Blog Vacation

August 1, 2016

Dear Readers,

I will be taking a month off while I transition to a new phase of my life – retirement! The Lord opened the door for me retire 11 months before I had planned and fulfill my dream of attending Spanish language school with the goal of becoming fluent in Spanish. During my retirement years, I hope to be able to teach the Bible in Spanish and/or English to women and children and to assist with the Spanish side of the free Bible studies on my church’s web site where we receive 5000 hits daily.

The Lord has blessed and challenged me with these verses in the past couple years as I asked Him what He would have me to do during my retirement years.

O God, Thou hast taught me from my youth: and hitherto have I declared Thy wondrous works. Now also when I am old and gray-headed, O God, forsake me not; until I have showed Thy strength unto this generation, and Thy power to every one that is to come. Psalm 71:17-18

I will be checking into school next week and will need to fully concentrate on it for the first month as I adjust to new surroundings. (See Culture Shock in my previous post!) Please pray for me to be strong in the Lord, have much wisdom in learning Spanish, and to glorify God. I am looking forward to meeting many other believers in the Spanish world. A dear friend just sent me this wonderful poem on prayer that I want to pass on.

I’ll Never Know

I’ll never know this side of heaven, What prayer poured forth has wrought in family, friends, and those I do not know and yet for whom I pray.

I’ll never know this side of heaven, what methods God will use to answer prayer.  Nor will I know how many times another’s prayer has put my hand into the Father’s when faced with need.

I’ll never know this side of heaven, how many times my God has eased discouragement, or sickness, pain, or danger, grief, or fear through pow’r unleashed by kneeling saints.

I’ll never know till I reach heaven why God fulfills His purposes through feeble, praying Saints.

But this I know, that when I pray, my lips present to God man’s highest service, reaching round the world at cosmic speed.

For prayer, He tells me, moves omnipotence….”Ask in my name, and I will do it.”

by Leona Mason, SIM, Ghana

The Lord allowed me to visit the Midwest recently, so I’ll close with a photo of the sunset over Winona Lake, Indiana where this beautiful hymn was written.

Winona Lake, Indiana, USA sunset.

Winona Lake, Indiana, USA sunset. Setting where Mr & Mrs Brock wrote the hymn, “Beyond the Sunset”.

Beyond the sunset, O blissful morning, When with our Savior, heaven is begun,

Earth’s toiling ended, O glorious dawning, Beyond the sunset, when day is done.

Here is the You Tube link for a beautiful arrangement of all the verses of the song.

Looking for that blessed hope, and the glorious appearing of the great God and our Savior Jesus Christ. Titus 2:13

Hasta luego, Amigos!!

Pamela, APRN

Transcultural Nursing Course – Dominican Republic – Part 4

Transcultural Nursing Course – Dominican Republic – Part 4

January, 1995

Over the next few days, I was assigned to work in the Mennonite clinic which was hosting us in nice motel-like rooms. I watched Dr Nancy examine patients all day long in much the same fashion as USA physicians do. She speaks some English and many of the medical terms are the same in Spanish, so I was able to understand quite a bit. One mother brought her newborn to Cora, NP. We looked at the baby with sadness who was born with a micro tongue, stubs for feet, and a lobster claw for a hand. Cora instructed the mother to pump her breasts and feed the baby girl with a syringe, and referred the baby to the specialty clinic in the capital, Santo Domingo. I also met Dolly, the clinic sheep, that supplies blood for the agar used in the laboratory plates for microbiology cultures.

Dolly, the lab sheep who supplied them blood for their agar plates.

Dolly, the lab sheep who supplied them blood for their agar plates.

At 11 a.m., a group of clinic workers started singing hymns and everything stopped. Then the Pastor preached a gospel message for 15 minutes and one young man prayed and received Christ as his Savior which was exciting! One of the young men who volunteered, Johnny, enjoyed practicing speaking English with me. I also observed the surgeons in the operating room which seemed to be done the same way we do it in the States.

