Clinic Fun

These days I have been busy helping out in the clinic along with Sean, Terianne, Colin (new guy).  Since Peter and Derek are fluent in Creole they work as our translators most days.  During clinic hours I keep track of people we are seeing and meds we are giving out.  I stick people and collect urine for test such as malaria, pregnancy, STD and HIV.  I also try to keep the place in order by cleaning up messes and putting things in their designated places.  After hours I reorganize, make clinic books for patients, restock meds with Terianne, make Gentian Violet and sterilize instruments and water.

Under supervision of Sean and Terianne, I bandage patients with wounds.  I enjoy doing this for several reasons.  First, it is giving me good experience and teaching me valuable things about wound care.  I also build relationships with these people because they usually have to come every other day until they heal. It amazes me to see the healing process, to see ugly, smelly wounds become small and eventually only a scar.  It can be disheartening at times when I clean and bandage wounds neatly only to have patients come back with filthy bandages, infections, and also say they haven’t been taking their antibiotics.  But it is a great feeling when someone has been coming every few days for three weeks and you can them today is the last time they need to come back.

Two men with wounds started coming to the clinic a few months ago.  They usually came at the same time every other day.  One guy had a toe injury from cutting his big toe with a machete, through his nail.  The other guy had wiped out while playing soccer.  Originally he had a small patch of skin missing near his right elbow, but because he didn’t seek medical attention (rather went to a natural healer for a few weeks) the small patch became a very large 5 by4 inchpatch of missing/infected flesh.  So we filled out little books and gave them to them to bring back each time they have a bandage change so we can track their progress.  The first few times they came back we lectured them for not bring their books back.  Finally toe guy started bringing his book and started yelling at arm guy for not bringing his.  Toe guy wanted to go to the beach but we encouraged him not to since he was already having trouble with infection.  About two weeks later the toe wound looked really good and we praised him for his efforts but the arm wound still had little improvement.  We asked him, like usual, if he was taking his antibiotics and he said “yes”.  Toe guy asked the arm guy the same question and he admitted he wasn’t, he said it didn’t taste good.  Toe guy started telling him how he listened to us, took his meds, didn’t go to the beach, and his toe is doing great.  Every time toe guy came he asked arm guy if he was taking his meds and listening to out other instructions.  Toe guy pressured arm guy to listen to our instructions and the patch on his arm healed in a few months.  Toe guy helped us by yelling at others as well when he sensed they weren’t following our advice.  Terianne and I love when patients lecture other patients when they don’t listen to us because it usually works!

This week a family came to the clinic, all smiles, holding a 2 week old small but fully developed baby, plus their older child, a two year old doing acrobatics.  The father asked Terrianne if she remembered them.  After looking at their clinic book she did.  We did a pregnancy test for them 3 weeks ago.  When she had told them they were pregnant they were surprised and doubted it, but after she showed them the positive on the test they were excited.  We figured she was about four months along and referred her to a baby clinic (we don’t offer prenatal care).  We don’t think she carried full-term but she wasn’t too early.  The father said she had the baby fast, meaning she found out she was pregnant and had it shortly afterwards.  It was humorous and we are happy that it is obvious they are overjoyed with their new addition.  It confirms our worries about their unhappiness as false.

Starting the clinic here came with lots of learning and will require much more as time goes on.  We learned some about cultural difference in priority and respect.  Originally we were horrified by the unclean clinic conditions.  We would clean, only to have a film of dust covering it when we finished.  After our clientele grew we worried less about looks and more about seeing dozens of patients.  It got very easy to say “We’re in Africa, everything is dirty.”  We were approached and told how disrespectful it is to have a dusty clinic and an unswept veranda.  At first we all thought there was no way to keep it clean.  After dedicating a Saturday to cleaning it, though, I was embarrassed.  We would never let a doctor office in the US get so dirty.  Goats are always on our porch, but how does that appear to them if we don’t take the time each morning to sweep it off?  Cleaning it opened my eyes to other things we can improve on to show respect.  I admit sweeping the clinic just to see another layer of dirt is frustrating, but I feel better knowing I am doing my part.  Also as healthcare providers it can be frustrating when people do not follow our instructions, but as time goes on we are noticing more and more how frustrating it is for them as we explain things to them in our Creole that is less than perfect.  Another way to respect them is to continue to learn the language even for those of us who leave in four weeks.

This experience in Guinea-Bissau is unforgettable, especially with things related to the clinic.  It showed, and will continue showing life, be it an everyday pain, the horror of a child with burns or massive infection, anger at abuse, the mystery of an unexplained condition that we have no technology for, but also the joy of telling a woman she is pregnant and the contentment of building a relationship.  I thank God for this time here and thank you for supporting us in prayer.  Please continue to pray for the clinic as it continues to grow and develop, but especially pray for the people who come.


