Bleaching the wards

The field service is at days from it's end in Sierra Leone for the Africa Mercy. Our final patients have now left and are being seen by the Sierra Leonians that were trained for that purpose while onboard.

So what have we been spending our time doing? Why bleaching. Bleaching everything. Twice. The walls, the ceilings, the cupboards, everything in them, the beds, the mattresses, pillows, risers, toys, games, you name it. It's been bleached once, left to dry and bleached again. The smell of it is pretty pervasive at this point and I smell like a bleach bottle.

Once bleached down, everything that moves is getting strapped down for the sail... so it won't pitch and roll into someone or something. Huge amounts of work going on right now, and we're all pretty tired at the end of the day.

But of course we had have some fun with it all.

Waiting on her miracle

Not all the small ones who come to the Africa Mercy have time for their miracle to happen. I use miracle very freely in these terms because it is all of that. In West Africa without this ship there is zero chance of having tumors removed, legs straightened, etc. A benign facial tumor is a worse death sentence than a malignant one, as the malignant tumor will kill you rapidly, whereas a benign tumor will close off your windpipe slowly. Slowly asphixiating to death has got to be one of the worst ways to go, until you pass out from lack of oxygen. Quite a number of patients with large facial tumors are coming to mind, who otherwise would be "checking out". Their worried, anxious faces coming onboard, their sweet smiles and laughter postoperatively.

Sometimes however, the timing is not right. This is baby Fatmata Jalloh. Inappropriately named, there is not an extra ounce on this tiny treasure. She has a large cystic hygroma growing on the side of her neck.  A month or so ago her mother brought her to the ship having travelled all the way from Guinea, two countries over, with the hopes of having this alarming mass removed from her precious girl's neck.

However we learned from previous children that this is going to be a complicated recovery, and the quandry that comes to the ship at the end of every outreach commenced with Fatmata. What do you do with the patients who desperately need help, but the ship is not going to be here to undertake the necessary postoperative care? The ship is nearing the end of the Sierra Leonian outreach for 2011. And Fatmata's recovery is going to take months. In the western world it wouldn't be such a fix, of course, on several different counts. 1. Early detection would have significantly reduced risks. 2. Even postoperatively there is home health and physician followup, so whereas at home you'd send somebody home, here it's not a viable option as infection could easily set in in the squallor of the filthy cities.

God has his eye on this little one and will not forget her. And these are the moments that make me so happy that we serve an awesome God.  Did you know that the Africa Mercy is headed to Connakry, Guinea? heeheehe. I love it. The upcoming outreach is in Togo for the first half of the year, the second half is Guinea, where she is from. The ship is coming to her! Tiny Fatmata has her chance and it is going to work out so well for her, as her tiny can't even stand up on it's own yet. The hygroma has been so large it's affected her swallowing. The Africa Mercy dietician has placed her on a feeding program of swallowable, high calorie foods that she will actually eat. She is two years old and weighs as much as a 6 month old baby.

So God-willing, little Fatmata, who already has her appointment letter for the ship in Guinea will show up, fatter, and ready for the surgery that will save her life.

Water Wars

To say I've worked with the loveliest group of ladies in Africa is the understatement of the century. Tears, tons of laughter, hugs, good talks, cups of tea, back rubs, movie nights, frustrations, cross-cultural moments of angst and "huh!"... what's to say. Full and bounteous life has been ours while aboard. From arguments and disappointments to the wide range of experiences and patient stories, we've shared moments that could fill books.

So Merry Pineu and a band of other wicked gals got us all together on the dock, sat chairs in circles and we had a lovely moment of chatting, and then the water balloons started to fly. I believe the funniest comment I heard during the shrieking was "where is it coming from???!!!"

Evil. Just evil. Merry, Alyssa, Heather, Noel & Christina

Photos by Justin Grant - and maybe some waterballoon filling?

Sierra Leonian Signage

Here are a few odd or funny signs I've seen written on billboards, boats, canoes, trucks, mudguards, stores, etc. since arriving in Sierra Leone.

Bon Bons "filled with pleasure and emotions"

Slave of Allah (on a truck passing by)

Give Islam a Try (on another truck)

Retry Islam (the third truck. really....)

Sierra Leon-Iranian Consul (don't see that one at home...)

Female Condom - It is safe! It is nice!

Unity Welding Shop :-)

The truth will set you free! (front of another truck)

Hard Time/No Friends (on mudguards on a truck)

Nor pis ya!! Fine 50,000 SLL (translation, don't pee here!! Seen on a wall)

Looking Good is Beautiful Salon

Haj Account (local bank will set up a savings account exclusively to get you to Mecca)

Ingenering Sohp (yup, spelled just like that)

Baptist Dread Locks!!!!! (I wonder what makes them Baptist?!)

No Money, No Friend (on a boat)

God is good all the time (Front of another truck)

a photo of me and the Princess!

So a photo has emerged of myself and Princess Anne from her visit to the Africa Mercy! Go figure!

