The Queens birthday!

Today was 'Queens day,' a day acknowledging the Queen's birthday, and a huge deal for the deutchies on board the ship. to the extent that they set up a huge typical celebration on board and outside on the dock. there were stalls selling all sorts of things, food, local crafts, games for the kids, and outside landrover pulling races and many other random activities! There was a photo taking area where we dressed up in whatever bits and bobs were there and took silly photos. It's so fun to have lots of community things to do!
So before my night shift tonight, I went and had a go at pulling a landrover, oh yes, one rope, little old me... arrrggghhhhh! I did it too!! Check me out! I may never walk again but I did it....!
We had great fun, pics to follow in a little while!

Church in the village

Last Sunday we went to a small church 'Pillar of fire' in a village a short drive from the ship. It has some regular Mercy Ship attenders. We arrived after a pretty bumpy ride on some dirt tracks, surrounded by very lush green trees, and houses with precarious tin rooves dotted around, after lots of hearty waves from small kiddies around adn about outside as we passed by we arrived at the church. The whole area of land is the churches, so at one side is a concrete slightly raised up platform, with woven palm tree leave walls (I think that's what it was!) and a tin roof. Not exactly sturdy but so beautiful! There were rows of plastic chairs and a few benches. Outside there was an area with a roof but no walls, where they do studies, teaching etc. Just a little way from the church was a ploughed area of ground that the people from the church have started planting different types of vegetables in to see what they can grow more extensively. Lots of shoots were appearing and the Pastor (one of the dayworkers from teh ship) proudly showed us what they had been planting.
The service was being run by the kids, they did the notices, a story in drama and led all the singing. I tell you you haven't heard music till you've heard African drumming. It is such an amazing rhythm and sound. I am determined to get my 3 clap rhythm before my trip is out!! One person sings a line, the rest repeat it and so the singing continues, who needs power point?! The beautiful heartfelt sounds give me goose bumps every time! And the kids leading it, well anyone who knows me will know my heart is pretty much going all out...
What continues to be so amazing to me is the respect that people come to church with. As we eneterd the building, one of the men was just arriving having walked probably a good distance, he pulled out a cloth and began to polish his shoes. Only then did he enter the building. It seems so alien to me yet so humbling. The women too come in the most amazing outfits, beautuiful fabric and so bright. I am planning to get myself an African outfit made at the local tailors but I'll never be able to carry it off quite so well. I had to settle for my own semi African print dress I bought in the Uk before I left instead this time.

Weekend work and play

Saturday was a very exciting and somewhat chaotic morning. Remember the sisters who's girls had their cleft lip repairs? Well, they and 2 of our little boys who had bilateral club feet repairs went home. It was quite a chaotic morning but it was great to see them all disappear home! After that the ward was quite quiet so I joined in a few games of uno with the young lads on the ward.
We have a slight lack of nurses crisis right now so we have all been doing extra shifts, and covering for a few sick people. As the ward was quiet we were able to give some of the nurses some time back so I manned A ward from 3 til 7pm on my own. It was lovely though. The patients told me before I left I had done a very good job ;-) That made me laugh lots, I think the were happ because I had chance to play UNO again with them!
Every Saturday morning we have a team of people come and do a ward activity. It's great fun! The middle of the ward is set up with huge tables and table cloths, crayons, scissors and whatever else might be needed. For 2 and a half hours kids and adults, patients and carers come and sit and painstakingly colour and cut and stick. You have never seen such a great sight. They all just love to do stuff like that so much, so they all coloured then cut out a picture of africa which they then made into a jigsaw. They were all so proud. The people who couldn't get out of bed we gave things for them on their beds. One of my patients who is a pastor spent ages colouring his picture so perfectly. I can't get over how many of the normal things we do the just haven't had opportunity to do!

Friday night was English night!

