Goodbyes

So on the 17th September I said my goodbyes to the Africa Mercy. I was absolutely torn I can tell you. i have been stretched and challenged, laughed and cried, and experienced every emotional high and low I can possibly think of. Often times it can feel that these experiences have been more of a blessing to yourself than you blessing others, and this is no different. I wish I could share every single moment I have had with you, but I hope this blog has helped give you a bit of an insight into my beautiful world of the last 6 months. I will sorely miss everything, but mostly the sense of making a difference and being part of something out of this world, and not of my doing!
So to anyone who has prayed, thought about me, assisted financially, been on the ship or at home encouraging me, I thank you so much for being part of this amazing experience.
Many people have asked me 'what next?' Honestly right now I am not sure. I do know that Africa and nursing those in need have become even deeper set in my heart and I hope and pray it won't be long before I am 'living my dream' again. Watch this space!

A new life

The day I left the ship we had some very exciting news... during the night one of our children's mums (the child being the patient) began complaining of abdominal pain at 2am. She was 8 months pregnant but denied that he pain she was feeling was 'having a baby pain'. Our nurses called the doctor, and on the 'braking of the waters' called in one of our lovely nurses who is also a trained midwife. She arrived at around 4 am to examine the mum, and by 4.40 the baby was squeezed into the world, with mere paracetamol and a few 'it hurting plenty-o's'. No problems, super nurse Mandy was absolutely ecstatic to have helped bring this amazing new life into the world at just 4 pounds 9 ounces.
Not one patient on the ward batted an eyelid..perfectly normal occurrence in this culture! The baby was aptly named 'Mercy' and is doing well, although a little small. What a beautiful story to end my time!

My VVF ladies and their dress ceremony

I had the awesome privilege of being at the dress ceremony of several of my patients a few days before I left the ship. 4 of the ladies I had been looking after were squeezed into a little room to be prepared. As I peeked through the glass panel of the door, I saw an excited bunch of ladies, putting on make up, spraying perfume, having their hair done, and beautiful vibrant patterned fabric being wrapped around them - their new garments.
As I headed down to the ward, Finda (32), one of my 'live wire' patients popped out of the room. Spotting Dr Steve her surgeon in the distance she bounds up to him, shouting 'look no pee pee!!!' as she danced in a circle showing us her dry legs and feet. We all laughed and danced together.
I settled into my seat on the ward and waited for the familiar drumming to begin as the ladies came down the corridor singing. Dr Steve the surgeon sitting opposite me, having been to many ceremonies before, was clearly just as excited about this one as the first one he had ever been to! The music got louder and the singing more joyous, eventually the ladies bounding in the room and taking their seats at the end of the ward. After a word from our beautiful Clementine who works closely with the ladies every day, each of the ladies gave their testimony.
Garmai has had VVF for 26 years!!! She is amazing. Every day in the ward at least twice she would begin leading the ladies in worship and she would preach God's word to all those around her. She was so faithful to everything she knew and so vibrant and such a character on the ward. She has had a ministry of healing for years and years, and through her time in her church she has been able to pray for many people and see them healed of many afflictions. She explained to us how her first husband had left, but then how she became remarried despite her sickness. Still she asked God why He could heal so many others through her, but she was still sick. Now she was standing there, dry, proclaiming how faithful God had been to her, and realising how her story would be for the encouragement of so many others, with her adamant that God's timing was perfect! Garmai then became so excited as she proclaimed 'now I can stand at the front of my church because I won't have a wet butt!'

Next came Finda who is such a character. We had so much fun with her coining the phrase I used one day in jest 'you try it lady...' when I jokingly challenged one of my patients to do something she knew she couldn't. Day after day as I walked on the ward adn went about my nursing activities, there would be Finda in the background 'hey lady, you just try it lady!!' Many of my colleagues still haven't forgiven me for that little gem ;-) She sang so beautifully and then told us how she had been leaking for 13 years. Her husband had left her and her baby had died. Now she had new life and she was going to live it to the full!

In the corner of the room was Baby, who I have talked about before. The surgeons had done everything they could for the hole between her bladder, vagina and rectum, and after her catheter had been removed, she was tragically still leaking. She was so brave. She was offered a dress ceremony as a sign of God giving her life even though she was still wet. Understandably she declined but she came to support her friends. She quietly celebrated with them, and then at the end, tears in her eyes she sat very still. Our hearts were breaking for this poor sweet 19 year old. We prayed for her and cried with her, empathising with the image in her mind of her future. But, in true style, Garmai drew close to her, someone who had suffered for 26 years, encouraging her not to give up hope and thank God that he was going to use her. I was shaken to my core. I have it so good, and the faith of those who have it so bad is above and beyond anything I have ever dreamed of. These women have taught me so much it is unbelievable.

Before I left...

I am now back in sunny (??!!) UK and yearning to be back in my 'home'. I had a crazy time my last few weeks so I just had a few little gems I didn't get chance to write about...
My VVF ladies continued to be a huge source of inspiration to me. We had a hilarious moment taking some of the ladies up to deck 7. Several of the slightly older ladies were clearly bewildered by the concept of the lift... we crammed them into the dark lift, mainly used for the kitchens, and their faces were a picture. Hands gripped to the rails and wide eyes bored into the door of the lift. Many of them were unable to speak any English so just kept looking at me questioningly as the lift began... the ding of the lift as the doors swooshed open signified the moment for an exhaling of held breath on the part of the ladies and a bit of a chuckle from me :)
On returning to the ward a little later (after a slightly more giggle some trip down in the lift), the ladies went hurriedly around telling each other about the 'lift events'. the giggling, laughing and arms waving and pretending to leap in the air as if the lift were going up were obvious story telling moments. Oh how I laughed too!
It's amazing what we take for granted, a simple lift and even flights of stairs never encountered by other people...

Imagine...

This weekend I have been working again with the ladies with vaginal fistulas. This morning we had our church service and alaso a dress ceremony for 4 of our ladies who have had surgery, and are now 'dry'. It was a beautiful morning, The ward was packed with crew and all the patients from the wards. 4 red chairs had pride of place for those having their dress ceremony. The service began with the distant beat of an African drum, as the ladies came down the corridor. They had been spending time getting their new clothes, make up and jewellry on - a gift to signify their new start and how precious they are. As they came in the ward dressed up to the nines in vivid coloured fabrics, the worship continued.
Imagine - 26 years since having a baby and leaking urine constantly since then. Repeated surgeries failing, being disowned and rejected by family and friends. This was was the story of one of our ladies today. She is a muslim. Beautifully tall and elegant in her new clothes she told her story, all the time thanking God. She is now dry. A lady with a strong personality, she knows her mind. Everyone she knew warned her that Mercy Ships is a Christian Ship and that because of that she shouldn't go. Knowing she might finally have an operation to heal her, she ignored them and battled to come. She told us how she had vowed that if God healed her on the ship, she would become a Christian. Her husband, would disown her. Today she told us that was the decision she had made, because God was the one who created her, so He was the one she wanted to follow. I have never seen such commitment ever. Now she may suffer rejection for a different reason, yet she still chose it.

On the other side of the ward is my beautiful 'little girl'. Not such a happy story. She has a small childlike voice, her features so pretty yet so young, dimples in her beautiful cheeks. She is 19 and aptly named 'Baby'. She developed a tear between her bladder vagina and urethra. Not only has this girl lost a baby at so young an age, a baby growing likely in a far too underdeveloped body, she has been leaking urine and faeces. She has had very complex surgery, and has is still leaking urine and occasionally faeces too. Most of the time she giggles and laughs. We paint her toenails and giggle at the songs from the movie 'Madagascar'...that's what really get s me, she is still a child at heart, the youngest of 9 children I believe. Then I have to change her 'adult diaper' and the harsh reality of her situation comes flooding back to us both. She recounts stories of her frinds laughing and teasing her. My heart breaks a little bit more everytime she speaks. She breaks down in tears at her situation, and the worst of it is that the surgeons have come to the point where there is nothing more that they can do. All I can do is pray and cry with her, not knowing what her future holds.

19. Lost a baby. May never be able to have a child again. May never have anyone who wants to come near them. I have it good, really good.

These are the moments that break my heart over and over again, but oh what a privelage to do what I can do - pray and hope and love each of my beautiful ladies with all my heart. Sometimes that is all I can do.

