Olga

This is Olga and visual proof I'm on this ship :-) She's a lovely lady who had just had a volleyball-sized lipoma (lump) taken off her back. I'd taken care of her for two days and on the second day when I got to see her now-flat back, she was all blushes and giggles and "thank you's" and so thrilled to not be hauling that mass everywhere with her.

This sweetheart of a boy, age 12, had his hernia repaired the day before. Shown here with Debra Andrews, my very brave friend from Memorial Hospital in Chattanooga, TN, who accompanied me on this crazy adventure.

What we're doing

Here are some before and after pics of, well, some of what the medical staff is up to on this ship.

Sorry for the poor pics, but you get the idea- good before and after shots.

VVF

  One of the surgeries performed onboard the Africa Mercy is a vasico-vaginal fistula repair. This surgery is done in response to a desperate need in Africa that usually is required after a set of horrific circumstances. The ladies who undergo this surgery have a fistula - a hole - between their urethras and vaginas - caused by prolonged childbirth. Now, when I say prolonged childbirth, I'm talking 3 days, 4 days, 6 days, 7 days of labour. Can you even imagine. Miles and miles away from medical help, these ladies go into labour and every case results in a stillbirth, as no baby can survive being in the birth canal that long. The physiological effects on the mother is that the pressure form the baby's head has cut off the circulation to the tissues around the birth canal and after the horror and pain of the labour is finished, the grief-stricken woman now also discovers that she is leaking uring.

  In African culture, community is everything. In the States you can do an admirable effort at hiding such a condition - there's Depends, people live very isolated from each other anyways, so there's ways and ways around. Here in Africa, you walk leaking urine, a very strong-smelling infected urine and the women promptly get ostracized, laughed away from other people and can't take place in normal life. Sellers in the markets won't sell to them, husbands usually divorce and leave them. It's even a question on our admission sheet for Mercy Ships because the majority have now been abandoned.

How long was your labour? Answers usually 3-7 days
Did the baby survive? Never. Ever.
Did your husband leave you after you discovered you were leaking? About 3/4ths of admissions.
How long have you been leaking? 1 year, 5 years, 10 years. 15 years.

Enter Mercy Ships and the grace of God. The ladies are admitted for surgery and undergo their procedures. Then comes the waiting period to see if they are dry before discharge. The Africa Mercy has the most beautiful, beautiful way of celebrating these women once they are discharged. There is a Dress Ceremony onboard where each lady is given a new, beautiful dress, her hair and makeup done and are given a new lease on life. They are affirmed for the creatures God made them to be and their value and worth reiterated.

I can't listen to these women's testimonies without crying my eyes out. They usually go something to the effect of, "I was in labour for 8 days, my baby died and came out in pieces. To my horror then I discovered I was leaking and have been leaking for 12 years. My husband left me too because he could not handle the smell. But now by the grace of God I am dry and I thank papa God for seeing me in my distress." These ceremonies are loud, boisterous occasions, with guitars, clapping, stomping of feet, dancing, african drums, tears, hugs and smiles. There are no words really. Thanks be to God.

Here are some of our lovely ladies.

"I will praise you because I am fearfully and wonderfully made; your works are wonderful, I know that full well." Psalms 139: 13-15

pictures by Mercy Ships. http://www.mercyships.org/

Deck 7, Port

Day shift on the Africa Mercy looks very different than most hospitals. Ok, we're on a big white ship in Lome, Togo currently, and that continually changes, but one of my favorites is that at the end of day shift, we take the patients to the 7th deck, portside, to allow them to see the daylight (hospital is below the water line on deck 3), make phone calls, see what the world looks like from high up on a ship, see the port and city, and spend time singing and visiting together.

This is where the babies get passed around and I personally marvel at the surgeries that have been performed on other wards not my own. There's always a load of cute babies, either patients or the younger siblings who are not yet weaned from their mothers... and the nurses then make complete fools of themselves, kissing them, oohing and aaahing over their fat little cheeks. It's a lovely time.

the Sarakawa Pool!

Now, every once in awhile you get an awesome treat for being in a foreign land. On the ship itself it's pretty close quarters, 6 persons to a cabin sharing a very very tiny bathroom. Our pool on the ship is also out of commission currently due to a very deep green hue that apparently we've been unable to eradicate.

So, enter the Sarakawa! This is another taste of what dad calls, "suffering in a third world country". It cost us $12 US to get into the pool for the day and was absolutely worth every penny.

There is much more of a contrast in Togo between the rich and poor. Here there is a middle class and even a rather large group of expats-most of the people around the pool were French, and then there was our little group of gringos.

With other Mercy Shippers Rachel Jones, Heather Klaasen, Becca Noland, Debra Andrews and Jackie Huestiss

Togolese Festival of Knives

I'm hoping to find pictures of this, but i'll have to search for them on the web. Adossa - another big cross-cultural moment. Or, what's left over afterwards.