Well after a great day at work, a group of British people from the ship took a landrover and for a curry! We had a really lovely time sitting under a huge tin roof outside the restaurants building and ate amazing curry. Not quite sure what the need for the movie screen in the background playing some kind of Greese tpe movie (musical) with no sound...
Had lots of fun just chatting and being British ;-)
Stopped off for banana icecream on the way home (only because it was the only flavour they had!). Back at the dock we decided to sit outside and watch the huge storm that was rattling around out at sea. It was amazing, huge fork and sheet lightening. I love a good storm!

Just a bloomin brilliant mornin'!

Well, last night I came from work feeling a little like the most evil nurse in the world! Several of my patients were under 2, and you would be surprised how much some of them are either scared of nurses, but largely scared of white people in general. So, unfortunately, every time I tried to give medication or take vital signs, there was a quivering lip and eventually a huge sob. It became a running joke with my colleagues to shout as soon as a baby cried, 'Grace, what did you do now!?' On the flip side, their mum's were so lovely and just laughed it off.
Yesterday was also another 'first' day for me. I put in my first IV cannula, I am so excited! That may sound ridiculous to many of you but I haven't been trained in England (all about the paperwork and competencies there ;-) ) plus I didn't spill or anything. Hurrah!! My second hurrah, was a beautiful new 9 month old orthopaedic patient, and he was just precious and let me do everything I needed to do without even a whimper.

My shift today was a little more jolly. I really just wanted to connect with my patients. I managed to remove the most awkward sutures from a patient's eye and lip (eek, blade, eye equals shaking lots!), plus have you ever tried trying to spot dark blue sutures on black skin, through stubble? Not so easy I can tell you that! In fact, this was the guy that I wrote about a while back who had severe seizures and how amazed I was at teh patients all praying so fervently. Now he gets to go home AWESOME!

After that, I managed to spend time with one of my patients who had removal of an enormous tumour yesterday. He is such a gentle nice man. He had quite a lot of bleeding after his surgery last night so I spent some time today helping him wash, change sheets and getting him comfortable. It was so humbling. he was just so thankful and calm. A real privelage to look after and it was so nice to have the time to invest in him.

A little later I spotted a young man (not one of my patients but in my ward), he had had eye surgery yesterday. He was really upset and crying I had no clue why,but I sat and chatted to him for a while. It turns out he had just done his first set of eye wound care - we teach this so they can carry on at home using a mirror. He was obviously quite distressed with what it looked like. He just said to me 'I am just so worried about my eye'. It is all too easy, as i am sure any nurse or doctor anywhere can testify, to forget how significant and traumatic surgery can be. So, we just took some time, chatted and then prayed. Great!

Just to finish off such a lovely day, we went up to deck 7 where we take our patients to see a bit of the outside world between shifts. We took 2 little girls who had had cleft lip repairs (5 months old and cousins (and one of the girls twin brothers) and had a great time just playing. They are so beautiful, and it is so awesome to see them breastfeeding properly like they have never been able to before. It is so amazing to see the difference in the twins size, just as a result of the quality of feeding they have been able to have, one with and one without cleft lip. The girls mum's were sisters too, how great they could go through all this together.

Finally, news from down the corridor...we have had to have one of our wards open for patients with some very bizarre infections, to isolate them from other people. Today we were able to close that as all thpatients infections were either gone/settled enough to join the main ward. WOW!

So, today has been a fabulous exciting, blessed, fulfilling day. I know not everyday will leave me so elated but I am so thankful to be part of this on good days and bad days. These people are phenomenal and teach me new things everyday, and a smile...the key to so much!

