'So, tomorrow you have the day off right...?' That's how my bunk mate (and opthalmologist), Therese very subtly began leading me into agreeing to a day with the eye team, screening for patients for surgery. I agreed right away, it would be great to get out into the country and have a new experience. My natural instincts cried out 'out of your comfort zone, you won't know what you're doing, haven't you 'stepped out' enough already', thankfully I ignored that and jumped in the van with the 10 or so other people from the eye team including translators and another of my friends going along for the extra pairs of hands.
The team had ben invited by a doctor who ran a clinic for patients in quite a large area 'Tubmenburg', and had 200 patients lined up for us to screen for cataract removal. We arrived to hundreds of people milling around the clinic area, kids and families hanging out to see white people, people to be screened seated in large dingy building, many with canes or people with them to guide them while they walked. After unloading the van, we had the traditional 'welcome to the team' and several thank-yous anf welcomes from lots of local 'voices' and a message from the senator no less (who I was to meet a little later).
Then began the work. We set up 3 opthalmology stations, and a general medical assessment station for those definitely to receive surgery. Then I began to help with registration. I had the PA to the senator 'Thomas' come round with me, as I asked for names, ages, dominant hands, main eye complaint, he 'translated;' asked the same with a Liberian accent and a few key words ;-). Which hand you work with, your age/how many years/what president was there when you were born, all two eye or one hurting, you sew dew or it cleeaar etc etc. That in itself was an experience. So many people here do not have a clue what their age is. Many time Thomas just had to give a guess, but looking at them to work out ages was difficult, the war and hard labour had taken it's toll on some, and I am sure others were guessing 'generously!' I completed forms for about 2 1/2 hours straight, whilst shifting people along chairs as people went to have their visual acquity tested, eye drops inserted and full examinations. Thomas spent all this time spelling out unusual names for me (virtually every one!), very tiresome for him I am sure.
I have never seen so many clear as day cataracts in my life. People were completely blind because of them. We even saw some children under 15 with cataracts. When I had a second to think, I wondered at the skill of the mass of old and young, being guided everywhere and how they were able to function, some without even a stick, and manoeouver round their local town, and do their day to day work. Knowing the potholes in this place, that I have nearly missed on many occasions, I was astounded. The sea of desperate faces and continual, 'can you help me' was a challenge to the soul to say the least. 'You see doctor first' always had to be the answer.
At 1pm (announced in our meeting as lunchtime by white peoples clocks, not Africans!), we stopped for food. We were provided with massive bowls of rice, potato greens, fish and Casava leaves. I have quite a bad cold at the moment, and let me tell you, the spices stepped up the use of tissues something chronic!! After lunch, although all exhausted, we carried on through the remaining people (by this stage, screening numbers had risen from 200 to at least 300). I changed by job this time, helping Dr Craig with the final 'medical screening' before people were given a surgery date. I took probably close to 40 manual blood pressures, crouched at peoples feet in a tiny back room, and prepared their papers, writing out appointment cards. It was a little difficult as we only had one stethoscope between the two of us. The very helpful electric BP machine ran out 3 sets of batteries in 5 minutes (the joys of being a missionary!). If I had done this many BPs at home, and got the pressures I did, I would have been astounded. Elderly men and all other typically western high BP risk categories of patients, had pressures of 110/60, plenty plenty 90/60 with heart rates of 40 to 45.... Quite an eye opener!
I also had opportunity to pray for those that we were unable to help. Many had glaucoma and had to be advised to go to their clinic for drops. Some were given reading glasses to assist with minor problems, and others with traumatic blindness we were able only to give advice to, and explain the problem could not be reversed. The people here have so much faith that one of our translators has several 'healing' stories he shared with us for those we couldn't help after he had prayed for them.
The end of the day brought 50 scheduled surgeries. Several of the older men, literally danced out of the doctors room in anticipation of their sight being restored. Eventually after packing away, we all collapsed into the landrovers, exhausted, emotionally drained, spiritually awakened (Me barely able to walk with all the crouching I'd been doing, and following a few 'you give me your telephone number..') and set off on the hour journey through lush countryside trying to avoid the many potholes.
What a day. I cannot put half of it into words, but it has to be one of the hardest yet most fulfilling expereicnes of my life and time here so far.
Friday, 30 May 2008
The end of my night shift...
After a 12 hour shift and a speedy handover to the morning staff on Monday morning I dashed next door to A ward so that I could relieve the other nurse to go and handover. 'Talk at the speed of light!' I said, in an attempt to ensure we could both go upstairs, get breakfast and pack lunch and then dive into bed for the much need sensation of being horizontal. Sarah went off next door in the same hazy blur that I was in, and I propped myself up on the counter, trying desperately to stay awake, and hoping (I am a bad nurse....!) that no one needed anything too major in the next 10 minutes (bearing in mind keeping my eyes open was challenge enough right now.)
From somewhere I heard a little high pitched voice singing, and the voice though soft grew a little louder. I managed to see just behind the curtain that Benedict one of our 6 year old boys was lying on his bed, playing with his stuffed toy, bandaged legs flailing in the air, and like there was no one else in the world, was singing his song.
'There is no one like you...papa...aaaaoooooo...
'You woke me up this morning and send me on my way, so who then shall I praise.....
'I will praise him, I will praise him, and if I don't priase him, whom then shall I praise.'
You have no idea how much that song penetrated my soul. 6 Years old, perspective on the day ahead - God has woken him up and sent him on his way and therefore should be praised. Hang on, who's supposed to be the 'wise one' in this situation. As they say, out of the mouths of babes. So I may have not been 'woken up' I was clearly barely hanging on to being awake, but yes, God had sent me on my way today.
From somewhere I heard a little high pitched voice singing, and the voice though soft grew a little louder. I managed to see just behind the curtain that Benedict one of our 6 year old boys was lying on his bed, playing with his stuffed toy, bandaged legs flailing in the air, and like there was no one else in the world, was singing his song.
'There is no one like you...papa...aaaaoooooo...
'You woke me up this morning and send me on my way, so who then shall I praise.....
'I will praise him, I will praise him, and if I don't priase him, whom then shall I praise.'
You have no idea how much that song penetrated my soul. 6 Years old, perspective on the day ahead - God has woken him up and sent him on his way and therefore should be praised. Hang on, who's supposed to be the 'wise one' in this situation. As they say, out of the mouths of babes. So I may have not been 'woken up' I was clearly barely hanging on to being awake, but yes, God had sent me on my way today.