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Cultural Notes


Greeting people is an important cultural element of daily life.  You greet everyone you walk by on the path, regardless of whether you know them or not.  Almost everybody in the village knows who each of the missionaries are; people I don’t recognize greet me by name.  In America, we greet people according to the time of day (good morning, good afternoon, etc.).  Guinensis also do this, but they sometimes greet each other according to what they are doing: You are sitting.  You are braiding hair.  You are carrying water.

If you greet someone with the intent of engaging in conversation, at the beginning of the conversation you ask each other where their spouse/parents/siblings are.  This initially seemed nosy and irrelevant, but I eventually came to understand more of its significance.  Asking these questions shows respect and familiarity with their family members.  Locals also appreciate it when we, as outsiders, engage in this type of greeting and ask them about members of their household.


Women in Guinea Bissau generally find Western styles to be beautiful: imitation Louis Vitton purses, snug jeans, nail polish, and Caucasian hair.  I have long hair and I’ve had several very serious requests for my hair and the shampoo that makes it grow so long and straight.  Women like to put extensions in their braids and a large proportion of young, educated women in nearby cities have extensions or wigs.

Nail polish is an affordable luxury for many women in this place where the idea of wearing high heels is laughable.  One of the shops in Catel just started selling nail polish a few weeks ago.  For holidays or other splurging occasions, women feel beautiful wearing shiny nail polish.


The most important thing to say about personal space is this: there is none.

If you have a personal space “bubble,” it will immediately be popped upon arriving in many African countries.  Kids fight among themselves because there are five of them and you only have one lap and two hands.  While sitting down to converse, people sit so close to each other that their knees usually touch.  The same is true of mealtime.  If you’re not touching at least one other person while your spoon is in the rice bowl, you’re too far away.  Then there is public transport, where 30+ people are squeezed into a van that would comfortably hold 15 in the US.  One time on transport I was touching 6 different people at the same time.  Like other parts of life abroad, it’s not always comfortable, but you learn what is normal and adapt.


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Seekers Bible Study

One of my goals for this year was to create a program for teaching and discipling youth and young adults in Catel who have some interest in the gospel. So in the middle of January we initiated what we call a “seekers bible study” which we hold twice a week. Derek and Peter, myself, and Momadu Mane (local church leader) have all taken part in the leadership of the study. There are about ten youth / young men who participate, of which five have participated consistently. Few of these guys have made a firm commitment to Christ yet, but each of them has in interest in the gospel and has participated in our church services and activities to some extent. These guys have been drawn to the bible study through relationships. Many of them have been my friends for the last couple years, and many have also been drawn in by their friendships with the YES team members.

In the bible study, we explore what it means to follow Christ within the culture and environment of Guinea-Bissau. We began with the story of the prodigal son, and used it to compare the loving, forgiving character of God to the character of the spirits that people here serve. People here depend on spirits with their life, and turn to them to ask for physical healing, to ask for good fortune, to judge conflicts between people, and to curse enemies. But when asked if these spirits love them and forgive them, the guys at the bible study adamantly said no. Spirits are known to kill their followers if the follower fails to fulfill a contract to a spirit. They compared these spirits to a pig farmer, who gives his pig everything he wants – food, water, shelter – until the day the farmer wants to eat him, when he kills the pig. So it is a privilege to tell the good news about a God who loves us and forgives us to people who have been slaves to these spirits.

Through reading the word, we look at what it means to trust in Jesus when a family’s rice is almost finished, when someone feels spiritually attacked by frightening dreams, or when someone is sick. We study stories of Jesus and look to his model of compassion, forgiveness, humility, service, and love for enemies. We ask many reflection questions and allow the guys to respond to what they think it would look like for them to model Christ in this culture.

But following Christ comes at great cost in this culture, and many of these guys are still weighing that. They say that when someone chooses to follow Jesus they are often rejected and made fun of by their friends and family. These guys have family obligations to perform certain spiritual ceremonies and I can see that they are torn over which way to go. They know there is a lot they must leave behind in order to follow Christ. They realize that this is a process, and I have seen them make progress. We recently studied Jesus’ Matthew 13 parable in which a man sells everything he has in order to buy a field where he has discovered hidden treasure. We continue to pray for the release of the old things in order that they may have the greater treasure, the kingdom of heaven.


