Yesterday I went for a day trip to an old hydro plant about an hour and a halfs drive away. A group of 18 of us packed our bags and set off stuffed into 2 landrovers, running to them to escape the torrential rain. thankfully as we departed from the port the rain lessened and eventually stopped. We dashed through our end of town, then headed off deeper into the country, along horrendously pot holed roads. We passed through many tiny villages and communities, and the waves and staring peering eyes and curious yelps from many children continued all the way there.
We arrived to the bombed out building of the old hydro plant, net by two men who 'guard' the area by the massive gushing river behind the building. After trekking around the building , we set off with the two locals and our 'guides' Lourens and Carl from the ship. We walked through the old river bed and looked at the old dam where once the river had flown through. After the rebels had destryoed the dam and through the war it's parts had been salvaged for metal, very little of it remained.
The beginning of our adventure introduced us to fire ants by the millions! They were everywhere, and as we started down craggy rocks and through the greenery, we found they were everywhere, and got everywhere, particularly at that area just around the ankles above your socks...yak and ouch :) The greenery was so lush and as I clung onto a rock, face virtually touching it as I slipped down to the ground beneath me, I was so thankful to be outdoors. I had forgotten how much I liked being outside and facing those heart rate raising moments of the outdoor adventure.
We carried on up the side of the old river bed on reasonably well worn tracks, with absolutely amazing views of the river, which dropped markedly in many places producing huge waterfalls. Then we reached one of the first heart beating moments - a wade through some fairly fast moving water. We had been warned! So one by one we launched ourselves bags over our heads through the water, neck deep, and for the shorter of the group...swam to the other side. Then began the passing of bags and cameras and much hilarity as legs were caught in tree roots. Impressed that we all made it unscathed and still in good spirits we carried on the track through much denser vegetation, eventually reaching a huge plateau of rocks right next to the top of the largest waterfall. As we ate I was astounded of the beautuy of this place, and reminded of the remoteness of those living in the villages. Some of us took a different route back, climbing high up from the river, we had time to look back on stunning views. We came out in a small village, with several hut houses around an open area. Kids were playing, chics and chickens roamed around and people sat outside their huts, shy little children poking heads out from behind mum's lappa, intrigued at the 'white sight'. Again, it struck me as i saw a mamas swelling belly, how remote these places are, and my heart felt how easy it was for us to receive all taht we need medically, and here, how help is so rare. If this mama had any problems in childbirth she would have hours to the nearest hospital, even then she may well not have the money to receive that help.
After lots of hellos, we continued back to the hydro plant. Some very soggy wet people relaxing after a very physically challenging few hours trek. It was so much fun to be outside and really in the beauty of this country. I didn't break anything, for those of you who know me well that's a pretty big feat!! Many fire ant bites and quite a few bruises, not bad for a days work!!
On our return journey, it had become very much muddier and we had to pull the other landrover out at one point as it got stuck in the mud. Holding on to our seats was about all we could do to bear the jostling of the landrovers.
As we returned through one small community we were stopped by a huge family. They had a lady who was sick and wanted us to help. Well stocked with nurses and doctors, a small group went into the dingy house. Sadly after examing her it seemed she had had a stroke and was unresponsive. There was little we could do. We prayed and left, reminded again of the need of these people.
As we neared the ship, we passed a large group of kids by a huge flooded area of muddy water which we often saw them using to wash the cars. Our very much worse for wear vehicles needed a good scrub, so much to the delight of the kids we stopped and payed them to clean the cars. The mayhem ensuing was amazing! Every one wanted to join in, to the point of some of the kids stripping to their nothings so they could use their shorts to wash the cars. Unfortunately, the landrovers we had are pretty old, so their water-tightness is questionable! Those of us in the vehicle I think got about as wet through the doors adn roof and windows as the kids playing in the water! They loved it and it was a great way to end a hugely challenging day.
I think I need to be reminded toget out and enjoy our beautiful british countryside when I get home :) Friends, you can hold me to that. there's nothing like being outside!!
Sunday, 31 August 2008
Monday, 25 August 2008
Yeme
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Looking at these pictures you could be forgiven for thinking this little girl is not the one I spoke about in a previos entry. Yeme is the little girl who arrived with extensive neurofibroma to her leg, and a smaller one to her head (you can see it in this picture!). She is a little girl who I wrote about as a scared, frightened little girl, with no English to speak of, left at the Ship's Mercy to have her surgery, with no caregiver with her.