Ha! I'm one of the little ant-sized people hanging over the balcony on the far, faaaar top left :-)  

Here she is visiting with the patients, in this case with Fatmata and the adorable baby Ali, everybody's favorite "Snuffleupagus" as we've nicknamed him. Nurse Frances shown with her, Mary from Patient Life in purple, and a Day Volunteer as translator.

I had a shocking moment of realization today when I looked at the calendar and realized that there are a mere 16 whole days before leaving the Africa Mercy. I'm not the only one for sure, the Sierra Leonian visit of the Africa Mercy drawing to a conclusion. My fellow nurses are starting to leave one by one and the days are filling up with sad goodbyes. Those lucky enough to remain are also sad and get a bit of a pass 'cause they get to keep a few friends around, but still.

On the bright side, I get to take my bunkmate with me to South Africa! Rachel is coming with me for a good adventure further south before she comes back to the Africa Mercy for it's field assignment in Togo. Lucky girl!

But January 7th I'll be headed home :-)

Goat sacrifices and toddler group hugs

Nursing Report you won't give at home:

Report to the next charge nurse, Danielle, this afternoon went something like this, "and Ibrahim has permission to go off the ship to go kill a goat." Now, I didn't know if it was a particular goat that had offended him or what precisely was going on. Come to find out from Danielle who had made it to church this morning that the streets of Freetown are very busy, the mosques are packed and there are hundreds of goats lining the streets awaiting a sure demise. Hmm. And here i'm sitting on Deck 9 next to the pool and far away from the ever-infallible :-) Wikipedia to find out what holiday it is. It reminds me of New Year's eve in the south of Chile where hundreds of little white lambs were attached to fence posts kicking up an absolute ruckus on the 31st of December, followed by an eerie silence on the 1st. Then the most tantalizing smoke would fill the air as roasting lamb filled the town. Yummmo! I remember Auntie Nisey coming to visit us in Chile appalled by the whole little lamb thing, and she spent an entire afternoon crying next to one little white fluffy thing, stroking it's ears. Don't think the goats are gonna have the same reception though. Or maybe they do get eaten, I don't know!
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Another interesting favorite from reading another patient's History and Physical, under Social History, "4 wives, 16 children." 
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We've also admitted 6 adorable two to four year olds to have their growth plates removed. They've invented a new game and taken to collectively mass-hugging anybody who walks through the door. You step into A ward and 6 tiny four year olds come yelling and plaster themselves in a group hug around your legs.

These little ones came to the ship for orthopedic surgery at the beginning of the outreach. They're called the 8 plate children, because their legs looked like parentheses - or that you could place an 8 in. plate between their knees. Growth plates were inserted to straighten their legs as they grew. However, there is more motivation to pray as some of them aren't straight yet and the ship is getting ready to depart. Decisions need to be made as to whether to remove the plates now, and still leave them better than they were before, or leave the plates in and somehow arrange for these children to make the journey to Guinea, one country over, in a few months once their legs are straighter. Travel is very difficult in West Africa and there is the risk that the journey can't be made, for any of a dozen reasons. The risk is that then their legs will keep on growing inwards until the parentheses are formed in the opposite direction. Quandry! Please pray for wisdom and traveling mercies for these children and their parents.

They are so beautiful though. Melt your heart.

Babies in knitted caps and booties

A tiny sleeping beauty needs a kiss!

I got her, I got her!

Some kind ladies knitted booties and caps for the babies on the Africa Mercy.

"Dis bed no gud!"

How do you explain to a patient that the reason why his bed is bucking is the ship's fault, not his bed?

We transferred some patients from D ward to B ward, as D was ready for some deep cleaning, and the patients were happily lodged in their newly assigned beds. Or so I thought. I came across one seriously disgruntled customer... we were getting dark looks and impatient sighs, snapping lips. Though a translator I asked what is the problem. "This bed no gud. I want my other bed back. It moves too much. It make me 'ed de turn!"

Try as I may to explain that it is very windy outside and the choppy seas are making everybody's bed move, no luck. He wanted back to D ward. "Dis bed no good!" as he waves his arms back and forth, mimicking the movement of his new crib.  And this is a 46 year old patient too!

I'm afraid he wasn't satisfied at all, and we couldn't convince him that everybody's beds were bucking too :-)

the Dawn of a New Day

Yesterday evening the crew of the Africa Mercy had the pleasure of a screening of the film "Dawn of a New Day". This documentary was filmed onboard in Benin in 2009, and in Cape Town, South Africa, following the steps of Dr. Tertius Venter. I'm going to get ahold of it and we'll have a movie night when we get home! Popcorn! Yeah! It shows the ship and patient's stories beautifully set to haunting music, and I can't wait to show it all to you. It was lovely to be able to see patient's stories from the beginning of their journeys at home to the ship and their joyous reunions with their families afterwards.