Each student was required to prepare a health topic to teach the patients. I chose to teach them on how to prevent getting worms since it is endemic in tropical countries. I remembered treating it when I was in Honduras. I studied Cora’s tropical medicine book and then taught the patients with the help of Cora’s poster while she translated for me. The main thing I emphasized was hand-washing after using the bathroom and before eating. This is challenging when many of them don’t have access to clean water as I discovered in the village where we stayed and in the city hospital. If one doesn’t have running water, one has to get it from the river, boil it after building a fire, and then let it cool which is a tremendous amout of work.

Teaching the patients on how to prevent getting worms.

Teaching the patients on how to prevent getting worms.

Round worms are widespread in tropical countries.

Round worms and other parasites are widespread in tropical countries.

On our last evening, I watched a lady weave her baskets and hats. All the children gathered around, and she let them model her hats as I took a photo. I will miss these children. We closed tonight by sharing how this trip has changed us. I said it had increased my observation skills, and that I now realized that maybe we didn’t need nearly as much expensive equipment to get the same patient results. The most positive experience for me was delivering the baby. The most negative experience was dealing with the filthy outhouse in Pan Dia. Cora thanked us for being so culturally sensitive. She is such a sweet godly lady. She has been so sick all week with recurrent typhoid fever. I pray for God’s healing hand upon her.

Cute village children model the hand woven hats!

Cute village children model the hand woven hats!

Santo Domingo

We have returned to the capital city for our final few days. I was greatly blessed in worshiping with the brethren at the city church started by Pastor N and his wife 30 years ago. On Monday, they took us to see their daughter, Dr Marilyn, and the clinic, church, and school which she started. It was very impressive. The people have a much higher standard of living here than they did in the western city of San Juan where we were earlier.

Then we went to a stately old white colonial building which houses the Peace Corps offices for the Dominican Republic. The Chief Nurse gave us a lecture on her role here. There are 7500 Peace Corps workers worldwide. The overall attrition rate is 30%, but only 14% in the D.R. Contracting HIV is a big problem among the volunteers. They are given birth control and condoms, but some of the women still get pregnant. They are counseled  and flown to Washington DC for an abortion. If they have more than two abortions, they are dismissed. Everyone must take anti-malarial medicine weekly and wear a helmet when riding on a motor scooter or they are dismissed.

These facts broke my heart. I thought to myself about how much better it is to follow God’s way of only having sex within the marriage relationship of one man and one woman.

“Marriage is honorable in all, and the bed undefiled, but fornicators and adulterers God will judge.” Hebrews 13:4

Then we toured a city clinic where Mary, a Peace Corps volunteer works. Mary has worked here for 18 months doing health promotion. She started out in San Juan, but was in two bus accidents. In the second accident, the driver and all the people riding toward the front of the bus were killed when the bus rolled over. Mary broke her cheekbone and was flown back to the USA for surgery. She lives here in a poor slum area where the houses are close together on a hill with lots of steps. When we saw a huge rat, a woman ran after it and smashed it with a big rock.

The clinic nurse attended vocational school for six months after she finished the eighth grade. They are taught how to take vital signs, give injections, and a few other basic things. I’m guessing she is equivalent to somewhere between a certified nurse’s aide and a licensed practical nurse in the USA.

Then Dr Elaine gave us a lecture on Culture Shock. She said there are three stages. The first is the Honeymoon stage where everything is exotic and wonderful about your new country. It usually lasts 1-6 weeks. The second stage is the Frustration stage where everything is awful, backward, and makes no sense. The third stage is Stabilization where the person appreciates the new country and learns to be flexible with its flaws. One missionary told me the best way to get through culture shock is to stop comparing the new country with one’s country of origin, but just accept the new country as it is.

On January 6, Three Kings Day, all the stores were closed for this major holiday. This is when the Dominicans exchange gifts rather than on Christmas day. I think they calculate that it took the wise men about 12 days to travel from the east and find the Christ child to present their gifts of gold, frankincense, and myrrh.