Missionaries of charity

As time is drawing to a close for me here, i am still trying to do as many things as I can...
I went again to Missionaries of Charity this week and we have 3 new very very tiny babies :)
Tene is a baby who came in at a mere 1kg in weight. His Mama came to the sisters of charity very sick, apparently not with HIV however. She died 2 weeks after she arrived. The babies father was around but has not been seen since the mother died. The sisters are focusing on trying to help the baby become strong and healthy and they will try and get him back to his father. Even in 2 weeks he has become much stronger, and with a very precarius weighing method on kitchen scales I managed to weigh him this week and he is now just over 2kg which is really so much better. One of the girls who came for a short time was a paediatric nurse so gave the sisters some advice on adding some oil to his feed to build up his fat stores somewhat.
There are also a set of twins that have been taken in who are basically malnourished. It is very difficult sometimes to appreciate the way of thinking here. One of the twins is doing better than the other so the mum has been spending all her time nurturing and cuddling and feeding taht one. The other one she ignores. She was trying to feed it with a bottle with a split teet which meant the milk was going everywhere, so instead of doing anything else she just stopped feeding the child! We were quite upset so asked the sisters to talk to her, which she did thankfully and mum was shown how to feed her properly. It seemed she has really just 'given up' on the smallest baby.
I am continuing to be amazed at the improvement of some of the children. One young boy probably around 7 or 8 was so listless and fragile just a few weeks ago, with open sores on his body. This week, although he was very shy, he was interacting, able to hold his own body weight and even sneaked out a smile as we did face paints :)

A day out

Yesterday I went for a day trip to an old hydro plant about an hour and a halfs drive away. A group of 18 of us packed our bags and set off stuffed into 2 landrovers, running to them to escape the torrential rain. thankfully as we departed from the port the rain lessened and eventually stopped. We dashed through our end of town, then headed off deeper into the country, along horrendously pot holed roads. We passed through many tiny villages and communities, and the waves and staring peering eyes and curious yelps from many children continued all the way there.
We arrived to the bombed out building of the old hydro plant, net by two men who 'guard' the area by the massive gushing river behind the building. After trekking around the building , we set off with the two locals and our 'guides' Lourens and Carl from the ship. We walked through the old river bed and looked at the old dam where once the river had flown through. After the rebels had destryoed the dam and through the war it's parts had been salvaged for metal, very little of it remained.
The beginning of our adventure introduced us to fire ants by the millions! They were everywhere, and as we started down craggy rocks and through the greenery, we found they were everywhere, and got everywhere, particularly at that area just around the ankles above your socks...yak and ouch :) The greenery was so lush and as I clung onto a rock, face virtually touching it as I slipped down to the ground beneath me, I was so thankful to be outdoors. I had forgotten how much I liked being outside and facing those heart rate raising moments of the outdoor adventure.
We carried on up the side of the old river bed on reasonably well worn tracks, with absolutely amazing views of the river, which dropped markedly in many places producing huge waterfalls. Then we reached one of the first heart beating moments - a wade through some fairly fast moving water. We had been warned! So one by one we launched ourselves bags over our heads through the water, neck deep, and for the shorter of the group...swam to the other side. Then began the passing of bags and cameras and much hilarity as legs were caught in tree roots. Impressed that we all made it unscathed and still in good spirits we carried on the track through much denser vegetation, eventually reaching a huge plateau of rocks right next to the top of the largest waterfall. As we ate I was astounded of the beautuy of this place, and reminded of the remoteness of those living in the villages. Some of us took a different route back, climbing high up from the river, we had time to look back on stunning views. We came out in a small village, with several hut houses around an open area. Kids were playing, chics and chickens roamed around and people sat outside their huts, shy little children poking heads out from behind mum's lappa, intrigued at the 'white sight'. Again, it struck me as i saw a mamas swelling belly, how remote these places are, and my heart felt how easy it was for us to receive all taht we need medically, and here, how help is so rare. If this mama had any problems in childbirth she would have hours to the nearest hospital, even then she may well not have the money to receive that help.
After lots of hellos, we continued back to the hydro plant. Some very soggy wet people relaxing after a very physically challenging few hours trek. It was so much fun to be outside and really in the beauty of this country. I didn't break anything, for those of you who know me well that's a pretty big feat!! Many fire ant bites and quite a few bruises, not bad for a days work!!
On our return journey, it had become very much muddier and we had to pull the other landrover out at one point as it got stuck in the mud. Holding on to our seats was about all we could do to bear the jostling of the landrovers.
As we returned through one small community we were stopped by a huge family. They had a lady who was sick and wanted us to help. Well stocked with nurses and doctors, a small group went into the dingy house. Sadly after examing her it seemed she had had a stroke and was unresponsive. There was little we could do. We prayed and left, reminded again of the need of these people.
As we neared the ship, we passed a large group of kids by a huge flooded area of muddy water which we often saw them using to wash the cars. Our very much worse for wear vehicles needed a good scrub, so much to the delight of the kids we stopped and payed them to clean the cars. The mayhem ensuing was amazing! Every one wanted to join in, to the point of some of the kids stripping to their nothings so they could use their shorts to wash the cars. Unfortunately, the landrovers we had are pretty old, so their water-tightness is questionable! Those of us in the vehicle I think got about as wet through the doors adn roof and windows as the kids playing in the water! They loved it and it was a great way to end a hugely challenging day.
I think I need to be reminded toget out and enjoy our beautiful british countryside when I get home :) Friends, you can hold me to that. there's nothing like being outside!!

Yeme

Looking at these pictures you could be forgiven for thinking this little girl is not the one I spoke about in a previos entry. Yeme is the little girl who arrived with extensive neurofibroma to her leg, and a smaller one to her head (you can see it in this picture!). She is a little girl who I wrote about as a scared, frightened little girl, with no English to speak of, left at the Ship's Mercy to have her surgery, with no caregiver with her.

This little girl had a 7kg smelly ulcerated tumor extending from upper thigh to mid calf removed in surgery. She walked hunched over, unable to lie or sit, constant ooze from her wounds. Since her first surgery this little girl has truly become a gem and a shining light in the ward.

She now stands tall for most of the time, her limp lessening by the day. Her frightened look is now replaced with the cheekiest of grins, and her tears replaced with th emost delightful and infectious laugh. She loves to peer around the door frame and giggle whilst we hand over. She has become queen bee at making bracelets, and at plaiting barbie dolls (and nurses!) hair! she is beautiful and becomes more so by the day. She will soon be having surgery for a skin graft to a small patch on her leg that needs a bit of help along the way to heal, and her characteristic lump to her head will be removed. This young girl is such an inspiration, makes me wonder how I complain about such little things as I witness her plight daily!

Noma

Noma is a flesh eating disease which has been the reason several of our patients come through our doors. One such young lady was my patient last week. In the west the condition if treated early with antibiotics will not develop into anything serious. Here where medicine is costly and treatment and consultation is also at a price, noma takes it's holds regularly.
Beindhu is a young girl with a 4 month old baby. She arrived to us with a hole in her cheek, through which you could see the inside of her mouth and her tongue. After extensive surgery she has had a muscle flap and skin grafts to reconstruct her face.
As her case was handed over to me I was more than a little apprehensive. She would be a complex case to care for. She had a drain, NG feeds (food through a tube in her nose) and medication to be given via her NG tube, dresssings to be done, intravenous antibiotics to be given, a catheter for her to pee, a nasal 'trumpet' through which to suction her airway, nebulisers to give, regular mouth suctioning and mouth washes needed doing, plus her baby needed looking after! Her baby, Mary, had been a little distressed as her mum was in surgery so would not have milk from a bottle spoon or by any other means, but was crying out in hunger. She in true '2 for the price of 1 patient' style, ended up having an NG tube inserted so we could make sure she got fed! So I had feeds for her to give, as well as 3 other patients to care for. It was however, a challenge I need not have worried about. As Beindhu looked at me through puffed up lips and tight head bandages and drips and drains of all kinds, she was clearly overwhelmed, but quickly we were able to get into a pattern of pointing and prompting so I could suction her when she needed it. As I organised myself I found that I loved every minute of the busyness!
As the shift progressed, so did her condition, she became more alert and ready to hold her baby. I had the task of trying to get Mary to breastfeed without yanking at Mama's various tubes adn drains, and without her getting upset at her Mama's looks. Thankfully it went like clockwork and a look of contentment passed over both Mary and Beindhu's face as she snuggled once again with her Mum. Beindhu was able to have her drip down and her catheter out during my shift, and I was able to take her for her first walk. Now she will continue to be cared for as her wounds heal.
Her first dressing change was done after I left, but was reported to be looking very good. It will be a long recovery, but quite an amazing feat!

