Grace on Mercy

Goodbyes

2008-09-22T14:51:00.000-07:00

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

A new life

2008-09-22T14:42:00.000-07:00

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

My VVF ladies and their dress ceremony

2008-09-22T14:20:00.000-07:00

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

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

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

Before I left...

2008-09-22T14:11:00.000-07:00

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

Imagine...

2008-09-07T14:41:00.000-07:00

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

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

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

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

Missionaries of charity

2008-09-05T01:49:00.000-07:00

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

A day out

2008-08-31T08:38:00.000-07:00

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

Yeme

2008-08-25T19:08:00.001-07:00

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

2008-08-25T18:18:00.000-07:00

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

Me my boys and their Mama's!

2008-08-25T18:15:00.000-07:00

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

Oscar and I

2008-08-25T18:12:00.000-07:00

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...

2008-08-25T06:51:00.000-07:00

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

Some more orthopaedics

2008-08-25T06:32:00.000-07:00

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

VVF

2008-08-25T06:06:00.000-07:00

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

My first day back at work...

2008-08-14T04:54:00.000-07:00

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

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

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

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

More wedding pics

2008-08-14T04:52:00.000-07:00

The wedding party...

Where have I been...wedding!

2008-08-14T04:49:00.001-07:00

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

More celebration pics

2008-08-04T07:17:00.000-07:00

My lovely girls!

Some birthday fun!

2008-08-04T07:09:00.001-07:00

Chocolate Fondu!!

Before I have a week away...

2008-08-04T06:30:00.000-07:00

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

Yesterday at work

2008-08-01T06:30:00.000-07:00

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

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

Kossi pictures

2008-08-01T05:07:00.001-07:00

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!

2008-08-01T04:57:00.000-07:00

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

Baby Caroline Pictures

2008-08-01T04:53:00.000-07:00

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

2008-08-01T04:47:00.000-07:00

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

Baby Nursing

2008-08-01T04:28:00.001-07:00

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

Baby Greg

2008-07-29T06:06:00.000-07:00

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

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

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

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

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

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

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

Sisters of charity

2008-07-26T12:46:00.000-07:00

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

Day with the HIV team

2008-07-26T11:50:00.000-07:00

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

I have been renamed...!

2008-07-23T01:08:00.000-07:00

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

Night shift

2008-07-23T00:49:00.000-07:00

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

Everyone works together

2008-07-20T16:31:00.000-07:00

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

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

On the ward

2008-07-20T15:50:00.000-07:00

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

The ward

2008-07-10T10:29:00.001-07:00

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

My friend Katy

2008-07-10T10:26:00.000-07:00

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

A game of pairs

2008-07-10T10:05:00.000-07:00

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

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

2008-07-10T09:56:00.000-07:00

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

James and Moses

2008-07-10T09:24:00.000-07:00

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

A song

2008-07-07T08:15:00.000-07:00

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

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

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

Baby Greg update...

2008-07-07T08:09:00.000-07:00

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

Courage and something a whole lot more powerful

2008-07-07T07:55:00.000-07:00

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

Running on the dock!

2008-07-05T04:25:00.000-07:00

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

Baby twin Moses

2008-07-05T04:17:00.000-07:00

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

Baby Greg

2008-07-03T10:04:00.000-07:00

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

Thyroidectomys........ Eeeeeeeeeeek!

2008-07-03T09:52:00.000-07:00

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

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

A different kind of surgery

2008-07-03T09:37:00.000-07:00

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

Firestone Rubber Plantation

2008-06-29T06:46:00.000-07:00

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

Feeling the pressure...and other musings

2008-06-25T08:35:00.000-07:00

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

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

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

The raft pictures...

2008-06-20T08:31:00.001-07:00

The man with the raft! Tee hee...

By the River after church at GSBC

2008-06-20T08:27:00.000-07:00

By the river we stopped at after GSBC. My friend Katy (she's a legend, just for the record!!). These were pics just before the girl calling and the raft escapade!

GSBC photos

2008-06-20T08:25:00.000-07:00

One of the sets of sibblings I met :)

2008-06-20T08:22:00.000-07:00

One of my African outfits!

2008-06-20T08:19:00.000-07:00

Trip to GSBC and me in my African outfit!

