Edoh

Don Stephens wrote the following from his book Mercy Ships of Mercy (2005):

“She’s tall and slender, sixteen going on seventeen, a French-speaking African young women  with the blood of three nations in her veins, or so it was eight years ago, when a younger Edoh underwent several surgical procedures and blood transfusions from crew members onboard a Mercy Ship.  She was nine at the time, a tiny child with spindly arms and legs and a massive tumor on the side of her face.  The renegade mass had shifted her left eye two inches off centre and stretched her mouth to an unimaginable eight-inch diameter.  Teeth stuck out at odd angles, and worse, a new backward growth of the tumor threatened a slow and horrible death by suffocation.  In shock and horror, her parents, having exhausted every possible avenue of hope, finally gave up.  They, along with their village, prepared for her death.  And then her parents heard that a Mercy Ship was coming.  Edoh remembers only the blood she would cough up, the difficulty breathing, the fear in her parents’ eyes.  She remembers too, the day they traveled a long way to stand in line, how she suddenly began fighting for breath, how she was snatched up from the press of a huge crowd and tossed screaming over a steel gate.  She remembers landing in the arms of a giant white man and screaming more until she finally saw her parents again, inside the big ship on the other side of the fence.  Years have now passed, and the Mercy Ship has docked once again in Togo.  Edoh has returned for a follow-up small reconstructive surgery, and everything comes flooding back to her, especially the care and the kindness of the nurses and the surgeons.   She understood nothing of their speech, then, or now.  But there is no forgetting the language of their touch.  And when she does find someone to translate her words, she tells them all she wants to become is a nurse.” (Ch. 8)

 Psalm 23:4 Even though I walk through the valley of the shadow of death, I will fear no evil, for you are with me;your rod and your staff, they comfort me.

Dovi Edoh is now 24 years old and the spunkiest African women I’ve met thus far from Togo during this field service.  She’s able to converse quite a few words in English and seems to understand everything when spoken to in English.  One thing I’ve realized is African people are brilliant at learning language.  I’m not surprised anymore now when I hear that someone knows seven languages.  Last week  she arrived back on our unit feeling very nauseous after undergoing an ICBG (iliac crest bone graft) and was quite withdrawn and appeared quite depressed.  She’s finally back to her usual self trying to make all the nurses and other patients laugh and calls everyone “her sister”. She’s constantly knitting booties for all the babies on the ward and seems to always have a smile on her face, quite a contrast from last week.  It was quite shocking hearing her story, knowing that she was at one time destined for her life on earth to end at only nine years old from slow suffocation or so her parents thought.  It also made me realize how loving and unselfish a group of random strangers can be.  Dovi was unable to breathe and the people of Togo who were also waiting in line that screening day knew that and let her cut in line so she might live.  They didn’t just let her cut in line, they crowd surfed her in order to save her life so she might live.  After being thrown over the gate and landing in the arms of a Mercyshipper she was trached immediately so she wouldn’t suffocate from her massive tumor.

Her mother was also on Mercy Ships these past couple of weeks receiving a hernia repair.  They’re from KPalimet, the prettiest place in all of Togo. Its always fun for those who have been here long-term to have reunions with these patients.  Mercy ships rotates around the same countries so patients often come back for more surgeries every couple of years.  They are happily welcomed back and have an instant bond with those who remember them.  Don Stephens, founder of Mercy Ships, and his wife remember her from many years ago and as soon as they saw each other again an instant connection was rekindled.

These past few weeks have been pretty interesting.  The surgeries are coming close to the end with the last surgery being on June 1 because we want to give the last surgical patients several weeks to recover and heal before the ship takes off to its next destination.  Time is flying by and I'm trying to really appreciate and soak up everything here, but at the same time its hard not to anticipate coming home a little over a month from now and seeing friends and family whom I haven't seen in nearly four months.  I really am going to miss the Togolese especially all the kids and babies so it will be bitter sweet.

60 minutes has been here all week because they're going to show a short segment on Mercy Ships in October.  Its kinda funny how they do hours and hours of footage and have been here for several weeks, while they only plan on showing less than 20 minutes on Mercy Ships during the episode.  There's definitely a ton of work that goes into their show.  The host of 60 minutes came today to interview my charge nurse Ali who has been volunteering with Mercy Ships for several years, Dr. Gary, and Don Stevens the founder of Mercy Ships who also flew in for the interview.  They've been following several patient's stories so it will be interesting seeing which patient they choose to aire.  They're extremely intrigued by the whole blood donation process because when we give blood it usually goes directly to the patient within five minutes instead of waiting in a fridge so they were really hoping to catch some footage.  One of the filmmakers was shocked when he saw Esther's before picture and couldn't believe she was the same person. 

