A last look out my window

Well, this isn't exactly out my window -- it's actually from a whole different district in front of a swanky hotel -- but it's the view I feel from this country. It is a gracious and growing place, morphing discernibly into a fully developed member of the world. Our last meetings confirmed our earlier themes -- they need a more educated work force, and need help to do it. Just today, on the front page of the newspaper, the Ministry of Education announced all university faculty need masters degrees, and the Ministry of Health announced all hospital administrators will need one as well. Given there is only one MSN program and no doctorates in the entire country, they are desperate for help.

Sara and I have a lengthy conversation and come up with four areas of focus to explore. She kept the list and my brain is full so we will share when we get home. We brainstorm our dream team to help. We may be calling you ;)

Myths have been busted, replaced with fondness for this culture and its people, and an odd sense of wistfulness in leaving. So I depart with ten things I learned in VietNam:

1. Always carry toilet paper with you, even in fancy places.
2. Even if a million bucks is only $5, it still feels pretty darn good.
3. If you want to lose weight, try using chopsticks exclusively for a week.
4. Don't touch the monkeys, even if they are listening to something mellow on the iPod.
5. When you cross the street, hold hands with two people and just keep moving.
6. Any food that looks like worms probably is.
7. Putting soy sauce on rice is apparently like putting ketchup on steak.
8. People universally smile back if you smile first.
9. Humidity means never having to say you're chilly.
10. Learn to say thank you in as many languages as possible; you will need it, particularly in this country.

Amazing trip, early flight, signing off. Stay tuned for the next adventure.

All revved up with nowhere to go

The brand new nursing building at Eastern International University has six well equipped labs, a full English tutoring system, 140 new nursing students, and only 6 faculty -- only one of whom has a Masters' degree.

We need to teach the man to teach other men to fish

We visit the University of Medicine and Pharmacy, and Eastern International University. The refrain from the hospital administrators on Thursday is echoed here: We have to educate our work force. The hospitals want more BSN and MS nurses, physical therapists, administrators. The universities need masters and doctorates for their faculty. Their buildings are outpacing their workforce, and applications for existing educational spots far exceed capacity.

The EIU is an interesting concept. A huge corporation -- Becamax, a holding company for 31 different entities -- is building a town for its workforce. Called "The New City" they have built a brand new town, a 1000 bed hospital to take care of the folks that work there, and a university to educate its workforce. They have 140 new nursing students and only 6 faculty. We focus on supporting faculty development; they want us to send teachers. We need to come up with something in between.

It is of note that the standard administrative structure in their healthcare colleges is that the Dean is a physician. It is the credential required by the ministry of education, even if it is solely a school of nursing. It does make conversations about curriculum challenging and, sometimes, at odds with what we believe about the professions we represent.

I have no answers for any of them. Can we teach their classes? Of course not; even if we had capacity, that is not the Jesuit way. We don't just teach the man to fish; we teach the man to teach other men to fish. But they clearly need support in nontraditional ways; creativity is called for. There is huge opportunity here to make a real difference. I'm just not sure how. This will require substantial reflection and discernment -- something I have to work at. I wish they would just let me count something. Stay tuned.

Big statue, I mean really big

One of my favorite students, partly because he rides a scooter 4 hours one way from his hometown and stays in a boarding room so he can come to school. That is motivation.

Looks weird, tastes delicious

Best food of the day. I must admit I was quite skeptical that I would consume more than a token amount, but it was actually wonderful.

Our endearing students

In the rowboat; our junket is on the right.

Evidence: she paddles the row boat

And didn't veer into the jungle even once. Quite motivated to stay on course.

I think he was listening to Lionel Ritchie

Yes, the monkey is listening to an iPod. In the jungle.

Their horse is healthy

Through the jungle in a horse cart

A day on the Mekong

Several of the students from the MS class ask to take us for a tour of the Mekong Delta on Sunday. It is amazing. We start at 6:30 a.m. with a drive through rice paddy fields, lush with greenery, topiary gazebos, and cultivated bonsai. There are periodic raised vaults with ornate carvings -- one here, two there, right in the middle of the rice paddies. We're told they ask to be buried in their fields, and apparently are. We stop for breakfast at a display of ancient homes, wild orchids and lotus blossoms filling the air. On to a river cruise on a junket -- it lists to the right pretty seriously. I gauge the distance to shore and figure I could make it, so I just go with it.

