Tuesday

Up and on the bus by 7:40 am, even with Paul & Paul's alarm not going off til 7:25.  Typical breakfast was served after a singing prayer. After morning instructions and encouraging words from leadership we headed off to Sebekenta.  1.5 hour drive through very heavy traffic.  Senegal roads are much improved but there are twice as many vehicles.  There are hawkers on the roadways who dash between vehicles and may tap you if are by an open window.  Kat knows well.
There was a lot of sand in the air blocking direct sunlight and showing up in our noses and eyes.  Pastor Paul was out in the "sun" all day and showed no signs of sunburn.  Yes, dear spouse, he did put on sunblock at the beginning of the day.

We unloaded the bus after arriving at our clinic point and unpacked. Before beginning we met with the village leaders who thanked us for coming and offering a free clinic in their community.   Bob had a "God Moment" as his morning devotion was on Jesus saying how blessed we are when we "minister to the least of these" and the Muslim leader said those very words.
We went to work with our clinic starting a bit slow as most spoke only Wolof requiring two translators at near all stations: Wolof to French to English.  Some of the local translators were not very good slowing us down.  We made adjustments there and changed a few roles to increase efficiency so that we would see about 150 people by the end at 6:15 pm.  Kat started doing advance triage to separate out who really needed to be seen by the Docs and who had simpler needs that nurses Nicole and Katy could address with translator/chaplain Morley.  Donna V was shifted to translating French to English for nurse practitioner Andre who doesn't speak English, and Christine was brought in to translate Wolof for the the nurses replacing a local person who struggled.  Christine is the missions financial officer.  We make these kinds of changes every day to adjust to our situation and available  staff.
We were upset after working for an hour and half to discover that the local people were charging people 500cfa (about 2 dollars) to be seen. After thanking us for offering a "free" clinic at the beginning, they were charging entrance at the outer gate.  Our leadership conferenced and made the the decision to let it be known that no future clinics will be offered if such charging was done.  We could not alter their practice today without causing a major scene with those who had paid and already been processed and left versus those who had not.  As it was, they had to manage people who had paid but we're not able to be seen at the end of day even when we stayed an hour late. A few were a bit angry but we're reimbursed . We deferred people to the next village over where we would be the next day. 

We continue to see lots of hypertension,  dehydration,  worms, diabetes,  high blood pressure. 
We did want to give a woman an Academy Award: she came seemingly unable to walk and was given a lift to the Dr's room where she collapsed on the floor.  After examination Doc Strong gave her two Tylenol she rested for a few moments and miraculously walked away without any problems.  Hallelujah!

Despite a few glitches in the day there were many joys.  We identified a man with a severe diabetic situation.  He was given an IV to stabilize him and called for a taxi to take him to the hospital.  Numerous people were given relief from their infirmities and offered thanks.  Pastor Paul emptied his shoes of sand many times as he was running the most between stations.  Socks were quite soaked in sand as well.
After a farewell picture for the local press we headed home.  Lots of singing, storytelling, and laughter on the way back to the mission.  We did learn that Andre, the nurse from the mission, had been in medical school and was half way through when he got word his father had been murdered back in the Congo.  His father was a professor of gynecology at a university. Andre had to stop school and go home.  Without his father's income he could not continue in school and hopes for a scholarship to complete his degree.  Andre does valuable work for the mission's medical program.
Dr Strong was able to see Nurse Valerie's daughter whom he had helped medically on a prior visit.  She is 21 now, and doing great.  She hopes to go to medical school and has been earning grades that can get her there.  Pastor Paul also enjoyed seeing her again as she said in Avatar movie style, "I see you."
We returned to the mission for a typical supper and reflection on our day.  God is blessing us on this trip.  Again, this is an amazing team.
Our last blessing of the day was getting Laundry back from the Gibson's (missionaries from Wisconsin) housekeeper.  It was cleaned and folded flat just like out of the store.  Amazing.  Perfect for packing a suitcase for the way home. More laundry will be done later this week.
Thanks to Doc, Sue, Kat, Pastor Paul for doing the evening data entry of medical info.
Time to rest.  Six hours to wakeup.
Pastor Paul for the team.