This little girl had a 7kg smelly ulcerated tumor extending from upper thigh to mid calf removed in surgery. She walked hunched over, unable to lie or sit, constant ooze from her wounds. Since her first surgery this little girl has truly become a gem and a shining light in the ward.
She now stands tall for most of the time, her limp lessening by the day. Her frightened look is now replaced with the cheekiest of grins, and her tears replaced with th emost delightful and infectious laugh. She loves to peer around the door frame and giggle whilst we hand over. She has become queen bee at making bracelets, and at plaiting barbie dolls (and nurses!) hair! she is beautiful and becomes more so by the day. She will soon be having surgery for a skin graft to a small patch on her leg that needs a bit of help along the way to heal, and her characteristic lump to her head will be removed. This young girl is such an inspiration, makes me wonder how I complain about such little things as I witness her plight daily!
Noma
Noma is a flesh eating disease which has been the reason several of our patients come through our doors. One such young lady was my patient last week. In the west the condition if treated early with antibiotics will not develop into anything serious. Here where medicine is costly and treatment and consultation is also at a price, noma takes it's holds regularly.
Beindhu is a young girl with a 4 month old baby. She arrived to us with a hole in her cheek, through which you could see the inside of her mouth and her tongue. After extensive surgery she has had a muscle flap and skin grafts to reconstruct her face.
As her case was handed over to me I was more than a little apprehensive. She would be a complex case to care for. She had a drain, NG feeds (food through a tube in her nose) and medication to be given via her NG tube, dresssings to be done, intravenous antibiotics to be given, a catheter for her to pee, a nasal 'trumpet' through which to suction her airway, nebulisers to give, regular mouth suctioning and mouth washes needed doing, plus her baby needed looking after! Her baby, Mary, had been a little distressed as her mum was in surgery so would not have milk from a bottle spoon or by any other means, but was crying out in hunger. She in true '2 for the price of 1 patient' style, ended up having an NG tube inserted so we could make sure she got fed! So I had feeds for her to give, as well as 3 other patients to care for. It was however, a challenge I need not have worried about. As Beindhu looked at me through puffed up lips and tight head bandages and drips and drains of all kinds, she was clearly overwhelmed, but quickly we were able to get into a pattern of pointing and prompting so I could suction her when she needed it. As I organised myself I found that I loved every minute of the busyness!
As the shift progressed, so did her condition, she became more alert and ready to hold her baby. I had the task of trying to get Mary to breastfeed without yanking at Mama's various tubes adn drains, and without her getting upset at her Mama's looks. Thankfully it went like clockwork and a look of contentment passed over both Mary and Beindhu's face as she snuggled once again with her Mum. Beindhu was able to have her drip down and her catheter out during my shift, and I was able to take her for her first walk. Now she will continue to be cared for as her wounds heal.
Her first dressing change was done after I left, but was reported to be looking very good. It will be a long recovery, but quite an amazing feat!
Beindhu is a young girl with a 4 month old baby. She arrived to us with a hole in her cheek, through which you could see the inside of her mouth and her tongue. After extensive surgery she has had a muscle flap and skin grafts to reconstruct her face.
As her case was handed over to me I was more than a little apprehensive. She would be a complex case to care for. She had a drain, NG feeds (food through a tube in her nose) and medication to be given via her NG tube, dresssings to be done, intravenous antibiotics to be given, a catheter for her to pee, a nasal 'trumpet' through which to suction her airway, nebulisers to give, regular mouth suctioning and mouth washes needed doing, plus her baby needed looking after! Her baby, Mary, had been a little distressed as her mum was in surgery so would not have milk from a bottle spoon or by any other means, but was crying out in hunger. She in true '2 for the price of 1 patient' style, ended up having an NG tube inserted so we could make sure she got fed! So I had feeds for her to give, as well as 3 other patients to care for. It was however, a challenge I need not have worried about. As Beindhu looked at me through puffed up lips and tight head bandages and drips and drains of all kinds, she was clearly overwhelmed, but quickly we were able to get into a pattern of pointing and prompting so I could suction her when she needed it. As I organised myself I found that I loved every minute of the busyness!
