Final Totals from Our Trip

Our final statistics from the trip.....we saw 799 patients. In the six days we had clinics, we treated 799 patients! That's amazing. That is about  75 more people than last year and we had one less provider. It helps that this was our second year, everyone was more organized and we had a better idea of how to set up and manage the flow. 

This is only a drop in the bucket compared to the needs. Since our trip last year I've been paying more attention to the events impacting the refugees, especially in Jordan. The Syrian crisis is the biggest humanitarian emergency of our era. According to the UNHCR in Jordan, as of February 2015, over 622,000 Syrians had registered with them. Some refugees live in the camps and about half a million live in host communities. As of 2012, over 150,000 people lived in one of the camps. Since then two other camps have been opened. In both living arrangements, the conditions are rough. 

The UN's report titled "Living in the Shadows" is based on home visits to the refugees living outside the camps in 2014. Almost half of the households researchers visited had no heating and a quarter had unreliable electricity.Rental costs accounted for more than half of households expenditures and many families shared accommodations to keep the expenses low. 

In addition to the Syrian refugees, Iraqi refugees have been entering Jordan since 2003. This number has increased over the last few months as more and more people are fleeing Iraq. According a study conducted by the UN, one in six of the refugees live in extreme poverty. 

I know to the people we saw, what we did made a difference. I know our hosts appreciated our help and our visit seemed to encourage them. I am grateful for Jordan and the other countries that have kept their borders open and have allowed the refugees to enter. I can't begin to imagine what it must be like to leave you house, your job and/or school and walk away with only what you can carry. I saw in the eyes of the people we treated what a toll that takes on your heart, your soul and your physical well-being. I am thankful for our hosts and their commitment to help the refugees. I truly saw that the workers are few and the needs are great.

    ...................until next year, when Lord willing we can return and help some more. 

Snow Day!

Not speaking Arabic can be a small barrier to getting an accurate weather report when you don't have internet access for most of the day. On Tuesday we heard snow was predicted for Thursday. As day went on it, it became Thursday night it would start and end Friday night. Until we got back to our rooms, we were at the mercy of those around us. One translator told us it was going to be the worst storm Jordan has ever seen. Our hosts told us not to worry. By Wed, the report was a little clearer and our hosts told us more than likely it would be a short work day. The translator suggested we stay at the airport Thursday night because weren't going to be able to get to the airport on Saturday. Later that night it was announced schools were closed on Thursday. I took that to mean, we'd either have a lot of patients or none.

Thursday morning as we headed out the sun was shinning and we joked about the universal struggle of being a weather reporter. A little after lunch time it started to rain. The site we had set up as the clinic, the majority of the waiting room is outside. We moved those who were waiting inside and everyone crammed in the hallway. The noise level rose a bit but other than that we kept plugging along. Our hosts recommended we finish up because we needed to get back before the snow started. We snuck in one last patient and finished for the day. Our final total for the last day, a record breaking 147!

Just as we pulled up to the place we were having dinner, the snow started falling. By the time we left, I could see why there was concern. A good comparison is probably when it snows in the south. It's not a normal occurrence so the level of comfort in navigating the hilly roads is less. There isn't much pre-treatment for the roads and the plows are not plentiful. By Friday morning, 5-6 inches accumulated, there was a travel ban and it was very apparent we were spending the day at the hotel.

It's been a little like college, hanging out in one another's rooms. Chatting, eating snacks and taking a nap. By no means has this been a hardship. We are thankful this happened on our day off and didn't impact a clinic day. And it looks like we will be able to get out on time tomorrow. Also very glad the translator wasn't accurate in his weather report.

Flat Tire

Yesterday we were working in an area that's a pretty decent drive from where we are staying. The area is poorest area that we have been to. The needs are overwhelming. This year a lot more people asked us if we had milk for their babies. It was hard to tell them that we didn't and somehow giving them a toothbrush didn't seem like enough.

We ended up seeing 142 patients, our highest for the week has been 143. It didn't seem like a lot, the pace was good but they came to triage as a "tribe." When the women managing triage poked her head in to see if we were ready for the next patient, she told me we have three families to see. I told that was fine, two triage stations were open and ready. She looked at me and said, one is a family of nine, the next has eleven and then seventeen. I didn't say this out loud but my inside voice was screaming, "17, 17, how in the world are we going to fit them in this room." I told her we can't have all those people in here at the same time and when I say people, the "tribe" was one parent and the rest children. Some how we did it. All three groups were triaged, seen by a provider and given the medications they needed. It all happened with as minimal amount of chaos that all those children bring.

