Now that I'm home, I can blog about our trip. Thank you Heather for letting me copy your blogspot in the meantime! Now sit back, relax, and prepare yourself for a very long and wordy blogpost...
Heather and me in Albania: 2008
Some history about why we went to Albania.
Gypsy's are a colorful, mystical people that have spread themselves throughout Europe. There are two types of Gypsy's: Egyptian Gypsy's (from Egypt) and Roma Gypsy's (from India). All Gypsy's in Albania are discriminated against. We specifically worked with the Roma Gypsy's.
Roma people in general are very discreminated against. Most aren't allowed to go to school, get healthcare, or find jobs. Mostly because the Romas themselves as a general rule don't conform to the Albanian culture. Even during communism they were pretty much left alone. However, those Romas that have adopted the Albanian way of life fit in a little better and are able to get education and some healthcare.
Megan Mays (see picture below) has done and incredible job pulling together a school for Roma girls of Berat. These girls come from a Roma tribe that faces extreme discrimination. They live on the town dump (literally) in little shacks that I wouldn't let my dog stay in. Even when on the verge of death, they cannot receive healthcare at the local hospital. The girls have an especially hard life as not only do they face Albanian prejudice, but their own culture discriminates against women. Many times baby girls are abandoned by their parents because they wanted a boy.
At this school, Megan is helping these girls develop skills that will allow them to be more accepted and hopefully allow them to find work. At this school she teaches them to brush their teeth, wash their hair, read, write, eat healthfully, etc. She has organized this entire project on her own with the help of other teenage friends in the USA. She has raised her own funds and pays the rent for the school and other supplies for books, food, clothes, medicine, etc. She is only 17 and was 15 when she started the project. She loves the Romas and wants to work with them the rest of her life. Her 12 y/o sister also helps with the project.
We went out to provide basic health care and help Megan start a small clinic which will allow her to treat some of the more common diseases. Most of these children had NEVER had a physical exam. None of them have EVER received immunizations (which unfortunately we weren't able to bring at this visit).
Picture of Megan
Day 1:
I Leave Sacramento and arrive in Munich. This is a picture of me in the Sacramento airport. Notice the big coat, it was NOT cold in Sacramento, I was roasting!
I meet Heather in Munich, Germany and we transfer planes to Tirana. Below is a picture of Heather in the Munich airport beside our terminal.
We finally arrived in Tirana (the only airport in Albania) on Monday morning around 11:30. We'd been traveling for over 20 hours.
We took this jeep (we nicknamed it MT for missionary truck for reasons you will discover) to Berat. Berat is 70 Km from Tirana but the trip took us over 2 hours. The roads were terrible: people, sheep, donkeys, trucks, and cars all fighting over a two lain road. It's crazy these people turn a two lain road into a four lane highway by 1) driving on the wrong side of the road into oncoming traffic, 2) driving on the outside of the white line, and 3) driving on the sidewalk to pass the people already driving on the outside of the white line. Do you get the picture? It was absolutely crazy!
Berat is a beautiful city in the Southern Portion of Albania. Here is a picture of the city taken from the oldest inhabited castle in Europe which is on a bluff overlooking the city.
We hit the sack early that evening and slept almost 12 hours!
Day 2:
We tour the school and meet the children. We will be holding clinic the next day. Below is a picture of the front of the school. This school is actually a house that Megan rents. It has four rooms and one bathroom. She uses two rooms as classrooms and one room as the kitchen/clinic. After every school session, she must mop the entire building as the kids are SOOO dirty!
Here's a picture of the classroom for older children.
These children are taught by a wonderful Albanian teacher who donates his time (and risks his reputation) to teach these children. He's truly a hero because he faces severe discrimination for helping these children.
Megan picks up all the children in the MT (see pictured above). It is not safe for the girls to walk by themselves to the school Believe it or not, she stuffs up to 30 children in this vehicle! She is actively raising money for a larger truck! If you would like to donate, let me know.
Here's some of the children. I don't know if you can tell, but they are dressed in old clothes they fished out of the dump. They are quite malnourished, although you may not be able to tell. Most of them are the size of 5-6 y/o children but they are actually 8-10 y/o. They live on candy, white bread, and occasional meat. Since coming to school, however, they have started eating better and gaining some weight. Megan feeds them a nutritious meal before they leave.
After we dropped all the children off, we were asked by a parent to make a house call. The child we visted was a poor crippled lad who had been very ill for two weeks: unable to eat, terrible cough, and losing weight. When we saw him, he looked on the verge of shock: febrile, tachycardic, tachypnic, poor skin turgor. He had vertially no air exchange. If he'd been in the states, he'd have been admited to PICU. But there's no PICU even for Albanians (see story about hospital visit later).
