Nursing adventures in faith...around the world!

Twas the night before screening

2012-02-13T06:55:00.002-05:00

It was a small and huddled group we drove by on our way in to the stadium Tuesday evening. 8:30 pm, and already hopeful people were lined up in preparation for the screening tomorrow...prepared to wait all night outside the gate on the chance that they would get to see a doctor in the morning.

Maaike and I had sent over a backboard saran-wrapped full of medical supplies earlier that afternoon, named it Frank, and prayed that things would stay calm and Frank would not be needed. Volunteer security from the ship, together with local gendarme, had been securing the gates since 2 pm and keeping people under control. Maaike and I were the medical advance team - the two nurses on site overnight to talk to potential patients and redirect some of the people we would not be able to help. I stashed a bottle of hand sanitizer in my back pocket along with a good flashlight, put on my headlamp, and we walked out to the group waiting outside - stopping just inside the gate to pray for a safe and secure night, for healing, for strength and wisdom.

Maaike talking with a potential patient

Dennis

I don't know how many we saw that night. Hundreds came for information on eye and dental screenings, hundreds more hopeful for a chance at life. One of the local gendarme volunteered to join our team, and stayed with me most of the night translating my words into Ewe. We screened the group already there, and over a hundred with facial tumors, hernias, burn contractures, and children with cleft lips settled down to stay the night. Around three, after a long break while our patients slept, we continued to screen as new people flooded in to fill the line and stretch it out along the wall and down the road until the end was out of sight. Dennis, one of the mechanics from ship, was one of my guardian angels through the night - an intimidatingly solid wall of man who reassured me "I've got your back," and who stayed with me during the long hours of screening.

Waezooonh, you are welcome. My smile and quiet introduction were answered with a shy yooooo and story after story of heartache, inability to work, rejection. I looked at CT and Xray films by flashlight, and examined lumps and bumps and contractures and hernias and wounds by headlamp. I forgot how badly I needed to pee, and wished with all my heart I could speak enough Ewe or French to personally encourage them with a yes, please stay in line, this is a surgery we can do! or to voice my own regret beyond a simple Je suis désolé, monsieur as the translator explained my words. There were too many we could not help...we had no orthopedic surgeon or neurologist or urologist or facilities for purely medical care. We cannot remove a brain tumor or fix sciatica and infertility. And there are limited spots for the hernias that seem so prevalent here in Togo. Conditions that could be treatable almost anywhere else in the world can instead be a life sentence...or a death sentence. Life is not fair.

Lines of people waiting to be seen

Even as I examined these people and loved them regardless of their surgical status, so much more I know Jesus was there with me, walking among the crowds and loving them. Jesus is not limited by surgery slots or what doctors and facilities we have available. For some, maybe healing started that night with a kind word, a welcome, a handshake...or maybe healing came with a miraculous release from pain and deformity. I may never know the end of their story, but I pray that night they saw the heart of God.

Jesus went through all the towns and villages, teaching in their synagogues, preaching the good news of the kingdom and healing every disease and sickness. When he saw the crowds, he had compassion on them, because they were harassed and helpless, like sheep without a shepherd. Then he said to his disciples, 'The harvest is plentiful but the workers are few. Ask the Lord of the harvest, therefore, to send out workers into his harvest field.' - Matthew 9: 35-38

By the time the screening ended the following afternoon, at least 4,000 people had been initially screened, with 1,600 passed through to the medical pre-screeners inside, and almost 500 scheduled for surgery or further testing. Praise God for a safe and successful screening!

Below are a few still shots and some video footage from screening day...a few of the patients featured are already recovering from surgery or home and healed!

to keep a quiet heart

2012-02-04T07:27:00.001-05:00

It's been a busy busy two weeks, and it promises to continue as we gear up for our first day of surgery for this outreach, tomorrow. Our nursing team has moved from orientation to putting on a wildly fun hospital open house for the crew; from a full-blown mock hospital evacuation to screening thousands of patients at a sports stadium, all in a week. Amazing...successful...utterly exhausting. Each time I sit down to start a blog post I end up closing the computer, taking my headphones out of my ears, and falling asleep long before 10 pm. After testing the evacuation stretchers to trial a few ways to secure a ventilated patient, a few thoughtful friends threatened to strap me into one and haul me down the hallways back to bed if I didn't go get some sleep.

Melisa volunteered to be our initial victim for
stretcher-testing before the evacuation drill.
Although firmly secured with a good airway
(mock-intubated), she could not see much
of what went on.

When this involved being carried up and
down the stairs blind, we definitely
challenged how much she was willing to trust
us! If you ever find me strapped
into an evac stretcher sleeping, I blame Melisa.

In a momentarily peaceful moment last weekend, I spent time in the warm sun looking out over the water from deck 8 and reflecting on life. The view is the same as when we were here in 2010, with the whole of the navy on one side and the bustling port on the other. The ship is mostly the same, but with constantly new and different crew finding their way around with life and excitement and vision. To them the wards are empty, full of promise and potential.

As I look into the ward, I don't always see the smoothly tucked blankets over the empty beds or the beautifully clean floor sparkling in the light. I don't see the new ventilators and monitors by the ICU bedside, or my own hands full of freshly revised paperwork.

Instead there are still faces and memories everywhere - some filled with wonder and reflection on the goodness of God, many with laughter and dancing and incredible stories of healing. And some, as I uncover them, are still a little raw and tender with sorrow.

Here in Togo I first saw things happen that weren't medically possible and watched in wonder as we prayed and an arterial bleed stopped underneath my hands. It was here that I realized physical healing was useless unless the soul healed as well and began to hope again. Here I saw people who owned nothing and still had everything. Here I helplessly cuddled a dying baby as he began to slip away in my arms, and I asked God why. It was here I realized that I can't have all the answers and, as difficult as it was, resolved to surrender.

I'm excited for this outreach in Togo. Tomorrow the wards will start to fill with patients again, scared and full of an unfamiliar hope. Tomorrow our nurses get to be nurses again, and we get to be a small part of God at work in healing lives and faces and bodies and souls. God is already at work, and I can't wait to see what he is going to do!

My prayer for this outreach reflects that of George Dawson, who begged for heavenly vision and a heart full of trust. I, too would ask to see through God's eyes - to see more than just the physical deformity and need, and to see more than the pain and difficulties of this life. I would ask for a quiet heart, constantly trusting in the Lord who promises to carry me, even when I can't see.

O Lord our governor, we beseech Thee, of Thy mercy,

That we may have the heavenly vision,

And behold things as they seem unto Thee.

That the turmoil of this world may be seen by us

To be bringing forth the sweet peace of the eternal years,

And that in all the troubles and sorrows or our own hearts

We may behold good, and so, with quiet mind

And inward peace, careless of outward storm,

We may do the duty of life which brings to us

A quiet heart, ever trusting in Thee.

~ George Dawson

A life worthy

2012-01-22T11:58:00.000-05:00

"Put your Bible on your head to show how much you love Jesus...everyone must daaance!"

If I heard that coming from any western worship leader, I would be a little shocked, to say the least. Here, most of the congregation yelled enthusiastically in response, and put everything from Bibles to purses and large rocks on their heads. I retrieved my Bible out of my purse and looked at it a little uncertainly. Up until now the worship style had involved a lot of hallelujahs and amens and foot stomping and arm swinging and butt shaking. I wasn't sure my Bible would stay on my head through all of that.

It's been almost two years since I've been to the fishing village church. My fond memories involved beach chairs, a wooden-pole church without walls, a few goats wandering through the non-road, and a lot of sand. We've progressed to bare concrete walls with a variety of holes (ventilation?), wooden benches, and rubber hoses hanging through the ceiling at strategic spots. The children were just as friendly as ever, willing to enthusiastically greet us and explore hairstyles, watches, water bottles, and Bibles as a variety of service entertainment. As I tried to communicate with them, my words came out in a jumble of Ewe and Krio and French and Indonesian and English, with a little pantomime thrown in for good measure.

And so we sang in Ewe, and I sang along in my jumble of languages; and we danced to the shekere and drums, along the aisles and in the front of the church and next to our bench seats. And the Bible stayed on (mostly) through the end of worship. The sermon was on unity, but a section from the main text reached out off the pages and into my heart.

As a prisoner for the Lord, then, I urge you to live a life worthy of the calling you have received. Be completely humble and gentle; be patient, bearing with one another in love. Eph 4:1-2

Right now the calling is surgical wards aboard a little white hospital ship: faces and legs and hands and eyes and lives and souls. The calling is training nurses with humility and gentleness and patience, reaching out to the needy, being the face and hands and heart of Christ. The calling is to live a life of radical love.

And a life worthy of that calling would be dancing, dancing...sometimes with a Bible on my head, and sometimes with a baby drooling down my back, and sometimes with tears running down my face. A life worthy of this trust would indeed be a wild and radical and difficult and wonderful life. Lord, give me the strength and the patience and joy to live a life worthy of this calling. To live with only You as the audience, as Your love saturates until it spills out of the cracks and overflows uncontrollably into life...

Urban airport camping

2012-01-12T12:59:00.000-05:00

My day started yesterday at 4 pm and stretched out and out through an extra 7 hours of time change backwards and oozed into the little holes on the long benches of the Accra arrivals area. I tossed and turned for a while, hoping the holes wouldn’t be permanently imprinted on my hip, and wondered at the intensity of the animatedly loud and heated conversation of the 20 people apparently upset at the vending machine to my right. On the next bench over, an airline worker is stretched out napping, with his bright yellow neon and retro-reflective vest crumpled over his chest. Another conversation at the bottom of my bench seems to inspire a lot of gesticulating and bench-banging, and my I-pod music is almost completely drowned out despite the headphones as my makeshift bed rattles and shakes with the conversation’s punctuation.

My amazing campsite, complete with bedding

For reasons that all seemed very good and logical at the time, I’ll be spending the better part of a day in the Ghana airport. And by better, I mean pretty much all. The movie The Terminal has never been a completely far-fetched oddity for me – I have lived it in pieces, over and over again, sleeping on benches and floors and wandering in shops and washing my hair in the bathroom sink at 3 am when the whole airport belongs to me. Although I have to say, a 23-hour layover is one of the longest I can claim to date. It’s only been 5 hours so far, and already I’ve met an amazing amount of people, from the friendly Egyptian engineer behind me in the looooong immigration line, to one of our Togolese translators who came over to say hi when he simultaneously recognized me and my flamboyantly orange Mercy Ships water-bottle, to a little brown girl who shyly wandered over when I forgot I was in West Africa and waved at her. Here, a side-to-side wave means a friendly hello, while a down-wards wave means “come here.” Just as I was starting to get back into Indonesian mannerisms…time to remember the African ones again!

All in all – it may shape up to be a relatively comfortable layover. After all, the benches don’t have intermittent armrests, so far no one is smoking indoors, and the baggage people thoughtfully agreed to keep my checked bag (although it could have made a very comfy pillow). The only main problem is that there doesn’t seem to be a bathroom in this particular part of the airport. Maybe I’ll walk over to Departures to find one…just in case I need to wash my hair tonight.

Explore

2012-01-08T08:59:00.000-05:00

These last few weeks it’s been a blessing to explore Indonesia again. To hike the volcanoes and rainforests with my brothers and sisters and friends. To see my world as it was when I was 10, and 15, and 17, and now again through fresh eyes; to enjoy the tastes and sounds and sights and smells with a new sense of wonder.

Just after Christmas we headed down as a family to meet friends for a few days of vacation in a little villa by the ocean. The sunsets are just as majestically colorful as I remembered, dotted here and there with the black kites of hopeful bat fishermen. If I listen hard enough I can hear the peaceful twilight of 10 years ago shattered by high-pitched shrieks on the night the bat fishermen brought down a fruit bat tangled in the hooks and broken glass along the kite strings, piled sand on the majestic 6-foot wings, and grilled the bat meat over a driftwood fire on the beach. If I squint I can see the “tribe” children I grew up with building sand forts on the beach, and my mother and aunt coming back from a walk with their hands full of sand dollars. If I walk a mile or two, I can find the place I learned that driving a motorcycle along the rice paddies and down unpaved roads can be dangerous. A few things have changed since the tsunami in 2006 – restaurants missing, and tsunami evacuation route signs everywhere, but the wide stretch of ocean is unchanged.

One of my favorite adventures is fast becoming a popular tourist attraction. A river runs through Green Canyon to the sea, banks filled to overflowing from the constant rain and overhung with dripping vines dangling from the canopy above. The real fun begins after a short boat ride upriver to a small waterfall. We’ve done it before – the swim against the current, pulling ourselves up hand over hand and climbing over rocks to try and reach the source, only to ride the rapids back down to the beginning. This time the river was high and our guides cautious, and we didn’t make it up as far as we had hoped. But it was still gorgeous and wet and green and amazingly fun.

A day later we wound our way through the buses of Indonesian tourists to the forest preserve for a hike along trails well off of the marked routes. I’m pretty sure it’s not just called rainforest because of the precipitation frequency. The other reason became immediately clear only 30 minutes into our hike through the caves and up to a cliff top overlooking the ocean. Sweat dripped down my face, into the tank top and bathing suit underneath, and soaking into the backpack straps. It really wasn’t that hot – a cloudily cool day to hike through the teak and rattan and up across quietly bubbling streambeds. There was simply nowhere else for the sweat to go in an atmosphere almost 100% saturated with water already.

Just looking down at the ground I could have believed I was on a hike in Northern Pennsylvania. Leaves and dirt and mold and roots often look the same anywhere. It was the little things that gave it away: the brightly colored tree frog watching us pass, the large ant nest on a branch above, the thick vines and soaring green treetops and breathtaking view from a small pool we swam in at the top of the cliff. It was the rafflesia blossoms and buds sprouting out along the ground and decaying fallen trees. It was the monkeys cautiously watching us from the brush, and the young teak leaves we crushed to try as lipstick. It was the scattered openings of limestone caves hollowed out in the hillsides by chisel during the Japanese occupation in 1942, waiting to be explored by headlamp.

All photos are borrowed from siblings and friends who carry their cameras much more often than I do :-)

I'll be home for Christmas

2012-01-04T02:10:00.003-05:00

There are some that dream and sing of a white Christmas, of fires and sleighs and hot chocolate. My Christmas this year involved none of these. And yet, I am home.

Gamelan music blares from a mosque loudspeaker, echoing across the rice fields and red tile roofs and banana trees to the white tile-and-concrete open porch on top of our house. The street sellers call out advertising their wares, and we can hear neighborhood conversations and passing motorcycles as clearly as if they were in the house with us. The clouds announce rain soon, as they have almost every day, and promise a glorious show for tonight – colorful tropical sunset drowning behind the mountains in the maghrib call to prayer. These last two weeks our family has been together in a country we moved to over 18 years ago, where I haven’t visited in a long time and my sisters-in-law are getting to experience for the first time.

It’s been six years since I’ve been to Indonesia. I flew into Jakarta in darkness, blind to the scattered green-blue of the islands and ocean below. I approached the immigration desk in the Jakarta airport ready to fall back on English if I needed, and found myself chatting casually with the officials in fluent Indonesian as passing tourists shot me strange glances out of the corners of their eyes. I don’t look like someone who is coming home. My white skin and blond hair bleached lighter by the African sun stand out among the creamy brown skin and black hair of everyone else. I am at least a foot taller than every Indonesian woman in the airport. And yet, the language and culture, even the accent, have come back easily from somewhere I had stored them away after high school. In another week I’ll store them back again, in a rattan and batik treasure chest in the back of my brain, and pull out the bright and flamboyant bits of Togolese culture and gutteral Ewe I’ve learned so far.

I told Immigration I was pulang kampung (returning home to my village for a visit). It’s been more true than they could have guessed, and than I could have known. This time has been an amazing mish-mash of time with family, classic Indonesian-style adventures, incredible food that always somehow seems to involve white rice and coconut milk and ginger, childhood memories, and soaking in the beauty of the island. Even as my definitions of home shift and shift again and I realize I may never again be able to call Java home, I can say with full confidence that it is good to be home for Christmas.

Christmas adventures in Accra

2011-12-18T12:10:00.000-05:00

Noel and Justin point out the goudge our tro-tro
left in the road

We had initially planned to go somewhere else entirely. It was meant to be a leisurely lunch with friends, followed up with a traipsing adventure through downtown Accra, hitting up all the interesting cultural and historical landmarks we could manage in an afternoon.

Instead of following the original plan, we ended up skipping lunch at the mall and embarking instead on a lively outing involving a palace, a broken axel, plenty of yummy Ghanian snacks, and Colin Powell.

I started out with a rather large group of Mercyshippers, enjoying the fresh(er) air and relative cleanliness of Tema port as we hiked out from our slip to the nearest taxi station. It was my first time in Ghana, and I felt like I had walked out into my own world. The architecture, traffic patterns and weather...everything down to the painted curbs along the sidewalk and brightly lit advertisements for Indomie...it all reminded me of Indonesia in a rather African way.

Our tro-tro, shortly before we started walking

Surreal...to the point I almost started speaking Indonesian multiple times. But it also meant I felt totally at home when our taxi went a different way from the other taxis and left five of us on the brink of adventure. We flagged down a tro-tro (strangely reminiscent of the angkots and tok-toks of my childhood, and the bush taxis and poda-podas of more recent African adventures) and crammed in with twenty strangers, only to find ourselves on the curb two hours later after a loud noise and grinding sideways halt. Thankfully, the wheel and axel decided to come off while we were turning rather than while driving fast.

Jamestown Palace

When we found out we had gone well past the intended stop because our tro-tro had taken an entirely different route, we set off walking instead, following a rather battered and damp sketch of the Accra waterfront. We passed Independence Arch and Kwame Nkrumah's grave, two forts and a palace on our way down to the Jamestown lighthouse. Lively haggling got us a tour of the "palace" - a concrete building with cultural murals along the walls - and a trip to the top of the lighthouse. Through the haze we could see an old slave castle a few miles away (to be visited another time). The view was also filled with fishing boats along the waterline and anchored just off shore; inland there were concrete offices and tiny huts and children playing in the streets.

Fishing boats, with Osu castle in the
distance

Heather, Noel, Michelle and I...with Colin Powell

Later that afternoon we stopped at a local craft market (mainly to look at fabric), and as we were waiting for one last friend to finish, we met a man who proudly named the capitols of our respective countries and states, and then delivered quite a lot of commentary on the development of Canadian territories. I'm not sure if Colin Powell was his real name or just one he's chosen to adopt, but along with significant potential as a future geography teacher, Colin does some excellent woodcarving.

We made it back to ship just after dark - tired, dirty, and full of fun, and were greeted at the gangway by lights and wreaths and a ship-style Christmas decor. It's not snow and hot chocolate and pepperment and pine, but somehow it's starting to feel a lot like Christmas. :-)

A go se yu bak

2011-12-11T10:48:00.000-05:00

From the inside, my home looks the same. Sparse crew members are scattered around the couches this afternoon, checking email and napping. There are Christmas trees up around the ship, a Nativity scene is starting to take shape, and it's been a little while now since the hospital closed so we could pack it all away.

It's the little things that hint at the fact that life is slightly different today. The bins to sort out biodegradable trash. The view of sparkling deep blue water stretching out as far as the eye can see...where there used to just be containers and concrete. The deck isn't quite always where your foot expects it to be, and a constant rumble fills the air. A walk in town is no longer a viable option. Instead, we practice our life jacket technique just in case.

