Learning to say goodbye

How do i say goodbye to a place I've been wanting to come to for the last 10 years ?

I finished my last shift yesterday. It's hard to believe my time is finished here. I feel like it just began. I remember my first shifts so clearly, but I suppose I adapted quickly. Things soon became routine to the point that I was orientating new staff to the ward a few weeks later. This last week has been different though. Maxillofacial surgeons arrived on the ship last week and as a result, the patient population has changed dramatically. The ward was full of patients like the ones i saw on the Mercy Ships brochures 10 years ago. Their faces are what drew me here in the first place.

One young boy, hardly a teenager, walked down the hallway with a large piece of cloth covering his face. He walked slowly, eyes cast downwards as he shielded himself from the prying eyes of the people around him. Once in the safety of the ward, the cloth is removed and a large tumor encompassing the entire right upper portion of his face is revealed. He is very quiet and he never smiles. Most of the time he hides under his sheets. A stoic man sits in the corner, his condition though medically completely different, presents in a similar way. His eye protrudes from it's proper place, concealed partially by heavy framed glasses. He wears his glasses while he sleeps.
An elderly woman sits nervously on her bed, awaiting surgery. Her eyes do not line up like they should. The right one has fallen 2 inches and sits about an inch forward. Still she manages a smile for the nurses, and laughs occasionally at the small family across from her.

I positioned myself between two patients last night in such a way that i could keep an eye on the monitors of the one, and hold a syringe full of tube feed for the other. Giving an adult a tube feed is a good 15-20 minute procedure here most times. It simply means i become an IV pole while holding a syringe in the air, allowing gravity to infuse the 'food' into the patient at a slow rate. While doing this, i turned my head to answer a nurse's question and i felt a tug on my pants. The man i was feeding whispered something i couldn't understand. I got down closer when he said "please nurse, concentration on me, no someone else." I thought this a strange comment, but settled thinking i had inadvertently tugged on his tube when i turned to answer the nurse's question. I admit, i was a little annoyed because the lady beside him was very sick and demanded more attention than he did at that minute. He had been quiet earlier in the shift as i played Jenga with some of the kids on the ward, and later as I flew a toddler around the room airplane style. Occasionally, I would look over at him, asking him if he was comfortable or had any pain. He was fine, he said. I received a patient back from the OR which translates to a good hour of busyness as the patient is settled. In her case, it was a good two hours before she was comfortable and all the lines of the monitor were in a satisfactory place for her. He stayed silent through the procedure, watching my every move. He was fine he said, shaking his head no thank you, that he didn't need anything. But, now, when i was busy with someone else, he needed me. He needed some attention.

Later as i left the ward for the night, I thought back to his comment. I surveyed the room and saw what people at home might very well think a circus. Sadness mixed with hope. I watched a young girl slowly pack up her things. She would be travelling home in the morning. She was prepped and ready for surgery that day, but the surgeon decided after reviewing her CT one last time that he didn't have the skill needed to remove the large tumor from her jaw. Beside her, a small family of three were also packing their things as they settled in for the night. They were heading home with hope. They'll be back in a month or two for the next stage in her treatment. But, after three weeks on the ward, an infection that was eating her nose and upper lip was finally curbed. The antibiotics worked! The man with the glasses pulled up his blankets around his face while he slept, sighing comfortably. IV fluids running in anticipation of surgery the next day. A Mama and her small baby born with a cleft lip & palate are here for the feeding program in preparation for surgery in the fall. They are already sleeping peacefully in the corner.

"Concentrate on me" Was his simple request a mask for what he's been asking for ever since the tumor started to grow? Or was it simply because i pulled a little on his feeding tube? The message received though, while looking at the strange collection of people before me as I left the ward was not far off from his request. These people came to the ship because they had no where else to turn. No one else was 'concentration' on their need. And so they came. I will always struggle with the reality that so many are turned away. So many are beyond surgical help and must go back to their lives of hiding behind lapas and hooded shirts. I cried a long time last night, they too have left their faces in the permanent photo album of my heart along with the VVF ladies who left wet.