As the shift progressed, so did her condition, she became more alert and ready to hold her baby. I had the task of trying to get Mary to breastfeed without yanking at Mama's various tubes adn drains, and without her getting upset at her Mama's looks. Thankfully it went like clockwork and a look of contentment passed over both Mary and Beindhu's face as she snuggled once again with her Mum. Beindhu was able to have her drip down and her catheter out during my shift, and I was able to take her for her first walk. Now she will continue to be cared for as her wounds heal.
Her first dressing change was done after I left, but was reported to be looking very good. It will be a long recovery, but quite an amazing feat!
Oscar and I
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Quite possibly the most beautiful little boy! His newly cast corrected club feet. Sadly Oscar's Dad left him and his Mama when he was born because of his feet!!
It's a small world...
One of my new admissions over last weekend was a story in itself! His name was Amos from Zimbabwee, and as I admitted him for the second surgery to reconstruct his jaw, we talked. He asked if this was my first trip to Africa. I explained about my several other trips, and my trip to Swaziland, and the project we visited. As we talked, I explained that the man who we met who ran the project was from South Africa, now living in Swaziland. As we continued to chat about the name of the project, he explained to me that he had travelled from Zimbabwee to a conference in South Africa, and that he was pretty sure he had met this man.
I couldn't believe it, a girl from the UK, a man from Zimbabwee, meeting in a hopsital ship in Liberia, talking about a guy from Swaziland that Amos had met in South Africa. I CAN'T BELIEVE IT!!!
I couldn't believe it, a girl from the UK, a man from Zimbabwee, meeting in a hopsital ship in Liberia, talking about a guy from Swaziland that Amos had met in South Africa. I CAN'T BELIEVE IT!!!
Some more orthopaedics
Between my VVF shifts, I have had several days on B ward where most of the orthopaedic surgery is. In fact, over the ships holiday weekend I had 4 days in a row with the same patients. 2 of them were toddlers who had had club feet repairs, the adults were gentlemen who had had serious accidents causing non union of femur and humerus which our surgeons were endeavouring to fix. One of the men had had a below knee amputation. The days were very intense, despite being quite quiet. I spent time with the gentleman who had had his leg amputated. He had adapted so well to the surgery and was really keen to get up and about. He will eventually have surgery to his arm also.
My two youngest patients (Oscar and Prince) were waiting for cast changes and so were very well and full of fun and antics. trying to keep two 2 year olds off their casts and not allow them to crawl and even try to walk on them was impossible! Oscar, one of the boys is an absolute bundle of giggles. A very very strong willed young boy, but absolutely beautiful. Both Oscar and Princes mum's were very young. Oscar and Prince's mums spoke Kpelle/Basa and very very little English. Somehow over those 4 days we all bonded incredibly. Each of us laughing at the other whilst trying to work out what all the arm flailing was about. I was in awe of these two young mums (much younger than me). Both boys clearly a handful, and Prince's mum 7 months pregnant with her 2nd child. I saw the struggle in their eyes at times, especially Prince's mum. The children here can be quite 'attached' to their mum's as they are virtually never away from them, normally in a lappa on their back or sleeping next to them. I saw that Prince especially was very demanding of his mother, and being 7 months pregnant her patience at times wore thin. The other patients made 'comments' and I just really felt for her as I could see she at times was made to feel inadequate. I determined to spend time just investing in encouraging her and nurturing her and telling her she was a good mum, for her new baby's sake as well as Prince's. I have no clue about motherhood but I do know when people need some love and attention. It was such a privelage to be th eone to spend time doing that. This is on e ofthe things I love most about being here - the opportunity to invest time adn love in people other than the patients. Investing in family life and futures.
