Mali

I had the opportunity to got to Mali (not to be confused with the tropical vacation island of Bali) with Interplast, as head nurse for our surgical team. It was an exhausting, rewarding 2 weeks and I love being able to use my nursing skills to travel and help improve peoples lives. We worked long days and did some big cases; 70 procedures in 8 days of work! I love meeting and working with the medical team on these trips. It's nice to associate with like minded people, many of whom put me to shame with the number of these trips they have been on and places they've traveled. (Most of them are twice my age, I guess i have time to catch up).

Gabriel Torre Hospital was our home for 2 weeks. All I saw of Bamako the first week was our hotel, the hospital, and the 2 block walk from the hotel to the hospital.

We hit the ground running. While the physician's were running clinic (evaluating patients for surgery), the nurses were setting up the OR getting ready for the coming days. This was the clinic waiting hall, at the end of the day. We had people waiting when we arrived, filling 3 hallways.

I limited pictures i took in the OR, I love surgery, but realize that most people get a little grossed out by it (and i was busy working!)

Our resources are very limited on these trips and we get creative in how we do things. We used a gown to cover the feet, not to keep them warm, but to cover the smell!

There are always a few patients that catch our hearts. There was a 16 year old boy who was like a gazelle (tall and lean). He grabbed a live wire and was electrocuted, he has burns on both his legs leaving him without skin from his knees down. We did a skin graft on one leg and a dressing change the next week. He got to know the team members names and would great us when we did rounds. He was so sad that we were leaving and wouldn't be able to help him with the other leg. I wish we could have done more. (This is the gazelle and his mom in his hospital room he shares with 6 other patients. There is no hospital cafeteria, the patient family members cook in the hallways to feed them. Nursing care is minimal).

There was another little girl, about 12 years old, that was picking fruit with a stick and hit a power line. She has holes in her wrists and palms, and severe burns below both her knees. As we were removing her bandages to prepare for surgery her toes on her right foot came with the bandages. This is just one story among many, she's lucky to have survived.

The majority of our procedures were burn reconstructions; hand, arm, leg, and foot contractures. We all sat back realizing that every patient we saw and were able to help there were 100 more out there with similar problems. It was sad, yet rewarding to know that we were able to help so many people.

This was the only view I saw for the first week, from the supply room. It was fascinating to watch the people and glimpse into their lives. This is a mosque. There was a man that filled the tea pots, the patrons took them, sat in the bench and washed their feet before they entered the mosque to pray.

The women's side was on the other end of the bench.


Another view out the supply room window.

We had a lot of help from the local workers, such a blessing!
Our nurse educator arrived a week before the rest of the team, did some teaching, and identified those that were interested in learning from us. I worked with 2 local OR nurses (Gandjingo is in the picture with me bel0w) during the week, they were a great help and eager to learn.
We had a whole gaggle of residents and interns watching and working. I reviewed sterile procedure and proper gloving with them many many times in the weeks we were there.

One of our helper was Moussa. He was a man of many talents: washing our instruments, gathering linen, transporting patients, or anything else that was needed. We could not have made it without him.
Marion was my fellow OR nurse, a very experienced OR nurse. Her goal is to make it to as many countries as she can. She hit at least 50 so far.

These are my fellow "young" team mates. Richard is the Webster Fellow and will be traveling on most of the Interplast trips this year. He coined the phrase of the trip:
"T.I.A. This Is Africa"
We used it constantly. Things never went as we planned- (T.I.A.)

Manon was my roommate. She is fabulous! It helps liking the person you're rooming with for 2 weeks.

I have to give a little shout out to this fabulous drink: Gingembre.
It was my drink of choice when we went out. Basically it's ginger juice, with fresh squeezed ginger! Everyone made it just a little different, sometimes it was so strong it made your eyes pop!
We ate a lot of Capitaine (the local fish from the Niger River). Everyone served capitaine- fried, braised, kabobed, it was generally a safe dish to order.
Bamako was surprisingly diverse in it's food options, we had French, Thai, Tex Mex, and Italian.

A few views of Bamako...
We were able to get out and about over the weekend as well as our last day there.

We took a little boat tour of the Niger River. (The fisherman were catching Capitaine!)

The nice things about these trips is that we get the weekend off and have a little time to see the sights and experience the culture.
We took a 24 hour whirl wind trip down to Dogon Country on Saturday. We woke up early, took a flight to Mopti, got in a land cruiser, visited a few villages, slept at a dirty hotel (T.I.A), and flew back to Bamako the next morning!
This was the our guide in the male circumcision cave.

The adobe village

The Dogon bury their dead in caves on the cliffs.

I love the kids. Even if it was set up for the "tourist" the singing and clapping was adorable!

And the girls carrying water on their heads, amazing!
`

This was the town elder. The people come to him with questions, he writes them in the sand, places peanuts next to the questions, and a fox comes at night, eats the peanuts and answers the questions...

I can't remember the significance of this building. The end of the day became a blur, but it's pretty.

This waterfall only flows during the rainy season (we were there at the end of it), there are cliff dwellings below it.