I haven't been naive to the fact that we're leaving shortly, and I thought i was ready. For the past few weeks i had been working with patients whose average length of stay was 3 days. Arriving late on the first day, and leaving early on the third day. This didn't leave a whole lot of time to build relationships as with the VVF ladies. I thought it would be a good transition into leaving. But, on my last three shifts I have been faced with the living people that drew me here in the first place. People who need so much more than physical nursing care, and so desperately need love and attention.

Life isn't easy on either side of the ocean. Heartache happens everywhere. Injustice is rampant all over the world. Perhaps here, I feel like I make more of a difference than i do in the lives of patients back home. I know in my head, that probably isn't true. I have learned so much here, and will take home so much. I will always remember the sadness, but with equal clarity I will remember the good. I don't think any nurse can come away from this experience and not be changed. It's not possible to go back to the land of excess and not remember being an IV pole for a few minutes, or using what you have - not what you want. My shoulders and back ache from leaning over these short beds and I will be forever grateful for the powered beds at home. But, I will not quickly forget to look under the bed for a sleeping caregiver. If I trip over something, I'll likely think it was a piece of lego or a small car rather than a patients 4th suitcase. I'll probably open the curtains and welcome day light in every room I walk into. Imagine the delight i will have when there is a commode for a patient to use instead of juggling everything in and out of the world's smallest airplane bathrooms! I will miss all the colourful lapas that encircle the waists of the adult patients, covering their backsides from being seen by the world from the ever indecent hospital gown! I am rather fond of having all my patients in the same room, it's much less walking for me! This is only the beginning of the things i will miss, and the things i look forward to.

This experience has changed me deeply, perhaps not in a way that the average person could decipher, but it has. If anything, it has strengthened weak beliefs I already had and created some new ones. I will come back someday for longer. Maybe with Mercy Ships, maybe not. We'll see. Here, perhaps the only time in my life, have I finally realized the difference one person can make. I look around me and there are 400 people at any given time on this ship. All here to help in various departments, all having sacrificed something to be here. In talking with one of the ship chaplains he said, "if any business person would look at what Mercyships is trying to do they'd think we're crazy. It just doesn't make sense when you account for the expense of running a ship. But, God must be in it because it's been going on for over 30 years." Truth to that! God doesn't consider the expense of caring for his children. Coordinating a volunteer based surgical hospital must be an absolute administrative nightmare, but each one of us was called to be here and the people keep coming to help. So, here we are

"We follow the 2000 year old example of Jesus, bringing hope and healing to the forgotten poor"

Mercy Ships Mission Statement

The ship sails for a day

We sailed yesterday! Well, my guess is that true sailors wouldn't really call what happened yesterday a sail. But, for a prairie girl, the boat moved thus it sailed! The ship simply moved from one side of the port to the other to get fuel. The nurses on the ward thought the patients would enjoy it. So, with the exception of one man, deck 7 was a buzz with excitement as the ship moved from point A to point B. On the far side of the deck, the kids raced around each other on little cars. One little boy, born with club feet, laughed joyously at his new found freedom as he zoomed up and down the deck. A little further up, some adults were playing cards, while others stood in curiousity watching the boats coming in and out of the port.

For me, coming off of night shifts, it was a leisurely day. I walked around the ship in my scrubs-turned-pajamas eating cheerios, and watched the deck crew lift the gangway. Horns blowing, the tug boats pulled us away from our dock until the ship carried itself towards the fueling dock. The tug boats then pushed us back towards our new resting place for the night. Seemed simple enough to the prairie girl in her pajamas. Giles, however, now deck hand/line handler, worked some long hard hours over the last two days.

(up comes the gangway - we walk up this thing to get into the ship)

Into the Night

We're into the single digits now, counting the days until we come home. Are we counting, well yes. But the reason for it changes with the minute the question is asked. As it stands, i have four shifts left before we leave this big float-able boat. I'm in the middle of another set of night shifts, which if you've been following our blog, usually means some sort of lengthy thought provoked blog entry. Only, this time i have been thoroughly engrossed in a book the last two nights. I call them 'fluff' books, long stories about nothing much. But, it makes the time go by faster.