As the field service came to a close our leaders discussed all that had been accomplished in Sierra Leone. Almost 3,000 surgeries of various types, 34,000 dental procedures, health and agricultural education and eye care and mental health and all kinds of different methods of outreach that have touched thousands on thousands of West Africans here over the last 10 months. Reflecting back over what God has done and claiming promises of what He will continue to do, I saw so much more than numbers there.

Instead of numbers and lists my mind is filled with faces and snapshots of moments. Sierra Leone is Naamah and Ismael and Finda and Mariama and Hardy and Christophe...all the individuals you've met through my blog and more besides. It is the incredulous smile on the face of Josi's papa and his wholehearted declarations of praise to God. It is Jon and Tambo demanding a dance party to the tune of "Jizos go do am for me" (Jesus has done it for me). It is the heavy weight of Joseph in my lap during a water break at Yams Farm, as he drowsily declares dis na me mama (here is my mother). It is the look on Isata's face reflecting back out of the mirror during her first dressing change, as she realizes that the tumor truly is gone. It is getting mobbed by piles of orthopedic kids that remembered me from 6 months ago, scrubs covered in warm drool, roads that look like riverbeds, beaches straight out of a Caribbean postcard. It is the Krio phrases and songs and humorous comments still here with me, tucked away in the nooks and crannies and corners of my heart.

I didn't save my goodbyes for when we pulled out of the dock. It was earlier, in the soft haze of a sunrise, and with the insistent call to prayer from the minarets drowned out by the overwhelming Krio praise songs in my heart. I think back over my time here and realize that I have given months of my life and poured out my heart here, and I have been given back so much more than I ever gave.

I learned early on in my childhood overseas that saying goodbye is just too hard. People and friends, homes and countries will all come and go...some more quickly than others. Who is to say when I may see a person or place again, where I will be next year, or who I will see in the multitudes of worship at the heavenly throne. It is easier just to say A go se yu bak (I will see you later) - not a promise, necessarily, but as a sincere hope.

Only God can know what the true impact is from the ship's field service here and my own time in Sierra Leone. I can't bring myself to tally numbers or count the years until I may be back again. All I can say is that God has done amazing things this year in Sierra Leone, and I look forward to seeing what God will do there in the future. Until then, I'll continue to pray for God to glorify Himself in the hearts and lives of my people there, and that they will continue to proclaim with exuberant joy in celebration of what He has done for them.

Packing the PACU

2011-12-04T17:35:00.001-05:00

Post-Anesthesia Care Unit

Walking by our PACU on ship, you might think that this is not only the name of the unit, it's also a strong suggestion for events that should go on inside. Because quite a lot of the hospital is now stowed away in PACU; packed in a three-dimensional spatial relations tetris challenge held together with rope and ratchet straps. The patients have left, the nurses are leaving, and those of us who are still here bleach and pack, strip and wax, and attempt to fit into very small spaces.

My pager went off, and I answered the phone only to hear "do you want to be a monkey?" Apparently I have been making a name for myself in the last week by clambering around the top of carts and pallets, army-crawling across packed stretchers, and diving through large piles of bed frames and hospital equipment to find secure points to hook more little straps to so that things will stay put when we sail. Later this week I'll get to climb back over it all again, searching for anything out of place, as we finish preparing the ship to sail. My truckers hitch knot I remember from a backcountry medicine class in school has served me well, as we rope chairs and chairs and more chairs together in some semblance of stability.

It was standing on top of the beginnings of our pile when it hit me. Stowing away the hospital isn't like boxing up your winter clothes in a garage, or even like packing a moving van. Generally (we hope), both the garage and van will remain upright for as long as your items stay there. The same is not really true here. It's a bigger playing field, with bigger consequences; our storage place moves. A bad packing job could mean broken equipment or a hole in the wall. A bad cleaning job could mean infection for future patients.

And yet, even in the seriousness of the tasks there is still plenty of opportunity to have fun with it.

I've done things this week I honestly never thought I would say. I mean, let's be honest, how many of you have saran-wrapped an ICU bed full of orthopedic equipment? Danced to Beyonce's "All the Single Ladies" to the rhythm of a panic strobe light while bleaching? Tied mattresses to laundry room shelves? Accidentally attempted to be a stowaway? Ice skated in socks to "The Sound of Music?" Rearranged cupboards while standing on your head? All this and more have brought the idea of "secure for sail" to a whole new level for me.

As we met for praise and prayer each morning, we found the acoustics of an empty ward could make 30 nurses worshipping sound like a beautiful choir performance. We've discovered hidden talents, and who we are as a team when we're not actively taking care of patients. We went crazy this week in worshipping our King, even through the small and lowly jobs in life.

Who knew the incense of worship could smell like bleach and floor stripper and sweat?!

Yu de pillar

2011-11-22T17:53:00.001-05:00

Working aboard a hospital ship in West Africa isn’t the most secure and predictable job I’ve ever had. There are so many things that we don’t always know, that we can’t know. Things we think we know and then find out that actually we didn’t after all. Questions come up that I never really thought about at when I lived in the States:

Will the frozen food container come through so we’ll have meat to eat, or will it be stuck on the dock for the next 3 weeks?

Will I be woken up for an emergency in the middle of the night tonight?

Will I get malaria tomorrow?

Has one of the mischievous children on A ward escaped down the hallway?

Will the water truck show up so we’ll be able to continue showering regularly?

Who will move in this week when my roommate moves out…and who will be moving in next month?

Is the floor sideways (or in nautical terms…are we listing)?

Realities are true here that weren’t my reality before. Like the fact that in less than a week my hospital temporarily won’t be a hospital any more. Or in two weeks I’ve been reassigned to the hospitality department for the duration of the sail. Or that I don’t actually know what date I’m leaving the country, even though it’s only 2 or 3 weeks away, because we won’t know until a day or two ahead of time for security reasons (and you all won’t know until after we’ve sailed).

There is a truth that holds firm in my life when everything else changes. I hear it in the streets, in the wards, in a soft chant that soothes my heart in the busy office and in the silent hum of the engines through the night. It’s in the songs we sing at church and in ward worship, that we murmur as we rock children to sleep.

Yu are de pillar that holds my life

Masta Jesus, yu are de pillar that holds my life

It's only on the truth of my master Jesus that I can stand, tall and strong and confident. He is my rock, my strength, my constant. It is only He that holds my life.

Glady boku-boku

2011-11-20T08:05:00.000-05:00

Thursday was the end of surgery for this outreach. There is one more week for faces to mend and graft sites close over, for little stomachs to start digesting food again. The ward is full of bewhiskered cleft lip babies and the leftovers from the plastic surgery rotation waiting for wound healing.

We gathered in A ward to celebrate and tel God tenki (give thanks to God) - patients and parents and nurses and doctors and day volunteers and OR sterilizers and physical therapists....and the odd stray we pulled in from the hallway. We lifted our hands in praise for successful surgeries, lifted our voices to the deckheads and up the stairwell, and danced as the ship gently rocked. Nurse after nurse was pulled into the dance circle as well, as Abu spun wildly and yelled, "shake you bodi and dance like an African!!" Later on as patient after patient shared testimonies of God's goodness in their lives, a small voice in my lap murmured through steristrips and sutures, "Amen, amen, He has turned my life around. A--MEN!"

I have wished a thousand times that I could bring you here with more than words; that you could experience the wonder of a ward worship service with me and join us in being glady boku-boku (very happy) for what the Lord has done. Deb, one of our nurse-turned-photographers, captured a few moments of worship from our Thursday. If a picture is worth a thousand words, maybe the clip below will finally give you a window into our lives. Come and join us, just for a few moments, in telling Papa God tenki :-)

Home again, home again, jiggety jig

2011-11-14T05:30:00.000-05:00

For a week I’ve been learning my new job of nurse educator, planning ahead for next year, organizing the desk that will soon be mine. The piles of paperwork have slowly diminished and the ever-growing to-do list I’ve been compiling is already half crossed-out. The rest of the list will take a bit more time, I think. I’ll be dividing my time between nurse educator and working on the wards, and so for now it’s time to learn the job I haven’t done yet.

Throughout the week it was a bit of a strange feeling to walk by the wards and look in from the outside. I didn’t know the nurses in blue that bent over the beds to assess and medicate, to try out Krio and Mende with the patients and be a part of healing. I didn’t know the woman who waved to me from the bed as she nursed her baby, her pressure garment tight on her head above burn scars that streaked down her neck. I didn’t know the mischievous escapee from the plastic surgery ward that came to my office to visit again and again, hand outstretched in a continual wave from a hand brace, begging me to come and play with him. The translators remembered me by name, welcomed me home, and eagerly asked when I would be coming back to the ward. I told them, honestly, that I wasn't sure but I promised to work with them again as soon as I could.

This weekend the wards became mine again. I was called in to work as a nurse on D ward - land of nasogastric tubes and steri-strip-whiskered lips and suction and dressings, the ward I worked in during the first few months of our time in Sierra Leone. Life on the ward puts all the paperwork and planning into perspective and gives it a fresh purpose.

I'm not sure exactly when it was that I realized I was home.

It might have been the smile on Isata's face when she looked in the mirror to see her new jaw after I took the bulky dressing off. It might have been the guilty look from 5-year-old Kadi when I discovered her once-sterile thigh dressing half pulled off, or the pleading in Temne for her papa's rice when I chased her around her bed with an NG feed. It might have been the toddler popo securely on my back with a sheet, drowsily drooling down my scrubs as I went from bed to bed to finish my daily vital signs. It might have been the mama who patted me in church the next morning, as I danced past with Kadi on my back, who attempted to claim my skirt for her own and told me I dressed like "fine African woman."

I don't know when it happened exactly. There's not a specific moment I can define and pin down. All I know is that I'm right back where I belong.

Journey to a different world

2011-11-07T15:30:00.000-05:00

Two+ weeks ago:

Thirty hours on land, air, and sea. It seems an endlessly long and turbulent ride, but in reality such a short trip to a wildly different world. Let me take you with me here – riding along in my backpack from plane to plane with our group of 21, past the smooth punctuality of Brussels and the welcoming grins of Salone immigration and health officials – through to outside the Freetown airport where men throw our luggage high on top of a waiting poda-poda and tie it down securely with only a tarp to cover from the rain. I stand guard like a watchdog over the two bags full of fragile surgical supplies as I repeat over and over, “this one is medical supply; it needs to go in the car.”

Let me take you past the lush tropical greenery and bare concrete buildings with bold-patterned cloth doors fluttering in the wind. Look with me through the sea-salty breeze as our ferry draws closer across the bay to a large blue-and-white hospital ship. Can you see the light shining out from your cabin window? Veer with me through the erratic traffic, and don’t forget to duck your head and hang on as we bump down the half-paved road after a brief ship visit. There is less chance of whiplash and head injuries if you just go limp and disjointed, flopping aimlessly with the jolts like a rag doll in the clothes dryer.

This place is familiar to me. The sellers call in the streets, the sticky heat presses down like an electric blanket; the dusty breeze is reminiscent of salt air and chickens and frying plantain chips and humanity. A fruit seller dressed in a lappa and lit up only by a single flame from roasting peanuts looks up to wave and smile a welcome. Well Come, Massey Sheep (welcome, Mercyshippers), welcome home.

Our hostel is tile and concrete, reminiscent of my Indonesian childhood home. It is beautiful here, with the mountains surrounding and a view of the ocean in the distance. The evenings are peaceful and dark (at least until the electricity comes on again), and the cool of the trickling showers is briefly refreshing, a reprieve from the continual sweat and stickiness. We live a few minutes drive and a thousand friendly greetings away from the village we will be working in, Yams Farm Wharf. Yams Farm is perched at the mouth of a river, with much of the livelihood gleaned from collecting wood and selling sand for construction gathered by boat from the river. Our welcome is nothing short of wildly enthusiastic as we bounce in over the potholes - serious faces light up into broad grins from adults and children alike. One little boy wearing only tattered overalls is jumping up and down outside his house, with both hands outstretched and opening and closing furiously in greeting. We pull in just down the hill from the school as a roaring crowd of uniformed schoolchildren surround our poda-poda to beat on the sides and shake hands through the windows as they run alongside. Well-come whiitaman (white man), well-come. The chant grows louder and louder as we open the door to climb out. I feel like an undeserving celebrity as I wade out into the crowd holding hands with twelve kids at once.

There is a school there already – a small one-room building for 270 children in 7 different grades. On Sunday the building doubles as a church, with the school benches and desks as pews. The décor reflects a bit of both, with a banner and lectern on the raised concrete podium and blackboards encircling the edges of the room. The chickens attend both school and church on occasion, gleaning any bits of crumbs that have fallen from our lunch, or bugs they find in the dirt floor. Out the window you can see our construction site less than 10 feet away. Over the next few weeks we will be working on building another school so that the classes can spread out into both buildings as the numbers of children continue to grow. Everywhere I look there is excitement and hope, reflected out of shining eyes and back into my own. I am excited to see what God will do over the next two weeks!

Shrinkwrapped for sea

2011-10-17T22:20:00.000-04:00

I almost felt like a little kid again, wriggling into my footie pajamas and duck-walking around the poolside to jump off the diving board. Except the suit was bright orange, with a tight-fitting hood, mittens, and a chin flap that closed over top of my nose. It was also a lot warmer than my childhood footie pajamas, floated much better, and held at least two gallons of water...per leg.

After jumping off the diving board in my immersion suit, all the trapped air inside blew up the suit like a pillsbury doughboy. With the top flap unzipped and feet back down in the water, the air rushed out and left my suit shrinkwrapped around my body. Big mitten flippers made swimming floppy but effective.

Friday night's pool practical wrapped up our week of maritime Basic Safety Training, with exercises in immersion suit use and group swimming and huddling (how to stay together and move and keep warm in the ocean). We also learned all about life jackets and life rafts, practiced hauling each other into the life rafts and streaming a sea anchor, and ended the night by taking turns flipping the life raft upright (see the video below!). Sadly, we did not do the last activity with anyone in the raft, even though it could have been very entertaining. Lord willing nothing will happen while sailing, but if it does we will be well prepared.

One more day and we'll be headed out to Sierra Leone! We leave Wed morning for Freetown, and will be spending 2 1/2 weeks in a village outside of the city, helping to build a school. Because we will be living in the village, we won't have internet access until we reach the ship in early November. I look forward to updating you on our next adventures then!

When firefighting...watch out for snails!

2011-10-12T21:09:00.000-04:00

This week has been a bit of a different tack - from theory and classes to...theory and practical! The first two days included basic firefighting strategy, gear, and search and rescue, and a morning of practical techniques.

After trying on all our gear the day before, we suited up for instructions and took turns extinguishing fires with hose and extinguishers, and rescuing "Buck," our 165 lb firefighter dummy.

I have a newfound respect for firefighters - the gear is quite a bit heavier than it looks, and we had a great and very warm workout. We successfully rescued Buck (a group effort) and extinguished our fires, and learned a lot. We have an awesome team to work and learn with, and we definitely had a lot of fun.

I did learn one unexpected lesson, though...when fighting fires, it is important to watch out for snails. Yes, snails. Halfway through fighting our Class A fire in the container, my partner Esther and I suddenly lost water pressure. After troubleshooting for hose kinks etc and not finding the problem, we retreated and sent in another team to continue the firefighting. It turns out our hose problems were due to snails that had climbed up into the hoses in search of water. Sadly, although they did successfully find water, they did not survive long after that.

The rest of the week promises to be interesting as well, with personal survival techniques and water safety. One week from today...we'll be on our way to Sierra Leone!

Vapour

2011-10-05T14:55:00.001-04:00

I'd like to share this video - a powerful and touching short film based on quotes from the people of Freetown and some of our Sierra Leone patients, and filmed by Mercy Ships crew. Much of the footage was shot within Freetown, where we will be going in just two weeks! The hospital footage is within the ward and on deck aboard the Africa Mercy, and transports you for a few moments to where I will be working again shortly. Let Amara speak to your heart on behalf of his people.

The stories are real. The heartbreak is real. Please pray for unity and purpose, for healing and for hope and release from fear and guilt, and for forgiveness.

Quilt blocks

2011-10-02T17:59:00.000-04:00

Curled up on the couch mending the freshly washed quilt spread across my knees yesterday, I glanced back at the last few weeks of life.

We have been in Texas three weeks now. Three weeks of sitting in a classroom stretching our brains to wrap around deep theological concepts of spiritual warfare and the power of prayer, of opening our hearts to the differences in culture and worldview, of creating and performing skits and summaries of everything...for the challenge and education and entertainment of our crewmates.

After each evening run my lungs and feet are dyed burnt-orange from the clay that could be mud if there were water. I step outside and wonder at the deep untouched blue of the sky, the constant steady sun, the green and brown of trees that (in my mind) should already be gold and orange and red.

I can’t imagine what living by myself would feel like again. I have three roommates, and our room feels spaciously empty sometimes because of the unfilled last bunk. I share a kitchen and living room with 19 other men and women…each of them wonderful in a unique and different way, each of them family despite different languages and countries and cultures, each of them friends.

I have been in Texas for 21 days. I have been here forever. I stepped off the plane yesterday.

If my life were a quilt, this block would be a patchwork log cabin, with all different colors and patterns worked together, carefully designed to make a temporary shack along the trail to adventure. There is a mix of wild African fabrics, sedate patterns and colors, and a bit of Indonesian batik. Worked in among the other bits are the deep orange and bright blue of this place we call not-quite-home.

It feels like we might be here forever. We fly out in 17 days. I watch time come almost to a standstill; as one foggy breath evaporates it will disappear, leaving me with learning, with memories and friendships, with one hand-stitched quilt block.

Be still

2011-09-25T17:03:00.000-04:00

In a world that defines identity by job title and accomplishments, it goes against the grain to take time to just sit and...be.

This weekend we drove out to Tyler State Park and took several hours just to spend alone with God - a date, if you will. In previous similar retreats over the last few years I had found just sitting a challenge, and walked or wrote or sang as I prayed. Apparently that wasn't what God had in mind this time.

After a short hike partway around the lake, I put up my portable hammock and settled in to marvel at the beauty of creation. After months of almost-constant busyness, I had an exclusive invitation for the here and now - just to soak in the goodness and creativity and presence of God. What a refreshing delight!

My job title and travels and adventures and struggles are not what defines me....my identity is secure as a child of the King. God is pleased with a life lived out in faith, but He is also pleased with a people who delight themselves in Him and take time just to sit at His feet to watch and listen and marvel.

He says, "Be still, and know that I am God; I will be exalted among the nations, I will be exalted in the earth." ~ Psalm 46:10

Scorpion wranglers extraordinaire

2011-09-22T21:11:00.001-04:00

After a thorough introduction to Mercy Ships history, philosophy, and support seminars last week, the 22 of us that remain will be learning together for the next few weeks in preparation for...Sierra Leone!

It has only been a week in Gateway so far, but already my classmates feel like family. Nothing brings together a group of people like having classes and meals together, living together and sharing bathrooms, herding cattle and hunting scorpions.

To the right is the first unfortunate victim of our scorpion wrangling. Little no-name showed up while many of us were hanging out in the family room, emailing or playing games. After much excitement, he made it safely into a mens-room toilet and down the drain.

About 30 minutes later we were ALL invited to one of the ladies bedrooms for a group scorpion hunt, which was successful as well.

During our tour of the property, we stopped briefly at a farm on the property, and the cowboy invited us all to help him herd cattle. Several of my "family" got quite excited at the opportunity, and we all enjoyed a tramp through the pasture guiding the cows while carefully avoiding fresh manure. On a side note, please continue to pray for rain, as we are still in a significant drought.