Esther still has a long way to go though.  They've been downsizing her trach all week and were finally able to officially remove it yesterday.  She can now talk although her voice is quiet and it takes quite a bit of energy whenever she says anything although she has been making tremendous progress.  When she went back to the OR last week to get her whiteheads pack(gauze packing with antibiotics) removed, Dr. Gary decided to do another flap on her to make her "prettier".  He also decided to give her more of a nose since he had extra tissue to work with.  She looks absolutely amazing although the finished product won't really being complete until at least 6 months from now.  She has quite a bit of extra skin which isn't taken off initially because over a period of six months the skin contracts back to the way it used to as it does after someone has a baby or loses weight.  If it is removed too soon it would cause major problems and could make her skin way too tight.  It will also take time for the skin to change back to its original color that had been changed from the stretching over many years.  The next time Mercy Ships comes back to Togo or a country close to Togo she will qualify for an ICBG(iliac crest bone graft).  This is when part of the hip bone is taken and placed over the titanium metal plate that replaced her mandible from the mandibulectomy.  Bone miraculously fuses to titanium which then adheres to the tissue on her chin.  This is necessary because over time the titanium rubbing on chin tissue causes friction and can actually come through the chin and become visible.  If this procedure is done initially the hip bone transplant would likely fail because the previous tumor would prevent the site from being sterile.  Therefore, she has to wait at least 6 months to get this procedure as well as then get any extra skin also removed.

As far as patients having any real complications I believe we have been really blessed this field service.  However, one patient sadly did pass away last month named Chantal who was only 25.  Towards the end of her life she had been placed on hospice because of a chronic disease that had taken over her body and everything we were doing just wasn't working.  It was quite difficult for some of the nurses who had grown quite close to her.  She came from a family that was really involved in voodoo and had a daughter who was only 4 years old.  I was told though that she had accepted Christ just two weeks before she passed away so even though her physical body wasn't healed perhaps she spent the last few weeks of her life on the ship for a bigger purpose.

A complication did start to develop with a patient named Esther, a different Esther.  This Esther had a cyst drained above her left eye.  She had been a patient of Mercy Ships in 2010 so she was chosen to receive this simple procedure.  I arrived on shift and was quickly told by my one of my roommates that there was a patient in PACU who had been unresponsive for over 5 hours and the doctors didn't know why.  They had completed multiple tests including a head CT and had pretty much ruled everything out.  I looked down on my assignment sheet and then realized that she was going to become my ICU patient.  I started getting a little nervous especially because no one really knew the reason on why she wasn't responding to any stimuli.  During each handover all the nurses and day workers gather around in prayer for our patients or anything else we want to pray about and we also discuss any announcements or things we need to work on with charting ect..  I usually avoid praying out loud in front of large groups of people, but every blue moon I get a really strong feeling to pray for certain things with other people.  This time it was for Esther whom I was about to have as my unresponsive patient.  A couple other nurses also prayed for Esther.  Then literally about five or ten minutes later one of the PACU nurses comes in and reports to us that Esther has just woken up without explanation and is fine now and the doctors can't explain it and are baffled.  We then half seriously and half jokingly told the PACU nurse well we did just pray for her.  One of the doctors then came up with a syndrome that I've never heard of that basically is caused by a reaction to one of the muscle relaxants she received during the procedure called central anti-cholinergic syndrome.  They then brought her over to me about 15 minutes after that and my whole shift I didn't have any issues with her.   I happened to see her joyfully leaving the ship yesterday to go home and we waved to each other as she was leaving the ships entrance.  Perhaps it was just a coincidence that right after we all prayed for her she came out of it, or maybe God really did answer our desperate prayers that she would be healed.  Either way though I'm happy that God healed her and she was able to go home without any complications.

Mother's Day Suprise!

Thank You Lindsey!
Around the world Hugs and Kisses,
Love You,
Mom

VVF Dress ceremony

B ward has been taken over by all the VVF(vesicovaginal fistula) women this last month.  I work on D ward with the maxfax patients so I haven't had the opportunity to work with them.  However, I was able to witness one of their dress ceromonies which they have one to two times a week.  It was incredible.  They all looked gorgeous with beautiful brand new dresses and hats with matching jewlry and earings and even some makeup.  They have dress ceremonies whenever a group of them are deemed "dry" meaning the surgery worked and they are cured.  The women are also given the opportunity to recieve a mirror, soap, and a Bible in their language.  The women all shared their testimonies many of which included years of praying that they would recieve a cure.  Many of these women have been shunned by society, left by their old husbands, and sometimes their own family.  It was quite a site to see all these women smiling and dancing.

