Monday, March 20, 2017

2000 kids reached

These are all empty bottles.  What does that translate to?  In the 1 year I've been here, 2,000 children have received anti-parasite medication, and over 500 children 5 years old and under have received life-changing Vitamin A.  
Vitamin A distribution
Why Vitamin A?  I receive Vitamin A from the an organization called Vitamin Angels.  And from their web site they state, "Our bodies use vitamin A for many purposes. If this essential nutrient is lacking while children are still developing, they can get sick, go blind and even die. While the symptoms are not always visible, vitamin A deficiency puts the health and survival of children at risk every day."

Vitamin A's top sources are from Beef liver, carrots, sweet potatoes, kale, spinach, apricots, broccoli, butter, eggs, and winter squash.  All but eggs and butter (although most people here eat margarine as butter is much more expensive) are not available here.  So, everyone in the country is chronically deficient in Vitamin A.  

Waiting for their parasite meds

Why are parasites a problem?  Contamination comes from contaminated food, water, contamination from someone else infected, and in the soil -  and can be completely asymptomatic until there are serious problems.  The results of parasites in someone include anemia, weight loss, malnutrition, and tiredness.  In an extreme case, the parasites can clump in the bowels and cause a bowel obstruction, and surgery becomes the only option.  As less than 50% of the country has access to potable water - parasite infestations are an assumption in almost everyone.

My goal is to go to as many schools as I am allowed to and distribute medication to every child I can get my hands on - these simple medications can change a child's life.

Wednesday, March 1, 2017

Doing what I love

Health Education – “charlas”

My love for being a nurse is for many reasons, and one of the primary reasons is the ability to give health education to my patients.  I feel this is so important, and allows a patient to have personal investment in their own health.  It gives patients power over their own illnesses (for some illnesses), and puts the ball back in their court – they are the ones that can make a difference in their own lives.
I’ve learned this first hand.  I’ve had to put to my own personal use many of the health education classes I’ve been teaching over the last 10 years of my missionary/nurse career.

To start my clinic today, I thought I would start it a little differently, for many reasons.  I wanted to start it with a health education (or charla) to all my waiting patients.  The first reason is for wanting to speed things up, but not diminish my health education to my patients.  Instead of giving the same health education to each of my patients with high blood pressure, I can give a one-time class to everyone – so not only those who have high blood pressure, but those who have family members living with them that I may not know about all receive the same information.  This will help significantly decrease my individual education time with each patient and therefore gives me more time overall to see more patients.  In 6 hours I will see 25 patients – it allows me about 15 minutes per patient (no break time), and typically I’m “done” by the end of that 6 hours. 

Once a patient came to see me, and I saw that they had high blood pressure, I asked them what they learned in the health education class.  Basically, I want a return demonstration of precautions and ways of changing their lifestyle and diet that they learned in the class, to ensure they had good understanding.  Without exception, all my patients who came to see me were able to repeat what I had told them – one man even brought his wife into the room (who prepares the food in the house) to ensure she didn’t have any questions.
I realize that this seems like such a SMALL thing – but in my little world, where health education is all but non-existent, it’s a huge milestone and personally encouraging to me.

So – this is just the beginning.  I’m going to be training the nursing staff that work with me (I have anywhere from 2-4 Guinean nurse volunteers) to continue with the teaching so in the future I’ll have Guineans teaching Guineans, and I’ll be doing more classes.  So those who are there and waiting – they are a captive audience J  The next one will be on HIV/AIDS – I have the seminary class I teach, so all the research and writing in Spanish has been done – I just now need to consolidate just the health education portion to a 30-minute health education class.

Potable water, typhoid prevention (or at least a reduction in cases), and breastfeeding are just a few of the other health education classes I want to offer to my waiting patients.  I’m excited for this process and look forward to see what will come of it.   

Wednesday, February 15, 2017


After a month in Belgium, and all the amenities of a 1st world country, then another 2 weeks in the U.S. where I was able to spend time with Madison, spoke at Houston Lake Presbyterian Church, and got in some doctor visits at the same time, I am preparing to head back to Africa.

In the time I've been in 1st world countries, has given me time to think about where I am and what I am doing.  I truly have come to understand and appreciate all that 1st world countries have to offer, and has given me an even greater appreciation for living in an extreme 3rd world, and living with those whom I have come to serve.  In Honduras we lived in a house in the "nicer" side of town.  However where we are now, we live just as the Nationals do.  It gives us a closer feel to those whom we have come to serve.  We gather water just as they do, we suffer power outages as they do, but it also brought to focus even closer the disparities of the health care services that are available.