We've done quite a lot of discussion this week on spiritual warfare and looking at attributes of the God that we serve - a great encouragement to delve deep into topics that will significantly affect how and why we serve the people of West Africa.

In between classes we've had a few Texas style adventures, and I look forward to many more as we move into the next week of personal and interpersonal development :-)

FMS

2011-09-17T23:56:00.000-04:00

Week 1 - Packed with learning about foundational beliefs of Mercy Ships and finances...finished! Above you can see our group (from 6 different countries), many of them I will be working with on ship and attending class with for the rest of the time in Texas!!

Flood

2011-09-14T20:41:00.001-04:00

We stepped over a makeshift barrier – a wall of concrete blocks and weighted plastic across the sidewalk – and out onto the low bridge across the Susquehanna. Other than occasional sirens it was eerily silent, the road lonely in the dusk and stripped bare of cars. As we hung over the railing to watch, the river rushed by only a few feet beneath. By the time we went to bed that night, the street perpendicular to ours was already mostly covered in water. Life was a prayer for the floodwalls to hold.

I woke to a different world.

"Residents of New Street, come to your doors.” The police bullhorn instructing evacuation of the next street over continued as we began to pack for imminent evacuation. The floodwalls held, but the river was still rising, almost to the top of the wall. The top of a tan car was just visible above the restless brown of the street-turned-lake. We showered in the dark as the water dripped through dark ceiling, watched as the water leaked over the floodwalls to creep up the street and cover the sidewalks, joked half-heartedly about kayaks to get across the river to the hospital, set out extra food and water for the dog, piled into the car to drive the few miles down the road to the University shelter that already housed almost 1600 people.

Little did I know when I left Potsdam the morning before that I would be spending Thursday afternoon on my former college campus.

“Hi. I got evacuated this morning and I’m a Registered Nurse…do you need any help?” The rather harried-looking resident just looked at me for a moment, startled. And then I went to work. A rather faded Mercy Ships badge from the rear-view mirror of my car served as identification as I joined EMS, nurses, and medical residents in treating any sick and injured among the crowds already sheltered in the Events Center. Cots covered the floor where I had once watched basketball games, families huddled in the ticket area with their pets, uniformed military and police guarded the doors and maintained order, and in a back room we had three cots set up as makeshift exam rooms. Another basketball court served as a special needs area and pharmacy – staffed by volunteers and nursing students, and a few instructors I recognized from my own days as a student there.

When I left 8 hours later to spend the night at a friend’s house, our shelter was already full and the river had finally crested…25.7 feet.

Now in East Texas, I find myself ironically wishing for just a few hundred gallons of that floodwater – to somehow dampen down the tinder-dry foliage and see the hills green again.

The beginning - an update on life!

2011-09-11T20:53:00.002-04:00

After a whirlwind few months of weddings, classes, support raising, work, and packing up life….the journey has finally begun! I’m in Texas now as I write this, planning to be here for about 5 weeks doing additional Mercy Ships training, and then fly to Sierra Leone.

Two months ago I sent an email asking for prayer and financial support. I'm now 60% funded for the entire next two years – praise the Lord!! Thank you to those who have committed to joining with me. If you have not already done so, please prayerfully consider joining me in this next adventure – by committing to prayer or financial support, or by coming with me!

As I have been wrapping up things and finishing my packing and goodbyes in New York, I headed down to Binghamton a few days ago and arrived just in time for the flood! We were evacuated from my friend's apartment as the water began to come over the flood walls and up our street, and I was able to spend some time volunteering as a nurse at one of the local shelters. In Broome County alone, at least 20,000 people have been temporarily displaced from their homes. The Binghamton U events center is housing between 1600-1800 people, many with specific medical needs. I joined the emergency responders at this shelter for several hours, treating any evacuees with injuries or illness, then I volunteered briefly in the makeshift "hospital" set up for evacuees with special needs. I’ll be writing more about this as I have time to process, but praise God for safety and for good interactions with many people!

As you pray for our time in Texas preparing to serve, please also remember to pray for the people who have been significantly affected by flooding in Binghamton and across the Northeastern US...for spiritual awakening and revival as well as help for physical needs.

In His footsteps,

Laura

personal space

2011-08-10T23:16:00.002-04:00

I took the train into Manhattan last week, and the subway, and walked the streets of midtown and Chinatown in the rain. I may be from New York State, but this was the first time in at least 15 years that I experienced New York City on a personal level...if this could be called personal.

People everywhere - in the streets and the shops and the rain, crossing the street without even looking to notice the sea of taxis bearing down on them. The air smells like car exhaust and people and fried food and coffee. The people are multicolored, but still somehow I do not fit. The practical cargo pants and rain jacket and sneakers are out of place among suits and shoes that could feed a family for a year. Cell phones and earpieces and sunglasses and coats. No one will meet my eyes. No one accidentally brushes against me in the crowd. There is no friendly idle conversation. Each person is alone. I am alone. I am a stranger. I am not here. I do not exist.

There is a homeless man in the doorway of a classy hotel, wearing all the clothing he owns, sleeping in oblivion. The rough red rash on face and hands marks unwashed and untreated skin; the sign and upturned hat next to him mark an unwanted man.

"Help. Homeless. HIV positive."

There is nothing in the hat. No one can see him. He is alone in the crowd. He too does not exist.

I couldn't help but step outside myself for a moment and compare this city with the one I have recently called mine, the bustle of Freetown, Sierra Leone.

It is a pressure cooker of people: hot and loud and close. People push up against me from all directions, sellers call out and advertise their wares in 4 different languages. There is a small hand in mine. I look down to see an unfamiliar child grinning up at me, calling me Auntie, wanting to touch and to play and to question, joining us with five other friends as we are carried along with the people. The men look and whistle and suggest and propose. The ladies call and smile and ask about my health and wonder aloud where my man is. A poda-poda (bush taxi) side mirror whizzes past, just missing my shoulder as I step off across the open sewer. There are no cracks, no spaces, no room in the flow of traffic and people to just slip through, and everything smells of trash and goat and human body odor and cooking oil and soap. It is a city of war refugees-turned-residents, an unexpected population explosion that stayed, a casual stream now at flood capacity.

I am different. I am the funny colored one. The one who smells strange and has shiny straight long hair and doesn't wear a bright-colored lappa with a baby snugly tied in back, who speaks English with an American accent and not the usual Mende or Temne or pidgin Krio. But I am known and accepted, welcomed and protected.

"Massy Sheep", they call us, with a light in their brown eyes that maybe wasn't there before. "Massy Sheepa! Sista! Come, please, is ma yay (eye)...ma leg...ma pikin (child)." Even just walking to the market, in civilian clothes, we are still known. There are so many who need help and good food and clean water and medical care. Too many who have lived for years waiting for a miracle. For the outcast and the hopeless, too often we are their last hope.

Two cities, two continents, two worlds. One impersonal and individual and alone, the other personal and noisy and filled with life. Both still have the outcast who call the streets home, the needy who call out to be heard.

Do you hear them? Can you see the value of a person behind the filth and the mask and the deformity and the smells? Will you see enough to come close and touch, to meet the hopeless when they need it the most?

“Then the King will say to those on his right, ‘Come, you who are blessed by my Father; take your inheritance, the kingdom prepared for you since the creation of the world. For I was hungry and you gave me something to eat, I was thirsty and you gave me something to drink, I was a stranger and you invited me in, I needed clothes and you clothed me, I was sick and you looked after me, I was in prison and you came to visit me.’

“Then the righteous will answer him, ‘Lord, when did we see you hungry and feed you, or thirsty and give you something to drink? When did we see you a stranger and invite you in, or needing clothes and clothe you? When did we see you sick or in prison and go to visit you?’

“The King will reply, ‘Truly I tell you, whatever you did for one of the least of these brothers and sisters of mine, you did for me.’ Matt 25:34-40

Binghamton...babies and blueberry picking

2011-07-21T13:39:00.000-04:00

It's nice but a little strange to be back in Binghamton, albeit a little temporarily. I've been seeing friends I haven't seen in a year (or years) and got an exclusive tour of the ED I started at 5 years ago - the beautiful new beds and spacious rooms completely different, and a staff I have dearly missed.
I'm at peace back, knowing that my place is no longer here, and so I'm able to simply enjoy things one moment at a time. The last few days have been a simpler life: homemade pizza and a movie, blueberry picking with friends in the sunshine surrounded by the rolling greenness and cut-grass smells of the Southern Tier, singing 7-month-old Shawn to sleep as he fretfully chews on my thumb, curling up with a good book in between studying for ACLS, time to rest and enjoy God and his blessings.
It's a refreshingly peaceful pause in the middle of a wildly intense summer. All I need now is a good place to put up the hammock...

We Will Stay.

2011-06-28T14:12:00.000-04:00

In my camp nurse adventures this spring I had the distinct pleasure of hearing this spoken word presentation - written by InterVarsity staff and good friend of mine, Jonathan Walton. It is direct, powerful, challenging, and triumphant. Be blessed and encouraged, as I have been!

- My name is hopelessness
But you can call me misery, despair, depression or any other term that pops up when you
Press shift F7 on your pc while writing your paper about Darfur, Gulu, Xinjiang,
Chechnya or….Haiti from your climate controlled classroom far, far away from me.

I live in the foundations of fallen buildings, in the cracks of
concrete, and just left of the air pockets under the rubble.
Reside in the front of supply trucks after all the pallets have been
removed, and the empty space under the Parachute where the
helicopter supposedly dropped more food. I love the bottoms of
bottles of water, formula, canned and baby food and whisper
there’s not enough to families, and say to aid workers, there’s
nothing you can do.
I love the phrases irreconcilable differences and hang out at
negotiation table in NGO’s board rooms and come up with
conflicts of interest and difference of opinion.
All you can see is me when you can’t see a way out. And if I hang
out long enough my family comes around.
My brother is poverty and my cousin is exploitation and as soon as
the sky stops raining or the earths quits shaking they are sending pimps to find sex slaves and johns to exchange services for donations. Traffickers snatch up cheap labor and victims are abducted, taken for slavery.

I inhabit that space in your brain that makes your question your
donation, the conartists are my kin because they capitalize on these
situations.

I will be here long after the Washington Post and the New York
Times. Long after I’m not mentioned in the headlines. Still here,
when NBC and CNN are gone and Anderson Cooper’s chopper has lifted off. I’ll be here until you come and chase me away but based
On history, me and my family have no reason to be afraid.

=====
Dear Poverty, hopelessness, misery and the kin of exploitation and any
other unnamed power or principality driven apathy, distraction and our
propensity to escape.

My name is Jonathan and my Father is God and he whispers in the
stillness of morning, noonday and nighttime that He is there and we
are coming. Those that sing freedom songs and write love poems with our lives for those that we can't see and those we have never met.
Seeking justice, lovin mercy and walking humbly into suffering with a steadfast peace
that screams quietly, we shall overcome.
We will not be like those before us turning people into projects and
individuals into interests, names into entries on a to-do list.
oh no, we will build roads and relationships, rebuild ruined city
streets so that children can go to school and find a path to peace
because the reality is we are coming so you must flee, we will stay so
you must leave, because where light is the darkness can never be.

I'm tired of what I see, and it's time to turn my dreams into reality so with every breath that I breathe, with every
word that I speak I'll bring a gospel of equality with my words and
strap good news to my feet -- and you best believe I'm
dangerous by myself but I'm bringing an army with me. Those who are
free from expectation, guilt and shame and past mistakes, not looking
to capitalize on capitalism and post-colonial exploitation. A people that don't lower their standards for low prices
compromise convictions for a great value and look past the price tags,
to contemplate true cost and are striving to be sure that because they have coffee, sugar, chocolate, and clothing -- not one life was lost.

We are coming from five boroughs and fifty states, from all ages and every race with our two fish and five loaves and a faith to feed and free all nations.

We are coming and when we get there, we will stay. You have good reason to be afraid.

Sincerely,

Us.

Only God has done it

2011-06-24T11:39:00.002-04:00

It was a desperately prayerful father that broke my heart in early May, as I sat down to write a scattered blog post and mourn our limitations. Two-year-old Josi lay intubated in the ICU with no clear hope of recovery. She had been transferred to us from a local hospital, and everything we tried so far had failed. David refused to eat, fasting as he prayed aloud over his little girl, again and again claiming the blood of Jesus over her life. Their only other child had died just a few months before.

Unlike many of our other patients on ship, Josi was just a normal toddler – happy and healthy less than two weeks before, no tumors or deformities to scar her face or twist her body, and the most beautiful bright-eyed grin you ever saw. It was the pebble she had inhaled that threatened her life now – and after hours and hours of trying our surgeons could not get it back out.

The 5:30 am call blared into every hallway, every cabin, and woke me up out of a deep sleep, “Emergency Medical Team to the ICU STAT, Emergency Medical Team to the ICU stat.”

Josi was our only ICU patient that night.

I won’t take you through the early morning, through the CPR the previous night, or the days of wondering if a two year old be sentenced to die by slow inches as her breathing failed…just because she was born in the wrong country? Why was this family who had already lost so much losing another?

As David prayed and we joined in with him over those few days, impossible things happened. A girl that by all rights should have died in a local hospital days ago was still alive. In the middle of the night a Pediatric ICU nurse had trouble sleeping and walked down to the ICU, just in time to do CPR. The next night Josi had breathing difficulties and so many staff responded within a few minutes that we had our very own code prayer team. When all our transfer plans had fallen through, a pediatric thoracic surgeon who had never heard of Mercy Ships before flew in from Kenya to do the surgery and put in a chest tube, assisted by a pediatric anesthetist that left a few days later. The funding, resources and staff were all provided, just when they were needed.

I got off the phone Monday afternoon with the OR supervisor and walked through the ICU door…”David, the Operating Room just called – they got the rock out of Josi’s lung and she’s doing fine.”
I can still see him, jumping up and down with tears streaming down his face, rejoicing for his world to hear, “Only God has done it, only the blood of Jesus has saved my Josi.”

Shipping out

2011-06-09T10:30:00.000-04:00

It’s a bit startling sometimes to look out the window and realize that outside lies the greeny damp of an Adirondack spring, and more so, that I actually have a window! The air blowing in is fresh and cool and damp and sweet, without the tang of salt and sweat and dust to generously paint everything in orange streaks. It’s been a good time to relax and refresh, to hang my hammock and nap, to get reacquainted with black flies and ponder life…in between radio calls.

With my last update I hinted broadly at a return to Mercy Ships and Sierra Leone in the near future. That hint is quickly becoming a reality. After a lot of thought and prayer, I’ve accepted a position as nurse educator for the surgical ward aboard the Africa Mercy. This means that I’ll be in charge of orienting new nurses to working on board, and educating them about the types of surgery and related nursing care. Together with another charge nurse, we will be training preceptors, organizing continuing education sessions, and providing follow-up evaluations for ward nurses. I also plan to continue working on the wards as a charge nurse and pediatric nurse. It’s not so much a life choice as a driving need to go back – at least for a season. Here’s why:

We as Westerners take so much for granted: food, clothing, and a life in pursuit of health and happiness. This is a secret luxury…for so many people in the world it is a fairytale dream rather than a guaranteed right.

In looking at health and healthcare alone:

In the United States –

8 children in every 1000 die by age 5

800,000 doctors total

31 hospital beds for every 10,000 people

In Sierra Leone –

192 children in every 1000 will die by age 5

95 doctors…total

4 hospital beds for every 10,000 people

The disparities aren’t new for any of us, but they can be easy to ignore until personalized.

Until one of those 192 children is a name and a face with a set of parents you have prayed and mourned with, until you grow angry at the social disparities and the effects of sin on the world, and are driven to search for answers.

Until you realize that a hospital you thought cramped is a great luxury to patients because they have their own bed and don’t need to share with two other patients.

Until you meet a woman who has lived almost completely devoid of human contact for ten years because of a tumor that marks her as cursed, and because there is no doctor trained to remove it and no hospital equipped enough to care for her afterwards.

I have shared in the reality of social disparity and seen the faces of hopelessness.

This is why I’m going back…

because I have seen and know that there are people hungry for the right to be human,

because God loves these people so much,

and because I can help show them this.

I can’t return to a comfortable life; I can’t turn my back on them now.

I’d like to invite you to partner with me in reaching these precious hearts. I sense the Lord leading me to join the Africa Mercy (AFM) for at least two more years of ministry, starting this September. In order to do this I need to raise about $9000 per year for crew fees and airline flights.

Contributions can be made on line at https://connect.mercyships.org/page/outreach/view/crewmates/colesl. You can also mail donations directly to Mercy Ships, P.O. Box 2020, Garden Valley, TX 75771, with a note attached that they are for Laura Coles, Acct# 2699. No donation is too large or too small.

I encourage you to also join with me in prayer, and I am thankful to know that as I go you will be here praying for an incredible outpouring of hope and joy and new life.

Aiming for His footsteps,

Laura

Laura Coles

Gud Nyus

2011-06-01T18:09:00.000-04:00

Have you ever noticed that when you look at things from a different perspective you can learn something new? That in learning a language, the hidden secrets of people and culture are suddenly more accessible and more visible?

I’ve been learning Krio…and more now than just the songs and greetings and basic medical evaluation. About a week before I left Sierra Leone I obtained a Krio New Testament. I was holding it in my hand, about to leave work, when one of our translators asked me skeptically if I “can read that.” I sounded out the cover…Gud Nyus fɔ ɔlman.

Good news for all men

It’s a fitting title, and one that very much reflects the content in its entirety. After a surprised nod and approving “fine job, Laura Koroma” from the translator, I realized that this might be a great way to get to know more Krio, and a wide open window to so much more.

Since then, the Gud Nyus has been a part of my daily quiet time. I started out with the Lord’s Prayer, and I’ve enjoyed the refreshing perspective and blatant honesty. It's an insightful puzzle just waiting to be cracked!

Mek a tɛl una aw una fɔ pre, una fɔ se:

‘Papa Gɔd we de na ɛvin:

Na yu wan gren na Gɔd, mek ɔlman pre to yu ɛn ɔna yu;

Wi de pre mek yu rul wi; mek wetin yu want, bi na dis wɔl, lɛkɛ aw I de bi na ɛvin.

Gi wi wetin wi fɔ it tide.

Padin wi fɔ di bad tin dɛn we wi dɔn do, lɛkɛ aw wisɛf de padin dɛn pipul we de do wi bad.

Mek we nɔ lɛf fɔ biliv pan yu ɛnitɛm we Setan tray wi; nɔ mek Setan ebul wi.

Na yu de rul di wɔl, na yu gɛt pawa, ɛn na yu gɛt prez ɛn ɔna, fɔ ɛva ɛn ɛva. Emɛn.”

Matyu 6: 9-13

I’ll admit though, sometimes I miss that challenge of simplicity in my everyday life. Sometimes I almost give in to the overwhelming urge to ask my next patient, “You feel bad? You got pain?” or to reduce a lengthy discussion of upcoming activities to “We de go na waka waka yonda.” And at some incredible times I find myself bursting out in song that’s clearly unintelligible to most Americans. The language of my soul is no longer just a simple swirl of Bahasa and Sunda and English - it's well seasoned now with bits and pieces of Krio and Mende and Ewe and French and Zulu, with ever-expanding space for more :-)

I’d like to leave you with a thought from my quiet time yesterday; a clear challenge on priorities in the Christian life, and word for word the prayer of my heart:

Mek Gɔd de insay una gud gud, so dat ples nɔ lɛf fɔ ɔda tin…(Lɛta Fɔ ɛfisɔs 3:19b)

Snapshots

2011-05-27T16:26:00.000-04:00

I’ve started and stopped and started again…a half-dozen messages and a thousand ways to share them. The gentle rocking of the porch swing and a large spider I found comfortably lounging in my hair know more of my thoughts than you do; my radio sits silent and heavy on my belt this afternoon, with the students gone home and more arriving tomorrow. Quiet Adirondack woods and the sun in patches on the white birches should inspire a proliferation of words, and instead I’ve found myself strangely mute, a victim of writer’s block in the heart of a writer’s paradise.