On this holiday, we enjoyed touring the 500 year old colonial part of the city and seeing the oldest cathedral in the New World, and the oldest protestant church started in Dominican Republic in 1922. I also had my photo taken next to the statue of Christopher Columbus who discovered the island in 1492.

The oldest protestant church in D.R. built in 1922.

The oldest protestant church in D.R. built in 1922.

Pam and Christopher Columbus who discovered D.R. in 1492.

Pam stands beside Christopher Columbus who discovered D.R. in 1492.

Julie and I had a scary experience as we were leaving D.R. at the international airport. This strange man nearly tackled me, saying he would get us to the front of the long check-in line. We told him “NO” and checked our baggage, but he would not leave us alone ,and said he would get our departure tax for us. We told him “NO” again, but he would not go away. Julie gave him 5 pesos and he gave it back and almost spit, “That is only 5 cents in the USA!” She asked him how much he wanted, and he didn’t answer. He kept badgering us, so I put 4 pesos in his hand and ran for the locked gate and told Julie to run too. I heard him throw the coins on the floor in disgust. I was so thankful he couldn’t follow us through the security gate. I was so glad when the plane took off and then later landed in Miami, back in the good ‘ole USA!!

Reflection

And so ended my two weeks in Dominican Republic. I thank God for all I learned about other cultures during this journey which has helped me in my encounters with patients from other countries over the years. It is fun when I can tell patients from the D.R. about my two weeks in their country!

Transcultural Nursing Course – Dominican Republic – Part 3

Transcultural Nursing Course – Dominican Republic – Part 3

January 3, 1995

It seems hard to believe that our trip is half over. Today, we returned to the city hospital to work as a group so Tammy could translate for us. We made rounds in the pediatric ward and watched a skilled nurse easily start several IV’s in babies, unlike yesterday. She wore a cap with a blue velvet band, so she has a Bachelor’s degree in nursing.

Then we went to the Labor and Delivery unit. When the nurses learned I had experience in labor and delivery, they assigned us to a 28 year old woman having her fourth baby who had just been admitted. The doctor examined her and said she was half way dilated and broke her water. We went on rounds and I checked her before lunch. No change. We felt her contractions and I tried to listen to the baby’s heart beat with my new stethoscope, but couldn’t hear anything. There is no fetal monitoring available here.  She looked very comfortable, so we had a leisurely lunch. When we returned at 2 p.m., she was writhing in bed in pain and looked like she was in the transition stage. I asked for a sterile glove, checked her, and she was totally dilated. I asked her to push and the baby’s head crowned, so I told her to blow so she wouldn’t have the baby in bed.  The Dominican nurse said it was time for her to go to the delivery room. We watched in amazement as the mother stood up, and walked in her sandals to the room, laid on the table, and put her feet in the stirrups.

The nurse then told me that they do all the normal deliveries rather than the physician, and motioned me to deliver the baby! It has been 13 years since I worked in labor and delivery, so I silently prayed, Dear Lord, help me! Bring this new baby into the world safely. Amen. The mother gave two pushes and the baby came out with a cord around his neck once which the Dominican nurse quickly removed so he wouldn’t strangle. The baby boy then let out a loud scream, and we all breathed a sigh of relief. It was so exciting! Then the nurse put two clamps on his cord, cut it, and motioned me to carry him to the bassinette. I rubbed him down and gave him an Apgar score of 8 at 1 minute, and 9 at 5 minutes which is totally normal. Thank you, Lord.

The nurse gave me a sterile string and motioned me to tie the cord closer to his abdomen, so I tied my best Girl Scout square knot, and asked if I did it right? She said, “Si!” (yes). Then Julie cut the cord again between the clamp and the string. They removed the 2 clamps so they could sterilize them and reuse them. We examined the cord, and it had three vessels which was normal. Julie and Paula then delivered the placenta. I handed the baby to Mom and she began to breastfeed him. After the nurse cleaned Mom, she stood up and walked to the wheelchair, and was wheeled down the hall to the postpartum area. Mom never screamed the whole time, but only grimaced. She made childbirth look so incredibly easy.

