Nomsa is dead. The rest is history.

Last night Nomsa left this life of pain and suffering. Her work was complete and she went to be with Jesus, no doubt receiving a “well done, good and faithful servant.”   I am posting this blog a day early so that you will all know.  She leaves behind five children including a 7-year old son and two sets of twins. 

I first met Nomsa (her real name is Gcebile Mabuza) on December 13, 2012.  The story is recounted in my blog called wednesdayswithnomsa.blogspot.com.   Her second set of twin girls, Rachel and Leah, live at the toddler home on Project Canaan.  They were born on my birthday, November 19, 2012.  

Nomsa’s struggle with Drug Resistant TB has been a long one, years in fact.  She has lived longer than anyone would have expected.  In the middle of 2013 she put on weight and it looked like she was getting better, but the test results never reflected our hopes and dreams.

In August 2013 she got the news that her resistance to the drugs had increased and, as seen in the “must see” PBS/BBC Documentary film called “TB The Silent Killer,”  Nomsa learned that her MDR-TB had become XDR-TB.  Very few people have survived XDR-TB and with her HIV positive status, the likelihood that she would survive was low, but we still prayed for a miracle.

In April 2014 I was told by the doctor that they almost lost her, but again she rallied and the desire to live kept her alive.  In June 2014 she couldn’t take it any more at the hospital and begged me to take her out so that she could die at “home” – meaning Project Canaan.  And we did.

It was a difficult decision because she was suffering from a deadly and highly infectious disease, but we put precautions in place and brought her in the back of an open truck to the room that had been built for her.  Chloe and Nomsa became very close over the past 18-months and it was so timely to have her home while Chloe was off on summer break.  They got to visit, talk about “boys,” eat snacks together, and Chloe even got to help her choose her clothes, hair and jewelry for her big speech at the opening of the El Rofi Medical Center.  If you haven’t read her speech from that memorable day please go to: http://janinemaxwell.blogspot.com/2014/07/nomsa-addresses-nation-and-her-voice-is.html.

Funnily, she was quite a difficult and demanding patient.  For someone who is so sick and comes from abject poverty, her demands have been high and often unreasonable.  The entire team of caregivers did their best to be patient, gracious and loving through it all.

One day not too long ago, Nomsa's brother dropped off 400 Rand at the front gate for us to give her ($40 US). Up until that point he had never come to visit or care for her, but that day he dropped off cash. It is literally the only cash she had in years, since she had been in the hospital for almost three years. Do you know what she did with it? She quietly tucked it into my hand and asked me to buy Chloe an 18th birthday gift. She had me lean in close to her and she looked me straight in the eye and said, "Janine, it must be something very beautiful. Very beautiful." Can you even imagine that? Needless to say I bought a very beautiful necklace and returned lots of change.

 On a daily basis, Nomsa struggled taking her medication.  She was supposed to take dozens of pills each day and get an injection three times each week.  All day she worked to get the pills down her throat, but she never finished them. Some days she would take the yellow ones and other days she would only get the red ones down. On top of that, she would not eat or rarely ate (unless we brought her “goodies” … KFC or pork ribs).  In addition to that, she was very stressed all day long about taking her pills.  We learned that only four of the pills were actually for her Tuberculosis, the rest were to ward off the side effects of those four pills.  So a week or two ago we had a difficult conversation and she decided to stop taking her pills.  She said, "Janine, the Lord has numbered my days, and only HE knows when I will die.  These pills are not helping me anymore.  Only God can help me."  I supported the decision because it was easy to see that she was not improving by taking them and she was suffering physically and emotionally by taking them.   

On Thursday, August 21^st we had an urgent call to go and visit her.  She was in respiratory distress and was afraid. Ian and I rushed to her side and prayed with her to calm her down.  The next day some new friends from Medecins Sans Frontieres (MSF - Doctors Without Borders) visited to do some further training on dealing with infectious diseases and to counsel us through the days ahead with Nomsa.  They recommended that we take her back to the hospital for her final days as it would potentially be a terrible death and they wanted to spare us the heartbreak, pain and memories of her death.  I was almost sold on the idea until I spoke with the other girls who live at the Sicala Lesisha Kibbutz. When I told them that we might take her back to the hospital, they were shocked and begged me not to. They said, “Janine, she is our sister now and she must die at home.”  I was stunned.  I told them that it could be a terrible death, and did they really want to see that and have their children see it too?  They would never forget it.

