Thursday, February 10, 2011

TFC



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When you first enter the property of Magbenteh Hospital, you notice a group of buildings to the left with a gazebo in the center. This is the Theraputic Feeding Center, or the TFC.   The TFC is a program that works with World Food, Unicef and the Minister of Health to deal  particularly with the problem of malnourishment.   In the last year or so the program has moved toward sending workers out to the villages to teach people how to deal with these issues, referring the more critical cases to Magbenteh for stabilization.  This is a good situation as many of the children who are severely malnourished have other medical issues which require a doctor's wisdom  The families stay in one of these buildings, in large rooms with plastic covered foam pads on the floor.  There is no privacy, no deluxe accomodations, no tray of food delivered three times a day.  But this is a dry, safe environment in which learning and hope dovetail. 
During intake, each person who comes to the TFC  receives malaria meds, de-worming, folic acid and antibiotics for stomach infection.  Some things are just so common that it makes sense to have a blanket response initially.... what's crazy is that these are the needs that are common.  Because it is not the rainy season, and because of the workers going to the villages, the numbers are down right now at the TFC. (malnutrition rises in the rainy season)  I think that is a yeah.... and yet there are still are too many big eyed, distended bellied little people living there.

Three times a week Musa records the weight of each child to make sure he/she is gaining.  This happens at 7:30 a.m.... when it is a brisk 65 degrees or so.  That  temperature is heavenly to a northerner who rues the approaching 90 degree day ahead, but these tykes have no natural insulation on their bodies, so the process is pretty uncomfortable for them.   The babies are stripped down, slipped into a vinyl 'seat hammock' (brrrrr) which is hung on a scale.  This is not a happy time at the TFC, especially when some ghosty white woman shows up clicking pictures their indignant morning.  (Some kids really are scared of our white skin and think we are ghosts.)  

 
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weigh in time
In addition to the Feeding Center, there is a day clinic where women can come for a check up on their baby, or help with a cold or other ailments.  I happened to be in the waiting room one morning when the medical staff (a nurse?) came out to instruct them on hand washing, but first lead the group in the Lord's Prayer.  
thank you, Dale Linton
Muhamud Suaree, the director of the TFC was kind enough to show me around and answer my questions.  He introduced me to a staff person, Fatmata Cici, who works with Family Planning.  Dr. Moosavi was a blessing to them with her collection of birth control. I also met a woman whose job is to work with the mothers and children together to learn to play.  Every afternoon she would lead in a game (we learned to play musical chairs) and open the play room for the kids to play with toys, and the mothers to drum and sing together.  Dale Linton, a Saint Louis, MI man generously gifted me with 20 little wooden vehicles  to share with the kids.  Many of them ended up at TFC.  

beautiful, colorful laundry
The TFC is where Mallory and Kendall learned how to 'strap' the babies on their backs, African style.  "So me bambah" is what they were taught to say.  This action, so natural to even the smallest  African girl, was an amusing show for the moms.  Balloons were a happy event as well....for the short duration of their lives.  We blew them up and tossed them around, then worried about the little pieces that could be swallowed when they popped.  These events were happy diversions from day to day living where life still demands laundry and cooking over an open fire even in their added stresses. Finding health is a long, slow process that requires patience and certainly, in such poverty, the help of those who already have it.

"so me bambah"
K"ariatu






Abu










Thursday, January 27, 2011

MORE OUTREACH....CRAZY


Crazy poster in Yele
More Out Reach…. Crazy

On day two of the Out Reach, Stephanie said that it would be helpful to know the ages of the patients and Abraham and I decided we would make that a part of our job.  The first woman I asked (having had to guess the spelling of the name since she didn’t know) looked about 45 or so.  “how old are you?”  I asked and Abraham interpreted.  She said something, he responded, she said more, so did he.  They were having a regular conversation and I was wondering just how the number system worked  here.  Then the lady walked over to the door which Ron had commanded shut because people kept sneaking in and stealing a spot, and opened it and yelled out.  I asked Abraham, “what is she doing??? All I wanted was to know how old she is!!”.  “Oh, she’s asking her family.  She doesn’t know.”  He said this in a matter of fact way, so I realized this is a common occurrence.  She was born in the year of the Big Rain, was her final answer.  I wrote down 45.  Another lady who had to be 60 answered the age question confidently with “age:32” to which I replied, “and so am I sister, so am I.”  Crazy.
Abraham registers patients with help of Kariatu, (pink)
my old reading glasses on a "32" yr old
Here’s a thing about Out Reach that you must know.  Taking temperatures is really not a big deal…usually.  We had digital thermometers that we used under armpits instead of mouths, so once we had a name and complaints, I’d move in for the temperature.  Babies, having never been so close to such a white person (and getting whiter in that dark, unlit building day after day)  thought we were ghosts, and they would often cry.  Adults, trying to be helpful would just whip up their shirts right as I was leaning in to get the device in place.  I would’ve sworn some folks had a gland that sprayed pit odor right at me.  Then, women of any age or shape would just stand there all exposed until the ‘beep beep beep’ of the thermometer would give them leave to pull their shirt down.  All I could do is laugh at my own inhibitions, and move on to the next crazy adventure in registration.  Also, I vote for ear thermometers for next visit. 

