The Final Week of Surgery, 2012

I hate finals. Final exams, final projects, final goodbyes. Perhaps I represent the sentimental portion of the human race, but at various points in my life when I've come face to face with "finals" of anything, I have felt absolutely heartbroken that whatever it was, was coming to an end. I couldn't bear the thought of not seeing a person or experiencing a certain activity ever again. How ironic that the last 2 1/2 years of my life have been spent in constant transition and change, with more "finals" than I can count on two hands.

These next two weeks aboard the Africa Mercy will be no different.

I have never been with Mercy Ships for the end of an outreach before. Previously, my goodbyes to nurses, day workers/translators, and patients always took place during the middle of the outreach, when the hospital was in full swing. Now, as surgeries aboard the Africa Mercy are coming to a close, there is a strange sense of finality hanging in the air. While we've said goodbye to our VVF (vesico-vaginal fistula) ladies and plastics patients weeks ago, there remain a few slow-to-heal patients with complications left in our care. One of these little patients was my friend when I left the ship in March, was (delightfully to me) still on the ward with his father when I arrived, and is living in B Ward up to this moment. He, and a handful of other patients on B Ward are those who I'm asking God for miraculous healing.

This week (today, Thursday, and Friday) our Operating Rooms will be be finishing their final cases with double general and double max-fax (two general surgeons, and two maxo-facial surgeons). We are performing all of our smaller surgeries to allow enough time for each patient to heal after their perspective surgeries. The wards themselves will be open one more week after surgeries, with our final discharges and goodbye's to our patients on Friday, June 8th.

My heart aches just thinking about that final goodbye. I keep crying out to God for miracles, knowing that we may very well leave many patients not fully healed, needing to follow up with local doctors and hospitals.

One of the Patient Life dayworkers caught me in the dining room yesterday, and as we were talking, she looked me in the eyes and said, "you know, the patients are not just those lying on the beds. We (as dayworkers) are, like the patients, blessed by your love and greetings. You all come to provide physical healing, but you also bring emotional healing; more than you know. We (dayworkers) are also the patients, and our hearts are so heavy to think that we must say goodbye to you very soon."

It nearly brought me to tears. How amazing is God's intricate design of how interpersonal our lives and relationships truly are. To think back at each person we have met at the specific times we have met them; that our lives collided together to cross paths into beautiful complexity. All the individual people who have loved us, challenged us, or been touched by us is mind-blowing. Even those we recognize are a very small fraction of the impact we have in the lives of those around us. If we try to stop and think of how we have been changed and moved, I would venture that many have been because of specific meetings, specific conversations, and specific challenges that have brought us to the places we stand today. What a measure of peace knowing that God had this all orchestrated before the dawn of time, and that He delights to watch each specific interaction unfold. Our time is precious and impactful. We will never know how much so.

So, as this final week of surgery, and then next week, our final week the wards will be open, I invite you to join me in prayer- to intercede for so many of our patients who are in need of miraculous healing. As I was spending time with two of our patients, I asked permission from their father's (who came as their caregivers) if I could share their names and stories for you to be praying specificially.

First, we have Komla

He was one or our plastics patients who received surgery for a burn contracture to his left knee when I was first on the ship in March. His father came on board to care for him as his wife stayed at home to care for their other four small children. Komla's surgical recovery was going well until infection took over the healing donor and graft sites. His vivacious personality left him (and us) full of life and energy, but also created expressions of frustration, creating further detriment to his healing process, during the intense therapies and dressing changes after surgery. One thing is for sure; he is a fighter! He certainly has the potential to be a dynamic leader in his family and in his community in the future. I pray that Jesus get's a hold of his heart and shapes him into a man of strength, love and integrity in the years to come.

One avenue of postive expression the ward nurses attempted, was when Komla needed multiple IV starts for prolonged IV antibiotic treatment for his infection, they decided to let Komla "practice" finding veins on them. It turned out he had been watching much closer than they had thought. As my dear friend, Laura Coles stated- "His technique was amazing, but he nearly stabbed that plastic practice catheter through my skin!"

He is one of our pateints who has come so far, but still needs so much healing. He currently has little to no feeling in his left foot/toes, and is still receiving dressing changes onboard the ship. He has become like the hospital puppy, making his rounds to greet us; knowing each nurse by name. Please pray for miracles in that boy's life; for healing and protection on whatever road is ahead. I am praying for a miracle and testimony of God's amazing power in his life, his family, and his community.

