEEP!!
Tomorrow we head back to Kampala to catch our flight to Ethiopia, then Italy, then DC, then Charleston. Pictures will be posted as soon as we’re back!

Love to all!

March 11

DIRTY has been the theme of the week. We have been working for the last two days in a huge one room church with a bright red dirt floor. As if walking in red dust all day is not enough, we ride for an hour and a half one way in a non air conditioned van on a dirt road with the windows down. Most of us could pass for Latinos and in a few days would blend right in with our dear African patients and translators. Speaking of patients and translators, Rachel got to do her first pelvic exam today and I got to pull a molar. I spent the day in triage and found several enlarged spleens, interesting neuro cases (Dad and Dr. Ken would have been proud!), and mostly just enjoying hearing all the CRAZY stories people told to try and convince me they had malaria.  Rachel got to be with the doctors and PA’s all day and so learned some good diagnostic techniques and got to teach the PA students how to draw up and give an IM injection. Speaking of IM injections, I got to give two on Tuesday night. They were, unfortunately, on Rachel, but being the baby nurse that I am, I was excited anyways. She had a pretty bad migraine and the only thing that it seemed was going to work were two IM phenergan shots and I happily obliged. She woke up migraine free and was fortunately able to come to clinic (Rachel here: though 50 mg of phenergan and two ibuprofen pm and two regular ibuprofen may have been overkill...it was hard to keep my eyes open that day.)

(Rachel here) Back to today. We saw just over 200 patients and had to turn away at least that many. Since we were there for the second day in a row, word had spread that we were coming back and so the line stretched around the corner. We saw lots of coughs, heartburn and high blood pressure, but the day also included several children with seizures, a boy who had a broken arm with a piece of bone sticking out near his elbow (it had been broken for over a year) and a girl with a six inch infected abscess on her head that was eating away at her scalp. Not only is basic health care lacking, but education on how to care for wounds is as well. So many of the problems we saw today were due to a lack of hygiene. Patient after patient came through with bug bites that they had scratched and that had become infected with staph because they do not wash themselves or clean open sores. It was a particularly hot day and the flies swarmed on any open wound they found. Most of the time spent with patients was spent educating them on diet, hygiene and the cause of their discomfort or illness.

Tomorrow is the last day of clinic. It has flown by and although we had hoped to post something every night, by the end of each day we have been exhausted (not to mention that I kept Mandie up till almost two am the night I had a migraine. She was very kind and made a great nurse…I’m pretty sure I was not a great patient…though I did give her the opportunity to give not one, but two shots since the first one didn’t work). Anyway, my hope is that we will both be able to be with the doctors and physician assistants doing diagnosing and prescribing. It’s great practice for what we will do when we live here. I’m hoping to be able to pull a tooth and any wound care or exciting diagnostics will be exciting. On Saturday we will have a day off and relax and see the Nile River! We were hoping to spend some time with Michael and Amanda, the couple overseeing the building project. They won’t be there, unfortunately, but it will be good to spend time with the team, without the chaos of clinic. On Sunday morning we will start the journey home!

The days are blurring together!

March 9th:
Copang ‘o! (“hello” in Luo)
Today we drove an hour and a half outside of Masindi towards northern Uganda to do the first of two days at a church located near several refugee camps. My translator told me that there are over 57 languages spoken in a 10 mile radius of the clinic site. The main language of Masindi, where Rachel and I will be living, is Runyoro. A bit farther north, most people speak Luo. Swahili seems to be a common thread through all the languages I have heard. Many phrases in Luo and Runyoro retain at least one word from the Swahili phrase of the same meaning. Today, I had the opportunity to work with Amber, a PA, who was a great teacher. We saw several interesting cases and I got to do my first pelvic exam. We diagnosed a man with absence seizures, treated a small boy who had had seizures since birth, treated parasites, ear infections, STD’s, pneumonia, and tons of other things. Of course one of my main goals on this trip was to get a grasp of the local languages so that I can spend this summer learning them. Today was very exciting as I started being able to understand a lot of what our translator said when the patient spoke either Runyoro, Luo, or Swahili. I still blurt out Spanish when I don’t stop to think first. (Rachel here to finish) Mandie has astounded everyone with her language learning ability. I’m quite confident she’ll be starting on her third local language when I’ll still be struggling with the first. I’m glad I’ll be living with someone who understands the people here.