They looked at each other and said, “Yes, if we were in our homestead she would die there. Just like our other sisters, brothers, mother and father.  This is our home now and she must stay. If you take her back to the hospital she will think we have abandoned her and that she is not loved.  We will be with her until the end. Please allow her to stay.” 

Wow.  These young women who have come to us through very difficult situations and circumstances took my breath away. They were willing to suffer the pain of watching someone die, so that she would die knowing that she is loved.  I agreed.

I explained this to our MSF friends and they were very moved by this bold and selfless decision.  We then met with Nomsa to discuss what would happen as she became sicker.  My concern was a question of resuscitation, or at what point DO we need to take her to the hospital?  The only hospital that would accept her was the TB Hospital, and I know how much she hates being at that hospital.  So, we had that conversation too with the nurses from MSF.  I asked her under what conditions would she want to be taken back to hospital?  Bleeding?  Pain?  Nomsa was very clear that under no circumstances would she want us to take here there.

On Sunday, August 25^th Nomsa called me and begged me to take her to the TB Hospital. She said she didn’t believe that she was dying, but said when she got there they would put her on a potassium IV, she would get better and come back home.  She could not walk anymore and was in a lot of abdominal pain.  On Monday morning we met and again she begged and pleaded with me to take her to the hospital.  The problem was that I wanted to honor the agreement I made last week with witnesses that I would not take her back.  I tried to buy time by saying that I didn’t have an open-backed vehicle that I could take her in that day.  But she was a determined young woman and called the doctor at the TB Hospital herself, and he sent an ambulance to pick her up.  The decision was taken of my hands, and for that I was thankful.  

When they lifted her up into the back of the ambulance, I immediately recalled the day I first met her. It was December 13, 2012, and she was in the back of the same ambulance heading to the TB Hospital, just as she was this day. Not knowing how infectious her disease was back then, I climbed up into the back of it and gave her a big hug as she handed me her twin girls who were almost a month old.  They had been living and dying with her in her mud hut until someone reported her to the hospital.  I assured her that I would care for them as if they were my own.  The doors were closed and off they drove.

Nomsa lived with us on Project Canaan for the last two and a half months of her life.  As the ambulance drove past the toddler home we brought her twin girls, Rachel and Leah, out to wave to their mom.  It would be the last time they would get to see her alive.

On Tuesday and Wednesday she called frequently to talk, tell me how badly she was feeling, and of course to ask me to bring her “goodies.”  But this time it wasn’t KFC that she wanted, it was her Bible, disposable diapers and anti-diarrhea pills.

Late in the evening on Thursday she took a turn for the worst and the diarrhea was unstoppable. She went into respiratory distress around 10 PM and was given oxygen as well as medication to try to pull her back from deaths door.  At midnight she took her final breath and was gone.

I didn’t know this was happening, but couldn’t sleep that night. I was awake thinking and praying from 2 PM until morning.  At 6:17 AM I got a call from the young woman who was here caring for Nomsa on the farm, telling me that she got a call from one of the cleaners at the TB Hospital to say that Nomsa had died in the night.  I didn’t want to believe her, so I called every doctor and nurse I had phone numbers for to get confirmation.  At 7 AM I heard the news officially.  She was gone. 

No more pain. No more suffering.  No more tears.  No more fear. 

As I reflect on my sleepless night, I realize that I didn’t once think to pray for her.  I prayed for my children, my husband, the babies and Aunties, all of our staff around the world and our long-term volunteers, but not once did I think to pray for her.  Now I know why, there was no need.  She was with Jesus.  And for that I am thankful.

“Blessed are those who mourn, for they will be comforted.”  Matthew 5:4

Live from Swaziland … my heart is so sad, but I know that she is at peace.

Janine

PS – We have established a Nomsa Memorial Fund at Heart for Africa.  If her life has touched you as it has touched mine I encourage you to make a contribution and leave a note in the comments box for her twins. All notes will be printed out and put in the girls special keepsakes boxes to read when they are older.  All donations will be used to provide hospital/medical care to Nomsa’s children, and all the children who living on Project Canaan. We will put a plaque in her memory at the El Rofi Medical Centre.  Click here.