After we settled Mom in bed, she thanked us profusely, while hugging and kissing each of us.  It was so gratifying. The other students had never participated in a delivery before, so we were all thrilled. The miracle of birth never ceases to amaze me. God is so magnificent!

Lo, children are an heritage from the Lord; and the fruit of the womb is His reward. Psalm 127:3

Holding the new baby after I delivered it!

Holding the new baby after I delivered it!

Mom brought two disposable diapers with her. I saw a price tag of 3 pesos on one which equals 25 cents in the US. This is lots of money for her.  Each patient is only given one bed sheet their entire stay.

We then made rounds on the rest of the hospital. The men’s ward had 20 beds with quite a few men in traction from femur fractures from motor scooter accidents. We then went back to the ICU. The three patients we saw yesterday are about the same. The lady with high blood pressure actually had a stroke rather than a blood clot in her lung. Her right pupil was enlarged and non reactive to light. Her left arm was limp, but she could move her left leg. I checked her blood pressure, and it was back up to 196/110 and her heart rate was only 56. There was a new lady who was there with an asthma attack and was on oxygen. They had the head of her bed propped up with a chair since there is still no electricity today.

Through Tammy’s interpretation, I found out more about, Martha, the ICU nurse. She works 9 days out of 14 with two days in a row on each shift, and then she gets two days off. Dr. Elaine said nurses and doctors are not respected in the Dominican culture and the pay is very low. The head nurse makes the equivalent of $120 per month in U.S. dollars.

We then met with a lady in charge of infant feeding who has a doctorate degree from Santo Domingo. She showed us their beautiful classroom with a TV and video player. Mothers complete an 18 hour course of nine two hour classes on infant care. They have posters all over the hospital forbidding baby bottles and other posters showing a beautiful dark haired Mom breastfeeding her baby. This hospital has 190 beds for the whole region, which is not enough. They had 4000 births in 1993, and 6000 births in 1994.

At the end of the day, I rode back to the clinic Dominican style taxi, on the back of a motor scooter, hanging on to the driver for dear life and asking the Lord for safety the whole way. Then I paid him the going rate of 3 pesos – 25 cents. What a day!

Dear Lord, Thank you for the safe delivery. I pray this new baby boy and his Mom will receive you as personal Savior. Thank You for all You have taught me today and for the strength and health You have blessed me with. In Christ’s Name, Amen

 

 

Transcultural Nursing Course in Dominican Republic – Part 2

January, 1995 – San Juan, Dominican Republic

After awakening, I began reading my English-Spanish Bible in my Pan Dia village home, when Maria, a ten year old girl came in and shyly started reading over my shoulder. I gave her a Spanish gospel tract to read, and she was thrilled.  Before we said goodbye, the cute children gathered around us for a final photo.

The village children loved chatting with us!

The village children loved chatting with us!

After we returned to the clinic, we compared our clinic stays. It sounds like Debbie and Julie stayed in a much wealthier community and even had an indoor bathroom, but I think Paula and I had a truer picture on Dominican life for the majority of people. We all watched Paula analyze the water samples she had collected from the boiled water they had given us, the town pump, and the clinic. Paula is doing an extra project on water quality since her first degree is in biology.

The next day, Paula discovered the water that we drank in Pan Dia was unboiled and the filtered water here at the clinic is almost as bad. The tap water here came out clear of bacteria. She will repeat all the tests to confirm her results.  Thankfully, neither Paula nor I became sick from the unboiled water. Perhaps I’m building up a little immunity since this is my fourth trip to the Caribbean region. But it does make me realize how much I take for granted clean water in the USA. (We later learned that the clinic’s board of directors took steps to improve their water filtration system as the result of Paula’s work.)

