Things continue to trek along here in Impfondo! Not many huge cases have come in the past few days, so that is nice. However some who are here I continue to work with on a daily basis.
I still see Mama Virginia, the woman with the leg burns. Her autograft is now healed, however her burn was too large to cover the entire burn with autograft, so I tease with her saying that her leg looks like a map of islands. So since the autograft didn't cover the entire wound the rest of the burn continues to SLOWLY heal around the edges of the "islands" of skin Dr. Fuka transplanted.
Yesterday she FINALLY did some active movement for me (before she had been refusing and wanted me to do it... it is difficult to coax, barter, and educate someone when you don't speak their language, but I'm starting to get the hang of it more. She cracks me up, she is very dramatic, and sometimes refuses to listen to me unless I speak Lingala, so I either ask Oliva if she is with me, or I consult my little moleskin book that doesn't leave my pocket with my self made Lingala dictionary. So we are making progress... we walked about 40 feet as well. (Cassie, if you are reading this you would be happy to know that I prompt her to not use a walker, and I strongly encouraged a normal heel strike! :) )

I am also seeing a little 2 and 1/2 year old girl named Alexandrine, she came in around 3 weeks ago unconscious and seizing, with meningitis. She is now awake, and somewhat responsive to sounds, and touch, but has minimal active movement, no speech, (but plenty of crying), and increased tone in her arms and legs, and on her left side especially. I worked with her on strengthening her neck, sitting up, feeding, managing her hyper-responsiveness to touch, and engagement. Her parents are wonderful... whatever I suggest, they are right on it. Because her tone was so great in her arms and legs, early on I did range of motion and positioning with her a few times a day. I taught her dad how to do it, and I don't know if he has missed a time yet. These parents are a rarity... they understand, they want the best, and they accept that there may be permanent changes with their sweet little daughter, but they love her and each other just the same. It took them 24 hours including crossing the river to reach the hospital here. They have been married for 14 years and have 5 children, Alexandrine is the youngest. They want to do what is right, and they seek out help, but it is hard when they know nothing other than traditional medicine, which may have contributed to their daughters lasting deficits. However, I am very thankful that they made it here, that Sean was able to treat this little one, and now they are being educated in more effective ways to help their daughter. I pray they can pass it on to those around them when they return home!

Koumou (3 year old boy) is another little guy that is very near and dear to us... we haven't mentioned him much on the blog, maybe because it hurts sometimes to think about his story, but he continues to progress. He is Peya's twin brother (Peya is the little guy who rode on Mary Rose's bike - see the picture on a previous post) Suzy wrote out part of his story which I hope to post soon... but I saw the sweetest thing a few days ago: Koumou is weak, and we believe is seeing double, and therefore has some difficulty walking (especially on all the uneven ground here!). His twin brother is fairly healthy, and stronger than Koumou. Typically their mother just gets up and leaves them when she needs to go get food, or do laundry or something like that, so then the boys get up and follow her at a distance since she doesn't really attend to their presence all too often. A few days ago I looked ahead of me as I was crossing the hospital grounds and saw Peya holding Koumou's hand as they walked along the dirt path following their mother at a great distance. It was so neat to see a little 3 year old help his brother in a practical and necessary way. I love these two boys, and if they fit in my carry on bag... they would come home with us!

Tomorrow morning I am doing a little "inservice" on rehabilitation, to educate the staff and nurses here. It is difficult to know what would be the most effective things to mention, and to keep it clear and concise. I pray that I can present the right material, and that important facts will not be lost in translation! (I most certainly will not be presenting it in French or Lingala! Yikes... that would be scary!) Thank goodness for multi-lingual people! We continue to take it one day at a time, and are trying to "finish the race" strong!
Fun Fact #11: We went out to dinner on Tuesday night this week to the "BiBi Star Restaurant" here in town. Suzy (pharmacist, house mate,USA), Sarah (nurse, housemate, USA), Ginny (English teacher, and pastors wife, Canada), Rachel (Hospital administrator, Canada), and Ciska (Blue house cook, Impfondo) all came! It is about a 10 minute walk from the Hospital grounds. It was delicious! We had antelope, kwanga (which is that completely non-nutritional rubber stuff which is basically their bread), saki saki ( the leaves of a root they grow here called Maniok), and rice. The kwanga really wasn't that bad if you ate it with everything else! It is kind of like dumplings... kind of... But the funny thing is that we had leftovers, and they didn't have take home bags... so they just said..."oh yeah, just take the serving dishes and bring them back tomorrow." Imagine St.Elmo's steak house saying that! Sean and I got a kick out of walking out the door with the dishes...