Good morning Sunday! Today the sun is
coming up brightly through some haze – people must be burning some
fields nearby after their harvest. The breeze whistling through the
trees is cool and refreshing. The bows are rippling as brids sing,
children coo and the cooks are busy preparing. Their kitchen is
blessed with clean water piped from the solar borehole, they use a
bush as a drying rack. We gave them christmas pots holders and
towels and they were so happy. They now have cupboards in their lean
to kitchen and the solar lights the Grace Bible team installed is
still working with the same panel years later! Richard has added
solar lights to the huts we stay in and guest latrine as well! There
is a new kitchen being built for the Emmanuel clinic staff and it
will be shared with the nursery school. Cooks will be hired under the
Emmanuel clinic budget for the clinic staff Tues – Sat for
breakfast and lunches. They need pots and pans for their start up so
this will be added to their start up budget. The full time nurse and
accountant/administrator also need their own huts as they stay on the
farm tues – saturday and have families in distant towns. This will
allow privacy for their families to also visit them here. So far the
nurse, Judith, has shown a great heart for the impoverised people of
this region. I had two challenging meetings with the Suzan, clinic
staff and doctor yesterday. This revolved around budgets, projected
patient numbers and fees to match the budget for sustanability and
the fee structure. It was soon apparent their understanding of fee
for service (itemized bill) and the american term was interpeted
quite differently! I was for the teir system of 5, 000 shillings,
10,000 shillings and 20,000 shillings depending on the cost of the
medicines, the series of visits needed for the problem or if a
procedure/IV etc was involved. Another cultural misunderstanding
ensued, as we all are a little stressed about meeting the budget
especially early on...as the patient numbers are quite low so far.
It appears they cannot afford even the 5,000 shillings very well.
They are used to coming in the droves when the clinic provided
medications and services for free while our teams worked under trees
or in the partially built building. Suzan had provided free services
as well for so long prior to this opening. In order for the clinic
to be sustainable long term for generations to come, a paradigm shift
will be needed. It may take some time but all in all the staff are
good people and here for service. We hope and pray for mobilization
and some training for the local economy – this is where the soil
testing and the fertilizer or legume project may come in well.
Meanhwile, Tom, did a good job assessing the land for the goat
sustanability project to sustain Emmanuel clinic long term after H20
subsidizes for 3 years. Tom left us a few days ago after a whirlwind
6 days trip in Uganda, but all of his expertise and time was so
valuable and well recieced. WE thank you Tom! The water projects are
coming along beautifully! The passion fruit orchard amazing, more
drip irrigation plots are being plowed that will be piped from the
solar water – including our first micro loan for drip lines project
with the FEM Women's empowerment group and some few men – a dream
come true as well and part of my vision – or should I say- God's
vision through me, as I feel all of this has been given to me as the
messenger. What do I know about mico loans - ha, ha- (can't hardly
balance my check book!). It is really an honor and a privelege to
see how grateful and happy the people here are for the opportunity
and it empowers them to work and and gives such amazing hope!
Meanwhile, I have also met with the
building contractor and we will be completing the second ward and
verrhanda within the budget, with a passage door added. The
microscope fuse and centrifuge blew some parts as they did not know
how to use the converter. Now we will add a step down unit and I was
able to get Joint medical stores to fix both! The lab tech loves her
lab! They are using the frig for reagents and we are doing simple
tests. The glucometer works! We need a hemoglobin machine and will
see how that goes at the 6 month point as it is quite expensive, same
with HIV tests. Praying for guidance and wisdom as this new limited
resource concept unfolds! The Clinical Officer and Nurse were amazed
with the vital signs machine and had no idea what the oximeter for
oxygen saturation readings were...some very new things for them,
which they like a lot. The challenge will be quality care,
consistency among providers, safety and cost effective use of
medications and supplies that are subsidized. I learned something
about this at Riverstone and it has come in handy! I simply need to
be here for a few months I can see.... Chart reviews were quite
interesting to begin with! Thankfully Leigh will be here in January.
I hope and pray I can get away from work again soon. The mentoring
process for success may be quite crucial. I am also reminded that
our American ways are much different than the African ways, so must
be very careful to lead well without them feeling intimidated –
giving freedom for open communication...not just every thing, "My
Way". It is truly such a joy to be here and they are all trying
very hard to serve well and faithfully. Keep praying for Emmanuel
(God with Us) clinic!
This afternoon, we will go back to
Kampala village and teach on the protection of the borehole, hygiene
and sanitation and handwashing. Mariel and Heather are looking so
forward to this outreach and so am I. Geoffrey surprised us and came
to the farm last night and sang and played his beautiful music..we
were so blessed! He is doing well in school, thanks to the Jacques
sponsorship! Heather is teaching some of the kids in school break
sponsored either by a few individuals or the farm...they love it are
learning a lot with the individual teaching! Mariel has dove right
in for all projects, pictures, videos as well! We cannot wait to
start using her village healthcare manuel this afternoon, tomorrow
and tuesday!
I have also been involved with the
vocational tailoring projects and crafts – new to me! Usually we
have very talented creative team members who head this project! I
had to even figure out a pattern, cut it pin it – on folds etc and
teach it to the tailoring teacher – this goes way way back for me!
My mom and sister tried to teach me but I was not so teachable in the
past! I blame it on being left handed and the scissors hard to use –
and this was definitely the case here! I could not cut with their
sewing scissors! All is well and we are overcoming challenges with
this project as well. They are learning and the new crafts are
beautiful! Cant wait to show you all!
Most importantly, I am reminded to
remain humble, respectful, serve and do well, no matter what is
happening around me. Enjoy, slow down, relax, listen, breathe and be
patient. All will be revealed and the correct path and wisdom will
be provided even and especially with "waiting" on God for
the perfect triming, perfect way........... I am eternally grateful
to all of you for your love and support and prayers!
- Nadine
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