Esther

There is a girl from Nigeria, sixteen years old, who we have been expecting and were told was coming last week.  She is one of the few patients who we know will go to the ICU straight from surgery because she would likely need a tracheostomy due to the tumors occluding her airway.  All the nurses were asked to start praying for her last week and we were told her name is Esther.  She is a special case because she will be getting both a mandibulectomy and a maxillectomy because her facial tumors have been growing in both places.  They started when she was 3 months old and now she is sixteen.
Yesterday my roomate and I went outside on the dock and stopped by the admissions tent while we were waiting for one of the jeeps to arrive so we could visit the Hope Center.  We started talking to some of the patients and then my roomate immediately put two and two together and noticed Esther.  She immediately said Esther, your name is Esther right!? She told her we have been waiting for you and praying for your surgery and are so glad you're here.  Esther smiled and gave us both hugs.  Since she's from Nigeria she could speak English which was very very nice.  We talked to her for awhile and found out she has a very large family with six siblings.  She was wearing a very pretty dress and flower flip flops with a colorful scarf around her face.  She said she couldn't wait to go inside the ship and we assured her it shouldn't be too much longer. They just had to clear out the other patients and clean her bed.  Later on in the night my bunkmate and I peaked in the wards to say a quick hello and wish her well for her surgery.
So right now she is still in the OR getting worked on by Dr. Gary who just had his 60th birthday a couple days ago.  I was told that the mandibulectomy went well and now they're working on the maxillectomy which is more complex.  She's been in everyones prayers all day and I can't wait to see her after surgery and talk with her in English.  I work four nightshifts starting this weekend and hopefully will get to have her as my patient.

Its hard to put in words everything that has gone on these last few weeks on the wards.  The longer I've been here the more I've been able to connect with the patients and the easier it is to understand them and know how to act around them.  The language barrier and cultural differences made it difficult to connect in the beginning, but now I find myself becoming attached to many of the patients and really miss many of them when they leave.  More than anything though I'm more than ever starting to understand that many of these people really are going through live changing transformations spiritually, physically, emotionally right before our eyes.. 

There are several people who come to mind right off the bat.  The first one being a young girl at the age of 13.  I remember when she first came to our hospital a couple weeks ago with half her face covered by a cloth.  She looked around realizing that it was now safe to remove her veil.  It was rather shocking at first, but after looking at her straight in the eyes you could see behind the massive tumor on the right side of her face she was just the same as any other 13 year old girl just maybe a little stronger.  I showed her where the shower was and then went over what to expect from the surgery.  She listened to everything the translator said and didn't seem to have any fear at all.  There wasn't anyone with her as her uncle would be coming the next day.  Even on screening day when over 3,500 people came through the lines I don't remember seeing anyone with a facial tumor this large.  Dr. Gary would be performing her surgery the next day who has 25 + years of experience with maxillo facial tumors on Mercy Ships.  He seems to be the most passionate about facial tumors.

The next day we would show her the mirror so she could see herself and that it was real.  The tumor really was gone and a tear streamed down her face.  She told Dr. Gary that she had started to get really really scared from the tumor.  She had every right to be since this tumor likely would have slowly suffocated her.  Dr. Gary then told her that Jesus was taking her on a journey and she smiled.

Another patient that comes to mind goes by Alex.  He was referred to us by another mission hospital in Chico.  Surprisingly we have had several cases just like his affecting the eye.  Basically a tumor starts growing in their eye and completely takes over.  If there is no access to medical care it can be quite horrifying for the person and their family.  They likely just won't attend school and people will think they have been cursed.  In the beginning of him arriving to the ship before his surgery he had quite a blank expression on his face.  He was pretty withdrawn and didn't interact with any of the other kids.  However by the time he left he was playing with all the kids and actually became quite the trouble maker:) We even had make a list of rules for him including putting him in time outs occasionally only because we loved him.