My second patient is sweet Hougno (Hoon-yo)

This 15 year old patient has a life-long diagnosis and battle with neurofibromas. Neurofibromas are benign tumors of nerve tissue in the body that slowly and continually grow over time. The only treatment is symptomatic; when a tumor gets to big, you remove it so that it doesn't impair function. This is not the kind of situation you want for your child in West Africa, where health care access is poor and funds for surgery even moreso. Hougno, I am certain, waited a very long time before finally being able to have a debulking surgery for his left leg aboard the Africa Mercy.

 Also accompanied by his father, Hougno has had many battles with poorly healing graft and donor sites. He and his father have also been here many weeks, and are now just seeing the results of their patience and hard work- they will be going home in the next couple of days. In addition to teaching Hougno's father to perform Hougno's wound care and dressing changes (which are minimal at this time, praise God!), we also are fitting Hougno with a platform shoe to help balance out a significant difference in leg length to improve his gait and overall function. Hougno's shoe is due to the Africa Mercy tomorrow, with Hougno and his father set to leave for home the following day. While this may seem like a cut and dry situation, the risk of future infection, especially now at the start of rainy season, and overall healing and provision of surgical needs for Hougno's future are all concerns that are heavy on my heart.

 I would like to invite you to join me; to come, for just a few minutes, and sit down in B Ward, between these two boys beds, hold their hands, play a game of Uno, and hear their giggles and bits of English phrases they continue to try out on us (my personal favorite being the song "Tomorrow" from the movie "Annie" that I found mimicked back to me after I sang it to them one night when I came in to give them goodnight kisses). My desire is that, through prayer, you may experience a small part of their hearts and lives. May their joy be your joy and their challenges, your challenges as together, we partner in prayer for their lives. These two boys only represent a portion of those who we will leave behind. May our hearts be ever moved to continue to pray for miracles upon miracles and provision upon provision in this country of Togo for months to come after Mercy Ships work is complete. Because, you see, God's work is not yet complete.

How amazing how we each get to be a small part of it, no matter where we are.

1.  

Ghana Galavanting, Part 2!

Ready for the time warp? Moving back to February to finish the rest of the story....

For those of you who were wondering whatever happened during the rest of my Ghana trip in February, here is the last bit of the story… FINALLY!

 

Beginning where I left off (with our travel from the border of Lome to Kumasi where we moved hotels at the last moment due to TIA power outage)… we left our new hotel around 0730 (am) to start up for Bodinka to visit my World Vision child! Francis, our trusty driver, picked us up and we started on the 3 ½ hour journey to the small farming communities of the Sene district. 

On that long World Vision land rover ride, the terrain sped past us from hilly, wooded Kumasi to lush mountains , to flat, Palm-tree dotted farmland of the Sene district.

 As I was talking with Francis on our way out there, I found out that the Sene district is one of the poorest districts in all of Ghana. It’s an area of mostly farming communities connected by very rough, washed-out dirt roads that are difficult to drive on during dry season, and nearly impassable during rainy season. Apparently, the Ghanaian government has been promising for years to improve and repair these roads that would connect the farming communities to the markets of Kumasi, but have so far left their promises empty to these communities.

Francis, who has been working in the Sene district with World Vision for over 8 years, says that because the farmers find it so difficult to bring their goods to market, they are often forced to sell their produce to large buyers who manage to bring trucks and transportation into the small communities. When these large buyers come in, the farmers are forced to take much lower prices than they themselves would be able to get if they sold them in the markets. This leaves even less money in the pockets of the farmers, inhibiting them from providing for their families, supporting their communities, and saving for future investments, such as transportation for their goods. This vicious cycle keeps them barely making ends meet.  This is why World Vision has come along side many communities in the Sene district to help support the breakdown of basic community resources such as clean water, sanitation, education, and health care.

The district reminded me a lot of my home in Minnesota- Beltrami County- where we have some of the highest rates of poverty in the entire state. Difficulties and poverty strike every country. It was an interesting perspective to keep while we were traveling through each small village.

As I mentioned above, the road was ROUGH.  We got quite jostled and jolted around as the landrover bounced and weaved its way through and around massive eroded areas of the red dirt road. Fitch (right) is demonstrating what we were all doing that morning until we reached the Sene ADP (Area Development Program).  We finally arrived and were warmly welcomed by the entire World Vision Sene ADP staff (see picture below). George (far left) was our guide and assistant to the supervisor of the Sene ADP. David (next from L-R), is the man responsible for all of the child sponsorship management. He oversees over 500 children! He’s the one who opens and re-packages the letters I write to Nyanjah. Then, it’s Melinda, me, Fitch, Jon, one of the other World Vision staff members and Francis, our amazing driver!