A Sunday out

2008-06-20T07:37:00.000-07:00

Last Sunday I was off work and decided to go out to a church called Good Shepherd Baptist Church inn Cheesmanburg (yes that's a real place name!!). It is quite a drive from the ship, and requires landrovers as the weather her gets wetter and wetter. After a somewhat bumpy ride, and following a track through pretty thick vegetation, occasionally popping out into a clearing with a group of homes centred around a cooking area, we drove up to a small area of elevated ground just above a small village. A large white washed building protruding on the top, with it's initials GSBC laid out artistically in white stones in front of the building. We waited outside as the sunday school came to an end, then sat down on tiny little pews with desks, built for fairly small people!
The vast majority of the church were kids aged 2 to 8, but we were informed that a lot of the adults would be out and about harvesting their crops before rainy season began. As the service continued, the pastor occasionally slipped into the local dialect of Gola to make sure his local congregation understood his message of the prodigal son. As always, everyone was so welcoming of us from Mercy Ships, and we all had to stand and say our names.

I peeped behind me through the service (by which time I had a little girl of about 6 sprawled across my lap having a good nap, and radiating serious amounts of heat!), and at the back of the church, several of the mama's had spread out their lapas (large piece of fabric they use to carry kids on their backs). One by one the children began dozing off during the sermon, to be fair to them, they had been in church in the stiffling heat since 9.30am, and it was now getting on for 12.30. Each was subsequently hauled by one arm and laid out on the floor behind the pews to nap, a sea of little hot black bodies laid out on beautifully extravagant coloured fabric. I can't believe how quiet so many kids can be, sleeping or not! After the service we went outside to chat to some of the congregation and were mobbed by the inquisitive children.

After church our plan was to go to the beach for the afternoon, but this was preceeded by our adventurous drivers deciding we should check out some of the tracks around the area. So we went through some tiny villages with adults and children alike coming to wave and shake hands. We eventually ended up through a heavily wooded area reaching a river. The track appeared to come out the other side of the river, the local 'Grandma' that was there telling us it was not too deep. The men resisted the temptation to drive through it, but we got out to have a little look around. A young girl had followed us up the path and climbed up the river bank. She made a strange noise aiming over o th other bank. After a few seconds, we heard a 'reply', and in 5 minutes or so a gentleman appeared out of the bushes. He came down to the bank, and stepped onto a raft made of logs. Pulling on a rope strung between 2 trees either side of the river bank, he gradually pulled the raft over to the girl. On she hopped, and sat like the queen on a kind of chair at one end of the raft. It was so lovely to see more of life out of the city, quite a surreal moment!
The peace by that river was phenomenal. I am sitting in a cabin trying to drown out the sounds of drills and machinery working on the deck constantly, so that kind of peace was a little unusual for me!

By this time, 'Grandpa' had arrived on the scene, and Lee one of the drivers was chatting to him about his crops. He ended up agreeing to buy a sack of Casava, the traditional staple food crop here. as Grandpa went disappearing into the bush the word of our whereabouts obviously spread. By the time the exchange of a dollar (50 pence!!) for a sack of casava had been completed, the landrovers were surrounded by 10 or so kids and young men all eager to shake hands and say hello.

After that we set off to our afternoon at the beach. Just another random day in Liberia...!

Jitter Bug before her operation

2008-06-20T07:35:00.001-07:00

Miracle baby!

Feeding programme and Jitta Bug

2008-06-20T06:38:00.000-07:00

One of the things we often find here is that our patients can be very dehydrated, and malnourished. Oral rehydration salts are a very common pre op prescription. It requires the person to drink a pretty vile tasting solution of salts, sugars and water, sometimes a few litres over several days. i can testify that it is pretty grim, after my ill stomach, I was subjected to a small taster of it....yak!!
Another great thing one of our nurses focuses on is the feeding programme. Just this week, one of our babies who's mum had had surgery was in a pretty bad state. He wasn't holding his head up, he looking very skinny, his ribs protruding, his skin wrinkly from apparent rapid weight loss, was not feeding properly, had oral thrush and had blood in his stool. A pretty bleak picture. As often happens, the care of the patient extended to the family. He was started on a feeding regime and various other things, and yesterday when I went to work after only 3 days input, the results were miraculous!
He was lying on his tummy lifting his head, smiling as wide as wide can be, he looked visibly chubbier inn his cheeks and his eyes sparkled. Some of the things I witness here are phenomenal, and are clearly not just acts of human input. There just has to be a greater input for things that happen here...which brings me to another patient...Jitta -Bug...

