May 2, 2012  9:45 pm

We started the morning with a c-section for a woman who had labored for 4 days. I have never been more thankful for every cry I hear as a new life emerges. The little boy was covered with old sticky meconium and still had a robust cry. Our next patient wasn't as fortunate. Her baby had died before coming to the hospital, and I initially thought her uterus had not ruptured because she was only 7 months along and it would be extremely rare. This morning her abdomen was more tender and we were more suspicious of a rupture. Indeed, she had ruptured through the top of her uterus, and the reason became clear when we realized she had a uterine anomaly. She had a unicornuate uterus, which means she had a half sized uterus and was missing a tube and ovary, as well as her right kidney. After we finished reparing the uterus I noticed a cyst on her only ovary and it turned out to be a dermoid with black curly hair and teeth inside (sorry for you squeemish folks, but to me it was interesting).
This afternoon in clinic a beautiful young woman came in for what I thought was just an ultrasound to determine her due date. Her swollen belly was obvious under her long pink head covering. She was accompanied by her mother and 1 year old daughter. Just as I was motioning her towards the ultrasound, she took off her head covering and revealed a cantelope sized tumor on her left shoulder. I had the general surgeon take a look at it, and he felt it was an osteosarcoma. He said as soon as the baby delivered (in 6 weeks) he would need to amputate her arm and even then she would probably not survive. I know she saw my wet eyes as he was explaining this to her in Hausa. It broke my heart looking at her daughter knowing she would not grow up with her mommy. After we prayed for her, OB called and urged me to come. As I was walking briskly down the hot, gruesome smelling hallway I whispered a prayer that I would arrive to see a live baby. Instead I saw a dead baby with the body delivered and the head entrapped. Hal and I experienced this our first night and I chose not to write about it, but it is too common here and extremely disturbing. The reason this baby had died was very clear on ultrasound. Her head was as big as a soccer ball and completely filled with fluid. After I delivered the baby I told the patient (via the interpreter) that the baby would not have lived and it wasn't her fault that she died. I could see the relief on her face. I wonder how many women here think they are guilty for their baby dying (when really they are the victim in many ways).
People don't throw anything away here. I was instructed by the director of the hospital to feel free to throw away the old oxygen masks, vacuums, amnihooks and bulb suctions as I  (almost secretly) replaced them with new items we had brought from the states. We finally have an oxygen mask that will fit the baby.
People also don't waist a bite of food. Remember the saying your mother told you about cleaning your plate because of the starving children in India....well it's true for Niger. Everything that possibly could get eaten, is eaten. It amplifies the amount of food waist I see just in my own house, let alone the city of Portland and our country. I felt guilty putting some old cooked rice in the compost here because I thought it would be seen.
My morning devotion from Jesus Calling really hit home as I prepared to dive in for my last 48 hours here....
"Living in dependence on me is the way to enjoy abundant life. You are learning to appreciate tough times, because they amplify your awareness of my presence. Tasks you used to dread are becoming rich opportunities to enjoy my closeness. When you feel tired, you remember that I am your strength; you take pleasure on leaning on me."
Everyday I remind myself that everything is possible with God....I just need to get out of the way and let him lead me through it all.
I am grateful for the opportunity to serve here and I pray you all hear God's calling to serve from your backyard, to your city or half way around the world. It doesn't matter where you are, if your heart is willing, God will work.