In a moment of prayer

It was a fun morning in the office, as we were joking around about old songs we used to listen to in high school. There were lots of smiles and laughs (which, let’s be honest, is not hard to make me do). As the conversation died down, I zoned into my work. It was going pretty well, and then one of the team members walked into the room. He said a few words and the mood immediately changed in the room. We turned off the music, closed our laptops and bowed our heads.

We received a text from my supervisor, who is on the medical mission in Basra right now. This mission was scheduled intentionally to handle the more complicated medical cases. From his text, we learned that one of the children was fighting for his life on the table. It was a baby boy. He's so young, I thought.

The text said, “Medicine has run its course and he is in need of miracle.”

Everyone felt for the family and this baby, and we took a moment to pray for a long time, lifting up the baby, the family and the medical professionals.  

I wasn’t expecting anything like this. We had recorded over 11 successful surgeries on this mission at this point, and I guess my fairy-tale-mind just felt more comfortable thinking about never having to encounter the worse case scenario. This is not healthy, as the worse is very much a real part of life.

In the moment, I was saddened, concerned, hopeful and yet trying to keep myself from all the questions of “why.”

These were my feelings alone, and I could not fully imagine the parents’ thoughts at the time.

I continued to listen to the prayer, and I was thankful for the wisdom behind it.

Of course we prayed for the family in the waiting area and the nursing staff in the ICU looking after the baby, but we also prayed for the medical staff in another way, that I don’t think I have ever had to think about before. We prayed that they did not overstep or in anyway rob this child of few more days with his parents. Powerful, I thought.

This  made me reflect more, and it challenged me in different ways as it relates to medicine and my area of studies, but it also just reinforces an aspect of truth: We rely so much on medicine sometimes, but it’s clear that the power remains in someone else’s hands.  

So scandalous these days. Pray for me.

I don’t know where to begin, really.

My alarm went off at 4 a.m. I’ve been waking up early to get some hw out of the way before I head to work. My plan was a success. I had a very productive morning, as I managed to eat breakfast and begin my workday just fine. Even when I got to work, I was able to find some key parts of my research. It was, overall, a productive morning. Despite feeling really tired and overwhelmed in some ways, I was happy that it looked like it was going to be a good day.

When 12 p.m. rolled around, my friend invited me out to lunch. There’s a great Kurdish restaurant down the street from the office, and we were craving one of our favorite meals. When he was ready to go, I saved my work, put on my shoes, and headed out the door to the restaurant. The restaurant has two sections: a family section and a man(?) section. I don’t really know how to describe the other side. I’ve only seen men sitting over there. It’s loud, and … just for men, I guess, so we sat on the family side and ordered our meal.

We get the same thing every time. I think it’s called “Sada.” For this meal, you’re served a bowl of rice with raisins sprinkled on it, and there are multiple other bowls filled with vegetable toppings in the middle of the table. It’s pretty good stuff, and we enjoyed it. During the meal, we were stared at, and, lately, our reaction to the stares has been to figure out which one of us is doing something wrong. We can normally figure it out, but this time, however, I couldn’t think of anything, which is a good thing because it normally means we’re being stared at because we’re foreigners. However, we later learned that we thought wrong.

After our meal, we asked for tea, and went to the front of the restaurant to pay. I handed my friend $10,000 dinar, so he could pay. We waited for a while for change, and I again felt the eyes on us. I rubbed my head and did motions that covered my face, so that people would stop staring at me, and then I nervously fixed my ponytail. As I adjusted my hair, I looked down, and figured out what the big deal was…

It was me (being culturally inappropriate, again). The left side of my dress was not zipped.

Great, I thought. Way to keep it classy, Yvette.

I tend to layer my clothes a lot around here, and I normally am extra careful with how I dress, but to forget to zipper? Really? It didn’t make sense, especially since I had such a productive morning. And out of everything I could have forgotten … this was it? Well, that’s not even fair.

“Inapprop,” at it’s finest (in this culture). 

Yes. I had spent half the day with my dress half-unzipped. I walked to work like this, and to the restaurant like this. Luckily, I was wearing a tank top and pants under it, and you really couldn’t see anything, but in this culture, that doesn’t really matter because what was seen was my dress unzipped. Awesome.

When we left, as most of you can imagine, I panicked a bit. I felt so embarrassed. But not too long after, I couldn’t help but laugh. What on earth? This was such a random thing to happen, and of all the places … in one of the most culturally conservative countries.

That’s.just.wonderful.

I felt so scandalous, and couldn’t help but laugh on the walk back to work, which is also not completely appropriate, especially if you're walking with someone of the opposite sex. It makes you look flirtatious.  