While in the U.S. I had the ability to see specialists, get procedures unavailable in my host country, have labs taken that don't exist, and go to pharmacies filled with any type of medication I needed.  Seeing the severe disparities in medical care only helps solidify what I'm trying to accomplish there.

Please pray for me as I begin to re-acclimate to my life in Africa.  How quickly I have already become accustomed to consistent electricity, potable water, air conditioning, awesome internet, a fully stocked grocery store, and the conveniences of stuff 24/7.  I will miss my kid, and it makes it hard knowing I won't see her until November - I'll miss her 21st birthday.  But God has called us to be where we are for now, so we endeavor to do what He has called us to do.

Wednesday, January 25, 2017


So here we are in Belgium...and many have asked why.

In the year prior to us departing for Honduras, our mission agency, Mission to the World, had us attend a 1 month intensive training in New York where we learned working cross-culturally, took classes on everything from Team Conflict, to Evangelism, and language acquisition.  In the afternoons we worked with a church and did ministry with them, and on the weekend we worked with the same church in Sunday School.

Why is this important?  Working (potentially) WAY outside of your comfort zone is what missions looks like.  Most of the time you are leaving your home country and headed to a different country, a different culture, and a different language.  This training is a way to get a taste of what that will look like, and equip you with lots of tools to help you succeed.

We have been asked here to act as coaches for new missionaries headed to fields all around the world.  We meet weekly with our group, and individually with the couples, and we also participate in the training.  I will be teaching a module on Mentors and Thriving on the Field.  It is great to have coaches from the MTW office with experience on the mission field, but it's also great to have people who are currently on the mission field - us - to give another perspective and to be a resource.

talking about how speaking the local language can have a huge impact 
I have always loved teaching and being a mentor to new nurses when I was in the hospital, and to new missionaries in my role as a missionary.  Having had people who have spoken into my life has been an invaluable asset to me and has helped me grow as a missionary, a Christian, a mom, and a wife.  Being able to do this for others just brings me great joy.  In addition, it's kind of nice having "modern" 1st world features like running water, potable water, flushing toilets, fast internet, consistent electricity, lots of ethic foods, and laundromats has just been a nice added bonus.

Mike heads back to Africa soon, and after this training I will be headed to the U.S. for a few church visits, see Madison for a few days, and then back to Africa.

I love how invested Mission to the World is in equipping, preparing, training and vetting their missionaries - this training is just a small example of what they do to set their missionaries up for success on the mission field.

Thursday, December 15, 2016

Celebrating Christmas in a country that doesn't celebrate Christmas

Our first Christmas in our new little country.  It is an interesting time indeed.  It will be the first Christmas of Madison's life we won't be sharing it with her.  She came for the summer, and therefore we don't have the funds to get her here twice in one year.  So - she will be spending the time with her grandparents and her Aunt and Uncle in California. They have great plans for her, and I know she will be well cared for.

But here I sit, in a country that doesn't celebrate Christmas, and it's my favorite time of the year.  I'm not sure what to do with that yet.  Because we sold everything before we came, all of my Christmas decorations were sold right along with everything else.  I didn't realize that that was going to be a problem, thinking I would just pick up new stuff when I arrived in country.  However, we found out that the country doesn't celebrate it.  What do I mean by that?  Well - it's two-fold.  The first, the primary African culture here doesn't celebrate it, so there's that.  And secondly, the church does not celebrate it.  I've talked with a lot of pastors  since I've been here in respect to that, and have received varying reasons behind that.  The primary reason is that they believe celebrating a day that is not really Christ's birthday, along with all the peripheral decorations, etc. is offensive.  There are a few exceptions - and the little Baptist church we attend is one of them.  But, for 95% of the churches here, December 25th is just another day.

I love Christmas.  I love everything about it.  I love people getting together, I love Christmas parties, I love candle light worship services, I love hearing Christmas music in the mall, drinking hot cocoa in the cold, sitting in front of a fire place, decorating my house, seeing lights around the neighborhood, hearing Christmas music on the radio, every store decked out in lights, cutting down a Christmas tree, and just living in the season as we read our daily Advent and prepare our hearts for the coming of our Lord and Savior Jesus Christ.  For me, all the things around Christmas all help lead my heart to that incredible celebration of the birth of the most important person to ever have lived.  That may sound superficial and materialistic to many.  I don't apologize for it - every time I see a Christmas display, I think of Jesus.  Every time I hear a Christmas song while out and about, I think of Jesus.  Every time I see lights and decorations, I think of Jesus.  For me, it's a time to say a prayer, and give glory to Him who is the Highest.