Watching Paula analyze village water samples.

Watching Paula analyze village water samples.

The next day, Dr Elaine had me work in the city hospital in the Intensive Care Unit (ICU). There was no running water or electricity that day, so no one was on an EKG monitor, and it was very hot since they could not run fans or air conditioning. The only way I could wash my hands was with wet wipes that I brought with me. The nurse pulled out their only stethoscope which had five foot long tubing on it and no diaphragm on the bell, so she grabbed a piece of paper and placed it over the bell. After she checked a 46 year old woman’s blood pressure who had a blood clot in her lung, I rechecked it with my stethoscope. I was shocked that it was very high at  180/120 and that they only checked her blood pressure every 12 hours. She then gave the woman Procardia under her tongue and pushed Ranitidine intravenously quickly through her IV line. I checked the patient’s blood pressure twice after that and it came down to 150/88. There was a can of pear nectar on the woman’s bedside table, so Dr Elaine and I helped her sit up and she drank it thirstily. There was no water pitcher beside her bed. I pitied her because it was so hot in the ICU.

The doctor then came in and changed the abdominal dressing of a man who had a ruptured appendix using Betadine and sterile gloves. The nurse then had me give him a gentamicin antibiotic injection in his arm. Normally I would have given it by IV drip slowly or given it in his thigh. Then she mixed up 1 gram of ampicillin in 5 ml. of normal saline and gave it rapid IV push through his line. She asked me to give it, but I refused and told her I was used to dripping it slowly through the IV over 30 minutes. She then gave him 100 ml. of Gatorade with brown sugar added for lunch. There was a quart of it, but she said he couldn’t have any more. Then she offered Dr Elaine and me a glass of Gatorade as she drank one, but we politely declined.

The third patient in ICU was a woman who had been stabbed by her husband. She had a tube in her stomach with the drainage bag lying on the floor under her bed. She also had a tube in her bladder, with that bag also lying on the floor. She had on no gown and was exposed from the waist up. She was behind a curtain so no nurse could observe her, and her IV ran dry. When the nurse discovered it, she hung a new IV bag and ran a tube full of air into the patient. Since there was no running water, none of the patients were bathed and the nurses never washed their hands. All the patients appeared dehydrated from lack of fluids in the heat.

The medicine cabinet had 3 more bags of IV fluids, and medicines in bottles with labels. Another nurse came to the door and asked for a pill, so the ICU nurse took one from the bottle and handed it to her. Each patient had a chart with doctor’s orders, operating room record, and nurse’s notes. The nurse’s note was divided into four sections: date, hour, medicine, and observation. Dr Elaine pointed out that the nurse’s note didn’t have much room, but at least they had a chart.

On our way to lunch, we stopped by to see Julie in the pediatric ward.  There was a baby in severe respiratory distress. She watched the nurses try 20 times to start an IV in a baby with the same butterfly needle. One male nurse accidentally stuck himself with the needle, and then continued to stick the baby with it.

Since the operating room was closed for the holidays, we went with Cora, NP,  as she made home visits to families who have infants on her nutritional program. This very poor village is a number of shacks beside a bean field and the river. We watched them wash their clothes in the river and cook their food over a charcoal fire. One home had two babies because one baby’s mother had died in childbirth. The remaining mother was trying to breastfeed her own baby and the orphan, who appeared to weigh only about three pounds.

Cora spoke with an  18 year old woman about family planning who already has four children. Many women have their first baby before they have their first period. The poor people don’t marry, but just change from one man to another. It is estimated that 25% of the population is HIV positive.

After walking down dirt roads and fording several streams, we arrived at the local midwife’s home. She delivers 100 babies yearly and charges no fee. She was a dear friendly 40 year old grandma who got down on the ground and demonstrated how she delivered her own twins alone! Until last year, when she spent three days training at a local hospital, she had never received any formal instruction. At the end of our visit, she handed us each a chicken egg as a gift. It was difficult for us to accept this gift as we knew we were taking most of her food for the entire week, but Cora said we would have offended her greatly if we would have refused. In turn, we gave her a gift of several boxes of gloves for her home deliveries since she could no longer obtain them. She hugged us all as we left.