Did anyone have a Baby Shower for the Mothers of our 69 babies?

Today I attended a baby shower for Kristal Flentge, one of our amazing long-term volunteers.  It was a lovely gathering of women, yummy food, games and then the ceremonial opening of gifts.  Each gift was cuter than the gift before and Baby Flentge will be dressed in style upon his arrival.  It was a time to gather and celebrate the coming of a little baby boy who will be born in Swaziland in the weeks to come.  A baby who will be loved by his immediate and extended family, he will be well fed, educated and grow up knowing his mother, father and siblings. 

Kristal has no plans to dump the baby in an outhouse/pit latrine after he is born. She has not been to the Social Welfare office to see if anyone can take him off her hands when he is born because she already has two children.  Her husband Chad has not run off with another woman or taken another wife since her pregnancy and he is not beating her every day because she is pregnant.  In fact, he is still living with her, loving her, bringing her special treats when she has a tough day and providing for his growing family.

Kristal is not HIV positive and she does not have any level of Drug Resistant Tuberculosis so she doesn’t need to worry about the side effects on the baby of taking dozens of pills for her illness.  She has filtered water that she can drink from her own tap in her house and she doesn’t have to walk to the river every day with her two small children to gather water to drink, cook or bathe.

As I left the shower I couldn’t help but reflect on how that party, steeped in tradition from my culture, didn’t happen for the mothers of the 69 babies who call Project Canaan “home” now.    Did any of those mothers them get excited when they heard that they were pregnant?  Did any of them call friends and family and tell them the great news like Kristal did?  Did any of them have friends gather to have a “girls” party for them and bring them special food and gifts before the baby came so that the pregnant woman was loved and so was her baby?  No, they didn’t.   

Many of the biological mothers to our 69 children wept when they heard they were pregnant, again. They cursed the baby in their belly and the man who put him or her there.  They tried all possible means to abort the child so that no one would know that they were pregnant, and when that failed, they often ran away from home so that their families didn’t know that they were pregnant, or even start suspecting that the father of the baby might be her own father/brother/uncle/neighbor/Pastor. 

We received six babies in the past two weeks.  They are:  Luke (1-day old), Adam (3-weeks old), Michelle (2-months old), Jacob (6-months old), Malachi (18-months old) and Lori (2-years old).  Each of them was created by God and made in His image.  Some of their mothers are dead, some are prostitutes, some are mentally disabled and some we just don’t know, because they were never found.  But these babies were not accidents, and they are seen by El Roi, the God who sees.  Their mothers are also seen by him too, and loved just as much.   It’s hard to reconcile a God who loves Kristal just as much as he loves his daughter who tied her newborn baby in a plastic bag and left her under a bush to die.  But he does and so must we, even when it’s hard.

Krista’s baby shower was a great celebration of life and of love and I am thankful that I could attend it.  It was also such a stark reminder of the two worlds that we live in here in Swaziland.  Thank you Kristal and Chad for packing up your lives and moving here to serve our Lord through the people of Swaziland.  MOST people would be too afraid to move here with young (or any) children. Imagine all that you would have missed if you had said “no” or “not now”?

Your family is a gift to us all.

Live from Swaziland … living in a strange world.  

Janine

Things that make you say, "huh??"

To live in a new and different culture successfully it helps to work diligently to learn about the customs and practices of the people whose country or region you are living in.  This was true when we moved from Ontario, Canada to Georgia, USA.  While we might look the same, culturally it was a huge change for us and one that required study and understanding.

Moving to Swaziland is much the same, but different.  Just when I think I have heard it all, I am smacked up the side of the head as a new cultural practice is explained to me.  Last week I had one of those conversations that made me say, “huh??”  Today I will do my best to share it with you.

Swazi culture is steeped in tradition including many that include Traditional Healers/Medicine Men or what we might call Witch Doctors.   Last week a friend of mine was called to the funeral of the woman whom her husband’s brother had been living with for eight years. Typically funerals here start in the evening and include an all night Vigil filled with many things I won’t talk about in this blog.  In the wee hours of the morning the actual funeral takes place and the burial happens as the sun comes up.

