Sandy's revenge

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

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

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

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

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

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

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?