Missionaries of charity visit 2

You may remember last week that I visited a hospice type place, run by a group of sisters and working to look after children and adults suffering with HIV and other debilitating diseases.
Well, this morning I went again, our team was a little smaller but 2 of us did go to spend time with the children again. We were fairlly well mobbed as we arrived, and decided to try and focus our attention on the slightly younger children this week. There were a few more ladies around helping today, but still the ratio was 4 to 35 kids age from a few weeks to 10 years (most falling in the 1 year to 3 year bracket).
So much of what we do is just giving out love and affection to the children. We decided to take fewer activities and sing some songs. The kids just liked us being there. It was particularly hard because the kids can at times be a little violent to each other in order to get our attention, they all want to be on your lap. It's hard to shout at them when really you are the only one on one attention they ever get, how can you say no to them? so we did our best to cuddle and involve a few children in what we were doing.
A little later I went to assist one of the sisters with feeding the smallest babies their milk. There were 4 all in cots and so clearly crying for their lunch! They were able to have their bottles but because of lack of hands the bottles were propped up on blankets if they couldn't hold them. It was so nice to be able to pick up a little one and feed them their bottle properly.
Several of the kids you could feel their body temperatures were so hiigh because they were sick. You may remember from my last visit I mentioned a tiny boy who had disturbingly low tone in his limbs who was clearly quite poorly. I looked for him today and he wasn't there. He may have gine home or to hospital but sadly I fear the worst may have happened. That's what makes leaving the kids in this place so tough! The sisters clearly care so much but there are limits to what they can do. I just simply went and loved and cuddled the children, not a huge sacrifice to me at all, (in fact I couldn't have been happier doing much else!) but to these kids, absolutely a crucial act of kndness.

The background of many of our 'plastics' patients

I thought I would just give a bit of information about how many of our patients requiring plastics and burn surgery come about. The main way of cooking in Liberia is either open fire or using oil stoves and lamps. As a result many of our patients have had quite horrific burns from fire or from spilt oil. Children are particularly at risk of having such burns. Our team have recently been involved in 'releasing' burn contractures, where skin as become tight and forced a limb into an abnormal position. For example, one child I have been looking after had burnt his legs and one foot in particular had been pulled inwards so it was difficult to walk. He has been able to have surgery from a skin graft to ensure the foot is able to go into the correct position. Without it, he may well have been considered 'disabled' and unable to walk and support a family in the future.

I have also heard some quite distressing stories of other burns. It is not uncommon to have more than one wife here, and on occasions there can be a great deal of jealousy between them. One very sad story is of a lady who had hot water/oil from a cooking stove poured over her by the 'other wife' because of her jealousy. Consequently she has huge burns covering her arms, and back and her skin is severely disfigured. Her surgery was to try and return function to her arms using skin grafts from healthy tissue. She is doing quite well now and her face lights up in a way before her surgery she would never have dreamed of. It has been tough to look after her knowing her story but her guts and her now smiling face is a delight!

Worms and other stories (not for the squemish!)

Well, it has taken me a few days to proces the remainder of this week. It was a little strange and a little eventful. A large part of what Mercy Ships is involved in is health education. Largely this can be the community projects that go on, HIV and aids teaching, handwashing etc when being taught how to prevent the spread of infection and diseases common place here. This week I have really had to step it up with a couple of my patients and thier caregivers.
Unfortunately, worms is a common complaint for many people. Poor hygiene just because of lack of education and understanding about the spread of worms is the most common reason for it's spread. Two of my smallest patients this week have been found to have worms (unfortunately, one of them by me!!). The treatment is very straightforward, but without explaining how we can stop it next time, it's a pretty futile battle. So I have spent some of my time at the end of this week, reiterating the need to wash hands before and after using the toilet, and especially for little ones to try not to put their hands in their mouths (easier said than done for a one year old!). I had the great joy of being called over by one of the aunties this week and asked to look in her niece's nappy...lovely, a live worm! Well, one of many things I have had to learn while being here. If you find anything unusual anywhere, keep it! I hadn't quite realised the importance of this but the lab actually has to look under the microscope and analyse worms to check if the treatment given is appropriate. Strangely this little girl had already had treatment which would have killed any worms. So, here is aother little one of my 'everyday' occurances here. What is quite difficult is the limit ofthe teaching we can do. On the ship the patients have a bathroom and a sink and soap t owash hands, at home many don't even have dug latrines, infact as I have witnessed, many people will go and toilet wherever, near houses and even the markets, especially children. So the ministries we have in the community are crucial to continue this work effectively.