Payakey is another one of those patients who I really really don't want to leave.  He has practically become part of our nursing staff.  He knows Kabaye and French and therefore helps translate from Kabeye to French since its such a rare language.  The other day he was helping me with one of my fresh post ops doing everything he could think of to help me from covering her up with a blanket to helping me move an IV bag onto the hook.  He is a patient who has been here for so long because we made him a nose, which is a very involved process with multiple sterile dressing changes and several surgeries.  His nose had been cut off in a robbery many years ago so its quite a good feeling knowing this wonderful man finally got a new nose.

It is not unusual for miracles to happen on this ship.  Like one of our surgeons said, we don't exactly go looking for them either.  None of us like feeling out of control ESPECIALLY in the medical profession.  However, there are those times that we really really need them and we are reminded that God is the real healer in all of this.

This is Bernice.  She is one of those toddlers who is constantly being held by all the nurses because she is just so adorable.  She's very very quiet and stares intently in peoples eyes.  She came in to get her cleft palate and cleft lip repaired.  She is an orphan who was brought in by a lady who works at her orphanage in Ghana.  When Bernice came in it was found that her leg was hot and swollen.  It was then determined that her femur had been broken as was seen on an x-ray, likely a few weeks prior.  This outreach we weren't treating any orthopedic patients.  Therefore, there was no reason we were to have an orthopedic surgeon on board at all at any point during our time in Togo.  However, God just so happened to have provided us with one at the right time.  The surgeon who had come for a very short time to treat the hernia patients in A Ward just so happened to also be a pediatric orthopedic surgeon.  What are the chances?  It truly seems as though God has been looking over this orphan.  Instead of being crippled for life, God provided her with the exact type of surgeon she needed at just the right time.

Bernice attacking me with a phone:)

Our hostel

The canopy walk

The bridge approximately forty feet high

Cape Coast, Ghana view from the castle

Hanging out on the beach

Cape Coast Beach

The castle from the 1600s

From inside a cell.  100's of people who would be sold as slaves would be forced to live inside a cell which would end up getting extremely dirty

Inside a female dungeon

Bats make a home in a cell in the castle

Crocodile outside our hostel.  The manager of the hotel let us feed them bred crumbs.  There are about 40 crocodiles in their pond.  We almost went paddle boating with them, however the paddle boat wasn't working at that time.

Crossing the Border!

C 

Sticker I saw in the window driving through Ghana

 Arriving in our hostel

Protected from malaria by a mosquito net

Adventure to Ghana

            This past weekend was spent with my friends Jill from Indianapolis, Susanne from Canada, and Victoria who is one of our translators.  She is a native from Ghana so going to Ghana with her definitely made our trip go much smoother.  We all had the weekend off so we left Friday and spent 11 hours in a taxi van getting to our destination.  On our way there we had to cross through the border and show them our visas that we had purchased the previous week for 20,000 ceefas each or $40 USD. However, it was cheaper for my friend Susanne because she's Canadian.
          Crossing the border was an experience in itself.  I used some of the tips my Dad's coworker who's a native from Ghana gave me on traveling through customs.  Some of the guards weren't very friendly especially to this poor women who had cans of coke and a bag of beans that they conveniently ripped open.  They then threw her cans across the table probably because she wouldn't give them any money is what Victoria said.  We then found a taxi van that Victoria bartered and found for us.  On our way there our taxi van was stopped randomly by guards and only us the "jovos" were made to get out.  Victoria was also made to get out because she was with us.  They then brought us to a room with a curtain to show them our passports again and a guard started questioning us.  We then acted very firm with them and they finally let us go and Jill had apparently been praying the whole time.  We thought our taxi van had left us because they were no where in sight and we had already paid them, but then found that they were waiting for us the whole time.  The police had only made them move ahead on the road.  After getting back into the taxi I looked over and saw a cross sticker that happened to be in the window.  I then got this feeling that God would be with us this trip.
            We then arrived in Akra and had to switch to a new taxi.  Taxi vans are quite hard to come by at night so as soon as we pulled in we were closed in by a crowd of people who started opening our doors.  My friend Susanne was pulled out of the taxi and landed on the pavement in a puddle of who knows what, while Jill pushed her way through with her luggage.  Meanwhile, I'm still in the very backseat trying to figure out how I'm going to get out due to that fact theres no way out and tons of people are coming in pushing their way through.  All of a sudden I see the trunk open and a lady swings her luggage over the seat and starts coming in through the back.  I then take this opportunity to fly over the back seat through the trunk with my backpack and make it out into the street before the crowd sees the trunk open.  I then give my friend Susanne some hand sanitizer and we make our way to find a new taxi.
           We finally arrive at our hotel, which is called Hans Cottage Botel and chose a room with four beds and a couch.  It is considered a hostel and we only had to pay $5 USD per night per person.  Victoria immediately started killing huge spiders and all kinds of bugs I had never seen before.  She even killed a little lizzard only because she said it was poisonous.    While Jill was showering a frog jumped on her back and crawled all over her until Victoria wacked it with her shoe.  After much screaming that went on several Africans and the manager came out to see what all the screaming was about and we told them there were just a lot of bugs.
           The next day we paid a taxi driver quite a bit of money to drive us around Cape Coast to visit a castle which explained the horrific history on slavery.  The castle had quite a few dungeons and cells where the slaves had been kept in the 1600s.  The Dutch and the Portuguese had owned the castles and bought and sold people who were shipped to other areas of the world.  It was a very weird and creepy feeling being inside a cell that I knew many women and men had been treated so horrifically in.  Jill said that it gave her the same feeling as when she had visited the holocaust museum.
After that we went on a canopy walk, which is basically a bridge 40 feet in the air through a forest.  There was a college class visiting from London who were in Ghana to do a mission trip on micro-management.  This one guy from their group kept screaming at every bug he came across.  You would have thought he was being attacked.
           That night Jill realized she lost her ipod touch.  This had everything on it including all her pictures, her music, everything. She was more sad that she had lost all her pictures from the Hope Center of all her patients than anything.  She thought she had left it in our hostel and didn't think she brought it that day.  It made her feel sick thinking she had lost it.  We then started praying for her that it would somehow turn up or that someone would turn it in.  We then suggested that she call our taxi driver b/c maybe just maybe she had indeed brought it.  We just so happened to have his number.  The next morning Jill called him and he did indeed have it and said he was going to try to get a hold of us at the hotel to give it back.  He had found it and some bananas that we forgot in the taxi.  Him giving it back to Jill went above and beyond. He could have made a lot of money off it, but instead he was an honest man.  It was quite refreshing b/c quite often you have to be on guard.  Palm Sunday we spent the morning thanking God for protecting us and keeping the stuff thats important to us safe.
            On our way back to Togo was also an adventure, but with Gods protection we all made it back safely.  It was very nice though to come back to the safety of the ship with our Girkas from Nepal, the security guards.