Sunday, 25 May 2008
My roommates, or at least for one more week :(
So these are the mottley crew of cabin 3431 (I think, I still can't remember my room number and it's been 2 months!). They are each in their own right awesome and I love 'em. i am the longest standing member of the cabin so far, I have a week on a few of them. On the left my Irish bud Jane, then the lovely Laura from the USA with surname inpronouncable, me, Therese of Norway, and Kristina the petite from Sweden. Bless them all! We have great times together, and sadly Kristina and Therese will be leaving us soon, so to anyone who will be joining Laura, Jane and me, prepare yourselves!.We have a very entertaining 'teaching' programme going through our cabin. Laura and Kristina decided that I was very 'proper' and that when I spoke I sounded very sophisticated (yes, to all my family and friends you have permission to tell the people reading this the actual truth). So I am apparently teaching them to be 'proper' (Laura to use a knife not just a fork...'nuff said), we are all giving Kristina an 'English word for the day' which is taped to her wall in an effort to increase her vocabulary with completely useless but very exciting words. 'Wellies' 'biodegradable' to name but a few, and what's even better is that each word picked has a story.
So there you have it. my 'family'. They are lovely.
Emmanuels friend and my source of joy!
Yup, Emmanuel had a chum while he was with us, Matthew. You know what, whenever I needed a lift, this is where you could find me. In the end, these two boys had their beds shoved together with a cotside in between. they played cards over it, cars on it, giggled, drew pictures told stories...in short they were as thick as thieves adn two of the smiliest boys we have had. Not a complaint out of either of them despite their painful surgery, and hard work to get back on their feet. Basically having to learn how to walk again.
Emmanuel
Okay, so this guy is Emmanuel. Let me tell you a bit about him. This little guy has been on Mercy ships twice now for correction of his club feet. He lives in a local orphanage attached to a church, and one of the Mercy Ministries regular links. He had his left foot operated on at the last outreach, and came back last month for his second foot. He is an amazing young man. Yes, his face always displays this huge grin, who couldn't he make smile is all I can say!
Quite a lot of us on board, will escape to the dock after dinner each night. Lots of us walk (or run if we're feeling energetic...) up and down the dock for exercise. I think that dock has heard many a 'deep and meaningful' conversation, and been pounded by the feet of an enormous number of people deep in thought of the dramas of the day. I find it a place to really explain myself to my closest friends, let out pent up frustration. A stroll after dinner...(I won't kid you, I haven't once mustered the 'get up and go' to run, leaving behind my trainers was all part of the plan), I could get used to it!
Haemoglobin...
So, one of my patients is probably, to put it mildly, a little anaemic. For those of you out there who are medical people, you know pre -op bloods are important before surgery. One of our guys who came in for surgery tomorrow, walking, talking, laughing, having travelled from Nigeria (!!)was found to have a haemoglobin of 3.6. I am not kidding you, 3.6! Man alive (normal Hb of someone without severe medical problems would be at least 12). We get twitchy in my hospital if an HB is less than10, transfuse under 8, and under 5... well. But 3.6!!?? We'd all be having hernias by now, seriously too close to 0 for my liking.
Instead, the blood from one of our crew was calmly drawn a little later, and one unit given and his blood to be checked again tomorrow. Our blood supply is our crew on board, so we are all on alert to be called day and night in case we're needed. Yes things are a little different here, I guess that's why I love it so much!
Instead, the blood from one of our crew was calmly drawn a little later, and one unit given and his blood to be checked again tomorrow. Our blood supply is our crew on board, so we are all on alert to be called day and night in case we're needed. Yes things are a little different here, I guess that's why I love it so much!
Friday, 23 May 2008
Don't you just love it when...
...you arrive on a night shift, do the rounds for your patients, letting them know to call you if they need you, then asking if there's anything you can do before lights out, and the response is...will you pray for us?!?!
Ok, wait, WHAT? I love it! This is why I am here...
...you're trying to get hold of a doctor at 2am and his room phone and pager aren't working and you call reception to check his pager details, the man himself just 'happens' to be there talking to the receptionist, you tell him how happy you are that he's there and his response is "God obviously knew..."
...you're sitting on top of someone else in a taxi (literally) and you can see the road flashing by through the massive great crater hole in the door, wondering how you'll actually survive if the door you couldn't shut properly decided to open.
...the phrase 'Mama, it is not good for baby to eat the shoe' (picture 10 month old chomping on said dusty flip flop, no holds barred) is quite a normal statement.
...you walk down the street and a random man says "I wanna marry you, what do ya think about that".
...handover consists of 3 small children telling you what songs to sing!?!
...being covered head to toe in white powder means you've counted out 8000 paracetamol into small medicine bags at 3 oclock in the morning.
Ok, wait, WHAT? I love it! This is why I am here...
...you're trying to get hold of a doctor at 2am and his room phone and pager aren't working and you call reception to check his pager details, the man himself just 'happens' to be there talking to the receptionist, you tell him how happy you are that he's there and his response is "God obviously knew..."
...you're sitting on top of someone else in a taxi (literally) and you can see the road flashing by through the massive great crater hole in the door, wondering how you'll actually survive if the door you couldn't shut properly decided to open.
...the phrase 'Mama, it is not good for baby to eat the shoe' (picture 10 month old chomping on said dusty flip flop, no holds barred) is quite a normal statement.
...you walk down the street and a random man says "I wanna marry you, what do ya think about that".
...handover consists of 3 small children telling you what songs to sing!?!
...being covered head to toe in white powder means you've counted out 8000 paracetamol into small medicine bags at 3 oclock in the morning.
Getting chubby...
Well, maybe not quite chubby, but certainly healthier. This week I was able to go back to the Missionaries of Charity home run by sisters looking after babies, kids and adults suffering from a variety of problems including malnutrition, HIV and TB. I love this place! The last few times I have been and spent time with the children. I just can't help but love it. The sunshine beams out of those little faces as we arrive, and little hands reach out and cling on. The little girl who on my last visit had been displaying very strange behaviour (very violent, very jealous of any other children and the attention they were getting), had clearly mellowed. We had a great time getting out picture books and pointing to things while I held and fed one of the babies, silently praying fervently for each child as I interacted with them. The last time I saw her she was pinching and punching me every time I went near another child. Something is clearly changing.