We were treated to a delicious lunch of cabbage stew with rice and noodles. For all you food gurus, I thought you might appreciate a photo of the local dish (below, left).  

From the Sene ADP we headed to the small village of Bodinka, where Nyanjah lives. As we passed through each little community along the road, children and adults, as they saw the World Vision vehicle and the strange white visitors, smiled and waved, with some of the children yelling and running after the land rover. J It was such a joy to be so welcomed. As soon as we started pulling into the Bodinka village, children began running out from EVERYWHERE. I couldn’t believe how many children there were! Then, before I knew it, a group of the children came up, parading the sign you see here. I was one of the sweetest welcomes I have ever experienced…

Following the display of the sign, the parade of children never stopped, even unto the last moment we left Bodinka. So many smiling, curious faces. Many of the smaller children saw us and ran away crying, afraid of the strange white people. 

After our overwhelming welcome, George took us to Nyanjah’s class where I would meet him. Having no idea of this prior, I was asked, in front of Nyanjah’s entire class to “find him” amongst all of his classmates.

Granted, I had studied Nyanjah’s sweet face and very Ghanaian characteristics many times before, but for some reason, among all the attentive faces in matching school uniforms, I was not able to find him! I felt a bit frantic, but was easily calmed when George brought me right to his desk and pointed him out to me. I hoped he wasn’t terribly offended that I wasn’t able to find him among the other children. As we met, an awkward glance, then handshake, and them embrace brought the two of us together.

In his first letter following my visit, Nyanjah’s sweet comment was “When I saw you, I didn’t know what to do”. How perfectly sweet and fitting as I was unsure, myself, of what to do. I wanted to show my love for him in a culturally acceptable way. I hope I hit the mark. However, when it really comes down to it, I think that love is one of the actions that translates across to every part of the world.  

We spent the remainder of out morning/afternoon visiting his family, seeing his home, and watching a community cultural presentation complete with dancing, singing, and drumming! One of my favorite moments was when his entire community was singing and dancing in their local language around a beating drum, one man with metal dangles jingling on his boots heading up the entire company. It was in this moment that George leaned over to me and asked, “Do you know what they are singing about? They are singing that once, they worshiped idols and pieces of wood and stone, but ever since they turned and followed Jesus, they now have lives full of joy and happiness. “ Wow. A song of thanksgiving to God in their local language. AMAZING. I got goosebumps just hearing their voices echo from the dancing circle.

Then, Nyanjah (with encouragement from George) went up and joined the conga-like circle around the drum, dancing. I laughed and watched with joy, this shy boy participating in something so normal to his community. It wasn’t five minutes later that I found this small boy standing in front of me with a shy expression of invitation, holding out his hand for me to join him and his community in the dance. How could I say no! I nervously laughed out loud, and then jumped up and joined in! As I was dancing around this drum with mamas, papas, Nyanjah, and I, I couldn’t help but think of how far I had come in cultural openness. If someone had asked me to dance with their village in front of everyone about 2 years ago, I would have said, “NO WAY!” How amazing are God’s plans for our lives- that what He has in store for us is beyond our wildest dreams. 

I left a few small tokens of Minnesota behind  (including a rendition of the song “This is the Day” compliments of the good sports Jon, Melinda, and Fitch) for Nyanjah and his family, but more importantly, I left a small piece of my heart behind with that small boy, soon to become a man, in that small village of Bodinka.

Transformation

Transformation.

 According to Webster's definition, to transform is to

"...change the outward form or appearance of; to change in character or condition..." 

When I think about Mercy Ships and I think about the mission and vision of the organization, transformation is at the very heart and center of it.

Taking people in need of a transformation; those who are broken, ostracized by their communities, some abandoned by their families, others without the resources to even attempt to treat and change their condition. I would venture to say that all come hoping for a physical transformation, but also come in need of a great spiritual transformation. To know and experience love and acceptance; to hear the message that they are not forgotten, they are not alone, and that their life matters. This love is at the very center of Christianity; that God, through Jesus Christ, loves to come and take what was old, what was lost, and what was broken and renew it to make is something beautiful.

Come and see the transformation yourself...

 

 "Therefore, if anyone is in Christ, he is a new creation. The old has gone and the new has come!"

2 Corinthians 5:17

"The LORD is close to the brokenhearted and saves those who are crushed in Spirit."

Psalm 34:18

"Then will the eyes of the blind be opened and the ears of the deaf unstopped."

Isaiah 35:5

 

"Speak up for those who cannot speak for themselves, for the rights of all who are destitute."

Proverbs 31:8

 

"Oh LORD, open my lips, and my mouth will declare your praise."