                                          Everyday we go outside on the deck with the patients who are able in order for them to get some sun and run around.  A lot of times someone will play the guitar for a little bit of entertainment.

This young girl is definitely one of the most inspiring people I've ever met.  She is soo friendly and fearless and is always smiling.  She fell in a fire when she was very young and had severe burns.  Mercy Ships did surgery on her a couple years ago and now she's back for more surgeries.

A Walk To Beautiful

Next month we start taking VVF patients.  This population of women are our modern day lepers.  They are treated as being cursed and a lot of times are for the most part shunned by society and many times are shunned by even their own family.  VVF stands for vesicovaginal fistula and this condition is a lot of times caused by poor obstetric care and early marriage in women.  Many of these women needed to get a cesarean surgery but instead went into labor for days and many times sadly lost their babies.  VVF is very preventable and treatable if help is there.  Many of these women are forced into marriage when they are very young, sometimes as young as 10 or 11.

We watched the documentary called A Walk to Beautiful to give us more insight on these patients we'll be getting next month to know where they're coming from.  This documentary was on Ethiopian women who went to a clinic in Addis Abba which is ironically where our flight originally got re-routed to on our way to Togo.  I remember getting on the plane and we had to ask what country we were going to because we had never heard of Addis Abba.  Mercy Ships also has a VVF clinic on land in Sierre Leon that we were told about.  Sierre Leon's main language is creole which is broken English.