The Paramount Chief....Yele
Ideally we wanted to leave Makeni at 8 each day of the Out Reach, but 9:30 seemed to be our calling.  That means we’d arrive around 11, set up and get on with the day.  We packed Fiber One bars and such for lunch, and I realized that even that was bonus living.  Abraham, Shaq (Stephanie’s nickname for O’neil) and Abdul just went with us.  They didn’t pack a stash of food and water, they just were there.  These three young men have our hearts for all their cheerfulness, kindness and service.  Not to mention some mean games of SPOONs. 
squatty potty
The Paramount Chief (like the governor of village chiefs in that region) lived in Yele and had someone bring in rice (of course) and some spicy sauce which a taste told me was hot and yummy, but probably not the best choice for me to eat.  He was grateful that we came to serve his people and we were grateful for his hospitality.  It’s nice when a plan comes together.  And we were always bummed at 4:00 when we knew we had to see the last 10 or 15 people because we had to pack up and be back to the hospital by 6:30 because none of us wanted to ride in the dark.  One dilemma was whether we could wait to go to the bathroom upon our return (and if the answer was yes, we surely weren’t drinking enough water) because our option was the “squatty potty”.  Yup, they had to padlock the door shut to this deluxe unit.  Etiquette said that we should take a teapot of water in to rinse the floor after we were done.  At least the girls did.  Guys always have it easier in these situations.  
First customers. 

waiting
Early on, one lady came in with a child. (in the pink turban above) She had typical symptoms, and had some concerns for her child.  Never once did she mention the huge tumor that was growing in her face. 
knee man
With hundreds waiting outside, Ron would open the door and let in ten people at a time.  Now that meant 10 adults, and usually there were multiple children with them.  I think after a while moms would start sending in their kids with someone else just so they could be seen.  When the door would open there would be a roar of noise, people pressing to the front, desperate to get in, because to get in meant help.  We tried a number system, but that was not successful after a short time.  I laughed once to look up and see Ron trying to get the doors shut as people pressed in, and a little woman crawled through his legs like a runner making it to home plate.  Ron was bellowing, “A little help here!!!”  When the crowd started feeling more mobbish, I vascillated between aching for their desperation and irritation at their lack of regard for how we were trying to get them in as best we could.  It’s a psychotic thing to deal with these intense situations and I’m not entirely pleased with the rawness of my own reactions.  May God’s mercy cover us all. 

crazy knee (before draining)
We couldn't see them all.  But we tried.
One young man came in with a massively swollen knee.  Mike Karr got to pull off like a liter of fluid, and it still look giant.  Mike also got to stitch up a lip and do all kinds of things EMT’s don’t normally do.  Abraham, my interpreter, eventually started registering people on his own.  Every now and then I’d pass the hand sanitizer and smile.  He loved helping this way, and a few times when I’d see him pulling down eyelids looking for signs of malaria,  I had to remind him that WE were not diagnosing.  What a hoot.  Meanwhile O’neil was in with Stephanie and Dean interpreting more than their comments… he was initiating health education.  In one situation Stephanie asked if the mother was still nursing the child.  To answer, the mother picked up her breast and gave it a squeeze.  Much to everyone’s surprise milk shot across the room and splatted O’neil’s cheek and shirt.  That time the loud noise was not from the crowd outside trying to get in, but from Steph, Dean and everyone in that room busting out laughing.  