Me my boys and their Mama's!

Oscar and Prince. My 'terrible two'. A handful but such a delight!

Oscar and I

Quite possibly the most beautiful little boy! His newly cast corrected club feet. Sadly Oscar's Dad left him and his Mama when he was born because of his feet!!

It's a small world...

One of my new admissions over last weekend was a story in itself! His name was Amos from Zimbabwee, and as I admitted him for the second surgery to reconstruct his jaw, we talked. He asked if this was my first trip to Africa. I explained about my several other trips, and my trip to Swaziland, and the project we visited. As we talked, I explained that the man who we met who ran the project was from South Africa, now living in Swaziland. As we continued to chat about the name of the project, he explained to me that he had travelled from Zimbabwee to a conference in South Africa, and that he was pretty sure he had met this man.
I couldn't believe it, a girl from the UK, a man from Zimbabwee, meeting in a hopsital ship in Liberia, talking about a guy from Swaziland that Amos had met in South Africa. I CAN'T BELIEVE IT!!!

Some more orthopaedics

Between my VVF shifts, I have had several days on B ward where most of the orthopaedic surgery is. In fact, over the ships holiday weekend I had 4 days in a row with the same patients. 2 of them were toddlers who had had club feet repairs, the adults were gentlemen who had had serious accidents causing non union of femur and humerus which our surgeons were endeavouring to fix. One of the men had had a below knee amputation. The days were very intense, despite being quite quiet. I spent time with the gentleman who had had his leg amputated. He had adapted so well to the surgery and was really keen to get up and about. He will eventually have surgery to his arm also.
My two youngest patients (Oscar and Prince) were waiting for cast changes and so were very well and full of fun and antics. trying to keep two 2 year olds off their casts and not allow them to crawl and even try to walk on them was impossible! Oscar, one of the boys is an absolute bundle of giggles. A very very strong willed young boy, but absolutely beautiful. Both Oscar and Princes mum's were very young. Oscar and Prince's mums spoke Kpelle/Basa and very very little English. Somehow over those 4 days we all bonded incredibly. Each of us laughing at the other whilst trying to work out what all the arm flailing was about. I was in awe of these two young mums (much younger than me). Both boys clearly a handful, and Prince's mum 7 months pregnant with her 2nd child. I saw the struggle in their eyes at times, especially Prince's mum. The children here can be quite 'attached' to their mum's as they are virtually never away from them, normally in a lappa on their back or sleeping next to them. I saw that Prince especially was very demanding of his mother, and being 7 months pregnant her patience at times wore thin. The other patients made 'comments' and I just really felt for her as I could see she at times was made to feel inadequate. I determined to spend time just investing in encouraging her and nurturing her and telling her she was a good mum, for her new baby's sake as well as Prince's. I have no clue about motherhood but I do know when people need some love and attention. It was such a privelage to be th eone to spend time doing that. This is on e ofthe things I love most about being here - the opportunity to invest time adn love in people other than the patients. Investing in family life and futures.

VVF

I had a very challenging experience last week as, unbeknowns to me, a new group of VVF ladies arrived, a week in advance of their operations. As I walked down the corridor to the hospital wards, I was struck by a phenomenol smell, one I had never smelt before. It took my breath away. A little later I had the same thought again as I was walking down the corridor. I mentioned it to someone, and she said, 'the new VVF ladies have arrived'. The bottom seemed to fall out of my stomach. I felt sick. The thought hadn't even crossed my mind. It was then that I had a new appreciation for what the ladies experience every day. The disgust of others, their judgement and the reason that they are belittled in their society. Believe me, at that moment I felt hideous. It took me a few days to really take stock and try and process that event, trying to use it to make sense of so much going on in my mind.
A little later that day, I went along to D ward (currently closed) where the new VVF ladies had been admitted to from another hospital, a week prior to their surgery. I went along to help with the mountain of admission paperwork. I was only there for an hour but it was a great time. I didn't notice the smell that had earlier been so intense. As I pottered around filling in papers and putting on wristbands, I chatted to the ladies. They were all curled up in their beds with their blankets tight up around their necks. Quiet, and looking a little apprehensive. Clearly they were very cold with the airconditioning! So I did a round of giving out blankets. As I did so, I asked how each lady was and their smiles grew as we talked. Some giggled nervously, others needed new pads, and others snuck off to the bathroom. The tension in the room became less and less.
A few hours later I returned to put on the televisions in the ward with the afternoon movie for them to watch. I popped my head in later and each one had rearranged their pilow and their bed so they could see the screen well. There was much giggling as they laughed at the 'muppets' (cartoons!) in the movie Madagascar.
It was such a beautiful sight to see these ladies that had felt so alone in their plight, surrounded bythose in the same situation as them. Their emotional healing begins just by meeting eachother, and it is such a privelage to be a small part of that.

My first day back at work...

Well, after my whirlwind trip back to the UK, I arrived back in Monrovia at 9pm on Monday. Unfrtunately, my luggage didn't arrive, but aside from that the journey was fine. I was back in the deep end with my first shift back being Tuesday at 2pm! I was working with the ladies who have had vesico-vaginal-fistula surgery.
The ladies have gone through labour which has for whatever reason become obstructed. As a result the baby is left in the birth canal for too long, tissue becomes ischaemic (dies) because of the pressure of the baby in the birth canal. This develops and causes a hole between the bladder and vagina and results in the permanent leaking of urine. In the western world, a lady would have had assistnace to give birth or a C-section long before any tissue was damaged. Not only do these ladies lose their babies because of the traumatic birth, they are left with the constant leaking of urine. Their 'purpose' in a country such as Liberia - to have sex with their husbands whenever they want, to produce children to provide for their future and to be mother and wife, is destroyed. Their inability to fulfill their 'purpose' means they become outcasts, and along with their constant pungent smell due to leaking urine, they become the despised of society. These women are destroyed physically mentally and spiritually.

To be honest, I was pretty daunted at the prospect having not yet looked after them, I wasn't quite sure what I was doing. But, I loved it!!! It was an incredibly busy shift, as their care takes a lot more intense nursing: checking of urine output and their fluid intake. The primary aim is to give the ladies wounds time to heal. The leaking of urine that has occured around the tissues means that it takes a very long time to heal. Another important aspect of their care is teaching them pelvic floor exercises, to enable them to have good control once their catheter is removed. The whole process is such a delicate experience. We spend a lot of time just being with these ladies because they have been void of personal touch and interaction because of their ailments. They are taught to knit and crochet too.

I spent a lot of time with my ladies teaching them to do their exercises, it is a very intimate thing for me to be involved with and we have to check very carefully they are doing it well. So I tried to make it as comfortable as possible, reiterating how important it was, and really encouraging them as they did it right. I even agreed to do the exercises at the same time with them (I am going to have the best pelvic floor I can tell you!), which caused lots of giggling and laughter as I empathised at how difficult the exercises are to do!

Tomorrow we will have a dress ceremony. More on that after it happens!!

More wedding pics

The wedding party...

Where have I been...wedding!

So my beautiful sister got married and I was a bridesmaid...

More celebration pics

My lovely girls!

Some birthday fun!

Chocolate Fondu!!

Before I have a week away...

well, I am just 2 hours from setting off back to the UK for just a 6 day visit to be bridesmaid at my sisters wedding so I thought I'd fill you in on my weekend antics.
It has been a busy weekend with two of my closest friends having birthdays. We started Thursday night by decorating my frined Claire's door and floor with balloons and happy birthday signs. The next day we had mid morning tea party for her, then dinner on the dock, followed by a barbeque to melt marshmallows and have chocolate digestives with them (AKA: 'Smores') - very yummy! The life of a missionary huh...
That evening we celebreated Claire's and Hannah's birthday going to a restaurant and having sushi and chocolate fondu. This place called the 'Living Room' made us all feel like we were somewhere out of Liberia...however the pencil used as the 'roller' inside the toilet roll holder in the bathroom did remind me where we actually were! A group of 12 of us went and had a great time just enjoying being off ship.
Sunday I went to an awesome church which is in the process of being passed over from the American founding pastor to the local Liberian pastor. His sermon was really amazing, and so encouraging. It is quite an international church in that many other west Africans attend and a few from NGO's but it was really refreshing to be there!
In the afternoon we were spoiled again and went to a farm an hours drive from us. We went and saw crocodiles, emu's and best of all, monkeys! They just appeared from nowhere bouding up the road and leapt up into our arms for a cuddle. It was just like holding a baby...if a little more surreal! We finished the visit off by leaping into the pool at the small restaurant at the farm. It was so nice to not be in sea that you had to spend all your concentrationon staying upright because of huge waves. It has been a lovely but exhausting weekend so i hope I'll be tired enough to sleep on the plane...more soon!