The biggest change was in the tiniest of the children. The babies I had seen in the weeks previously were so malnourished it was difficult to see how they could survive, but this week...one of them looked positively fleshy! It was such an awesome sight and brought a lump to my throat to think that this fragile little life might continue, when a few weeks ago I was pushing out of my mind the thought that they may not be able to fight much longer. I am still not sure in what context these babies will grow up, with parents, a family or as orphans, but there is a great sense of hope and determination in the bones of this place, the more I go, the more it gets in my bones! Ines who is head of Mercy Ministries and takes the group each week, is keen for me to go and be the 'regular' person visiting the children.
Just before the end of each visit the children receive their lunch. That in iteself is an adorable experience; they are all placed in a circle and stripped down to their nappies (to save on the washing!), very few of the children are given help to eat, they are pretty independent, but it is quite a sight to watch. The tiniest of the toddlers manages with a spoon, failing that, ditch the spoon, and then some kind of mad dash with 2 hands right in the bowl of rice ensues. Not a grain goes wasted, the little fists polish off every one (except for those less experienced ones who finish covered all over their tummys in rice!) Then one little boy, Ben, turns over his bowl in a determined 'I've finished' action and bursts into tears in the realisation his bowl is empty, desperate for some more he looks to one of the sisters and thankfully there is a bit more to go around. Though I'm not sure I could eat all of that rice they pack away!
It's great to see how well looked after the kids are, despite less than perfect circumstances, and so few staff. Going to help for just one morning seems quite futile in a way, but if those little ones are being blessed as much as my heart is praying and yearning for them, it is defnitely worth it!
The biggest change was in the tiniest of the children. The babies I had seen in the weeks previously were so malnourished it was difficult to see how they could survive, but this week...one of them looked positively fleshy! It was such an awesome sight and brought a lump to my throat to think that this fragile little life might continue, when a few weeks ago I was pushing out of my mind the thought that they may not be able to fight much longer. I am still not sure in what context these babies will grow up, with parents, a family or as orphans, but there is a great sense of hope and determination in the bones of this place, the more I go, the more it gets in my bones! Ines who is head of Mercy Ministries and takes the group each week, is keen for me to go and be the 'regular' person visiting the children.
Just before the end of each visit the children receive their lunch. That in iteself is an adorable experience; they are all placed in a circle and stripped down to their nappies (to save on the washing!), very few of the children are given help to eat, they are pretty independent, but it is quite a sight to watch. The tiniest of the toddlers manages with a spoon, failing that, ditch the spoon, and then some kind of mad dash with 2 hands right in the bowl of rice ensues. Not a grain goes wasted, the little fists polish off every one (except for those less experienced ones who finish covered all over their tummys in rice!) Then one little boy, Ben, turns over his bowl in a determined 'I've finished' action and bursts into tears in the realisation his bowl is empty, desperate for some more he looks to one of the sisters and thankfully there is a bit more to go around. Though I'm not sure I could eat all of that rice they pack away!
It's great to see how well looked after the kids are, despite less than perfect circumstances, and so few staff. Going to help for just one morning seems quite futile in a way, but if those little ones are being blessed as much as my heart is praying and yearning for them, it is defnitely worth it!
Bong Mines Hospital
A variety of pictures from Bong Mines Hospital, the staff and the educational posters!
Tuesday, 20 May 2008
Club foot delights!
I have just finished the most lovely shift. I have to say it started pretty manically with all my patients coming and going to the operating room at the same time, and all needing things at the same time. It was a little hairy for a while.
However, there are some little sparkles that made the shift especially lovely, and they were all the new kids with club feet coming for surgery tomorrow. We have a 2 1/2 year old little girl and 2 boys aged 6 and 9. They are so much fun! They are just so bright. the little girl is actually having bilateral club feet correction, the boys just one. She was scooting around like I've never seen a child before, she was so dainty despite her little turned in feet. The boys have been playing football, and when I got the lego bricks out, you should have seen their eyes light up! One of the little boys has the most distinctive ears, he is such a beautiful looking boy. They all played so well together. I am just so amazed at how they get about so well. None of them seem phased by it.
My other 'club feet delight' was one of my post operative patients. he is 4 months old and came back to the ward fast asleep. He is the chubbiest little one we have had in a long time and my word his mum is clearly so proud of her little chap! He got a little grizzly earlier, and his mum became quite distressed, but after a few cuddles (and a bit of winding by me...anything for a cuddle!) he settled down and went back to sleep.
It is so awesome to think that just a few days in hospital and a few weeks in casts that these kids will have a new lease of life. Heres just hoping and praying these little sparkeles will be quite as bright and happy after their surgery with big clumpy casts on...
However, there are some little sparkles that made the shift especially lovely, and they were all the new kids with club feet coming for surgery tomorrow. We have a 2 1/2 year old little girl and 2 boys aged 6 and 9. They are so much fun! They are just so bright. the little girl is actually having bilateral club feet correction, the boys just one. She was scooting around like I've never seen a child before, she was so dainty despite her little turned in feet. The boys have been playing football, and when I got the lego bricks out, you should have seen their eyes light up! One of the little boys has the most distinctive ears, he is such a beautiful looking boy. They all played so well together. I am just so amazed at how they get about so well. None of them seem phased by it.
My other 'club feet delight' was one of my post operative patients. he is 4 months old and came back to the ward fast asleep. He is the chubbiest little one we have had in a long time and my word his mum is clearly so proud of her little chap! He got a little grizzly earlier, and his mum became quite distressed, but after a few cuddles (and a bit of winding by me...anything for a cuddle!) he settled down and went back to sleep.
It is so awesome to think that just a few days in hospital and a few weeks in casts that these kids will have a new lease of life. Heres just hoping and praying these little sparkeles will be quite as bright and happy after their surgery with big clumpy casts on...
Trip to Bong Mines
At the weekend I had the opportunity to go with about 25 of us to a place up country called Bong Mines. The whole thing was quite an experience. We got up early Saturday morning and drove a mile or so up the road to the railway ( I say railway, I wouldn't really call it a 'station'!). There is a 'flat' or open train which heads up to the north to the Iron Ore Mining areas taking various goods and chattles up and down the same route every week. The rail line is pretty much the only direct connecting route to the area apart from some roads which are pretty ropey in rainy season, so is the main route for 'trade' etc.
The landrovers drove onto the very rickety looking train backwards, and then we were able to sit up on top of the roof. A few of our group cycled to the train, and joined us. Just next to the train there was a huge area where there had been a delievry of rice, charcoal and fruit etc, so there were hundreds of people swarming round to buy thng sto sell at the markets, quite a colourful site!