As exciting as Mandie’s day was, my day was predictable. I spent the day in triage again and I perfected the art of taking blood pressures quickly. Each of us in triage had a Ugandan nursing student with us. They are only four weeks into the program and did not know the normal heart rate or blood pressure, so I spent as much time teaching my nursing student as I did talking to the patient. It reminded me of the first week of nursing school and how overwhelming it was to try and absorb everything being taught. I’m glad I survived and can now teach someone else.

Most of the time I still feel like a student, but it has started to set in on this trip that I'm a "real nurse" when the MUSC nursing students come to me for help. Yikes, and to think Mandie and I are thinking of coming and being the primary American staff for the hospital.

Thank goodness the Lord knows what He is doing!

Day 2: First Clinic

(Mandie here): I was an "escort" today, which is kind of a loose job description. It included walking patients from triage to doctors, from doctors to pharmacy, and so on. The day started out early for Rachel and I and the several others who went to the clinic site early for registration. I found myself with nothing to do and so started down the line of 150+ people, shaking each person's hand and saying the one work I learned from our bus driver on the way: "oraireota?", which means "how did you sleep?". The first person I spoke to gave me my pet name, a tradition in Uganda. It is Akiki (ah-KEE-kee). By person 50, I had learned the correct response to "oraireota" and several other phrases. Those all came in handy through the rest of the day. I spent some time playing games with Heather and the children, started an IV on a severely dehydrated grandma, pulled a tooth, dressed a third degree wound, and then saw patients on my own. We had a rather large patient load today and the doctors got a little behind, so they put me and Wendy (a med student) together to see patients. That was taking too long, however, so they split us up after the first patient. Most of what we see here is the usual dehydration, malnutrition, and parasite infections. That can get frustrating as I got tired of telling the translator the SAME things over and over, but it is so good to know that even the small things we can offer then can make a big difference in their lives. This was my first day on a medical mission trip where I wasn't a translator and I loved it. I miss being able to communicate directly with patients and several times blurted out Spanish to them, but the opportunities to actually DO the medicine I've been studying was wonderful.

(Rachel here): I worked in triage today from 8:30 to 6:30....what does that mean? Three nursing students and I took 260 blood pressures, heart rates, asked "what brought you here today?," watched people chew up disgusting non-chewable worm medicine and vitamins, and hopefully made the lives of the doctors easier with our many many questions. It was a long day, but rewarding when the leader of the trip made the comment that he would never have gotten such a detailed history from the patients. Overall, I didn't drink enough water and may or may not have bruises from sitting on a hard bench, but will sleep well tonight knowing that 260 people got great health care consults. We keep saying we'll post pictures, but so far have been so exhausted each night it's enough to just write. Maybe tomorrow...they've promised to make the clinic day shorter! Thanks for your comments and emails! I can't wait to share more!

Day 1

Day 1: the “calm before the storm.”  I’m not sure I would have called it that other than that breakfast wasn’t until eight am and we had some free time in the afternoon.  We started out the morning at the local orphanage, hearing the kids sing, playing with them and providing vitamins, and doing check-ups on the children with complaints.  Mandie handed out vitamins and then helped take vital signs while I was the triage person.  I now understand the difficulty in eliciting information from a child who does not speak English and thinks a fever is the same thing as malaria.  After lunch we went on a tour of the local hospital.  Dismal and primitive are the two words that come into mind.  After walking through the maternity ward where women were lying on dirty mattresses recovering from labor, Mandie and I chose not to walk through the other wards gawking at the patients.  While we agree that it’s important to see the state of the health care conditions, we realize that we’ll have plenty of chances come August to be in the hospital and did not want to be two more white faces staring at the misery.