Even in Honduras, where Christmas is a huge event, although I was typically sweating on the day, there still were people all over who decorated for Christmas, Christmas programs at the schools, the mall was decked out to the max, they had bands playing music at the mall, and lights and displays around town.  Here?  Almost nothing.  So, in my attempts to make it feel a little like Christmas, I did the best I could with what I had.  Anyone who has come over to my house during Christmas would look around my house now and know how bare it looks.

I am making my cookies, and going to a gathering this weekend, and am trying to enjoy this season through the sweat of 95 degree days.  With no Christmas tree, no presents to unwrap, and no kid here to celebrate with, Christmas day is going to be a quiet event at the Pettengill house - just the two of us, with a city closed down, the streets empty, and no one around us celebrating.  A strange thing indeed.

Friday, December 9, 2016

First seminary class done - HIV/AIDS and The Responsibility of the Church

My awesome class
Think back to the 1980's, when HIV, unfortunately, became the new deadly disease.  Rumors flew about how it was transmitted, who was at risk, and was essentially a death sentence.  We've since come a long way.  Now, at least in the majority of first world countries, HIV has been placed into the category of "chronic" diseases - and is no longer (for the most part) a death sentence.  Here, in Africa however, it continues to run it's deadly rampage and remains as the #1 cause of death in a large majority of African countries.

As I am concluding teaching my first seminary level class on the subject it has become more and more apparent as to why this is the case.  I will only speak of the country I am living in, because that is as far as my personal knowledge goes.  I have read more books over the last few months about the subject, so have become a lot more educated about HIV/AIDS in Africa, but my personal experience with it only covers this little country.

My first day of class I wanted to explore what the myths surrounding HIV were in this country.  So I made up "sticky" notes that had a combination of true and false statements, and asked the students to place them up on the board under each category so I could get a feel for what my students thought.  This is the list I came up with, and their responses next to each statement (I have put the actual answer next to it)

o - in Africa, more men are infected with HIV than women   - their answer: true; reality: this is false
o - in Africa, more women are infected with HIV than men - their answer: false; reality: this is true
o - You can look at a person and know they have HIV/AIDS - their answer: true; reality: false
o - The number one way HIV in transmitted is at the barber or manicurist - their answer:  true; reality: there is no documented case of HIV being transmitted via manicurist instruments (other diseases, yes, but not HIV)
o - Witch doctors can curse you with HIV - their answer:  true
o - You can have HIV and your test can come up negative (window of infection) -their answer: false; reality:  true
o - HIV/AIDS is the same thing - their answer:  yes; reality: no (HIV is the virus that causes AIDS)
o - mosquitoes can infect you with HIV - their answer:  yes; reality: no
o - there is a cure for HIV - their answer:  yes; reality: no

Some of my students diligently working on an in-class assignment
In addition, no one in the class believed that HIV/AIDS was the number one cause of death in their country - they all believed that malaria is the number 1 cause of death (it's actually #3).

This was a great way to start the class, because I could immediately counter the myths, teach them the realities of the disease, and educate them on prevention and methods of transmission.  I can't say this went over easy - it was a much heated conversation, and took a lot of convincing, showing of evidence, and showing statistics before people started to come around and believe it.

I was, however, still worried about the overwhelming statistics of HIV/AIDS related deaths in a country where testing and medication is free.  And I found out the reasons why.  1 - sex education is considered a taboo in this country.  It simply isn't discussed in the home, in church, or anywhere for that matter.  2 - the huge stigma that continues to be attached to this disease, people are ashamed, and don't want to be seen going to the hospital to get their medication. 3 - polygamy is an accepted cultural norm.

The thing I continued to discuss when my students were getting frustrated was that this was not something that could be changed in a day, in a few months, or even a few years.  These were cultural norms that were going to take a generation to change, but that did not alleviate the necessity that we start NOW, and start with THEM in THEIR churches.  That it was our job to break the cycle and to be part of the solution.  So, I challenged each of my students to talk to their children, to start programs in their churches, and to be active and vocal in their communities.

We, as North Americans, as people of a completely different culture, and shake our heads in wonder as to why people believe what they believe.  But I ask you to step back, and consider your surroundings, your resources, and remember where we came from in the early stages of this disease.  It took a lot of public health education to help everyone have a better understanding of this disease, and here, in Africa, we still have a long way to go.