I've been sorting through hundreds of photos, taking myself back to a reality I left only three weeks ago, and replaying again the incredible transformations of body and spirit in generous answer to our prayers for life and hope.

It’s impossible to share all the stories. The immense heartache and fears and outcast lives…and the incredible hope and joy that can only be known when one has been utterly hopeless. My brain is a jumble of before-and-after photos, Krio greetings giggled in little voices, the smell of bleach and Whiteheads packs and Ensure, wholehearted joyous dance parties to the beat of an enthusiastic two-year-old drummer, the weight of a small sweaty child drooling down my back as they sleep snuggled in tight...a series of still shots.

If I wrote ten thousand words I could not take you there completely. If I post these photos will you turn away in horror and disgust at the marred faces and bodies of social rejects, the bare scars of poverty? Will I only be trivializing the struggles of these precious hearts and putting their hidden shame on display?

Blink, and look at them again through different eyes, as souls that hunger for transformed life and a renewed spirit, that long to be seen as someone of worth.

Emmanuel

2011-05-23T14:38:00.001-04:00

Eyes open wide a window to the soul for those who are prepared to look and ask...

Five-year-old Emmanuel loves football (soccer), Ninja turtles, playing games with his buddies and all the other things little boys like to do. He is also a member of the children’s choir at his church. “He’s a boy who likes to sing,” said his father, Daniel, with obvious pride.

Three years ago, Emmanuel’s face suddenly swelled. He was taken to Children’s Hospital, but after three weeks they still had no idea what his problem was. The doctor prescribed several kinds of medicine, but Daniel had no money to pay for them.

One day, Daniel heard that Mercy Ships was on its way to Sierra Leone. He decided to do everything he could to take his son to the medical screening. When they arrived, they sat on a bench in front of the containers on the dock, waiting patiently for Emmanuel’s turn to be screened. The little boy’s beautiful face was marred by the growth on his left cheek that extended down to his neck. But when he smiled, his dimpled cheeks glowed and his big brown eyes sparkled.

Their patience was rewarded when Emmanuel received the coveted appointment card for a surgery.

When the anxiously awaited day arrived, Emmanuel was admitted to the onboard hospital. Even though he was scared, he was very brave as he was wheeled into the operating room. His father was also nervous. He waited in tears outside the operating room’s door, with a nurse holding his hand. “I have never experienced anything like that,” he confessed. “I prayed all night. I thought my son would never come out of the surgery.”

But Emmanuel did come out – with a bandage on his head and a smile on his face. Daniel heaved a sign of relief.

Both father and son were delighted with the results of the surgery. “There will be no more taunting now,” Daniel said. Emmanuel’s friends would no longer be able to laugh at him because of the growth. The little boy could start school with all the confidence a five-year-old should have.

In a few days, the dressing was removed and replaced by thin adhesive strips. “I’m glad they took off the bandage,” said Emmanuel. But he wanted to stay on the ship because he was enjoying all the attention from the nurses.

But when Emmanuel was discharged, he left with a brilliant smile. “I thank God to have the operation,” said Emmanuel with an impish grin. “Now, I can play ball!”

Story by Elaine B. Winn
Edited by Nancy Predaina
Photos by Liz Cantu and Tom Bradley

change

2011-05-17T11:25:00.000-04:00

The wind bites through my jacket in sharp reminder that I am back in a place I once called home. It's a cold and rainy spring in New York, and my golden tan staring back at me in the mirror marks me an outsider. Everything is different, down to the freedom to steam up the mirror in a hot shower, the taste of milk on my cereal, the spacious room with windows that I wake up to alone, the skin color and language of my patients.

God, family, friends...these are the only constants in my life. And I am so thankful for them! God has been consistently good, no matter what continent I find myself on. Long, cramped car rides and wedding celebrations are our family reunion, and we are having such fun with the time that we do have. I know that with these people who have known me so well I can call myself home regardless of what continent I'm on.

We've gone our separate ways for now, and I've headed north to the Adirondacks.

It is good to sit and just relax in front of a wood fire, enjoy the pristine lake ringed with green, and see old friends again. I've temporarily traded in my ship crew for another 400+ people who love Jesus, who worship with heart and soul, and who need someone on-call for emergencies (that's me!). I breathe the moment in deeply - enjoying the fellowship I have now and also looking ahead to the expectation of a return to West Africa in the near future. I am so blessed by the promise of family and life found in following Jesus with abandon, and I have found it amazingly true in my own path.

I'm no longer sure which is the dream and which is the reality now...but both are exciting, wildly interesting and fulfilling, and both are oh so good.

always enough

2011-05-10T12:54:00.001-04:00

Let me share with you my heartsong for Africa...the song I'll be singing through the long plane ride home and through the summer months: God's promise for my people

In a dry and weary land
Lord, You are the rain
In a sea of shattered ones
Your love comes rushing in

You hold the world within Your hands
And see each tear that falls
Through every fire and every storm
You're always enough, always enough

Your love is peace to the broken
Faith for the widow, hope for the orphan, strength for the weak
Your love is the anthem of nations, rings out through the ages
And You're always enough for me

You keep my heart in perfect peace
My life is in Your hands
When confusion hides my way
You're always enough, always enough

Your love is peace to the broken
Faith for the widow, hope for the orphan, strength for the weak
Your love is the anthem of nations, rings out through the ages
And You're always enough

I rejoice for my Savior reigns
I rejoice for He lives in me
God on high, He has set me free
And worthy is the Lord (x2)

Your love is peace to the broken
Faith for the widow, hope for the orphan, strength for the weak
Your love is the anthem of nations, rings out through the ages
And You're always enough for me

Your love is peace to the broken
Faith for the widow, hope for the orphan, strength for the weak
Your love is the anthem of nations, rings out through the ages
And You're always enough

I rejoice for my Savior reigns
I rejoice for He lives in me
God on high, He has set me free
And worthy is the Lord

In a dry and weary land
Lord, You are the rain

I'm claiming this promise for Salone...
Let the rainy season come!

Just visiting

2011-05-05T20:54:00.000-04:00

Come with me to a day shift on D ward a week ago:

I step out into the hallway and see a wheelchair scooting towards me. The two year old on top is laughing uproariously as she sways back and forth, holding to the rigid casts sticking out from underneath her. Gladys has tried every possible method of escape, toddling quickly down the hallway anytime the door to B ward is open, excited to make it as far as D ward to visit new faces and fun. Today she's picked her favorite vehicle, her brother Jon. John is just starting to walk again after a bilateral osteotomy, proud to show off his duck-waddle on the crocs-turned-cast covers that are duct taped on. Right behind him Tambo scoots along with his wheelchair and casts, and Bintu struggles to catch up with her walker.

Jon loves to sit and color with his favorite nurses, and seems to find a good reason to visit several times a day ("Football pages, Laura!"). Tambo has decided that he is a doctor, and showed up a few days ago with a stethoscope tucked under his shirt. Between him and Sandy, we're well staffed!

Sandy has gone back to surgery...her tongue looks beautiful, and she loves to show it off proudly as she sticks it out at me in between practicing staff names. She joined us for shift report again on Friday, and shyly joined in the singing. She'll be going home to Guinea tuesday, eager to show off her new mouth, and will be coming back to us in the fall. I wish I could be there to see her children's faces.

Just behind me Hardy pulls out his mirror and looks again, a long look, touching his lip and nose where the huge tumor used to hang, unable to stop smiling. Was it just a few days ago he started reading his new Bible, just yesterday he prayed with sister Clementine to give his new life to Christ?

I looked back at what I had written and realized that although tonight the wards are full, almost all of the patients above have been discharged home. They're showing off new faces and celebrating life and family and a place in community...and that is so exciting!

I miss them, but I still have my fill of people to serve and kids to love on. Tambo is still here, making wheelchair rounds with the anaesthetists to make sure they behave themselves. Isaia, a wonderfully bouncy three, rode down the hallway on my back this afternoon, trying to stick his head under my arm, making faces and yelling gitttatikagittatika until he got tickled (his current favorite activity). Mary showed up at the gate last week and had a large facial tumor removed the next day. She is still working on controlling her saliva and insists on being quite cuddly - the result being a thoroughly soaked scrub top halfway through the shift, and a large amount of drool on my allocations...well worth it!

And in the ICU, surrounded by new patient faces, a family is celebrating the goodness of God. A successful surgery we could not have done a week ago, a shyly smiling little girl who came close to death is headed home this weekend, and her jubilant father covering all in the blood of Jesus, exclaiming, "Only God could have saved my daughter."

Come down for a visit and join us in praising our amazing God...

Sovereign LORD, you have begun to show to your servant your greatness and your strong hand. For what god is there in heaven or on earth who can do the deeds and mighty works you do? - Deut 3:24

Praise God in his sanctuary;

praise him in his mighty heavens.

Praise him for his acts of power;

praise him for his surpassing greatness.
Let everything that has breath praise the LORD.

Praise the LORD. - Psalm 150: 2, 6

Beyond recovery

2011-05-01T09:21:00.003-04:00

I wish I could tell you that life here is all sunshine and happiness and smiles and dancing...

I can't.

I want to forget sometimes that there is more out there. It's so easy to focus on the ones we can help. That would be a shortsighted escape into a fantasy world, where everyone lives happily ever after.

That is not my reality. That world, while we eagerly await it with the return of our Messiah, is not always tangible in the here and now.

This is my world, wounded and bleeding and full of pain and loss:

Inside the ICU a toddler sleeps peacefully as her parents pray desperately for a miracle. Outside the gate a boy lies dying in the dust...faceless, nameless, burned beyond recovery even if we sent him to the best burn units in the world rather than the small hospitals here. There are the hundreds of people with goiters who we can't safely operate on because there is no thyroid replacement hormone available in the country, the surgeries we can't do because we don't have the surgeons or the bed space. There is four-year-old Christophe, sent back to his village with club feet because the casting didn't work, told to wait six years until he's old enough for surgery. Each represent thousands of others with only prayer to hold to now, when we in our human fallibility recognize that there is nothing else we can do for them, when our surgical capacity is limited and our medical treatment relies heavily on local hospitals. If I could run an emergency room out of my own cabin I would, even as it too became overrun with overwhelming need, a drop in the ocean. How could I have thought that Africa needs me, that we can do anything with a truly lasting impact except by the grace of my God?

Gathering my tiny faith in my hands I will stand and proclaim with these hopeful masses that He is King and Lord, and there is no other. I will stand with the fathers and mothers and nursing staff in the dim hospital lights of an early morning and pray for a miracle, even when it's not the miracle we might expect. I will sit and laugh in delight with the mother as her son who was ventilated 2 weeks before proudly shows us how far he can stick out his tongue, and comfort the panicked man even as I feel the pulsing spray of his arterial bleeding stop beneath my hands. I will lie prostrate in awe at what I have witnessed and say with complete assurance that God has done it. I will cling doggedly to joy and promise, even when everything around me threatens to collapse.

Through my tears I can thank Him who deserves all the glory for everything that happens here, whether clearly miraculous or seemingly ordinary. And I will not limit my God.

Sandy's revenge

2011-04-24T08:42:00.000-04:00

Those of you who have been following my blog since last year will remember Aimee, our love starved little girl with noma, an opportunistic infection that strikes the weak and malnourished following a serious illness. It's a disease that eats away the face, marking victims who could not afford good nutrition, penicillin, or the basic wound care that would have easily treated the infection.

Meet Sandy (not her real name), another Noma victim. Aimee and Sandy are the strong ones, part of the debatably lucky 10% who survive the disease only to live the rest of their lives scarred and outcast.

It's been a rough few weeks for Sandy. Her surgery almost three weeks ago was extensive, with her tongue sutured to the roof of her mouth to help grow back a palate, and skin flaps here and there to help replace the other missing tissue. It's a delicate work of art; we'll get to see the results soon when she heads back to surgery to have the flaps released. Meanwhile, she's been slowly shedding her plethora of oral and nasal airways, tubes, and IVs as she gets used to breathing and eating on her own again.

Communication has been a challenge as well. Sandy arrived with a large group from Guinea, and is fluent in a tribal language none of our translators or staff speak (even if we did, it's really difficult to talk with your tongue sewed to your palate and your mouth sewed partly shut). We got creative, rotating through other Guinean patients in an elaborate puzzle of who-speaks-what, using basic French which she seems to understand some of, and relying on our fluent pantomime to get us through. Now that the rest of the Guinean patients have left, we're down to just pantomime, and she is a master. Still, I was a bit concerned about the social aspects of living in a community where no one speaks your language, wondering if she would start to pull back into herself.

I wish that you could have seen her last night.

Armed with a colored pencil and a small piece of cardboard, Sandy began following one of our nurses around like a duckling, mimicking each chart notation and assessment on her own scrap of paper. Helping herself to an extra stethoscope from the hook on the door, she listened to each of our breath sounds in turn, front and back, demonstrating for us the deep breaths we were supposed to be taking during our exam. Each nurse working was then bodily hauled over to the monitor and sternly instructed to stand still while she checked a full set of vital signs and properly sanitized the thermometer in between "patients." A few of us even got medicated.

Through it all there was a little twinkle in Sandy's eye, a gleam of fun at this chance to get back at each of the nurses who had repeatedly checked vital signs and assessed, nebulized and medicated and suctioned and tube-fed her over the last few weeks. Now it's her turn for revenge.

I printed off a patient assignment sheet for her at shift change, and presented it to her on a clipboard with each of the nurses names written in. She joined us for prayer, sat proudly in the charge nurse chair and indicated that this was her place, here in the circle of nurses, and then very seriously jotted notes on her sheet as we "gave her report" on each of her patients. My favorite moment was when I introduced her as our new charge nurse: she giggled and blushed as she tucked her head down and peeked out at us, her new friends, laughing and clapping encouragement.

She'll be here with us for a few weeks yet, to surgery and back again before making the long trip home to Guinea. But I'm not concerned about her psychosocially anymore. Sandy has made herself right at home. God has done what none of us could do, reached out and touched a soul, and given Sandy back her smile.

Bo, part 2

2011-04-23T10:26:00.001-04:00

It was that first afternoon in Bo that was my favorite, despite the fun and adventure of the village trip the next day. This was my unexpected blessing, the icing on the cake.
Do you remember my lapful of children from C ward, the wait-listed patients who got surprise-vaulted to the start of surgery? The line of solemn faces and twisted legs lined up outside the ship on their arrival?
I would love to introduce you to just a few who are home now, who Anna and I had the huge blessing of being able to visit at their homes in Bo (names changed for privacy). They are fondly known as "8-plate kids;" each now has a piece of metal fixed to their bone to help it grow back straight over the next few months.

Marima is three, a sweet little love bug with bowed legs. With every opened door she was there to greet you, demanding hugs and cuddles, always ready to dance and sing or "help" with assessments or paperwork. She's back in a hut with her grandma now, already walking barefoot, with just a few steristrips and a bit of knee swelling to show that she was ever gone at all. She was excited to cuddle as soon as we arrived, but needed a little encouragement to "show you teef fo a snap (Smile for a photo)." She just kept hugging and hugging both of us, and Grandma looked on and smiled and smiled, clapping her hands as she exclaimed "Tel God tenki (Thank God)."

Fodai A little mini bald man, he spent his first few days on the ward with intermittent high fevers from malaria. I picked him up off the cool floor and held him, waiting for the tylenol to kick in, as he moaned over and over in Mende, "I just want to sleep, sleep." He's now walking again as well, a tentative little duck waddle of a walk, surrounded by siblings and cousins and neighbors and a proud mama cheering him on.

Kadija saw us and burst into tears, remembering only her blood draws and IVs and her outraged accusations directed at all nurses in general..."Yu chuk me! (You stuck me with a needle)." She'll forgive us eventually. Her young mother was enthusiastic to pull forward another village child with badly bowed legs, asking if just maybe we could fix this one too.

Finda is smart and sweet, a hard worker who pushes herself to her limits. Already she is running, and her father promises a reunion as soon as we can make it back to Bo again.

It is so rewarding to send patients walking back into their lives, a steri-strip-whiskered child strapped "po-po" on a mama's back as she walks off into the afternoon sun, enthusiastic hugs with a woman dressed in her very best to show off a new face to her village, the click of crutch tips down the gangway. To have a glimpse into their futures, a surgery successful not just now but with lasting impact, body and soul full of life...this is why I am here.

Bo, part 1

2011-04-22T09:33:00.000-04:00

Anna and Mattu

It started over 6 months ago when Anna asked if I would join her in visiting a World Vision sponsor child. Of course I said yes, enthusiastically jumping at a chance to adventure with Anna and see a bit more of Sierra Leone at the same time.

"Really African road"

After a smooth ride to Bo and a relatively uneventful (except for the spontaneously exploding lightbulbs) stay in a hostel overnight, we set out for a butt-numbing land rover ride that sent us careening through what our driver termed "really African road." Although the constant and violent rocking over deep ruts and vegetation in the road threatened to throw us through the windshield if we didn't hang on, we were able to enjoy a really fabulous view of the surrounding mountains and greenery and little villages filled with people. Almost the opposite of Freetown, where trucks and poda-podas and motorcycles threaten to run over the thousands of pedestrians...here we were the only car out there for miles.

They greeted us with dancing and singing, enthusiastic chatter, and a whole troupe of uniformed schoolchildren. Because this village had a school, and a well, and a clinic - here a luxury and a blessing rather than an assumed necessity.

It was a humbling thing to tour the clinic, with its three maternity mattresses and mosquito nets, the stenciled "drug store" sign for just a few medications, the one nurse with a baby tied on her back who proudly pointed out their exam tables and beds and almost bare cupboards of supplies. It can be so easy for me even now to see something as a medical "need" or "necessity" until I realize just how many clinics make do without. It's easy to look through the hundreds of barefoot children who walk for miles to go to school, and see only the bare concrete of a building and the mud outhouses. It's only now that I start to realize what I have not seen.

What is poverty, and what is wealth? Overlaid with a richness of community and culture, this village and our patients challenge the ideals of the American dream just by their lives. Individualism, health, wealth and possessions are not all they promise, and they were never something that was promised to us. I have seen contentment despite monetary poverty, and it makes me wonder what it is that so much of the Western world is missing. Are we the ones who lack understanding, the ones who are impoverished?

Ecclesiastes 5: 19-20 Moreover, when God gives someone wealth and possessions, and the ability to enjoy them, to accept their lot and be happy in their toil—this is a gift of God. They seldom reflect on the days of their life, because God keeps them occupied with gladness of heart.

Screening day...take two

2011-04-16T17:18:00.000-04:00

Remember back with me, just 5 weeks ago, when our hearts were devastated by a screening day so full of hope that ended in broken tragedy. We picked up the pieces slowly, carefully, taking the love and care we had to give, overflowing out of the brokenness, and giving it to our unexpected and formerly wait-listed group of orthopedic little ones from upcountry.