We also had quite a situation on the ward this week with someone who was quite sick following surgery. It was a very hard situation as the wards have no curtains around the beds, (we put up curtains around the beds using magnets for particularly invasive dressings etc) so we had to move all of one side of the ward to another while we worked on the sick patient, with quite limited instruments and supplies. Thankfully 25 people (anaesthetists, surgeons and nurses) appeared with the emergency call out. What was so amazing to me was the response of the other patients. I went to check everyone was ok and asked all the other patients to join me praying for this person as the team tried to help him. expecting 'Amens' when I finished, I was moved to tears from the loud heartfelt prayers that came flying out even from the kids on the ward for this patient. I have never heard anything like it in a hospital! AWESOME!
...and the patient is well and now back on the ward, even better!

A little miracle!

Well, last night I went to work on the ward I did my night shifts on. As soon as I arrived to B ward, I noticed a distinct difference...
One of the little boys I had been looking after was sitting on the floor with some of the other children laughing and playing with the blocks. I couldn't believe it! This time last week, the doctors and physios had commented the child was 'a quiet child'. Now he was anything but! He tended to lie on his bed and speak only when spoken to. He was removed from all social interaction, and wasn't anywhere near as cheeky as some of the other children! Now it seems he has turned a corner. Medically he is getting better and clearly he is having a much more fun time now too...
That's what it's all about!

The drive home

The drive home from the hospice was somewhat of an experience also. Picture traffic policeman in the middle of a huge junction having a chat while the cars do as they please, people darting in and out of the cars with various containers basket and fruit on their heads and you start to get an idea! Add rickety shacks from which material, fruit, peppers and every other random thing you can think of bags of water, papers, candy...Oraginised (?) chaos reigns!
We passed by the university and certainly one of the much more impressive buildings of the lot. Many other buildings are still in pieces from the war, around and about are bilboards advertising how Liberia is going to be changed and rebuilt. Quite odd advertisements!
As we get nearer to the ship, we cross a river, in it are many people washing their clothes, children playing, and a few people in large canoes made out of hollowed trees. Quite an amazing sight!
Hope that gives you a bit of a picture, it's quite tough to be able to take photos here so, until I brave it...

Missionaries of charity visit

This morning before my evening shift I visited a home run by a group of wonderful nuns. It is part of 'Mercy Ministries' a none Mercy Ship organisation but that is supported in some way by Mercy Ships. In tis case a weekly visit to the home.
They are an amazing group of women who's purpose is to look after people needing hospice care, as well as caring for people who have a short lived period of sickness where family cannot cope. Largely the people are HIV positive, and in many cases because of the stigma are brought to the ladies and abandoned. This includes children and adults. there are 3 sections to the hospice, women, men and children. Depending on the number and mix of the Mercy Ships team who go each Wednesday morning, we will try and go to each area in the hospice.
A small group of ladies spent time asking the ladies to share their stories, sing songs (it was amazing to here the wonderful African voices and drums from where I was with the children!) The team were then able to spend time one on one just talking, painting nails, doing crafts and generally pampering and ministering to them.
I spent the morning with the 40 or so children from 2 months to 12. They were such an amazing bunch of tiny tots. Many were bouncy and obviously well nourished, but there were many little ones who were visibly skinny, very subdued and looked so helpless. We layed with balloons, painted the older girls nails, gave LOTs of cuddles, played with blocks and toys that we took with us. There were quite a few characters that need a firm word, but mostly the kids were just excited to have some one to one attention. I particularly looked after a little boy who must have been 10 or 12 months old. He looked so forlorn! We had lots of cuddles, but I was struck by the poor tone in his body, He needed help to sit up properly and seemed most comfortable over my shoulder.
One of the main focuses for all the people there is to make sure they are well nourished, and there was one particular sister who I am told really spends lot of time ensuring particularly the babies are fed adequately. It is hard to believe that these wonderful children could be abandoned.
One of the particular issues the nuns face, is the issue of when people in their care pass away. Because many are abandoned by their families they often find that no one claims their bodies, they have a hard time affording to pay for an appropriate burial. This is a harsh reality, but I am so thankful they have taken care of these people so well, and it was a privelege to send time with them. I am hoping that I may make a regular thing of going to share in this amazing ministry.