http://fistulafoundation.org/

~~25th Birthday~~

Yesterday on my 25th birthday was spent eating a lot of cookies and brownies that were made by some of the other nurses.  Several of the other nurses and crewmates got together in the Queen's Lounge to watch one of my all time favorite movies Signs.  For some reason watching it this time was a lot more intense and scarier than previous times seeing it probably b/c of the swaying back and forth of the ship and the creepy small windows that people frequently poke their head against to peer into to see whats going on.  My new bunkmate Jill from Indianapolis and other close friend Susanne from Canada wrote me cards and organized everyone to help come celebrate.  They had also made a sign on the door to my cabin that was elaborately decorated w/ balloons and their bubble lettered artwork.  My previous bunkmate Summer had bought brownie mix supplies for the party before her departure a couple days ago and had written me a card for my birthday in advance.  
The departure of several of the crewmates a couple days ago was one of those times that were tough due to the fact that you grow close to and comfortable with the people that you first met on the ship or randomly in the airport in Washington D.C. waiting for our planes, and thats planes plural, to be fixed.  We also spent hours, and thats hours running around Brussels airport trying to get Summers flight changed so she wouldn't have to sleep in a random African country, Dakar, by herself.  (and actually secretly purposefully missed her connecting flight:) You bond with the people you started out with so it is very tough to see them leave.  However, we do plan on hanging out again and running a marathon or half-marathon somewhere in the U.S. and inviting each other to each other's weddings one day.
Its also going to be extremely tough next month with another wave of the people I started out with start leaving.  However, we all do plan on staying in touch and so I thank Mark Zuckerberg for inventing facebook.
Another nurse talked me into going to the special needs school as something fun to do on the morning of my birthday before work.  I was kind of hesitant b/c I really just wanted to sleep in, but I am really glad I was able to go.  The school is connected to the kindergarden so when we first walked into the playground about 20 kindergardeners greeted us and wanted us to pick them up to hold them.
We then went into the special needs school which had music blaring in French that they were all dancing to.  These kids have the most fun.  They seem so happy and full of joy and they really seem to just be living in the moment.  One of our crew members then spoke about gentleness and did an activity that included an egg.  The rest of the morning we spent coloring, play musical chairs, and getting my hair braided and combed with a plastic toy.
We plan on celebrated Part II of my birthday tonight w/ my other friend Erica from Canada who is turning 25 on the 25th of March.  We plan on playing ultimate frisbee and then going out to dinner.  Half of the adventure is finding the restaurant by bartering with the taxi drivers and then trying to give them directions in French or through gestures since most of us don't know French.

Mercy Ships Post Operation

Mercy Ships photo, a photo by lgangstad4691 on Flickr.

Mercy Ships photo from the 2012 Togo Field Service. Credit: "© Jacques-Jean Tiziou / www.jjtiziou.net for Mercy Ships"

Mercy Ships photo

Mercy Ships photo, a photo by lgangstad4691 on Flickr.

Mercy Ships photo from the 2012 Togo Field Service. Credit: "© Jacques-Jean Tiziou / www.jjtiziou.net for Mercy Ships"

Mercy Ships photo

Mercy Ships photo, a photo by lgangstad4691 on Flickr.

Mercy Ships photo from the 2012 Togo Field Service. Credit: "© Jacques-Jean Tiziou / www.jjtiziou.net for Mercy Ships"

 At the market, these dough balls basically taste like doughnuts and are   reeeally cheap to buy, but probably fattening, costing about 10 cents in american money.

                                      Video of the marketplace on market day in Togoville.

                                               On our way to Togoville crossing the Lake.

Bananas

                                                      Women selling bananas

Church in Togo

At a Togo church.  The kids are all very friendly and love getting their pictures taken.

Bike ride to Koko Beach

On our way to Koko Beach.  The bike I was riding stopped working and so we had to leave it there and one of us had to take a taxi back.  The bikes we use are pretty used and abused.  I was really wishing my Dad was with us at that point.  He loves fixing bikes.

Jesus Film

During the Jesus Film, my friend Summer was asked to share her testimony by one of the Africans.  Just prior to them starting the Jesus film, I accidentally tripped over one of the cords and the whole film projector shut off.  I felt so bad with about a 100 Africans patiently waiting for the movie to start afraid they wouldn't be able to fix it.  Luckily some of our crew members fixed it about ten minutes later.  The film was in their language so I didn't get to hear what was said during the movie, but there were definitely moments during the film when the whole crowd of Africans started clapping.  The Jesus Film is basically a way to share about death and resurrection of Christ.

Its almost March

Time is starting to go by very quickly.  Its hard to believe I only have about three and a half months left here, but at the same time a 100 days is a long time.  A lot can happen in a 100 days back at home and here also.  I've really started enjoying taking care of the kids as I've picked up quite a few tips on how to calm a screaming child who thinks we're torturing them.

Yesterday we went to the beach and took a taxi to get there.  As we were looking out the window we saw one of our patients who I had just taken care of the previous day on the back of a motorcycle waving and smiling at us.  He recognized us and knew who we were and we knew his name.  It was the coolest feeling ever knowing that this man just left the ship renewed and was going to go back to his life here in West Africa.  He had gotten a tumor removed from his face.  We watched him weave in and out of the traffic of cars and motorcycles through the dusty streets and back to his home.