It's been a lifetime since then, and many of our upcountry patients have had their surgeries, recovered, and gone home. My bunkmate Anna and I had the privelege of visiting just a few of these precious kids last week during an exciting and adventurous trip upcountry (more to come on that in future blog posts!).

And as our leadership analyzed and strategized in an effort to avoid a repeat of the unruly and desperate large crowds, it came time to screen again. Although I was unable to join physically, I worked night shift and prayed as I cared for the patients we already had. Everything went extremely well from all reports, and we are blessed to have lots and lots of patients!! Below is the official press release, take two:

Report from the Field: Update on ScreeningGiven the events that occurred at the first scheduled screening in Freetown, we are delighted to announce that this past Saturday, March 26 was a highly successful screening day. Three-thousand individuals arrived and waited calmly and patiently for many hours—some arriving the day before—in hope that today would be the day they would finally hear the words, “Yes, we can help you.”

Africa Mercy Managing Director Donovan Palmer was on hand to assist with screening day. “We’ve seen about 3,000 people come through the lines and be contacted with us one way or the other and we’ve been able to manage that very, very well.”

About 150 Mercy Ships crew members staffed the screening for security purposes, medical services and prayer support.

Mid-day, Chief Medical Officer Dr. Gary Parker, took a break from seeing patients and provided an update. “We’ve had an excellent screening morning. The team worked together so well from security to medical to logistics. We’ve seen most of the people who have come through and mostly conditions that we can help them with. I’ve been at a lot of screenings, and this one is very smooth.”

Many individuals with large tumors or deformities have resorted to living a life of solitude—secluded and alone in their homes. Attending medical screening is an opportunity for human contact that the soul craves.

“We’ve had a lot of fun with the people,” Palmer said, “We’ve been able to talk to them and engage and even if we can’t help them, we pray with them and hear their stories.”

The hugely successful screening allowed Mercy Ships to schedule surgeries for the remainder of the Field Service in Sierra Leone. Thanks to a dedicated crew and helpful local civil authorities, this screening day was a vast success

A thousand words

2011-04-15T17:40:00.000-04:00

I find it rather ironic that after almost two weeks on wanting to write and not having time I am finding myself with an acute case of writers block.

I keep wanting to say that things have been busy…busy but so so good. I am just starting to realize that the longer one is here the more responsibility is accrued; the more things there are to be involved in, people to see, and amount of things there are to manage at work. And so my life has become busier and busier, a series of choices and longer shifts and piecemeal time with friends, and over it all the knowledge that I am here to serve and I have been given the opportunity.

It’s hard even to know what to write sometimes. There is so much that happens even just on a daily basis. The adventures that have become my life are hard to sum up in a simple blog post or a few words and photos.

How can I introduce you to each one of my wonderful patients…they are all mine, with their own stories and struggles and lives. (Don’t worry, I’ll still try!) How do I express the challenge and frustrations and responsibilities and exuberant love that are charge nursing? How do I share my life: the flying hugs from Mohmed and Ada every time I just walk onto C ward, drawing up medications with Abu Bakar clinging stubbornly to my leg, the games and worship and prayer in 7 different languages, meaningful midnight chats over fresh croissants, poda-poda dust baths careening through the streets packed with people, the days without showering during a water shortage so that surgery can continue…and not knowing when we’ll be able to shower again?

I want to share my life here in such a way that you can taste the dust, feel the crush of people in the market, smell the chicken poop and hear the incessant beat of the drums until you just can't help dancing. I want to make you understand the excitement and the sorrow that comes with working on a surgical hospital in Africa...but how? If I take a hundred pictures, use a thousand words, can I bring you here into my world?

Maggie was here

2011-04-04T08:30:00.000-04:00

I had expected a slow day off. As I walked out sleepy-eyed to take a phone call, our door opened and my friend Maggie was outside. “Come on Coles, I need you in C ward. I know you’d rather give blood than sleep!”

I mumbled something about putting on clothes and started chugging water, as much water as I could get down, and eating whatever we had in the room on the way there.

10 minutes and a liter of water later I was watching my blood flow through one huge needle into the familiar blood collection bag on the round metal scale. Since my bunkmate Anna had been woken up also she came along as photographer, water caddy, and thoughtfully held pressure on the hole in my arm so I wouldn’t bruise after. Maggie signed my bandage in sharpie, and I was good to go!

There’s something strangely special about holding your own warm blood in your hands, to watch the patient improve and see a hematocrit rise knowing that those are your cells being counted too. It’s a personal, tangible impact in a life, and one that gets me every time.

An "upscale"church

2011-04-03T17:40:00.000-04:00

Our land rover stopped at an undecorated concrete doorframe squashed between the buildings on either side. Barefoot, happy children played in the trash-filled gutters along the narrow street. There was a covered area over the gutter big enough to fit three cars tightly parked…the church parking lot.

I had come with a group of Mercy Ships crew including some families from Ghana – good friends of mine. 18 month Esther has adopted me as her “auntie”, and solemnly read my bible during the sermon while trying to push my sunglasses up over her nose with one small brown finger.

The lightbulbs were bare, strung across the ceiling on a bit of wire. The church banner was in crayon, with some tinsel and a few balloons as decoration. We sat in lawn chairs on the pitted concrete and dirt floor. The sermon was in Krio, with an English translation over top.

But the people were warm and welcoming, dressed in their best. The worship was lively and heartfelt, the sermon to the point and challenging, and the presence of God walked among us. Despite the surroundings, this was a church in the truest sense of the word.

I asked Gina (Esther’s mother) later if she had been to that church before. She had, several years ago. “So what was it like before,” I asked. “Does it look about the same?”

“Oh no,” Gina said. “It’s much nicer now. They have walls.”

Last Sunday I rewrote my mental definition of an “upscale” church, a “fancy” building. And if we’re truly honest, how much does the décor matter beyond our own pride and distraction. When God walked into our church service last Sunday did he see the décor and surroundings, or did he look through all of that straight into the souls of the worshippers gathered?

Sleep in peace

2011-03-28T01:07:00.000-04:00

His little weight is heavy against my lap, bare brown belly in a rhythmic rise and fall against mine, fist clenched tight on my thumb. It is warm in the wards tonight, and Ismael (not his real name) settled into a sound sleep once I stripped off the sweat-soaked shirt and left him blinking confused in the soft light of the emergency overheads. Three in a bed might be comfortable at home, but here when the AC goes off, it's more like a bedroom sauna.

It's the last shift in our stretch of nights, and the little ones were having a wild time tonight. One last hurrah before surgery tomorrow...when three broken lips will be sewed back together, three young lives given a chance at school, jobs, a family, a normal life.

Naamah (not her real name) is one of my cuddle bugs. Head wreathed in bandages from her noma repair, she insisted on sitting on my lap through report and prayers, then riding on my back down to A ward to visit everyone while I checked in with the evening charge nurses. Most of our visit involved choppy questions in Krio on our part and solemn nods and a few high fives on hers. Once back we decided to color, and after I scolded Naamah for cleaning the floor with her head bandage, a lively chase ensued involving a hobby horse and balloons, and all the children under 10. Ismael attempted escape out the door when the doctors came for rounds, but happily settled for eating my calculator and removing the pens from my pockets one by one while we discussed surgical status and preop medications. We ended with a group teaching session (my instructors would have been proud) on everything from IV medications to how a thermometer works.

They've been sleeping since, a dark and quiet ward tonight as the nurses round with flashlights. Sleep in peace, little ones, morning is almost here.

Take two

2011-03-25T22:57:00.000-04:00

This morning will be screening day...take two. Our security team left yesterday at 2 pm to provide overnight crowd control, and we are praying that God will bring the people and patients who HE wants to bring, and who He has purposes for at screening in the morning. Our location is changed, our strategy is different, but our faith is steadfast.

My role is a little different this time...I won't be going to screening today. Instead I am here in the deceptive and dimmed peace of the D ward nurses station, pager at my belt, listening to Mari's whistling breaths through the nasal bolster, checking a temperature here and an NG feed there, and praying for the difficult morning ahead for the screening team: most of the hospital staff with many volunteers from among the non-medical crew. This time I'm here with the already-patients - night charge nurse and emergency medical backup...and hopefully there will be no emergencies to wake me midday.

Friends, we desperately need your prayers this early morning. Pray for peace and order at screening. Pray that God would bring those he has purposes for with the team, with the surgeons, and with the prayer warriors. Pray that He would move in power!

We pray for healing...and for hope.

God smiled

2011-03-25T09:11:00.000-04:00

    As you come down the aft stairwell, just follow the sound of the drums.

     It started out as a nursing devo meeting, group worship, gathered in the little floor space between our patient beds. After a few songs we asked the day volunteers and patients and families for some Krio songs...and the hospital routine suddenly became a dance party.

    After clarifying that what we wanted was "wosip fo dancing," a caregiver launched us into a whole string of Krio and English songs, with the other patients and caregivers enthusiastically joining in clapping. Halfway into the first song we brought out the big set of drums, and the nurses started dancing, and the patients started dancing too.

On my first circuit round the room there was a little boy in a patient gown looking up at me with sparkling eyes, arms held high and the telltale steristrips and coban around both knees from his corrective orthopedic surgery. I swung him onto my back, African style, and he held on tight as we danced together to the drums and sang "Send yo fia, de holy gost fia. Send yo fia again, de holy gost fia." and several other lively and apparently well-known praise songs.

The little bowlegged kids danced awkwardly along, or were swung up on backs as the nurses danced by. Our little amputee stumped by with her crutch, her face pure joy despite the challenge of dancing one-footed. On my back, my little one fell asleep, completely at home with the rhythm and drums...and as he slept and we worshipped, I looked up and saw God smile.

Pineapple and poda-poda parts

2011-03-21T11:57:00.000-04:00

We headed off-ship the moment I had a chance to change scrubs from night shift, packed 18 crew into our poda-poda, and careened through the countryside over pot-holed dirt roads towards a beach known only as "River Number 2." It was a perfect sunny Saturday morning, and after 3 weeks I was starting to think it was about time I worked on finally getting off ship. I nodded off against the rusting back of the seat in front of me, lulled to sleep with the blaring hip-hop Afro-pop music of national radio and "Sweet, sweet Salone (Sierra Leone)."

The beauty of Sierra Leone's beaches is well-known; their draw only slightly lessened by the threat of riptides. River Number 2 certainly lived up to expectations. The white cliffs of sand surrounded by rings of forested mountains and clear blue-green ocean around the river mouth was the perfect peaceful setting to spend a day.

On returning to our poda-poda that afternoon, however, we were a little surprised to notice that one of the tires had been replaced with a concrete block. "The poda-poda definitely looks knackered," Frances commented. Knackered is a new favorite word of mine, a Brit expression for exhausted or worn out. Quite honestly, what was more surprising for me was that more parts hadn't come off during the ride there. By all rights we should have left a few bits behind in the potholes.

After realizing we might be stranded 2 hours from anywhere for quite some time we decided to break into our stash of food, and also find out what options were available locally. Chris came back with a pineapple, and after realizing that none of us had knives we were momentarily stumped on what exactly to use. In case any of you have this problem in the future, a pair of trauma shears (clean, of course) works surprisingly well!

Fruit chutney Nik-naks (corn puffs) were also a popular hit after their initial slow start. If you can get past the dubious flavor name these little treats are quite good. Even Frances enjoyed them, after initially declaring she would prefer to eat the bag (boiled). Various members of the initial group found alternative transportation home...the photo below is of the final "survivors."

Our driver Mohamed arrived back with the newly fixed tire and we bumped our way back with heads ducked to avoid hitting the ceiling on the bounces. Expanding on Anna's earlier prayer for safety and traffic mercies, Heather prayed that all the poda-poda bits would stay on this time as we pulled out onto the familiar dirt road. We arrived back in one piece, two shades darker from the orange dust that filtered in through the windows and streaked us in a muddy false tan. Late dinner and a full moon on the rise were a perfect way to end the day.

A chaos of children!

2011-03-16T13:13:00.000-04:00

Imagine...
You made it to an early screening day with your child, a young son who loves football (soccer), whose legs are so bowed that he's a full foot shorter than they should be. Hopes are high until you're told...there may be too many people for surgery. Your life waits on a phone call or visit...the waiting list.
And then, suddenly, surgery slots are open!

The hospital opened sunday afternoon, and already two of our wards are filled to overflowing with orthopedic patients from the north, children with their parents and younger siblings, an overnight census explosion. For them, this is an unexpected answer to prayer. Another ward is slowly filling with maxillo-facial patients as A and C wards have started to flood into B.

My day today was spent in the loving craziness that is C ward: 10 kiddos still waiting for surgery with their parent and some small siblings sleeping under the bed. There are children everywhere, lively, laughing, full of fun, and looking for entertainment - being treated for everything from malaria to wounds to worms and scabies before they are ready for surgery. Their giggles are infectious as I try out my Krio and Mende, teach them how to use the ever popular stethoscope and thermometer, and try to fit as many as possible into my lap for hugs, tickling and cuddling. The nursing care itself is not difficult; the challenge lies in keeping everything straight: obtaining meds and supplies from a different ward, managing staff so that one of us is on the ward all the time (out of 1.5 nurses and a translator) and figuring out who gets treated for what when and how. My charge nurse laughingly told me I received the assignment because I "thrive on chaos"...whoever told her that must know me well, because this kind of chaos is right up my alley!

Shared grief

2011-03-12T11:27:00.000-05:00

Blessed are those who mourn, for they will be comforted ~ Matthew 5:4

My thoughts are scattered and piecemeal; in attempting to write from the heart I'm finding my heart still broken on the floor. I'm trying to make sense of something senseless, and find that I just need to cling to my rock and trust. It's not the trust of not knowing, of a safe and sheltered life...this is the trust in the middle of the storm. God is my shelter when there is no other shelter left, he is my strength when I am weak and broken.

We're still a community in mourning, and in it's own odd way I find that mourning is a comfort. Because how can you mourn for something you never had and never lost? How can you mourn unless you first have loved? And how can we love a people we have never known, except by the grace of God? We witnessed a tragedy of desperation - something so incomprehensible from the Western medical mind. So many of us feel a sense of entitlement to things: to good, safe and speedy medical care, clean water, sufficient food, pursuit of happiness however we see fit.

And yet the reality is that there are people fighting just to survive. So desperate for even basic medical care that they could run unseeing over another person, many of them having spent days or weeks walking, or using up all of their savings just to have a chance at hope. They are the ones so often unseen, unremembered, left behind.

I can't play ostrich and bury my head in the sand when there is no sand left. In watching, in remembering, in mourning I find a clarity of purpose, a meaning for hope. In a world of chaos I have found one thing that stands firm, and that is Jesus and His love - for me and for humanity. And on that rock I can stand.

Promises shattered
Answers don't come
Friends say goodbye
Plans come undone
Dreams get crushed
Lies get told
Words can turn cruel
Hearts can grow cold

You make sense of the madness
And make darkness flee
You bring such a calm
To the chaos in me
Show me life
Tell me truth
Day after day I keep running to You

In a broken world where we cry to feel
Some hope that helps these hearts to heal
You're my strength, You're my refuge

In a broken world, Jesus I'm holding to You ~ Across the Sky

Right to be human

2011-03-08T16:59:00.003-05:00

It started out like any other screening day, just a little earlier. We pulled on scrubs and whispered in the bathroom to keep from waking our new roomate, filled waterbottles, and filed out to a waiting convoy of landrovers. We set up chairs and tables in the early dawn, asked about hernias and malaria and tumors, checked blood pressures and lab work, tried out our new Krio words, walked the hopeful patients from place to place, prayed for them.

The sun rose quickly, and the hot African sun beat down as we continued screening. I was called out to treat several people who had fainted outside the gate, only to find that they had revived with a little water and melted back into the crowd of thousands. It was around midmorning when I got another call to respond to a fainting victim outside the gate. With blood pressure cuff and stethoscope in hand and another nurse behind me we headed out through the inner gate into the crowd looking for our patient. The the voices behind the main gate were frantic and growing louder, but there was friendliness and hope in the eyes around me.

As I turned around the outer gate suddenly buckled in and gave way, and a sea of lives flooded in and piled up and up as the crowd continued to come...desperate eyes looking up from the ground, pleading for a right to be human. Carefully guarded hope, hours and days of waiting and sleeping in line crushed in the weight of the mass. Suddenly the high concrete wall was against my back and people all around, more people than could fit through the little inner gate, but still they tried. I found my voice lost in the crowd as I yelled for order, that everyone would be taken care of, that everyone mattered. From nowhere a calm little man appeared, told me it was time to leave, parted a way across so that I could hand off my stethoscope and jump over the wall back into the stadium...when I looked back he was gone as though he was never there at all.

We linked arms, shoulder to shoulder, as they came through the little gate one by one, and suddenly I was an emergency nurse, kneeling beside an unconscious man in the thick red dust with another nurse, asking about breathing and pulse and shade...

And then we were four, and ten, and twenty and fifty, a sea of blue scrubs under the tent we had moved the injured to for staging and treatment. The supplies we packed the night before in preparation for a one or two person emergency stretched and stretched, and I found myself in silent thanks for the urge to pack more than I had thought would be needed. I was soon pulled away from my first patient to find supplies, to create supplies when we had no more, to triage and make transport decisions, to check on the little groups of medical personnel revolving around each victim, to soothe and offer a brief word of comfort. It was a moment, a minute, a lifetime, until the last landrover-turned-ambulance pulled away and there were no injured left to treat.

It wasn't what we had expected, winding through the bustling market and past the big cotton tree in the soft dark early that morning. It wasn't what we had planned and hoped and waited and prayed for, the anticipation of surgeries and hope to come, of lives restored and God's love for humanity found. It also wasn't the familiar pang from previous screenings, from deformity and outcast and helpless and starving. This was a sharper pain, an unexpected and terrible occurrence.

Our hearts are broken for families in tragedy...our hearts are broken for the thousands that were left behind the gate after screenings were cut short for the day...my heart is broken for the helpless that were trampled unseen, and for those that trampled them too desperate to notice...my heart is broken because I watched a man die yesterday, and I don't even know his name.

I'm broken and hurting, and it's hard to pick the pieces back up as I pray for faith. All the people we saw yesterday and the ones that we didn't...they are already in God's hands. Every broken face, every blind eye, every bowed leg, every outcast. I am so thankful that despite all the chaos and apparent hopelessness, he is still in control. And only He can open the eyes of the hopeless to let them know that not only are they human, but they are also loved.

All I can do is pray...and trust in His promises for each of these helpless:
At that time I will deal with all who oppressed you. I will rescue the lame; I will gather the exiles. I will give them praise and honor in every land where they have suffered shame. At that time I will gather you; at that time I will bring you home. I will give you honor and praise among all the peoples of the earth when I restore your fortunes before your very eyes," says the Lord. ~ Zeph 3: 19-20

The official Mercy Ships statement is below. Please read and pray for the crew, the victims, our patients, and the hurting people of Sierra Leone.

Mercy Ships is deeply saddened by the tragic events that occurred today during medical screening at the Freetown National Stadium when a crowd stormed the gate resulting in several injuries and one life lost.
Mercy Ships personnel working at the site attended the injured and accompanied them to local hospitals.
"Our hearts and prayers are with the individuals and families of those affected by today's events. The occurrence of this incident in the course of activities intended to restore lives is tragic. We move forward with tremendous sadness, but great determination, to assist as many people as possible in the next ten months," stated Mercy Ships Founder, Don Stephens.
Mercy Ships exists to serve the forgotten poor and has served Sierra Leone five times over the past two decades, also helping establish two land-based health care facilities. For the next ten months, Mercy Ships will be providing surgeries for qualified patients while working alongside the Sierra Leonean Government to support its five-year healthcare plan and strengthen the functions of the national health system.