Local midwife tells us the amazing story of how she delivered her own twins!

Local midwife tells us the amazing story of how she delivered her own twins!

Reflection

Those days in the city hospital with hardly any supplies and in the homes of people who had very little material goods, once again brought home to me how I have grown up in such relative material wealth in the USA. The poorest people in the USA are wealthy compared to many people in the world. One missionary in Ecuador told me that the people there think that all Americans sleep on mattresses stuffed with money! She offered to let them look at her mattress to prove that there was no money in it:)

I was blessed as I read through some of the many verses in the Bible about poverty and wealth. The only kind of wealth that lasts for all eternity is our relationship with Jesus Christ. The person who has received Christ as Savior is the richest person in the world and the only one who can truly be happy.

“For ye know the grace of our Lord Jesus Christ, that, though He was rich, yet for your sakes He became poor, that ye through His poverty might be rich.” II Corinthians 8:9

“Lay not up for yourselves treasures upon earth, where moth and rust doth corrupt, and where thieves break through and steal, But lay up for yourselves treasures in heaven, where neither moth nor rust doth corrupt, and where thieves do not break through nor steal; For where your treasure is, there will your heart be also.” Matthew 6:19-21

 

Transcultural Nursing Course in Dominican Republic – Part 1

Transcultural Nursing Course in Dominican Republic – Part 1

December 28, 1994- Santo Domingo, Dominican Republic

By God’s grace, He opened the door for me to take my second course in graduate school over the next two weeks in the Dominican Republic. I was short three days of vacation time at work, but Marge RN, who is retiring on December 31, kindly gave me three days from her vacation account! She said she wanted to encourage me in my journey of becoming a Nurse Practitioner.

I arose at 5:30 a.m. and flew through Puerto Rico to get here. I heard Spanish throughout the plane, but they spoke so fast that I could only pick up bits and pieces. Dr. Elaine is the professor from State University and has been here quite a few times. She is single and has traveled all over the world, having worked for four years on the Ship Hope. She is very personable, and her Spanish is quite good. Debbie is a senior undergrad nursing student and speaks good Spanish, having been an exchange student in Spain when she was 14 years old. Julie is also a senior and seems a little nervous and speaks no Spanish. Paula will be my roommate, is a senior in nursing, and comes from a neighboring state university.

Dr. D, who is certified in tropical and travel medicine, gave us several very interesting lectures before our departure. I also completed the required readings on the culture of the Dominican Republic and their specific beliefs. We began taking our malaria prevention medicine two weeks ago. Dr. Elaine told us about a very helpful book written for the lay person called “Where There is No Doctor”.  It has also been translated into a number of languages. It tells how to treat common aliments with locally available plants and foods, how to build a sanitary latrine, how to administer first aid, etc.

I called missionaries who live here, and Pastor N. will give me a ride to church on Sunday, January 8. His daughter is a MD and began a clinic, church, and school about 20 miles from here which she administers, so he will also take the group there when we return to Santo Domingo. It is so wonderful to leave all the details of the next two weeks with the Lord. I don’t know exactly why the Lord brought me here, but I’m excited to be here and let Him work through me.

“And the Lord shall guide thee continually, and satisfy thy soul in drought, and make fat thy bones, and thou shalt be like a watered garden, and like a spring of water, whose waters fail not.” Isaiah 58:11

December 29, 1994 – San Juan

Paula arrived late last night, so our little group of four students is now complete. She is a kind outgoing girl and a very considerate roommate. Her first degree is in biology and her second will be in nursing. Her Spanish is much better than mine, so that is helpful. At noon, the clinic pharmacist, Angel, picked us up for our four hour ride to the the town of San Juan near Haiti where we will be living and working for the next nine days. As we rode through the lush green countryside, we passed blooming pampas grass, banana trees, bean fields, oxen, donkeys, goats, pigs, and trucks loaded with lemons. Dr. Elaine informed us that they are very racially conscious in the DR. The lighter one’s skin, the higher the class of the person. Every young person wants to marry a person with lighter skin than theirs so they can move up the social scale.