I'm attaching the link to the site:
http://www.journeyman.tv/62177/documentaries/the-dawn-of-a-new-day.html

a ward funny

Translator, "What state are you from?"
Me, "Tennessee"
Translator, "Oh, I only know New York, California, Texas and Mexico!"

Pics of that sunset

Photos courtesy of Joshua Young. Check out his blog at http://www.jky2003.blogspot.com/

Starry skies and flourescent plankton

This past weekend the Lord treated a very lucky group of us to the starriest of skies and a magnificent display of what He can do.

A group of us headed off to Bureh Beach for a weekend of camping and having fun for a friend's birthday. Bureh Beach of course lived up to it's reputation with clear beaches, swaying palm trees, good food, friends playing volleyball, crystal clear waves, dark jungle-covered mountains behind us and billowy white clouds. There is a small island across from the beach over that you can swim to if you've packed your sense of adventure with you. It's about a 15 minute swim and if you take it slowly and don't try to show off your strong swimming technique you can make it just fine, not even being tired once you get there! We walked around the tiny island jumping on the rocks around and eating this fruit that yes, it was brave to pick up and eat, but tasted like passion fruit and nobody bent over double afterwards. Or got any cases of what the Sierra Leonians call the fast-fast, which involves motion out the derriere at the aforementioned speed.

The beach boys, locals who pretty much take care of what you need food and drink-wise, cooked up some delicious smoked fish, couscous, tomato and onion sauce and crab. And a huge bonfire.

We were treated to a magnificent sunset, with a few of us lodged on a large rock overlooking the orange splendour as it set behind that tiny island, the rock warm from the sun and curved so it contours perfectly to your back.

But once the sun set, the true display began. The moon was a mere sliver so the stars came out in force, the full Milky Way on display. The only break in the stars came from the outline of the black palm trees. Looking down from the stars, a magnificent lightning storm broke over the horizon and continued for awhile, nice and far away so all we saw was the crashing light, and below us, the ocean lit with flourescent plankton.

A friend and I were walking in the dark on the beach when we noticed that the sand was sparkling. Running back to tell the rest of the crowd, most everyone headed off into the water once we realized that the plankton sparkles with motion. So general waterfights, twirling in the water, and back into the ocean we all go; it looked like a scene from the movie Avatar, where what you touch glows. Even the waves sparkled when they crashed. Those who opened their eyes underwater tell of a lit up land that you couldn't even see from standing in the water.

So it was starry skies above, lightning on the horizon, and sparkling waters beneath us. A true display of God's creativity. I giggled at all of us because we were really remarking that God loves us so much to put on such a show for us; we were with a group of Peace Corp people on vacation and they must have thought us nuts - maybe it entered into their consciousness that yes, "the heavens declare the glory of God, the skies proclaim the work of his hands." Ps. 19:1. It was impossible to ignore the unexpected beauty of the night and not give notice to Him who put it there.

One of my ship friends has a tiny tatoo of a star on her foot, and when I asked her about it she told me that to her, stars are just the most effusive display of love from God for us. He didn't have to put them there at all, He just did, and we get to enjoy it. Like every good thing that comes down from the Father of Lights.

James 1:17 "Every good and perfect gift is from above, coming down from the Father of the heavenly lights, who does not change like shifting shadows."

Chispita de Chocolate

Baby Ali

This is the Snuffleupagus, or my favorite chocolate milk dud. Soooo sweet, this little fellow's mom has had an involved recovery from burn wounds, so us nurses have had loads of lovely cuddle time with baby. He's usually a very smiley thing, but we'd just gotten him up from a nap and passed him around for photos. Spanish is his narcotic, and the fastest way to knock him out for a nap is to just cuddle and start, "Cosita linda, mi chispita de chocolate de adonde sacastes esos ojitos de caramelo" and he's out!  

This is why I'm here

My hero, Mafula! Thank you everybody who has been praying for her the last few weeks since I last wrote on her. She is healing so much better than she was originally, infection at bay and she is keeping in good spirits. Bless you all for praying for her and asking about her. I told her about everybody who was praying for her at home and she was so touched.

How to not chase a Princess, Part II

    Wednesday morning we knew that Her Royal Highness Princess Anne was coming on board for a tour of the Africa Mercy. So, the stalking began. We ended up in the only allowed spot, which was deck 7 starboard, looking down on the docks to watch her arrival. Which was just fine. The captain came overhead to tell us again to please not shoot any personal pictures of the Princess, so we didn't but it backfired a bit 'cause absolutely nobody got a photo of the Princess onboard! Not even the official photographers were allowed to shoot! And I don't think her personal photographer is sharing his pictures on facebook, so I'm just going to have to describe!