The Mekong is one of the largest rivers in the world, rivaling the Nile and the Amazon. We turn into what looks like a wall of reeds, and travel even deeper into the jungle. We dock, and follow a dirt path to a small shop for honey tea and coconut. Both are delicious, and we buy some, hoping it makes it past customs. There we board a horse wagon to our next destination. This is the only low part of the trip -- as we plod along, our driver tells the student in my cart that the horse is slow because he is sick. I am distraught -- many of you know my commitment to the humane treatment of animals. I ask to be let out of the cart to walk, but the student is adamant that I cannot. By the time I have convinced him I am ready to jump over the side while we are moving, we have arrived. I ask the horse for forgiveness and rub his nose. I feel awful about this part.

We are taken to a small jungle cafe where we're served fruit (don't ask me what -- I know some of it was mango, but the rest is an adventure) and treated to local musicians. Finally, onto a rowboat and paddling through the reeds. I am in front and so have to paddle, but I enjoy it; it's much like canoeing the rivers in Missouri except it's a jungle and there are things in the water that can eat you. We arrive safely back at the junket, onboard, listing to the right, slowly making our way back.

On the way back to the hotel, we stop at a pagoda and enormous Buddha. The students have been over-the-top hospitable. They fill our bowls, help us hold the chopsticks, even clean our utensils before we use them. They buy us gifts -- photos and bags and candy. I have to fend one off paying for a t-shirt purchase by swearing to her it is for my dad and I want to pay for it myself. We end the night with dinner out, with more queenly treatment, cards, and speeches. This is amazing graciousness, unexpected and quite endearing. I will miss them.

A long day, though, and the heat and humidity has turned me into a bedraggled pup. A shower and sleep await; pick up time tomorrow at 7:00. Stay tuned.

Sent from my iPad

...and then I realized it was my responsibility

Busy day today -- much to absorb. We started the day sitting in with the current MS class. What engaged students! Lora's question to the students: how has your vision of yourself as a professional changed since you started graduate school? Their answers were thoughtful and heart-breaking. "I used to think that moving the profession forward was someone else's responsibility," he said in halting English, "and then I realized it was my responsibility." Weighty stuff so early in the morning. It is easy to forget the struggles of all of our professions for respect and professional recognition, until we're shuttled two decades back in time.

The afternoon was spent touring a public hospital, then a private one. They are resourceful, and have to be because they have no resources. An open ICU with 36 patients, all on ventilators. One nurse for 15 patients. Seven physical therapists for 1300 patients. It is amazing they are able to accomplish patient care at any level. I tell the chief nurse that I admire what she has accomplished, and she tears up. "You have no idea what it means to hear you say that," she says. "I know you have the best care in the U.S."

She points out the VIP ward to me -- where there are only two patients in a room. The others have 4,5,6 -- often two in a bed. I'm not kidding. And while we were on the unit, they moved a fresh post-op fellow into a room with five women. We take for granted our embarrassment of riches.

Back to the students. They are remarkably gracious and attentive. They took us to lunch, walking on either side of us as they maneuvered us through the traffic. If you wonder why that was necessary, go to YouTube and search "crossing the street in Saigon". It is impressive. On the way back, they held umbrellas over us to protect us from the sun. I'm guessing I won't get this treatment at home!

Tomorrow to the University of Medicine and Pharmacy, where I'll meet with the Dean. Then to the students' final presentations and a potluck. Stay tuned!

City hall with park in front

Quite lovely. Humidity 98%. No worries that anyone would steal my rings 'cause I can't get them off.

And you thought you had power line issues

This is but one of many such electrical marvels.

I think I ate a fox

Still jet lagged. Tried to Skype my dad and realized it was 2:00 a.m. his time. Ooops.

This may seem an innocuous restaurant scene but for those of you who remember the war, the Rex Hotel -- upon whose rooftop Sara and I lunched -- was the favorite of wartime journalists and politicos. Step inside the lobby, and one could easily think it was The Hyatt downtown. Very European in both style and inhabitants. Step outside, and it is crazy scooterville.

Spent time with Trinh Thi Loan, Vice Dean of the school of nursing at Nguyen Tat Thanh University. They are desperate for a partner for both BSN completion and MSN. They have only 60,000 nurses in the whole country; contrast that with the 65,000 in Colorado alone Their pharmacy, medicine, and therapy programs are more developed, but still missing infrastructure. The Ministry of Education dictates the curricula, but no other accreditation exists, and there is no licensing for any of these professions. Physicians make about $600 a month, pharmacists about $400, and therapists and nurses $200-300. When there is so much to be done, it is either overwhelming or great opportunity. I feel both. Maybe it's fatigue. She slyly asked me if I wanted to sign an MOU before I left. Thank goodness I wasn't that fatigued.