We arrived at the Mennonite clinic and were warmly greeted by Cora, a Canadian Nurse Practitioner, and Tammy, a nursing student from my hometown who will translate for us. The gorgeous hot pink bougainvillea and red poinsettia trees are in full bloom. The thatched roof gazebo is so relaxing, complete with rocking chairs. Cora and Tammy served us a delicious dinner of three different kinds of pizza with fresh squeezed lemonade, bananas, and cookie bars. Cora then began our orientation. She said to be very careful of the young men, many of whom want to marry an American woman solely so he can become an American citizen, move to New York, and then disappear. She told us several sad stories of this happening to American single women.

Cora showed us photos of some of the 500 infants in her survival program. The changes were amazing! She has only had about ten infants die in the past 18 months since she initially started the program with 50 infants. Many mothers don’t return after the first visit, so accurate statistics are difficult to keep.

Then Cora helped me put my mosquito netting on my bed. Mosquitoes are very active this time of year. I am already itching and only brought a small tube of cortisone cream. Tomorrow we stay overnight in a village for our cultural immersion, so that should be quite the experience!

Mosquito netting in place to protect me from malaria.

Mosquito netting in place to protect me from malaria.

December 30-31, Pan Dia Village

Our morning began with delicious quiche, papaya, fresh pineapple, squeezed orange juice, homemade granola, and coffee for breakfast. Then Cora gave us a tour of the clinic run by the Mennonite church. They have several primary care exam rooms, two operating and recovery rooms, pharmacy, and a lab. It looks quite modern and advanced compared to other developing countries I have seen. Then we toured the crowded noisy busy market with fresh produce, rice, beans, and newly killed plucked chickens for sale. I bought a lime squeezer that looked unique.

Bananas for sale in the market

Bananas for sale in the market

Angel then drove us to Pan Dia Village (Our Daily Bread village) for our cultural immersion with the Health Promoter named Clara. Paula and I will live tonight in this village, and Julie and Debbie will be in another village. Since no one in either village speaks English, this way we will have at least one student who speaks fairly good Spanish. Clara showed us to the Peace Corps worker’s home where we will stay tonight while she is away on holiday. There is one double bed, a kitchen table, a small two burner gas stove, and oven. The outhouse was covered in excrement which Clara cleaned while we took a nap (siesta).

Our village home for cultural immersion. A family of 4 was on the other side of the thin wall.

Our village home for cultural immersion. A family of 4 was on the other side of the thin wall.

The Peace Corp worker's simple kitchen where we spent the night.

The Peace Corp worker’s simple kitchen where we spent the night.

Four teen girls and guys then took us on a hike through the village and the countryside. We didn’t know where we were going or how long we would be gone, so we made the mistake of leaving our water bottles behind on this very warm day. The country is beautiful with fields of corn, tobacco, beans, and banana trees. We crossed a river with much trepidation! Dr Elaine told us not to wade in the river in bare feet because we might pick up Schistosomiasis worms (Snail fever) through our feet. https://en.wikipedia.org/wiki/Schistosomiasis. One of the young guys, who weighed about 120 pounds, carried the other girls across the stream on his back, but I just couldn’t let him carry me. So I took off my shoes, held his hand, and waded across while asking the Lord to protect me from the worms. The water was refreshing because it was about 90 degrees out.

The boys helped me wade across the stream. I prayed I wouldn't get worms through my feet!

The boys helped me wade across the stream. I prayed I wouldn’t get worms through my feet!

