I am settling into the new normal here in Koutiala, Mali. I am truly so happy to be back and am so confident that this is where I’m supposed to be! My spirit is so at rest, and I’ve never been more confident that God’s hand is in the middle of my life. However, moving to a different country has not come without challenges!
New home, New Name:
There are many new things to navigate in my new home here in Africa. First, I have a new name - it's much easier for the locals to say, and it's kind of a cultural thing to accept a local name. Also it's an honor to accept a local last name, and everyone has one. So along with several new things- I'm now Binta Kamate (sounds like kah-muh-tay) :) Everything right now is either an adventure or a new learning experience. Just the simple daily things takes extra time, thought or preparation. I’m starting to find a bit of a routine. All food is made from scratch after shopping in a crowded market using my broken french or Bambara with help from the locals.
I have been driving a “moto” everywhere that I go, including back and forth the hospital each day. The “moto” is literally just a Yamaha dirt bike that has been a blast to drive everywhere - no complaints here - I’ve always wanted my own dirt bike! Now learning to navigate a crowded market, donkey carts or wandering herds of sheep/cattle is a different story - but I can gladly say no-one has been hurt yet! ;)
Praise God for such a wonderful team here in Mali! My mission team consists of Pediatric Surgeon Dan Kim with his wife Julie and 3 kids Sophia (12), Judson (10) and Anise (8); as well as Mariam -another young woman single missionary who works in the adult side of the hospital. Right now I live in the same home as Mariam, and another woman Tammy (who helps out at the hospital and teaching English). We live down the street from the Kim’s. We have found such a unity in our mission and I truly am crazy about my Malian family!
My birthday was in September and my team and I had a blast taking our moto’s out to the bush of Africa on a little adventure! We started with a few people on moto’s and a few on road bikes but ended with 3 on one moto and 4 on another haha! This is true malian style.
These first few months here for me are dedicated to intensive language study. The main language here is French - it is spoken and used in the Hospital, but most of the locals speak the native African language, Bambara. French is my first priority to be able to function at the hospital. Right now I spend 3 days a week working with a tutor and 2 days a week at the hospital. All other time is spent continuing to study language and get out and about in the culture/villages etc to meet with people and practice language. This will begin to taper to where I do less language and more time in the hospital, but for now French is the most critical to learn!
Right now I am the only expat nurse working in Peds working alongside all Malians. I really truly am loving the team of Malian nurses I work with! This brings many challenges as we don’t speak the same language and I am often confused, but little by little I have figured out the system here and how to be a help. Praise God for several little “breakthroughs” this last week where I understood enough French to communicate needs for the patients.
For the Babies:
Overall I’m very impressed by what is available for us to take care of the babies. We have assembled enough parts for 3 Bubble CPAP set ups, which has been a total game changer here! The other clinics send their sick babies to us because we have “bubble”. This oxygen support has really saved lives. Also, we have been able (for the most part) to have each baby attached safely to a monitor and pulse oximeter - praise God!
Nutrition is hard here. The Moms are very dehydrated or sick themselves and don't make much milk. The alternative is a powdered milk bought locally that does not provide enough nutrition or is too expensive for the family. We’ve found some donated powdered HMF which has been great for extra calories. We also found a breast pump that had been a GODSEND! Several moms that were making no milk are now able to.
Temperature control is a big issue. We have several isolettes (some work and some don’t) that provide homes for our tiny humans. The ones that work best come from Germany shipped to use “Ikea-style” and we can assemble them ourselves. They really work great! We can adjust air control and even some humidity. We can add lights for high bili levels - the only problem is we have no legit way to decrease the heat, so these little kids under the lights often get WAY too hot and we have to come up with make shift ways to adjust their temperatures. I often see babies with a temp of 96.5 warm up much too fast - to as high at 102 within an hour! There is much teaching about basic care needing to be communicated with nursing staff. The staff is eager to learn and hardworking, so with time I can foresee patient care increasing.
With so much temperature instability, I have been trying to implement Kangaroo care. This is putting the baby skin to skin on the mom's chest -which is the most effective way to regulate a baby's temperature, especially when premature. The key is not just doing something once, but getting it to stick as a "good practice" in this culture to help warm a baby up. Here is our first "Kangaroo care" success. This baby was far too cold, and warmed up perfectly after being skin to skin with mom. The local nurses seemed to like this concept and saw the positive results - which is great! Hopeful to continue to make this a standard of practice here.
God is sovereign..
I’ve seen more death here in just 4 shifts than I ever did in several years back in the states. Within just a few days time I've had to code, bag, give chest compressions/Epinephrine and the whole works to 3 kids that died right in front of me when there was nothing else we could have posssibly done. Coordinating CPR in english is hard enough, but running a code in another language is intense. We also have to make hard calls. For example, we only have enough equipment for BCPAP for 3 kids, so if 4 are sick then we take it off the healthiest and give it to the weakest. Please pray for these families of the little lives. Also please pray for strength for me to continue to press forward when death is frequent and days are more often than not harder than words can express.
It’s very hard to know what kind of care COULD be provided in the US and watch the suffering here. However, I remain optimistic as I know God is sovereign and does not let one tear fall to the floor without knowing the pain (Psalm 56:8)! When the days are hard, I am so thankful for a Savior in Jesus Christ who gives more purpose to life than I could ever create for myself or these little lives. Only the God of all creation can bring such joy in the hardest of places!
Prayers for Mali:
1. Prayers for endurance and strength mentally and physically as I navigate this new life - and finding a balance of rest.
2. For language study - that I will be a good student and learn all that I can so that I can be more helpful in the hospital.
3. For the new NICU (neonatal ICU) - for enough money to cover the building and needed supplies for these babies. More importantly that these mom’s and families will come the saving knowledge of Jesus Christ as they stay in this building with their babies! (*more info to come!)
4. Praise God with me for such a wonderful and supportive team here in Koutiala that is battling for the kingdom of God with me! I could not be more grateful for my teammates.
5. Praise God for overall good health. I’ve battled a few bouts of the typical overseas sickness these first few weeks, but I have broken through and am feeling much better.
1. I’d like to get more breast pumps here if possible! We have an older simple modela model electric pump that is amazing! Even some hand pumps would be great. Anything to help these mom’s out a bit. If you have any extra you’d be willing to part with please let me know.
2. A few of the other expat doctos and myself are taking on the project of building and starting an actual NICU here so all the babies can be monitored in one place (rather than spread out throughout the hospital- as they are now). We will be raising money, and there are many needs! I will send a more complete list soon - stay tuned!