Precious sick baby
We never got to see everyone that came and waited.  I got to walk around and see these folks, sitting, waiting, wanting.  Lots of happy children wanting me to “snap me”  (take their picture) then show them so they could immediately reminisce.  “aaaaaaAAAAhhhhhHHH” they laughed at every pose.  Love that sound.  Lots of bellies big, but not big with food.  Little herniated belly buttons, limp and dazed infants, fevered brows, hungry eyes all mixed in with white teeth, sparkling eyes and amused giggles.  It really is Crazy.

OUT REACH


Out Reach

Yele Out Reach Team and friends
I won’t lie… knowing that I would be with medically adept people on this trip to Africa soothed many of my fears.  As it turns out Kyle probably imported some version of the nasty flu which was going around Alma before we left, and he was relieved as well.  He had a rugged night and spent our ‘work’ first day in bed, thanking God for flush toilets, as some of us headed to Yele for a ‘ clinic’, and the other surgical types stayed at the hospital to work their magic.  Dr. Moosavi also shared a similar misery with Kyle but no one else got as sick as these two. 

The Out Reach Clinic was in Yele, home town of Drs. ABD and Turay.  To get there, African style, you must load the vehicle to capacity, then add 2 more people, drive on a decent paved road for about 30 minutes, get suckered into thinking ‘this isn’t so bad’, then turn right and begin an hour of pot-hole-hell.  One must choose between sitting in the middle on the hump, or on the outside risking brain damage from whacking the side window when the driver doesn’t brake soon enough and dips  half the car into the core of the earth.    Ron Woolsey actually got to drive one of the vehicles on day 1.  I was a little jealous and a little relieved because a) driving in a different country = COOL but b) aquiring the skills of honking the horn, shifting the gears, and dodging the humans all at the same time = nerve wracking. 
Ah' Poo Toe!!!!!!
One of the highlights on these trips was the response of the children of the villages we were passing.  They would spot our white faces and begin shouting “Ah’-poo-toe!!”  as they waved or started running along side our car.  Ah’-poo-toe is the phonetic spelling for “white person”.  There is no racial slur in this pronouncement, it is just a joyful observation that seemed an automatic response to our presence.  Even on the hospital grounds I would be walking along and hear little distant voices singing out, “ah’-poo-toe!” like background music.  I learned that I could respond “Oh-knee-bee” which meant “black person”, but it just didn’t carry the same pizzazz that those cute shouting babies had. 

on the way to Yele
 The homes we passed were made of block or thatch, just like in the pictures I’d seen. And the further we got from the city, the more we saw children just buck naked or women with only a wrap around their waists.  Breasts are really not the Hooters turn on duo as they are seen here in the states.  They are very functional parts of a beautiful body that is staying cool in the heat.  Nevertheless, my shirt did, and will, stay on. 
don't let that ghost touch me!
Hard work starts early
Kid Vitamins, once a day
working on "waist pain"
Kendall and Mallory at the pharmacy
Yele is a large city that looks like a poor rural town.  No paved streets, but it has a turn about in the center of an intersection of rutted dirt roads. Funny.  When we arrived there were some people waiting on the back porch of the clinic.  This is a building where people come to see a mid-wife, or a doctor who has been there 5 years.  If there were any medicines there couldn’t have been many.  We brought extra to leave for their use.  We set up a “pharmacy” in the corner by stacking wooden plank benches to create a barrier.  Kendall was our ‘pharmacist’ with the help of Abdul who could translate.  Abraham and I worked on ‘registering’ which means on a small piece of paper (we had ripped notebook paper into 6 sections….fancy), we wrote their names, temperature, and complaints.  I learned that in Krio you say, “Whey  you wahn?” (what you want) which seemed a bit  direct, but they answered in a fairly consistent way.  “Waist pain, cough, gastric pain, body aches, fever.”  I had never heard of “waist pain”, but Kariatu’ who was later my interpreter explained, “these are all things from the hard work they do to live”.  Waist pain is really their back hurting because they walk EVERYwhere, often carrying a load on their heads and a child on their back.  They haul water and pound rice and wash clothes in the river.  They have heart burn or ulcers from the stress of making a living, a cough from, among other things, the dirt and the dust that is everywhere, and they have fevers from the malaria that each of them will have multiple times in their lives.  The few that were waiting on the porch swelled to hundreds in a few minutes.  Dean Wilson and Stephanie Benn set up in one room to see patients and Mike Karr set up with Dr. Turay in another room.  Mallory was the blood pressure/pulse queen, and Ron was crowd control…a formidable job the later it got in the day.  We had basics to give them:  vitamins, malaria meds, Sudafed, ibuprofen, cough medicine but to them we had relief and for four days they came, they waited, they hoped that this group of ‘ah’-poo-toe’ would be able to soften the hardness of their lives, even for a little while. 
going home without being see at the Out Reach