Yesterday at work

Yesterday I prepared one of my ladies to go for surgery to remove a massive goiter from her neck. The ladyhad such a beautiful smile, and despite her nerves she just couldn't stop saying how happy she was. Her English was remarkable, and as I took her down to the seating area outside the theatres, her breathing became a little quiverry. We sat down on the bench and I reminded her that God was with her, and that soon the massive swelling would be gone. The operating room nurse arrived and after we had completed our final checks, we offered to pray with her. She prayed fervently as we prayed, and went into the anaesthetic room with a huge smile on her face and tears in her eyes.
She returned to the ward following her operation, very sleepy, her now 'flat' neck pulsating slightly (something which I have had to learnt not to freak out about!!). She had quite a lot going on with medication and drains so I sat at her bedside. She looked so content. As she stirred I asked her if she would like to see herself in the mirror. I brought her the mirror and she took a deep breath and as she looked, her eyes filled, and she let out a quivering breath. A huge sleepy smile crept across her face and she whispered 'thank God thank God' as her hands rested at her sides and she dozed off back to sleep.
I love sharing these moments of deep realisation with people.

We have another little girl who arrived 2 days ago. As I type she is having her 2nd unit of blood before her surgery (not usually done!), such is her condition that she need this before her operation. She has a massive neurofibroma tracking from her backside down below her knee. It looks as though she has an extra hip, it is so swollen with the tumour. She has the same type of tumor on her forehead the size of a tennis ball. This young girl (she says she is about 10) arrived and was left at the ship by her family. She speaks French, but Kpele French, and so has been consequently been plunged into a completely alien environment, cold noisy and without being able to understand a word anyone says to her. Our 'charades' skills are paramount...Her admission process took 3 hours, using 2 translators to translate to French then her language. It was found that she also has Malaria right now. Usually that would mean cancelling surgery for a few days, but in her case, time is key.
Yesterday, as she was lying in her bed, on her side because she cannot rest on the massive pungently smelling tumour, she lay quiet as a mouse her eyes empty - I am sure her head was buzzing. She occasionally ventured to the bathroom, others in the ward aware of the odour of her wounds. I was determined that I would not allow my shift to go by with her being left to snooze quietly.
Determined to find something we could do together, I went and got a pack of beads and bracelet/necklace thread and some play doh. I sat down beside her bed and grinned, racking my brain for my few words of French, I asked her how she was and introduced myself. I then started to show her how to make the necklace. She shyly copied what I had done. I was called off to do some other work but a little later we picked up where we left off. Conscious that this little girl probably has been suffering rejection emotionally and particularly physically, I made every effort to be aware of giving her a pat on the hand, a rub on the back and a tickle under the chin as I tied the necklace around her neck. That was the moment she squezzed out a little smile.
She will have the tumour mostly removed today. Crew spent a long time last night donating 10 units of blood, the tumour itself bleeding before the surgery has even started. Now we can only hope and pray for a positive outcome.

Kossi pictures

This is Kossi before his operation. This developed over quite a short period of time because he came to the ship for eye surgery a few years ago. He was surprisingly still just about walking.

Another play-doh moment!

During my crazy 'baby shift' I had a lot of fun with my little shadow Kossi. He follows me pretty much everywhere, and becomes cheekier every moment! His legs are healing well in casts since his bilateral osteotomy surgery. Whilst I was very busy I really hate to ignore the little ones that want to interact! So, it was another play-doh moment...of which there are many.
I set Kossi up with a borad and some fluorescent play-doh. Unbeknowns to me, one of my older female patients was watching very carefully what he was doing as I started him off and made an armchair! I soon spotted her craning her neck to see, and offered her some - she declined, but I knew secretely she was dying for a turn. So a few minutes later I discreetly snuck into her hands a pot of pale blue doh, whispering 'go on, give it a go!' A shy smile swept across her face, she winced just a little as the wound to her neck where a massive goiter had been removed pulled a little. Soon she had a full on kitchen creation made of soft play-doh. A cooking pot, a fire, a pan...you name it, it was there. Before long, I had a group of 6 people kids and adults all creating and laughing and making adjustments to their creations.
Times like these are such a good conversation starter. I love those moments when I can just share even split seconds as I whizz by in the middle of another job, taking time to appreciate their creations!

Baby Caroline Pictures

What can I say, a beautiful little family who let me be a part of it for just a glimpse!

Baby Caroline and her Mama Caroline pictures courtesy of:
http://alirae.net/blog

Baby Nursing

Being an adult nurse is something that has had to be quite a fluid concept for me whilst I have worked here! We are all asked to state what we are comfortable with when we first arrive and our patients are assigned accordingly. I however, have loved looking after kids (you may have noticed...) and I made it known to my supervisors when allocation became difficult. So last week when they threw me in at the deep end with a 4 and an 8 month old baby as part of my all under 10 patient allocation, I shouldn't have been surprised. dragging my baseline observations, and drug calculations from my dusty brain, small small freaked out is probably where I was at really! One of my babies (called Caroline - 4 months old) was born without a rectum, and had had surgery at a local hospital to create a colostomy (an opening from the skin to the bowel). She had come to us to have her rectum formed and at some point the colostomy reversed. She was a precious baby and her mum, also called Caroline was clearly absolutely adoring of her child. I had such a beautiful day with her and the other baby Moses (8 months having a hernia repair). The mums got on so well and we laughed most of the day, they loved that I spent time playing peek-a-boo with their babies. After their surgery they were absolute angels. They took their meds like champs. I had to give baby Caroline an injection and she merely let out a little whimper then continued to smile. I had the biggest smile on my face all shift, I was so exhilarated.
Baby Caroline unfortunately couldn't have the surgery complete as planned. Her tiny little body hadn't devloped enough for them to use the colon to form the rectum. She will have to have another surgery to complete the process, but in the mean time Mum wil have to care for her with a catheter and a small drain where her back passage would be. When I changed Carolines nappy, it was quite a complex process with all the tubes she had. Her mum was quite distressed about how her baby looked. I spent some time trying to explain what everything was doing, but she was so sad it had not worked as planned just yet. Moses mum tried to encourage her as well and between us we cheered her up. Carolines mum dotes on her daughter with such love and adoration, I do hope and pray that we can successfuly complete her surgery.
The shift continued to be very busy, but the babies and their mums reminded me of how fragile these little lives that we come into contact with are. I can't believe I actually get to be part of all of this. Huge big thanks needs to be said to my wonderful Paeds nurse friend Ali who is always on hand for advice and support...

Baby Greg

After my morning at Sisters I went to work. I was in A ward, and orientating a new nurse to the ward and it's unusual ways! At dinner time I had a conversation with Ali who is one of our paeds nurses who has looked after Baby Greg for many many weeks. She had expressed how he continued to struggle his way through each day.

A little later in the evening, after staff doing as much as we could, Baby Greg passed away. He went quietly and quickly. Despite him being so unwell since his surgery, the little one had continued to persevere every day, and it was a shock to all of us when it happened. Greg's mother was deeply distressed as any mother would be.

My heart and the hearts of the nurses here were so very heavy, all of us having been part of his little world as we worked around his bed area. The beeping machines, hum of the oxygen and occasional crys, as well as Greg's mum's laughter, tears and prayers were so much a part of everyday, not one of us could not help but be touched and moved at his death.

We can all question, wonder and plead with God for reasons why this happened and why he had held on for so long just to be carried home to his father in heaven. What I know to be true is that his Mum Marion, virtually a child herself, has had the most phenomenal times of prayer, sharing, and being ministered to whilst being with us. She has an amazing story. Her father for reasons I will not go into had proclaimed over her life that she had disgraced her family and that she would never keep hold of a live baby in her hands. A curse that has been true in her past pregnancies. She has been gripped by fear by this. We know that this curse has been broken despite baby Greg's recent death. As one of her family put it when we carried Marion, Baby Greg home the night he died "some of the babies just have to go back" - to the hands of their father. I can not explain this situation more in my blog, I only know God is bigger than this.