Please keep the people of Sierra Leone and the Mercy Ships crew in your prayers, not just today but in the months to come.

2011-03-07T16:03:00.000-05:00

The week has slipped by in a whirlwind of unpacking, sorting, cleaning, bleaching, and more bleaching. New staff ready and eager to work have jumped in with both feet, and by Friday afternoon I was thinking, "wow, this is actually starting to look like a hospital again!" Praise music, great teamwork, and the occasional disco dance party with the ICU panic lights have turned a potentially dreary job into (rather exhausting) fun.

Who could have thought that even this dirty, sweaty, and often disgusting work could truly be worship?

here!

2011-02-28T15:30:00.000-05:00

Last night I woke up and realized that something was not right. It took a minute for my sleep-fogged mind to realize what the problem was...my bed is no longer in a constant state of motion, and the comforting hum of the big engines is stopped. We are anchored!!

We arrived yesterday, in a flurry of bright african dress, waving hands and smiling faces, and the triumphant rise of our voices - everyone on shore and on ship - singing the proud Sierra Leone national anthem. We were greeted by new crew, old friends, a marching band, and the Minister of Health: a mixed crowd but an excited one, and one we were excited to finally meet as well.

We've started unpacking pretty much immediately, and it is exhilirating to see the hospital unfold and unpack and start to look like a hospital today. I celebrated my first time on Sierra Leone soil by riding African-style over to the Hospitality center, on top of a large truckload of dental supplies (picture to come, I hope).

It seems like only yesterday that we crossed the equator and celebrated our shellback seaman status, that we competed in the sail olympics for a prize of a soda can replica of the Africa Mercy, that we put on eyepatches and earrings and danced the night away, and that we prayed for the arrival and ensuing field service.
Well, that day is here at last. Watch out, Sierra Leone...mercy's on its way!

Can you see it?? Do you see the equator!!

Ah biliv em

2011-02-23T16:20:00.000-05:00

In preparation for our entry into Sierra Leone we've been having classes and discussions on everything from local culture to history to language. While I am really enjoying the Krio language lessons with the Sierra Leone crew members, one of my favorite parts of these mornings is the West African-style worship.

They are practical songs, uncomplicated delight in trust. I will try and post another few with lyrics as I get spellings/meanings/Krio words down. One of the simpler ones from this morning goes

I go do am (He will do it)
Yes, I go do am (Yes, He will do it)
God don tak am (God has said it)
Ah biliv em (I will believe/trust in Him)

Just like that. God has said it, and I believe Him. No demands for tangible blessings, further confirmation, or a need for instant vending-machine style gratification.

So as we get closer to the wire and I wonder if we will be set up in time, pray for strength in taking on new job responsibilities and challenges, ask for guidance for the days ahead and wonder at how God would choose to use me in all of my flawed frailty, I will claim His promises and say:
God don tak am, Ah biliv em!

Life at sea

2011-02-20T15:55:00.000-05:00

Hundreds of seals swam along with us as we rounded the Cape of Good Hope and sailed into the beautiful port of Cape Town.

Cape of Good Hope

Cape Town is ringed by tall mountains on every side, with Table Mountain an imposing challenge in the backdrop...a challenge we could not refuse.

Our brief stop did allow enough time for several of us to get off ship, and Monday morning my friend Becca and I braved the baking sun to climb what seemed an unending stone staircase with a dreamy view behind and near impassible cliff up ahead. We reached the top parched, thankful, and exhilarated...and resolving to never mountain climb in Africa again without an entire backpack full of water. That night we sailed out again under an orange and pink sky.

View from the trail up Table Mountain

Sunset over Cape Town

We have been sailing since then for almost a week, and all I can see is ocean in every direction...a deep cheerful blue that seems laced with sunlit smiles. It is incredible to think that the love of God is even wider and deeper than this. Knowing that makes it easy to trust that His plan for me is crazy and glorious and unimaginably delightful.

It's an adventure to live at sea. It would have never occurred to me in the past that while cooking I would need to guard the frying pan so it would not come off the stove. Or that it would be smart to bungee cord my sewing machine to the table (hopefully the table is a sturdy one!). Nights "out" are conveniently close to home, sometimes with community organized activities like sock golf tournaments or karaoke. We've sailed out well ahead of an expected storm, and smooth sailing has been a blessing. I'm looking forward to sleeping soundly in my little cabin cave tonight, a bit startled to realize that it will be strange when my bunk no longer rocks me to sleep. One more week-ish till go time!

sailing at last!

2011-02-12T03:35:00.000-05:00

"Attention all crew: This is a drill, this is a drill, this is a drill." The captain's voice sounds out over the loudspeaker as emergency teams rush to their muster stations and gear up. Our team assembles as well, ready to respond to a medical emergency should the need arise. It's a familiar sound, and a familiar action. We've been drilling on and off since our arrival back on ship, preparing for the sail.

Except finally, we're done with preparation...it's time to sail! After a muster with head-count, crew paused their jobs to line the rails on deck 7 and 8, and wave goodbye to a city that has sheltered our ship for the last few months. With the rest of the medical team, I also got to watch as our South African pilot was picked up by helicopter.

Our sail has been frequently joined by large pods of dolphins, and pilot whales, who seem very talkative and more than happy to show off and entertain the children (and adults) on board. I'm looking forward to seeing some larger whales and flying fish as well :-)

First stop...Cape Town, South Africa!

Swab the decks

2011-02-07T13:00:00.000-05:00

I've broadened my job description since coming to South Africa. Pretty extensively broadened, in fact. Last year I had varied jobs as well, but mostly within nursing. Pediatric nurse turned into hospital floor-waxer, expert ward bleacher and bedmaker, pre-surgical screener, adult care, ICU, PICU, and IV team depending on the need. But I'm used to that. It makes me feel right at home.

It's been a bit different this time, with my job description extended now far beyond "being a nurse". I've joined what is the not-so-secret society of incognito nurses...(nurse by day, deadly ninja by night!). Except in this case we're not ninjas exactly.

Since the hospital isn't open yet, most of the nurses have been assigned to jobs in other departments for now. Along with a few housekeepers and several other hospital staff, I'm swabbing the decks...and the bulkheads, and the deckheads, and quite a few just plain heads. (Translation for the non-sailors - we clean and mop the floors, clean walls and ceilings and bathrooms...but it sounds much more fun using sailor lingo :-)

All it takes though is the loud ring of the emergency alarm or an overhead or beeper page to send me into the nearest phone booth to magically and instantly transform back into an emergency nurse. While I'm eager to get to Sierra Leone, I'll enjoy the more relaxed role while I have it. After all, this is my first 8-5 job (unless you count the on-call bits)!

Because where else can I watch from my softly rocking hammock as the sun drowns in the sea, join my fellow sailors for worship on the bow, catch my food flying off the table, stand pirate watch at midnight with a friend, dream of roller coasters and wake up still believing that I'm on one, swab the decks and the heads not out of duty but because this too is worship for my God, and still be a nurse at the drop of a hat?

I'm telling you, this is gonna be quite a cruise :-D

11 cows

2011-02-03T12:04:00.000-05:00

It’s a confusing thing when two men are asking you questions in a language you don’t understand – especially when one of them is dressed only in animal skins and carrying a large war shield and stabbing spear.

I was proud of myself for getting it on the second try, albeit a little startled with the translation and their excited confirmation. “He has six wives, you have two, and you want me to be number three?” I asked. From the hand clapping and smiles I realized that I had gotten it right, and jumped in quickly with a polite refusal. There was a slight hitch in the wedding plans as they realized that my father wasn’t there to accept the bride price of 11 cows.

We toured the village, watched the men making spears and shields and the women pots and beaded ornaments. We got to smell the medicine man’s herbs, and watch the tribal dances. We even tried a sip of the local beer offered in hospitality – a rather gritty beverage we learned had been strained through a reed basket.

How can I turn down the offer? I would get my own hut, my own wooden pillow, and join a culture rich in tradition. And I’m already learning the language, even though the clicks have been a bit difficult. And dad, I forgot to tell them where to send the cows.

So I think I’m going to hold out for a proposal to be a first wife, or maybe a few more cows.

Welcome home, Appelsbosch crew!

2011-01-31T09:35:00.000-05:00

Imagine that your friends and co-workers and half your neighborhood all decided to pack up and move one day; teams mopping their way through offices the day before, a whole caravan of buses and land-rovers and one huge truck driving down the major highways...

Yep, we've finally moved "home" again! Crew already on board were waiting to greet us; our ship home decked out in balloons and world flags and a large sign that excitedly welcomed us back.

And it truly is good to be back. Our directors warn us that it might not be quite "homey" yet, that the internet and electricity and water and AC may go in and out, we'll have scheduled blackouts and frequent emergency drills to prepare for the sail. My cabin is partly underwater (so no windows) and pitch black with the door closed - excellent for night shift in the future, and for now lit camping-style with a mag light.

But it's a wildly fun adventure. And if blackouts and drills bring us closer to the sail then I say...bring them on!

I heard my baby breathe

2011-01-27T08:09:00.000-05:00

It all revolves around generators. Generators and pipes. Something I know very little about. So I find myself praying in vague terms, doing what I can to prepare for the sail, thankful that the engineers and plumbers and electricians and deck crew know what they are doing.

They are testing the first generator, with a relatively positive report before they shut it back off for more tests. “I heard one of my babies take a breath today,” one of the mechanics said happily when I asked him yesterday how it went. And breathing babies are definitely an answer to prayer. We need them breathing so that we can sail. Our patients are ready for us to come in Sierra Leone, and the hospital staff are raring and ready to go.

Please pray for Dennis’s babies to breathe, and breathe well.

499 feet

2011-01-27T03:07:00.000-05:00

Termite wings beat frantically against my window, a constant flutter in the background of my head. I’m the insect hunter in my room…two mosquitoes, a large spider and one termite later I headed out to the shower...only to find that another active termite was sharing the shower with me today. I’m thankful for my childhood in Indonesia that introduced me to bugs and sweat as a part of everyday life, for shower flip-flops, for the sweet sleep that comes even knowing exactly what live animals have joined me in the room.

This is the luxury in my days: the hot 2-minute shower and maybe a cup of hot chocolate with a friend; a breath of relaxation. We’ve been diligently and thoroughly cleaning, every area of the ship that we can reach. 499 feet long and 8 decks high seems small after a week at sea but right now each foot stretches out longer as we scrub. It’s tiring but incredibly satisfying to watch our ship go from muddy and dusty to bright and shining again. Yesterday we cleaned even the parts of the ship we couldn’t reach. Siah and I suited up in safety harnesses and went up on scaffolding to wipe down the ceilings midships in the lounge. In the bits we couldn’t reach with tables, that is. We definitely had a blast, so much so that Ruth was inspired to join us without a harness. I’m telling you, Mercy Ships must have the most versatile medical personnel ever.

We’re still living at Appelsbosch, with clouds and cool rain and an Internet café that was damaged in the last thunderstorm (the reason for the late blog posts ;-), with a rollercoaster commute of mountains and ocean and startled pedestrians in the fog. Waiting, praying that the generator tests will go well so we can all move back on board and prepare to sail.

the sweat team

2011-01-19T13:39:00.000-05:00

Several of the hospital staff named ourselves the sweat team today. It's generally descriptive of our current job onboard ship, and also our personal appearances most of the waking day.

At 0800 every morning we hop on the "shuttle" - a 13-15 passenger van - for a 2 hour trip that feels more like a rollercoaster ride. The hills of Kwa-Zulu Natal are beautiful, all sharp angles and odd ridges and flatness, topped with a generous dusting of long grass and scattered round huts, rows of palms, odd-shaped evergreen, and what look like grown-up bonsai trees wiggling around in contours to a little tuft of leaves at the top. Every night we ride home covered in grime and chemicals, sweat cooling into a sticky film in the breeze.

Our sweet ship is riding high in port, aft gangway in place and surrounded by pipes and landrovers on the dock. Our job is simply to clean. To clean and dust and scrub and dance with praise music blasting, and sort through mildewed supplies and equipment to clean anything even remotely salvageable, and then clean it again when we set up the hospital in Sierra Leone. Because our ship has been at rest for the last few months...and now it's time to turn it back into a hospital, and a village. And let me tell you, there's no one that cleans like nurses! We're stripping and waxing the hospital floors again too, something we did last year when we arrived in Togo. But this year we need to get everything possible done before we sail...because we'll be hitting the ground running.

I haven't taken many pictures, because I would rather not get my camera covered in dirt and sweat and wax and floor stripper. But I'm sure there will be plenty of photo ops to come!

Going...going...gone!

2011-01-16T07:53:00.000-05:00

Hello friends!! The journey has started and I am at my first stop – Appelsbosch, South Africa! I’ve been pretty much without internet since Rochester, so let me catch you up on the last few days…

Jan 12 – 2200
I'm packed and ready to fly.

It’s the strange things that define my luggage. I imagine some unsuspecting TSA officer opening one of my checked bags to discover…whaaat??

Because seriously…who packs like this? Between the conservative dress skirts and rugged cargo pants the well-stocked first aid kit and SAM splints…shampoo and mosquito spray and a hammock with…enough doxycycline to make an elephant nauseous, a random bit of Tupperware, a single fitted sheet, an otoscope, a set of magnetic poetry. But no shorts.

There is a pattern to the inane, I promise.

I’m just trying to figure out how to explain to South African Immigration why I don’t have an actual departure flight…and that I’m not sure when exactly I’ll be leaving their country.
In the meantime, it’s time to wrestle a large box spring and mattress upstairs so that we can go to bed, and get up in a few hours. I'm hoping the snow stops enough that the flights out will still fly.

Jan 13, 2011 – 1230

I feel like a little girl at a sleepover, wandering around in sweatpants and fleece with a pillow under one arm. I’m stretched out now across a row of airline terminal seats, backpack slung beneath my feet, watching the people go by as I type and mourn the lack of free Wi-Fi in Dulles International Airport. A glimpse of scrub pants and a stethoscope earpiece peeking out from the open backpack brings me back to reality: I’m a pediatric nurse again, flying to Africa…now!

The rough spray of the de-icer ran across and down our small windows this morning, just before we took off into the soothing grey of early dawn. All of Buffalo was covered in snow, airport runways included. But wait…Buffalo is always covered in snow. No problems there, still good to go!

It’s been a blessed two weeks since leaving my travel assignment in Massachusetts, weeks full with packing and driving and packing and driving, brothers and sisters and close friends, dancing and celebration, and quiet evenings to relax with a cup of homemade chai with the snow falling thickly outside. I’m homeless right now, it’s true…but being homeless really isn’t so bad when you actually have about 10 homes filled with love. I can’t imagine anything more amazing I could have done with those two weeks.

South Africa still seems surreal – something that I’ve imagined in a dream. It’s hard to wrap my mind around the fact that I will be there in 24 hours. It’s exciting, but not really scary. In a way I could never have imagined this feels like, just maybe, I’m at the start of a long journey home.

January 14 – 2200

I met up with not the one Mercy Ships friend I expected, but 4! We made the flight together from Dulles and caught up on lost time. There is safety in numbers, and it’s always nice to be able to go to the bathroom without your whole world parked next to you in the stall.

We were waved through security with no problems. The official didn’t even look at my visa waiver letter; just smiled and said, “I trust you.” Surprisingly, our luggage made it too. It’s fun listening to all the different accents of English here – thick British, Dutch and Indian accents intermixed with the African.

We’re spending the night in a hotel, all five of us, because it’s too late now to make the drive out to Applesbosch. I’m the one with bedding, so I’ll be sleeping on the floor. And honestly, I doubt I’ll have problems sleeping as long as it’s a horizontal spot :-)

January 16 - 1400

It’s gorgeous here, and sunny and breezy, with frequent drizzly rain showers. I had quiet time in my hammock today…I’ve missed my hammock the last few months.

We’re living in Appelsbosch, at an abandoned college campus with rolling green hills stretched out to either side. It’s about 1-2 hrs drive outside of the port of Durban, so we’ll be driving in for now to work on the ship, until our generators are up and running. Here at least we have electricity, limited water, even limited internet. I share a room just slightly smaller than a college dorm room with another woman; we have shared bathrooms and showers with the rest of the floor. In comparison to ship quarters this is luxuriously spacious; we're enjoying it while we have the chance.

I’ve got one more day to recoop, settle in, figure out my paperwork, and then we’re jumping into work with a vengeance – cleaning and waxing the hospital floors initially, and then God only knows what. Probably everything. I’m excited to get started, and ready to work!!

Out of control

2010-12-20T11:20:00.001-05:00

It was a warm spring day in Binghamton when I joined the other carefully picked students for a "meet and greet" and tour of the campus for prospective freshmen and their families. One of the parents struck up a conversation, asking how I liked the school, what my major was, and if I had plans for after college. He was enthusiastic about the fact that I was majoring in nursing ("good job security there") but not so much about my future plans.

"Don't you know those people get killed?" he asked, obviously concerned. "It's not safe to go overseas. There are cannibals. You can't do that, especially not on your own. It's not safe," he repeated, with a concerned glance at his daughter as if she might catch some sort of contagious illness from me. I wanted to laugh, not really sure what to say.

I never told him that I grew up overseas, not always knowing from day to day whether it was safe to go to school, or if we would show up to church only to find it burning to the ground. We rode motorcycles and climbed exploding volcanoes, hid behind cars during riots, kept our bags packed for months at a time in case of emergent evacuation, and walked by the training schools that sent Jihad warriors overseas to fight the Americans. As childhoods go, it wasn't really a safe one. My future plans were only in keeping with the same radical existence...a realization that safety isn't everything.

It is dangerous to work in emergency nursing, never knowing what contagious diseases you may be exposed to or which patients will become suddenly violent. It isn't safe to sail to one of the poorest countries in the world, a country still recovering from 11 years of civil war and teeming with refugees and demobilized child soldiers, in hopes of reaching out to touch the hurting. But I don't choose this life because of my background or a blatant disregard for my own safety. It is in a realization that to live life one must encounter danger on some level. Danger is not only in a life of wild adventure, it is also in driving a car, in trying new foods, in living, in loving. Can we neglect our responsibility to reach out and touch lives because of a fear of failure?

We were never promised a comfortable long life as Christians - rather persecution and hardship. We were not promised riches, but instructed to store up treasure in heaven. It is an uncomfortable life and an uncomfortable gospel. Our God is not a "safe" God...

"Then he isn't safe?" said Lucy.

"Safe?" said Mr. Beaver. "Don't you hear what Mrs. Beaver tells you? Who said anything about safe? 'Course he isn't safe. But he's good. He's the King, I tell you." ~C.S. Lewis

"Hidup mulia atau mati syahid"...live gloriously or die a martyr. My neighbors in Indonesia understood radical faith...how is it that my neighbors in America have missed the boat? What is the point of hiding in a hole? To live a timid existence with minimum risk, only to die in a car crash or fade away with cancer? You may pass through life with no ripples in the pond, never having lived at all. Who is to know when your days are through and God will call you home? You are not in control of your future. It is God who is in control; God who holds you in the palm of his hand. As my Dad so often liked to say, "The safest place for us is in the center of God's will." A life of wild adventure in following Christ may not be overtly safe, but it is GOOD, and God is ultimately in control of what happens.