So we gave him oral rehydration fluid, started him on antibiotics and antiparasitics (parasitic pneumonia is extremely common there), and prayed and prayed and prayed. To complicate matters, this child was the grandson of the witch doctor (yes, a real live witch doctor) and if he didn't get better, we would be blamed.
Below is a picture of the child. Please note, his shack is about the size of my guest bedroom (10ft by 10ft) and it contained at least 9 people all stretched out on the floor. Also note the large speaker phone which is next to a TV (not pictured). Despite extreme poverty, they can afford a television???
And thus ends day 2.
Day 3: The Clinic
We spent all morning preparing for clinic: setting up, buying ceftriaxone and pcn injections, and preparing the clinic to handle all the people. Local peace corp volunteers came to help translate. By 2:30 we were ready to start seeing patients.
Below is a picture of Heather and me in our white coats. Ready to see patients:
Here's a picture of the clinic closet with all our medicines.
And here's a picture of my skirt (Roma's require women to wear skirts, and since we didn't want to offend anyone, we also wore skirts). It was cold, so I wore pants underneath. I'd not be caught dead in this contraption state-side.
Here's some pics of the clinic. We took lots of pics, but unfortunately the camera that took the pics went to Greece prior to our leaving (long complicated story) and so we don't have those pictures yet. Hopefully they'll be coming soon...
We saw over 50 girls (including several grandmas and mothers). Every mouth had gaping horific looking cavities. Many eye problems (mostly esotropia with consequent vision impairment). Also saw several interesting rashes. Everyone had headaches and stomaches ache. The women had various OB complaints that I won't detail here, suffice to say I wished that my OB rotation wasn't over 3 years ago... All the children were malnourished (stunted height and low weight to height). We saw otitis media, pylonephritis, tonsilitis, and all sorts of other itises. We gave liberal doses of ceftriaxone IM since many of them cannot reliably finish an antibiotic course. Everyone got a MVI and many of them got Tylenol packs for aching teeth (best we could do without a dentist). I felt very helpless at times. They needed so much and we could offer so little. I wish I had brought immunizations. I thought we could procure them in Albania. Unforutnately, Romas are not considered worth enough by the government to provide immunizations for them. I'll have to bring them with me next time I come. And we only saw the tip of the iceburg we didn't see any of the boys, men, old men, women, or old women. We just didn't have time.
Thus almost ended day 3, before it ended, we revisted our ill child. He looked MUCH better: sitting up, eating, and able to hobble about. We gave him more oral rehydration solution and more Abx (in all we hand delivered 14 doses of Abx over a period of 7 days as we didn't trust his grandmother to administer the medicine).
Day 4: Visit to Tirana
Today we visited Tirana. We hoped to visit the ADRA clinic to see about arranging for them to sponsor a team next year (more about that later). Unfortunately, the office was closed. Instead we ended up touring a history museum, nearby touristy town, and a bunker (there are over 50,000 bunkers in albania). The town is splashed with apartments of every shape and color. During communism, the people were not allowed to paint their houses any color but gray. After it fell in 1992, the people went crazy. You see neon green houses next to red houses next to aparments painted in red, orange, purple, green, blue, and yellow stripes. It truly is a colorful town.
Here's a few pics from the day.
Imitation McDonalds
Begger boy
Here is an interesting purple houses. It actually is a home for a family threatened by the avenger of blood. I don't know their name, call them the family of Joe. Joe insulted Terry. Now, Terry's family is obligated to kill someone from Joe's family to preserve Terry's family honor. Terry's avenger of blood (the person who will kill a family member of Joe or Joe himself) is not allowed to kill Joe's family inside Joe's house. Thus they wait outside the house. Children are growing up in this house having never been outside. People bring them food and water. The avenger of blood from Terry's family is waiting outside and has been for years for someone to step outside the house so he can shoot and kill him/her). Once a person from Joe's famil is killed, then Joe's family has to kill someone from Terry's family and Terry's entire family goes into hiding. It's a crazy complicated system but really truly is in existance. I'm told there are hundreds of families currently locked up in their homes like this. 
Here's a picture of a Tirana Gypsy hut (one of the nicer ones)
Here's a local butcher shop (many foreign tourists become vegetarian after seeing Albanian butcher shops!)
That concludes the highlights from Day 4.
Day 5:
We spent most of the morning working on random projects. In the afternoon, we did house calls to the local village. Again, saw all sorts of different maladies. What follows are pics from the day.
Here's a tear jerker.
We passed this doll while walking to the village.
