Malaria, cholera, typhoid, dengue fever . . . the list of potentially-deadly diseases that we face overseas is long and frightening. We do what we can to avoid them - taking prophylaxis, using bug spray, drinking only purified water - yet we still face the possibility of contracting on of these sicknesses.

I am no medical professional - I have had basically no training, and my husband has had just a little. Yet in our three years in West Africa, we were forced to study and learn to diagnose many common illnesses as we raised our children without good access to medical care. {Let me put a plug in here for Missionary Medical Intensive. We highly recommend their training if you are living in a location with poor medical care. We also highly recommend learning to use their "Village Medical Manual" even if you can't take the course - we use the manual in America too, not just in Africa!} One thing that I was surprised to learn was the true "killer" of most children in third-world countries. It's not malaria or cholera, although these may be the root cause - the actual cause of death in many, many cases is dehydration. And it can happen just as easily with a case of the stomach flu in America as it can with malaria or typhoid overseas!

Please realize I am NOT minimizing the dangers of these tropical diseases. However, I do want to HIGHLIGHT the danger of dehydration! Recognizing and treating dehydration quickly can mean the difference between life and death. The younger the child, the more serious the threat of dehydration. So what are the warning signs of this dangerous condition? And what can you do to treat it?

Any of these signs indicate that your child is dehydrated or is becoming dehydrated:

  • More than six hours without urinating
  • Dark yellow, strong-smelling urine
  • Lethargy
  • A dry, parched mouth and lips
  • No tears while crying
  • Sunken fontanelle (soft spot on baby's head)

These signs indicate that your child may be seriously dehydrated:

  • Less elasticity in the skin (doesn't "bounce back" when pinched into a fold)
  • Sunken eyes
  • Hands and feet that feel cold and look splotchy
  • Lightheadedness, dizziness, or delirium
  • Excessive sleepiness or fussiness

 Obviously, prevention is the best cure. If your child is running a fever, he needs more liquids than normal and will probably not feel like eating or drinking. You will need to work and make sure he is staying hydrated. Don't wait until your child is showing signs of dehydration before you start giving him extra liquids. Any vomiting or diarrhea can cause dehydration very quickly, especially in a younger child or infant. If you need to, use a teaspoon or medicine dropper to give your child a small amount of liquid every few minutes. Seriously, set a timer if you need to and make sure your little one is getting a sip LITERALLY every 5 minutes. This could save you a trip to the hospital, depending on the cause of vomiting or diarrhea.

If your child is showing signs of mild dehydration, you can still get on top of things. Use Pedialyte or an ORS powder if available, or make your own rehydration fluid (ORS recipe below). Get your child to drink as much and as frequently as possible. (With vomiting, frequent tiny amounts are essential, do not let your child gulp large amounts or it will probably come right back up!) If your baby is breast-feeding, let them nurse as often and as much as they are willing. Fluid replacement can take more than 24 hours, so keep pushing the liquids even if your child begins to feel better.

For severe dehydration, your child may need IV fluids in the hospital. If you feel that your child is not improving or is getting worse, or if you are not able to keep any fluids down at all, see a doctor right away.

Oral Rehydration Solution (ORS) Recipe:

Combine 2 Tbsp (6 tsp) granulated sugar, 1/2 tsp salt, and 1 liter water. Be accurate in your measurements! Mix well until salt and sugar are dissolved. This will keep in the refrigerator for several days, or at room temperature for 24 hours.

 Do you have any tips or wisdom to add? Any stories to share about a time that your child was sick and in danger of becoming dehydrated?

The other day, my husband and I were talking about what we should be praying towards as we look at moving back to Africa this summer. As we discussed our past experiences overseas, one thing stood out to me - one factor that has made the difference for me between just living in Africa and actually loving Africa. I spent time in a country in West Africa, about evenly divided between the north part of the country and the south. And in both those areas, I had a Friend-with-a-capital-F.

I had a Friend in the north. It just sort of happened - I was helping her with her English and we often ended up laying on the floor in her room talking. We'd go to her farm and laugh and talk the day away. We'd chat about what we were thinking. We went places together, biking and talking. I loved it!

After a couple years, I moved south. This was going to be a new experience for me - a new tribe, a new language, a different culture. I distinctly remember praying about this and asking God to give me another Friend. Not until months later did I realize that He had answered my prayer far beyond my expectations. "Z" and I got so close. She was incredibly patient with my babytalk in her language, and it wasn't long till we could chat for hours (ok, disregarding grammar rules, but hey!) We were pregnant together. Moaned through morning sickness together. Discussed our religions (she was Muslim). Laughed our heads off. Brought each other meals. I'd hold her colicky baby while she got a quick bath. Now that we're living in the States, she calls regularly. She, single-handedly, made the difference for me. I loved living there.