The Captain came overhead to tell us to please not take pictures and hang around being a nuisance (not his words, he was kinder). He told us she would be here in under 5 minutes and as he switched off the intercom the sirens of her police escort could be heard making their way onto the dock. A couple of motorbikes led three white SUVs, the second of which flew a flag from it, so we could pick out in which one she was in. They pulled up to the gangway and stopped. A bevy of men hurried forward and her door was opened and out came HRH, followed by her husband and a group of people whom we surmised to be from the British High Commission, and some bodyguards. She wore a pale lavander dress and white gloves, and strode up the gangway to greet the Captain and have her tour.

Now, I didn't see her anymore, but I'm told by people on the wards that she did stop for a long time and chatted with nurses and patients, asked good, pointed questions about the patients and in general was a jolly good sport about the whole thing. She was gracious and also talked at length with our Sierra Leonian day volunteers and various people along her tour of the ship. She asked about them personally, if we treated them well on the ship, and about Sierra Leone.

Now, had I stuck with plan A to see her, which was, hang out in the midships area and I might get to see her up close, apparently was the winning plan 'cause she talked with several people in midships while passing through. I, however, had rejected plan A for plan B, which involved rapelling down the side of the ship in an effort to be taken down by 007 and at least getting a cross look from the dear lady. Sigh.

I've had "Hail, Brittania" stuck in my head for two days now.

Need I add that I didn't take these pictures? :-)

How to not chase a Princess

Today the ship is spic and span, newly waxed floors, walls washed down, carpets smelling clean, hospital washed anew, because Princess Anne is coming onboard! The eldest daughter of the Queen of England is here in Sierra Leone and is visiting the Africa Mercy.

Cue my brilliant schemes to meet her. To be promptly smacked down during the community meeting as our Operations Director read out the list of "thou-shalt-nots". Thou shalt not hang over the side rails of the ship. Darn it. Thou shalt not point high-powered cameras at her- the 007's might mistake that for a rifle. (Do you think my little point and shoot counts? And do I really look that threatening?) Thou shalt not line the hallways on her marked path through the ship. (Scratch plan number 3) Thou shalt not show up at her hangout spot unless you've been invited, and I've not been. Hmmm. I might feel a real need to go to the pool on deck 9 at a ridiculous hour of the morning, see if I see her pull up, from on high.

Not so great to be a princess though. In the area that she's going to be talking to people they've removed all the chairs. Poor lady's got to stand all the time. Apparently that's just protocol. Or, Frances suggested they might be bringing in special thrones or something :-)

Weeeee'llll seeeee!!! (skips for joy)

(The lady on the right)

"Comedy of Errors" or "How I shouldn't have bothered getting out of bed yesterday"

Some days I shouldn't even bother attempting the day, Carpe Diem be hanged. It's like you should have a heavenly signboard over your bed with warnings that post like facebook status update lines. "Good day ahead" or "remember your makeup!" or "don't even bother, stay put". Yesterday was a "stay put" kind of a day. It finally became comical and I had to laugh or I'd just cry...

So a rather largish group of us headed out to River No. 2, a gorgeous beach, to spend the day. It started out promisingly enough, one of our group,Mourad, having already arranged for a poda poda to meet us at the dock gate to take us. Usually finding transportation the most complicated part of getting around, so first challenge met. Mourad, who is Egyptian, probably grew up bargaining 'cause he was awesome... people don't take us for rides (figuratively) when he's around; we manage to pay a fair price... he probably grew up bargaining for his candy when little, really, he was great. So we all pile into the poda and head off. One hour into the trip, on the other side of Waterloo we hear a bang! and now this sounds weird. Poda pulls off to the side of the road. Breakdown Number One.  The tyre is smoking and something is off-center in the middle.

Out we pile from the poda, after all, it's Africa, you can expect at least one breakdown. We don't even bat an eyelash. If the driver can't fix it, he'll call a friend with another poda to pick us up, so no worries. Only he wasn't able to fix it, and after waiting on the side of the road for an hour figured out he hadn't been able to locate that friend. A woman walking past said there are podas 2 towns down, so we gamely head off down the road.

Did I mention it's all flowers and butterflies right now? Dozens of butterflies, lovely flowers blooming on the sides of the roads and thick, lush greenery.

So we march a couple of km past the town of York and almost reach the 2nd town when a mini-van taxi pulls up. Mourad whips out his mad bargaining skills.

Yes, this mini-van. Yes, we are a ton of people. Yes, we fit us all in. 3 people in the passenger seat, 5 in the middle, 5 in the back, 3 hanging out the back crammed like sardines, sweating profusely, singing songs, making up games and rather enjoying the adventures. After all, we'd had our token breakdown already so we're home free now, right? Wrong. Another bang! Breakdown Number Two, and a cloud of steam rising from under the hood. The picture is not uploading, so you're gonna have to take my word on this one. This is probably the reason why they have rules about not overloading vehicles. They can't go through trecherous terrain with 18 people squashed into a 8 seater minivan. 