My two youngest patients (Oscar and Prince) were waiting for cast changes and so were very well and full of fun and antics. trying to keep two 2 year olds off their casts and not allow them to crawl and even try to walk on them was impossible! Oscar, one of the boys is an absolute bundle of giggles. A very very strong willed young boy, but absolutely beautiful. Both Oscar and Princes mum's were very young. Oscar and Prince's mums spoke Kpelle/Basa and very very little English. Somehow over those 4 days we all bonded incredibly. Each of us laughing at the other whilst trying to work out what all the arm flailing was about. I was in awe of these two young mums (much younger than me). Both boys clearly a handful, and Prince's mum 7 months pregnant with her 2nd child. I saw the struggle in their eyes at times, especially Prince's mum. The children here can be quite 'attached' to their mum's as they are virtually never away from them, normally in a lappa on their back or sleeping next to them. I saw that Prince especially was very demanding of his mother, and being 7 months pregnant her patience at times wore thin. The other patients made 'comments' and I just really felt for her as I could see she at times was made to feel inadequate. I determined to spend time just investing in encouraging her and nurturing her and telling her she was a good mum, for her new baby's sake as well as Prince's. I have no clue about motherhood but I do know when people need some love and attention. It was such a privelage to be th eone to spend time doing that. This is on e ofthe things I love most about being here - the opportunity to invest time adn love in people other than the patients. Investing in family life and futures.
VVF
I had a very challenging experience last week as, unbeknowns to me, a new group of VVF ladies arrived, a week in advance of their operations. As I walked down the corridor to the hospital wards, I was struck by a phenomenol smell, one I had never smelt before. It took my breath away. A little later I had the same thought again as I was walking down the corridor. I mentioned it to someone, and she said, 'the new VVF ladies have arrived'. The bottom seemed to fall out of my stomach. I felt sick. The thought hadn't even crossed my mind. It was then that I had a new appreciation for what the ladies experience every day. The disgust of others, their judgement and the reason that they are belittled in their society. Believe me, at that moment I felt hideous. It took me a few days to really take stock and try and process that event, trying to use it to make sense of so much going on in my mind.
A little later that day, I went along to D ward (currently closed) where the new VVF ladies had been admitted to from another hospital, a week prior to their surgery. I went along to help with the mountain of admission paperwork. I was only there for an hour but it was a great time. I didn't notice the smell that had earlier been so intense. As I pottered around filling in papers and putting on wristbands, I chatted to the ladies. They were all curled up in their beds with their blankets tight up around their necks. Quiet, and looking a little apprehensive. Clearly they were very cold with the airconditioning! So I did a round of giving out blankets. As I did so, I asked how each lady was and their smiles grew as we talked. Some giggled nervously, others needed new pads, and others snuck off to the bathroom. The tension in the room became less and less.
A few hours later I returned to put on the televisions in the ward with the afternoon movie for them to watch. I popped my head in later and each one had rearranged their pilow and their bed so they could see the screen well. There was much giggling as they laughed at the 'muppets' (cartoons!) in the movie Madagascar.
It was such a beautiful sight to see these ladies that had felt so alone in their plight, surrounded bythose in the same situation as them. Their emotional healing begins just by meeting eachother, and it is such a privelage to be a small part of that.
A little later that day, I went along to D ward (currently closed) where the new VVF ladies had been admitted to from another hospital, a week prior to their surgery. I went along to help with the mountain of admission paperwork. I was only there for an hour but it was a great time. I didn't notice the smell that had earlier been so intense. As I pottered around filling in papers and putting on wristbands, I chatted to the ladies. They were all curled up in their beds with their blankets tight up around their necks. Quiet, and looking a little apprehensive. Clearly they were very cold with the airconditioning! So I did a round of giving out blankets. As I did so, I asked how each lady was and their smiles grew as we talked. Some giggled nervously, others needed new pads, and others snuck off to the bathroom. The tension in the room became less and less.
A few hours later I returned to put on the televisions in the ward with the afternoon movie for them to watch. I popped my head in later and each one had rearranged their pilow and their bed so they could see the screen well. There was much giggling as they laughed at the 'muppets' (cartoons!) in the movie Madagascar.
It was such a beautiful sight to see these ladies that had felt so alone in their plight, surrounded bythose in the same situation as them. Their emotional healing begins just by meeting eachother, and it is such a privelage to be a small part of that.
Thursday, 14 August 2008
My first day back at work...
Well, after my whirlwind trip back to the UK, I arrived back in Monrovia at 9pm on Monday. Unfrtunately, my luggage didn't arrive, but aside from that the journey was fine. I was back in the deep end with my first shift back being Tuesday at 2pm! I was working with the ladies who have had vesico-vaginal-fistula surgery.