One of the final activities I had my students do was to give a bible study on key verses that I provided them with.  They were required to tie in the biblical truths with HIV/AIDS outreach, and as a church body.  The results were incredible!  As the last student gave their bible study, I stood up in front of the class and said, "Remember how, on day one of this class you couldn't 'see' how HIV/AIDS was in the bible?!  Do you see now?!"  To which I received a resounding YES, accompanied with applause, hooting and hollering, and grins all around the class.
Jonas giving a bible lesson and incorporating HIV/AIDS into it
I have challenged the class to now take action.  To not just take this information in, but to apply it to their everyday lives - start ministries in their churches, do outreach into their communities, and to serve those who are infected, and strive for prevention through education.  Only time will tell - but to me this is the best solution of all - Nationals serving Nationals.  When one of the students told me that I needed to go to every church in the country and give out this information - I told them that I will go as often as I am asked, but the "answer" was that THEY were the ones to now go forward and to make things happen.  THEY are the answer for THEIR country -I'm just a small part to play for how ever long I am here, but the country will only be changed if each take on accountability and responsibility to make that change.

Wednesday, November 23, 2016

I stared at the face of death on my patient's face today...and cried...

My ministry revolves around hosting medical clinics and teaching HIV/AIDS classes.  Each clinic I can typically see about 25 patients in that time frame - this allows me to do patient education, which is what my heart loves.

Today I was able to tell a diabetic the way to change their diet which will change their life.  My patient, who has been a diabetic his whole life (needs insulin), had never received any type of this information before.  In a country where the primary item on every dish is cups and cups of rice - this was hard information to process, but he listened intently, asked some great questions, and we both felt good about it as he left.

Image result for african woman with aidsAbout half way through my day a young 22 year old young mom with her 4 month old baby came to see me with "constant fever."  Each patient here is responsible for their own medical information.  They carry around with them their "cuaderno" - or their notebook - where the doctors write down their visits, exam results, and the prescriptions they give them.  The hospital does not keep medical records on the majority of their patients - this is the responsibility of each person.  Upon reading her cuaderno, it became evident that both she and her 4 month old baby were HIV positive.  So I had to ask the next question - Are you taking your meds?  To which she replied with a quavering voice, tears in her eyes, and without eye contact - No.

I took a deep breath - not because I was frustrated, not because I was angry, but because as I looked at her, I saw the look of death across her face.  I saw hopelessness.  I saw a young woman in her prime taken down by this disease, and my eyes wandered down to her baby as well.  I took the deep breath because I needed time to think through this and figure out a way to help her, give me time to process.

So I talked about how beautiful she was, and how much life had to offer her.  I told her that her baby needed his mother, and she needed to see her son grow up.  I held her hand and made her look into my face as my own eyes welled up with unshed tears. I told her I wanted to see her live!  To not look death in the face - to let the medication do it's job and how she could live for many decades more.  But...she said...she could "sneak" her baby in to get his meds at the hospital, and no one knew, but when she want to "that place" everyone knew why she was there, and she just couldn't bare that.  She knew what people were thinking about her, and how ashamed she was.  She "knew" it was HER fault (her words). She knew the inevitability of her death, I could see it in her face...I could see the hopelessness and the helplessness.  I could see that she knew it was only a matter of time - her face told me this with her single look of despair.

I told her that this is when she needed to be courageous - if not for her, then for her baby.

She gently nodded her head, with her head bent deep, staring absently into the folds of her skirt.

I softly lifted her chin with my shaking hands, so her eyes were looking at mine.  And I said to her - "You need to not just say need to make me a promise."  She looked back, and didn't say anything...her eyes were darting back and forth to my eyes - trying to understand what I was asking, and her mind was trying to decide what to do.  She finally looked at me...."yes...I promise."  "You promise what?" I whispered in response to her comment.  "I promise to you that I will go to the hospital and start taking my meds."

It was all I could do.  I kissed her cheeks, she stood up, with her baby in tow, and I bent my head, and the unshed tears came streaming down my cheeks.  To feel so hopeless, helpless, rejected, and unloved - her lack of her own self-worth radiated from her as he walked away. She arrived alone, just she and her baby, and was leaving alone.  Abandoned and uncared for.   And I was burdened.  My heart ached...I felt it in my bones!  If I could have done anything else I would have...but what I had done that day was give her a hand to hold, a kiss on the cheek, and tears to help share her burden, if just a little, and to tell her as much as I could that she WAS worth something...that she DID matter...that she was a child of God and had so much left to give. And she made me a promise...

I pray it was enough.