Dinner with Maureen and Lora. Their tales of the students are inspiring. The students stand up when they enter the classroom. Yes, you read that right. The students took them to lunch and attempted to teach them chopsticks 101. It was during this adventure that Maureen uttered the subject line of this post.

Headed to bed but first am crazy trying to catch the mosquito that is living in my room. Made crazier by the fact that I elected not to take the anti-malarials this trip. I think I feel a fever coming on. Stay tuned.

A high level view

From my window, I could be in nearly any city. Except -- there are actually construction cranes in action here. Some of these rooftop gardens would be the envy of Lodo. Awakened by the sounds of traffic and roosters; made for a bit of disorientation when mixed with jet lag. That is one big pond to fly over.

Got in about 1:00 a.m.and there were two graduate students waiting on us to bring us to the hotel! They looked unwrinkled and fresh; one could not say the same for us. They were gracious and thoughtful, particularly given they had class this morning at 0730. I believe we would have students willing to do the same, but I must say I was impressed.

The drive was an adventure at 2:00 a.m. on narrow dark streets. The taxi and a scooter bumped, and we discovered road rage isn't limited to Denver. The scooter drove beside Sara's open window, and smacked the rear view mirror. I think we all held our breath, wondering where this little exchange was going, until the scooter driver gave an internationally understood hand gesture and moved on. Sara was cool and non-plussed; I had locked my door and was prepared to wet my pants if necessary. Thankfully it was a non-incident.

We passed the hotel, and I was extremely grateful that Sara knew where it was, as she gestured to the driver that we had passed it. We were on a one-way street, so she tried to get the driver to understand he needed to go around the block. He took the somewhat unconventional approach of simply driving in reverse back to the hotel. Apparently, if your car is facing forward, then you are officially one-way.

Started the day with a conversation about the nature of service and education in a foreign country. What kinds of service are unique and sustainable? If we just want to come and work in clinics, then frankly we're better off just sending the money. For what it takes to get here, we could support half a year of a nurse. On the other hand, the idea of education as service is intriguing to me. Could our doctoral students provide a unique service as part of their capstones, helping to develop health care practitioners here with innovative blends of intensives, online, and exchanges? I have to think that developing leaders and educators that stay in-country is better than short-term mission trips. And do we bring our programs here, or our standards and state of the art and adapt to them to this emerging country? And so begins the familiar process of generating more questions than answers.

I've not had a chance yet to visit with Maureen and Lora, as that will have to wait until dinner. I understand we will also be visiting with a feisty, innovative, and opinionated Dean of a school of nursing for tea. How cool. Stay tuned.

The airport saga continues unrevised

Those of you that have followed my travels from Nicaragua to the present know that I have historically been relegated to the screaming-baby-who-spits-up-on-me section of lengthy flights (see 2010). . The leg from Denver to San Francisco continued my good fortune, where I seem to have found myself in the pediatric ward of a small hospital. Poor kids. All the crying -- and that was just me. Meanwhile, Ms. Premier-executive-frequent-flyer-queen Sara was in first class, quietly sipping what looked like a mimosa. The next leg is 17 hrs. I feel certain my fate is sealed judging by the number of strollers in the boarding area. Pray for me. Stay tuned.

Preparations commence

Bags are getting packed and final lists have been made. I'm anxious to hear what opportunities will present on this trip-- for students and faculty. On a personal note, I'm looking forward to my own personal myth-busting trip. Here is the scenario that most stands out in my mind when I think of VietNam: it's 1970, and we gather at a friends house to watch the draft lottery, clutching pieces of paper with our boyfriends bithdates, waiting for the first 175 lottery draws, the ones most likely to get drafted. I had only the most vague understanding of the politics of the war then; even less about what has happened since. I understand VietNam is not third world, but rather an emerging, middle class market that has made remarkable progress in the last four decades. I look forward to this trip with an open mind, intending to listen carefully for opportunities for mutual benefit, and hoping to change my long-held impressions of this country. Stay tuned

Gus already looks forlorn

He's watched me pack.

A video on the ground in Joplin

It is hard to describe the devastation we saw. The pictures truly do not do it justice. Amy took a video while driving to their work site; you can find it at http://www.facebook.com/video/video.php?v=2029335423739&comments

Dad has a message for us

Called dad this morning to let him know we got back okay.

He said to tell the team that he really enjoyed having you around. He said the farm is really quiet now.

He used an additional adjective in there, but I won't print it here :)

Photos to come!

I will be adding photos of the trip to Joplin as they come in. Many of the people who went took many, many shots, and we'll be sifting through them for a bit. Stay tuned!