The train set off, and the journey was fantastic. We passed through Monrovia and the chaos and the tin roofs by the hundreds all swarmed together. People already outside, kids waving frantically, chickens all over the place. As we went further, the surroundings became more and more lush, there was some farmland, samller villages, with houses grouped around fires. eventually the vegetation was thick as can be. Every now and again people would appear at the side of the railway track from paths we couldn't even see. Lots of people were carrying machettes, presumably coming from fields or work. The further we got, the more 'activity' there was in front of us. Many people use the railway track as their walking route, so the driver had to continually blow the horn so people would move out of the way. Many people had huge and amazing bamboo contraptions on wheels that they had to hurrdily heave out of the way when they heard the train coming. The response as we went past was crazy! All the children and a lot of adults would point and shout and wave and leap around, I guess 25 white people sitting on top of a landrover, flying past on a train is not exactly a common place site.
We did have a few mishaps with the train breaking down, and we gathered quite an audience at one point. One of the kids who had seen us dashed off in the undergrowth and came back a few minutes later with several eager faces. We waved and asked for names and they giggled so much. Then we decided that singing and action songs cross all boundaries, so we started a 'heads, shoulders knees and toes' rendition which they caught onto pretty quickly. After much giggling they then sang us a song, this went on until finally after hoying some water from a pretty grimey looking stream into goodness knows where in the engine, we set off again.
We eventually arrived at Bong Mines and were shown by the guy who was our guide where different areas of the mines were. We went up some pretty steep 'roads' but the fantastic views were worth it. We also saw a huge valley where in the war the rebels had taken many innocent poeple to , tortured, lined them up and shot them. Our driver and guide, had actually been there in that valley lined up, but for whatever purpose his life was spared. Pretty horrific to think of, and amazing that he was prepared to return there. We then headed down the mountain , after spotting a clearly leaking tyre, 'we'll fix it when we get down' said our guide...what are you kidding me...were you there when we barely made it up in first gear??!! But. we survived with a completely flat tyre by the time we got down, quickly repaired by the blokes ( I don't do tyre changing...!).
We visited the Bong Mines Hospital (see hospitals post) and then headed to catch our train back. Our guide bought some bags of charcoal, and people purchased a few other things from the locals, who were very interested in these strange white poeple. being so far out in the bush, it is quite likely many of the people had never seen a white person before.
On the way back, it was the time of day when lots of people were out doing their washing in the rivers, so there were lots of families washing themselves and their clothes. All along the railway there were little areas where clothes were lain out next to the railway tracks, presumably to take advantage of the heat of the tracks and the rocks. I did wonder if that was a bit risky though! We had an awesome day, and everywhere we looked on the way back there were new things to see and my mind was overloaded with images of homes, chickens, children, lush vegetation and trees. It was such an amazing way to see more of Liberian life out in the sticks!
The landrovers drove onto the very rickety looking train backwards, and then we were able to sit up on top of the roof. A few of our group cycled to the train, and joined us. Just next to the train there was a huge area where there had been a delievry of rice, charcoal and fruit etc, so there were hundreds of people swarming round to buy thng sto sell at the markets, quite a colourful site!
The train set off, and the journey was fantastic. We passed through Monrovia and the chaos and the tin roofs by the hundreds all swarmed together. People already outside, kids waving frantically, chickens all over the place. As we went further, the surroundings became more and more lush, there was some farmland, samller villages, with houses grouped around fires. eventually the vegetation was thick as can be. Every now and again people would appear at the side of the railway track from paths we couldn't even see. Lots of people were carrying machettes, presumably coming from fields or work. The further we got, the more 'activity' there was in front of us. Many people use the railway track as their walking route, so the driver had to continually blow the horn so people would move out of the way. Many people had huge and amazing bamboo contraptions on wheels that they had to hurrdily heave out of the way when they heard the train coming. The response as we went past was crazy! All the children and a lot of adults would point and shout and wave and leap around, I guess 25 white people sitting on top of a landrover, flying past on a train is not exactly a common place site.
We did have a few mishaps with the train breaking down, and we gathered quite an audience at one point. One of the kids who had seen us dashed off in the undergrowth and came back a few minutes later with several eager faces. We waved and asked for names and they giggled so much. Then we decided that singing and action songs cross all boundaries, so we started a 'heads, shoulders knees and toes' rendition which they caught onto pretty quickly. After much giggling they then sang us a song, this went on until finally after hoying some water from a pretty grimey looking stream into goodness knows where in the engine, we set off again.
We eventually arrived at Bong Mines and were shown by the guy who was our guide where different areas of the mines were. We went up some pretty steep 'roads' but the fantastic views were worth it. We also saw a huge valley where in the war the rebels had taken many innocent poeple to , tortured, lined them up and shot them. Our driver and guide, had actually been there in that valley lined up, but for whatever purpose his life was spared. Pretty horrific to think of, and amazing that he was prepared to return there. We then headed down the mountain , after spotting a clearly leaking tyre, 'we'll fix it when we get down' said our guide...what are you kidding me...were you there when we barely made it up in first gear??!! But. we survived with a completely flat tyre by the time we got down, quickly repaired by the blokes ( I don't do tyre changing...!).
We visited the Bong Mines Hospital (see hospitals post) and then headed to catch our train back. Our guide bought some bags of charcoal, and people purchased a few other things from the locals, who were very interested in these strange white poeple. being so far out in the bush, it is quite likely many of the people had never seen a white person before.
On the way back, it was the time of day when lots of people were out doing their washing in the rivers, so there were lots of families washing themselves and their clothes. All along the railway there were little areas where clothes were lain out next to the railway tracks, presumably to take advantage of the heat of the tracks and the rocks. I did wonder if that was a bit risky though! We had an awesome day, and everywhere we looked on the way back there were new things to see and my mind was overloaded with images of homes, chickens, children, lush vegetation and trees. It was such an amazing way to see more of Liberian life out in the sticks!
