Nautical Nursing

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.

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."