We strike out on our own

We started the day with Charlie and Kate. We are able to clear their entire corner, remove the porch, and repair their fence. The dogs are ecstatic! They can run again! Charlie and Kate are grateful and tearful. They suggest we help their elderly neighbors, and we do. Large trees are down, stumps need to be pulled. Both are taken care of by noon.

Meanwhile, the calls for “we could use your help” begin to roll in. I take the van by properties to determine if we can make a difference. The ones that are completely leveled need more than we can do. We find one couple that needs a tree felled and other trees cut up and moved. His recent heart surgery meant he could only do minor work, and then he hurt his back. It takes only an hour or so. More calls come to my cell. A pastor, “Can you pull a stump and cut up some wood and take it to the curb?” A friend of Kate’s, “Can you get the debris from the yard to the curb?” There is a dumpster in front of her house with a terrible smell coming from it. Something in there is dead. Definitely. We decide it must be a bird – perhaps a large bird with fur and four legs, but our story is that it is a bird. We keep working.

At 4, we come to a halt. We return to Americorps and leave our tools with them. We started out with two full trucks of supplies, equipment, and tools and now are empty. After cleaning up, we head to Pittsburg to Chicken Annie’s for regional delicacies. Shock! These folks have not tasted chicken livers, gizzards, hearts, German potato salad! Faces are made, others find new delicacies. We toast Smiley and Ande for their help, hold hands for a long grace.

Outside, a waitress takes our picture in front of the giant red chicken. We started this trip five days ago, strangers inside the van, setting out to help strangers, staying in the homes of strangers. We ended it friends staying with friends helping other friends. We’ve learned a great deal about human resiliency and disaster relief. This has been an experience unlike any other; we will stay tuned to see how the rebuilding progresses. We could not do everything – but we did this. We have thrown many starfish into the sea since yesterday. For Charlie and Kate and Ray and Mary and Tim and Mary and Tom – “It will matter to this one…”

I need to check you for ticks

Today, two of us head to the Salvation Army, everyone else to the field.

The day is defined by “hurry up and wait.” Told to be at the central site at 7:30, it’s a full ninety minutes before heading out. Taken to a home that abuts some dense woods, removing debris in the sun and 95 degree heat, feeling like something is crawling all over us. Wait! Something is crawling all over us! John lifts his shirt to cool off and discovers a new mole. No, make that a tick. Soon everyone is brushing them off and, unfortunately, pulling them off. Eric holds the record with 8 of them. It’s time to leave the woods.

Waiting more than an hour today for lunch and even later for the shuttle back, we decide to abandon the organized clean up and strike out on our own. I call Cathy, the distributor of the funds we sent last week, and she sends us a name. Charlie and his wife need help repairing a porch, removing debris. We head that way and they do indeed need our help. We spend the rest of the afternoon getting a good start on their yard. Their daughter, Kate, tells us her story. She and her mother heard the alarms, thought the storm had passed, and – in the yard – heard a freight train. “That’s what everyone tells you, she says, “and it is really true.” They each grabbed a dog and headed for the basement. She said she could hear breaking glass and the wind tugging at the back of her shirt. “We were sure this was it. We’re the lucky ones.” Their house is still standing.

The porch is not reparable; we’ll return tomorrow to remove it safely. They are most concerned with the fence that is down; their dogs need room to run. We leave at 4, with a promise to return in the morning.

Meanwhile, at the Salvation Army, Brittany is on day 2 and has become so proficient she is put in charge of the personal item distribution section. Lots of people coming and going, but she is steady and takes care to give the homeless what they need.

Back at the farm, joined by older sister Anne, we have a picnic with our host families. One of them, Jannette, cannot resist and brings two pans of lasagna. Anne finishes off dinner with homemade brownie sundaes. The community has welcomed us, and there is much laughter amid the conversation.

We make the rounds safely. By now Jeremy has learned the “city route” well and the “farm group” no longer gasp as I hurtle down the gravel roads. I am not a good driver, but I make up for it with excessive speed. Everyone will make one more check for ticks, wipe down with bleach to avoid chigger bites, and sleep deeply in the quiet. Stay tuned.

First Day on the Ground

First day on the ground.We have partnered with the university here, and, on their campus, life looks normal. Driving to the center of town, our vans cross 20th street and the surroundings look like a nuclear meltdown. This truly looks like a bomb site - we have been told there is more rubble here than at the World Trade Center, and it is believable. Stark tree branches, houses in rubble, piles of brick and wood that were schools and churches and homes that are now just piles.

