More goodbyes

We have achieved another milestone—our replacements have arrived! We were so excited to see them walk off the plane last week. It brought back memories of that day, so many months ago, when we stumbled onto the tarmac at Bagram, suffering from jetlag but excited to get started with our mission. They have stars in their eyes, eager to implement their ideas and do things their way. I believe our time has been too short, but one benefit is the infusion of fresh blood that re-energizes the mission every nine months.

I have spent the last few days saying more goodbyes. We visited the providers at both the provincial and district hospitals, and thanked them for all the hard work they are doing. It was especially hard to say goodbye to the hospital administrator at the district hospital. He has done an amazing job implementing our Strong Food program for malnourished children, and I wish so much I had a chance to do more with him and his staff. This is us, in front of the administration building at the hospital:

Then, tonight, the rest of our security-forces platoon headed to Bagram for their redeployment. Due to our "hodge-podge" of Air Force and Army members, we have been forced to leave the country at different times, something we had hoped to avoid. We had looked forward to sharing that first cold beer together in Germany on our way home. Much like the last time, we had to say goodbye to our constant protectors. I did get a little teary. These men have taught me much, both about myself and "soldiering," things I could never have imagined needing to know (and, before this, never wanting to know). I respect them immensely and look forward to our paths crossing again.

But, I think I am getting better at this goodbye thing. This time, as they drove away, I didn't cry nearly as hard and I have yet to shed one tear as I write this. Just think, by the time I say goodbye to everyone else at Bagram, it will be "old hat" and I can just smile at the memories as I walk onto the plane! My tears will become the happy kind as I approach home and see those two little humans (and a bunch of big ones, too) waiting there for me!

Lori

For Reflections on Nursing Leadership, published by the Honor Society of Nursing, Sigma Theta Tau International.

A cold, dreary day in Afghanistan

I want so much to post something new and exciting but the blogger muse seems to have left me. It is a cold, dreary day here in Afghanistan, better suited for a warm fire, good book and a bottomless cup of coffee. But, the mission goes on—a little like the postal service!

Since I last wrote, so much has happened. We have all relocated to our base up in the province and are well established here. It was tough at first. Initially, we had just a French dining hall, and the food was very different. I was given the choice of liver or tongue one night, and frog legs were on the menu another night. At least, there is always good cheese, and that makes it worth the walk. We now have three American cooks, so mealtime is looking much better.

Our living accommodations are not bad. We live in tents but, honestly, I like my space here better than what I had at Bagram. It is brighter and is more pleasant. Not that I spend much time there; we work 14- to 16-hour days most of the time.

Our main focus right now is getting ready for our replacement's arrival in a month. We are working hard to make their orientation to the job and the province as smooth as possible. The more work we do now, the easier it will be once they arrive. Our goal is to get on the plane knowing they can do missions the next day, and that will take lots of effort on all our parts.

I did sneak out of the office over the weekend to deliver more supplies for our Strong Food program. In case you don't remember, that is a pediatric supplement for malnutrition. It's made from almonds, sugar, dried milk, oil and vitamins. I so enjoy the time we spend out with the medical providers. They are excited to show us the progress they are making, the success they are seeing. So far, we have served this supplement to more than 800 children in our province, and we have another six months of supplies ready to go.

The medical director was excited to show us some "new" equipment he had received. Apparently, an organization had donated dialysis machines, an OR anesthesia machine, several fetal non-stress test monitors and a pediatric ventilator. The staff has no idea how to use any of it. It underscores one of the issues here. People want so much to help but, often, what happens is not what the Afghans need. This facility doesn't need fancy machines, but more trained staff, medicines to treat the people and opportunities to teach disease prevention with improved sanitation and clean water. That is the challenge for my replacement—how to get those basic things accomplished.

In all honesty, the nine months we are here is almost too short; we are just getting comfortable with where we want to go next, and it is time to leave. But, our families are ready to see us and we miss the "real" world. I will keep you posted on our transition back to it over these next two months.

Lori

For Reflections on Nursing Leadership, published by the Honor Society of Nursing, Sigma Theta Tau International.

Strong food, strong babies

A month ago, we initiated a children's malnourishment program at one of the hospitals in our province. I did a long story on it, but was never able to post due to connectivity issues. The program is called "Strong Food" and is intended to bring severely malnourished children to a point where they regain their appetite and are able to eat regular food again. The food is a paste-like mixture of ground almonds, dried milk, sugar, oil and vitamins. It has a very stable shelf life and actually does taste pretty good.

A month ago, we spent two days training medical staff at one of the two hospitals in the province. It was a great time. We felt a connection with the staff and it appeared that they were really taking in the information and developing a plan to administer the program. We spent the first day teaching about malnourishment, how to mix the food and how to select the children for the program. The second day was spent screening more than 50 children by taking height/weight measurements. Seventeen children were selected. We then left the staff with a month's worth of raw materials, mixing directions and my phone number.

I was pleasantly surprised when we rolled back in there yesterday. In the preceding month, a total of 75 children had been given the supplement, and I had asked if a few could come so I could see them. Ten children were present who had benefited from the program. What's more, there was raw material left over. Corruption is rampant in this nation and I fully expected to find all the supplies gone and no children to evaluate.

I am sure this program is benefiting someone besides the children but it wasn't obvious to us, which was good. Staff members were quite proud of the room they had designated for mixing and storing the food. It was very clean, and all the mixing tools we had brought a month earlier were still present. We left an additional month's worth of raw material and promised to return soon to further evaluate progress. I consider the staff's ability to manage this program so well during the last month a success and look forward to returning.

I head back to home base today—compliments of a helicopter! My postings will again become sporadic, but I will continue to be creative in submitting posts and hope to soon share the experience of my first helicopter ride.