Still, i suppose i do have a few more stories left in me. Say for example, when the A/C breaks down for 10 hours in the belly of a hospital ship situated on the equator. Turns out it gets hot, really hot, fairly quickly. Ya ya ya, i hear you saying, "poor little white girl fanning herself complaining that it's hot in Africa." Well, I am proud (maybe not the right word) to say that the African translators were agreeing with me by 3 am, as were the patients who were all very awake and agitated around the same time! Agitated really isn't a fair word, it just meant the kids were up colouring and the adults were up getting showered to cool off. I was the one agitated that everyone was awake so early! That and, I may be leaving out a few hilarious details for the privacy of all persons involved in the heat wave, but that is only because you had to be there to appreciate them!

(ward empty of patients)

There was little rest going on that night. As the temperature climbed, the layers of blankets fell to the floor in equal increments. One Mama, sleeping under the bed of her daughter, pulled back the curtain that acts as a light shield during the night, waving at us that she was hot. She fell asleep shortly after only for her hand to flop out from under the curtain suddenly in her sleep. Now, picture us, on the other side of the curtain minding our own business, when a hand suddenly appears in the corner of our eye. We had to stifle a startled laugh! Not long after, her daughter who is a very 'active' sleeper suddenly fell off her bed, pulling the curtain down on her. (This curtain had already fallen down 5 times that night). The precious girl didn't even wake up! Around 2am, 6 people decided it was tea time, all asking for tea and bread! Now, at home this wouldn't be all that shocking, but here, I'll admit it was a little out of the ordinary. We spent the night procuring fans, settling a startled patient, and walking other who were too hot to sleep. Later, as the patients calmed down, our energetic translators begged us for lessons on facebook as we surrounded the screen looking at pictures ship friends had posted from their various travels around Benin. Night shifts rarely fail to deliver some kind of unexpected story.

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10:30 am the drums start to beat. A door opens and a beautiful young African lady emerges singing her heart out. She comes down the hallway gently swaying to the music in a new yellow dress, complete with a matching hat she has created using clever folding and weaving techniques that I have never been able to follow. She walks toward the ward, the place she has lived for the last 3 weeks with her son. The drums get louder and louder as she approaches. Inside the doors she is welcomed by dozens of faces. Some, the smiling faces of the nurses who have looked after her and her son. Others, ladies from other areas of the ship who have heard about her story and her son. They have spent time with her over her stay, bring craft projects and smiles with them. Still others, translators and disciplers who know her better than we do greet her with cheers. Everyone smiling, singing and dancing to the music as she makes her way to the seat of honour at the front of the room. She carries with her an instrument which she shakes rhythmically to the beat without thinking, calling out loudly in a way i can only describe as African yoddling! She is beautiful, she is going home.

The ward is full of patients awaiting Maxillofacial surgery. Our friend was the last of the VVF patients to go home, and she celebrated her healing unashamedly with her new friends. They stared curiously at the celebration taking place in front of them. A young man sat quietly smiling as he watched. A large mass protruding off the side of his jaw, the size of a small grapefruit, didn't hinder his one-sided grin as the Yovo (nickname for white person) nurses tried to dance African style. Across the room was another young woman, already joining the singing, though reservedly. A larger mass was taken from her neck the day earlier, now replaced by a large bandage. Her face now swollen from the surgery did not mask her joy as she celebrated her own new day of hope. A small girl sat a few beds away, anxiously waiting for her to surgery. A large lesion occluding the vision in her right eye was to be removed today. Another girl sat propped up on pillows as her mother stroked her hand while her nurse administered pain medication. Her surgery took place the night before, taking 6 hours while the surgeons removed a bony mass from her neck. She's doing well, though the sight of so many drains and IV tubes was obviously unfamiliar and uncomfortable to her. The drums grew louder, and the singing even more so. From the other side of the room, another young man roused from his bed, cautiously guarding his abdomen from a hernia repair. He slowly made his way toward the celebration, taking a seat in the corner, clapping his hands.
(picture from previous dress ceremony in June)