We have weekly meetings with all the nurses called Breathe sessions to discuss how we're feeling about everything and cool stories that people have.  One of our older patients has not had a nose for many years due to noma which is a bacteria that eats away at the face.  Due to the stigma of deformities here he has lived in social isolation and rejection for many years and became an alcoholic.  We were told by one of the African day workers that he does not know how to live in community and be part of a group.  He also speaks Ewe which is a very rare language that no one on our wards ever speaks.  However, miraculously when he was here there were four other patients who just so happened to speak Ewe.  The patient across from him had an uncle who speaks Ewe and took on the role as caregiver and translator for this patient just because he's a nice guy.  You would have thought they were family.  He even offered to meet up with him after he went home to help debrief.  Everyone agrees that God definitely provided a translator for this patient and friends on the ward that spoke his language, otherwise we would have been at a loss on how to communicate with him.  It is extremely rare that we have people who speak Ewe.

This evening I went with a few people to get Fufu. It basically is doughy play dough like texture that you dip in meat sauce.  The meat I chose was goat, which was the least adventurous of all the options. Our friend Lewis drove us in his van that he's used to truck all the way across Africa in and has used as a place to sleep.  As we drive through town I still feel like I'm watching a scene from a movie outside the van window.  It still doesn't seem real.  Luckily hes a very good driver.

We are weak but we have a great God

The surgeon here who has been volunteering on Mercy Ships for the last 25 years with his family always says he is very weak, but he has a great God.  Dr. Gary Parker has devoted his whole life to serving the people of Togo.  He keeps telling us that God likes to use broken and weak people to do His work.  I find this to be true in many cases with the volunteer nurses who seemed to be really struggling to speak English have improved dramatically and its been a little easier giving and getting report on the patients.  The testimonies some of these patients have given really shows how much God loves us and can work miracles in peoples lives. 
Today I got to work day shift and help discharge a couple patients.  The mom of a 1 1/2 year old who had her cleft lip fixed looked so happy and proud of her baby that all of the nurses adored.  We were all very sad that she had to leave.  I have a picture of her that I will post as soon as they download it.  My fifteen year old patient who had a massive tumor on her face removed had the hugest smile when she was told she got to go home.  They have follow-up appointments, but are responsible for making sure they eat the proper food and clean their wound properly.  Since they don't have normal saline to clean their wound they boil clean water and add 1 teaspoon of salt.  Many are not allowed to eat rice for several months because it can get caught in their wounds and are only allowed to eat soft or mashed foods.  Some people who have more complicated wounds stay at our Hope Center where we can keep a closer eye on them.  Tomorrow there will be a group going to show a village the Jesus Film.  I've never seen it, but I know it basically shares the message of the gospel in many different languages.

Screening Day video footage

Mercy Ships Togo Screening 2012

http://www.youtube.com/watch?v=UwrBKTbhaCc

On February 1, 2012, Mercy Ships (http://www.MercyShips.org) volunteer crew from the hospital ship, the Africa Mercy, conducted a medical screening in Lomé, ...

The last three shifts of work went by really fast.  I worked nights which was from 930 pm to 7am.  I'm starting to feel more comfortable, but still do not know where everything is quite yet.  Working nights included getting vitals, performing assessments, passing meds, tube feedings, trach care and preparing people for surgery in the morning.  The difference here is that you have to start getting everything ready way ahead of time compared to the hospital I work at because everything takes much longer without the luxury of computers and other technology.  I had six patients the other night which is the most I've ever had in my life, but the patients we do surgery on usually do not have extensive medical history and do not have very many medications.  One of the 2 year olds we were preparing for surgery in the morning on Monday was screaming at the top of her lung waking everyone up on the unit since she wasn't allowed to eat for several hours due to the cleft lip surgery she was about to receive.  No matter how much her mother and nurse tried to console her she would not stop crying.  Finally when one of the male Togo day worker translators arrived in the morning the baby's nurse asked him to hold her.  She pretty much instantly stopped crying and just stared at him looking up in awe and fell asleep.  We now call him the baby whisperer.

The man who had his giant tumor removed from his throat that I've had since before he got his surgery is doing quite well and took pictures of all his nurses.  He got really into the championship soccer game between Zambia and the Ivory Coast.  The people here are all really into soccer.  There are constantly people playing soccer on the beach and on the streets in the village.  The day workers and all the patients had their eyes glued to the TV the last few seconds of the game during overtime.  Most of the people were rooting for Ivory Coast, except for a few.  They were all heartbroken when one of the players missed several final penalty kicks and the game was over with Zambia being victorious.  However, it was a great day for Zambia.  They dedicated their victory to their 18 players who all died in a plane crash during the evening of  April 27, 1993.