To others it may look like the terrifying adventures of someone with a blatant disregard for their own life. Trust me, I don't have a death wish. For me the safest place for me to be next month is aboard a converted ferry ship in the wide ocean, watching out for pirates, sailing towards a life of love amidst poverty, refugees, and ex-child soldiers. If I die a martyr...so be it. I will have lived gloriously in obedience to my King.

...I am out of control.

Prayer Letter

2010-10-29T15:20:00.000-04:00

It’s a shock to realize that what you once dreamed is no longer the dream of your heart. That where your heart once was is no longer your home.

It hits me hard when I look out on the beauty of small-town New England in the autumn and realize that, gorgeous as it is, there is so much more to life. My past goals of living here, raising a family, saving lives at a local hospital – it’s a transient reality, lived for a moment and then ready to go on the back burner to simmer again.

I thought that when I came home from Togo I could go back to normal, that the heartache would heal in time. Instead I find myself still there, in the stark, bare reality of a life without resources and a soul joyfully reflecting the glory of God, regardless of the cost. My skin may be white, but my heart still beats with the rhythm of the djembe. My naiveté has been lost and instead I sing with Brooke Fraser, “Now that I have seen, I am responsible; faith without deeds is dead. Now that I have held you in my own arms, I will not let go…”

I found myself debating the point with a doctor from work at 4 am this week. Night shift can sometimes be good for substantial debate. Dr. Duke is wrong…a life of service cannot and should not be separated from faith. In reality, a life of service can only be lived by faith, a reflection of Christ at work in a soul…a heart surrendered in worship. Otherwise it becomes dry and meaningless.

And so, friends, I am headed back to West Africa. To be a part of the miracle of a child living only by the grace of a good God and the fervent prayers of a mama. To love the outcast and touch the hurting. I will be a pediatric nurse again with Mercy Ships, this time in Sierra Leone – a country already torn apart from years of war. My commitment is from January - May, 2011, and I am very excited!

I plan to meet the Africa Mercy in South Africa for the sail to Freetown, Sierra Leone. Along with my responsibilities as a pediatric nurse I expect to participate again in surgical screenings, respond to the need for Pediatric ICU (PICU) and ICU nurses, and most likely joining the emergency team again as well.

I covet your prayers and welcome your support. Because all of our surgeries on Mercy Ships are provided free of charge, I will need to raise just over $5000 for my 4 months of crew fees and the plane tickets. Regardless of whether or not God leads you to contribute financially or join me overseas, please pray for my co-workers, patients, and myself. Please pray for volunteer medical staff to be raised up, for God to prepare our way in the hearts and lives of the West Africans, for safety and for opportunities to witness. I have continued keeping up with my blog here at this address, and plan to continue to do so throughout my trip.

To learn more about Mercy Ships or make a donation, you can visit my page at https://connect.mercyships.org/page/outreach/view/crewmates/colesl. Donations can also be mailed directly to Mercy Ships, P.O. Box 2020, Garden Valley, TX 75771, with a note attached that they are for Acct # 2699.

Aiming to reflect His love,

Laura

Reflection of Glory

2010-10-25T17:08:00.000-04:00

Autumn in New England is a glorious thing; autumn in the Berkshires is no less beautiful. Stretches on vast stretches of rolling green-and-gold hills. A mountain view on the walk into work that makes me just stop, and stare, and sigh. My heart sings with the brooks and creeks as they wander along the path God guides them in.

I stop for a moment and stare, lost in the reflection of fall colors so perfect it's hard to know which is reality and which is only the reflection in the smooth water. A few hundred feet down the current swirls, speeds around rocks, and the perfect image is broken.

We were created to reflect the glory of God. It's hard to remember that sometimes, living in a world that frowns on vulnerability, encourages us to trust in our own strength. In a job where I need to present confidence and competence in the first few minutes of meeting a patient, twenty, fifty or a hundred times a day. Where co-workers tell me that service overseas is a farce of proselytizing and coercion rather than a God-given calling and ministry. Where genuine joy is the oddity and not the typical.

I love the Emergency Department. It's not the adrenaline rush, not anymore. It's reality. Where facades are stripped away and people show who they truly are. I miss the innocence of before, but now that I know the reality I can't stay away. It's not just in Africa where there are the poor, the forgotten, the outcast and the needy. They are here too, our neighbors and friends, the town drunk, the lady camped out under the bridge, the girl who intentionally overdosed, the young father with a new diagnosis of cancer. It's just that here in America we try to hide our brokenness. It may not be physical, not always. We have to look a little harder to see beyond the mask.

Lord, to these the hurting let me be a reflection of Your glory, albeit still a little broken sometimes.

The limitations of Wong-Baker

2010-10-03T14:04:00.015-04:00

I was getting patient report during an early orientation shift at an ED nursing travel job in New England. The nurse reporting off added as an afterthought..."oh, and you may have trouble communicating with "John". If a family member's not there you may need to call the translator."

I went and assessed my patients, had a nice conversation with "John", and came back out to touch base with my preceptor for the day. "Oh, and "John" is doing well, no nausea, vitals are great, and he needs a little more pain medicine."

"So, family was still there?" she asked.

"No, he stepped out, but he'll be back in a few minutes." And no, I don't know "John''s language. Within a few minutes I found myself explaining to a new staff how I came to be semi-fluent in medical pantomime.

It was difficult for them to wrap their American medical minds around a place where ATT translators are not readily available. Where we hire aides for their language skills rather than medical knowledge and background. Where conversations may go through multiple nurses, translators, and other patients or family members. Where a little girl and her uncle could spend a month on a ward with no one who spoke their language, and our one translator for them came

down a few times a day; where complex sterile dressing changes, NG feeds and assessments could take place with little or no verbal communication if necessary.

And so in an effort to convey the challenge and the reward of care in this environment, I found myself telling them about Sayeed.

Sayeed was born nine years ago into a society and culture where any physical disability could be fatal. Babies with any deformity could be thrown out on the belief that they were cursed; even if the family kept a child he became a liability because the family had to care for his needs. Until May, Sayeed lived life on his hands and knees.

I first took care of Sayeed just as he was coming out of the recovery room. His beautiful innocent grin lit up his face, a response to my welcoming smile as he rolled in the doors of B ward. One of the translators was next to me for this first crucial moment - an initial set of vitals and assessment, explanation of postop procedures, circulation checks and pain medicine. Reassurance that he would have his own legs back and they were indeed still there under the strange hard whiteness of the casts. He wiggled his toes, giggled and gave me a thumbs up when I pinched them, and pointed to the smiley face (0) on the Wong-Baker pediatric pain scale, then settled in happily coloring.

I opened his chart to look over the postop orders and stopped, half-stunned, at the medical history: cerebral palsy. Only the strong love of a mother and the grace of God could have brought him this far in the villages of West Africa. I glanced over at his bed and he gave me a brilliant smile and thumbs up, then went back to coloring.

He breezed through the first few hours after surgery with no complaints, no problems, no need for pain meds. Around dinnertime I went to check on him again, a routine becoming familiar to him by now. He turned on the pulse ox and put it on his finger, put the thermometer under his armpit and held it there until the beep. Vitals...WNL. I pinched his toes and wiggled my fingers. He grinned and wiggled his toes, gave me a thumbs up. CMS checks...good.

Finally I pulled the laminated Wong-Baker faces scale off the wall and ran my finger along it. Are you having pain, Sayeed? He pointed to 4, a slightly sad face, and gave me a happy smile. I pointed to the 4, shrugged and looked confused, and ran my finger along the scale again. Are you sure you are having 4/10 pain? Again the nod, beautiful smile, finger on the 4. Then he went back to coloring with his mother.

Confused, I called over one of the translators. "Yaovi, can you ask Sayeed if he is having pain?" I asked. He came back with the same answer, "A 4, Afua."

"But Yaovi, he looks very cheerful. Can you ask him again if his legs are paining him and if he would like some paracetamol?" He did. "Afua, he says his legs do not hurt, and he does not need medicine."

Now I was really confused. "Then why did he tell me it was a 4? Can you ask him what he thinks the faces mean? Yaovi did, and came back laughing uproariously. "I think he does not understand the faces, Afua. I have taught him again what it means."

I found out later that the faces meant something a little different to Sayeed than what Wong and Baker initially had in mind. The zero- I am having a lot of fun; a two - I am having fun. A four...I'm a little bit bored. I love the pure, uncomplicated mind of this little boy who was completely unconcerned that he would be the object of horrified pity in my country, a symbol of family shame in his. He didn't know that he had just had surgery and by any stroke of logic he should be thinking about his legs, crying, fighting the nurses....instead, in total innocent oblivion he trusted that we would fix his legs. And in the meantime, he just wanted to play!

Sayeed hanging out with a few of his friends at the Hospitality Center, including Bo, Komla and Abe. Photos by the ever-talented Liz Cantu.

Mental preparation

2010-09-29T01:52:00.003-04:00

As my next trip to West Africa with Mercy Ships is coming up soon (YAAAYYY!!) I've been planning ways to get back into the groove. After all, living on a ship and working in this unique hospital does take some creativity and adjustment. If you have been thinking about living or working on board a hospital ship in West Africa, feel free to try a few of these out and see how well you adjust. And of course, post and let me know how it works out for you!

*Disclaimer…”hospital life” suggestions are not meant to be tried in actual American hospitals, as some of these are by design not intended for western healthcare facilities.

Ship Life:

Invite five of your friends to stay with you for the next three months. You should all live in a partitioned one-room apartment, and take turns sleeping in the closet. Remove all the doors and hang curtains instead. All wall decorations should be magnetic.

Most of these new roommates will be medical professionals. At any given time, two should be working days, evenings, and nights respectively. Rotate shifts to keep things interesting.

At least half of your new roommates should speak another language. Learn medical terms in that language and try them out at work.

Set aside a small room for privacy and prayer, and spend time there regularly. Donate books in 10 different languages to the local library. Check them out in the middle of the night.

Line up for mealtimes at 0730, 1200 and 1700 each day. Eat together with 400 of your closest friends. Have fried plantains at least once a week.

When you go out into town, don’t wear shorts no matter how hot it is. Go with at least 5 other people for safety. At least 8-12 people should fit into each taxi...15-20 per van. Never pay the initial asking price. Sit on top of each other. Bring goats.

Move somewhere very sunny, and then take Doxycycline. Keep your apartment temperature above 90 degrees. Drink at least 4 liters of water daily. Eat the goats.

Fill plastic bags with water. Refuse to drink any water that comes out of the tap. Instead, drink out of the bags...or your nalgene.

Leave a lawnmower running in the living room for proper noise levels. Occasionally bang on pots. Turn on the vacuum every time you flush the toilet. Color water green and put it in the bathroom. Once a week measure some out and flush it down the toilet.

When you take showers, make sure you turn off the water while soaping down. Limit yourself to two total minutes of shower water per day and one load of laundry per week.

Have a birthday party at least once or twice a week. Invite 50 friends. Play baseball with an empty Pringles can as a bat. Cook plenty of sweets, using at least 5 mangoes. If you bake a cake, GoogleTranslate the instructions into Dutch, then ask your roommates to help you figure them out.

Stop wearing heels. Climb 50 flights of stairs per day. Watch the sunset over the ocean.

Ask famous national leaders to visit. Invite them to make a speech, or share their testimonies. Then give them a tour of your workplace. Introduce them to patients. Throw them a party.

Bring maracas and drums to church. Dance excitedly during worship. Encourage friends to dance with you. Sing in several different languages. Provide two translators for the pastor. Have a 100 person church service in your living room with all the patients from the hospital.

Announce emergency drills every other Thursday afternoon. Gather with a group of your friends in the dining room. Pretend to do CPR. Every few months change the drills to 3 times a week with life jackets. Take roll call.

Set up a rotating schedule to watch for pirates. Dress up like pirates. Watch Pirates of the Caribbean on a laptop. Then watch Titanic and the Guardian. Then hide for an hour in an undisclosed location.

Get up excited for work, knowing that God is in control and making a difference in hearts and lives!

Hospital Life:

Make individualized balloon animals for each patient. Hang them above their beds. Play volleyball with the balloons.

If family members want to stay, provide mattresses for them under the bed. Encourage family to stay for a few days...the more, the merrier!

Put all the patient beds two feet apart. Encourage your patients to get to know each other.

Pantomime all instructions and questions to patients. Insist on teaching each new admission how to use a toilet. Put up signs depicting improper toilet use.

Go to work in flip-flops. Bring your Ipod. Play music with a catchy beat to entertain the patients.

If the patient needing a transfusion is your blood type, offer to be the donor. Have your friend collect the unit while your bed is moving. Then start the IV and transfuse your own blood...by drip.

Refuse to use prefilled saline flushes. Draw up all of your own flushes instead. Wash the medicine cups and basins, and the Toomey syringes.

Start IVs with an emesis basin at the bedside. Don’t retract your needles; instead, put them in the basin. All IVs should be 18ga or larger.

Carry your pediatric patients up several flights of stairs, then take them outside in the sunshine and let them play on tricycles. Draw pictures on their casts with sharpie markers.

Refuse to use regular IV pumps. Instead use burettes, or syringe pumps, or calculate drip rates.

When the pain meds aren't working...blow bubbles, color, and put on fake tattoos!!

Dress your patients in surgical gowns and caps. Have tricycle races at 5 in the morning. Then wrap their IV sites in trash bags and encourage them all to shower.

Chart all of your temperatures in Celsius and weights in kilograms. If a temperature is above 37.5 consider malaria.

Hang privacy curtains from hooks in the ceiling. Move them around according to need.

CPAP? Take apart the crash cart and put together equipment that fits. Use Coban instead of elastic face straps.

Regularly have dance parties at work. Play the drums. Encourage your patients to play the drums. Provide crochet hooks in place of drumsticks.

Pray during shift change and ask your patients to join you. Wear matching scrubs with all your co-workers.

Play Jenga with your patients.

Scrub the wards on your hands and knees…on camera. Then watch when Discovery Channel airs the episode.

Pray during emergency codes. Ask for the resuscitation trolley. Who needs a crash cart??

Make sure to specify if a regular diet includes snake or not. This may be important.

Announce an emergency blood drive overhead. Draw blood from all your friends that are A+ or B+.

Need to do a stress test? Have your patient run up and down several flights of stairs, and then do an EKG.

Import medications from Europe. Ask other nurses to translate instructions for you. Refer to acetaminophen products as “paracetamol” and Versed as “midaz.” Double check with pharmacy before giving your IV medications orally, and optical preparations aurally.

Let your patients check their NG tube placement when you do, and ask if they would like to watch dressing changes with a mirror.

Crying baby? Tie them to your back with a sheet and keep doing your nursing work. They'll happily fall asleep soon.

Look at the drool spots on your scrubs...and smile fondly at the adorable brown baby who fell asleep while you were charting. Thank God that you get to be here.

Sierra Leone 2011!

2010-09-22T02:09:00.002-04:00

I'm going back...and I can't wait!

Since I got back to the States in May things have been different. It's a good different, a challenging one. I love what I do here, but I found that I've left pieces of my American-Indonesian heart with the innocent little brown hearts I met aboard an ex-Dutch ferry boat. It's no longer a constant ache. I don't feel as guilty about showers longer than two minutes, I don't accidentally use Ewe or French in my sentences any more. But it hasn't totally gone.

There are reasons I'm in the US right now. But that doesn't stop my heart from asking when I can go back. There are so many triggers - the lyrics of a song, a call from a friend, an innocent co-worker's question about where I've traveled as a nurse....

All this brought me to my knees one afternoon at the lake, asking God for the privilege of being his hands once again aboard the white mercy box, for the opportunity to love on the unloved, that he would give me His heart and break it once again.

Questions like that should only be asked if you mean it. Because it's not a question of whether we are called to missions, but where. It's not if we are called to love, but how and who.

Isaiah 58 is a chapter that's spoken to me in the past, a set of Bible verses God has used to direct my choices of who and how to love. There is nowhere more than aboard Mercy Ships that I was truly able to say that verses 6-10 were truly being fulfilled in my life. But I hadn't really paid attention to verse 11 before: "The Lord will guide you always; he will satisfy your needs in a sun-scorched land and will strengthen your frame. You will be like a well-watered garden, like a spring whose waters never fail."

I think I can honestly say that God has a sense of humor. With this verse that afternoon I felt his clear call back to a sun-scorched West Africa, and with it direction and peace on a number of other questions I had been wrestling with. Friends, I can tell you with certainty that unless something drastically changes, I'll be headed back to Africa with Mercy Ships from January-May 2011!! I'll be a Pediatric Ward Nurse again, knowing that this will not be my only job. There will be ICU and PICU shifts again with my heart in my throat and a constant prayer on my lips, the difficult IV starts and lab draws saved for an ER-trained nurse, riding a stretcher down the narrow metal corridor doing compressions as a part of the Emergency team, the challenge of caring for a friend, crowded screenings in the hot sun and surrendering my own need for control when He chooses to take a child home forever.

My heart, still healing from my last trip there, is going to be irrevocably broken, again and again and again. While I'm not sure my heart can stand another medical missions trip to West Africa...I'm sure without a doubt that I can't afford not to go. Africa needs me, sure. But I need Africa more. The fog is gone, and I can see clearly again.

Isaiah 58: 5-11

⁵ Is this the kind of fast I have chosen,
only a day for a man to humble himself?
Is it only for bowing one's head like a reed
and for lying on sackcloth and ashes?
Is that what you call a fast,
a day acceptable to the LORD ?

⁶ "Is not this the kind of fasting I have chosen:
to loose the chains of injustice
and untie the cords of the yoke,
to set the oppressed free
and break every yoke?

⁷ Is it not to share your food with the hungry
and to provide the poor wanderer with shelter—
when you see the naked, to clothe him,
and not to turn away from your own flesh and blood?

⁸ Then your light will break forth like the dawn,
and your healing will quickly appear;
then your righteousness will go before you,
and the glory of the LORD will be your rear guard.

⁹ Then you will call, and the LORD will answer;
you will cry for help, and he will say: Here am I.
"If you do away with the yoke of oppression,
with the pointing finger and malicious talk,

¹⁰ and if you spend yourselves in behalf of the hungry
and satisfy the needs of the oppressed,
then your light will rise in the darkness,
and your night will become like the noonday.

¹¹ The LORD will guide you always;
he will satisfy your needs in a sun-scorched land
and will strengthen your frame.
You will be like a well-watered garden,
like a spring whose waters never fail.

moving on

2010-09-21T16:02:00.004-04:00

The leaves are just starting to turn, green and red rustling softly together in the breeze. Blue skies and the mountains behind visible just outside my apartment window, it promises to be a beautiful autumn.

After a busy summer in NH, a relaxing week with family in Virginia and one with friends in Binghamton, I stopped off briefly in Potsdam and Saranac before hightailing it off on another adventure. I also got to go hiking in the Adirondacks with a Mercy Ships friend, enjoying the gorgeous view of mountains and lakes all around at sunset from the fire tower, topped off with a long and bumpy ride along narrow unpaved roads.

Travel nursing really can be described as nothing less than a crazy adventure into the unknown. 3 weeks on ice - with not-quite job offers from 3 hospitals in the Dallas area, I started wondering if there was a hiring freeze, or if perhaps Texas was plotting to secede from the union. Then after a brief and cheerful phone interview I found myself rather dazedly accepting an offer that seemed almost ideal in a state I was already licensed in...and an ASAP start date.