The next day we had a time to share and talk about what happened. It seemed strange for many as they had met in a similar situation only the day of Greg's death and made a plan for the next week to fit a tracheostomy, as a step in the right direction for when the ship leaves at the end of the year, in order to continue his care. Clearly Greg and God had other plans! The meeting was a really important healing time for us all. Our ward supervisor shared with us how at Marion's home the night before, that the family had thanked and thanked us as a team for giving them 'more than the best care'. Each of us hold on to the fact that now Greg is in more than the best place.

Our contact with Marion and her family has continued, in order to continue to support her. Just now Ali shared with me how they have just visited her house. One of our ship crew happened to drove our discipler and Ali to see them. He shared his families testimony of experiencing the exact same 'curse' placed on his mother, and how through God's Grace and Mercy, the curse was destroyed, his birth being the result of it being broken. Being able to be a living testimony of God's work is astounding and can only have encouraged her. God is evidently continuing to work in this family and I don't believe this is the end by any means.

I did not come to this ship realising the extent to which I would be shown new, wonderful, difficult and challenging things. Every day my God gets bigger and more astounding. I am but a tiny small and insignificant part in God's intricate plan, yet I am here, he called me into it. I only hope I remeber these life changing things I am sharing as time passes.

Sisters of charity

I went again to my regular Mercy Ministry this week - a home for adults and children affected by HIV, malnourishment and TB run by Sisters. The week before I came home from the kids section absolutely exhausted and feeling pretty like I had done very little to help. The kids were WILD! It had been raining intensely the whole time we were there which probably didn't help, but I felt I just spent the whole time there just policing the box of activities we took with us.
This week, we were able to use a slightly larger covered area, but chose to spend the first 15 minutes with the activities out of sight and just play with the children, giving them plenty of hugs and tickles. It worked brilliantly! They responded so well. There are some triplets there at the moment who are a real handful, but we managed to get them occupied by a heads, shoulders, knees and toes rendition!
I still just love this place, despite th ebad days, it is a place where they are so well and humbly looked after. The children are visibly chubbier, better behaved adn healthier the longer they are there. Last week there was a small boy, maybe 8 or so, looking extrememly ill. He is HIV positive, His bones poked out, his eyes were filled with pain, and he was lying on a bench with a blanket under him, scrunched in the foetal position. My heart physically pained to see the agony it was for him to lift his head. This week, the boy was so different. He was sitting up, shy but interacting, there was a little glint in his eye, and occasionally a little smile crept across his face. The sisters are vigilant in administering medication, vitamins, and in feeding regularly through the day. His progress is testimant to that. Obviously, this child will never be 'cured', and I don't know his home circumstances. His family may not have been able to care for him properly. What I know now for sure is that he is in excellant hands.
I decided that rather than trying to interact with all the children I would focus on a few littlle girls. They were squabbling for my attention between eachother but then we began to play games all together They loved 'round and round the garden' and I managed to read a story book to them too. a little later, 2 of the boys about 4 years old had started to draw pictures. They were so proud of their scribbles and kept coming to me for encouragement, big smiles all around when I told them how good they were! It is so humbling to see how little these children want in some senses. A hug, a smile, a happy encouragement. This I can do in abundance!
A while before we left, I went to see the tiniest babies. Currently there are 3 babies under 5 months who's mothers are in the other area of the home and unwell. I had a cuddle with one of them, showing the older chidlren how to be jus a bit gentle as we started playing with the play dough and bubbles.
Leaving is always the hard part, but a day at work was to follow that I will never forget...

Day with the HIV team

One of Mercy Ships off ship programmes is the HIV team. Their main way of working is through workshops for local pastors/churches, with an emphasis on the managebility and prevention of HIV. Pastors are invited to bring together 4 or 5 of their congregation to the 6 day workshop, following which they will have been taught and empowered to teach those in their church and their families, then going into local communites. There is a huge focus on how to integrate, accept and encourage people with HIV to be open and honest. I went along to the second day of the latest workshop. 22 people attended, and it was an absolutely fantastic day!
The day began with a traditional African worship time, which I love so much! The team had then asked a local counsellor who works at a catholic clinic, where HIV testing, treatment and counselling is available to come and talk to the people. It was an amazing 3 hour session. Johnny talked about a huge array of things; the discovery of HIV in the 80's, how it is transmitted, how treatment programmes run, how to encourage people to get tested. Currently in Liberia the known rate of HIV is 8-10% but because of the war and the situation of the country there is very little data available.
It was absolutely awesome to watch the interaction of the pastors as Johnny challenged them about the stigma attached to HIV. All of the people were open about their own experiences of HIV and how they would prevent their children from playing with those they knew to be positive, they would not share food etc. It was amazing to see what false beliefs about the disease that they had. What was amazing was their obvious hunger to know more. They all spoke out and asked question after question. No stone was left unturned! I was so moved by their desire to know and have the knowledge that they needed. Johnny, also a Christian was amazing at integrating Biblical principles and really challenged them to think about the way they treated people from a Christian perspective also.
We had a break for lunch (which began my renaming session...see previous post!) in which we sat outside the simple school building beneath a tree in a wonderful breeze despite the scorching heat! It was wonderful. The building was tucked amidst a small quiet village surrounded by trees and small tin roof houses all focused on a central point, a real community. We tucked into our hot and spicy African meal (hot in both senses!!) and enjoyed just listening to the continued chatter and discussion.
Each night, those attending are asked to do some homework. A group of them had been asked to perform a short play. I have never seen anything like it. 10 grown men and women (mainly pastors), with tabbards with labels like 'fever' 'white blood cell' 'cough' played the part of bugs invading teh body of a 'healthy person' (also a 'character'). They then demonstrated how the presence of HIV in an otherwise healthy body, made it more susseptible to other problems. The white blood cell character literally acted out 'beating up' the fever, pain, cough characters. They absolutely threw themselves into it. I was in awe! I'd like to see my pastors and people at my church strutting their stuff with so much vigor! The best bit though, was that when they talked about it afterward they had learnt so much it was untrue.
Following the sketch, Anoukke and Claire who are the HIV team members did some consolidatory teaching and then they began to talk to them about how they can teach themselves. They encouraged the group to think of ways they could reproduce the flip chart drawings and information. The group were so resourceful, picking out people in the church who had artistic skills. They were then asked to go and spend an hour or so with poeple from different churches (a cunning way of networking) practicing with some of the teaching aids they were given, teaching eachother.
I sat in with one group, and they were each so gifted in certain areas. One young mother was clearly concerned for the topic of mother to child transmission and spoke from the heart about the best way to protect mother and child in and after pregnancy. Another pastor had a great way of bringing everyday Liberian cultural themes into their teaching. I was astounded for this a first try. Tucked away in a dark, unlit, cool classroom, their time and efforts took on new meaning. This group will impact so many people around them, they will share with their family members, and they will bring the hope of Christ with them as they do it.
At the end of the workshops, the group is encouraged to go together to be tested so that they know their status, and as a way of starting to break down the stigma by helping with counselling of fellow group memebers if necessary.
I was privaleged and amazed at the enthusiasm and concern each person had. They all spurred one another on as they began to teach, they all shared openly and honestly about the things that had come across. This is an awesome programme!

I have been renamed...!

Yesterday I spent the day with our HIV team (much more on that in another post!). It was another of my most enjoyable days off ship. We went to a place in Upper Caldwall to a smaller more rural village area. The journey there was the bumpiest I have ever had, no opportunity for dosing! we spent the day with 22 pastors/leaders of nearby churches, and it was fanatastic. There was one moment that stuck out for me a little more than the rest on a personal level and taht was during lunch.
We were eating a traditional African meal of rice and 'meat' (!!) in spicy sauce (and I mean spicy...in the blazing sunshine that was around today!). Debbie one of the pastors wives looked at me quite deeply and asked my name again. A few minutes later after she had been sitting in thought, she said to me I am going to give you your Liberian name in Pele (a West African dialect/language). It is 'Lelah'. She smiled profusley and knowingly...We all continued to chat and relax and that seemed to be the end of it.
Before we left she shook my hand and said 'Don't forget your Liberian name...Lelah'. 'Remind me what it means' I asked: and there it was plain and bold as day
"I am satisfied" She said as she looked right into my eyes, with a look that felt like she was seeing inside my heart!
Kind of took the wind out of my sails and made me stop in my tracks. Satisfied. Am I, will I be, have I been? Questions tha have been running through my mind since she said the words.
I don't know why she gave me that name but it certainly fits in with a lot of my thought processes recently.
Where am I looking for my satisfaction and is it enough?
Well I am not there yet, but one thing I know for sure, particularly whenI am working and being in a place like Liberia, my satisfaction is not coming from any earthly thing.