Jitta is one of our miracle babies. She was just barely a few months old when she came to Mercy Ships. She had basically a hole in her skull, through which her brain was protruding. As you can imagine, if left this way, brain damage could easily occur (if it hadn't already!) It was imperitive that she had this surgery. After a long and complicated surgery, Jitta-bug (so named by us from her actual name Jitter because of how she looks all wrapped in blankets I believe...) was cared for on ICU for some time. Now she is a few weeks on and we are all astounded by her progress. Although we will never really know if she has incurred and developmental delay or brain damage until she gets bigger, she is showing amazingly normal 'baby behaviour'. She crys, eats, drinks, follows people and moves as we would all hope though we remember daily, it is an absolute miracle. We are all watching in anticipation as she continues to get better. You have no idea how beautiful that baby is to all who have cared for her. For a longtime she had bandages between her nose and round her head. Those are gone now, revealing an absolutely beautiful baby, with little evidence of the trauma she has incurred.

John and David Smith

2008-06-20T06:13:00.000-07:00

Have you ever thought any Liberians would be called John and David Smith??!! well, aside from the names, this father and son combo have a pretty neat story, a story which is not uncommon here, and just another of those quirks you would never see at home, and is just another reason why I love it here.
John is 6 and had a club foot repaired. The night he arrived he was like a whirling dirvish leaping around and waving and giggling at us all in absolute excitement. An absolute poppet. Dad came as his caregiver to his appointment pre operatively, and as John was being assessed, the surgeon noted a largish growth on David's (Dad's) finger. In true Mercy Ships form, the surgeon said, would you like to have that off while you're in, it's only a 15 minute job...Two patients for the price of one! So both Dad and son had their surgery on the same day, and then David has continued to look after his slightly more subdued son!
That leads me to another great moment. John was really grizzly and we were really trying to distract him and get him focused on an activity so, we brought out colouring books and crayons (always a massive hit!) hoping he would be interested. Sadly not, but he settled down for a nap. Instead, Dad took up the crayons and book, and began to colour. Time and time again adults will just love to colour and take so much time over it. It still just touches my heart to see something so simple, be so interesting and even therapeutic to people here. It really makes me think how much we take for granted.
When was the last time you really took time to enjoy, and concentrate on one seemingly insignificant task or activity, and truly enjoy it for what it was?

So here's a challenge for you, pick something you do often, slow down and think about it. Enjoy it for it's simplicity. What have you not noticed about that activity that you haven't thought about before? What does it give you the time and space to think about?

Go one, I dare you, I did it when I was doing my laundry of all things, put a whole different spin on the whole thing. Very random!

Alisain

2008-06-20T05:57:00.000-07:00

Alisain is a little 2 year old boy who has been with us for quite a while. He had a cleft lip repaired and is now blooming. All his wound is healed, and he is now just here with Mama as what we call a 'Hotel patient'. All care is finished but mama's cousin is still in with her baby, and can't speak much English, so Alisain and his mum are staying to help out with the continuing care of her little one.
As you may know, we start each of our shifts with a prayer time and Wednesday was no different. Often when we group together little bodies appear out of nowhere and crawl into our laps. they are generally very well behaved and join in with heart felt 'Amens' at the end.
Alisain was parked on the floor near to the nurses, with his bowl of 'soft diet' corn starch mash (very appealing!!) and like any child might do, he was enjoying playing and mashing it about in his bowl. Let me let you in on a bit of Alisain's personality. When he first arrived he was scared to death of white people and pretty much any procedure sounded like we were going to murder the poor child. However, he has now become a little bit of a monkey, schooching out the door when people aren't looking and running full pelt into any of the nurses he vaguely recognises for hugs and tickles. Quite frankly a bit of a tinker!! He has also since arriving on the ward learnt the words 'Hi' and 'Bye' and continuously runs back and forth just so he can wave hi and bye.
Whilst we were praying he noticed what we were doing, and decided he would join in. His hands covered in mash he closed his eyes and put on a very serious face. Both Ali and I spotted his little antics and caught his eye a few times, he gave a huge cheeky grin as he peeked through one eye and then quickly put back on his serious face again. This went on for 10 minutes or so, and was hilarious!!
To top it off at the end of our prayer time he shouts a big 'Amen' and then giggles furiously, gets up and starts running around again in a too big hospital gown covered in flip flops...

please note: I was endeavouring to pay attention to the prayers too...!!

