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!

Twas the night before screening

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

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

"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

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.