On the way home, our bus got a flat tire. We pull over of the side of the road and our driver was amazing. Changed that tire relatively quick. We broke down in front of what turned out to be a some small military installation. It was up on the hill and we couldn't tell what it was. They drove down to make sure we weren't anything suspicious. It was a little bit of an adrenaline rush to have military truck rushing at you when you are in a different country. They were great tho. All ended well and we made it back safe and sound. 

Patient Stories

Sometimes as a nurse and I'm sure it's the same for other professions, you meet people and they leave an impression. Working with refugees and hearing their stories is profound. I know as we continue this week and move to poorer areas, the stories will be more raw.

Yesterday we saw 143 patients. The providers worked as they said in 5th gear. I met this one family who have been here for eight months. The wife is pregnant. This will be her fifth child. Not uncommon in this part of the world. Her and her husband came to the clinic with their two youngest children in tow. They were 5 and 3 years old. His chief complaint, back and neck pain. He lost his arm in a battle just under a year ago and he thinks during that struggle he fractured some vertebra. The wife, she has had a headache for 4-mons. After some further questioning, that wasn't her chief complaint. My guess, she's depressed. She has a hard time getting out of bed, has no energy and a generalized headache. She saw her husband lose his arm, they left everything they have and are now living in another country and she is going to have another baby. They have very little.

Another gentleman we saw, his chief complaint: bilateral shoulder pain. We ask all the typical questions, how long have you had it, can you describe the pain and on and on. What were you doing when it started; for 20 days I was held in captivity and was hung by arms for hours at a time.

 There are plenty of patients we treat that have similar concerns like we see back home.We have done education on hypertension, the importance of taking your medication, dental hygiene and how to prevent cold and flu. We've seen people with urinary infections, asthma exacerbation and scabies. But these two, these two stories will stick with me. 

Arrived in Jordan

We arrived in Jordan yesterday late afternoon but it seems like we have been here for much longer. We landed with all of our luggage and had no problems finding our hosts. Checked into our hotel and went to a restaurant and ate like kings and queens. The first course was an array of traditional appetizers. Our hosts had to tell us this was not that main course but it easily could have been. The second course and then dessert, where all equally delicious.

In the lobby of the restaurant an old women sat and made the nan. I'm not sure why she sat there but it was fun to watch her roll it out by hand and put it on the plate to cook. The hot plate looked like a turtle shell, it was rounded and rather large. I think it helped heat the lobby?

We organized our supplies when we returned to the hotel and then it was off to bed. The next day started at 0700; team meeting,breakfast and off we went. The clinic doors opened at 1000. By 1300 we had to tell anyone new who arrived to come back tomorrow. By 1730 we saw 114 people, all ages. We did some dental hygiene education and tried to keep all the kids distracted while they waited with their families to see one of the three doctors. We ran out of coloring books so we blew gloves into balloons and hit them around the room. That turned out to be a blast.

 It was a busy day. Looking forward to what tomorrow holds.

Overwhlemed by the gifts! But need toothbrushes!

(above photo was taken last year on the trip)

Many thanks to all of you who made a donation to the Jordan trip. We raised much more than we were hoping to raise. That is absolutely amazing! Thank you all so much. The funds have been wired and the pharmacist is busy purchasing the medication and supplies we will need. The extra money will be used to cover follow-up medical costs for the patients that have needs our team may not be able to help. This is truly a blessing. Thank you for making this possible.

The team is comprised of three providers, six nurses, one physical therapist and two non-medical helpers. For many of the team this will be their first trip to this region. Five us went last year. 

This year we were unable to find a dentist who was able to come. As a result, we won't be able to provide dental care. One piece we added this year is health education. As the refuges are waiting to pick up their prescriptions we will be teaching some generic health topics; how to prevent the spread of infection, healthy eating, acid reflux, scabies and many others. The topics were selected based on what we saw last year. Since we don't have a dentist we would love to be able to give toothbrushes and tooth paste. During the health education time we can cover some dental hygiene topics. If you think you will see me before Wednesday and want to donate some toothbrushes/toothpaste let me know. 

Depending on how the conversations with the refuges go, our hosts have counseling resources to help with anyone who wants to talk about the trauma they have experienced. 

I am extremely excited about this opportunity and overwhelmed by the generous support my friends and family have provided. Please keep us in your thoughts and prayers as we prepare to leave and while we are there. 

Keep Smiling!