(Mandie writing now)  During the free time, we walked through part of the town with Josh, the photographer, and saw the site for the clinic and the house that is being renovated for Michael and Amanda, the couple overseeing the building of the hospital. This is also the neighborhood where our house will potentially be, so we took some pictures and smiled at our future neighbors and tried to imagine walking down those red dirt roads every day. It seems like a good town to live in. There’s not much that looks familiar, or even comfortable, but the people are warm (well, at least the women and children are) and there is a lot of lush vegetation…and electricity and plumbing...so what could there be to complain about?

After walking around, we came back to the hotel for dinner and evening announcements, etc. What was supposed to be an early night turned into a 4 (and inappropriately named) hour pill-packing “party”. It was not a party. We counted out and bagged packs of 40 multi vitamins, Tylenol, and ibuprofen, while a few people filled prescriptions from the orphanage this morning. At 10:30, we decided to call it quits. Tomorrow we eat breakfast at 6:30 and the few of us who signed up for registration will leave at 7:30. It will be our first real clinic day and everyone is excited to see how it goes and what we see…

WE MADE IT!

After 24 hours of airline travel with another five hours on a bus, we made it to the Masindi Hotel.  Highlights of the trip include the best airline food Mandie and I both have ever had (we recommend Ethiopian Air).  Not only that, but it was a very social airline and we made friends with everyone around us.  The man and his son sitting behind us were flying to Uganda first for a building trip.  After the trip they are flying back to Ethiopia to pick up an eleven year old son they are adopting.  The two women sitting in front of us were going to Ethiopia for a medical mission trip similar to ours.  One of the women is a long time Registered Nurse and Lactation Consultant.  We swapped stories and contact information, Ibuprofen and homeopathic remedies for immune health and detox.  

Tomorrow we will visit the orphanage and conduct well child check-ups for about 100 children and then visit the Masindi Hospital to get an idea of the only healthcare available here.

It’s 8:30 in the evening now and we’ve just finished dinner.  We’ll update more later, but the room hasn’t stopped moving around us and neither of us have any brain power (in which case disregard all typos and sentences that don’t make sense).

We have a professional photographer with us on this trip and he’s been taking both photos and video.  Since we won’t be posting every day, visit the PMI blog to see pictures and updates posted daily: www.palmettomedical.org

TWO DAYS! :)

Two days from now Mandie and I will be sitting on a plane (hopefully next to each other...keeping our fingers crossed) on our way to Uganda.  Three weeks ago today I was telling Matt that I was ok with Mandie going to Uganda on a site visit without me.  That wasn't acceptable to him so here I am, going with her.  My bags are not packed and I need to work on it.  The pre-travel jitters are starting to set in and I'm constantly having to remind myself to trust the Lord.  I have my vaccinations and my malaria meds and my passport at Mandie's house with hers so that I won't have to go through the process of checking one hundred times to make sure I have everything important.


Mandie got her approval today to go to the March orientation for PIONEERS and they have finally appointed a new area leader for Uganda, so things are finally starting to fall into place on the PI end.  Hopefully we'll be able to start raising support soon!

Yikes it's becoming real!

Oh...check out Mandie's handiwork: http://somethingbeautifulafrica.com

I don't know how often we'll be able to update the blog for this ten days in Uganda, but I am taking my computer so we'll try! :)

Hmm....maybe I should start packing. :)

A website!

Hello friends,

We've just opened the website that hopefully will serve to keep you updated on what we're up to in Uganda over the next year or two. We'll be leaving for Uganda this Friday, March 5th for a preliminary site visit and hope to be able to keep you all updated on what we're doing throughout the week.

Go here for the new website www.somethingbeautifulafrica.com.

Mandie & Rachel