Latest pictures

A few more photos...Young boy is Matthew, mentioned in previous blog inserts!

Older boy is Winston, a patient who had eye surgery and release of contractures to his hand.

Kristina is the other nurse on the photo.

Views of all the patients on the deck.

Deck fun!

Well, after finishing my night shifts on Monday morning, I dragged myself out of bed in time to go up to deck 7. Deck 7 is the place we take any of the patients wishing to have a bit of fresh air between 2.30 and 3.30 each day (at least until the rainy season starts...!). It's a great time for the adults and kids to see the outside world, and feel the Liberian temperatures (instead of the air con the patient's are so not used to!)
It is also one of the places that we are able to take photos with the patients if they are happy for us to. Lets just say most of them are! So I went to deck 7 adn we had lots of fun taking pictures and enjoying the outside. We have a really great system of being able to print out colour pictures and laminate them so that the patients can have memories of the people who have looked after them. So as soon as I have finished here, that is what I will do! One little one, Matthew (I have mentioned before) has a very cheeky grin. Another of my quieter patients Winston, was also made uop to be photographed. We had quite a lot of interaction on my night shift, sadly because he was in a lot of pain, but despite that, we have become great buddies.

Some more stories

Well, the last few days have been busy and held many a moment worth recounting. Today I arrived to the ward for my night shift, somewhat in a tiz waz on account of just having had a pizza delivered to the ship (??!!) only half an hour before my shift began. No sooner had i arrived than several hands from teh nearby beds waved asking 'how ah you'. My patients who I have looked after for the last few nights now more relaxed, and also a lot brighter a few more days down the line from their surgery. After a quick 'round' of each one to say hello, and a few cheeky tummy tickles of two of my precious little girls, I park myself in a chair ready to have pray and have hand over.
A little body by the name of Matthew scrambles on my lap and demands to go for a 'ride' on teh wheely chair! Off we go just quickly a few spins round the room...followed by lots of giggles and plenty plenty kisses from Matthew! Matthew has had release of contractures to his hand, with a skin graft, and despite his bandages is an absolute delight. He has, as he well knows, been renamed 'monkey moo' by me. Nothing else would surfice!
Following handover and a quick whip round with meds and checking charts, I then managed some time to colour with 2 of my youngest patients. Both little girls had suffered severe burns and have had surgery to release the contractures developed. We then had a crazy half hour leaping around with bubbles. A little later after some more 'nursing duties', I managed to play several games of jenga with one of the children's caregivers. Building relationships with the patients and families in this way is so important, and so rewarding too, for both parties!

We have had some very interesting talks at our orientation in the last week. In particular I loved hearing about the differences in culture and 'cold climate' and 'hot climate' countries. We were taught the importance of using mama/papa, or sister/brother for any Liberian older than ourselves. This is 'expected' of fellow Liberians, but commands a huge amount of respect here. I will have to make a real effort to change my vocabulary... We also discussed how many African nations would never begin a conversation 'getting straight down to business' that would be considered rude. Time is taken for people to make pleasantries and an effort to find out what is happening with the other person. It was interesting to talk to a local Liverian who is living on board and workingin the housekeeping department. Apart from the air conditioning to get used to, he said he had to get used to everyoone being so 'busy' all the time. Everyone seems to be cold climate friendly, i.e. everyone smiles and says hi as they go past but don't stop for a chat! He had taken this quite hard at first, but was soon assured this was just one of the cultural differences of many people on board. Quite an important lesson! so if I am to build relationships here, my awareness of these things needs to get up to speed pretty quickly!