Ditching her mop, one of our day workers joined in the dancing. Energetic to the core, she pulled in others and a dance-off ensued. I laughed from my seat in the back of the room as my African friends laughed joyously, dancing their hearts out in agreement with our patient's joy. The celebration was the best one, i thought, since the start of the VVF surgeries in May. Perhaps because we all knew this little family so well. Perhaps because after 8 weeks of laborious care, we were all due for a large celebration... and opportunity to truly praise and thank God for what he had done. Tears clouded the eyes of our patient as she shared her story, a story of hopelessness, abandonment and sadness. But, while her little boy ran around the room looking for anyone of the nurses who love him so much to lift him up for a better view, she praised God. She praised him for her son, she praised him for the nurses who have looked after her son as much as they've looked after her. She praise him for the hope she now had. After 13 years of being wet with urine, after being abandoned by 2 men who said they loved her, she was now setting out for a new life. Her face will forever be ingrained in my mind, the true image of joy.

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Last night, i looked after a little old man who had had a little medical excitement the previous shift. I positioned my chair close to his bed to keep an eye on his monitors early in the shift and prayed that he would be alright. I had an ICU nurse next door should i need assistance, but I still felt that uncomfortable unease any primary nurse would in a new situation. I have gained a new appreciation for surgical nurses and their special set of skills during my stay here, turns out it's not all as straightforward as i naively thought before! I would look up from my charting periodically to check him and he would open one eye instinctively to smile at me. His smile was one of those grandfatherly grins that will melt any nurse's heart. His face, aged by the sun, was wrinkled, though i thought filled with smile lines. His small frame, crippled by bowed legs, moves slowly as he maneuvers about the ward with a well aged cane. This small man had seen more of life than i can probably imagine, he bore a look on his face saying, I've been through worse than this, don't worry. I wondered what this man was thinking as he struggled to find a comfortable position to sleep amidst the tubes, lines and drains. What must it be like for him, living 80+ years now confined to a bed at the bottom of a ship? I suppose I'll never know, I wasn't about to ask him in the middle of the night. Later, early in the morning as i was preparing to leave i said through a translator that his heart was doing much better and soon we could take off some of the monitors. He smiled and simply said "thank you" with a little pat on my hand. He signaled "are you done?" i said yes, smiling once more he disappeared under his sheet. "I'll see you tomorrow," i said in my limited French. Silent thankfulness,... he will be just fine.

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I am where I am supposed to be.

Carpent-eering

Some, albeit many, may ask what a carpenter is doing on board a ship. I must admit I asked the same questions myself before arriving on board the Africa Mercy. I thought to myself about what types of projects I might find myself doing here in Africa. I really had no idea! Many people here actually ask me the same thing.... the funny thing is when the ship was converted to a hospital ship they really did not think they needed a carpenter. I have definitely found out there is a never ending supply of work.

In addition to my carpentry work I am also part of the Deck department. We are responsible for all the daily work that happens with a ship. Loading and unloading cargo, operating cranes, forklifts, general maintenance, safety, mooring lines and more. I often get called up to help with some operation or the other. I also carry a pager every couple days where I will be on call for 24 hours at which time I could be called up for work at any point. The deck crew also do a rotation through night watch where for 7 days you would be in charge of the security of the ship. This means you would do a complete search of the ship from end to end and bottom to top every hour all night long. I have not had the pleasure of experiencing this and will not have to but it is a job I would not mind as you get to explore when no one else is around.

The last ship, the Anastasis, had a huge carpentry shop and four or five carpenters working full time. That ship was very old and had a lot of wood on it. New ship regulations extremely limit the use of combustible material on board a vessel of this size. This means that almost everything is metal. Even the walls in our cabin are metal, so if anyone if coming to the Africa Mercy, bring Magnets!