Community meeting
Last week we had a really great evening during our 'community meeting'. It's almost a mini church service with time of worship, a talk and afterwards a time where a lot of people gather in the cafe area and just chat. each week we have an opprortunity to take an offering from the crew to contribute towards an area of Mercy Ships ministries. This could be one of the orphanages, for a programme on board the ship. This week it was the wards turn to explain our needs. On the ward (with no windows!) the patients have long stretches where they are unable to be up and about or go outside, so we try and organise activities like crafts for them to do and they absolutely love it! We have made pom poms, friendship bracelets, paintings, cards, ceiling mobiles, puppets...the list goes on! Obviously being in the middle of Liberia, we can not always get the resources we need so we have them shipped out.
We asked a few of our patients to join us in our crew community meeting to show us the things they had made so people could see what their money could contribute to. It was such an awesoem night, I was so touched. We had to get them from deck 3 to deck 6 to start with, which was pretty difficult as there is only 1 elevator essentially for kitchen use. so we got Alice, Blessing and Gaye ready (they had all gone to a big effort to be dressed in their finest clothes, even sent people home to get them in anticipation!), then began the expedition upstairs. Blessing (I have talked about her before...) still has difficulty walking a long way with her crutches so we decided to put her on a 'wheelchair' (aka: office chair, we don't exactly have wheelchairs to hand sadly!). So, we trundled over all the water tight door seals, heaved over the carpetted areas, went up in the lift, popping out in the middle of the massive kitchen. They were all prety overwhelmed by that let alone anything else!
During the service Laura our assistant ward manager asked all three to stand at the fron t with us and show their crafts. It was such a great time. They were so eager and Blessings mum who also came, was so enthusiatic in our worship time. It was just great to have them in our meeting and show them what we do when we aren't on the ward!
So the crafts will continue...(which is very exciting as you know how I like to make a mess with our kids back home - it continues here!!)
We asked a few of our patients to join us in our crew community meeting to show us the things they had made so people could see what their money could contribute to. It was such an awesoem night, I was so touched. We had to get them from deck 3 to deck 6 to start with, which was pretty difficult as there is only 1 elevator essentially for kitchen use. so we got Alice, Blessing and Gaye ready (they had all gone to a big effort to be dressed in their finest clothes, even sent people home to get them in anticipation!), then began the expedition upstairs. Blessing (I have talked about her before...) still has difficulty walking a long way with her crutches so we decided to put her on a 'wheelchair' (aka: office chair, we don't exactly have wheelchairs to hand sadly!). So, we trundled over all the water tight door seals, heaved over the carpetted areas, went up in the lift, popping out in the middle of the massive kitchen. They were all prety overwhelmed by that let alone anything else!
During the service Laura our assistant ward manager asked all three to stand at the fron t with us and show their crafts. It was such a great time. They were so eager and Blessings mum who also came, was so enthusiatic in our worship time. It was just great to have them in our meeting and show them what we do when we aren't on the ward!
So the crafts will continue...(which is very exciting as you know how I like to make a mess with our kids back home - it continues here!!)
Hospitals in Liberia
I have now had opportunity to visit 2 hospitals in Liberia. One wsa the 'JFK' hospital in Monrovia, which one of our dayworkers invited us to look around. the other was this weekend when we took a day trip on an open train to a place called Bong Mines (up country, and somewhat out of the way at the iron ore mines). Both had quite a similar atmosphere.
The JFK hospital is HUGE! I was surprised at how big it was, and in it's former glory before the war it must have been quite impressive. It was quite a shock to see how much the war has impacted the hospital. They are gradually restoring it floor by floor, but the areas open are by no means at full capacity.
The wards are fairly open with anything from 8 to 20 beds. No curtains, often no sheets on the mattresses. No piped oxygen except for in intensive care. Resources seemed scarce, yet there were labs for testing, and xray area, operating theatres. The accident and emergency department was a little small, but had cubicles as we do back home. The corridors were wide and full of queues of people, the 'checking in' system was intense, with you having to line up in at least 3 different areas to just get your notes and your name on the list, then you just had to wait, potentially all day.
We had arrived thinking our day worker had preorganised our visit, not the case! He just used to work there and asked on the spot if we could be shown round. 2 of the directors were pulled from whatever they were doing to show us around, something that would never happen back home!! We were shown in everywhere, no questions asked...again, not exactly something that would happen at home. There were a few odd things that stuck out for example; the childrens immunisation clinic shared the same waiting area as the kids 'clinic' so basically new babies without immunity, mixed with sick ones, slightly vulnerable situation! The JFK hospital is also linked in some way to China and Japan. We were introduced to several doctors from Japan who did not speak a word of English, they appeared to write in their own language, and their assistants evidently did not speak their language. How on earth any examinations etc took place I will never know.
The hospital up in 'Bong Mines' was smaller but still quite extensive. Be fore the war, you could imagine it being a very busy place, right now it was virtually desolate apart from a few patients. When the mine was running to full capacity, the community was more extensive. Now the staff that work there work for free, not having been payed for months and months. Our Mercy Ministry teams have been out to the hospital to work with the education team to assist in awareness of HIV and Aids as well as nutrition. Again, there was a similar feeling of space but dinginess. There is a generator for the hospital but this only works for a few hours a day, so otherwise no electricity. The systems to sterilise equipment for the operating room were crude but obviously did the job.
I think what was most upsetting about both places, was that there was huge potential for both to have a real impact on the community if they were running and staffed effectively. So many people in the community can't afford their healthcare so just do not go to hospital. As I understand it, a few days to pay for food/general nursing care before even purchasing medicine like antibiotics that might be needed, a weeks wages would be needed. Another problem I discovered was that with reagrd to antibiotics, people are often told the one they need, but because they have to pay for them , they will ask for whichever one is cheapest, or on occasions some donated drugs will be free. Obviously this causes problems of resistance developing, and also prevents illnesses being treated effectively.
This is why our work here is so heavily involved in education. When our patients leave the ships ward, we spend a considreable length of time explaining medicines, why and how they should be taken, and to never share them with others.
Hopefully you can have a look at the photos I've attached to give you a bit of an idea about Bong Mines hospital (this is run by christians I believe, whereas JFK is a government building so we couldn't take pictures).
The JFK hospital is HUGE! I was surprised at how big it was, and in it's former glory before the war it must have been quite impressive. It was quite a shock to see how much the war has impacted the hospital. They are gradually restoring it floor by floor, but the areas open are by no means at full capacity.
The wards are fairly open with anything from 8 to 20 beds. No curtains, often no sheets on the mattresses. No piped oxygen except for in intensive care. Resources seemed scarce, yet there were labs for testing, and xray area, operating theatres. The accident and emergency department was a little small, but had cubicles as we do back home. The corridors were wide and full of queues of people, the 'checking in' system was intense, with you having to line up in at least 3 different areas to just get your notes and your name on the list, then you just had to wait, potentially all day.