The volunteer organizers on the ground are orderly, but lacking central leadership. Part of this is due to the sheer volume of work that needs to be done, partly because of bureaucratic issues, partly due to the number of volunteer agencies here. The field group begins cutting and moving trees, and are told they have to move to front areas, as we need individual waivers and permits in order to clean back yards. Given the houses are completely razed, it's hard to beievee that crossing from the front to the back of the rubble is a problem -- but apparently it is. We're asked to place personal items on the front stoop in case the residents return. It is unsettling to sort through the wreckage -- literally -- of lives and place items we might think are important on the porch. It is overwhelming, heart wrenching work, coupled with crushing heat.

Still, our spirits are good. So many generous hearts. We didn't need our MRE's (darn!) as so many people were driving around in their cars, handing out food to workers.

End of day, we head to Columbus, Kansas, my hometown, about 30 miles from Joplin, to the host homes that have volunteered to take us in. Past wheat fields, cows, horses, and the Kansas National Forest (thanks for the renaming, Eric!) we arrive in early evening. Hospitality abounds and we are warmly welcomed. Some are luckier than others -- Aunt Peggy leaves warm cookies on the counter for Brittany and Maggie, Gary has cold beer and a swimming pool for Tom and Nasim. After quick showers, back to my dad's farm where my sister, Ande, has made us a wonderful dinner. Root beer floats for dessert, we watch the sun set over the fields. It is quiet and serene; we are reflective as we make the rounds, taking people home.

Up at 5:30 to make the pickup runds again, on the road at 6:30. Today, most of us are out to the debris fields. Another hot day, sun already beating down. There is so much to be done! It is truly overwhelming. We know we can't do much, but we can do this. Mike Harris reminds us of the story of the young boy throwing starfish back into the ocean. "You aren't ever going to get them all out there," he's told "It won't matter in the end." The boy looks up as he throws another. "It will matter to this one."

Arrival -- Finally!

It's not really an adventure if you don't have adversity. Adversity really early in the process. We left Regis with a send-off from Channel 7 news, and a blessing from University Ministry. In a reflective mood, excited but apprehensive, still wondering what we're to face--we had our first hurdle when the truck broke down near the Colorado border. Well, not really a breakdown -- a gauge showed gas, the truck ran out. It seems nothing too serious (the tanks won't switch) but we lost an hour finding an open gas station in far eastern Colorado and gas cans to boot. It was a long trip, but no whining. Two vans, a truck and a flatbed don't make fast time. The eleven hour trip turned into 12, then 13, then....on the last leg, after midnight, final state road approaching the town where we were to stay -- a detour! The road was out. Took us a final 20 miles out of our way. We arrived at the hotel near 2:00 a.m. exhausted but (take note, Jeremy!) still no whining. Up in the a.m. to head to Joplin. Not sure what to expect. Stay tuned.

Headed to Joplin to help

We just held our preparatory meeting with the 18 Regis employees who are traveling to Joplin Missouri to help with disaster recovery from the tornado two weeks ago. I was so touched by the generosity of time and expertise demonstrated by this group of people. I worked at the hospital that was destroyed by the tornado; it was my home for 15 years. My sister still works there. Thank goodness she is safe.

Every employee at Regis gets mission leave, and so this is an opportunity for them to use it. We don't know what we're in for -- other than heat and humidity -- but it's clear this is a bunch of people who we can rely on to have our backs.

I'm a little scared and apprehensive about what we will see, but also excited. We have nursing faculty and students with us who will get to see firsthand what health care delivery is like under extreme circumstances. We may be able to tour the mobile MASH unit that has been established. It apparently has six wings and looks like something out of science fiction. They can deliver babies and do surgery there, which is really needed, as the area has lost its major regional medical center, heart center, trauma center, and cancer center.

The group will also get a cultural immersion in rural America! We are all staying in the Kansas town of my childhood, Columbus, Ks. It only has 2800 people and a lot of farms. It's about 20 miles from Joplin, and most people there used Joplin as their go-to place for retail goods and groceries. Relatives and high school friends have stepped up and will give us all a place to stay.

This is such a chance to contribute in a meaningful way under dire circumstances. I'm grateful to work in such a place and ready to get rolling. I'll keep you posted on our experience over the next few days. Stay tuned.

If you want to help, too, there is a fund set up for the more than 3000 employees of St. John's Medical Center whose future is uncertain. The Missouri Hospital Association has set up a fund for them called HERO, or the Hospital Employee Relief Operation. You can donate to them at https://www.mhanet.com/herofund/