Monday

We were on the bus at 7:30 am and rolled thru traffic for the now familiar breakfast of juices, croissants,  jams, coffee and today's addition: eggs.  We were on the bus to the Rufisque women's prison. Picture taking was prohibited in the prison so we had to turn in our cameras/phones  to Pastor Armstrong for safe keeping.
There are two women's prison in Senegal.  The maximum security prison is in Dakar.  Rufisque is the minimum security prison.  The women are here for a variety of reasons including drugs, theft, domestic violence and unlicensed prostitution. Some women have been in the facility for 5 years without being before a judge. The United Methodist mission provides an advocate for the women's prisons, Ndeye Fatou Diouf. She works with the prisoners and prison staff to create a caring community,  assists in reconciling prisoners with their families especially near release (many families disown them), helps as a judicial advocate,  and assists in food and health matters.  Mother's can bring infants and toddlers up thru 3 yrs of age so they  can be nursed. The cost of milk substitutes is too high so nursing is encouraged. We saw several children in the prison and a total of 78 prisoners, guards and staff. Lunch didn't come until 3:15 so we were running low of energy by then.
Lunch was a traditional Senegalese lunch of rice with some vegetables and beef added in the middle.  It was served on large steel plates about 25 inches with 5 to 6 people eating off the same plate.  We were given spoons to carve out one's territory on the plate.  We also had some cold soda which helped break the heat.
Some went on the prison balcony to watch the children letting out of school and to see the ocean a couple of blocks away.  We finished our work around 5:30, packed, and had a farewell moment with the prison director who thanked us profusely along with an inmate's representative. We were told that we are the only medical group being allowed to come this year because of the integrity, reputation of past United Methodist medical teams, fair treatment of all, and professional care.  All other groups are being denied.  This reflects the work of Ndeye along with Dr Strong' wisdom and care over the years and the amazing teams we are able to bring.  This year's team is one of the strongest we have ever had here.  Give praise to God.
We journeyed back to the mission and had supper at 8:00.  The meal featured grilled chicken, a bowtie pasta mix, vegetable mix, bread and a mix of juices.  We were so glad to get back to our motel for rest.  Dr & Sue Strong did data recording tonight relieving Pastor Armstrong and assistants  Kat and Paul M. for one night.
One last comment regarding building construction. Buildings are not built like in America.  There are staircases with varying heights to steps along with some real headbanging overhangs.  We have to help each other with reminders every time we encounter one and they are all over.  Even then one is still surprised, especially at the end of the day.  Dr. Strong, our beloved and gracious doctor, now has a Rufisque bump from a low beam.  He is quite fine and in good humor.
Keep us in your prayers. Off to the village of Sebakatone tomorrow for a little different experience.
We are thinking of all of our loved ones and dear friends as we move to sleep.
Till tomorrow.
Pastor Paul with a little help from Paul and Jeff.

Sunday

Our day began with the bus ride to the mission for breakfast.  We again had a choice of croissants and breads and juice.  The worship service followed.   The service was joyful, Senaglese contemporary with keyboard, drums, guitar,  flute, singers, dancing and clapping.  Donna V. sang "Breath" in French and English joined by Andre the nurse practioner and the whole congregation. Pastor Paul had the honor of being the preacher of the day preaching on Luke 4:14-21, Jesus at his hometown of Nazareth.  The congregation was surprised as the sermon was only 15 minutes in length as they were used to 30 minute or longer sermons.  The service time was 2 hours and regarded by all as a good day of celebration and inspiration.
After the service we went to a Brazilian restaurant in downtown Dakar.  It was a delicious meal with a variety of meats shaved off the skewers. Yum.
We drove by the USA embassy and the renaissance monument before stopping at the home of Senegal superintendent Rev.  Joseph Bleck.  He broke his leg recently so we stopped to visit him and learned more of the mission work from him.
We then headed back to the hotel  to relax, process the data cards, enjoy a sunset from the rooftop and eat sandwiches brought to us at 8 pm.  A few people watched some Senaglese  TV to see the results of the wrestling match which was nothing like American wrestling.   They danced in manly gyrations after having oil poured on them.  Prebout trash talking ensued in front of a crowd of tens of thousands.  The match itself was in a sand court at least as big as a volleyball court.  One guy was about 100 lbs heavier.  The match was composed of a lot of posturing, some punching and finally the big guy got the little one down in the sand.  The match was over in less then 10 minutes.
We were cautioned not to be out after the match as people can be roudy.
There was also a French show trying to explain the English phrase "from the horses mouth."  Quite funny to hear them try to explain that.  How would you explain it to a person from a different language?
We regret we can't post pictures as the connections for us keep blocking submission.   For those of you with Facebook you can look for the Senegal United Methodist page and see some pictures there.
Time for bed.  Off to Rufisque Women's Prison in the morning.
Paul A & company.