We had arrived thinking our day worker had preorganised our visit, not the case! He just used to work there and asked on the spot if we could be shown round. 2 of the directors were pulled from whatever they were doing to show us around, something that would never happen back home!! We were shown in everywhere, no questions asked...again, not exactly something that would happen at home. There were a few odd things that stuck out for example; the childrens immunisation clinic shared the same waiting area as the kids 'clinic' so basically new babies without immunity, mixed with sick ones, slightly vulnerable situation! The JFK hospital is also linked in some way to China and Japan. We were introduced to several doctors from Japan who did not speak a word of English, they appeared to write in their own language, and their assistants evidently did not speak their language. How on earth any examinations etc took place I will never know.
The hospital up in 'Bong Mines' was smaller but still quite extensive. Be fore the war, you could imagine it being a very busy place, right now it was virtually desolate apart from a few patients. When the mine was running to full capacity, the community was more extensive. Now the staff that work there work for free, not having been payed for months and months. Our Mercy Ministry teams have been out to the hospital to work with the education team to assist in awareness of HIV and Aids as well as nutrition. Again, there was a similar feeling of space but dinginess. There is a generator for the hospital but this only works for a few hours a day, so otherwise no electricity. The systems to sterilise equipment for the operating room were crude but obviously did the job.
I think what was most upsetting about both places, was that there was huge potential for both to have a real impact on the community if they were running and staffed effectively. So many people in the community can't afford their healthcare so just do not go to hospital. As I understand it, a few days to pay for food/general nursing care before even purchasing medicine like antibiotics that might be needed, a weeks wages would be needed. Another problem I discovered was that with reagrd to antibiotics, people are often told the one they need, but because they have to pay for them , they will ask for whichever one is cheapest, or on occasions some donated drugs will be free. Obviously this causes problems of resistance developing, and also prevents illnesses being treated effectively.
This is why our work here is so heavily involved in education. When our patients leave the ships ward, we spend a considreable length of time explaining medicines, why and how they should be taken, and to never share them with others.
Hopefully you can have a look at the photos I've attached to give you a bit of an idea about Bong Mines hospital (this is run by christians I believe, whereas JFK is a government building so we couldn't take pictures).
Tuesday, 13 May 2008
A nice rest...
Nurses on the ward here have been going down like flies with viruses, sickness, nausea, headaches, so it was nice that this last weekend was the ships holiday. Lots of us have had quite 'tough' patients and several quite hard situations on the ward. Some of us have done extra shifts and pretty much lots of us were at the end of our tethers! On a holiday weekend, we don't do surgery on Friday and Monday and have a long weekend off (though the nurses still work, it gets quieter and more of us are able to have an extra day off). It gives everyone a chance to have a rest and lots of people go up country.
I worked Saturday and Sunday, but had Sunday afternoon and Monday and Tuesday off. I have had the loveliest days! Today, I spent a little time sorting out photos and getting things in order and then my friend katy and I decided on a random trip to the beach. By the tim ewe planned to leave, our little group grew to 5 lovely nurses, all very excited as we hadn't been anywhere alltogether. We hopped in a taxi and went to Whitesands beach. It was just the most perfect day....beautiful blue sky and gorgeous sea (and not so rough that you couldn't stnad up which makes a change I can tell you! Having said that I did end up spectacularly washed up on the shore several times with sand in quite surprising places...!!). We had a great time chatting and playing in the sea then retreated to the shore and we all relaxed, read and napped a little. Absolutely perfect!
This evening I decided to go to the ballroom dancing class taught by the lovely Val (who works in the post office and cafe on board). We had so much fun, even the touch rugby people gave in and joined us. I am now the Tango queen i can tell you.....Hmmm well, lets not get carried away, slow slow quick quick slow. All is well as long as the man leads! Hilarious and so nice to be out at the end of the dock, lightening flashing in the background, a nice cool breeze. Ahhhh...
Some people may think I am just having one long holiday, but really this weekend has been such a blessing particularly for our ward nurses. All of us were at breaking point, and moments like these are what you need to get you through. All I can say is thank God for days like this, and thank the Lord for laughter...
I worked Saturday and Sunday, but had Sunday afternoon and Monday and Tuesday off. I have had the loveliest days! Today, I spent a little time sorting out photos and getting things in order and then my friend katy and I decided on a random trip to the beach. By the tim ewe planned to leave, our little group grew to 5 lovely nurses, all very excited as we hadn't been anywhere alltogether. We hopped in a taxi and went to Whitesands beach. It was just the most perfect day....beautiful blue sky and gorgeous sea (and not so rough that you couldn't stnad up which makes a change I can tell you! Having said that I did end up spectacularly washed up on the shore several times with sand in quite surprising places...!!). We had a great time chatting and playing in the sea then retreated to the shore and we all relaxed, read and napped a little. Absolutely perfect!
This evening I decided to go to the ballroom dancing class taught by the lovely Val (who works in the post office and cafe on board). We had so much fun, even the touch rugby people gave in and joined us. I am now the Tango queen i can tell you.....Hmmm well, lets not get carried away, slow slow quick quick slow. All is well as long as the man leads! Hilarious and so nice to be out at the end of the dock, lightening flashing in the background, a nice cool breeze. Ahhhh...
Some people may think I am just having one long holiday, but really this weekend has been such a blessing particularly for our ward nurses. All of us were at breaking point, and moments like these are what you need to get you through. All I can say is thank God for days like this, and thank the Lord for laughter...
Sunday, 11 May 2008
Paediatrics...how do you do it?!
Well, to all those kids nurses out there, I salute you! I am not qute sure how you do it, well I wasn't until a bit of a breakthrough happened.
Because of the nature of what we do on the ship, a large part of my job is giving out pain meds and wound care. Have you ever tried playing and having fun with little ones who know you for the person who comes and makes them drink yukky medicine from a syringe, and pull and tug at things stuck to your skin? Not so easy I tell you!
I had a pretty hard going shift this week where I had to care for 5 kids who had had cleft lip/palette repairs. 4 times a day they have to have their lip and mouths swabbed with cleaning solution (wouldn't be nice for grown ups either, but at least you can explain!). So, I had had a pretty horrid day making grumpy in pain babies, initially even more grumpy by giving them medicine into sore mouths (for the eventual pain relief benefit of course!), then cleaning their mouths while they fought me off for dear life, and then wouldn't look at me for at least 20 minutes. It doesn't exactly make your heart warm and fluffy, what a bad nurse I am...