I've been here just over a week. After a brief and intensive orientation I found myself on my own, ED nurse once again. It came back to me quicker than I could have hoped...the first large bore IV slid in easily, the impersonal beep of the cardiac monitor registering "NSR, we're good" in my mind, a slightly quickening pulse as the sirens get closer, a calm smile for the anxious mother, a high-five from the 6-year old who "wants to be a doctor when I grow up". It's not the glamour and adrenaline rush of another life saved...not always. It's not the desperate creativity of a nursing staff without first-world resources. We don't dance at shift change or pray as a staff for the little ones that have filled our hearts. No, it's not quite the same.

But it's still a mission field...MY mission field for the next few months until I follow my heart back to the rolling blue waves that rock me to sleep and deep brown eyes that dare to hope despite the pain they have known. I still pray for eyes to see the wounded soul behind a cursing demand for narcotic pain relief, the drunken stupor, the anxious questions, the intentional drug overdose, the look of fear at the sound of a baby's wheeze. These are hurting and in need as well, just here it comes across a little differently. America has the needy too - people in need of hope, of reassurance and love, of a sense of purpose and an understanding that material wealth and drugs cannot solve all of their problems either. Lord, give me patience and love for these ones too...

Finally Home

2010-08-03T13:00:00.008-04:00

I found out just a few days ago, chatting with one of my Mercy Ships friends over the telephone. We were rejoicing over Abe's recent reunion with his family after months of surgery and physical therapy, overjoyed that he finally made it home. He is walking and running again, with chicken legs now straight like any little boy's legs should be. I can see him beaming at me from bed 5 in B ward, drumming away happily on the djembe with two crochet hooks for drumsticks, patiently waiting for the day that he would be able to play football with other boys again. He's there, he's home...excitedly showing off his new straight legs to the village, a living testament of God's healing power.

And then she said it. "I don't know if you heard, Laura, but Mariam died at home a few weeks ago. Her husband called the ship to let them know." No, I hadn't heard. Mariam was the little mother we had given a pint of my blood just a few months ago in April, a fixture in our ICU for weeks as the doctors struggled for a diagnosis. Her husband read his bible over her and prayed as the nurses flowed around him in the choreographed dance of IVs and fluids, monitors and medications. We sent her home with a tracheotomy - still not knowing why she couldn't breathe when we took out the tube.

I flashed back for a quick second to the night I met her - the concerned voice of the charge nurse asking for an ER nurse to start an IV as I untied my lappa and gave away the baby on my back, the pale resigned face in the bed, the one small vein I carefully slid the IV catheter into, the smell of benzoin and alcohol, the voice of our translator/pastor Yaovi telling me "I don't need to explain to her what you will do, Afua, the other nurses have tried this already. But I told her God gave you magic eyes to see the veins that no one else can."

I can see her smile around the endotracheal tube that allowed her to breathe those first few days, hear her husband greet me by name as I come back to start another IV, and another, and another over the weeks that followed, feel the tears on her cheeks and mine as she hugged us good bye and mouthed "akbe, akbekaka" as she walked home - breathing from a hole in her throat, but definitely breathing on her own.

I'm happy for her to finally dance free, to sing again in praise, to breathe without anything to hold her back. I grieve for her husband and little boy. Please pray for them as they face a life without her...with her gone home ahead of them.

Pray also for the Mercy Ships crew - finishing up the outreach and headed home all over the world. Pray for strength, for patience, for love and for a sense of wonder at home as well as in Africa. It is so easy to wonder at the clear evidence of God at work there in the bright sunshine, to dance in praise to the beat of the djembe, to love on the little ones that have lost so much and yet still smile and hope. Sometimes things are not so clear here; sometimes it is hard to see through the fog.

Life after Africa

2010-07-04T10:14:00.002-04:00

Friends, this post is long overdue and I apologize for the delay. Life since I got back from Togo has not slowed down. If anything, it's speeded up into double overdrive and some days I am hanging on for dear life watching the scenery race by.

God has blessed me beyond what I could have imagined. In between snippets of time with friends and family and co-workers, I've also been working and started back up at school. Most of May was with InterVarsity at a camp in the Adirondacks - working on-call and leading small groups and work crew. It was an incredibly busy time but also truly blessed. Spending a life truly focused on God and His glory, and worshipping with hundreds of other believers with that heart really was incredible. And as I pushed myself to the limit I realized exactly where that limit lies, and how important it is to rely on God for everything. It is in my own weakness that I am truly strong.

Come mid-June I headed over to New Hampshire, where I'm the full-time camp nurse at a lakeside Christian camp. I still get to take care of kids, but it's a little different here. They all speak the same language as me. We don't have spontaneous dance parties. Most of them are the same color. I don't get peed on as much. Most of them grew up knowing that they are loved.

They're still kids who need care and love, but are already privileged beyond what they will ever know. There is clean water, and food, and vaccines, and medical care. And while there is still the sadness of broken homes and unloved children and sickness sometimes, there is not the constant tragedy of the poor, the broken and deformed, the outcast, the discarded child. And while my heart still breaks, it's not the constant and overwhelming crush of pain.

I'm still asking God every day why I'm not in Africa. When I will get to go back and pour out into a people that still need to know they are not forgotten. Whether I will be back on the big white Mercy box as a constant and living expression of His love for the lost.

But for while I'm here, let me live that love for these kids. This staff. These co-workers. This family.

The day I was a vampire

2010-05-23T11:04:00.003-04:00

There is nothing like living on a mobile blood bank...nothing.

Rewind back with me to just over three weeks ago. I, again, should have been sleeping. Instead I was up praying for Brian and his mama, as I had just heard that Brian had been transferred back to the ICU that morning, and I was sure I would be taking care of him again that night, if he made it that long.

Unable to sleep, I read and prayed for a while, then made my way up to deck 8 to relax in the sunshine, enjoy the breeze, and watch the sun slowly sink into the ocean. I had been up there a few hours and was almost asleep when we heard the announcement, "All crew with type A+ or B+ blood please report immediately to the laboratory. If we do not find enough donors then surgeries may have to be cancelled." I packed up my things and headed down, knowing they wouldn't let me donate again after just 3 weeks, figuring I could help draw samples or units for donation. Less than a minute later I found myself unable to get down to the lab via normal routes; the stairs were already packed with potential donors, and nurses there to volunteer. As I rapidly set up a makeshift phlebotomy station with tourniquet, tubes and alcohol, I heard the next overhead page. "All nurses not currently working, please report to the laboratory immediately." And the floodgates opened.

Most of our patients have type A+ or B+ blood. We have no way of separating blood parts, or even properly storing units, which means donors must be an exact match, and donate immediately before transfusion. Since A+ and B+ are less common among Caucasians, those of us with this type blood and no debilitating illness end up donating often, though even this is not always enough.

An hour later I found myself marveling along with the lab techs at our small miracle. Down from 1 B+ donor left on the grid, we now had several. Enough A+ blood for the next few weeks, Lord willing. Deckhands, ship officers, doctors, galley crew...and the nurses! There were nurses everywhere, donating blood, collecting, and generally helping organize everything. It's amazing to live and work in an environment with such a heart for others. Thank God for my amazing crew mates! And God bless them as they continue their work and service...with just a little less blood now that it's been given away.

Peace and rest

2010-05-09T10:22:00.005-04:00

Last friday...

I should be sleeping, or packing, or spending a last few precious minutes with friends. But instead I can only grieve.

I got the call this afternoon, just as I settled down for a little packing and then a post night-shift nap. "Hey Laura...Brian just died. I know you took care of him a lot so we wanted to let you know, you're welcome to come down to the ward." He was 5 months old, and weighed 7 pounds. A whole month of his short life he spent aboard the big white Mercy box with tubes and oxygen and monitors so he could eat and breathe. Was it only a month ago God had reached out his mighty hand and allowed him to breathe again before we put down a tube and began to breathe for him?

Last night he was my baby again, swallowed up in the big ICU bed as he fought for each breath-80, 90, 100 times a minute. Bits and pieces of shift report from the charge nurse floated through my mind, "his heart is enlarged because it's so hard for him to breathe...can't tolerate CPAP again...we talked to his mama already...no heroic measures...he would never come back off the vent...only a matter of time now." I lived the long shift in moments and in breaths. It was a constant prayer: to get back in the IV catheter he had pulled out in his struggles, for healing again, to stop his vomiting and bring down the fever, and with each rapid breath that he would take another one. By midnight I had stopped praying for miraculous healing, and in a desperate "your will be done," I prayed for peace and rest for my little boy...whatever it takes.

He settled only in the safety and security of my arms, so I sat and we cuddled. Sharon and Clare peeked in on my other sleeping patients, brought me food and water, while I whispered to Brian of his mama's love and sang him a promise...

You will be safe in His arms

'Cause the hands that hold the world are holding your heart

This is the promise He made

He will be with You always

When everything is falling apart

You will be safe in His arms

And we had a small miracle. He rested and slept. The hot little body stayed snuggled in my arms, the oxygen blowing reassuringly in his face and hand curled in trust around my index finger, and he slept.

While in my head I know that baby Brian is better off snuggled happily in the arms of God, eating and drinking on his own and breathing effortlessly, my heart cries for the little mama going home with empty arms and the baby that never had a chance to live. We helped his mama bathe the tiny gray body, dressed him in a white fleece jumper and warm hat, and mingled our tears with hers. She called for each of her nurses by name, those of us who weren't there already, and we filled the room to sing and pray and show her in a language without words that they were dearly loved.

It may not be the miracle that I would have asked for. We had one healing, and like a greedy child I demand why we didn't have another. And while I don't understand it, I pray that it is enough. The extra time Brian's mama had with us, to open her heart to Jesus. An extra month of love with a broken little boy. The terrible, amazing thing is that my desperate constant prayer of that night has been answered in full. Brian has been healed, fully and forever, and he is finally at peace.

Welcome home?

2010-05-08T16:57:00.002-04:00

I wanted to tell them it was a mistake. That we needed to turn the plane around so I could go back where I was supposed to be. I may be in the country I call home, but while it is good to see friends and family again I feel like this is the dream, and there is the reality. So as I do the jobs I've committed to do here, knowing that this is where God wants me NOW, I'll be praying and see if maybe I am supposed to go back next year to where I've left little pieces of my heart scattered all over the red clay and wide brown eyes of Africa.

So much happened in the last four months; it's impossible to sum up in a dry and sporadically written blog with a few pictures. I've left out so many pieces of my life because there simply wasn't time to write. Even within my last week aboard, so much happened that I could only be and be a part of...and store up everything to process later. So if you don't object I plan to continue sharing bits and pieces of Africa and my life with Mercy Ships, interspersed with the ministry and life to which God has called me for the rest of this year.

Why me...why Africa?

2010-05-01T09:15:00.005-04:00

I was thinking about that question this week, as I prepare to leave and head back to the States. It's easy enough to spout platitudes about helping the poor, to say that I'm a nurse and help heal the hurting. Truly, none of us can take credit for any of this. The more I work in the medical field the more I realize that no matter how good of a job I do as a nurse, it will never be enough. I just do the best job I can, pray, and have to let God do the rest.

So why am I here? It didn't make sense to me at first. An ER nurse going to work on a surgical ship as a pediatric postop nurse; a girl fluent in Indonesian and English going somewhere where they speak French and Ewe. Wouldn't it make sense to go somewhere else, to be involved in something other than surgery? In short, why did God tell me to come to the Africa Mercy?

It was for you my prayer partners to be a part of something bigger that challenges all you might take for granted. It was for the patients and families to see an expression of Christ's love for THEM. And it was for me. I've been strengthened, challenged, stretched, and had my faith deepen in a way I've never known before. I have had my heart broken for the things that break Christ's, and my eyes are wide open.

Life is not all about making sense. That's the wild and crazy thing. It is in our weakness that God can show His strength. Being here, in part, is for me. When I realize my own limitations it is so easy to step back and let God take over. Things that I've never seen happen in the US, things that go against all my emergency training, somehow work. Prayer works, in desperate situations where nothing else does. The prayer, the life, the love and the service is direct contradiction to everything my culture holds up as an ideal, a healthy challenge to a worldly standard. He truly is showing his power in the lives of these patients, my coworkers, and my life. And without a doubt, worship will never be the same after the wild ward church dancing!

Would it have happened without me? Absolutely. Will it go on when I leave? You bet. Can God work in and through my life and talent? That is why he gave them to me. I was here for a purpose. I was here to strip and wax floors and bleach the hospital inside out, to give Mariam my blood when she didn't have enough of her own, to put IV after IV into her and other patients with dehydration and difficult veins. To get a struggling little girl through her first postop night in the ICU, to hold pressure on a bleeding artery, to be CPAP for baby Brian and to soothe and cuddle him as he fought for each breath, to grieve with his mama at her devastating loss. I was here to have long talks with roommates and friends, to give back massages, to carry a love-starved child on my back until she fell asleep. To sing on deck in the sunrise of an Easter morning, to dance with cast footed kids to the beat of the drums, to bring my last gatorade packet to a sick friend or nurse them through an illness...

But if it was only one of these small things that I was here to do, it would be enough...just one.

Angels amongst the Sons of Men...

2010-04-27T06:40:00.002-04:00

I wanted to share a poem with you, written by a patient aboard the Africa Mercy last year...a tribute to my co-workers. It's also a challenge to you and to myself, to stop and think about how others see you in your life and work. Are YOU the light of Christ, am I the hands of Christ to a hurt and dying world? And if not, what needs to change?

Angels Amongst the Sons of Men

The day the Big White Whale landed on the black shores of Africa
was a blessed day to the Sons of Men.
It came with Angels to walk amongst the Sons of Men.

Why do I call them Angels?
Let me tell you of my time with them.

I came on board the White Whale
with rooms filled with the lame
the maimed
the formed
the deformed
the wrong
and the rough.

And deep into the darkest part of the night,
I saw men and brethren,
maidens and ladies,
though flesh as us,
yet with hearts as Angels.

Sleeplessly and tirelessly they toiled through the night,
through the pains and aches of men;
they with hands to heal and mend,
bringing from above the Father's love to the Sons of Men.

Some they cut.
Some they tie.
Some they seal,
and yet others they fix with tools untold.

Like messengers of the Most High they came.
Not thinking of their own,
they risked their lives
and sailed the seas to lands beyond the endless world,
to shores of Men afflicted and in pain.
Their hearts and lives they came to share,]
as Angels walking amongst the Sons of Men.

Some in this life are born to pass,
and some are born in life to live,
yet these Angels are born to preserve humanity.

Though some may see lives as waste,
yet with speed they move to save.
With words of love and touch of peace,
they endlessly toil to make right the wrong.

You were born as Men to your lands,
and yet as Angels you served the earth.

Gold is digged from earth beneath.
Treasures are hunted on high seas.
But love so pure and true
can only in hearts like yours be found.
Your labor in the Lord shall not be in vain.
For every life you touch and every soul you save,
For every bone you mend and every face you straight,
The Lord of Life and Light will light your path
and guide your life.

For you are truly Angels amongst the Sons of Men.

noma

2010-04-24T15:29:00.002-04:00

No, not Rob Bell's video productions. Noma is a disease that most of us in the western world have not even imagined, much less seen. Photos, inservices, and teaching times aside...up close and personal, noma is a pretty wacky illness. I had my first noma repair patient for the last few days, a full challenge and a half!

"an acute, necrotizing ulcerative process involving mucous membranes of the mouth. The condition is most commonly seen in severely malnourished, debilitated persons, especially children with poor nutrition and hygiene. There is rapid spreading and painless destruction of bone and soft tissue accompanied by a putrid odor...Treatment involves high-dose penicillin, debridement, and improved nutrition. Healing eventually occurs, but often with disfiguring defects."

That's cut-and-dried for, "sorry kid, you don't have a face any more." At 7 years old, that can be totally devastating.

Aimee arrived on the ward a few days ago. She is one of the survivors, the 10% that make it through acute noma to live an ostracized life, hiding the hole in her face with a rag, struggling to chew soft foods when they fall out as she chews...without even daring to hope for normalcy. Graft after graft have failed, leaving a scarred cheek and a scarred heart. One of the blessed ones - her infection was caught early, before it took an eye or nose. She's chunky now, her exhausted body on my back and soft cheek relaxed, tired from the last love-starved tantrum that we ignore, basking happily in the aftermath of love. We talk in pantomime, waiting for the one staffmember that speaks a little of her tribal language to come down so we can explain surgeries and dressings and drains and tubes. Our plastic surgeon had been held up in Europe, airplane grounded by a volcano a million miles away.

As of yesterday, Aimee has a face again. The physicians assistant that brought her from Cameroon came down to excitedly show photos of surgery - of sutures and skin where there was no skin. My night was filled with IVs and antibiotics, NG tube feeds and codeine and JP drains...and mainly just praying hard that our irrepressible little girl with discipline issues wouldn't pull any tubes out or sensitive plastic surgery dressings off. Her bandages won't come off for a few days yet (we hope!), but we know that underneath there's a new face just waiting to smile!

I am not forgotten

2010-04-22T07:01:00.006-04:00

Chantalle's face lit up as she danced her whole heart out in praise to the Lord. Arms lifted high in praise, her feet pounded out the rhythm along with other mama and patients, a worship service like no other. Because this congregation is still bandaged, still bleeding, still casted, still disfigured. Nurses mixed in with the patients - a fussing child tied on a yovo back here and there to give a mama some relief.

Jasmine sat on my lap, still drooling a bit after her palate surgery almost a week ago. I remember just the day after I had taken care of her in the ICU mama called me over on deck to rejoice with her that the nasal airway was taken out and she was breathing well on her own. The little nose is clear now of airways and feeding tubes, the small fingers twined around mine as we sing, "I can't do without you in my life, oh Lord..."

Baby Brian lay in mama's arms in a corner bed, body bouncing a bit as she clapped in time. He is still on a bit of oxygen, our miracle baby is still a sick little boy, still has his moments where he struggles to breathe and then stops, to start again.

Like everything else in our floating world, the songs and sermons and sharing are a mix of English translated to French to Ewe and Fon, or vice versa. The maracas and small drums played by patients and staff, a whiskered cleft lip baby dancing on his mother's lap. A little girl with her face melted away by Noma banging legos together and singing in a language no one else understands.

It puts my heart to shame, witnessing this unabandoned joy in worship. How often do we refuse to rejoice, refuse to be thankful, thinking of all that we could have. And these who have nothing, worshipping with everything they have. Those who have been cast out and forgotten, the broken and hurting, with maybe just enough to survive.

I haven't told you about Chantalle. She came early with her little boy Mark, a skeletal 4-month-old with a smile for everyone. Bit by bit he gained weight, tucked away in a corner of the ward or at the hospitality center until his lip and palate could be fixed. I didn't recognize him when I saw him again, with dimples in his knees and a chubby fist tucked in around the cleft.

Like so many of our babies with holes in their mouths, he inhaled his milk one day and surgery had to be postponed until the pneumonia was treated. Finally the surgery day arrived, only to have his throat close down in reaction to the anesthetic gas. Emergently intubated, then trached, Mark is still in the ICU with a hole in his throat allowing him to breathe, connected to oxygen and tube feeds and central IV lines. "What about this one," I asked God. "Ana you took home, Brian you kept here. Have you forgotten this one?" And yet in all of this Chantalle continues to praise her Lord with her whole heart, with total abandon.

What makes us think that we can demand things of God, that we are entitled to privelege, health, and wholeness? When is it that we will finally be able to say with Job, "The Lord gave, and the Lord has taken away; may the name of the Lord be praised!" When will we be able to rejoice in the presence of God, knowing with certainty that they, and we, are NOT forgotten.