My friend (who shall remain nameless) planned to skip the Night Vigil and arrive at the funeral at 5AM.  At the last minute she was told that she must arrive at 3AM because there was to be a wedding first.   The man wanted the woman to be buried in his homestead (part of a Chiefdom) and because they had never married (either legally or traditionally) there had to be a wedding between the dead woman and the live man or else she could not be buried there by traditional Swazi law.

Also as a part of Swazi culture, the younger sister of the dead woman was to step in to her place as “wife” after the marriage ceremony took place to the deceased.  The grooms’ family had to meet with the “bride’s” (still the deceased) family and negotiate the Lobola (the number of cows the family would require for the bride … who is now dead).  Once that negotiation took place and several cows were brought in as a down payment they proceeded with the wedding ceremony with the coffin and the groom present. 

Meanwhile, the younger sister cries out and laments the woes of getting married, on behalf of her dead sister (traditional weddings require the bride to cry out loud because she is being married.  My friend further explained that since the bride was dead “someone had to cry” so the sister did the crying on behalf of the dead bride). 

After the wedding ceremony finishes, the funeral continues and the wife of the man is buried in the family homestead. After the burial is finished the sister of the deceased, who is now the wife of the widower, then stays at the homestead with her new husband.  After I asked a million questions that resulted in some nervous laughter and a million answers the thing I was the most perplexed about was that Christian Pastors participate in these ceremonies alongside the Traditional Healers.  Why?  The answer I was given was because if the Traditional Marriage didn’t happen then the burial could not continue, so the Christian Pastor is there for the first ceremony so that he can perform the second ceremony.  I will do some follow up on this one with some of our local Pastors to get their “take” on it. 

On a side note, my friend was “fined” by the family of the deceased for not wearing the appropriate Swazi clothing (her Swazi wedding dress made with goat skin etc) and had to pay the fine of a live goat to those whom she offended.

The more I learn, the less I know.

1-week old Luke.

In other news … we got three new babies this week. Luke was born on August 6^th and abandoned by his mother in the hospital.  Malachi is 18-months old and severely malnourished.  His drunkard mother would leave him alone all day and night locked in a room by himself. He also arrived with a present … chicken pox!  So he moved directly in to the infirmary and is enjoying one-on-one time with one of the few Aunty’s who has had chicken pox. (Sadly, this same Aunty is the one whose house burned to the ground only a few short days ago). 

18-month old Malachi.

The third baby was born on May 26^th 2014 and she has been named Michelle in memory of my friend Teri McClure’s sister-in-law who passed away in 2006.  This baby’s mother and Grandmother are severely mentally disabled and have no way to care for the baby.   As ‘fate’ would have it, Michelle McClure was also mentally disabled and after being raped she found out that she had contracted HIV/AIDS.  Before her death her heart’s desire was to go to Africa.  Sadly she passed away before that was possible, but the family came in her stead and now Baby Michelle is a living reminder of another Michelle’s life.  I am thankful that Teri and her daughter Morgan were here to be extra hands and loving arms this week as we welcomed babies #65, 66 and 67 to their home on Project Canaan.

A plaque in memory of Michelle McClure is on the El Rofi Medical Centre.

2-month old Michelle.

Live from Swaziland … you can’t make this stuff up.

Janine

PS - if you want to help us feed and clothe these new babies on a monthly basis please sign up to be a Heart for Africa ANGEL today.

In the US: https://heartforafrica.secure.force.com/pmtx/cmpgn__donations?id=701C0000000VFWR


In Canada:  http://www.heartforafrica.ca/Project%20Canaan%20Children.aspx

Too many babies.

Baby "Lori" - abandoned 3 days before her 1st birthday.

This week I was admittedly overwhelmed.  It was “the wave”.

Several years ago, before Project Canaan existed, I had a vision.  I was standing on the side of a mountain looking out across a valley to a mountain on the other side.  Something was pouring over the mountaintop like a wave and it kept pouring and pouring.  The closet thing I can liken it too would be from the movie “The Lion King” when the wildebeest are pouring down the mountain in to the valley and they keep coming and coming over the mountaintop with seemingly no end in sight.  That is the image I had, but I didn’t know what it was that was coming over the mountain, and it wasn’t wildebeest.

