Sunset Club

 There is an insistent breeze that lifts off of the water, dancing in the gray-gold of sunset and the cloudless dusty blue of harmattan sky.  It whispers poetry to me, cool and steady, weaving between my bare toes, wildly fluffing the skirt I try to hold down, and teasing the wisps of my damp hair.

A small tug sails by slowly, low in the water from fish caught that day, or a few scattered holes. It looks more like a child's bath toy than a seaworthy boat; rust-covered sides make me wonder if it will soon join the other shipwrecks scattered along the sea wall.   Wooden canoes paddle by constantly, and there are a few patched sails of other boats in the distance.  The larger ships leave long wakes in the water, reflective trails there long after a ship has gone, a path of promise to open oceans and distant lands.  I follow their calm wakes out past the rocks and into the sea until they are lost in distant ripples.

When I was a teenager my family would trickle up to our open gazebo rooftop just before maghrib and watch spectacular displays of color surround us as the sun set over rice paddies and red-tile roofs and the call to prayer echoed off the mountains.  Here on ship,

Sunset Club is a tradition that carried over from our outside "family" picnics in Sierra Leone and into the early weeks of the Guinea outreach, one of my favorite evening activities even now.  Almost every evening at the beginning of September found groups of nurses and most of the ward team leaders in a row along the deck facing the ocean sunset.  It was a quiet time away from the busyness of the hospital deck, a taste of fresh air and sunshine and beauty.  Some days the books and ipods came out, while other evenings were filled with lively discussions and back massages.  Attendance began to decrease as life picked up pace, and some days I had sunset club alone with Jesus on the narrow, netted walkway next to lifeboat 3.

 A peace is here, where seabirds wheel and dive, or wing their low way home across the water.  A peace that draws me up to settle with friends every free night after dinner, for chats or chocolate or silence.  No sunset is ever the same, and I marvel at God's endless creativity when the lightning storms crackle through the pink twilights and touch the early stars.

Photos courtesy of Jenny Darvas and Heather Klassen, who documented this amazing beauty while I put my feet up on the railings and drank it all in.

One more

Halima (The previous star of blog posts Looking for you and Yourself again) came back last week for a scheduled outpatient appointment.  Her face is filling out nicely, and the place where there was once a huge tumor is marked only with a small white dressing.  She was feeling fine, blowing kisses through lopsided lips and hugging everyone in sight.  The marketing team had arranged a small photo shoot with Halima, introducing her to some of the many crew members whose blood she now calls her own.

It's come full circle now, from the streets and crowds of her hometown village, and blood tests that I ran on a 6-inch square of clean floor mat in the back of a land rover, to hugs and Pular lessons after surgery on the dock in Conakry.

Every field service there are the patients that stay in my heart long after the ship sails away with us into the open sea.  My feet remember the VVF ladies whose names I don't know but who greet me and walk with me down the hallway to work in the mornings.  My arms remember the small weight of babies once struggling for breath, now fat and grinning the triumphant whiskered grin of a newly repaired cleft lip.  My eyes remember the moments of wonder when bandages are taken off for the first time to reveal the new face beneath.  I watch news reports on the CBS website and I can pick out each patient and each moment I spent with them...and for a few minutes I am in the ICU with Rudy content to sit in my lap and pat my face as he calls me auntie. For a few minutes I am dancing again with Maurice in my arms, teaching wound care or praying with a patient before surgery.

There must be a limit to the spaces I can find to tuck away one more story and one more face to remember.  But there is no limit.  Always there is room for another to be wrapped in sunset reflection and tucked away; always room for another drool spot on my scrubs, another walk down the hallway, another life touching mine.  One of the lasting life lessons I am learning from Africa: there is always room for one more.

dry

One of our hospital chaplains caught me walking through the hallway last night as I was on my way back to my cabin after a long day.  Laura, do you have a moment?  I want you to witness something.  I cannot hear this testimony alone.

I was a little confused but intrigued.  Of course I had a few minutes to spare!  So we walked together into C ward, greeted Senay and her brother, and pulled up a few stools in a circle with them.  Senay smiled at me, then dropped her eyes to the pastel hospital-gown patterns in her lap and said, every night I wet the bed before I came to the ship.

Vesicovaginal Fistula (VVF) is dry medical terminology for a condition that is anything but dry.  For small women who live days walk away from any kind of professional health care, an initially joyous childbirth can turn into up to 10 days of obstructed labor with no hope of a cesarean section, resulting in a dead baby and no way to stop the constant flow of urine through a newly-created hole.
It's a outcast sisterhood of over 2 million women worldwide leaking infected urine, living abandoned on the outskirts of their villages so no one will have to touch their uncleanness or put up with the foul smell.  It's a condition of poor medical access, of hard work and not enough food to grow tall and strong, of pregnancy at an early age, of poverty and loss.