The ladies have gone through labour which has for whatever reason become obstructed. As a result the baby is left in the birth canal for too long, tissue becomes ischaemic (dies) because of the pressure of the baby in the birth canal. This develops and causes a hole between the bladder and vagina and results in the permanent leaking of urine. In the western world, a lady would have had assistnace to give birth or a C-section long before any tissue was damaged. Not only do these ladies lose their babies because of the traumatic birth, they are left with the constant leaking of urine. Their 'purpose' in a country such as Liberia - to have sex with their husbands whenever they want, to produce children to provide for their future and to be mother and wife, is destroyed. Their inability to fulfill their 'purpose' means they become outcasts, and along with their constant pungent smell due to leaking urine, they become the despised of society. These women are destroyed physically mentally and spiritually.
To be honest, I was pretty daunted at the prospect having not yet looked after them, I wasn't quite sure what I was doing. But, I loved it!!! It was an incredibly busy shift, as their care takes a lot more intense nursing: checking of urine output and their fluid intake. The primary aim is to give the ladies wounds time to heal. The leaking of urine that has occured around the tissues means that it takes a very long time to heal. Another important aspect of their care is teaching them pelvic floor exercises, to enable them to have good control once their catheter is removed. The whole process is such a delicate experience. We spend a lot of time just being with these ladies because they have been void of personal touch and interaction because of their ailments. They are taught to knit and crochet too.
I spent a lot of time with my ladies teaching them to do their exercises, it is a very intimate thing for me to be involved with and we have to check very carefully they are doing it well. So I tried to make it as comfortable as possible, reiterating how important it was, and really encouraging them as they did it right. I even agreed to do the exercises at the same time with them (I am going to have the best pelvic floor I can tell you!), which caused lots of giggling and laughter as I empathised at how difficult the exercises are to do!
Tomorrow we will have a dress ceremony. More on that after it happens!!
The ladies have gone through labour which has for whatever reason become obstructed. As a result the baby is left in the birth canal for too long, tissue becomes ischaemic (dies) because of the pressure of the baby in the birth canal. This develops and causes a hole between the bladder and vagina and results in the permanent leaking of urine. In the western world, a lady would have had assistnace to give birth or a C-section long before any tissue was damaged. Not only do these ladies lose their babies because of the traumatic birth, they are left with the constant leaking of urine. Their 'purpose' in a country such as Liberia - to have sex with their husbands whenever they want, to produce children to provide for their future and to be mother and wife, is destroyed. Their inability to fulfill their 'purpose' means they become outcasts, and along with their constant pungent smell due to leaking urine, they become the despised of society. These women are destroyed physically mentally and spiritually.
To be honest, I was pretty daunted at the prospect having not yet looked after them, I wasn't quite sure what I was doing. But, I loved it!!! It was an incredibly busy shift, as their care takes a lot more intense nursing: checking of urine output and their fluid intake. The primary aim is to give the ladies wounds time to heal. The leaking of urine that has occured around the tissues means that it takes a very long time to heal. Another important aspect of their care is teaching them pelvic floor exercises, to enable them to have good control once their catheter is removed. The whole process is such a delicate experience. We spend a lot of time just being with these ladies because they have been void of personal touch and interaction because of their ailments. They are taught to knit and crochet too.
I spent a lot of time with my ladies teaching them to do their exercises, it is a very intimate thing for me to be involved with and we have to check very carefully they are doing it well. So I tried to make it as comfortable as possible, reiterating how important it was, and really encouraging them as they did it right. I even agreed to do the exercises at the same time with them (I am going to have the best pelvic floor I can tell you!), which caused lots of giggling and laughter as I empathised at how difficult the exercises are to do!
Tomorrow we will have a dress ceremony. More on that after it happens!!
Monday, 4 August 2008
Before I have a week away...
well, I am just 2 hours from setting off back to the UK for just a 6 day visit to be bridesmaid at my sisters wedding so I thought I'd fill you in on my weekend antics.
It has been a busy weekend with two of my closest friends having birthdays. We started Thursday night by decorating my frined Claire's door and floor with balloons and happy birthday signs. The next day we had mid morning tea party for her, then dinner on the dock, followed by a barbeque to melt marshmallows and have chocolate digestives with them (AKA: 'Smores') - very yummy! The life of a missionary huh...
That evening we celebreated Claire's and Hannah's birthday going to a restaurant and having sushi and chocolate fondu. This place called the 'Living Room' made us all feel like we were somewhere out of Liberia...however the pencil used as the 'roller' inside the toilet roll holder in the bathroom did remind me where we actually were! A group of 12 of us went and had a great time just enjoying being off ship.