I have found the work on board to be very varied and requiring some resourcefulness in order to complete a task. Many of our supplies are shipped to Africa via a container loaded on a ship in the US and then shipped to a major port and then transferred to another ship, finally arriving in Benin about a month later. This means that if you need parts that can not be sourced locally that you can expect the wait to be over a month before you see the parts you need to complete a job.

It is possible to find a lot of interesting and useful things in Benin. Most prices I have found are about the same as at home and a lot of prices are actually more than at home. Very few items I have found are cheap in comparison. It is not hard for me to go out and spend some 70000 CFA and return after a three hour endovour with only two sheets of plywood. 40000 CFA exchanges to about $80 american.

The markets are something to be experienced here. Throngs of people going about life as usual and me the lone Yovo (white person) standing amongst the swirling tides of traffic. All I hear is the noise of zimmy-johns (motor bikes) and people calling out their wares. You hear a lot of people making a kissing sound which is the local call to get your attention. The occassional call of 'mon ami' (my friend) followed by a banter of uninterpreted and potentially not too friendly words at my ignoring their wares. You can not just look at an item and ask for a price. The process is the following: you ask the price, they tell you a ridiculous price, you counter, repeat process until item is in a bag and in your hand with the owner looking like you have just stolen the food out his own mouth! This is actually a very invigourating and endering experience in Africa and believe it or not has earned me some respect from the shopkeepers. I have had many a good laugh with a shop keeper with my style of bargaining and made a few enemies as well. Usually this bartering process is very friendly but sometimes intimidating as the shop keeper plays his part of being shocked by the low price you keep offering.

Adrienne and I had an interesting experience last sunday. We went out to the local craft market to purchase some memorabilia from the local crafstman. We were going to look for a couple of carvings that we were interested in. The craft market consists of a lot of small huts divided into four where each shop keeper sets up there items for sell. We manouvered our way through the different shops trying to ignore the beckoning kissing sounds emiting from all around us calling for our attention. We would enter a shop and look at the different carvings try to explain that we would not be buying something even the next item that they would hold out, or the next item they would try to put in our hands. We would escape the shop and make our way into the next shop where we would look at excatly the same carvings and occasionally we would ask what the price was. This is never a good idea unless you intend on buying an item so it makes the process very difficult to judge which items are in your price range. Typically, they will tell you a price that is three times what you will end up paying. We probably went into at least 50 different shops which all sold roughly the same carvings of varying quality and skill. In the end we bartered for a number of items which the locals found very amusing. I was told that I am an African and Adrienne was reminded she is still 'american'. A number of times I was told by the locals that this how is works, you ask the price, we tell you, you try different price. They often got mad at me when I would ask the price of something and when they told me their first price I would put the item down and walk out. I found it amuzing but I was not going to waste my time on poor quality material when it often takes 15 minutes to actually get the price you want.

I should explain that in Africa there is a strange pattern that I see here. The shop keepers of certain wares always group themselves together. For instance if you wanted to sell watches, you would move your watch stand to where all the other sellers of watches are standing. This is common for almost all things that are being sold. I have been wondering about why they follow this strange marketing process and have no solid conclusions but I believe it is intended to make things easier for the customer. If you want to buy a piece of fabric you go to the road where all the people who sell fabric are. If you want some wood you go to where all the people who sell wood are. This makes it a little easier to find out where you should go, however the major downfall of this system is that if you need socks and a pinnaple you will be traveling to two different sides of the city before you are done. Economically speaking this system makes no sense to me but to make things even stranger is the mentality that if you buy from one person you should buy from the rest too. This means that if you were to go buy some fresh pinapple from a fruit stand the rest of the fruit stands would be mad at you for not buying from them.

One of my tasks here that consumes a lot of my time is trying to find the local materials I need to work on a project. I have found a number of suppliers that carry some items but it is always a possibility they only have one or just happen to not carry the item you need. It is a never ending process on board of juggling the projects I have on the go (currently I think about 25 projects) with the daily additions of quick jobs that need a remedy right away.