So we jump out, walk a few more kilometers, the engine is now cooled and refilled with water, so we pile back in.  A few more kilometers and bang! You've guessed it, Breakdown Number Three. Behold:



At this point it's close to 2 pm, having left at 9 am on a trip that should take an hour and a half, tops. So we now hoof it the rest of the way, maybe another couple kilometers. To crash land on the beach, throw ourselves in to the ocean and an exhausted nap. We left around 5 pm to head back to the ship arriving around 7:30, now having waaaay missed dinner. But I did have a "There is a God" moment when my sweet, darling roommate Rachel noticed I wasn't back in time for dinner and saved me a plate. Having had a very similar experience the week before involving two breakdowns :-) she thought maybe that's what had happened to make us late. Thank the Lord for her! So I chowed down, regaling her with the story of our adventures, finally being able to laughing merrily about it. Food is good. I crawled back into bed with the realization I should never have left the bed in the first place, but it does make for a good story.

a lili Krio lesson

Krio is the main language in Sierra Leone, so I thought I'd share my nursing hit list of top sayings:

Me name na Lycia (my name is Lycia)

Nami na u nurse disnight (I'm your nurse tonight)

I do ken teki blud presah (I am going to check your blood pressure)

Ah do come put iV pa yu (I'm going to put an IV for you)

It is for watah en mereson in de vein (It's to put water and medicine in your vein)

U wan vomeet? (Are you gonna vomit?)

U do feel chuck? or Yu 'ead de turn? (Are you dizzy)

U no for wear nuting under de gown! (don't put your nasty clothes on under your hospital gown now that i've finally gotten you scrubbed off... awww. nuts. rinse, lather, repeat. )

U get for eat small small after de operation (Eat slowly after the operation)

Ah no understand. (my favorite line)

Whatina u age? Ah no believe yu, yu pass dat! (What's your age, I don't believe you, you're past that!)

Ah wan go eat. (Hungry!)

Ah get for learn bucoup (I have lots to learn!)

At the market:

Ou mus fod' material (How much for the material?)

D' material na 5,000 leones (It's 5,000 leones)

It too day, bring d' price dong (It's too expensive, bring the price down!)

Ah no JC (I didn't just come/ I'm not an idiot)    Love that one!

4 am, C ward.

4 am on night shift and pulling out all the stops and full arsenal of aides to keep me awake while my patients merrily snore. Out come the ladies; Lady Antebellum and Lady Gaga - she has it right lady Gaga, well, on some things; "Just dance - gonna be ok, too doop too doop" and Apphia is just shaking her head next to me at my 4 am boogie. The stroopwafelen is out and red eye reduction drops. Oh yeah. That old guy comes to mind "for dry, itchy eyes, Clear Eyes is awesome."  And caffeine! And catching up on friend's blogs and cyberstalking facebook photo albums - and finding out who all the insomniac americans are... who'se awake and up with me on facebook. And bleaching surfaces. And checking those charts again, yup, did that twice already. Checking on the cute babies. Visiting the next ward over to see what's up there.

Comfort

don't know if this will work or not... one of my friends wrote a great blog post on Comfort, with a picture of her as well, postop.

http://ruthnurse.blogspot.com/2011/10/max-fax-patients.html

In and among the containers

No, I don't usually go walking among the containers, we were coming back from the orphanage.

This is a Terex. Pronounced T-rex. They will eat you up if you don't watch it... drive like maniacs :-)

Parallel parking a container ship

Glad I didn't have to do it. They do come close though! Might explain why I was making a face :-)

Laughing Comfort

So I was having a tickle war with two small boys in the hallway of the hospital wing this evening, and another little 11 year old girl joins us. She's got incisions all over her face, but is playing with two large gloves blown up into balloons and laughing. It wasn't until one of the other nurses asked her her name that I realized who it was; Comfort! the sweet child with the massive facial tumor we removed that I wrote about earlier. Didn't even recognize her! Praise God! Running, laughing, talking clearly, the works!

On dressing Mafula and spiritual warfare

The bravest lady we're caring for now is Mafula. Mafula is about 46 years old and was burned last November to within an inch of her life. Pretty much from her ears down to her knees, her skin all melted together and fused. Dr. Tertius performed wound contracture releases, allowing her to raise her head from her chest, where it was fused together, and her arms from her sides. Imagine being caught in a fire and the subsequent pain; you shrivel up and hold yourself, then skin does what it does best - it heals, the pain subsides and you find yourself permanently curled up in whatever position you curled into initially. We have lots of children with little curled up hands who Mercy Ships has released. There's a Paula Kirby poem on wall in OR waiting room about "tough love 'neath a surgeon's hands." No kidding.

Mafula has been undergoing dressing changes that take three hours in the morning and then again in the evening. Now, we premedicate her with a good dose of pain medicine and sedatives to help as well. But there is just no taking it all away, and three nurses are required to help.