Sunday I went to an awesome church which is in the process of being passed over from the American founding pastor to the local Liberian pastor. His sermon was really amazing, and so encouraging. It is quite an international church in that many other west Africans attend and a few from NGO's but it was really refreshing to be there!
In the afternoon we were spoiled again and went to a farm an hours drive from us. We went and saw crocodiles, emu's and best of all, monkeys! They just appeared from nowhere bouding up the road and leapt up into our arms for a cuddle. It was just like holding a baby...if a little more surreal! We finished the visit off by leaping into the pool at the small restaurant at the farm. It was so nice to not be in sea that you had to spend all your concentrationon staying upright because of huge waves. It has been a lovely but exhausting weekend so i hope I'll be tired enough to sleep on the plane...more soon!
It has been a busy weekend with two of my closest friends having birthdays. We started Thursday night by decorating my frined Claire's door and floor with balloons and happy birthday signs. The next day we had mid morning tea party for her, then dinner on the dock, followed by a barbeque to melt marshmallows and have chocolate digestives with them (AKA: 'Smores') - very yummy! The life of a missionary huh...
That evening we celebreated Claire's and Hannah's birthday going to a restaurant and having sushi and chocolate fondu. This place called the 'Living Room' made us all feel like we were somewhere out of Liberia...however the pencil used as the 'roller' inside the toilet roll holder in the bathroom did remind me where we actually were! A group of 12 of us went and had a great time just enjoying being off ship.
Sunday I went to an awesome church which is in the process of being passed over from the American founding pastor to the local Liberian pastor. His sermon was really amazing, and so encouraging. It is quite an international church in that many other west Africans attend and a few from NGO's but it was really refreshing to be there!
In the afternoon we were spoiled again and went to a farm an hours drive from us. We went and saw crocodiles, emu's and best of all, monkeys! They just appeared from nowhere bouding up the road and leapt up into our arms for a cuddle. It was just like holding a baby...if a little more surreal! We finished the visit off by leaping into the pool at the small restaurant at the farm. It was so nice to not be in sea that you had to spend all your concentrationon staying upright because of huge waves. It has been a lovely but exhausting weekend so i hope I'll be tired enough to sleep on the plane...more soon!
Friday, 1 August 2008
Yesterday at work
Yesterday I prepared one of my ladies to go for surgery to remove a massive goiter from her neck. The ladyhad such a beautiful smile, and despite her nerves she just couldn't stop saying how happy she was. Her English was remarkable, and as I took her down to the seating area outside the theatres, her breathing became a little quiverry. We sat down on the bench and I reminded her that God was with her, and that soon the massive swelling would be gone. The operating room nurse arrived and after we had completed our final checks, we offered to pray with her. She prayed fervently as we prayed, and went into the anaesthetic room with a huge smile on her face and tears in her eyes.
She returned to the ward following her operation, very sleepy, her now 'flat' neck pulsating slightly (something which I have had to learnt not to freak out about!!). She had quite a lot going on with medication and drains so I sat at her bedside. She looked so content. As she stirred I asked her if she would like to see herself in the mirror. I brought her the mirror and she took a deep breath and as she looked, her eyes filled, and she let out a quivering breath. A huge sleepy smile crept across her face and she whispered 'thank God thank God' as her hands rested at her sides and she dozed off back to sleep.
I love sharing these moments of deep realisation with people.
We have another little girl who arrived 2 days ago. As I type she is having her 2nd unit of blood before her surgery (not usually done!), such is her condition that she need this before her operation. She has a massive neurofibroma tracking from her backside down below her knee. It looks as though she has an extra hip, it is so swollen with the tumour. She has the same type of tumor on her forehead the size of a tennis ball. This young girl (she says she is about 10) arrived and was left at the ship by her family. She speaks French, but Kpele French, and so has been consequently been plunged into a completely alien environment, cold noisy and without being able to understand a word anyone says to her. Our 'charades' skills are paramount...Her admission process took 3 hours, using 2 translators to translate to French then her language. It was found that she also has Malaria right now. Usually that would mean cancelling surgery for a few days, but in her case, time is key.