Night shift

Last week I did my set of nights and I had a really great night shift. Lately I have been quite tired and I am embarrased to say have felt myself 'living' for my days off. It has been quite a challenge to think about that mindset in a place such as this, and it's hard not to judge myself and my attitude and feel pretty horrible. So after some rest and some determination on my part to try and change my attitude, I went to my night shift praying hard and with a renewed attitude.
The shift began with me as always introducing myself and explaining I was their nurse for the night. As I went around, it was obvious that a couple of my female patients understood very little English. So the sign language ensued. Both ladys had had goitres removed from their necks and so I spent a lot of my time going round doing all sorts of checks of their necks and faces, prodding and poking, trying to explain what I was doing was pretty hard but they were very tolerant! I have noticed that often people with the same types of problem will group together, and my ladies were no different. We had 3 other ladies on the ward with massive goitres who were having their operation the next day. This is the place where their large swollen necks (and whatever else they have problems with!) are not looked down upon, and someone else knows exactly what it is to be rejected, stigmatised and made fun of.
Somehow my night with these ladys was different. Sometimes language and having to point, gesture and simplify can be really hard and a huge effort, often to no avail. But my ladies were patient, and somehow with smiles, points, and showing eachother what we meant we were able to get by, and what's more is that it was fun.
I was also looking after Kossi again, so we had a bit of a play as I went round, he is turning into quite a live wire! He loves to be cheeky now and is a lot of fun.
As I turned the lights out and prepared for the long night ahead, I remembered my intentions to pray for my patients. I snuck around the curtains which we set up to dull the night lights to a comfortable level, I went to see who was still awake. I offered to pray for 2 gentlemen who had been quietly resting for most of the evening from 7pm when I arrived. They were most enthusiastic and so I prayed, one of them ferevently agreeing for all I was praying. Yet again I think the patients were more of an encouragement to me than the other way round! Often you will find that during the day but particularly in the mornings, many of them will dig out their bibles and quite openly pray or read psalms out loud. I love to hear that, and am reminded of their focus every day as they get up, by the first thing that they do.

Everyone works together

In my last post I forgot to mention one of the most 'warm heart' moments of the day. After the admissions for the next day arrived, we asked the translators to prepare some patient activities. We have thread which we use to teach and make friendship bracelets with the patients, so on occasions we spend time bagging up thread of the right length and attaching safety pins etc. Well, this was an amazing sight. Within 5minutes of the new kids and the bubblefest, the mums and dads of the new arrivals were sat with the translators in a circle, cutting measuring and bagging thread.
This was a community event. A time of just chatting and sharing. Mamas (many just young girls) laughing and joking, sharing I expect the events leading up to the big white ship, and these funny white people. There was no complaining, only joy, laughter, and a great sense of purpose amongst the new group.
Many times I think we miss the simple pleasures of being with others. The people of Africa are daily teaching me how important community is. This is how many have survived the war in one piece. Everyone pitches in and gets on with the dull tasks by making an event of it. The young girls help out their elders. I have also witnessed men, being men, but also being the most amazing fathers.
we had a young lady with a baby who was having surgery, and the young man in the bed next to her was ready and waiting whenever she needed a hand. He comforted the child, played with her, entertained her and fed her whenever needed, without being asked.It was just an innate response!

I love to witness these moments. I will never tire of them. We may 'be bringing hope and healing to the forgotten poor', but what this experience is giving me I can't even articulate!

On the ward

Tuesday was just 'another day' on the ward, I use that term carefully because I am so conscious that nothing I do here is just another day...I began my day with 5 patients. As the patients woke from their deep slumbers, I tiptoed round checking charts and getting my brain in gear for the day ahead. We are assigned patients according to level of care rather than a certain area of the ward so it is a habit of mine to introduce myself to each patient so they know who to ask for! When I first arrived, I wasn't quite so clued up on this and how important it is to them to know your name. On the odd occasion I forget they will remind me. I find that quite a challenge because sometimes I am the world's worst at remembering translators names, and even the patients sometimes.
2 of my patients for the day were men who had had hernia repairs, and they were to be discharged. One of the big things we have to do is teach wound care to each patient. It may seem like an easy thing to do, but I have had to learn the right words to use; water from the pump, put pan in fire for 10 minutes etc etc, and then teach it in very short sentences. We English know how to make things complicated just by using lots of words! I am slowly developing my Liberian English, 'wait small' 'it hurting you?' 'you whan pan?' but often have to rely on the translators to help when I teach. It is so important that they are taught everything from how to wash hands (and with soap and 'clean' water) to not touching wounds with fingers, and making clean salt water ever day.
The two men I spent time explaining this to picked it up pretty quickly. I recently spent some time designing a 'how to make water for wound care' leaflet in words and also in pictures. It was a challenge to come up with pump pictures instead of taps and a fire showing how they usually boil water. It has taught me to think a lot about the lifestyle here.
Having discharged the 2 men I thought I might have a quiet day, not so! I had one lady going for thyroid surgery (oh how I love those...??!!) She was quite nervous so I spent some time talking to her about things. When I finally took her to surgery, we walked slowly down the long corridor, so alien to her, carrying her fluid bag in the air, heading towards 'the bench' outside the anaesthetic room. As we sat down, she let out a quivering breath. I forget this moment is even more strange to people here than a 'first surgery timer' at home. Many having not stepped into a medical environment before, let alone a ship or anything air conditioned! As the theatre nurse arrived we asked, as we do all patients, if we could pray for her. She agreed, and we prayed for peace, rest and guidance for the surgeons. No where else have I ever seen prayer so readily received than 'the bench'.
Returning to the ward I spent sometime with Kossi my little boy who has had bilateral osteotomys. He was sporting a woolly jumper, donated from somewhere, a bit of an 'off the shoulder number' as it was a little too big, but he loves it. He previously had to have one of his eyes removed and a false one is now in it's place. Somehow that false eye gives him an even more deeply beautiful look about his cheeky smile. Every now and again, I feel a little dig in the back of my legs. He is behind me in his wheelchair, with crutches and pillows rigged up for leg supports. It's his cheeky way of just letting you know he's still there! Kossi loves playing 'pee po' despite him being 10!
In the afternoon there was an influx of patients for the next days surgery. Laura our assistant ward supervisor had found stacks of bubbles so because of the influx of kids, we had a big bubble blowing session. The shiny bubbles were flying in all directions and even the smallest of kids were following them carefully and reaching out to pop them.
One little girl that arrived was quite shy, but such a sweet spirit. She
sadly had had an infection in one of her eyes. It bulged out in quite an ugly manner, she was to have the eye removed the next day. Completely used to just using her one eye, she will bounce back after her surgery, and she joined in the games no problem.
Ali (of team awesome!!) was a gem and talked to one of my little ones about his surgery the next day. Each person gets a teddy in their admission pack, so Ali dressed up his bear with dressings to show him how his tummy would look after his surgery. He was a little nervous, but was put ease seeing what he would look like.
My patient who had thyroid surgery returned a little later, and so ensued the pointing sign language that I am developing quite admirably! She was so relieved if a little shell shocked. Some time after she returned I got a mirror to show her her neck. The lump she had removed was the size if a melon. As she looked in the mirror her eyes glazed over but she said nothing, gently touching her neck, I could read it all in her eyes. A small time later her family came to see her, and is often the case, thanked and thanked us profusely. At times like that, I find it so hard to 'accept' the thanks. It's a struggle to feel like we have done anything more than these wonderful people deserve.

The ward

One part of our ward. We have a no ward photo policy so this was after team awesome Ali Grace and Katy had just finished the major ward clean a while back.

My friend Katy

This is my closest friend Katy. She's a gem. We have the same schedule and always have lots of fun when we work together.