It goes like this. First her clingy coban wrap is removed, then the Kerlix (gauze) at this point she starts crying, out of fear knowing the bottom layer is coming. She also starts singing. I've never used singing as a coping mechanism during a dressing change before. But she sings and sobs, holding our hands and making us sing with her,
                     "Tell Him tenki, tell Him, Tell Papa God tenki
                      What He do for me, I do tell Him tenki
                      What He do for me, I do tell Papa God tenki"

Talk about being able to thank God in the midst of bad circumstances!

The bottom layer peels off her dressing, exposing her burned flesh and donor sites... let me explain why this is so painful. Imagine you've had your skin burned off. Bad enough. You get skin from a donor site on a thigh, usually, removed by something that resembles a cheese grater, shaving bits of skin to be attached to the graft site of burned flesh. So your burn patient now has two sites that are beyond belief painful to touch/expose. A mere breath of air is sensitive, let alone us touching it to cleanse and redress.
So this layer comes off and she tells us "Time to pray, time to pray, time to pray!" Where we then take turns praying over her, for pain relief, for peace, for calm, for healing. Then she turns the song to,
                           
                                 "Tell da nurses, tell dem, tell da nurses tenki"

At which point I'm crying along with her. Way to break my heart.

Please pray for her. As of yesterday we are down to doing her dressing change just once daily, and her sites already look so much better than what they used to, but we're really praying for some supernaturally-enhanced wound healing for her, that her sites would heal faster than what they have been and to keep infection away.

One of the nurses asked me yesterday at the end of our shift if I think that Mafula's wounds wll heal before we sail away, to which I answered, "Well, if prayer has anything to do with wound healing, yes." And as we are all praying a ton for her, we obviously believe it, so the answer is yes. She will be healed, in Jesus' name, before we leave.

Which leads me to another question that I'm going to have to ask my pastor or someone when I get back home, is about spiritual warfare. I get the feeling I know zip about it and like it's not so much of an optional thing over here as we might be lulled into believing at home.

At home it's a different battle. You get lulled into apathy and comfort - like the Green Witch in the Chronicles of Narnia who enchants the children by playing on her mandolin to get them to forget that there is another world to which they belong to "thrum, thrum" on her mandolin, sweet smoke filling the air to blind their senses and make them forget where they come from and where they belong to. That's America to me. Overloaded with information so you don't know what to care about or that there is a world in pain. 28,000 children die of hunger every day "thrum thrum". HIV/AIDS is decimating the population of Africa leaving 3/4 of the population under the age of 16 "thrum thrum thrum" "forget forget forget". Here you hold the hands of the people screaming in pain through their dressing changes from fires called down on them by witch doctors. Excuse me??!!

Now, my logical little brain wants to find a good, physiological reason as to how this happened. Mafula was in her bathroom, in a cinderblock house, not the wooden structures that you can easily see going up in flames from the open-fire cooking going on. There were no gas lines, there was no flame in or around the house, she was in her bathroom, and she burned, and nothing else. At first we had thought that she was caught in her bathroom as the house burned down around her, but Harry, one of our day volunteers, a lovely Christian guy who is friends with her family tells me that the house is intact. The only way he can reason is that it had something to do with the witchcraft which he says is very very common. Mad at somebody, go see a witch and get her to burn somebody. He told me of a few instances where he has even seen people "followed by flame" who were in a crowd, and only they got burned.

Now, again, my mind seeks other explanations, but we ca't find our way around it on this one. Ephesians 6:12 "For our struggle is not against flesh and blood, but against the rulers, against the authorities, against the powers of this dark world and against the spiritual forces of evil in the heavenly realms." So as we battle alongside Mafula, sharing in her suffering, praying over her that the Lord would be merciful, I see; these spiritual battles do very much so spill out into the physical realm, but we don't forget where the battle lines are drawn. It's so much deeper and farther than what is encompassed on the work shift.

Frances, one of our lovely nurses was praying during hospital devotions on Tuesday morning that the ship would leave a spiritual stronghold here in Freetown, and encouragement for the saints who live here, and a beacon of light. I think it's part of God's plan that he knew that this ship needed to be placed at the end of Bad Boy lane, leading off of Savage Square, in eastern Freetown (the sketchy, shyst-ey part of town). These parts of town are aptly named and I'll just leave it at that.

So all that's to say, if you feel led to pray for the ship, our patients, their lives, their healing, their hearts, minds and souls, and the hearts and minds of the saints in Freetown, and for the testimony that they will take off the ship when they leave, please do so. This is serious business. You yourselves, read Ephesians 6, wow! Paraphrasing: "Put on the full armor of God. Stand firm. Be alert, always keep on praying for all the saints. Pray also for me that when I open my mouth words may be given me so that I will fearlessly make known the mystery of the gospel, for which I am an ambassador in chains. Pray that I may declare it fearlessly, as I should."

Where are all the nurses?

Where do the nurses go when the sun is out and not on shift? Why deck 9 of course.

Lovely ladies, Kari, Merry, Annike and Frances

Jessie, Lynette and Kelly

You can see where we're docked, Freetown on the starboard side, lovely storm brewing that cut our fun short.