I do a lot of maintenance and repairs for the some 500 crew members, patients, day workers, and tours that travel through the ship every day. Stairs, doors, hinges, you name it all get a lot of use and are broken more often than not. The last few days I have been attempting to work on a set of staircases where the stair nosing has fallen off. The stairs happen to be in a location vital to mobility between decks which means they have a lot of traffic. If I was to close these stairs for the day there would likely be a lot of unhappy people as they would have to travel down to deck 3 in order to go up to deck 5, or else they would have to go all the way aft (back) in order to go all the way forward. I decided I would try to work around the people using the stairs. I ended up spending more time moving all my tools off the stairs to let people pass through then I did actually fixing the stairs. It was a little amusing but made for slow progress. Today I gave up and put signs up to close the stairs... this seemed to have the opposite effect than intended and traffic seemed to actually increase on the stairs rather than decrease. In the end the stairs are finished and many complaments and thanks you were passed on as people walked through my portable job site.



Life is very busy and sometimes amuzing on the ship. I must say that I really enjoy living on board and working for such a good cause. I keep myself fairly busy with visits to the hospital wards, the hospitality center for playtimes, soccer on monday and wednesday nights, ultimate frisbee on friday nights, date nights with my wife, community meetings on tuesday morning, thursday and sunday night, deck work, fire fighting training and drills.... life is good!

Below are pictures of a place called Bab's Dock in Benin that Adrienne and I went to for an afternoon off last saturday. It was relaxing and rejuvinating not to forget to mention beautiful too!

Smiles

Part of me thought I should just publish these pictures on their own and not spoil them by writing about them. But the other half of me won, so you get to hear a little from me. This little boy and his Mom are so special. If i can, I will get her permission to share their story at a later time. But for now, you can met them by their smiles. When the photographer came to take pictures, she explained what they might be used for. That the nurses like to send pictures home to their friends and families to show them a little of what they're doing over here in Africa. She was very excited to be a part of it. Her little son wasn't (though you wouldn't be able to tell from his smiles). He was more interested in playing with one of his favourite toys on the ward, my glasses. Whenever I walk onto the ward his eyes light up and he runs full force into my legs begging to be picked up so he can reach them. He's so clever. If I say no, he'll find someone else close by and try to reach them from his newly achieved height. If the glasses are off limits, there is always another favourite toy, my room key. He knows I keep it in my pocket, right where he can find it. I'll walk around with him on one hip while he plays with my key, and take vital signs. I'm sure the ladies wonder why I wouldn't just tie him on my back like they do, but i haven't mastered that skill yet.
I think i have the best job on the ship, and i'm not afraid to say so. I have so much fun on the wards. Recently, as the VVF block has finished, there have been more and more kids on the ward. Some are patients, others are the children of patients. Regardless, they all love to play.

A day in the life of a land rover

After finally deciding that I would see nothing in Benin if I waited for Giles to join me, I decided to venture out on my own with various groups of friends during my days off. Giles and I always seem to work opposite weekends, meaning that we rarely have days off together to go exploring. The few that we’ve had have been rainy ☹ ps. Rainy in Benin means torrential downpours.

So, today’s entry will take you on a little tour of Benin through the eyes of my camera and the camera of the Mercy Ship’s photographer. Many of Mercy Ship’s events/locations are restricted from random crew’s photography attempts for obvious reasons. However, there is almost always a crew photographer present to take photos on behalf of us. One camera vs. 100 is much less intrusive to the locals. Which, as it turns out, is not so bad after all. Crews are given access to the photos a few days or weeks later, and the majority of them are fantastic. This is a magical little folder, quite dangerous to a scrapbooker’s hard drive. As of today, our Africa Photos file is > 1100 pictures! So, if you see the Mercy ship’s copyright logo on some of our photos, you’ll understand why. I was still physically there in most cases, but couldn’t use my own camera.