Saturday

Day 2 of clinic.  Today we took two buses loaded with people, meds, and one monkey.  He is so cute.  He greated us this morning on top of our luxurious  bus and continued to be our guide until we arrived at Diamniadio, about an hours ride from Nord Foire. 
I am a chaplain in a Trauma hospital  in Colombus,  Ohio and from time to time I am called to interpret Spanish or French.  Piece of Cake!  Easy button right?  Right!  Well today we had a patient that spoke Creole.  Well guess what?  None of us spoke Creole either.  What to do?  Answer- Creole to Woolof, Woolof to French, French to English.   Awesome amazing teamwork all working together to help  this woman  with her health  needs.
One more comment  then I leave the tiny key board of  cell phone.  The people of this community were so gracious.  So many returned to us to say thank  prior to  leaving with their meds in hand.  Quelle journee. 
Morley

I also work with an interpreter, Valerie, a nurse with the mission health ministry.  She is a valuable source of information with knowledge of local resources and customs. On the medical side, I've seen some fantastically elevated blood pressures. We've identified 4 new cases of diabetes, with many other known diabetics with poor control.  I've performed some minor procedures such as joint injections, lancing of abscess,  and removal of foreign body from nose. Common complaints are back pain, joint pain, heartburn, eye irritation,  and cough. My goal is to keep the team healthy. We had two incidents today that made us gasp, but fortunately resulted in no injury:  hand slammed by van door and collapse of plastic chair at lunch.  The team has still been trying to catch up on sleep after our flight, will appreciate off tomorrow. Paul, Mary, and Morley will all play a role with church tomorrow.
Jeff
P.S.  About the collapse of this plastic chair - Peter Pan has lost his wings!!

Friday

    Hello everyone. Today was our first day of clinic at the mission in Dakar. We served over 200 people (which is a record first day for the previous missions) I am a nurse from Columbus and this is my first time serving in a medical mission. I am both tired and exhilerated. We were able to help so many people. I am amazed at the dehydration, diabetes and hypertension that I see with the senegalese. But what stuck out to me the most was a young man, I never cought his name, who volunteered to help Donna Morley (interpreting French for me) to interpret Wolof into french for her. He sat there for hours helping us before being seen himself for a painful hernia.
     It is amazing the hospitality (teranga in Wolof) that we have been shown though the missionaries that live here. So much preparation to feed us and set up space to be able to help others in senegal.
     I am very tired and should probably help the others pack up medications so that we can get up early and do it all again tomorrow. Continue to pray for our energy to keep up and that we all stay healthy to help each other as well.

Thank you,
Nicole Smith RN (columbus,oh)

Thursday Evening

Today, which started with departures yesterday, went very well.  It looks like we a wonderful team with a great attitude and spirit.  After we settled into our rooms we went to the United Methodist mission and we're served a good breakfast with scrumptious breads and fruit.  We then had a tour of the mission facility meeting people and learning what they do.  We then went back to our rooms and took some naps and organized our rooms.  It was warm, upper 80's and sunny.
Oh, we stopped at a pharmacy to see if they had distilled water for some medical devices.  A few of the team told the pharmacist that the milk they were buying was going to the women's prison to help feed the young children who are incarcerated with their moms.  He was moved and donated a bunch of bibs to share- a sign of God's grace for all.
We have air conditioning and some fairly nice rooms with stiff foam beds.  We headed back to the mission and had a late lunch of fish, rice, fruits and vegetables before starting work on reorganizing the 550 lbs of pharmaceuticals and equipment for the clinic tomorrow.  It took all 11 of us 3 hours to make all the preparations we could make before supper call.  The largest task after sorting was prepackaging the vitamins and certain meds into easy to handout ziplock bags and press labeling them for people who can't read. 
Supper was at 9:00 pm and was a nice warm sandwich with meat and fries in the bun.  We are all ready for a good night's rest after being up for nearly two days.  Better rest now.  Midnight here.
Paul A

Airport Pickup