For the last three months on ship our surgeons have been screening these ladies and performing fistula repair surgeries.  The fistula patients stay for weeks or months, loving on us as we care for them, pouring out hugs and kisses and scoldings from overfull cups.  Many of the surgeries are successful, and we rejoice with the tiny women, newly dry, who dance exuberantly in their new dresses and share stories of what God has done.

But some, too many, are too complicated for our surgeons.  Repairs have been tried and tried again at other hospitals, leaving only scar tissue and tiny bladders for the surgeons to work with.  Diseases and sickness make it unsafe to operate.  Even modern medicine has limitations, and not all holes can be closed.  What is wet cannot always be made dry.  This too was Senay's truth, and she would be going home to her village today still leaking and smelly, still outcast.  Except for this new testimony she shared with me last night:

It is a miracle.  Before I came I wet the bed every night, but since I have come to the ship I am dry.

I am dry.

We prayed there in our small circle in the middle of C ward, hands outstretched and overlapping, cupped to receive the blessing.  All I understood of the prayer was the repeated phrase nom de Jesu...in the name of Jesus.  It didn't matter that I couldn't understand the rest or pray in French together with them, because healing in the name of Jesus was the life-giving message we saw in our cupped hands, and the truth in the fingertips we touched to our faces.

As Jesus was on his way, the crowds almost crushed him.  And a woman was there who had been subject to bleeding for twelve years, but no one could heal her.  She came up behind him and touched the edge of his cloak, and immediately her bleeding stopped.  But Jesus said, “Someone touched me; I know that power has gone out from me.”  When they all denied it, Peter said, “Master, the people are crowding and pressing against you.”Then the woman, seeing that she could not go unnoticed, came trembling and fell at his feet. In the presence of all the people, she told why she had touched him and how she had been instantly healed. Then he said to her, “Daughter, your faith has healed you.  Go in peace.” ^~ Luke 8:43-48

I have not greeted Senay as she wakes up in the morning or held her dry sheets in my hands.  I cannot say if her testimony is a desperate hope for normalcy or the beginnings of healing for a damaged body and discouraged spirit.  But I pray that Senay and her brother will see truth.  I pray that she will know an unconditional love and acceptance.  And I pray she will remain dry and live a testimony of love and power, hope and forgiveness in her home so far from Conakry...that others will see, and know, and believe in a God who heals the outcasts when no one else can.

Yourself again

I can still count your ribs under my fingers, prominent beneath the thin patient gown.  It's all you wear now, besides the bold headwrap and clean white bandages.  You weren't yourself yet when you woke up after surgery, eyes confused and sad, and a wrinkled insistent finger pointing to the well-taped NG tube.  This does not belong here...remove it.

You tell us you are on a ship, but do you know which ship that is?  Do you remember that this is the hospital that promised to remove your tumor?  Do you recognize that you are Halima when you look in the mirror and see a face that is so much smaller now?  I watch you struggle to swallow around a mass that is no longer there, and sometimes I see you reaching up past the bandages to touch the thin air in wonder.  Does it surprise you every time?

Who were you before this lump appeared on your face...do you remember what life was like when you were only yourself?

I brought my own warm blood while you slept in the operating room and I prayed it would make you strong.  After you woke up after surgery I tried the little Pular I knew but you struggled to reply.  You sat still on your bed and did not stroke the soft hairs on my arm or hug me tight.  Did you remember you were looking for us?

This morning I came in to work and you hugged me and hugged me again as you passed by, thin fingers stroking my arm hairs and a sparkle in your tired eyes.  The chaplains came with their guitar and drums and the joyful steady beat of African praise, and you shuffled into the center of the circle with your arms raised and then clasped tight around me as we danced together in rhythm with the djembes.

Your face and your throat have begun to heal, but it will take time to fill in where the tumor has been.

Will it take that long to fill your heart?  I think not.  Already you are becoming yourself again.

Looking for you

Halima is a petite little grandma...not much left but skin and bones and tumor.  I can feel each of her ribs through her dress as we embrace - the same bright dress she was wearing when we met in the market between here and Mamou. I have been looking for you, she tells me, for a month I have been looking for you.  She takes my hand and places it on her tumor and it throbs warm and alive beneath my bare fingers.  This pains me and chuks (pricks) and suffocates me at night...I just want it to be gone.  Will you take it away?

Halima, I have been looking for you too.

Every day for the last month I have thought of the morning we met in the market, when we came in the land rovers and asked them to find you, when you rode up on the back of a motorcycle and unveiled your face for your neighbors to see your shame.  Every day I think of the first moment I saw you and realized the lump on your face you had covered so carefully was almost as big as your face itself, and I looked past into eyes so full of life and impossibly joyful.  When I lie in my bed at night I remember you told me you had trouble breathing when you sleep, and I looked in your throat then and could not see an airway, only tumor and palate, and I wondered how you were breathing still.