Baby Powder

2008-06-20T05:46:00.001-07:00

Yesterday I had another two of those moments when I just remember where I am and realise this is not my normal environment.
I was dashing along the corridor by the wards to go to our sluice room (and by dashing, I don't mean my usual UK nurse walk, that has departed long since, can you believe it!!), and I poked my head into B ward. A ward where I was working is full of adults, with only two children, B ward on the other hand is virtually all kids and so is full to overflowing with people, kids and their care givers. I am having serious withdrawal from my lack of pediatric patients, so I felt a quick detour to B ward for some kiddy time was neccessary.
Across the room I spied a young couple, clearly doting on their very young little baby. Mama had just finished giving the baby a good scrub and had him lain over her lap. Here I have noticed that whatever we give to the patients, be it soap, build up drinks or moisturiser in their admission packs, they seem to think it must be very important, and what one person has, others always want the same.
This mama had been given a bottle of baby powder, and use it she did. I could barely contain myself as this chocolate coloured mini person became gradually what can only be described as a big white ball of cotton wool. Every inch of the baby's skin was gradually dowsed in powder, leaving only a tiny little chocolate head free of the stuff. My word, I really had to giggle! Another moment where the simplist thing is the most precious!

Adwina...

2008-06-18T06:30:00.000-07:00

This Monday I had a gorgeous little girl admitted to the ward. She has hair tied in little plaits sticking right out of her head in all directions. Adwina, has a bouncy little walk and a coy head tilt. I went and introduced myself to her and her family and she asked me 'wha yor nam', I answered and she giggled, burying her head into her mothers lap. She has the sweetest countenance.
Her next question was, 'give me your hand', see Adwina is 4 and she has bilateral cataracts! She is virtually blind, barely being able to see light and dark. Her mum guides her everywhere, but still he leaps and skips everytime she has to go to the bathroom (though that sometimes does cause a few mishaps!). Right now we have an eye surgeon, who does between 25 and 30 cataract extractions everyday...the record is 36! We don't have all of these patients on the ward but some like Adwina, need to stay overnight at least. It is such a simple operation, yet here so many people are literally crippled because of cataracts, rendered unable to participate in the labour of society.
I looked after Adwina for a short while after her surgery yesterday afternoon. Not surprisingly she was a little scared. she understood her surgery and I explained she would have patches over her eyes, but her insecurity showed. I had to be careful to call her name as I got close so she would know I was there. After gently coaxing her from her sleepy state to eat and drink, she fell back to sleep.
Adwina will probably be going home today. I can only imagine the excitement she gets to experience when she finally gets those patches off and can experience, colours, shapes and seeing her Mum's face again.

A duvet day...

2008-06-18T06:24:00.000-07:00

Last Saturday it was my weekend off and after a hectic few days, was surprisingly not disappointed to see that it was chucking it down with rain outside. I got up and had a long chat with my friend Hannah over breakfast, then crawled back to bed to listen to a sermon from CLC online (loving the power of the internet!). A little later armed with lunch and my recent delivery of Cadburys buttons and G tips, what followed was an afternoon of bliss.
A bunch of us hit the lounge upstairs and collapsed in disarray on the sofas in front of the Rugby. Armed with books and random conversation, and LOADS of tea (some things will never change in my world!) we stayed put for about 5 hours. It was blissful. There was laughing till our sides hurt, peace and quiet, whooping at the Rugby and Football. Just nice. Though I'm not sure how many of those days I can cope with when rainy season comes....

Inspired by Play-Doh

2008-06-10T23:24:00.000-07:00

Sometimes the nurses from the ward are asked to go and run a ward activity instead of their usual nursing duties. This is a great time for the patients and great fun for us too. So, just recently Ali (of 'Team Awesome...') decided to go for a PLay Doh creation story experience. She gave the patients and relatives/carers that wanted to join in a lump of play doh. After explaining to them how God created everything from nothing, and encouraging them to think about the fact that He created us too, she gave them a 'small thing' (a lump of play-doh)to create 'something'. Ali asked and the rest of the nurses to use their imagination and create whatever they liked.
So began the creations, a little nervously at first but soon the budding artists were producing things fast. Snakes, spiders, cooking pots, huts... Not a cat, dog or person in sight!! It just struck me what a different context and environmental influences we have.