A game of pairs

We try and do interactive games, particularly with the kids. They love it One of the favourites is the game 'pairs', where we have lots of picture cards turned upside down and the aim is to find by turning over 2 at a time, the matching card. Unfamiliar pictures of purple monkeys, dinosaurs, birthday cake, rag dolls and such keep the kids particularly interested.
Last night I had a few games with two of my patients. One little girl speaks only French (and those who know me know how much French I remember...), the other little boy speaks Liberian English (which to be fair can be as undecipherable as French to me sometimes!). Konhu has a large mass on her neck and has been waiting over a week now for our CT scanner to be fixed so she can be scanned before they go ahead with her operation. Fixing tings here can be painfully slow but with her home being 3 days travel away, the little girl and her Mama have decided to sit it out on the ship. Kossi had bilateral osteotomys on his legs, which before surgery were so bent he was virtually sitting in the floor. He is now wheelchair bound until his casts are removed after 3 months and he begins physio to get him walking again.
Both children are quite shy, but they love pairs. With games like that, language is no barrier, and we settled down to several rounds with plenty of laughing and giggling as the 2 tried to cheat sneaking a look at cards before they turned them over. I am sad t say, I am particularly horrendous at the game, and I lost every time!
It is such a nice thing to have time to invest just being with my patients. They all love just spending time with us. I can't quite imagine how I will adapt to such a different way of working at home, generally with so little time just to sit and 'be' with the patients. It's sometimes means as much to the people here as the surgery itself. I think everyone should get a taste of this...

Have you ever seen me dancing I mean really dancing....?!!

It is a fact here, that white people are thought of as pretty 'special' when they dance. I don't know if it's that there aren't many white people so they don't see them dance or that they just think we can't, but whenever one of us puts our hand to dancing, there is uproar!
Two nights ago I was passing through B ward with some medicine, and spotted half of the ward focusing on the nurses' computer screen. There was some kind of African music pumping out of the speakers, and on the screen some people dressed in traditional outfits dancing to the beat of the traditional drums. On the screen one of the men started doing some kind of bandy legged manoeuver, and shaking his arms, so instinctively, not really paying attention to what I was doing, I thought I'd give it a try as I passed the screen...well, you'd think I was the worlds best comedian as the cheers, hysterical laughter, pointing and general astonishment erupted! I sneaked out of the door to the ward still dancing glad that I had 'entertained' the masses for a few minutes...

James and Moses

The twin stories continue! James has now had his second surgery to repair his hernia, following his diagnosis of Malaria. Moses' cerebral malaria has settled and has not had any seizures for sometime.
I have been on night shifts this week and B ward was a hive of activity all 3 nights. James and Moses had their 'family bed' right near the nurses station. Last night I witnessed 2 hilarious and touching moments in the twins day. They are both now feeling a whole lot better and are up and about on their feet and back to mischief.
In the evenings we let the kids play or wander between the wards providing they behave themselves, as I was tending to on of my patients in A ward, the door opened and in wandered 2 little figures with chocolate skin and chubby cheeks. The boys dressed, one in red and white stripes and the other in tie dye mini theatre gowns, a little too big for them, wrapped almost twice around their podgy waists, the gowns virtually touching the floor, entered the room clearly on a mission. heading straight for the corner they retrieved the big yellow physio exercise ball. Then began the hilarious ball exchange between the twins, uttering some little phrases with much indignation, the 2 boys loved every second of their playtime together. One of my friends Katy began playing pee-po with the boys as they buried their faces in to the big yellow ball, giggling with delight. It is hard to imagine that these 2 little boys had just over 24 hours ago both been clammy, grizzly, lying pretty much motionless in their 'family bed', with us trying our best to make them smile to little or no avail.
The next of the delightful moments came a little later in the evening, and I popped to B ward to speak to someone. I stopped in my tracks as I heard James and Moses' mother say 'Go!' What was before my eyes? The twin boys, in their slightly too long and too big gowns, in their little sandals, trudging one behind the other toward the bathroom door. Moses was carrying a large shiny rustling bag crammed with soap and towels and toothbrushes, James with a big blue washing-up-esque bowl, both piled on top of their heads, held secure by their squidgy little arms straining up to the top of their loads. We were all laughing and delighting in how the 2 foot something boys carried on not a care in the world. Then their Mum did it, she brought the tears to mine and Ali's already unstable emotional cascade...She piped up, singing loud and rhythmically, dancing a little with one of the songs we often here in church and on the ward...'He will carry my load...'
I think Ali and I could have had an aneurysm at that point...
Another 'this is why I am here' moment!

A song

One of our Mum's this week (Mum to twins Moses and James) asked to share her thanks to God at ward Church. She began to sing the most spine tingling, hairs standing on end song. People here grasp music in a way we don't often see back home. They are not concerned for the right notes, pitch, key or even rhythm. They just care for what it means to them and to who they are singing it to. The words roll out rich and heartfelt, deep and yearning for something deeper than human contentment. For much of this song, I did not understand the words that were sung, they were in a local dialect, what I did know was that she truly beleived every word she spoke in praise to her awesome God.

Her baby Moses had to come back to the ship because he contracted cerebral Malaria and started having seizures after his hernia operation. He has improved, but his twin brother who has had the same operation (who had to come back with Moses to be looked after by Mama) was found to have popped his hernia again, and when doing his pre op blood work to repeat the surgery, he was found to have Malaria too.

The saga just keeps continuing, yet Mama's praise keeps coming! The two boys, though a little grouchy with their fevers continue to be precious, in matching Christmas Red gowns, they are bright eyed and mischievous. Their story continues...

Baby Greg update...

Baby Greg who has been quite sick has had a good weekend. In fact, on Sunday when I went to ward church, I found out that he had actually had a bottle feed and had spent several hours on nasal cannulae rather than the CPAP mask. A pretty exciting moment for us all, and quite frankly, a miracle in his little life. He is still ill adn only time will tell how he will do, but for now, his Mama and Papa can rejoice in these miracles.
Last week, Greg's Mama had wanted to share her testimony with us, but Clementine one of our crew who runs ward church said she could share the next week as we didn't have time left. Several of us were pretty distressed, thinking that Greg may not be here this Sunday, and that his Mum would not have had a chance to share her thanks to God despite everything. I guess we all learned that sometimes God wants us to hold back until the right time and we need to trust the wisdom of others, because this week Greg's Mum had an amazing opportunity to rejoice for God's hand at work in her baby's life.

Courage and something a whole lot more powerful

This last week I was listening to some stories one of the Mercy Ships crew had gleaned from some of our patients. They were remarkable stories. Often the people here are suspicious of what we do, possible from a lack of knowledge and maybe from the stories made up by other people. One person was told that if she came to the ship she would have her hea completely shaved by us. Another man was needing an operation and believed he would be circumcised whilst he was having his other surgery that he needed. Another lady had been told that the ship would sail away with her still on it.
But you know what, each of these people still came, so desperate for their surgery and for some hope, they were willing to come anyway. What is even more remarkable is that the lady who was told she would have her head shaved, shaved her own head before she came to the ship...
To know that people come despite their fears, tells something about the need here. So many of our patients tell us of how God has spoken to them and told them to come to the ship.
One of our patients told us about his journey to the ship in ward church yesterday. He had had to wait and take a long time to get here to be seen, but he was determined and has had his surgery and is so thankful.

Running on the dock!

Well, I am pretty sure many of you will be quite surprised but I have started running several times a week now. I don't mind telling you that muscles I didn't even know I had are hurting, but my word it's pretty satisfying!
Days as I am sure you can imagine can be quite intense, and getting some time out to go and pound my frustration out on the dock is a lifesaver!
Normally I try to go in early evening or when it's dark, but that dock has heard many a thought about my day, and been subjected to many a cry out to God. It's quite freeing to be alone with my thoughts and God, and I certainly need it.
The dock from the end to the main gate by the road and back is a mile apparently. I am managing to run between 2 and 5 of those depending on the day, amidst a bit of walking. Also gives me time to discover songs I don't even know I have on my MP3 player!! Thanks to Emma for many of those!!
Hopefully I'll be bringing this habit home with me...watch out the streets of Brum, my orange t shirt will be coming!!