My heart remembers you. 

I have often thought of the morning I unfolded a square of gauze on the rubber mat of the land rover floor, between the backpacks and baskets of food and guitars, and laid out the laboratory equipment in my island of clean white, when I pressed a lancet to your wrinkled finger and read your blood test in the main street as your whole village watched.

I saw them rejoice with you when we gave you the golden ticket: a patient card with your name and a screening date in four days.  I met your husband and your granddaughter and that man who translated for us from French to Pular.  I cannot remember his name...do you?  What do you remember of that sunny morning when we met?  What captures your heart in the darkness as you struggle to breathe?

When your screening date on ship came and went and you were not here, I asked what had happened to you and no one knew.  Did you forget to come?  When your surgery date arrived and you still had not, I wondered if a night had passed when you finally fell asleep and did not wake back up.  Were you lost and alone?  I looked for you but I did not see you.  I prayed for you...God sees you.

Now you are here and your voice has changed and you still struggle to breathe every night.  You tell me the Hope Center is a good place with plenty of milk to make you fat, and you pinch your arm proudly in display.  You look at me with a spark still in your weary eyes and ask me to take away the monster that pains and steals your breath.

I send you away with pillows to prop your head at night and paracetamol and a promise of hope.  Just a few more days, Halima, and the operating rooms will open again.  A few weeks only, and Insha'Allah you will no longer cover your face in shame.  After looking for the last month you have finally found us, and I welcome you with open arms.  

Interior screening: Lemon tree thorns

It crept up on me slowly, barefoot on the cool tile floor
Tiptoeing in the near-dark to where I stood
Lighting the gas stove with a match
To boil filtered water for coffee.

It whispered warm across my face
A breeze that bent the rice stalks
And blew fingers of fog through the vines
Hanging looped in the forest,
Waiting for Tarzan to swing through.



And then it hit
With a flip-flop smack that killed the bathroom spider,
Cold water splashes of dipper baths under the stars,
Splatters of mud from under a motorcycle tire.

I was comfortable.

Comfortable in an environment most would find a hardship
Rejoicing in a lifestyle mistakenly called primitive.

I can transport live chickens and run barefoot through the mud
Tie my backpack to the top of a land rover
and pee in the prickers without getting hurt.
I can chew the rocks out of street rice
Or perform a blood test in the middle of a busy market street.

I cherish my nights without electricity as a gift
A chance to see so many more stars
To meditate without the distractions of modern convenience.

The eclectic collections of skills I have so carefully collected
Filed away like scrapbooks on a living room shelf
Start to fit together
In a complex puzzle of belonging.

The idea niggles in the back of my mind
A lemon tree thorn caught and driven deep
Until I turn on the headlamp to dig and find
An epiphany hiding underneath.

Interior Screening: N'Zerekore to Kankan to Mamou

There's a space of time before dawn when the world seems to stop - just to take a moment and breathe - before jumping into a new day.  In sandals and scrubs in the twilight before the morning, I turned off my night-vision headlamp, ignored the chatter from my radio earpiece, and prayed for wisdom.  The whole purpose of this trip is to find surgical patients, but we came with limited surgical slots, a few handfuls of hope to share among hundreds.

Because these hours of dirt roads in between town, a minor inconvenience or adventure for me, are the difference in medical access for thousands.

And they came, as the sun began to rise.  Young and old, wearing their shame under a carefully wrapped lappa or nursing it along on crutches or hidden under a keffiyeh.  There were the cleft palates and noma patients I rejoiced to find, a boldly written MAXFAX across the top of the pink screening sheet.  An alcohol-cleaned finger held out in a prayer that the HIV test would be negative and the immune system strong enough for surgery.  A tentative smile that danced in brown eyes with a carefully held patient card - the golden ticket for a screening slot on ship and a chance at surgery.

And there were the moments that ripped my heart in half again and again and again.  A double line on an HIV test, a plastic surgery desperately needed but no spaces in the surgery schedule and a waiting list already too long, a medical illness with no medical doctors or medication available to help, a brand-new baby in my arms and no orthopedic slots to straighten tiny deformed legs.

 From town to town the schedule steadily filled with the carefully reserved spots I had counted out for each location.  From town to town they came, and the need was great.  My own wisdom could not possibly have been enough to make the choices on which so many lives depended, and I was left in freefall - trusting in the wisdom and guidance that could only come from the One with the power to see and touch every life, the only One who can truly heal.

When Jesus heard what had happened, he withdrew by boat privately to a solitary place. Hearing of this, the crowds followed him on foot from the towns. When Jesus landed and saw a large crowd, he had compassion on them and healed their sick...And when the men of that place recognized Jesus, they sent word to all the surrounding country. People brought all their sick to him and begged him to let the sick just touch the edge of his cloak, and all who touched him were healed. ~ Matthew 14:13-14, 35-36