Today I joined a group of crew to visit the Mercy Ships land based projects. I was particularly interested in seeing the agricultural project that Giles had told me about when we first got here. He saw it earlier while doing some work related errands. Mercy Ships has partnered with a local NGO called Bethesda, and is helping build an agricultural school. One of our crew, originally from the Congo, is training the future teachers of the school how to cultivate the land and grow productive crops using what they already have available to them.

Construction is hopefully going to be finished Mid-End of August, and classroom studies will begin.




(picture: beans & corn)

I had a lesson in farming today, and have included some pictures of the practice farms. There are 9 students (the future teachers of the school) presently working on this piece of land. They started from the beginning, learning how to clear the land without destroying the nutrients of the soil. The traditional method of clearing the land is a two-step process where the growth is cut down by machete, then burnt. This however kills the soil, and the crops don’t grow. We had a brief half hour lesson which included:


(picture: termite hill)
- how to make compost
- how to plant seeds where the bugs won’t kill them,
- how to plant corn and beans alternatively
- which plants when ground up and sprayed on the corn will ward of flying pests
- which trees, when planted around the perimeter of the bush will help deter animals and flies.
- Onion & garlic, when planted on the outskirts under a fence will ward of rats and other small animals.
- If ash is poured around the corn crop, it will deter snails.
- Coconut skins help retain water in small raised plots of land, and the fibers will keep the soil moist.
- Soil close to termite hills is the most fertile.




(picture: tomatoes & eggplant nursery)
It was a lesson in how all plants, and worms, when used properly, can help each other. Some of these students are already applying the principles they’ve learned in their own farms at home and teaching the community (which is the idea). Some of the community members were doubtful that there was anything valuable to be learned until they started to see the dramatic difference between their crops of corn and the ones now growing in the small demonstration gardens.




Students will stay at the school for 3 months, where they will learn in the classroom and on demonstration plots like the ones we saw today. Mercy Ships’ involvement with the school will end once the ship sails and Bethesda will continue its work there.

We also visited the dental center. This building was built a few years ago by a NGO for the department of health as a maternity hospital. The building has sat empty since it was completed due to a lack of finances to run it. The government has lent it to the ship for our dental and eye clinics. I don’t think there could have been a better set up for the dental clinic. True, I’ve been told the heat is a little overwhelming when it’s sunny… but I suppose you can’t have it all ?!


I think everyone should have a land rover experience in Africa. It’s something else, and if you didn’t have a headache at the start, you will likely have one at the end from all the jostling in and out of potholes. Being the rainy season, there were some huge bigger-than-puddles to be driven through. My pictures don’t even begin to capture it!

Visiting old friends

This is the evidence of our date night yesterday

We had the whole day planned, but it rained and suddenly the hour walk to the craft market was less appealing. We still wanted to go out for supper though, to celebrate the end of a long weekend. We made a little detour to the Hospitality center to visit some of our friends. For Giles, it was the kids, and for me, the ladies. I had hoped to find one particular lady who was discharged earlier in the week, I didn't get to say goodbye. Instead, I found another dear one who smiled and clapped her hands when she saw me walking up the path. All in all, it was a lovely afternoon!

"Merci Sista"

Here i sit in my whirly chair, counting the minutes until another night shift is over. Funny, as I spin round and round, watching the clock with one ear open for the 'tist' noise I have now trained myself to hear (the African call bell system), I start to think of the lessons I've learned throughout the week.

Tonight's ramble, as I call it, has everything to do with nursing. I truely didn't know what to expect when i arrived here. I had spoken with a variety of people who had worked with Mercy Ships in the past, each with varying degrees of recommendations. I was assured that given my work experience, that i would be fine here. And, it's true, I am, skills wise. One of the last parting comments made to me before we left by a friend of mine was, 'Adrienne, be forewarned, it's a much slower pace than you're used to.' Little did i realize how great an impact this would be.