Pictures from Liberia

Arrival of the Africa Mercy to Monrovia, a 'welcome' celebration




























Medical screening in the centre of Monrovia. Hundreds of people arrive to be assessed for surgery. Each person is seen by the crew of the Africa Mercy in hope of receiving surgery on board the ship




























Nurses and doctors who were on board the Africa Mercy from the beginning of the outreach in February

Ward Life and other things

Now I have settled in a little, the reality of the lives of my patients has begun to sink in. Today was a lovely shift. I have loved teaching my patients about caring for their wounds when they go home. We teach them hand washing and how to make sterile saline water to clean their wounds, as well as getting them to take part in redressing their wounds. I have been working with patients undergoing maxillo facial surgery the last few days. When they eventually have their bulky bandages removed and see their faces in the mirror it is quite an experience. Many have large facial tumours removed, others need reconstruction of their jaws.
We have also had some more orthopaedic surgeons arrive, so we will be having many more orthopaedic patients through the wards now.

On occasions patients are not able to have surgery because of conditions such as HIV or TB diagnosed on their admission to the ship. One of those moments happened recently, and it was pretty tough. Fortunately on board there are trained counsellors to give the information needed and refer for treatment. It is difficult to express to people who's language you can't speak, the concern and sadness you feel for them. I just wanted to take this girl in my arms and cry with her.

The war in Liberia ended in 2003 and looking at some of the patients, the aftermath has clearly taken it's toll. I was able to chat to someone when out in the town the other day, and they pointed out the obvious infrastructure that was in place previously. Lampposts are in place drainage systems and the like, but all in pieces, destroyed for every thing salvagable. A huge high rise hotel can be seen from the ship in central Monrovia, it is a fairly impressive building, but now just a shell. It is obvious that the war continues to impact on the health of the people as they come in for surgery.

I am amazingly privelaged to be here and trying to make a difference...!
More to follow soon...

PS THe Kayley on the dock, awesome, we had bag pipes adn everything!!

A contrasting set of Saturday activities!

Well, today has been interesting...
This morning I went to a local children's orphanage which is linked to Mercy Ships. A team from the ship goes each Saturday morning to visit around 40 children. The leader sets up activities and tells stories from the Bible. The children range from 2 to 16, and are children from surrounding areas of Monrovia who were found to be parentless following the recent war. Consequently, each child's level of english varies, and many speak different dialects in their own language. There is currently a new building being built. We spent an hour or so talking about 'Grace'. Quite a difficult topic to teach to little ones that barely speak English!
After indoor activities we played games outside, bubbles, frisbee, and just spent time with the children. The outdoor area wasn't exactly to western play area standards to say the least. It felt like such a privelage to share it with them though!
When we had finished we headed back down Jamaica Road, one of the main streets from where the ship is docked. Smiles and waves from children are common place, as are the scenes of people carrying things on their heads, the local tailor (surprisingly many men) sitting out and ironing. the heat is phenomenol!
After we got back to the ship I quickly packed a bag, and in one of the Mercy Ships land rovers, we headed to CeCe beach, a very lovely beach attached to a hotel. It was such a contrast to what I had experienced in the morning. The sea is beautiful and it was a restful afternoon. I have to say I did struggle a little with me relaxing and enjoying such an idyllic environment after such a morning!
And now...
I am off to a Scottish Kayley! Some of the Scots on board have organised a Kayley on the dock, with music and callers. Should be great, if we can all survive the heat even at 7 pm!

Welcome to my blog!

Hi all! Welcome to my blog! Hoping that this will give you all a chance to have an insight into my world for the next 6 months on this wonderful ship that is the Africa Mercy.
Arrived here on the 28th March, and it's been all go and lots of 'orientation' since. Already I have fallen in love with the patients that I am caring for. Plus I am expanding my orthopaedic horizons to include maxillo facial, oncology and general surgery of all types...more to follow as the days go by!