Pomp and Dinner


POMP AND DINNER
Church on Sunday
Church had been on Saturday, so our Sunday seemed open.  Our group met in the church building that is right there on the hospital grounds.  We sang and shared favorite scriptures and were joined by a few African men who altered (and improved) the sound of our hymns.  What a beautiful serendipity, this impromptu international worship.  After that we started organizing and sorting our meds brought in the 13 tubs assigned to each of us.  Separating things to go on the outreach and pre-packaging pills, like vitamins and ibuprofen was tedious and necessary.  Surgical mesh and other supplies were set aside for the hospital.  At  some point in the afternoon a few boys came in with a note asking for financial help.  Not having even exchanged dollars made this impossible, so we played with them.  Frisbees, jump ropes, volleyballs, and balloons all came out.  Soon 50 or more children from the hospital, some patients, some family came and we played.  I am sad to report that my camera battery died, teaching me the importance of planning ahead when the generator is running.  But we had fun playing and getting to know a few people.  We had been on rounds Saturday and a few faces looked familiar.  I saw the parents of  a little boy who had been undergoing debridement of his necrotic leg tissue.  Ok, I’m not medical and I probably just spelled a bunch of stuff wrong, so I’ll just explain:  This little guy had received a shot in the leg, probably with a dirty needle from someone in the village—a witch doctor?—and the skin  had become infected and started rotting away.  In an effort to save him, the dead flesh had been removed regularly.  By the time we were there he pretty much had no left leg.  Every effort was being made on his behalf, and I was surprised to see his folks out with us.  Dr. Erdi predicted that the infection would spread and he would not make it…but she didn’t slack in her care of him.  Daily she hopes for miracles.  Why did I not write down his name??  I will never know him or hear his laugh.  He died Tuesday morning at 5 a.m.

Dinner at ABD's
Big Jeff and baby Jeff
Kumba and friends
Our playing with the kids made us late for a dinner Dr. ABD was hosting in our honor at his home.  Much rearranging had been done as a series of tables joined to overtake the front room where we could all eat together.  Several people had been invited to join us…people important to the cause of Magbenteh and grateful for our arrival.  Kumba, Dr. ABD’s wife and 2 friends put together a meal that was deluxe.  (One thing on the menu was a ‘scottish egg’ (I think)…a boiled egg, coated in some breading and fried.)  Before we ate speeches were made and thanks given for our arrival.  I was struck by the eloquence of  their words and the sense of importance their ceremony gave this dinner.  People were everywhere, sitting in the hallway, and many neighbors on the front porch looking in at us thru the windows.  We were a spectacle and the source of entertainment for the evening, but the informality of our setting was transcended by the elegance of our hosts.  How many of those people actually live at ABD’s home, I do not know.  At any given point there will be 15-35 people staying there.  Many are children who belong to his family…they send the kids there to stay so they can go to school. (His actual birthed children include Abdul, Daniel, Daniela and baby Jeff)  The sense of family is much more inclusive…. When someone says, “he’s my brother” what they mean is ‘we grew up together, we belong to one another’.  What they don’t necessarily mean is “we share at least one parent”.  It’s rather confusing, and kinda cool.  Makes me think about baby dedications when the parents commit to raising a child in this community of faith and the church commits to helping.  I think we need to step it up a bit, my brothers and sisters.  We have much to learn about being in community with one another.   
One person we met was Harold Fifer, a Swiss man who helped ABD start the hospital in 2004.  His commitment to the people of Sierra Leone and Magbenteh Hospital is intense.  He has worked tirelessly to secure finances and stay true to the dream of being a humanitarian presence in Makeni.  We also met Dr. Turay,  Sierra Leone’s former ambassador to Moscow.  He is a national raised in the same village as ABD (and SL’s current president) who, after 36 years of practicing medicine in Germany has “come home” to help his people.  He is the elfish little powerhouse of a man who hiked to out of the way places to find the neediest people to benefit from Dr. Smith’s surgical skills.  All in all, a humbling evening which inspired us to get ready for Monday, our first big day of work. 