Psalm 51:50

"A man with leprosy came to him and begged him on his knees, 'if you are willing, you can make me clean.' Filled with compassion, Jesus reached out his hand and touched the man. 'I am willing' he said. 'Be clean!' Immediately the leprosy left him and he was cured."

Mark 1:40-41

 

"You turned my wailing into dancing; you removed my sackcloth and clothed me with joy, that my heart may sing to you and not be silent, Oh LORD my God, I will give You thanks forever."

Psalm 30:11-12

   

  

You see, this life transformation is not about a ship of really nice people who are especially good at knowing how to be kind to other people; it's about something greater than us. A love that is beyond our ability or knowledge; the love that is poured into us is everything we have to give. The love that Jesus had to touch the Leper, to associate with the prostitute at the well, and to be with and spend time with those who were tax colletors and unaccepted by their society. Who Jesus was and who he is today is exactly the reason why it does not make sense to our home countries and cultures of why we would pay money to come and work to touch diseases and disfigurments that would, even in a medical community, make us shudder. It's because of this great power of transformation that WE experience, that we can, in turn, bring it to others.

When the Sun Goes Down

In Lome’, Togo, West Africa along the grimy, gray unevenly cobblestoned seaport, the Africa Mercy sits, slowly lulling back and forth with the gentle tide. It’s after dark, the temperature has come down to a “chilly” 28 degrees Celsius. The ship has come to a peaceful silence, with only the hum of the generators from Deck 8 echoing off the empty dock.  If you chose, like many Mercy Shippers, to walk along the dock at this time of night, you’re bound to dodge gigantic cockroaches and even a  rat or two scurrying along the high wall of shipping containers, stacked two high, that surround and protect our little section of dock.

We’re lucky, in Lome’, to be docked in a bay, away from the tides and currents of the ocean, and thus only feel a slight listing of the ship as you move about.  Some may complain that on certain days they feel the rocking more intensely, but I assure them that it is nothing compared to our open-bay dock in Sierra Leone.  I smile to myself, seeing a little glimpse of the different seasons and “normalcy” of the Africa Mercy that I’m sure so many long-termers before me know all too well.

This night, I went up to deck 8 to attempt to capture some scenes from the sleeping ship. The city of lights, far off in the distant horizon represent ships awaiting safe harbor or simply taking the opportunity to rest in the waters off the coast of Lome’. From Deck 8, the bright lights from each ship glitter off the navy blue mirror in the distance.  Beautiful.

A strong, turbulent ocean breeze bursts its way across the ship; a welcome mosquito repellant. A few crew members sit or stand on the nearly empty deck as the rest of the ship sleeps. 

Silvery schools of fish glimmer in the turquoise water, lighted by the Africa Mercy. The Togolese Naval ships rest on the opposite end of the port, the bugle and soldiers all tucked away for the night.

And so the ship sleeps. With only night shift workers to keep the ship running, the hospital patients well cared for, and emergency stations manned, the rest of the night leaves an empty, welcome silence. In a place where calm and quiet is a commodity rarely found living with 400 other people, I often just stand, stare out to the open ocean and just be. Pray. Sing. Rest. 

Welcome to one snapshot of Africa Mercy peace. 

So Good to be "Home" Again

The surgical wards of the Africa Mercy... SO good to be back aboard this big, white hosptial ship; one of the many places my heart now calls home. My heart has been SO full as I've come back to the nursing I love most- with dear, Togolese patients and my amazing day workers/translators and fellow international nurses. I thought I would share some snapshots of my first week back on A Ward as a REAL nurse with my own patients!

 Working as one of my favorite "resource" jobs- starting IV's! (Don't ask any men from our IV start class about the 14 gauges I started on them) Here we're looking for a good vein on one of my thyroidectomy patients the morning of her surgery day.

After the work, then of COURSE there must be time for some play therapy! My little patients with the enlarged thyroid gland came to A Ward with the expectation of having surgery, but thankfully left us without a single incision! Medical treatment of his enlarged thyroid with simple thyroid medication was enough to treat and begin shrinking his thyroid gland back to a normal size.

Here, we're playing with little brother; mama watching on.

Trying to get a smile with the tickle bug!

Please keep this family in your prayers. Mama told me that she was a widow with little or no family in her village. Her son needed simple, affoardable thyroid medication, but the mom was unsure if she would be able to even affoard the small cost of his treatment. With so many stories like this of sucessful treatment in the face of so many life-long challenges, it's one of those times when all we can do as medical professionals is pray and trust that God will care for them. He is the same God who saw their need and provided for them before Mercy Ships and through Mercy Ships. He will be the same God to provide for them when they go out from our care into their life back at home.