But then, one of the mammas was in desperate need of a snooze so insisted I 'carry her baby wit me' (fine by me!!). Earlier she had been pretty grumpy with me, having had a cleft lip repair, she had encountered my above described nursing duties. After a few grizzles, she snuggled in and was happily content for an hour and a half as we took a group patients up onto deck 7 for their 'outside' time off the ward. That made all the hours before pale into the background.
Later that shift I realised the same baby had a visitor. I noticed the man had a bolster in his nose and a suture line to his lip. It suddenly clicked to 2 of us, this chap was her Papa and he too had been with us a week previously and had had his cleft lip repaired too!! What an awesome story, daddy and daughter having their surgery virtually at the same time. It stills sends shivers up my spine when I think how special that situation is.
Because of the nature of what we do on the ship, a large part of my job is giving out pain meds and wound care. Have you ever tried playing and having fun with little ones who know you for the person who comes and makes them drink yukky medicine from a syringe, and pull and tug at things stuck to your skin? Not so easy I tell you!
I had a pretty hard going shift this week where I had to care for 5 kids who had had cleft lip/palette repairs. 4 times a day they have to have their lip and mouths swabbed with cleaning solution (wouldn't be nice for grown ups either, but at least you can explain!). So, I had had a pretty horrid day making grumpy in pain babies, initially even more grumpy by giving them medicine into sore mouths (for the eventual pain relief benefit of course!), then cleaning their mouths while they fought me off for dear life, and then wouldn't look at me for at least 20 minutes. It doesn't exactly make your heart warm and fluffy, what a bad nurse I am...
But then, one of the mammas was in desperate need of a snooze so insisted I 'carry her baby wit me' (fine by me!!). Earlier she had been pretty grumpy with me, having had a cleft lip repair, she had encountered my above described nursing duties. After a few grizzles, she snuggled in and was happily content for an hour and a half as we took a group patients up onto deck 7 for their 'outside' time off the ward. That made all the hours before pale into the background.
Later that shift I realised the same baby had a visitor. I noticed the man had a bolster in his nose and a suture line to his lip. It suddenly clicked to 2 of us, this chap was her Papa and he too had been with us a week previously and had had his cleft lip repaired too!! What an awesome story, daddy and daughter having their surgery virtually at the same time. It stills sends shivers up my spine when I think how special that situation is.
Song time!
This week we had a half hour of really quiet moments on the ward. One of the girls I work with Inneke, plays the guitar, so we decided we'd have a song session!
One of the older male patients (we called 'papa' - a sign of respect to those older then yourself), was a little preoccupied with one of the babies in the bed next to him. Papa Moses is about 75 years old, and such a gentleman, smiling and trying to help all the time, despite his eye problem. The little one in the bed next to him is about 14 months old, a little game ensues...baby Sonnie pushes a new found bright piece of card shaped in a heart over the bed cotside to Papa Moses, then disappears behind the cotside giggling, Papa puts the heart on his head, and sonnie pops up. The heart is grabbed by a little podgy hand, and then Papa hides...the game goes on. I could have watched the interaction all day, but on with the other story...
So with the chairs in the middle of the ward Inneke began playing some songs, many the patients knew, some they didn't . Two of our little girl are very excited by the whole thing, and come really close. So, then it was time for some kiddy songs, back in my old familiar comfort zone for a few minutes!! The songs 'HIgher Higher' and 'Who's the king of the jungle' appear from the depths of some of the nurses hearts! The girls loved the action songs, and before a few times through had passed, we had te adults doing the monkey actions, waves and laughing so much! The atmosphere was fantastic, even those in beds who were newly post surgery, joined in where they could, and made suggestions for other songs. Do you know, I am pretty sure these times are as good if not better than any other medicine they could have.
Between our shift change overs we always have a time to pray, but sometimes we sing or ask our translators (local Liberians who work on the ward) to start singing for us, and we all join in 'African' stylee... Instead we thought we'd get all the nurses to come and join the singing. So for 20 minutes we just praised and sang, and got the little ones to show everyone the actions to the new songs they'd learnt. Sooooo much fun! Now how many times have you done that in a shift change over? In fact, half way through i had to escort a patient down to the OR (check me out getting all American... theatre I mean, clearly!!) and he was still singing 'Who's the king...'
Tee hee!! Can you see why I love it here yet?
One of the older male patients (we called 'papa' - a sign of respect to those older then yourself), was a little preoccupied with one of the babies in the bed next to him. Papa Moses is about 75 years old, and such a gentleman, smiling and trying to help all the time, despite his eye problem. The little one in the bed next to him is about 14 months old, a little game ensues...baby Sonnie pushes a new found bright piece of card shaped in a heart over the bed cotside to Papa Moses, then disappears behind the cotside giggling, Papa puts the heart on his head, and sonnie pops up. The heart is grabbed by a little podgy hand, and then Papa hides...the game goes on. I could have watched the interaction all day, but on with the other story...
So with the chairs in the middle of the ward Inneke began playing some songs, many the patients knew, some they didn't . Two of our little girl are very excited by the whole thing, and come really close. So, then it was time for some kiddy songs, back in my old familiar comfort zone for a few minutes!! The songs 'HIgher Higher' and 'Who's the king of the jungle' appear from the depths of some of the nurses hearts! The girls loved the action songs, and before a few times through had passed, we had te adults doing the monkey actions, waves and laughing so much! The atmosphere was fantastic, even those in beds who were newly post surgery, joined in where they could, and made suggestions for other songs. Do you know, I am pretty sure these times are as good if not better than any other medicine they could have.
Between our shift change overs we always have a time to pray, but sometimes we sing or ask our translators (local Liberians who work on the ward) to start singing for us, and we all join in 'African' stylee... Instead we thought we'd get all the nurses to come and join the singing. So for 20 minutes we just praised and sang, and got the little ones to show everyone the actions to the new songs they'd learnt. Sooooo much fun! Now how many times have you done that in a shift change over? In fact, half way through i had to escort a patient down to the OR (check me out getting all American... theatre I mean, clearly!!) and he was still singing 'Who's the king...'
Tee hee!! Can you see why I love it here yet?