Monday, January 24, 2011

Nor die for de poor





“NOR DIE FOR DE POOR”
 (A bumper sticker which is to be interpreted as “Folks shouldn’t be dying just because they’re poor”.  I definitely missed the meaning when I first read it)

A view of  part of Magbenteh (Physio unit on rt)
)
women's ward...w/mosquito nets
We finally arrived at our destination 53 hours after leaving.  Visiting the hospital in Lungi, spending the night and plain ole traveling takes a lot of time, right?  It was 4 p.m. by the time we laid our eyes on Mallory and Kendall, two college girls who came a week earlier.  We had to hustle to unload, settle in rooms and look around a bit because being this close to the equator means a fairly consistent 12 hour day…6:45 a.m. to 6:45 p.m.  A generator runs from 7 p.m. to 10 p.m. so we can have lights, the hospital can pump water into the holding tank and life can continue.  Middle of the night surgeries require the generator to come on as well.  It is not a flippant thing to use this energy as every drop of fuel cost must come from someplace in an already taut budget.  Part of our costs as a group include providing money for fuel for vehicles and generator, food and water for our group (there is a cook, David who was wonderful to us), and the cost of surgery for the patients we serve.  Fees for surgeries and hospital stays vary according to ability, a process which I don’t begin to comprehend, but I do know that each surgery we did costs about $200.oo which includes meds and however long a person stays—AND 2 pints of blood from someone, no matter the type, to stock the blood bank.  (I think this is a brilliant idea…is there a reason not to implement it here?)    While there are nurses aides in each ward (a large room with, say 20-30 beds, no dividers) each patient’s family is responsible to provide food and care for the patient (and themselves) while they are in the hospital.  There is no hospital cafeteria, no call button, no meal provided.   And, get this, the hernia’s that hang to the knee?  That’s elective surgery.  Acute, life threatening surgeries (ex: if the hernia strangulates) are provided by the hospital, no matter what, but if you’ve been hoisting around a growing 5 pound cyst for years,  it is elective to get it out as long as it behaves.  The limits of care are necessarily different in Sierra Leone than in the States.  When I say the need there is overwhelming, these are pieces of information that feed that statement. 
One surgery that became acute in the first hours of our visit involved a woman whose uterus ruptured during labor.  Dr. Moosavi was called and I, only ever at the head end of deliveries, tagged along, anxious to see my first baby being born.  The C section produced a gray baby that didn’t cry.  She had been dead for hours. This perfectly formed little human lay there with no breath, no spark.  And I had nothing to offer.  The mother was bleeding and I watched as the team worked creatively and quickly to save her life.  When the final stitches were done and Dr. Moosavi left, the mother was alive, but at some discreet moment, as I stood there observing people working hard to help this woman, she died too.  This is my first comprehension of how poverty isn’t just  hunger…poverty kills.  Had this woman come in earlier, not waited so very long until there was nothing that could be done to save her and her baby, not been intimidated by how to pay for medical care, she would be walking back home right now.  But she is dead, as is her child, and though I did not know her, I grieve her even as I type. 

Sunday, January 23, 2011

Back to the beginning



leaving Hotel Lungi


Back to the beginning….  Our trip to Sierra Leone began by meeting at the church parking lot at 4:00 A.m.  Considering I was up til 2 trying to do some final posts, it was a ridiculous beginning.  Mark Prout is a wonderful human being and driver who served us generously by driving us there and promising to return for us (there’s something escatological sounding in this set up).  After unloading all of us and our luggage at United, we discovered our flight was cancelled.  Reload…go to a different terminal…unload.  After that exciting start, Mark left the bus on the curb for a few minutes, and can now testify that A) airport security does NOT appreciate empty vehicles left unattended for any amount of time, and  B) they are lightning fast at wenching up said vehicle to a wrecker for towing.  I took copious notes on the various delays and cancellations which followed us into the next day, but I’ll summarize by saying that we were detained in D.C. due to a suspicious looking package, concerned that we’d miss our flight in Brussels, which ended up being cancelled anyhow and totally skipped a segment to Dakar as they rerouted us directly to S.L. 
Steph and Dawn in Hotel Lungi