Oh, this was no longer my day. 

When I tried to stop laughing, I had a huge smile on my face, so I just covered my mouth with my hands on the way back to work. Yes, even my smiles could get me in trouble. This was a problem because I just could not turn off the smile. Being scandalous was totally not the look I was going for, and I definitely nailed it with my unzipped dress and my smiling face. 

When we returned to the office, we told a colleague the story. He shook his head and laughed with us. I still felt awful, as it was an honest mistake, but at this point, there was nothing I could do.

In my colleague’s words, “In the States, that’s nothing, but here … You just flashed half of this city.”

Fabulous. Pray for me <3

The Patient’s Arrival (Hospital Visit Pt. 2)

Around 10:30 a.m., a tiny baby, her grandmother and brother arrived with a volunteer nurse. This family was coming from the Syrian refugee camp right outside of town. They could have been delayed for many reasons, but I’m simply glad they arrived because the baby definitely needed care.

At six months of age, the baby weighed 8 lbs.  Unbelievable! She was so little (And she was so adorable!). Her grandma who held her, put her on the table, and moved the baby bottle of water to the side, so the doctor could begin to examine her.

While the doctor checked her with the echo, he began to express his concerns in Arabic. However, the Syrian family looked at him oddly because they didn't know what he was saying. Syrians speak a different Arabic than Iraqi Arabic, which is the reason communication was so difficult. To help communicate the status of the baby's health, he used hand motions, wrote down instructions, and then, he instructed the med student, his nurse and the nurse from the Syrian camp to go over it one more time to ensure that everyone was on the same page. 

They talked about when the doctor would plan to see them again, and discussed what was expected of them before they came back. The doctor  gave basic instructions on how to properly clean the bottle. He told them to boil the water, put it in the bottle and place the cap on it. Then, I couldn't really make out the other part of these instructions. He pointed to the bottle using his finger to show them how much water they should put in the bottle and how much of the prescribed nutritional ingredient he wanted them to include. This was interesting because his instructions required them to go to the pharmacy.

The pharmacy doesn't open until later in the afternoon here, and to get this medicine from the pharmacy would cost money. I'm not sure if the family or the doctor had to pay for the first round of medicine for this baby, but I do know that if they ran out, the Syrian family would most likely be responsible for getting the medicine and paying for it. This was so interesting to think about because, after all, they were from the Syrian camp, and you don't know their whole situation and whether or not they can afford this cost of care.

I had a lot of thoughts and questions, but I continued to observe everything. (Some ideas came to mind about the topics I would like to write about for my independent study course, and I made a note of them.)

Watching everyone in the room was interesting to see because there were two different languages being spoken, and a lot of confusion. The main concern the doctor was trying to share with the family was in regard to the baby's weight. She was too small for the operation in this city. He wanted to first "aggressively treat her nutritionally," and then see her in a few weeks (hoping that she would gain enough weight by then). His plan was to move forward appropriately with the operation after the right amount of weight gain. 

This tiny baby had VSD, a common heart defect in babies. She could have been treated for this immediately if she could go to another hospital in the area that has the equipment for such a young baby, but in this town, there is no equipment available for the operation. She is just too little for the local hospital's machines in this town. She is also without papers -- papers, like a passport -- that can help her get past the checkpoints in this country or even possibly leave the country for the operation. Thus, she is stuck, and her surgery will have to be delayed for about three weeks.

After the nurses and the med student figured everything out, the Syrian family left. We met the family to see if there was anything we could do for her, but due to reasons previously stated, like the lack of passport or accessible equipment, PLC is unable to help her.

Interested and want to learn more? 

More is to come on my academic blog. 

Check there for more details.

I went to the Hospital today! (Hospital Visit Pt. 1)

I had the opportunity to go to the hospital and learn a bit about how PLC receives patients and determines whether or not they can help the child. The original plan was to meet the prospective PLC patient at 8:30 a.m. during her appointment with a local cardiologist, but plans changed, as they arrived a couple of hours later.

As we waited for the child and the family, the cardiologist kept doing his rounds and checking back with us to see if the family arrived. I was glad he was making an effort to fit this appointment into his already-crammed schedule, but I could tell he was afraid they were not going to show. We kept looking out for them, spending quite a bit of time in the hospital hallway.