A speech and language session
The following little situation made me laugh so much but I could have cried just as easily! We have 2 little girls, 7 and 9 in beds next to each other. The younger 'Blessing' has been in the hospital for a long time having a skin flap created in order to use to reconstruct part of her face, due to it being destroyed by a flesh eating disease called 'noma'. It is a condition which can be treated early with antibiotics, but if not, can cause the flesh to be destroyed and eaten away. The older child 'Kadiatu' had a hole in her palette. This has been reconstructed, but she too had been in the hospital for a long time. They have built quite a friendship.
Blessing has to do intense physio (mum is very strict, they are up at 5.30 am starting every day!!), and she also does schoolwork. Kadiatu has to do speech and language therapy because she essentially has to re-teach herself how to speak and swallow.
Picture it... mammas asleep midafternoon (under the beds, blankets over heads!), Blessing and Kadiatu on one bed, cross legged opposite each other, Blessing has her book for 'sounds' in her hand. Then begins the session, Blessing says a word, kadiatu repeats, Blessing corrects her, Kadiatu tries again. Wrong again, Blessing raises her voice, Kadiatu tries again, Blessing repeats in a muffled voice...and this goes on and on for at least 5 minutes. they begin hysterically laughing as they realise Blessing can't pronounce things properly because she can't manipulate her lips, and Kadiatu can't yet quite get her 'new mouth' to do what she wants. Neither are saying things quite right!
But the voices get louder and they try harder. It was a precious moment, one that will stick in my mind as 'determination'. One of the girls went home today,proud as punch, with a whole different life now ahead of her.
Blessing has to do intense physio (mum is very strict, they are up at 5.30 am starting every day!!), and she also does schoolwork. Kadiatu has to do speech and language therapy because she essentially has to re-teach herself how to speak and swallow.
Picture it... mammas asleep midafternoon (under the beds, blankets over heads!), Blessing and Kadiatu on one bed, cross legged opposite each other, Blessing has her book for 'sounds' in her hand. Then begins the session, Blessing says a word, kadiatu repeats, Blessing corrects her, Kadiatu tries again. Wrong again, Blessing raises her voice, Kadiatu tries again, Blessing repeats in a muffled voice...and this goes on and on for at least 5 minutes. they begin hysterically laughing as they realise Blessing can't pronounce things properly because she can't manipulate her lips, and Kadiatu can't yet quite get her 'new mouth' to do what she wants. Neither are saying things quite right!
But the voices get louder and they try harder. It was a precious moment, one that will stick in my mind as 'determination'. One of the girls went home today,proud as punch, with a whole different life now ahead of her.
Wednesday, 7 May 2008
Monrovian Taxis
Hmm, ever got in a taxi, closed the door, then thought, might just open the window? Well, that's what I regularly think when I get in taxis here, but we often use the same local chap, who has lets just say a rather old taxi. So when the thought crossed my mind the other day...out he jumped of the drivers seat, whipped open my door, took out a metal rod, then cranked the window open with the inner mechanism of the door! See, most taxis are lucky to have windows stuck together with masking tape, and door handles, and really, seatbelts...?? Not a chance! Many cars you'll see the chassis trailing an exhaust pipe on the floor.
I do however love the 'taxi world' here. standing on the road people give random unfathomable hand gestures (not of the rude kind!), which apparently indicate where they want to go, eventually what I would call a 'full' taxi will pull up and allow the person to hop in, 4 in the back seat at least, and 2 in the front passenger seat. Nice and cosy... I experienced the front seat the other day - gear stick jammed in one leg, and pretty much sitting on a random strangers lap. If you get out of the taxi without the driver asking for your number...?!
What can be a little distressing is that some locals have commented as we have gone past 'oh you carry white people' and assume we don't want to share our cab and step back. It's such a strange and uncomfortable assumption to me, sharing doesn't bother me in the least, but how can I impact on a culture/attitude that appears so resigned to certain things??!!
Yes, life here gets more and more interesting by the day!
I do however love the 'taxi world' here. standing on the road people give random unfathomable hand gestures (not of the rude kind!), which apparently indicate where they want to go, eventually what I would call a 'full' taxi will pull up and allow the person to hop in, 4 in the back seat at least, and 2 in the front passenger seat. Nice and cosy... I experienced the front seat the other day - gear stick jammed in one leg, and pretty much sitting on a random strangers lap. If you get out of the taxi without the driver asking for your number...?!
What can be a little distressing is that some locals have commented as we have gone past 'oh you carry white people' and assume we don't want to share our cab and step back. It's such a strange and uncomfortable assumption to me, sharing doesn't bother me in the least, but how can I impact on a culture/attitude that appears so resigned to certain things??!!
Yes, life here gets more and more interesting by the day!
Sunday, 4 May 2008
A different meal out
Yesterday I was invited to go to a restaurant for some traditional Ghanaian food. I went with a group of girls and a guy who is originally from Togo who works on the ship. He craves his 'normal' diet but invited us to go with him. We were in quite a small darkish room with very little ventilation, in fact we had to move a little to get underneath the fan as two of my friends were pretty close to fainting with the heat! We ordered foo foo (I think that's how you spell it!), I ordered mine with plum nut sauce and 'meat' (a little risky!). Foofoo looks like a big ball of dough, made from casava leaves (spelling??!!). It is very bland and it's consistency is sort of stretchy doughy (not for the faint hearted or blancmange haters), the sauce it came with was quite spicy, and the bowl of meat, although tasty was quite bony. Anyway, we all survived, some ate more than others, and I actually quite enjoyed mine. the foofoo is supposed to be more filling than tasty it appears.
To top off the visit, we went out the back to the landrover, saw them pounding casava manually. I then spotted a little goat leaping around out the back...how lovely BUT NO!
No sooner did I spot the goat than it had it's legs tied up. A hole (I learned, to drain the blood into) was dug, then a knife sharpened, and then the guy just carved it's head off right there and then, all in the space of 2 minutes...well at least I know my meat was freshly made on site...!!
Hmm...not one of my favourite memories I don't think!
To top off the visit, we went out the back to the landrover, saw them pounding casava manually. I then spotted a little goat leaping around out the back...how lovely BUT NO!
No sooner did I spot the goat than it had it's legs tied up. A hole (I learned, to drain the blood into) was dug, then a knife sharpened, and then the guy just carved it's head off right there and then, all in the space of 2 minutes...well at least I know my meat was freshly made on site...!!
Hmm...not one of my favourite memories I don't think!
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