Of course, we had more friends than that. Lots of people I could go hang out with, visit, or have a meal with - there's nothing like African hospitality. Lots of people I related with daily, and loved. But the gift of a Friend-with-a-capital-F... that's on a different level. Someone who will voluntarily open up and share. About anything, everything. Someone that will initiate in the friendship. That will tell me if I'm blundering culturally in some way. That will actually tell me how I am perceived in the village. Someone that treats me like a Friend, not like the foreigner that I am. That is huge!

I am not talking about an official "language helper" here. At the same time, I believe having friendships like this is an ideal way to learn more about the language and culture. Also, I believe it is a powerful antidote for culture shock and loneliness. It means that instead of always turning to your fellow expats or your social media to fill those friendship needs in your life, you can start being blessed by relating within your host culture, too. As wives and mothers, it is easy for us to get stuck in our house, relating to our family only. Don't let it happen to you. I believe God wants you to love your new culture, too; and some genuine friendships are a huge help with that.

Of course, besides prayer, there's some work to this, too.

To begin with, you have to build as many relationships as you can. Make friends everywhere. Keep your eyes open for a potential Friend. Don't expect someone to just walk in the door someday. In both instances I told you about, it took months. You do have to do something - get out of your house, get out of your comfort zone, and get into people's lives. My Friend in the north was actually hiding inside of someone I had known for quite a while, and she didn't pop out until I started spending time with her on a regular basis.

Here are a couple ideas to get started. For example, incorporate a daily stroll with your children into your routine. Maybe there's someone that's always in the same place each afternoon, such as a shop keeper? She might be bored waiting for customers and happy to hang out for a little bit. Maybe there's someone sick or disabled who has all the time in the world? Maybe there's a neighbor lady who would love to help you learn to cook local food, or someone who has children the ages of yours, and you can sit with her while the little ones play.... My experiences are in rural Africa, but with a little creative thinking, these suggestions probably work in other places, too.

Sure, it takes a lot of time, and it is not easy. Sometimes, all you want to do is stay home - the last thing you feel like doing is venturing out, again, to bug people, again. To make a fool of yourself, again, because you don't speak the language well and you don't know the culture well. Sometimes, someone you thought was going to be an awesome Friend, turns out to just be someone who thinks they can get some sort of material benefit from your relationship. It's happened to me, and it's hard. But don't give up! When you do find a Friend, the hard work will pay off.

And when you found her? Go on and find another one :-D

Have fun!

How about you? Have you had a Friend-with-a-capital-F in your location? Any more tips on how to find those Friends or nurture those friendships?

Holidays are one of my biggest challenges overseas. I missed out on the creative gene somehow, and I'm terrible at planning ahead, so it just makes special occasions a problem for me. Add to that the difficulty of romance in a third-world country - lack of good restaurants or date options, lack of babysitters, busy schedules, no florists or chocolatiers - and Valentine's Day can just be a pretty lame holiday.

But we all know how important it is to have times of focusing on our marriage - especially when it's so hard to do. So I've assembled a list of Valentine's ideas - some quite simple, some that will take a little more preparation - that hopefully most of you can do regardless of your location or situation. (And I have to admit most of these ideas are not original with me, but are adapted from a dozen other websites.)

Word Ideas:

1) Love Notes. So much can be done with these. Write a bunch of little love notes and leave them all over the house where your hubby will find them. Or bind them all together into a small book. Or roll them up and tie individually, then put in a basket or jar to give to your Valentine.

2) Give IOU's - for anything from kisses and backrubs, to taking out the trash or cleaning the car, to making his favorite meal!

3) Go to puzzlemaker.discoveryeducation.com and create your own crossword puzzle using words and clues from your relationship. Be sure to include things from your first dates and your wedding and honeymoon as well as your relationship now.

4) If you're going to be separated for most of the day, do a text-a-thon. Send your Valentine a sweet or steamy text every hour, on the hour. Build anticipation for your evening together.  It will be fun for both of you!

Food Ideas:

1) Make a meal with symbols of love. Make soft pretzels and form them into heart-shapes. Shape our favorite biscuit recipe into hearts. Bake a heart-shaped cake, or cut-out heart cookies. You can use anything from string beans or carrot sticks to ranch dressing or ketchup to write "I love you"  and other Valentine's messages. If you do this as a family, it will be a hit with the children as well!

2) Make a desert bar, if you have enough supplies available. Set out all kinds of sundae fixings, or supplies to build-your-own sandwich cookies, or decorate-your-own cupcakes. Or if you like a slightly healthier twist and have the ingredients, set out supplies for layered fruit and yogurt parfaits, including granola, nuts, or chocolate chips.

3) Do you have leftover candy-canes from Christmas? Put two together to make a pretty red-and-white candy heart. You can even soften them in the oven for a few minutes to melt the heart into one piece.