An hour in the Africa Mercy Operating Rooms

Got to go down to our OR's for a few hours this week, and WOW. Are all OR's as cool as this? (Or theater as my British friends call it). In the space of two hours I got to see pieces of 6 different surgeries in progress in 4 OR rooms.

In the first room, Dr. Tertius Venter from South Africa was putting back together a man's toes that looked like he'd stepped on a landmine - a "T-bomb" as the OR staff joked - he had localized macrodactyly - i.e., his toes were enormous. They hadn't stopped growing so Dr. Tertius was debulking them, taking out extra tissue, fat, muscle, and fashioning new toes for the chap that fit in shoes. Plump weird and way cool. Not a huge fan of the little basin of extra toe pieces though. Gag.

The second about broke everybody's heart around and what a priveledge to see her surgery. Sweet little eleven year old girl who was flown in from Nigeria to have her surgery. I had seen her quite by accident before her surgery. I'd gotten up late one morning, went for a cup of tea on the 5th deck cafeteria, looked down and choked on my tea. This little girl, calmly waiting in the admissions tent had a bone tumor the size of a melon right below her eyes. A massive bone tumor. Solid as a rock made of enamel and calcium. You couldn't discern a face because all there was is a huge tumor. I wish I could show you picture, but i'm sure that the Mercy Ships will be writing an article on their website about her in the near future, so keep your eyes out. When I walked into that OR, Dr. Parker had been at it for about 3 hours already. The tumor was sitting on a side table with a couple of teeth sticking out of it, and the little girl didn't have a face at that point, just a bit hole.

It's a fascinating surgery and what a miracle that we have this awesome team who can do this surgery. It involves taking out the tumor, opening up a flap on the side of the head, bringing down the temporalis muscle to swing down and create into a barrier between her nasal and bucal cavities, then sewing that flap back after placing some drains, and then creating a face out of the hole that is left after the tumor is out. All I could identify was the child's tongue. And guess what, apparently she's doing just fine two days after surgery. I can't wait to see what she looks like.

The other four surgeries were cataract removals. Super way cool 'cause one minute they can't see and the next they can. They're awake for the surgery, with local anesthetics deadening the eye and (I hope) something to chill the patient out. I got to watch the eye surgeons slit into the base of the squishy clear stuff, scrape out the cataract, replace it with a lense and then suture it back shut. And the blind shall see.
One dude needed a bit more anesthetic as he flinched... they were asking him, "Are you feeling pain, do you hurt?" and he wasn't answering.... I busted out my sucky Krio on him, being a nurse, I do know how to ask a patient if he's in pain. The surgeon looked up at me wide-eyed and said, "Welcome to the Eye Team". heehee. yeah right.

Lionel just became way even cooler in my eyes.

Seventy two hours of prayer

I am unbelievably blessed and so completely not worthy to be working alongside such fabulous nurses as they have onboard the Africa Mercy. I will maintain it as long as I live. Caring, like, for real. Hearts full of compassion and brilliant ideas for their patients, such as the latest scheme some great soul has cooked up. As the nurses we're doing a 72 hours of prayer for our hospital, the ship, our patients, time of personal reflection, confession of sin, dedicating our steps to the Lord, using the time for worship and communion with the Lord. We're praying for the physical recovery of our patients and so much more importantly for their souls, that they may come to see and know the Lord while onboard. That those who know Him may know and see that He has not forgotten them.

E Ward has been redecorated by creative minds to be comfy and cozy. There are dimly lit lamps around the room, pillows on mats on the floor, somebody found a carpet! There are corners for creative expression and words the Lord gives us during this time. Journals to write reflections in. A map for us to pin requests on in the world. A cross for us to confess sins at. We are signing up for hour prayer slots, yes, even though the wee hours of the morning and I am so proud of everybody 'cause there are only three or four slots left open. I must admit that my rather skeptical self took a look at this loooong signup list and I did really doubt the nurses alone would fill it, but there they go... with help of a few ancillary staff as well.

I was talking with one of my roommates and she was telling me about how her colleague had visited the mother/baby hospital in town and was horrified by some of the stuff, mainly the sterilization room (chlorine in buckets for O.R. utensils, washing and reusing gauze (!!!!!) and that intubation equipment doesn't get even washed between cases... yeah, here's some TB for you, for you and for you). She was mentioning just a real need to pray for all of this stuff and start doing something about it, where I took her hand and marched her up to our prayer signup sheet... I love it when I see people's eyes light up about something cool like that.. isn't that just the way the Lord works?

So I'm just praying as the Lord pours his mercy out on the people of Sierra Leone through us, that He would have mercy on us too while He's at it... healing those wounds, healing hearts, mending broken lives, restoring individuals to their families and communities.