Yesterday, as she was lying in her bed, on her side because she cannot rest on the massive pungently smelling tumour, she lay quiet as a mouse her eyes empty - I am sure her head was buzzing. She occasionally ventured to the bathroom, others in the ward aware of the odour of her wounds. I was determined that I would not allow my shift to go by with her being left to snooze quietly.
Determined to find something we could do together, I went and got a pack of beads and bracelet/necklace thread and some play doh. I sat down beside her bed and grinned, racking my brain for my few words of French, I asked her how she was and introduced myself. I then started to show her how to make the necklace. She shyly copied what I had done. I was called off to do some other work but a little later we picked up where we left off. Conscious that this little girl probably has been suffering rejection emotionally and particularly physically, I made every effort to be aware of giving her a pat on the hand, a rub on the back and a tickle under the chin as I tied the necklace around her neck. That was the moment she squezzed out a little smile.
She will have the tumour mostly removed today. Crew spent a long time last night donating 10 units of blood, the tumour itself bleeding before the surgery has even started. Now we can only hope and pray for a positive outcome.
She returned to the ward following her operation, very sleepy, her now 'flat' neck pulsating slightly (something which I have had to learnt not to freak out about!!). She had quite a lot going on with medication and drains so I sat at her bedside. She looked so content. As she stirred I asked her if she would like to see herself in the mirror. I brought her the mirror and she took a deep breath and as she looked, her eyes filled, and she let out a quivering breath. A huge sleepy smile crept across her face and she whispered 'thank God thank God' as her hands rested at her sides and she dozed off back to sleep.
I love sharing these moments of deep realisation with people.
We have another little girl who arrived 2 days ago. As I type she is having her 2nd unit of blood before her surgery (not usually done!), such is her condition that she need this before her operation. She has a massive neurofibroma tracking from her backside down below her knee. It looks as though she has an extra hip, it is so swollen with the tumour. She has the same type of tumor on her forehead the size of a tennis ball. This young girl (she says she is about 10) arrived and was left at the ship by her family. She speaks French, but Kpele French, and so has been consequently been plunged into a completely alien environment, cold noisy and without being able to understand a word anyone says to her. Our 'charades' skills are paramount...Her admission process took 3 hours, using 2 translators to translate to French then her language. It was found that she also has Malaria right now. Usually that would mean cancelling surgery for a few days, but in her case, time is key.
Yesterday, as she was lying in her bed, on her side because she cannot rest on the massive pungently smelling tumour, she lay quiet as a mouse her eyes empty - I am sure her head was buzzing. She occasionally ventured to the bathroom, others in the ward aware of the odour of her wounds. I was determined that I would not allow my shift to go by with her being left to snooze quietly.
Determined to find something we could do together, I went and got a pack of beads and bracelet/necklace thread and some play doh. I sat down beside her bed and grinned, racking my brain for my few words of French, I asked her how she was and introduced myself. I then started to show her how to make the necklace. She shyly copied what I had done. I was called off to do some other work but a little later we picked up where we left off. Conscious that this little girl probably has been suffering rejection emotionally and particularly physically, I made every effort to be aware of giving her a pat on the hand, a rub on the back and a tickle under the chin as I tied the necklace around her neck. That was the moment she squezzed out a little smile.
She will have the tumour mostly removed today. Crew spent a long time last night donating 10 units of blood, the tumour itself bleeding before the surgery has even started. Now we can only hope and pray for a positive outcome.
Kossi pictures
This is Kossi before his operation. This developed over quite a short period of time because he came to the ship for eye surgery a few years ago. He was surprisingly still just about walking.Another play-doh moment!
During my crazy 'baby shift' I had a lot of fun with my little shadow Kossi. He follows me pretty much everywhere, and becomes cheekier every moment! His legs are healing well in casts since his bilateral osteotomy surgery. Whilst I was very busy I really hate to ignore the little ones that want to interact! So, it was another play-doh moment...of which there are many.
I set Kossi up with a borad and some fluorescent play-doh. Unbeknowns to me, one of my older female patients was watching very carefully what he was doing as I started him off and made an armchair! I soon spotted her craning her neck to see, and offered her some - she declined, but I knew secretely she was dying for a turn. So a few minutes later I discreetly snuck into her hands a pot of pale blue doh, whispering 'go on, give it a go!' A shy smile swept across her face, she winced just a little as the wound to her neck where a massive goiter had been removed pulled a little. Soon she had a full on kitchen creation made of soft play-doh. A cooking pot, a fire, a pan...you name it, it was there. Before long, I had a group of 6 people kids and adults all creating and laughing and making adjustments to their creations.
