Perfect timing

Tell your family, tell your friends what God has done for me.  If I had not been here at just the right time, I would already be dead.  When I go home I will tell everyone in my church and all my friends how God has saved my life. ~Dandy (name changed for privacy)

Dandy's story starts like so many of our other general surgery patients...An exam from a doctor at screening, an appointment to come in to admissions to be admitted for a hernia repair, a patient card as a golden ticket for entry to the port and to the ship.  But there, the story began to change.  Shortly after Dandy showed up for admission, the intestine bulging out into his hernia would no longer go back into his abdomen where it belonged...it became intensely painful, and the pain started to get worse and worse as he waited just outside the admission tent.

I first met Dandy in an Emergency Medical Team call a few minutes later, a sweaty, scared man that Dan and I reassured as we covered him with a sheet and moved him onto a stretcher for the quick ride up the gangway and down into the ICU.  Our doctor had already alerted the operating room, and the general surgeons were just finishing up on their case.

It was a 90 minutes strangely reminiscent of my time in the emergency room...frequent vital signs, changing him into a patient gown and a basic nursing assessment, IVs and labwork and OR consents explained and signed in a hurry and then morphine and more morphine and a surgical scrubdown and prayer before we loaded him on a stretcher and whisked him off down the corridor to the operating room.

Afterwards, still in my pajamas from sleeping in that morning, I sat down with my charting and prayed that we had been in time.  Would he be coming back to A ward missing a part of his intestine because it had been cut off from its blood supply for too long?  I found out soon enough - after some lunch and a shower I headed down to A ward for my regular shift.  A sleepy, pain-free Dandy rolled in the door on a stretcher shortly after my shift began, sporting a small incision.  We were just in time, the OR nurse told me later, much longer and we he probably would have needed a bowel resection.

All week Dandy greeted me in perfect English from his bed, told me he was doing well, remembered my face from the pain-filled haze surrounding his time in the ICU.  We talked about his experience, and the perfect timing of God in sparing his life.  Had this happened anywhere else in West Africa, he would probably already be dead.  He asked me to share his story with you, his life as a living testament of the goodness and sovereignty of God.  

We were just in time...only an hour or two more and the story might have ended differently.

Looking at Dandy now, less than two weeks later, only a small scar and a few steri-strips remain as evidence of his miracle.  He has been discharged from the hospital, and is just waiting for his incision to finish healing before he goes home.  

Of all the places in West Africa to have a hernia strangulate, Dandy was in the perfect place at the perfect time.  We had general surgeons already on ship, with the operating rooms and bed capacity to receive patients.  Our surgeons had just had their surgical schedule open up because of several cancellations that morning, and were closing a case just in time to prepare for emergent surgery.  Even though we are not set up as a full-fledged hospital with emergency room, our emergency team and ICU nurses were in place to care for him before surgery, and we had a bed with surgical nurses ready to receive him afterwards.  And on top of it all, things started happening after Dandy arrived on our dock, giving us just enough time to get him into surgery immediately. 

 Even just an hour more waiting for surgery, and part of Dandy's intestine would have died.  Just an hour, and Dandy might have left with a colostomy.  Much longer than that, or anywhere farther away from a surgical hospital, he would have died in agony somewhere on the streets.  Praise God for his goodness, and for his perfect timing.

Be merciful to me, O LORD, for I am in distress; my eyes grow weak with sorrow, my soul and my body with grief. My life is consumed by anguish and my years by groaning; my strength fails because of my affliction, and my bones grow weak.

But I trust in you, O LORD; I say, “You are my God.” My times are in your hands; deliver me from my enemies and from those who pursue me. Let your face shine on your servant; save me in your unfailing love. ~Psalm 31: 9-10, 14-16

old friends and new

One of my prayers on returning to Togo was that I'd be able to connect with some of my old patients.    Their small voices and shy smiles still echo in my heart, wisps of mist from a wonderful and challenging time here two years ago.  There is a running repetitive prayer list in my heart of the ones that went home healed and the families of the ones we lost...Abe and Komla and Aimee, Mariam and Brian and Mark and Ana and so many others, babies and mamas and papas of all sizes and problems...all beautiful.

Two weeks ago a few of those prayers blossomed into reality.  The physiotherapy team, following up on some of our orthopedic patients from two years ago, thoughtfully agreed to page me if any of the patients on my list turned up.

And so I got my first page Wednesday morning, to go down and meet Komla (now 6 years old).  He proudly showed off his strong, straight legs and informed me that he enjoys playing football (soccer).  His little brother, a two-year old mirror image of Komla, interestedly watched the reunion from his place on mama's back.  Sadly, because of timing we weren't able to take pictures together with Komla, but I'm hoping to maybe see them again before we ship out.

Abe's surgery was much more extensive, and he also lives quite a bit farther away.  After a physiotherapy follow-up, he stayed for a day or two at the Hope center before heading back home with dad.  So I headed down to the Hope center with two friends, looking to visit with Abe and his dad before they left.  We all played football (soccer) together - Abe with his straight legs and some of our boys who had just been discharged.  5-year old Malachi joined in pantless.  After a week on the ward wearing nothing under his hospital gown, we found out that Malachi's dad had left with his pants, leaving mom nothing but the football shirt (He now proudly sports a pair of small shorts).

After football, my friends and I left so the patients could have their dinner, while we lunched on the street on FanIce and peanuts.  We came back in time for a rocking worship session, and some time sharing and hearing testimonies of God's goodness.

Below: Anna and I both took care of Abe for over a month in 2010.  Now reunited two years later...I am in awe of the way that God works things out!  Praise the Lord for this amazing gift!

Hernialand

In between nursing orientations for the new nurses, A ward has become my new home.  One side is full of the left-over maxillo-facial patients...the ones with draining wounds or extra-long NG feeds, the ones that we're keeping an eye on for just a little while longer.

The other side is filled with mostly men, 18-60 years old, and almost all here for the same thing.  We have the occasional goiter removal or lipoma, but for the most part we're doing hernia repairs. If we did a thousand hernia surgeries, it would be only a drop in the bucket for West Africa.  With the few hundred we have scheduled for hernia repairs, even the waiting list is already full.

They're not the pretty surgeries...the dramatic facial tumors or child with noma that are the face of Mercy Ships.  There's not much publicity down at this end.

For these men, it's a chance at life in a different way.  Maybe they haven't been a social outcast for years, but inability to work and provide for a family can be crippling as well.

They file in in groups, patient and quiet, and have their tour of the bathrooms and introduction to the ward.  After showers all around, the ice starts to break as they chat among themselves and realize they all have something in common.  I caught my 5 new admissions giggling together like little boys and asked the translator what was so funny. "They are talking about hernias problems," was the answer.  Charades came next, with demonstrations of how to walk and cough and sit up after surgery.  Adam, an admission from the day before, volunteered to teach the class...because, after all, he had already learned it yesterday!

A day or two after surgery, they leave in ones and twos and threes...another living testimony to the work God is doing in changing hearts and lives here in Togo.

There are so many waiting, and so few surgery slots.  Part of our limitations are bed space and surgeons, but a huge limiting factor is also the number of nurses.  In a few weeks our nursing numbers will drop, and we badly need nurses willing to come or stay to fill that hole.  Please pray for nurses to hear God's call on their lives and come to join us for the remainder of our time in Togo!