This little girl found the doll, picked it up, hugged it, and started loving it. This is the same girl 3 days later, still caring for her only toy, this doll.
The witch doctor with her grandson, who is much better (praise the Lord!)
Also saw twin baby girls. Last year, Megan found abandoned twin girls. She then discovered that twins in general are bad luck, twin baby girls are REALLY bad luck. Megan has done extensive education with the mothers, they now look on twins as a double blessing. This mother was very excited to show off her babies to us. Notice the house these baby's are living in (inside and out pictured below) This house is home sweet home to at least 15 people.
More pics of some of the village kids. Aren't they adorable?
Another village baby
This is grandma, who is a more well to do Roma. However, she still is unable to access healthcare and so came to our clinic with an OB complaint (not detailed here). We treated her as best we could with our limited OB experience (and knowledge). She was so greatful and kept kissing us and hugging us again and again.
Severe case of likely Tinea Capitus (any other suggestions?)
Day 6:
We were very happy for Sabbath! We drove to Valore, which is on the coastline of Albania (the Adriatic sea forms Albania's Western border). We attended church and church potluck which consisted of a mix of Albanian and American dishes. Very good. After church, we drove to the coastline and visted a tiny Greek Orthodox church perched on a hill amidst a fertile valley.. This this valley had the sea to the West, an imposing mountain chain to the East, while it's north and south borders consisted of gently rolling hills. There were several flocks of sheep grazing on the nearby hillside. The only sounds one could hear were the gently blowing wind, soft tinkle tinkle of sheep bells and baaing of the sheep. It's a place I will treasure in my memory bank as long as I live.
Day 7:
We took the morning of day 7 to tour the oldest inhabited castle of Europe. It perches on a mountain overlooking Berat. In the afternoon, we did more house calls.
Picture of the castle.
House calls (pictures of the village)
Day 8:
We spent the morning touring the local regional hospital. Wow. They have absolutely nothing! They have ONE EKG machine for the entire hospital. NO monitors (the OR doesn't even have monitors for those under anesthesia!). The PICU has only wall oxygen, nothing else! They don't even have medicines (the patients have to get their own at the local pharmacy). People smoke in the hallways and rooms. They took us to the OR and insisted we walk into the OR rooms so we could see the equipment (we had no masks, gloves, hats, etc). One of the surgeons emerged from an OR suite with his white coat, stethascope and NO gloves, a patient was layed out on the table clearly anesthatized having just undergone an operation (no monitors were on the patient and there was no anesthesia drape!). Oh, and there's no ventilators in the entire hospital EXCEPT for the OR. Well, they actually have ONE pediatric ventilator but they don't know how to use it. Here's some photos, just in case you don't believe me!
The one and only EKG machine (located in the ED)
The lab
Table for gyn procedyres
NICU
OR suite (notice the high tech anesthesia machine WITHOUT any monitors!)
Hospital laundry
This is the PICU (I'm not kidding either!)
In the afternoon, we had school for the girls and again did visits to the village. Please see previous pictures as I kind of got tired of taking pictures at this point...
Day 8
On day 8 we visited another Roma community about 15-20 minutes from Berat. A British missionary, Esther, has been working with this village for 7 years. This village is much more educated with some of the people having completed collage. They still face discrimination, but not to the same extent. Esther is a dear and has completely devoted her entire life to the Romas. She actually married a Roma man and they have two daughters. She and her husband plan to live and die with the Roma people. I count her among the most dedicated Christian missionaries I know. She has done much to benefit this village. She started a school, she also has special classes just for women. At this village we did lots of house calls. We saw young people, old people, and kids. The older people had joint pains, stomach pains, and congestive heart failure. One poor old man I'm quite sure has liver cancer (an ultrasound report shows calcified masses in his liver) but the doctor's won't tell him he has cancer because that wouldn't be appropriate in his culture. Among the diseases we saw: epilepsy, degenerative genetic disorder of some sort (two sisters born normal now unable to move but still seem cognitively with it, they have an older brother who died of similar condition), asthma, allergies, and fungal skin infections. Because one of the patient's wasn't home, I was asked to come back in the evening after we'd left. I rode back on this cool little motorcycle with Sean Mays. It was really fun!!!!
Here's some pics of our day.
This is a picture of one of the children with the degenerative (I'm quite sure) genetic disorder. Unfortunately, I had no way of testing to find out what she actually has. The mother is a Christian and takes very good care of these children (if she weren't a Christian, they would have been left to die).
This lady had CHF. She kept hugging me and kissing me and thanking me for examining her.
This dear old lady fell in love with us. This is a picture of Heather with her.