Baby twin Moses

I heard a little sad news yesterday. One of the gorgeous twins who had a hernia repair that I wrote about a few days back was readmitted yesterday. Overnight at home he began to have seizures and was fitting for the majority of the night.
He was brought back to us and was diagnosed with cerebral malaria. It is obviously not to do with his surgery, and ironically I believe he was tested for Malaria whilst he was with us and nothing showed up.
Right now his fits have settled, but it's not exactly what you want to hear. Because of rainy season, Malaria is around in abundance. Patients arrive to the ship with fevers and we have to test a large number of them. Many of them end up having surgery cancelled or delayed until they have had treatment. Although obviously there is always some risk, it is hard when you think that so many people contract malaria which could be preventable, and with it there are so many deats. Mosquito nets are as far as I can tell not widely used. Another factor is that actually trying to afford or get to clinics for treatment here is difficult, especially for those in far off villages. Thankfully we are able to try and help Moses, but in reality if he hadn't just been a patient with us it is likely it would have been a very different story.
What we take for granted just being able to pop to the chemist in a car eh?!

Baby Greg

One of the great things I witness every day is our ward disciplers. They come around the ward to talk to each person, to lead them in a time of prayer and to sing with them. It always happens when you need it most. Well this week has been no exception. We have a tiny tiny baby called Greg who has been with us for several weeks now. He had a large mass attached to his trachea which was removed in major surgery. He appeared to recover quite well from it initially, but in the last weeks his situation is becoming more desperate. His trachea is such that it is too 'floppy' to support itself for him to breath and do everything else his body does. He is on a mask which assists in forcing the air into his lungs.
At home there would be more that could be done for this little one, but sadly the country does not have the hospital care needed to go down such routes, because the care he would need after we left could not be given.
We are doing the best that we can right now, but the situation is so hard. His parents are young and frightened. The disciplers on the ward have been an absolute beacon of light. Every day they pray for Greg and every patient is interested and concerned for him, and asked to join in with praying. Each day the prayers that go up in the ward from patients for patients gets me right in the gut. Why we have so little gusto and faith when we pray sometimes is beyond me when I see these guys!
People may well ask me how I can believe that what is hapening to this little baby is right, all I can say is that I can only trust in My Creator, that he has this little boy in his hand. He needs a miracle, and I can only continue to pray for that miracle to happen, and soon.

Thyroidectomys........ Eeeeeeeeeeek!

Ok so, along with the new 'general surgeries' has come thyroid problems. Around here, thyroid problems are not uncommon. For me, this probably has to be one of the most nerve racking post op care situations...
Thyroidectomys involve removing massive swelling from peoples necks. Because of where the surgery takes place the airway is something that has to be carefully thought about. Having not been party to caring for such a patient before I was given lots of information on what to look for, incase bleeding or a drop in calcium occured. There is the potential for massive bleeding in the neck which can occlude the person's airway pretty quickly (ie less than a minute). You have to keep an eye on swelling so that if needed you can open up the incision line straight away there at the bedside...
Hmmm...not so keen on that idea I can tell you. So I guess you could say i am learning new skills at the very least...

Oo, in case you wondered, my patient was fine, all went to plan and I didn't have to get my scalpel out - thank the Lord!!

A different kind of surgery

This last week has seen a change in the surgery that we do. Sadly, all the orthopaedics have finished for now, but general surgery has begun. Yesterday I had several patients going for hernia repairs. Many of them are young little ones.
I had one of a set of twins, James and Moses. James was the 'chubbier' of the two twins, but before their surgery they were playing together so beautifully with our huge yellow exercise ball which the physios use. One of our nurses was telling me that she remembered the twins from screening, The smaller of the two had been quite sick, but Moses was actually looking really well right now.
When tey came in we pushed 2 beds together so Mama could continue to look after both boys in close proximity, so there was a big family set up in the corner of the ward. The boys are 18 months old, but here it is common for Mama's to continue breast feeding for a long time or until another child comes along (they may even continue feeding different aged children!). So we figured, having this set up would make life easier.
They are a funny pair. As part of a premedication, both of the boys were required to have some pain relief and a mild sedative. James, the twin I was looking after went second, and had a little longer for the medication to work. Consequently he had a few minutes desperately trying to sit up and comically rolling over on the bed instead. The things we do!! What was really lovely was that James started to call out for Moses about 10 or so minutes after Moses had gone for his surgery, realising his twin wasn't there.
When they had both returned to the ward they greeted each other with drowsy nudges and the pair settled to sleep wrapped up in their fleece blankets. The patients here often complain of the coldness because of the air conditioning. As the boys came around, Mama did a great job of handling the twins, consoling and feeding the pair of them. Pretty admirable! Their crys were exactly the same whch was a little disconcerting for the other nurse and I (who happens to be called Grace too...!) because we kept looking to see if it was our patient crying!

Firestone Rubber Plantation

Yesterday I went to the Rubber Plantation that is owned by Firestone. You may have firestone tyres? We went driving through the massive platation which is esentially a huge community. It has a school, clinic, the rubber factory and all teh rubber stations. The workers are required to tap 1000s of rubber trees. they use a sharp instrument to score the tree and then around each tree a small collecting pot like the size of a small plant pot is strung around the tree. As the sap drips it is channelled into the pots. We were talking to some of the guys that work there. They work 7 days a week and very long hours. It is hugely heavy work. It takes 4 hours for a tree to fill one cup, then this is all added together in a bucket of about 8 gallons. In the one station we stopped at, the guys are expected to collect 68 gallons per day of the rubber sap. That is a phenomenol amount! Plus once they have collected the small pots of rubber, they have to fill their buckets then carry them (walking), some of them for 45 minutes from their tree area to the main station, using a bamboo yoke. Several of the workers were coming back to their station as we arrived and they looked exhausted.
the workers get paid £1.50 a day and work 7 days a week. It was pretty enlightening to say the least. I never knew what a process was gone through to get rubber! It seems pretty strange to think how much this company is making when their workers are getting paid so little.
The forest itself was beautiful, really tranquil and so peaceful. I forget how noisy it is here in Monrovia, there is never any let up with noise!

Feeling the pressure...and other musings

This week we began the first trial of our 12 hour shifts. unfortunately, it happened that I was on a stretch of 8 days with one day off, and I ended the stretch in 3 consecutive 12 hour shifts, eek! As you can imagine I was pretty tired. I wasn't quite aware of how demanding my group of patients had been until Monday, but Monday came the pressure. I didn't stop. My patients who I love dearly just need so much right now. Not only do they have their physical needs, they have an emotional and spiritual need that in my own strength I cannot fulfill. I guess that's what I was trying to do , and let me tell you it didn't work! It can be so difficult here. We have one patient who I have looked after for some time now who to many of us, seems quite irate and angry all the time. he is 'demanding' and it can be hard to keep calm with him. Monday I was with him for a long time as he talked to me, and I just had to ask, 'What is it that you need from me, what can I do?' We prayed together for a long time. This man is 24, we have done surgery to his leg and arm for him, but he has had a stay in another hospital which has caused other wounds that we are now trying to treat. He has little education, few family, does not live locally, has no money, and is pretty much desperate. Since the war this is not an uncommon thing, however, his injuries mean that he is limited in what he can do for work, and as unemployment rate is 75-85% here. The outlook is bleak. This was a day when I came to breaking point, what am I doing, is it enough, I can't do everything, I am one person, and I am not superwoman (though I may like to think so!).

Yesterday I read Haggai, and that really spoke to me. In Haggai, it talks of how the peoples own lives were not being productive and fulfilling. God told the people through the prophet Haggai that they needed to rebuild God's temple because while they were busy with their own 'houses' God's house remained in ruin, and therefore things were being held back from them. I guess in my own life, I realised that I haven't been so careful to nurture God and my relationship with him in recent weeks, and in many ways, this is likely limiting how effective what I am doing and being could be. Don't get me wrong, everyone has good and bad days in life, and there will always be needs that can't all be met for my patients, but what I am spending some of my free time doing could be building me up and making me stronger for those tough times.

There was one little 'saving Grace' on that stressful day...Every now and again, I went to say hi to one of our precious boys aptly named 'Darling Boy' - he is an absolute treasure. He has long curled up eyelashes, and the deepest brown eyes. He is 6 and the most polite and gentle natured little boy. He is quite happy to just sit on your lap and be cuddled. He often runs back and forth to the water tap to fill up cups for those bed ridden, and has only ever once asked me for anything, and that was amidst the demands of Monday. 'Please get me a baaallooon' he asked coming right up to my ear as I gave him little snuggle. Well, after we skipped down the corridor together giggling all the way, a balloon he got. Entertainment for him and 4 other kids for the next 4 hours...
These are the things I try to remember to thank God for amidst everything else.

The raft pictures...

The man with the raft! Tee hee...