The hospital scene is a bit difficult to describe because there was so much going on, but I’ll do my best. I saw a few little kids running, several children walking around holding an IV in their hand, a baby screaming and being held down by a few nurses, a crowded patient room with about six moms and their children, people frequently walking through the Pediatric Intensive Care Unit (PICU), and so much more. I also noticed women wearing green coverings or white jackets. I learned that they were wearing such garments for identification purposes. The women wearing white jackets—jackets that you would normally see doctors wearing—are nurses. And the women wearing green gowns over their regular clothes are the moms of the children. Doctors are free to wear whatever they want, which made it hard to identify them sometimes.

There was a lot of movement in the hallway, so we stood out of the way, near the stairway in the corner. I spent the whole time observing and talking to a PLC worker who shared a bit of her hospital experience with me. I found it all fascinating, and wanted to learn as much as possible, but the cardiologist found us and invited us to his echo room, where we would continue to wait for the patient.

The echo room was also an interesting experience. In order to get to the echo room, you have to walk through the PICU. I didn’t have to wear or do anything special to enter the PICU or the echo room. In fact, for the last 30 minutes or so while I was waiting in the hallway, I had noticed others doing the same: just walking on through. Some people walking through the PICU continued their conversations at a loud volume, and others looked out of place. In my eyes, security seemed a little loose, but to those who are there everyday, they probably see security differently than I do.

When I entered the Echo room, I stood to the side to let people exit/enter. This could be a busy room for many reasons, but one reason is because every baby gets their heart screened now. Another reason that it seemed so busy is because of its size. This was a very small room, and there was not much space to move around. There was a customizable, dividing wall in the middle of the room to create a bit of patient privacy, but in such a small room, it’s hard for there to be any privacy. There were two families in there when we arrived, and at one point, I counted more than 11 people in this room (not including myself).

In addition to the people frequently walking in and out of the room, the room had a patient table, an echo machine, a rolling stool for the doctor, a desk for the doctor, two comfy couch chairs and a bigger loveseat on the other side of the room for people waiting, extra plastic chairs stacked up, a few piles of papers, a small desk for the nurse and a phone. The nurse handles all the calls, appointment setting and more in this room, while the doctors tend to patients, and she also assists the doctor with the patient be keeping them smiling, moving their hands out of the way or doing anything else that assists the doctors work.

There was a lot to think about after seeing this all in action, but it made me hopeful that the cardiac center being built across the street would soon be completed. This would allow for more space, and other opportunities of care for the patients and doctors. However, the project has been underway for the last three years. I really hope someone finishes it soon.

A morning of hiking

This weekend, I went hiking. It was so fun. I loved it, and I loved the company. These are just a few of the pictures for the morning trip.

This morning of hiking was probably one of my favorite things that I've done here so far. I spend a lot of time inside, and I do not go a lot of places. I don't even run outside or anything, so getting the chance to be active and in nature was awesome. 

 

I was surprised to see cows on our hike. We would struggle to get up some parts of the rocks, and when we got to the top, we'd often see cows just chilling and staring at us with this look of "what took you guys so long?" Well, that's just wonderful, I thought. How on earth did these cows get up here? We figured out that there was a probably an easier way, because this kept happening the higher we got. Cows ... just chilling. Too funny. Instead of getting frustrated with them, I went into photographer mode, and tried to get as close as I could. :-) 

Here's one photo I took before I chickened out:

Yep, just me and my friend Betsy (or Bob?) here.

 Yes,  and this was as close as I was getting for this picture. (Guys, the cow was huge. What can I say?).

 I ended up taking a lot of pictures of the scenery on this trip, and because of this, I was often falling behind. Here's to being that photographer -haha. Classic. Here are some of my favorite pics:

There are only a few green leaves on this mountain.

Just a glimpse of the view.

Everything seemed pretty dry on the mountain.

This is probably my favorite. I'm pretty sure I took a similar picture on a mountain in Korea.

This was the view from the top. It was a beautiful.

When we got to the top of the mountain, we sat down, and talked for a while. I loved just relaxing and looking out into the distance, but then I realized that we would have to leave soon. My one question was: how are we getting down? We had climbed some pretty steep areas, and I was a bit scared. We made it down okay, though, and I even kept stopping along the way to take more pictures (even on some of the steepest parts <--probably not the best decision (I know, mom), but I got some awesome photos!). 

On the way down the mountain, I came across something that really made me think about the history of this country and its people. Check out this picture below. Do you know what it is?

This is a bullet.

On the mountain, I found a bullet. I was hiking with three other girls, and there is nothing about us that appeared intimidating.

Hmmm …

So yea, I tried to forget that I saw this, but I had so many questions starting with "is this normal?" and "are we going to make it down this mountain?"