Timbuktu- we didn't make it there. Really wish we could have, just to say i've been...

Yet another eye opening experience. I am so grateful for the opportunity to travel and experience another culture and part of the world.

Bolivia

I recently had the opportunity to spend 2 weeks in Bolivia. I went with a group of 30 singles and a humanitarian group (CHOICE) to work in the Altiplano region of Bolivia. We spent a week living at 13,00 feet, sleeping in a small adobe building on straw mattresses, without a shower, and bathroom facilities we affectionately named "the wolves lair."
I've done trips like this before and I am always amazed at the humility of the people and how much physical labor they do on a daily basis to survive. We were able to help them bring water from the mountain spring to their village, the first time they have had running water (hence our lack of showers for a week). I feel like they did most of the work, our weak little American muscles were no match for them, but we had a great experience working along side them. We also had a great group of doctors, nurses, and dentists; we taught classes and ran a clinic in a different village every day. I loved working with the local health care workers and seeing their excitement as we shared our knowledge and skills with them.
After the expedition was over I crazy week traveling through other parts of Bolivia with some friends from the group. It was an exhausting, yet amazing experience.

THE FACES OF BOLIVIA

(Edwin the Llama, he followed this lady through town!)


The Medical Team

The orthopedic doctor taught a splinting class to the local health care workers. We used each other as "patients," they loved the hands on experience!

Heidi and I (both nurses) taught the local nurses how to start I.V.'s. I started by showing them how to start an I.V. on Heidi and i totally blew the vein! They loved it and felt much more comfortable when we turned our arms over to them to practice.

I taught a neonatal resuscitation class a few times (making me wish again that I spoke Spanish). They were so excited for the information and the mask we gave them to use on future patients. I surprised myself at how much i enjoyed teaching!

The Water Project:
This was our main project for the week. We arrived on a Sunday, then goal was to have it finished by Saturday, we were done on Wednesday! It was by no means because of us, the locals has the trench dug by the time we arrived, and came out every day to lay the pipe and cover it back up. The spring that we started from was a 3 hour hike up a mountain from the "town center." The locals had wells near their homes where they could collect water, but they frequently dried up, when they did they walked to the spring to gather water. They were so excited to have water flowing to the village and their homes.

The finale: running water!
We had a huge party on Saturday with the villagers to celebrate the completion of the project! Those people really know how to party. They started at 10am and were still going when I went to bed that night; music, dancing, potatoes, streamers, and more dancing!

A day in the life:
We spend one morning visiting the home of a local family, working alongside them as they did their choirs and getting a small glimpse of life in rural Bolivia.
This little woman took care of her home, land, and animals (pigs, sheep, cows, ducks) while her husband worked 3 hours away in La Paz during the week, coming home on the weekends.
This is her green house, she was very proud of it.

We helped carry straw from the field to the animals pins and stacked it. It took 6 of us 4 trips back and forth, I can't imagine how long it would have taken her on her own.

The adventure begins (or continues):
On our way back to La Paz we stopped at Tihuanacu, Incan ruins.

Mountain Biking: The Most Dangerous Road in the World
This is a one lane dirt road, with 2 way traffic, and a 4,000 ft. drop. So named due to the high number of deaths each year- cars going over the edge. A new road was built in the past few years, much safer, and the "death road" is left to the mountain bikers and a few crazy cars that still have a death wish.
We started on our bikes at 15,00o ft. rode down 65km to 3,000ft. (I used my brakes a lot!).
It was an amazing ride, the scenery was beautiful- we our guide reminded us not to look at on the way down. We weren't supposed to watch the birds of butterflies either: "they want you to die." We then drove back up the road on the bus, stopping to look at the scenery, take pictures, and hear stories of recent accidents.

(a little blurry, but you get the idea)

Next stop: Lake Titicaca
We'd heard about Isla del Sol, on Lake Titicaca, told it was a site not to be missed. They were right, it was a great taste of Titicaca, with amazing views.
We started at the north end and walk across the island to the south, where we spend the night.

Lake Chocata in the Condoriri
On the way back to La Paz from Titicaca we did a hike to a beautiful glacial lake. It was very picturesque, I think the llamas were put there just for us.

The final experience was an overnight bus ride (thank you Ambien) to Uyuni and a 3 day 4x4 tour of the Salt Flat and desert.

The salt flats were a little erie. We were told by our guides that "this is where you take crazy pictures." Godzillas provided.

The Red Desert. I felt like I was on Mars, or maybe when they show us pictures of Mars, this is what we are actually seeing.

The stink pots, imagine Yellowstone, but without the guard rails. In Bolivia you can walk right up to them, throw things in them, and hope as your walking along you don't fall in.

Did you know there were Flamingos in Bolivia? There are, lots of them. Their pick color comes from the red algae in the lakes. The algae from the minerals in the water.

Our last day of the tour we ate lunch in this valley. We did eat a lot of Llama on this trip, more than I've ever wanted or need to eat again.

My friend Becca and I spent our last day in Bolivia in La Paz; stuffing ourselves at Sunday Brunch at the Raddison and watching a movie (for $3!).
Did I say it was an amazing trip?