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Tempu di Kaju

Cashew Fruit

We now are entering into the cashew season in Guinea-Bissau. The cashew season means several things, for one it means a lot of work. Everyday people go to thier cashew orchards to pick up cashews. First they scour the orchard picking up every cashew off the ground, or as we call it “the floor of Africa”, and carry them to a central location in the orchard. Afterwards the cashew nut must be pulled off of the cashew fruit and thrown away or put into a hollowed-out log to be squeezed for juice. The cashew juice is delicious when fresh and chilled with ice. After the nuts are pulled off the fruits they are carried back to the village where they are sold to cashew dealers who come to live in the villages during the cashew season. In Catel there are at least ten cashew dealers. They buy the cashews and then take them to the port in Bissau, the capital, to sell to Indian businessmen who ship them to India for processing.
The result of the cashew season is that everyone has cash on hand and people are willing to spend money on things that they wouldn’t normally buy. There are people who come through the village and sell little bags of flavored ice and others who open little businesses around the village. For example, someone opened a little resturant that serves plates of spaghetti and one of the shop owners started frying fish and “pankets” (fried dough, think funnel cakes) everyday. There is an overall different feel to this time of year, people are happier and cheerful and parties are thrown often. One of those parties is nationwide and takes place every year on May first. On “Un di Mayu” most people go swimming and hold a festival by the water, which usually consists of lots of music and food, more specificly meat. Mmmm meat!
Sean and I went to Verela, a popular party spot by the ocean for “Un di Mayu”, to run a medical/first-aid clinic with the local Red Cross team. Sean and Terianne, who run the clinic here in Catel, developed a relationship with the Red Cross and they invited them to attend the annual event. Terianne stayed in Catel to run the clinic while Sean invited me to come with him to translate for him. It was a lot of fun hanging out with the Red Cross team and doing consults with sick people while the Red Cross did most of the first-aid for people with cuts and scrapes. We were there for four days before returning to Catel.
That gives a little insight into this season in GB.

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Trip to Cacheo

Cacheo is a village15 miles south of Catel. A church member named Chelino goes there to do evangelism once a week.  Peter, Andrew and I (Sharon) joined Chelino on his journey to Cacheo.  Even though it’s 15 miles away it really is a journey because we have to go 40 miles to a bridge to cross the river.  We had to catch four different transport cars on the way there.  It took us a total of six and a half hours to arrive at Cacheo.  Most of the trip we were squished in the cars so tight we really could not move. 

On one van we were packed in so tight we were losing circulation and we stopped at a school and picked up about ten kids.  They just stood in the van or sat on our laps.  Talk about uncomfortable.  On the last van ride I was sitting beside a woman with a toddler.  The child threw up all over her.  As I was watching her clean up, someone told me to watch my other side.  A young girl was sitting on her dad’s lap throwing up as well, but thankfully into a bag.  I didn’t feel bad for littering when I threw that bag out the window. 

We arrived at the village and had a short Bible study with about 25 people.  The teaching was on John 3 where Jesus tells Nicodemus you need to be born again.  There was a good discussion following the message.

Lucianna, a woman who lives in Cacheo, took us to the community garden.  It was beautiful and they were growing all kinds of vegetables.  The tomato plants had little flowers on them and looked very healthy.  I helped Lucianna and some girls water the garden while the guys looked at the school and talked with some village men. 

We walked to Chelino’s family’s house where we going to spend the night.  The three of us went down to see the showering facilities.  I was so impressed.  It had a cement floor with zinc walls and you couldn’t even see through the walls while a battery powered light was on inside.  But when I went down for my shower I came back and asked, “Is there no door for shower?”  Andrew just laughed and said, “Don’t worry, no one will come in.”  If it hadn’t been over a hundred degrees that day and I didn’t have throw up on me, I would have skipped showering.  Instead I just turned off the light and showed by moonlight.

After showers Chelino told us we could go to bed.  Peter and I asked Andrew if they forgot about us and already ate supper.  He told us that some people eat only one meal a day.  That meal is lunch, breakfast and supper are optional.  I made up my mind that once again this was part of the adventure.  If it means not having supper, I wasn’t going to complain. I was ready for bed but a bowl of meat was brought out to us.  It was rat meat.  Peter and Andrew dug in.  I wasn’t so willing, but after thinking about not having breakfast the next morning, I ate a small amount.  I admit it was good but I could barely get past what it was and had to swallow gag reflexes.  The funny thing is, after we finished eating rat, they brought us a big bowl of rice.  By that time I had made up my mind that I wasn’t going to eat anything so I wasn’t even hungry, I was only able to eat several spoonfuls. 

 They have no bathroom which made for the scariest bathroom experience ever.  Every time I squatted, some critter would moved underneath me.  Everywhere I tried to go, leaves would crinkle around me.  I was afraid something was going to bite me.  Eventually I realized I would not be alone no matter where I was, so I just went.

It was a long night.  I laid awake most of the night not knowing what time it was, listening to people snore and loud, blaring radio static.  I was thankful I had packed my sweater even though it made my backpack heavier because I had no blanket and it got pretty cold.  Towards morning, people were going in and out constantly to go to the bathroom, which also hindered sleep. 