The sense of comraderie amongst the patients and people here is refreshing.  I was told they would think we were punishing them if we gave them their own room or isolated them from everyone else. They like to learn together and feed off each other whenever we're doing teachings about their different surgeries. It is very frustrating though that I can't talk to them directly since I don't speak French and have to go through a translator anytime I want to say something.  I am getting really good at charades though!

Last day of orientation

Today was my last day of orientation.  I tried to suck as much information out of my preceptor as possible due to the fact that my next shift I will not have a preceptor, however they say there is always going to be someone available to answer questions.  Many of these people would likely not live if they didn't get medical treatment so I keep trying to keep that in mind in order to stay positive.  There is a lot to learn and I wish I could just fast forward to a month from now where I was comfortable knowing where everything is and how to exactly take care of a pediatric patient.  They try to give the adult nurses only adult patients, but that will not always be the case.  We have to do quite a few calculations w/ our medications.  It makes it an extra challenge working with people from many different countries who have many different accents and have different ways of doing things. However, we're all here for the same reason so everyone I've worked w/ so far is very patient and respectful towards each other.

My patient I took care of today was an adult and likely would not have lived another month or two if the surgeon didn't take out the benign massive tumor in the back of his throat.  He would have likely slowly suffocated if he wasn't chosen for surgery on screening day.  When I received him from PACU he was pretty sedated, but as he woke up we were able to tell him that the tumor was gone and out and the surgery went really well.  We could tell he was scared with all the tubes, but I could see a sense of relief on his face.  It will be really interesting when they take out his trach and he can talk.  That won't be for another couple days.  The cleft lip babies I had taken care of the previous day also had their surgeries.  They looked amazing even though their faces were still swollen and the steri strips were still intact.  The moms looked happy and were extremely attentive feeding their babies and keeping them calm. Getting to know the patients has been fun.  The adults seem to have a great sense of humor even though many of them have massive tumors on their face.  They all thought it was really funny that we gave them all coloring books.  They kept looking at them and laughed.  There were coloring books in each admission bag because we didn't know if kids would get the bags.  They are are very thankful and do not always admit when they're in pain so we have to really pry to know when to give them pain medicine.

The marketplace.. picture taken from taxi window..Its very unsafe to take out a camera in public. Wearing jewelry is also not advised.

The beach from a taxi window.  We're advised not to go to the beach near our ship b/c of the danger w/ the drug trafficking.

Hut on the beach

My bunkmate, Summer, from Baton Rouge, Louisiana and friend Lewis at a cafe. They had the best icecream.

First day of Surgeries

Yesterday evening D ward finally opened after much anticipation from everyone on the ship.  Seven patients all arrived around 3 pm all at once which was slightly overwhelming at first, but then I realized the caregivers, being the mothers, had everything under control. They know how to calm and take care of their babies much better than me.  Two of my assigned patients had cleft lips and were 3 months and 6 months.  My lady, 29, had ankylosis which is a condition that results from trauma or disease and the jaw becomes locked.   It basically causes severe TMJ.  She also has micronation, which is a really small jaw or mandible.  Sometimes ankylosis is caused by a noma or cancrum oris, which is a gangrene condition that results from tissue infection in the oral/nasal cavity.  Noma is very preventable with proper treatment if treatment is available.

We helped everyone get settled including getting everyone showers and did a lot of preoperative teaching.  The mothers were all sooo excited when I explained that their babies' surgeries would be tomorrow.  My lady patient kept sneaking in a smile after going over all the details.  Her surgery won't be until Tuesday.  The day workers translated everything we said to each other the best they could since I don't know French.  My lady patient speaks Moba, which the day workers do not know how to speak.  Therefore, her family member came with her to help translate from French to Moba and vice versa.  You wonder how much was lost during all the translations, but I could tell she got the jist of most everything that was said.  So this morning the surgeries began!  I just sneaked past the recovery room and peaked in the window.  It looked like some of the nurses were hooking up one of the babies to a pain pump.  I go back to work in about half an hour and am slightly nervous.

Pics from Screening day

^{Zephaniah 30: 20} At that time I will gather you;
   at that time I will bring you home.
I will give you honor and praise
   among all the peoples of the earth
when I restore your fortunes^[e]
   before your very eyes,”
            says the LORD.