This older gentleman had high blood pressure. It was already being treated appropriately. All I did was tell him to keep taking his medicine.
Here's Heather and one of the baby's we saw. There were chicken droppings all over the floor of this baby's living room.
Outside one of the homes, this child is cooking dinner
Me on the motorcycle (aside: dad, I did actually push the helmet over my forehead better, it was just after the picture was taken)
Thus concluded our clinic days. It was so sad to see the last patient and know we would be leaving them and they won't see another doctor until...we return...next year... I'm trying to pull together a team of dentists, OB, derm, and FP or Internal medicine to bring back next year and hold traveling clinics for the villages. We only went to two villages and there are hundreds. If you are interested in volunteering, please e-mail me at rachelannnelson@gmail.com. I'm working with the local ADRA presence to arrange all the logistics. I've also talked with the local hospital and they are very supportive. An albanian physican has already agreed to provide legal coverage.
Day 9
This day is a sad day, we have to leave. I was sad, Heather was sad. It was cloudy, cold, and windy (I think the weather was sad as well). We said goodbye, loaded up for one last time in the MT, and drove to Tirana.
In Tirana we boarded a plane for Munich. Or that's what we thought. We actually landed in a city for a connecting flight. After getting off the plane, heather and I realized we had no idea what city or what country we had landed in. It's a kind of disconcerting feeling for a well educated doctor and nurse to have no idea where they are geographically. It's a slight predicament because you don't want to just ask somebody "hey, where are we?" because that would look, well rather stupid. Unforutnately, we couldn't read the language of the country, so that didn't help. We finally had the brillian idea of looking at our tickets (amazing what sleep deprived brains won't think of first) which of course solved the problem immediately.
We finally arrived in Munich and found our hostel, sleep felt good.
Day 10: Heidelburg castle
We took the train to Heidelburg. Heather and I slept the entire way. Germany looks like TN anyway so I don't feel like we missed much. The castle was impressive, as all castles are. Can't say too much about it. We also toured a cathedral. That night we took the overnight train to Vienna. We rode 2nd class. Rather uncomfortable: lights on all night, seats don't really stretch out and face each other, people getting on and off. We sort of slept. If you want pictures, google Heidelburg castle under google images, I'm too lazy too add my own pictures (I did take some, and if you REALLY want to see them, come and visit me).
Day 11: Vienna
I love Vienna. It's a beautiful city. We arrived at 6 am. Dropped our stuff off at the hostel lobby and toured the city. Saw three cathedrals, two palaces, and all sorts of old looking buidlings. We took all sorts of pictures which I won't include here. Just google Vienna and you'll see pictures of much higher quality than mine. Prior to sunset, we bought zoo tickets so we could tour the zoo on Sabbath afternoon. It's the oldest zoo in the world. We spent the night at a really nice hostel on the 10th floor of an old, old building.
Day 12: Vienna
We attended the English speaking SDA church on Sabbath. Great youth group (I mean really great youth group), great pastor, good music, really friendly people. After church we made our way to the Vienna zoo. Had some difficulty finding it, but did at last succeed in locating it. Really great zoo. After the zoo, we toured the local gardens. After sundown, we went out to eat at this really great Asian restaurant called Mr. Lee. They have wonderful tofu. If you are ever in Vienna, you have to go to Mr. Lee. It's located on Dr. K Lueger Ring right across from the Schottentor subway station. Take the U2 subway to the Shottentor station to get there. That night we took the train back to Munich.
Day 13: Munich and home
We arrived in Munich at 6:15, Heather's plane was to leave at 8:55. Unfortunately, we got on a subway going away from the airport instead of toward the airport. We didn't figure out our mistake until we had already left Munich and were headed to who knows where. We immediately got off the subway at a random station where we waited all by ourselves for 30 minutes for a subway going the opposite directions (the subway personal are on strike right now, so subways are few and far between). By now it's 7:20. It takes the subway almost an hour to get back to the airport. We arrived at 8:10. By the time we get off the subway and make it to the correct check in point it's 8:24. Heather races to the counter and they allow her to check in. We then RACE to the gate and get there at 8:44, just as they page over the intercalm "would passenger Heather Stearman please come to gate G13 for immediate departure." She barely made it.
My plane left 2 hours later. After a very long flight, very long wait in customs line, and another long flight I finally made it home.
It's good to be home, but I really miss Albania. Those children kept a part of my heart. I will never be the same again. Touring Europe was OK, but I wish I could have spent the entire time with those children in Albania. It just didn't seem fair for me to spend money on touring when this little girl didn't even have money for a simple doll. I miss those children terribly.
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-love, Jennifer