Orphanage building

2008-06-10T17:58:00.000-07:00

Each Saturday a group of people from Mercy Ships travel an hour or two to a place in the bush where some ex Mercy Shippers are helping to buiild a school. The school is for children who are at an orphanage on the same site, and eventually they will have a new building to live in too. The two guys who work there are lovely and clearly hae a heart for the kids there. They sleep in a hut in the middle of the compund in mosquito nets, and have a traditional stove to cook on.
I went along with a group of 7 of us (mostly blokes) to go and help continue the building work.
We drove into the area and were quickly surrounded by many of the orphans, after lots of hugs and hi fives I was introduced to one of the guys David who is working there for another few weeks. We had barely got through the hello how are you, names etc before David asked me, 'are you a nurse by any chance?' My heart kind of skipped a beat, and with a nervous smile, yes I am actually. 'What can I do for you...?' I said, let's be honest with fear and trembling, again another leap out of my already stretcched comfort zone. An elated David sent one of the kids off to find Darling Boy, a boy about 6 or 7, he came to me with a raggy hanky wrapped around his leg. We ducked inside the hut and I grabbed the only set of medical supplies they had - a small first aid kit. Peeling off the hanky and plaster underneath I was faced with a cut that appeared to be devloping into an ulcer type wound. Ok, what now...? No running water, no dressings bigger than a plaster...hmmm.

At that moment I guess I felt quite a lot of pressure but at the same time,I was actually quite excited, my brain started ticking and the plan came together. A rinse with bottled water (no running water obviously), betadine and a patch up with non adherent dressing and tape later, I felt at least this was better than a hanky! A few instructions, and things to look out for in case it got worse, and with the promise of trying to send some more dressing supplies I set to work on helping paint.

We needed to undercoat the bare plastered walls, so after much debate about the consistency of the powdered paint, I set to work with one of the locals who was also helping with the project. We chatted and he explained to me that he was going to teach in the shool when it was finished, but right now he was trying to work so that he could go back to school and finish his education too. The more I talk to people the more it seems they take time off from school, to earn money to go back to school, the cycle repeating itself as time goes on. Some people at university will hold down night shift jobs alongside their studies, in fact, many of our translators are in that boat.
I have to say, my painting skills weren't as great as I hoped, the paint being virtually dry before my roller hit the wall, but it helped if only small small.

A little later we had our lunch (that was a difficult experience... the kids were all telling me how hungry they were when I came from out of the hut after my food. Pointing to their tummies and asking for bread. It's pretty heart breaking, but I made up for it by playing lots of games in the next hour or so. Lawrence one of the guys was able to cut up an apple and share it out to each of the kids which they loved. (They do actually get fed well by the people who run the orphanage by the way!!).
'Round and round the garden', 'This little piggy..' were the hit rhymes for the afternoon with lots of giggles and cheeky smiles as we played. Then stupidly I began twizzies, flinging the kids about, and completely exhausting myself but there was much hilarity and laughter and right then that was what counted.

The guys continued doing some other work while I went for a little walk with Shayla. She has been going to the orphanage quite regularly and so has got to know someof the mama's and families around. We had a little walk through a small group of houses. Tin roofs and mud roofs, all the houses focused around the main cooking area. They showed me how some of them made palm nut oil to sell at the markets, an arduos time consuming process. The nuts are 'shelled', mashed, and placed in an enormous pot, boiled and eventually what is separated on top of the water is scooped off, leaving the rich red oil for cooking. Those bottles of oil at the supermarket we don't even think about, here, someone has spent hours preparing.

Amidst the houses there are clothes on the line or placed on rocks drying, kids playing, babies feeding. The place was boiling hot, and the women working so hard round the massive fires. I noticed at that point though, despite everything, how peaceful it was here. In Monrovia, the city is bustling, the car horns never stop, even when I sleep there is the constant hum of the ship engines roaring. Here, it was just serene, quiet, almost eerie how different the feel of the place was.

Not long after that we played our final games and packed up. waving mad good byes to the kids we piled into the land rover.

Another adventure, another peek into a whole different world...