First post from Liberia!

Well hello everyone. I am yet to quite get my blog sorted (not too long now) so thought I'd better get myself organised and tell you what has happened in the last few days....now where was I?

Monday was another day of orientation stuff around the ward and my head was full of information. then the evening was spent doing yet more form filling and sorting bank accounts etc etc. Tuesday was my first official day on the ward but I was extra to the numbers. It's so different here, but so similar too, it's quite odd.

All I can say to you nurses out there is that discharges are a dream (so far!). takes all of 10 minutes, miracle! I've had quite a mix of patients so far, but yesterday I was with orthopaedic patients. Lots of casts and neurovascular obs, ooo I felt so at home! The only crazy thing was that they were all tiny wee little kiddies from age 2 to 15. Wow, I hate drug calculations for kids, my head hurt such a lot I can't tell you! The kids were so adorable though, plus I got to play bubbles and colouring and all sorts of great stuff, brilliant!

I'm having to train my brain to change it's ways in so many nursey things, so I can't imagine what I'll be like to work with after I come back. Although there are resources, they are sometimes pretty scarce so we really have to be careful what we use. we have a slight situation with antibiotics in particular, in that the supply is limited, so we have some people with infections which we don't have the right antibiotic to treat them with. What is fantastic is just to see how much praying comes into it all as a result! Every shift starts with us praying together, it's lovely.

Another surprise I keep getting is that the kids can have their parents or a caregiver stay with them, and they sleep under the childs bed, so every now and again a person pops out from underneath my patient when I am doing a dressing or something, very random! Also the other way round is that some mums come to have surgery and are still nursing babies, so we have them on the ward too! It makes for the mum's recovery being pretty fast, and for us effectively getting 2 patients for the price of one (plus having a baby to play with ;)!

The wards themselves are at the bottom of the ship so there are no portals to see outside, plus with the aircon it is a very strange environment for the patients used to being outdoors in the heat all the time, so at shift changeover, we talk those that want to onto the upper deck for fresh air. More games and general chit chat ensue.

I am still astounded by the type of problems people come in with, it's pretty amazing. Sadly today one of our smallest kids was told that they could not perform any more surgery on a huge growth the size of a tennis ball in her eye. She had to be referred to the palliative care team for help at home. That was a pretty tough situation today, and we all felt for her mum. We can only trust that this little girl will be well cared for as she goes home too. Another person was found to have HIV and so her surgery was cancelled and she has been referred for treatment too. We have a team of trained counsellors who are called to explain and support patients in these situations, the set up for that kind of thing is great.

We had a couple more screening days at the beginning of the week so surgery will be hotting up again fairly quickly. It's quite an amazing sight, the patients come and register in the tents pitched on the dock next to the ship. They are seen and screened, and given a date to return as appropriate. It is a pretty overwhelming experience for most of them, and much of the process involves explaining things like how to use a western toilet as many have not come across them. It has been known for people to actually try to stand on the seat to go to the loo! I had great fun teaching a gorgeous little 4 year old how to use a tooth brush and how to shower today. Needless to say, we both got a little wet!

I have managed to venture off the ship again this week and took a walk up the road near the dock. It's very very busy with cars round this area, and by I cars I mean anything that is made of metal and has 4 wheels, some are pretty ricketty! It was scorching hot but it was really nice to get out and about and see life. I'm booked on a visit to a local orphanage this Saturday which is something one of the crew is involved in as part of Mercy Ships, it's linked to the church I went to last week too. Sat night some people are running a Kayley on the dockside, and I am hoping at some point this weekend to get out and have a meal in a local restaurant.

Well, I think that is probably about enough blabbering for now. I will love you and leave you!
Thinking of you all. Please keep the emails coming, it's so nice to know what is happening!

Big hugs xx

PS this isn't my official 'newsletter' but feel free to forward it as you like :)