We packed up in the morning and headed back to Catel.  We considered walking to the river to see if we could get someone to take us across in a dugout canoe and walking the rest of the way home.  But instead we piled back into the van and took a 5 hour ride home.  This journey may not have been the most comfortable or predictable, but that’s okay.  You never know what will happen next, who you will meet, what you will eat, or where you will go to the bathroom.  It’s one big adventure.



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This last week …

This last week was a fairly difficult week as it goes. Sharon and Pete were sick, the well broke so we couldn’t water the palms and our orange trees still have no fruit, you know what the bible says about trees that don’t produce fruit! This last Sunday a YWAM team from Ziguinchor came and did a service at our church. I was impressed, most of them spoke French and I sort of learned a French worship song.
My English class is going well, they all seem to be passionate about learning English which excites me. Even though they seem excited I happen to think that very few of them will do well on my test which may simply reflect on my teaching ability but I don’t know. On Friday we played a game in class which they absolutely loved! I had two teams and two people from each team would come up and ask questions to each other in English and whoever messed up speaking would lose. They absolutely had a great time. They all started yelling and cheering and fighting by the end.
Often when I sit and think about why they have a good time in English class I come to the conclusion that they’re hungry to be accepted. I think what is probably true of most poor cultures is they constantly hear the resounding message of you’re not good enough, thus an entire culture of people lack the confidence they need which stifles creativity and causes people to be hard pushed to make money in a different way then everyone around them. I’ve noticed that telling someone they are capable of learning something anywhere is very inspiring, I know this from personal experience. With my class I’ve found they get excited when  I tell them they are capable of learning, they get excited and start to put themselves into it. But, of course you always have those people who are bent to make their friends feel inferior and incapable. I hope and pray that they will continue to enjoy learning but like everything discipline must come into play sometime. Thank you for your prayers  and support!!

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Frequently asked quesions

We have received many questions about our living conditions. These explanations describe the mission house. Our amenities are far more limited than they are in the US, but we still have a higher standard of living than everyone else in Catel, especially with our access to electricity.

What is the weather like? Guinea Bissau has a monsoon climate, meaning that it is dry most of the year with a few months of heavy rain. Right now we are in the middle of the dry season, though we had a surprise last week when it started to sprinkle! We probably won’t see any rain again until June. It is clear and sunny almost every day. The daily high is usually in the low 90s and it gets into the 60s at night. One of our friends who lives here told us that in Guinea Bissau it is so cold that you can feel it in your bones. He imagines that in America the cold is only skin deep, much less intense than in Guinea Bissau. At first we thought it was funny because it wasn’t true. Two months later, I’m starting to understand his thoughts. It is surprising how cold 70 degrees feels, even though it is literally freezing at home in Pennsylvania.

Do you have electricity? We have electricity here, though it is limited. There are three solar panels that charge three batteries put out 360 watts. It is enough for us to have electric lights all the time. We also use computers and charge batteries for about six hours a day while the sun is high. There is not enough power to support larger things like appliances. We have enough electricity to do everything we need to do, but I also have a sense of needing to conserve electricity. Living here has given me a new appreciation for the ways that constant access to electricity enables me to do so many things like charging a cell phone at night and heating food in a microwave.

How do you get water? The only place to find running water around here is when it runs out of the well while you pump it. There is a pump in the garage at the mission house where we get our water. We need water for washing laundry, washing hands and feet, cooking, doing dishes, showering, and general cleaning. At first it was surprising how many chores required water, but after a few weeks I realized how I am able to use so much less water here than I do in the US. There are quite a few wells throughout Catel and several households typically share one well. Most wells don’t have pumps, instead you must throw a bucket down and pull it up with a rope.

In the last answer you said there is a pump in the garage. Do you have a car? Do many people in Catel have cars? There is a garage where Beryl keeps his car. Beryl is a long term missionary who lives here and he has one of three privately owned cars in Catel. The other two are owned by European immigrants. A couple people own mopeds and there are quite a few bicycles. Most people simply walk everywhere. People who go to nearby towns walk, ride bikes, or take public transportation. Transport vans are about the size of 15-passenger vans, but usually hold over 30 people.

Have you seen any wild animals? There are a lot of animals here, but it isn’t like a jungle. We have flies, small spiders, big spiders, crickets, and termites. Most people own livestock, so we cross paths with chickens, pigs, goats, sheep, and cows constantly. It’s not exactly exotic, especially if you live in rural Pennsylvania. The most unusual things we see and hear are birds. There are a lot of beautiful birds that make all sorts of different chirping, cooing, and laughing noises.

Thank you for your faithfulness in supporting us. Please continue to pray for the team’s physical and emotional health and that we will continue to love each other and our community.


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