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.