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.
Monday, March 28, 2011
Friday, March 25, 2011
Take two
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.
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
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.
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.
Monday, March 21, 2011
Pineapple and poda-poda parts
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.
Wednesday, March 16, 2011
A chaos of children!
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!
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!
Saturday, March 12, 2011
Shared grief
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
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
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
Tuesday, March 8, 2011
Right to be human
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.
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.
Monday, March 7, 2011
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?
Who could have thought that even this dirty, sweaty, and often disgusting work could truly be worship?
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