"Date" Ideas:

1) Watch the sunrise together sipping hot chocolate. This way you can have your date before your children wake up in the morning. :-)

2) Build a fort in the living room using couch cushions, sheets, blankets, and pillows. Build it with the kids and have a bedtime snack inside, then turn it into a love cave after the kids are in bed!

3) Sit down with your laptop and go through old pictures of your engagement, your wedding and/or your honeymoon. This is sure to stir up good memories and lots of romantic feelings!

4) On slips of paper, write down every kind of kiss you can think of. (This could be done with more steamy actions than just kissing, too!) Fold them and put in a jar, basket or envelope. Then take turns drawing a paper and doing what it says.

5) Have a picnic in your bedroom - spread a blanket on the bed and start your evening off with some goodies.

So are you inspired to make the day special for your Valentine? Maybe you already have plans that you can share with us in the comments below. Or tell us what you've done for a simple but romantic date in the past.

Today's reader question is on a medical topic. If any of you are medical personnel, we would especially love to hear from you! But let's all chime into this discussion with the understanding that we are sharing our own experiences and choices, not giving medical advice!

Question:

What do other people do for malaria prophylaxis, especially for their children?

My Answer:

We have been told by a doctor that since we are long-term residents of Africa, we should not use prophylaxis but rather allow our bodies to build up a natural resistance to malaria. Another doctor was shocked by this advice and instructed us to be on prophylaxis at all times. We have chosen a 'happy medium' that has worked well for our family. Our babies begin taking prophylaxis when I begin to wean them at 12-15 months old. Our whole family stops taking prophylaxis for a few months in the height of dry season, when the mosquito population is significantly decreased. Of course we take as many other precautions as possible, especially not spending a lot of time outside in the evenings.

We use proguanil, brand name Paludrine, which has few or no side effects and is reasonably priced. It is safe for pregnancy and children. I also recommend Malarone (combo of proguanil and atovaquone), which is more effective than proguanil alone, but also significantly more costly.

**Please be sure to do research or ask a medical professional IN YOUR AREA OF SERVICE. Many regions have developed resistance to certain medications, so not all drugs are effective in all parts of the world.**

What have you done for malaria prevention? Do any of you have natural remedies that have worked for your family?

I have to admit up front, I'm not qualified to address this subject, because I personally have not successfully learned a second language. My husband and I were in a language learning (LL) situation for a few months, and then were re-directed. So I'm going to share a few ideas, most of which were shared with me before we began, and then I really need you more experienced ladies to pitch in and give us your thoughts!

As we approached LL, it looked like an impossible mountain to me. How in the world was I supposed to learn to cook, shop, clean, and live in a new place, at the same time as settling into and setting up a new house, and also meet the needs of my children, all while learning a foreign language for the first time? Surely I couldn't possibly do it all?!!

And that, dear ladies, is the only real answer I have for you: YOU CAN'T DO IT ALL.

You have to choose what the priorities are and then let the rest go. Language learning is only for a season. It's okay, for a season, to let some things go. Otherwise LL is what will suffer, because you just can't do it all! Sit down with your husband and pray together and discuss what are the priorities to focus on during LL time.

Here are a few ideas along that line -

1) Keep housework as simple as possible. Lower your expectations. This is not the time for gourmet American meals made from scratch with all local ingredients. This is the time for hot dogs and tuna sandwiches - or whatever simple foods you can get where you live. Find nearby street vendors where you can buy lunch or supper several times a week. Let the house-cleaning go to the minimum. Don't worry about home decorating and really settling in. If you're not able to do it before LL starts, then wait. There will be time later.

2) Be willing to "switch roles" with your hubby. If you are both in full-time LL and not in ministry yet, then you need to be realistic about household and child-care responsibilities. It will not work for you to do it all and him to do nothing. He will learn the language and you will not. Discuss how you can take turns taking care of the children while the other one has study time. Divide up the housework so that you are both doing a share.

3) Get help. This will look different depending on where you live and what your situation is, but I highly recommend getting local help, and ideally someone that has worked for expats before. A cook, a nanny, a cleaning lady, a gardener: I'm not saying you have to hire three or four individuals, but do seriously consider what kind of help is available. Surely paying for help is worth the reduced stress and more effective language learning time.

4) Consider and prioritize your children's needs. They are adjusting to a lot of big changes, including all the stress in Dad and Mom's lives. Be sure to give them the love, security and attention that they need. But also consider what you can put on hold with your children. Are you homeschooling? Maybe this is a year to just do the basics and let some of the extras wait til next year. Consider doing video school or online school that will not require as much involvement from you.

5) Take breaks. We need to be focused on the essentials and let the other things go, but be sure to schedule in some necessary breaks. Make Sunday a "special food day" after eating simple meals all week. Do a holiday craft with your children on a Saturday morning. Find the things that refresh you, and do them on a regular basis.

*****

So now it's your turn! Can we hear from some of you that have been through the language learning season? What worked for you? How did you balance it all? Please share in the comments below!