During my first few weeks here, the words of a senior nurse i used to work with at home came to me. 'You young nurses are great. You're so enthusiastic about starting IV's, running for this and for that. But, you all forget about your patients. You forget to talk to them and walk with them. You forget about the nursing part of nursing. Nursing sure isn't what it used to be. We never used to have to write that we walked a patient, it was assumed.' The conversation that started as a result of this comment was long, and obviously impacting because i remember it. Largely because she's one of the best nurses I've ever worked with. She absolutely hated it when we refered to a patient by their room and bed number and challenged me to get to know them. "There is a way to know your patients, care for them and not let their stories keep you up at night." I never believed her until this week.

We have fun on the ward. There is much laughing and giggling that goes on as we nurses make our way around to see the ladies. I usually stumble over something at least once when the ship makes a lurch to one direction, or one of the patients does the same thing. Perhaps one of the largest learning curves I've had to climb is the one of teaching. There is so much to be taught here, and not all of it is easy. Often I will try the same lesson with three different translators at different times and it is amazing the different results. It makes me nervous sometimes as I am never 100% sure the message is getting across. That in itself has been a lesson learned.

Probably one of the most impacting lessons I've learned here on the ship, is what nursing a person can really accomplish. I admit I was pulling my hair a little too tightly the first few weeks, looking for something to 'do.' At home I'm used to running nonstop. I prided myself in my efficiency and ability to keep straight one hundred little details. I could tell you at a drop of a hat the names of patients from room 1-30, and on the days I was the charge nurse, I could tell you one hundred other little details most could care less about. But here, the world is different. The atmosphere is different, and the work is so much calmer and peaceful.

I think I'm finally starting to get the working environment here. I've moved beyond the smiles and handshakes to conversations with my patients. It's hard to explain what a milestone that can be here. But, I'm glad to say that I've finally accomplished that. There are some wonderful translators here who are more than willing to sit with me and be the in between. When these few gems are working, I've taken every opportunity to get to know the story behind the smiles and the handshakes.

Tonight is one of those surprising night shifts. There are three small children on the ward, babies of the VVF ladies who are still breastfeeding. I had to tell one Mama not to breastfeed her child until the morning due to the drugs in her system. After finding a translator and waking up another lady to help, we had a chat. But, it was about far more than breastfeeding and figuring out a way to appease her rambunctious 2 yo. should he awake wanting food. It was a brief glimpse into her hurting heart. She told me how she was an orphan for as long as she could remember. She was abandoned twice by her husbands due to her condition. The conversation went on for sometime while the lady across the room consoled her before the message was relayed to me. This lady, only 10 years older than me just walked into my heart tonight. Her quiet words, "merci sista," trying not to wake her son, as she grasped my hand firmly, have echoed in the night.

My new found resolve to get to know my patients beyond their medical chart has come with a cost. Tears. I fight them every day, at the end of every shift. Some sad, some happy. These are marvelous ladies. They've fought hard to get here to the ship. Their stories have slowly been edging themselves from my brain where all of them lay arranged orderly and systematically, to my heart that aches for each one. "Wet for 30 years, wet for 13 years, wet for 28 years, abandoned, cast out, left alone, my baby died, nobody wants me,.... wanted to kill myself." Soon after though, come smiles. I've just walked up and down the hallway carrying a very angry 2 yo as his screams cut through the silence of the night with an ear piercing squeal. But, with each step, his cries became more and more of an effort as his little body falls asleep again. Now, here i sit in my whirly chair, rocking from right to left, mimicking his Mama's walk. He's asleep, pouty face wedged into my chest, and calm peaceful breathing fills the night once more.

Some moments are harder than ever, and others are getting easier. I've just tucked in that little boy, his Mama rolled over in their small shared bed, eyes closed, and clapped her hands silently for my achievement. For tonight, she lays in wait, hoping and praying that the day's surgery was successful. I have by no means reached perfection in my nursing. I have a long ways to go before I'll be satisfied with the job I've done. But, I hold on to those little moments of victory, marking the long path. Tonight my job is to watch over 8 ladies and one little boy. Perhaps these night shifts aren't too bad after all.