Yes, I'm on a ship

malaria, disappointment and Uncle Peter

It's the rainy season and malaria is spreading rather rifely throughout the population of Freetown and my guess would be the rest of Sierra Leone right now. People are going down with it rather all over. Yesterday's surgery admission's sheet was a grim reflection on the matter. Surgery cancellations were marked in orange, and of the list of 15 people or so, every other person on the list was in orange, had malaria and had to be sent home without their operation. My heart just goes out to them, to look forward to having your operation and to be sent home must just be a cruel blow. Their disappointment so keen. As it is i'm covered in mosquito bites and here Randy Nabors told me to watch it at dusk and that was my own fault. Yes, I'm taking the doxycycline so I won't (hopefully) take a hit of the bad mojo. (sorry mom!)

It happens a lot with our pregnant patients as well. Standard protocol is to check for pregnancy in women of a certain age and you just don't do it if they're pregnant. They get sent home in keen disappointment - and then the admissions team goes all aghast when they show up the next day, "I'm not pregnant anymore."  This has happened quite a few times already that I know of... and it's just through the grapevine. Heartbreak.

And yet as nurses we have all remarked at one huge difference between nursing here and nursing at home. No matter how bad the news we have to deliver is, the patients here never take out their frustrations and anger on the staff. At home you just brace yourself because you're about to have your very existance belittled if you so much as inform a patient that their surgery has been delayed a few hours. It's not a grim resignation here, although I'm sure there is a measure of that, they just channel it differently. They do cry, they might even yell, but it's not at you. Very interesting and it's been part of why so many of us nurses have enjoyed nursing here... you're allowed to just take care of people and have them appreciate it! Imagine that.

Thank you to everybody who enquired about my grandfather in the last few days. My mom called me this morning to tell me that Uncle Peter has gone to be with the Lord this morning. Please pray for my grandmother today. What a bittersweet joy to know he is in that promised place, he's no longer in pain, he's no longer suffering, no longer fighting for breath, but in the sweet presence of Jesus. I'm crying but so relieved it's over.

Oh, we call him Uncle Peter because although he's really the only grandfather we've ever known, our blood grandfather passed away in 1989. Uncle Peter has been in our family's lives since my mom was a little girl, and Granny and he were married around 15 years ago.

Toilets on the wards

So toilets are sometimes a new concept for a culture long used to holes in the floor. All new patients get a "this-is-a-toilet" lecture when they arrive on the ward, with a demonstration on how to flush, to use toilet paper (and not the showerhead please). And don't wee in the shower either. It doesn't always sink in, but the artwork on the bathroom walls helps. :-)

A moment on night shift

It's 2:30 am, GMT and A ward has finally settled into a bit of a quiet lull, with an occasional cough or baby's cry disrupting the peace. There are 20 beds in this room, however many of the patients are children, so their parent or caregiver sleeps on a mattress literally under the bed. Sometimes mom has another baby, or mom is the patient, so there are two people under each bed. There are a lot of warm bodies packed into this hot room right now!

Some nights it gets complicated when mom decides to sleep on the bed and your patient gets relegated to the mattress below, baby brother is in your way too, it's 3 am and you can't reach your patient to check vitals- 'cause he's buried too deeply in the little cave under the bed. :-) That's when imagination and perseverance kick in - clambering over their bags, pulling at the mattresses with all your might at an angle through the bed's legs, trying valiantly not to land on your own rump, giggling at the situation and wondering how you're ever going to describe this one to people at home. And how that would so not work at home - could you imagine the look on people's faces? "Sir, here's your bed, ma'am, you go right under the bed."

We've switched from general surgery to plastic surgery now, for the simple reasons that those are the surgeons we now have onboard. No, we're not doing boob jobs and facelifts! I would encourage people to check the Mercy Ships website, http://www.mercyships.org/ for pics of what we get up to- crazy facial tumors, burn contracture releases, etc., that we're up to now. I'm learning so much and feel quite a fish out of water, mainly because I have no clue about plastics. Cardiothoracics, all the way. (Go CTSU!)

For example, I have two patients who have seizure disorders and have fallen into fires, whose limbs have shrivelled up and are now useless. So, what our surgeons are doing is releasing the taut skin, the scarring,  stretching out limbs, covering wounds with grafts of their own skin shaved from a healthy spot on a leg usually. So these patients have a graft site and a donor site, sometimes a few sites if the burn was not contained to just one part of the body. It's all very painful as  you can imagine and prone to infection, so we nurses are being a bit overly neurotic about infection control right now. The difference between a clean wound and an infected one can mean a hundred days onboard as you wait for it to slowly heal- with daily painful dressing changes - and we're only here for another 3 months then the ship sails away. Well, there's your motive for prayer for these next few months! That wounds will heal!!

A surefire way to make my heart explode

So this is a shameless plug for my beautiful niece. I have the two sweetest sisters in the world, is all I can say. They sent me this video a few weeks ago, and i'm sharing it with you all 'cause Elie's so stinkin' cute!

some random pics

All the way. Africa Mercy 2011 Crew shirt. With phonetic Krio writing.

Arabic Sprite?!