One of the girls said it could have been from people celebrating the recent elections in town. They often shoot their rifles up in the air during celebrations. Oh okay, I said calmly, hoping that no celebrations would be happening during the next 40 minutes or so. Then, she pointed to some other mountains in the distance. My friend said that there were caves over there where people used to hide out. 

Hide out? These mountains felt so bare with all the greenery appearing so dried up. I thought it would be easy for anyone to spot you. 

 

She continued and explained that there were not many places for people to go, and when Saddam was oppressing the people in this city through attacks, they fled to the mountains to hide in the caves. This made me really begin to think about some of the scary things this country has faced. 

This was not that long ago in history. People my age lived through this, and they remember some of these times very clearly. Someone on my team, who is around my age, put it this way:

“When we were playing outside and just learning to ride a bike, [Iraqi] kids our age were running for their lives with their families.”

Some of them can even clearly remember some of the hardships, which is really sad. This put more into perspective for me. There is so much history—history that is recent—in this region, and it directly effects the way people view one another today.

On Prejudice

Last night, I learned that one of the local Iraqi health professionals who works with the medical teams during Remedy Missions was recently killed in a terrorist attack. I learned that this Iraqi health professional was killed for his faith. I don't know what he believed, what the problem was with his belief or how this all happened.

All I know is that he was killed because of it.

Recent headlines of the killings in Iraq

Dr. King wrote about this from a racial prospective, but this
can definitely apply to religious tensions here.

This was upsetting to learn. It made me step back and think about some of the religious tensions in this country. Recently, there have been a growing number of killings in specific parts of Iraq. The problems here are intricate, but I can say that some of these killings do result from differences of thought. To have different ideas, and freely support or express them here is limited in many ways.

This is unfortunate because this is a country that is desperately in need of peace. From a healthcare lens, the lack of peace has greatly contributed to the low quality of care in parts of this nation. 

These are real people saving real lives. And to think that this man, who was dedicating a part of his career to saving lives, was killed is disturbing. 

I've been doing a lot of research lately, and I've learned that many health professionals fled the country during the war. Others were killed or kidnapped. Now, that the wars have ended, I'm hopeful that the numbers of health professionals will grow, but the truth is, despite numbers growing, health professionals, not only their patients, will have to face the current tensions in this area.

Some of the tensions include the following:

• Arab Iraqis vs. Kurdish Iraqis
• Syrians vs
• Shiite Muslims vs. Sunni Muslims 
• Syrian supporters vs. non-Syrian supporters
• And I'm sure there's so much more.  

I remember reading about this over the summer, but I put it in the back of my mind as I had to focus on some other areas for school and work. It's sad to go from reading about it, and then learning about it in this environment.  

Within a week of being here, there was bombing in Erbil, which was the the first bombing since the last six years in the north. Over 40 people died, and it was said to have been caused by Syrians.

Yes, prejudice plays a major role here, and its taking things to an unnecessary level: death. 

Despite your experience with this word, prejudice, it's important to realize that it could hold more weight for those who have closely felt the burdens of such thoughts. There's a lot to be said here, but honestly, after learning of this situation, I was left a bit speechless.

My supervisor posted the following on his Facebook page after learning about his friend,

"We don't ignore the violence taking place across Iraq. We choose to look it right in the eyes and tell of a better way. #preemptivelove"

Thus, after decades of enduring wars and sanctions, I'm very hopeful that this region will one day find peace. It will take time, and definitely a lot of effort, but I think that it's well worth it all. 

Rules n' such

Some of you have asked about the rules. Here's a brief list of things I have to constantly think about.

• Must be in before dark
• Always have your elbowscovered
• Wear long skirts or leggings that can cover your ankles
• Don’t smile or laugh a lot when you’re talking to a man, so they don’t see you as flirtatious
• Never walk alone to work or other places
• No staring at men in the eyes
• Never initiate conversations with men and engage them
• Don’t play with your hair in public
• Be careful with how you position your feet (showing the soles of your feet to someone is offensive)
• Don’t run or hurry
• Only run in the park where women can run for exercise
• Don’t play soccer with the cute kids 
• These kids are allowed to be outside after dark. Think about this: they're half my age and they have a later curfew. Never thought I would want to switch places with an eight-year-old before)
• Always take your shoes off before entering a house or office.
• Don’t forget to carry your Visa on you at all times
• Never ride in a taxi by yourself
• Don’t shake anyone’s hand (yea, definitely learned that one the first weekend I was here)

The whole goal in upholding the rules and dressing appropriately is to avoid culturally offending anyone. For women visiting this culture, you want to be seen as a respectable woman. That's what I'm trying to do, despite my mistakes here and there. Wish me luck.