As I continued to stare and focused my eyes on the distant mountaintop I saw that the wave was a wave of children and I KNEW in an instant that they were orphaned and vulnerable children.  I was sick to my stomach and started to panic.  I ran around on my hillside and was shouting to the people around me that a wave of children was coming to us from over that mountain!  I pulled on their arms and tried to get them to look, but no one was interested in what I had to say. I was screaming, and no one was listening.

I got a sense this week that the wave has begun.  I was called on Wednesday morning about two babies who were abandoned. One was allegedly 9-months old and had been abandoned by her prostitute mother. The other one was 6-months old and had been abandoned by her mentally disabled mother.  We picked up the first child on Thursday and it turns out she had turned one-year old on August 5^th.  She has not had any vaccinations since her hospital birth and is severely malnourished and developmentally delayed.  We will get the 6-month old next week when the Court Order is complete.  The very next day I received an email about a 5-month old and an 18-month old child whose mother had just died, whose father was a “foreigner” and unable to care for them, with no family here to help.  He locks the two babies in his room all day, alone, with no food, no diaper changes, no supervision or love, while he goes out.  Could we help and take both children? 

I felt sick as I read that email.  Any time I get a call or message from a Social Welfare officer I have a moment of great joy that we can help another child in need, but then a moment of great sadness that another child needs help.  But this feeling in my stomach was different. I immediately remembered the vision of the wave coming over the mountain and I looked up and saw the very mountain that I had seen in my vision.

Project Canaan is a place of hope and is currently home to 64 babies (not including the three that will likely come this week).  But it is more than just a home – it is an ark of safety. As HIV/AIDS, Tuberculosis and the effects of Poverty wipe out this tiny nation, there is a remnant that is being saved.  These children are HIS children – children of the King of Kings, chosen for “such a time as this”.   For what purpose?  Only God knows. 

I am taking a day of rest today and then need to put on my “big girl panties” as I look to what next week has in store for those of us who are responsible for the children at Project Canaan.  I am weak, but He is strong and I am clinging to that truth right now.

Live from Swaziland … Come Lord Jesus.

Janine

36 children die in Swaziland Rotavirus outbreak

“A rotavirus outbreak that has affected some 3,000 people in Swaziland over the past three weeks has resulted in 36 fatalities, according to a Swazi Observer news report today.

Image/CDC

In an announcement by Prime Minister Sibusiso Dlamini, 3,042 cases of diarrhea due to rotavirus were treated in outpatient departments of hospitals countrywide. More than 500 children affected required hospitalization for their illness.

Dlamini assured the public that all treatment requirements for the management of the disease have been distributed to all facilities and health workers have been refreshed on case management and treatment guidelines. 

According to the US Centers for Disease Control and Prevention (CDC), rotavirus disease is most common in infants and young children, but adults and older children can also become infected with rotavirus. It is responsible for the death of over 600,000 children annually worldwide. Once a person has been exposed to rotavirus, it takes about 2 days for symptoms to appear.” http://outbreaknewstoday.com/thirty-six-deaths-reported-in-swaziland-rotavirus-outbreak-41120/

Rotavirus hit the El Roi Baby Home too and it took its toll on three of our babies (Elisha, Seth and Roy).  For more than a week there was good news and bad news.  The good news was that earlier this year we were able to purchase vaccines against Rotavirus and vaccinate all of our babies between ages 2-4 months and NONE of those babies got sick.  The bad news is that not all of our babies come to us before 4-months of age and many others were past that age when we were able to buy the vaccines so that is why several got sick. Elisha and Seth recovered quickly as Brooke and her team of amazing Aunties focused on rehydration.  The bad news was that Roy was really sick (vomiting and diarrhea for more than a week) and just didn’t seem to be getting better.  On Friday I got a call that he had turned the corner to health and was doing so much better.  We dodged a bullet AND did it at our new infirmary (quarantine building) at the Children’s Campus while not incurring any costs from having to have our babies in the private hospital in town.

We give thanks to El Rofi (the God who heals) for healing all our babies. 

Live from Swaziland … we are doing a lot of extra hand washing.

Janine