Times like these are such a good conversation starter. I love those moments when I can just share even split seconds as I whizz by in the middle of another job, taking time to appreciate their creations!
I set Kossi up with a borad and some fluorescent play-doh. Unbeknowns to me, one of my older female patients was watching very carefully what he was doing as I started him off and made an armchair! I soon spotted her craning her neck to see, and offered her some - she declined, but I knew secretely she was dying for a turn. So a few minutes later I discreetly snuck into her hands a pot of pale blue doh, whispering 'go on, give it a go!' A shy smile swept across her face, she winced just a little as the wound to her neck where a massive goiter had been removed pulled a little. Soon she had a full on kitchen creation made of soft play-doh. A cooking pot, a fire, a pan...you name it, it was there. Before long, I had a group of 6 people kids and adults all creating and laughing and making adjustments to their creations.
Times like these are such a good conversation starter. I love those moments when I can just share even split seconds as I whizz by in the middle of another job, taking time to appreciate their creations!
Baby Caroline Pictures
What can I say, a beautiful little family who let me be a part of it for just a glimpse!
Baby Nursing
Being an adult nurse is something that has had to be quite a fluid concept for me whilst I have worked here! We are all asked to state what we are comfortable with when we first arrive and our patients are assigned accordingly. I however, have loved looking after kids (you may have noticed...) and I made it known to my supervisors when allocation became difficult. So last week when they threw me in at the deep end with a 4 and an 8 month old baby as part of my all under 10 patient allocation, I shouldn't have been surprised. dragging my baseline observations, and drug calculations from my dusty brain, small small freaked out is probably where I was at really! One of my babies (called Caroline - 4 months old) was born without a rectum, and had had surgery at a local hospital to create a colostomy (an opening from the skin to the bowel). She had come to us to have her rectum formed and at some point the colostomy reversed. She was a precious baby and her mum, also called Caroline was clearly absolutely adoring of her child. I had such a beautiful day with her and the other baby Moses (8 months having a hernia repair). The mums got on so well and we laughed most of the day, they loved that I spent time playing peek-a-boo with their babies. After their surgery they were absolute angels. They took their meds like champs. I had to give baby Caroline an injection and she merely let out a little whimper then continued to smile. I had the biggest smile on my face all shift, I was so exhilarated.
Baby Caroline unfortunately couldn't have the surgery complete as planned. Her tiny little body hadn't devloped enough for them to use the colon to form the rectum. She will have to have another surgery to complete the process, but in the mean time Mum wil have to care for her with a catheter and a small drain where her back passage would be. When I changed Carolines nappy, it was quite a complex process with all the tubes she had. Her mum was quite distressed about how her baby looked. I spent some time trying to explain what everything was doing, but she was so sad it had not worked as planned just yet. Moses mum tried to encourage her as well and between us we cheered her up. Carolines mum dotes on her daughter with such love and adoration, I do hope and pray that we can successfuly complete her surgery.
The shift continued to be very busy, but the babies and their mums reminded me of how fragile these little lives that we come into contact with are. I can't believe I actually get to be part of all of this. Huge big thanks needs to be said to my wonderful Paeds nurse friend Ali who is always on hand for advice and support...
Baby Caroline unfortunately couldn't have the surgery complete as planned. Her tiny little body hadn't devloped enough for them to use the colon to form the rectum. She will have to have another surgery to complete the process, but in the mean time Mum wil have to care for her with a catheter and a small drain where her back passage would be. When I changed Carolines nappy, it was quite a complex process with all the tubes she had. Her mum was quite distressed about how her baby looked. I spent some time trying to explain what everything was doing, but she was so sad it had not worked as planned just yet. Moses mum tried to encourage her as well and between us we cheered her up. Carolines mum dotes on her daughter with such love and adoration, I do hope and pray that we can successfuly complete her surgery.
The shift continued to be very busy, but the babies and their mums reminded me of how fragile these little lives that we come into contact with are. I can't believe I actually get to be part of all of this. Huge big thanks needs to be said to my wonderful Paeds nurse friend Ali who is always on hand for advice and support...
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