I took care of a patient a couple of days ago who also had a hernia surgery. His arms however bore the scars of a hundred cuts on them. Long scars from one side of his arm to another, all up and down the length of his arms.

So now of course, I'm worried. You see somebody at home with scars like that, they've been cutting on themselves, but usually they're shorter lacerations, in various stages of healing and lighter. Some will still be scabbed over, some still bleeding. This fella looked like he'd survived a murder attempt.

So I asked. Tracing the scars with my fingertips, and questioning look. Thank the Lord for interpreters-in the next bed over we have a patient who is also a Mercy Ships translator. He tells me, "Strength!"
Me, "I don't understand."
Translator, "He is strong. He has proved his strength."
Me, "He cut himself to prove his strength?"
Translator, "Yes. It is cultural here, in the northern province. You prove your male strength."

Come to find out, it's called Adossa Kadao, and is just that. Men of that province, as part of their cultural rite of passage, cut themselves to prove their strenght and fearlessness. The women dress up to the hilt and there is a lot of dancing as well. Once the festival is finished, the men who've participated in this Festival of Knives then rub ash into their wounds, so that their scars will be prominent and show to the world that they are a strong man. I suppose we have our western equivalent in our NFL rings to prove you've run headlong into a wall of muscle seemingly developed for human destruction as well. sigh. men. just gotta prove you're that strong. sheesh. Trying to read up on it, apparently the festival is not for the faint at heart even to watch, and also involves the men drinking some kind of potion that is supposed to protect them from the knives hurting them (according to the ever-infallible wikipedia).  :-)

There is a video on Youtube that somebody has posted, but I honestly can't say I can recomment it as I can't load youtube on the ship - takes too much broadband width, so it, along with skype, are out of the question, but I would be interested in hearing anybody's take on it. I also won't post anything more, shall we say, visually florid, than these pictures 'cause I know that there are children who read this.

My patient had a good laugh with me after he woke up from surgery, recovered well, and then he had to take his first postoperative walk down the ship hospital hallway. Hernia patient's abdomens are tender from their new incision, and I asked him if this is strong enough to prove he's a man- and he laughed at me and said yes, this is a big cut too, but that this one will end his suffering.

Such is the difference when God is in the picture.

Togolese sunset over the m/v Africa Mercy

Donkey under anesthesia

Donkey got placed under anesthesia today. Or, at least that's what my little 8 year old patient, Iliasson, thought today. He is onboard the Africa Mercy to have his inguinal hernia repaired today. When the time came to go to surgery, I held his hand and walked him and his mother down to the little room where the OR personnel come to review the patient's chart and take the patients back to surgery. He was all smiles and giggles in the morning when I handed him a sheet of paper and some crayons and spent the time coloring a very vivid african drum. His initial reticence at this strange room on this big white ship was overcome earlier when he danced with one of the nurses during ward worship, but his little smile faded to a sombre, scared little look once we headed down the hall.

Until donkey appeared - a stuffed Shrek donkey that filled his lap. The OR nurse and translator came out and placed donkey on his lap and started to explain that donkey is also having his surgery today to have his hernia repaired. Donkey is going to have a special mask placed on him (on goes the mask) and donkey is going to breathe deep and fall asleep, and when the operation is finished, he will be able to get up and play (donkey bounces around).  "Then you will do the same, we will place this mask and get you to breathe deep (the child complied) and when you wake up, you can then get up and play.

The translator then prayed for this little one and in he went to the OR, clutching the donkey. The recovery room nurse told me that Iliasson woke up with a smile from his anesthesia and later that day proceeded to wallop me in a game of balloon volleyball. He at least will not be one of those suffering with a massive hernia for ten or twenty years until some help can be found.

Whistling and Dwarves

I have arrived in Togo! I'm blessed to have another run on the Africa Mercy, nursing those assigned to my care. I was going to write about the trip here and culture shock, but a conversation on the wards today trumped that.

Our charge nurse for the evening was merrily whistling a tune, and she stopped short and asked one of the local day workers (our translators, et al.) if whistling is considered rude in Togo. She said that in Sierra Leone, in the town where she lived inland, it was considered very rude for a woman to whistle and that only men were allowed to. It is so rude the women get beaten for it.

The day worker smiled and said, "No, it just means that you're happy." But then his smile faded and he added, "unless it's past 6 o'clock".

Charge nurse; "What happens after 6 o'clock?"

Day worker; "You will find yourself in a forest."

At this point i'm confused so I ask "If you whistle, does that mean you're telling people you're lost and need some help?"

With a puzzled look, he tells us, "No, the dwarves will take you away. You will find yourself in a forest unable to get out. You don't whistle after 6. But I'm from Ghana, maybe that isn't the same here." He motions to another translator, from Togo, and repeats the scenario to him in rapid-fire French. He gets a definite nod and answer and they both turn to us and say that yes, whistling after 6 o'clock pm definitely will call to the dwarves.

So our charge nurse smiles and asks them, "So should I not whistle then after 6?"

Day worker, with a laugh, "Of course you are OK, you're on a ship!"