Missionaries of Charity visit

2008-06-10T17:34:00.000-07:00

So before being unwell, nearly two weeks ago now, I returned to Missionaries of Charity. I led the group of people who wanted to come to help with the kids. I explained to them ho hyper they often were, and how we could help at meal times. We had a group of 5 of us this time which was great because the more hands, the better, lots of little bodies wanting a cuddle and someone to play with. they were actually quite a lot calmer than usual when we arrived which was a good sign. I had a few more exciting plans for the visit today...
The smallest of babies continued to look so much healthier, one in particular I actually didn't recognise he had got so big.

I met a new helper who had volunteered to come on a regular basis who was a nurse. she had been to Liberia before working with another charity. She was lovely and obviously has the same passion for the place as I do.

A few of us did a nail painting session, it is the most hysterical scene. From no where, suddenly limbs just begin to appear, a few heads burrow their way through the crowd to the front, pushing to be the next. Feet and hands are suddenly up close and personal. What madness! The children's eyes light up, the boys even clamour for bright orange, red, turquiose adn purple splodges on their grubby little hands and feet. Giggles of delight as one by one their nails change colour. You can't help but smile. Eventually most of the little ones are satisfied at their suitably bright nails, and we look at what we can do next...

We had a traditional instrument (it's name escapes me right now!!) which is a hollow shell, surrounded by a mesh with beads. It is used at most churches adn is a very unusual looking contraption, but by holding onto the mesh and moving the shell, an awesome sound is created. So I got it out and in my very western bad rhythm began to make sounds. In walks little prince, barely walking actually, only a little tot, and starts shiking his little nappied butt in time with the sound. Bouncing up and down and jigging whilst playing with a building block I might add. It just confirmed yet again how innate the sense of rhythm and music is to the people here. Awesome!

Being as the kids were so 'calm', we got out some play-doh too. The biright colours were unfortunately a little appealing to one or two of the little mouths, but once shown what it was really for, snakes and blobs and creatures began emerging from the soft stuff. A lesson on colours in English began. Many of the children speak Bassa, though they are quite convinced if they just keep chattering to us that eventually we will understand what they're saying..I'm still hoping too!

Next I took a bit of a big risk. Lots of the kids were playing with play-doh and balloons and just having cuddles, so I decided to try out the facepaints........ I am pretty sure these kids have never seen or had face paints before so my first little victim was a little nervous. Perched on a little stool I showed her on my hand how the paint brush would put colours on her skin. With a few winces to begin with I created a small purple butterfly, with green spots on her cheek. Picking up one of the toys which had a mirror in, she had a careful long look, a little bewildered. Then a definite decision, and she pointed at her other cheek. By this time a little crowd was gathering, so next came a big red star for one of the boys. Boy, did he giggle when he saw his image in the mirror! So the face paints continued... on foreheads, cheeks, noses. Even though there was a little audience, I think it was an activity which had with it a sense of intimacy to really connect with each child. I let each one choose their colours and they just stared straight into my eyes as I concetrated on painting, saying silent prayers in my heart for each one. Maybe they knew, but for sure they barely moved a muscle. The result of each was beaming smiles and cuddles.

I left that place with my heart filled, my hands covered in paint, nail varnish on my face (???!!)and play-doh on my bum. What more can a girl want?

Sorry it's been a while!

2008-06-10T17:06:00.000-07:00

So after a very hectic week last week (more on that in a bit...) I was pretty ill so the updates kind of went out the window! Bit of a huge thank you to my room mates - ice packs, back rubs, pills, bread, water, quietness, being willing to vacate the bathroom at the drop of a hat, what more could you ask for!!
So on with the stories...

This is a horrible day.

2008-06-01T16:23:00.000-07:00

That's how I felt this last Friday. You know when you just can't get yourself to be chirpy. Something doesn't sit right and you just feel horrendous, unsociable, on the brink of tears, and so fed up...So just in case you wondered not every day is perfect and bright and breezy. My shift began, I had had a parcel sent to me, gone to the mail room and it wasn't there, panic sent in, like it was the only thing in the world that mattered right now (yes, see previous posts and I'm worrying about a parcel...?!) Logically someone had picked it up by mistake or had collected it for me. I asked around, no one knew anything. My word, it seemed like the end of the world!! Then appeared Ali (of the nursing A team...more about that another time), parcel in hand. I was so relieved and everyone else too I think, no one wants to work with a grumpy Grace. Things were a little better. Even more so when the package contained Cadbury's buttons and PG tips, what more of a luxuary could a girl in Liberia want?