Where Does the Time Go? Do Intentions Count for Anything?

I’m sure that many of you are sadly getting used to my sporadic blogging habits. I am absolutely ashamed that, in the 5 weeks I have been home in Minneapolis, not a single blog-post was published. I felt like I had barely got home, unpacked, done laundry, started working, caught up on mail and bills, worked more, and then.. POOF! 5 weeks was GONE!

 5 weeks until what, many of you may ask. It was the 5 weeks I was home until l returned to the Africa Mercy, yet again, to help finish out the Togo, 2012 field service! Many of you are undoubtedly surprised (or not surprised at all) at this news. To be fair, I was surprised myself at my sudden return. Let’s just say it wasn’t in MY plans or agenda for my spring, but it certainly was God’s.

I’m sure many of you remember my posts and/or emails about there being a shortage of nurse volunteer s for the end of the Togo outreach, starting in about mid-April. Since late January when I had arrived on the ship, our dear Ward Supervisor, Kirstie asked us to “pray about extending” to help cover these needs. I thought and prayed about it, and felt unable/not called to extend as I was already coming back on extra funds, and on a very tight budget to manage the remainder of the costs and my own bills at home.

 So, there I was, minding my own business, working in the general ward for my final 2 weeks in March, when I was approached one night after work. Turns out that there were special funds made available to cover my cost for an extension or return to the ship if I agreed to come for at least 4 weeks. What could I say? I mean, really? What was I going to do at home? Work and save money for… something? So, after prayer and time with God, I said yes to return to the ship April 30-June 11th, 2012! And so here I am!

 It has been a wild ride and has left me feeling even more that you never know where God will call you and when. But for now, here I am again, completely blessed and taken aback by this opportunity! I'm not sure what God has in store for these next 6 weeks, but there must certainly be a pretty significant one! More stories (and catch-up stories) to come! Until then, re-orienting to life in Togo, West Africa! :) Please feel free to send me mail or messages onboard! :) I'd love to hear from you!

A Ward Miracles

Of all the specialties you will hear about on the Africa Mercy, general surgeries are the least talked about, least shared at Mercy Ships fundraising events, and least featured stories from the media teams. Hernia repairs are not glamorous, no Mercy Ships photographer or writer will highlight the care and transformation of the lives of our hernia repair patients, but we, the nurses of A Ward (General surgery), know and see the life-changing difference these simple surgeries make.

I was just working last night, a typical weekend evening shift on A Ward, as charge nurse, and stopped and considered the stories of the patients we currently had recovering in our ward. A5- he’s a 4 days after his hernia surgery. He was our emergency incarcerated hernia (a hernia that begins to strangulate and loose blood flow to the tissues of the bowel- resulting in a life or death situation if not emergently repaired with surgery). This man had showed up to our admission tent Tuesday morning, perfectly fine, getting ready for his surgery the following day when he suddenly experienced significant pain and the doctors decided his hernia was strangulating and that he needed immediate surgery. What a place for his hernia to strangulate… only a few hundred feet from a hospital ship!

I was talking with the surgeons last night about this patient, and they had said that if he had been delayed even another 30 minutes, his bowel probably would have died. Amazing that, first-off, he was HERE when that hernia strangulated, and secondly, we were ready and able to give him his surgery in the nick of time! Praise be to God for how he has been answering our prayers to bring just the right patients we need to help here in Lome, Togo! A5 is doing very well now and will probably go home Monday.
Our other miracle man was A4, a man who came back to A Ward after his surgery two nights ago. The evening of his surgery, his nurse and I noted significant increase swelling in his surgical area. It was alarming enough that I paged the surgeons to come and see him. We all examined him and talked about if surgery was needed. It was decided to try and wait until the next morning to take him back to surgery. That night we prayed that the Lord would work to heal him through the night, that we wouldn’t have an emergency surgery during the wee hours of the morning. The next afternoon I came back to work, expecting to see A4 back, fresh from surgery. Instead, he was comfortably sitting up and enjoying his regular diet meal! Somehow, by a miracle I believe was from Jesus himself, his swelling had gone down by HALF; enough so, that the doctors said they didn’t think he would need any further surgical intervention! Franck, one or our day workers/ward translators, reminded me today how important prayer is to the healing of our patients.

I’m passing on this reminder to you and me as well! Let’s remember to keep praying for all the patients of the Africa Mercy, for their healing and divine intervention during their time here with us and that their physical transformation would spur on transformation in every way in their country of Togo!