Although my ticket said we were flying to Freetown, the airport is actually in Lungi which is across the bay (river/inlet…some big body of water) from Freetown.  We unloaded on the tarmac and immediately felt the humidity and heat.  Dr. ABD met us  and he, Dr. Smith and Ron took our passports and went to collect our luggage as the rest of us waited in a “VIP” lounge which was a slightly air conditioned room away from the chaos of the crowd of passengers trying to negotiate customs without the aid of someone like ABD.  Those who were here last year raved about the beauty of this deluxe treatment compared to last year.  We loaded vans and trucks in the dark (no street lights in the dirt parking lot we were in) using our trusty flashlights to try to distinguish between who was with us, who was helping us and who was just hanging out trying to get a tip from the stupid Americans.  The truck with most of our luggage (each of us took a big tote full of medical supplies as 1 piece in addition to a suitcase for our own belongings) was stack higher than the cab, and one guy spidermanned himself somehow on the side ‘securing’ our things as we drove a few blocks to our hotel.  In context, it was a nice place, though appreciation for Super 8 might have increased among us that night.  The bar right across the road was rocking some tunes just this side of the sound barrier until about 4 in the morning.  All my journal says is “I wonder how long the bar will be open”, and I want to clarify that it is because of the loud factor, not any plan to go drinking.  

Ferry Friends
pic of a blanket at Mahera Hospital
Saturday morning we awoke, ate breakfast and loaded up.  We visited Mahera Hospital in Lungi which is overseen by Hassan, ABD’s brother.  Of course our surgeons were consulted on some cases and Dr. Moosavi recruited a surgical patient for Magbenteh before we even arrived there!!!  Back into the autos and we headed toward our ferry ride, then a two hour ride (decent paved road) to Makeni where Magbenteh Hospital is located. My first lessons in Time and Krio—languages spoken in S.L.—came from Ali, Saidu, Foday, and Santigie, 4 adorable boys who ride the ferry daily in order to sell things to make money for going to school.  Already I love these kids.    

Friday, January 21, 2011

Begin with the end in mind

The loaded ferry from Lungi to Freetown
4a.m. group on the go

I must confess that sometimes when I am reading a book with some suspense, I skip to the last few pages to make sure everything turns out ok.  Alas, it is true with this whole blogging attempt with Virtual Africa that my reports begin at the end.  We tried for 5 days just to get enough download ability to send an email….getting on the blog to keep you posted in the moment was just not going to happen where we were.  
It has been said, “Begin with the end in mind” as a way to encourage people to live toward a worthy goal in life.  Allow me to begin this journey with the end in mind, and reported, before I go back and try to draw you through the experiences of our African Journey.  

From the time we got into the van at Magbenteh Hospital in Makeni, Sierra Leone, until the time we stepped out of the van at First Church of God, Alma, MI, forty (40) hours had elapsed.  From heat in the 90 degrees to cold in the barely 0 we traveled in car, on ferry and aboard planes.  In the entire trip one out of eight flights departed on time.  A few were completely cancelled, and yet in coming and going we were only about an hour late each way.  Amazing.  To begin our journey home we managed checking in at the Lungi airport after having lunch at Hassan’s home (Dr. ABD’s brother who is in charge of the hospital in Lungi. We ate kasava leaves in rice with a spicy fish sauce.  I’m probably not going to be making this any time soon.)   It is a sure thing that Dr. ABD’s influence eased our path through customs once again.  The man is a rock star, as Jeff Smith has christened him.  Of course, our being brought to the front of the line was not appreciated by those who were there, and one woman was intimidatingly vocal about it.  Dr. Turay (you will meet him later) talked to her to apologize and say, ‘these people have been here at their own expense to help our people and though I understand your frustration, this is something we can do for them to express our appreciation.’  We were glad to see her accept this as we shared the next long flight with her.  That flight boarded two hours late, and then sat on the tarmac for another 3 hours.  5 hours and still in Sierra Leone.  We heard later that they were minutes from cancelling the flight (the second engine was having trouble with reverse), which would’ve been traumatic as these flights leave only every other day, and we were all ready to be home.  Once we finally left, we were to stop in Dakar to fuel, then on to Brussels.  In Brussels the gate changed 3 times before we finally boarded for Chicago where de-icing delayed us, but, YEAH, got us to Detroit where the wonderful Mark Prout and Dave Martin picked us up in the church vans.  Delirium hit around St. John’s, and I’m pretty sure my brain is still riding some luggage carousel in another hemisphere, but we’re home and glad for it, snow and all.