Then as always, God stepped in and gave a reality check, in the form of 3 of our previous bilateral club feet patients, coming in for cast changes. You may remember hearing about them in my club foot entry. These 3 little ones are the kind that actually make your heart hurt to be around them. They came in and Ali Katy and I were leaping off the ceiling in delight, cuddles handshakes, tickly tummys and all those things that come with some kind of reunion. The next half hour resembled some kind of organised chaos, their Mama's just as excited to be back too.

Something in my spirit changed in those few moments. Everything made sense again.

What ensued after dinner can only be described as mayhem as I imagine will be happening in the kids corner in heaven. I got out some quilted mats, blocks, and lego, and we played, and played and knocked over bricks, tickled, sang (the older of the little ones was singing he's got the whole world...), dashed them to the bathroom just in time because we were too busy having fun (and I'll be honest there were 2 not quite in time moments...not for the none nurses among us). Amidst that, I looked after my adult patients too, who to be honest were loving watching us play together. I have never felt so exhausted and energised by a shift that I can remember. Then I had a moment to just sit and watch the 3 little ones we had placed on a bed together to colour and sing and chatter nonsense with each other. It was like I was getting a VIP glimpse at something so special that it was kept secret from virtually everyone. It was a few moments of blissful innocent peace amongst a crazy, confused, erratic world.

I wish you could have felt and seen and been part of that shift. You just can't help but be challenged and changed and blessed. I am so thankful for each day, even the rubbish ones but I wonder every day, why me and not someone else?

A day with the eye team.

2008-05-30T04:42:00.000-07:00

'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.

The end of my night shift...

2008-05-30T04:28:00.000-07:00

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.

My roommates, or at least for one more week :(

2008-05-25T22:33:00.000-07:00

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.

Our 'local' road, at a quiet moment

2008-05-25T22:32:00.001-07:00

2008-05-25T22:29:00.000-07:00

Two of my closest buddies, shopping for material in Water Street market. Girls just have to shop you know!

Emmanuels friend and my source of joy!

2008-05-25T22:19:00.000-07:00

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

2008-05-25T22:08:00.000-07:00

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!

2008-05-25T21:53:00.000-07:00

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!

2008-05-25T21:51:00.000-07:00

How beautiful is our view?! Pretty much everynight, the sun sets just between the two areas of land you can see jutting out. It's perfect evrytime...

A few sights

2008-05-25T21:47:00.000-07:00

Just a typical little scene on the roads...

Haemoglobin...

2008-05-25T17:32:00.000-07:00

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!

Don't you just love it when...

2008-05-23T21:56:00.001-07:00

...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.

Getting chubby...

2008-05-23T21:32:00.000-07:00

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!

More Bong Mine Pictures

2008-05-23T14:44:00.000-07:00

Bong Mines Hospital

2008-05-23T12:37:00.000-07:00

A variety of pictures from Bong Mines Hospital, the staff and the educational posters!

Club foot delights!

2008-05-20T15:32:00.000-07:00

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...

Trip to Bong Mines

2008-05-20T04:23:00.000-07:00

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!

Community meeting

2008-05-20T04:08:00.000-07:00

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!!)

Hospitals in Liberia

2008-05-20T02:17:00.000-07:00

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).

A nice rest...

2008-05-13T14:20:00.000-07:00

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...

Paediatrics...how do you do it?!

2008-05-11T15:56:00.000-07:00

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.

Song time!

2008-05-11T15:35:00.000-07:00

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?

A speech and language session

2008-05-11T15:20:00.000-07:00

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.

Monrovian Taxis

2008-05-07T16:42:00.001-07:00

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!

A different meal out

2008-05-04T02:42:00.000-07:00

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!

The Queens birthday!

2008-04-30T19:41:00.001-07:00

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

Church in the village

2008-04-30T19:25:00.000-07:00

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

Weekend work and play

2008-04-29T09:47:00.000-07:00

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

Friday night was English night!

2008-04-29T09:40:00.000-07:00

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

Just a bloomin brilliant mornin'!

2008-04-25T09:27:00.000-07:00

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

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

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

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

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

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

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

Missionaries of charity visit 2

2008-04-23T06:39:00.000-07:00

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

The background of many of our 'plastics' patients

2008-04-22T06:05:00.000-07:00

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

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

Worms and other stories (not for the squemish!)

2008-04-20T11:36:00.000-07:00

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

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

A little miracle!

2008-04-17T06:44:00.000-07:00

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