Then one of the boys shinnied up a coconut palm tree and threw down a bunch of ripe coconuts. The other guy pulled out a machete , sliced off the top of the coconut, and handed us each one to drink. The coconut milk tasted wonderful and quenched my thirst as I drank two of them. Dr Elaine taught us that coconut milk is an isotonic solution (same pH as human blood) and could be infused intravenously for fluids in an emergency.

Refreshing coconut milk on a very hot day!

Refreshing coconut milk on a very hot day!

Then a man took us back to Pan Dia in his pick up truck. Clara served us a beautiful lunch of chicken, rice, fried vegetables, and banana. I added orange soda pop to drink that I bought at the local store. It’s exhausting to try and communicate and listen to the Spanish. I’m trying hard to remember all the new phrases and words I’m learning. There is a baby screaming on the other side of our thin wall in our home, dogs barking outside, and loud motor scooters speeding by constantly. So much for peace and quiet in the country!

Reflection

And so began our two week transcultural nursing course in the Dominican Republic. I was totally exhausted the next morning after being up most of the night from the screaming baby on the other side of the thin wall, blaring latino music, and dogs barking. But it was a great experience to learn how many people in the world learn to live with very little.

Homework on Thanksgiving Day

October, 1994

I have been enjoying my first semester in graduate school tremendously as I study Nursing Issues. It feels like my brain is coming out of mothballs, and the group discussions are very enlightening. Our professor is excellent and gives interesting lectures. I just went to the hospital library to do some literature searches on my ethical dilemma for my paper. I have chosen to write about Euthanasia. I was surprised to learn that euthanasia (ending a person’s life) is legal in the Netherlands. We need to use the American Psychological Association (APA) format to write all our papers. I have a large textbook with all the writing rules for this format which is a bit overwhelming to learn. I also decided to invest in a personal computer to help me write my papers, so I am trying to learn this also. During my lunch break at work one day, I stopped at the local library and the librarian showed me how to use this pointer called a “mouse” to find my place on the screen. I am not very good at it yet, so I will have to keep practicing.

The "mouse" was difficult for me to use at first!

The “mouse” was difficult for me to use at first!

Thanksgiving Day, November, 1994

I turned in my paper on Euthanasia and my professor handed it back to me without a grade. She said I totally missed the point, so I have to rewrite it before she can grade it. She said I did a report rather than addressing both sides of the ethical dilemma and stating my viewpoint clearly. I am so disappointed and feel very discouraged. I also have to finish writing my final paper on Prescriptive Authority for Nurse Practitioners. This is interesting because the laws are different in each state. Some states allow NPs to prescribe all medications including narcotics independently without a physician on site, while others require a MD co-signature, and still others don’t allow NPs to write for any prescriptions.

No one at church  invited me to Thanksgiving dinner this year, and I live too far away from my family in the Midwest to go home. One of the single fellows in the career group, George, does not have any where to go on Thanksgiving day either. He asked if we could eat together at my house? I said I could take a three hour break from writing my two papers, so he is bringing the turkey and pie, and I am making the side dishes.

We had a pleasant meal together, sharing what the Lord has been teaching us lately.

My 3 hour break from homework for Thanksgiving dinner.

I took a three hour break from homework for Thanksgiving dinner.

I was able to finish both papers by Saturday night after working on them the rest of Thursday, all day Friday, and all day Saturday. Thank You, Lord, for helping me finish on time!

If any of you lack wisdom, let him ask of God that giveth to all men liberally, and upbraideth not (ungrudgingly); and it shall be given him. James 1:5

Reflection

I was so thankful that my professor accepted both my papers and I received an A- for my first course in graduate school. It was quite a stretch for me to get back into the study mode, learn how to write in APA format, and learn how to work a computer while working full time as a visiting nurse.

George and I sometimes laugh about our Thanksgiving dinner together when I gave him three hours of my time! He later married a dear friend of mine from church, and they are both growing faithfully in the Lord.